弱脉,极软而沉细,按之乃得,举手无有(《脉经》)。弱乃濡之干者。《脉诀》言∶轻手乃得。黎氏譬如浮沤,皆是
濡脉,非弱也。《素问》曰∶脉弱以滑,是有胃气。脉弱以涩,是谓久病。病后老弱见之顺,平人少年见之逆。
〔体状诗〕弱来无力按之柔,柔细而沉不见浮。阳陷入阴精血弱,白头犹可少年愁。
〔相类诗〕见濡脉。
〔主病诗〕弱脉阴虚阳气衰,恶寒发热骨筋痿。多惊多汗精神减,益气调营急早医。寸弱阳虚病可知,关为胃弱与
脾衰。欲求阳陷阴虚病,须把神门两部推。弱主气虚之病。仲景曰∶阳陷入阴,故恶寒发热。又云∶弱主筋,沉主骨,
阳浮阴弱,血虚筋急。柳氏曰∶气虚则脉弱,寸弱阳虚,尺弱阴虚,关弱胃虚。
散脉,大而散。有表无里(《脉经》),涣漫不收(崔氏),无统纪,无拘束,至数不齐,或来多去少,或去多来少。
涣散不收,如杨花散漫之象(柳氏)。戴同父曰∶心脉浮大而散,肺脉短涩而散,平脉也。心脉软散,怔忡;肺脉软散,
汗出;肝脉软散,溢饮;脾脉软散, 肿,病脉也。肾脉软散,诸病脉代散,死脉也。《难经》曰∶散脉独见则危。柳
氏曰∶散为气血俱虚,根本脱离之脉,产妇得之生,孕妇得之堕。
〔体状诗〕散似杨花散漫飞,去来无定至难齐。产为生兆胎为堕,久病逢之不必医。
〔相类诗〕散脉无拘散漫然,濡来浮细水中绵。浮而迟大为虚脉,芤脉中空有两边。
〔主病诗〕左寸怔忡右寸汗,溢饮左关应软散。右关软散 肿, 居两尺魂应断。
弱脉,极其柔软且沉细,重按才能触及,轻取则无(《脉经》)。弱脉是濡脉的干枯表现。《脉诀》中说:轻手即可触及。黎氏将其比喻为水面上的浮沤,这些都是濡脉的特征,并非弱脉。《素问》说:脉象软弱而滑利,说明有胃气。脉象软弱而涩滞,称为久病。病后或年老体弱者出现此脉为顺证,健康年轻人出现此脉为逆证。
〔体状诗〕弱脉来势无力,重按感觉柔和,柔细而沉,不见浮象。阳气陷入阴分,精血虚弱,老年人见到尚可,年轻人见到则令人忧愁。
〔相类诗〕参见濡脉。
〔主病诗〕弱脉主阴虚、阳气衰微,症状包括恶寒发热、筋骨痿软。易受惊吓、多汗,精神减退,需益气调营,尽早治疗。左寸部弱脉可知阳气虚,关部弱脉主胃弱与脾衰。若想探究阳气下陷、阴虚之病,必须推察神门穴及尺部脉象。弱脉主要主气虚之病。张仲景说:阳气陷入阴分,所以恶寒发热。又说:弱脉主筋病,沉脉主骨病,阳浮阴弱,血虚导致筋脉拘急。柳氏说:气虚则脉弱,左寸弱为阳虚,右尺弱为阴虚,关部弱为胃虚。
散脉,脉形大而涣散。有表无里(《脉经》),涣漫不收(崔氏),没有统纪,没有拘束,至数不齐,有时来多去少,有时去多来少。涣散不收,像杨花散漫的样子(柳氏)。戴同父说:心脉浮大而散,肺脉短涩而散,这是平脉(正常脉象)。心脉软散,主怔忡;肺脉软散,主汗出;肝脉软散,主溢饮;脾脉软散,主水肿,这些是病脉。肾脉软散,诸病脉见代脉兼散脉,是死脉。《难经》说:散脉单独出现则危险。柳氏说:散脉主气血俱虚,根本脱离之脉,产妇得此脉可生,孕妇得此脉则堕胎。
〔体状诗〕散脉像杨花散漫飞舞,去来不定,至数难以整齐。产妇见此为生兆,胎儿见此为堕胎之兆,久病之人逢到此脉不必医治。
〔相类诗〕散脉无拘束,散漫自然,濡脉浮细如水中绵絮。浮而迟大为虚脉,芤脉中空两边实。
Weak pulse (Ruo Mai), extremely soft and deep-thin, can only be felt with heavy pressure, and is absent upon light touch (Mai Jing). The Weak pulse is the dry manifestation of the Soft pulse (Ru Mai). The Mai Jue states: "It can be felt with light hand." Li Shi describes it as resembling floating bubbles on water; these are characteristics of the Soft pulse, not the Weak pulse. The Su Wen states: "A pulse that is weak yet slippery indicates the presence of Stomach Qi." A pulse that is weak and choppy indicates a chronic illness. For patients after an illness or the elderly, this pulse is favorable (Shun); for healthy young people, it is unfavorable (Ni).
