寸口脉迟心上寒。
寸口。阳位也。所以候胸中者也。心居膈上。迟脉为寒。今见寸口。故曰。心
上寒也。
按脉经云。寸迟上焦有寒。心痛咽酸。吐酸水。宜服附子汤。生姜汤。茱萸
丸。调和饮食以暖之。脉影云。手足厥冷。气胀攻痛。主上焦寒。
当关腹痛饮浆难。
关所以候腹中者。关脉见迟。为寒湿之气大作。燥热之气不行。寒湿之
气作。故腹痛。燥热之气不行。故饮浆难也。
按脉经云。关迟胃中寒。宜桂枝丸。茱萸汤。针胃管补之。脉影云。关迟中焦寒。吞酸吐水。
流入尺中腰脚重。浓衣重覆地也嫌单。
尺部法地。所以候腰以下之疾者。迟为寒湿之脉。腰脚者。肾之所主。尺部而见迟脉。则为寒湿之气。客于下
焦。故腰脚重也。人身之所以常温暖者。以下焦命门之真火。得以温分肉也。今尺部而见阴寒之脉。则寒气作。而真火
无光。是以浓衣重覆也嫌单耳。
按脉经云。尺中迟。下焦有寒。背痛。又云。尺脉迟。下焦有寒。宜服桂枝丸。针气海关元补之。
六伏者。阴也。指下寻之。似有呼吸。定息全无。再再寻之。不离三关曰伏。主毒瓦斯闭塞。三关四肢沉重。手足
时冷。
伏阴。木也。何谓阴木。厥阴之木也。厥阴者。阴之尽也。阴已极。则阳将绝矣。脉之所往来指下者。正以阴阳相
维。和合交结。而脉道乃行。今阴已极。而阳将绝。则脉道不行。故指下寻之似有。呼吸定息全无。即脉经所云伏脉
极重。手按之着骨乃得也。然脉之所以往来于寸关尺部者。正以三焦之气。呼吸相通耳。今阴毒之气。壅遏三焦。
使荣卫之气。不得行于十二经隧之中。故上焦绝。则寸不行。中焦绝。则关
不行。下焦绝。则尺不行。虽依稀隐现于寸关尺部之中。而实不能往来于上下。故曰。不离
乎三关也。四肢者。诸阳之本也。阳气将绝。故四肢沉重。而手足时冷矣。
按脉经云。伏脉极重指按之着骨乃得。一曰手下裁动。一曰按之不足。
举之无有。一曰关上沉不出。名曰伏。经云。伏者霍乱。
寸口脉象迟缓,提示心部有寒。
寸口属于阳位,因此用来诊察胸中的情况。心脏位于膈肌之上,迟脉主寒证。现在在寸口见到迟脉,所以说心部有寒。
根据《脉经》记载:寸口脉迟,说明上焦有寒,症状包括心痛、咽部泛酸、吐出酸水,适宜服用附子汤、生姜汤、茱萸丸,并通过调和饮食来温暖身体。《脉影》记载:手足厥冷,气胀攻痛,主要病机为上焦寒盛。
到了关部出现腹痛,饮水进食困难。
关部用来诊察腹中的情况。关部脉象见迟,是寒湿之气盛行,而燥热之气不能运行的结果。因为寒湿之气作祟,所以腹痛;因为燥热之气不能运行,所以饮水进食困难。
根据《脉经》记载:关部脉迟,说明胃中有寒,适宜服用桂枝丸、茱萸汤,并针刺胃管穴用补法。《脉影》记载:关部脉迟,说明中焦有寒,症状包括吞酸、吐水。
脉象延伸至尺部,导致腰脚沉重,即使穿着厚衣层层覆盖,仍嫌单薄寒冷。
尺部效法地,用来诊察腰部以下部位的疾病。迟脉是寒湿之脉。腰脚由肾所主,尺部见到迟脉,说明寒湿之气客居于下焦,所以腰脚沉重。人体之所以常保持温暖,是因为下焦命门的真火能够温煦肌肉皮肤。现在尺部出现阴寒之脉,寒气发作,而真火失去光辉,所以即使穿着厚衣重重覆盖,仍觉得单薄寒冷。
根据《脉经》记载:尺部脉迟,说明下焦有寒,伴有背痛。又记载:尺脉迟,下焦有寒,适宜服用桂枝丸,针刺气海、关元穴用补法。
伏脉共有六种,属阴。手指下探寻时,似乎有呼吸之感,但定息(屏住呼吸仔细体会)时完全感觉不到。反复探寻,脉动不离三关部位,主毒瓦斯闭塞。表现为三焦及四肢沉重,手足时常发冷。
伏脉属阴,对应五行中的木。什么是阴木?即厥阴之木。厥阴是阴气的尽头。阴气已至极点,阳气就将断绝了。脉气在指下往来流动,正是依靠阴阳相互维系、和合交结,脉道才能通行。现在阴气已极,阳气将绝,脉道就不能通行,所以在指下探寻时似乎有脉动,但在定息时完全消失。这就是《脉经》所说的伏脉极重,手按至骨头处才能触及。然而,脉气之所以能在寸、关、尺三部往来流动,正是依靠三焦之气的呼吸相通。现在阴毒之气壅遏三焦,使得营卫之气不能在十二经脉隧道中运行,所以上焦气绝,则寸部脉不动;中焦气绝,则关部脉不动;下焦气绝,则尺部脉不动。虽然脉象依稀隐现于寸、关、尺三部之中,但实际上不能在上下之间往来流动,所以说“不离乎三关”。四肢是诸阳之本,阳气将绝,所以四肢沉重,手足时常发冷。
根据《脉经》记载:伏脉极重,手指按至骨头处才能触及。另一种说法是手下仅微微跳动,或者按之无力。举取时无脉,另一种说法是关上脉沉伏不出,名为伏脉。经书说:伏脉多见于霍乱病。
The pulse at the Cun (Inch) position is slow, indicating cold in the Heart region.
