浮脉之诊，浮于指下，按之不足，举之有余，再再寻之，状如太过，瞥瞥然见于皮毛间
。其主表症，或为风，或为虚。浮大而散者，心也。浮而短涩者，肺也。浮而数者，热也。而反
恶寒者，疮疽之谓也。
洪脉之诊，似浮而大，按举之则泛泛然满三部，其状如水之洪流，波之涌起。其主血实
积热疮肿。论曰∶脉洪大者，疮疽之病进也。如疮疽结脓未成者，宜下之。脓溃之后，脉见洪大
则难治。若自利者，不可救也。
滑脉之诊，实大相兼，往来流利如珠，按之则累累然滑也。其主或为热，或为虚，此阳
脉也。疮疽之病，脓未溃者，宜内消也。脓溃之后，宜托里也。所谓始为热，终为虚也。
数脉之诊，按之则呼吸之间，动及六至，其状似滑而数也。若浮而数则表热，沉而数则
里热也。又曰∶诸数为热。仲景云∶脉数不时见，则生恶疮也。又云∶肺脉俱数，则生疮也。诊
诸疮洪数者，里欲有脓结也。
散脉之诊，似浮而散。按之则散而欲去，举之则大而无力，主气实而血虚，有表无里，
疮肿脓溃之后，而烦痛尚未痊退，诊其脉，洪滑粗散者难治，以其正气虚，邪气实也。又曰∶肢
体沉重，肺脉大则毙，谓浮散者也。
长脉之诊，按之则洪大而长出于本位，其主阳气有余也。伤寒得之，欲汗出自解也。长
而缓者，胃脉也，百病皆愈，谓之长者，则易治也。
芤脉之诊，似浮而软，按之中央空两边实，其主血虚，或为失血。疮肿之病，诊得芤脉
，脓溃后易治，以其脉病相应故也。
牢脉之诊，按之则实而弦，且沉且浮而有牢坚之意。若瘰 结肿，诊得牢脉者，不可内
实脉之诊，按举有力而类结，曰实。经曰∶邪气胜则实。久病虚人，得此最忌。疮疽之
人，得此宜急下之，以其邪气与脏腑俱实故也。
弦脉之诊，按之则紧而弦，其似紧者为弦。如按弦而不移，紧如切绳而转动，以此为异
。春脉浮弦而平，不时见则为饮为痛，主寒主虚。疮疽论曰∶内寒外热，欲发疮疽也。
紧脉之诊，似弦而紧，按之如切绳而转动，其主切痛积癖。凡疮肿得之，气血沉涩也，
涩脉之诊，按之则散而复来，举之则细而不足，脉涩则气涩也。亦主血虚疮肿，溃后得
短脉之诊，按举则不及本位。《内经》曰∶短则气病，以其无胃气也。诸病脉短者，皆
难治。疮肿脉短，真气短也。
细脉之诊，按之则萦萦如蛛丝而欲绝，举之如无而似有，细而微，其正亡阳衰也。疮肿
之病，脉来细而沉，时值者，里虚而欲变症也。
微脉之诊，按之则软小而极微，其主虚也。真气复者生，邪气胜者危。疮肿溃后，脉微
而匀，举自瘥也。
迟脉之诊，按举来迟，呼吸定息，方得三至。其状似缓而稍迟，痼疾得之则善，新疾得
之则正气虚惫。疮肿得之，溃后自痊也。
缓脉之诊，按之似迟，而稍 于迟。仲景云∶阳脉浮大而濡，阴脉浮大而涩，阴阳同等
，谓之长缓。脉见长缓，百疾自瘳。凡疮肿溃后，其脉涩迟缓者易愈，以其脉病相应，是有胃气
沉脉之诊，举之不足，按之方见如烂绵，其主邪气在脏也。水气得之则逆，此阴脉也。
伏脉之诊，比沉不同，伏于筋下，推筋而后见。与沉相类，而邪气益深矣。
虚脉之诊，按之不足，极大而软，轻举指下豁然而空。经曰∶脉虚则血虚，血虚生寒，
阳气不足也。疮肿脉虚，宜托里和气养血也。
软脉之诊，按之则如帛在水中，极软而沉细，亦谓之软，其主胃气弱。疮肿得之，宜补
弱脉之诊，似软而极微，来微而似有。仲景云∶微弱之脉，绵绵如泻漆之绝，其主血气
俱虚，形精不足。大抵疮家沉迟濡弱，皆宜托里。
促脉之诊，按之则去数，来时一止而复来。仲景云∶阳盛则促，主热蓄于里也，下之则
和。疮肿脉促，亦宜下之。
结脉之诊，按之则往来迟缓，时一止而复来。仲景云∶阴盛则结。经曰∶促结则生，代
代脉之诊，其止有常数而不忒，如十动一止，虽数十次皆见于十动之后；如二十动一止
十次皆见于二十动之后。代者气衰也，诸病见之不祥。凡疮肿之病，脉促结者难治，而况见
动脉之诊，见于关上，无头尾，如豆大，厥厥然而动摇者是也。《脉经》曰∶阴阳相搏
，故谓之动。动于阳，则阳气虚而发厥，动于阴，则阴气虚而发热，是阳生于尺而动于寸，阴生
于寸而动于尺，不可不辨也。
谨按∶脉者，人身之造化，病机之外见，医家之准绳，不可不精究而熟察。至于太溪、
冲阳，又为诊法之要，生死之机也。故十二经脉，皆系于生气。是气者，人之根本。寸口脉平而
死者，生气独绝于内也。《难经》云∶上部有脉，下部无脉，其人当吐，不吐者死；上部无
脉，下部有脉，虽困，无能为害。是脉有根本，人有元气也。夫人受气于谷，乃传于脏腑，
清者为荣，浊者为卫，荣行脉中，卫行脉外，阴阳相贯，如环无端，周流一身，昼夜各有常
度，其不相应者病也。病至于甚，脉道乃乖抑。尝治雀啄屋漏之类，若因药饵克伐所致，急
用参、 、归、术、姜、附之剂，多有复生者，不可遂弃而不治也。
