《素问·玉机真脏论》岐伯曰∶春脉者，肝也，东方木也，万物之所以始生也，故其气来，软弱轻虚而
滑，端直以长，故曰弦，反此者病。帝曰∶何如而反？岐伯曰∶其气来，实而强，此谓太过，病在外；其气
来，不实而微，此谓不及，病在中。太过，则令人善忘，忽忽眩冒而巅疾；其不及，则令人胸痛引背，下则两
胁满。
春生夏长，秋收冬藏，气之流行，生化万物，肝应东方之木，其气柔嫩，故脉软弱，轻虚而滑，滑者，流
动也，端直以长而象弦，阳气调达也。凡五脏之脉，各有本脏之形，而春令弦象，为应时之平脉也，夏秋冬皆
然。若脉气之来，不轻虚而实，不柔和而强，此为太过，病在外者，外邪乘之，肝气郁逆，故令人善怒，风性
上摇，故忽忽眩冒，为巅顶之疾，谓目眩昏冒，巅
顶掣痛，以肝经之脉上顶，与督脉相会也；若其气来，不实而微，是为不及，而中虚之病，乏阳和生气，三焦
水道不宣，上则胸窒，痹痛引背，下则两 及胁虚满，经所云∶脏寒生满病也。须用补阳以和阴，不可作实痛
实满而用攻散也。 者，胁下软处，皆肝经所行之部也。
夏脉者，心也，南方火也，万物之所以盛长也，故其气来盛去衰，故曰钩，反此者病。帝曰∶何如而反？
岐伯曰∶其气来盛，去亦盛，此为太过，病在外；其气来不盛，去反盛，此为不及，病在中。太过，则令人身
热而肤痛，为浸淫；其不及，则令人烦心，上见咳唾，下为气泄。
阴阳生化之机，无非升降出入。夏令阳气升浮出外，故万物盛长，人身之气应之，故脉气升多出多，为来
盛，降少入少，为去衰，而其形如钩也。若来去皆盛，为太过，心火感召外火，火邪劫烁津液而肤痛，热邪弥
漫营卫，如水之浸淫于周身也；若脉气来不盛，去反盛，是升出少，而降入多，其阳内虚，心气不足以荣养，
故心烦不宁，中虚津液不化，气滞痰凝，上见咳唾，下则时泄秽气，此因火虚，而脾土不实也。
秋脉者，肺也，西方金也，万物之所以收成也，故其气来，轻虚以浮，来急去散，故曰浮，反此者病。帝
曰∶何如而反？岐伯曰∶其气来，毛而中央坚，两旁虚，此为太过，病在外；其气来，毛而微，此为不及，
病在中。太过，则令人逆气而背痛，愠愠然；其不及，则令人喘，呼吸少气而咳，上气见血，下闻病音。
秋令阳气下降入地，万物成实，夏脉之浮洪，转为轻浮，来急者，收束绷急之象，去散者，阳气下降之象，
以其浮部轻
虚，故名毛脉。若其气来毛而中央坚、两旁虚，此本有内热，外凉收束，故中央坚，为太过之脉，令人肺气逆
而背痛，愠愠然者，郁闷不快之状也；其气来毛而微者，按之虚微无力，此为不及之脉，病在中气虚，故喘息，
而呼吸少气且咳，气虚不能摄血，随咳而出，喉下闻痰阻之病音也。
冬脉者，肾也，北方水也，万物之所以合藏也，故其气来，沉以搏，故曰营，反此者病。帝曰∶何如而
反？岐伯曰∶其气来如弹石者，此为太过，病在外∶其去如数者，此为不及，病在中。太过，则令人解 。脊
脉痛，而少气不欲言；其不及，则令人心悬如病饥， 中清，脊中痛，少腹满，小便变。
冬令阳气尽入于地，万物归藏，故脉气之来沉以搏，是浮按不足，沉按有力也。阳藏而营运于内，故名营，
以沉部有力，故又名石脉也。若其气来如弹石，则少柔和之气，此为太过之脉，病在外者，精伤阳气外露不固，
故经脉懈弛，病名解 ，而脊脉痛，元气耗散，故少气不欲言也；其去如数者，降入之气速，则鼓动之力弱，
此为不及之脉，病在中，心悬如饥者，中气空虚，心少主宰，如悬宕似饥，而又不能食也， 中清冷，脊痛，
者，软腰，脊属督脉，皆肾虚肝郁，故少腹满，小便变其常，或短或涩，乃下焦气化无权也。此两证，皆内
伤之病。
帝曰∶四时之序，逆从之变异也，然脾脉独何主？岐伯曰∶脾脉者，土也，孤脏以灌四旁者也。帝曰∶然
则脾善恶可得见之乎？岐伯曰∶善者不可得见，恶者可见。其来如水之流者，此为太过，病在外；如鸟之喙
者，此为不及，病在中。太过，则令人四肢不举；其不及，则令人九窍不通，名曰重强。
弦钩毛石之脉，合春夏秋冬之气，其有逆从变异，即可验病之吉凶。惟脾土居五行之中，故为孤脏，鼓运
输布胃中水谷精气，以灌溉上下四旁，故凡弦钩毛石之脉，皆以和缓之象为本者，是脾胃之气，故云其善处不
可得见也。恶者，其脉来如水之流者，柔弱太过，即前所云∶弱多胃气少之病脉也，盖弱则不能输布胃气，以
达四肢，故四肢无力，不能举也，其气有升降，而无出入，故如水之流，则无鼓动之力矣；其脉来如鸟之喙者，
