（真脉，真脏脉也，即死脉也。文有异同，义无差别，总之不见胃气之脉，乃名真脏脉。）
真肝脉至，中外急，如循刀刃责责然，如按琴瑟弦。
真心脉至，坚而搏，如循薏苡子累累然。
真脾脉至，弱而乍数乍疏。
真肺脉至，大而虚，如毛羽中人肤。
真肾脉至，搏而绝，如弹石状辟辟然。
【按】凡持真脏脉者，肝至悬绝，十八日死。心至悬绝，九日死。肺
至悬绝，十二日死。肾至悬绝，七日死。脾至悬绝，四日死。
春胃微弦曰平，弦多胃少曰肝病，但弦无胃曰死。
夏胃微钩曰平，钩多胃少曰心病，但钩无胃曰死。
长夏胃微软弱曰平，弱多胃少曰脾病，但弱无胃曰死。
秋胃微毛曰平，毛多胃少曰肺病，但毛无胃曰死。
冬胃微石曰平，石多胃少曰肾病，但石无胃曰死。
蔡氏曰∶“不大不小，不长不短，不滑不涩，不浮不沉，不疾不迟，应手中和，意思欣欣，难以名状者，胃气脉也。”
东垣曰∶“有病之脉，当求其神。如六数七极，热也。脉中
有力，即有神矣。为泄其热。三迟二败，寒也。脉中有力，即
有神矣。为去其寒。若数极迟败，脉中不复有力，为无神也。
而遽泄之去之，神将何根据耶！故经曰，脉者，气血之先；气血
者，人之神也。”（按王宗正曰∶“诊脉之法，当从心肺俱浮，肾肝俱沉，脾在中
州。”即王氏之言，而知东垣所谓“脉中有力”之中，盖指中央戊
己土，正在中候也。胃气未散，虽数不至于极，迟不至于败，尚可图也。故东垣之所谓有神，即《内经》之
所谓有胃气也。）
（真脉，也就是真脏脉，即是死脉。文字表述虽有差异，但含义没有区别，总之是看不到胃气的脉象，才称为真脏脉。）
真肝脉到来时，脉象中外皆急迫，如同触摸刀刃般锐利扎手，又像是按压琴瑟的弦。
真心脉到来时，脉象坚硬且搏指，如同触摸薏苡子那样颗粒分明、累累相连。
真脾脉到来时，脉象虚弱，时而快速时而疏缓。
真肺脉到来时，脉象大而空虚，如同羽毛轻触人的皮肤。
真肾脉到来时，脉象搏动强劲而断续，如同弹击石头般辟辟作响。
【按语】凡是诊察到真脏脉的情况，如果肝脉出现悬绝之象，十八天后死亡。心脉出现悬绝之象，九天后死亡。肺脉出现悬绝之象，十二天后死亡。肾脉出现悬绝之象，七天后死亡。脾脉出现悬绝之象，四天后死亡。
春季脉象中带有微微的弦象（胃气），称为平脉（健康）；弦象多而胃气少，称为肝病；只有弦象而没有胃气，称为死脉。
夏季脉象中带有微微的钩象（胃气），称为平脉；钩象多而胃气少，称为心病；只有钩象而没有胃气，称为死脉。
长夏季节脉象中带有微微的软弱象（胃气），称为平脉；软弱象多而胃气少，称为脾病；只有软弱象而没有胃气，称为死脉。
秋季脉象中带有微微的毛象（胃气），称为平脉；毛象多而胃气少，称为肺病；只有毛象而没有胃气，称为死脉。
冬季脉象中带有微微的石象（胃气），称为平脉；石象多而胃气少，称为肾病；只有石象而没有胃气，称为死脉。
蔡氏说：“不大不小，不长不短，不滑不涩，不浮不沉，不疾不迟，按之中和舒适，意态欣欣向荣，难以用言语形容的，就是胃气脉。”
李东垣说：“患有疾病的脉象，应当探求其‘神’。如脉数至六次或七次，或极快，属于热证。脉中仍有力量，就是有‘神’了。治疗应通过泄法来清除热邪。如脉迟至三次或二次，或衰败无力，属于寒证。脉中仍有力量，就是有‘神’了。治疗应通过去法来驱除寒邪。如果脉既极数又极迟且衰败，脉中不再有力，这就是无‘神’了。此时如果贸然使用泄法或去法，神的依据在哪里呢！所以《内经》说，脉是气血的先导；气血，就是人的神。”（按：王宗正说：“诊脉的方法，应当遵循心肺脉俱浮，肾肝脉俱沉，脾脉在中州（中部）。”从王氏的话可以得知，李东垣所说的“脉中有力”的“中”，大概是指中央戊己土，正在中候（中层取脉）。胃气尚未散失，虽然脉数不至于极快，脉迟不至于衰败，还可以救治。所以李东垣所说的有“神”，就是《内经》所说的有“胃气”。）
(Real pulse, also known as the pulse of the Zang organs (Zhen Zang Mai), is the pulse of death. Although the textual descriptions may vary slightly, the meaning is identical; in essence, it refers to a pulse devoid of Stomach Qi (Wei Qi), which is named the pulse of the Zang organs.)
