人有三虚三实，何谓也？然∶有脉之虚实，有病之虚实，有诊之虚实。脉之虚实者，脉来软者为虚，牢者为实。病
之虚实者，出者为虚，入者为实；言者为虚，不言者为实；缓者为虚，急者为实。诊之虚实者，痒者为虚，痛者为实；
外痛内快为外实内虚，内痛外快为内实外虚。故曰虚实也。
问曰∶何谓虚实？答曰∶邪气盛则实，精气夺则虚。何谓重实？所谓重实者，言大热病，气热脉满，是谓重实。
问曰∶经络俱实如何？何以治之？答曰∶经络皆实是寸脉急而尺缓也，当俱治之。故曰滑则顺，涩则逆。夫虚实者，
皆从其物类。始五脏骨肉滑利，可以长久。
问曰∶脉有相乘，有从、（仲景从字作纵字）有横，有逆、有顺，何谓也？师曰∶水行乘火，金行乘木，名曰从；火
行乘水，木行乘金，名曰横；水行乘金，火行乘木，名曰逆；金行乘水，木行乘火，名曰顺。
经言∶脉有伏匿者，伏匿于何脏，而言伏匿也？然∶谓阴阳更相乘、更相伏也。脉居阴部反见阳脉者，为阳乘阴也。
脉虽时沉涩而短，此阳中伏阴；脉居阳部反见阴脉者，为阴乘阳也；脉虽时浮滑而长，此为阴中伏阳也。重阴者癫，重
阳者狂。脱阳者见鬼，脱阴者目盲。
问曰∶脉有残贼，何谓？师曰∶脉有弦、有紧、有涩、有滑、有浮、有沉，此六脉为残贼，能与诸经作病。
问曰∶尝为人所难，紧脉何所从而来？师曰∶假令亡汗，若吐，肺中寒，故令紧；假令咳者，坐饮冷水，故令紧；
假令下利者，以胃中虚冷，故令紧也。
问曰∶翕奄沉名曰滑，何谓？师曰∶沉为纯阴，翕为正阳，阴阳和合，故脉滑也。
问曰∶脉有灾怪，何谓？师曰∶假令人病，脉得太阳，脉与病形证相应，因为作汤，比还送汤之时，病者因反大吐
若下痢，（仲景痢字作利）病腹中痛。因问言∶我前来脉时不见此证，今反变异故，是名为灾怪。因问何缘作此吐痢？答
曰∶或有先服药，今发作，故为灾怪也。
问曰∶人病恐怖，其脉何类？师曰∶脉形如循丝，累累然，其面白脱色。
问曰∶人愧者，其脉何等类？师曰∶其脉自浮而弱，面形乍白乍赤。
问曰∶人不饮，其脉何类？师曰∶其脉自涩，而唇口干燥也。言迟者，风也；摇头言者，其里痛也；行迟者，其表
强也；坐而伏者，短气也；坐而下一膝者，必腰痛；里实护腹如怀卵者，必心痛。师持脉病患欠者，无病也；脉之因伸
者，无病也（一云呻者，病也）。假令向壁卧，闻师到不惊起，而目眄视（一云反面仰视）。若三言三止，脉之，咽唾，
此为诈病。假令脉自和，处言此病大重，当须服吐下药，针灸数十百处乃愈。
【平虚实第十】
人有三虚三实，是什么呢？回答说：有脉象的虚实，有病证的虚实，有诊察的虚实。脉象的虚实，是指脉来柔软无力的为虚，脉来坚实有力的为实。病证的虚实，是指病邪外出的为虚，病邪内入的为实；能言语的为虚，不能言语的为实；脉势缓弱的为虚，脉势急疾的为实。诊察的虚实，是指患处发痒的为虚，疼痛的为实；外部疼痛而内部舒适的是外实内虚，内部疼痛而外部舒适的是内实外虚。所以说这就是虚实。
问：什么是虚实？答：邪气亢盛就表现为实证，精气耗损就表现为虚证。什么是重实证呢？所谓重实证，是指大热病患者，气息炽热且脉象满大，这就叫做重实证。
问：经络俱实证如何治疗？答：经络皆实的脉象是寸口脉紧急而尺部脉缓弱，应当同时进行治疗。所以说脉滑利者为顺，脉涩滞者为逆。至于虚实的变化，都遵循事物的类比规律。如果五脏和骨肉滑润流利，就可以长久健康。
【从横逆顺伏匿脉第十一】
问：脉象有相乘（五行相生关系的过度克制），有纵、有横、有逆、有顺，这是什么意思？老师说：水行乘火，金行乘木，称为“纵”（注：仲景本中“从”字写作“纵”）；火行乘水，木行乘金，称为“横”；水行乘金，火行乘木，称为“逆”；金行乘水，木行乘火，称为“顺”。
经文说：脉象有伏匿的，伏匿在哪个脏腑，为什么说伏匿呢？回答说：这是指阴阳相互乘袭、相互潜伏。脉象位于阴部（尺部等），反而出现阳脉（浮、数、大等），这是阳邪乘袭阴位。脉象虽然有时沉涩而短，这是阳中伏藏阴邪；脉象位于阳部（寸部等），反而出现阴脉（沉、迟、细等），这是阴邪乘袭阳位；脉象虽然有时浮滑而长，这是阴中伏藏阳邪。阴气过重的患癫证，阳气过重的患狂证。阳气脱失者看见鬼怪，阴气脱失者双目失明。
问：脉象中有残贼脉，是什么意思？老师说：脉象中有弦脉、紧脉、涩脉、滑脉、浮脉、沉脉，这六种脉象属于残贼脉，能够导致各条经脉发生病变。
问：曾经被人诘难，紧脉是从哪里来的？老师说：假如患者亡汗，或者呕吐，肺中有寒，所以导致脉紧；假如患者咳嗽，因为饮用冷水，所以导致脉紧；假如患者下利，因为胃中虚冷，所以导致脉紧。
问：脉象忽而轻浮忽而深沉称为滑脉，这是什么意思？老师说：沉脉属纯阴，轻浮脉属正阳，阴阳调和，所以脉象表现为滑利。
【辨灾怪恐怖杂脉第十二】
