体象 芤乃草名，绝类慈葱；浮沉俱有，中候独空。
主病 芤脉中空，故主失血。左寸呈芤，心主丧血。右寸
呈芤，相傅阴伤。芤入左关，肝血不藏。芤现右关，脾血不摄。左尺如芤，便红为咎。右尺如芤，火炎精漏。
【按】芤之为义，两边俱有，中央独空之象也。芤乃草名，其状与葱无以异也。假令以指候葱，浮候之
着上面之葱皮，中候之正当葱之空处，沉候之又着下面之葱皮，以是审察，则芤脉之名象，昭然于心目之
间，确乎无可疑矣。刘三点云∶“芤脉何似，绝类慈葱。指下成窟，有边无中。”叔和云∶“芤脉浮大而软，
按之中央空，两边实。”二家之言，其于芤脉已无遗蕴矣。戴同父云∶“营行脉中，脉以血为形。芤脉中空，
脱血之象也。”伪诀云∶“两头有，中间无。”以头字易《脉经》之边字，未明中候独空之旨，则是上下之脉划
然中断，而成阴绝阳绝之诊矣。又云∶“寸芤积血在胸中，关里逢芤肠胃痈。”是以芤为蓄血积聚之实脉，非
失血虚家之空脉矣。以李时珍之博洽明通，亦祖述其言为主病之歌，岂非千虑之一失乎？伪诀又云∶“芤主淋
沥，气入小肠。”与失血之候，有何干涉！种种邪讹，误人不小，不得不详为之辨也。即叔和《脉经》云∶“
三部脉芤，长病得之生，卒病得之死。”然暴失血者脉多芤，而谓卒病得之死可乎？
其言亦不能无疵也。至刘肖斋所引诸家论芤脉者，多出附会，不可尽信。
体象：芤脉的形态如同一种名为“芤”的草，其形状极像慈葱（一种大葱）；轻取（浮候）和重取（沉候）都能感觉到脉搏的存在，唯独中取（中候）时感觉中间是空的。
主病：芤脉中空的特点，因此主要主失血之证。左寸部出现芤脉，表示心主所藏的血液亏损。右寸部出现芤脉，表示相傅（肺脏）的阴液受损。芤脉出现在左关部，表示肝血不能固藏。芤脉出现在右关部，表示脾血不能统摄。左尺部呈现芤脉，提示大便带血为病。右尺部呈现芤脉，提示虚火炎上导致精微物质泄漏。
【按语】芤脉的含义，是指两边有脉气、中央独空的形象。芤是一种草名，其形状与葱没有区别。假如用手指去模拟触摸葱，轻按时手指接触的是上面的葱皮，中按时手指正好处于葱的空心处，重按时手指接触的是下面的葱皮，通过这样的审察，芤脉的名称和形象就在心中清晰显现，确实无可怀疑了。刘三点说：“芤脉像什么？极像慈葱。指下感觉成窟窿状，只有边缘而没有中间。”王叔和说：“芤脉浮大且柔软，按压时中央空，两边实。”这两家的言论，对于芤脉的描述已经没有任何遗漏了。戴同父说：“营气运行在脉管之中，脉以血液作为形体。芤脉中空，是脱血的征象。”伪诀（指《脉诀》等伪托之作）说：“两头有，中间无。”用“头”字替换《脉经》中的“边”字，未能阐明中候独空的宗旨，这就变成了上下脉气截然中断，成为阴绝或阳绝的诊断了。又说：“寸部见芤脉是胸中有积血，关部遇到芤脉是肠胃生痈。”这是将芤脉当作蓄血积聚的实脉，而非失血虚损之人的空脉了。凭借李时珍的博学通达，也沿袭这种说法作为主病的歌诀，这难道不是千虑之一失吗？伪诀又说：“芤脉主淋沥，气入小肠。”这与失血的证候，有什么关联！种种邪谬讹误，误导人很深，不得不详细加以辨析。即使是王叔和《脉经》中说：“三部脉都见芤，久病得此可生，急病得此则死。”然而暴发性失血者脉象多呈芤，却说急病得此会死，这说得通吗？他的言论也不能没有瑕疵。至于刘肖斋所引用的各家论述芤脉的内容，大多出于附会，不能完全相信。
**Physical Manifestation:** The Kou pulse (Kou Mai, 芤脉) resembles a plant named "Kou," which is very similar in shape to *Allium fistulosum* (Cibotium onion/Scallion); it is perceptible at both the superficial (Fu, 浮) and deep (Chen, 沉) levels, but feels empty at the middle level (Zhong Hou, 中候).
