(一首集次王适斋等脉诀)
人身元气由太极动静阴阳一如式。阴血静兮阳气动。血逐气行无暂息。周流身体似循环
。荣
养百骸由此力。五行五脏布其中。妙合乾坤纤芥悉。上中下体号三焦。在诊排名寸关尺。寸
为阳分尺为阴。关者阴阳界限位。天真始注手太阴。百脉周流所朝会。右为气口左人迎。腑
脏脉宗荣见尔。脉行三寸呼吸中。呼吸定息行六寸。十二时周数几何。一万三千五百息。气
行八百一十丈。脉循五十度周身。复还会于手太阴。此是平人形之道。度合阴阳昼夜停。不
大不小脉曰平。呼吸来停至脉匀。数迟数至违呼吸。损曰离经与夺精。一息四至号平和。更
加一至大无 。三迟二败冷所谓。六数七极热之多。八脱九死十命尽。十一十二魂入墓。三
至为迟一二败。两息一至死非怪。迟寒数热古今传。难经越度分明载。
意见九难。
寸关尺内十二经。脏腑阴阳合五行。唯有君火更相火。母子相通真气生。
意见十八难。
失正邪干乃相克。各有刚柔位相逢。
意见十难。
阴阳变病脉危殆。关格覆溢与相乘。
意见三难。后有图。
太过不及分轻重。诊后先须部分定。左心小肠肝胆肾。右肺大肠脾胃命。即心主包络也
。
女人反此背看之。尺脉第三同断病。
言男子面南受气。则两寸居前亦阳。脉之三阳从上走下。女人面北受气。则两尺居前亦
阴。
脉从下走上。经所谓男子阳生。脉在关上。寸脉常盛女阴生。脉在关下。尺脉常盛。是其常也。
心与小肠居左寸。肝胆同归左关并。肾居尺脉合膀胱。用意调和审安静。肺与大肠居右
寸。
脾胃脉从关里认。三焦心包络脉同。尺中仔细须寻趁。若诊他脉覆手取。要自看时仰手认。
三部须教指下明。九候了然心里印。上部头。候听会。迎香。人迎之动脉也。以察头面之疾
。中部手。候合谷。神门。经渠之动脉也。以察头下至脐上之疾。下部足。候太溪。冲阳。
太冲之动脉也。以察脐下至足之疾。
大肠共肺为传送。心与小肠为受盛。脾胃相通五谷消。膀胱肾合为津庆。三焦无状空有
名。
寄在胸中膈相应。肝胆同为津液府。能通眼目为清净。智者能调五脏和。自然察认诸家病。
掌后高骨号为关。骨下关脉形宛然。以次推排名尺泽。三部还须仔细看。关后为阴乃是尺。
关前为阳名寸口。阳弦头痛定无疑。阴弦腹痛何方走。阳数即吐兼头痛。阴微即泻脐中吼。
阳实应知面赤风。阴微盗汗劳兼有。阳实大滑应舌强。阴数脾热并口臭。阳微浮弱定心寒。
阴滑食注脾家咎。关前关后辨阴阳。察病根源应不朽。
经云。谨熟阴阳。无与众谋。此之谓也。
病脉传见举要中。脉经素难尤宜究。
见后方脉举要。
春弦夏洪秋似毛。冬石根据经分节气。阿阿缓若春杨柳。此是脾家居四季。浮芤滑实弦紧
洪
。七表还应是本宗。微沉缓涩迟并伏。濡弱相兼八里同。九道脉名长短是。虚促结代劳动细
。在意专心察脉理。二十四种真玄微。互须脉证参虚实。勿失于邪病脉机。
\r脉所当然之图\ps16a1.bmp\r
凡在左者皆克诸右。凡在右者皆受左克。此脏腑五行自相克制。脉所当然也。至如太过不及
。当视本位及邪干自异尔。
\r五行子母相生之图\ps16a2.bmp\r
两手交义。则六脉五行。子母毒相生养。本心包络与三焦二脉。皆系右尺。今脉诀以两肾分两尺。则遗失心
心包络一经矣。
右手太阴阳明金。生左尺足太阳少阴水。太阳少阴水。生左关足厥阴少阳木。生左关足厥阴少阳木。厥阴少阳木。
生左寸手太阳少阴火。太阳少阴火。通右尺手心主少阴火。通右尺手心主少阳火。手心主少阳火。生右关足
太阴阳明土。足太阴阳明土。复生右寸手太阴阳明金。此皆五行子母更相生养者也。
（一首汇集王适斋等脉诀）
人体的元气源自太极的动静与阴阳，如同一个法则。阴血主静，阳气主动。血液随着气运行，片刻不停息。在身体中循环流动，依靠这种力量来滋养全身的骨骼。五行和五脏分布在其中，精妙地契合天地，细微之处无不周全。上、中、下三部分称为三焦。在诊脉时排列出寸、关、尺三个部位。寸部属于阳分，尺部属于阴分，关部则是阴阳界限的位置。天真之气开始灌注于手太阴肺经，全身经脉在此汇聚。右手为气口，左手为人迎，脏腑的脉象根源都体现在这里。脉搏在三寸之间随呼吸运行，一呼一吸定息间脉行六寸。十二个时辰周流一圈是多少次数呢？是一万三千五百次呼吸。气运行八百一十丈，脉循行五十度周身，最后又回到手太阴肺经。这是健康人的生理之道，度数符合阴阳，昼夜平衡。不大不小、脉搏均匀的称为平脉（正常脉象）。如果呼吸与脉搏节律失调，导致亏损，称为离经（偏离常道），会耗夺精气。一息四至称为平和，再多一至则盛大无虚。一息三至为迟脉，二至为败脉，所谓寒冷所致。一息六至为数脉，七至为极脉，多为热证。八至为脱脉，九至为死脉，十至则生命终结。十一至、十二至则魂魄入墓。一息三至为迟脉，一二至为败脉。两息一至，死亡并不奇怪。迟脉主寒，数脉主热，这是古今相传的经验，《难经》越度篇有明确记载。
参考《难经》第九难：
寸、关、尺内部对应十二经脉，脏腑阴阳合于五行。唯有君火和相火，母子相通，真气由此产生。
参考《难经》第十八难：
