黄帝曰∶余闻九针于夫子。众多博大。不可胜数。余愿闻要道。以属子孙。传之后世。
着
下副
九焉
以
有
地以候肾。人以候脾。帝曰∶中部之候奈何。岐伯曰∶亦有天。亦有地。亦有人。天以候肺
。地以候胸中之气。人以候心。帝曰∶上部何以候之。岐伯曰∶亦有天。亦有地。亦有人。
天以候头角之气。人以候耳目之气。地以候口齿之气。三部各有天。各有地。各有人。三而
成天。三而成地。三而成人。合则为九。九分为九野。为九藏。故神藏五。形藏四。合为九
藏。五藏已败。其色必夭。夭必死矣。帝曰∶以候奈何。岐伯曰。必先度其形之肥瘦。以调
其气之虚实。实则泻之。虚则补之。必先去其血脉而后调之。无问其病。以平为期。帝曰∶
决死生奈何。岐伯曰∶形盛脉细。少气不足以息者危。形瘦脉大。胸中多气者死。形气相得
者生。参伍不调者病。三部九候皆相失者死。上下左右之脉。相应如参舂者病甚。上下左右
相失。不可数者死。中部之候虽独调。与众相失者。皆死也。
凡诊脉。视其人大小长短。及性气缓急之脉。皆如其人形性则吉。反之者则凶。
夫脉者血之府也。长则气理。短者气病。数则心烦。大则病进。上盛则气高。下盛则气
胀。
短而急者病在上。长而缓者病在下。弦而沉者病在内。浮而洪者病在外。
滑而微浮病在肺。下紧上虚病在脾。长而弦者病在肝。脉少血少病在心。大而紧者病在
肾。
脉实者病在内。脉虚者病在外。
浮而大者风。浮而涩者气。沉细疾者热。迟紧者为寒。
诸腑脉为阳主热。诸脏脉为阴主寒。阳微则汗。阴为自下。阳数则口疮。阴数则恶寒。
阳芤
脉与肌肉相得。久持之至者。可下之。弦小紧者可下之。弦迟者宜温药。紧数者可发汗。
寸口脉浮大而病者。名曰阳中之阳。病苦烦满身热头痛腹中热。寸口脉沉细者。名曰阳中之
阴。病苦悲伤不乐。恶闻人声。少气。时时汗出。阴气不通。两臂不举。尺脉沉细。名曰阴
中之阴。苦两胫酸疼。不能久立。阴气衰。小便余沥。阴下湿痒。尺寸脉牢而长。关中无此
。为
痛。
寸口脉紧者。中风。风攻头痛。夫疟脉自弦。弦数多热。弦迟多寒。初持脉如躁之状。
久久
脉来乍大乍小。乍短乍长。为祸祟。脉来但实者。为心劳。脉来洪大袅袅者。为祸祟。
寸口脉弦中手短者。头痛。脉来过寸口入鱼际者。遗尿。脉来中手弦长者。腰疼。足胫
痛。
脉来中手弦从上紧者。肩背痛。脉但数细。心下热盛。
脉盛滑紧者。痛在外。脉小实紧者。痛在内。脉小弱而浮滑。久病。脉涩浮而病。新病。
脉沉而弦者。其人有 。腹内痛。脉来缓滑者。热在胃中。脉来盛紧者。腹胀。脉弦急。
疝
者
迟
下重痢。脉滑而浮散者。有风。脉短而滑者。病酒。脉紧而滑者。吐逆。脉迟而缓者。脾胃
有寒。脉弦而钩。胁下如刀刺。状如飞。脉沉而迟。腹藏有冷病。脉浮而细滑。伤于寒饮。
脉沉而数。其人中酒。冬时不治自愈。脉滑者。阳气盛。脉微而紧者。有寒。脉涩细而紧者
。痹病。脉沉而滑。为下重。背膂痛。脉短而数。心痛必烦。脉紧而数。寒热俱发。必当下
之乃愈。脉微弱者。有寒。少气。脉迟紧者。胃中有寒。若不能食。时时利者。当难治。脉
弦而紧。胁下痛。脉大细滑。中有短气。脉细小者。血气俱少。脉涩者、少血多气。脉滑者
、多血少气。脉大者。血气俱多。两手脉前部阳绝者。苦心下寒。内中热。脉洪大紧急。病
在外。苦头痛。发痈肿。脉细小紧急。病在中。寒疝瘕。积聚。腹中痛。脉浮大。中风头重
鼻塞。脉微浮。秋吉冬病。脉来疾者。为热。迟者。为寒湿。为鬼疰。弦。为切痛。脉沉重
而直前绝者。腹间血。病在内。脉沉重而中散者。因寒食成症。脉沉而急。病伤暑。暴发虚
热。脉来中散绝者。病渴。脉沉重。前不至寸口徘徊绝者。在肌肉遁尸。脉累累如贯珠不前
至。有风寒在大肠。伏留不去。脉来累累而止。不至寸口软者。结热在小肠膜中。而伏留不
去。脉微。即阳气不足。虚热汗出。凡无阳即厥。无阴即呕。阳微不能呼。阴微不能吸。
呼吸不足。胸中气促。前大后小。即头痛目眩。前小后大。即胸满短气。上部有脉。下部无
脉。其人当吐。不吐者死。阳邪来见浮洪。阴邪来见沉细。水谷来见实坚。浮而滑者宿食。
洪大伤寒热病。弦小者寒癖。浮滑之脉速疾者。食不消脾不磨也。关脉紧而滑者。蛔虫也。
三部或至或不至。冷气在胃中。故令脉不通也。尺脉沉滑者。寸白虫也。脉紧而急者、为遁
尸。脉紧而长过寸口者。疰病。关脉浮。积聚。热在胃中。尺脉浮者、客热在下焦。诸浮诸
紧。诸弦诸沉。诸涩诸滑。若在寸口。膈以上病。若在关上。胃以下病。若在尺中。肾以下
病。寸口脉沉。胸中短气。若弦上寸口者。宿食头痛。若有表有里者。邪之所止。得鬼病。
何谓表里。寸尺为表。关上为里。两头有脉。关中绝不至也。尺脉上不至关为阴绝。寸脉下
不至关为阳绝。阴绝与阳绝皆死。不可治也。
Huangdi said: I have heard from you about the Nine Needles. The content is vast and profound, innumerable. I wish to hear the essential principles so that I may pass them on to my descendants and transmit them to future generations.
Qibo said: The human position of the lower section observes the Spleen, and the earth position observes the Kidney. Huangdi asked: How are the pulses of the middle section observed? Qibo replied: There is also heaven, earth, and humanity in the middle section. The heaven position observes the Lung, the earth position observes the Qi in the chest, and the human position observes the Heart. Huangdi asked: How is the upper section observed? Qibo