脉有三部,阴阳相乘。荣卫气血,在人体躬(《千金》作而行人躬)。呼吸出入,上下于中,因息游布,津液流通。
随时动作,效象形容,春弦秋浮,冬沉夏洪。察色观脉,大小不同,一时之间,变无经常,尺寸参差,或短或长。上下
乖错,或存或亡。病辄改易,进退低昂。心迷意惑,动失纪纲,愿为缕陈,令得分明。师曰∶子之所问,道之根源。脉
有三部,尺寸及关。荣卫流行,不失衡铨,肾沉心洪。肺浮肝弦,此自经常,不失铢分。出入升降,漏刻周旋,水下二
刻,(臣亿等详水下二刻疑检旧本如此)脉一周身,旋复寸口,虚实见焉。变化相乘,阴阳相干。风则浮虚,寒则紧弦,
沉潜水 ,支饮急弦,动弦为痛,数洪热烦。设有不应,知变所缘。三部不同,病各异端。太过可怪,不及亦然,邪不
空见,终必有奸。审察表里,三焦别分,知邪所舍,消息诊看,料度腑脏,独见若神。为子条记,传与贤人。
脉,平旦曰太阳,日中曰阳明,晡时曰少阳,黄昏曰少阴,夜半曰太阴,鸡鸣曰厥阴,是三阴三阳时也。
少阳之脉,乍小乍大,乍长乍短,动摇六分。王十一月甲子夜半,正月、二月甲子王。
太阳之脉,洪大以长,其来浮于筋上,动摇九分。三月、四月甲子王。
阳明之脉,浮大以短,动摇三分。大前小后,状如科斗,其至跳。五月、六月甲子王。
少阴之脉紧细,动摇六分。王五月甲子日中,七月、八月甲子王。
太阴之脉、紧细以长,乘于筋上,动摇九分。九月、十月甲子王。
厥阴之脉,沉短以紧,动摇三分。十一月、十二月甲子王。
厥阴之脉急弦,动摇至六分以上,病迟脉寒,少腹痛引腰,形喘者死;脉缓者可治。刺足厥阴入五分。少阳之脉,
乍短乍长,乍大乍小,动摇至六分以上。病头痛,胁下满,呕可治;扰即死(一作伛可治,偃即死)。刺两季肋端足少阳
也,入七分。阳明之脉,洪大以浮,其来滑而跳,大前细后,状如科斗,动摇至三分以上。病眩头痛,腹满痛,呕可治;
扰即死。刺脐上四寸,脐下三寸,各六分。从二月至八月,阳脉在表;从八月至正月,阳脉在里。附阳脉强,附阴脉弱。
至即惊,实则 。细而沉,不 即泄,泄即烦,烦即渴,渴即腹满,满即扰,扰即肠 , 即脉代,乍至乍不至。
大而沉即咳,咳即上气,上气甚则肩息,肩息甚则口舌血出,血出甚即鼻血出。变出寸口,阴阳表里,以互相乘。如风
有道,阴脉乘阳也。寸口中,前后溢者,行风。
寸口中,外实内不满者,三风、四温。寸口者,劳风。劳风者,大病亦发,快行汗出亦发。软风者,上下微微扶骨,
是其诊也。表缓腹内急者,软风也。猥雷实夹者,飘风。从阴趋阳者,风邪。一来调,一来速,鬼邪也。阴缓阳急者,
表有风来入脏也。阴急者,风已抱阳入腹。上逯逯,下宛宛,不能至阳,流饮也。上下血微,阴强者,为漏癖;阳强者,
酒癖也。伛偷不过,微反阳,澹浆也。阴扶骨绝者,从寸口前顿趣于阴,汗水也。来调四布者,欲病水也。阴脉不偷,
阳脉伤,复少津。寸口中后大前兑,至阳而实者,癖食。小过阳一分者,七日癖;二分者,十日癖;三分者,十五日癖;
四分者,二十日癖;四分中伏不过者,半岁癖。敦敦不至胃阴一分,饮 饵癖也。外勾者,久癖也。内卷者,十日以还。
外强内弱者,裹大核也,并浮而弦者,汁核。并浮紧而数,如沉,病暑食粥(一作微)。有内紧而伏,麦饭若饼。寸口脉
倚阳,紧细以微,瓜菜皮也;若倚如紧,荠藏菜也。赜赜无数,生肉癖也;附阳者,炙肉癖也。小倚生,浮大如故,生
麦豆也。
脉象分为三部,阴阳相互影响。营气与卫气、气与血,在人体自身之中,随着呼吸的出入,上下运行,借着气息的流动布散全身,使津液畅通无阻。
脉象随四时变化而呈现不同的形态,春天脉弦,秋天脉浮,冬天脉沉,夏天脉洪大。观察面色和诊察脉象,大小各不相同,在一时之间,变化无常,寸口与尺部的脉位参差不齐,或短或长。上下脉位错乱,有的存在有的消失。病情随之改变,进退起伏。心中迷惑不解,行动失去法度,希望老师能详细陈述,使其分明清楚。老师说:你所问的,是脉道的根本。脉分三部,即寸、关、尺。营卫之气流行,不失去衡量的标准,肾脉沉,心脉洪大。肺脉浮,肝脉弦,这是正常的规律,不差毫厘。脉气的出入升降,随着时间的推移循环往复,水下滴两刻的时间(臣亿等考证认为“水下二刻”疑为检阅旧本如此),脉气运行一周身,重新回到寸口,虚实的征象就显现出来了。各种变化相互影响,阴阳相互干扰。风邪致脉浮虚,寒邪致脉紧弦,水饮内停致脉沉潜,支饮致脉急弦,动脉主痛证,数脉且洪大主热烦。假如有不符合上述规律的,要知晓变化的缘由。三部脉象不同,疾病的端绪各异。脉气太过令人惊怪,不及也是如此,邪气不会凭空出现,最终必有奸邪作祟。仔细审查表里,分别三焦,知道邪气停留的地方,斟酌诊察,推测脏腑情况,就能像神一样独见真知。为你条理记述,传给贤人。
