夫平心脉来，累累如连珠，如循琅 ，曰心平，夏以胃气为本；病心脉来，喘喘连属，其中微曲，
曰心病；死心脉来，前曲后居，如操带钩，曰心死。
琅 ，似珠盛满滑利，即微钩之义也。喘喘连属，急促相仍也。前曲者，谓轻取则坚强而不柔；后居者
。则牢实而不动，如持革带之钩，全失冲和之气，是但钩无胃，故曰心死。
平肺脉来，厌厌聂聂，如落榆英，曰肺平，秋以胃气为木；病肺脉来，不上不下，如循鸡羽，曰肺病；
死肺脉来，如物之浮，如风吹毛，曰肺死。
厌厌聂聂，众苗齐秀貌。如落榆荚，轻浮和缓貌，即微毛之象也。不上不下，往来涩滞也。如循鸡羽
，轻浮而虚也，亦毛多胃少之义。如物之浮，空虚无根也。如风吹毛，散无
绪也，亦但毛无胃之义。
平肝脉来，软弱招招，如揭长竿末稍，曰肝平，春以胃气为本；病肝脉来，盈实而滑，如循长竿，
曰肝病；死肝脉
来，急益劲，如新张弓弦，曰肝死。
平脾脉来，和柔相离，如鸡践地，曰脾平，长夏以胃气为本；病脾脉来，实而盈数，如鸡举足，
曰脾病；死脾脉来，锐坚如鸟之喙，如鸟之距，如屋之漏，如水之流，曰脾死。
和柔，雍雍不迫也。相离，匀净分明也。如鸡践地，从容轻缓也。此即冲和之义。实而盈数，强急
不和也。如鸡举足，轻疾不缓也。前篇言弱多胃少，此言实而盈数，皆失中和之气，故曰脾病。鸟喙、鸟
距，坚锐不柔也。屋漏，点滴无伦也。水流，去而不返也。是皆脾绝怪脉，但代无胃。
平肾脉来，喘喘累累如钩，按之而坚，曰肾平，冬以胃气为本；病肾脉来，如引葛，按之益坚，曰
肾病；死肾脉来，发如夺索，辟辟如弹石，曰肾死。
喘喘累累，如心之钩，阴中藏阳，而得微石之义。引葛，坚搏索连也。按之益坚，石甚不和也。
索若相夺，甚劲又甚。弹石，其坚可知，但石无胃也。
真肝脉至急，如循刃，责责然，如按琴瑟弦，色青白不泽，毛折乃死。真心脉至，坚而搏，如循薏苡子
累累然，色赤黑不泽，毛折乃死。真肺脉至，大而虚，如以羽毛中人肤，色白赤不泽，毛折乃死。真肾脉至
，搏而绝，如指弹石辟辟然，色黑黄不泽，毛折乃死。真脾脉至，弱而乍数乍疏，色黄青不泽，毛折乃死。
真脏见乃死也。
青本木色，而兼白不泽，金克木也，五脏准此。然率以毛折死者，皮毛得血气而充，毛折则精气败矣，
故皆死。
柯韵伯曰∶经云∶能合色脉，可以万全。取色脉之相应也。又云∶色夭不泽，谓之难治。今见本脏色，
又兼见相胜之色，且天然不泽，是色脉之不相应也。虽云肺朝百脉，输精于皮毛，毛脉合精，留于五脏，
气归权衡，今毛折是精气
不输皮毛也，毛脉之精不合矣。此色诊之易见也。
见真脏曰死，何也？岐伯曰∶五脏皆禀气于胃，胃者五脏之本也，脏气者，不能自致于手太阴，
必因于胃气，乃致于手太阴也，故五脏各以其时，自为而至于手太阴也。故邪气胜者，真气衰也。故病甚
者，胃气不能与之俱至于手太阴，故真脏之气独见，独见者，病胜藏也，故曰死。
此论真藏而拈胃气为本，最为发明显切。夫五脏虽各有本气以主时，要必得胃气之赡养，而其真
得藏焉。如心脉之累累连珠，肾脉之喘喘累累以下，皆形容其藏之得胃以为脏真，故浮而不浮，沉而不沉，
急而不急，缓而不缓，有神存于其间，此能以时自为，而至于手太阴也。若喘喘连属以下，则五脏之邪气
胜而真气衰矣。若胃气竭绝，已不能自至于手太阴，亦不能复藏其神而真脏见，胃家饷绝，真神孤削，故
其恶见如此。是以古圣于四时五脏，皆占胃气以为本也。
鼓一阳曰钩，鼓一阴曰毛，阳胜急曰弦，阳绝而亟曰石，阴阳相过曰溜。
此言钩、弦、毛、石之正象，以为诸脉之准则也。经曰∶太阳为开，阳明为阖，少阳为枢。三阳者
，不得相失也。搏而勿浮，名曰一阳。此一阳者，阳之盛，即太阳也，为心家主脉，其气纯和而一，正心脉
之得其平者也。钩脉主夏，故鼓一阳曰钩。
又云∶三阴者，不得相失也。搏而勿沉，命曰一阴。清静为阴，而勿沉者，正清轻之谓，当 敛燥金之