坚锐动数，是柔缓之气不及也，因而升降不调，清浊淆混，则九窍不能通利，内外壅滞，故名重强，谓邪实也。
此柔缓之气不及，与上之柔弱太过，皆未得脾胃中和之气而致病也。
《素问·玉机真脏论》中，岐伯说：春脉对应肝脏，位于东方，五行属木，是万物开始生长的时节，所以它的脉气来时，软弱、轻虚而滑利，形态端直且长，因此称为弦脉；如果与此相反，就是病脉。黄帝问：怎样算是相反呢？岐伯说：如果脉气来时，坚实而强劲，这叫做“太过”，病位在体表（外）；如果脉气来时，不充实而微弱，这叫做“不及”，病位在体内（中）。脉气太过，就会使人容易健忘，时常感到头晕目眩甚至头部疾病；脉气不及，就会使人胸痛并牵引至背部，向下则导致两侧胁肋部胀满。
春季生发、夏季生长、秋季收敛、冬季闭藏，这是气的流行规律，化生养育万物。肝对应东方的木，其气柔嫩，所以脉象软弱、轻虚而滑利。“滑”的意思是流动，“端直以长”像琴弦一样，象征阳气调达舒畅。大凡五脏的脉象，各有本脏的形状，而春季的弦象，是顺应时令的正常平脉，夏、秋、冬三季也是如此。如果脉气来时，不轻虚反而实，不柔和反而强，这就是“太过”。病在体表的，是外邪侵袭，肝气郁结逆乱，所以使人容易发怒；风性主动向上摇动，所以使人突然头晕目眩，发生头顶部的疾病，即眼睛昏花眩晕，头顶掣痛，因为肝经的脉络上行至头顶，与督脉相交会。如果脉气来时，不充实反而微弱，这就是“不及”，属于中焦虚弱的病证，缺乏阳气和和煦的生发之气，三焦水道不通畅，向上则胸部窒塞，痹痛牵引背部，向下则两胁及胁下软处虚满。经文所说：“脏腑寒冷产生胀满病”。必须用补阳的方法来调和阴气，不可当作实证疼痛或实证胀满而使用攻伐消散的方法。“胁”是指胁下的软处，都是肝经所经过的部位。
夏脉对应心脏，位于南方，五行属火，是万物盛大生长的时节，所以它的脉气来时旺盛，去时衰弱，因此称为钩脉；如果与此相反，就是病脉。黄帝问：怎样算是相反呢？岐伯说：如果脉气来时旺盛，去时也旺盛，这叫“太过”，病在体表；如果脉气来时不旺盛，去时反而旺盛，这叫“不及”，病在体内。脉气太过，就会使人身体发热且皮肤疼痛，症状像浸淫疮一样蔓延；脉气不及，就会使人心中烦闷，向上可见咳嗽吐痰，向下可见气泄（如失禁或排气过多）。
阴阳化生万物的机理，无非是升降出入。夏令阳气升浮出于体外，所以万物盛大生长，人身之气与之相应，所以脉气升出多而入内少，表现为“来盛”，降入少而出内少，表现为“去衰”，其形状像钩子。如果来去都旺盛，就是“太过”，心火感召外火，火邪劫灼津液导致皮肤疼痛，热邪弥漫于营卫之间，就像水浸淫于周身一样；如果脉气来不旺盛，去反而旺盛，说明升出少而降入多，体内阳气虚弱，心气不足以荣养心神，所以心烦不宁，中焦虚弱导致津液不化，气滞痰凝，向上出现咳嗽吐痰，向下出现排泄秽气，这是因为心火虚弱，导致脾土不实。
秋脉对应肺脏，位于西方，五行属金，是万物收成成熟的时节，所以它的脉气来时，轻虚而浮，来势急而去势散，因此称为浮脉（毛脉）；如果与此相反，就是病脉。黄帝问：怎样算是相反呢？岐伯说：如果脉气来时，像羽毛一样但中央坚硬、两旁虚弱，这叫“太过”，病在体表；如果脉气来时，像羽毛一样但微弱，这叫“不及”，病在体内。脉气太过，就会使人气逆且背痛，心情郁闷不快；脉气不及，就会使人喘息，呼吸短促且咳嗽，上部咳血，下部听到病变的声音。
秋令阳气下降入地，万物成熟结实，夏脉的浮洪之象转为轻浮。“来急”是收束绷急的景象，“去散”是阳气下降的景象，因为其浮取部位轻虚，所以称为毛脉。如果脉气来时像羽毛但中央坚硬、两旁虚弱，这说明本有内热，被外凉收束，所以中央坚硬，这是太过的脉象，使人肺气上逆且背痛，“愠愠然”是郁闷不快的状态；如果脉气来时像羽毛但微弱，按之虚微无力，这是不及的脉象，病在中气虚弱，所以喘息，呼吸短促且咳嗽，气虚不能摄血，血液随咳而出，喉下可听到痰阻的病变声音。
冬脉对应肾脏，位于北方，五行属水，是万物闭藏的时节，所以它的脉气来时，沉而搏指有力，因此称为营脉（石脉）；如果与此相反，就是病脉。黄帝问：怎样算是相反呢？岐伯说：如果脉气来时像弹石一样坚硬，这叫“太过”，病在体表；如果脉气去时急促数乱，这叫“不及”，病在体内。脉气太过，就会使人肢体懈怠弛缓，脊柱疼痛，气少不想说话；脉气不及，就会使人心里空虚像生病时的饥饿感，膈中清冷，脊柱疼痛，小腹胀满，小便异常。
