微为虚,为弱,为衄,为呕,为泄,为亡汗,为拘急。微弱为少气,为中寒。
沉为在里,为实,为水,为寒,为喘,为 ,为瘕。沉弱为寒热,沉细为少气,臂
不能举,沉滑为风水、为下重,沉紧为上热下冷,沉重而直前绝者,为瘀血,沉重而中散,
为寒食成瘕,沉重不至寸,徘徊绝者为遁尸,沉紧为悬饮,沉迟为痼冷,沉重为伤暑发热。
缓为在下,为风,为寒,为弱,为痹,为疼,为不仁,为气不足,为眩晕。缓而滑为热
中,缓而迟为虚寒相搏,食冷则咽痛。
涩为少血,为亡汗,为气不足,为逆冷,为下痢,为心痛。涩而紧为痹,为寒湿。
迟为寒,为痛。迟而涩为 瘕咽酸。
伏为霍乱,为疝瘕,为水气,为溏泄,为停痰,为宿食,为诸气上冲,为恶脓贯肌。
濡为虚,为痹,为自汗,为气弱,为下重。濡而弱为内热外冷自汗,为小便难。
弱为虚,为风热,为自汗。
细为气血俱虚,为病在内,为积,为伤湿,为后泄,为寒,为神劳,为忧伤过度,为腹
满。细而紧为 瘕积聚,为刺痛。细而滑为僵仆,为发热,为呕吐。
数为热,为虚,为吐,为痛,为烦渴,为烦满。
动为痛,为惊,为挛,为泄,为恐。
虚为寒,为虚,为脚弱,为食不消化,为伤暑。
促,经并无文。
释曰∶其促有五∶一曰气,二曰血,三曰饮,四曰食,五曰痰。但脏热则脉数,以气血
痰饮留滞不行则止促,止促非恶脉也。
结为痰,为饮,为血,为积,为气。
释曰∶气寒脉缓则为结,数则为促,虽缓数不同,结亦当如促脉分别可也。
散,经无文。
释曰∶六腑气绝于外,则手足寒,上气;五脏气绝于内,则下利不禁,甚者不仁,其脉
皆散,散则不聚,病亦危矣。
革为满,为急,为虚寒相搏,妇人半产漏下。
释曰∶革者革也,固结不移之状。三部应之,皆危脉也。
代者,一脏绝,他脏代至。
释曰∶代,真死脉,不分三部,随应皆是。
如前所例,皆本圣经,学人当熟读,令心开眼明,识取体状,然后交络互织,所谓六经
流注,五脏相传,各以部位推寻,使了然不昧。其如随病分门,诸脉证状,尤当参对审详之
。如是精诚,方可为医者之万分;不尔则倚傍圣教,欺罔贤良,为含灵之巨贼,幸宜勉旃。
微脉主虚证,主弱证,主鼻出血(衄血),主呕吐,主泄泻,主大汗亡阳,主筋脉拘挛紧急。微脉与弱脉并见主少气无力,主中寒邪。
沉脉主病在里,主实证,主水饮,主寒证,主喘促,主癥瘕积聚(腹内结块)。沉脉兼弱主寒热往来,沉脉兼细主少气无力、手臂不能抬举,沉脉兼滑主风水病、主下身重坠感,沉脉兼紧主上热下冷,沉脉沉重且脉搏中断前绝者主瘀血,沉脉沉重且中间散乱者主寒食积滞成癥,沉脉沉重但不到寸口部位,徘徊断续者主遁尸(一种古代认为由鬼邪引起的突然死亡或昏厥病症),沉脉兼紧主悬饮(胸胁积水),沉脉兼迟主久冷之疾,沉脉沉重主伤暑发热。
缓脉主病位在下,主风邪,主寒邪,主弱证,主痹证,主疼痛,主麻木不仁,主气不足,主眩晕。缓脉兼滑主热邪在中焦,缓脉兼迟主虚寒相搏,进食生冷食物则咽喉疼痛。
涩脉主血少,主大汗亡津,主气不足,主四肢逆冷,主下痢,主心痛。涩脉兼紧主痹证,主寒湿。
伏脉主霍乱,主疝气及癥瘕,主水气病,主溏泄(大便稀薄),主停痰,主宿食,主各种气机上冲,主恶脓溃烂肌肤。
濡脉主虚证,主痹证,主自汗,主气弱,主下身重坠感。濡脉兼弱主内热外冷、自汗,主小便困难。
细脉主气血俱虚,主病在内,主积聚,主伤湿,主后泄(腹泻),主寒证,主神劳,主忧伤过度,主腹部胀满。细脉兼紧主癥瘕积聚,主刺痛。细脉兼滑主猝然跌倒僵仆,主发热,主呕吐。
促脉,经典原文无具体描述。
解释曰:促脉有五种成因:一是气滞,二是血瘀,三是饮停,四是食积,五是痰阻。只要脏腑有热则脉数,若因气血痰饮留滞不行导致脉搏时有中止,即为促脉,这种中止并非恶脉。
结脉主痰饮,主水饮,主瘀血,主积聚,主气滞。
解释曰:气寒则脉缓而成结脉,脉数则成促脉,虽然缓与数不同,但结脉也应当像促脉那样进行区分辨析。
散脉,经典原文无具体描述。
解释曰:六腑之气衰竭于体表,则手足寒冷,气逆向上;五脏之气衰竭于体内,则下利不止,严重的甚至感觉麻木不仁,其脉象皆表现为散脉,散脉意味着气血不聚,病情也已危重。
革脉主胀满,主急迫,主虚寒相搏,妇女半产(小产)漏下(非经期阴道出血)。
解释曰:革,即皮革之意,指脉象坚劲如按鼓皮,固结不移的状态。三部脉均见此象,均为危重脉象。
代脉,指一脏之气绝灭,他脏之气代为应至。
解释曰:代脉是真正的死脉,不分寸关尺三部,凡见到皆是死征。
如同前面的例子,都依据经典经文,学习者应当熟读,使心胸开阔、眼目明亮,识别脉象的体状特征,然后纵横交错、相互联系,所谓六经流注、五脏相传,各自以部位推寻,使之清晰明了。至于按照疾病分类,各种脉象与症状,尤其应当参照对照、审慎详查。如此精诚努力,才能成为医生的万分之一水平;否则就是依附圣教,欺骗贤良,成为危害众生的大贼,希望勉力为之。