平旦时脉属太阳,日中时脉属阳明,晡时(下午3-5点)脉属少阳,黄昏时脉属少阴,夜半时脉属太阴,鸡鸣时脉属厥阴,这是三阴三阳对应的时间段。
少阳之脉,忽小忽大,忽长忽短,动摇幅度六分。王相于十一月甲子日的夜半,以及正月、二月甲子日。
太阳之脉,洪大且长,脉气来势浮于筋上,动摇幅度九分。王相于三月、四月甲子日。
阳明之脉,浮大且短,前大后小,形状像蝌蚪,脉至跳动明显。王相于五月、六月甲子日。
少阴之脉,紧细,动摇幅度六分。王相于五月甲子日的日中,以及七月、八月甲子日。
太阴之脉,紧细且长,乘于筋上,动摇幅度九分。王相于九月、十月甲子日。
厥阴之脉,沉短且紧,动摇幅度三分。王相于十一月、十二月甲子日。
厥阴之脉急弦,动摇超过六分以上,若病迟脉寒,少腹痛牵引腰部,身体喘息的,预后不良;脉缓的可以治疗。针刺足厥阴经,进针五分。少阳之脉,忽短忽长,忽大忽小,动摇超过六分以上。若病头痛,胁下胀满,呕吐的,可以治疗;若身体蜷曲(一作伛)可治,仰卧则死。针刺两侧季肋端的足少阳经,进针七分。阳明之脉,洪大且浮,脉来滑利且跳动,前大后细,形状像蝌蚪,动摇超过三分以上。若病眩晕头痛,腹部胀满疼痛,呕吐的,可以治疗;若身体蜷曲则死。针刺脐上四寸、脐下三寸各六分。从二月到八月,阳脉在表;从八月到正月,阳脉在里。附阳脉强盛,附阴脉虚弱。脉气至则惊恐,实则……(原文此处有缺漏或异文)。脉细而沉,若不泄则腹泻,腹泻则心烦,心烦则口渴,口渴则腹部胀满,胀满则身体蜷曲,蜷曲则脉代,脉气乍来乍不来。脉大而沉则咳嗽,咳嗽则气逆上冲,气逆严重则肩息,肩息严重则口舌出血,出血严重则鼻出血。病变出现在寸口,阴阳表里互相干扰。如风之道,阴脉乘袭阳脉。在寸口中,前后溢出的,是行风。
在寸口中,外实内不满的,是三风、四温。寸口脉象表现为劳风。劳风者,大病也会发作,快步行走出汗也会发作。软风者,上下微微扶骨,这是其诊断特征。表缓腹内急的,是软风。猥雷实夹的,是飘风。从阴趋阳的,是风邪。一来调顺,一来急促的,是鬼邪。阴缓阳急的,是表有风邪入脏。阴急的,是风已抱阳入腹。上逯逯,下宛宛,不能至阳,是流饮。上下血微,阴强的,为漏癖;阳强的,为酒癖。伛偷不过,微反阳,是澹浆。阴扶骨绝的,从寸口前顿趣于阴,是汗水。来调四布的,是想病水。阴脉不偷,阳脉伤,复少津。寸口中后大前小的,至阳而实的,是癖食。小过阳一分的,七日癖;二分者的,十日癖;三分者的,十五日癖;四分者的,二十日癖;四分中伏不过的,半年癖。敦敦不至胃阴一分,是饮饵癖。外勾的,是久癖。内卷的,十日以内。外强内弱的,是裹大核。并浮而弦的,是汁核。并浮紧而数,如沉,病暑食粥(一作微)。有内紧而伏的,麦饭若饼。寸口脉倚阳,紧细以微,是瓜菜皮;若倚如紧,是荠藏菜。赜赜无数的,是生肉癖;附阳的,是炙肉癖。小倚生的,浮大如故,是生麦豆也。
Pulse positions are divided into three parts, with Yin and Yang interacting. Ying (Nutritive) Qi and Wei (Defensive) Qi, along with Qi and Blood, circulate within the human body. Through inhalation and exhalation, they move up and down within the center. Relying on breath, they flow and distribute throughout the body, allowing body fluids to circulate freely.
