物之所茂。垂枝布叶。皆下曲如钩。故其脉之来疾去迟。故曰钩。又曰。夏脉钩。反者为病。何谓反。然。气来实强。
是谓太过。病在外。气来虚微。是谓不及。病在内。脉来累累如环。如循琅 曰平。来而益数。如鸡举足者。曰病。前
曲后倨。如操带钩曰死。故又曰。夏脉微钩曰平。钩多胃气少曰病。但钩无胃气曰死。夏以胃气为本。
脾属四季。迟缓为宗。
谓三月建辰。六月建未。九月建戌。十二月建丑。如是辰戌丑未之月。谓之季月。土旺四季。寄旺于春夏秋冬之初。
土旺用事。各旺十八日。共成七十二日。其脉当缓。以土之性迟缓故也。十五难曰。脾者中州也。其平和不可得见。衰
乃见耳。来如雀之啄。如水之下漏。是脾衰之见也。
申酉是金为肺。微浮短涩宜迟。
谓七月建申。八月建酉也。值此之时。太阴用事。其脉当微浮短涩。即经所云毛者是也。十五难曰。秋脉毛者。肺。
西方金也。万物之所终。草木华叶。皆秋而落。其枝独在。若毫毛也。故其脉之来。轻虚以浮。故曰毛。又曰秋脉毛。
反者为病。何谓反。然。其气来实强。是谓太过。病在外。气来虚微。是谓不及。病在内。其脉来蔼蔼如车盖。按之益
大曰平。不上不下。如循鸡羽曰病。按之萧索。如风吹毛曰死。故又曰。秋脉微毛曰平。毛多骨气少曰病。但毛无骨气
曰死。秋以胃气为本。
按刘守真曰。涩物湿则滑泽。干则涩滞。燥湿相反故也。如遍身中外涩滞皆属燥金之化。故秋脉涩。涩涩也。
月临亥子。是乃肾家之旺。得其沉细。各为平脉之容。谓十月建亥。十一月建子也。值此水旺之时。其脉宜沉而细。
即经所谓石者是也。十五难曰。冬脉实者。肾。北方水也。万物之所藏也。极冬之时。水凝如石。故其脉之来。沉濡而
滑曰石。又曰冬脉石。反者为病。何谓反。然。气来实强。是谓太过。病在外。气来虚微。是谓不及。病在内。脉来上
大下锐濡滑。如雀之啄曰平。啄啄连属。其中微曲曰病。来如解索。去如弹石曰死。故又曰。冬脉微石曰平。石多胃气
少曰病。但石无胃气曰死。冬以胃气为本。
既平脉之不衰。反见鬼兮命危。
此言春弦夏洪。秋毛冬石。不失其常。是为平脉。是元气之不衰也。忽见鬼克之邪脉来侵。其命当危而败矣。何谓
鬼克之邪也。克我者是也。如春日浮短涩脉。夏见沉细脉。四季见弦长脉。秋见洪大脉。冬见迟缓脉。皆鬼克之邪也。
假令四季之中。虽见贼邪之脉来侵。然春犹带弦。夏犹带洪秋犹带毛。多犹带石。尚有可生之理。倘本季之脉。全然不
见。但见鬼克之脉。则其命也危矣。
子扶母兮瘥速。
我所生者为子。子扶母者。如春得洪大脉。夏得迟缓脉。季夏得浮涩脉。秋得沉细脉。冬得弦长脉。又如心脉见缓
大。肝脉见洪散。脾脉见浮涩。肺脉见沉滑。肾脉见弦长。亦是子来扶母。乃从前来者谓之实邪。其病易已。故曰瘥速。
母抑子兮退迟。
生我者为母。所谓母抑子者。如春得沉细脉。夏得弦长脉。季夏得洪大脉。秋得迟缓脉。冬得浮涩脉。又如心脉见
弦。肝脉见沉。脾脉见洪。肺脉见缓。肾脉见浮涩。又如肾病传肝。肝病传心。心病传脾。脾病传肺。肺病传肾之类。
是皆母来抑子。乃从后来者。谓之虚邪。病虽不死。必稽延而难愈也。
此事难知云。脉地也。色天也。地生天则顺。天生地则逆。假令得弦脉而面赤色。地生天也。地生天则顺也。子扶
母兮瘥速也。假令得弦脉。而面黑色。天生地也。天生地则逆也。母抑子兮退迟也。
得妻不同一治。生死仍须各推。
我克者为妻。如春见缓脉。夏见浮涩。长夏得沉细。秋见弦长。又如肝脉见迟缓。心脉见浮涩。脾脉见沉滑。肺脉
见弦长。肾脉见洪大。是皆谓之微邪。不足畏。然又有反以微邪为可畏者。则生死仍须各推可也。详见下文。
假令春得肺脉为鬼邪。得心脉乃是肝儿。肾为其母。脾则为妻。
此作赋者。恐人不知鬼邪。实邪。虚邪。微邪。故举春以为例。然已详见上文。不必复赘。
脉经云。脉从前来者为实邪。从后来者为虚邪。从所不胜来者为贼邪。从所胜来者为微邪。
春得脾而莫疗。冬见心而不治。夏得肺以难瘥。秋得肝亦何疑。
此复发明得妻不同一治。生死仍须各推之理。凡我克者为妻。乃微邪也。假令春脉弦而缓。冬脉沉而洪。夏脉洪而
涩。秋脉涩而弦。虽见妻脉来乘。是为微邪不足畏。如春脉但见迟缓。而不见其带弦。是为土旺生金。反来克木。冬脉
