五迟者。阴也。指下寻之。重手乃得隐隐曰迟。主肾虚不安。
迟者。阴土也。何为阴土。土之性也。缓迟则较缓更甚。故亦曰土也。观其
指法。则曰重手乃得隐隐。是病在里而为阴可知矣。自古迟则寒。此节
独不言寒。而专言肾虚不安者。何也。以迟为阴土。是土不务其德。而乘
其所胜。夫土所胜者。水也。肾为水藏。乘其虚而克之。肾其能安乎哉。
按脉经云。迟脉呼吸三至。去来极迟。一曰举之不足。按之尽牢。一曰按
之尽牢。举之无有。经云。迟则为寒。
迟脉人逢状且难。遇其季夏不得痊。神工诊得知时候。道是脾来水必干。
今人皆言三至为迟矣。究未得迟脉之情状也。其于指下寻之。重手乃
得隐隐耳。故曰。迟脉人逢状且难也。今人皆言迟则为寒矣。究未尽迟
脉之体性也。其理又主脾来克水。肾虚不安。如此则迟脉不专主于寒
可知矣。然脉迟而曰遇其季夏不能痊者何也。以迟脉属土。季夏又值
土旺之时。水得土而绝。故曰遇其季夏。不能痊也。然季春季秋季冬。皆
土旺之日。何独见畏于季夏也。不知季春虽土寄旺之月。而木气尚余。
子能扶母。即迟脉来见。土其畏木而不暇克水。季秋亦土季旺之月。而
金气尚余。金能生水。纵迟脉来见。子受母荫。而水不畏土。季冬亦土寄
旺之月。水适当旺。旺者不受邪。纵迟脉来见。亦无所畏。惟季夏乃土正
旺之时。谓之长夏。言其生长于火也。况火为土之母。所畏者水耳。今借
居土后。则火挟子势。而反来侮水。夫火乃耗水坚土之物也。今得土以
合之。而水未有不涸者矣。故曰。遇其季夏不能痊也。
按经云。迟而涩。中塞有 结。又云。迟而滑者胀。又云。迟而缓者有寒。仲
景曰。如阳明脉迟。不恶寒。身体 然汗出。则用大承气汤。又洁古曰。
迟。阴也。季夏。阳也。此证为失时反候。阴盛阳虚治之。宜泻心肺。补肝肾。
泻心者。导赤散。补肾者。地黄丸。
迟脉属于阴脉。在指下寻按，必须重手按压才能隐约感觉到脉搏跳动，这就是迟脉。它主要主肾虚导致的不安。
迟脉对应五行中的阴土。为什么说是阴土呢？这是由土的属性决定的。缓脉已经比较慢，而迟脉比缓脉更慢，所以也称之为土。观察它的指法，说必须重手按压才能隐约感觉到，这说明病位在里，属于阴证，是可以确定的。自古以来都说“迟脉主寒”，但这一节唯独不说寒，而是专门讲肾虚不安，为什么呢？因为迟脉属阴土，这意味着土不能履行其正常的德性（克制水），反而去欺凌它所克制的对象。土所克制的对象是水。肾是藏水的脏器，当肾气虚弱时，被土乘虚克制，肾怎么能安宁呢？
按照《脉经》记载：迟脉在一呼一吸之间只跳动三次，来去非常缓慢。一种说法是轻取（举之）感觉不足，重按（按之）却坚实牢靠；另一种说法是重按时感觉坚实牢靠，轻取时却感觉不到。经典经文说：“迟脉则代表寒证。”
患者遇到迟脉，病情往往沉重且难以治愈，如果在季夏（夏季的最后一个月）患病，很难痊愈。高明的医生诊察后知道这是时机不对，说是脾（土）气过盛导致肾（水）气必然受损。现在人们都说三至为迟脉，但实际上并没有真正掌握迟脉的情状。它在指下寻按时，必须重手按压才能隐约感觉到。所以说，“患者遇到迟脉，病情沉重且难治”。现在人们都说“迟脉主寒”，但实际上并没有完全理解迟脉的本质属性。其道理又在于主脾（土）气来克制肾（水），导致肾虚不安。像这样，就可以知道迟脉并不专门主寒证了。然而，为什么说遇到迟脉的人在季夏不能痊愈呢？因为迟脉属土，而季夏又是土气旺盛的时候，水遇到旺土就会被绝灭，所以说遇到季夏就不能痊愈。但是，春季、秋季、冬季也是土气寄旺的日子，为什么唯独害怕季夏呢？不知道季春虽然是土气寄旺的月份，但木气还残余，木能生火（子能扶母），即使出现迟脉，土畏惧木气而没有余力去克制水。季秋也是土气寄旺的月份，但金气还残余，金能生水，即使出现迟脉，水受到母亲（金）的荫庇，水也不畏惧土。季冬也是土气寄旺的月份，但水正当旺盛，旺盛的气血不受邪气侵犯，即使出现迟脉，也没有什么可畏惧的。只有季夏才是土气真正旺盛的时候，称为长夏，意思是生长在火气之中。况且火是土的母亲，土所畏惧的是水。现在火借居在土之后（火生土），那么火就挟带儿子（土）的气势，反过来欺侮水。火是消耗水、坚固土的物质。现在得到土的配合，水没有不枯竭的。所以说，遇到季夏就不能痊愈。
按照经文记载：“迟而涩，中塞有结聚。”又说：“迟而滑者胀满。”又说：“迟而缓者有寒。”张仲景说：“如果是阳明脉迟，不恶寒，身体自然汗出，则使用大承气汤。”另外李东垣（洁古）说：“迟脉属阴，季夏属阳。这种病症属于失时反候（违背时令的反常现象），阴盛阳虚。治疗应当泻心肺，补肝肾。泻心用导赤散，补肾用地黄丸。”
Chi pulse (Slow Pulse) belongs to Yin. Under the fingers, it requires heavy pressure to faintly perceive the beat; this is the Chi pulse. It primarily indicates Kidney deficiency leading to restlessness.