replied: There is also heaven, earth, and humanity in the upper section. The heaven position observes the Qi of the head and horns (temples), the earth position observes the Qi of the mouth and teeth, and the human position observes the Qi of the ears and eyes. Each of the three sections has its own heaven, earth, and humanity. Three times three constitute heaven, earth, and humanity. Combined, they form nine positions. These nine positions are divided into nine fields, corresponding to nine Zang organs. Thus, there are five Shen (Spirit) Zang and four Xing (Form) Zang, totaling nine Zang organs. If the essence of the Five Zang organs fails, the complexion will inevitably become withered and lifeless; a withered complexion indicates death. Huangdi asked: How should one observe [the pulse] to judge the condition? Qibo replied: One must first measure the patient's fatness or thinness to regulate the deficiency or excess of their Qi. For excess conditions, use draining methods; for deficiency conditions, use tonifying methods. One must first unblock the blood vessels before regulating the body. Regardless of the disease, the goal is to restore balance. Huangdi asked: How does one determine life and death? Qibo replied: If the body is robust but the pulse is thin, and there is shortness of breath insufficient for respiration, the condition is critical. If the body is emaciated but the pulse is large, with excessive Qi in the chest causing distension, death ensues. If the form and Qi are harmonious, the patient lives. If the Qi is disordered and irregular, illness occurs. If all nine positions in the upper, middle, and lower sections are inconsistent, death ensues. If the pulses above and below, left and right correspond to each other like the rhythmic pounding of a mortar, the disease is severe. If the pulses above and below, left and right are inconsistent and cannot be counted, death ensues. Even if the pulse of the middle section alone is harmonious, if it is inconsistent with the others, death ensues.
When palpating the pulse, one must observe the patient's size, length, and temperament, as well as the slowness or urgency of their nature. If the pulse matches the person's physical form and character, it is auspicious; if contrary, it is inauspicious.
The pulse is the residence of Blood. A long pulse indicates regulated Qi; a short pulse indicates diseased Qi. A rapid pulse indicates heart vexation; a large pulse indicates advancing disease. Excess in the upper part indicates Qi rising; excess in the lower part indicates Qi stagnation and abdominal distension.