但见其洪大。而不见其带沉。是为火旺生土。而反来克水。夏脉但见其涩。而不见其带洪是为金旺生水。而反来克火。
秋脉但见其弦长。而不见其带涩。是为木旺生火。而反来克金。如此之脉。不得谓之小逆反以微邪为可畏也。譬如人家。
其夫良善。其妻不能。难能相夫以成家。而夫纲犹整。是为美 。不足畏也。倘若其夫懦弱。其妻强悍。事无大小。操
窃其权。虽有夫君。视同奴隶。流渐日久。弑逆之祸。其不免矣。岂非反以微邪为可畏欤。故曰。得妻不同一治。生死
仍须各推。复有一说。谓春夏秋冬四季之时。倘得妻脉。其生死判断有不同者。试观四句赋中。惟夏得肺以难瘥一句。
为一定之辞。其余三句。俱属两可。况别有诀云。春中诊得四季脉不治。多应病自除。则知春夏秋冬。四季之中。倘得
妻脉。其生死仍须各推。不可一例而论也。假令春得脾脉。春属木。脾属土。木非土不生。况木得湿土之滋。反能长养。
故云莫疗。而病自愈也。又令冬见心脉。冬为寒冰。心为君火。如严寒之时。得太阳一照。使流水不冰。纵有微邪。亦
无大害。故不必治也。惟夏得肺脉。夏为赤帝司辰。万物赖以长化。倘见肺脉。肺为阴金。其气肃杀。故杀菽陨霜。春
秋所警。是以夏得肺以难瘥也。至于秋得肝脉。肝为青阳。主东方之生气。秋得肝脉。是当摇落之时。而得生长之气。
如阳明司天之岁五之气。厥阴风木客气加临。春令反行。草乃生荣。民气和之谓也。又何疑其为害也哉。
此乃论四时休旺之理。明五行生克之义。
此总结上文之脉。反四时者。由五行有相克之义存焉耳。
举一隅而为例。则三隅而可知。
如前偶举一春以为例。则夏秋冬季可以类推矣。
按平弦而若紧。
此节言脉有相似者。当详明分别之。不可混淆也。平字非弦脉之平。当与下文欲识之识字相对。南方诊脉谓之看脉。
北方诊脉谓之平脉。如脉经平脉早晏。平脉虚实之类。故曰按平弦而若紧。弦者。不散也。端直而长。状若筝弦。曰弦
紧者。不缓也。脉来劲急。按之长。举之若牵绳转索之状。弦属少阳。为疟为饮。为寒热。为气血。收敛紧属太阳。为
寒为痛。在人迎为伤寒。在气口为伤食。不可以其同一长而直。而不分其孰为弦。孰为紧也。
欲识涩而似微。
涩不滑也。参伍不调。如雨沾沙。又如轻刀刮竹曰涩。涩为气多血少。为伤精。为痰阻气机。为中雾露。微者不显
也。脉来极细而软。若有若无曰微。为气血俱虚。为败血不止。面色无光。然涩者。言脉道之謇涩。而不流利也。微者。
言脉道之微细。而不充满也。二者皆难定息数。诊之者须辨其孰为涩孰为微。
浮芤其状相反。
浮者。不沉也。按之不足。举之有余曰浮。有力为风。无力为虚。芤则初无定体。芤草名。其叶似葱。以脉轻手。
则浮而大。重则中空。故借以命名也。即先贤论芤脉。亦有不同。如本诀中指法。则曰两头即有。中间全无。或又谓四
畔有。中间无而脉经则又曰芤脉。其象两边似有。中间全无仲景伤寒论曰。脉弦而大。弦则为减。大则为芤。减则为寒。
芤则为虚。虚寒相搏。此名为革。男子忘血失精。女子半产漏下。古人谓芤脉之不同如此。或云两头有。中间无或曰四
畔有。中间无或曰两边有。中间无余尝按此三法。诊人之脉。皆断之为失血。并无差忒。因思芤脉轻手则浮。重则中空。
虽有上下左右四畔之不同。要之皆因血去故也。但据仲景之言观之。脉弦则为减。大则为芤。是轻手取之。则觉其弦大。
及乎重手则减而为芤。与剖竹相似。非两边有。中间无乎。至本诀中指法主病则曰。两头即有。中间全无。主淋沥气入
小肠。与仲景之主病不合。大抵从仲景之指法。其病为虚为寒。从脉诀之指法。其病为阳为热。不得张凿而李枘也。不
独芤脉为然。凡读古人书。不可胶柱鼓瑟。况脉之理。至精至微。脉不自立其名。因古人之指法而立名。假令其古人之
指法如此。故其主病如此。某古人之指法如彼。故其主病如彼。戴起宗之流。造脉诀刊误。每用一古人之指法。如定脉
之名。复用一古人之主病。强牵以合之至使后人病脉不相对。误人岂浅鲜哉。不知古人各有得心应手之妙。非若后世之
人。泥于字句者比也。
沉伏殊途同归。
沉不浮也。轻手不见。重手乃得。曰沉为入里。脉之首伏不见也。脉经云。伏者。极重手按之。着骨乃得。为三阴