正气失守，邪气干扰，乃相互克制。各有刚柔之位相逢。
参考《难经》第十难：
阴阳变化致病，脉象危殆。出现关格、覆溢及相乘等脉象。
参考《难经》第三难：后有图。
太过与不及分为轻重。诊脉后必须先确定部位。左手的寸关尺分别对应心、小肠、肝、胆、肾。右手的寸关尺分别对应肺、大肠、脾、胃、命门（即心包络）。
女性与此相反，需反向观察。尺脉的第三个位置同样用于断病。
说男子面南受气，则两寸居前亦属阳。脉的三阳经从上往下走。女子面北受气，则两尺居前亦属阴。
脉从下往上走。经典所谓男子阳生，脉在关上。寸脉常盛；女子阴生，脉在关下，尺脉常盛。这是常态。
心与小肠位于左寸。肝胆同归于左关。肾位于尺脉，合膀胱。用心调和，审视安静。肺与大肠位于右寸。脾胃脉从关部识别。三焦和心包络脉相同，在尺部仔细寻找。如果诊察其他脉象，需反手取脉。要看自身脉象时，需仰手辨认。三部必须让指下清晰，九候了然于心。上部头部，候听会、迎香、人迎的动脉，以察头面部的疾病。中部手部，候合谷、神门、经渠的动脉，以察头部以下至脐上的疾病。下部足部，候太溪、冲阳、太冲的动脉，以察脐下至足部的疾病。
大肠与肺共同负责传导。心与小肠负责受纳和盛放。脾胃相通，消化五谷。膀胱与肾结合，生成津液精华。三焦无形状，空有其名。寄存在胸中，与膈相应。肝胆同为津液之府，能通达眼目，保持清净。智者能调理五脏和谐，自然能察认各种疾病。
手腕后方的高骨称为关。骨下的关脉形态宛然。依次推排命名尺泽。三部还需要仔细看。关后为阴，即是尺部。关前为阳，名为寸口。阳脉弦紧，头痛无疑。阴脉弦紧，腹痛去向何方。阳脉数，即呕吐兼头痛。阴脉微，即腹泻，脐中作响。阳脉实，应知面赤风热。阴脉微，盗汗劳损兼有。阳脉实大滑，应舌强。阴脉数，脾热并口臭。阳脉微浮弱，定是心寒。阴脉滑，食积注于脾家之过。关前关后辨别阴阳，察病根源应不朽。
经典说：谨慎熟悉阴阳，不要与众人商议。说的就是这个道理。
病脉传变见要在中，《脉经》、《素问》、《难经》尤其应当深究。
见后方脉举要。
春季脉弦，夏季脉洪，秋季脉似毛，冬季脉石，根据经典区分节气。柔和缓慢如春柳，这是脾家居于四季之末。浮、芤、滑、实、弦、紧、洪。这七种表脉还应是本宗。微、沉、缓、涩、迟、伏。濡、弱相兼，这八种里脉相同。九道脉名长短是。虚、促、结、代、动、劳、细。在意专心察脉理。二十四种真玄微。互须脉证参虚实。勿失于邪病脉机。
\r脉所当然之图\ps16a1.bmp\r
凡在左侧的皆克制右侧的。凡在右侧的皆受左侧克制。这是脏腑五行自相克制，是脉象理所当然的规律。至于太过与不及，应当视本位及邪气干扰而有所不同。
\r五行子母相生之图\ps16a2.bmp\r
两手交叉义理，则六脉五行，子母毒相生养。本心包络与三焦二脉，都系于右尺。现在的脉诀将两肾分为两尺，则遗失了心包络这一经。
右手太阴、阳明金，生左尺足太阳、少阴水。太阳、少阴水，生左关足厥阴、少阳木。厥阴、少阳木，生左寸手太阳、少阴火。太阳、少阴火，通右尺手心主、少阴火，通右尺手心主、少阳火。手心主、少阳火，生右关足太阴、阳明土。足太阴、阳明土，复生右寸手太阴、阳明金。这都是五行子母更相生养的规律。
(An excerpt compiling pulse formulas from Wang Shizhai and others)
The vital energy (Yuan Qi, 元气) of the human body originates from the dynamic and static aspects of Taiji and Yin-Yang, following a specific pattern. Yin-blood is static, while Yang-Qi is active. Blood follows Qi in its movement, never ceasing for a moment. It circulates throughout the body, relying on this force to nourish all bones and tissues. The Five Elements (Wu Xing, 五行) and Zang-Fu organs are distributed within, exquisitely aligning with Heaven and Earth, attending to even the finest details. The upper, middle, and lower sections are referred to as the San Jiao (Triple Burner, 三焦). In pulse diagnosis, the Cun (Inch, 寸), Guan (Bar, 