浮脉的诊察，脉搏在指下感觉浮浅，重按时力量不足，轻取时感觉有余，反复寻按，脉象显得过于明显，轻轻飘忽地显现于皮毛之间。它主表证，或者是风邪所致，或者是虚证。浮大且散的脉象，对应心脏。浮而短涩的脉象，对应肺脏。浮而数的脉象，主热证。如果反而出现恶寒症状，这是疮疽的表现。
洪脉的诊察，脉象似浮而大，重按和轻取时都感觉泛泛然充满寸、关、尺三部，其形态像水的洪流，波浪涌起。它主血实积热导致的疮肿。医论说：脉象洪大的，是疮疽病情进展的表现。如果疮疽脓液尚未形成，应当使用下法治疗。脓液溃破之后，如果脉象仍然见洪大，则难以治疗。如果出现自发性腹泻，则不可救治。
滑脉的诊察，脉形实大兼有滑利之象，往来流利如珠子滚动，重按时感觉累累然滑润。它主热证或虚证，这属于阳脉。对于疮疽病，脓液未溃破时，应当采用内消法；脓液溃破之后，应当采用托里法。这就是所谓的开始为热证，最终转为虚证。
数脉的诊察，重按时呼吸之间，脉搏跳动达到六次以上，其形态似滑而快。如果浮而数，则是表热；沉而数，则是里热。又说：各种数脉都主热证。张仲景说：脉数不时出现，就会生恶疮。又说：肺脉俱数，就会生疮。诊察各种疮疡，若脉象洪数，说明体内即将有脓液结聚。
散脉的诊察，脉象似浮而散漫。重按时脉气散乱欲去，轻取时脉体大而无力，主气实而血虚，有表无里。疮肿脓液溃破之后，如果烦痛尚未痊愈，诊察其脉象，若见洪滑粗散者，难治，因为正气虚弱，邪气盛实。又说：肢体沉重，若肺脉大（浮散），则预后不良，甚至死亡。
长脉的诊察，重按时脉象洪大而长，超出本位，它主阳气有余。伤寒病见到此脉，想要通过出汗而自愈。长而缓的脉象，是胃脉，各种疾病都会痊愈，称为长脉，则容易治疗。
芤脉的诊察，脉象似浮而软，重按时中间空两边实，它主血虚，或者为失血。疮肿病，诊得芤脉，脓溃后容易治疗，因为脉象与病情相应。
牢脉的诊察，重按时脉实而弦，且沉且浮而有牢坚之意。如果是瘰疬结肿，诊得牢脉者，不可用内补法（注：原文此处似有缺字或断句问题，结合上下文“不可内”及后文“实脉之诊”，推测原意可能为不可单纯内补或需攻邪，但根据指令不增添内容，仅翻译可见部分）。
实脉的诊察，轻取重按都有力且类似结脉，称为实。经书说：邪气胜则表现为实脉。久病体虚之人，得到这种脉象是最忌讳的。疮疽病人，得到这种脉象应当急用下法，因为邪气与脏腑都呈实象。
弦脉的诊察，重按时脉紧而弦，那种类似紧脉的为弦脉。如按琴弦而不移动，紧脉如切绳而转动，以此作为区别。春季脉象浮弦而平和，如果不按时出现，则为饮邪或疼痛，主寒主虚。疮疽论说：内寒外热，将要发疮疽。
紧脉的诊察，脉象似弦而紧，重按时如切绳而转动，它主切痛和积癖。凡是疮肿得到这种脉象，说明气血沉涩。
涩脉的诊察，重按时脉气散而复来，轻取时脉细而不足，脉涩说明气机涩滞。也主血虚疮肿，溃后得到涩脉……（注：原文此处似乎截断，接着是短脉）
短脉的诊察，轻取重按都不及本位。《内经》说：短则气病，因为它没有胃气。各种疾病脉象短的，都难治。疮肿脉短，是真气短少。
细脉的诊察，重按时脉气萦萦如蛛丝而欲绝，轻取时若无似有，细而微，这是正亡阳衰的表现。疮肿病，脉来细而沉，正值某时（注：原文“时值者”语意不明，保留原意），是里虚而欲发生变症。
微脉的诊察，重按时脉软小而极微，它主虚证。真气恢复者生，邪气胜者危。疮肿溃后，脉微而匀，自然痊愈。
迟脉的诊察，轻取重按来势迟缓，一呼一吸定息之间，才得三次搏动。其形态似缓而稍迟，痼疾得到此脉则好，新疾得到此脉则正气虚惫。疮肿得到此脉，溃后自愈。
缓脉的诊察，重按时似迟，而稍……（注：原文此处似有缺字，通常为“大于迟”或类似描述，依原文翻译）比迟脉略快。张仲景说：阳脉浮大而濡，阴脉浮大而涩，阴阳同等，称为长缓。脉见长缓，百病自愈。凡是疮肿溃后，脉象涩迟缓者易愈，因为脉病相应，是有胃气的表现。
沉脉的诊察，轻取不足，重按方见，如烂绵一般，它主邪气在脏。水气得此脉则逆，这是阴脉。
伏脉的诊察，与沉脉不同，伏于筋下，推筋而后见。与沉脉相类，但邪气更深了。
虚脉的诊察，重按不足，极大而软，轻举指下豁然空虚。经书说：脉虚则血虚，血虚生寒，阳气不足。疮肿脉虚，应当托里、和气、养血。
弱脉的诊察（注：原文写作“软脉”，但后文又提“弱脉”，此处依原文顺序处理前一个“软脉”），重按时如帛在水中，极软而沉细，也称为软，它主胃气弱。疮肿得到此脉，应当补益。
弱脉的诊察（原文后半部分），似软而极微，来势微弱而似有。张仲景说：微弱之脉，绵绵如泻漆之绝，它主血气俱虚，形体精神不足。大抵疮家脉象沉迟濡弱，都应当托里。