之尽。
洪与实而形同仿佛。
洪者。脉来满指而大也。实者。浮中沉。皆有力也。二脉皆满指。然洪有浮沉之别。而实谓浮沉皆有力也。
濡与弱而性带依稀。
濡与弱。其状相似。但有浮沉之别。与阴阳之分耳。诸家皆以极浮细而软曰濡。极沉细而软曰弱。惟本诀指法主病
中。则曰指下寻之。似有再再还来。按之根据前却去曰濡。指下寻如烂绵相似。轻手乃得。重手稍无。怏怏不前曰弱。据
诀所云。
似乎以极沉而无力为濡。极浮而无力为弱。矣。两说龃龉。何去何从也。不知濡为阴水当沉。弱为阴金当浮。濡为阳
不足不当于浮中见。弱为阴不足不当于沉中见。据理而论。当以诀之指法为是。而以他说为非矣。况濡弱二脉。但可以
极沉而软。极浮而软言之不必更加细字。先辨此情。后明其理。更复通于药性。然后可以为医。
今人但知脉理之难。而不知药性之难也。但知药之功。而不知药之性耳。能尽其药之性然后可以为医也。夫所谓性
者。非山楂消食。贝母清痰。枳壳宽胸。陈皮下气之谓也。乃寒热温凉。升降浮沉。阴阳清浊之谓也语云。用药如用兵。
兵家之道。知彼知己。百战百胜。知彼者。知贼之虚实也。知己者。知我兵之水陆奇正也。如为医者。但知脉理。而不
知药性。是犹用兵者。但知贼之虚实。而不知我兵之宜水宜陆。宜奇宜正纵有百万之师。其不为贼所陷者鲜矣。
既已明其三部。须知疾之所有。
此承上起下之词。言既明寸关尺之三部。须知三部之中。所现之脉不同。而所生之病亦各异也。
寸脉急而头痛。
寸。阳部也头。诸阳之会也。今诊得寸脉而急。急则近于紧。诸紧为寒。当是风寒客于其脑。而作痛也。
平人气象论云。寸口之脉中手短者。曰头痛。
弦为心下之咎。
心之下。胃之上也。弦则为饮。脉经曰。寸脉弦。心下 。谓心下有痰饮也故寸弦而曰心下咎也。
紧是肚痛之征。肚痛者。胃脘痛也。经云。紧在寸口。或膈上有寒。或膈下有水。寒在上焦。
风满而噎。或风寒外入。病苦头痛。（当是左寸紧。）或宿食内停。腹中不化。（当是右寸紧。）缓即皮顽之候。
寸。阳位也。缓则为湿。风从阳。湿从阴。风从上。湿从下。今缓脉见于阳位。
即经云寸缓。主皮不仁。风寒在肌肉也。宜防风汤。
微微冷入胸中。
寸。阳部也。胸中。阳位也。微者。阳气虚也。阳虚则寒。故寸微而知胸中有冷气也。
数数热居胃口。
数为热。经云。寸数即吐。以有热在胃脘熏胸中。宜药吐之。及针胃脘。服除热汤。则知热在胃口矣。
滑主壅多。
经云。寸滑阳实。胸中壅。满吐逆。宜前胡汤。
涩而气少。
凡涩为气多血少。而此独云涩而气少者。何也。盖以胸为气海。若关脉涩。则当谓之血少。何也。以其营出中焦也。
至于寸口所以候胸中者。胸为气海。安得不谓之气少也哉。
胸连胁满。只为洪而莫非。 引背疼。缘是沉而不谬。
洪为阳。沉为阴。洪为火。沉为寒。胸为阴。背为阳。寸部而见洪脉。为肠火之邪。干于心胸。而作满闷经云。诸
逆冲上。皆属于火者是也。寸部而见沉脉。为阴寒之气干于肺。而作引痛。经云。诸气 郁。皆属于肺者是也。更过关
中。浮缓不餐。
关中所以候中焦者。中焦属脾土。土之性宜镇静。今脉见浮缓。缓虽土之本脉。而浮则为风为虚。如大风扬沙。失
其镇静之德。而成虚浮之象。其不食也宜矣。
紧牢气满。喘急难痊。
紧则为寒。牢则为病根深固。今二脉见于关中。是脾胃为冷物所伤。脾病则留满痞塞。故气满喘急。而成不拔之证
矣。
弱以数兮胃热。弦以滑兮胃寒。
数则为热。见于关中。则为热壅胃口。热壅胃口。则不食。不食则脉因之而弱矣。弦则为饮。滑主壅滞。今弦滑兼
见于关中。是为胃中停积寒饮矣。
微即心下胀满。
