一息六至稍为数。只有儿童独安乐。（儿童以六至为平脉、外此皆为火。）浮沉实数散且清。（浮数有力。为实火在表、
宜散、沉数有力、为实火在里。宜清。）无力为虚宜补药。（数而无力。虚火也。宜补气。或益火之元。）寸为喉舌疼。呕
吐嗽烦渴。（胃口当心。亦寸主之。胃有火。故呕吐。火迫肺。故为嗽。为烦、肺金爆。故渴。）关中补谷易于饥。（胃有
大。则消谷善饥。）尺部恶寒气淋作。（脉经谓尺脉数。恶寒。小便黄赤。又曰。少阴脉数。男子气淋。盖肾为阴。属水。
阴虚而阳凑之。内热故外恶寒。火伏水中。故小便黄赤。甚则膀胱之气不化。小便不利。痛而为淋。）
（脉经载扁鹊之言曰。脉有表无里者死。经名曰结。何谓结。脉在指下。如麻子动摇。按如麻子动摇者。轻辄之。
则散乱无纪。重按之。则不可得。故曰有表无里。乃肾绝也。与缓时一止之结不同。）
缓时止。谓之结。阴盛阳衰凝气血。（气、温血行血者也气虚不能温血。则血寒。气虚不能行血。则血滞。血寒而滞
则结。血结气亦结矣。）浮为痛积外相攻。沉为痛积内相迫。
数时一止何其促。阳有余。阴不足。痰火煎熬。或为喘嗽。或斑毒。（内上红紫盛凡者。斑也。黑斑难治。痈疽。皆
毒也。）
动而中止不能还。止有常数斯名代。不是伤寒心悸多。即有腹疼泄痢害。久病固为凶。（扁鹊曰。脉五来一止。不复
增减、或七来一止。不复增减者经名曰代、死。）平人亦脏败。（灵枢曰。一日一疸五十营。以营五脏之精。所谓五十营
者。持其脉口。数其至、也。五十动而不一代者。五脏皆受气。四十动一代者。一脏脏无气。三十动一代者。二脏无气。
二十动一代者。三脏无气。十动一代者。五脏无气。予之短期。据脉经。谓四十动一止。四岁死。三十动一止。三岁死。
二十动一止。二岁死。十动一止。岁内死。五动一止。五日死。此亦概言之也。不必泥。）女胎三月余。见之不为碍。（旧
谓胎三月。其脉代。按胎脉有五月七月亦代者。当于两尺候之。如胎来成九至。或十至一止。良久方来。又九至或十至
一止。良久方来。此所谓有常数也。再来。或九至或十至不止又于十二至。或十五至一止。但有常数。皆是代脉。代之
止有常数。乃信也。土主信。此脾胃之气至也。出为万物之生气。脾胃乃五脏之生气。生气至。故有胎也。且天一生水。
次生火木金土。而五行备。胎之初结。乃天一之水也。次生火木金土。而五脏之气全。五脏之气全。故脉代也。代又何
以为死脉。以生数论。五脏之气全。应天五生土之数。故其脉代。以浅数论。有形之后。则营卫之气与天地之书液周流。
而无一息之止者也五脏无气。独胃气尚在。故其脉亦代。然此胃气。乃油尽之灯。故不久必死。）
脉不以浮沉至数辨。而以形辨者。曰弦。直而长。如按弓弦。曰紧。往来有力。左右弹人手。如转索无常。曰长。
迢迢自若。如揭（长）竿末稍。曰短。不能满部。两头缩缩。曰细。直而 应指指如丝线。曰涩。细而往来难。应指如
轻刀刮竹。曰滑。往来前却。流利如珠。曰动。大如豆。厥厥摇动。凡八脉。
一呼一吸之间脉搏跳动六次，稍微偏快即为数脉。只有儿童独自安乐（儿童以六至为平脉、外此皆为火。）浮沉实数散且清。（浮数有力。为实火在表、 宜散、沉数有力、为实火在里。宜清。）无力为虚宜补药。（数而无力。虚火也。宜补气。或益火之元。）寸为喉舌疼。呕 吐嗽烦渴。（胃口当心。亦寸主之。胃有火。故呕吐。火迫肺。故为嗽。为烦、肺金爆。故渴。）关中补谷易于饥。（胃有 大。则消谷善饥。）尺部恶寒气淋作。（脉经谓尺脉数。恶寒。小便黄赤。又曰。少阴脉数。男子气淋。盖肾为阴。属水。 阴虚而阳凑之。内热故外恶寒。火伏水中。故小便黄赤。甚则膀胱之气不化。小便不利。痛而为淋。）
（《脉经》记载扁鹊的话说：脉象有表无里的会死。经书上称为结。什么是结？脉在指下，像麻子一样动摇，重按时像麻子动摇那样，轻取则散乱无章，重按则摸不到。所以叫有表无里，这是肾气绝的表现。这与偶尔停顿一次的结脉不同。）
偶尔停顿，称为结脉。阴盛阳衰导致气血凝滞。（气，是温煦血液和推动血液运行的。气虚不能温煦血液，则血寒；气虚不能推动血液，则血滞。血寒而停滞就会形成结脉，血结则气也结。）浮取为疼痛积聚在外相攻。沉取为疼痛积聚在内相迫。
数脉中偶尔停顿，这叫做促脉。阳气有余，阴气不足，痰火煎熬，或者出现喘咳，或者发斑毒。（内部红紫盛大凡者。斑也。黑斑难治。痈疽。皆 毒也。）
脉动中途停止但不能立即恢复，停止的时间有固定规律，这就叫代脉。这不一定是伤寒引起的心悸多。就是有腹痛泄痢危害。久病确实凶险。（扁鹊说：脉象五次跳动一次停顿，不再增减，或者七次跳动一次停顿，不再增减的，经书上称为代脉，主死。）普通人也会出现脏气败露。（《灵枢》说：人一天呼吸五十营，用来滋养五脏的精气。所谓五十营，就是持住脉口，计算脉搏次数。五十次跳动而没有一次代脉的，五脏都得到气血。四十次跳动有一次代脉的，一脏无气。三十次跳动有一次代脉的，二脏无气。二十次跳动有一次代脉的，三脏无气。十次跳动有一次代脉的，五脏无气，给予短期寿命。根据《脉经》，四十次跳动一次停顿，四岁死。三十次跳动一次停顿，三岁死。二十次跳动一次停顿，二岁死。十次跳动一次停顿，一年内死。