时，而其气不沉于下，而渐收于上，清明之极，故谓之鼓一阴曰毛，此正肺脉应秋之和也。
至于弦者，本阴部厥阴之脉。厥阴为阴中之少阳，木性本达，方沉厥阴之下，与厥阴争而直上，是
以阳胜急而弦。要
其主春者，惟少阳令之，春生则木气已发，软弱轻虚，端直以长，斯谓之主春之弦。不然，阳之胜急，
正仲景所谓残贼之脉也，弦脉本象如此，故谓阳胜急曰弦。
肾为阴中之太阴，水体沉滑之极，此为阳绝不至，而阴独至。阴独至，则至搏而沉，动而且坚，故
曰石也。
若夫阴阳之相过，则阴阳之交驰者也，诸家注皆以为脾脉。然以溜言之，非脾脉之正，不可以脾言。然其
脉顺而不逆，去而不滞，滑而不衰败，绝似少阳之脉，故曰溜。本文举此以明阴阳之交者耳。若夫脾脉
在诸脏，善者不可得而见，故不拈出，欲人体认也。
正常的脉象，心脉来时，连续不断如连珠般圆润滑利，如同抚摸光滑的玉石，这叫做心脉平和，夏季以胃气为根本；患病的心脉，来势急促相连，其中略带弯曲，这叫做心病；死绝的心脉，前段弯曲后段僵硬不动，如同拿着带钩的革带，这叫做心死。
所谓“琅玕”，是指像珠子一样饱满滑利，这就是微钩的含义。“喘喘连属”是指急促相续。“前曲”是指轻取时感觉坚强而不柔和；“后居”则是指重按牢实而不动，如同手持革带之钩，完全失去了冲和之气，这是只有钩脉而没有胃气，所以称为心死。
正常的肺脉，来势连绵轻柔，如同榆钱飘落，这叫做肺脉平和，秋季以胃气为本（注：原文“木”疑为“本”之误）；患病的肺脉，来去涩滞不上不下，如同抚摸鸡羽，这叫做肺病；死绝的肺脉，如同物体漂浮，如同风吹羽毛，这叫做肺死。
“厌厌聂聂”形容众多禾苗整齐秀美的样子。“如落榆荚”形容轻浮和缓的样子，这就是微毛的征象。“不上不下”指往来涩滞。“如循鸡羽”形容轻浮而虚，这也是毛多胃少的含义。“如物之浮”形容空虚无根。“如风吹毛”形容散乱无绪，这也是只有毛脉而没有胃气的含义。
正常的肝脉，来势软弱舒展，如同高举长竿的末梢，这叫做肝脉平和，春季以胃气为根本；患病的肝脉，充实而滑，如同抚摸长竿，这叫做肝病；死绝的肝脉，紧急且强劲，如同新张开的弓弦，这叫做肝死。
正常的脾脉，来势和柔相间，如同鸡踏地，这叫做脾脉平和，长夏以胃气为根本；患病的脾脉，实而充盈快速，如同鸡举足，这叫做脾病；死绝的脾脉，尖锐坚硬如同鸟嘴，如同鸟爪，如同屋顶漏水点滴无序，如同水流去而不返，这叫做脾死。
“和柔”指雍容不迫。“相离”指匀净分明。“如鸡践地”指从容轻缓，这就是冲和的含义。“实而盈数”指强急不和。“如鸡举足”指轻疾不缓。前篇说弱多胃少，这里说实而盈数，都失去了中和之气，所以称为脾病。鸟嘴、鸟爪，指坚锐不柔。屋漏，指点滴无伦次。水流，指去而不返。这些都是脾绝的怪脉，只有代脉而没有胃气。
正常的肾脉，来势急促连续如钩状，重按时坚实，这叫做肾脉平和，冬季以胃气为根本；患病的肾脉，如同牵引葛藤，重按时更加坚实，这叫做肾病；死绝的肾脉，来势如争夺绳索般紧张，或如弹石般辟辟作响，这叫做肾死。
“喘喘累累”如同心脉的钩象，阴中藏阳，得到微石的义理。“引葛”指坚搏索连。“按之益坚”指石脉甚且不和谐。“索若相夺”指非常强劲又非常急。“弹石”其坚硬可知，这是只有石脉而没有胃气。
真脏脉中的肝脉，来势急迫，如同触摸刀刃，责责然作响，如同按压琴瑟之弦，面色青白而无光泽，毛发枯折就会死亡。真脏脉中的心脉，坚实搏指，如同触摸薏苡子连续不断，面色赤黑而无光泽，毛发枯折就会死亡。真脏脉中的肺脉，大而虚弱，如同羽毛中人皮肤，面色白赤而无光泽，毛发枯折就会死亡。真脏脉中的肾脉，搏动断绝，如同手指弹石辟辟然，面色黑黄而无光泽，毛发枯折就会死亡。真脏脉中的脾脉，微弱而忽快忽慢，面色黄青而无光泽，毛发枯折就会死亡。
出现真脏脉就会死亡。
