病非表则里，非热则寒，非虚则实耳。故序浮沉迟数虚实六脉于先，余脉于后。
长大实滑等有余之脉，主证多同；短细虚涩等不足之脉，为病相类，当会通观之。
非入于此者，即不入于彼也。如头痛身热，隶之浮数，岂他脉便无此二证哉？
览者但取其意，勿泥其文，便触类旁通，引伸不尽矣。
浮 阳脉也。阳外阴内，故浮主表，沉主里。又阳上阴下，故浮主上部，沉主
下部。以外感言之，凡六淫之邪中于表，清邪中于上，脉必浮也。以内伤言之，里
气失守而虚邪外越，肾阴失守而浮阳上冲，脉亦必浮也。
浮迟 为表冷，（浮主表，迟主寒也。）伤湿，（表中湿邪，滞其经络。）中风。（
虚风内发故浮，内虚寒
故迟。若兼风邪中表，滞其经络，则亦浮迟也。）
浮数 为头痛，运眩，吐衄，（皆风热上攻所致。）表热，疮，阳结，（能食，
不大便。）胸满，肩背痛。
浮虚 为表阳虚，伤暑，（大热伤气，汗出过多故虚。）劳倦，喘，咳血。
浮实 为表邪实，（六淫之邪，或痰凝血滞之在表者，皆是也。）胀满，（胃热。）气逆痛，
（肺热。）肤痛，疮。
浮大 为风热瘾疹，（风热嘘血，沸腾于外也。）身痒，（名泄风，热蒸汗出，为风
所闭，故痒也。）表
邪盛、痂癞，（即疠风。风热久不散，郁而为湿，相蒸生虫，肌肉溃烂也。）气高，气实血虚，失血，
燥结，阳厥，关格，（浮为正虚，大为邪实，邪实正虚，不能运化，故关而不得小便，
格而不纳食也。）为
癫疾。
浮小 为表阳衰。
浮缓 为伤风，（伤风有汗，内热得泄，故脉不紧。）伤湿。（湿伤肌表、肌肉，血脉缓弱，
如土湿则软也。）
浮紧 为伤寒，身痛。
浮弦 为头痛，吐食，风饮。
浮滑 为风痰，衄血，吐逆。
浮涩 为麻木，身热无汗，肺燥，汗多津伤，血虚气浮。
浮长 为头痛，风痫。
浮短 为喘乏。
沉 主里，主下部。七情郁结，痰血停滞，凡属内邪，脉必见沉。若不因内邪
而见沉，则为阳气内陷，为里虚不能外达，分别观之。
沉迟 为里寒，泄泻，气血滞，蓄水。
沉数 为内热外寒，（内热反觉外寒，热聚于内，不达于外也。）便难，消谷，（
食多而便少也，盖为
热所消化。）热厥（厥，手足冷也。热聚于内，不达于四肢，故冷。又有手足
热者，详《医碥》厥门。
沉虚 为里虚，泻血，下利。
沉实 为积聚，血瘀，烦心，（热乘心。）咳唾。（热乘肺。）
沉缓 为里湿，蓄水。
沉紧 为冷痛，奔豚，（肾中阴寒之气，从小腹上冲心，若豚奔突。）瘕疝，（瘕，积块也。
疝，为小腹有形之病，皆寒邪之凝聚而成者。）腰脊痛。（肾附背，肾寒则气滞而脊痛。）
沉弦 为胁下有积，（弦为肝脉，肝主胁腹。）少腹痛，内饮，疝。
沉滑 为食痰，便脓血。
沉涩 为血滞，精伤，不月，不孕，内疽。
沉大 为内邪盛。
沉细 为血少，洞泄亡阴。
迟 主寒，以寒则气少而行慢也，属水。
迟大 为寒邪，顽痹。
迟细 为寒泻。
迟虚 为虚寒。
迟实 为寒积。
迟缓 为寒湿。
迟紧 为寒痛，（寒滞气不通故痛。）为筋急，（筋寒则收引故急。）
迟涩 血寒而滞。
数 主热，以热则气盛而行速也，属火。
数大 为烦躁，渴， 疹，胀满。
数虚 为虚热，怔忡，虚损。
按虚热者，脉必虚数无力，固矣。然有过服寒剂，寒热搏击，或肝邪克土，脉
反弦大有力者，投以温补之药，则数者静，弦者缓，大者敛矣。此最当知。又有虚
寒而逼火浮越者，真阳欲脱者，脉皆数，甚者亦弦大有力，皆当以证参之，勿误也。
数实 为实热，痈疮，烦躁，谵妄。
数滑 为热痰，血热，渴。
数涩 为热灼血干。
虚 为正气不足。
虚滑 为正虚挟痰。
虚涩 为血液不足，气滞。
虚弦 为虚损，少食，虚痛。
虚缓 为虚弱，泄泻。
虚细 为气血不足。
虚大 为血虚。
实 为邪气有余，不作正气充实论。以正气止有不足，无太过，太过即为邪气
也。参长脉条。坎中满，离中虚，水脉多实，火脉多虚。
实滑 为痰结，为宿食。
实大 为邪盛而实。
实大浮数 为肿，胸胁壅满，不小便。（气有升无降。）
紧 为寒邪，为木邪。微者不过抑遏正气，甚则戕贼中州，为真脏见。
紧迟 为肝气寒滞。
紧数 为寒郁热，咳嗽，（外寒束热攻肺。）痛。（寒热相搏故痛。）
紧大 为寒邪盛，下利。（土败木贼，难治。）
紧实 为有形之邪。（瘕疝瘀血之类。）
缓 主湿邪，土湿则泥泞而软也。问∶缓本和柔之名，乃脾胃之正气，何以谓
之病脉？曰∶脾胃脉本中和，不紧不缓，原无紧缓可名，今曰缓，即非不紧不缓之
中和矣。盖凡有可名者，即非中和，即为病脉也。旧谓四至为缓，三至为迟，湿滞
故脉迟缓，亦通。盖缓有两义；一对数言，一对紧言。以主湿则亦有两义∶一为湿
