七濡者阴也。指下寻之似有。再再还来。按之根据前却去曰濡。主少力。五心
烦热。脑转耳鸣。下元极冷。
濡。阴水也。他本俱释为阴金。非也。洁古曰。浮涩弱属金。沉滑濡属水。是
以知濡为阴水也。然濡而为不及之水者。何也。谓阳已竭。而阴无所附
也。指下寻之似有者。非若他脉之真有。而似乎有也。则为阳已竭矣。再
再还来。是阴欲附也。按之根据前却去。是阴欲附而无所附也。经云。阳为
阴使。今阳已竭。故主少气力。阴无附。故五心烦热。水不足。故脑转耳鸣。
阳已衰。故下元极冷。
按脉经第一篇。有软脉而无濡脉。要知濡即软也。又云。软脉极软而浮
细。一曰按之无有。举之有余。一曰小而软。软一作濡。曰濡者如帛衣在
水中。轻手相得。
按之似有举之无。髓海丹田定已枯。四体骨蒸劳热甚。脏腑终传命必殂。
按之似有。阴无所附也。举还无。阳已竭也。髓海丹田定已枯。肾水已涸
也。四体骨蒸劳热甚。谓水已涸。而虚火煎熬也。脏腑终传命必殂。谓肾
病传心。心病传肺。肺病传肝。肝病传脾。脾复传肾。经曰。传终者死。是传
其所胜也。
按经云。三部脉濡弱。久病得之不治自愈。治之死。卒病得之生。
濡脉关前人足汗。
关前。阳位也。濡。阳衰之脉也。足汗。多汗也。汗阴血所化也。阳部而见阳
衰之脉。是阳气已虚。不能卫护其阴。则阴气外泄。故其人多汗耳。
按脉经云。寸口脉濡。阳气弱。自汗出。是虚损病。宜服干地黄汤。薯蓣丸。
内补散。牡蛎散并粉。针太冲补之。
当关少气精神散。
夫精气神。乃身之三宝也。经曰。精生气。气生神。是以精极则无以生气。
气少则无以生神。中焦者。荣气之所出也。今关部而见濡脉。则中气大
虚。而精与神亦为之耗散矣。
按脉经云。关上濡下重。又云关脉濡。苦虚冷。脾气弱。重下病。宜服赤石
脂汤。女萎丸。针关元补之。
尺部绵绵即恶寒。骨与肉疏都不管。
尺所以候下焦者也。尺部而见濡脉。是为阳衰于下。故恶寒。经云。足少
阴气绝。则骨枯。少阴者。冬脉也。伏行而温于骨髓。故骨髓不温。即内不
着骨。骨肉不相亲。即肉濡而却。肉濡而却。故齿长而枯。发无润泽。发无
润泽者。骨先死。戊日笃。己日死。土胜水也。
按脉经云。尺中濡少血。发热恶寒。又云。尺脉濡。若小便难。宜服瞿麦汤。
白鱼散。针关元泻之。千金翼云。脚不收风痹。
Among the seven pulse types, the Ru (Soft) pulse belongs to Yin. When seeking with the fingers, it seems present but elusive, appearing repeatedly. Upon pressing, the pulse qi retreats forward and disappears; this is the Ru pulse. It primarily indicates insufficiency of Qi and strength, five-palm heat (heat in the palms, soles, and chest), vertigo with tinnitus, and extreme coldness of the lower Yuan (original Qi).
The Ru pulse corresponds to Yin Water in the Five Elements. Other editions interpret it as Yin Metal, which is incorrect. Zhang Jiegu said: Fu (Floating), Se (Choppy), and Ruo (Weak) pulses belong to Metal; Chen (Deep), Hua (Slippery), and Ru pulses belong to Water. Thus, we know the Ru pulse belongs to Yin Water. However, why does the Ru pulse represent deficient Water? This is because Yang has already exhausted itself, leaving Yin without attachment. When seeking with the fingers, it seems present, not truly existing like other pulses, but seemingly so, indicating that Yang has exhausted itself. Its repeated appearance signifies Yin's desire to attach. Upon pressing, the sensation of retreating forward indicates Yin's desire to attach but having nowhere to attach. The Classics state: "Yang serves Yin." Now that Yang is exhausted, the main symptom is insufficiency of Qi and strength; since Yin has no attachment, five-palm heat occurs; due to insufficient Kidney Water, vertigo and tinnitus occur; because Yang has declined, extreme coldness of the lower Yuan results.
