眼上赤脉、下贯瞳人、囟门肿起、兼及作坑、鼻干黑燥、肝大青筋、目多直视、睹不转睛、指甲黑色、忽作鸦声、
弄舌虚出、齿戛咬人、鱼口气急、啼不作声、 虫鼻出、必是死形。用药速救,十无一生。
小儿三岁至五岁 呼吸须将六至看
七至不安十至田 短长大小有邪干
小儿脉大多风热 沉细原因乳食结 弦长多是膈肝风 紧数惊风四肢掣 浮洪胃口是火烧 沉紧腹中痛不歇 虚
濡
少气更兼惊 脉芤便痢并失血 前大后小童脉顺 前小后大必食结 四至洪来主烦满 沉细腹中痛切切 滑主雾露冷
所伤 弦长客忤分明说 五至夜甚浮大昼 六至夜细浮昼别 息数平和六至五 此是圣人传妙诀
浮沉迟数四般脉 五脏六腑为准则 浮主风邪病在表 沉主在里及筋骨 迟脉为寒兼是虚 数者热多根据此例
肝在天为风,在地为木,在人为肝,在时为春。肾水为母,心火为子。主筋,主藏魂。其声呼,其液泣,其味酸。
上应眼,外应爪甲,其色青,欲如青玉之光泽,不欲如蓝。肝主风,风喜伤肝,病主惊风。急怒气逆则伤肝气。痘主水
泡。燥气盛则病。面白则逆(金邪克木也。)
肝病∶面青筋急,多怒目痛,自闭不欲见人,脐左动气。
肝实∶目赤,多怒,头眩,引胁痛,连小腹之下。
肝虚∶目昏,胸痛,筋缩拘挛,恐惧如人将捕。
肝绝∶唇反腮青,四肢多汗,多泣,舌卷囊缩。
当春之脉则弦缓而长,为善,旺春七十二日。
贼脉浮涩而短,(金克木。)危脉弦如弓弦,无胃气死。
心在天为热,在地为火,在人为心,在时为夏。肝木为母,脾土为子,克肺金。主血,主藏神。其声言,其液汗,
其味苦,上应舌,外应掌。其色赤,赤欲如帛裹朱不欲如赭。心主热,热喜伤心。病主惊热,忧愁思虑则伤心。痘主红
斑。寒气甚则病。面黑则逆。(水克火。)
心病∶面赤喜笑,心烦掌热,口渴开目,妄语,脐上动气。
心实∶口干喜笑,身热汗出,肋胁应背作满痛。
心虚∶恍惚多惊,忧烦少色,咳嗽舌强,腰背酸疼。
心绝∶摇头直视,色如烟煤。
长夏之脉,当洪缓浮大而散,来疾去迟为善。
贼脉沉濡,(水克火。)旺夏七十二日。
危脉洪大无胃气者死。
脾在天为湿,在地为土,在人为脾,在时为四季。心火为母,肺金为子,克肾水。主肌肉,藏意智。其声歌,其液
涎,其味甘,上应口,外应四肢。其色黄,欲如罗裹雄黄不欲如土。乳食饥饱则伤脾,痘为脓浆。风胜湿则病。而青为
逆。(水克土也。)
脾病∶面黄善思善嗜,体重卵痛,四肢怠惰不收。
脾实∶肢体重着而不举,腹胀尿秘而若饥。
脾虚∶呕逆泻痢,乳食不消,肿胀肠鸣,四肢无力。
脾绝∶脐突唇反,环口黧黑,柔汗发黄。
脾土之脉和缓温浓,行于脏腑之间,平和不见衰乃见焉。四季之月,各旺一十八日。
贼脉弦长而紧。(木克土。)危脉来如雀啄、屋漏者死。
肺在天为燥,在地为金,在人为肺,在时为秋。脾土为母,肾水为子,克肝木。主气,主藏魄。其声哭,其液涕,
其味辛,上应鼻,外主皮毛。其色白,白欲如白玉之光泽,不欲如垩。肺主燥,燥则伤肺,病咳嗽。形寒饮冷则伤肺。
痘
为脓泡。痧属肺经,面赤则逆。(火邪克金也。)
肺病∶面白悲愁不乐,寒热喘咳,喷嚏吐衄,右胁动气。
肺实∶喘促咳嗽,上气鼻塞,胫股肩背疼痛胸满。
肺虚∶呼吸少气,鼻涕嗌干,喘乏咳血。
肺绝∶汗出如珠,发毛气出汗而不休。
秋肺之脉宜微浮短涩为善。旺秋七十二日。
贼脉洪大牢。(火克金也。)危脉如风吹毛,无胃气死。
肾在天为寒,在地为水,在人为肾,在时为冬。肺金为母,肝木为子,克心火。主骨,主藏精志。其声呻,其液唾,
其味咸,上应耳,下应腰肾。其色黑黑欲如漆光泽不欲如炭。肾主寒,寒则伤肾。其病疝。(偏坠。)欲甚伤肾。痘主黑
陷。湿气盛则病,面黄甚则逆。(土邪克水。)
肾病面黑恐欠,手足寒厥,腹痛渗泻,后重,脐下动气。
肾实∶腹胀体重,少气不言,骨痛餐泄,小便少。
肾虚∶心悬如饥,胸痛引脊,厥逆,溲多,耳鸣。