滞之而迟，一为湿浸之而软也。
缓大 为湿盛。
缓细 为正虚挟湿。
缓数 为湿热，肉痿。（不能行动曰痿，肌肉、四肢并见软弱也。脾主肌肉、四肢，湿
热盛则困倦。
经谓脉缓多热，盖对脉急多寒言。寒则筋脉收引故紧，热则筋脉弛纵故缓也。然必兼见热证，
乃为热，不可不知。）
缓浮数 为多汗。
缓数大 为狂笑，（心热则笑。）湿热壅胀。
缓长数 为喜呕，（湿热挟肝火上逆。）水瘕，（水积也，土受木克，不能制水，水郁成热也。）
痹。（麻木不知痛痒也。土受木克，不能行痰，聚于肌肤，故痹。痹而不行，郁滞成热，故数。）
缓滑 为湿痰。
缓涩 为解 。（困倦意，气血衰弱使然。）
长 为邪气长。问∶经曰长显气治，是长本佳脉，何以云病？曰∶长大实滑，
皆有余之脉，短小虚涩，皆不足之脉，不及太过，皆为失中，故长大不作正气有余，
实滑不作血气充足也。然衰弱之病，脉由短而渐长，则为佳兆。诸脉之变异，皆当
以此推之，吉凶自见也。
长数 为热炽。
寸长 为足胫痛，（阳盛阴伤也。）格，（寸脉长九分，过此为太过，遂上鱼名溢。格，不
纳食也。阳盛
于上，胃中血枯，故食不得入。）逆气喘息。
尺长 为关。（尺脉长一寸，过此为太过，名覆。关，不得小便也，热结在下，故不得小便。）
尺寸俱长大 为阳明病。（伤寒热在阳明，则脉大而长。）
短 短，为正气短。
短涩 为肺燥。
寸短 为头痛。（阳不足，则阴气得而上干之。）
大 为邪气盛。经谓大为病进，乃指大而有力者，其病为实邪，邪加盛则脉
加大也。仲景谓大为虚，又谓大为劳，乃指大而无力者，其病为虚邪，虚则气
散，劳则气张，故脉亦应之而虚大也。当分别观之。（阴静而敛，阳动而张，故火旺者脉必大而
浮数虚豁，水足者脉不必大，即大亦沉静而有力也。）
小 为正衰，血气皆少，形体消瘦。（阳不张则小，水不足亦小，兼迟则火尤衰，兼数则水更损。）
细数 为血虚发热。（虚劳得此难治。）
芤 为失血。
芤数 为亡血发热，身体瘦，肌肉甲错。（甲错，枯燥也。）
芤迟 为气虚脱血。
芤动微紧 为男子失精，女子梦交。
弦 为肝邪伤脾，为痛，为饮，（皆脾气被伤而停滞之故。）甚则与紧同论。
弦迟 为寒疟，慢惊风。
弦数 为热痛，急惊风，正气大虚。
弦实 为肝实，善怒不乐，（肝郁不畅。）眩冒，（肝火上冲故眩，乘心故冒。）
巅病。（肝脉会于巅，
火上冲故痛。）
弦大 为肝邪盛。
弦小 为虚损。
弦滑 为痰饮。
滑 流动属阳，主风热，（热气如风，吹血流动。）主痰饮，（凡物干涸则涩，湿润则滑，
故滑为血盛痰多。）主胎孕。
滑大 为多痰，多血。
滑缓 为痰湿。
滑紧 为寒痰，冷食。
涩 血少而滞，属阴。
涩大 为火盛血枯。（此经所谓阳有余也。）
涩小 为血气俱少，少食，心痛，（血少不养心。）痹，（气滞血涩。螈挛，血不养筋。
）噎膈
反胃，肠结。
微濡弱 皆血气衰微之脉。
微浮 为阳气微。
微紧 为虚损多汗，（阴寒逼阳于外。）短气（阴寒逼阳浮上。）
微涩 为体痹，（气滞血涩。）寒栗，咳逆唾腥。
濡弱 为亡血发热，烦心，厥逆。（阳气不能四达，故手足冷。）
弱涩 为精冷无子。
散 为脱，为 仆。
牢 为痼寒， 疝，（阴病，睾丸连少腹急痛。）瘕 。
革 为寒盛，男亡血失精，女半产漏下。（并寒不摄血。）
动 阴阳相搏，虚者则动，阳动见于寸，阴动见于尺，阴动为发热，血崩，阳
动为汗出，惊，痛。（阴阳相搏，气不顺，故痛。）
伏 不过一时偶伏，乃暴病，久元气调即通。为霍乱，痛剧，阴阳痞隔，气闭，
血滞，忿怒气逆，战汗。（伤寒服药后，烦躁冒瞀，脉忽伏不见，寒战，此正邪相争，欲作汗，
宜静待，勿
仓皇误治。）
伏涩 为吐逆，（血枯不能纳食。）水谷不化。（气滞不运。）
结 为寒滞，七情郁结，气血滞，疽，癖。
促 为热壅，痈毒，便脓血。（痈毒不成，则下泄也。若非热壅，则为气脱。）
代 为脏绝，霍乱，跌打闷绝，暴绝，疮痛极，胎气阻。
按以上所列脉病，略举大概，难以执泥。如浮主表，沉主里，而内伤发热，大
类外感，脉亦浮数。寒邪初感，遏郁表气，脉不能外达，反见沉紧，不细辨，则以
表为里，以里为表，而误治矣。脉数为热，然阴虚发热，阳虚发热者，脉皆数，愈虚愈数，一当滋阴，
一当补阳，而概以实热治之，可乎？（尝见实热之脉，多缓软不数，故经
以缓为热，宜知。）脉迟为寒，然热滞于内者，脉亦壅滞似迟，以为寒，误矣。有邪盛而
正未衰者，有邪盛而正已衰者，脉见实则不见虚，既无虚脉可参，则正之已衰者，
又何由而见乎？（按此当以兼紧兼缓辨之，又以形气之盛衰参之。）凡此皆当参伍求之，而不可刻舟