冬令阳气完全进入地下，万物归藏，所以脉气来时沉而搏指，是轻取不足，重按有力的表现。阳气潜藏并在体内营运，所以称为营脉，因为沉取有力，所以又名石脉。如果脉气来时像弹石一样，就缺少柔和之气，这是太过的脉象，病在体表的，是肾精受伤，阳气外露而不固，所以经脉懈弛，病名“解㑊”（肢体懈怠无力），脊柱疼痛，元气耗散，所以气少不想说话；如果脉气去时急促数乱，说明降入的气快，鼓动之力弱，这是不及的脉象，病在体内，心里空虚像饥饿，是因为中气空虚，心失主宰，像悬空似的饥饿，但又吃不下东西，膈中清冷，脊柱疼痛，“腰”是指软腰，脊柱属督脉，都是肾虚肝郁所致，所以小腹胀满，小便改变常态，或短少或涩滞，这是下焦气化功能无权的表现。这两种证候，都属于内伤病。
黄帝问：四季的顺序，有顺逆变化的差异，但是脾脉单独由什么主导呢？岐伯说：脾脉属土，是孤独的脏器，负责灌溉滋养四方（其他四脏）。黄帝问：那么脾脉的好坏可以看出来吗？岐伯说：好的脾脉看不出来，坏的脾脉可以看出来。脉气来时像水流一样，这叫“太过”，病在体表；脉气来时像鸟嘴一样坚锐，这叫“不及”，病在体内。脉气太过，就会使人四肢不能抬起；脉气不及，就会使人九窍不通，名叫“重强”。
弦、钩、毛、石四种脉象，分别合应春、夏、秋、冬四时之气，如果有逆从变异，就可以验证疾病的吉凶。只有脾土居于五行之中，所以被称为孤脏，它鼓动输布胃中的水谷精气，以灌溉上下四方，所以凡是弦、钩、毛、石的脉象，都以和缓为根本，这是脾胃之气的体现，所以说脾脉处于正常状态时是看不出来的。所谓“恶者”（坏脉），脉气来时像水流一样，是柔弱太过，即前面所说的“弱多胃气少”的病脉，因为弱就不能输布胃气到达四肢，所以四肢无力，不能抬起，这种气只有升降而没有出入的动力，所以像水流一样，没有鼓动之力；脉气来时像鸟嘴一样，坚锐动数，是柔缓之气不及，因而升降不调，清浊混淆，导致九窍不能通利，内外壅滞，所以名叫“重强”，意思是邪气实盛。这种柔缓之气不及，与上面的柔弱太过，都是因为未能得到脾胃中和之气而致病。
In the *Suwen: Yuji Zhenzang Lun* (Plain Questions: Discussion on the Jade Machine and True Viscera), Qibo stated: The spring pulse corresponds to the Liver, located in the East, belonging to Wood in the Five Elements. It is the time when all things begin to grow. Therefore, its qi comes forth soft, weak, light, empty, and slippery; it is straight and long, hence called the Xian (String-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth solid and strong, this is called "Excess" (Tai Guo), and the disease is in the Exterior. If the qi comes forth not solid but faint, this is called "Deficiency" (Bu Ji), and the disease is in the Interior. Excess leads to forgetfulness, sudden dizziness and vertigo, and diseases of the vertex (top of the head). Deficiency leads to chest pain radiating to the back, and downward, fullness in both hypochondriac regions.
