寸部脉紧一条弦。胸中急痛状绳牵。
寸部脉弦。则宗气不行。为寒引经络。故胸中急痛。状若绳牵也。
按脉经云。寸口脉弦。心下 微头痛。心下有水气。宜服甘遂丸。针期
门泻之。又云。脉弦上寸口者。宿食。又云寸口脉弦者。则胁下拘急而痛。
其人啬啬恶寒也。又曰。寸口弦。胃中拘急。
关中有弦寒在胃。
若关中有弦。主寒痰。令饮停于胃口。
按脉经云。关脉弦。胃中寒。心下厥逆。此以胃气虚故耳。宜服茱萸汤。温
调饮食。针胃管补之。又云。关上弦。胃中有寒。心下拘急。
下焦停水满丹田。
若弦脉见于尺部。则丹田无暖气。而失运化之机。故水停下焦。而满于
丹田也。
按脉经云。尺中弦。少腹脐下拘急。又云。尺脉弦。小腹疼。小腹及脚中拘
急。宜服建中汤当归汤。针气海泻之。
六紧者。阳也。指下寻之。三关通度。按之有余。举之甚数。状若洪弦曰紧。主
风气。伏阳上冲。化为狂病。
紧者。阳木也。何为阳木。以其脉带弦长也。指下寻之。三关通度。脉道长
矣。按之有余。邪气有余也。举指甚数。热邪在阳分也。状若洪弦者。洪为
阳明。弦为少阳。洪弦相合。此名为紧。紧为太阳。诸紧为寒。夫既曰寒。而
曰风气伏阳者。何也。如水穴论。帝曰。人伤于寒。而传为热者。何也。岐伯
曰。夫寒甚则热生也。又如冬伤于寒。春必温病是也。盖以初感其寒。伏
久则化而为热也。故主病曰风气伏阳。夫既曰弦为少阳。洪为阳明。紧
为太阳。则为三阳合病。重阳者狂。故曰风气伏阳上冲。化为狂病。洁古
曰。此太阳少阳相合。主伏阳上冲而为狂病。治之之法。宜以黄连泻心
汤。此言深为得理。学人宜玩味之。诸家言紧脉。或云如切绳。或云如转
索。皆不过形容其左右无常耳。戴起宗乃摭拾诸说。以为或转在左。或
转在右。且以两股三股。纠合徽 以为紧。安有是理也哉。不通甚焉。
按脉经云。紧脉数如切绳状。一曰如转索之无常。刘氏云。数而带弦为
紧。脉影云。紧者。其来之且急。去之且速。按举急大如转索无常。又曰动
静无常。如纫单线。诊翼曰。紧者有力而不缓也。其来劲急。按之长。举之
若牵绳转索之状。为邪风击搏。伏于荣卫之间。
寸部脉象紧而带弦，如同一条紧绷的弦线。患者感到胸部紧迫疼痛，感觉像被绳子牵拉一样。
如果寸部脉象呈弦象，说明宗气（胸中大气）运行不畅。这是因为寒邪牵引经络所致，因此出现胸部紧迫疼痛，感觉就像被绳子牵拉。
根据《脉经》记载：寸口脉弦，会出现心下部轻微头痛，心下部有水饮之气停留，适宜服用甘遂丸，并针刺期门穴以泻实。又说：脉象弦且出现在寸口部位，主宿食停滞。又说：寸口脉弦，则胁下拘急且疼痛，患者会有怕冷的表现。又说：寸口脉弦，胃中拘急不适。
根据《脉经》记载：关脉弦，表示胃中有寒，心下部出现厥逆之气。这是因为胃气虚弱所致。适宜服用茱萸汤，温养调理饮食，并针刺胃管穴用补法。又说：关上脉弦，胃中有寒，心下部拘急不适。
下焦停聚水饮，充满丹田。
如果弦脉出现在尺部，说明丹田缺乏暖气，失去了运化功能，因此水饮停滞在下焦，充满丹田。
根据《脉经》记载：尺部脉弦，少腹及脐下拘急。又说：尺脉弦，小腹痛，小腹及脚部拘急。适宜服用建中汤、当归汤，并针刺气海穴用泻法。
六紧脉属于阳脉。手指寻按脉象时，三关（寸、关、尺）通畅无阻，重按时感觉有余力，轻举时脉数明显，形状像洪大兼弦，称为紧脉。紧脉主风气，伏藏的阳气上冲，化为狂病。
紧脉属于阳木。什么是阳木？因为它的脉象带有弦长之象。手指寻按时，三关通畅，脉道显得较长。重按时感觉邪气有余，轻举时脉数明显，说明热邪在阳分。形状像洪大兼弦，洪脉对应阳明经，弦脉对应少阳经，洪与弦相合，这就叫紧脉，紧脉对应太阳经。各种紧脉都主寒证。既然说是寒，为什么又说是风气和伏阳呢？这就像《水穴论》中黄帝问岐伯：“人受寒邪侵袭，却转化为热证，为什么呢？”岐伯回答说：“寒邪极盛就会产生热。”又如冬天受寒，春天必发温病。大概是因为初感寒邪，潜伏日久就化而为热。所以主治病症说是风气伏阳。既然说弦为少阳，洪为阳明，紧为太阳，这就是三阳合病。重阳则狂，所以说风气伏阳上冲，化为狂病。洁古（张元素）说：这是太阳经与少阳经相合，主伏阳上冲而发为狂病。治疗的方法，适宜用黄连泻心汤。这番话深得医理，学习者应当仔细玩味。各家论述紧脉，有的说像切绳子，有的说像转动的绳索，都不过是形容其左右无常罢了。戴起宗收集了各种说法，认为有时向左转，有时向右转，并且用两股或三股丝线绞合来比喻紧脉，哪里有这种道理呢？这太不通了。
根据《脉经》记载：紧脉急促，像切绳子的样子。一说像转动的绳索那样无常。刘氏说：急促且带弦象就是紧脉。《脉影》说：紧脉，其来势急迫，去势迅速。按举之间，紧急宏大，像转动的绳索那样无常。又说动静无常，像缝纫的单线。《诊翼》说：紧脉有力而不舒缓。其来劲急，重按之长，轻举时像牵拉绳索转动绳索的样子。这是邪风搏击，伏藏在营卫之间。
The pulse at the Cun (inch) position is tight and wiry, like a taut string. The patient experiences urgent pain in the chest, feeling as if being pulled by a rope.
