医学传心录
编辑者 钱乐天 郭中元 孙桐轩
修订说明
《医学传心录》原是中医大夫钱乐天生前所得的秘本，原书写于清道光年间，封面上载有"上海刘一仁"五字，从内容看，似是刘一仁所著。一九五四年曾由原河北省卫生工作者协会定名《中医捷径》内部出版，作为中医会员的学习材料，一九五八年原河北省中医研究所筹备处责成我们进行整理，并以原名--《医学传心录》正式出版。
本书内容为诊脉、汤头、本草、证治等。文多赋体歌决，简明扼要，便于诵记。其理论引证以经典为主，兼顾历代名家之长。取材简短，能使读者提纲挈领。但原本因传抄之故，差错很多，我们将论述引证，与原著进行了校对。书中古僻字句，或代以通俗字句，或加注解。汤头歌诀中的药名，用小字作了旁注。时方药味与原方有出入者，恐系作者临床经验，一律末加修改。有方无歌者，则补以汤头歌。当时我们虽然做了上述一些工作，但过于强调了保持原貌，对一些不妥的节段，末予删改。
"中国医药学是一个伟大的宝库，应当努力发掘，加以提高。"目前全国西医学习中医、中西医结合的群众运动正蓬勃发展，为了便于广大医务人员学习参考，这次修订时，我们对一些不妥的节段，又作了一些删改，不便删改者，附加了按语。同时，对一九五八年版本的注释、按语，也作了一些修改和补充。但是，因为原作者受其阶级地位、社会实践和历史条件的限制，书中有些观点，读者需用马克思主义观点批判地接受，作为临床和研究工作参考。我们由于受水平所限，修订工作也难免有错误之处，望读者予以指正。编者
写在卷首
一、先将抄本传心录一册(共计八十七章)开首十三章先读熟。
用药传心赋一篇，读之药性大概便知矣。
治病主要诀一篇，读之即知每病主药。
引经药二行，盖百病各有经络，药材众多，非所引药，则众药无所依归，反致生害，譬如同众拜客，无人作引，终不能入其室中，所谓无针不引线也。
三部总看一条，读之则知三部相同之脉，便知犯何病症矣。
发言须当理一条，读之则知问病之法。
汤头歌要旨五章共五条，如脉息略明，病状已得，药性初知，而不知古人一定之方，随时加减，是舍绳墨而意裁曲直，弃权衡而手揣轻重，终于错谬，盖古人定方，必先诊脉，知系何脏腑何经络之病，即应用何经络之药，每方必有主药、辅助药、调和药以配合，而药味中一经炮炙，便尔更变原性，或方中之药，各有相犯相忌相助，岂可乱用，故必斟酌尽善，始定成方，以为加减，垂示后学，以为准绳，若使药性不熟，不知加减，诊脉而后，举目茫然，不知作何立方也。
病因赋一章最妙，人犯病症，一经外现，茫然不知其病因何而得，亦不知何脏腑何经络受伤，倘看脉后，人问因何而得，系何脏腑经络所致，如何答应，此篇一熟，一见便知，不独医人，而自己倘觉有病，亦知其何因，庶不为庸医所害耳。
以上自诊脉传心诀至病因赋，不过十三章，数日可熟，以下七十四章，皆以病因赋内每一句为题，分病原治法成为一章。其用药汤头犹恐人不能记忆，将一方各药练成五言绝句，亦甚便易；如能熟知更妙，或不能熟，常常读之，自能入腹。
药有三百余味，此本分寒热温平四种，共计一百四十六味，虽缺半未全，而首面上之药亦可足用，间有药性不能尽列，而药性之大概已具。
古人精义，为医学大纲，系属秘本，并无坊刻，熟此一本，给人诊治，不致错谬矣。
二、再看《图注难经脉诀》一部，计四小薄本。
医之一道，必先详知脉理，脏腑经络，五行生克，此书专讲脉络，其中有图、有注解，惟诊脉入式歌、五脏歌、七表八里九道、下指诊脉歌皆七言绝句，读之为妙。其余常读，便顺口入腹，至内中卷三一本，《难经》有细注，可与第一卷《难经·图》，两本摊于案上对看自明。
按：《图法难经脉诀》唯心的东西较多。不如参考《濒湖脉学》或《金鉴．脉诀》。
三、再看汪讱蓭《本草备要》一部，四五薄本，专讲药性，后面附有《汤头歌诀》一薄本，方共三百有零，分为二十门，每一汤头仅数句，亦必须熟读。至于古方，岂能个个讲明，只就《伤寒》坏病内最难措手之方选四五个，以参悟其用药之方，则不烦而心得矣。
四、再看汪讱蓭所注《医方集解》一部，专载古人陈方，讲明古人因病立方，用药精义，而且分明补益、发表、涌吐、攻里、表里、和解、理气、理血、祛风、祛寒、清暑、利湿、润燥、泻火、除痰、消导、收涩、杀虫、明日、痈疡、经产、救急，共二十二门。凡补益等名目下，各有细注，而各方亦有细注，虽不必读，不可不静心三复细看也。
至脉与所现之症侯，有相合者，为脉症相合，照"汤头"加减立方自易。至有脉如此，而所现之症如彼，是为脉症不符，凡脉与症不符者，病多难治。盖究不知所患何症，未便冒昧以投药，或舍脉从症，舍症从脉，必有依据，故此《医方集解》一部，不可不细玩也。
左手脉三部，心、肝、肾为脏。小肠、胆、膀脏为腑。脏属阴、腑属阳，此谓三阴三阳。
诊脉须将二三四指甲剪去，盖人之指尖最灵，指尖直督向下，按之则脉中动静虚实，无微不到。若用三指平按脉上，则不得脉中之细微矣。
诊家之要四般脉，浮沉迟数为之则。浮沉轻重指端详①，迟数息中分缓急②。浮而无力即为虚③，浮而有力便为洪。脉沉而无力是弱④，微沉有力是为实。迟而有力滑脉居⑤，迟而无力缓与涩⑥。数而有力为紧弦⑦，数而无力为芤脉⑧。浮迟即是表间虚，沉迟即是里冷极。浮数原来表热真，沉数原来里热炎。此言不出古人书，是我传心之秘识。
