浮脉按之不足,轻举有余,满指浮上曰浮。为风虚运动之候、为病在表、为风应人迎、为气应气口、为
热、为痛、为呕、为胀、为痞、为喘、为满不食。浮大为伤风鼻塞;浮滑疾为宿食;浮大长
为风弦癫疾;浮细而滑为伤饮。
芤脉浮大而软,按之中空旁实,如按葱叶,中心空虚曰芤。为失血之候。大抵气有余,血不足,血
不能充气,故虚而大,若芤之状。
滑脉往来流利,应指圆滑如珠曰滑。为血实气壅之候。盖不胜于气也。为呕吐、为痰逆、为宿食、为
经闭。滑而不断绝者,经不闭;其有断绝者,经闭也。上为吐逆,下为气结。滑数为热结。
实脉浮、中、沉三字皆有力曰实。为三焦气满之候。为热、为
呕、为痛、为气塞、为气聚、为食积、为利、为伏阳在内。
弦脉端直以长,如弦隐指曰弦。为气血收敛不舒之候。为阳之伏阴,或经络间为寒所滞、为痛、为饮、
为疟、为疝、为拘急、为寒热、为血虚盗汗、为寒凝气结、为冷痹、为劳倦。弦数为劳疟,弦
紧为恶寒,双弦胁痛,弦长为积,随左右上下。
紧脉举按急数,指下如牵绳转索之状,曰紧。为邪风激搏伏于
荣卫之间。为寒、为痛。浮紧为伤寒身痛;沉紧为腹中有寒,为风痫;紧数为寒热。
洪脉极大,在指下来大去长而满指曰洪。为荣卫大热血气燔灼
之候、为表里皆热、为烦、为满、为咽干、为大小便不通。洪实为癫;洪紧为痈疽喘急,亦为胀满不食。
微脉极细而软,无浮沉之别曰微。为血气俱虚之候。为虚弱、为呕、为泄、为虚汗、为拘急、为崩漏败
血不止。微弱为少气,浮而微者为阳不足,主脏寒下痢。
沉脉轻手不见,重手乃得曰沉。为阴逆阳郁之候。为气、为水、为寒、为喘、为停饮、为 瘕、为胁胀、
为厥逆、为洞泄。沉细为少气,臂不能举;沉迟为痼冷;沉滑为宿食;沉伏为霍乱。沉而数
主内热;沉而迟主内寒;沉而弦主心腹冷痛。
缓脉举按大而慢,一息四至曰缓。为风、为虚、为痹、为弱、
为疼。在上为项强、在下为脚弱。浮缓、沉缓血气弱。
涩脉按之则散而复来,举之则细而不足曰涩。为气多血少之候。为血痹、为亡汗、为伤精。女人有孕为
胎漏,无孕为败血病。
迟脉呼吸之间脉仅三至,随浮沉而见曰迟。为阴盛阳虚之候。
为寒、为痛。浮而迟,表有寒;沉而迟,里有寒。居寸为气不足,居尺为血不足。气寒则缩,血寒则凝。
伏脉轻手取之绝然不见,重手取之亦不得,必按至于骨乃见曰伏。为阴阳潜伏、关格闭寒之候。为积聚、
为疝瘕,为霍乱、为溏泄、为停食、为荣卫气闭而厥逆。关前得之为阳伏,关后得之为阴伏。
濡脉极软而浮细,轻手乃得,不任寻按曰濡。为血气俱不足之
候。为虚、为痹、为少气、为无血,为自汗、为下冷。
弱脉极软而沉细,按之欲绝指下曰弱。由精气不足,故脉痿弱
而不振也。为元气虚损、为痿弱不同、为痼冷、为哄热、为泄精、为虚汗。
长脉按之则洪大而长,出于木位曰长。气血俱有余也。为阳毒
内蕴,三焦烦郁、为壮热。若伤寒得长脉,欲汗出而自解也。
短脉两头无,中间有,不及本位曰短。为气不足,以前导其血也。为阴中伏阳、为三焦气壅、为宿食不消。
虚脉按之不足,迟大而软,轻举指下豁然而空曰虚。为气血两
虚之候。为暑、为烦满多汗、为恍惚多惊、为小儿惊风。
促脉按之来去数,时一止复来曰促。阳独盛而阴不能相和也,或怒逆上,亦令脉促。为气 、为狂闷、为
瘀血发狂。又为气、血、饮、食、痰。盖先以气热脉数,而五者或有一流滞乎其间,则因之而为促。
结脉按之往来迟缓,时一止复来曰结。阴独盛而阳不能相入也。为 结、为七情所郁。浮结为寒邪滞
经,沉结为积气在内。又为气、血、饮、食、痰。盖先以气寒脉缓,而五者或一有流滞于其间,则
因之而为结。故张仲景谓结、促皆病脉,然渐加即死,渐退即生。
代脉动而中止,不能自还,因而复动,由
是复止,寻之良久,乃复强起曰代。主形容羸瘦,口不能言。若不因病而人羸瘦,其脉
代止,是一脏无气,他脏代之,真危亡之兆也。若因病而气血骤损,以致元气不续,或风家、痛家、脉见
代止,只为病脉。故伤寒家亦有心悸而脉代者,心腹痛亦有结涩止代不匀者。盖凡痛之脉,不可
准也。又妊娠亦有脉代,此必二月胎也。
牢脉沉而有力,动而不移曰牢。为里实表虚,胸中气促为劳伤
痿极,大抵近乎无胃气,故诸家皆以为危殆,亦有骨间疼痛,气居
于表。
动脉状如豆大,厥厥动摇,寻之有,举之无,不往不来,不离
其处,多于关部见之。为痛、为惊、为虚劳体痛、为崩、为泄利。阳动则汗出,阴动则发热。
