王肯堂曰。诸脉数为热属腑。诸迟脉为冷属脏。阳数脉。主吐逆。不吐必发热。阴微脉。主泄泻。不泻必盗汗。沉
数脉。寒热。寒多热少。亦主骨蒸热。紧数脉。寒热。热多寒少。又主骨蒸。急则惊痫。沉紧脉。心腹痛。短数同。亦
主咳嗽。沉细脉。乳食不化。亦主腹痛下痢。沉伏脉。为积聚。亦主霍乱。微缓脉。乳不化泄泻。沉缓亦同。微涩脉。
螈筋挛。微急脉。寒热唾血。浮滑脉。宿食不消。亦主咳嗽。浮紧脉。疳气耳聋。浮洪脉。头疼身热。紧滑脉。吐血
恶心。心脉急数。惊痫。否则疳淋。肝脉急。癫痫风痫。痰涎流液。肺脉浮实。鼻塞。并大小便不通。关脉紧滑。主蛔
虫。尺脉沉同。尺脉微细。溏泄冷利。乳食不化。尺脉微涩。便血。否必盗汗。脉入鱼际。主遗尿。
滑伯仁曰。小儿三岁以内。看男左女右虎口三节。日三关。纹色紫热。红伤寒。青惊风。白疳病。黄色淡红。乃平
常小恙。其筋纹宜藏。不宜暴露。若黑色。则为危险。再脉纹见下截风关为轻。中截气关为重。上截命关为尤重。直透
三关为大危。
鳌按。从前言看三关。法虽大同小异。总不如滑氏之直截明简。
王肯堂曰。全幼心鉴十三种脉纹云。流珠只一点红色。环珠差大。长珠圆长。以上非谓圈子。总皆红脉贯气如此。
来蛇即是长珠散出。一头大一头尖。去蛇亦如此。分上下向。故曰来去。角弓长张向里为顺。向外为逆。枪形直上。鱼
骨分开。水字即三脉并形。针形即过一二粒米许。射甲命脉向外。透指命脉向里。虽然余尝治之。亦有不专执其形脉而
投剂者。盖但有是症。即投是药。而亦多验。流珠形。主饮食所伤。内热欲吐。或肠鸣自利。烦躁啼哭。用助胃膏。环
珠形。主脾虚停食。胸膈胀满。烦渴发热。五味异功散加山楂、枳实。长珠形。主脾伤饮食腹痛。寒热不食。大安丸。
异功散。来蛇形。主脾胃湿热。中脘不利。干呕不食。此疳邪内作。四味肥儿丸。去蛇形。主脾虚。食积吐泻。烦渴气
短。喘急不食。困极。七味白术散。弓反里形。主感寒惊悸。哽气出气。四肢梢冷。倦怠。小便赤。咳嗽吐涎。惺惺散。
弓反外形。主痰热。心神恍惚。夹惊夹食。风痫痰盛。天麻防风丸。枪形。主风热。生痰惊。抱龙丸。鱼骨形。主惊痰
发热。抱龙丸。抑青丸。水字形。主惊风。食积。胸膈烦躁。顿闷少食。或夜啼痰盛。口噤搐搦。大安丸。针形。主心
肝热极生风。惊悸顿闷困倦。痰盛搐搦。抱龙丸。射指形。主惊风痰食聚膈。牛黄清心丸。射甲形。主惊风。及一切木
克土之败症。六君子汤加木香、钩藤钩、官桂。未应。即加附子。
Wang Kentang said: Various rapid pulses (Shu Mai, rapid pulse) indicate heat syndromes and belong to the Fu organs; various slow pulses (Chi Mai, slow pulse) indicate cold syndromes and belong to the Zang organs. A rapid pulse in the Yang aspect indicates vomiting and regurgitation; if there is no vomiting, fever must occur. A faint pulse in the Yin aspect indicates diarrhea; if there is no diarrhea, night sweats must occur. A deep and rapid pulse indicates alternating chills and fever, with more chills than fever, and also indicates bone-steaming tidal fever. A tight and rapid pulse indicates alternating chills and fever, with more fever than chills, and also indicates bone-steaming consumption fever. An urgent pulse indicates convulsive epilepsy. A deep and tight pulse indicates heart and abdominal pain; a short and rapid pulse is similar, and also indicates coughing. A deep and fine pulse indicates indigestion of milk and food, and also indicates abdominal pain and dysentery. A deep and hidden pulse indicates accumulation and mass, and also indicates cholera-like disease. A faint and moderate pulse indicates failure to digest milk leading to diarrhea; a deep and moderate pulse is the same. A faint and choppy pulse indicates twitching and muscle cramps. A faint and urgent pulse indicates alternating chills and fever with blood in saliva. A floating and slippery pulse indicates retained food not digesting, and also indicates coughing. A floating and tight pulse indicates malnutrition (Gan syndrome) and deafness. A floating and surging pulse indicates headache and body heat. A tight and slippery pulse indicates hematemesis and nausea. An urgent and rapid pulse at the Heart position indicates convulsive epilepsy; otherwise, it indicates Gan syndrome with stranguria. An urgent pulse at the Liver position indicates epilepsy and wind-phlegm epilepsy with flowing phlegm-saliva. A floating and solid pulse at the Lung position indicates nasal congestion and obstruction of both large and small intestines. A tight and slippery pulse at the Guan position indicates roundworms; a deep pulse at the Chi position is similar. A faint and fine pulse at the Chi position indicates loose stools and cold diarrhea, and failure to digest milk and food. A faint and choppy pulse at the Chi position indicates blood in stool; otherwise, it indicates night sweats. A pulse entering the Yuji area indicates urinary enuresis.