按：脉学讲的越繁琐，初学的人越难掌握。前人曾说："切脉之事，明于书未必明于心，明于心未必明于手"，所谓"胸中了了，指下难明"。本诀以浮、沉、迟、数四脉为纲，再从四脉的有力无力分出虚、实、洪、弱等十种脉象。这种以纲带目，从简到繁，先易后难的诊脉方法，使初学的人容易掌握。作者对诸脉脉象形容不够全面，间或有与历代脉学说法不尽符合处，但因作者已经申明"此言不出古人书，是我传心之秘识"，故未修改。读者可参阅其它脉学，结合实践，互相印证。
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①轻手按于皮肤之上即见者，谓之浮脉。重手按至肌肉之间始见者，谓之沉脉。
②一呼一吸叫做一息。一息脉来三至谓之迟脉。一息脉来六至谓之数脉。(数：读朔，当快讲。)
③虚脉，迟大而耎，按之不足，隐指豁豁然空。
④极耎而沉细，按之乃得，举手无有者．谓之弱脉。
⑤崔嘉彦《脉决》谓滑脉："迟而有力，滑而流利"又谓："滑脉如珠，往来旋转"。
⑥缓脉：一息四至，应指和缓．往来自匀。涩脉：细而迟，往来难。
⑦紧脉：来往有力，左右弹人手，数如切绳。弦脉：端直以长如张弓弦。
诸脉主病
浮为风虚芤失血，滑为吐逆实为热，弦为拘急紧为疼，若是洪来多发热。沉寒积痛微①冷结，缓主风虚涩少血，迟病冷顽伏积攻，濡弱气血少分别②。长为壮热短为食，虚脉心中多恍惚，促③缘积聚热相攻，结④为阴寒有所积，动⑤为惊悸血崩淋，牢⑥为寒痛木乘牌，代⑦为正气已飘离，细⑧是精枯形瘦极。
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①微脉：极细而耎，若有若无，按之若欲绝，至数不明。
②濡脉：虚耎无力，如棉絮之浮水中，轻手乍来，重手却去，主血虚，又主湿。弱脉主气虚。
③促脉：古人有两种解释，数时一止叫促脉(脉经)；脉博急促也叫促脉(脉学辑要)。
④结脉：往来缓慢，时一止复来。
⑤动脉：古人有两种解释，一谓"动乃数脉，见于关上下，无头尾，如豆大，厥厥动摇"（《濒湖脉学》)。一谓"数而跳突名动"(《脉学辑耍》何梦瑶)。
⑥牢脉：似沉似伏，实大而长，微弦。
⑦代脉：动而中止，不能自还，良久复动。且止有常数，必依数而止。
诊脉总要
脉中义理极微玄，一诊传心即了然。左寸心脉浮大散，左关肝胆脉长弦，右寸肺脉浮涩短，右关脾胃缓大兼，两尺属肾宜沉软，此为无病体安然。
春脉弦兮夏脉钩，秋脉毛兮冬脉石①，顺时为吉逆为凶，指下须详辨生克。
左手人迎②脉一盛，便是风寒暑湿症，恶寒发热更无殊，四脉四症要审定。浮而无力是伤风，浮而有力伤寒症，浮而虚者暑伤心，浮而缓者湿之病，发散渗利不可差，用药和平保元命。
右手气口脉一盛，便是内伤饮食症。内伤劳倦脉浮洪，饮食伤脾脉洪盛。又有七情气所缠，喜散怒弦忧涩认，悲紧思结恐为沉，惊则脉来动不定，平其胃气保安全，实实虚虚能损命。
左关脉实肝有余；右关脉涩脾土虚。左关涩兮血不足；右关滑兮食积居。左尺浮芤小便血，右尺浮洪大便结，左尺迟兮阳事衰，右尺数兮相火烈。
一息四至号和平，更加一至无大疴，三至为迟一二败，两息一至即云殂，六至为数七至极，八脱九险十危急。脉无上下阴阳绝，脉无来去本元枯，动止频频不久矣，直须决绝莫含糊。大凡诊脉要数息，五十不止身无疾，指下欣欣生意多，虽然有病将安逸。
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①钩：脉来疾去迟曰钩，亦即今之洪脉。毛：即今之浮脉。李士材谓系浮涩，亦通。石：脉沉溺而滑也。
②人迎：关部分做上、中、下三等分，靠近寸部的上三分之一，左手叫人迎，右手叫气口。
诊脉六法
切脉下指先看心，心脉浮大为正形。浮而有力心经热，热主舌破小便疼。感冒风寒弦又紧，头疼寒热数难平。惊悸怔忡沉细弱。上焦蓄热洪大应。(心脉)
次看肝脏弦又长，总然有病也无妨。忽然浮大风为患，紧带洪兮疟痢当。微涩原来阴血少。数为着怒缓为尫（wang1音汪。瘦弱的意思）。有余因实知肝火。沉细为虚亦是常。(肝脉)
若逢肾脉沉无病，洪大须知阴火生。男子下元微不足，女人滑利定为妊。弦紧极虚芤下血。痛连腰胁现微沉。五心烦热洪无力。犯着房劳数不宁。(肾脉)
右寸诊之浮短涩，肺家清净病无干。邪气上冲多发嗽，洪大分明仔细看。弦紧必然咽燥破。数时胸府热难安。浮而有力风外感。沉主生痈滑生痰。(肺脉)
脾家性燥宜迟缓，倘逢滑数知伤食。洪大原来胃火炽，弦紧定遭北□（疪的比下面加白）疟疾。虚汗泄泻腹膨膨。嗳气吞酸是数热。土不制水肢浮肿，沉细而微见肾脉。(脾脉)
命门相火只宜静，虽然沉细未为病。若逢盛旺反成殃，阴虚盗汗肌消甚。浮洪呕血梦遗精。滑数昏花耳聋症。迟缓多缘下部寒。女子旺时应有孕。(命门脉)
三部总看歌
三部俱浮肺脏风。恶寒发热鼻难通。沉迟冷积真元惫。弦数猖狂怒气冲。两手紧兮寒与食。二关缓作痹和癃。虚濡微涩阴阳竭，洪滑不堪久病逢
发言须当理
病人问所便（问所便者，问其居处、动静、阴阳、寒热性情之宜也）。如问其为病热，则便于用寒。问其为病寒，则便于用热。尝有居奥室之中、帷幔之内，甚则复以帛蒙首，不言所病，令人诊候，若细问因由，便谓医业不精。既不能望形色、闻声音，又不能问病情，只凭切脉，以决百病之死生，苟非通明之士，何能若是。故医者必须徐徐问其所苦何物，所思何物，所欲何物，所疑何物，年之少长，形之肥瘦，饮食起居若何，二便通塞若何，所发之始与今之方病。病经几日，曾服过何药。妇人室女须问经事若何。产后须问恶露有无多少。小儿但见憎寒壮热，须问曾经发斑疹否。凡诸病痛，须问曾跌扑损伤否。此为大法，务要一一详审，以彼所说，校吾所诊，或同或异，以折衷之，则万全之功，庶可收矣。