促脉的诊察，重按时去数（注：通常促脉为数而一止，此处原文表述较特殊，依字面译），来时一次停止后又来。张仲景说：阳盛则促，主热蓄于里，用下法则调和。疮肿脉促，也应当用下法。
结脉的诊察，重按时往来迟缓，偶尔一次停止后又来。张仲景说：阴盛则结。经书说：促结则生，代……（注：原文此处断句混乱，“代代脉之诊”应为“代脉之诊”）
代脉的诊察，其停止有常数且不差错，如十动一次停止，即使数十次都是出现在十动之后；如二十动一次停止，十次都出现在二十动之后。代脉代表气衰，各种疾病见到此脉不祥。凡是疮肿病，脉象促结者难治，何况见到代脉？
动脉的诊察，见于关上，无头尾，如豆大，厥厥然而动摇。《脉经》说：阴阳相搏，所以称为动。动在阳分，则阳气虚而发厥；动在阴分，则阴气虚而发热。阳生于尺部而动于寸部，阴生于寸部而动于尺部，不可不辨别。
谨按：脉象，是人身的造化，病机的外在表现，医家的准绳，不可不精究而熟察。至于太溪、冲阳二穴，又是诊法的要害，关乎生死之机。所以十二经脉，都系于生气。这个气，是人的根本。寸口脉平而死者，是因为生气独绝于内。《难经》说：上部有脉，下部无脉，其人应当呕吐，不吐者死；上部无脉，下部有脉，虽然困顿，但无大害。这说明脉有根本，人有元气。人受气于谷，乃传于脏腑，清者为营，浊者为卫，营行脉中，卫行脉外，阴阳相贯，如环无端，周流一身，昼夜各有常度，如果不相应就是病。病至于严重，脉道乃乖异。曾经治疗雀啄、屋漏等怪脉，如果是因药物克伐所致，急用人参、黄芪、当归、白术、干姜、附子之剂，多有复生者，不可轻易放弃而不治疗。
The diagnosis of the Floating Pulse (Fu Mai, 浮脉): The pulse feels floating under the fingers; pressure reveals insufficiency, while light touch reveals excess. Repeated searching shows a state of apparent excess, appearing faintly and flutteringly between the skin and hair. It indicates exterior syndromes (Biao Zheng), which may be due to Wind pathogen or deficiency. A floating, large, and scattered pulse corresponds to the Heart. A floating, short, and choppy pulse corresponds to the Lung. A floating and rapid pulse indicates Heat. If accompanied by aversion to cold, it signifies Carbuncle and Ulcer (Chuang Ju).
The diagnosis of the Surging Pulse (Hong Mai, 洪脉): It resembles floating and is large; upon both pressing and lifting, it feels overflowing and fills all three positions (Cun, Guan, Chi). Its shape is like a torrent of water or rising waves. It indicates Blood Excess and accumulated Heat leading to sores and swellings. As stated in medical discussions: A surging and large pulse indicates the progression of Carbuncle and Ulcer. If pus has not yet formed, purgation should be used. After pus discharges, if the pulse remains surging and large, treatment is difficult. If spontaneous diarrhea occurs, it is incurable.
