四营者。轻重清浊也。轻清者阳也。重浊者阴也。夫欲知人贵贱贫富寿夭。须于四营脉中求之。若前论五阳五阴脉
者。只言脏腑之偏。此四营之论。为统贯一体。而精神魂魄气血升降。靡不与焉。
故脉清则神清。神清则气清。气清则骨肉形禀之亦清矣。此则轻清重浊。故可知也。
夫欲切此脉。须忆叔和脉中求之有疾。疾则变而难审其证。盖五脏六腑。或为邪气所袭故也。今明轻清重浊四脉于
后。
轻者如指摸玉。纯粹温润。识性明敏。禄位权贵。
清者平清而浮。状如轻羽。不沉不濡。隐隐常动。
重者缓而粗。以手按之。其脉浊。脉浊气亦浊也。
重者中浊而沉如紧。索隐重浊。亦在究其本原。
肝部轻清。衣禄荣贵。重浊一身不足。
心部轻清。聪明发达。重浊夭亡身死。
肾部轻清。智巧谦和。重浊智少多淫。
肺部轻清。义勇谋略。重浊贪淫死临。
脾部轻清。富贵声名。重浊很毒无情。
弦洪长大为岁热。短促微沉气冷疼。实主肝虚并热上。脉浮虚肿冷中生。滑时呕逆腰肢困。缓疾原来气不宁。涩血
病时因妇孕。男儿有此漏精神。男子但有疾。伤神劳怯。妇人有疾。劳心受气。温肝血气不调。伤寒伤风积热。头眩发
热
骨蒸。不可一类察之。惟察手足冷热。观脉听声。专在轻清重浊虚实之理。不可妄议善主。设为详细再三审察明白。脉
病相应。方可用药。不致伤经错络。用药如行兵。取胜得功。万全而生。庸医不详其正。药性是非服入重地。不得其命。
负
尔何辜。医学不能明察其精。治其病。全其生。实为难矣。
太素之脉。七表八里。轻清重浊。四时逆顺。可见官禄生死。祸福疾病缘由。岂不神乎。
四营，指的是脉象的轻、重、清、浊四种属性。轻而清的属于阳，重而浊的属于阴。想要了解一个人的贵贱、贫富、寿命长短，必须从这“四营”脉象中去探寻。如果前文论述的五阳五阴脉，只是说明了脏腑功能的偏盛偏衰；那么这关于“四营”的论述，则是贯通整体，精神、魂、魄、气、血以及升降出入，无不包含其中。
所以，脉象清则神志清，神志清则气机清，气机清则形体骨骼禀赋也清。这就是通过轻清与重浊来推断的道理。
要想切按这种脉象，必须记住叔和（王叔和）所说的：脉中有疾（病邪），若有疾邪，脉象就会变化，难以准确审察证候。这是因为五脏六腑可能被邪气侵袭的缘故。现在明确阐述轻、清、重、浊四种脉象如下：
轻脉：感觉如同手指抚摸玉石，纯粹温润。主识性明敏，地位尊贵有权势。
清脉：平和清扬而浮取即得，状如轻羽，不沉也不濡软，隐隐常有搏动感。
重脉：缓大而粗，用手按压时，感觉脉体浑浊。脉象浑浊，说明气机也浑浊。
重脉（另一种描述）：中取浑浊且沉紧，索隐深重而浊，也需要探究其根本源头。
肝部脉象若轻清，主衣禄荣华尊贵；若重浊，主一身精气不足。
心部脉象若轻清，主聪明发达；若重浊，主夭折身亡。
肾部脉象若轻清，主智慧巧思、谦逊温和；若重浊，主智力低下、多淫欲。
肺部脉象若轻清，主义勇谋略；若重浊，主贪婪淫逸，面临死亡。
脾部脉象若轻清，主富贵声名；若重浊，主狠毒无情。
弦脉、洪脉、长大脉，主岁运炎热；短促、微脉、沉脉，主气冷疼痛。实脉主肝虚兼有热上冲；脉浮虚主水肿寒冷内生。滑脉主呕吐逆乱、腰肢困倦。缓脉或疾脉，原本主气机不宁。涩脉主血病，或因妇女怀孕所致。男子出现此类脉象，是漏精耗神。男子若有疾脉，是伤神劳损导致的怯弱之症；女子若有疾脉，是劳心受气所致。这些情况会导致温养肝的血气不调，或者伤寒、伤风积热，出现头眩、发热、骨蒸等症状。不可一概而论地观察，只有察看手足的冷热，观察脉象，听声音，专门在于辨析轻清、重浊、虚实的道理。不可妄加议论，随意定夺。必须设为详细标准，再三审察明白。只有脉象与病症相应，才可以用药，以免损伤经络。用药如同用兵打仗，取胜立功，才能万无一失地保全生命。庸医不详察正理，药性是非不分，服用后进入重病之地，导致丧命。辜负了你什么罪过呢？医学如果不能明察精微，治疗疾病，保全生命，实在是很难啊。
The "Four Operations" (Si Ying) refer to the four attributes of pulse: lightness, heaviness, clarity, and turbidity. Light and clear belong to Yang; heavy and turbid belong to Yin. To understand a person's nobility or baseness, wealth or poverty, and longevity or shortness of life, one must seek these answers within the Four Operations pulse. If the previously discussed Five Yang and Five Yin pulses only indicate the bias of Zang-Fu organs, this discussion on Four Operations integrates the whole body, encompassing spirit (Shen), soul (Hun), ethereal soul (Po), Qi, blood, and their ascending and descending movements.