青色本是木色，如果兼见白色且无光泽，是金克木的表现，五脏以此类推。然而大多因毛发枯折而死，因为皮毛依赖血气充养，毛发枯折说明精气败坏了，所以都会死亡。
柯韵伯说：经文说：能结合色诊与脉诊，就可以万无一失。这是取色脉相应的道理。又说：面色枯槁无光泽，称为难治。现在见到本脏之色，又兼见相克之色，而且天然无光泽，这是色脉不相相应。虽然常说肺朝百脉，将精气输布于皮毛，毛脉合精，留存于五脏，气归于权衡，现在毛发枯折说明精气不能输布到皮毛，毛脉之精不合了。这是色诊容易见到的现象。
为什么见到真脏脉就说是死证呢？岐伯说：五脏都禀受胃气，胃是五脏的根本。脏气本身不能独自到达手太阴肺经，必须依靠胃气，才能到达手太阴。所以五脏各自在其当令之时，凭借胃气而至手太阴。所以邪气盛的时候，真气就衰弱了。所以病重的时候，胃气不能伴随脏气一起到达手太阴，因此真脏之气单独显现。单独显现，说明病邪胜过脏气，所以称为死证。
这段论述真脏脉并强调以胃气为本，最为发明显切。五脏虽然各有本气以主四时，但必须得到胃气的滋养，其真脏之气才能得以体现。如心脉的累累连珠，肾脉的喘喘累累以下，都是形容其脏得胃气以为脏真，所以浮而不浮，沉而不沉，急而不急，缓而不缓，神气存于其间，这是能随四时自至手太阴。若喘喘连属以下，则是五脏邪气胜而真气衰了。如果胃气竭绝，已不能自至于手太阴，也不能复藏其神而真脏现，胃家粮绝，真神孤削，所以其恶候如此。因此古圣人在四时五脏中，都以占察胃气为根本。
鼓动一阳之气称为钩，鼓动一阴之气称为毛，阳气胜且急称为弦，阳气绝而急称为石，阴阳相交称为溜。
这里讲钩、弦、毛、石的正常形象，作为各种脉象的准则。经文说：太阳为开，阳明为阖，少阳为枢。三阳之气，不可偏失。搏动而不浮，名叫一阳。这一阳，是阳之盛，即太阳，为主管心家的脉，其气纯和一致，正是心脉得其平和的状态。钩脉主夏，所以鼓动一阳称为钩。
又说：三阴之气，不可偏失。搏动而不沉，命为一阴。清静属于阴，而不沉，正是清轻的意思，应当收敛燥金之时，而其气不沉于下，而渐收于上，清明至极，所以称为鼓一阴称为毛，这正是肺脉应秋之和的状态。
至于弦脉，本是阴部厥阴之脉。厥阴为阴中之少阳，木性本达，方才沉于厥阴之下，与厥阴争而直上，所以阳气胜且急而呈弦象。要其主春者，唯有少阳令行，春生则木气已发，软弱轻虚，端直以长，这才称为主春之弦。不然，阳之胜急，正是仲景所说的残贼之脉，弦脉本象如此，所以称为阳胜急曰弦。
肾为阴中之太阴，水体沉滑之极，此为阳气绝不至，而阴独至。阴独至，则至搏而沉，动而且坚，所以称为石。
至于阴阳之相过，则是阴阳之交驰，各家注释都认为这是脾脉。但以“溜”而言，并非脾脉的正象，不可以脾言。然而其脉顺而不逆，去而不滞，滑而不衰败，极似少阳之脉，所以称为溜。本文列举此脉以明阴阳之交者耳。至于脾脉在诸脏中，善者不可得而见，故不特意提出，想要让人体认罢了。
Normal heart pulse arrives continuously, like connected pearls, smooth and slippery as if touching a lustrous stone; this is called a normal heart pulse. In summer, the stomach qi (Stomach Qi) serves as the foundation. A diseased heart pulse arrives hurriedly and continuously, with a slight curve within; this is called heart disease. A dying heart pulse arrives with a curve at the beginning and rigidity at the end, like handling a belt hook; this is called heart death.