The diagnosis of the Slippery Pulse (Hua Mai, 滑脉): It combines fullness and largeness with smoothness, flowing freely like rolling pearls; pressing reveals a continuous slippery sensation. It indicates either Heat or Deficiency; this is a Yang pulse. For Carbuncle and Ulcer, if pus has not discharged, internal resolution is appropriate. After discharge, supporting the interior (Tuo Li) is appropriate. This is described as starting with Heat and ending with Deficiency.
The diagnosis of the Rapid Pulse (Shu Mai, 数脉): Upon pressing, the pulse beats more than six times per respiratory cycle. Its appearance is similar to Slippery but faster. Floating and rapid indicates Exterior Heat; sinking and rapid indicates Interior Heat. It is also said that all Rapid pulses indicate Heat. Zhang Zhongjing stated: "If a rapid pulse appears intermittently, malignant sores will arise." He also said: "If both Lung pulses are rapid, sores will arise." Diagnosing various sores with surging and rapid pulses suggests impending pus formation internally.
The diagnosis of the Scattered Pulse (San Mai, 散脉): It resembles floating and is scattered. Pressing reveals dispersion and departure; lifting reveals largeness without strength. It indicates Qi Excess and Blood Deficiency, having an exterior but no interior. After sores and swellings discharge pus, if pain and irritability persist, and the pulse is surging, slippery, coarse, and scattered, it is difficult to treat because Healthy Qi is deficient and Pathogenic Qi is excessive. It is also said: Heavy limbs with a large Lung pulse (floating and scattered) indicate death.
The diagnosis of the Long Pulse (Chang Mai, 长脉): Pressing reveals a surging, large, and long pulse extending beyond its normal position. It indicates excess Yang Qi. In Cold Damage (Shang Han), this pulse suggests sweating will lead to resolution. A long and slow pulse is the Stomach pulse; all diseases will resolve. Being called "Long" implies ease of treatment.