A short and urgent pulse indicates disease in the upper part; a long and slow pulse indicates disease in the lower part. A wiry and deep pulse indicates internal disease; a floating and surging pulse indicates external disease.
A slippery and slightly floating pulse indicates Lung disease; a tight lower and deficient upper pulse indicates Spleen disease; a long and wiry pulse indicates Liver disease; a pulse indicating deficient Blood indicates Heart disease; a large and tight pulse indicates Kidney disease.
An excess pulse indicates internal disease; a deficient pulse indicates external disease.
A floating and large pulse indicates Wind; a floating and choppy pulse indicates Qi disorder; a deep, thin, and rapid pulse indicates Heat; a slow and tight pulse indicates Cold.
The pulses of the Fu organs are Yang and primarily indicate Heat; the pulses of the Zang organs are Yin and primarily indicate Cold. Yang deficiency leads to sweating; Yin deficiency leads to lower tract issues. Yang heat leads to mouth ulcers; Yin heat leads to aversion to cold.
A Kun (hollow) pulse that feels consistent with the muscle and remains distinct upon prolonged pressing can be treated with purgatives. A wiry, small, and tight pulse can be treated with purgatives. A wiry and slow pulse is suitable for warming medicines. A tight and rapid pulse can be treated with diaphoresis.
If the Cun Kou (radial artery at the wrist) pulse is floating and large in a diseased state, it is called Yang within Yang. The patient suffers from vexation, generalized fever, headache, and internal heat. If the Cun Kou pulse is deep and thin, it is called Yin within Yang. The patient suffers from sadness and unhappiness, aversion to human voices, shortness of Qi, frequent sweating, obstruction of Yin Qi, and inability to raise both arms. If the Chi pulse is deep and thin, it is called Yin within Yin. The patient suffers from soreness and pain in both calves, inability to stand for long periods, deficiency of Yin Qi, dribbling urination, and dampness and itching in the genital area. If the Cun and Chi pulses are firm and long, but absent at the Guan (middle) position, it indicates pain.
A tight pulse at the Cun Kou indicates Zhong Feng (Wind Stroke), where wind attacks causing headache. The pulse of Nue (Malaria) is naturally wiry. A wiry and rapid pulse indicates much Heat; a wiry and slow pulse indicates much Cold. Initially, if the pulse feels restless, and after a while comes alternately large and small, short and long, it indicates Huo Sui (malevolent spirits or psychosomatic disorders). A purely excess pulse indicates Xin Lao (Heart Exhaustion). A surging, large, and wavering pulse indicates Huo Sui.
A wiry pulse at the Cun Kou that is short upon palpation indicates headache. A pulse that extends past the Cun Kou to the Yu Ji point indicates enuresis. A wiry and long pulse upon palpation indicates lumbar pain and shin pain.
A wiry pulse upon palpation that becomes tight from top to bottom indicates shoulder and back pain. A purely rapid and fine pulse indicates excessive heat in the epigastrium.
A surging, slippery, and tight pulse indicates pain in the exterior; a small, solid, and tight pulse indicates pain in the interior. A small, weak, and floating-slippery pulse indicates chronic disease; a choppy, floating, and diseased pulse indicates acute disease.