引经药
手足太阳经，藁本羌活行。少阳厥阴地，总用柴胡去。手足阳明经，白芷升（麻）葛根。肺（白）芷升（麻）葱（白）用。脾升（麻）白芍应。心经黄连使。肾独加桂灵。分经用此药，愈病即通神。
用药传心赋
Medical Transmission of Heart Records
Editors: Qian Letian, Guo Zhongyuan, Sun Tongxuan
Revision Notes
"Medical Transmission of Heart Records" was originally a secret manuscript obtained by the Traditional Chinese Medicine (TCM) physician Qian Lesheng during his lifetime. The original text was written during the Daoguang reign of the Qing Dynasty, and the cover bears the five characters "Shanghai Liu Yiren." Judging from the content, it seems to have been authored by Liu Yiren. In 1954, it was internally published under the title *Shortcuts to TCM* by the former Hebei Provincial Health Workers Association as study material for TCM members. In 1958, the preparatory office of the former Hebei Provincial TCM Research Institute commissioned us to organize it, and it was officially published under its original name, *Medical Transmission of Heart Records*.
The content of this book covers pulse diagnosis, herbal formulas, materia medica, and syndrome differentiation and treatment. The text is mostly in the form of fu-style rhymed verses, concise and essential, facilitating recitation and memorization. Its theoretical citations primarily rely on classics while also considering the strengths of famous experts from successive dynasties. The selected materials are brief, enabling readers to grasp the main points. However, due to errors introduced through copying, many mistakes existed in the original. We proofread the discussions and citations against the original work. Archaic or obscure characters and sentences were either replaced with common ones or annotated. Herbal names in the formula rhymes were noted in small print alongside the text. For contemporary prescriptions where the ingredients differed from the original formulas, fearing they might reflect the author's clinical experience, we did not modify them uniformly. Where there were formulas without accompanying rhymes, we supplemented them with formula verses. Although we performed the aforementioned tasks at that time, we overly emphasized preserving the original appearance and did not delete or revise some inappropriate sections.
