五迟者。阴也。指下寻之。重手乃得隐隐曰迟。主肾虚不安。
迟者。阴土也。何为阴土。土之性也。缓迟则较缓更甚。故亦曰土也。观其
指法。则曰重手乃得隐隐。是病在里而为阴可知矣。自古迟则寒。此节
独不言寒。而专言肾虚不安者。何也。以迟为阴土。是土不务其德。而乘
其所胜。夫土所胜者。水也。肾为水藏。乘其虚而克之。肾其能安乎哉。
按脉经云。迟脉呼吸三至。去来极迟。一曰举之不足。按之尽牢。一曰按
之尽牢。举之无有。经云。迟则为寒。
迟脉人逢状且难。遇其季夏不得痊。神工诊得知时候。道是脾来水必干。
今人皆言三至为迟矣。究未得迟脉之情状也。其于指下寻之。重手乃
得隐隐耳。故曰。迟脉人逢状且难也。今人皆言迟则为寒矣。究未尽迟
脉之体性也。其理又主脾来克水。肾虚不安。如此则迟脉不专主于寒
可知矣。然脉迟而曰遇其季夏不能痊者何也。以迟脉属土。季夏又值
土旺之时。水得土而绝。故曰遇其季夏。不能痊也。然季春季秋季冬。皆
土旺之日。何独见畏于季夏也。不知季春虽土寄旺之月。而木气尚余。
子能扶母。即迟脉来见。土其畏木而不暇克水。季秋亦土季旺之月。而
金气尚余。金能生水。纵迟脉来见。子受母荫。而水不畏土。季冬亦土寄
旺之月。水适当旺。旺者不受邪。纵迟脉来见。亦无所畏。惟季夏乃土正
旺之时。谓之长夏。言其生长于火也。况火为土之母。所畏者水耳。今借
居土后。则火挟子势。而反来侮水。夫火乃耗水坚土之物也。今得土以
合之。而水未有不涸者矣。故曰。遇其季夏不能痊也。
按经云。迟而涩。中塞有 结。又云。迟而滑者胀。又云。迟而缓者有寒。仲
景曰。如阳明脉迟。不恶寒。身体 然汗出。则用大承气汤。又洁古曰。
迟。阴也。季夏。阳也。此证为失时反候。阴盛阳虚治之。宜泻心肺。补肝肾。
泻心者。导赤散。补肾者。地黄丸。
Chi pulse (Slow Pulse) belongs to Yin. Under the fingers, it requires heavy pressure to faintly perceive the beat; this is the Chi pulse. It primarily indicates Kidney deficiency leading to restlessness.
The Chi pulse corresponds to Yin Earth in the Five Elements. Why is it called Yin Earth? This is determined by the nature of Earth. The Huan pulse (Moderate/Sluggish Pulse) is already relatively slow, whereas the Chi pulse is slower than the Huan pulse, hence it is also referred to as Earth. Observing its palpation method, which states that heavy pressure is needed to faintly perceive it, indicates that the pathology is interior and Yin in nature, which is certain. Since ancient times, it has been said that "Chi pulse indicates Cold." However, this section uniquely does not mention Cold but specifically discusses Kidney deficiency and restlessness. Why? Because the Chi pulse belongs to Yin Earth, implying that Earth fails to perform its proper virtue (controlling Water) and instead overacts upon what it controls. What Earth controls is Water. The Kidney is the organ storing Water. When the Kidney is deficient, it is attacked by Earth taking advantage of the weakness; how can the Kidney remain tranquil?
According to the *Mai Jing* (Pulse Classic): The Chi pulse beats three times per respiration cycle, coming and going extremely slowly. One description says: light pressure (Ju Zhi) feels insufficient, while heavy pressure (An Zhi) feels firm and solid. Another description says: heavy pressure feels firm and solid, while light pressure feels absent. The classic text states: "Chi pulse indicates Cold."
When a patient encounters the Chi pulse, the condition is often severe and difficult to treat. If contracted during Ji Xia (the last month of summer), recovery is unlikely. An expert physician, upon diagnosis, recognizes this as an unfavorable timing, stating that Spleen (Earth) Qi excess inevitably depletes Kidney (Water) Qi. Modern people all say that three beats per respiration constitute the Chi pulse, yet they have not truly grasped the actual characteristics of the Chi pulse. Under the fingers, one must press heavily to faintly perceive it. Hence it is said, "When a patient encounters the Chi pulse, the condition is severe and difficult to treat." Modern people all say "Chi pulse indicates Cold," yet they have not fully understood the essential nature of the Chi pulse. The underlying logic again points to Spleen (Earth) Qi overcoming Kidney (Water), causing Kidney deficiency and restlessness. Thus, it is evident that the Chi pulse does not exclusively indicate Cold syndromes. However, why is it said that patients with a Chi pulse cannot recover if encountered in Ji Xia? Because the Chi pulse belongs to Earth, and Ji Xia is the time when Earth Qi is at its peak. Water is extinguished by thriving Earth, hence it is said that encountering Ji Xia leads to non-recovery. But Spring, Autumn, and Winter are also periods when Earth Qi is寄旺 (provisionally prosperous). Why fear only Ji Xia? It is unknown that although Ji Chun (early Spring) is a month where Earth Qi is provisionally prosperous, Wood Qi still lingers. Wood generates Fire (child supports mother); even if the Chi pulse appears, Earth fears Wood and lacks the strength to overcome Water. Ji Qiu (late Autumn) is also a month where Earth Qi is provisionally prosperous, but Metal Qi still lingers. Metal generates Water; even if the Chi pulse appears, Water benefits from the protection of its mother (Metal), so Water does not fear Earth. Ji Dong (late Winter) is also a month where Earth Qi is provisionally prosperous, but Water is at its peak. What is strong does not accept pathogenic factors; even if the Chi pulse appears, there is nothing to fear. Only Ji Xia is the time when Earth Qi is truly prosperous, called Chang Xia (Long Summer), meaning it grows under Fire. Moreover, Fire is the mother of Earth, and what Earth fears is Water. Now, Fire resides behind Earth (Fire generates Earth), so Fire leverages the momentum of its child (Earth) to reverse-attack Water. Fire consumes Water and consolidates Earth. Now combined with Earth, Water will inevitably dry up. Hence it is said, "Encountering Ji Xia leads to non-recovery."
According to the classics: "Chi and Se (Choppy) pulses indicate obstruction and nodules in the middle jiao." It also says: "Chi and Hua (Slippery) pulses indicate distension." It also says: "Chi and Huan (Moderate) pulses indicate Cold." Zhang Zhongjing stated: "If the Yangming pulse is Chi, without aversion to cold, and with spontaneous sweating of the body, Da Cheng Qi Tang (Major Order the Qi Decoction) should be used." Additionally, Li Dongyuan (Jiegu) stated: "Chi pulse is Yin; Ji Xia is Yang. This syndrome represents a deviation from seasonal norms, characterized by Yin excess and Yang deficiency. Treatment should involve draining the Heart and Lung, and tonifying the Liver and Kidney. To drain the Heart, use Dao Chi San (Guide Out Red Powder); to tonify the Kidney, use Di Huang Wan (Rehmannia Pill)."