制于金。而反乘金。侮所不胜。其事不直。故曰横。水生于金。而反乘金。火生于木。而反乘木。
子来犯母。其势悖。故曰逆。金能生水而乘水。木能生火而乘火。母之及子。其势从。故曰顺也。
上条言脉原于五脏。合二五而成部位之次第。乃推明脉之所以始也。此条言脉具五行刑生制化之
义。乃五脏六腑吉凶死生之枢机。脉之大要也。而其所以为斯道之根源可见矣。
问曰。脉有残贼。何谓也。师曰。脉有弦。紧。浮。滑。沉。涩。此六者。名曰残贼。能为
诸脉作病也。
残。伤也。贼。害也。浮滑。阳盛也。沉涩弦紧。阴盛也。阳盛为太过。阴盛为不及。皆可
怪之脉。能伤害血气者也。诸脉。谓各部之脉也。作。起也。言六者若见于各部之脉中。则皆能
为其部生起病端。如太阳之为病脉浮。伤寒脉阴阳俱紧之类。所谓邪不空见者。此之谓也。
问曰。脉有灾怪。何谓也。师曰。假令人病。脉得太阳与形证相应。因为作汤。比还。送汤
如食顷。病患乃大吐若下利。腹中痛。师曰。我前来不见此证。今乃变异。是名灾怪。又问曰。何缘作此吐利。
答曰。或有旧时服药。今乃发作。故名灾怪耳。
此勉医家病家。当两相敬慎。庶不为灾怪。致生疑累之意。
问曰。东方肝脉。其形何似。师曰肝者。木也。名厥阴。其脉微弦濡弱而长。是肝脉也。肝
病。自得濡弱者。愈也。
凡脉言濡。皆读软。微。非脉名。盖脉以有胃气为吉。微微之弦。有胃气之谓也。难经曰。
春脉者。肝也。东方木也。万物之所以始生也。故其气来。软弱轻虚而滑。端直以长。故曰弦。
盖肝主筋。故其脉如此。此述素难而成文。素难详而此略。且多错误。
假令得纯弦脉者。死。何以知之。以其脉如弦直。是肝脏伤。故知死也。
纯弦。即素难所谓真肝脉至。如弦直。即素难所谓中外急如循刀刃责责然。如按琴瑟弦。如
新张弓弦是也。
南方心脉。其形何似。师曰。心者。火也。名少阴。其脉洪大而长。是心脉也。心病自得洪
大者。愈也。
心主血脉。其王在夏。故其脉洪大而长。应万物盛长之象也。然素难皆言心脉钩。钩以性情言。
洪大而长以体势言。
假令脉来微去大。故名反。病在里也。脉来头小本大者。故名覆。病在表也。上微头小者。则
汗出。下微本大者。则为关格不通。不得尿。头无汗者。可治。有汗者。死。
尿。与溺同。反复。钩之反复也。此条下文脱二节。错一节。在前。此节亦疑多错误。
西方肺脉。其形何似。师曰。肺者金也。名太阴。其脉毛浮也。肺病自得此脉。若得缓迟者皆
愈。若得数者。则
剧。何以知之。数者南方火。火克西方金。法当痈脓。为难治也。
肺主皮毛。上为华盖。故脉毛浮。缓迟者。脾土之脉也。兼得缓迟为愈者。肺金得土为逢生
也。法当痈脓者。金逢火化也。
此下当有如上文假令云云之转语。一节。疑脱落。
假令下利。寸口。关上。尺中。悉不见脉。然尺中时一小见。脉再举头者。肾气也。若见损
脉来至。为难治。
下利属少阴。损脉自上下由肺而之肾为极。故肾病见损脉为难治。此上当有北方肾脉其形何
似云云。问答起语一节。此乃其下文转语一节也。旧错在第十一条前。今移。
问曰。二月得毛浮脉。何以处言至秋当死。师曰。二月之时。脉当濡弱。反得毛浮者。故知
至秋死。二月肝用事。肝脉属木。应濡弱。反得毛浮者。是肺脉也。肺属金。金来克木。故知至
秋死。他皆仿此。
应。平声。此承上条复以四时脉气。属五行生克应病。以主吉凶死生之理。揭一以例其余。
所以示人持诊之要法也。
师曰。脉肥人责浮。瘦人责沉。肥人当沉。今反浮。瘦人当浮。今反沉。故责之。
责。求也。肥人当沉者。肌肤浓。其脉深也。故求其病于浮。瘦人当浮者。肌肤薄。其脉浅
也。故求其病于沉。褚氏曰。肥人如沉。而正沉者愈沉。瘦人如浮。而正浮者愈浮。此之谓也。
师曰。寸脉下不至关为阳绝。尺脉上不至关为阴绝。此皆不治。决死也。若计其余命死生之
期。期以月节克之也。
寸为阳。阳生于尺而动于寸。故下不至关为阳绝。尺为阴。阴生于寸而动于尺。故上不至关
为阴绝。言生息断绝也。余
命谓未尽之天年也。上期。日期也。下期。期约也。月节克之。与前条二月得毛浮脉至秋死同推。
师曰。脉病患不病。名曰行尸。以无王气。卒眩仆。不识人者。短命死。人病脉不病。名曰
内虚。以无谷神。虽困无苦。