"Chinese medicine is a great treasure house; efforts should be made to explore and improve it." Currently, the mass movement across the country for Western-trained physicians to learn TCM and for integrated Chinese and Western medicine is developing vigorously. To facilitate learning and reference for medical personnel, during this revision, we deleted and revised some inappropriate sections again. For those inconvenient to revise, we added editorial notes. Meanwhile, we also modified and supplemented the annotations and notes from the 1958 edition. However, because the original author was limited by their class status, social practice, and historical conditions, some viewpoints in the book require readers to accept critically from a Marxist perspective, serving as reference for clinical and research work. Due to our limited level, errors in the revision work are inevitable; we hope readers will point them out. Editors
Preface
I. First, read and familiarize yourself with the first thirteen chapters of one copy of the *Chuanxin Lu* manuscript (totaling eighty-seven chapters).
Read the "Fu on Transmitting the Heart of Medication," and you will roughly understand the properties of herbs.
Read the "Essential Rules for Treating Diseases," and you will immediately know the principal herb for each disease.
Regarding "Meridian-Guiding Herbs": All hundred diseases involve specific meridians. With numerous medicinal materials, if not guided by specific herbs, the other medicines will have no direction, potentially causing harm. It is like visiting guests with a crowd but without a guide; ultimately, one cannot enter the room. This is what is meant by "without a needle, one cannot thread the line."
Read the "Pulse Diagnosis Heart-Transmission Rules," and you will know the names and forms of pulses, as well as their lightness/heaviness, slowness/rapidity, deficiency/excess, and exterior/interior nature.
Read the "General Principles of Pulse Diagnosis," and upon raising your hand to press the pulse, you will know the patient's condition.
