数则呼吸定息每见五至六至，应指甚速。凡滑动紧促（四脉）皆属数类。不似滑脉之往来流利，动脉
之厥厥动摇，疾脉之过于急疾也，（语出张璐。又濒湖体状诗曰∶数脉息间常六至，阴微阳盛必狂烦；浮沉表
里分虚实，惟有童儿作吉看。又相类诗曰∶数比平人多一至，紧来如数似弹绳；数而时止名为促，
数见关中动脉形。又曰∶七至为极为疾，八至为脱，九至为绝。）数为寒热内搏，风火冲激。是以人见数脉，多作热治。
讵知脉有真假，数有虚实，仍须察其兼症兼脉（眼意周到），
及脉有力无力，以为分耳。若使数兼洪滑，且极有力，或者内热蒸腾，伏火发动，当作实看。如系细小强滑
细数绵软，纵有身热，须宜温治。或引阳归阴，其数自平；或补精化气，其数自除；或温中发表，其气自舒；
或宣壅去滞，其数自消。矧有并无热候，症有虚寒，脉见虚数，温补尚恐不及，其可以数为热，妄用苦寒之味
乎。（景岳曰∶里数为热，而真热者未必数。凡虚损之症，阴阳俱困，气血张皇，多有是候。林之翰曰∶数脉
须知主寒。如脉浮数大而无力，按之豁然而空，此阴盛逼阳外浮，是寒焰也。医家竟不审病新久，有力无
力，鼓与不鼓，一概混投寒剂，遽绝胃气，可不畏哉。）
迟则呼吸定息不及四至，举按皆迟。凡代涩结伏，皆属迟类。不似涩脉之三五不调，缓脉之去
来徐缓也。（语出张璐。又濒湖诗曰∶迟来一息至惟三，阳不胜阴气血寒；但把浮沉分表里，消阴须益火之原。
又相类诗曰∶脉来三至号为迟，少快于迟作缓持；迟细而难知是涩，浮而迟大以虚推。又曰∶二至为
败。）迟为虚寒不振，阳气不舒，故见迟滞。若迟而见浮，则为表寒；迟而见沉，则为里寒；迟而见涩，则为
血病；迟而见滑，则为气病；迟兼滑大，则多风痰头痹；迟兼细小，则为真阳亏弱；或阴寒留蓄而为泄泻，或
元气不营于表而寒栗拘挛，总皆元气亏损，不可妄施攻击。然亦有热邪内结，寒气外郁，而见气口脉迟者；又
有阳
明腑症悉具，而见脉迟有力者；又有太阳脉浮。因误下结胸，而见脉迟者；又有余热未清，而脉多迟滞。总
在知脉起止，及察症候以分虚实，讵可一见脉迟，便认为寒，而不究其滑涩虚实之异哉。（景岳曰∶迟虽为寒。
凡伤寒初退，余热未清，脉多迟滑，见迟不可以概言寒。林之翰曰∶迟脉须知主热。如热邪壅结，隧道不利，
失其常度，脉反变迟。又云∶辨脉必须合症审察。如举按无力，是主寒之迟脉；举按有力，症兼胸膈饱满，便
闭溺赤，是主热之迟脉。涩滞正是热邪蕴结于内，致经脉涩滞而行迟也。）
数脉表现为医生一呼一吸之间，脉搏跳动达到五至六次，指下感觉非常快速。凡是滑脉、动脉、紧脉、促脉这四种脉象，都属于数脉的范畴。它们不像滑脉那样往来流利，不像动脉那样厥厥动摇，也不像疾脉那样过于急疾。（这段话出自张璐。另外李时珍《濒湖脉学》体状诗说：数脉在呼吸之间常为六至，阴气微弱阳气盛则必然出现狂躁烦闷；需根据浮沉表里来分辨虚实，只有儿童出现数脉视为吉利。相类诗又说：数脉比正常人多一次跳动，紧脉似数脉但按之如弹绳；数脉而时有停止称为促脉，数脉出现在关部且呈动脉形态。又说：七至脉为极脉，八至脉为脱脉，九至脉为绝脉。）数脉多因寒热邪气在内搏结，风火冲激所致。因此人们见到数脉，大多当作热证治疗。哪里知道脉有真假之分，数脉也有虚实之别，仍然需要观察其兼夹的症状和脉象（考虑周全），以及脉象有力还是无力，以此来区分。如果数脉兼见洪大滑利，且极其有力，可能是内热蒸腾，伏火发动，应当当作实证看待。如果是细小而强滑，或细数绵软，即使身体发热，也适宜用温法治疗。或者引阳入阴，其数脉自然平息；或者补精化气，其数脉自然消除；或者温中解表，其气机自然舒畅；或者宣通壅滞，其数脉自然消散。况且有的根本没有热象，症状表现为虚寒，脉象呈现虚数，使用温补恐怕还来不及，怎么能因为脉数就认为是热证，妄用苦寒的药物呢？（张景岳说：里证见数脉多为热，但真正的热证未必都见数脉。凡是虚损的病证，阴阳俱困，气血慌张，多有这种脉候。林之翰说：数脉须知主寒。如脉浮数大而无力，重按豁然空虚，这是阴盛逼迫阳气外浮，是假热的表现。医家如果不审察病情的新久，脉象的有力无力，鼓动与否，一概混投寒凉药剂，迅速断绝胃气，难道不令人畏惧吗？）
迟脉表现为医生一呼一吸之间，脉搏跳动不足四次，轻取重按都觉得迟缓。凡是代脉、涩脉、结脉、伏脉，都属于迟脉的范畴。它们不像涩脉那样三五不调，不像缓脉那样去来徐缓。（这段话出自张璐。另外李时珍诗说：迟脉一息仅跳三次，阳气不胜阴气故气血寒；只需通过浮沉分辨表里，消除阴寒必须益火之源。相类诗又说：脉来三至称为迟，稍快于迟的为缓脉；迟而细难以辨知的是涩脉，浮而迟大推之为虚脉。又说：二至脉为败脉。）迟脉多因虚寒不振，阳气不舒展，所以出现迟滞。如果迟脉兼见浮象，则为表寒；迟脉兼见沉象，则为里寒；迟脉兼见涩象，则为血分病变；迟脉兼见滑象，则为气分病变；迟脉兼见滑大，多属风痰引起的头痹；迟脉兼见细小，则为真阳亏弱；或者是阴寒留滞体内导致泄泻，或者是元气不能荣养体表导致寒战拘挛，总归都是元气亏损，不可妄施攻伐。然而也有热邪内结，寒气外郁，而见气口脉迟的情况；又有阳明腑实证悉具，而见脉迟有力的情况；又有太阳病脉浮，因误下导致结胸，而见脉迟的情况；还有余热未清，而脉多迟滞的情况。关键在于知晓脉象的起止规律，以及观察症状来分辨虚实，怎么能一见脉迟，就认定为寒证，而不探究其滑涩虚实的差异呢？（张景岳说：迟脉虽主寒，但凡是伤寒初退，余热未清，脉多迟滑，见到迟脉不可以一概说是寒证。林之翰说：迟脉须知主热。如热邪壅结，经络不利，失去常态，脉反而变迟。又说：诊脉必须结合症状审察。如举按无力，是主寒的迟脉；举按有力，症状兼见胸膈饱满，便秘尿赤，是主热的迟脉。涩滞正是热邪蕴结于内，致使经脉涩滞而行进迟缓。）
Shu Mai (Rapid Pulse) manifests as five to six beats per respiration cycle, feeling very rapid under the fingers. The Hua Mai (Slippery Pulse), Dong Mai (Pulsating Pulse), Jin Mai (Tight Pulse), and Cu Mai (Hasty Pulse) all belong to the category of Shu Mai. They do not resemble the smooth flow of the Slippery Pulse, the trembling motion of the Pulsating Pulse, nor the excessive urgency of the Ji Mai (Excessively Rapid Pulse). (This statement is from Zhang Lu. Additionally, Li Shizhen's *Binhu Maixue* states