"Lustrous stone" implies fullness and smoothness like pearls, which is the meaning of a slight hook (Hook Pulse). "Hurriedly and continuously" refers to urgency following one another. "Curve at the beginning" means that upon light palpation, it feels hard and unyielding; "rigidity at the end" means that upon deep palpation, it is firm and immobile, like holding a leather belt hook. It completely loses the harmonious and gentle qi (Harmonious Qi), possessing only the hook quality without stomach qi, hence it is called heart death.
Normal lung pulse arrives gently and softly, like falling elm seeds; this is called a normal lung pulse. In autumn, the stomach qi serves as the foundation. A diseased lung pulse comes neither up nor down, feeling like stroking a chicken feather; this is called lung disease. A dying lung pulse floats like an object adrift or scatters like wind-blown feathers; this is called lung death.
"Gently and softly" describes the appearance of many seedlings growing uniformly. "Like falling elm seeds" describes a light, floating, and slow manner, which is the image of a slight hair (Hair Pulse). "Neither up nor down" indicates rough and stagnant flow. "Like stroking a chicken feather" indicates lightness, floating nature, and emptiness, also signifying much hair quality but little stomach qi. "Like an object floating" indicates emptiness and lack of root. "Like wind-blown feathers" indicates scattering and disarray, also signifying only hair quality without stomach qi.