细脉按之则萦萦如蛛丝,如欲绝,举之如无而似有,且微曰细。盖血冷气虚,不足以充故也。为元
气不足,乏力无精,内外俱冷,痿弱洞泄,忧劳过度。为伤湿、为积、为病,在内及在下。
数脉一息六至,过平脉两至曰数。为烦满。上为头疼上热;中为脾热口臭,胃翻呕逆。左关为肝热目赤,
右尺为小便赤黄,大便闭涩。浮数,表有热;沉数,里有热。
散脉举之则似浮而散大无力;按之则满指散而聚,来去不明,
漫无根底,为气血耗散,脏腑气绝,在病脉主阳虚不敛,又主心气不足。
浮脉:轻取即得,重按力量减弱,满指皆感浮在表面称为浮脉。主风邪虚损、病位在表、风邪应验于人迎脉、气机应验于气口脉;也主热证、痛证、呕吐、胀满、痞塞、气喘、脘腹胀满且食欲不振。浮大脉象多见于伤风鼻塞;浮滑而疾数者多为宿食停滞;浮大且长者为风邪引起的弦目或癫疾;浮细而滑者多为饮邪内停所致的外感。
芤脉:脉位浮大但质地柔软,重按时中间空虚而两边实,如同按压葱叶,中心空虚称为芤脉。主失血之候。大体上是气有余而血不足,血液不能充盈脉道,所以脉象虚大,呈现如芤脉的状态。
滑脉:脉搏往来流利,应指圆滑如珠滚动称为滑脉。主血实气壅之候,盖因气不胜血所致。主呕吐、痰逆、宿食停滞、经闭。滑脉若不断绝,说明月经未闭;若有断绝现象,则为经闭。上部见滑脉主吐逆,下部见滑脉主气结。滑而数者主热结。
实脉:浮取、中取、沉取三部皆有力称为实脉。主三焦气满之候。主热证、呕吐、痛证、气塞、气聚、食积、泄利、伏阳在内。
弦脉:脉体端直以长,如琴弦隐于指下称为弦脉。主气血收敛不舒之候。主阳气潜伏阴分,或经络间为寒邪所阻滞;也主痛证、饮邪、疟疾、疝气、拘急痉挛、寒热往来、血虚盗汗、寒凝气结、冷痹、劳倦。弦数脉主劳疟,弦紧脉主恶寒,双弦脉主胁痛,弦长脉主积聚,其部位随左右上下变化。
紧脉:举按皆急数,指下感觉如牵绳转索状称为紧脉。主邪风激搏,潜伏于营卫之间。主寒证、痛证。浮紧脉主伤寒身痛;沉紧脉主腹中有寒,或为风痫;紧数脉主寒热。
洪脉:脉形极大,在指下来势大而去势长,满指皆感充实称为洪脉。主营卫大热、气血燔灼之候;主表里皆热、心烦、胀满、咽干、大小便不通。洪实脉主癫疾;洪紧脉主痈疽喘急,也主胀满不食。
微脉:极细而软,无浮沉之分称为微脉。主气血俱虚之候。主虚弱、呕吐、泄泻、虚汗、拘急、崩漏及败血不止。微弱脉主少气,浮而微者主阳气不足,主脏寒下痢。
沉脉:轻手触摸不见,重手按压方能触及称为沉脉。主阴逆阳郁之候。主气病、水病、寒证、气喘、停饮、瘕块、胁胀、厥逆、洞泄。沉细脉主少气,手臂不能抬起;沉迟脉主久冷;沉滑脉主宿食;沉伏脉主霍乱。沉而数主内热;沉而迟主内寒;沉而弦主心腹冷痛。
缓脉:举按皆大而慢,一息四至称为缓脉。主风证、虚证、痹证、弱证、疼痛。在上部主项强,在下部主脚弱。浮缓、沉缓均主血气虚弱。
涩脉:重按时脉散而复来,轻取时脉细而不足称为涩脉。主气多血少之候。主血痹、亡汗、伤精。女子有孕见涩脉主胎漏,无孕见涩脉主败血病。
迟脉:呼吸之间脉搏仅三至,随浮沉显现称为迟脉。主阴盛阳虚之候。主寒证、痛证。浮而迟,主表有寒;沉而迟,主里有寒。脉居寸部主气不足,居尺部主血不足。气寒则收缩,血寒则凝滞。
伏脉:轻手取之绝然不见,重手取之亦不得,必须按至于骨方可见称为伏脉。主阴阳潜伏、关格闭寒之候。主积聚、疝瘕、霍乱、溏泄、停食、营卫气闭而厥逆。关前得伏脉为阳伏,关后得伏脉为阴伏。
濡脉:极软而浮细,轻手乃得,不耐寻按称为濡脉。主气血俱不足之候。主虚证、痹证、少气、无血、自汗、下冷。
弱脉:极软而沉细,按之欲绝,指下感觉无力称为弱脉。由精气不足所致,故脉痿弱不振。主元气虚损、痿弱不同、痼冷、哄热(假热)、泄精、虚汗。
长脉:按之洪大而长,出于木位称为长脉。主气血俱有余。主阳毒内蕴、三焦烦郁、壮热。若伤寒病见长脉,预示欲汗出而病自解。
短脉:两头无脉,中间有脉,不及本位称为短脉。主气不足,无法推动血液运行。主阴中伏阳、三焦气壅、宿食不消。
虚脉:按之不足,迟大而软,轻取指下豁然空豁称为虚脉。主气血两虚之候。主暑证、烦满多汗、恍惚多惊、小儿惊风。
促脉:按之来去急促,时常有一止而后复来称为促脉。主阳独盛而阴不能相和,或因怒逆上气,也可导致脉促。主气滞、狂闷、瘀血发狂。又主气、血、饮、食、痰五者之病。盖因先有气热脉数,而这五者中有一种流滞于其间,因而形成促脉。