求剑者。况一脉而数病，亦一病而数脉，即欲胶执 言之，又乌可得哉？
疾病不外乎表证或里证，热证或寒证，虚证或实证罢了。因此先论述浮、沉、迟、数、虚、实这六种脉象，其余脉象放在后面。
长大、实、滑等属于有余（邪气盛）的脉象，所主病症大多相同；短、细、虚、涩等属于不足（正气虚）的脉象，所患疾病也相似，应当融会贯通地观察。
如果不深入理解这些原理，就无法触类旁通。例如头痛身热，归属于浮脉和数脉，难道其他脉象就没有这两种症状吗？
阅读者只需领会其精神实质，不要拘泥于文字表面，就能触类旁通，引申出无穷的道理。
浮脉：属于阳脉。阳气在外而阴气在内，所以浮脉主表证，沉脉主里证。又因阳气在上而阴气在下，所以浮脉主上部病变，沉脉主下部病变。从外感病来说，凡是六淫邪气侵袭体表，清邪侵犯上部，脉象必然呈现浮象。从内伤病来说，如果是里气失守导致虚邪外越，或者肾阴失守导致浮阳上冲，脉象也必然呈现浮象。
浮迟脉：主表冷（浮脉主表，迟脉主寒），伤湿（湿邪滞留于肌表经络），中风（虚风内发故见浮脉，体内虚寒故见迟脉。若兼有风邪侵袭肌表，阻滞经络，也会出现浮迟脉）。
浮数脉：主头痛、眩晕、吐血衄血（皆由风热上攻所致）、表热、疮疡、阳结（能进食但大便不通）、胸满、肩背痛。
浮虚脉：主表阳虚、伤暑（大热耗伤元气，汗出过多故脉虚）、劳倦、喘促、咳血。
浮实脉：主表邪实（六淫邪气，或痰凝血滞停留在体表的，都属于此类）、胀满（胃热）、气逆痛（肺热）、肤痛、疮疡。
浮大脉：主风热瘾疹（风热迫血妄行，沸腾于体表）、身痒（名为泄风，热蒸汗出，被风邪闭塞，所以发痒）、表邪盛、痂癞（即疠风。风热久不散，郁积化为湿，相互熏蒸生虫，导致肌肉溃烂）、气高、气实血虚、失血、燥结、阳厥、关格（浮脉表示正气虚，大脉表示邪气实，邪实正虚，不能运化，所以关格不通，小便不得排出，格拒不受饮食）、癫疾。
浮缓脉：主伤风（伤风有汗，内热得以宣泄，所以脉不紧）、伤湿（湿邪损伤肌表肌肉，血脉缓弱，就像土湿则柔软一样）。
浮短脉：主喘促乏力。
沉脉：主里证，主下部病变。七情郁结、痰血停滞，凡属内邪引起的疾病，脉象必然见沉。如果不是因为内邪而见沉脉，则是阳气内陷，或者是里虚不能外达，需要分别观察。
沉数脉：主内热外寒（内热反而感觉外寒，是因为热聚积在内部，不能通达于外部）、便难、消谷（吃得多但排便少，这是因为被热邪消化了）、热厥（厥，指手足寒冷。热聚积在内部，不能通达四肢，所以寒冷。又有手足发热的情况，详见《医碥》厥门）。
沉实脉：主积聚、血瘀、烦心（热邪侵犯心脏）、咳唾（热邪侵犯肺部）。
沉缓脉：主里湿、蓄水。
沉紧脉：主冷痛、奔豚（肾中阴寒之气，从小腹上冲至心，像猪奔跑冲撞一样）、瘕疝（瘕，指积块。疝，指小腹有形之病，都是寒邪凝聚而成）、腰脊痛（肾附于背部，肾寒则气滞而脊痛）。
沉弦脉：主胁下有积（弦为肝脉，肝主胁腹）、少腹痛、内饮、疝。
沉滑脉：主食积痰浊、便脓血。
沉大脉：主内邪盛。
沉细脉：主血少、洞泄亡阴。
迟脉：主寒证，因为寒则气少而行进缓慢，属水。
迟大脉：主寒邪、顽痹。
迟细脉：主寒泻。
迟虚脉：主虚寒。
迟实脉：主寒积。
迟缓脉：主寒湿。
迟紧脉：主寒痛（寒邪阻滞气机不通所以痛）、筋急（筋受寒则收缩牵引所以紧急）。
迟涩脉：主血寒而滞。
数脉：主热证，因为热则气盛而行进迅速，属火。
数虚脉：主虚热、怔忡、虚损。
按：所谓虚热，脉象必然是虚数无力，这是肯定的。但是如果有过服寒凉药物，导致寒热搏击，或者肝邪克制脾土，脉象反而弦大有力，此时投以温补药物，则数脉会静下来，弦脉会变缓，大脉会收敛。这一点必须知晓。还有虚寒逼迫火气浮越，真阳欲脱的情况，脉象也都数，严重的甚至弦大有力，都应当结合症状参详，不要误治。
数涩脉：主热灼血干。
虚脉：主正气不足。
虚滑脉：主正虚挟痰。
虚细脉：主气血不足。
虚大脉：主血虚。
实脉：主邪气有余，不作正气充实来讨论。因为正气只有不足，没有太过，太过即为邪气。参考长脉条。坎卦中满，离卦中虚，水脉多实，火脉多虚。
实大脉：主邪盛而实。
紧脉：主寒邪、木邪。轻微的不过抑制遏制正气，严重的则伤害中州脾胃，出现真脏脉。
紧迟脉：主肝气寒滞。
紧数脉：主寒郁热、咳嗽（外寒束表，热邪攻肺）、痛（寒热相搏所以痛）。
紧大脉：主寒邪盛、下利（土败木贼，难治）。
