经曰∶人无胃气则死。（此言脉以有胃气为主也。胃属土，其德中和，其气之达于脉也，
不刚不柔，
不疾不徐，不大不小，不浮不沉，有雍容和平之状，无过不及之伤者也。）春胃微弦曰平，（雍容
和缓中略带弦
意也。）弦多胃少曰肝病，（肝邪胜，胃气衰也。）但弦无胃曰死，（胃气已绝故也。）
胃而有毛（犹云得秋脉。
）曰秋病，（金克木也，春木旺尚无伤，至秋则必疾矣。）毛甚曰今病。（目下即病也。）
夏胃微钩曰平，钩多胃少曰心病，但钩无胃曰死，胃而有石曰冬病，石甚曰今
病。（石者，沉实之意，冬脉也。）
长夏胃微 弱曰平，（长夏未月也，土湿则软，故微软弱，即缓脉也。）弱多胃少曰脾病，
（犹言脾
胃自病也。）但代无胃曰死，（代，更代也。春弦、夏钩秋毛、冬石，脉体随时而更，但
见其所更者，而不见胃
气则死矣。不言但弱无胃曰死，以弱但正气不足，非有邪气相乘，且弱止可言胃气衰，不可言
胃气绝也。何则？胃
脉虽曰中和，而长夏土湿，则略近柔软一边，可云柔软之甚为弱，不可云但弱无柔软也。）
弱有石曰冬病，
（土气衰而水反乘之，故至冬必病矣。）弱（当作石）甚曰今病。（春夏以克我者言，此下皆以我
克者言，互文以见例也。
又春言胃有毛，夏言胃有石，此及下文变胃言软弱毛石，亦互文也。）
秋胃微毛曰平，毛多胃少曰肺病，但毛无胃曰死，毛而有弦曰春病，弦甚曰今病。
冬胃微石曰平，石多胃少曰肾病，但石无胃曰死，石而有钩曰夏病，钩甚曰今病。
真肝脉至，（此下皆言真脏脉，真犹言纯。真肝脉者，言此为纯乎肝脉，毫无胃气者也。
盖肝弦肺涩心浮肾沉，各得一偏，惟胃气六脉，不弦不涩，不浮不沉，中和合德，有以化四者之偏。
故肝虽乘春令，以呈其弦象，
而中和柔软之胃气，即与之偕行，而胃之和缓意多，肝之弦意少，是为平脉。若弦多胃少，
即为病脉矣。况毫无胃
气，而纯乎弦劲耶？此盖胃绝使然。故凡病真脏脉现者，必死也。余脏仿此论之。）
如循刀刃，如按琴瑟弦。
（皆挺劲之意。）真心脉至，坚而搏，如循薏苡子。（坚实之状，累累然见手指下也。）
真肺脉至，大而虚，如以毛羽中人。（虚浮无力之意。）真肾脉至，搏而绝，（绝，陡绝，无余韵也。）
如指弹石。（坚实。）真脾脉至，弱而乍数乍疏。
《内经》说：人如果没有胃气就会死亡。（这句话的意思是，脉象以具备胃气为根本。胃属土，其德性中和，其气达于脉时，不刚硬也不柔弱，不急促也不缓慢，不大也不小，不浮也不沉，呈现出雍容和平的状态，没有过与不及的伤害。）春季脉象中带有微弱的弦意而兼有胃气称为平脉（即在雍容和缓中略带弦意）。弦意多而胃气少称为肝病（肝邪盛，胃气衰）。只有弦意而没有胃气称为死证（因为胃气已经断绝）。
如果脉象中有毛（即秋脉）的特征，称为秋季发病（金克木，春季木旺时尚未受伤，到了秋季必然生病）。毛象严重称为当下发病（眼下即刻发病）。
夏季脉象中带有微弱的钩意而兼有胃气称为平脉。钩意多而胃气少称为心病。只有钩意而没有胃气称为死证。如果脉象中有石（即冬脉）的特征，称为冬季发病（石指沉实之意，是冬脉）。石象严重称为当下发病。
长夏（农历六月）脉象中带有微弱的弱意而兼有胃气称为平脉（长夏未月，土湿则脉软，所以微软弱，这就是缓脉）。弱意多而胃气少称为脾病（也就是脾胃自病）。只有代脉（更代之脉）而没有胃气称为死证（代，意为更代。春弦、夏钩、秋毛、冬石，脉体随季节更替，但如果只见到所更替的脉象特征，而见不到胃气，就会死亡。这里不说“只有弱而无胃”为死证，是因为弱只是正气不足，并非有邪气相乘，且弱只能说明胃气衰，不能说明胃气绝。为什么呢？胃脉虽然说是中和，但长夏土湿，脉象略近柔软一边，可以说柔软之极为弱，但不能说只有弱而没有柔软之意）。如果弱脉中带有石象，称为冬季发病（土气衰而水反乘之，所以到了冬季必然生病）。石象严重称为当下发病（春夏两季是以“我克者”来论述，下文皆以“我克者”而言，这是互文见义。另外春季说“胃有毛”，夏季说“胃有石”，此处及下文变“胃”言“软弱毛石”，也是互文见义）。
秋季脉象中带有微弱的毛意而兼有胃气称为平脉。毛意多而胃气少称为肺病。只有毛意而没有胃气称为死证。如果毛脉中带有弦意，称为春季发病。弦意严重称为当下发病。
冬季脉象中带有微弱的石意而兼有胃气称为平脉。石意多而胃气少称为肾病。只有石意而没有胃气称为死证。如果石脉中带有钩意，称为夏季发病。钩意严重称为当下发病。
真肝脉出现时（以下所述皆为真脏脉，“真”犹言“纯”。真肝脉，意指此为纯粹的肝脉，毫无胃气。肝脉弦、肺脉涩、心脉浮、肾脉沉，各得其一偏，唯有胃气六脉，不弦不涩，不浮不沉，中和合德，能够化解四者的偏颇。所以肝脏虽当春令，呈现弦象，但中和柔软的胃气与之同行，胃的和缓意多，肝的弦意少，这才是平脉。如果弦多胃少，就是病脉了。何况毫无胃气，而纯粹是弦劲呢？这大概是胃气断绝所致。所以凡是疾病中出现真脏脉的，必定死亡。其余脏腑仿照此论）。脉象如触摸刀刃，如按压琴瑟的弦（都是挺劲的意思）。