肾绝∶反目直视,狂言遗尿,腰折骨枯。
冬肾之脉宜沉濡,旺冬季七十二日。
贼脉缓而大。(土克水。)危脉来如解索,去如弹石,无胃气者死。
眼上出现赤色血脉、向下贯穿瞳孔,囟门肿胀突起、甚至凹陷成坑,鼻干黑燥,肝脏肿大且青筋暴露,眼睛多直视、眼球固定不转动,指甲发黑,突然发出乌鸦般的叫声,伸弄舌头且气息虚浮,牙齿格格作响并咬人,鱼口状呼吸且气急,啼哭却不出声,鼻孔有虫爬出,这些都是必死的征象。此时用药急救,十个人中也救不活一个。
小儿从三岁到五岁,诊脉时以每息六次为正常标准;七次则不安稳,十次则病情危重(田通“险”或指极度危险),脉搏长短大小异常是有邪气干扰。
小儿脉象大多主风热;脉沉细的原因是乳食积滞;脉弦长多是膈间肝风;脉紧数则是惊风,伴有四肢抽搐;脉浮洪说明胃口有火(胃火);脉沉紧是腹中疼痛不止;脉虚濡兼见少气且受惊;脉芤主便血痢疾及失血;脉前大后小是儿童顺证;脉前小后大必有食积;脉四至且洪大主烦闷胀满;脉沉细且切痛明显主腹中剧痛;脉滑主雾露寒气所伤;脉弦长明确主客忤(外邪惊吓);脉五至夜间加重、白天浮大,脉六至夜间细弱、白天浮别;呼吸平和、每息五至六次,这是圣人传授的妙诀。
浮、沉、迟、数这四种基本脉象,是判断五脏六腑疾病的准则。浮脉主风邪,病在表;沉脉主里证及筋骨病变;迟脉主寒兼虚;数脉主热多。依据此例类推。
肝在天对应风,在地对应木,在人对应肝,在季节对应春。肾水为母,心火为子。肝主筋,主藏魂。其声音为呼,其体液为泪,其味道为酸。上应于眼,外应于爪甲,其色为青,希望像青玉一样有光泽,不希望像蓝色那样死板。肝主风,风容易伤肝,疾病主要表现为惊风。急怒导致气逆则损伤肝气。痘疹表现为水泡。燥气盛则致病。面色白则相逆(金克木)。
肝病:面色青,筋脉拘急,易怒目痛,闭目不欲见人,脐左侧有动气。
肝实证:眼睛红,易怒,头晕,牵引胁肋疼痛,连及小腹下方。
肝虚证:眼睛昏花,胸痛,筋脉收缩拘挛,恐惧好像有人要抓捕自己。
肝绝证:嘴唇反张,腮部发青,四肢多汗,多流泪,舌卷缩,阴囊收缩。
春季的肝脉应当弦缓而长,为好脉,旺于春季七十二日。
贼脉(相克之脉)浮涩而短,(金克木)。危脉弦硬如弓弦,无胃气者死。
心在天对应热,在地对应火,在人对应心,在季节对应夏。肝木为母,脾土为子,心火克肺金。心主血,主藏神。其声音为言,其体液为汗,其味道为苦,上应于舌,外应于手掌。其色为赤,希望像丝帛裹着朱砂一样有光泽,不希望像赭石那样暗红。心主热,热容易伤心。疾病主要表现为惊热,忧愁思虑则伤心。痘疹表现为红斑。寒气甚则致病。面色黑则相逆。(水克火。)
心病:面色红,喜笑,心烦,手掌发热,口渴,睁眼,胡言乱语,脐上有动气。
心实证:口干,喜笑,身体发热出汗,肋胁背部感到胀满疼痛。
心虚证:恍惚易惊,忧郁烦躁面色不佳,咳嗽舌强,腰背酸痛。
心绝证:摇头直视,面色如烟煤般黑。
长夏的心脉,应当洪缓、浮大而散,来势急去势缓为好。
贼脉沉濡,(水克火)。旺于夏季七十二日。
危脉洪大无胃气者死。
脾在天对应湿,在地对应土,在人对应脾,在季节对应四季。心火为母,肺金为子,脾土克肾水。脾主肌肉,藏意智。其声音为歌,其体液为涎,其味道为甘,上应于口,外应于四肢。其色为黄,希望像罗纱包裹雄黄一样含蓄光泽,不希望像泥土那样枯黄。乳食饥饱不均则伤脾,痘疹表现为脓浆。风胜湿则致病。青色为逆。(水克土也。)
脾病:面色黄,多思多嗜睡,身体沉重,睾丸疼痛,四肢懈怠无力。
脾实证:肢体沉重不能抬起,腹胀尿秘但感觉像饿。
脾虚证:呕吐腹泻痢疾,乳食不消化,肿胀肠鸣,四肢无力。
脾绝证:肚脐突出,嘴唇反张,口周黧黑,冷汗发黄。
脾土的脉象和缓温浓,行于脏腑之间,平和不见衰败才显现。四季之月,各旺十八日。
贼脉弦长而紧。(木克土。)危脉来如雀啄、屋漏滴水者死。