The *Wei* (Fine/Weak) pulse indicates deficiency (*Xu*), weakness, epistaxis (*Nu*, nosebleed), vomiting, diarrhea, profuse sweating with loss of Yang energy, and muscle spasms/tightness. The combination of *Wei* and *Ruo* pulses indicates shortness of breath and cold invasion from within.
The *Chen* (Deep) pulse indicates disease located in the interior (*Li*), excess conditions (*Shi*), fluid retention (*Shui*), cold syndromes (*Han*), wheezing, abdominal masses (*Jia*). A *Chen* pulse combined with *Ruo* indicates alternating chills and fever; a *Chen* pulse combined with *Xi* (Thin) indicates shortness of breath and inability to raise the arm; a *Chen* pulse combined with *Hua* (Slippery) indicates wind-water edema and a sensation of heaviness in the lower body; a *Chen* pulse combined with *Jin* (Tight) indicates heat above and cold below; a heavy *Chen* pulse that abruptly stops before reaching the front indicates blood stasis (*Yu Xue*); a heavy *Chen* pulse that is scattered in the middle indicates cold food stagnation forming masses; a heavy *Chen* pulse that does not reach the Cun position and lingers intermittently indicates *Dun Shi* (a traditional term for sudden collapse or death attributed to pathogenic factors); a *Chen* pulse combined with *Jin* indicates suspended fluid accumulation (*Xuan Yin*); a *Chen* pulse combined with *Chi* (Slow) indicates chronic cold conditions; a heavy *Chen* pulse indicates heat due to summerheat injury.
The *Huan* (Moderate/Relaxed) pulse indicates disease in the lower part, wind pathogens, cold pathogens, weakness, bi-syndrome (painful obstruction), pain, numbness, Qi deficiency, and dizziness. A *Huan* pulse combined with *Hua* indicates heat in the middle jiao; a *Huan* pulse combined with *Chi* indicates a struggle between deficiency and cold, causing throat pain after eating cold foods.
