（脉经谓弦脉举之无有。按疟脉有浮弦者。未尝举之无有也。经曰。疟皆生于风。惟旺于风。故其脉浮弦。且头疼
如破也。即脉经伤寒条中。亦有阳明中风脉弦浮之语。则所谓弦脉。举之无有。疑其误也。）
硬然在指下。端直似弓弦。（弦。春脉也。夏秋冬见之。则病脉也。然在春 弱而滑。平脉也。若而实强。此谓太过。
不实而征此谓不及。亦病脉也。）夏秋则主疟相缠。（风寒暑湿之气皆为疟。其脉皆强。惟夏秋患疟者甚多。冬春亦间有
之。）弦数热。弦迟寒。寸弦头痛膈多痰。（弦主痰。痰随厥气上升。故头痛。）关若 瘕胃气逆。（血凝气滞。久而坚硬。
在脐旁。曰 瘕。胃中寒气。冲窗心下曰逆。）尺当 疝脚拘挛。（ 疝者。睾丸肿痛。上迟小腹也。盖肝脉络阴器。主
疝。或寒。或涩。或热或虚。或气分或血分。临症以脉之迟数软弱辨之。肝主筋、肾主骨。筋束骨者也。寒则筋急。
故抱挛。拘挛痛。屈伸不利也。）
（内经谓之急。）
左右弹手其力强。状如转索名为紧。（紧主寒。浮紧表寒。沉紧里寒。）人迎主伤寒。还把风痫诊。（左手寸关之间曰
人迎。人迎紧。主泻寒。头痛。恶寒。发热。风气通肝。木得风则动摇。故身螈 。肝火鼓动心火。火炎神越。故卒不
知人。吐涎沫曰风痫。）气口主伤食。喘嗽亦宜审。（右手寸关之间。曰气口气口紧。主伤食。心下苦满。肺恶寒。寒则
气逆。故为喘与咳。脉经曰。紧为实。以上皆实邪。故其脉紧。）关尺见紧时。痹疝极其准。（经谓青脉之至也。长而右
左弹人手。有积气在心下支 。名曰肝痹。得之寒湿。与疝同法。）
《脉经》中说弦脉轻取（举之）感觉不到。我认为疟疾的脉象有浮而弦的，并没有轻取就感觉不到的情况。经典说：“疟疾都因风邪而生，且随风气旺盛。”所以其脉象表现为浮弦，并且伴有头痛如裂的症状。即使在《脉经》伤寒条文中，也有阳明中风脉象弦浮的说法。那么所谓“弦脉轻取无有”，我怀疑是错误记载。
（弦脉的特征是：坚硬地在指下显现，端正挺直像弓弦一样。）弦脉本是春季的平脉，如果在夏、秋、冬三季出现，就是病脉。但是在春季如果脉象弱而滑，属于正常的平脉；如果脉象实而强，这叫“太过”；如果不实而显得微弱，这叫“不及”，这些也都属于病脉。
在夏秋季节，弦脉主要主疟疾缠绵难愈。（风寒暑湿各种邪气都能导致疟疾，它们的脉象大多强劲。只有夏秋季节患疟疾的人非常多，冬春季节也偶尔有。）
脉象弦而数，主热证；脉象弦而迟，主寒证。寸部脉弦，主头痛和胸膈多痰。（弦脉主痰饮，痰饮随着厥逆之气上升，所以导致头痛。）关部脉弦，主瘕积和胃气上逆。（血液凝滞、气机阻滞，时间久了变得坚硬，位于脐旁，称为瘕积。胃中的寒气冲撞心下部位，称为气逆。）尺部脉弦，当主疝气和脚部拘挛抽搐。（疝气是指睾丸肿痛，牵引小腹疼痛。因为肝经络循阴器，主管疝气。无论是寒、涩、热、虚，还是涉及气分或血分，临症时通过脉象的迟数、软弱来辨别。肝主管筋，肾主管骨，筋包裹着骨头。寒邪会导致筋脉紧急，所以出现拘挛。拘挛疼痛，屈伸不利。）
（《内经》将这种脉象称为急脉。）
脉象左右弹手，力量强劲，形状像转动着的绳索，这叫做紧脉。（紧脉主寒证，浮紧为表寒，沉紧为里寒。）人迎穴（此处指左手寸关部）脉紧主伤寒，也可用于诊断风痫。（左手寸部和关部之间称为人迎。人迎脉紧，主泻除寒邪，症状包括头痛、恶寒、发热。风气通于肝，木遇到风就会动摇，所以身体会出现抽搐。肝火鼓动心火，火势炎上导致神志散越，所以突然不知人事。吐涎沫称为风痫。）气口（此处指右手寸关部）脉紧主伤食，喘咳也需要仔细审察。（右手寸部和关部之间称为气口。气口脉紧，主饮食停滞，心下苦闷胀满。肺厌恶寒冷，寒邪导致气机上逆，所以出现喘和咳。《脉经》说：紧脉代表实证。以上都是实邪所致，所以脉象表现为紧。）关部和尺部出现紧脉时，对于痹证和疝气的诊断非常准确。（经典说：青色的脉（即弦脉/肝脉）到来时，长而左右弹手，心下有积气支撑，称为肝痹，这是由寒湿引起的，治疗方法与疝气相同。）
The *Mai Jing* (Classic of Pulse Diagnosis) states that the Xian pulse (String-taut pulse, a taut and straight pulse resembling a guitar string) cannot be felt upon light palpation (lifting). I argue that malaria pulses can be floating and Xian; they are not necessarily imperceptible upon light palpation. The classics state: "Malaria arises from wind and flourishes with wind." Therefore, its pulse is floating and Xian, accompanied by severe headache as if splitting. Even in the *Mai Jing*'s section on Cold Damage, there is mention of Yangming Wind-Strike presenting with a Xian and floating pulse. Thus, the statement that "the Xian pulse is imperceptible upon lifting" is suspected to be an error.
