微脉极细而软,按之如欲绝,若有若无,细而稍长。《素问》谓之小,气血微则脉微。
∶轻诊可见,按之欲绝者,微也。往来如线而常有者,细也。仲景曰∶脉瞥瞥如羹上肥者,
阳气微,萦萦如蛛丝细者,阴气衰,长病得之死,卒病得之生。
主病 气血微兮脉亦微,恶寒发热汗淋漓,胃为劳极诸虚候,女作崩中带下医。寸微气
促或心惊,关脉微时胀满形,尺部见之精血弱,恶寒消痹痛呻吟。又曰∶微主久虚血弱之病,阳
微恶寒,阴微发热。《脉诀》云∶崩中日久成白带,漏下多时骨木枯。
动乃数脉,见于上下,无头无尾如豆,厥厥动摇。仲景曰∶阴阳相抟,名曰动。阳动则
,阴动则发热形冷恶寒,此三焦伤也。成无己曰∶阴阳相抟则虚者动,故阳虚则阳动,阴虚
则阴动。庞氏曰∶关前三分为阳,关后三分为阴,当关之位,半阴半阳,故动由虚见。又曰
∶动脉摇摇数在关,无头无尾豆形圆,其源本是阴阳战,虚者补之胜者安。《脉诀》言寻之
似有,举之还无,不离其处,不往不来,两关数见,含糊谬妄,殊非动脉。詹氏言其形数动
,如钩如毛者尤谬。
主病 动脉专司痛与惊,汗因阳动热因阴,或为泄痢拘挛病,男子亡精女子崩。
牢脉似沉似伏,实大而长,微弦。扁鹊曰∶牢而长者,肝木也。仲景曰∶寒则牢坚,有
之象。沈氏曰∶似沉似伏,牢之位也,实大弦长,牢之体也。《脉诀》不言形状,但言寻之
则无,按之则有,云脉入皮肤辨息难,又以牢为死脉,皆孟浪谬误。李氏曰∶弦长实大脉牢
坚,牢位长居沉伏间,革脉芤弦自牢起,革虚牢实要详看。
主病 寒则牢坚里有余,腹心寒痛木乘脾,疝气 瘕何愁也,失血阴虚却忌之。又曰∶
寒实之病,木实则为痛。扁鹊云∶软为虚,牢为实,失血者,脉宜沉细,反浮大而牢者死。
虚病见实脉死。《脉诀》言骨间疼痛,气居于表。池氏以为肾传于脾,皆谬妄不经之说。
The Wei (Micro) pulse is extremely fine, weak, and soft. Upon deep pressure, it feels as if it is about to cease, appearing now present, now absent; it is fine and slightly long. The *Suwen* refers to it as the Xiao (Small) pulse; when Qi and Blood are deficient, the pulse appears Wei.
It can be perceived with light palpation; when deep pressure makes it feel as if it is about to cease, this is the Wei pulse. When the pulse comes and goes like a thread but remains constantly present, this is the Xi (Fine) pulse. Zhang Zhongjing stated: "When the pulse flutters like fat floating on soup, Yang Qi is deficient; when it lingers like a spider's silk, Yin Qi is depleted. In chronic diseases, this indicates death; in acute diseases, it indicates survival."
**Diseases Governed:**
When Qi and Blood are deficient, the pulse also appears Wei. Symptoms include aversion to cold, fever, and profuse sweating. It indicates extreme exhaustion of Stomach Qi and various deficiency syndromes. In women, it manifests as uterine bleeding (Beng Lou) and leukorrhea. If seen at the Cun (Inch) position, it may cause shortness of breath or palpitations. If seen at the Guan (Bar) position, it presents with abdominal distension. If seen at the Chi (Cubit) position, it indicates weakness of Essence and Blood, accompanied by aversion to cold, relief from Bi pain, and groaning. Furthermore, the Wei pulse primarily governs diseases of chronic deficiency and blood weakness: Yang deficiency leads to aversion to cold, while Yin deficiency leads to fever. The *Mai Jue* states: "Uterine bleeding lasting long turns into white discharge; prolonged leakage causes bones to become dry and withered."
The Dong (Moving) pulse belongs to the Shuo (Rapid) category. It appears in the upper and lower aspects, without head or tail, resembling a bean, quivering and shaking. Zhang Zhongjing stated: "When Yin and Yang struggle against each other, it is named Dong." Yang movement causes tremors; Yin movement causes fever, cold body, and aversion to cold; this indicates injury to the Sanjiao (Triple Burner). Cheng Wuji stated: "When Yin and Yang struggle, the deficient aspect moves; thus, Yang deficiency leads to Yang movement, and Yin deficiency leads to Yin movement." Pang stated: "One-third anterior to the Guan is Yang, one-third posterior to the Guan is Yin. The position at the Guan is half-Yang and half-Yin; therefore, the Dong pulse arises from deficiency." He further stated: "The moving pulse quivers rapidly at the Guan, without head or tail, round like a bean. Its origin lies in the struggle between Yin and Yang; the deficient should be tonified, and the victorious will be at peace." The *Mai Jue* claims that searching for it yields presence, lifting the finger yields absence, it stays in place without moving back and forth, and is frequently seen at both Guan positions. This description is vague and erroneous, completely failing to describe the true nature of the Dong pulse. Zhan claimed its form is rapid and moving, resembling a hook or hair, which is even more absurd.
**Diseases Governed:**
The Dong pulse specifically governs pain and fright. Sweating results from Yang movement; fever results from Yin movement. It may also indicate diarrhea, dysentery, or spasms/convulsions. In men, it indicates seminal emission/wasting; in women, it indicates uterine bleeding.
The Lao (Firm) pulse resembles the Chen (Deep) and Fu (Profound) pulses; it is solid, large, long, and slightly wiry. Bian Que stated: "A firm and long pulse corresponds to Liver Wood." Zhang Zhongjing stated: "Cold causes firmness and solidity, presenting a solid appearance." Shen stated: "Resembling Chen and Fu defines its location; being solid, large, wiry, and long defines its form." The *Mai Jue* does not describe its shape, only stating that searching yields nothing while pressing reveals presence, and that distinguishing it by skin respiration is difficult, labeling it a death pulse. These are all rash and erroneous. Li stated: "Wiry, long, solid, and large constitutes the Firm pulse. The Firm pulse resides deeply between Chen and Fu positions. Ge (Leather) and Kou (Hollow) pulses arise from variations of the Firm pulse. Ge indicates deficiency, while Lao indicates excess; these must be carefully distinguished."
**Diseases Governed:**
Cold causes the pulse to be firm and solid, indicating interior excess. It manifests as cold pain in the abdomen and heart, or Liver Wood overacting on Spleen Earth. One need not worry about hernia or masses (Jia). However, patients with blood loss or Yin deficiency must avoid seeing this pulse. Furthermore, in diseases of Cold Excess, Wood excess generates pain. Bian Que said: "Soft pulses indicate deficiency; Firm pulses indicate excess. For blood loss, the pulse should be deep and fine; if it instead appears floating, large, and firm, it indicates death. Deficiency diseases presenting with Excess pulses indicate death." The *Mai Jue* claims bone pain with Qi residing on the surface. Chi believed this indicated transmission from Kidney to Spleen. Both are absurd and unfounded theories.