结脉:按之往来迟缓,时常有一止而后复来称为结脉。主阴独盛而阳不能相入。主气结、七情所郁。浮结主寒邪滞经,沉结主积气在内。又主气、血、饮、食、痰五者之病。盖因先有气寒脉缓,而这五者中有一种流滞于其间,因而形成结脉。故张仲景认为结、促皆为病脉,若脉象逐渐加重则死,逐渐消退则生。
代脉:动而中止,不能自行恢复,因而再次跳动,由此再次停止,寻之良久,才勉强再起称为代脉。主形体消瘦,口不能言。若非因病而人消瘦,脉见代止,是一脏无气,他脏代之,是真危亡之兆。若因病而气血骤损,以致元气不续,或风家、痛家,脉见代止,只为病脉。故伤寒家也有心悸而脉代者,心腹痛也有结涩止代不匀者。凡疼痛之脉,不可作为准据。另外妊娠二月亦有脉代,此必是二月胎也。
牢脉:沉而有力,动而不移称为牢脉。主里实表虚,胸中气促,为劳伤痿极。大体上近乎无胃气,故诸家皆以为危殆。也有骨间疼痛,气居于表的情况。
动脉:形状如豆大,厥厥动摇,寻之有,举之无,不往不来,不离其处,多于关部见到。主痛证、惊证、虚劳体痛、崩漏、泄利。阳动则汗出,阴动则发热。
细脉:按之则萦萦如蛛丝,如欲绝,轻取如无而似有,且微称为细脉。盖因血冷气虚,不足以充脉所致。主元气不足、乏力无精、内外俱冷、痿弱洞泄、忧劳过度。主伤湿、积聚、病在内及在下。
数脉:一息六至,超过平脉两至称为数脉。主烦满。上部主头疼上热;中部主脾热口臭,胃翻呕逆。左关主肝热目赤,右尺主小便赤黄,大便闭涩。浮数主表有热,沉数主里有热。
散脉:轻取则似浮而散大无力;重按则满指散而不聚,来去不明,漫无根底。主气血耗散,脏腑气绝。在病脉中主阳虚不敛,又主心气不足。
Floating Pulse (Fú Mài, Floating Pulse): Obtained with light pressure but deficient with heavy pressure; the entire finger feels it floating on the surface. It indicates wind deficiency and movement, disease in the exterior, wind affecting the Renying pulse, qi affecting the Qikou pulse; it also indicates heat, pain, vomiting, distension, stuffiness, panting, fullness, and loss of appetite. A large floating pulse suggests wind-cold injury with nasal congestion; a slippery and rapid floating pulse suggests retained food; a long and large floating pulse suggests wind-induced strabismus or epilepsy; a fine and slippery floating pulse suggests injury from fluid retention.
Kou Pulse (Kou Mài, Scallion-Stalk Pulse): Floating and large but soft; pressing reveals emptiness in the center and solidity on the sides, feeling like pressing a scallion stalk with an empty center. It indicates blood loss. Generally, when qi is excessive and blood is deficient, blood cannot fill the vessels, resulting in a hollow and large pulse resembling the Kou pulse.