真心脉出现时，坚硬而搏指，如触摸薏苡子（坚实的样子，颗粒感明显见于手指下）。
真肺脉出现时，大而虚，如羽毛中人（虚浮无力的意思）。
真肾脉出现时，搏动而陡绝（绝，指陡然断绝，没有余韵），如手指弹石（坚实）。
真脾脉出现时，弱而忽快忽慢。
The *Classic of Internal Medicine* states: If a person lacks Stomach Qi (Wei Qi, the vital energy derived from digestion and transformation), they will die. (This statement emphasizes that the pulse must possess Stomach Qi as its primary characteristic. The Stomach belongs to Earth; its virtue is harmony and neutrality. When its Qi reaches the pulse, it is neither rigid nor soft, neither rapid nor slow, neither large nor small, neither floating nor deep, presenting a dignified and peaceful state without excess or deficiency.)
In Spring, a pulse with slight *Xian* (Wiry) quality accompanied by Stomach Qi is considered normal (indicating a slight wiry intent within a dignified and relaxed state). If *Xian* qualities are excessive and Stomach Qi is deficient, it indicates Liver Disease (Liver pathogenic factors prevail, while Stomach Qi declines). If there is only *Xian* quality without any Stomach Qi, it indicates death (because Stomach Qi has been exhausted).
If the pulse exhibits *Mao* (Hairy/Floaty, corresponding to Autumn) characteristics, disease will manifest in Autumn (Metal overcomes Wood; although Wood is prosperous in Spring and unharmed, it will inevitably become ill in Autumn). If *Mao* qualities are severe, illness manifests immediately (illness occurring at present).
In Summer, a pulse with slight *Gou* (Hook/Curved) quality accompanied by Stomach Qi is considered normal. If *Gou* qualities are excessive and Stomach Qi is deficient, it indicates Heart Disease. If there is only *Gou* quality without any Stomach Qi, it indicates death. If the pulse exhibits *Shi* (Stone/Sinking-solid, corresponding to Winter) characteristics, disease will manifest in Winter (*Shi* implies sinking and solid, which is the Winter pulse). If *Shi* qualities are severe, illness manifests immediately.