王。去声。卒。清勿切。周氏曰。形体之中。觉见憔悴。精神昏愦。食不忻美。而脉得四时
之从。无过不及之偏。是人病脉不病也。形体安和。而脉息乍大乍小。或至或损。弦紧浮滑沉涩
不一。残贼冲和之气。是脉息不与形相应。乃脉病患不病也。经曰。形气有余。脉气不足者。死。
行尸之谓也。又曰。人受气于谷。谷入于胃。乃传于五脏六腑。五脏六腑皆受于气。然则内虚以
无谷神者。谷气弗充之谓也。
问曰。翕奄沉名曰滑。何谓也。沉为纯阴。翕为正阳。阴阳和合。故令脉滑。关尺自平。阳
明脉微沉。食饮自可少阴脉微滑。滑者紧之浮名也。此为阴实。其人必股内汗出。阴下湿也。
合。音阁。令。平声。翕。起而盛动于上。旋复丛聚而合也。与论语始作翕如之翕同。奄。
忽然覆也。沉。没于下也。纯阴。以其没于下言也。正阳。以其盛于上言也。和合。言阴阳并集
无偏胜也。阳明胃也。食饮自可。言胃不病也。少阴。肾也。微滑。水沉如石之滑。故谓紧之浮
名也。阴实。言邪在肾也。少阴之脉。出 内廉。上股内。贯脊。属肾。肾主水。肾为阳。阳主
热。阳陷入阴。热郁而蒸发。所以股内汗出。而阴下湿也。
问曰。曾为人所难。紧脉从何而来。师曰。假令亡汗。若吐。以肺里寒。故令脉紧也。假令
咳者。坐饮冷水。故令脉紧也。假令下利。以胃中虚冷。故令脉紧也。
难。去声。此条一问三答。以揭紧之为寒。而有三因之不同。以见脉非一途而可取之意。
寸口卫气盛。名曰高。荣气盛。名曰章。高章相搏。名曰刚。
难经曰。寸口者。脉之大会。手太阴之脉动也。五脏六腑之所终始。故去取于寸口是也。高
者。丰隆而有充满之貌。章者。文采而有润泽之貌。刚言血气俱盛。则脉有纲维之意。
卫气弱名曰 。荣气弱名曰卑。 卑相搏。名曰损。
。音牒。 。震惧也。言卫气不足者。则心常自怖。卑。伏下也。言荣气不足者。则心常
自抑。损。减也。伤也。言荣卫俱弱。外不足以固护。内不足以荣养。则脏腑为之有所减而伤损
也。
卫气和。名曰缓。荣气和。名曰迟。迟缓相搏。名曰沉。
缓。纵也。言荣不与卫和。而卫自和。则血不足以荣筋。病则四肢纵强而不能收。痿类是也。
迟。滞也。言卫不与荣和。而荣自和。则气乏神昏。病则百体滞 倦怠而嗜卧。瘵类是也。沉。溺
也。言溺于所偏则病也。
寸口脉缓而迟。缓。则阳气长。其色鲜。其颜光。其声商。毛发长。迟则阴气盛。骨髓生。
血满肌肉。紧薄鲜硬。阴阳相抱。荣卫俱行。刚柔相搏。名曰强。
缓。以候胃。迟以候脾。阳气长者。言胃气有余也。颜色声音毛发皆阳也。鲜。丽也。光。
辉也。商。清也。长。美也。形容胃阳之有余也。阴气盛者。言脾气充足也。骨髓血肉皆阴也。
紧薄。结也。鲜硬。坚也。形容脾阴之充足也。相抱。言和洽也。俱行。言周流也。相搏。言合
一也。极言二气得其和平。皆由脾胃盈余之所致。如此则其人健王而强壮。故曰强也。
趺阳脉滑而紧。滑者胃气实。紧者脾气强。持实击强。痛还自伤。以手把刃。坐作疮也。
趺阳。在足跗上骨间动脉处。去陷谷三寸。一名会元。主脾胃也。滑为食。故在胃则主谷气实。
紧为寒。故在脾则主邪气强。持实击强。言胃实脾强。两相搏击而为病。譬则以手把刃而自伤。
盖谓非由别脏腑而传变也。
寸口脉浮而大。浮为虚。大为实。在尺为关。在寸为格。关则不得小便。格则吐逆。
素问曰。精气夺则虚。邪气胜则实。尺以候阴。关。闭也。不得小便者。阴闭于下。则内者
不得出也。格。拒也。吐逆者。阳拒于上。则外者不得入也。
趺阳脉伏而涩。伏则吐逆。水谷不化。涩则食不得入。名曰关格。
趺阳见前。主候脾胃。故复言此。以见与上条有相符之意。
脉浮而大。浮为风虚。大为气强。风气相搏。必成阴疹。身体为痒。痒者名泄风。久久为痂
癞。
痂。与HT 同。音加。素问曰。外在腠理则为泄风。又曰。泄风之状多汗。汗出泄衣上。口中
干上渍。其风不能劳事。身体尽痛。则寒。癞。疥也。
寸口脉弱而迟。弱者卫气微。迟者荣中寒。荣为血。血寒则发热。卫为气。气微者心内饥。
饥而虚满。不能食也。
寒之为言虚也。与贫之称寒同。虚寒发热者。血气在人身。犹水火在天地。水干则火炽也。
饥而虚满者。阳主化谷。卫阳衰微。不化谷。故虚满而不能食也。
趺阳脉大而紧者。当即下利。为难治。
大为虚。紧为寒。脾胃虚寒。故主下利。为难治也。