五次跳动一次停顿，五日内死。这也是大概的说法，不必拘泥。）孕妇怀孕三个多月，见到这种脉象也不为害。（旧时说怀孕三个月，其脉代。按胎脉有五月七月也有代的，应当在两尺部候诊。如胎来成九至，或十至一止，良久方来，又九至或十至一止，良久方来，此所谓有常数也。再来，或九至或十至不止又于十二至，或十五至一止，但有常数，皆是代脉。代之止有常数，乃信也。土主信。此脾胃之气至也。出为万物之生气。脾胃乃五脏之生气。生气至。故有胎也。且天一生水。次生火木金土。而五行备。胎之初结。乃天一之水也。次生火木金土。而五脏之气全。五脏之气全。故脉代也。代又何以为死脉。以生数论。五脏之气全。应天五生土之数。故其脉代。以浅数论。有形之后。则营卫之气与天地之书液周流。而无一息之止者也五脏无气。独胃气尚在。故其脉亦代。然此胃气。乃油尽之灯。故不久必死。）
脉象不以浮沉和至数来辨别，而以形态来辨别的，叫做弦脉。直而长，像按弓弦。叫做紧脉。往来有力，左右弹人手，像转索无常。叫做长脉。迢迢自若，像揭（长）竿末稍。叫做短脉。不能满部。两头缩缩。叫做细脉。直而应指指如丝线。叫做涩脉。细而往来难。应指如轻刀刮竹。叫做滑脉。往来前却。流利如珠。叫做动脉。大如豆。厥厥摇动。凡八脉。
A respiration cycle with six pulses is slightly rapid, termed *Shu Mai* (Rapid Pulse). Only children are uniquely at ease (Children consider six beats per respiration as a normal pulse; anything else indicates Fire.) Floating, sinking, solid, rapid, scattered, and clear (Floating and rapid with force indicates Excess Fire in the exterior, suitable for dispersing; Sinking and rapid with force indicates Excess Fire in the interior, suitable for clearing.) Weakness indicates deficiency, requiring tonifying herbs (Rapid but weak indicates Deficient Fire, suitable for tonifying Qi or benefiting the origin of Fire.) The Cun position indicates pain in the throat and tongue, vomiting, coughing, irritability, and thirst (The stomach opening corresponds to the heart center, also governed by the Cun position. Stomach Fire causes vomiting; Fire forcing the Lung causes coughing and irritability; Lung Metal being scorched causes thirst.) The Guan position relates to digestion and easy hunger (Stomach having excess leads to consuming food easily and feeling hungry quickly.) The Chi position indicates aversion to cold and strangury (The *Mai Jing* states that a rapid Chi pulse indicates aversion to cold and yellow-red urine. It also says a rapid Shaoyin pulse in men indicates Qi Strangury. Since the Kidney is Yin and belongs to Water, Yin deficiency allows Yang to converge, causing internal heat and thus external aversion to cold. Fire hidden in water causes yellow-red urine. In severe cases, Bladder Qi fails to transform, leading to difficult urination, pain, and strangury.)