缓脉：主湿邪，土湿则泥泞而软。问：缓本是和柔之名，是脾胃的正气，为什么说是病脉？答：脾胃的脉本应中和，不紧不缓，原本没有紧缓可以命名，现在说缓，就是非不紧不缓的中和状态了。大概凡是可命名的，就不是中和，就是病脉。旧说四至为缓，三至为迟，湿滞故脉迟缓，也通。大概缓有两层含义：一是对数而言，一是对紧而言。以主湿来说也有两层含义：一是湿滞导致迟缓，一是湿浸导致软弱。
缓大脉：主湿盛。
缓细脉：主正虚挟湿。
缓数脉：主湿热、肉痿（不能行动叫痿，肌肉、四肢并见软弱。脾主肌肉、四肢，湿热盛则困倦。经书说脉缓多热，是相对于脉急多寒而言。寒则筋脉收缩牵引所以紧，热则筋脉弛纵所以缓。但必须兼见热证，才是热，不可不知）。
缓浮数脉：主多汗。
缓长数脉：主喜呕（湿热挟肝火上逆）、水瘕（水积也，土受木克，不能制水，水郁成热）、痹（麻木不知痛痒。土受木克，不能行痰，聚于肌肤，所以痹。痹而不行，郁滞成热，所以数）。
缓滑脉：主湿痰。
长脉：主邪气长。问：经书说长显气治，长本是佳脉，为什么说病？答：长大实滑，都是有餘之脉，短小虚涩，都是不足之脉，不及和太过，都是失中，所以长大不作正气有余，实滑不作血气充足论。然而衰弱之病，脉由短而渐长，则是佳兆。诸脉的变异，都应当以此推演，吉凶自然可见。
长数脉：主热炽。
寸长脉：主足胫痛（阳盛阴伤）、格（寸脉长九分，超过此为太过，遂上鱼际名溢。格，指不纳食。阳盛于上，胃中血枯，所以食不得入）、逆气喘息。
尺长脉：主关（尺脉长一寸，超过此为太过，名覆。关，指不得小便。热结在下，所以不得小便）。
短脉：短，主正气短。
短涩脉：主肺燥。
大脉：主邪气盛。经书说大为病进，是指大而有力者，其病为实邪，邪加盛则脉加大。仲景说大为虚，又说大为劳，是指大而无力者，其病为虚邪，虚则气散，劳则气张，所以脉也相应而虚大。应当分别观察。（阴静而敛，阳动而张，所以火旺者脉必大而浮数虚豁，水足者脉不必大，即使大也是沉静而有力。）
小脉：主正衰，血气皆少，形体消瘦。（阳不张则小，水不足亦小，兼迟则火尤衰，兼数则水更损。）
芤脉：主失血。
芤迟脉：主气虚脱血。
弦脉：主肝邪伤脾、痛、饮（都是脾气被伤而停滞的缘故），严重时与紧脉同论。
弦实脉：主肝实、善怒不乐（肝郁不畅）、眩冒（肝火上冲故眩，乘心故冒）、巅病（肝脉会于巅，火上冲故痛）。
弦大脉：主肝邪盛。
弦滑脉：主痰饮。
滑脉：流动属阳，主风热（热气如风，吹血流动）、主痰饮（凡物干涸则涩，湿润则滑，所以滑为血盛痰多）、主胎孕。
滑缓脉：主痰湿。
涩脉：血少而滞，属阴。
涩大脉：主火盛血枯（此经所谓阳有余也）。
涩小脉：主血气俱少、少食、心痛（血少不养心）、痹（气滞血涩）、螈挛（血不养筋）、噎膈反胃、肠结。
微、濡、弱脉：都是血气衰微之脉。
微浮脉：主阳气微。
濡弱脉：主亡血发热、烦心、厥逆（阳气不能四达，所以手足冷）。
弱涩脉：主精冷无子。
动脉：阴阳相搏，虚者则动，阳动见于寸，阴动见于尺，阴动为发热、血崩，阳动为汗出、惊、痛（阴阳相搏，气不顺，所以痛）。
伏脉：不过一时偶伏，乃暴病，久元气调即通。主霍乱、痛剧、阴阳痞隔、气闭、血滞、忿怒气逆、战汗（伤寒服药后，烦躁冒瞀，脉忽伏不见，寒战，此正邪相争，欲作汗，宜静待，勿仓皇误治）。
促脉：主热壅、痈毒、便脓血（痈毒不成，则下泄也。若非热壅，则为气脱）。
按：以上所列脉病，略举大概，难以执泥。如浮主表，沉主里，而内伤发热，大类外感，脉亦浮数。寒邪初感，遏郁表气，脉不能外达，反见沉紧，不细辨，则以表为里，以里为表，而误治矣。脉数为热，然阴虚发热，阳虚发热者，脉皆数，愈虚愈数，一当滋阴，一当补阳，而概以实热治之，可乎？（尝见实热之脉，多缓软不数，故经以缓为热，宜知。）脉迟为寒，然热滞于内者，脉亦壅滞似迟，以为寒，误矣。有邪盛而正未衰者，有邪盛而正已衰者，脉见实则不见虚，既无虚脉可参，则正之已衰者，又何由而见乎？（按此当以兼紧兼缓辨之，又以形气之盛衰参之。）凡此皆当参伍求之，而不可刻舟求剑者。况一脉而数病，亦一病而数脉，即欲胶执言之，又乌可得哉？
Diseases are either exterior or interior, heat or cold, deficiency or excess. Therefore, the six pulses of Floating (Fú), Sinking (Chén), Slow (Chí), Rapid (Shuò), Deficient (Xū), and Excess (Shí) are discussed first, followed by other pulses.