寸口脉弱而缓。弱者。阳气不足。缓者。胃气有余。噫而吞酸。食卒不下。气填于膈上也。
填。音田。阳气以胃中之真气言。不足。则不能化谷。胃气以胃中之谷气言。有余。言有宿
食也。有宿食。则郁而生热。故噫饱而吞酸。此盖以饮食之内伤者言也。
趺阳脉紧而浮。浮为气。紧为寒。浮为腹满。紧为绞痛。浮紧相搏。肠鸣而转。转即气动。
膈气乃下。少阴脉不出。其阴肿大而虚也。
腹满者。胃气虚而邪气实也。绞痛者。脾家寒而邪壅滞也。鸣者。气之鼓也。转。则气之运
也。下。则气之壅滞者极甚而反也。少阴之脉。循阴器而主水。脉不出。其阴肿大者。正虚邪实。
水不得泄。盖趺阳之土败。而少阴所以无制也。
寸口脉微而涩。微者。卫气不行。涩者荣气不逮。荣卫不能相将。三焦无所仰。身体痹不仁。
荣气不足则烦疼。口难言。卫气虚。则恶寒数欠。三焦不归其部。上焦不归者。噫而酢吞。中焦
不归者。不能消谷引食。下焦不归者。则遗溲。
数。音朔。噫。音隘。酢。与醋同。卫主气。不行。言不用事也。荣主血。不逮。不及也。
不能相将。言荣卫不相和谐。不能相与也。仰。倚赖也。痹。顽痹也。不仁。言不知痛痒。不省
人事也。难言者。心虚。神短。舌强。而声不出也。恶寒数欠者。卫疏。表不固。不
能御寒。所以气乏而好为欠也。不归其部。言不还足其所有之分内也。酢吞。吞酸也。吞酸则受
纳妨矣。不能消谷引食
者。言不司腐熟也。遗溲者。言不司约制也。盖上焦主受纳。中焦主腐熟。下焦厘清浊。主出而
专约制。此甚言荣卫不相和谐。致三焦皆失其常。故各废其所司之职事如此。
趺阳脉沉而数。沉为实。数消谷。紧者病难治。
沉以候里。故在脾胃则主实。谷气实也。数为热。阳也。紧为寒。阴也。言趺阳主脾胃。
脾胃主谷。谷气实。若脉见数而阳热甚。阳能化谷。虽病不足为害。若脉得紧而阴寒胜。阴不化
谷。病为难治。
寸口脉微而涩。微者卫气衰。涩者荣气不足。卫气衰。面色黄。荣气不足。面色青。荣为
根。卫为叶。荣卫俱微。则枝叶枯槁而寒 。咳逆唾腥。吐涎沫也。
首三句与前条差衰字。然衰则不行。不足亦不逮。更互发明者也。气为卫。色本白。白属金。
黄。土色也。金生于土。金无气。色不显。故土之色反见也。血为荣。色本赤。赤属火。青。木
色也。火生于木。火无气。色不明。故木色反见也。荣为根者。言血荣于人身之内。犹木之根本
也。卫为叶者。言气卫于人身之外。犹木之枝叶也。寒 。荣不足以养。而卫亦不能外固也。
咳逆唾腥。吐涎沫者。气不利而血亦不调也。
趺阳脉浮而芤。浮者。卫气衰。芤者。荣气伤。其身体瘦。肌肉甲错。浮芤相搏。宗气衰微。
四属断绝。
芤。音抠。浮为风虚。故曰卫气衰。芤为失血。故曰荣气伤。身体瘦者。卫衰而形损也。肌
肉甲错者。荣伤而枯坼也。宗气。三焦隧气之一也。针经曰。宗气积于胸中。出于喉咙。以贯心
脉而行呼吸是也。四。皮肉肌髓也。盖三焦乃气之道路。卫气衰而荣气伤。所以宗气亦衰微。四
属不相维而断绝也。
寸口脉微而缓。微者卫气疏。疏则其肤空。缓者胃气实。实则谷消而水化也。谷入于胃。脉
道乃行。而入于经。其血乃成。荣盛则其肤必疏。三焦绝经。名曰血崩。
疏言不能固护。卫主温分肉。肥腠理。疏则分肉不温。腠理不肥。故曰空也。缓为胃气有余。
实。犹言强也。所以谷消而水化。谷入于胃。至其血乃成。乃承上文而言水谷化消。则胃益实而
能淫精于脉。以成其血。而使荣盛。荣盛则卫益衰。故曰其肤必疏也。三焦者。气之道路也。经。
Constrained by Metal, yet conversely overcoming Metal. This is insulting that which one cannot overcome (i.e., reverse control), and its principle is incorrect. Hence it is called "Heng" (Horizontal/Rebellious). Water is born from Metal, yet conversely overcomes Metal; Fire is born from Wood, yet conversely overcomes Wood.