(The *Mai Jing* records Bian Que's words: A pulse that has an exterior but no interior portends death. The classic calls this *Jie Mai* (Knotted Pulse). What is Jie? Under the fingers, it feels like moving hemp seeds. Pressing lightly makes it scatter chaotically; pressing heavily makes it disappear. Thus, it is said to have an exterior but no interior, indicating Kidney exhaustion. This differs from the Knotted Pulse characterized by occasional pauses.)
Occasional pauses are called *Jie Mai* (Knotted Pulse). Yin excess and Yang deficiency cause Qi and Blood stagnation (Qi warms and moves Blood. Qi deficiency fails to warm Blood, causing Blood Cold; Qi deficiency fails to move Blood, causing Blood Stasis. Cold and Stagnant Blood forms knots; when Blood knots, Qi also knots.) Floating indicates painful accumulations attacking from the exterior. Sinking indicates painful accumulations pressing from the interior.
A rapid pulse with occasional pauses is called *Cu Mai* (Hasty Pulse). Yang is excessive, Yin is insufficient, Phlegm-Fire cauterizes, leading to wheezing/coughing or macules/toxins (Internal red-purple abundance constitutes macules. Black macules are hard to treat. Carbuncles and sores are all toxins.)
Movement stops midway and cannot return immediately. If the pause has a constant rhythm, it is named *Dai Mai* (Intermittent Pulse). This is not necessarily frequent palpitations due to Taiyang Disease. It may involve abdominal pain, diarrhea, and dysentery causing harm. Chronic illness is indeed ominous (Bian Que said: A pulse stopping once after five beats, without further change, or once after seven beats, without further change, is named Dai Mai in the classics, portending death.) Even in healthy people, it indicates organ failure (*Ling Shu* states: One day consists of fifty circuits of Ying Qi, nourishing the essence of the Five Zang organs. To count these fifty circuits, hold the pulse point and count the beats. Fifty beats without a Dai pulse mean all Five Zang organs receive Qi. Forty beats with one Dai pulse mean one Zang lacks Qi. Thirty beats with one Dai pulse mean two Zangs lack Qi. Twenty beats with one Dai pulse mean three Zangs lack Qi. Ten beats with one Dai pulse mean five Zangs lack Qi, granting a short lifespan. According to the *Mai Jing*, forty beats with one stop indicate death within four years; thirty beats with one stop, three years; twenty beats, two years; ten beats, within one year; five beats, within five days. This is a general statement and should not be applied rigidly.) In women, during pregnancy beyond three months, seeing this pulse is not an obstruction (Old texts state that at three months of pregnancy, the pulse is Dai. However, Dai pulses can occur at five or seven months. It should be assessed at both Chi positions. For example, nine beats followed by one pause, returning after a long time, or nine to ten beats with one pause, returning after a long time—this is what is meant by "constant number." Again, nine to ten beats without pause, or twelve to fifteen beats with one pause, as long as there is a constant number, it is a Dai pulse. The constant pause of Dai reflects trustfulness (Xin), which Earth governs. This is the arrival of Spleen-Stomach Qi. It emerges as the vital Qi of all things. The Spleen and Stomach are the vital Qi of the Five Zang organs. When vital Qi arrives, pregnancy occurs. Heaven generates Water first, then Fire, Wood, Metal, and Earth, completing the Five Elements. The initial formation of the fetus is Heavenly One Water. Then Fire, Wood, Metal, and Earth generate, making the Qi of the Five Zang organs complete. With complete Zang Qi, the pulse becomes Dai. Why is Dai considered a death pulse? From the perspective of generation numbers, complete Zang Qi corresponds to the number of Earth generating five, hence the pulse is Dai. From a superficial view, after form is established, Ying and Wei Qi circulate with heaven and earth fluids without any pause per breath. If the Five Zangs lack Qi but only Stomach Qi remains, the pulse is still Dai. However, this Stomach Qi is like a lamp running out of oil, so death will soon follow.)
Pulses are distinguished not by floating/sinking or rate, but by shape. *Xian Mai* (Wiry Pulse) is straight and long, like pressing a bowstring. *Jin Mai* (Tight Pulse) is forceful in both directions, snapping against the hand like a turning rope. *Chang Mai* (Long Pulse) extends far and naturally, like the tip of a raised pole. *Duan Mai* (Short Pulse) does not fill the position, shrinking at both ends. *Xi Mai* (Fine/Thready Pulse) is straight and responds to the finger like a silk thread. *Se Mai* (Choppy Pulse) is fine and difficult to flow, responding like a light knife scraping bamboo. *Hua Mai* (Slippery Pulse) moves forward and backward, smooth like pearls. *Dong Mai* (Moving Pulse) is large like a bean, quivering and shaking. These are eight pulses.