关), and Chi (Cubit, 尺) positions are arranged. The Cun position belongs to the Yang aspect, the Chi position to the Yin aspect, and the Guan position serves as the boundary between Yin and Yang. Primordial Qi initially enters the Hand-Taiyin Lung Meridian (Shou Taiyin Fei Jing, 手太阴肺经), where all meridians converge. The right wrist represents the Qi Kou (Qi Gate, 气口), and the left represents the Ren Ying (Human Welcoming, 人迎); the root of Zang-Fu pulses manifests here. The pulse travels three cun during respiration; at the end of one exhalation and inhalation, it travels six cun. How many cycles occur in twelve double-hours? It is thirteen thousand five hundred breaths. Qi travels eight hundred and ten zhang, and the pulse circulates fifty times around the body before returning to the Hand-Taiyin Lung Meridian. This is the physiological path of a healthy person, conforming to Yin-Yang balance and day-night rhythms. A pulse that is neither too large nor too small, and is uniform with respiration, is called a Ping Mai (Normal Pulse, 平脉). If respiration and pulse rhythm deviate, causing deficiency, it is termed Li Jing (Departing from the Canon, 离经), which depletes essence and spirit. Four beats per breath indicate harmony; adding one more beat indicates excess. Three beats per breath is a Chi Mai (Slow Pulse, 迟脉), two beats is a Bai Mai (Declining Pulse, 败脉), indicating cold. Six beats per breath is a Shu Mai (Rapid Pulse, 数脉), seven beats is a Ji Mai (Extreme Pulse, 极脉), often indicating heat. Eight beats is Tuo Mai (Escaping Pulse, 脱脉), nine beats is Si Mai (Death Pulse, 死脉), and ten beats signifies the end of life. Eleven or twelve beats imply the soul entering the tomb. Three beats per breath is slow; one or two beats is declining. One beat per two breaths indicates death is not surprising. Slow pulses indicate cold, rapid pulses indicate heat; this has been transmitted since ancient times and is clearly recorded in the *Nan Jing* (Classic of Difficult Issues, 《难经》) chapter on "Exceeding Limits".