When the child offends the mother, the momentum is rebellious. Hence it is called "Ni" (Reverse/Opposite). Metal can generate Water but overcomes Water; Wood can generate Fire but overcomes Fire. When the mother's influence extends to the child, the momentum is compliant. Hence it is called "Shun" (Smooth/Following).
The previous section discussed how pulse originates from the Five Zang Organs, combining with the Five Elements to form the sequence of positions, thereby elucidating the origin of the pulse. This section discusses how the pulse embodies the principles of punishment, generation, constraint, and transformation of the Five Elements. It is the pivot for the auspiciousness, inauspiciousness, death, and life of the Five Zang and Six Fu Organs. This is the major essence of pulse diagnosis, and the reason why it serves as the root of this art becomes apparent.
Question: What is meant by "Can Ze" (Damaging and Harassing) pulses?
The Master said: There are six types of pulses: Xian (Wiry), Jin (Tight), Fu (Floating), Hua (Slippery), Chen (Deep), and Se (Choppy). These six are named "Can Ze". They can cause pathology in various other pulses.
"Can" means injury. "Ze" means harm. Fu and Hua indicate Yang Excess. Chen, Se, Xian, and Jin indicate Yin Excess. Yang excess is termed "Tai Guo" (Excessive); Yin excess is termed "Bu Ji" (Deficient). Both are abnormal pulses capable of damaging Qi and Blood. "Various pulses" refers to the pulses at different locations. "Zuo" means to arise. It means that if these six pulse qualities appear in the pulses of any location, they can all initiate pathological conditions in that location. For example, Taiyang disease presents with a Fu pulse, or Shang Han (Cold Damage) disease where the pulse is Jin at Cun, Guan, and Chi. This is what is meant by saying that pathogenic factors do not appear without cause.
Question: What is meant by "Zai Guai" (Disaster and Anomaly)?
The Master said: Suppose a person is ill, presenting with a Taiyang pulse and corresponding physical signs, so a decoction is prepared. Before returning, after about the time it takes to eat a meal, the patient suddenly experiences severe vomiting or diarrhea with abdominal pain. The Master would say, "I did not see these symptoms during my initial examination, yet they have now appeared variably. This is called 'Zai Guai'." Another asked, "What causes such vomiting and diarrhea?"
The answer is: Perhaps the patient had taken medicine previously, which is now taking effect. Hence it is called "Zai Guai".
This admonishes both physicians and patients to be mutually respectful and cautious, so as to avoid disasters and anomalies that might lead to doubt and blame.
Question: What does the Liver pulse of the East look like?
The Master said: The Liver belongs to Wood and is named Jueyin. Its pulse is slightly Wiry (Xian), Soft (Ru), Weak (Ruo), and Long. This is the Liver pulse. If a Liver disease presents naturally with a Ru and Ruo pulse, recovery will occur.
Whenever a pulse is described as "Ru", it is pronounced as "Ruan" (Soft). "Wei" (Slight) is not a pulse name itself. Generally, a pulse possessing Stomach Qi (Wei Qi - digestive energy) is auspicious. A "slightly wiry" quality indicates the presence of Stomach Qi. The Nan Jing states: The Spring pulse corresponds to the Liver, belonging to Eastern Wood, the time when all things begin to grow. Therefore, its Qi comes forth soft, weak, light, void, slippery, straight, and long; hence it is called Wiry (Xian). Since the Liver governs the sinews, the pulse manifests thus. This text synthesizes the Su Wen and Nan Jing; while those texts are detailed, this summary is brief and contains many errors.
If a pure Xian (Wiry) pulse is found, death ensues. How do we know? Because the pulse is rigid and straight like a string, indicating injury to the Liver organ, thus predicting death.
"Pure Xian" refers to what the Su Wen and Nan Jing call the True Liver pulse. "Like a string straight" refers to what they describe as urgent inside and out, feeling like running a finger along a knife edge (ze ze sound), like pressing a lute string, or like a newly tightened bowstring.
What does the Heart pulse of the South look like?
The Master said: The Heart belongs to Fire and is named Shaoyin. Its pulse is Hong (Surging/Vast) and Large (Da), and Long. This is the Heart pulse. If a Heart disease presents naturally with a Da pulse, recovery will occur.
The Heart governs blood vessels and prospers in Summer; therefore, its pulse is Hong and Da, corresponding to the image of all things flourishing and growing. However, the Su Wen and Nan Jing both describe the Heart pulse as "Gou" (Hook). "Gou" describes its nature/character, whereas "Hong and Da" describes its physical form/momentum.
If the pulse comes weakly and departs largely, it is named "Fan" (Reverse), indicating disease in the interior. If the pulse head is small and the root is large, it is named "Fu" (Covered/Inverted), indicating disease in the exterior. If the upper part is weak and the head small, sweating will occur. If the lower part is weak and the root large, it leads to Guan Ge (Obstruction and Rejection) with inability to urinate. If there is no sweat on the head, it is treatable; if there is sweat on the head, it is fatal.
