芤则如指着葱,浮取得上面之葱皮,却显弦大,中取减小空中,按之又着下面之葱皮而有根据。
凡浮革弦洪,皆属芤类。不似虚脉之瞥瞥虚大,按之豁然无力也。(语出张璐。又濒湖体状诗曰∶芤形浮大软
如葱,按之旁有中央空。火犯阳经血上溢,热侵阴络下流红。相类诗曰∶中空旁实乃为芤;浮大而迟虚脉呼;
芤更带弦名曰革,芤为亡血革寒虚。)芤为血虚不能濡气。其症必见发热、头昏、目眩、惊悸、怔忡、
喘急、盗汗、失血、脱血。然或芤见微曲,则芤必挟瘀积阻滞。芤兼弦强搏指,症见血溢身热,则芤又为真
阴槁竭。所以芤挟瘀积阻滞,止属一部两部独见。若至左右皆芤,或兼弦搏,定为必死之候,无足异也。
(戴同父云∶营行脉中,脉以血为形,芤脉中空,脱血之象也。)
濡则虚软少力,应指虚细,如絮浮水,轻手乍来,重手乍去。凡虚微细弱,皆属濡类。不似虚脉
之脉大无力,微脉之微细如丝,弱脉之沉细软弱也。(语出张璐。又濒湖体状诗曰∶濡形浮脉按须轻,水面浮
绵力不禁;病后产中犹有药,平人若见是无根。相类诗曰∶浮而柔细知是濡,沉细而柔作弱持;微则浮微如欲
绝,细来沉细近于微。注曰∶浮细如绵曰濡,浮而极细如绝曰微,沉细如绵曰弱,沉而极细不断曰细。)濡为胃
气不充。凡内伤泄泻自汗喘乏,多有是脉。张璐、士材论极精明,
谓其治宜峻补。不似阴虚脱血,纯见细数弦强,欲求濡弱,绝不可得也。盖濡脉之浮软,与虚脉相类;但虚
则浮大,而濡则弱小也。濡脉之细小,与弱脉相类;但弱在沉分,濡在浮分也。濡脉之软弱,与微脉相类;但
微则欲绝,而濡则力微也。濡脉之无力,与散脉相似;但散则从大而按之则无,濡则从小而渐至无力也。夫
从小而渐至无力,气虽不充,血犹未败;从大而按之即无,则气无所统,血已伤残,阴阳离散,将何所恃而可
望其生乎。由斯言之,则濡与散,不啻天渊矣。所以濡脉多责胃气不充,或外感阴湿。故治宜温补而不可
用伤残之药耳。(李士材曰∶濡脉者,浮小而软也。)
The Kung pulse (Cleft Pulse) feels like a finger pressing on a green onion stalk; upon light palpation, one perceives a string-like and large sensation akin to the onion skin; upon moderate pressure, the pulse diminishes and feels hollow in the center; upon heavy pressure, one touches the bottom of the onion skin, feeling a sense of foundation.
Any floating, wiry, or surging pulses belong to the category of the Kung pulse. They do not resemble the Deficient pulse, which is fleeting, large, and feels empty and powerless upon deep pressure. (This passage is attributed to Zhang Lu. Additionally, Li Shizhen's "Body Form Poem" states: The form of the Kung pulse is floating, large, and soft, like an onion; pressing it reveals sides but emptiness in the center. Fire invading Yang meridians causes blood to overflow upwards; heat invading Yin collaterals causes red blood to flow downwards. The "Similar Forms Poem" states: Hollow in the center and solid on the sides constitutes the Kung pulse; floating, large, and slow is called the Deficient pulse; if the Kung pulse carries a wiry quality, it is named the革 (Ge/Crisis) pulse; the Kung pulse indicates loss of blood, while the Ge pulse indicates cold and deficiency.) The Kung pulse signifies that blood deficiency fails to nourish Qi. Symptoms must include fever, dizziness, vertigo, fright palpitations, anxiety palpitations, panting, night sweats, hemorrhage, and severe blood loss. However, if the Kung pulse appears slightly curved, it implies that the Kung pulse is accompanied by blood stasis and accumulation obstructing the channels. If the Kung pulse is combined with a wiry, strong, and pounding sensation, and symptoms manifest as bleeding and body heat, then the Kung pulse indicates the exhaustion of True Yin. Therefore, when the Kung pulse is accompanied by blood stasis and obstruction, it typically appears only in one or two positions (cun, guan, chi). If the Kung pulse appears in both left and right hands, or is combined with a wiry and pounding sensation, it is definitely a fatal sign, which is no surprise. (Dai Tongfu said: Ying Qi circulates within the vessels; the vessel takes blood as its form. The Kung pulse is hollow in the center, representing the image of blood depletion.)
The Ru pulse (Soft Pulse) manifests as weak, soft, and lacking strength; responding to the finger, it feels deficient and fine, like cotton floating on water—appearing lightly upon superficial touch and disappearing upon deep pressure. Any deficient, minute, fine, or weak pulses belong to the category of the Ru pulse. They do not resemble the Deficient pulse, which is large and powerless; nor the Minute pulse, which is minute and thread-like; nor the Weak pulse, which is deep, fine, and soft. (This passage is attributed to Zhang Lu. Additionally, Li Shizhen's "Body Form Poem" states: The Ru form is a floating pulse requiring light pressure; like floating cotton on water, it cannot withstand force; after illness or during postpartum, medicine can still be used; if seen in a healthy person, it indicates rootlessness. The "Similar Forms Poem" states: Floating and soft-fine is known as the Ru pulse; deep, fine, and soft is held as the Weak pulse; the Minute pulse is floating and minute, seeming to cease; the Fine pulse comes deep and fine, close to the Minute. Commentary notes: Floating and fine like cotton is called the Ru pulse; floating and extremely fine as if ceasing is called the Minute pulse; deep and fine like cotton is called the Weak pulse; deep and extremely fine but unbroken is called the Fine pulse.) The Ru pulse indicates insufficient Stomach Qi. Conditions such as internal injury leading to diarrhea, spontaneous sweating, and asthenic panting often present this pulse. Zhang Lu and Li Shicai discussed this very clearly, stating that treatment should involve vigorous tonification. This differs from Yin deficiency and blood loss, which present purely with fine, rapid, wiry, and strong qualities, where finding a Ru or Weak pulse is absolutely impossible. Generally, the floating and soft nature of the Ru pulse resembles the Deficient pulse; however, the Deficient pulse is floating and large, whereas the Ru pulse is small and weak. The fine nature of the Ru pulse resembles the Weak pulse; however, the Weak pulse is found in the deep position, while the Ru pulse is found in the superficial position. The soft and weak nature of the Ru pulse resembles the Minute pulse; however, the Minute pulse seems to cease, whereas the Ru pulse merely has weak force. The powerlessness of the Ru pulse resembles the Scattered pulse; however, the Scattered pulse starts large and disappears upon pressure, whereas the Ru pulse starts small and gradually becomes powerless. From small and gradually becoming powerless, although Qi is insufficient, Blood has not yet deteriorated; starting large and disappearing immediately upon pressure means Qi has no control, Blood is already damaged, Yin and Yang are dispersed, and what reliance remains for hope of survival? Thus speaking, the difference between the Ru pulse and the Scattered pulse is as vast as heaven and earth. Therefore, the Ru pulse is mostly attributed to insufficient Stomach Qi or external contraction of Yin-dampness. Hence, treatment should favor warming and tonifying, avoiding drugs that damage the righteous Qi. (Li Shicai said: The Ru pulse is floating, small, and soft.)