往来难。细短涩。轻刀刮竹形容切。血少气有余。寸涩心疼神亦怯。（胃属阳明。多血多气。其上口当心。血虚。则
气凑之气血攻冲。则当心而痛。阳明又主惊。惊气归心。故神怯。）关中胁胀胃虚呕。（肝藏血、属厥阴。其脉布胁肋。
血少气胜。故胁肋胀。胃为水谷之海。血少则掺。气胜则逆。爆则血枯。逆则气。故不纳水谷而呕吐也。）尺部肠枯五心
热。（血虚则肠枯涩血虚而相火动。则肝热肝。热下移之于母。则肾热上移之于子。则心热肾之脉起于足心。心之脉入于
手心。故手足心热。）妇女当为经不通。或为胎病宜区别。（血养胎。故脉涩。）崔紫虚谓涩主自汗。濒湖士材皆宗之。愚
按内经云。涩满阳有余也。阳气有余。则为身热无汗。当以经言为是。
流利如珠便是滑。多汗阴有余。风痰更可察。（经曰。滑者。阴气有余也。阴气有余。为多汗。身寒。滑脉主风。又
主痰。）寸滑吞酸咳嗽呕。（滑又主热。胃中湿气。与热气。熏蒸。蕴而浅酸。停在胃脘。故吞酸。湿热生痰。故咳嗽及
呕吐。）当关积热掌中发。（食积胃。胃生热。胃热上熏则包络与心肺皆热。包络之脉。入掌中。肺脉行其前。心脉行其
后。故掌中就热。经所谓掌中热者。腹中热是也。）痢疾 癃尺部者。（滑又主宿食。食积成痢。 者睾丸肿大痛连小腹
也。癃者。小便不通。脉经谓尺滑当溺血也。）女子或为经闭煞。（脉经谓尺脉滑。女子经脉不利。按滑为血有余。若滑
而结。及浮滑迟滑者。蓄血也。不然则是胎脉。）
脉象往来艰涩不畅，脉形细短而涩，如同轻刀刮过竹子般形容真切。此为阴血亏少而阳气偏盛之象。若寸部见涩脉，主心区疼痛且心神怯弱。（胃腑属阳明经，多血多气，其经脉上口正当心窝处。若血虚，则气机凑聚于此处，气血攻冲，导致当心部位疼痛。阳明经又主惊惧，惊气归于心，故出现心神怯弱。）关部见涩脉，主胁肋胀满、胃虚呕吐。（肝藏血，属厥阴经，其经脉布散于胁肋。若血少气胜，故胁肋胀满。胃为水谷之海，血少则胃体干枯，气胜则气机上逆。干枯则血枯，上逆则气逆，故不能受纳水谷而发生呕吐。）尺部见涩脉，主肠道干枯及五心烦热。（血虚则肠道干枯涩滞；血虚导致相火妄动，则肝热；肝热下移于肾（母），则肾热；肾热上移于心（子），则心热。肾之经脉起于足心，心之经脉入于手心，故手足心发热。）妇女若见尺部涩脉，多为月经不通，或为妊娠胎病，需加以区别。（血以养胎，故脉象呈涩。）崔紫虚认为涩脉主自汗，李时珍（濒湖）和张景岳（士材）都宗奉此说。我认为《内经》中说：“涩脉是阳气有余的表现。”阳气有余，则表现为身体发热而无汗，应当以《内经》的说法为准。
脉象流利如珠滚动便是滑脉。滑脉主多汗，属阴气有余，可进一步察知风痰之邪。（《内经》说：滑脉是阴气有余的表现。阴气有余，表现为多汗、身寒。滑脉主风，又主痰。）寸部见滑脉，主吞酸、咳嗽、呕吐。（滑脉又主热。胃中湿气与热气相互熏蒸，蕴结而致泛酸，停滞在胃脘，故出现吞酸。湿热生痰，故引起咳嗽及呕吐。）关部见滑脉，主积热，手掌中心发热。（食积于胃，胃生热，胃热上熏则心包络与心肺皆热。心包络的经脉进入掌中，肺脉行于掌前，心脉行于掌后，故手掌中心发热。经文所说的“掌中热”，指的就是腹中热。）尺部见滑脉，主痢疾、疝气和癃闭。（滑脉又主宿食，食积成痢疾。疝气是指睾丸肿大疼痛并牵连小腹。癃闭是指小便不通。《脉经》说尺部滑脉当见尿血。）女子若尺部见滑脉，可能是月经闭止，也可能是煞气（瘀血阻滞）。（《脉经》说尺脉滑，女子经脉不利。按滑脉为血有余之象，若滑而兼结，或浮滑、迟滑者，为蓄血证。否则就是胎脉。）
The pulse movement is difficult and unsmooth, thin, short, and choppy (Se), described accurately as if a light knife were scraping bamboo. This indicates insufficient blood and excess qi. If the Cun (inch) position shows a choppy pulse, it signifies heart region pain and a timid spirit. (The Stomach belongs to the Yangming channel, possessing abundant blood and qi; its upper opening corresponds to the heart area. When blood is deficient, qi congregates there; the attack of qi and blood causes pain in the heart region. Yangming also governs fright; when fright qi returns to the Heart, the spirit becomes timid.) At the Guan (bar) position, it signifies distension in the hypochondrium and vomiting due to stomach deficiency. (The Liver stores blood and belongs to the Jueyin channel; its vessels distribute along the hypochondrium. With insufficient blood and excess qi, hypochondriac distension occurs. The Stomach is the sea of water and grain; insufficient blood leads to dryness, while excess qi leads to rebellion. Dryness results in blood exhaustion, and rebellion results in qi counterflow, thus failing to receive food and drink, leading to vomiting.) At the Chi (cubit) position, it signifies intestinal dryness and heat in the