"Niao" is synonymous with "Niao" (urine). "Fan Fu" refers to the fluctuation of the Gou pulse. Two sections are missing from the following text of this section, and one section is misplaced at the front; this section is also suspected of containing many errors.
What does the Lung pulse of the West look like?
The Master said: The Lung belongs to Metal and is named Taiyin. Its pulse is Mao (Feather-like) and Fu (Floating). If a Lung disease presents naturally with this pulse, and additionally shows Huan (Relaxed) and Chi (Slow) qualities, recovery will occur. If it shows Shu (Rapid) quality, the condition will worsen. How do we know? Shu belongs to Southern Fire, and Fire conquers Western Metal. According to medical principles, this should lead to carbuncles and pus, making it difficult to treat.
The Lung governs skin and hair and sits superiorly like a canopy, hence the Mao Fu pulse. Huan and Chi are pulses of Spleen Earth. Recovering by obtaining Huan and Chi occurs because Metal receives birth from Earth (Earth generates Metal). The likelihood of carbuncles arises because Metal transforms under Fire.
There should be a transitional phrase similar to the "Suppose..." examples above, but one section is suspected to be missing.
Suppose there is diarrhea, and the Cun, Guan, and Chi pulses are all imperceptible. Yet, occasionally the Chi position reveals a slight pulse beat twice (two rises). This indicates Kidney Qi. If a Sun (Damaged) pulse appears, it is difficult to treat.
Diarrhea belongs to Shaoyin. The Sun pulse descends from top to bottom, moving from Lung to Kidney as the extreme. Thus, when Kidney disease presents with a Sun pulse, it is difficult to treat. There should have been a question-and-answer section regarding the shape of the Northern Kidney pulse above; this is the transitional section below. In old editions, this was incorrectly placed before Article 11; it is now moved.
Question: Why is it said that obtaining a Mao Fu (Feather-Float) pulse in the second lunar month predicts death in autumn?
The Master said: In the second month, the pulse should be Ru Ruo (Soft and Weak). Obtaining a Mao Fu pulse instead indicates death in autumn. In the second month, Liver Qi is active. The Liver pulse belongs to Wood and should manifest as Ru Ruo. Obtaining a Mao Fu pulse instead indicates a Lung pulse. Lung belongs to Metal, and Metal conquers Wood; hence, death is predicted in autumn. Other months follow this pattern.
"Ying" is pronounced with the level tone. This follows the previous section, reiterating the theory that four-season pulse energies correspond to the generation and conquest of the Five Elements to determine auspiciousness, inauspiciousness, death, and life. It highlights one example to illustrate the rest, demonstrating the essential method of pulse diagnosis.
The Master said: For obese persons, one must investigate whether the pulse is Floating (Fu); for thin persons, one must investigate whether the pulse is Deep (Chen). Obese persons should have a Deep pulse; if it is instead Floating, this anomaly must be investigated. Thin persons should have a Floating pulse; if it is instead Deep, this anomaly must be investigated.
"Ze" means to seek/investigate. Obese persons should have a Deep pulse because their flesh is thick and the pulse position is deep. Therefore, pathology is sought in a Floating pulse. Thin persons should have a Floating pulse because their flesh is thin and the pulse position is superficial. Therefore, pathology is sought in a Deep pulse. Chu Shi stated: An obese person's pulse tends to be Deep; if it is truly Deep, it sinks even deeper. A thin person's pulse tends to be Floating; if it is truly Floating, it floats even higher. This is what is meant.
The Master said: If the Cun pulse does not reach down to the Guan position, it is called Yang Jue (Absolute Severance of Yang). If the Chi pulse does not reach up to the Guan position, it is called Yin Jue (Absolute Severance of Yin). All such cases are untreatable and certain death. To calculate the remaining lifespan and time of death, one uses the mutual conquest of monthly solar terms.
Cun is Yang; Yang is born at Chi and moves to Cun. Thus, failing to reach Guan downwards is Yang Jue. Chi is Yin; Yin is born at Cun and moves to Chi. Thus, failing to reach Guan upwards is Yin Jue. This signifies the severance of vital breath. "Yu Ming" refers to the unexhausted natural lifespan. "Shang Qi" refers to the expected date; "Xia Qi" refers to the agreed period. Using the conquest of monthly solar terms is the same deduction as in the previous section regarding the Mao Fu pulse in the second month leading to death in autumn.
The Master said: When the pulse indicates disease but the body does not show signs of illness, it is called "Xing Shi" (Walking Corpse), due to the absence of Wang Qi (Prosperous Qi). If sudden dizziness and collapse occur, with loss of consciousness, death follows shortly. When the body shows signs of illness but the pulse does not, it is called "Nei Xu" (Interior Deficiency), due to the absence of Gu Shen (Grain Spirit). Although distressed, there is no suffering.
