沉脉主里主寒主积有力痰食无力气郁沉迟虚寒沉数热伏沉紧冷痛沉缓水畜沉牢痼冷沉实
热极沉弱阴虚沉细痹湿沉弦饮痛沉滑宿食沉伏吐利阴毒聚积此言沉脉兼诸脉主病之义脉按之
至骨曰沉故曰主里寒乃水寒积乃藏积皆见沉脉沉而有力有物在里非痰即食沉而无力里原非实
但气不伸畅沉为在里而复迟虚寒可必沉为在里而加数伏热何疑沉而紧则寒为敛实故冷痛也沉
而缓则阳不健行故水蓄焉沉而牢乃阴寒之滞着应当痼冷沉而实是阳气聚搏宜乎热深沉为阴弱
为虚沉弱必主阴虚沉为里细为湿沉细定成痹湿沉为阴弦为饮沉弦则饮停腹阴而时痛沉为里滑
为食沉滑则食宿肠里而难推沉已气沉于骨伏则至骨如无势甚笃危须分久暴暴则既吐且利而暴
脱温补可回久则阴毒聚积之久阻非峻攻莫愈
迟脉主脏阳气伏潜有力为痛无力虚寒此言迟脉之为病也迟为阴脉五脏为阴故主脏（难经
九难曰）迟者脏也又曰迟则为寒（伤寒论亦曰）迟为在脏以阳气伏潜不能健行故至数迟耳迟
而
有力有壅实不通利之意痛可想见迟云阳伏而又无力焉虚寒必矣
数脉主腑主吐主狂有力为热无力为疮此言数脉之为病也数脉为阳六腑亦为阳故主腑（难
经九经曰）数者腑也又曰数则为热（伤寒论亦曰）数为在腑此以迟数分阴阳配脏腑耳数脉主
吐
者吐则胃气逆乱主狂者狂则神志昏迷（难经二十难曰）重阳者狂又（病能论曰）狂生于阳也
观此
则狂病之见数脉明矣数而有力聚热所鼓数而无力虽有热而虚散热散于外发疮之候也
沉脉主里证、主寒证、主积滞。有力者为痰食阻滞，无力者为气机郁结。沉迟脉主虚寒，沉数脉主热邪内伏，沉紧脉主冷痛，沉缓脉主水湿停蓄，沉牢脉主顽固性冷证，沉实脉主热极，沉弱脉主阴虚，沉细脉主痹症与湿邪，沉弦脉主饮邪与疼痛，沉滑脉主宿食停滞，沉伏脉主呕吐泄泻及阴毒积聚。以上论述的是沉脉兼见其他脉象时的主病意义。
脉象按至骨方得者称为沉脉，故曰主里证。寒邪乃水寒之邪，积滞乃脏腑之积，均可见沉脉。沉而有力，说明里有实物，非痰即食；沉而无力，说明里本不虚，只是气机不舒展。沉脉在里，若兼见迟脉，则虚寒可断；沉脉在里，若兼见数脉，则热邪内伏无疑。沉而紧，因寒邪收敛致实，故为冷痛；沉而缓，因阳气不健运，故水湿停蓄；沉而牢，乃阴寒之邪滞留不去，应当是顽固性冷证；沉而实，是阳气聚结搏击，适宜于热邪深重。沉而阴弱即为虚，沉弱必主阴虚。沉脉主里，细脉主湿，沉细相兼定成痹症与湿邪。沉脉属阴，弦脉主饮，沉弦相兼则饮邪停于腹部阴分而时时作痛。沉脉主里，滑脉主食，沉滑相兼则宿食停留肠中难以推荡排出。沉脉之气已沉于骨，伏脉则按至骨若无，病情甚为笃重危急。需分辨病程之久暂：暴病者既吐且利而突然脱失，用温补法可挽回；久病者则是阴毒积聚日久阻塞，非峻猛攻下之法不能治愈。
迟脉主脏病，因阳气伏潜。有力者为痛证，无力者为虚寒证。以上论述迟脉所致疾病。迟脉为阴脉，五脏属阴，故主脏病（《难经·九难》说：“迟者脏也”），又说“迟则为寒”（《伤寒论》也说）：迟脉表示病在脏，因阳气伏潜不能健运运行，故脉搏至数迟缓。迟而有力，有壅实不通利之意，疼痛可以想见；迟而阳气伏潜又无力，则必为虚寒。
数脉主腑病、主呕吐、主狂证。有力者为热证，无力者为疮疡。以上论述数脉所致疾病。数脉为阳脉，六腑亦属阳，故主腑病（《难经·九经》说：“数者腑也”），又说“数则为热”（《伤寒论》也说）：数脉表示病在腑。这是以迟数和阴阳配属脏腑而言。数脉主呕吐，是因为呕吐则胃气逆乱；主狂证，是因为狂证则神志昏迷（《难经·二十难》说：“重阳者狂”），又（《素问·病能论》说）：“狂生于阳”。观此可知，狂病出现数脉是很明显的。数而有力，是聚热鼓动所致；数而无力，虽有热但属虚热，散热于外，是发疮的征候。
The deep pulse (Chen Mai, 沉脉) indicates interior syndromes, cold syndromes, and accumulation. If forceful, it indicates phlegm or food retention; if forceless, it indicates qi stagnation. A deep and slow pulse (Shen Chi Mai, 沉迟脉) indicates deficiency-cold; a deep and rapid pulse (Shen Shu Mai, 沉数脉) indicates latent heat; a deep and tight pulse (Shen Jin Mai, 沉紧脉) indicates cold pain; a deep and moderate pulse (Shen Huan Mai, 沉缓脉) indicates water retention; a deep and firm pulse (Shen Lao Mai, 沉牢脉) indicates entrenched cold; a deep and excess pulse (Shen Shi Mai, 沉实脉) indicates extreme heat; a deep and weak pulse (Shen Ruo Mai, 沉弱脉) indicates yin deficiency; a deep and fine pulse (Shen Xi Mai, 沉细脉) indicates bi-syndrome and dampness; a deep and wiry pulse (Shen Xian Mai, 沉弦脉) indicates fluid retention and pain; a deep and slippery pulse (Shen Hua Mai, 沉滑脉) indicates retained food; a deep and hidden pulse (Shen Fu Mai, 沉伏脉) indicates vomiting, diarrhea, and accumulation of yin-toxin. This discusses the principle of diseases indicated by the deep pulse combined with other pulses.
A pulse felt only when pressed to the bone is called deep, hence indicating interior syndromes. Cold refers to water-cold accumulation, and accumulation refers to organ accumulation, both presenting with a deep pulse. If deep and forceful, there is a pathogenic substance in the interior, either phlegm or food; if deep and forceless, the interior was originally not excess, but merely qi failing to flow smoothly. Since the deep pulse indicates an interior location, combined with a slow rate, deficiency-cold is certain; since the deep