Referencing Chapter 9 of the *Nan Jing*:
Within the Cun, Guan, and Chi positions lie the twelve meridians, with Zang-Fu organs and Yin-Yang combining with the Five Elements. Only the Ministerial Fire (Xiang Huo, 相火) and Sovereign Fire (Jun Huo, 君火) interact through mother-son relationships, generating true Qi.
Referencing Chapter 18 of the *Nan Jing*:
When upright Qi is lost and evil Qi interferes, mutual restriction occurs. Each has its position of rigidity and flexibility meeting.
Referencing Chapter 10 of the *Nan Jing*:
Yin-Yang transformations cause disease, and pulses become critical. Guan Ge (Obstruction and Repletion, 关格), Fu Yi (Reversal and Overflow, 覆溢), and Xiang Cheng (Mutual Overacting, 相乘) appear.
Referencing Chapter 3 of the *Nan Jing*: Followed by diagrams.
Excess and deficiency are distinguished by severity. After diagnosis, one must first determine the location. On the left: Heart, Small Intestine, Liver, Gallbladder, Kidney. On the right: Lung, Large Intestine, Spleen, Stomach, Ming Men (Gate of Life, 命门), which is also the Pericardium (Xin Bao Luo, 心包络).
For women, this is reversed, observed from the back. The third position of the Chi pulse is also used for diagnosis.
It is said that men receive Qi facing south, so both Cun positions are anterior and Yang. The three Yang meridians of the pulse travel from top to bottom. Women receive Qi facing north, so both Chi positions are anterior and Yin.
The pulse travels from bottom to top. As the classics state, men generate Yang, with the pulse located above the Guan. The Cun pulse is often strong; women generate Yin, with the pulse located below the Guan, and the Chi pulse is often strong. This is the normal state.
The Heart and Small Intestine reside in the Left Cun. The Liver and Gallbladder return to the Left Guan. The Kidney resides in the Chi pulse, harmonizing with the Bladder. Use intention to harmonize, examine calmly. The Lung and Large Intestine reside in the Right Cun. The Spleen and Stomach pulses are recognized from the Guan area. The San Jiao and Pericardium pulses are the same, carefully sought in the Chi region. If diagnosing other pulses, take them with the hand turned over. To view one's own pulse, recognize it with the palm up. The three regions must be clear under the fingers; the nine inspections must be imprinted in the heart. Upper region head: inspect the arteries at Ting Hui (Auditory Convergence, 听会), Ying Xiang (Welcome Fragrance, 迎香), and Ren Ying to observe diseases of the head and face. Middle region hand: inspect the arteries at He Gu (Union Valley, 合谷), Shen Men (Spirit Gate, 神门), and Jing Qu (Channel Spring, 经渠) to observe diseases from the head down to above the umbilicus. Lower region foot: inspect the arteries at Tai Xi (Great Stream, 太溪), Chong Yang (Surging Yang, 冲阳), and Tai Chong (Great Surge, 太冲) to observe diseases from below the umbilicus to the feet.
The Large Intestine and Lung together handle transmission. The Heart and Small Intestine handle reception and storage. The Spleen and Stomach connect to digest the five grains. The Bladder and Kidneys combine to produce fluids and essence. The San Jiao has no form but exists in name. It resides in the chest, corresponding to the diaphragm. The Liver and Gallbladder are both reservoirs of fluids, capable of connecting to the eyes and maintaining clarity. Those who are wise can harmonize the five Zang organs, naturally allowing them to identify various diseases.