(The characteristic of the Xian pulse is that it feels firm under the fingers, straight and upright like a bowstring.) The Xian pulse is the normal pulse of Spring. If seen in Summer, Autumn, or Winter, it is a pathological pulse. However, in Spring, if the pulse is weak and slippery, it is a normal pulse. If it is solid and strong, this is termed "Excess" (Tai Guo); if it is not solid but appears weak, this is termed "Deficiency" (Bu Ji), both of which are also pathological pulses.
In Summer and Autumn, the Xian pulse primarily indicates persistent Malaria. (Wind, cold, summer-heat, and dampness can all cause Malaria, and their pulses are generally strong. Many people suffer from Malaria in Summer and Autumn, though it occasionally occurs in Winter and Spring.)
A Xian pulse with a rapid rate indicates Heat; a Xian pulse with a slow rate indicates Cold. A Xian pulse at the Cun position (distal position) indicates headache and excessive phlegm in the chest/diaphragm. (The Xian pulse governs Phlegm; Phlegm rises with Jue Qi [rebellious Qi], causing headache.) At the Guan position (middle position), it indicates Zha masses (accumulations of blood and qi forming hard lumps) and rebellious Stomach Qi. (When blood coagulates and Qi stagnates for a long time, it becomes hard; located beside the umbilicus, it is called a Zha mass. Cold Qi in the Stomach rushing upward to the epigastrium is called Rebellious Qi.) At the Chi position (proximal position), it indicates Shan disease (hernia/testicular pain) and leg spasms/cramps. (Shan disease refers to swelling and pain of the testicles radiating to the lower abdomen. The Liver meridian connects to the genitalia and governs Shan disease. Whether due to Cold, Stagnation, Heat, Deficiency, Qi aspect, or Blood aspect, clinical differentiation is made based on whether the pulse is slow/fast or weak/solid. The Liver governs sinews/tendons, and the Kidneys govern bones; sinews bind the bones. Cold causes sinew tension, leading to spasms. Spasms involve pain and difficulty in flexion and extension.)
(The *Nei Jing* [Inner Canon] refers to this type of pulse as the Ji pulse [Tight/Urgent].)
If the pulse beats against the fingers from left and right with strong force, resembling a turning rope, it is named Jin (Tight) pulse. (The Jin pulse governs Cold: Floating-Jin indicates Exterior Cold, Sunken-Jin indicates Interior Cold.) The Renying position (referring to the Cun-Guan positions of the Left Hand) governs Cold Damage and is also used to diagnose Feng Xian (Wind Epilepsy). (The area between the Cun and Guan positions of the Left Hand is called Renying. A tight pulse here indicates the need to purge Cold, with symptoms including headache, aversion to cold, and fever. Wind Qi communicates with the Liver; Wood moves when encountering wind, causing body convulsions. Liver Fire stirs Heart Fire, fire flares up causing spirit dispersion, resulting in sudden loss of consciousness. Vomiting saliva/phlegm is called Wind Epilepsy.) The Qikou position (referring to the Cun-Guan positions of the Right Hand) governs Food Injury (indigestion), and asthma/cough should also be carefully examined. (The area between the Cun and Guan positions of the Right Hand is called Qikou. A tight pulse here indicates food stagnation, bitter fullness below the heart. The Lung dislikes Cold; Cold causes Qi rebellion, thus leading to asthma and cough. The *Mai Jing* states: "Jin represents Excess." All the above are excess pathogens, hence the pulse is Jin.) When a Jin pulse appears at the Guan and Chi positions, it accurately diagnoses Bi syndrome (obstruction/painful obstruction) and Shan disease. (The classics state: When the Green pulse [Liver/Xian pulse] arrives, long and beating left and right against the hand, with accumulated Qi supporting beneath the heart, it is called Gan Bi [Liver Obstruction], caused by Cold-Dampness, treated similarly to Shan disease.)