Read the "General View of Three Positions," and knowing the identical pulses in the three positions allows you to identify the disease.
Read the "Principle of Speaking Must Be Reasonable," and you will know the method of questioning patients.
Read the "Five Chapters and Five Rules of Key Points in Formula Rhymes": If one slightly understands the pulse and respiration, has obtained the symptoms, and initially knows the herb properties, but does not know the fixed ancient formulas and how to add or subtract according to circumstances, it is like abandoning the carpenter's ink line to judge straightness by eye, or discarding the steelyard to guess weight by hand, eventually leading to error. Ancient people established formulas only after first diagnosing the pulse, knowing which zang-fu organs and meridians were affected, and thus applying herbs corresponding to those meridians. Each formula must have a principal herb, auxiliary herbs, and harmonizing herbs to coordinate. Once processed (paozhi), the original nature of the herbs changes. Furthermore, herbs within a formula may have conflicting, incompatible, or synergistic relationships; how can they be used randomly? Therefore, one must deliberate until perfect before finalizing a formula for addition/subtraction, leaving it for future students as a standard. If one is unfamiliar with herb properties and does not know how to modify, after diagnosing the pulse, one would look around blankly, not knowing how to compose a prescription.
The chapter on "Fu on Etiology" is most excellent. When a person suffers from a disease, once it manifests externally, one is bewildered and does not know the cause, nor which zang-fu organs or meridians are injured. After examining the pulse, if asked why the disease occurred and which organs/meridians caused it, how would one answer? Familiarity with this chapter allows immediate recognition upon sight. Not only for treating others, but if one feels ill oneself, one can know the cause, thereby avoiding harm from incompetent physicians.
The above, from the "Pulse Diagnosis Heart-Transmission Rules" to the "Fu on Etiology," comprises only thirteen chapters, which can be memorized in a few days. The following seventy-four chapters all take each sentence from the "Fu on Etiology" as a topic, dividing etiology and treatment methods into separate chapters. Fearing that people cannot memorize the medication formulas, the herbs in each formula are condensed into five-character quatrains, which is very convenient; it is even better if thoroughly known, but if not, frequent reading will naturally internalize them.
There are over three hundred types of herbs. This book categorizes them into four natures: cold, hot, warm, and neutral, totaling 146 types. Although incomplete, the commonly used herbs are sufficient. While not all herb properties can be listed, the general principles are present.
The profound essence of the ancients serves as the outline of medicine. It belongs to secret manuscripts and has no commercial printing. Mastering this single book ensures accurate diagnosis and treatment for others without error.
II. Next, study the "Illustrated Diagrams and Pulse Rhymes of Nan Jing," consisting of four small thin volumes.
In the art of medicine, one must first thoroughly understand pulse theory, zang-fu organs, meridians, and the generation and restriction of the Five Elements. This book specifically discusses pulse vessels, containing diagrams and annotations. The "Song of Entering Pulse Form," "Song of Five Zang Organs," "Seven Surfaces, Eight Interiors, Nine Channels," and "Song of Finger Placement for Pulse Diagnosis" are all seven-character quatrains, which are wonderful to read. Reading the rest regularly makes it flow smoothly into memory. Regarding Volume 3 inside, the *Nan Jing* has detailed annotations; compare these two volumes spread on the desk to see clearly.
Note: The "Illustrated Diagrams and Pulse Rhymes of Nan Jing" contains较多 idealistic elements. It is better to refer to *Binhu Pulse Studies* or *Jinjian Pulse Rhymes*.
III. Next, study Wang Renzhu's *Bencao Bei Yao* (Compendium of Materia Medica Prepared for Needs), consisting of four or five thin volumes, specifically discussing herb properties. Attached at the back is a thin volume of *Tangtou Gejue* (Formula Rhymes), containing over three hundred formulas divided into twenty categories. Each formula consists of only a few lines and must be memorized. As for ancient formulas, how can every one be explained? Select four or five of the most difficult-to-handle formulas from the mishandled cases in *Shanghan Lun* (Treatise on Cold Damage) to ponder their medication methods, and you will gain insight without trouble.
