浮大而散心之平。弦而长肝之平。按至骨举指来疾而实者肾之平也。肺平浮而涩,脾胃平缓
而满指。凡诊脉,下指本部,不平便可寻详病情矣。(《医通》)
《难经》云∶脉有伏匿,然谓阴阳更相乘更相伏也。脉居阴部而反阳脉见者,为阳乘阴也。
脉虽时沉涩而短,此为阳中伏阴也。脉居阳部而反阴脉见者,为阴乘阳也,脉虽时浮滑而长,此
谓阴中伏阳。
《难经》云∶颠狂之脉,三部阴阳俱盛是也。又云∶重阳者狂,重阴者颠。脱阳者见鬼,脱
阴者目盲。(重阴重阳是寸愈盛而尺愈盛,脱阴脱阳是寸至微而尺至微。)
两手脉浮之俱有阳,沉之俱有阴,阴阳皆实盛者,此为冲督之脉也。冲督之脉者,十二经之道
路也。冲督用事,则十二经不复朝于寸口,其人皆若恍惚、狐疑不省,必当犹豫而两心也。
两手阳脉浮而细微绵绵不可知,俱有阴脉亦复细绵绵,此为阴跷阳跷之脉也。此人曾有病鬼
魅风死,若恍惚亡人为祸也。
尺寸脉俱浮,直上直下,此为督脉,腰背强直不得俯仰,大人颠病,小儿风痫疾。尺寸脉俱
牢,直上直下,此为冲脉,胸中有病寒疝也。二十九难曰∶奇经为病何如而然?阳维维于阳,阴
维维于阴,阴阳不能自相维则怅然失志,溶溶不能自收持。阴跷为病,阳缓而阴急;阳跷为病,
阴缓而阳急。冲之为病,逆气而里急。督脉为病,脊强而厥。任之为病,其内苦结,男子为七疝,
女子为瘕聚。带之为病,腹满腰溶溶若坐水中。阳维为病苦寒热,阴维为病苦心痛。此奇经八脉
之为病也。
心脏正常的脉象是浮大而散。肝脏正常的脉象是弦而长。按压至骨,抬起手指时脉搏来势疾速且充实的,是肾脏正常的脉象。肺脏正常的脉象是浮而涩,脾和胃正常的脉象是平缓且充盈指下。凡是诊察脉象,先按本经所属部位的脉,如果不平(正常),就可以详细推求病情了。(出自《医宗必读》)
《难经》说:脉象有潜伏隐匿的情况,这是指阴阳相互乘袭、相互潜伏。脉象位于阴部(尺部),却出现阳脉(如浮、大、数等),这是阳邪乘袭阴分。脉象虽然有时表现为沉涩而短,这属于阳中潜伏阴邪。脉象位于阳部(寸部),却出现阴脉(如沉、细、迟等),这是阴邪乘袭阳分,脉象虽然有时表现为浮滑而长,这属于阴中潜伏阳邪。
《难经》说:癫狂病的脉象,是寸关尺三部阴阳脉气都旺盛。又说:阳气重盛则发为狂病,阴气重盛则发为癫病。阳气脱失者会看见鬼怪,阴气脱失者会双目失明。(注:重阴重阳是指寸脉特别盛而尺脉特别盛;脱阴脱阳是指寸脉极微弱而尺脉极微弱。)
两手脉象轻取都有阳脉,重按都有阴脉,阴阳脉气都实盛的,这是冲脉和督脉的脉象。冲脉和督脉,是十二经脉运行的道路。当冲脉和督脉主事时,十二经脉就不再汇聚于寸口,这样的人往往神情恍惚、狐疑不定、神志不清,必定处于犹豫不决、内心矛盾的状态。两手阳脉(轻取)浮取细微连绵不断难以感知,阴脉(重按)也细微连绵,这是阴跷脉和阳跷脉的脉象。这种人曾经患过被鬼魅风邪所致的重病,或者出现类似被鬼魂作祟导致的恍惚症状。
寸部和尺部的脉象都浮,直上直下,这是督脉的病脉,表现为腰背强直,不能俯仰,成人患癫病,小儿患风痫疾。寸部和尺部的脉象都牢(沉实有力),直上直下,这是冲脉的病脉,表现为胸中有寒邪引起的疝气病。第二十九难说:奇经八脉生病是怎样的呢?阳维脉维系一身之阳,阴维脉维系一身之阴,如果阴阳不能互相维系,就会怅然若失、意志消沉,身体软弱无力,不能自我控制。阴跷脉生病,表现为外侧弛缓而内侧拘急;阳跷脉生病,表现为内侧弛缓而外侧拘急。冲脉生病,表现为气逆和腹部拘急。督脉生病,表现为脊柱强直和厥逆。任脉生病,表现为体内苦闷结滞,男子患七疝,女子患瘕聚(腹内结块)。带脉生病,表现为腹部胀满,腰部松软无力,如同坐在水中一样。阳维脉生病,苦于寒热往来;阴维脉生病,苦于心痛。这就是奇经八脉生病的情况。
The normal pulse of the Heart is floating, large, and scattered. The normal pulse of the Liver is wiry and long. Pressing to the bone, when the finger is lifted and the pulse comes rapidly and is solid, this is the normal pulse of the Kidney. The normal pulse of the Lung is floating and choppy; the normal pulses of the Spleen and Stomach are moderate and full under the fingers. In all cases of pulse diagnosis, pressing on the local section allows one to seek out and detail the condition if it is not normal (Ping). (From *Yi Zong Bi Du*)
The *Nan Jing* states: There are pulses that are hidden or latent, referring to Yin and Yang mutually attacking and mutually hiding. When a pulse is located in the Yin position (Chi/Cun) but reveals Yang characteristics (such as floating, large, rapid), it is Yang invading Yin. Although the pulse may sometimes appear deep, choppy, and short, this indicates Yin hidden within Yang. When a pulse is located in the Yang position (Cun/Guan) but reveals Yin characteristics (such as deep, fine, slow), it is Yin invading Yang. Although the pulse may sometimes appear floating, slippery, and long, this indicates Yang hidden within Yin.