Therefore, if the pulse is clear, the Shen is clear; if the Shen is clear, the Qi is clear; if the Qi is clear, the physical form and bone structure are also clear. This is how one can deduce from lightness/clarity versus heaviness/turbidity.
To palpate this type of pulse, one must recall Wang Shuhe's statement: "If there is disease in the pulse." If disease pathogens are present, the pulse changes and becomes difficult to accurately diagnose. This is because the Five Zang and Six Fu organs may be invaded by pathogenic factors. The following clarifies the four pulses of lightness, clarity, heaviness, and turbidity:
Light Pulse: Feels like fingers touching jade, pure and warm/moist. It indicates sharp intellect and high status/power.
Clear Pulse: Peaceful, clear, and floating upon superficial palpation, resembling a light feather, neither sinking nor soft, with a faint but constant pulsation.
Heavy Pulse: Slow, large, and coarse. Upon pressing with the hand, the pulse feels turbid. A turbid pulse indicates turbid Qi.
Heavy Pulse (Alternative description): Turbid at middle pressure and deep/tight, profound and heavy/turbid; one must investigate its root origin.
Liver Area: Light/clear pulse indicates honor and wealth; heavy/turbid pulse indicates deficiency of the whole body's essence.
Heart Area: Light/clear pulse indicates intelligence and success; heavy/turbid pulse indicates premature death.
Kidney Area: Light/clear pulse indicates wisdom, skillfulness, humility, and harmony; heavy/turbid pulse indicates low intelligence and excessive lust.
Lung Area: Light/clear pulse indicates bravery and strategy; heavy/turbid pulse indicates greed and lust, leading to death.
Spleen Area: Light/clear pulse indicates wealth and fame; heavy/turbid pulse indicates cruelty and lack of affection.
Xian (Wiry), Hong (Surging), and Chang-Da (Long-Large) pulses indicate hot years; Duan-Cu (Short-Sudden), Wei (Fine), and Chen (Deep) pulses indicate cold Qi and pain. Shi (Excess) pulse indicates Liver deficiency with rising heat; Floating-Empty pulse indicates edema and internal cold. Hua (Slippery) pulse indicates vomiting/reversal and waist/limb fatigue. Huan (Slow) or Ji (Rapid) pulses originally indicate unsettled Qi. Se (Choppy) pulse indicates blood disorders, possibly due to pregnancy in women. In men, such pulses indicate leakage of essence and depletion of spirit. If men have diseased pulses, it indicates injury to spirit and labor-induced weakness; if women have diseased pulses, it indicates mental labor and qi constraint. These conditions lead to disharmony of Liver blood and Qi, or accumulation of heat from Cold Damage (Shang Han) or Wind Strike (Shang Feng), resulting in dizziness, fever, and bone-steaming consumption. One cannot observe them uniformly. Only by examining the coldness/warmth of hands and feet, observing the pulse, and listening to the voice, specifically analyzing the principles of light/clear vs. heavy/turbid and empty/full, can one avoid reckless judgment. Detailed standards must be set for repeated examination. Medication should only be administered when the pulse and disease correspond, to avoid damaging meridians and collaterals. Using medication is like deploying troops; victory ensures safety and preservation of life. Quack doctors fail to examine the truth, confuse the properties of herbs, and upon administration into severe illness, cause death. How have they failed you? Medicine, if it cannot clearly perceive subtleties, treat diseases, and preserve life, is truly difficult.
The Taisu pulse method, including Seven Exterior and Eight Interior positions, light/clear and heavy/turbid attributes, and seasonal reversals/properness, can reveal the origins of official rank, wealth, life/death, fortune/misfortune, and disease. Is this not miraculous?