东垣曰∶西北二方极寒，肃杀之气，伤寒者多；东南二方，温和之地，伤寒
者少。经曰∶邪之所凑，其气必虚。内伤者用补中益气汤，从六经所见之证加减
用之。气虚甚者，少加附子以行参 之功。北方无内伤者用仲景法。
《素问》云∶寸口脉浮而盛，病在外。外者表也。寸口脉沉而紧，曰病在中。
中者里也。
仲景云∶脉浮者病在表，可发汗。又曰∶表有病者脉当浮。结胸证，脉浮者不
可下，则知脉属阳证无疑矣。
《难经》曰∶伤寒之脉，阴阳俱盛而紧涩。
《伤寒论》曰∶阴阳脉俱紧，名曰伤寒。寸口脉浮而紧，浮则为风，紧则为寒，
浮涩而紧为伤寒。
《脉经》曰∶迟紧为寒。脉阳浮而阴弱谓之伤风。脉紧而无汗谓之伤寒。脉阴
阳俱盛，重感于寒而紧涩，变为温疟。阴阳紧盛，伤寒之脉，前病热未已，后复感于
寒也。脉阳浮而滑，阴濡而弱，更遇于风，变为风温。脉阳洪数，阴实大太过，温热两
合，变为温毒。脉阳濡弱，阴弦紧，更遇温气，变为瘟疫。病发热，脉沉细，
表得太阳，名曰 病。病太阳关节疼痛而烦，脉沉细，名曰湿痹。病太阳身疼痛，脉微
弱弦芤，名曰中 。脉沉细而疾，身凉四肢冷，烦躁不欲饮水，狂闷，名曰阳厥伤寒。
热盛得脉大者生，沉细者死。已汗，沉小者生，浮大者死。
《保命集》∶脉浮而紧者为表实，可汗。（麻黄汤主之。）脉浮而缓者为表虚，可固
表驱寒。（桂枝汤主之。）脉沉而数，或疾而滑，或沉实有力，皆为里实，兼大便燥者可
下。（大承气汤主之。）脉沉而细，或微而迟，按而无力，尺中弱，皆
为里虚，可救里二便利，手足厥冷者，四逆汤主之。脉沉细者不可汗，尺脉迟者不可
汗。浮而数为表实，当汗之。（麻黄汤之类，）浮而迟为表虚，宜固表。（桂枝汤之类。）不浮不
沉，中诊而数，为中焦之实热。（调胃承气汤之类）兼有头痛恶寒者，大小柴胡汤斟酌用
之。不浮不沉，中诊而迟，或微或细为中虚也。（建中理中汤之类。）沉而数者为里实，法当
下。（大承气汤之类。沉而迟者为里虚，法当温。（姜附之类。）
陶节庵曰∶伤寒脉专以浮中沉迟数辨其阴阳寒热及表里虚实而断。诸浮在表，轻手
得之曰浮。略重手于皮肤之下，肌肉之上，阴阳各半，故属半表半里，得之曰中。沉为在
里，重指于肌肉之下、筋骨之间，得之曰沉诸迟为寒，诸数驽热。阴阳寒热虚实，用在有力
无力中分。有力者为阳为热为实，无力者为阴为寒为虚。杂病以弦为阳，伤寒以弦为阴；
杂病以缓为弱，伤寒以缓为和。伤寒以大为病进，以缓为邪退。缓为胃脉，有胃气曰生，
无胃气曰死。伤寒脉中有神曰生，神者，气血之先也。两手无脉曰双伏，一手无脉曰单
伏，必有正汗也。寸口阳脉中或见沉细者，但无力者，为阳中伏阴；尺部阴脉中或见沉
数者，为阴中伏阳。寸口数大有力为重阳，尺部沉细无力为重阴。寸口细微如丝为脱阳，
尺部无力为脱阴。寸口脉浮而有力。主寒邪表实，宜汗；浮而无力，主风邪表虚，
宜固。尺脉沉而有力，主阳邪在里，为实，宜下；无力，主阴邪在里，为虚，宜温。寸脉
弱而无力，切忌发吐；尺脉弱而无力，切忌治下。初按来疾去迟，名曰内虚外实；去疾来
迟，名曰内实外虚。尺寸俱均匀，名曰缓，缓者，和而生也。汗下后脉静者生；躁乱身热
者死，乃邪气胜故也。温之后脉来歇至者，正气脱而不复生也。纯弦之脉名曰负，负者死。
按之解索名曰阴阳离，离者死。阴病见阳脉者生，阳病见阴脉者死。
李东垣说：西北两个地区极其寒冷，肃杀之气盛行，患伤寒的人多；东南两个地区气候温和，患伤寒的人少。医经上说：邪气聚集的地方，人体的正气必然虚弱。对于内伤导致的疾病，使用补中益气汤，根据六经所见的证候进行加减运用。气虚严重的，少量加入附子以辅助人参的功效。北方没有内伤疾病的，使用张仲景的方法。
《素问》说：寸口脉浮而盛大，病在体表。表就是外。寸口脉沉而紧，叫做病在体内。里就是内。
张仲景说：脉浮的，病在表，可以发汗。又说：表有病的，脉应当浮。结胸证，如果脉浮，不可以用下法，由此可知脉浮属于阳证无疑了。
《伤寒论》说：阴阳脉都紧，叫做伤寒。寸口脉浮而紧，浮代表风，紧代表寒，浮涩而紧是伤寒的脉象。
《脉经》说：迟紧为寒。脉象阳部浮而阴部弱叫做伤风。脉紧而无汗叫做伤寒。脉象阴阳两部都盛大，再次感受寒邪而变得紧涩，转变为温疟。阴阳紧盛，这是伤寒的脉象，前一种热病未好，又再次感受寒邪。脉象阳部浮而滑，阴部濡弱，再遇到风邪，转变为风温。脉象阳部洪数，阴部实大太过，温热两种邪气结合，转变为温毒。脉象阳部濡弱，阴部弦紧，再遇到温气，转变为瘟疫。患病发热，脉象沉细，病位在太阳经，叫做（注：原文此处缺字，据上下文推测可能为“湿病”或类似，但依规则不增补，故译为“名为...病”）病。患太阳经关节疼痛且烦躁，脉象沉细，叫做湿痹。患太阳经身体疼痛，脉象微弱弦芤，叫做中（注：原文此处缺字，据上下文推测可能为“中暑”或“中寒”，依规则不增补）。脉象沉细而快，身体凉四肢冷，烦躁不想喝水，狂乱闷乱，叫做阳厥伤寒。热盛而脉大的能生，脉沉细的死。已经发过汗，脉象沉小的能生，脉象浮大的死。