Pulses such as Long (Cháng), Large (Dà), Excess (Shí), and Slippery (Huá) belong to "excess" (abundant pathogenic factors); their associated syndromes are largely similar. Pulses such as Short (Duǎn), Fine (Xì), Deficient (Xū), and Choppy (Sè) belong to "deficiency" (insufficient healthy qi); the diseases they indicate are also similar, and should be understood through comprehensive integration.
Without deep understanding of these principles, one cannot draw inferences by analogy. For instance, headache and fever are attributed to Floating and Rapid pulses; does this mean other pulses never present with these two symptoms? Readers should grasp the underlying intent rather than adhering strictly to the text, thereby enabling them to draw inferences and extend their knowledge indefinitely.
Floating Pulse: A Yang pulse. Since Yang is external and Yin is internal, Floating indicates Exterior syndromes, while Sinking indicates Interior syndromes. Furthermore, since Yang is superior and Yin is inferior, Floating indicates lesions in the upper body, while Sinking indicates lesions in the lower body. Regarding exogenous diseases, when the Six Evils (Liù Yín, referring to Wind, Cold, Summer-heat, Dampness, Dryness, and Fire) invade the exterior, or clear pathogens attack the upper regions, the pulse will necessarily be Floating. Regarding endogenous diseases, if the Qi of the Interior loses its hold causing deficient pathogens to protrude outward, or if Kidney Yin fails to contain the Floating Yang which rushes upward, the pulse will also necessarily be Floating.
Floating-Slow Pulse: Indicates Cold in the Exterior (Floating indicates Exterior, Slow indicates Cold), injury from Dampness (Damp pathogens stagnating in the muscle layer and meridians), or Wind-stroke (Deficient Wind arises internally causing Floating; internal deficiency-cold causes Slow. If accompanied by Wind pathogens invading the exterior and blocking the meridians, a Floating-Slow pulse may also appear).
Floating-Rapid Pulse: Indicates Headache, Vertigo/Dizziness, Hematemesis/Epistaxis (all caused by Wind-Heat attacking upward), Exterior Heat, Sores/Ulcers, Yang Binding (ability to eat but inability to pass stool), Chest Fullness, Shoulder and Back Pain.
Floating-Deficient Pulse: Indicates Deficiency of Exterior Yang, Injury from Summer-heat (Intense heat damages Qi, excessive sweating leads to deficiency), Fatigue/Labor, Panting, Hemoptysis.
Floating-Excess Pulse: Indicates Excess of Exterior Pathogens (including the Six Evils, or Phlegm and Blood Stasis remaining in the exterior), Distension and Fullness (Stomach Heat), Rebellious Qi and Pain (Lung Heat), Skin Pain, Sores/Ulcers.
Floating-Large Pulse: Indicates Wind-Heat Urticaria (Wind-Heat forces blood to move recklessly, boiling on the exterior), Body Itching (named Xie Feng [Leaking Wind]; heat steams sweat, closed by Wind, causing itching), Excess of Exterior Pathogens, Leprosy/Madarosis (i.e., Lepra. Wind-Heat lingers without dissipating, condenses into Dampness, steams together to generate worms, causing muscle ulceration), Qi Rising, Qi Excess with Blood Deficiency, Blood Loss, Dryness/Binding, Yang Jue (Cold Extremities due to Heat), Guan Ge (Obstruction and Refusal; Floating indicates Healthy Qi Deficiency, Large indicates Pathogen Excess. With Pathogen Excess and Healthy Qi Deficiency, transformation and transportation fail, leading to Guan [inability to urinate] and Ge [inability to accept food]), and Mania.
Floating-Fine Pulse: Indicates Decline of Exterior Yang.
Floating-Relaxed Pulse: Indicates Wind-Injury (Wind-injury presents with sweating, allowing internal heat to vent, so the pulse is not tight), or Injury from Dampness (Dampness injures the muscle layer and muscles; the blood vessels become relaxed and weak, just as wet earth becomes soft).
Floating-Tight Pulse: Indicates Cold Damage (Shang Han), Body Pain.
Floating-Wiry Pulse: Indicates Headache, Vomiting Food, Wind-Water Retention.
Floating-Slippery Pulse: Indicates Wind-Phlegm, Epistaxis, Vomiting/Rebellious Qi.
Floating-Choppy Pulse: Indicates Numbness, Fever without Sweating, Lung Dryness, Excessive Sweating damaging Body Fluids, Blood Deficiency with Floating Qi.
Floating-Long Pulse: Indicates Headache, Wind-Epilepsy.
Floating-Short Pulse: Indicates Panting and Fatigue.
Sinking Pulse: Indicates Interior syndromes and lower body lesions. Emotional stagnation, Phlegm and Blood stasis, and all Internal pathogens typically present with a Sinking pulse. If a Sinking pulse appears not due to internal pathogens, it indicates sinking of Yang Qi or Interior Deficiency failing to reach the exterior; these must be distinguished.
Sinking-Slow Pulse: Indicates Interior Cold, Diarrhea, Qi and Blood Stagnation, Water Retention.