During Late Summer (the sixth lunar month), a pulse with slight *Ruo* (Weak) quality accompanied by Stomach Qi is considered normal (Late Summer corresponds to Wei month; Earth is damp, making the pulse soft, hence slightly weak, which is essentially the *Huan* (Moderate) pulse). If *Ruo* qualities are excessive and Stomach Qi is deficient, it indicates Spleen Disease (referring to self-disease of the Spleen and Stomach). If there is only a *Dai* (Intermittent/Replacing) pulse without Stomach Qi, it indicates death (*Dai* means replacing. Spring is *Xian*, Summer is *Gou*, Autumn is *Mao*, Winter is *Shi*; the pulse body changes with the seasons. If one sees only the changing pulse characteristics but no Stomach Qi, death ensues. The text does not say "only *Ruo* without Stomach Qi" leads to death because *Ruo* merely indicates insufficiency of righteous Qi, not necessarily invasion by pathogenic factors. Furthermore, *Ruo* only suggests decline of Stomach Qi, not its absolute extinction. Why? Although Stomach Qi is harmonious and neutral, during Late Summer when Earth is damp, the pulse tends towards softness. One can say extreme softness is *Ruo*, but one cannot say there is only *Ruo* without any softness). If *Ruo* pulse exhibits *Shi* characteristics, disease will manifest in Winter (Earth Qi declines, allowing Water to overcome it, so illness occurs in Winter). If *Shi* qualities are severe, illness manifests immediately (Spring and Summer discussions focus on "that which I overcome," while the following sections also focus on "that which I overcome," illustrating mutual textual references. Similarly, Spring mentions "Stomach has Mao," Summer mentions "Stomach has Shi," and here and below, varying "Stomach" with "Ruo, Ruan, Mao, Shi" also illustrates mutual textual reference).
In Autumn, a pulse with slight *Mao* quality accompanied by Stomach Qi is considered normal. If *Mao* qualities are excessive and Stomach Qi is deficient, it indicates Lung Disease. If there is only *Mao* quality without any Stomach Qi, it indicates death. If *Mao* pulse exhibits *Xian* characteristics, disease will manifest in Spring. If *Xian* qualities are severe, illness manifests immediately.
In Winter, a pulse with slight *Shi* quality accompanied by Stomach Qi is considered normal. If *Shi* qualities are excessive and Stomach Qi is deficient, it indicates Kidney Disease. If there is only *Shi* quality without any Stomach Qi, it indicates death. If *Shi* pulse exhibits *Gou* characteristics, disease will manifest in Summer. If *Gou* qualities are severe, illness manifests immediately.
When the True Liver Pulse appears (the following descriptions all refer to True Viscera Pulses; "True" implies pure. The True Liver Pulse refers to a pulse purely of the Liver, completely lacking Stomach Qi. The Liver pulse is *Xian*, Lung is *Se* (Choppy), Heart is *Fu* (Floating), Kidney is *Chen* (Sinking); each obtains only one bias. Only the six pulses of Stomach Qi are neither *Xian* nor *Se*, neither floating nor sinking, embodying harmony and neutrality, thereby resolving the biases of the other four. Thus, although the Liver governs Spring and presents *Xian* imagery, the harmonious and soft Stomach Qi travels with it; if the harmonious/slack intent of Stomach Qi is predominant and the *Xian* intent of Liver is minor, this is a normal pulse. If *Xian* is excessive and Stomach Qi is deficient, it is a pathological pulse. How much more so if there is absolutely no Stomach Qi and it is purely wiry and stiff? This results from the exhaustion of Stomach Qi. Therefore, whenever True Viscera Pulses appear in disease, death is inevitable. The remaining viscera follow this logic.). The pulse feels like touching a knife's edge, or pressing a lute string (both indicating stiffness and tension).
When the True Heart Pulse appears, it is firm and beating, like touching Coicis Semen (Job's Tears) (a solid and hard sensation, appearing granularly under the fingers).
When the True Lung Pulse appears, it is large and empty, like feathers striking a person (indicating emptiness and lack of strength).
When the True Kidney Pulse appears, it beats abruptly and cuts off (abrupt cutoff, leaving no lingering resonance), like fingers flicking a stone (solid and hard).
When the True Spleen Pulse appears, it is weak and alternates between rapid and slow rhythms.