问：脉象中有灾怪脉，是什么意思？老师说：假如有人患病，脉象呈现太阳病脉，脉象与病症表现相应，因此开具汤药，等到送药回去的时候，病人却突然发生剧烈呕吐或严重腹泻，并伴有腹痛。于是询问原因说：“我刚才诊脉时没有见到这些症状，现在反而出现变异情况，这叫做灾怪。”接着问为什么会发生这种呕吐腹泻？回答说：“或许病人之前已经服用了其他药物，现在药效发作，所以造成这种灾怪现象。”
问：人受惊恐时，脉象是什么样？老师说：脉象像顺着丝线摸去，连绵不断的样子，面色苍白失去血色。
问：人感到羞愧时，脉象是什么样？老师说：脉象自浮而弱，面色时而白时而红。
问：人不喝水时，脉象是什么样？老师说：脉象自涩，嘴唇和口腔干燥。说话迟缓的，是有风邪；说话时摇头的，是体内疼痛；行走迟缓的，是体表强直；坐着俯身的，是气短；坐着时只垂下一只膝盖的，必定腰痛；腹部充实护住腹部像怀着蛋一样的，必定心痛。老师诊脉时病人打哈欠的，是没有病；诊脉时因伸展身体而呻吟的，是没有病（另一种说法认为呻吟是有病）。假如面向墙壁躺着，听到老师到来不惊起，而是斜视眼睛（另一种说法认为是翻身仰视）。如果话未说完又停止，诊脉时吞咽唾液，这是装病。假如脉象平和，却说此病很重，必须服用催吐泻下的药物，针灸数十上百个穴位才能痊愈。
[Chapter 10: Differentiating Deficiency and Excess]
Humans have three types of deficiency (Xu) and excess (Shi). What are they? The answer is: there is the deficiency and excess of pulse, the deficiency and excess of disease, and the deficiency and excess of diagnosis. Regarding the deficiency and excess of pulse: a pulse that feels soft and weak indicates deficiency, while a firm and solid pulse indicates excess. Regarding the deficiency and excess of disease: symptoms moving outward indicate deficiency, while those moving inward indicate excess; the ability to speak indicates deficiency, while inability to speak indicates excess; a slow and relaxed pulse indicates deficiency, while a rapid and tense pulse indicates excess. Regarding the deficiency and excess in diagnosis: itching indicates deficiency, while pain indicates excess; external pain with internal comfort signifies external excess and internal deficiency; internal pain with external comfort signifies internal excess and external deficiency. Thus, these are referred to as deficiency and excess.
Question: What is meant by deficiency and excess? Answer: When pathogenic factors are vigorous, it is excess; when essential qi is depleted, it is deficiency. What is heavy excess (Chong Shi)? Heavy excess refers to cases where a patient with a severe heat disease exhibits intense heat in the qi and a full pulse, which is termed heavy excess.
