外邪脉。浮主风。迟主寒。紧主寒。缓主湿。细主湿。沉主湿。虚主暑。
内邪脉。数主火。洪主火。实主火。长主热。清主热。滑主痰。主食。弦主痰。主食。弦主痛。紧主痛。牢主痛。
短主痛。促结主痛。主久积。涩主痛。主痹。动主痛。主惊。代主痛主泄。实主胀。紧主胀。微主胀。细主胀。主吐。
伏主吐。
外邪兼见脉。浮紧主风寒。浮迟主风寒。浮缓主风湿。浮细主风湿。沉迟主寒湿。外邪内邪兼见脉。浮洪主风火。
浮数主风火。浮弦主风痰。浮滑主风痰。风热。浮长主风热。风痫。迟滑主胀。迟涩主瘕。紧滑主吐。紧涩主痹。缓滑
（主）热中。气虚脉。滑主气虚。代主气虚。沉无力。主气虚。血虚脉。涩主血虚。芤主血虚。洪主血虚。浮无力。主
血虚。气血两虚脉。微主气血两虚。窍主气血两虚。虚主气血两虚。细主气血两虚。浮迟无力。主气血两虚。沉数无力。
主气血两虚。
脉经。凡脉浮大数勤长滑为阳。沉微弦弱短涩为阴。阳病见阴脉者。过也。阴病见阳脉者。顺也。按脉之说。本仲
景伤寒论。在伤寒症。则阳病见阳脉者顺。阴病见阳脉者亦顺。若内伤病。阴病见阳脉者。又为逆也。经曰。阴病而阴
脉大者为逆。如虚劳失血之病。喜沉细阴脉。忌洪数阳脉是也。脉经不辨误。经脉从阴阳。病易已。按男子阳。左脉大
为从。女子阴。右脉大为从。春夏阳。脉浮大为从。秋冬阴。脉沉细为从。外感病。阳症见阳脉为从。阴症见阳脉亦为
从。内伤病。阳症见阳脉为从。阴症见阴脉亦为从。
四言脉诀。脉贵有神。李东垣曰。脉之不病。其神不言当自有也。脉既病。当求其中神之有无焉。如六数七极。热
也。脉中有力。即有神也。三迟二败。寒也。脉中有力。即有神也。热有神。当泄其热。则神在焉。寒有神。当去其寒。
则神在焉。寒热之脉。无力无神。将何药而泄热去寒乎。按东垣以脉中有力为神。固是也。然所谓神者。即胃气也。经
曰脉弱以滑。是有胃气。又曰滑则从。涩则逆。故五脏骨肉。滑利可以长久。以此与脉中有力合参。则得之矣。滑伯仁
谓东垣脉中有力之中字。乃浮中沉之中。其意盖谓脾居中州。以中候有力为神。然则沉脉者。其神将何以候之乎。伯仁
误矣。
外邪所致脉象。浮脉主风邪。迟脉主寒邪。紧脉主寒邪。缓脉主湿邪。细脉主湿邪。沉脉主湿邪。虚脉主暑邪。
内邪所致脉象。数脉主火邪。洪脉主火邪。实脉主火邪。长脉主热邪。清（指脉来清晰流利）主热邪。滑脉主痰饮、主食积。弦脉主痰饮、主食积。弦脉主痛证。紧脉主痛证。牢脉主痛证。短脉主痛证。促脉、结脉主痛证，且主久病积聚。涩脉主痛证，主痹证。动脉主痛证，主惊悸。代脉主痛证，主泄泻。实脉主胀满。紧脉主胀满。微脉主胀满。细脉主吐逆。伏脉主吐逆。
外邪兼见脉象。浮紧脉主风寒。浮迟脉主风寒。浮缓脉主风湿。浮细脉主风湿。沉迟脉主寒湿。
外邪与内邪兼见脉象。浮洪脉主风火。浮数脉主风火。浮弦脉主风痰。浮滑脉主风痰。浮长脉主风热。迟滑脉主胀满。迟涩脉主瘕聚（腹中结块）。紧滑脉主呕吐。紧涩脉主痹证。缓滑脉主中焦有热。
血虚脉象。涩脉主血虚。芤脉主血虚。洪脉主血虚。浮而无力主血虚。
气血两虚脉象。微脉主气血两虚。弱脉主气血两虚。虚脉主气血两虚。细脉主气血两虚。浮迟而无力主气血两虚。沉数而无力主气血两虚。
《脉经》说：凡是脉象浮、大、数、疾、长、滑的属于阳脉；沉、微、弦、弱、短、涩的属于阴脉。阳病见到阴脉，是病情加重（逆）；阴病见到阳脉，是病情好转（顺）。关于按脉的说法，本源于张仲景的《伤寒论》。在伤寒病症中，阳病见到阳脉为顺，阴病见到阳脉也为顺。如果是内伤杂病，阴病见到阳脉，反而被认为是逆证。医经说：阴病而脉象大的为逆证。例如虚劳失血这类疾病，喜欢见到沉细的阴脉，忌讳见到洪数的阳脉。《脉经》没有辨析清楚这一点。经脉顺应阴阳规律，疾病就容易痊愈。对于男子属阳，左手脉大为从（顺）；女子属阴，右手脉大为从（顺）。春夏季节属阳，脉象浮大为从（顺）；秋冬季节属阴，脉象沉细为从（顺）。外感病，阳证见到阳脉为从（顺），阴证见到阳脉也为从（顺）。内伤病，阳证见到阳脉为从（顺），阴证见到阴脉也为从（顺）。
《四言脉诀》说：脉象贵在有神。李东垣说：脉象未病时，其神不言自明，自然存在。脉象既已生病，应当探求其中是否有“神”。如六至为数脉，七至为极脉，这是热证，若脉中有力，就是有神。三至为迟脉，二至为败脉，这是寒证，若脉中有力，就是有神。热证而有神，应当清泄其热，那么神就存在于体内了。寒证而有神，应当祛除其寒，那么神就存在于体内了。如果寒热之脉，无力无神，用什么药物来泄热去寒呢？按照李东垣的观点，以脉中有力为神，这固然是对的。然而所谓的“神”，其实就是胃气。医经说：脉象软弱而滑利，是有胃气的表现。又说：滑利则顺，涩滞则逆。所以五脏和骨肉滑利，可以长久健康。将此观点与脉中有力结合起来参详，就能明白了。滑伯仁认为李东垣所说的“脉中有力”中的“中”字，是指浮、中、沉三部取脉法中的“中候”。他的意思大概是认为脾居中州，以中候有力为神。然而对于沉脉来说，它的“神”又该如何诊察呢？滑伯仁的理解是错误的。