[Body Form Poem] The Weak pulse comes without strength, feeling soft upon heavy pressure; soft, thin, and deep, never floating. Yang energy sinks into Yin, essence and blood are deficient; acceptable in old age, but causes sorrow in youth.
[Similarity Poem] See Soft pulse (Ru Mai).
[Main Disease Poem] The Weak pulse indicates Yin deficiency and decline of Yang Qi, with symptoms such as aversion to cold, fever, and flaccidity of bones and sinews. Prone to fright, excessive sweating, and reduced spirit; one must tonify Qi and regulate Ying (Nutritive) Qi, treating urgently and early. Weakness at the Cun position (left) reveals Yang deficiency; weakness at the Guan position indicates Stomach weakness and Spleen decline. To investigate diseases of sinking Yang and Yin deficiency, one must examine the Shenmen acupoint and the Chi positions. The Weak pulse primarily governs Qi deficiency diseases. Zhang Zhongjing stated: "When Yang sinks into Yin, there is aversion to cold and fever." He also said: "The Weak pulse governs sinew diseases, the Deep pulse governs bone diseases; when Yang floats and Yin is weak, blood deficiency leads to sinew tension." Liu Shi stated: "Qi deficiency results in a Weak pulse; left Cun weakness indicates Yang deficiency, right Chi weakness indicates Yin deficiency, and Guan weakness indicates Stomach deficiency."
Scattered pulse (San Mai), large and scattered. It has a superficial aspect but lacks depth (Mai Jing), spreading out and unrestrained (Cui Shi), lacking regulation and constraint, with irregular rhythm, sometimes coming more and going less, or going more and coming less. Scattered and unrestrained, resembling the drifting image of willow catkins (Liu Shi). Dai Tongfu stated: "Heart pulse floating, large, and scattered; Lung pulse short, choppy, and scattered; these are normal pulses (Ping Mai)." Heart pulse soft and scattered indicates palpitations (Zhengchong); Lung pulse soft and scattered indicates sweating; Liver pulse soft and scattered indicates overflowing fluid retention (Yi Yin); Spleen pulse soft and scattered indicates edema; these are pathological pulses. Kidney pulse soft and scattered, or any disease pulse showing intermittent (Dai) and scattered characteristics, indicates death. The Nan Jing states: "If the Scattered pulse appears alone, it is critical." Liu Shi stated: "The Scattered pulse indicates dual deficiency of Qi and Blood, representing the detachment of the root; if seen in laboring women, birth occurs; if seen in pregnant women, abortion occurs."
[Body Form Poem] The Scattered pulse flies like drifting willow catkins, coming and going unpredictably, difficult to count regularly. In childbirth, it signifies life; in pregnancy, it signifies abortion; for chronic illness, encountering it means no need for treatment.
[Similarity Poem] The Scattered pulse is unconstrained and naturally dispersed; the Soft pulse is floating and thin, like cotton in water. Floating, slow, and large indicates a Deficient pulse; the Knotted pulse (Kou Mai) is hollow in the center with solid sides.
[Main Disease Poem] Left Cun scattered pulse indicates palpitations; Right Cun scattered pulse indicates sweating; overflowing fluid retention corresponds to the left Guan soft and scattered pulse. Right Guan soft and scattered pulse indicates edema; if found in both Chi positions, the soul should be considered severed.