肺在天对应燥,在地对应金,在人对应肺,在季节对应秋。脾土为母,肾水为子,肺金克肝木。肺主气,主藏魄。其声音为哭,其体液为涕,其味道为辛,上应于鼻,外主皮毛。其色为白,希望像白玉一样有光泽,不希望像白垩那样死白。肺主燥,燥则伤肺,疾病表现为咳嗽。形寒饮冷则伤肺。痘疹表现为脓泡。痧症属肺经,面色赤则相逆。(火邪克金也。)
肺病:面色白,悲伤愁闷不乐,寒热喘咳,喷嚏吐衄,右胁下有动气。
肺实证:喘促咳嗽,气逆鼻塞,小腿大腿肩背疼痛胸满。
肺虚证:呼吸少气,鼻涕咽干,喘乏咳血。
肺绝证:汗出如珠,毛发脱落气出不止。
秋季肺脉宜微浮短涩为好。旺于秋季七十二日。
贼脉洪大牢。(火克金也。)危脉如风吹毛,无胃气者死。
肾在天对应寒,在地对应水,在人对应肾,在季节对应冬。肺金为母,肝木为子,肾水克心火。肾主骨,主藏精志。其声音为呻,其体液为唾,其味道为咸,上应于耳,下应于腰肾。其色为黑,希望像漆一样有光泽,不希望像炭那样枯黑。肾主寒,寒则伤肾。其病为疝气(偏坠)。欲望过甚伤肾。痘疹表现为黑陷。湿气盛则致病,面色黄甚则相逆。(土邪克水。)
肾病:面色黑,恐惧欠伸,手足寒冷厥逆,腹痛泄泻,里急后重,脐下有动气。
肾实证:腹胀体重,少气不言,骨痛飧泄,小便少。
肾虚证:心中悬空如饥,胸痛牵引脊背,厥逆,小便多,耳鸣。
肾绝证:两眼反视,胡言乱语遗尿,腰部折断骨骼枯槁。
冬季肾脉宜沉濡,旺于冬季七十二日。
贼脉缓而大。(土克水。)危脉来如解索,去如弹石,无胃气者死。
The appearance of red vessels on the upper eyelids extending downward through the pupil, swelling and protrusion of the fontanelle (anterior fontanelle) even sinking into a pit, dryness and blackening of the nose, hepatomegaly with exposed cyanotic veins, frequent staring with fixed eyeballs, blackening of the fingernails, sudden emission of crow-like sounds, protrusion of the tongue with deficient breath, grinding of teeth accompanied by biting, fish-mouth breathing with急促 respiration, crying without sound, insects crawling out of the nostrils—all these are signs of inevitable death. Even with urgent medicinal intervention, fewer than one in ten will survive.
For children aged three to five years, the pulse rate is assessed based on six beats per respiratory cycle; seven beats indicate instability, while ten beats indicate critical danger. Abnormalities in pulse length and magnitude suggest pathogenic interference.