When all things are flourishing, the branches hang down and leaves spread out, all curving downward like a hook. Therefore, the pulse comes swiftly and departs slowly, hence it is called "Hook" (Gou). It is also said: The summer pulse is Hook; that which is contrary is pathological. What is meant by contrary? The answer is: When the qi arrives solid and strong, this is called "Excess" (Tai Guo), indicating disease in the exterior; when the qi arrives deficient and faint, this is called "Deficiency" (Bu Ji), indicating disease in the interior.
If the pulse comes continuously like a ring, as if touching fine jade (Lang Gao), this is the Normal Pulse (Ping Mai). If it comes increasingly rapid, like a chicken lifting its feet, this is a Diseased Pulse (Bing Mai). If it comes curved at the front and rigid at the back, as if holding a belt hook, this is a Death Pulse (Si Mai). Thus it is said: A summer pulse slightly hooked with harmonious Stomach Qi (Wei Qi) indicates health; many hooks with little Stomach Qi indicates disease; only hooks without Stomach Qi indicates death. Summer takes Stomach Qi as its foundation.
The Spleen belongs to the four seasons, taking Slowness and Languor (Chi Huan) as its essence. The months of Chen (3rd lunar month), Wei (6th lunar month), Xu (9th lunar month), and Chou (12th lunar month) are called Seasonal Months. Earth flourishes in the four seasons,寄旺 (lingeringly flourishing) at the beginning of Spring, Summer, Autumn, and Winter. When Earth is in command, it flourishes for 18 days each, totaling 72 days. The pulse should be slow because the nature of Earth is sluggish. Chapter 15 of the *Nan Jing* states: The Spleen belongs to the Central Plain (Zhong Zhou); its peaceful state cannot be seen, only its decline is visible. A pulse coming like a sparrow pecking or water dripping intermittently indicates Spleen decline.