Pulse of External Pathogens. A floating pulse indicates Wind pathogen. A slow pulse indicates Cold pathogen. A tight pulse indicates Cold pathogen. A relaxed pulse indicates Dampness pathogen. A fine pulse indicates Dampness pathogen. A deep pulse indicates Dampness pathogen. A deficient pulse indicates Summerheat pathogen.
Pulse of Internal Pathogens. A rapid pulse indicates Fire pathogen. A flooding pulse indicates Fire pathogen. A full pulse indicates Fire pathogen. A long pulse indicates Heat pathogen. A clear pulse indicates Heat pathogen. A slippery pulse indicates Phlegm-fluids or Food retention. A wiry pulse indicates Phlegm-fluids or Food retention. A wiry pulse indicates Pain syndrome. A tight pulse indicates Pain syndrome. A firm pulse indicates Pain syndrome. A short pulse indicates Pain syndrome. A hurried pulse or a knotted pulse indicates Pain syndrome, and also indicates long-standing accumulation. A choppy pulse indicates Pain syndrome, and also indicates Bi syndrome (painful obstruction). A moving pulse indicates Pain syndrome, and also indicates Fright. A intermittent pulse indicates Pain syndrome and Diarrhea. A full pulse indicates Distension. A tight pulse indicates Distension. A minute pulse indicates Distension. A fine pulse indicates Vomiting. A hidden pulse indicates Vomiting.
Combined Pulses of External Pathogens. A floating-tight pulse indicates Wind-Cold. A floating-slow pulse indicates Wind-Cold. A floating-relaxed pulse indicates Wind-Dampness. A floating-fine pulse indicates Wind-Dampness. A deep-slow pulse indicates Cold-Dampness.
Combined Pulses of External and Internal Pathogens. A floating-flooding pulse indicates Wind-Fire. A floating-rapid pulse indicates Wind-Fire. A floating-wiry pulse indicates Wind-Phlegm. A floating-slippery pulse indicates Wind-Phlegm. A floating-long pulse indicates Wind-Heat. A slow-slippery pulse indicates Distension. A slow-choppy pulse indicates Masses (Jia Ju). A tight-slippery pulse indicates Vomiting. A tight-choppy pulse indicates Bi syndrome. A relaxed-slippery pulse indicates Heat in the Middle Jiao.