**Predominant Diseases:** Due to its hollow center, the Kou pulse primarily indicates blood loss. A Kou pulse at the left Cun position (Left Cun, 左寸) indicates loss of blood governed by the Heart. A Kou pulse at the right Cun position (Right Cun, 右寸) indicates damage to the Yin of the Ministerial Official (Lung, 肺). A Kou pulse entering the left Guan position (Left Guan, 左关) indicates that Liver Blood fails to be stored. A Kou pulse appearing at the right Guan position (Right Guan, 右关) indicates that Spleen Blood fails to control. If the Kou pulse is present at the left Chi position (Left Chi, 左尺), it signifies hematochezia (blood in stool) as an ailment. If the Kou pulse is present at the right Chi position (Right Chi, 右尺), it signifies flaming fire leading to the leakage of essence.
**Commentary:** The meaning of the Kou pulse is the image of having pulse qi on both sides but being empty in the center. Kou is a plant name, and its shape is indistinguishable from that of a scallion. Suppose one uses fingers to simulate touching a scallion: upon superficial palpation, the finger touches the outer skin; upon middle palpation, the finger falls into the hollow center; upon deep palpation, the finger touches the inner/bottom skin. Through such examination, the name and image of the Kou pulse become clear in mind and eye, leaving no room for doubt. Liu Sandian said: "What does the Kou pulse resemble? It is exactly like a scallion. Under the fingers, it feels like a cavity, with edges but no center." Wang Shuhe said: "The Kou pulse is floating, large, and soft; when pressed, the center is empty while the sides are solid." The statements of these two masters leave no omission in describing the Kou pulse. Dai Tongfu said: "Ying Qi circulates within the vessels, and the vessel takes blood as its form. The Kou pulse is empty in the center, which is the sign of blood depletion." The Apocryphal Canon (referring to pseudo-apocryphal texts like *Mai Jue*) stated: "There is [pulse] at both ends, none in the middle." By substituting the character "head" (Tou, 头) for "side" (Bian, 边) from *Mai Jing*, it failed to clarify the principle of emptiness at the middle level. This implies a complete interruption of pulse qi between upper and lower, resulting in a diagnosis of absolute Yin or absolute Yang deficiency. It further stated: "Kou at Cun indicates accumulated blood in the chest; Kou at Guan indicates intestinal abscess." This treats the Kou pulse as a excess pulse of blood stasis and accumulation, rather than the empty pulse of a deficient patient who has lost blood. Despite Li Shizhen's profound knowledge and clarity, he also adopted this statement as the main song for predominant diseases. Is this not a lapse in judgment among thousands of considerations? The Apocryphal Canon also stated: "Kou governs strangury, with Qi entering the Small Intestine." What connection does this have with signs of blood loss? Such various heresies and errors mislead people significantly, necessitating detailed refutation. Even Wang Shuhe's *Mai Jing* states: "If all three positions show a Kou pulse, it is survivable if obtained in chronic illness, but fatal if obtained in acute illness." However, patients with sudden massive blood loss often present with a Kou pulse; can it truly be said that obtaining it in acute illness leads to death? His words also contain flaws. As for the various discussions on the Kou pulse cited by Liu Xiaozhai, most are forced interpretations and cannot be fully trusted.