Spring generates, Summer grows, Autumn harvests, Winter stores; this is the circulation of qi that transforms and produces all things. The Liver corresponds to the Wood of the East; its qi is tender and soft, so the pulse is soft, weak, light, empty, and slippery. "Slippery" means flowing. "Straight and long" resembles a string, symbolizing the free flow of Yang qi. Generally, the pulses of the five viscera each have the shape of their respective organ. The Xian (String-like) image in Spring is the normal pulse corresponding to the season, and the same applies to Summer, Autumn, and Winter. If the pulse qi comes forth not light and empty but solid, not soft but strong, this is "Excess." When the disease is in the Exterior, external pathogens attack, causing Liver qi to stagnate and rebel, leading to irritability. Since Wind nature moves upward and shakes, it causes sudden dizziness and vertigo, resulting in diseases of the vertex, such as blurred vision and pulling pain at the top of the head, because the Liver meridian ascends to the vertex and intersects with the Du Meridian. If the qi comes forth not solid but faint, this is "Deficiency," indicating a deficiency of the Middle Jiao, lacking Yang qi and harmonious vital energy. The water passages of the Sanjiao (Triple Burner) are not unblocked. Upward, there is chest stuffiness and bi-syndrome pain radiating to the back; downward, there is empty fullness in the hypochondrium and flanks. As the classic states: "Cold in the zang organs generates fullness diseases." One must use methods to tonify Yang to harmonize Yin, and one must not treat it as excess pain or excess fullness by using purgative or dispersing methods. "Hypochondrium" refers to the soft areas under the ribs, which are all parts traversed by the Liver meridian.