Shen and You correspond to Metal and belong to the Lung. The pulse should be slightly floating, short, choppy, and suitable for slowness. These are the months of Shen (7th lunar month) and You (8th lunar month). At this time, the Taiyin (Lung/Metal) is in command. The pulse should be slightly floating, short, and choppy, which is what the classics call "Feather" (Mao). Chapter 15 of the *Nan Jing* says: The autumn pulse is Feather, corresponding to the Lung, Western Metal. All things terminate here; flowers and leaves fall in autumn, leaving only branches like hairs. Thus the pulse comes lightly, void, and floating, hence called "Feather." It is also said: The autumn pulse is Feather; that which is contrary is pathological. What is contrary? The answer is: When the qi arrives solid and strong, this is Excess, disease in the exterior; when the qi arrives deficient and faint, this is Deficiency, disease in the interior.
If the pulse comes abundant like a chariot canopy, and feels larger upon pressure, this is Normal. If it comes neither up nor down, like tracing a chicken feather, this is Diseased. If it feels desolate upon pressure, like wind blowing hair, this is Death. Thus it is said: An autumn pulse slightly feathery with harmonious Stomach Qi indicates health; many feathers with little Bone Qi (Kidney Qi) indicates disease; only feathers without Bone Qi indicates death. Autumn takes Stomach Qi as its foundation.
According to Liu Shouzhen: Objects are smooth when wet and choppy when dry, due to the opposition of Dryness and Dampness. If the whole body feels choppy, it belongs to the transformation of Dry Metal, hence the autumn pulse is choppy. Choppy means stagnation.
When the moon passes Hai and Zi, this is the flourishing of the Kidney. The pulse manifests as Deep (Chen) and Fine (Xi), which are forms of the Normal Pulse. These are the months of Hai (10th lunar month) and Zi (11th lunar month). During this time of Water flourishing, the pulse should be deep and fine, which is what the classics call "Stone" (Shi). Chapter 15 of the *Nan Jing* says: The winter pulse is Solid, corresponding to the Kidney, Northern Water. All things are stored here. In extreme winter, water freezes like stone, so the pulse comes deep, soft, and slippery, called "Stone." It is also said: The winter pulse is Stone; that which is contrary is pathological. What is contrary? The answer is: When the qi arrives solid and strong, this is Excess, disease in the exterior; when the qi arrives deficient and faint, this is Deficiency, disease in the interior.
If the pulse comes large above and sharp below, soft and slippery, like a sparrow pecking, this is Normal. Pecking continuously but slightly curved within indicates Disease. Coming like untying a rope and departing like striking stone indicates Death. Thus it is said: A winter pulse slightly stony with harmonious Stomach Qi indicates health; many stones with little Stomach Qi indicates disease; only stones without Stomach Qi indicates death. Winter takes Stomach Qi as its foundation.
Since the Normal Pulse does not decline, if Ghost-Overcoming (Gui Ke) pulses appear instead, life is endangered.
This refers to Spring String (Xian), Summer Surging (Hong), Autumn Feather (Mao), and Winter Stone (Shi) adhering to constancy, which are Normal Pulses, indicating undiminished Yuan Qi. Suddenly, a pathogenic pulse that overcomes the organ invades, and life becomes critical. What is a Ghost-Overcoming pathogen? It is the element that overcomes me. For example, Floating, Short, and Choppy pulses in Spring; Deep and Fine pulses in Summer; String and Long pulses in the seasonal months; Surging and Large pulses in Autumn; Slow and Moderate pulses in Winter. These are all Ghost-Overcoming pathogens.
Suppose in the seasonal months, although Thief Pathogens invade, if the Spring pulse still carries String qualities, Summer carries Surging, Autumn carries Feather, and Winter carries Stone, there is still hope for survival. However, if the seasonal pulse is completely absent and only the overcoming pulse is seen, life is endangered.
Zi supporting Mu leads to rapid recovery.
What I generate is Zi. Zi supporting Mu: For example, obtaining a Surging/Large pulse in Spring (Fire is Son of Wood), a Slow/Moderate pulse in Summer (Earth is Son of Fire), a Floating/Choppy pulse in Late Summer (Metal is Son of Earth), a Deep/Fine pulse in Autumn (Water is Son of Metal), and a String/Long pulse in Winter (Wood is Son of Water). Similarly, Heart pulse showing Slow/Large, Liver pulse showing Surging/Scattered, Spleen pulse showing Floating/Choppy, Lung pulse showing Deep/Slippery, Kidney pulse showing String/Long. This is also Zi supporting Mu, coming from the front, called Excess Pathogen (Shi Xie). The disease is easy to heal, hence rapid recovery.
