三部俱浮肺藏风。鼻中多水唾稠浓。壮热恶寒皮肉痛。颡干双目泪酸疼。
浮为风三部俱浮。则肺为风所伤。肺主气。气者卫也。风伤卫。则卫气不
得主于外。与风邪之气相角。循肺窍而出。是以鼻中多水。久则渐传于
肺之本脏。风火相煽。煎熬津液。而成涕唾浓痰。卫气者。阳气也。阳气郁
而不行。故壮热而恶寒。肺主皮毛。肺伤故皮肉痛。颡者。肺之系也。风火
相煎。故干。张世贤曰。金衰不能制木。木火俱盛。故双目流泪而酸疼也。
肺脉浮兼实。咽门燥又伤。大便难且涩。鼻内乏馨香。
肺脉本浮。今云浮兼实。盖浮而有力也。浮而有力为风。咽门。肺之道路
也。今肺有风邪。则咽门燥伤矣。藏病传府。故大便难且结也。又肺开窍
于鼻。上文云。鼻闻香臭辨。壅塞气相煎。今肺脉浮而兼实。则肺为风邪
所壅。故鼻窍为之壅塞矣。
实大相兼滑。毛焦涕唾粘。更和咽有燥。秋盛夏宜砭。
夫脉之实大为火。滑则为痰。今实大见于肺部。则知火煎熬而成痰矣。
咽。肺之道路。肺既有火。则咽燥矣。但此证非暴疾。乃陈年之疾也。每遇
秋则作。盖以其肺家素有火邪。当金旺之时。则乘时为虐。故秋盛也。治
之者。宜于长夏。当金沐浴之时。迎其气而夺之。至秋则不再作矣。
沉紧相兼滑。仍闻咳嗽声。
沉紧为寒。寒气客于肺。则肺有寒痰。故脉相兼而滑也。肺之变动为咳。
肺有寒痰故见咳嗽声也。
微浮兼有散。肺脉本家形。
微浮而散。秋之毛也。为肺之本脉。
溢出胸中满。气滞大肠鸣。
肺脉当浮涩而短。所谓短者。重手按之缩入关中也。今云溢出。是溢出
乎鱼际。肺苦气上逆。肺脉而溢。则是气上逆。而胸为之满矣。肺主气。气
盛则传于府。上盛则下虚。故气下泄。而大肠鸣也。
弦冷肠中结。
肺主气。大肠为传送之官。然大肠之所以传送者。盖赖肺气通畅。有力
传送而下也。张世贤曰。肺脉见弦。乃金不足。而妻乘之也。主大肠不温。
而为病结。治用温药。其气自通。
芤暴痛无成。
芤。失血脉也。肺为气多。血少之脏。肺脉见芤。无血可失。然芤为阳火。火
之发也暴。不过临时暴痛。而不能成其大害也。
沉细仍兼滑。因知是骨蒸。皮毛皆总涩。寒热两相承。
肺脉当浮。今脉见沉。是为阳虚。阳虚则生外寒。及乎重手取之。其脉见
细。是为阴虚。阴虚则生内热。滑为水中之火。从阳化则热。从阴化则寒。
故知其为骨蒸劳热之证。肺主皮毛。肺脉见沉细而滑。则其阴阳两虚。
皮毛失养。而寒热交作之证现矣。
All three positions (Cun, Guan, Chi) present a floating pulse, indicating wind pathogen invading the Lung Zang. There is excessive nasal discharge and thick, viscous saliva. The patient experiences high fever, aversion to cold, and pain in the skin and muscles. The nasopharynx is dry, and the eyes tear with an acrid, painful sensation.
A floating pulse indicates wind. If the pulse is floating at all three positions, it signifies that the Lung has been injured by wind. The Lung governs Qi, which corresponds to Wei Qi (Defensive Qi). Wind damages Wei Qi, preventing it from properly guarding the exterior. It contends with the wind pathogen and exits through the orifices of the Lung. Consequently, there is excessive watery nasal discharge. Over time, this transmits to the Lung Zang itself. Wind and fire mutually exacerbate each other, scorching body fluids and forming thick phlegm and sputum. Wei Qi is Yang Qi; when Yang Qi is constrained and fails to circulate freely, it results in high fever and aversion to cold. The Lung governs the skin and hair; injury to the Lung causes pain in the skin and muscles. The "Sang" (nasopharynx) is the connection of the Lung. Scorching by wind and fire causes dryness. Zhang Shixian stated: When Metal (Lung) is deficient and cannot control Wood (Liver), both Wood and Fire flourish, causing the eyes to tear and ache.