"Wang" is pronounced with the departing tone. "Cu" is pronounced qing-wu-qie. Zhou Shi said: Within the form, one feels haggard, spirit is confused, and food lacks appeal, yet the pulse conforms to the four seasons without excess or deficiency. This is "body ill, pulse healthy". The form is peaceful, but the pulse fluctuates—sometimes large, sometimes small, arriving or damaged, varying between Wiry, Tight, Floating, Slippery, Deep, and Choppy. Damaging Qi assaults the Harmonious Qi. This means the pulse does not correspond to the form; this is "pulse ill, body healthy". The Classics state: If Form-Qi is sufficient but Pulse-Qi is insufficient, death results. This is the Walking Corpse. It also states: Humans receive Qi from grain; grain enters the stomach and transmits to the Five Zang and Six Fu organs, which all receive Qi. Thus, Nei Xu without Gu Shen refers to the insufficiency of Grain Qi.
Question: "Xi Yan Chen" is called a Slippery (Hua) pulse. What does this mean?
Chen is Pure Yin; Xi is Correct Yang. The harmony and combination of Yin and Yang cause the pulse to be Slippery. The Guan and Chi positions are balanced. The Yangming pulse is slightly Deep; digestion is normal. The Shaoyin pulse is slightly Slippery. Slippery is the floating name of Tightness; this is Yin Solidity. The person will likely experience sweating in the inner thighs and dampness in the genital area.
"He" is pronounced ge. "Ling" is pronounced level tone. "Xi" means rising and surging upward, then suddenly gathering and combining. It is the same as "Xi" in the Analects ("shi zuo xi ru"). "Yan" means suddenly covering. "Chen" means sinking downward. Pure Yin refers to its sinking downward. Correct Yang refers to its surging upward. Harmony and combination mean Yin and Yang gather together without dominance. Yangming refers to the Stomach. Normal digestion means the Stomach is healthy. Shaoyin refers to the Kidney. Slightly Slippery: Water sinks like a stone's slipperiness; hence it is called the floating name of Tightness. Yin Solidity means pathogen in the Kidney. The Shaoyin meridian emerges from the medial aspect, ascends the inner thigh, penetrates the spine, and connects to the Kidney. The Kidney governs Water. The Kidney is Yang; Yang governs Heat. Yang sinks into Yin, heat stagnates and evaporates, causing sweating in the inner thighs and dampness in the genitals.
Question: I have been questioned before: Where does the Tight (Jin) pulse come from?
The Master said: Suppose there is profuse sweating or vomiting due to Cold in the Lungs; this causes the Jin pulse. Suppose there is coughing due to drinking cold water; this causes the Jin pulse. Suppose there is diarrhea due to Deficient-Cold in the Stomach; this causes the Jin pulse.
"Nan" is pronounced departing tone. This section has one question and three answers to reveal that Jin pulse indicates Cold, but with three different causes, showing that pulse diagnosis is not limited to a single pathway.
At the Cun position, if Wei Qi (Defensive Qi) is excessive, it is called "Gao" (High). If Ying Qi (Nutritive Qi) is excessive, it is called "Zhang" (Manifest/Clear). The interaction of Gao and Zhang is called "Gang" (Rigid/Hard).
The Nan Jing states: Cun is the great assembly of pulses, where the Hand Taiyin meridian moves. It is the beginning and end of the Five Zang and Six Fu organs; hence, pulse assessment is done at Cun. "Gao" means lofty and full. "Zhang" means literary and moist. "Gang" implies that when Blood and Qi are both excessive, the pulse has a structural integrity.
If Wei Qi is deficient, it is called "Que" (Timid). If Ying Qi is deficient, it is called "Bei" (Low/Submissive). The interaction of Que and Bei is called "Sun" (Damaged/Lost).
"Que" is pronounced die. Que means trembling fear. Insufficient Wei Qi causes constant fear. Bei means lying low. Insufficient Ying Qi causes constant suppression. Sun means reduction or injury. When Ying and Wei are both weak, they cannot protect externally or nourish internally, leading to damage and reduction of the Zang-Fu organs.
If Wei Qi is harmonious, it is called "Huan" (Relaxed/Slow). If Ying Qi is harmonious, it is called "Chi" (Slow). The interaction of Huan and Chi is called "Chen" (Deep/Sinking).
Huan means relaxation. If Ying does not harmonize with Wei, but Wei is self-harmonious, Blood is insufficient to nourish the sinews. Illness manifests as flaccidity and weakness of the four limbs, unable to contract, similar to Wei syndrome. Chi means stagnation. If Wei does not harmonize with Ying, but Ying is self-harmonious, Qi is lacking and spirit is dim. Illness manifests as bodily stagnation, fatigue, and lethargy, similar to Zhai syndrome. Chen means drowning. Falling into bias leads to illness.
At the Cun position, if the pulse is Huan and Chi: Huan indicates the growth of Yang Qi, resulting in fresh complexion, radiant face, clear voice, and long hair. Chi indicates the prosperity of Yin Qi, generating marrow, filling muscles with blood, and creating firm, hard texture. Yin and Yang embrace each other, Ying and Wei circulate together, Gang and Rou combine; this is called "Qiang" (Strong).
Huan assesses the Stomach; Chi assesses the Spleen. Growth of Yang Qi means excess Stomach Qi. Complexion, voice, and hair belong to Yang. Fresh means bright/lustrous. Radiant means shining. Shang (clear) means crisp. Chang (long) means beautiful. This describes the abundance of Stomach Yang. Prosperity of Yin Qi means sufficient Spleen Qi. Marrow and blood belong to Yin. Jin Bo (firm/knotted) means condensed. Xian Ying (bright/hard) means solid. This describes the sufficiency of Spleen Yin. Xiang Bao means harmonious integration. Ju Xing means circulating throughout. Xiang Bo means becoming one. This極ly describes the peace of the two Qi, resulting from surplus Spleen and Stomach function. Such a person is vigorous and strong, hence called Qiang.
