脉法
大浮数动滑为阳也，沉涩弱弦微为阴也。凡阴病见阳脉者生，凡阳病见阴脉者死。
脉浮而数（阳脉也），能食不大便者，里实也，名曰阳结，期十七日当剧（为阳气固结，阴
脉不得而杂之，阳结为火，至十七日传少阴水当愈，水不能制火，故剧。）
脉沉而迟（阴也），不能食，身体重，大便反硬，阴病也，名曰阴结，期十四日当剧（阴病
见阴脉当下利，今反硬者，是阴气结固，阳不得而杂之，阴结属水，至十四日传阳明土，当愈，
土不制水故剧，此病要死。）
脉霭霭如车盖者，名阳结也；大而厌厌聂也，为阳气郁结于外，不与阴杂也。
脉累累如循长竿者，名曰阴结也；连连强直也，为阴气郁结于内，不与阳
杂也。
脉瞥瞥如羹上肥者（轻浮也），阳气微也，衰也。
脉萦萦如蜘蛛丝（萦萦惹之不利者至细也）。阳气衰也。
脉绵绵（缓而连绵）如泻漆之状者（前大后小也）亡其血也。
脉来缓，时一止复来，名曰结（结阴也）阴气胜而阳不能相续也。
脉来数，时一止复来，名曰促（促，阳也）阳气胜而阴不能相续也。
脉三部浮沉大小迟数同等，为阴阳和平，虽剧当愈。
脉浮而洪，邪气胜也；自汗如油，喘而不休，正气脱也；水浆不下，胃气尽也；形体不仁，
荣卫绝也；乍静乍乱，正邪交争，此为命绝。
汗出发润（津脱也），喘而不休（气脱也），此状为肺先绝也。
阳反独留，身体大热是血先绝，为气独在；形体如烟熏，身无精华，血不荣也；直视，心经
绝也；头摇，阴绝阳无根也，此为心先绝也，心主血。
唇吻反青，脾部见木色，四肢 习，手足振动，此为肝绝也。
环口黧黑，脾主口，无精华则黑；冷汗，阳脱也；发黄，此为脾绝也。
溲便遗屎，肾绝不能约制也；狂言，肾藏志，志不守也；目反直视，此为肾绝也。
脉阴阳（表里也）俱紧（紧为寒）口中气出，唇口干燥（阳气渐复也。）
倦卧足冷，鼻中涕出，舌上胎滑，知阴独在也，勿妄治也，自解。到七日微发热，手足温者，
阴气已绝，阳气得复，解矣。到八日以上，反大热者，阴极变热，邪气胜正，此为难治，设使恶
寒者，必欲呕也，寒邪发于上焦，腹内痛者，必欲利也，寒邪胜于下焦。
脉阴阳俱紧，至于吐利，其脉独不解，紧去乃安，为欲解矣。若脉迟，至六七日不欲食，为
吐利后脾胃大虚，此为脱，水停故也，为未解。食自可者（脾胃已和，寒邪已散）为欲解。
病六七日，手足三部脉皆至（阳正胜也，大烦热也，）而口噤不能言，其人躁扰者则阴阳争胜
也，此欲解也。
脉和，其人大烦，目内 皆黄者，欲解。
脉不和者，病进。脉浮（阳也）而紧（阴也）按之反芤（虚也），此为本虚，当战汗出而解。
脉浮而数（阳也），按之不芤（阳实也），不战而汗解矣。
脉自微（邪气弱正气微），此以曾经汗吐下亡血，内无津液，此阴阳自和，必不汗不战而自解。
风（伤阳），则浮虚（伤阴）则牢坚沉潜，水蓄支散也，饮急，弦动阴阳相搏则为痛，
数则热烦，设有不应知变所缘，三部不同，病各异端。
人恐怖，脉形如循丝累累然，面白脱色者，血气不足。
人愧，脉浮，面色乍白乍赤者，神气怯也。
人不饮食，脉自涩，涩阴也，主亡津液，唇口干燥也。
下利三部无脉，冷气在胸中，令脉不通，然尺中时一小见脉再举头者，肾气也，脾虚肾气所
以乘，若见损脉来，至为难治。
趺阳脉滑而紧，滑者胃气谷气实，紧者胃气阴气强特实，击强痛还自伤。
寸口脉浮而大，浮为正虚，大为邪实，在尺为关（邪关下焦），在寸为格（邪格上焦），关则
不得小便，格则吐逆。趺阳脉伏而涩，伏者胃气伏而不宣，则吐逆水谷不化；涩者，脾气涩而不
布，则食不入，名曰开格。
趺阳脉大而紧者，当即下利为难治，下利者脉微小，今反紧者，邪胜也。
寸口诸微亡阳，诸濡亡血，诸弱阴虚也发热，诸紧为寒。
诸寒乘虚，寒乘气虚，抑佚阳气，则为厥郁（昏也，胃不仁，强直不知人也），以胃无谷气，脾
涩不通（上下也），使口急不能言，战寒（在表也），栗寒（在里也）。病欠者（阴阳相引，故欠和也，）
无病言迟者，风也（风中经络，舌难运用，）摇头者，里痛也，行迟者，表强也（邪中经络也）。坐
而伏者，短气也；坐而一脚下者，腰痛也。裹实护腹如卵者，心痛也。
伤寒证治
冬时触冒杀厉之气，实时为病，名曰伤寒。寒毒藏于肌肤，伏留至春，再感乖戾之气，名曰
春温，至夏变为暑病。春湿者，至夏至以前也，脉数而大散，似太阳发热不恶寒，同中暑烦渴不
憎寒，治宜升麻葛根解肌类也；热多，小柴胡；发渴烦躁便秘，大柴胡微利之；脉实者可下之。
阳脉浮滑，阴脉濡弱，更遇于风，变为风温，以前热未歇，又感于风者也，又因发汗身犹灼
然，自汗喘息切忌再汗，亦不可下及烧针类也。又云∶寸尺俱浮，误则死矣。宜葳蕤汤、知母葛
根汤也。
热病者，夏时发也，热极重于温也，治宜寒凉解其内外之烦毒也。如头疼恶寒身热，脉洪盛
有汗，夏至前，阳旦汤；夏至后，桂枝加石膏升麻汤。无汗，夏至前后，麻黄加知母石膏汤，烦
躁大青龙汤加黄芩，大热栀子升麻汤。
阳脉洪数，阴脉实大，更遇温热，变为温毒，以前热未已，又感温热，以其表里俱热，病之
最重者也。
阳脉濡弱，阴脉弦紧，更遇温气，变为温疫。
Pulse Diagnosis Methods
A large, floating, rapid, surging, or slippery pulse belongs to Yang; a deep, choppy, weak, string-taut, or faint pulse belongs to Yin. Generally, if a Yin disease presents with a Yang pulse, the prognosis is good (life); if a Yang disease presents with a Yin pulse, the prognosis is poor (death).