IV. Next, study the *Yifang Jijie* (Collected Explanations of Medical Prescriptions) annotated by Wang Renzhu. It specifically records ancient established formulas, explaining the essence of ancient medication based on diseases. It clearly categorizes into tonification, releasing the exterior, inducing vomiting, purging the interior, harmonizing interior/exterior, harmonizing, regulating qi, regulating blood, dispelling wind, dispelling cold, clearing summerheat, draining dampness, moistening dryness, purging fire, eliminating phlegm, promoting digestion, astringing, killing parasites, brightening eyes, treating sores and ulcers, gynecological disorders, and emergency rescue, totaling twenty-two categories. Under categories such as tonification, there are detailed notes, and each formula also has detailed notes. Although not necessary to read, one must calmly review them carefully multiple times.
When the pulse matches the manifested symptoms, it is called "pulse-symptom concordance," and composing formulas by adding or subtracting according to "Formula Rhymes" is easy. When the pulse is one way but the symptoms are another, it is called "pulse-symptom discordance." Cases of pulse-symptom discordance are often difficult to treat. Since one does not know exactly what the disease is, it is unwise to blindly administer medicine. One must either abandon the pulse to follow the symptoms or abandon the symptoms to follow the pulse, both requiring basis. Therefore, this *Yifang Jijie* must be studied carefully.
On the left hand, the three pulse positions correspond to the Heart, Liver, and Kidney as zang organs. The Small Intestine, Gallbladder, and Bladder are fu organs. Zang belong to Yin, Fu belong to Yang; this is referred to as Three Yin and Three Yang.
On the right hand, the three pulse positions correspond to the Lung, Spleen, and Mingmen (Gate of Life) as zang organs. The Large Intestine, Stomach, and Sanjiao (Triple Burner) are fu organs.
When diagnosing the pulse, trim the nails of the second, third, and fourth fingers. The fingertips are the most sensitive; pressing directly downwards allows one to perceive every subtle detail of movement, stillness, deficiency, and excess in the pulse. If using three fingers to press flatly on the pulse, one cannot detect the subtleties.
Rules for Transmitting the Heart of Pulse Diagnosis
The essentials of pulse diagnosis lie in four types of pulses: Floating, Deep, Slow, and Rapid. These serve as the standard. Lightness and heaviness of Floating and Deep are examined at the finger tips; slowness and rapidity are distinguished by breath count.
Floating without force indicates Deficiency; Floating with force indicates Surging.
Deep without force indicates Weak; Slightly deep with force indicates Excess.
Slow with force suggests Slippery pulse; Slow without force suggests Moderate or Choppy pulse.
Rapid with force indicates Tight or Wiry; Rapid without force indicates Scallion-stalk pulse.
Floating and Slow indicate Exterior Deficiency; Deep and Slow indicate Extreme Interior Cold.
Floating and Rapid indicate True Exterior Heat; Deep and Rapid indicate Interior Heat inflammation.
These words do not come from ancient books; they are my secret knowledge transmitted from the heart.
Note: The more complicated pulse studies become, the harder it is for beginners to master. Ancients said: "Understanding pulse theory in books does not necessarily mean understanding it in the heart, and understanding it in the heart does not necessarily mean mastering it with the hands." This is the saying "clear in mind, difficult under the fingers." This rule takes Floating, Deep, Slow, and Rapid as the main categories, then distinguishes ten pulse images such as Deficiency, Excess, Surging, and Weak based on forcefulness. This method of guiding details with main categories, moving from simple to complex, and easy to difficult, helps beginners master it easily. The author's description of various pulse images is not comprehensive, and sometimes differs from traditional pulse studies. However, since the author stated "These words do not come from ancient books; they are my secret knowledge transmitted from the heart," we did not modify them. Readers may consult other pulse studies and verify through practice.
[Footnotes omitted for brevity in translation, corresponding to definitions of specific pulse qualities]
Main Diseases of Various Pulses
Floating indicates Wind or Deficiency; Scallion-stalk indicates Blood Loss; Slippery indicates Vomiting/Nausea; Excess indicates Heat.
Wiry indicates Spasm/Tension; Tight indicates Pain; Surging indicates Fever.
Deep indicates Cold/Stagnation/Pain; Micro indicates Cold Accumulation; Moderate indicates Wind/Deficiency; Choppy indicates Blood Deficiency.
Slow indicates Cold/Difficult diseases/Hidden accumulation; Soft/Weak indicates Qi/Blood Deficiency.
