暴病玄机在右关。右关神在岂伤残。更将脉症来参看。休把斯言作等闲。(各部虽脱。中宫
独存。尚可生也。)
久病根源在绛宫。绛宫流利势从容。若还肉脱难同例。九候虽调命亦凶。(久暴之病。存乎
寸关。不可不知。)
阳生识趣善形容。但在中和四季中。虚实若兼无损害。正存邪散色晴空。(大抵脉来和缓。
病虽重可治。以其有胃气也。大凡病能饮食。虚能受补。即有胃气。如无胃气。见食即畏。服补
即胀。食下即胀不治。)
火盛元虚脉急。有余不足交加。医能分别脉无差。正复缓来邪罢。(急脉之急。非急数之急
也。诊其势来勇去柔。已知邪胜于正。必得汗解而正复。若脉来急中无缓。有余之症。正宜疏泄。
若急去缓来。邪去正复方妙)。
清脉非邪气自伤。药宜温补是良方。病从内出无他故。诀有言传不可忘。(脉来轻清滑软而
无力。正气虚也。清中有神。病虽重必安。平人脉法。清轻则主富贵)。
脉浊邪干气有余。药宜疏泻莫踌躇。病因外入无他故。得诀回来好看书。(脉浊无神。乱也。
必死。如脉来紧涩。按之鼓击。知其邪气实也。如无外邪。即乏胃气与内有伏火。宜辨明之)。
往来流利名为滑。缓大相兼气必伤。莫作痰看根据古诀。当来阳分漫推详。(如身热而脉滑大无力。乃真气虚也。法
当验症施治。或兼呕恶腹痛。或兼食积痰火。俱宜调理脾胃为先。攻补兼行。不宜凉药。如滑而且数。痰火也。宜吐下
。不可汗。)
暴病(急性发病的疾病)的玄机在于右关脉。右关脉的神气是否完好无损?还需将脉象与症状相互参合考察,切勿将此言视为平常之事。(虽然各部脉象出现败象,但中焦脾胃之气独存,尚可求生。)
久病(慢性迁延的疾病)的根源在于绛宫(指心部或寸口脉中的特定部位,此处借指心或上焦)。绛宫处脉象流利、气势从容。如果肌肉消瘦脱失,则不能按常理推断。即使九候脉象调和,若见肉脱,预后也凶险。(无论是久病还是暴病,关键在于寸关脉的变化,不可不知晓。)
阳气生发需识得情趣并善于形容其状态,主要体现在中和之气的四季之中。虚实兼夹若无损害,正气尚存而邪气消散,面色如晴空般明朗。(大抵脉来和缓,病虽重也可治愈,因为还有胃气。大凡病人能进食,虚证能受补,即表示有胃气;如果没有胃气,见到食物就畏惧,服用补药就腹胀,食后即胀满者属不治之症。)
火盛导致元气虚弱,脉象急迫,这是有余(实)与不足(虚)交加的表现。医生若能仔细分辨脉象无误,正气恢复则脉象转缓,邪气自罢。(急脉之急,并非急数之快。诊察其势来势勇猛而去势柔和,已知邪气胜于正气,必须通过发汗解表使正气恢复。如果脉来急骤且无缓和之象,属于有余之症,正宜疏泄。如果是去势急而来势缓,则是邪去正复的好现象。)
清脉并非邪气自行损伤所致,用药宜用温补之法才是良方。病从内出没有别的原因,口诀中有言传,不可忘记。(脉来轻清滑软而无力,是正气虚的表现。清脉中若有神气,病虽重也必安。平人脉法中,脉象清轻则主富贵。)
脉浊是邪气干扰、气有余(实)的表现,用药宜疏泻,不要犹豫。病因从外入没有别的原因,得到口诀回来后可好好看书研读。(脉浊而无神气,是混乱之象,必死。如脉来紧涩,按之如鼓击,知其邪气实。如无外邪,即是缺乏胃气或内有伏火,应辨别清楚。)
往来流利称为滑脉,若与缓大相兼,说明气必受伤。不要将其当作痰证看待,依据古诀,应当详细推究阳分的情况。(如身体发热而脉滑大无力,乃真气虚也。治法应当验证症状施治,或兼有呕恶腹痛,或兼有食积痰火,都应以调理脾胃为先。攻补兼行,不宜使用凉药。如果滑而且数,是痰火,宜用吐下法,不可发汗。)
The mystery of sudden illness lies in the right Guan position. Is the Shen (Spirit) at the right Guan intact and unharmed? One must further examine the pulse in conjunction with symptoms, and not treat these words as trivial. (Although pulses in various positions may show signs of depletion, if the central palace [Spleen/Stomach] remains alone, survival is still possible.)