A large pulse in children mostly indicates Wind-Heat; a deep and fine pulse results from milk and food retention; a string-taut and long pulse often indicates Liver Wind in the diaphragm; a tight and rapid pulse indicates Convulsive Disease (Jing Feng) with twitching of the four limbs; a floating and surging pulse indicates Stomach Fire; a deep and tight pulse indicates unceasing abdominal pain; a deficient and soggy pulse, accompanied by shortness of breath and fright, suggests deficiency with fright; a knotted pulse indicates dysentery with blood or hemorrhage; a pulse that is large anteriorly and small posteriorly is favorable for children; a pulse that is small anteriorly and large posteriorly indicates food retention; a pulse at four beats per cycle that is surging indicates vexation and fullness; a deep and fine pulse with cutting pain indicates severe abdominal pain; a slippery pulse indicates injury by cold mist and dew; a string-taut and long pulse clearly indicates external shock (Ke Wu); a pulse at five beats per cycle worsening at night but floating and large during the day, and a pulse at six beats per cycle being thin at night but distinct and floating during the day—these are distinctions. A peaceful respiration of five to six beats per cycle is the secret method passed down by sages.
Floating, Deep, Slow, and Rapid pulses are the four basic types, serving as criteria for the Five Zang and Six Fu organs. Floating indicates Wind pathogen and exterior disease; Deep indicates interior disease involving sinews and bones; Slow indicates Cold and Deficiency; Rapid indicates excess Heat. This principle applies by analogy.
The Liver corresponds to Wind in Heaven, Wood in Earth, the Liver organ in Humanity, and Spring in Seasons. Kidney Water is its Mother, Heart Fire is its Child. It governs the sinews and stores the Hun (Ethereal Soul). Its voice is shouting, its fluid is tears, its taste is sour. It connects upward to the eyes and outward to the nails. Its color is Green; it should resemble the luster of green jade, not the dullness of blue dye. The Liver governs Wind, and Wind easily injures the Liver, with diseases primarily manifesting as Convulsive Disease. Sudden anger causing Qi rebellion injures Liver Qi. In smallpox, it manifests as vesicles. Excess Dryness causes disease. A white complexion is adverse (Metal overacts on Wood).
Liver Disease: Cyan complexion, tense sinews, irritability, eye pain, closing eyes unwilling to see people, pulsation to the left of the umbilicus.
Liver Excess: Red eyes, irritability, dizziness, pain radiating from the hypochondrium to the lower abdomen.
Liver Deficiency: Blurred vision, chest pain, tendon contraction and spasms, fear as if being pursued.
Liver Exhaustion: Everted lips, cyan cheeks, excessive sweating of the four limbs, frequent weeping, curled tongue, and retracted scrotum.
In Spring, the Liver pulse should be String-Taut, Moderate, and Long, which is auspicious; it prospers for 72 days in Spring.
Thief Pulse (Pulse of the Overacting Element) is Floating, Choppy, and Short (Metal overacts on Wood). Critical Pulse is String-Taut like a bowstring; death occurs without Stomach Qi.
The Heart corresponds to Heat in Heaven, Fire in Earth, the Heart organ in Humanity, and Summer in Seasons. Liver Wood is its Mother, Spleen Earth is its Child, and Heart Fire overacts on Lung Metal. It governs Blood and stores the Shen (Spirit). Its voice is speaking, its fluid is sweat, its taste is bitter. It connects upward to the tongue and outward to the palms. Its color is Red; it should resemble silk wrapping cinnabar, not the dullness of hematite. The Heart governs Heat, and Heat easily injures the Heart, with diseases primarily manifesting as Fright-Heat. Worry and overthinking injure the Heart. In smallpox, it manifests as macules. Severe Cold causes disease. A black complexion is adverse (Water overacts on Fire).
Heart Disease: Red complexion, excessive laughter, mental restlessness, hot palms, thirst, open eyes, delirious speech, pulsation above the umbilicus.
Heart Excess: Dry mouth, excessive laughter, body heat with sweating, fullness and pain in the hypochondrium radiating to the back.
Heart Deficiency: Mental confusion and frequent fright, melancholy and irritability with poor complexion, cough with stiff tongue, soreness and pain in the waist and back.
Heart Exhaustion: Shaking head with staring eyes, complexion like soot.
In Late Summer, the Heart pulse should be Surging, Moderate, Floating, Large, and Scattered, coming rapidly and departing slowly, which is auspicious.
Thief Pulse is Deep and Soggy (Water overacts on Fire). It prospers for 72 days in Summer.
Critical Pulse is Surging and Large without Stomach Qi leads to death.