Mu suppressing Zi leads to delayed recovery.
What generates me is Mu. Mu suppressing Zi: For example, obtaining a Deep/Fine pulse in Spring (Water is Mother of Wood), a String/Long pulse in Summer (Wood is Mother of Fire), a Surging/Large pulse in Late Summer (Fire is Mother of Earth), a Slow/Moderate pulse in Autumn (Earth is Mother of Metal), and a Floating/Choppy pulse in Winter (Metal is Mother of Water). Similarly, Heart pulse showing String, Liver pulse showing Deep, Spleen pulse showing Surging, Lung pulse showing Slow, Kidney pulse showing Floating/Choppy. Also, Kidney disease transmitting to Liver, Liver to Heart, Heart to Spleen, Spleen to Lung, Lung to Kidney. These are all Mu suppressing Zi, coming from behind, called Deficient Pathogen (Xu Xie). Although not fatal, the disease will linger and be difficult to cure.
*Cishi Nanzhi* states: Pulse belongs to Earth, Color belongs to Heaven. Earth generating Heaven is Smooth (Shun); Heaven generating Earth is Adverse (Ni). For instance, obtaining a String pulse with red face is Earth generating Heaven (Smooth), meaning Zi supports Mu, leading to rapid recovery. Obtaining a String pulse with black face is Heaven generating Earth (Adverse), meaning Mu suppresses Zi, leading to delayed recovery.
Obtaining Wife pulse requires different treatments; life and death must be deduced separately.
What I overcome is Wife. For example, Slow pulse in Spring, Floating/Choppy in Summer, Deep/Fine in Late Summer, String/Long in Autumn. Similarly, Liver pulse showing Slow/Modulate, Heart pulse showing Floating/Choppy, Spleen pulse showing Deep/Slippery, Lung pulse showing String/Long, Kidney pulse showing Surging/Large. These are all called Minor Pathogens (Wei Xie), not to be feared. However, some consider Minor Pathogens worthy of fear; thus, life and death must be deduced separately. See below.
For example, in Spring, Lung pulse is Ghost Pathogen; Heart pulse is Liver's Son; Kidney is Mother; Spleen is Wife.
The author of this ode mentions Ghost, Excess, Deficient, and Minor Pathogens to clarify distinctions, using Spring as an example, as detailed above.
The *Mai Jing* states: Pulse coming from the front is Excess Pathogen; from behind is Deficient Pathogen; from the unconquerable (overcoming me) is Thief Pathogen; from the conquerable (I overcome) is Minor Pathogen.
Spring obtaining Spleen pulse need not be treated; Winter seeing Heart pulse needs no treatment; Summer obtaining Lung pulse is hard to heal; Autumn obtaining Liver pulse raises no doubt.
This reiterates the principle that Wife pulses require different treatments. All I overcome are Wives, belonging to Minor Pathogens. If Spring pulse is String and Slow, Winter is Deep and Surging, Summer is Surging and Choppy, Autumn is Choppy and String, these are Minor Pathogens, not to be feared. But if Spring pulse is only Slow without String quality, Earth generates Metal and overcomes Wood. If Winter pulse is only Surging without Deep quality, Fire generates Earth and overcomes Water. If Summer pulse is only Choppy without Surging quality, Metal generates Water and overcomes Fire. If Autumn pulse is only String/Long without Choppy quality, Wood generates Fire and overcomes Metal. Such pulses are not minor reversals but make Minor Pathogens fearsome. Like a good husband with an incompetent wife, the family structure holds; not to be feared. But if the husband is weak and the wife domineering, seizing power, eventually rebellion occurs. Hence, "Wife pulse requires different treatment; life and death must be deduced separately." Another view: In the four seasons, if Wife pulse appears, prognosis varies. Only "Summer obtaining Lung pulse is hard to heal" is definitive. Others are ambiguous. As another rhyme says: "Diagnosing seasonal pulse in Spring, disease often heals itself." Thus, prognosis varies. Spring obtaining Spleen pulse: Wood is born of Earth; moist Earth nourishes Wood, so disease heals without treatment. Winter obtaining Heart pulse: Winter is ice, Heart is Fire; like sun in cold, water doesn't freeze; minor pathogen causes no harm. Summer obtaining Lung pulse: Summer is hot, Lung is Yin Metal with killing energy; hence hard to heal. Autumn obtaining Liver pulse: Liver is Green Yang, governing growth; in autumn (falling season), obtaining growth qi is like spring returning; beneficial, not harmful.