Sinking-Rapid Pulse: Indicates Internal Heat with External Cold (Internal heat feels like external cold because heat aggregates internally and fails to reach the exterior), Difficulty in Defecation, Xiao Gu (Consuming Grain; eating much but passing little stool, digested by heat), Heat Jue (Jue refers to cold hands and feet. Heat aggregates internally, failing to reach the limbs, causing coldness. There are cases of hot hands and feet; see the Jue section of *Yi Bian*).
Sinking-Deficient Pulse: Indicates Interior Deficiency, Bloody Stool, Dysentery.
Sinking-Excess Pulse: Indicates Accumulation/Masses, Blood Stasis, Irritability (Heat affecting the Heart), Coughing up Saliva (Heat affecting the Lung).
Sinking-Relaxed Pulse: Indicates Interior Dampness, Water Retention.
Sinking-Tight Pulse: Indicates Cold Pain, Ben Tun (Rushing Pig; Yin-Cold Qi from the Kidneys rushes from the lower abdomen to the heart, resembling a rushing pig), Xia Shan (Xia refers to masses; Shan refers to painful conditions in the lower abdomen with visible forms, all caused by凝集 of Cold pathogens), Lower Back and Spine Pain (The Kidneys attach to the back; Kidney Cold causes Qi stagnation and spine pain).
Sinking-Wiry Pulse: Indicates Masses under the Hypochondrium (Wiry is the Liver pulse; the Liver governs the hypochondrium and abdomen), Lower Abdominal Pain, Internal Water Retention, Shan.
Sinking-Slippery Pulse: Indicates Food and Phlegm retention, Pus and Blood in Stool.
Sinking-Choppy Pulse: Indicates Blood Stagnation, Essence Injury, Amenorrhea, Infertility, Internal Abscesses.
Sinking-Large Pulse: Indicates Excess of Internal Pathogens.
Sinking-Fine Pulse: Indicates Blood Deficiency, Hole-like Diarrhea with Yin Exhaustion.
Slow Pulse: Indicates Cold, because Cold reduces Qi and slows circulation; it belongs to Water.
Slow-Large Pulse: Indicates Cold Pathogens, Stubborn Bi Syndrome.
Slow-Fine Pulse: Indicates Cold Diarrhea.
Slow-Deficient Pulse: Indicates Deficient Cold.
Slow-Excess Pulse: Indicates Cold Accumulation.
Slow-Relaxed Pulse: Indicates Cold-Dampness.
Slow-Tight Pulse: Indicates Cold Pain (Cold stagnates Qi, causing obstruction and pain), Tendon Cramping (Cold tendons contract and pull, causing tension).
Slow-Choppy Pulse: Indicates Cold Blood with Stagnation.
Rapid Pulse: Indicates Heat, because Heat increases Qi and accelerates circulation; it belongs to Fire.
Rapid-Large Pulse: Indicates Irritability, Thirst, Rash, Distension and Fullness.
Rapid-Deficient Pulse: Indicates Deficient Heat, Palpitations, Consumption.
Note: In Deficient Heat, the pulse is necessarily Deficient, Rapid, and Forceless. However, if excessive use of Cold/Cooling herbs causes a struggle between Cold and Heat, or if Liver Pathogens overact on Spleen Earth, the pulse may paradoxically appear Wiry, Large, and Forceful. Administering Warm/Tonic herbs will calm the Rapid pulse, relax the Wiry pulse, and reduce the Large pulse. This must be understood. Additionally, in cases of Deficient Cold forcing Fire to float outward, or impending collapse of True Yang, the pulse may be Rapid, and even severe cases may show Wiry, Large, and Forceful qualities. These must be evaluated based on symptoms to avoid misdiagnosis.
Rapid-Excess Pulse: Indicates Excess Heat, Carbuncles/Sores, Irritability, Delirium.
Rapid-Slippery Pulse: Indicates Heat-Phlegm, Blood Heat, Thirst.
Rapid-Choppy Pulse: Indicates Heat scorching and drying the Blood.
Deficient Pulse: Indicates Insufficiency of Healthy Qi.
Deficient-Slippery Pulse: Indicates Healthy Qi Deficiency with Phlegm.
Deficient-Choppy Pulse: Indicates Blood Deficiency, Qi Stagnation.
Deficient-Wiry Pulse: Indicates Consumption, Poor Appetite, Deficient Pain.
Deficient-Relaxed Pulse: Indicates Weakness, Diarrhea.
Deficient-Fine Pulse: Indicates Qi and Blood Deficiency.
Deficient-Large Pulse: Indicates Blood Deficiency.
Excess Pulse: Indicates Abundance of Pathogenic Factors; it is not interpreted as robust Healthy Qi. Healthy Qi only suffers from insufficiency, not excess; excess constitutes a pathogen. Refer to the Long Pulse section. Kan trigram is full in the middle; Li trigram is empty in the middle. Water pulses tend toward Excess; Fire pulses tend toward Deficiency.
Excess-Slippery Pulse: Indicates Phlegm Knotting, Retained Food.
Excess-Large Pulse: Indicates Pathogen Excess and Reality.
Excess-Large-Floating-Rapid Pulse: Indicates Swelling, Chest/Hypochondriac Fullness, Urinary Retention (Qi rises but does not descend).
Tight Pulse: Indicates Cold Pathogens, Wood Pathogens. Mildly, it suppresses Healthy Qi; severely, it damages the Middle Jiao, revealing the True Zang pulse.
Tight-Slow Pulse: Indicates Cold Stagnation of Liver Qi.
Tight-Rapid Pulse: Indicates Cold Trapping Heat, Cough (External Cold binds, Heat attacks the Lung), Pain (Cold and Heat contend, causing pain).