The Cun position belongs to Yang and is therefore used to inspect the chest area. The Heart resides above the diaphragm. A slow pulse indicates Cold. Since a slow pulse is observed at the Cun position, it is said that there is Cold in the Heart region.
According to *Mai Jing* (Pulse Classic): A slow pulse at the Cun indicates Cold in the Upper Jiao, with symptoms such as heart pain, acid regurgitation in the throat, and vomiting of sour fluid. It is appropriate to administer Fuzi Tang (Aconite Decoction), Shengjiang Tang (Fresh Ginger Decoction), or Zhuyu Wan (Evodia Pill), and to warm the body by regulating the diet. *Mai Ying* (Pulse Shadow) states: Cold limbs, abdominal distension with attacking pain, primarily indicate excess Cold in the Upper Jiao.
At the Guan (Carpal) position, abdominal pain occurs, and drinking or eating becomes difficult.
The Guan position is used to inspect the abdomen. A slow pulse at the Guan position indicates that Damp-Cold Qi is prevailing, while Dry-Heat Qi fails to circulate. Because Damp-Cold Qi is active, abdominal pain arises; because Dry-Heat Qi fails to circulate, difficulty in swallowing liquids or food results.
According to *Mai Jing*: A slow pulse at the Guan indicates Cold in the Stomach. It is appropriate to administer Guizhi Wan (Cinnamon Twig Pill) or Zhuyu Tang (Evodia Decoction), and to needle Weiguan (CV12, Conception Vessel 12) using the tonification method. *Mai Ying* states: A slow pulse at the Guan indicates Cold in the Middle Jiao, with symptoms such as acid regurgitation and vomiting of water.
When the pulse extends to the Chi (Cubit) position, heaviness in the waist and legs occurs; even wearing thick clothes and heavy coverings, one still feels they are too thin.
The Chi position corresponds to Earth and is used to inspect diseases below the waist. The slow pulse is a sign of Damp-Cold. The waist and legs are governed by the Kidney. When a slow pulse is seen at the Chi position, it indicates that Damp-Cold Qi has lodged in the Lower Jiao, causing heaviness in the waist and legs. The reason the human body remains warm is that the True Fire of the Mingmen (Gate of Life) in the Lower Jiao warms the flesh and skin. Now, since a Yin-Cold pulse appears at the Chi position, Cold Qi arises, and the True Fire loses its brilliance. Therefore, even with thick clothes layered heavily, one still feels the need for more warmth.
According to *Mai Jing*: A slow pulse at the Chi position indicates Cold in the Lower Jiao, accompanied by back pain. It also states: A slow pulse at the Chi position indicates Cold in the Lower Jiao. It is appropriate to administer Guizhi Wan (Cinnamon Twig Pill) and needle Qihai (CV6, Conception Vessel 6) and Guanyuan (CV4, Conception Vessel 4) using the tonification method.
There are six types of Fu (Deep/Hidden) pulses, which belong to Yin. When seeking with the fingers, it seems as if there is a breath-like sensation, but upon holding the breath to focus (Ding Xi), it completely disappears. Repeated searching reveals the pulse does not leave the three positions (Cun, Guan, Chi). It indicates obstruction by toxic vapors, manifesting as heaviness in the three Jiaos and four limbs, and cold hands and feet from time to time.
The Fu pulse is Yin, corresponding to Wood in the Five Elements. What is Yin Wood? It is the Wood of Jueyin (Terminal Yin). Jueyin represents the extreme of Yin. When Yin reaches its extreme, Yang is about to perish. The movement of the pulse under the fingers relies on the mutual maintenance and harmonious integration of Yin and Yang for the pulse channel to flow. Now that Yin is extreme and Yang is about to perish, the pulse channel cannot flow. Thus, when seeking under the fingers, it seems present, but during Ding Xi, it is completely absent. This is what *Mai Jing* refers to as an extremely deep Fu pulse, which can only be felt when pressing down to the bone. However, the reason pulse Qi flows through the Cun, Guan, and Chi positions is precisely due to the respiratory connection of the Sanjiao (Triple Burner) Qi. Now, Yin-Toxic Qi obstructs the Sanjiao, preventing Ying (Nutritive) and Wei (Defensive) Qi from circulating within the twelve meridians. Consequently, if the Upper Jiao is cut off, the Cun pulse does not move; if the Middle Jiao is cut off, the Guan pulse does not move; if the Lower Jiao is cut off, the Chi pulse does not move. Although the pulse may faintly appear within the Cun, Guan, and Chi positions, it actually cannot flow up and down. Hence, it is said to "not leave the three positions." The four limbs are the root of all Yang Qi. As Yang Qi is about to perish, the limbs become heavy, and the hands and feet become cold intermittently.
According to *Mai Jing*: An extremely deep Fu pulse can only be felt when pressing the finger to the bone. Another description says it moves slightly under the hand, or feels insufficient upon pressure. It is absent upon lifting (Ju), or another description says it sinks and does not emerge at the Guan position, named Fu Pulse. The classics state: The Fu pulse is characteristic of Huoluan (Cholera-like syndrome with vomiting and diarrhea).