Slippery Pulse (Hua Mài, Slippery Pulse): The pulse flows smoothly back and forth, round and smooth like rolling pearls upon the fingers. It indicates excess blood and congested qi, as qi fails to overcome blood. It indicates vomiting, rebellious phlegm, retained food, and amenorrhea. If the Slippery pulse is uninterrupted, menstruation is not closed; if interrupted, it indicates amenorrhea. Upper body manifestation indicates vomiting and rebellion; lower body manifestation indicates qi knotting. Slippy and rapid indicates heat knotting.
Full Pulse (Shi Mài, Full Pulse): Forceful at all three depths: floating, middle, and deep. It indicates fullness of qi in the Sanjiao. It indicates heat, vomiting, pain, qi obstruction, qi gathering, food accumulation, diarrhea, and latent yang within.
Wiry Pulse (Xian Mài, Wiry Pulse): Straight and long, hidden under the fingers like a string. It indicates constrained and unrelaxed qi and blood. It indicates latent yang within yin, or cold stagnation in the meridians; it also indicates pain, fluid retention, malaria, hernia, spasm, alternating chills and fever, night sweats due to blood deficiency, cold coagulation and qi knotting, cold bi syndrome, and fatigue. Wiry and rapid indicates labor malaria; wiry and tight indicates aversion to cold; double wiry indicates hypochondriac pain; wiry and long indicates accumulation; its position varies according to left/right and upper/lower.
Tight Pulse (Jin Mài, Tight Pulse): Rapid and urgent upon both lifting and pressing, feeling like pulling a rope that twists under the fingers. It indicates pathogenic wind struggling and lurking between Ying and Wei. It indicates cold and pain. Floating and tight indicates Taiyang cold injury with body pain; deep and tight indicates cold in the abdomen or wind epilepsy; tight and rapid indicates alternating chills and fever.
