小儿一岁有病,则当切脉,但部位甚小,只以一指诊之,而寸、关、尺三部。胥在其中。切脉法分别详列于下。
一息者,人之一呼一吸也。至者,脉之至数也。一息六至,为和平之脉,则曰无病。
浮脉者,轻取皮肤之上,故曰浮。其病在表,主外感风寒。
沉脉者,重按筋骨之间,故曰沉。其病在里,主内伤饮食。
数脉七至或八至,主病在六腑,属阳也。
迟脉四至或五至,主病在五脏,属阴也。
滑脉如珠,往来流利,病主痰盛。
涩脉滞涩,往来艰难,病主血少。
芤脉者中取无力,病主失血。
微脉者,按之微细,若有若无,病主怯弱之证。
洪脉者,来时虽盛,去时无力,病主火热。
促脉者,数而时止,病主惊痫。
结脉者,缓而时止,病主积聚。
紧脉者,左右如转索之象,沉紧病主腹痛。浮紧病主感寒。
弦脉者,端直如张弓弦,病主停饮。
浮中沉三部无力,为虚,虚为不足。
浮中沉三部有力,为实,实为有余。
洪紧者,痘疹欲发也。
大小不匀者,中恶之证也。
一息三至,是虚寒之极。九至十至,乃火热太甚。若一息只一至二至,或十一至十二至者,皆不治之症。
浮散无根又沉,及浮取之不应指,皆难治之脉。
小儿诊脉,不过如此。凡病之阴、阳、表、里、虚、实。仍当合望闻问三者。参考而得病情矣。
小儿若在一岁时患病,就应当进行切脉诊察。但由于小儿寸口部位非常小,只需用一个手指来诊察,而寸、关、尺三部脉象都包含在这个范围内。切脉的具体方法分别详细列举如下:
“息”,是指人的一次呼气与一次吸气。“至”,是指脉搏跳动的次数。一呼一吸之间脉搏跳动六次,属于平和正常的脉象,表示没有疾病。
浮脉,是指在皮肤表面轻轻按压即可触及,所以称为“浮”。这种脉象主病在体表,通常由外感风寒引起。
沉脉,是指在筋骨之间用力重按才能触及,所以称为“沉”。这种脉象主病在体内,通常由内伤饮食引起。
数脉,指一呼一吸间脉搏跳动七次或八次,主病在六腑,属性为阳。
迟脉,指一呼一吸间脉搏跳动四次或五次,主病在五脏,属性为阴。
滑脉,脉象如珠子般圆润,往来流利,主痰湿盛行的病症。
涩脉,脉象滞涩不畅,往来艰难,主血虚不足的病症。
芤脉(Kou Mai, Hollow Pulse),指中等力度按压时感觉无力,中间空软,主失血病症。
微脉,指轻按重按都感觉脉象微弱细小,似有似无,主体质怯弱虚损的病症。
洪脉,指脉搏来时气势盛大,但去时却无力,主火热亢盛的病症。
促脉,指脉搏快速且偶尔间歇停顿,主惊风癫痫类病症。
结脉,指脉搏缓慢且偶尔间歇停顿,主体内积聚包块类病症。
紧脉,指脉象左右弹指,如同转动绳索的感觉;其中沉紧主腹痛,浮紧主感受寒邪。
弦脉,指脉象端直且长,如同拉开的弓弦,主停饮(水液停滞)病症。
如果在浮、中、沉三部取脉均感觉无力,即为虚脉,虚代表正气不足。
如果在浮、中、沉三部取脉均感觉有力,即为实脉,实代表邪气有余。
脉象洪大且紧,是痘疹即将发出的征兆。
脉象大小不均匀,是中恶(突受秽浊邪气侵袭)的证候。
一呼一吸间脉搏仅跳动三次,是极度虚寒的表现。九至十次,则是火热太过的表现。如果一呼一吸间仅跳动一至两次,或者达到十一至十二次,都属于难以治愈的危重症。
脉象浮散无根且兼见沉象,或者轻取脉搏不应指(感觉不到脉搏跳动),都属于难治的脉象。
If a child falls ill at one year of age, pulse diagnosis should be performed. However, due to the small size of the wrist area, only one finger is used for palpation, encompassing the Cun (Inch), Guan (Bar), and Chi (Cubit) positions. The specific methods for pulse diagnosis are detailed below.