This discusses the principles of Four Seasons Rest and Flourish, clarifying Five Elements generation and overcoming.
This summarizes the previous pulses; violating the four seasons is due to the existence of Five Elements overcoming relationships.
Knowing one corner allows knowing the other three.
As Spring was used as an example, Summer, Autumn, and Winter can be inferred similarly.
Examining Ping (Normal) String pulse resembling Tight pulse.
This section explains similar pulses that must be distinguished. "Ping" here does not mean Normal String pulse but contrasts with "Shi" (Recognize). Southern diagnosis is "Kan Mai," Northern is "Ping Mai." *Mai Jing* mentions Ping Mai early/late, etc. Thus, "Examine Ping String resembling Tight." String pulse is not scattered, straight and long, like a zither string. Tight pulse is not slow, forceful and urgent, long upon pressure, feeling like pulling a twisting rope. String belongs to Shaoyang, indicating Malaria, Fluid Retention, Cold/Heat, Qi/Blood issues. Tight belongs to Taiyang, indicating Cold, Pain; at Renying, it is Cold Damage; at Qikou, it is Food Injury. Do not confuse them just because both are long and straight.
To recognize Choppy pulse resembling Faint pulse.
Choppy is not slippery, irregular, like rain on sand or light knife scraping bamboo. Choppy indicates excess Qi and deficient Blood, Essence injury, Phlegm obstructing Qi, or Fog/Dew invasion. Faint is not manifest, extremely thin and soft, seeming present yet absent. Faint indicates deficiency of both Qi and Blood, unremitting bleeding, lusterless complexion. Choppy refers to vessel obstruction and lack of flow; Faint refers to vessel minuteness and lack of fullness. Both are hard to count breaths; one must distinguish Choppy from Faint.
Floating and Kun pulses have opposite shapes.
Floating is not deep, insufficient upon pressure, abundant upon lifting. Forceful indicates Wind, forceless indicates Deficiency. Kun pulse has no fixed form; named after Kun grass (like scallion). Light touch makes it float and large; heavy touch reveals hollow center. Ancient theories vary. This ode's finger method says ends are present, middle is empty; or sides present, middle empty. *Mai Jing* says sides seem present, middle empty. Zhang Zhongjing's *Shanghan Lun* says: String and Large, String implies reduction (Cold), Large implies Kun (Deficiency); Deficiency and Cold combine, called Ge pulse. Men lose blood/essence; women miscarry/bleed. Methods vary: ends present/middle empty, or sides present/middle empty. I have diagnosed loss of blood with all methods without error. Kun pulse floats lightly and is hollow heavily. Regardless of variation, it stems from blood loss. Zhongjing's view: Light touch feels String/Large; heavy touch reduces to Kun, like split bamboo. This ode's finger method says ends present, middle empty, indicating strangury/Qi entering Small Intestine, differing from Zhongjing. Zhongjing's method implies Deficiency/Cold; this ode's method implies Yang/Heat. Do not mix them. Reading ancients requires flexibility. Pulse names derive from ancient finger methods. Dai Qizong's *Mai Jue Kan Wu* mixed finger methods and indications, confusing students. Ancients had unique insights; later scholars were too literal.
Deep and Fu pulses differ in path but converge in result.
Deep is not floating, invisible lightly, felt heavily, indicating interior entry. Fu pulse is invisible even with heavy pressure, felt against bone, indicating exhaustion of Three Yin.
Surging and Shi pulses look alike.
Surging fills the fingers and is large. Shi pulse is forceful in Floating, Middle, and Deep levels. Both fill fingers, but Surging has floating/sinking differences, while Shi is forceful in all levels.
Ru and Ruo pulses are subtly similar.
Ru and Ruo are similar but differ in floating/sinking and yin/yang. Most say extremely floating, thin, and soft is Ru; extremely deep, thin, and soft is Ruo. This ode's method says: Seeking under fingers, seems present then returns, pressing moves forward/backward is Ru; seeking feels like rotten cotton, felt lightly, barely felt heavily, reluctant to advance is Ruo. This implies extremely deep/forceless is Ru, extremely floating/forceless is Ruo. Contradictory views exist. Logic suggests Ru (Yin Water) should be deep; Ruo (Yin Metal) should be floating. Ru indicates Yang deficiency, not seen in floating/middle; Ruo indicates Yin deficiency, not seen in deep. Thus, the ode's method is correct. Ru/Ruo need only be described as deep/floating and soft, not necessarily thin. Understand this before reasoning, and integrate with herb properties to become a physician.