Long indicates High Fever; Short indicates Food Retention; Deficient pulse indicates Mental confusion.
Hasty pulse arises from Accumulation/Fire attacking; Knotted pulse indicates Yin-Cold accumulation.
Moving pulse indicates Palpitations/Blood flooding/Strangury; Firm pulse indicates Cold pain/Wood overacting on Earth.
Intermittent pulse indicates Righteous Qi has drifted away; Fine pulse indicates Essence exhaustion and extreme emaciation.
[Footnotes omitted for brevity]
General Principles of Pulse Diagnosis
The principles within the pulse are extremely subtle and mysterious; one diagnosis transmits the heart and becomes clear.
Left Cun (Inch) Heart pulse: Floating, Large, Scattered.
Left Guan (Bar) Liver/Gallbladder pulse: Long, Wiry.
Right Cun Lung pulse: Floating, Choppy, Short.
Right Guan Spleen/Stomach pulse: Moderate, Large, Combined.
Both Chi (Cubit) Kidney pulses: Should be Deep and Soft. This indicates a healthy body without disease.
Spring pulse is Wiry; Summer pulse is Hooked (Surging).
Autumn pulse is Hairy (Floating); Winter pulse is Stone-like (Deep).
Following the season is auspicious; opposing it is ominous. One must carefully distinguish generation and restriction under the fingers.
If the Left Hand Renying (Guan position upper third) pulse is excessive, it indicates Wind-Cold, Summerheat, or Dampness syndromes. Chills and fever are similar; the four pulses and four syndromes must be determined.
Floating without force is Wind Injury; Floating with force is Cold Damage.
Floating and deficient is Summerheat injuring the Heart; Floating and moderate is Dampness disease.
Releasing and draining/diuresis must not be mistaken; use mild medications to protect vital energy.
If the Right Hand Qikou (Guan position upper third) pulse is excessive, it indicates Internal Injury from Diet.
Internal injury from fatigue shows Floating/Surging pulse; Dietary injury to Spleen shows Surging/Excessive pulse.
Also entangled by Seven Emotions: Joy leads to Scattered; Anger leads to Wiry; Sorrow leads to Choppy.
Sorrow leads to Tight; Pondering leads to Knotted; Fear leads to Deep.
Fright causes Moving/unstable pulse. Calm the Stomach Qi to ensure safety; Excess-on-Excess or Deficiency-on-Deficiency can damage life.
Left Guan Excess indicates Liver Hyperactivity; Right Guan Choppy indicates Spleen Earth Deficiency.
Left Guan Choppy indicates Blood Insufficiency; Right Guan Slippery indicates Food Retention.
Left Chi Floating/Scallion-stalk indicates Blood in Urine; Right Chi Floating/Surging indicates Constipation.
Left Chi Slow indicates Impotence; Right Chi Rapid indicates Vigorous Ministerial Fire.
Four beats per breath is called Peaceful; Adding one beat means no major illness.
Three beats is Slow; Two beats per breath indicates decline.
One beat per two breaths indicates death.
Six beats is Rapid; Seven is extreme; Eight is depletion; Nine is dangerous; Ten is critical.
Pulse without Up/Down indicates Yin/Yang severance; Pulse without Coming/Going indicates Root exhaustion.
Frequent stopping indicates short life; Decisions must be decisive, not ambiguous.
Generally, counting breaths for fifty beats without stopping indicates no disease. Vitality is abundant under the fingers; even if sick, recovery is likely.
[Footnotes omitted for brevity]
Six Methods of Pulse Diagnosis
Pressing the pulse, first examine the Heart. Heart pulse Floating/Large is normal shape.
Floating with force indicates Heart Meridian Heat; Heat causes tongue ulcers and painful urination.
Cold-Damage Wind-Cold shows Wiry/Tight; Headache, chills/fever, rapid pulse hard to calm.
Palpitations/Startle show Deep/Fine/Weak. Upper Jiao heat accumulation shows Surging/Large. (Heart Pulse)
Next examine the Liver. Wiry and Long; even if diseased, no harm.
Suddenly Floating indicates Wind disaster; Tight with Surging indicates Malaria/Dysentery.
Micro/Choppy originally indicates Yin-Blood deficiency.
