一息三至。号之曰迟。浮迟寒在表。沉迟作里医。有力无力皆寒症。抑阴扶阳不用疑。寸迟心痛吐酸水。(寒气攻心。
故痛。胃虚而寒气客之。则水入于胃。不输于脾。停于胃脘。水得寒气熏蒸变而为酸。此为寒症。故脉经治以附子汤。
茱萸汤。然此症亦有热者。肝移热于胃。土受木制。不能胜水。水得木味。蕴而浅酸。经所谓诸呕吐酸。属于热是也。
当清热燥湿。此以脉之滑数辨之。)关尺寒疼厥可知。(阴气盛。则从足五指至膝上寒。谓之寒厥。)迟涩 结。(迟涩则
血虚寒。血虚寒则凝滞不行。结成 结。)迟滑胀宜。(滑。主气虚。主食积。气虚则寒。寒则气收。故胀、寒饮食积于
肠胃。亦作胀。)
缓脉均均来四至。贵无偏胜 而和。(缓主脾胃。又主风湿在四季之月。不大不小。浮沉同等。 而和者。手也。若
三部不齐。则为偏胜。或又兼他脉者。病脉也。不在四季之月。他脉中带缓者。胃气也。若独见极者病脉也。)肌肉不仁
缓在寸。(风气之伤人。多在上。寸部。心肺也。心主血脉。肺主皮毛。风邪入皮毛。客血脉。故肌肉之间。不知痛痒。
曰不仁。)关知脾胃食难磨。(风气通肝。肝气移之于脾胃。脾胃实。故不欲食。实者邪实也。)尺为脚弱下体肿。(湿气
之伤人。多在下。湿濡筋。故脚弱。湿渗肌肤。故下膻。)小便难而余沥多。(湿积下焦。蕴而浅热。湿热壅滞。则膀胱
之气不化。故小便难。有余沥也。)浮缓为风沉缓湿。若逢缓滑热为 。(经以缓而滑。为热中、李士材以缓滑。为湿痰
误。)缓涩管虚缓细痹。(风寒湿三气。皆能为痹。风胜为行痹。寒胜为痛痹。湿胜为涩痹。脉缓细者。主风湿痹。)推详
三部自无讹。
Three beats per respiration is termed Chi Pulse (迟脉, Slow Pulse). A floating Chi indicates cold in the exterior; a deep Chi indicates pathology in the interior. Whether forceful or feeble, it signifies a Cold Syndrome; suppressing Yin and supporting Yang leaves no room for doubt. A Chi pulse at the Cun position indicates heart pain and regurgitation of sour fluid. (This is because cold pathogenic qi attacks the heart, causing pain; due to Spleen-Stomach deficiency, cold qi lodges within, causing water to enter the Stomach but fail to be transported by the Spleen, stagnating in the epigastrium. Water steamed by cold transforms into acidity, constituting a Cold Syndrome; thus, *Mai Jing* treats this with Fuzi Tang (Aconite Decoction) and Zhuyu Tang (Cornus Decoction). However, this syndrome may also involve Heat: Liver heat transfers to the Stomach, Wood overacts on Earth, failing to control Water; Water acquires the flavor of Wood, fermenting into slight acidity. This corresponds to the classic statement: "All vomiting and regurgitation of sour fluid belong to Heat." In such cases, one should clear Heat and dry Dampness, distinguishing it via a Slippery and Rapid pulse.) At the Guan and Chi positions, a Chi pulse reveals cold pain and Jue (Cold Reversal). (When Yin Qi is excessive, cold extends from the five toes up to the knees, termed Han Jue.) A combination of Chi and Se (Choppy) or Jie (Knotted) pulses indicates Blood deficiency with Cold. (Chi and Se signify Blood deficiency and Cold; Blood deficiency and Cold cause coagulation and stagnation, forming knots/clots.) A combination of Chi and Hua (Slippery) pulses indicates distension. (Hua primarily indicates Qi deficiency or Food Stagnation. Qi deficiency generates Cold; Cold causes Qi contraction, leading to distension. Cold and food stagnation in the intestines and stomach also cause distension.)
Huan Pulse (缓脉, Moderate/Relaxed Pulse) arrives evenly at four beats per respiration, prized for being balanced without excess or deficiency, manifesting harmony. (Huan primarily governs the Spleen and Stomach, and also indicates Wind-Dampness during the seasonal months. The pulse is neither large nor small, equal in depth and superficiality, appearing gentle and harmonious—this is the pulse of a healthy person. If the three positions are uneven, it indicates imbalance; if accompanied by other pulses, it is a pathological pulse. If not during the seasonal months, but Huan appears within other pulses, it represents Stomach Qi. If Huan appears exclusively and extremely, it is a pathological pulse.)
Huan at the Cun position indicates insensitivity of the muscles. (Wind pathogens often attack the upper body. The Cun position corresponds to the Heart and Lungs. The Heart governs blood vessels, and the Lungs govern skin and hair. When wind evil enters the skin and hair and lodges in the blood vessels, the muscles lose sensation of pain and itch, termed Bu Ren (Insensibility).) Huan at the Guan position indicates difficulty in digesting food in the Spleen and Stomach. (Wind energy connects with the Liver; Liver Qi transfers to the Spleen and Stomach, causing Excess patterns in the Spleen and Stomach, leading to anorexia. Here, "Excess" refers to Pathogenic Excess.) Huan at the Chi position indicates weak legs and swelling of the lower body. (Damp pathogens often attack the lower body. Dampness moistens the sinews, causing leg weakness; Dampness infiltrates the skin and flesh, causing lower abdominal and bodily swelling.)
It also indicates difficult urination with dribbling after voiding. (Dampness accumulates in the Lower Jiao, fermenting into mild Heat. Damp-Heat obstruction impairs Bladder Qi transformation, causing dysuria and post-void dribbling.)
Floating Huan indicates Wind; Deep Huan indicates Dampness. If Huan is combined with Slippery, it indicates Heat. (*Jing* states that Huan and Slippery indicate Internal Heat; Li Shicai’s view that Huan-Slippery indicates Phlegm-Damp is incorrect.) Huan combined with Choppy indicates Deficiency; Huan combined with Fine indicates Bi Syndrome. (Wind, Cold, and Dampness can all cause Bi Syndrome. Wind predominance leads to Wandering Bi; Cold predominance leads to Painful Bi; Damp predominance leads to Fixed Bi. A Huan and Fine pulse primarily indicates Wind-Damp Bi Syndrome.) Detailed analysis of the three positions will yield no errors.