Surging Pulse (Hong Mài, Surging Pulse): Extremely large; coming strongly and departing slowly, filling the entire finger. It indicates intense heat in Ying and Wei and blazing qi and blood; it indicates heat in both interior and exterior, vexation, fullness, dry throat, and obstruction of urination and defecation. Full and surging indicates epilepsy; surging and tight indicates carbuncles, sores, panting, and urgency, as well as distension and loss of appetite.
Minute Pulse (Wei Mài, Minute Pulse): Extremely fine and soft, without distinction between floating and deep. It indicates deficiency of both qi and blood. It indicates weakness, vomiting, diarrhea, spontaneous sweating, spasms, uterine bleeding, and unstoppable敗血 (decayed blood). Weak and minute indicates shortness of breath; floating and minute indicates insufficient yang, governing cold organs and dysentery.
Deep Pulse (Chen Mài, Deep Pulse): Not visible with light touch, obtained only with heavy pressure. It indicates rebellious yin and depressed yang. It indicates qi disorders, water disorders, cold, panting, retained fluids, masses, hypochondriac distension, reversal cold, and watery diarrhea. Deep and fine indicates shortness of breath and inability to raise the arm; deep and slow indicates chronic cold; deep and slippery indicates retained food; deep and hidden indicates cholera. Deep and rapid indicates internal heat; deep and slow indicates internal cold; deep and wiry indicates cold pain in the heart and abdomen.
Moderate Pulse (Huan Mài, Moderate Pulse): Large and slow upon lifting and pressing, four beats per respiration. It indicates wind, deficiency, bi syndrome, weakness, and pain. In the upper body, it indicates neck stiffness; in the lower body, it indicates weak legs. Floating and moderate, or deep and moderate, indicate weak qi and blood.
Choppy Pulse (Se Mài, Choppy Pulse): Disperses and returns upon pressing; fine and insufficient upon lifting. It indicates abundant qi and deficient blood. It indicates blood bi, loss of sweat, and injury to essence. In pregnant women, it indicates fetal leakage; in non-pregnant women, it indicates decayed blood disease.
Slow Pulse (Chi Mài, Slow Pulse): Only three beats per respiration, appearing with floating or deep pressure. It indicates excess yin and deficient yang. It indicates cold and pain. Floating and slow indicates exterior cold; deep and slow indicates interior cold. Located at the Cun position, it indicates qi deficiency; at the Chi position, it indicates blood deficiency. Cold qi causes contraction; cold blood causes coagulation.
Hidden Pulse (Fu Mài, Hidden Pulse): Completely invisible with light pressure; unobtainable even with heavy pressure; must be pressed to the bone to be seen. It indicates latent yin and yang, and closure/cold in Guan-Ge. It indicates accumulations, hernias, cholera, loose stools, retained food, and reversal cold due to closure of Ying and Wei qi. Obtained before the Guan position indicates latent yang; obtained after the Guan position indicates latent yin.
Soggy Pulse (Ru Mài, Soggy Pulse): Extremely soft, floating, and fine; obtained with light pressure, unable to withstand searching pressure. It indicates deficiency of both qi and blood. It indicates deficiency, bi syndrome, shortness of breath, lack of blood, spontaneous sweating, and cold in the lower body.
Weak Pulse (Ruo Mài, Weak Pulse): Extremely soft, deep, and fine; feels like disappearing under the fingers. Caused by insufficiency of essence and qi, resulting in a flaccid and unvigorous pulse. It indicates damage to original qi, varying degrees of flaccidity, chronic cold, false heat, seminal emission, and spontaneous sweating.
Long Pulse (Chang Mài, Long Pulse): Large, surging, and long upon pressing, originating from the Wood position. It indicates abundance of both qi and blood. It indicates internal accumulation of yang toxin, vexation and depression in the Sanjiao, and high fever. If a Long pulse appears in Taiyang cold injury, it indicates impending sweating and self-resolution of the disease.
Short Pulse (Duan Mài, Short Pulse): Absent at both ends, present in the middle, failing to reach its proper position. It indicates qi deficiency, unable to guide blood. It indicates latent yang within yin, congestion of qi in the Sanjiao, and indigestion of retained food.