Pulse of Qi Deficiency. A slippery pulse indicates Qi deficiency. An intermittent pulse indicates Qi deficiency. A deep pulse without force indicates Qi deficiency.
Pulse of Blood Deficiency. A choppy pulse indicates Blood deficiency. A scallion-stalk pulse indicates Blood deficiency. A flooding pulse indicates Blood deficiency. A floating pulse without force indicates Blood deficiency.
Pulse of Combined Qi and Blood Deficiency. A minute pulse indicates Combined Qi and Blood deficiency. A weak pulse indicates Combined Qi and Blood deficiency. A deficient pulse indicates Combined Qi and Blood deficiency. A fine pulse indicates Combined Qi and Blood deficiency. A floating-slow pulse without force indicates Combined Qi and Blood deficiency. A deep-rapid pulse without force indicates Combined Qi and Blood deficiency.
The *Mai Jing* (Classic of Pulse Diagnosis) states: Pulses that are floating, large, rapid, frequent, long, and slippery belong to Yang; pulses that are deep, minute, wiry, weak, short, and choppy belong to Yin. When a Yang disease presents with a Yin pulse, it is adverse (Guo); when a Yin disease presents with a Yang pulse, it is favorable (Shun). The theory of pulse diagnosis originates from Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage). In cases of Shanghan syndrome, a Yang disease presenting with a Yang pulse is favorable, and a Yin disease presenting with a Yang pulse is also favorable. However, in cases of internal injury diseases, a Yin disease presenting with a Yang pulse is considered adverse. The classics state: "When a Yin disease presents with a large pulse, it is adverse." For example, in diseases such as consumptive fever and blood loss, a deep and fine Yin pulse is preferred, while a flooding and rapid Yang pulse is contraindicated. The *Mai Jing* failed to distinguish this error. When meridians follow Yin and Yang principles, diseases are easily cured. For men, who are Yang, a larger left-sided pulse is favorable (Cong); for women, who are Yin, a larger right-sided pulse is favorable (Cong). In Spring and Summer, which are Yang seasons, a floating and large pulse is favorable (Cong); in Autumn and Winter, which are Yin seasons, a deep and fine pulse is favorable (Cong). In external contraction diseases, a Yang syndrome presenting with a Yang pulse is favorable (Cong), and a Yin syndrome presenting with a Yang pulse is also favorable (Cong). In internal injury diseases, a Yang syndrome presenting with a Yang pulse is favorable (Cong), and a Yin syndrome presenting with a Yin pulse is also favorable (Cong).
The *Si Yan Mai Jue* (Four-Character Pulse Rhymes) states: The pulse values Shen (Spirit/Vitality). Li Dongyuan said: When the pulse is not diseased, its Shen is naturally present and self-evident. Once the pulse is diseased, one must seek whether Shen exists within it. For instance, six beats per breath constitute a Shu (Rapid) pulse, and seven beats constitute a Ji (Extreme) pulse, indicating Heat; if the pulse has force, it possesses Shen. Three beats per breath constitute a Chi (Slow) pulse, and two beats constitute a Bai (Declining) pulse, indicating Cold; if the pulse has force, it possesses Shen. If Heat has Shen, one should drain the Heat, and Shen will remain. If Cold has Shen, one should dispel the Cold, and Shen will remain. If the pulses of Cold and Heat lack force and Shen, what medicine can be used to drain Heat and dispel Cold? According to Li Dongyuan, defining Shen as having force within the pulse is correct. However, the so-called Shen is actually Wei Qi (Stomach Qi). The classics state: "A pulse that is weak yet slippery indicates the presence of Wei Qi." It also states: "Slipperiness indicates favorability; choppy indicates adversity." Therefore, the five Zang organs and bones and flesh being slippery and smooth allows for longevity. Combining this with the concept of force within the pulse leads to understanding. Hua Bo Ren argued that the character "Zhong" (Middle) in Li Dongyuan's phrase "force within the pulse" refers to the "Zhong Hou" (Middle Position) in the Floating, Middle, and Deep palpation methods. His intention was likely to suggest that since the Spleen resides in the Central Region, Shen is indicated by force at the Middle position. However, how then is the Shen of a Deep pulse assessed? Hua Bo Ren was mistaken.