《保命集》说：脉浮而紧的是表实证，可以发汗。（用麻黄汤主治。）脉浮而缓的是表虚证，可以固护体表驱散寒邪。（用桂枝汤主治。）脉沉而数，或者快而滑，或者沉实有力，都是里实证，兼有大便干燥的可以攻下。（用大承气汤主治。）脉沉而细，或者微而迟，按之无力，尺脉弱，都是里虚证，可以救治里虚使二便通利，手足冰冷的，用四逆汤主治。脉沉细的不可以发汗，尺脉迟的不可以发汗。脉浮而数是表实证，应当发汗。（用麻黄汤之类的方剂。）脉浮而迟是表虚证，适宜固护体表。（用桂枝汤之类的方剂。）不浮不沉，中部诊察时脉数，是中焦的实热。（用调胃承气汤之类的方剂。）兼有头痛恶寒的，大小柴胡汤斟酌使用。不浮不沉，中部诊察时脉迟，或者微或者细，是中气虚。（用建中理中汤之类的方剂。）沉而数的是里实证，治法应当攻下。（用大承气汤之类的方剂。）沉而迟的是里虚证，治法应当温补。（用干姜、附子之类的药物。）
陶节庵说：伤寒的脉象专门通过浮、中、沉、迟、数来辨别其阴阳、寒热以及表里虚实从而做出判断。所有的浮脉都在表，轻手取到叫浮。稍微重手在皮肤之下、肌肉之上，阴阳各半，所以属于半表半里，取到叫中。沉是在里，重指在肌肉之下、筋骨之间，取到叫沉。所有的迟脉为寒，所有的数脉为热。阴阳、寒热、虚实，用在有力和无力的区分中。有力的是阳、是热、是实，无力的是阴、是寒、是虚。杂病以弦脉为阳，伤寒以弦脉为阴；杂病以缓脉为弱，伤寒以缓脉为和。伤寒以大脉为病进，以缓脉为邪退。缓脉是胃的脉象，有胃气叫生，无胃气叫死。伤寒脉中有神叫生，神是气血的先兆。两手都没有脉搏叫双伏，一只手没有脉搏叫单伏，一定会有正常的汗出。寸口阳脉中如果出现沉细的，只要无力的，是阳中伏阴；尺部阴脉中如果出现沉数的，是阴中伏阳。寸口脉数大有力是重阳，尺部沉细无力是重阴。寸口细微如丝是脱阳，尺部无力是脱阴。寸口脉浮而有力，主寒邪表实，宜发汗；浮而无力，主风邪表虚，宜固表。尺脉沉而有力，主阳邪在里，为实，宜攻下；无力，主阴邪在里，为虚，宜温补。寸脉弱而无力，切忌催吐；尺脉弱而无力，切忌攻下。初按时去快来慢，名叫内虚外实；去慢来快，名叫内实外虚。尺寸脉都均匀，名叫缓，缓是和而生发的意思。发汗攻下后脉象安静的能生；躁动混乱身体热的死，这是邪气胜的缘故。温病之后脉来有间歇的，是正气脱失而不能复生。纯弦的脉名叫负，负者死。按之像解索一样散乱的名叫阴阳离，离者死。阴病见阳脉的能生，阳病见阴脉的死。
Li Dongyuan stated: The northwest regions are extremely cold, with a severe and desiccating qi; thus, those suffering from Shanghan (Cold Damage) are numerous. The southeast regions are mild and warm, so cases of Shanghan are few. The Classics state: "Where pathogenic factors gather, the body's qi must be deficient." For diseases caused by internal injury, Buyi Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is used, modified according to the syndromes observed in the Six Channels. In cases of severe qi deficiency, a small amount of Fuzi (Prepared Aconite Root) is added to facilitate the efficacy of Renshen (Ginseng Root). In the north, where internal injuries are rare, the methods of Zhang Zhongjing are employed.
The *Suwen* states: "If the Cun Kou (Radial Artery at the wrist) pulse is floating and vigorous, the disease is external. 'External' refers to the exterior. If the Cun Kou pulse is deep and tight, it indicates disease in the interior. 'Interior' refers to the inside."
Zhang Zhongjing stated: "A floating pulse indicates disease in the exterior, for which diaphoresis (sweating therapy) may be applied." He also said: "When there is disease in the exterior, the pulse should be floating." Regarding Jie Xiong syndrome (Chest Binding), if the pulse is floating, purgation (downward-draining therapy) is contraindicated; thus, it is certain that a floating pulse belongs to Yang syndromes.