The *Nan Jing* states: The pulse of Dian-Kuang disorders involves excessive strength in both Yin and Yang across the three positions (Cun, Guan, Chi). It further states: Excess Yang leads to Kuang (mania); excess Yin leads to Dian (depression/lethargy). Loss of Yang results in seeing ghosts; loss of Yin results in blindness. (Note: "Excess Yin/Yang" refers to the Cun pulse being excessively strong while the Chi pulse is also excessively strong; "Loss of Yin/Yang" refers to both the Cun and Chi pulses being extremely weak.)
If the pulses in both hands show Yang upon superficial palpation and Yin upon deep palpation, with both Yin and Yang being robust and strong, this is the pulse of the Chong Mai (Penetrating Vessel) and Du Mai (Governing Vessel). The Chong and Du Mai serve as the pathways for the twelve regular meridians. When the Chong and Du Mai are dominant, the twelve meridians no longer converge at the Cun Kou (Radial Artery). Such individuals often exhibit trance-like states, suspicion, lack of awareness, and indecision, experiencing internal conflict. If the Yang pulses (superficial) in both hands are floating, fine, continuous, and difficult to perceive, and the Yin pulses (deep) are also fine and continuous, this is the pulse of the Yin Qiao Mai (Yin Heel Vessel) and Yang Qiao Mai (Yang Heel Vessel). This person may have previously suffered from severe illnesses attributed to demonic wind pathogens, or exhibit symptoms resembling possession or spiritual disturbance.
If pulses at both the Cun and Chi positions are floating, moving straight up and down, this is the pulse of the Du Mai (Governing Vessel), manifesting as stiffness and rigidity of the waist and back, inability to bend or extend, adult Dian disease, or pediatric Feng Xian (wind epilepsy). If pulses at both the Cun and Chi positions are firm (Lao), moving straight up and down, this is the pulse of the Chong Mai (Penetrating Vessel), manifesting as cold-type Hernia diseases in the chest. Chapter 29 asks: How do diseases of the Eight Extraordinary Vessels present? The Yang Wei Mai (Yang Linking Vessel) links Yang; the Yin Wei Mai (Yin Linking Vessel) links Yin. If Yin and Yang cannot link each other, there is a sense of loss and depression, with the body becoming flaccid and unable to control itself. Disease of the Yin Qiao Mai presents with relaxation of the Yang side and tension of the Yin side; disease of the Yang Qiao Mai presents with tension of the Yang side and relaxation of the Yin side. Disease of the Chong Mai presents with rebellious Qi and abdominal urgency. Disease of the Du Mai presents with spinal rigidity and Jue (cold extremities/fainting). Disease of the Ren Mai (Conception Vessel) presents with internal distress and knotting; in men, it manifests as Seven Hernias; in women, as Zha Ju (abdominal masses). Disease of the Dai Mai (Girdle Vessel) presents with abdominal fullness and a flaccid sensation in the waist, as if sitting in water. Disease of the Yang Wei Mai presents with aversion to cold and fever; disease of the Yin Wei Mai presents with heart pain. These are the diseases of the Eight Extraordinary Vessels.