浮 主表症浮数之脉。应发热不发热。反恶寒。痈疽也。
洪 主血实积热。肿疡洪大。则疮势进脓未成。宜下。溃脓后洪大难治。若自利不可救
滑 主热。主虚。脓未溃者宜内消。脓溃后宜托里。所谓始为热。终为虚也。
数 主热。仲景曰。数脉不时见。生恶疮。又曰。肺脉俱数。则生疮。诸疮脉洪数。里
欲有脓结也。
散 肿溃后。烦满尚未全退。其脉洪滑粗散。难治。以正气虚。邪气实也。又曰。肢体
沉重。肺脉大则毙。谓浮散也。
芤 主血虚。脓溃后见之。易治。
牢 按之实大而弦。且沉且浮。而有坚实之意。瘰 结核得之。不可内消。
实 久病虚人。得此最忌。疮疽得此。宜急下之。以邪气与脏腑俱实故也。
弦 浮弦不时见。为饮为痛。主寒主虚。弦洪相搏。外紧内热。欲发疮疽。
紧 主痛疮肿。得之气血沉涩。
涩 主气涩血虚。脓溃后得之。无妨。
短 诸病脉短。难治疮肿脉短。真气短也。
细 主亡阳。阳气衰也。疮肿脉来细而沉。时直者里虚欲变症也。
微 主虚。真气复者生。邪气胜者危。疮肿溃后。脉微而匀。当自瘥。
迟 痼疾得之则善。新病得之主血气虚惫。疮肿溃后得之自痊。
缓 疮肿溃后。其脉涩迟缓者。皆易愈。
沉 水气得之则逆。疮肿得之邪气深。
虚 脉虚。血虚。血虚生寒。阳气不足也。疮肿得之。宜托里和气养血也。
疮肿得之。补虚排脓托里。
弱 主气血俱虚。形精不足。大抵疮家沉迟 弱。皆宜托里。
促 主热蓄于里。下之则和。疮肿脉促。亦急下之。
代 诸病见之不祥。疮肿脉促结难治。况代脉乎。
动 动于阳。阳虚发厥。动于阴。阴虚发热。
浮脉:主表证。若见浮数之脉,应当发热却不发热,反而恶寒,这是痈疽的表现。
洪脉:主血实积热。肿疡期脉象洪大,说明疮势进展,脓液尚未形成,适宜用下法。溃破排脓后若脉仍洪大,则难治;若出现自利(腹泻),则不可救药。
滑脉:主热,也主虚。脓未溃时宜采用内消法;脓已溃后宜采用托里法。这就是所谓“起初为热,最终转为虚”。
数脉:主热。张仲景说:“数脉不时出现,会生恶疮。”又说:“肺脉俱数,则会生疮。”各种疮疡脉象洪数,表明体内欲有脓液结聚。
散脉:肿疡溃破后,烦闷胀满尚未完全消退,其脉象洪滑且粗散,属难治之症,因为正气虚弱而邪气盛实。又说:“肢体沉重,肺脉大而浮散,预后不良,甚至死亡。”
芤脉:主血虚。脓溃后见到此脉,容易治疗。
牢脉:按之坚实、大而弦,似沉似浮,具有坚实之意。瘰疬结核患者若见此脉,不可使用内消法。
实脉:久病体虚之人得此脉最为忌讳。疮疽患者若见此脉,宜急用下法,因为邪气与脏腑均处于实证状态。
弦脉:浮弦脉不时出现,主饮邪或疼痛,主寒主虚。弦脉与洪脉相搏,表现为外紧内热,即将发生疮疽。
涩脉:主气滞血虚。脓溃后见到此脉,无妨碍。
细脉:主亡阳,阳气衰微。疮肿脉来细而沉,若脉形直而不柔和,表明里虚且病情将发生变化。
微脉:主虚。若真气恢复则生,邪气胜则危。疮肿溃破后,脉象微而均匀,应当自愈。
迟脉:痼疾(慢性病)患者得此脉则好。新病患者得此脉主血气虚惫。疮肿溃破后得此脉,可自愈。
虚脉:脉虚,主血虚。血虚生寒,阳气不足。疮肿患者见此脉,宜采用托里、和气、养血之法。若疮肿见此脉,应补虚、排脓、托里。
弱脉:主气血俱虚,形体精神不足。大抵疮疡患者见沉、迟、弱脉,皆宜采用托里法。
促脉:主热蓄于内,用下法可使气机调和。疮肿患者脉促,也应急用下法。
Floating pulse: Indicates exterior syndrome. If a floating and rapid pulse is observed, fever should be present but is absent, accompanied by aversion to cold; this indicates carbuncle and ulcer (Yong Ju).