Tight-Large Pulse: Indicates Excess Cold, Diarrhea (Earth fails, Wood invades; difficult to treat).
Tight-Excess Pulse: Indicates Tangible Pathogens (such as Xia/Shan masses, Blood Stasis).
Relaxed Pulse: Indicates Damp Pathogens; wet earth is muddy and soft. Question: Relaxed implies gentleness and harmony, representing the Healthy Qi of the Spleen and Stomach. Why is it considered a pathological pulse? Answer: The Spleen/Stomach pulse should be harmonious, neither tight nor relaxed. Originally, there is no name for tight or relaxed. To say "relaxed" now means it is no longer the harmonious state of "neither tight nor relaxed." Generally, anything that can be named is not harmonious, thus it is a pathological pulse. Old texts define four beats per respiration as Relaxed, three as Slow; Damp stagnation causes slow and relaxed pulses, which is also valid. "Relaxed" has two meanings: one relative to Rapid, one relative to Tight. Regarding Dampness, there are also two meanings: one is Damp stagnation causing slowness, the other is Damp infiltration causing softness.
Relaxed-Large Pulse: Indicates Excess Dampness.
Relaxed-Fine Pulse: Indicates Healthy Qi Deficiency with Dampness.
Relaxed-Rapid Pulse: Indicates Damp-Heat, Muscle Wei (Inability to move is called Wei; weakness of muscles and limbs. Spleen governs muscles and limbs; Damp-Heat exhaustion causes fatigue. Classics state Relaxed pulses often indicate Heat, contrasting with Tight pulses indicating Cold. Cold causes tendon contraction and tightness; Heat causes tendon relaxation and slowness. However, Heat signs must accompany this to confirm Heat).
Relaxed-Floating-Rapid Pulse: Indicates Excessive Sweating.
Relaxed-Rapid-Large Pulse: Indicates Manic Laughter (Heart Heat causes laughter), Damp-Heat Obstruction and Distension.
Relaxed-Long-Rapid Pulse: Indicates Frequent Vomiting (Damp-Heat with Liver Fire rebelling upward), Shui Jia (Water accumulation; Earth controlled by Wood fails to control Water, Water stagnates and generates Heat), Bi Syndrome (Numbness and loss of pain/itch sensation. Earth controlled by Wood fails to transport Phlegm, which gathers in skin/muscles causing Bi. Bi stagnation generates Heat, hence Rapid).
Relaxed-Slippery Pulse: Indicates Damp-Phlegm.
Relaxed-Choppy Pulse: Indicates Jie Ji (Listlessness/Fatigue due to Qi and Blood decline).
Long Pulse: Indicates Proliferation of Pathogens. Question: Classics say Long indicates governing Qi health; why is it a disease? Answer: Long, Large, Excess, and Slippery are pulses of Excess; Short, Small, Deficient, and Choppy are pulses of Deficiency. Both insufficiency and excess represent deviation from the mean. Thus, Long/Large do not indicate abundant Healthy Qi, nor do Excess/Slippery indicate sufficient Blood/Qi. However, in wasting diseases, if the pulse changes from Short to gradually Long, it is a good omen. Variations in all pulses should be deduced this way to discern auspiciousness or inauspiciousness.
Long-Rapid Pulse: Indicates Intense Heat.
Long at Cun Position: Indicates Pain in Calves/Shins (Yang Excess, Yin Injury), Ge (Cun pulse exceeds 9 fen, reaching the fish margin, named Yi; Ge means refusal of food. Yang Excess above, Stomach Blood dry, food cannot enter), Rebellious Qi and Panting.
Long at Chi Position: Indicates Guan (Chi pulse exceeds 1 cun, named Fu; Guan means inability to urinate. Heat binding below prevents urination).
Long at both Cun and Chi: Indicates Yangming Disease (Heat in Yangming presents with Large and Long pulse).
Short Pulse: Indicates Shortage of Healthy Qi.
Short-Choppy Pulse: Indicates Lung Dryness.
Short at Cun Position: Indicates Headache (Yang insufficient, Yin Qi rebels upward).
Large Pulse: Indicates Excess of Pathogens. Classics say Large indicates disease progression, referring to Large and Forceful pulses where the disease is Excess Pathogen; as pathogen increases, pulse becomes Larger. Zhang Zhongjing says Large indicates Deficiency or Labor, referring to Large but Forceless pulses where the disease is Deficient Pathogen; Deficiency scatters Qi, Labor expands Qi, so the pulse becomes Vacuously Large. These must be distinguished. (Yin is still and contracting; Yang is active and expanding. Fire Excess results in Large, Floating, Rapid, Vacuous pulses; Water Sufficiency results in pulses that need not be Large, and if Large, are Deep and Forceful.)
Small Pulse: Indicates Decline of Healthy Qi, Scarcity of Blood and Qi, Emaciation. (Yang not expanding leads to Small; Water insufficient leads to Small. Combined with Slow, Fire is especially weak; combined with Rapid, Water is further damaged.)
Fine-Rapid Pulse: Indicates Blood Deficiency with Fever (Difficult to treat in Consumption).
Kou Pulse: Indicates Blood Loss.
Kou-Rapid Pulse: Indicates Fever from Blood Loss, Emaciation, Rough Skin (Jia Cuo, dryness).
Kou-Slow Pulse: Indicates Qi Deficiency with Blood Collapse.
Kou-Moving-Slightly Tight Pulse: Indicates Nocturnal Emission in Men, Dream Interourse in Women.
Wiry Pulse: Indicates Liver Pathogen injuring Spleen, Pain, Water Retention (due to Spleen Qi injury and stagnation); severely, it is treated similarly to Tight pulse.
Wiry-Slow Pulse: Indicates Cold Malaria, Slow Convulsive Wind.