A deep and wiry pulse indicates abdominal accumulation or hernia and internal pain. A slow and slippery pulse indicates Heat in the Stomach. A surging and tight pulse indicates abdominal distension. A wiry and urgent pulse indicates Shan (Hernia). A slow pulse indicates Li Ji Hou Zhong (tenesmus/dysentery). A slippery and floating-scattered pulse indicates Wind. A short and slippery pulse indicates alcohol-induced disease. A tight and slippery pulse indicates vomiting and reflux. A slow and moderate pulse indicates Cold in the Spleen and Stomach. A wiry and hook-like pulse (resembling a stone sinking and rising) indicates stabbing pain under the ribs, feeling as if flying. A deep and slow pulse indicates Cold disease in the abdominal viscera. A floating, thin, and slippery pulse indicates injury by Cold-Fluid retention. A deep and rapid pulse indicates excessive alcohol consumption; if untreated in winter, it may heal spontaneously. A slippery pulse indicates abundant Yang Qi. A minute and tight pulse indicates Cold. A choppy, thin, and tight pulse indicates Bi Syndrome (obstruction). A deep and slippery pulse indicates tenesmus and back/spine pain. A short and rapid pulse indicates Heart pain with vexation. A tight and rapid pulse indicates simultaneous Cold and Heat; purgation is required for recovery. A minute and weak pulse indicates Cold and shortness of Qi. A slow and tight pulse indicates Cold in the Stomach; if accompanied by anorexia and frequent diarrhea, it is difficult to treat. A wiry and tight pulse indicates hypochondriac pain. A large, thin, and slippery pulse indicates shortness of Qi in the center. A small and fine pulse indicates deficiency of both Blood and Qi. A choppy pulse indicates less Blood and more Qi. A slippery pulse indicates more Blood and less Qi. A large pulse indicates abundance of both Blood and Qi. Absence of Yang pulse in the anterior part (Cun) of both hands causes vexation due to Cold in the epigastrium and Heat internally. A surging, large, and urgent pulse indicates external disease, suffering from headache and abscesses. A small, fine, and urgent pulse indicates internal disease, Cold Hernia, Jia Ma (masses), accumulations, and abdominal pain. A floating and large pulse indicates Zhong Feng with heavy head and nasal congestion. A minute and floating pulse is auspicious in Autumn but indicates disease in Winter. A rapid pulse indicates Heat; a slow pulse indicates Cold-Dampness or Gui Zhu (ghostly transmission/chronic infectious disease). A wiry pulse indicates cutting pain. A heavy pulse that stops abruptly moving forward indicates blood stasis in the abdomen and internal disease. A heavy pulse that scatters in the middle indicates masses formed by Cold and food retention. A deep and urgent pulse indicates Summerheat injury with sudden onset of Deficient Heat. A pulse that scatters and stops in the middle indicates thirst disease. A heavy pulse that does not reach the Cun Kou and lingers/stops indicates Dun Shi (latent pathogen) in the muscles. A pulse that is bead-like but does not advance to the Cun Kou indicates Wind-Cold lodged in the Large Intestine, lingering without departing. A pulse that is bead-like but stops before reaching the soft Cun Kou indicates accumulated Heat in the membranes of the Small Intestine, lingering without departing. A minute pulse indicates insufficiency of Yang Qi, leading to deficient Heat and sweating. Where there is no Yang, there is Jue (cold limbs); where there is no Yin, there is vomiting. Yang deficiency prevents exhalation; Yin deficiency prevents inhalation. Insufficient respiration leads to shortness of Qi in the chest. Anterior large and posterior small indicates headache and dizziness; anterior small and posterior large indicates chest fullness and shortness of Qi. If there is a pulse in the upper section but none in the lower, the patient should vomit; if they do not vomit, death ensues. When Yang pathogens appear, the pulse is floating and surging; when Yin pathogens appear, the pulse is deep and thin; when water and grain stagnate, the pulse is solid and hard. Floating and slippery indicates retained food. Surging and large indicates Shang Han (Cold Damage) and Re Bing (Heat Disease). Wiry and small indicates Han Pi (Cold Phlegm/Stagnation). Floating, slippery, and rapid indicates indigestion due to Spleen failure to grind. Tight and slippery at the Guan position indicates roundworms. If the three sections show pulses intermittently or absent, Cold Qi in the Stomach obstructs the pulse. Deep and slippery at the Chi position indicates Taenia (tapeworm). Tight and urgent pulses indicate Dun Shi. Tight and long pulses extending past the Cun Kou indicate Zhu Bing (infectious/chronic disease). Floating at the Guan position indicates accumulations and Heat in the Stomach. Floating at the Chi position indicates wandering Heat in the Lower Jiao. For all floating, tight, wiry, deep, choppy, and slippery pulses: if at the Cun Kou, the disease is above the diaphragm; if at the Guan, below the Stomach; if at the Chi, below the Kidneys. Deep at the Cun Kou indicates shortness of Qi in the chest. If the wiry pulse extends past the Cun Kou, it indicates retained food and headache. If there are both exterior and interior signs, it indicates the location of the pathogen, resulting in "Ghost Disease." What are exterior and interior? Cun and Chi are exterior; Guan is interior. If pulses exist at both ends (Cun and Chi) but are absent at the Guan, it indicates Yin Jue and Yang Jue. If the Chi pulse does not reach up to the Guan, it is Yin Jue; if the Cun pulse does not reach down to the Guan, it is Yang Jue. Both Yin Jue and Yang Jue indicate death and are incurable.