The summer pulse corresponds to the Heart, located in the South, belonging to Fire in the Five Elements. It is the time when all things flourish and grow. Therefore, its qi comes forth vigorous and departs waning, hence called the Gou (Hook-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth vigorous and departs also vigorous, this is "Excess," and the disease is in the Exterior. If the qi comes forth not vigorous but departs vigorously, this is "Deficiency," and the disease is in the Interior. Excess leads to body heat and skin pain, resembling an oozing eruption (Jin Yin). Deficiency leads to vexation in the heart, upward manifestation of cough and expectoration, and downward manifestation of qi leakage.
The mechanism of yin and yang transforming and producing life is nothing other than ascending, descending, exiting, and entering. In summer, Yang qi rises and floats outward, so all things flourish and grow. Human qi responds to this, so the pulse qi rises and exits much while entering little, manifesting as "coming forth vigorous"; it descends and enters little while exiting little, manifesting as "departing waning," and its shape is like a hook. If both coming and departing are vigorous, it is "Excess." Heart fire attracts external fire; Fire pathogen scorches body fluids causing skin pain, and Heat pathogen permeates Ying (Nutritive) and Wei (Defensive) levels, like water soaking throughout the body. If the pulse qi comes forth not vigorous but departs vigorously, it means less rising/exiting and more descending/entering. Internal Yang is deficient, and Heart qi is insufficient to nourish, causing mental restlessness and vexation. Middle deficiency fails to transform fluids, leading to qi stagnation and phlegm condensation. Upward, there is cough and expectoration; downward, there is occasional discharge of foul gas. This is due to deficient Fire failing to keep Spleen Earth solid.
The autumn pulse corresponds to the Lung, located in the West, belonging to Metal in the Five Elements. It is the time when all things mature and are harvested. Therefore, its qi comes forth light, empty, and floating; it arrives swiftly and scatters upon departure, hence called the Fu (Floating) or Mao (Feather-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth feather-like but firm in the center and empty on both sides, this is "Excess," and the disease is in the Exterior. If the qi comes forth feather-like but faint, this is "Deficiency," and the disease is in the Interior. Excess leads to rebellious qi and back pain, with a feeling of oppression. Deficiency leads to panting, shortness of breath, and cough, with blood appearing upward from the lungs, and pathological sounds heard downward.
In autumn, Yang qi descends into the earth, and all things become solid. The floating and洪 (surging) quality of the summer pulse turns to light floating. "Arriving swiftly" is the image of gathering tension; "scattering upon departure" is the image of Yang qi descending. Because the superficial layer is light and empty, it is named the Mao (Feather) pulse. If the qi comes forth feather-like but firm in the center and empty on both sides, it indicates internal heat constrained by external coolness, making the center firm. This is an Excess pulse, causing Lung qi to rebel and back pain. "Yun Yun Ran" describes a state of depression and discomfort. If the qi comes forth feather-like but faint, pressing reveals emptiness and weakness; this is a Deficiency pulse. Disease lies in deficient Middle qi, causing panting, shortness of breath, and cough. Qi deficiency fails to control blood, so blood appears with cough, and obstructive sounds are heard in the throat.