The high bone behind the palm is called Guan. Below the bone, the Guan pulse shape is distinct. Push sequentially to name Chi Ze. The three regions require careful examination. Behind the Guan is Yin, which is the Chi. In front of the Guan is Yang, named Cun Kou. Yang Xian (String-like) pulse definitely indicates headache. Yin Xian pulse indicates abdominal pain. Yang Shu (Rapid) pulse implies vomiting and headache. Yin Wei (Weak) pulse implies diarrhea and roaring in the umbilicus. Yang Shi (Excess) pulse should indicate red face and wind. Yin Wei pulse implies night sweats and consumption. Yang Shi, Da (Large), Hua (Slippery) pulse should indicate stiff tongue. Yin Shu pulse implies spleen heat and bad breath. Yang Wei, Fu (Floating), Ruo (Weak) pulse definitely indicates heart cold. Yin Hua pulse implies food stagnation affecting the spleen. Distinguishing Yin and Yang between front and back of the Guan allows one to observe the root of disease without failure.
The classics say: Carefully master Yin and Yang, do not consult with the masses. This is what is meant.
Regarding the essentials of disease pulse transmission, the *Mai Jing* (Pulse Classic, 《脉经》), *Su Wen* (Basic Questions, 《素问》), and *Nan Jing* should be thoroughly studied.
See the pulse essentials after the diagram.
Spring pulses are Xian (String-like, 弦), Summer are Hong (Surging, 洪), Autumn resemble Mao (Feather, 毛), Winter are Shi (Stone, 石), based on classic seasonal divisions. Soft, slow, like spring willows; this is the Spleen dwelling in the four seasons. Floating (Fu, 浮), Kou (Hollow, 芤), Slippery (Hua, 滑), Solid (Shi, 实), String-like (Xian, 弦), Tight (Jin, 紧), Surging (Hong, 洪). These seven exterior pulses should belong to their original category. Micro (Wei, 微), Deep (Chen, 沉), Slow (Huan, 缓), Choppy (Se, 涩), Slow (Chi, 迟), Hidden (Fu, 伏). Moist (Ru, 濡) and Weak (Ruo, 弱) combined constitute the eight interior pulses. Nine types of pulse names relate to length. Empty (Xu, 虚), Urgent (Cu, 促), Knotted (Jie, 结), Intermitting (Dai, 代), Agitated (Dong, 动), Laborious (Lao, 劳), Fine (Xi, 细). Focus attentively on pulse principles. Twenty-four types are truly profound. Mutual pulse and symptom analysis must distinguish deficiency and excess. Do not miss the mechanism of evil disease pulses.
\rDiagram of Inevitable Pulses\ps16a1.bmp\r
Whatever is on the left restricts whatever is on the right. Whatever is on the right is restricted by the left. This is the mutual restriction of Zang-Fu Five Elements, which is the inevitable nature of pulses. Regarding excess and deficiency, one should look at the primary position and whether evil Qi interferes, which will differ.
\rDiagram of Mother-Son Generation of Five Elements\ps16a2.bmp\r
Crossing hands implies that the six pulses and Five Elements follow mother-son generation. The Pericardium and San Jiao meridians both relate to the Right Chi. Current pulse formulas divide the two kidneys into the two Chi positions, thereby omitting the Pericardium meridian.
Right Hand Taiyin and Yangming Metal generates Left Chi Foot Taiyang and Shaoyin Water. Taiyang and Shaoyin Water generates Left Guan Foot Jueyin and Shaoyang Wood. Jueyin and Shaoyang Wood generates Left Cun Hand Taiyang and Shaoyin Fire. Taiyang and Shaoyin Fire connects to Right Chi Heart Master and Shaoyin Fire, connecting to Right Chi Heart Master and Shaoyang Fire. Heart Master and Shaoyang Fire generates Right Guan Foot Taiyin and Yangming Earth. Foot Taiyin and Yangming Earth regenerates Right Cun Hand Taiyin and Yangming Metal. These are all the laws of Five Elements mother-son mutual generation.