旧皆以弦为百病之忌脉，今伏思之，亦有以弦为吉者。此必其始，脉来指下累累，断而
不续
，得药后脾、脾气续，而脉形通连也；其始寸不下关，或尺不上寸，或两头有脉，关中不至
，其后三焦气通，而脉形挺长也；其始 浮泛，空而无根，其后肾气归元，而脉形浓实也
；其始沉弱无力，萎靡不振，其后肝、脾气旺，而脉势强壮也；其始涣散无边，模糊不清，
其后阴回气聚，而脉形坚敛也；其始细数无神，起伏不明，其后阳回气充，而脉势畅大，能
首尾齐起齐落也。此皆以弦为败脉之转关，以其气由断而续，由屈而伸，由空而实，由散而
聚，由衰而振也。其不谓之长，而谓之弦者，阴阳初复，其气只能充于脉管之中，使脉形为
之挺亘而有力，尚未能洋溢脉管之外，使脉势条畅温润而有余也。仲景曰∶伤寒吐下后，不
大便五六日，循衣妄撮，谵语不识人，微喘直视，脉弦者生，涩者死。又曰∶汗多重发汗亡
阳，谵语，脉短者死，脉自和者不死。又曰∶痉病，脉伏坚，发汗后，其脉 如蛇，暴腹
胀大者欲解。慎柔曰∶虚损，六脉和缓，服四君、保元，热退而脉渐弦，反作泻下血，此阴
火煎熬，血结经络者，邪从下窍出也；有作伤风状者，邪从上窍出也。又曰∶紧数之脉，表
里俱虚，紧犹有胃气，数则无胃气。喻嘉言解仲景下利脉反弦，发热身汗者自愈，谓∶久利
邪气深入阴分，脉当沉弱微涩，忽然而转见弦，是少阳生发之气发见，生机宛然指下。此皆
以弦为吉之义也。故久病之人其脉弦紧有力者，是真气内遏而有根也，此尤当于尺部占之，
病势困笃，寸关或结或陷，而尺中充长弦实起伏有力者，根本未动也。何者?真气不能充达
于上，即当蓄积于下也。世只知尺脉忌弦，而不知尺脉不当忌弦，而忌缓、忌滑也。缓者，
呆软无气也；滑者，断而不续也。所谓忌弦者，孤硬之谓也，非长实之谓也。
过去人们都认为弦脉是各种疾病的禁忌之脉，现在我仔细思考后认为，也有将弦脉视为吉兆的情况。这必定是在疾病初期，脉搏在指下感觉颗粒分明、连续中断且不相接续，服药之后脾气恢复延续，脉象形态变得连通；起初寸口脉达不到关部，或者尺部脉上不到寸部，或者两头有脉而关部脉不至，后来三焦气机通畅，脉象形态变得挺直而长；起初脉象浮泛，空虚而无根底，后来肾气回归本源，脉象形态变得浓重坚实；起初脉象沉弱无力，萎靡不振，后来肝、脾之气旺盛，脉势变得强壮；起初脉象涣散无边，模糊不清，后来阴液回复、气机凝聚，脉象形态变得坚敛；起初脉象细数而无神，起伏不明，后来阳气回复、气机充盛，脉势畅达宏大，能够首尾同时起落。这些都是将弦脉视为败坏之脉向好转转折的关键点，因为脉气由断绝转为接续，由屈曲转为伸展，由空虚转为充实，由散乱转为凝聚，由衰微转为振奋。之所以不称之为“长”脉，而称之为“弦”脉，是因为阴阳之气刚刚恢复，其气只能充盈于脉管之中，使脉象形态挺拔横亘而有力，尚不能洋溢于脉管之外，使脉势条畅温润而有余裕。张仲景说：伤寒经过吐法或下法治疗后，五六天不大便，循衣摸床、胡乱抓取，胡言乱语、不认识人，轻微气喘、两眼直视，如果脉象弦，则生；如果脉象涩，则死。又说：发汗过多导致亡阳，出现胡言乱语，脉象短的死亡，脉象自和的不会死。又说：痉病，脉象伏而坚，发汗后，脉象如蛇般蠕动，突然腹部胀大的将要痊愈。慎柔说：虚损病，六脉和缓，服用四君子汤、保元汤后，热退而脉渐变为弦，反而出现腹泻下血，这是阴火煎熬，血液凝结在经络中，邪气从下窍排出；有的表现为类似伤风的症状，邪气从上窍排出。又说：紧数和数的脉象，表里都虚，紧脉还有胃气，数脉则无胃气。喻嘉言解释张仲景关于下利脉反见弦、发热身汗者自愈的说法，认为：久痢邪气深入阴分，脉象应当沉弱微涩，忽然转而见到弦脉，这是少阳生发之气显现，生机宛然存在于指下。这些都是将弦脉视为吉兆的道理。所以久病之人，如果脉象弦紧有力，是真气在内遏制而有根的表现，这尤其应当在尺部进行占测，病情危重困笃，寸部和关部或结滞或凹陷，而尺部充长、弦实、起伏有力的，说明根本未动。为什么呢？真气不能通达于上部，就应当蓄积在下部。世人只知道尺脉忌弦，却不知道尺脉不应当忌弦，而应当忌缓、忌滑。缓脉，是呆板软弱无气的表现；滑脉，是断绝而不接续的表现。所谓忌讳的弦脉，是指孤硬无根的脉象，而不是指长实有力的脉象。
In the past, it was universally believed that the Wiry pulse (Xian Mai) was an ominous sign for various diseases. Upon careful reflection, I have come to realize that there are instances where the Wiry pulse is considered auspicious. This necessarily refers to a situation where initially, the pulse feels granular and discontinuous under the fingers, with breaks in continuity. After taking medicine, the Spleen Qi (Pi Qi) recovers and continues, causing the pulse form to become connected; initially, the Cun position does not reach the Guan position, or the Chi position does not reach the Cun position, or there is pulse at both ends but not at the Guan, after which the San Jiao Qi (Triple Burner Qi) becomes unobstructed, and the pulse form becomes straight and long; initially, the pulse is floating and superficial, empty and rootless, after which the Kidney Qi (Shen Qi) returns to its origin, and the pulse form becomes dense and solid; initially, the pulse is deep and weak, lacking strength, listless and depressed, after which the Liver (Gan) and Spleen Qi flourish, and the pulse momentum becomes strong; initially, the pulse is scattered without boundary, vague and unclear, after which Yin fluids return and Qi gathers, and the pulse form becomes firm and condensed; initially, the pulse is fine and rapid, lacking Shen (Spirit), with unclear rising and falling, after which Yang Qi returns and Qi becomes abundant, and the pulse momentum becomes smooth and grand, rising and falling simultaneously from head to tail. These are all cases where the Wiry pulse represents a turning point from a failing pulse to