The root of chronic illness lies in the Jiang Gong (a term referring to the Heart or upper Jiao, often associated with the Cun position). The pulse at Jiang Gong should be fluent and its momentum leisurely. If flesh wasting occurs, it cannot be judged by usual standards. Even if the nine positions are harmonious, if muscle wasting is present, the prognosis is ominous. (For both chronic and sudden illnesses, the key lies in the Cun and Guan positions; this must be known.)
Yang generation requires understanding its nature and describing it well, primarily manifesting within the balanced harmony of the four seasons. If deficiency and excess coexist without damage, and upright Qi remains while pathogenic factors dissipate, the complexion will be clear like a bright sky. (Generally, if the pulse is harmonious and moderate, even severe illness can be treated because Stomach Qi exists. Generally, if a patient can eat, and deficiency patterns can tolerate tonification, it indicates the presence of Stomach Qi. Without Stomach Qi, one fears food, experiences bloating after taking tonics, and suffers immediate bloating after eating; such cases are untreatable.)
Excessive Fire leads to Yuan Qi deficiency, resulting in an urgent pulse, where excess and deficiency intermingle. If the physician can distinguish the pulse accurately, when upright Qi recovers, the pulse becomes slow/relaxed, and pathogens cease. (The "urgency" of an urgent pulse does not mean rapid frequency. Diagnosing its momentum: if it comes vigorously but leaves softly, it is known that pathogens exceed upright Qi; sweating is required to resolve the exterior and restore upright Qi. If the pulse comes urgently without any relaxation, it is an excess pattern, suitable for draining. If it leaves urgently but comes slowly, it indicates pathogens have departed and upright Qi has recovered, which is excellent.)
A clear pulse is not caused by self-injury from pathogens; the appropriate medication should be warm and tonifying, which is a good prescription. Illness arising from within has no other cause; the verbal instruction must not be forgotten. (The pulse comes light, clear, slippery, soft, and powerless, indicating deficiency of upright Qi. If there is Shen within the clarity, even severe illness will be safe. In normal pulse diagnosis, a light and clear pulse indicates wealth and nobility.)
A turbid pulse indicates pathogen interference and excess Qi; medication should be dispersing and purgative, do not hesitate. Illness entering from outside has no other cause; having received the instruction, return to study books carefully. (Turbid pulse without Shen indicates chaos and death. For example, if the pulse comes tight and choppy, and feels like drumming upon pressure, it indicates excess pathogenic Qi. If there is no external pathogen, it indicates lack of Stomach Qi or latent fire within; this must be distinguished clearly.)
Flowing freely back and forth is named Slippery pulse. If combined with slow and large qualities, Qi must be injured. Do not mistake it for Phlegm based on ancient instructions; one should elaborate in detail regarding the Yang aspect. (For instance, if body heat is present but the pulse is slippery, large, and powerless, it is deficiency of True Qi. Treatment should verify symptoms and apply therapy accordingly. If accompanied by vomiting, nausea, abdominal pain, or food stagnation and phlegm-fire, all should prioritize regulating Spleen and Stomach. Attack and tonify simultaneously; cool medicines should not be used. If slippery and rapid, it is Phlegm-fire, suitable for emesis and purgation; sweating is contraindicated.)