in the "Form" poem: "In each breath, the Rapid pulse often beats six times; Yin deficiency and Yang excess inevitably lead to mania and restlessness; distinguish deficiency and excess by floating and sunken, superficial and deep; only in children is it considered auspicious." In the "Similarity" poem, he adds: "The Rapid pulse beats one time more than the normal pulse; the Tight pulse resembles the Rapid but feels like a plucked string; when the Rapid pulse stops intermittently, it is named Cu Mai; when the Rapid pulse appears at the Guan position with the form of the Pulsating Pulse." He also says: "Seven beats per breath is the Ji Mai (Extreme Pulse), eight beats is Tuo Mai (Depletion Pulse), and nine beats is Jue Mai (Severed Pulse)." Shu Mai is caused by the internal struggle between cold and heat, or the impact of wind and fire. Therefore, when people see a Rapid pulse, they mostly treat it as a Heat syndrome. However, one must know that pulses have true and false distinctions, and Rapid pulses have deficiency and excess variations. It is necessary to observe accompanying symptoms and pulses, as well as whether the pulse is forceful or weak, to differentiate them. If the Rapid pulse is accompanied by Hong (Surging) and Hua (Slippery) qualities and is extremely forceful, it may indicate steaming internal heat or the activation of latent fire, and should be treated as an Excess condition. If it is fine, small, yet strong and slippery, or fine, rapid, and soft, even if there is body fever, warm treatment is required. One might guide Yang back into Yin, causing the rapidness to subside naturally; or tonify essence to transform Qi, causing the rapidness to disappear naturally; or warm the middle and release the exterior, allowing Qi to relax naturally; or disperse congestion and remove stagnation, causing the rapidness to vanish naturally. Moreover, in cases where there are no heat signs and symptoms indicate deficiency-cold, presenting a Xu (Deficient) and Rapid pulse, warm tonification might still be insufficient. How can one mistakenly use bitter-cold herbs simply because the pulse is rapid? (Zhang Jingyue said: "Interior Rapid pulses indicate heat, but true heat syndromes do not always present with a Rapid pulse. In cases of deficiency and damage, where both Yin and Yang are distressed and Qi and Blood are chaotic, such pulses are common. Lin Zhihan said: 'One must understand that Rapid pulses can indicate Cold.' For example, if the pulse is Floating, Rapid, large, and weak, and hollow upon deep pressure, this is Yin excess forcing Yang to float outward, representing false heat. Physicians who fail to examine the duration of the disease, the forcefulness of the pulse, and its pulsatory strength, indiscriminately administering cold agents, rapidly destroying Stomach Qi, should not this be feared?)"