recovery, as the Qi transitions from broken to continuous, from contracted to extended, from empty to full, from scattered to gathered, and from declining to revitalized. It is called "Wiry" rather than "Long" because when Yin and Yang Qi first recover, their energy can only fill within the vessel walls, making the pulse form straight and forceful, but not yet overflowing outside the vessels to make the pulse momentum smooth, warm, and abundant. Zhang Zhongjing stated: "After vomiting or purging in Cold Damage syndrome, if there has been no bowel movement for five or six days, accompanied by grasping at bedclothes, random grabbing, delirium, inability to recognize people, slight wheezing, and fixed gaze, if the pulse is Wiry, the patient will live; if the pulse is Choppy (Se), the patient will die." He also said: "If excessive sweating leads to Yang collapse and delirium, a Short pulse indicates death, while a self-harmonious pulse indicates survival." He further stated: "In Spasm disease, if the pulse is Deep and Firm, and after sweating, the pulse moves like a snake, or sudden abdominal distension occurs, the condition is about to resolve." Shen Rou stated: "In Deficiency Consumption disease, if the six pulses are Harmonious and Moderate, and after taking Si Jun Zi Tang (Four Gentlemen Decoction) or Bao Yuan Tang (Protect the Origin Decoction), the fever subsides and the pulse gradually becomes Wiry, followed by diarrhea and bloody stool, this indicates Yin Fire scorching and blood coagulating in the collaterals, with pathogenic factors exiting through the lower orifices; some present with symptoms resembling Wind-Cold invasion, with pathogenic factors exiting through the upper orifices." He also said: "For Tight and Rapid pulses, both exterior and interior are deficient. A Tight pulse still retains Stomach Qi, whereas a Rapid pulse lacks Stomach Qi." Yu Jiayan explained Zhang Zhongjing's statement regarding dysentery where a contrary Wiry pulse, accompanied by fever and sweating, leads to spontaneous resolution, stating: "In chronic dysentery, pathogenic factors have deeply penetrated the Yin levels, so the pulse should be Deep, Weak, Fine, and Choppy. If it suddenly turns Wiry, this indicates the emergence of Shaoyang (Lesser Yang) generating and ascending Qi, with vitality clearly palpable under the fingers." These are all arguments for considering the Wiry pulse as auspicious. Therefore, in patients with chronic illness, a Wiry and Tight pulse with strength indicates that True Qi (Zhen Qi) is contained internally and has roots; this is particularly evident in the Chi position. When the disease is critical and severe, and the Cun and Guan positions show Knotted or Sunken pulses, but the Chi position is full, long, Wiry, Solid, with distinct rising and falling and strength, it indicates that the Root remains intact. Why? Because True Qi cannot reach the upper body, it must accumulate in the lower body. The world only knows that the Chi pulse should avoid being Wiry, but fails to realize that the Chi pulse should not fear the Wiry quality, but rather fear Sluggish (Huan) and Slippery (Hua) qualities. A Sluggish pulse is stiff, soft, and devoid of Qi; a Slippery pulse is broken and discontinuous. What is feared as "Wiry" refers to isolated hardness without root, not to a Long and Solid quality.