At the Fuyang position, if the pulse is Hua and Jin: Hua indicates Stomach Qi Solidity; Jin indicates Spleen Qi Strength. Holding solidity against strength causes pain to hurt oneself, like holding a blade and cutting oneself.
Fuyang is located on the dorsal artery of the foot, three cun from Xangu, also known as Huiyuan, governing Spleen and Stomach. Hua relates to food/grain, so in the Stomach it indicates abundant Grain Qi. Jin relates to Cold, so in the Spleen it indicates strong Pathogenic Qi. "Holding solidity against strength" means Stomach Solidity and Spleen Strength clash, causing disease. It is likened to holding a blade and injuring oneself, implying the disease does not transmit from other organs.
At the Cun position, if the pulse is Fu and Da: Fu indicates Deficiency; Da indicates Solidity. At Chi, it is Guan (Closed); at Cun, it is Ge (Rejecting). Guan leads to inability to urinate; Ge leads to vomiting and regurgitation.
The Su Wen states: Depletion of Essence-Qi leads to Deficiency; victory of Pathogenic Qi leads to Solidity. Chi assesses Yin. Guan means closure. Inability to urinate means Yin is closed below, preventing internal substances from exiting. Ge means rejection. Vomiting and regurgitation mean Yang is rejected above, preventing external substances from entering.
At the Fuyang position, if the pulse is Fu (Hidden) and Se (Choppy): Fu leads to vomiting and regurgitation with undigested food/water. Se leads to inability to ingest food. This is called Guan Ge.
Fuyang was mentioned earlier, governing Spleen and Stomach, so this is repeated to show consistency with the previous section.
If the pulse is Fu and Da: Fu indicates Wind-Deficiency; Da indicates Qi-Strength. The interaction of Wind and Qi must form Yin Rash. The body will itch. Itching is called Xie Feng (Leaking Wind). Over time, it becomes scabs and leprosy.
Jia is the same as Jie (scabies/leprosy), pronounced jia. The Su Wen states: External to the couli (interstices) is Xie Feng. It also states: Xie Feng features much sweating, wetting clothes, dry mouth, and upper body oozing. The wind prevents labor, causing whole-body pain and chills. Lei is Jie (leprosy/scabies).
At the Cun position, if the pulse is Ruo (Weak) and Chi (Slow): Ruo indicates weak Wei Qi; Chi indicates Cold in Ying. Ying is Blood; Blood Cold causes fever. Wei is Qi; weak Qi causes hunger in the heart/mind. Hunger with false fullness leads to inability to eat.
Han (Cold) here means Deficiency, similar to using "Han" for poverty. Deficient-Cold fever: Blood and Qi in the body are like Water and Fire in heaven and earth; if Water dries up, Fire blazes. Hunger with false fullness: Yang governs the transformation of grain. If Wei-Yang is weak and fails to transform grain, false fullness occurs, preventing eating.
At the Fuyang position, if the pulse is Da and Jin, diarrhea will immediately occur, making it difficult to treat.
Da indicates Deficiency; Jin indicates Cold. Spleen-Stomach Deficient-Cold leads to diarrhea, hence difficult to treat.
At the Cun position, if the pulse is Ruo and Huan: Ruo indicates insufficient Yang Qi; Huan indicates excess Stomach Qi. Belching and acid regurgitation occur, food suddenly cannot go down, and Qi fills the diaphragm.
Tian is pronounced tian. Yang Qi refers to the true Qi in the Stomach; insufficiency means it cannot transform grain. Stomach Qi refers to Grain Qi in the Stomach; excess means retained food. Retained food stagnates and generates heat, causing belching, fullness, and acid regurgitation. This refers to internal injury from diet.
At the Fuyang position, if the pulse is Jin and Fu: Fu indicates Qi; Jin indicates Cold. Fu causes abdominal fullness; Jin causes colic. The combination of Fu and Jin causes intestinal rumbling and movement. Movement activates Qi, allowing Diaphragm Qi to descend. If the Shaoyin pulse does not emerge, the genitals will swell and feel empty/flaccid.
Abdominal fullness indicates Stomach Qi Deficiency and Pathogenic Solidity. Colic indicates Spleen Cold and Pathogenic stagnation. Rumbling is the drumming of Qi. Movement is the transport of Qi. Descending is the reversal of extreme stagnation. The Shaoyin meridian circles the genitals and governs Water. If the pulse does not emerge and genitals swell, it is Righteous Deficiency and Pathogenic Solidity, preventing water excretion. This is because Fuyang Earth fails, leaving Shaoyin unchecked.
