体象 实脉有力,长大而坚;应指 ,三候皆然。
实为邪盛有余之象,既大而且兼长,既长大而且有力,既长大有力而且浮中沉三候皆然,则诸阳之
象,莫不毕备。
主病 血实脉实,火热壅结。左寸实者,舌强气壅,口疮咽痛。实在左关,肝火胁痛。左尺得实,
便秘腹疼。右寸实者,呕逆咽痛,喘嗽气壅。实在右关,伏阳蒸内,中满气滞。右尺得实,脐痛便
难,相火亢逆。
脉实必有大邪、大热、大积、大聚。故《脉经》云∶“血实脉实。”又曰∶“气来实强,是谓太过。”由是测之,皆主
实热。其所主病,大约与数脉相类,而实则过之,以其蕴蓄之深也。
按《素问·大奇论》曰∶“肝满、肾满、肺满皆实,即为肿。”如肝雍两 满,卧则惊,不得小便;肾雍 下至
少腹满,胫有大小,髀 大跛,易偏枯;肺之雍喘而两 满之类。皆实脉也。实主邪气有余,易于体象,所
以叔和有“尺实则小便难”之说。乃伪诀谬以尺实为“小便不禁”,何适相反。又妄谓“如绳应指来”,
则是紧脉之形,而非实脉之象矣。夫紧脉之与实脉,虽相类而实相悬。但紧脉弦急如切绳,而左右弹
人手;实脉则且大且长,三候皆有力也。紧脉者,热为寒束,故其象绷急而不宽舒;实脉者,邪为火迫,故
其象坚满而不和柔。以证合之,以理察之,便昭昭于心目之间。又按张洁古惑于伪诀实主虚寒之说,
而遂以姜附施治,此甚不可为训。或实脉而兼紧者,庶乎相当;苟非紧象,而大温之剂施于大热之人,
其不立毙者几希!以洁古之智,当必是兼紧之治法无疑耳。夫阴阳对偶,不可稍偏。阳气过旺,不戢有
自焚之虞。今世宗丹溪者,以为阳常有余,喜用寒凉,乃致杀人如麻,恬不之怪。又有有激之论,为刘朱
之言不息,则轩岐之泽不彰,三吴两浙,翕然成风,以姜附为茶饭,其流毒更不可言。执一舍一,祸害相
寻,可胜叹哉!
[Body Manifestation] The morphological characteristics of the Shi (Full) pulse are forceful, wide and long, and firm; this state is present under all three degrees of pressure: floating (Fu), middle (Zhong), and deep (Chen).
The Shi pulse is a manifestation of excess pathogenic factors and sufficient healthy qi. It is both wide and long, both large and forceful, and consistent across the floating, middle, and deep levels. Therefore, it embodies all the characteristics of Yang pulses.
[Indications for Disease] A Full pulse in the blood level indicates excess, typically caused by the congestion and knotting of Fire-Heat. A Full pulse at the Left Cun position indicates stiffness of the tongue, Qi stagnation, mouth ulcers, and sore throat. A Full pulse at the Left Guan position indicates hypochondriac pain due to Liver Fire. A Full pulse at the Left Chi position indicates constipation and abdominal pain. A Full pulse at the Right Cun position indicates vomiting and regurgitation, sore throat, wheezing and coughing, and Qi stagnation. A Full pulse at the Right Guan position indicates latent Fire steaming internally, leading to chest and epigastric fullness and Qi stagnation. A Full pulse at the Right Chi position indicates umbilical pain, difficulty in defecation, and hyperactivity of Ministerial Fire ascending.
A Full pulse must correspond to major pathogens, major heat, major accumulations, or major masses. Thus, the *Mai Jing* (Pulse Classic) states: "When blood is excess, the pulse is Full." It also says: "When the Qi comes strong and solid, this is called 'Excess' (Tai Guo)." From this, we can deduce that these conditions all indicate Excess-Heat syndromes. The diseases indicated are roughly similar to those of the Shu (Rapid) pulse, but the Full pulse is more severe because the pathogenic factors are deeply accumulated.
According to the *Su Wen · Da Qi Lun*: "If Gan (Liver), Shen (Kidney), and Fei (Lung) are full and manifest as Excess, swelling will occur." For example, if Gan Qi is congested, there is fullness in both hypochondria, fright during sleep, and inability to urinate; if Shen Qi is congested, there is fullness from below down to the lower abdomen, calves of unequal size, enlarged thighs with limping gait, and susceptibility to hemiplegia (Pian Gu); if Fei Qi is congested, there is wheezing and fullness in both hypochondria, etc. These are all manifestations of the Full pulse. The Full pulse indicates excess pathogenic factors and is easy to identify by its body manifestation. Therefore, Wang Shuhe stated, "Full pulse at the Chi position indicates difficulty in urination." However, the spurious *Mai Jue* erroneously interprets Full pulse at the Chi position as "incontinence of urine," which is completely opposite to reality. It also falsely claims the pulse feels "like a rope pressing against the finger"; this is the shape of the Jin (Taut) pulse, not the Shi (Full) pulse. Although the Jin and Shi pulses are similar, they are actually vastly different. The Jin pulse is wiry and urgent like a cut rope, rebounding left and right against the fingers; the Shi pulse is both large and long, with force at all three levels. The Jin pulse occurs when Heat is constrained by Cold, so its manifestation is tense and unrelaxed; the Shi pulse occurs when Pathogens are driven by Fire, so its manifestation is firm and full without softness. By correlating with symptoms and analyzing through theory, the distinction becomes clear in one's mind. Furthermore, Zhang Jiegu was confused by the spurious *Mai Jue*'s claim that "Full pulse indicates Deficiency-Cold," and consequently used Ginger (Sheng Jiang) and Prepared Aconite (Zhi Fu Zi) for treatment. This should not be set as a model. If the Full pulse is accompanied by a Taut quality, this approach might be appropriate; but if there is no Taut quality, applying strongly warming agents to a person with major Heat would likely result in immediate death! Given Zhang Jiegu's wisdom, he undoubtedly intended this treatment only for cases where the pulse was Full and Taut. Yin and Yang are opposites and cannot be biased. If Yang Qi is excessively vigorous and not restrained, there is a danger of self-immolation. Today, followers of Danxi believe that "Yang is often in excess" and favor cold-cooling herbs, resulting in countless deaths while remaining unconcerned. There are also radical arguments stating that if the theories of Liu (Wansu) and Zhu (Zhenheng) do not cease, the benevolence of Xuanyuan (Huangdi) and Qibo will not be manifested. In the regions of Sanwu and Liangzhe, this has become a widespread trend, with people treating Ginger and Aconite as common food. The toxic consequences are indescribable. Clinging to one aspect while abandoning another leads to continuous disasters; how can one not sigh at this?