five centers (palms, soles, and chest). (Blood deficiency leads to intestinal dryness and choppiness; blood deficiency triggers the hyperactivity of ministerial fire, causing Liver heat. Liver heat transfers downward to the Kidney (mother), causing Kidney heat; Kidney heat transfers upward to the Heart (child), causing Heart heat. The Kidney meridian originates from the sole of the foot, and the Heart meridian enters the palm; hence, heat in the palms and soles occurs.) In women, this may indicate amenorrhea or pregnancy pathology, which must be distinguished. (Blood nourishes the fetus, hence the pulse appears choppy.) Cui Zixu stated that a choppy pulse governs spontaneous sweating, a view endorsed by Li Shizhen (Binhu) and Zhang Jingyue (Shicai). However, I hold that the *Neijing* states: "A choppy pulse indicates excess yang." Excess yang manifests as body heat without sweating; therefore, the statement in the *Neijing* should be considered correct.
A smooth and flowing pulse like rolling pearls is the Slippery (Hua) pulse. It indicates excessive sweating and excess yin, allowing for the observation of wind-phlegm. (The *Jing* says: "A slippery pulse indicates excess yin qi." Excess yin qi manifests as excessive sweating and cold body. The slippery pulse governs wind and also phlegm.) At the Cun position, it signifies acid regurgitation, cough, and vomiting. (The slippery pulse also governs heat. Dampness and heat in the Stomach steam each other, accumulating to cause acid regurgitation stagnating in the epigastrium. Damp-heat generates phlegm, causing cough and vomiting.) At the Guan position, it indicates accumulated heat and heat in the palms. (Food accumulation in the Stomach generates heat; stomach heat steams upward, affecting the Pericardium, Heart, and Lung. The Pericardium meridian enters the palm, the Lung meridian runs anteriorly, and the Heart meridian runs posteriorly, resulting in heat in the palm. The classic saying "heat in the palm" refers to heat in the abdomen.) At the Chi position, it indicates dysentery, hernia, and strangury. (The slippery pulse also governs retained food; food accumulation leads to dysentery. Hernia refers to swollen and painful testicles radiating to the lower abdomen. Strangury refers to urinary retention. The *Mai Jing* states that a slippery Chi pulse indicates hematuria.) In women, it may indicate amenorrhea or blood stasis. (The *Mai Jing* states that a slippery Chi pulse in women indicates irregular menstruation. Since a slippery pulse indicates excess blood, if it is slippery and knotted, or floating-slippery or slow-slippery, it indicates blood stasis. Otherwise, it is a pregnancy pulse.)