The diagnosis of the Gourd Kernel Pulse (Kou Mai, 芤脉): It resembles floating and is soft; pressing reveals emptiness in the center and solidity on the sides. It indicates Blood Deficiency or blood loss. In sores and swellings, obtaining a Gourd Kernel pulse after pus discharge indicates easy treatment because the pulse matches the disease condition.
The diagnosis of the Firm Pulse (Lao Mai, 牢脉): Pressing reveals solidity and wiriness, appearing deep yet floating with a firm and hard quality. In cases of scrofula and nodular swellings, obtaining a Firm pulse... [Text fragment] ...cannot be treated with internal tonification alone.
The diagnosis of the Solid Pulse (Shi Mai, 实脉): Both lifting and pressing reveal strength, resembling a knotted pulse. It is called Solid. The Classics state: "When Pathogenic Qi prevails, it manifests as Solid." For chronically ill and weak patients, this pulse is most taboo. For patients with carbuncles and ulcers, urgent purgation is indicated because both Pathogenic Qi and the Zang-Fu organs are solid/excessive.
The diagnosis of the Wiry Pulse (Xian Mai, 弦脉): Pressing reveals tightness and wiriness; what resembles tightness is defined as wiry. Like pressing a string that does not move, whereas tightness feels like cutting a rope that rotates. Spring pulses are floating and wiry and considered normal; appearing at other times indicates fluid retention or pain, indicating Cold and Deficiency. Discussions on carbuncles state: Internal Cold and External Heat suggest impending carbuncle development.
The diagnosis of the Tight Pulse (Jin Mai, 紧脉): It resembles wiry but is tight; pressing feels like cutting a rotating rope. It indicates sharp pain and accumulations. For any sore or swelling, this pulse indicates stagnant and choppy Qi and Blood.
The diagnosis of the Choppy Pulse (Se Mai, 涩脉): Pressing reveals dispersion followed by return; lifting reveals fineness and insufficiency. A choppy pulse indicates Qi stagnation. It also indicates Blood Deficiency in sores; after discharge... [Text continues to Short Pulse].
The diagnosis of the Short Pulse (Duan Mai, 短脉): Lifting and pressing do not reach the normal position. The *Neijing* states: "Shortness indicates Qi pathology," due to the absence of Stomach Qi. All diseases with short pulses are difficult to treat. A short pulse in sores indicates deficiency of True Qi.
The diagnosis of the Fine Pulse (Xi Mai, 细脉): Pressing reveals a thread-like pulse, fine as a spider's silk, nearly disappearing; lifting reveals it as almost non-existent yet present, fine and subtle. This indicates the loss of Yang and decline of Healthy Qi. In sores, a fine and sinking pulse occurring at specific times indicates Interior Deficiency and impending transformation of symptoms.
The diagnosis of the Micro Pulse (Wei Mai, 微脉): Pressing reveals a soft, small, and extremely minute pulse. It indicates Deficiency. Recovery of True Qi leads to life; dominance of Pathogenic Qi leads to danger. After sores discharge, a micro and even pulse indicates natural recovery.
The diagnosis of the Slow Pulse (Chi Mai, 迟脉): Lifting and pressing reveal a slow arrival; within one respiratory cycle, only three beats are counted. Its shape resembles Slow but is slightly slower. In chronic diseases, it is favorable; in acute diseases, it indicates exhaustion of Healthy Qi. In sores, it indicates self-healing after discharge.
The diagnosis of the Moderate Pulse (Huan Mai, 缓脉): Pressing feels similar to Slow, but slightly... [Text fragment] ...faster than Slow. Zhang Zhongjing stated: "Yang pulse floating, large, and moist; Yin pulse floating, large, and choppy; when Yin and Yang are equal, it is called Long and Moderate." Seeing a Long and Moderate pulse means all diseases will heal naturally. For sores after discharge, a choppy, slow, and moderate pulse indicates easy recovery because the pulse matches the disease, showing the presence of Stomach Qi.
