按之不足举有余。再再寻之指下浮。藏中积冷营中热。欲得生精用补虚。
凡脉浮以候表。沉以候里。今按之不足。是为里虚。故曰藏中积冷。举之
有余。是为表有邪。故曰营中热。池氏曰。乍病见浮脉。乃伤风邪。久病合
见沉弱之脉。今见浮脉。乃里寒表热。里寒而阴阳不和。阳盛则表有风
热。里虚则藏中积冷。治之者。须调其营卫。补其津液。勿谓脉浮而有表
邪。专事发表可也。张世贤曰。诊脉之法。在内者沉取之。按而得之。在外
者浮取之。举而得之。有余为热。不足为寒。今按之不足。藏中积冷也。举
之有余。营中有热也。阴不足而阳有余。治之宜地骨皮散。其说亦是。
按经云。浮而大者风。又云。浮而大者中风。头重鼻塞。又云浮而缓。皮肤
不仁。风寒入肌肉。又云。浮洪大长者。风眩癫疾。又云。浮洪大者。伤寒秋
吉。春成病。又云。浮而滑者。宿食。又云。浮滑而疾者。食不消。脾不磨。又云。
浮而细滑伤饮。又云。浮而急病伤寒。暴发虚热。千金方作伤暑。经云。浮
而绝者气。又云。浮短者。其人作肺。诸气微少。不过一年死。法当嗽也。又
云。浮而数中水。冬不治自愈。又云。浮滑疾紧者。以合百病又易愈。又云。
阳邪见。浮洪阴邪来见沉细。又云。微浮秋吉冬成病。又云微浮虽甚不
成病。不可劳。
又按丹溪心法拔萃方。人参地骨皮散。治藏中积冷。荣中热。按之不足。
举之有余。此乃阴不足。阳有余也。茯苓五钱。知母石膏各一两。地骨皮
人参柴胡生地黄黄 各两半。上锉每服一两。姜三片。水二钟。煎至一
钟。去渣。通口不拘时服。
The pulse feels insufficient upon deep pressure but excessive upon light pressure. Repeatedly searching, it feels floating under the fingers. There is accumulated cold in the Zang organs and heat in the Ying (Nutritive) level. To obtain vital essence and use tonification for deficiency.
Generally, a floating pulse indicates exterior conditions, while a sinking pulse indicates interior conditions. Now, insufficiency upon deep pressure indicates interior deficiency. Hence, it is said that there is accumulated cold in the Zang organs. Excessiveness upon light pressure indicates pathogenic factors on the exterior. Hence, it is said that there is heat in the Ying level. Chi Shi stated: When a disease first occurs and a floating pulse is seen, it is due to injury by wind pathogens; in chronic diseases, a sinking and weak pulse should be seen. If a floating pulse is now seen, it indicates interior cold and exterior heat. Interior cold leads to disharmony of Yin and Yang; excess Yang results in wind-heat on the exterior, while interior deficiency results in accumulated cold in the Zang organs. The practitioner must regulate the Ying and Wei (Defensive) levels and tonify the body fluids. One should not assume that because the pulse is floating with exterior pathogens, one should exclusively employ methods to release the exterior through sweating. Zhang Shixian stated: In pulse diagnosis, for internal conditions, one uses deep pressure to feel the pulse; for external conditions, one uses light lifting to feel the pulse. Excess indicates heat, insufficiency indicates cold. Now, insufficiency upon deep pressure indicates accumulated cold in the Zang organs; excessiveness upon light pressure indicates heat in the Ying level. With Yin insufficiency and Yang excess, treatment with Digupi San (Bark of Ground Tree Bark Powder) is appropriate. His explanation is also correct.
According to the Classics: A floating and large pulse indicates wind. It is also stated that a floating and large pulse indicates stroke, accompanied by heavy head and nasal congestion. It is also stated that a floating and moderate pulse indicates insensitivity of the skin, where wind-cold enters the muscles. It is also stated that a floating, surging, large, and long pulse indicates dizziness from wind and epilepsy. It is also stated that a floating and surging large pulse indicates Shanghan (Cold Damage); if occurring in autumn, it is auspicious; if in spring, it becomes a disease. It is also stated that a floating and slippery pulse indicates retained food. It is also stated that a floating, slippery, and rapid pulse indicates indigestion and spleen failure to transform. It is also stated that a floating, fine, and slippery pulse indicates injury by fluid retention. It is also stated that a floating and urgent pulse indicates Shanghan, sudden onset of deficient heat; the Qianjin Fang treats this as Shangshu (Summerheat Injury). It is also stated that a floating and interrupted pulse indicates Qi disorders. It is also stated that a floating and short pulse indicates lung pathology, with all Qi being weak and scarce, leading to death within a year, typically manifesting as cough. It is also stated that a floating and frequent pulse may heal spontaneously without treatment in winter. It is also stated that a floating, slippery, rapid, and tight pulse combines with hundred diseases yet heals easily. It is also stated that when Yang pathogens appear, the pulse is floating and surging; when Yin pathogens arrive, the pulse is sinking and fine. It is also stated that a slightly floating pulse is auspicious in autumn but becomes a disease in winter. It is also stated that although a slightly floating pulse may seem severe, it does not constitute a major disease, and labor should be avoided.
Furthermore, according to the Danxi Xinfa and the Baei Fang, Renshen Digupi San (Ginseng and Bark of Ground Tree Bark Powder) treats accumulated cold in the Zang organs and heat in the Ying level, characterized by insufficiency upon deep pressure and excessiveness upon light pressure. This represents Yin insufficiency and Yang excess. The prescription consists of: Fuling (Poria) 5 qian, Zhimu (Anemarrhena Rhizome) and Shigao (Gypsum Fibrosum) each 1 liang, Digupi (Cortex Lycii), Renshen (Ginseng Radix et Rhizoma), Chaihu (Bupleuri Radix), Shengdihuang (Rehmanniae Radix), and Huangqin (Scutellariae Radix) each 1.5 liang. These are cut into pieces. Each dose uses 1 liang, added with 3 slices of fresh ginger and 2 zhong of water, decocted to 1 zhong. Strain the dregs and take orally at any time.