The Spleen corresponds to Dampness in Heaven, Earth in Earth, the Spleen organ in Humanity, and the Four Seasons in Seasons. Heart Fire is its Mother, Lung Metal is its Child, and Spleen Earth overacts on Kidney Water. It governs muscles and stores Yi (Intellect/Intent). Its voice is singing, its fluid is saliva, its taste is sweet. It connects upward to the mouth and outward to the four limbs. Its color is Yellow; it should resemble yellow arsenic wrapped in gauze, not the dullness of soil. Irregular feeding (hunger or overeating) injures the Spleen. In smallpox, it manifests as pustules. Excess Wind overcoming Dampness causes disease. Green is adverse (Water overacts on Earth).
Spleen Disease: Yellow complexion, excessive thinking and lethargy, heavy body, testicular pain, flaccidity and weakness of the four limbs.
Spleen Excess: Heavy limbs unable to lift, abdominal distension, constipation despite feeling hungry.
Spleen Deficiency: Vomiting, regurgitation, diarrhea and dysentery, indigestion, bloating and borborygmus, weakness of the four limbs.
Spleen Exhaustion: Protruding umbilicus, everted lips, blackening around the mouth, soft sweat turning yellow.
The Spleen Earth pulse is Harmonious, Moderate, Warm, and Thick, circulating between the organs; peace without decline is observed. Each month of the Four Seasons sees it prosper for 18 days.
Thief Pulse is String-Taut, Long, and Tight (Wood overacts on Earth). Critical Pulse comes like a bird pecking or water dripping from a roof leads to death.
The Lung corresponds to Dryness in Heaven, Metal in Earth, the Lung organ in Humanity, and Autumn in Seasons. Spleen Earth is its Mother, Kidney Water is its Child, and Lung Metal overacts on Liver Wood. It governs Qi and stores the Po (Corporeal Soul). Its voice is crying, its fluid is nasal mucus, its taste is pungent. It connects upward to the nose and outward to the skin and hair. Its color is White; it should resemble the luster of white jade, not the dullness of chalk. The Lung governs Dryness, and Dryness injures the Lung, with diseases manifesting as cough. Exposure to cold and drinking cold fluids injures the Lung. In smallpox, it manifests as pustules. Sha disease belongs to the Lung Meridian; a red complexion is adverse (Fire overacts on Metal).
Lung Disease: Pale complexion, sadness and depression, aversion to cold and fever, wheezing and coughing, sneezing, vomiting blood or epistaxis, pulsation in the right hypochondrium.
Lung Excess: Wheezing and coughing, rebellious Qi with nasal congestion, pain in the shins, thighs, shoulders, and back with chest fullness.
Lung Deficiency: Shortness of breath, runny nose and dry throat, fatigue with cough and hemoptysis.
Lung Exhaustion: Sweat like pearls, hair loss, continuous exhalation without cessation.
In Autumn, the Lung pulse should be slightly Floating, Short, and Choppy, which is auspicious; it prospers for 72 days in Autumn.
Thief Pulse is Surging, Large, and Firm (Fire overacts on Metal). Critical Pulse like wind blowing feathers, without Stomach Qi leads to death.
The Kidney corresponds to Cold in Heaven, Water in Earth, the Kidney organ in Humanity, and Winter in Seasons. Lung Metal is its Mother, Liver Wood is its Child, and Kidney Water overacts on Heart Fire. It governs bones and stores Jing (Essence) and Zhi (Willpower). Its voice is groaning, its fluid is saliva, its taste is salty. It connects upward to the ears and downward to the waist and kidneys. Its color is Black; it should resemble the luster of lacquer, not the dullness of charcoal. The Kidney governs Cold, and Cold injures the Kidney. Its disease is hernia (scrotal swelling). Excessive desire injures the Kidney. In smallpox, it manifests as black sunken lesions. Excess Dampness causes disease; a very yellow complexion is adverse (Earth overacts on Water).
Kidney Disease: Black complexion, fear and yawning, cold and coldness of hands and feet, abdominal pain with diarrhea, tenesmus, pulsation below the umbilicus.
Kidney Excess: Abdominal distension and heaviness, shortness of breath and silence, bone pain with undigested stool in diarrhea, scanty urination.
Kidney Deficiency: Sensation of emptiness in the heart like hunger, chest pain radiating to the spine, coldness reversal, polyuria, tinnitus.
Kidney Exhaustion: Eyes rolling backward with staring, delirious speech and enuresis, broken waist and withered bones.
In Winter, the Kidney pulse should be Deep and Soggy; it prospers for 72 days in Winter.
Thief Pulse is Moderate and Large (Earth overacts on Water). Critical Pulse comes like unraveling a rope and departs like flicking stones, without Stomach Qi leads to death.