The *Nanjing* states: "In Shanghan, the pulses of both Yin and Yang are vigorous, tight, and choppy."
The *Shanghan Lun* (Treatise on Cold Damage) states: "When both Yin and Yang pulses are tight, it is named Shanghan. If the Cun Kou pulse is floating and tight, floating indicates Wind, and tight indicates Cold. Floating, choppy, and tight together indicate Shanghan."
The *Mai Jing* (Pulse Classic) states: "Choppy and tight indicate Cold. A pulse that is floating in the Yang position and weak in the Yin position is named Shangfeng (Wind Injury). A tight pulse without sweat is named Shanghan. When both Yin and Yang pulses are vigorous, and upon re-exposure to Cold they become tight and choppy, it transforms into Wen Nue (Warm Malaria). Tight and vigorous Yin and Yang pulses characterize Shanghan; this occurs when the heat of a previous illness has not yet subsided, and Cold is contracted again. A pulse that is floating and slippery in the Yang position and soft and weak in the Yin position, upon encountering Wind, transforms into Feng Wen (Wind-Warmth). A pulse that is surging and rapid in the Yang position and excessive and large in the Yin position, representing the combination of Warmth and Heat, transforms into Wen Du (Warm Toxin). A pulse that is soft and weak in the Yang position and wiry and tight in the Yin position, upon encountering Warm Qi, transforms into Wen Yi (Plague). If a patient presents with fever and a deep, fine pulse, involving the Taiyang channel, it is named [text missing] disease. If one suffers Taiyang joint pain accompanied by vexation and a deep, fine pulse, it is named Shi Bi (Dampness Bi). If one suffers Taiyang body pain with a faint, weak, wiry, or hollow pulse, it is named [text missing]. If the pulse is deep, fine, and rapid, with a cool body, cold limbs, vexation, aversion to drinking water, mania, and oppression, it is named Yang Jue Shanghan (Yang Reversal Cold Damage). If heat is intense and the pulse is large, survival is possible; if the pulse is deep and fine, death ensues. After sweating, if the pulse is deep and small, survival is possible; if floating and large, death ensues.
