凡病内虚者。脉弱为宜。洪大则忌。病外感者。阳脉为宜。阴脉则忌。○有神者吉。和
缓者吉。合于时令者吉。与面上五色中见那一色相生者吉。反是者凶。只此数语可遵。其余
皆不经之言。不可信也。
妇人两尺盛于两寸。常也。若肾脉微涩与浮。或肝脉沉急。或尺脉断绝不匀。皆经闭不
调之候。妇人尺脉微迟为居经。月事三月一下。血气不足故也。
妇人三部浮沉正等。无他病而经停者。孕也。尺大而旺。亦然。左尺洪大实为男。右尺
洪大实为女。(旧说。以左右尺为断。然经云。妇人手少阴脉动甚者。妊子也。今以寸脉动
滑。为断左叶熊罴。右应鸾凤之兆。)
体弱之妇。尺内按之不绝。便是有子。月断病多。六脉不病。亦为有子。所以然者。体
弱而脉难显也。脉经曰。三部浮沉正等。按之无绝者。孕娠也。何常拘于洪滑耶。阴搏阳别。
谓之有子。言尺内阴脉抟指。与寸口阳脉迥别。其中有阳象也。妇人不月。脉来滑疾。重手
按之散者。胎已三月也。和滑而代者。二月余之胎息也。重手按之。滑疾不散者。五月也。
妇人经断有呕。其脉弦者。后必大下。不成胎也。然有因病脉弦。又当保胎为务。气旺。则
弦自退矣。
阴虚阳搏谓之崩。言尺内虚大弦数。皆内崩而血下。妊娠七八月。脉实劳强大者吉。沉
细者难产而死。
女人得革脉。曰半产漏下。得离经之脉。曰产期。离经者。离乎经常之脉也。盖胎动于
中。脉乱于外。势之必至也。
新产伤阴。出血不止。尺脉不能上关者死。妇人脉平而虚者。乳子也。
妇人尺脉弱而涩。小腹冷恶寒。年少得之。为无子。年大得之。为绝产。
凡是体内虚损的疾病,脉象微弱是适宜的;若见洪大脉象则是禁忌。凡是外感邪气的疾病,阳脉(浮、数等)是适宜的;若见阴脉(沉、迟等)则是禁忌。○脉有神气为吉兆,脉象和缓为吉兆,脉象符合时令变化为吉兆,面色五色中有一色与脉象相生者为吉兆;反之则为凶兆。仅这几条原则可以遵循,其余的都是不经过验证的言论,不可相信。
妇女两尺部脉象强于两寸部,这是常态。如果肾脉(尺部)微涩且浮,或者肝脉(左关)沉急,或者尺脉断绝且不均匀,这些都是月经闭止或不调的征候。妇女尺脉微迟,称为“居经”,即月经三个月来潮一次,这是因为血气不足所致。
妇女三部脉(寸、关、尺)浮沉力度相等,没有其他病症而月经停止的,是怀孕。尺脉大而旺盛,也是怀孕之象。左手尺脉洪大实有力预示生男孩,右手尺脉洪大实有力预示生女孩。(旧时说以左右尺脉来判断,但《内经》说:“妇人手少阴脉动甚,是怀孕。”现在以寸脉动滑来判断,左叶熊罴,右应鸾凤的征兆。)
体质瘦弱的妇女,尺部按之脉搏不绝,便是有孕。虽然月经停止,但六脉没有病象,也是有孕。之所以这样,是因为体质虚弱导致脉象难以显现。《脉经》说:“三部浮沉正等,按之无绝者,是妊娠。”何必拘泥于洪滑脉呢?“阴搏阳别”,叫做有孕,意思是尺部阴脉搏击指下,与寸口阳脉截然不同,其中含有阳象。妇女月经停止,脉来滑疾,重手按之脉形散开的,是胎儿已满三个月。脉象和滑而代(间歇),是怀孕两个多月的胎息。重手按之,滑疾而不散的,是怀孕五个月。
妇女月经停止伴有呕吐,脉象弦的,后来必定出现严重的腹泻,不能成胎。然而如果有因病导致脉弦,又应当以保胎为要务。气旺,则弦脉自然消退。
阴虚阳搏叫做崩漏,意思是尺内脉象虚大弦数,都是内部崩漏而下血。妊娠七八个月,脉象实、劳、强大的是吉兆;脉象沉细的难产而死。
女人得革脉,说是半产(小产)漏下;得离经之脉,说是临产期。“离经”是指离开了经常性的脉象。大概是因为胎动于内,脉乱于外,这是必然的趋势。
新产后损伤阴血,出血不止,尺脉不能上达关部的,预后不良致死。妇人脉象平和而虚的,是正在哺乳期的妇女。
In cases of internal deficiency, a weak pulse is appropriate; a surging and large pulse is contraindicated. In cases of external contraction, a Yang pulse (floating, rapid, etc.) is appropriate; a Yin pulse (deep, slow, etc.) is contraindicated. ○ A pulse with Shen spirit (vitality) indicates good prognosis; a harmonious and moderate pulse indicates good prognosis; a pulse consistent with the seasonal changes indicates good prognosis; if one of the five colors on the face generates (in the Five Elements theory) with the pulse, it indicates good prognosis; the opposite indicates bad prognosis. Only these few principles should be followed; the rest are unverified statements and should not be believed.