Rapid indicates Anger; Moderate indicates Emaciation.
Hyperactivity due to Excess indicates Liver Fire.
Deep/Fine indicates Deficiency, which is also common. (Liver Pulse)
If Kidney pulse is Deep, no disease. Surging/Large indicates Ministerial Fire arising.
Men with insufficient Lower Yuan; Women with Slippery/Smooth pulse indicate Pregnancy.
Wiry/Tight, Extreme Deficiency, Scallion-stalk indicate Lower Bleeding.
Pain connecting to waist/flanks appears slightly Deep.
Five-center heat with Surging without force. Violating sexual fatigue causes Rapid unrest. (Kidney Pulse)
Right Cun Floating/Short/Choppy: Lung is pure and clear, disease does not interfere.
Evil Qi rushing up causes frequent coughing; Surging/Large requires careful observation.
Wiry/Tight必然 causes Dry throat/Ulceration. Rapid indicates Chest heat discomfort.
Floating with force indicates External Wind infection. Deep indicates Abscess formation; Slippery indicates Phlegm. (Lung Pulse)
Spleen nature is dry, suitable for Moderate/Slow. If Slippery/Rapid, indicates Food Injury.
Surging/Large originally indicates Stomach Fire blazing. Wiry/Tight definitely encounters Northern [Malaria].
Spontaneous sweating, diarrhea, abdominal distension. Belching/Acid regurgitation indicates Rapid Heat.
Earth failing to control Water causes limb edema; Deep/Fine/Micro reveals Kidney pulse. (Spleen Pulse)
Mingmen Ministerial Fire should only be quiet. Although Deep/Fine, it is not disease.
If flourishing, it becomes disaster; Yin deficiency causes night sweats and muscle wasting.
Floating/Surging indicates Hematemesis/Dream emission. Slippery/Rapid indicates Dim vision/Deafness.
Moderate/Slow often relates to Lower Body Cold. Women during fertile times should be pregnant. (Mingmen Pulse)
General View Song of Three Positions
All three positions Floating: Lung Wind. Chills, fever, nasal congestion.
Deep/Slow: Cold accumulation, true yuan exhausted.
Wiry/Rapid: Maniacal anger衝.
Both hands Tight: Cold and Food.
Two Guan Moderate: Bi syndrome and Strangury.
Deficient/Soft/Micro/Choppy: Yin/Yang exhaustion.
Surging/Slippery: Unbearable for chronic disease.
Principle of Speaking Must Be Reasonable
Questioning the Patient's Preferences (Asking about living environment, activity/rest, Yin/Yang preference, cold/heat temperament suitability).
If asking about Heat disease, it is convenient to use Cold meds. If asking about Cold disease, it is convenient to use Hot meds.
Sometimes patients reside in dark rooms, behind curtains, or even cover their heads with cloth, not stating their illness, letting others diagnose. If questioned carefully about causes, they claim the doctor is incompetent.
Since one cannot observe complexion/form, hear sounds, or ask about the condition, relying solely on pulse to determine life/death of hundred diseases, unless one is a thorough and enlightened scholar, how can one achieve this?
Therefore, the physician must slowly ask what suffering they endure, what they think about, what they desire, what they doubt. Ask age (young/old), body type (fat/thin), diet and daily routine, bowel/bladder passage/blockage, onset of disease vs current state. How many days has the disease lasted? What medicines have been taken?
For women, ask about menstruation. For postpartum, ask about lochia amount.
For children showing aversion to cold and high fever, ask if they have had macules/rashes.
For all pains, ask if there was trauma/falling.
This is the major principle;务必 examine every detail. Compare their statements with your diagnosis. Whether same or different, reconcile them, and then the work of ten thousand precautions can be achieved.
Meridian-Guiding Herbs
Hand-Foot Taiyang Meridians: Gaoben, Qianghuo move.
Shaoyang/Jueyin grounds: Always use Chaihu to remove.
Hand-Foot Yangming Meridians: Baizhi, Shengma, Gegen.
Lung: Baizhi, Shengma, Congbai used.
Spleen: Shengma, Baishao respond.
Heart Meridian: Huanglian guides.
Kidney alone adds Rougui, Lingzhi.
Using these herbs by meridian, curing disease becomes miraculous.
Fu on Transmitting the Heart of Medication