The Lung pulse is floating and combined with a Full (Shi) quality, leading to dryness and damage to the throat gate. Defecation is difficult and obstructed, and the sense of smell in the nose is diminished or lost.
The Lung pulse is naturally floating; now it is floating combined with Fullness, meaning it is forceful upon palpation. A forceful floating pulse indicates wind. The throat gate is the pathway of the Lung. With wind pathogen in the Lung, the throat gate becomes dry and damaged. Disease transmission from Zang to Fu organs results in difficult and constipated stools. Furthermore, the Lung opens into the nose. As mentioned earlier, "the nose distinguishes odors." If Qi is congested and scorched by heat, and the Lung pulse is floating and full, the Lung is congested by wind pathogen, causing nasal obstruction.
Full and Large qualities combined with Slippery (Hua) pulse indicate burnt hair and sticky sputum. If accompanied by dry throat, bloodletting with Bian stones should be employed during late summer.
A Full and Large pulse indicates Fire pathogen, while a Slippery pulse indicates Phlegm-Dampness. When Full and Large pulses appear in the Lung position, it indicates that Fire has scorched fluids to form Phlegm. The throat is the Lung's pathway; with Fire in the Lung, the throat becomes dry. However, this condition is not an acute onset but a chronic ailment. It flares up every autumn because the Lung inherently harbors Fire pathogen. When Metal Qi is prosperous (in autumn), the pathogen takes advantage of the season to wreak havoc, hence the severity in autumn. Treatment should be administered during late summer, when Metal Qi is in a state of rest (Mu Yu), to counteract the Qi and drain the excess, preventing recurrence in autumn.
Deep (Chen) and Tight (Jin) qualities combined with Slippery (Hua) pulse are associated with the sound of coughing.
Deep and Tight pulses indicate Cold pathogen. When Cold lodges in the Lung, Cold-Phlegm accumulates, resulting in a Slippery pulse. The manifestation of Lung dysfunction is cough; thus, Cold-Phlegm in the Lung produces coughing sounds.
Slightly Floating (Wei Fu) combined with Scattered (San) pulse represents the natural shape of the Lung pulse.
Slightly Floating and Scattered is the "Hair" pulse (Floating pulse) of autumn, representing the normal pulse of the Lung organ.
Pulse overflowing into the Thenar eminence (Yu Ji) indicates chest fullness, Qi stagnation, and borborygmus in the large intestine.
The Lung pulse should be Floating, Obstructed (Se), and Short. "Short" means that under heavy pressure, the pulse feels as if it retreats into the Guan position. Here, "overflowing" refers to overflow into the Yu Ji area. The Lung dislikes Qi rebellion. An overflowing Lung pulse indicates rebellious Qi, causing chest fullness. The Lung governs Qi; when Qi is excessive, it transmits to the Fu organs. Upper excess leads to lower deficiency, so Qi descends abnormally, causing borborygmus in the large intestine.
Wiry (Xian) pulse indicates cold and intestinal knotting.
The Lung governs Qi, and the Large Intestine is the official of transmission. However, the Large Intestine relies on smooth and powerful Lung Qi for transportation downward. Zhang Shixian stated: A Wiry pulse in the Lung indicates insufficient Metal being overacted upon by Wood. This primarily manifests as a cold Large Intestine leading to pathological knotting. Treatment involves warming herbs, after which Qi circulation will naturally resume.
Empty (Kou) pulse indicates sudden pain but does not lead to severe harm.
The Empty pulse indicates loss of Blood. The Lung is an organ abundant in Qi and deficient in Blood. An Empty pulse in the Lung suggests no significant blood loss. However, the Empty pulse also symbolizes Yang Fire. Fire attacks suddenly and violently, causing temporary severe pain, but it does not cause major devastation.
Deep (Chen) and Fine (Xi) qualities combined with Slippery (Hua) pulse indicate Bone-steaming Consumption Fever. The skin and hair appear generally rough and obstructed, with alternating chills and fever.
The Lung pulse should be Floating. A Deep pulse indicates Yang deficiency, which generates external cold. Upon heavy pressure, a Fine pulse indicates Yin deficiency, which generates internal heat. A Slippery pulse represents Fire within Water; transforming via Yang it becomes heat, transforming via Yin it becomes cold. Thus, this indicates Bone-steaming Consumption Fever. The Lung governs the skin and hair. A Deep, Fine, and Slippery Lung pulse indicates dual deficiency of Yin and Yang, causing malnourishment of the skin and hair, manifesting as alternating chills and fever.