The winter pulse corresponds to the Kidney, located in the North, belonging to Water in the Five Elements. It is the time when all things are stored. Therefore, its qi comes forth deep and pounding, hence called the Ying (Camp/Nourishing) or Shi (Stone) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth like bouncing stones, this is "Excess," and the disease is in the Exterior. If the qi departs rapid and frequent, this is "Deficiency," and the disease is in the Interior. Excess leads to laxity of sinews and bones (Xie Ji), spinal pain, shortness of breath, and reluctance to speak. Deficiency leads to a sensation of hunger as if ill, coldness in the epigastrium, spinal pain, lower abdominal fullness, and changes in urination.
In winter, Yang qi fully enters the earth, and all things return to storage. Thus, the pulse qi comes forth deep and pounding, meaning insufficient upon light pressure but forceful upon heavy pressure. Yang is stored and circulates internally, hence called Ying (Nourishing); because it is forceful in the deep position, it is also called Shi (Stone) pulse. If the qi comes forth like bouncing stones, it lacks softness; this is an Excess pulse. When disease is in the Exterior, Jing (Essence) is injured, and Yang qi leaks out without consolidation. Thus, meridians become lax, a condition named Xie Ji (laxity), with spinal pain. Yuan Qi is scattered, causing shortness of breath and reluctance to speak. If the qi departs rapid and frequent, the descending qi is fast, but the driving force is weak; this is a Deficiency pulse. Disease lies in the Interior. A heart hanging like hunger occurs because Middle qi is empty, and the Heart lacks mastery, feeling suspended and hungry yet unable to eat. Coldness in the epigastrium and spinal pain occur. "Yao" refers to the soft waist. The spine belongs to the Du Meridian. These indicate Kidney deficiency and Liver stagnation, leading to lower abdominal fullness and abnormal urination, either scanty or difficult, due to powerless Qi transformation in the Lower Jiao. Both conditions are internal injuries.
The Yellow Emperor asked: The sequence of the four seasons has variations of compliance and rebellion. But what governs the Spleen pulse alone? Qibo replied: The Spleen pulse belongs to Earth. It is the solitary Zang organ that irrigates the four directions. The Yellow Emperor asked: Then can the good and bad of the Spleen pulse be seen? Qibo replied: The good cannot be seen; the bad can be seen. If it comes forth like flowing water, this is "Excess," and the disease is in the Exterior. If it comes forth like the beak of a bird, this is "Deficiency," and the disease is in the Interior. Excess leads to inability to lift the limbs. Deficiency leads to obstruction of the nine orifices, named Zhong Qiang (Heavy Stiffness).
The Xian, Gou, Mao, and Shi pulses correspond to the qi of Spring, Summer, Autumn, and Winter. Their rebellious or compliant variations allow one to verify the auspiciousness or inauspiciousness of the disease. Only Spleen Earth resides in the center of the Five Elements, hence called the solitary Zang. It drives and distributes the essence of grain and water from the Stomach to irrigate above, below, and around. Therefore, the pulses of Xian, Gou, Mao, and Shi all take harmony and slowness as their root, representing the Qi of the Spleen and Stomach. Thus, it is said that when the Spleen is in a healthy state, it is not visible. "Bad" refers to the pulse coming forth like flowing water, which is excessive softness, i.e., the pathological pulse mentioned earlier where weakness exceeds Stomach qi. Weakness fails to distribute Stomach qi to the limbs, causing limb weakness and inability to lift. Such qi has ascending and descending but lacks exiting and entering dynamics, so like flowing water, it lacks driving force. If the pulse comes forth like a bird's beak, it is firm, sharp, rapid, and numerous, indicating insufficient softness and slowness. Consequently, ascending and descending are disregulated, clear and turbid mix, causing the nine orifices to be obstructed and internal/external stagnation, hence named Zhong Qiang, meaning excess pathogenic factor. This insufficiency of softness/slowness, and the aforementioned excessive softness, both result from failing to obtain the harmonious middle qi of the Spleen and Stomach, leading to disease.