Following the seasons, pulses exhibit varying forms: in Spring they are Xian (Wiry), in Autumn they are Fu (Floating), in Winter they are Chen (Deep), and in Summer they are Hong (Surging). Observing complexion and examining the pulse reveals differences in size. Within a short time, changes are unpredictable; the Cun (Inch) and Chi (Cubit) positions may be uneven, appearing either short or long. Upper and lower discrepancies occur, with some pulses present and others absent. Diseases change accordingly, advancing or retreating, rising or falling. One may become confused and lose track of principles. Therefore, I request a detailed explanation to clarify these matters. The Master said: "Your questions touch upon the root of the Dao. The pulse has three parts: Cun, Guan (Bar), and Chi. Ying and Wei Qi circulate without losing their balance. Kidney pulses are Deep; Heart pulses are Surging. Lung pulses are Floating; Liver pulses are Wiry. These are the constant norms, accurate to the finest degree. The entry and exit, ascent and descent of Qi rotate through the hours. In the time it takes for water to drip two 'ke' (ancient time units) [Note: Scholars Yi et al. suggest this phrase may stem from an old textual variant], the pulse completes one circuit of the body and returns to the Cun position, where deficiency and excess become apparent. Changes interact, and Yin and Yang interfere with each other. Wind causes Floating and Deficient pulses; Cold causes Tight and Wiry pulses. Sunken and submerged pulses indicate Water Retention; Zhi Yin (Branching Fluids) cause Rapid and Wiry pulses. Dong (Moving) pulses indicate Pain; Shuo (Rapid) and Hong pulses indicate Heat and Restlessness. If there is any discrepancy, understand the cause of the variation. The three pulse positions differ, and diseases have different origins. Excess is remarkable, as is deficiency. Pathogenic factors do not appear randomly; there is always a hidden evil. Carefully examine the Exterior and Interior, distinguish the San Jiao (Triple Burner), know where the pathogen resides, and judiciously diagnose. By estimating the state of the Zang-Fu organs, one can see clearly like a deity. I have organized this for you to pass on to worthy people.
At dawn, the pulse belongs to Taiyang (Greater Yang); at noon, to Yangming (Bright Yang); at dusk (Shen hour, 3-5 PM), to Shaoyang (Lesser Yang); at twilight, to Shaoyin (Lesser Yin); at midnight, to Taiyin (Greater Yin); and at cockcrow, to Jueyin (Terminal Yin). These correspond to the times of the Three Yin and Three Yang.
The Shaoyang pulse fluctuates between small and large, long and short, with a trembling amplitude of six fen. It reigns during the night of Jiazi day in the 11th lunar month, and during Jiazi days in the 1st and 2nd months.
The Taiyang pulse is Surging, Large, and Long. Its arrival floats above the tendons, with a trembling amplitude of nine fen. It reigns during Jiazi days in the 3rd and 4th months.
The Yangming pulse is Floating, Large, and Short. It is larger at the front and smaller at the back, resembling a tadpole, and its arrival is palpable and jumping. It reigns during Jiazi days in the 5th and 6th months.
The Shaoyin pulse is Tight and Fine, with a trembling amplitude of six fen. It reigns at noon on Jiazi day in the 5th month, and during Jiazi days in the 7th and 8th months.
The Taiyin pulse is Tight, Fine, and Long, riding over the tendons, with a trembling amplitude of nine fen. It reigns during Jiazi days in the 9th and 10th months.
The Jueyin pulse is Deep, Short, and Tight, with a trembling amplitude of three fen. It reigns during Jiazi days in the 11th and 12th months.