A pulse that is floating and rapid (a Yang pulse), accompanied by the ability to eat but constipation, indicates an interior excess syndrome, termed "Yang Jie" (Yang Knotting). It is expected that the condition will worsen on the seventeenth day (This is because Yang Qi is firmly knotted, preventing Yin from interfering; Yang Jie transforms into Fire. By the seventeenth day, it transmits to the Shaoyin Water meridian and should heal; however, if Water cannot control Fire, the condition worsens.)
A pulse that is deep and slow (Yin), accompanied by inability to eat, heavy body, and conversely hard stool, indicates a Yin disease, termed "Yin Jie" (Yin Knotting). It is expected that the condition will worsen on the fourteenth day (In Yin diseases presenting with Yin pulses, diarrhea is expected; conversely hard stool here indicates Yin Qi is firmly knotted, preventing Yang from interfering; Yin Jie belongs to Water. By the fourteenth day, it transmits to the Yangming Earth meridian and should heal; however, if Earth cannot control Water, the condition worsens, and this disease typically leads to death.)
A pulse that appears scattered like the canopy of a cart is named "Yang Jie"; a pulse that is large yet feeble and listless indicates Yang Qi knotted externally, not mingling with Yin.
A pulse that feels continuous like running along a long bamboo pole is named "Yin Jie"; a continuously stiff pulse indicates Yin Qi knotted internally, not mingling with Yang.
A pulse that flickers lightly like fat floating on soup broth (floating) indicates slight Yang Qi and declining Zheng Qi (Upright Qi).
A pulse that is slender and difficult to pull, like a spider's thread, indicates decline of Yang Qi.
A pulse that is continuous like the shape of pouring lacquer (large at first, small later) indicates loss of Blood.
A pulse that comes slowly and occasionally stops before resuming is named "Jie" (Knotted, Yin), indicating excess Yin where Yang cannot succeed continuously.
A pulse that comes rapidly and occasionally stops before resuming is named "Cu" (Surging, Yang), indicating excess Yang where Yin cannot succeed continuously.