If the pulse at the Cun position presents as wiry, it indicates that Zong Qi (Master Qi in the chest) fails to circulate freely. This is caused by Cold pathogen drawing into the meridians, resulting in urgent pain in the chest, feeling as if being pulled by a rope.
According to *Mai Jing* (Pulse Classic): A wiry pulse at the Cunkou (radial artery) position manifests as slight headache below the heart and fluid retention below the heart; Gan Sui Wan (Kansui Pill) is appropriate, along with needling Qimen (LR14) to drain excess. It further states: A wiry pulse appearing at the Cunkou position indicates retained food stagnation. It also states: A wiry pulse at the Cunkou position causes stiffness and pain in the hypochondrium, accompanied by aversion to cold. It also states: A wiry pulse at the Cunkou position indicates stiffness in the stomach.
A wiry pulse at the Guan (bar) position indicates Cold in the Stomach.
If the Guan position presents a wiry pulse, it primarily indicates Cold Phlegm, causing fluid retention at the gastric opening.
According to *Mai Jing*: A wiry pulse at the Guan position indicates Cold in the Stomach and rebellious Qi below the heart. This is due to deficiency of Stomach Qi. Zhu Yu Tang (Evodia Decoction) is appropriate, along with warming and regulating the diet, and needling Weiguan (CV12) using the tonification method. It also states: A wiry pulse at the Guan upper section indicates Cold in the Stomach and stiffness below the heart.
Fluid retention in the Lower Jiao fills the Dantian.
If a wiry pulse appears at the Chi (cubit) position, it indicates a lack of warm energy in the Dantian and loss of transformation and transportation functions, causing fluid retention in the Lower Jiao and filling the Dantian.
According to *Mai Jing*: A wiry pulse at the Chi position causes stiffness in the lower abdomen and below the umbilicus. It also states: A wiry pulse at the Chi position causes pain in the lower abdomen, with stiffness in the lower abdomen and legs. Jian Zhong Tang (Middle-Juggling Decoction) and Dang Gui Tang (Angelica Decoction) are appropriate, along with needling Qihai (CV6) using the drainage method.
Six Tight pulses belong to Yang. When seeking the pulse with fingers, all three positions (Cun, Guan, Chi) are unobstructed; pressing reveals surplus strength, while lifting reveals rapidness. Its shape resembles both Full and Wiry, hence called Tight. It governs Wind Pathogen; latent Yang Qi rushes upward, transforming into Mania.
Tight pulse belongs to Yang Wood. What is Yang Wood? Because its pulse carries a Wiry and long quality. When seeking with fingers, the three positions are unobstructed, and the pulse channel appears long. Pressing reveals surplus pathogenic Qi; lifting reveals rapidness, indicating Heat pathogen in the Yang aspect. Resembling Full and Wiry: Full corresponds to Yangming, Wiry corresponds to Shaoyang. The combination of Full and Wiry is named Tight; Tight corresponds to Taiyang. All Tight pulses indicate Cold. Since it is said to be Cold, why is it also referred to as Wind Pathogen and latent Yang? As discussed in *Shui Xue Lun*, when the Yellow Emperor asked Qibo: "Why does injury by Cold transform into Heat?" Qibo replied: "When Cold is extreme, Heat arises." Similarly, Winter injury by Cold leads to Warm Disease in Spring. Generally, initial Cold infection, after lying dormant for a long time, transforms into Heat. Thus, the governing disease is described as Wind Pathogen and latent Yang. Since Wiry is Shaoyang, Full is Yangming, and Tight is Taiyang, this constitutes a combined disease of the Three Yangs. Extreme Yang leads to Mania; thus, it is said that Wind Pathogen and latent Yang rush upward, transforming into Mania. Jiegu (Zhang Yuansu) stated: This is the combination of Taiyang and Shaoyang, governing latent Yang rushing upward to cause Mania. The treatment method should utilize Huang Lian Xie Xin Tang (Coptis Decoction to Drain the Heart). This statement deeply aligns with medical principles, and students should ponder it carefully. Various schools describe the Tight pulse as either like cutting a rope or like a turning cord, merely describing its erratic nature on left and right. Dai Qizong collected these sayings, suggesting rotation to the left or right, and likened it to twisting two or three strands of thread together. Where is the logic in this? It is extremely unreasonable.
According to *Mai Jing*: The Tight pulse is rapid like cutting a rope. One description says it is like a turning cord, unpredictable. Liu Shi stated: Rapid and carrying a Wiry quality is Tight. *Mai Ying* stated: Tight means coming urgently and departing quickly. Pressing and lifting reveal urgency and largeness, like a turning cord, unpredictable. It also states dynamic unpredictability, like a single sewing thread. *Zhen Yi* stated: Tight is forceful and not slack. It comes vigorously and urgently; pressing makes it long; lifting feels like pulling or turning a rope. This is Evil Wind striking and combating, lying dormant between Ying (Nutrient) and Wei (Defensive) levels.