The Jueyin pulse is Urgent and Wiry. If the trembling exceeds six fen, and the disease presents with slow pulse and coldness, lower abdominal pain radiating to the waist, and panting, the prognosis is fatal. If the pulse is Slow, it is treatable. Acupuncture should target the Foot-Jueyin meridian, inserting five fen. The Shaoyang pulse fluctuates between short and long, large and small, with trembling exceeding six fen. If the disease involves headache, fullness under the hypochondrium, and vomiting, it is treatable. If the patient curls up (or stands crookedly), it is treatable; if lying flat, it is fatal. Acupuncture should target the Foot-Shaoyang meridian at the ends of the costal margins, inserting seven fen. The Yangming pulse is Surging, Large, and Floating. Its arrival is Slippery and Jumping, larger at the front and finer at the back, resembling a tadpole, with trembling exceeding three fen. If the disease involves dizziness, headache, abdominal fullness and pain, and vomiting, it is treatable. If the patient curls up, it is fatal. Acupuncture should target four cun above the umbilicus and three cun below, inserting six fen each. From the 2nd to the 8th month, Yang pulses are in the Exterior; from the 8th to the 1st month, Yang pulses are in the Interior. Fu-Yang pulses are strong; Fu-Yin pulses are weak. When the pulse arrives, there is alarm; when Excess, ... [text missing/corrupt]. Fine and Deep pulses: if not diarrhea, then diarrhea occurs; diarrhea leads to vexation; vexation leads to thirst; thirst leads to abdominal fullness; fullness leads to curling up; curling up leads to Dai (Intermittent) pulse, where the pulse comes and goes irregularly. Large and Deep pulses lead to cough; cough leads to rebellious Qi; severe rebellious Qi leads to shoulder breathing; severe shoulder breathing leads to bleeding from mouth and tongue; severe bleeding leads to epistaxis. Variations appear at the Cun position, with Yin and Yang, Exterior and Interior interfering with each other. Like the path of wind, Yin pulses attack Yang. At the Cun position, overflow anteriorly and posteriorly indicates Moving Wind.
At the Cun position, exterior Excess with interior insufficiency indicates Three Winds and Four Warmths. Cun position indicating Lao Feng (Labor Wind): Lao Feng diseases also manifest during major illnesses or after sweating following brisk walking. Ruan Feng (Soft Wind) is diagnosed by slight support of the bones above and below. Exterior Slow with interior urgency indicates Ruan Feng. Wei Lei Shi Jia indicates Piao Feng (Drifting Wind). Moving from Yin toward Yang indicates Wind Pathogen. Regular then rapid indicates Ghost Pathogen. Yin Slow and Yang Urgent indicates Wind entering the Zang from the Exterior. Yin Urgent indicates Wind embracing Yang and entering the abdomen. "Shang Lu Lu, Xia Wan Wan" unable to reach Yang indicates Liu Yin (Flowing Fluids). Slight blood in upper and lower parts with Yin Excess indicates Lou Pi (Leakage Mass); Yang Excess indicates Jiu Pi (Alcohol Mass). Yu Tou Bu Guo, Wei Fan Yang indicates Dan Jiang. Yin Fu Gu Jue, moving quickly from Cun anteriorly to Yin indicates Han Shui. Regular distribution indicates impending Water Disease. Yin pulse not stealing, Yang pulse damaged, leading to lack of fluids. Cun position larger posteriorly and smaller anteriorly, reaching Yang and Excess, indicates Pi Shi (Food Stagnation/Mass). Slightly exceeding Yang by one fen indicates Seven-Day Pi; two fen, Ten-Day Pi; three fen, Fifteen-Day Pi; four fen, Twenty-Day Pi; if buried within four fen but not exceeding, Half-Year Pi. Dun Dun not reaching Stomach Yin by one fen indicates Yin Er Pi (Drink/Grain Mass). External hook indicates Long-term Pi. Internal curling indicates within ten days. External Strong and Internal Weak indicates Guo Da He (Wrapped Large Node). Floating and Wiry together indicates Zhi He (Juice Node). Floating, Tight, and Rapid together, resembling Deep, indicates Summerheat and Food Stagnation (or Mild). Internal Tight and Buried resembles Wheat Bread or Cake. Cun pulse leaning toward Yang, Tight, Fine, and Micro, indicates Melon/Vegetable Peel; if leaning like Tight, indicates Shepherd's Purse Vegetable. Ce Ce Wu Shu indicates Sheng Rou Pi (Raw Meat Mass); attaching to Yang indicates Zhi Rou Pi (Roasted Meat Mass). Small leaning birth, Floating and Large as before, indicates Raw Wheat/Beans.