Consulting the first chapter of *Mai Jing* (Pulse Classic), there is a Ruan (Soft) pulse but no Ru pulse. One must know that Ru is synonymous with Ruan. It further states: The Ruan pulse is extremely soft and floating-thin. One description says it is absent upon deep pressure but present upon light lifting; another describes it as small and soft. "Ruan" is written as "Ru" in some texts. The Ru pulse is described as feeling like silk clothing in water, perceptible with light touch.
Present upon deep pressure but absent upon light lifting indicates that Marrow Sea and Dantian are certainly depleted. Severe bone-steaming consumptive fever in the four limbs suggests that organ diseases will eventually transmit, leading to certain death. Present upon deep pressure indicates Yin has no attachment; absent upon light lifting indicates Yang has exhausted itself. Depletion of Marrow Sea and Dantian signifies that Kidney Water has dried up. Severe bone-steaming fever in the limbs signifies that Water is dry and deficiency-fire is simmering. Death from final transmission of organ diseases implies Kidney disease transmitting to Heart, Heart to Lung, Lung to Liver, Liver to Spleen, and Spleen back to Kidney. The Classics state: "Transmission through all organs leads to death," referring to transmission to the overcoming element.
According to the Classics: If the three positions (Cun, Guan, Chi) show weak Ru pulses, chronic patients may heal spontaneously without treatment; treating them leads to death. Acute patients showing this pulse will survive.
A Ru pulse at the anterior position of the Guan (Bar) indicates excessive sweating of the feet. The anterior Guan position is a Yang region. The Ru pulse is a sign of declining Yang. Foot sweat refers to hyperhidrosis. Sweat is transformed from Yin blood. Observing a pulse of declining Yang in a Yang region indicates that Yang Qi is deficient and cannot protect Yin, causing Yin Qi to leak outward, hence the person sweats excessively.
According to *Mai Jing*: A Ru pulse at the Cun (Inch) position indicates weak Yang Qi and spontaneous sweating, characteristic of deficiency damage. Suitable formulas include Gan Di Huang Tang (Rehmannia Root Decoction), Shu Yu Wan (Dioscorea Pill), Nei Bu San (Internal Nourishing Powder), and Mu Li San (Oyster Shell Powder) with powder. Needle Tai Chong (LR3) using the tonification method.
A Ru pulse at the Guan position indicates Qi insufficiency and scattered spirit. Essence, Qi, and Spirit are the three treasures of the body. The Classics state: "Essence generates Qi, Qi generates Spirit." Therefore, extreme essence deficiency fails to generate Qi, and Qi insufficiency fails to generate Spirit. The Middle Jiao is the source of Ying (Nutritive) Qi. A Ru pulse at the Guan position indicates severe deficiency of Middle Qi, causing Essence and Spirit to dissipate.
According to *Mai Jing*: A Ru pulse at the Guan position with heaviness below indicates suffering from deficiency-cold, weak Spleen Qi, and heavy lower disorders (such as dysentery). Suitable formulas include Chi Shi Zhi Tang (Red Halloysite Decoction) and Nu Wei Wan (Ancisus Pill). Needle Guan Yuan (CV4) using the tonification method.
A continuous, faint pulse at the Chi (Cubit) position indicates aversion to cold, with disregard for loose bones and flesh. The Chi position examines the Lower Jiao. A Ru pulse here indicates Yang decline in the lower part, causing aversion to cold. The Classics state: "When the Qi of the Foot Shaoyin meridian perishes, bones become withered." Shaoyin is the Winter pulse, lying hidden and warming the marrow. Thus, if marrow is not warm, it does not adhere internally to the bones, and bones and flesh do not unite; muscles become flaccid and recede. Flaccid muscles cause teeth to appear long and withered, and hair loses luster. Loss of hair luster indicates bone death first. Condition worsens on Wu days, death occurs on Ji days, representing Earth overcoming Water.
According to *Mai Jing*: A Ru pulse at the Chi position indicates Blood deficiency, fever, and aversion to cold. Also, a Ru pulse at the Chi position with difficult urination suggests suitability for Qu Mai Tang (Knotweed Decoction) and Bai Yu San (White Fish Powder). Needle Guan Yuan (CV4) using the reduction method. *Qian Jin Yi Fang* mentions foot weakness and wind-bi syndrome.