When the three positions (Cun, Guan, Chi) show equal floating/sinking, large/small, and slow/rapid qualities, it indicates Yin-Yang harmony; even if severe, recovery is expected.
A floating and surging pulse indicates pathogenic excess; spontaneous sweating like oil and unceasing panting indicate collapse of Zheng Qi; inability to take fluids indicates exhaustion of Stomach Qi; insensitivity of the body indicates severance of Ying and Wei; alternating quietness and chaos indicates struggle between Zheng and Xie, which signifies the end of life.
Sweating until hair is wet (collapse of Jin Ye/Body Fluids) and unceasing panting (collapse of Qi) indicates that Lung Qi is failing first.
If Yang remains alone externally, causing high fever, this indicates Blood has failed first while Qi remains; a smoky complexion and lack of luster indicate Blood failing to nourish; fixed gaze indicates failure of the Heart Meridian; head shaking indicates Yin failure with Yang lacking root, signifying Heart Qi failure first, as the Heart governs Blood.
Blue-green lips and mouth corners, Wood color appearing in the Spleen area, twitching limbs, and trembling hands and feet indicate Liver Qi failure.
Dark black around the mouth (Spleen opens to the mouth; loss of essence turns black), cold sweat (Yang collapse), and jaundice indicate Spleen Qi failure.
Incontinence of urine and feces indicates Kidney Qi failing to restrain; delirium indicates Kidney failing to store Zhi (Will); reversed fixed gaze indicates Kidney Qi failure.
When Yin and Yang pulses are both tight (tightness indicates Cold), with warm breath from the mouth and dry lips/mouth, it indicates gradual recovery of Yang Qi.
Fatigue and desire to lie down, cold feet, runny nose, and slippery tongue coating indicate that only Yin remains; do not treat rashly, as it will resolve spontaneously. If there is slight fever and warmth in hands and feet by the seventh day, Yin has ended and Yang has recovered, indicating resolution. If after eight days there is instead high fever, this is extreme Yin transforming into heat, with pathogen overcoming Zheng, making it difficult to treat. If chills are present, vomiting is likely, indicating Cold pathogen affecting the Upper Jiao; if abdominal pain is present, diarrhea is likely, indicating Cold pathogen prevailing in the Lower Jiao.
With Yin and Yang pulses both tight, if vomiting and diarrhea occur but the pulse does not resolve, relief comes only when the tightness disappears, indicating impending resolution. If the pulse is slow and by the sixth or seventh day there is no desire to eat, this is due to great deficiency of Spleen and Stomach after vomiting/diarrhea, constituting a collapse with water retention, thus unresolved. If eating is normal (Spleen/Stomach harmonized, Cold dispersed), resolution is indicated.
After six or seven days of illness, if pulses in hand and foot三部 (Three Positions) are all prominent (Yang Zheng prevails, causing great irritability and heat), but the mouth is locked and speechless, and the person is restless, this is a struggle between Yin and Yang, indicating impending resolution.
If the pulse is harmonious, the person is greatly irritable, and the whites of the eyes turn yellow, resolution is indicated.
If the pulse is not harmonious, the disease progresses. A floating (Yang) and tight (Yin) pulse that feels hollow (Xu) upon pressure indicates underlying deficiency; resolution occurs through shivering and sweating. A floating and rapid (Yang) pulse that is not hollow upon pressure (Yang Excess) resolves through sweating without shivering.
A naturally faint pulse (weak pathogen and weak Zheng) often follows previous sweating, vomiting, or purging that caused blood loss and internal fluid depletion; this represents self-harmonization of Yin and Yang, resolving without shivering or sweating.
Wind (injures Yang) presents with floating and deficient pulses; injury to Yin presents with firm, deep, and submerged pulses, with water accumulation and dispersion; urgent fluid retention presents with string-taut and surging pulses, where Yin-Yang struggle causes pain; rapid pulses indicate heat and irritability. If these patterns do not match, one must understand the cause; different pulses in the three positions indicate different etiologies.
Fear manifests as a pulse feeling like continuous threads, with pale, colorless face, indicating insufficiency of Blood and Qi.
Shame manifests as a floating pulse with alternating white and red facial color, indicating timidity of Shen Qi (Spirit Qi).
Refusal to eat manifests as a naturally choppy pulse; choppy is Yin, governing loss of Jin Ye, manifesting as dry lips and mouth.
Diarrhea with absent pulses in all three positions, with cold Qi in the chest blocking the vessels, yet occasional tiny pulses felt at Chi upon lifting or pressing, indicates remaining Kidney Qi; Spleen deficiency allows Kidney Qi to overact. If deteriorating pulses appear, treatment is difficult.