Hua Bo-ren said: For children under three years old, observe the three segments on the left hand for boys and the right hand for girls at the Tiger's Mouth, known as the Three Passes. Purple vein color indicates heat; red indicates cold damage (Shanghan); green indicates wind-stroke or convulsions (Jingfeng); white indicates malnutrition (Gan disease); yellowish pale red indicates minor common ailments. The veins should be concealed, not exposed. If black, it indicates danger. Furthermore, if the vein appears in the lower segment (Wind Pass), it is mild; in the middle segment (Qi Pass), it is severe; in the upper segment (Life Pass), it is especially severe. Penetrating all three passes directly indicates critical danger.
Shen Jin'ao noted: Previous descriptions of observing the Three Passes are largely similar but not as direct and concise as Hua's method.
Wang Kentang said: "Quan You Xin Jian" describes thirteen types of vein patterns: Liuzhu (Flowing Pearl) is only a single red dot; Huanzhu (Ringed Pearl) is slightly larger; Changzhu (Long Pearl) is round and long. None of these refer to circles; they all refer to red veins penetrating Qi in this manner. Laishé (Approaching Snake) is like a dispersed Long Pearl, wide at one end and pointed at the other; Qushé (Departing Snake) is similar, distinguished by upper and lower directions, hence called Approaching and Departing. Gonggong (Bow Shape) stretching inward is favorable (Shun); outward is unfavorable (Ni). Qiangxing (Spear Shape) goes straight up; Yugu (Fish Bone Shape) branches out; Shuizi (Water Character Shape) consists of three merged lines; Zhenxing (Needle Shape) extends beyond one or two grains of rice. Shejia (Shooting Nail) has the Life Pass pointing outward; Touzhi (Penetrating Finger) has the Life Pass pointing inward. Although I have treated cases where I did not strictly adhere to these shapes and pulses when prescribing, generally, treating symptoms with corresponding herbs yields good results. Liuzhu shape indicates injury from diet, internal heat with desire to vomit, or borborygmus and spontaneous diarrhea, irritability and crying; use Weizhu Gao (Stomach-Assisting Paste). Huanzhu shape indicates Spleen deficiency with food stagnation, chest and epigastric fullness, vexation, thirst, and fever; use Wuwei Yigong San (Five-Ingredient Yi-Gong Powder) added with Shan Zha (Crataegi Fructus) and Zhi Shi (Aurantii Fructus Immaturus). Changzhu shape indicates Spleen injury from diet causing abdominal pain, alternating chills and fever, and anorexia; use Da'an Wan (Great Peace Pill) or Yigong San. Laishé shape indicates Spleen-Stomach damp-heat, epigastric discomfort, dry retching, and anorexia, caused by internal Gan pathogen; use Siwei Fei'er Wan (Four-Ingredient Child-Nourishing Pill). Qushé shape indicates Spleen deficiency with food accumulation causing vomiting and diarrhea, vexation, thirst, shortness of breath, panting, anorexia, and extreme exhaustion; use Qiwei Baizhu San (Seven-Ingredient Atractylodes Macrocephala Powder). Gongfanli (Bow Reversing Inward) shape indicates cold invasion with fright palpitations, gasping, cold extremities, fatigue, dark urine, coughing, and expectoration; use Xingxing San (Xingxing Powder). Gongfanwai (Bow Reversing Outward) shape indicates phlegm-heat, mental confusion, combined with fright and food stagnation, wind-phlegm epilepsy with abundant phlegm; use Tianma Fangfeng Wan (Gastrodia and Saposhnikovia Pill). Qiangxing (Spear Shape) indicates wind-heat generating phlegm and fright; use Baolong Wan (Embrace Dragon Pill). Yuguxing (Fish Bone Shape) indicates fright-phlegm with fever; use Baolong Wan or Yiqing Wan (Suppress Green Pill). Shuizixing (Water Character Shape) indicates convulsions, food stagnation, chest vexation, sudden oppression, reduced appetite, night crying with abundant phlegm, locked jaw, and convulsions; use Da'an Wan. Zhenxing (Needle Shape) indicates extreme heat in Heart and Liver generating wind, fright palpitations, sudden oppression, fatigue, abundant phlegm, and convulsions; use Baolong Wan. Shezhixing (Shooting Finger Shape) indicates fright-phlegm and food accumulating in the diaphragm; use Niuhuang Qingxin Wan (Calculus Bovis Clearing Heart Pill). Shejiaxing (Shooting Nail Shape) indicates convulsions and all degenerative syndromes of Wood overacting on Earth; use Liujunzi Tang (Six Gentlemen Decoction) added with Mu Xiang (Aucklandiae Radix), Goutenggou (Uncariae Ramulus cum Uncis), and Guigui (Cinnamomi Cortex). If ineffective, add Fuzi (Aconiti Lateralis Radix Praeparata).