Normal liver pulse arrives soft and relaxed, like the tip of a long bamboo pole held high; this is called a normal liver pulse. In spring, the stomach qi serves as the foundation. A diseased liver pulse is full, solid, and slippery, like stroking a long pole; this is called liver disease. A dying liver pulse becomes urgent and increasingly stiff, like a newly tightened bowstring; this is called liver death.
Normal spleen pulse arrives in harmony and softness, distinct yet connected, like a chicken treading on the ground; this is called a normal spleen pulse. In late summer, the stomach qi serves as the foundation. A diseased spleen pulse is solid, full, and rapid, like a chicken lifting its foot; this is called spleen disease. A dying spleen pulse is sharp and hard like a bird's beak or claw, like water dripping from a leaking roof in disorder, or like flowing water that does not return; this is called spleen death.
"Soft and harmonious" means dignified and unhurried. "Distinct yet connected" means even, clean, and clear. "Like a chicken treading" means leisurely and slow; this is the meaning of harmonious qi. "Solid, full, and rapid" means strong, urgent, and disharmonious. "Like a chicken lifting its foot" means light, swift, and not slow. The previous section mentioned weak pulse with much stomach qi; here, solid and rapid pulse indicates loss of harmonious qi, thus called spleen disease. Bird beak and claw indicate hardness and sharpness without softness. Leaking roof indicates droplets without order. Flowing water indicates departure without return. These are all strange pulses of spleen exhaustion, possessing only the alternating (Intermittent) quality without stomach qi.
Normal kidney pulse arrives hurriedly and continuously like a hook, firm upon pressure; this is called a normal kidney pulse. In winter, the stomach qi serves as the foundation. A diseased kidney pulse feels like pulling a vine, becoming firmer upon pressure; this is called kidney disease. A dying kidney pulse arrives tense like competing ropes, or strikes like stones being flicked; this is called kidney death.
"Hurriedly and continuously" resembles the hook of the heart pulse, hiding yang within yin, obtaining the meaning of slight stone (Stone Pulse). "Pulling a vine" indicates firmness and connected tension. "Firmer upon pressure" indicates excessive stone quality and disharmony. "Competing ropes" indicates extreme strength and urgency. "Striking stones" reveals its hardness; this is only stone quality without stomach qi.
The true liver pulse arrives urgently, like touching a blade, sounding harsh, like pressing a zither string; with cyan-white complexion lacking luster, death occurs when hair breaks. The true heart pulse arrives firm and beating, like touching coix seeds continuously; with red-black complexion lacking luster, death occurs when hair breaks. The true lung pulse arrives large and empty, like a feather brushing against human skin; with white-red complexion lacking luster, death occurs when hair breaks. The true kidney pulse arrives with interrupted beating, like fingers flicking stones striking sharply; with black-yellow complexion lacking luster, death occurs when hair breaks. The true spleen pulse arrives weak and intermittently rapid and slow; with yellow-cyan complexion lacking luster, death occurs when hair breaks.
Appearance of the true organ pulse indicates death.
Cyan is originally the color of wood; if accompanied by white and lacking luster, it signifies metal overcoming wood. The five organs follow this principle. However, death generally occurs due to broken hair, because the skin and hair are nourished by blood and qi; broken hair indicates failure of essence and qi, hence death ensues.
Ke Yunbo said: The classic states, "If one can combine color diagnosis and pulse diagnosis, one can achieve perfection." This refers to the correspondence between color and pulse. It also states, "A dull and lusterless complexion is called difficult to treat." Now, seeing the color of the affected organ combined with the overcoming color, and naturally lacking luster, indicates non-correspondence between color and pulse. Although it is said that the lungs govern all vessels and transmit essence to the skin and hair, combining hair and vessel essence to reside in the five organs, with qi returning to balance, now broken hair indicates that essence is not transmitted to the skin and hair, and the essence of hair and vessels is not united. This is an easily observable aspect of color diagnosis.