The *Se* (Choppy) pulse indicates insufficient blood, loss of sweat/fluids, Qi deficiency, cold extremities, dysentery, and heart pain. A *Se* pulse combined with *Jin* indicates bi-syndrome and cold-dampness.
The *Chi* (Slow) pulse indicates cold and pain. A *Chi* pulse combined with *Se* indicates abdominal masses and acid regurgitation.
The *Fu* (Profound/Fixed) pulse indicates cholera-like disorder (*Huo Luan*), hernia and abdominal masses, water qi disorders, loose stools, retained phlegm, undigested food, upward rushing of various Qi types, and foul pus penetrating the skin.
The *Ru* (Floating/Soft) pulse indicates deficiency, bi-syndrome, spontaneous sweating, weak Qi, and heaviness in the lower body. A *Ru* pulse combined with *Ruo* indicates internal heat with external cold, spontaneous sweating, and difficulty urinating.
The *Ruo* (Weak) pulse indicates deficiency, wind-heat, and spontaneous sweating.
The *Xi* (Thin) pulse indicates simultaneous deficiency of Qi and Blood, disease in the interior, accumulations, dampness injury, posterior diarrhea, cold, mental fatigue, excessive sorrow, and abdominal fullness. A *Xi* pulse combined with *Jin* indicates abdominal masses and stabbing pain. A *Xi* pulse combined with *Hua* indicates sudden collapse/stiff fall, fever, and vomiting.
The *Shu* (Rapid) pulse indicates heat, deficiency, vomiting, pain, irritability with thirst, and irritability with fullness.
The *Dong* (Moving) pulse indicates pain, fright, spasms, diarrhea, and fear.
The *Xu* (Empty) pulse indicates cold, deficiency, weak legs, indigestion, and summerheat injury.
The *Cu* (Surging/Irregular) pulse: The classic text has no specific description.
Explanation: There are five causes for the *Cu* pulse: one is Qi stagnation, two is Blood stasis, three is Fluid retention, four is Food stagnation, five is Phlegm obstruction. If the Zang organs have heat, the pulse becomes rapid (*Shu*); if Qi, Blood, Phlegm, or Fluids are stagnant and fail to circulate, causing intermittent stops, it is called *Cu*. These stops do not necessarily indicate an ominous pulse.
The *Jie* (Knotted/Intermittent) pulse indicates phlegm, fluids, blood stasis, accumulations, and Qi stagnation.
Explanation: When Qi is cold, the pulse is slow and forms the *Jie* pulse; when rapid, it forms the *Cu* pulse. Although slow and rapid differ, the *Jie* pulse should also be differentiated in manner similar to the *Cu* pulse.
The *San* (Scattered) pulse: The classic text has no specific description.
Explanation: When the Qi of the Six Fu organs fails at the exterior, there is coldness in the hands and feet and rebellious Qi rising; when the Qi of the Five Zang organs fails at the interior, there is uncontrolled diarrhea, and in severe cases, numbness. In all these cases, the pulse appears *San* (scattered). A scattered pulse means the Qi and Blood do not gather, indicating a critical condition.
The *Ge* (Leather) pulse indicates fullness, urgency, a struggle between deficiency and cold, and in women, miscarriage or metrorrhagia (non-menstrual bleeding).
Explanation: *Ge* implies leather, referring to a pulse that feels firm and unyielding like pressing on a drumhead. If this pulse appears in all three positions (Cun, Guan, Chi), it is a critical pulse.
The *Dai* (Intermittent/Pulse with Regular Intervals) pulse: Indicates the failure of one Zang organ, with another Zang organ's Qi attempting to compensate.
Explanation: The *Dai* pulse is a true death pulse. Regardless of the three positions, its appearance signifies death.
As illustrated previously, all these principles are based on the sacred classics. Students must study them thoroughly to open their minds and clarify their vision, recognizing the characteristics of each pulse. Then, they must interweave these concepts, understanding the flow through the Six Channels (*Liu Jing*) and transmission among the Five Zang organs, searching by location to achieve clarity. Regarding the categorization of diseases and the correspondence of pulses and symptoms, careful comparison and detailed examination are essential. Only through such sincere diligence can one become a competent physician; otherwise, relying superficially on sacred teachings while deceiving others makes one a great thief harming sentient beings. One should strive diligently.