At the Cun position, if the pulse is Wei (Micro) and Se (Choppy): Wei indicates non-movement of Wei Qi; Se indicates failure of Ying Qi to arrive. Ying and Wei cannot support each other; the San Jiao has no reliance. The body suffers Bi numbness and insensitivity. Ying Qi deficiency causes vexation and pain, difficulty speaking. Wei Qi deficiency causes aversion to cold and frequent yawning. San Jiao fails to return to its sectors: Upper Jiao failure causes belching and acid regurgitation; Middle Jiao failure causes inability to digest food; Lower Jiao failure causes urinary incontinence.
Shuo is pronounced shuo. Yi is pronounced ai. Cu is the same as Cu (vinegar/acidity). Wei governs Qi; non-movement means inactivity. Ying governs Blood; failure to arrive means inadequacy. Cannot support each other means Ying and Wei are disharmonious and cannot assist one another. Yang means reliance. Bi means stubborn numbness. Bu Ren means lack of sensation (pain/itch) and unconsciousness. Difficulty speaking is due to Heart Deficiency, short Spirit, stiff tongue, and voice failure. Aversion to cold and yawning is due to loose Wei, insecure exterior, inability to resist cold, leading to Qi lack and yawning. Failing to return to sector means not fulfilling its designated portion. Acid regurgitation hinders reception. Inability to digest food means failure in rotting and ripening. Urinary incontinence means failure in restraint. The Upper Jiao governs reception, Middle Jiao governs digestion, Lower Jiao separates clear from turbid and controls output. This emphasizes that Ying-Wei disharmony causes San Jiao dysfunction, leading to the failure of their respective duties.
At the Fuyang position, if the pulse is Chen and Shu: Chen indicates Solidity; Shu digests grain. Jin makes the disease difficult to treat.
Chen assesses the interior; thus in Spleen/Stomach it indicates Solidity of Grain Qi. Shu indicates Heat/Yang. Jin indicates Cold/Yin. Fuyang governs Spleen/Stomach, which govern grain. If Grain Qi is solid and pulse shows Shu with strong Yang Heat, Yang can transform grain, so disease is not harmful. If pulse shows Jin with Yin Cold dominance, Yin cannot transform grain, making the disease difficult to treat.
At the Cun position, if the pulse is Wei and Se: Wei indicates decline of Wei Qi; Se indicates deficiency of Ying Qi. Decline of Wei Qi causes yellow complexion. Deficiency of Ying Qi causes green complexion. Ying is the Root; Wei is the Leaf. If Ying and Wei are both micro, branches and leaves wither, causing cold shivers, coughing/upward rebellion, spitting sputum with blood streaks, and drooling saliva.
The first three sentences differ slightly from the previous section ("Shuai" vs "Wei"), but Shuai means non-movement, and Bu Zu means failure to arrive; they explain each other reciprocally. Qi is Wei; color is originally White, belonging to Metal. Yellow is Earth color. Metal is born from Earth; if Metal lacks Qi, its color is not显现, so Earth color appears inversely. Blood is Ying; color is originally Red, belonging to Fire. Green is Wood color. Fire is born from Wood; if Fire lacks Qi, its color is unclear, so Wood color appears inversely. Ying as Root means Blood nourishes the interior like tree roots. Wei as Leaf means Qi protects the exterior like tree branches. Cold shivers occur because Ying is insufficient to nourish and Wei cannot secure the exterior. Coughing, bloody sputum, and drooling indicate Qi obstruction and Blood disharmony.
At the Fuyang position, if the pulse is Fu and Kou (Hollow): Fu indicates Wei Qi decline; Kou indicates Ying Qi injury. The body becomes thin, and muscle texture resembles fish scales (jia cuo). The interaction of Fu and Kou causes Zong Qi (Pectoral Qi) to decline and Si Shu (Four Belongings) to sever.
Kou is pronounced kou. Fu indicates Wind-Deficiency, hence Wei Qi decline. Kou indicates blood loss, hence Ying Qi injury. Thinning body is due to Wei decline and form damage. Fish-scale muscle texture is due to Ying injury and withering. Zong Qi is one of the San Jiao tunnel Qi. The Zhen Jing states: Zong Qi accumulates in the chest, exits the throat, penetrates the Heart vessels, and governs respiration. Si refers to Skin, Flesh, Sinew, and Marrow. San Jiao is the pathway of Qi. With Wei decline and Ying injury, Zong Qi also declines, and the Four Belongings lose connection and sever.
At the Cun position, if the pulse is Wei and Huan: Wei indicates sparse Wei Qi; sparseness means the skin is empty. Huan indicates solid Stomach Qi; solidity means grain is digested and water transformed. Grain enters the Stomach, pulse channels move, and it enters the meridians, forming Blood. When Ying is abundant, the skin must become sparse. San Jiao severs the meridians, named Blood Collapse.
Sparse means inability to secure. Wei warms the fenrou (muscle intervals) and plumps the coul i (pores). Sparseness means fenrou is not warm and coul i is not plump, hence "empty". Huan indicates excess Stomach Qi. Solid means strong. Thus grain is digested and water transformed. Grain enters the Stomach, until Blood forms. Following the previous text, water and grain digest, Stomach becomes stronger, transmitting essence to the pulses to form Blood, making Ying abundant. When Ying is abundant, Wei further declines, hence the skin becomes sparse. San Jiao is the pathway of Qi. Jing (meridian/vessel),