Why is seeing the true organ pulse considered fatal? Qibo said: All five organs receive qi from the stomach; the stomach is the root of the five organs. Organ qi cannot reach the Hand-Taiyin Lung Meridian by itself; it must rely on stomach qi to reach the Hand-Taiyin. Thus, each organ reaches the Hand-Taiyin in its respective season through its own mechanism. Therefore, when pathogenic qi prevails, true qi declines. When illness is severe, stomach qi cannot accompany the organ qi to reach the Hand-Taiyin, so the true organ qi appears alone. Appearing alone means disease overcomes the organ, hence it is called death.
This discussion on true organ pulses highlights the stomach qi as the foundation, which is most explicit and pertinent. Although each of the five organs has its own fundamental qi governing the seasons, it must obtain nourishment from stomach qi for its true organ nature to manifest. For example, the continuous pearls of the heart pulse and the hurried continuity of the kidney pulse describe how the organ obtains stomach qi to form its true nature, thus floating but not excessively floating, sinking but not excessively sinking, urgent but not excessively urgent, slow but not excessively slow, with spirit residing within. This allows it to arrive at the Hand-Taiyin according to the seasons. If it is hurried and continuous as described later, it means pathogenic qi of the five organs prevails while true qi declines. If stomach qi is exhausted, it can no longer reach the Hand-Taiyin independently, nor can it store its spirit, causing the true organ to appear. With the stomach's supply cut off, the true spirit becomes isolated and depleted, hence such ominous signs appear. Therefore, ancient sages regarded observing stomach qi as the foundation for the four seasons and five organs.
Beating with one yang is called Hook; beating with one yin is called Hair; yang prevailing and urgent is called Wiry; yang exhausted and urgent is called Stone; yin and yang interacting is called Sliding.
This describes the correct images of Hook, Wiry, Hair, and Stone pulses as standards for various pulses. The classic states: Taiyang acts as the opening, Yangming as the closing, Shaoyang as the pivot. The three yang meridians must not lose their balance. Beating without floating is named One Yang. This One Yang represents the abundance of yang, i.e., Taiyang, which is the main pulse for the Heart master. Its qi is pure, harmonious, and unified, representing the heart pulse achieving equilibrium. The Hook pulse governs summer, hence beating with one yang is called Hook.
It also states: The three yin meridians must not lose their balance. Beating without sinking is named One Yin. Clarity and stillness belong to yin; not sinking refers to clarity and lightness. During the time when dry metal should be收敛 (astringed/collected), its qi does not sink downward but gradually collects upward, reaching extreme clarity, hence beating with one yin is called Hair. This correctly represents the lung pulse corresponding to the harmony of autumn.
As for the Wiry pulse, it originates from the Jueyin pulse in the yin sector. Jueyin is shaoyang within yin; the nature of wood is to expand. Initially sinking below Jueyin, it contends with Jueyin and rises straight up, hence yang prevails and becomes urgent, resulting in a Wiry pulse. However, what governs spring is solely the command of Shaoyang. When spring generates, wood qi has already emerged, being soft, light, void, straight, and long; this is called the Wiry pulse governing spring. Otherwise, yang prevailing and urgent is precisely the harmful pulse mentioned by Zhang Zhongjing. The original image of the Wiry pulse is thus, hence yang prevailing and urgent is called Wiry.
The Kidney is taiyin within yin, the ultimate depth and slipperiness of water. This represents yang exhausting and failing to arrive, while yin arrives exclusively. When yin arrives exclusively, it beats and sinks, moving and becoming firm, hence it is called Stone.
Regarding the interaction of yin and yang, it refers to the interplay of yin and yang. Various commentators consider this to be the spleen pulse. However, speaking of "Sliding," it is not the correct image of the spleen pulse and cannot be defined as spleen. Yet, its pulse is smooth and not adverse, departing without stagnation, slippery without decline, resembling the Shaoyang pulse. Hence it is called Sliding. The text mentions this to illustrate the interaction of yin and yang. As for the spleen pulse among the five organs, its healthy state cannot be distinctly seen, so it is not specifically highlighted, intending for practitioners to realize it through contemplation.