It is normal for women's Chi pulses (Kidney pulses at the radial artery) to be stronger than their Cun pulses (Lung/Heart pulses). If the Kidney pulse (Chi position) is slightly choppy and floating, or the Liver pulse (Guan position) is deep and urgent, or the Chi pulse is intermittent and irregular, these are all signs of amenorrhea or irregular menstruation. A slightly slow Chi pulse in women is called "Ju Jing" (residing menstruation), where menstruation occurs once every three months, due to insufficiency of blood and Qi.
If the three positions (Cun, Guan, Chi) of a woman's pulse are equal in depth and force, without other symptoms, but menstruation has stopped, she is pregnant. A large and vigorous Chi pulse also indicates pregnancy. A surging, large, and solid pulse at the left Chi position predicts a male child; a surging, large, and solid pulse at the right Chi position predicts a female child. (Old theories relied on the left and right Chi pulses, but the *Neijing* states: "When the Hand-Shaoyin pulse moves vigorously, it indicates pregnancy." Currently, it is judged by the moving and slippery pulse at the Cun position, corresponding to the omens of bears on the left and phoenixes on the right.)
For women with weak constitutions, if the pulse at the Chi position does not disappear upon pressing, she is pregnant. Even if menstruation has ceased, if the six pulses show no signs of disease, it is also pregnancy. This is because a weak constitution makes the pulse difficult to manifest. The *Mai Jing* says: "When the three positions are equal in floating and sinking, and do not disappear upon pressing, it is pregnancy." Why restrict oneself to only surging and slippery pulses? "Yin bo yang bie" (Yin pulses beat distinctly different from Yang) indicates pregnancy, meaning the Yin pulse at the Chi position beats firmly against the fingers, distinctly different from the Yang pulse at the Cun position, containing Yang characteristics. When a woman's menstruation stops and the pulse comes slippery and rapid, if heavy pressure causes the pulse shape to scatter, the fetus is three months old. A harmonious, slippery, and intermittent pulse indicates a fetus of over two months. If heavy pressure reveals a slippery, rapid pulse that does not scatter, it is five months of pregnancy.
If a woman with stopped menstruation experiences vomiting and her pulse is wiry, she will likely suffer severe diarrhea later and will not conceive. However, if the wiry pulse is caused by illness, preserving the fetus must be the priority. When Qi is abundant, the wiry pulse will naturally recede.
Yin deficiency with Yang pounding leads to Bing Lou (metrorrhagia/metrostaxis), meaning the pulse inside the Chi position is deficient, large, wiry, and rapid, indicating internal collapse and bleeding. During the seventh or eighth month of pregnancy, a solid, labored, and strong pulse is auspicious; a deep and fine pulse indicates difficult labor and death.
If a woman presents with a Ge pulse (leather-like pulse), it indicates spontaneous abortion and persistent uterine bleeding. If she presents with a Li Jing pulse (pulse departing from the norm), it indicates the time of delivery. "Li Jing" means departing from the regular pulse pattern. This is because fetal movement occurs internally, causing pulse disorder externally, which is an inevitable trend.
After new childbirth, if Yin blood is damaged and bleeding does not stop, and the Chi pulse cannot reach the Guan position, the prognosis is fatal. If a woman's pulse is peaceful yet deficient, she is nursing an infant.
If a woman's Chi pulse is weak and choppy, accompanied by cold lower abdomen and aversion to cold, appearing when young, it leads to infertility; appearing when older, it leads to sterility.