Deficient Pulse (Xu Mài, Deficient Pulse): Insufficient upon pressing; slow, large, and soft; feels hollow upon light lifting. It indicates dual deficiency of qi and blood. It indicates summerheat, vexation and fullness with profuse sweating, mental confusion and frequent fright, and infantile convulsions.
Rapid and Interrupted Pulse (Cu Mài, Rapid and Interrupted Pulse): Rapid in arrival and departure upon pressing, occasionally pausing before returning. It indicates excessive yang unable to harmonize with yin, or rebellious qi rising due to anger. It indicates qi stagnation, mania and oppression, and madness due to blood stasis. It also relates to disorders of qi, blood, fluids, food, and phlegm. Generally, due to initial qi heat and rapid pulse, if one of these five factors stagnates, it results in a Cu pulse.
Knotted Pulse (Jie Mài, Knotted Pulse): Slow in arrival and departure upon pressing, occasionally pausing before returning. It indicates excessive yin unable to enter yang. It indicates qi knots and depression caused by seven emotions. Floating Jie indicates cold pathogen stagnating in meridians; deep Jie indicates accumulated qi within. It also relates to disorders of qi, blood, fluids, food, and phlegm. Generally, due to initial qi cold and slow pulse, if one of these five factors stagnates, it results in a Jie pulse. Thus, Zhang Zhongjing stated that Jie and Cu are pathological pulses; if they gradually worsen, death ensues; if they gradually recede, life is preserved.
Intermittent Pulse (Dai Mài, Intermittent Pulse): Beats pause and do not return immediately, resuming later, then pausing again; after searching for a long time, it rises forcefully again. It indicates emaciation and inability to speak. If a person is emaciated without illness and the Dai pulse appears, it indicates one organ lacks qi while others compensate, signaling true peril and demise. If due to illness causing sudden loss of qi and blood, leading to discontinuity of original qi, or in patients with wind or pain conditions where the Dai pulse appears, it is merely a pathological pulse. Thus, in Taiyang cold injury, palpitations may present with a Dai pulse; heart and abdominal pain may present with irregular Jie, Se, stopping, and Dai pulses. Generally, pulses in pain conditions should not be taken as standard reference. Additionally, during pregnancy, specifically at two months, a Dai pulse may appear.
Firm Pulse (Lao Mài, Firm Pulse): Deep and forceful, moving without shifting. It indicates interior excess and exterior deficiency, shortness of breath in the chest, and extreme flaccidity due to labor injury. Generally, it approaches a lack of Stomach Qi, so various schools consider it critical. It may also indicate bone pain with qi residing in the exterior.
Moving Pulse (Dong Mài, Moving Pulse): Shaped like a bean, quivering and shaking; felt upon searching, not upon lifting; does not move forward or backward, staying in place, mostly seen at the Guan position. It indicates pain, fright, flaccidity and body pain due to deficiency labor, uterine bleeding, and diarrhea. Yang Dong indicates sweating; Yin Dong indicates fever.
Fine Pulse (Xi Mài, Fine Pulse): Upon pressing, it feels thin like a spider's thread, nearly disappearing; upon lifting, it seems absent yet present, and faint. This is due to cold blood and deficient qi failing to fill the vessels. It indicates insufficiency of original qi, fatigue and lack of spirit, cold inside and out, flaccidity and watery diarrhea, and excessive worry and labor. It indicates dampness injury, accumulation, and disease in the interior and lower body.
Rapid Pulse (Shu Mài, Rapid Pulse): Six beats per respiration, exceeding the normal pulse by two beats. It indicates vexation and fullness. Upper body indicates headache and upper heat; middle body indicates spleen heat, bad breath, stomach reversal, and vomiting. Left Guan indicates liver heat and red eyes; Right Chi indicates red-yellow urine and constipation. Floating and rapid indicates exterior heat; deep and rapid indicates interior heat.
Scattered Pulse (San Mài, Scattered Pulse): Upon lifting, it seems floating, large, and powerless; upon pressing, it fills the finger but is scattered and uncollected, with unclear arrival and departure, lacking roots. It indicates consumption and dispersion of qi and blood, and exhaustion of zang-fu qi. In pathological pulses, it indicates yang deficiency failing to consolidate, and also indicates insufficiency of heart qi.