Wiry-Rapid Pulse: Indicates Heat Pain, Acute Convulsive Wind, Severe Healthy Qi Deficiency.
Wiry-Excess Pulse: Indicates Liver Excess, Irritability/Unhappiness (Liver Qi stagnation), Vertigo/Dizziness (Liver Fire rushing up causes vertigo, affecting Heart causes dizziness), Dian Disease (Liver meridian meets vertex; Fire rushing up causes pain).
Wiry-Large Pulse: Indicates Excess Liver Pathogen.
Wiry-Fine Pulse: Indicates Consumption.
Wiry-Slippery Pulse: Indicates Phlegm-Fluid.
Slippery Pulse: Flowing and belongs to Yang; indicates Wind-Heat (Heat moves blood like wind), Phlegm-Fluid (Dry things are choppy, moist things are slippery; thus Slippery indicates abundant Blood and Phlegm), and Pregnancy.
Slippery-Large Pulse: Indicates Abundant Phlegm and Blood.
Slippery-Relaxed Pulse: Indicates Phlegm-Dampness.
Slippery-Tight Pulse: Indicates Cold-Phlegm, Cold Food.
Choppy Pulse: Scanty Blood with Stagnation, belongs to Yin.
Choppy-Large Pulse: Indicates Fire Excess and Blood Dryness (referred to in classics as Yang Excess).
Choppy-Fine Pulse: Indicates Scarcity of Qi and Blood, Poor Appetite, Heart Pain (Blood insufficient to nourish Heart), Bi (Qi stagnation, Blood choppy), Twitching/Convulsions (Blood insufficient to nourish tendons), Dysphagia/Regurgitation, Intestinal Binding.
Micro, Soft, and Weak Pulses: All indicate衰微 (decline/extinction) of Qi and Blood.
Micro-Floating Pulse: Indicates Micro Yang Qi.
Micro-Tight Pulse: Indicates Consumption with Excessive Sweating (Yin-Cold forces Yang outward), Shortness of Breath (Yin-Cold forces Yang to float upward).
Micro-Choppy Pulse: Indicates Body Bi (Qi stagnation, Blood choppy), Chills, Cough with foul sputum.
Soft-Weak Pulse: Indicates Fever from Blood Loss, Irritability, Jue/Numbness (Yang Qi cannot reach extremities, causing cold hands/feet).
Weak-Choppy Pulse: Indicates Cold Essence and Infertility.
Scattered Pulse: Indicates Collapse, Fainting.
Firm Pulse: Indicates Chronic Cold, Shan (Yin disease, testicle pain extending to lower abdomen), Xia.
Leather Pulse: Indicates Excess Cold, Blood Loss/Essence Loss in Men, Miscarriage/Leukorrhea in Women (Cold fails to secure Blood).
Moving Pulse: Yin and Yang contend; movement occurs in deficiency. Yang Movement appears at Cun; Yin Movement appears at Chi. Yin Movement indicates Fever, Metrorrhagia; Yang Movement indicates Sweating, Fright, Pain (Yin/Yang contention, Qi unsmooth, causing pain).
Hidden Pulse: Temporary hiding indicates acute disease; prolonged recovery allows Qi to flow. Indicates Cholera, Severe Pain, Yin-Yang Blockage, Qi Closure, Blood Stasis, Anger with Rebellious Qi, Battle Sweat (After taking medicine for Cold Damage, irritability/confusion, sudden hidden pulse, chills—this is Healthy Qi fighting Pathogen, attempting to sweat; wait quietly, do not treat hastily).
Hidden-Choppy Pulse: Indicates Vomiting/Rebellion (Blood dry, unable to accept food), Indigestion of Water/Food (Qi stagnation fails to transport).
Knotted Pulse: Indicates Cold Stagnation, Emotional Stagnation, Qi/Blood Stagnation, Abscesses, Pi Masses.
Hasty Pulse: Indicates Heat Obstruction, Carbuncle Toxins, Pus/Blood in Stool (If toxin does not form, it drains downward. If not Heat Obstruction, it indicates Qi Collapse).
Intermittent Pulse: Indicates Zang Failure, Cholera, Trauma/Suffocation, Sudden Death, Extreme Carbuncle Pain, Fetal Qi Obstruction.
Note: The pulse-disease correlations listed above are general summaries and should not be applied rigidly. For example, Floating indicates Exterior, Sinking indicates Interior; however, Endogenous Fever resembles Exogenous patterns, presenting with Floating-Rapid pulses. Initial Cold invasion may suppress Exterior Qi, preventing outward expression, resulting in a Sinking-Tight pulse; without careful differentiation, Exterior may be mistaken for Interior, leading to misdiagnosis. Rapid pulse indicates Heat; however, in Yin Deficiency Fever or Yang Deficiency Fever, the pulse is also Rapid, becoming more Rapid as deficiency worsens. One requires Yin Nourishment, the other Yang Tonification; treating both as Excess Heat is incorrect. (Note: Excess Heat pulses are often Relaxed/Soft and not necessarily Rapid; thus classics associate Relaxed with Heat, which should be known.) Slow pulse indicates Cold; however, Internal Heat Stagnation may cause sluggish pulses resembling Slow; mistaking this for Cold is an error. Some cases have Excess Pathogens with intact Healthy Qi, others have Excess Pathogens with depleted Healthy Qi. If the pulse shows Excess without Deficiency signs, how can one detect the depletion of Healthy Qi? (Differentiate by accompanying Tight/Relaxed qualities and assess physical constitution/Qi strength.) All these require comprehensive analysis; one must not apply rules mechanically. Moreover, one pulse may correspond to multiple diseases, and one disease may present with multiple pulses. Even if one wishes to adhere strictly, is it possible?