Chi Mai (Slow Pulse) manifests as fewer than four beats per respiration cycle, feeling slow upon both light and heavy pressure. Dai Mai (Intermittent Pulse), Se Mai (Choppy Pulse), Jie Mai (Knotted Pulse), and Fu Mai (Deeply Hidden Pulse) all belong to the category of Chi Mai. They do not resemble the irregular rhythm of the Choppy Pulse or the leisurely pace of the Huan Mai (Moderate Pulse). (This statement is from Zhang Lu. Additionally, Li Shizhen's poem states: "The Slow pulse beats three times per breath; Yang fails to overcome Yin, resulting in cold Qi and Blood; distinguish superficial and deep to determine exterior and interior; eliminate Yin cold by benefiting the source of Fire." In the similarity poem, he adds: "Three beats per breath is called Slow; slightly faster than Slow is Moderate; Slow and fine and difficult to discern is Choppy; Floating, Slow, and large is inferred as Deficiency." He also says: "Two beats per breath is Bai Mai (Decayed Pulse)." Chi Mai is due to deficiency-cold failing to flourish and Yang Qi failing to circulate freely, thus appearing sluggish. If Chi Mai presents with a Floating quality, it indicates Exterior Cold; if with a Sunken quality, Interior Cold; if with a Choppy quality, Blood pathology; if with a Slippery quality, Qi pathology; if accompanied by Slippery and Large qualities, it often indicates Wind-Phlegm causing head bi-syndrome; if accompanied by Fine and Small qualities, it indicates deficiency of True Yang; if Yin-Cold accumulates internally leading to diarrhea, or Yuan Qi fails to nourish the exterior leading to chills and spasms, these are all due to Yuan Qi deficiency, and aggressive attack therapies should not be used rashly. However, there are cases where pathogenic Heat is knotted internally and Cold is constrained externally, resulting in a Slow pulse at the Qikou position; there are cases where all Yangming Fu-organ symptoms are present, yet the pulse is Slow but forceful; there are cases where Taiyang disease presents with a Floating pulse, but after mistaken purgation leads to Jie Xiong (Chest Binding), the pulse becomes Slow; and there are cases where residual heat remains unclarified, resulting in a generally Slow and sluggish pulse. The key lies in understanding the onset and termination of the pulse and observing symptoms to differentiate deficiency and excess. How can one simply identify a Slow pulse as Cold without investigating the differences in Slipperiness, Choppy nature, deficiency, and excess? (Zhang Jingyue said: "Although Slow pulses typically indicate Cold, after the initial resolution of Shanghan (Cold Damage), when residual heat remains, the pulse is often Slow and Slippery. Seeing a Slow pulse does not allow for a general conclusion of Cold. Lin Zhihan said: 'One must understand that Slow pulses can indicate Heat.' For instance, when pathogenic Heat is congested and collaterals are obstructed, losing their normal rhythm, the pulse may paradoxically become Slow. He further stated: 'Differentiating pulses requires combining them with symptom examination.' If the pulse is weak upon lifting and pressing, it indicates Cold; if forceful upon lifting and pressing, accompanied by chest/diaphragm fullness, constipation, and dark urine, it indicates Heat. The choppy/sluggish sensation is precisely due to pathogenic Heat accumulating internally, causing meridians to become sluggish and the pulse to move slowly.)