Surging pulse: Indicates blood excess and accumulated heat. During the swelling stage, a surging and large pulse suggests the lesion is progressing and pus has not yet formed; purgation is indicated. If a surging and large pulse persists after the abscess ruptures and drains, it is difficult to treat. If spontaneous diarrhea occurs, the condition is incurable.
Slippery pulse: Indicates heat and deficiency. Before rupture, internal resolution is appropriate; after rupture, supporting the interior is appropriate. This is described as "initially heat, ultimately deficiency."
Rapid pulse: Indicates heat. Zhang Zhongjing stated, "If a rapid pulse appears intermittently, malignant sores will arise." He also said, "If lung pulses are both rapid, sores will arise." For various sores, a surging and rapid pulse indicates that pus is about to accumulate internally.
Scattered pulse: After the swelling ulcer ruptures, if irritability and fullness have not completely subsided, and the pulse is surging, slippery, coarse, and scattered, it is difficult to treat due to deficiency of healthy qi and excess of pathogenic factors. It is also stated, "Heaviness of limbs with a large and floating-scattered lung pulse indicates death."
Hollow pulse: Indicates blood deficiency. Its appearance after pus drainage indicates an easy-to-treat condition.
Firm pulse: Feels solid, large, and wiry upon pressure, appearing deep yet superficial, with a sense of solidity. In scrofula (Luo Li) nodules, its appearance contraindicates internal resolution.
Excess pulse: Most taboo for patients with chronic illness and deficiency. For carbuncles and ulcers, urgent purgation is indicated because both pathogenic factors and zang-fu organs are in an excess state.
Wiry pulse: Intermittent floating-wiry pulse indicates fluid retention or pain, cold, and deficiency. The combination of wiry and surging pulses, presenting as external tightness and internal heat, indicates impending carbuncle or ulcer.
Tight pulse: Indicates pain and swelling/sores. Its presence suggests stagnant and sluggish qi and blood.
Choppy pulse: Indicates qi stagnation and blood deficiency. Its appearance after pus drainage is not detrimental.
Short pulse: A short pulse in various diseases indicates difficulty in treatment. In sores and swellings, it indicates deficiency of true qi.
Fine pulse: Indicates loss of yang and decline of yang qi. In sores and swellings, a fine and deep pulse that is straight rather than flexible indicates interior deficiency and potential transformation of symptoms.
Minute pulse: Indicates deficiency. Recovery of true qi leads to survival; dominance of pathogenic factors leads to danger. After rupture of sores and swellings, a minute and even pulse indicates spontaneous recovery.
Slow pulse: Favorable for chronic diseases; indicates severe deficiency of qi and blood in new diseases. Spontaneous recovery is expected after rupture of sores and swellings.
Moderate pulse: After rupture of sores and swellings, a choppy, slow, and moderate pulse indicates easy recovery.
Deep pulse: In water-retention diseases, it indicates rebellion. In sores and swellings, it indicates deep-seated pathogenic factors.
Deficient pulse: Indicates blood deficiency. Blood deficiency generates cold and insufficient yang qi. For sores and swellings, methods to support the interior, harmonize qi, and nourish blood are indicated. Specifically, tonifying deficiency, draining pus, and supporting the interior are required.
Weak pulse: Indicates simultaneous deficiency of qi and blood, and insufficiency of form and spirit. Generally, for patients with sores, deep, slow, and weak pulses indicate the need to support the interior.
Hasty pulse: Indicates heat accumulation in the interior; purgation brings harmony. For sores and swellings with a hasty pulse, urgent purgation is also indicated.
Intermittent pulse: Inauspicious in all diseases. Sores and swellings with hasty or knotted pulses are difficult to treat; how much more so with an intermittent pulse?
Moving pulse: When moving in the yang aspect, it indicates yang deficiency leading to syncope; when moving in the yin aspect, it indicates yin deficiency leading to fever.