The Chi pulse corresponds to Yin Earth in the Five Elements. Why is it called Yin Earth? This is determined by the nature of Earth. The Huan pulse (Moderate/Sluggish Pulse) is already relatively slow, whereas the Chi pulse is slower than the Huan pulse, hence it is also referred to as Earth. Observing its palpation method, which states that heavy pressure is needed to faintly perceive it, indicates that the pathology is interior and Yin in nature, which is certain. Since ancient times, it has been said that "Chi pulse indicates Cold." However, this section uniquely does not mention Cold but specifically discusses Kidney deficiency and restlessness. Why? Because the Chi pulse belongs to Yin Earth, implying that Earth fails to perform its proper virtue (controlling Water) and instead overacts upon what it controls. What Earth controls is Water. The Kidney is the organ storing Water. When the Kidney is deficient, it is attacked by Earth taking advantage of the weakness; how can the Kidney remain tranquil?
According to the *Mai Jing* (Pulse Classic): The Chi pulse beats three times per respiration cycle, coming and going extremely slowly. One description says: light pressure (Ju Zhi) feels insufficient, while heavy pressure (An Zhi) feels firm and solid. Another description says: heavy pressure feels firm and solid, while light pressure feels absent. The classic text states: "Chi pulse indicates Cold."
When a patient encounters the Chi pulse, the condition is often severe and difficult to treat. If contracted during Ji Xia (the last month of summer), recovery is unlikely. An expert physician, upon diagnosis, recognizes this as an unfavorable timing, stating that Spleen (Earth) Qi excess inevitably depletes Kidney (Water) Qi. Modern people all say that three beats per respiration constitute the Chi pulse, yet they have not truly grasped the actual characteristics of the Chi pulse. Under the fingers, one must press heavily to faintly perceive it. Hence it is said, "When a patient encounters the Chi pulse, the condition is severe and difficult to treat." Modern people all say "Chi pulse indicates Cold," yet they have not fully understood the essential nature of the Chi pulse. The underlying logic again points to Spleen (Earth) Qi overcoming Kidney (Water), causing Kidney deficiency and restlessness. Thus, it is evident that the Chi pulse does not exclusively indicate Cold syndromes. However, why is it said that patients with a Chi pulse cannot recover if encountered in Ji Xia? Because the Chi pulse belongs to Earth, and Ji Xia is the time when Earth Qi is at its peak. Water is extinguished by thriving Earth, hence it is said that encountering Ji Xia leads to non-recovery. But Spring, Autumn, and Winter are also periods when Earth Qi is寄旺 (provisionally prosperous). Why fear only Ji Xia? It is unknown that although Ji Chun (early Spring) is a month where Earth Qi is provisionally prosperous, Wood Qi still lingers. Wood generates Fire (child supports mother); even if the Chi pulse appears, Earth fears Wood and lacks the strength to overcome Water. Ji Qiu (late Autumn) is also a month where Earth Qi is provisionally prosperous, but Metal Qi still lingers. Metal generates Water; even if the Chi pulse appears, Water benefits from the protection of its mother (Metal), so Water does not fear Earth. Ji Dong (late Winter) is also a month where Earth Qi is provisionally prosperous, but Water is at its peak. What is strong does not accept pathogenic factors; even if the Chi pulse appears, there is nothing to fear. Only Ji Xia is the time when Earth Qi is truly prosperous, called Chang Xia (Long Summer), meaning it grows under Fire. Moreover, Fire is the mother of Earth, and what Earth fears is Water. Now, Fire resides behind Earth (Fire generates Earth), so Fire leverages the momentum of its child (Earth) to reverse-attack Water. Fire consumes Water and consolidates Earth. Now combined with Earth, Water will inevitably dry up. Hence it is said, "Encountering Ji Xia leads to non-recovery."
According to the classics: "Chi and Se (Choppy) pulses indicate obstruction and nodules in the middle jiao." It also says: "Chi and Hua (Slippery) pulses indicate distension." It also says: "Chi and Huan (Moderate) pulses indicate Cold." Zhang Zhongjing stated: "If the Yangming pulse is Chi, without aversion to cold, and with spontaneous sweating of the body, Da Cheng Qi Tang (Major Order the Qi Decoction) should be used." Additionally, Li Dongyuan (Jiegu) stated: "Chi pulse is Yin; Ji Xia is Yang. This syndrome represents a deviation from seasonal norms, characterized by Yin excess and Yang deficiency. Treatment should involve draining the Heart and Lung, and tonifying the Liver and Kidney. To drain the Heart, use Dao Chi San (Guide Out Red Powder); to tonify the Kidney, use Di Huang Wan (Rehmannia Pill)."