The *Baoming Ji* states: "A floating and tight pulse indicates Exterior Excess, suitable for sweating. (Ma Huang Tang is the primary formula.) A floating and slow pulse indicates Exterior Deficiency, suitable for consolidating the exterior and dispelling Cold. (Gui Zhi Tang is the primary formula.) A deep and rapid pulse, or rapid and slippery, or deep, solid, and forceful, all indicate Interior Excess; if accompanied by dry stool, purgation may be used. (Da Cheng Qi Tang is the primary formula.) A deep and fine pulse, or faint and slow, feeling weak upon pressure, with a weak Chi position, all indicate Interior Deficiency. To rescue Interior Deficiency with unregulated bowels/bladder, or cold hands and feet, Si Ni Tang is the primary formula. Deep and fine pulses are not suitable for sweating; slow Chi pulses are not suitable for sweating. Floating and rapid indicates Exterior Excess, requiring sweating. (Formulas like Ma Huang Tang.) Floating and slow indicates Exterior Deficiency, suitable for consolidating the exterior. (Formulas like Gui Zhi Tang.) Neither floating nor deep, but rapid at the middle position, indicates Excess Heat in the Middle Jiao. (Formulas like Tiao Wei Cheng Qi Tang.) If accompanied by headache and aversion to cold, Xiao Chai Hu Tang or Da Chai Hu Tang should be used judiciously. Neither floating nor deep, but slow, faint, or fine at the middle position, indicates Middle Qi Deficiency. (Formulas like Jian Zhong Li Zhong Tang.) Deep and rapid indicates Interior Excess, requiring purgation. (Formulas like Da Cheng Qi Tang.) Deep and slow indicates Interior Deficiency, requiring warming. (Herbs like Sheng Jiang and Fu Zi.)
Tao Jie'an stated: "For Shanghan pulses, one specifically distinguishes Yin/Yang, Cold/Heat, and Exterior/Interior/Excess/Deficiency through floating, mid-level, deep, slow, and rapid qualities. All floating pulses relate to the exterior; obtained with light pressure, it is called Floating. Slightly heavier pressure, between skin and muscle, where Yin and Yang are equal, relates to half-exterior/half-interior, called Mid-level. Deep relates to the interior; heavy pressure below muscle and between sinews and bones, called Deep. All slow pulses indicate Cold; all rapid pulses indicate Heat. Yin/Yang, Cold/Heat, Excess/Deficiency are distinguished by forcefulness. Forceful indicates Yang, Heat, Excess; forceless indicates Yin, Cold, Deficiency. In miscellaneous diseases, Wiry is Yang; in Shanghan, Wiry is Yin. In miscellaneous diseases, Slow is Weak; in Shanghan, Slow is Harmonious. In Shanghan, Large indicates disease progression; Slow indicates pathogen retreat. Slow is the Stomach pulse; having Stomach Qi means life, lacking it means death. A pulse with Shen (Spirit) in Shanghan means life; Shen is the precursor of Qi and Blood. Absence of pulse in both hands is Double Hidden; absence in one hand is Single Hidden; normal sweating will certainly occur. If the Cun position (Yang) shows deep/fine but forceless, it is Yin hidden within Yang. If the Chi position (Yin) shows deep/rapid, it is Yang hidden within Yin. Rapid, large, and forceful at Cun is Heavy Yang; deep, fine, and forceless at Chi is Heavy Yin. Fine as a thread at Cun is Yang Collapse; forceless at Chi is Yin Collapse. Floating and forceful at Cun indicates Cold Pathogen in Exterior Excess, suitable for sweating; floating and forceless indicates Wind Pathogen in Exterior Deficiency, suitable for consolidating. Deep and forceful at Chi indicates Yang Pathogen in Interior Excess, suitable for purgation; forceless indicates Yin Pathogen in Interior Deficiency, suitable for warming. Weak and forceless Cun pulse strictly forbids emesis; weak and forceless Chi pulse strictly forbids purgation. Initially, fast departure and slow return is named Internal Deficiency/External Excess; fast return and slow departure is named Internal Excess/External Deficiency. Uniform Cun and Chi pulses are named Slow/Harmonious, indicating harmony and generation. After sweating/purgation, a quiet pulse indicates life; restless, chaotic, with body heat indicates death, due to pathogen victory. After treating Warm diseases, if the pulse has intermittent stops, it indicates collapse of righteous Qi without recovery. A purely Wiry pulse is named Fu (Burden/Negative), indicating death. A pulse feeling like unraveling silk upon pressure is named Yin-Yang Separation, indicating death. Yin diseases showing Yang pulses indicate life; Yang diseases showing Yin pulses indicate death."