Question: How should one treat a condition where both meridians and collaterals present excess? Answer: When both meridians and collaterals are in excess, the pulse at the Cun position is urgent/tense while the Chi position is relaxed/slow; both must be treated simultaneously. Therefore, a slippery pulse indicates favorable progression, while a choppy pulse indicates unfavorable progression. The variations of deficiency and excess follow analogical principles. If the five zang organs and bones/flesh are smooth and lubricated, longevity can be achieved.
[Chapter 11: Pulse Patterns of Following, Horizontal, Reverse, Smooth, and Hidden]
Question: Pulses exhibit mutual overacting (Cheng), following/vertical (Cong/Zong), horizontal (Heng), reverse (Ni), and smooth/compliant (Shun). What do these mean? The Master said: Water acting upon Fire, and Metal acting upon Wood, are called "Zong" (Note: In Zhang Zhongjing's text, this character is written as Zong); Fire acting upon Water, and Wood acting upon Metal, are called "Heng"; Water acting upon Metal, and Fire acting upon Wood, are called "Ni"; Metal acting upon Water, and Wood acting upon Fire, are called "Shun".
The Classic states: There are hidden pulses. Hidden in which zang organ, and why are they called hidden? The answer is: This refers to yin and yang mutually overacting and mutually hiding. When a pulse located in the yin positions (Chi) unexpectedly shows yang characteristics (such as floating, rapid, or large), it is yang overacting on yin. Although the pulse may occasionally appear deep, choppy, and short, this indicates yin hidden within yang. When a pulse located in the yang positions (Cun) unexpectedly shows yin characteristics (such as deep, slow, or thin), it is yin overacting on yang. Although the pulse may occasionally appear floating, slippery, and long, this indicates yang hidden within yin. Excessive yin leads to manic-depressive psychosis (Dian); excessive yang leads to mania (Kuang). Loss of yang results in hallucinations (seeing ghosts); loss of yin results in blindness.
Question: What are the destructive/harmful pulses (Can Zei)? The Master said: Among pulses, there are wiry (Xian), tight (Jin), choppy (Se), slippery (Hua), floating (Fu), and deep (Chen). These six pulse qualities are considered destructive because they can cause pathology in various meridians.
Question: I was once challenged regarding the origin of the tight pulse. Where does it come from? The Master said: Suppose a patient suffers from profuse sweating or vomiting, and cold resides in the lungs; this causes a tight pulse. Suppose a patient coughs due to drinking cold water; this causes a tight pulse. Suppose a patient suffers from diarrhea due to deficiency-cold in the stomach; this causes a tight pulse.
Question: A pulse that suddenly floats and then sinks is called slippery. What does this mean? The Master said: Deepness belongs purely to yin, while sudden floating belongs positively to yang. When yin and yang harmonize, the pulse becomes slippery.
[Chapter 12: Differentiating Disaster, Strange, Terrifying, and Miscellaneous Pulses]
Question: What is a "disaster" pulse (Zai Guai)? The Master said: Suppose a person is ill, and the pulse corresponds to Taiyang disease, matching the clinical presentation. Consequently, a decoction is prescribed. However, upon returning to administer the medicine, the patient suddenly experiences severe vomiting or dysentery/diarrhea, accompanied by abdominal pain. Upon inquiry, the patient says, "I did not exhibit these symptoms during the initial pulse diagnosis; now there is an unexpected change." This is called a disaster. Why does this vomiting and diarrhea occur? The answer is: Perhaps the patient had taken other medications previously, which are now taking effect, causing this disastrous phenomenon.
Question: What kind of pulse appears when a person is terrified? The Master said: The pulse feels like tracing silk threads continuously, and the face is pale and devoid of color.
Question: What kind of pulse appears when a person feels ashamed? The Master said: The pulse is naturally floating and weak, and the complexion alternates between white and red.
Question: What kind of pulse appears when a person does not drink water? The Master said: The pulse is naturally choppy, and the lips and mouth are dry. Speaking slowly indicates wind pathogen; shaking the head while speaking indicates interior pain; walking slowly indicates exterior stiffness; sitting while leaning forward indicates shortness of breath; sitting with only one knee hanging down indicates lower back pain; guarding the abdomen with hands as if holding an egg indicates heart pain. If the patient yawns while the practitioner takes the pulse, there is no disease; if the patient stretches and groans during pulse taking, there is no disease (another version states groaning indicates disease). If a patient lies facing the wall, does not rise upon hearing the practitioner's arrival, but instead glances sideways (another version states turning the face upward), speaks intermittently stopping frequently, and swallows saliva while being palpated, this is feigned illness. If the pulse is harmonious, yet the patient claims the disease is severe and requires emetic/purgative drugs and dozens or hundreds of acupuncture points for cure, it is likely feigned.