Fuyang (Foot Yangming) pulse that is slippery and tight: slippery indicates fullness of Stomach Qi and Grain Qi; tight indicates strong and excessive Stomach Yin Qi; striking strength causes self-injury.
Cunkou (Radial) pulse that is floating and large: floating indicates Zheng deficiency, large indicates Pathogen excess. At Chi, it is "Guan" (Closing, pathogen closing Lower Jiao); at Cun, it is "Ge" (Blocking, pathogen blocking Upper Jiao). Guan results in inability to urinate; Ge results in vomiting and regurgitation. Fuyang pulse that is submerged and choppy: submerged indicates Stomach Qi hidden and not disseminating, causing vomiting and undigested food/water; choppy indicates Spleen Qi stagnant and not distributing, causing inability to ingest food, termed "Kai Ge".
Fuyang pulse that is large and tight indicates immediate diarrhea and difficulty in treatment; in diarrhea, the pulse should be minute and small; if tight, it indicates pathogen excess.
All faint Cunkou pulses indicate Yang collapse; all soggy pulses indicate Blood loss; all weak pulses indicate Yin deficiency with fever; all tight pulses indicate Cold.
Various Cold pathogens attacking deficiency suppress and dissipate Yang Qi, leading to Jue Yu (fainting, stomach insensitivity, rigidity, unconsciousness) due to lack of Grain Qi in Stomach and stagnation in Spleen (blocking upper and lower), causing tight mouth and inability to speak, shivering chills (exterior), and trembling chills (interior). Yawning indicates Yin-Yang attraction for harmony; delayed speech in healthy people indicates Wind (Wind invading collaterals, tongue difficult to move); head shaking indicates interior pain; slow walking indicates exterior stiffness (pathogen invading collaterals). Sitting leaning forward indicates shortness of breath; sitting with one leg raised indicates waist pain; guarding the abdomen like protecting an egg indicates Heart pain.
Treatment of Cold Damage Syndromes
Touching the killing Qi in winter causes immediate illness, named Shanghan (Cold Damage). Cold toxin hides in skin and muscles, lingering until spring; re-exposure to chaotic Qi names Chunwen (Spring Warmth); transforming in summer becomes Shubing (Summer Heat). Spring Dampness refers to the period before Summer Solstice; pulse is rapid, large, and scattered, resembling Taiyang fever without aversion to cold, similar to Zhongshu (Summerheat Stroke) irritability and thirst without aversion to cold. Treatment should use Shengma Gegen Tang (Rhizoma Cimicifugae and Radix Puerariae Decoction) or similar muscle-relieving formulas; if heat is predominant, use Xiaochaihu Tang (Minor Bupleurum Decoction); if thirsty, irritable, and constipated, use Daxiehu Tang (Major Bupleurum Decoction) to mildly purge; if pulse is excess, purgation is applicable.
Yang pulse floating and slippery, Yin pulse soft and weak, combined with wind exposure, transforms into Fengwen (Wind Warmth), as previous heat had not subsided and wind was contracted. After sweating, if body remains burning with spontaneous sweating and panting, avoid further sweating, purgation, or moxibustion. It is said: if Cun and Chi pulses are both floating, misdiagnosis leads to death. Use Weiyu Tang (Polygonatum Decoction) or Zhimu Gen Tang (Anemarrhena and Pueraria Decoction).
Rebing (Heat Disease) occurs in summer, with heat more severe than Wen. Treatment uses cold-cooling herbs to resolve internal and external irritant toxins. For headache, aversion to cold, fever, surging pulse with sweating: before Summer Solstice, use Yangdan Tang; after Summer Solstice, use Guizhi Jia Shigao Shengma Tang (Cinnamon Twig Decoction plus Gypsum and Rhizoma Cimicifugae). Without sweating, before/after Summer Solstice, use Mahuang Jia Zhimu Shigao Tang (Ephedra Decoction plus Anemarrhena and Gypsum); for irritability, use Daqinglong Tang (Major Green Dragon Decoction) plus Huangqin; for high fever, use Zhizi Shengma Tang (Gardenia and Rhizoma Cimicifugae Decoction).
Yang pulse surging and rapid, Yin pulse solid and large, combined with warm-heat exposure, transforms into Wendu (Warm Toxicity), as previous heat persisted and warm-heat was contracted, resulting in exterior-interior heat, the most severe condition.
Yang pulse soft and weak, Yin pulse string-taut and tight, combined with warm Qi, transforms into Wenyi (Warm Epidemic).