"Xi" refers to one complete cycle of inhalation and exhalation. "Zhi" refers to the frequency of the pulse beats. Six beats per breath cycle indicate a harmonious and healthy pulse, signifying no disease.
The Floating Pulse (Fu Mai, Superficial Pulse) is felt lightly on the surface of the skin, hence named "Floating." It indicates pathology in the exterior (Biao, 表), primarily caused by external contraction of wind-cold.
The Deep Pulse (Chen Mai, Deep Pulse) is felt only with heavy pressure between the muscles and bones, hence named "Deep." It indicates pathology in the interior (Li, 里), primarily caused by internal injury from diet.
The Rapid Pulse (Shu Mai, Rapid Pulse) features seven or eight beats per breath cycle, indicating pathology in the Fu organs (Six Bowels), belonging to Yang.
The Slow Pulse (Chi Mai, Slow Pulse) features four or five beats per breath cycle, indicating pathology in the Zang organs (Five Viscera), belonging to Yin.
The Slippery Pulse (Hua Mai, Slippery Pulse) feels like rolling pearls, flowing smoothly back and forth, indicating an excess of phlegm-dampness.
The Choppy Pulse (Se Mai, Choppy Pulse) feels stagnant and difficult to flow, indicating blood deficiency.
The Kou Pulse (Kou Mai, Hollow Pulse) feels weak upon moderate pressure, being empty in the center, indicating blood loss.
The Micro Pulse (Wei Mai, Fine/Weak Pulse) feels extremely thin and faint upon palpation, appearing as if present or absent, indicating a condition of frailty and weakness.
The Surging Pulse (Hong Mai, Flood Pulse) arrives with great force but departs weakly, indicating excessive heat-fire.
The Hasty Pulse (Cu Mai, Hasty Pulse) is rapid with occasional irregular pauses, indicating fright-convulsion or epilepsy.
the Knotted Pulse (Jie Mai, Knotted Pulse) is slow with occasional irregular pauses, indicating accumulation masses.
The Tight Pulse (Jin Mai, Tight Pulse) feels like a twisting rope moving left and right; a deep-tight pulse indicates abdominal pain, while a floating-tight pulse indicates cold contraction.
The Wiry Pulse (Xian Mai, Wiry Pulse) is straight and long like a drawn bowstring, indicating fluid retention (stagnant fluids).
If the pulse feels weak in all three positions (floating, moderate, and deep), it is a Deficiency (Xu, 虚) pulse, representing insufficiency.
If the pulse feels strong in all three positions (floating, moderate, and deep), it is an Excess (Shi, 实) pulse, representing surplus pathogenic factors.
A pulse that is both surging and tight indicates the impending eruption of variola (smallpox/rash).
An irregular pulse with uneven magnitude indicates Zhong-E (sudden attack by foul turbid pathogens).
Three beats per breath cycle indicate extreme deficiency-cold. Nine to ten beats per cycle indicate excessive heat-fire. If there are only one or two beats per cycle, or eleven to twelve beats per cycle, these are considered untreatable critical conditions.
A pulse that is floating, scattered, rootless, and also deep, or one that does not respond to light pressure, are all difficult-to-treat pulses.
These are the basic methods for pediatric pulse diagnosis. For determining the Yin/Yang, Exterior/Interior, Deficiency/Excess nature of any disease, one must still integrate observation (Wang, 望), listening/smelling (Wen, 闻), and inquiry (Wen, 问) to comprehensively assess the condition.