People know pulse difficulty but not herb property difficulty. Knowing function vs. nature. Mastering nature makes a physician. Nature refers to Cold/Hot/Warm/Cool, Ascending/Descending/Floating/Sinking, Yin/Yang/Clear/Turbid, not just Hawthorn digesting food or Ophiopogon clearing phlegm. Medicine is like warfare: Know enemy (pathogen) and self (herbs). Knowing only pulse but not herbs is like knowing enemy strength but not troop deployment. Millions of troops may still be trapped.
Having clarified the Three Regions (Cun, Guan, Chi), one must know the diseases present.
This transitions: Having understood Cun, Guan, Chi, note that different pulses indicate different diseases.
Cun pulse urgent indicates Headache.
Cun is Yang region; head is gathering of Yang. Urgent Cun pulse resembles Tight, indicating Cold. Wind-Cold invading brain causes pain. *Ping Ren Qi Xiang Lun* says: Short pulse at Cun indicates headache.
String pulse indicates pathology below the Heart.
Below heart is stomach. String indicates Fluid Retention. *Mai Jing* says: String at Cun indicates palpitations below heart due to Phlegm-Fluid.
Tight pulse is sign of Abdominal Pain.
Abdominal pain is epigastric pain. Classics say: Tight at Cun indicates Cold above diaphragm or Water below. Cold in Upper Jiao causes wind-fullness and choking, or Wind-Cold causing headache (Left Cun). Or retained food causing indigestion (Right Cun).
Slow pulse indicates skin numbness.
Cun is Yang position. Slow indicates Dampness. Wind follows Yang/Up; Damp follows Yin/Down. Slow at Yang position matches classics: Slow at Cun indicates insensible skin, Wind-Cold in muscles. Use Fangfeng Decoction.
Slight cold enters Chest.
Cun is Yang; Chest is Yang position. Faint indicates Yang deficiency. Yang deficiency causes Cold. Faint Cun indicates Cold Qi in Chest.
Rapid heat resides in Stomach Gate.
Rapid indicates Heat. Classics say: Rapid at Cun causes vomiting due to Heat steaming Chest from Stomach. Treat with emetics, acupuncture at Weizhong, and Heat-clearing decoctions.
Slippery pulse indicates excessive congestion.
Classics say: Slippery at Cun indicates Yang Excess, chest congestion, fullness, vomiting. Use Qianhu Decoction.
Choppy pulse indicates Qi deficiency.
Choppy usually means excess Qi/deficient Blood. Here, Choppy at Cun indicates Qi deficiency because Chest is Sea of Qi. Guan Choppy would indicate Blood deficiency (Qi/Blood origin). Since Cun monitors Chest, it indicates Qi deficiency.
Chest and Hypochondriac fullness due to Surging pulse; Back pain due to Deep pulse.
Surging is Yang/Fire; Deep is Yin/Cold. Chest is Yin; Back is Yang. Surging at Cun indicates Intestinal Fire disturbing Heart/Chest, causing fullness (All rushing upward belongs to Fire). Deep at Cun indicates Yin Cold disturbing Lung, causing radiating pain (All Qi oppression belongs to Lung).
Passing to Guan, Floating/Slow indicates anorexia.
Guan monitors Middle Jiao (Spleen/Earth). Earth prefers stability. Floating/Slow pulse shows instability (Wind/Deficiency), like wind blowing sand. Loss of stability causes anorexia.
Tight and Firm pulses indicate Qi fullness, panting, hard to cure.
Tight indicates Cold; Firm indicates deep-rooted disease. Tight/Firm at Guan indicates Spleen/Stomach damaged by cold foods. Spleen disease causes bloating/stagnation, leading to Qi fullness, panting, and intractable condition.
Weak and Rapid indicate Stomach Heat; String and Slippery indicate Stomach Cold.
Rapid indicates Heat. At Guan, Heat congests Stomach Gate, causing anorexia, leading to Weak pulse. String indicates Fluid; Slippery indicates stagnation. String/Slippery at Guan indicates Cold Fluid retention in Stomach.
Faint pulse indicates subcardiac distension.