When the real Liver pulse arrives, it is tense and urgent both superficially and deeply, resembling the sensation of sliding along the edge of a knife, or like pressing the strings of a qin or se instrument.
When the real Heart pulse arrives, it is firm and striking, resembling the sensation of touching Coicis Semen (Yiyiren, 薏苡仁) beads that are clustered together.
When the real Spleen pulse arrives, it is weak and intermittently rapid and slow.
When the real Lung pulse arrives, it is large and empty, resembling the feeling of feathers lightly brushing against human skin.
When the real Kidney pulse arrives, it is forceful yet intermittent, sounding like stones being struck, "pi pi" loudly.
[Commentary] In cases where the pulse of the Zang organs is detected: if the Liver pulse appears suspended and severed (Xuan Jue, 悬绝), death occurs within eighteen days. If the Heart pulse appears suspended and severed, death occurs within nine days. If the Lung pulse appears suspended and severed, death occurs within twelve days. If the Kidney pulse appears suspended and severed, death occurs within seven days. If the Spleen pulse appears suspended and severed, death occurs within four days.
In spring, a pulse with a slight wiry quality (Xian, 弦) indicating Stomach Qi is considered normal (Ping, 平). A wiry quality predominant with little Stomach Qi indicates Liver disease. A wiry quality without any Stomach Qi indicates death.
In summer, a pulse with a slight hook-like quality (Gou, 钩) indicating Stomach Qi is considered normal. A hook-like quality predominant with little Stomach Qi indicates Heart disease. A hook-like quality without any Stomach Qi indicates death.
In late summer, a pulse with a slight soft and weak quality indicating Stomach Qi is considered normal. A soft and weak quality predominant with little Stomach Qi indicates Spleen disease. A soft and weak quality without any Stomach Qi indicates death.
In autumn, a pulse with a slight hairy/light quality (Mao, 毛) indicating Stomach Qi is considered normal. A hairy/light quality predominant with little Stomach Qi indicates Lung disease. A hairy/light quality without any Stomach Qi indicates death.
In winter, a pulse with a slight stone-like heavy quality (Shi, 石) indicating Stomach Qi is considered normal. A stone-like quality predominant with little Stomach Qi indicates Kidney disease. A stone-like quality without any Stomach Qi indicates death.
Cai stated: "Neither too large nor too small, neither too long nor too short, neither slippery nor choppy, neither floating nor sinking, neither rapid nor slow, responding with harmony and balance, exhibiting a vibrant and thriving spirit, difficult to describe in words—this is the pulse of Stomach Qi."
Li Dongyuan stated: "For pathological pulses, one must seek the 'Shen' (Spirit/Vitality). For instance, a pulse rate of six or seven beats per breath cycle, or extremely rapid, indicates Heat syndrome. If there is strength within the pulse, this constitutes having 'Shen'. The treatment should be to drain the Heat. Conversely, a pulse rate of three or two beats per breath cycle, or failing/decaying, indicates Cold syndrome. If there is strength within the pulse, this constitutes having 'Shen'. The treatment should be to dispel the Cold. However, if the pulse is both extremely rapid and extremely slow/failing, and lacks strength entirely, this is 'no Shen'. In such a case, rashly applying draining or dispelling methods would leave the Shen without foundation! Therefore, the Classic states: 'The pulse is the precursor of Qi and Blood; Qi and Blood are the Shen of humanity.'" ([Note] Wang Zongzheng stated: "The method of pulse diagnosis should follow the principle that Heart and Lung pulses are generally superficial (Fu), while Kidney and Liver pulses are generally deep (Chen), and the Spleen pulse resides in the Central Region (Zhong Zhou)." From Wang's statement, we can understand that Li Dongyuan's reference to "strength in the middle" (Zhong) likely refers to the Central Earth (Wu Ji Tu, 戊己土), corresponding to the intermediate depth of palpation (Zhong Hou, 中候). As long as Stomach Qi has not dissipated, even if the pulse is rapid but not extreme, or slow but not failing, recovery is still possible. Thus, Li Dongyuan's concept of having 'Shen' is equivalent to the concept of having 'Stomach Qi' in the Neijing.)