pulse indicates an interior location, combined with a rapid rate, latent heat is undeniable. If deep and tight, cold contracts and becomes solid, thus causing cold pain; if deep and moderate, yang fails to circulate vigorously, thus water accumulates; if deep and firm, it is stagnation of yin-cold, indicating entrenched cold; if deep and excess, yang qi gathers and struggles, suitable for deep-seated heat. Deep and yin-weak indicates deficiency; deep and weak must indicate yin deficiency. Deep indicates interior, fine indicates dampness; deep and fine definitely form bi-syndrome and dampness. Deep is yin, wiry indicates fluid retention; deep and wiry means fluid retention stops in the abdominal yin region, causing intermittent pain. Deep indicates interior, slippery indicates food; deep and slippery means retained food stays in the intestines and is difficult to expel. The qi of the deep pulse has sunk to the bone; the hidden pulse feels as if absent even at the bone, indicating a critical and severe condition. One must distinguish between acute and chronic cases: in acute cases, with sudden vomiting and diarrhea leading to collapse, warming and tonification can restore health; in chronic cases, long-standing accumulation of yin-toxin blocks the body, requiring harsh purgation to cure.
The slow pulse (Chi Mai, 迟脉) indicates zang-organ diseases due to latent yang qi. Forceful indicates pain; forceless indicates deficiency-cold. This discusses diseases caused by the slow pulse. The slow pulse is a yin pulse, and the five zang organs are yin, hence it indicates zang diseases (as stated in *Nan Jing* Chapter 9: "Slow indicates zang"), and also "Slow indicates cold" (*Shang Han Lun* also states): slow pulse indicates disease in the zang organs because yang qi is latent and cannot circulate vigorously, resulting in a slow pulse rate. Slow and forceful implies obstruction and excess preventing free flow, so pain can be imagined; slow with latent yang and forceless must be deficiency-cold.
The rapid pulse (Shu Mai, 数脉) indicates fu-organ diseases, vomiting, and mania. Forceful indicates heat; forceless indicates sores/ulcers. This discusses diseases caused by the rapid pulse. The rapid pulse is a yang pulse, and the six fu organs are also yang, hence it indicates fu-organ diseases (as stated in *Nan Jing*: "Rapid indicates fu"), and also "Rapid indicates heat" (*Shang Han Lun* also states): rapid pulse indicates disease in the fu organs. This distinguishes yin and yang by slow and rapid rates, matching them to zang and fu organs. The rapid pulse indicates vomiting because vomiting involves rebellion of stomach qi; it indicates mania because mania involves confusion of spirit and mind (as stated in *Nan Jing* Chapter 20: "Extreme yang leads to mania"), and also (*Su Wen* Chapter on Disease Capabilities): "Mania arises from yang." From this, it is clear that mania presents with a rapid pulse. Rapid and forceful indicates heat gathering and driving; rapid and forceless, although there is heat, it is deficient heat, dissipating outward, which is a sign of developing sores/ulcers.