The diagnosis of the Deep Pulse (Chen Mai, 沉脉): Lifting reveals insufficiency; pressing reveals it like rotten cotton. It indicates Pathogenic Qi in the Zang organs. Water-Dampness obtaining this pulse causes rebellion; this is a Yin pulse.
The diagnosis of the Hidden Pulse (Fu Mai, 伏脉): Different from Deep, it lies beneath the tendons and is visible only after pushing the tendons aside. Similar to Deep, but the Pathogenic Qi is deeper.
The diagnosis of the Deficient Pulse (Xu Mai, 虚脉): Pressing reveals insufficiency; it is very large and soft. Light lifting feels hollow. The Classics state: "Pulse deficiency indicates Blood deficiency; Blood deficiency generates Cold; Yang Qi is insufficient." For sores with a deficient pulse, supporting the interior, harmonizing Qi, and nourishing Blood is indicated.
The diagnosis of the Soft Pulse (Ruan Mai, 软脉): Pressing feels like silk in water, extremely soft, deep, and fine. Also called Ruan, it indicates weak Stomach Qi. For sores, supplementation is indicated.
The diagnosis of the Weak Pulse (Ruo Mai, 弱脉): Resembles Soft but is extremely minute, arriving faintly and seemingly present. Zhang Zhongjing stated: "A micro and weak pulse, continuous like the end of pouring lacquer, indicates dual deficiency of Qi and Blood, and insufficiency of form and spirit." Generally, for patients with sores, deep, slow, soft, and weak pulses all require supporting the interior.
The diagnosis of the Hasty Pulse (Cu Mai, 促脉): Pressing reveals speed with occasional stops before returning. Zhang Zhongjing stated: "Yang excess causes Hasty pulse; it indicates Heat accumulation in the interior; purgation brings harmony." For sores with a hasty pulse, purgation is also indicated.
The diagnosis of the Knotted Pulse (Jie Mai, 结脉): Pressing reveals slow and intermittent flow, stopping occasionally before returning. Zhang Zhongjing stated: "Yin excess causes Knotted pulse." The Classics state: "Hasty and Knotted pulses indicate survival..." [Text fragment] ...whereas Dai Pulse...
The diagnosis of the Intermittent Pulse (Dai Mai, 代脉): Its stops have a constant number and do not err. For example, if it stops every ten beats, even after dozens of cycles, it always stops after ten beats; if every twenty beats, it always stops after twenty. Dai pulse indicates Qi decline; seeing it in various diseases is inauspicious. For sores, hasty and knotted pulses are difficult to treat, let alone the Dai pulse.
The diagnosis of the Moving Pulse (Dong Mai, 动脉): Seen at the Guan position, without head or tail, about the size of a bean, quivering and shaking. The *Mai Jing* states: "Yin and Yang struggle, hence it is called Moving." Movement in Yang indicates Yang Qi deficiency and syncope; movement in Yin indicates Yin Qi deficiency and fever. Yang originates at the Chi position and moves to Cun; Yin originates at Cun and moves to Chi. This must be distinguished carefully.
Carefully noted: Pulses are the creation of the human body, the external manifestation of disease mechanisms, and the standard for physicians. They must be studied meticulously. Taixi (KI3) and Chongyang (ST42) are crucial for diagnosis, determining life and death. Thus, the twelve meridians are connected to Sheng Qi (Vital Qi). This Qi is the root of humans. If the Cun Kou pulse is level but the patient dies, it is because Sheng Qi is exclusively severed internally. The *Nan Jing* states: "If there is pulse above but none below, the person should vomit; if they do not vomit, they die. If there is no pulse above but pulse below, although distressed, it poses no fatal threat." This shows pulses have roots, and humans have Yuan Qi (Original Qi). Humans receive Qi from grain, transmitted to Zang-Fu. The clear part becomes Ying (Nutritive) Qi, the turbid part becomes Wei (Defensive) Qi. Ying circulates within the vessels, Wei outside. Yin and Yang interconnect like a circle without end, circulating through the body, following regular daily rhythms. Disconnection indicates disease. When disease becomes severe, the pulse pathways become abnormal. I have treated strange pulses like Sparrow Pecking or House Leaking; if caused by harsh drug treatments, urgently using formulas with Ginseng, Astragalus, Angelica, Atractylodes, Ginger, and Aconite often results in recovery. One must not abandon treatment.