五弦者。阳也。指下寻之不足。举之有余状若筝弦。时时带数曰弦。主劳风
乏力。盗汗多出。手足酸疼。皮毛枯槁。
五弦者。阳也。阳木也。何为阳木。少阳之木也。少阳主春升之令。故其春
脉弦。而伤寒少阳证。其脉亦弦。是以知其。弦为阳也。说者有曰。仲景以
弦脉为阴。而叔和独以弦脉为阳者。何也。不知仲景所论者伤寒。是自
表渐入于里。自外而至内言之也。故以弦为阴。叔和所论者。劳证自内
而渐达于表。是自内而至于外言之也。故以弦为阳。然弦则为劳。故指
法则曰。指下寻之不足。阴不足也。举之有余。阳偏胜也。状若筝弦。气血
收敛也。时时带数。阴虚而生内热也。故主病曰劳风乏力。夫既曰劳。而
又曰风者何也。或因用力入房。则肾汗出。肾汗出则元府开。虚之所在。
邪必凑之。故成劳风乏力之证矣。阴不足则盗汗出。凡人之精血足。内
则渗入骨髓。外以淖泽肌肤。今既为劳风所煎熬。内无以充实骨髓。而
手足酸疼。外无以淖泽肌肤。而皮毛枯槁也。
按脉经云。弦脉举之无有。按之如弓弦状。一曰如张弓弦。按之不移。又
曰沉紧为弦。经云。弦数为疟。又云疟脉自弦。弦数多热。弦迟多寒。弦为
痛痹。为风疰。偏弦为饮。双弦则胁下拘急而痛。其人啬啬恶寒。又曰弦
而钩。胁下如刀刺。状如蜚尸。至困死。经又云。弦急疝瘕小腹痛。又为癖
病。又云弦小者寒 。又云沉而弦者悬饮内痛。又云。弦数有寒饮。冬夏
难治。又云弦而紧胁痛。藏伤有瘀血。又云弦小紧者。可下之。又云弦迟
者。宜温药。
又按此事难知曰。仲景论弦涩为阴。叔和言弦涩为阳何意。大抵弦涩
东西也。以南北分之。故有阴阳之别。涩本燥火。弦本水少。虽有南北之
分。总而言之。则不离诸数为热。诸迟为寒。仲景叔和。言本两途。非相违
背。合而论之。皆是也。仲景所言。言伤寒自外而入者。叔和所言。言五脏
自内而出者。伤寒从气而入。故仲景以弦脉为阴。自艮而之内。从外入。
先太阳也。位在东北。杂病从血而出。故叔和以弦脉为阳。自巽而之外
从内出。先少阳也。位在东南。
五条弦脉，属于阳。指下重按感觉力量不足，轻取则感觉有余，脉象形状像筝上的弦，时常兼有数脉的跳动频率，称为弦脉。主要主治劳风病，表现为乏力、夜间盗汗且出汗量大、手足酸痛、皮肤毛发干枯憔悴。
五条弦脉，属于阳，即阳木。什么是阳木？就是少阳之木。少阳主管春季升发的气令，所以春天的脉象是弦脉；而伤寒病中的少阳证，其脉象也是弦脉。因此可以知道，弦脉属于阳。有人说，张仲景将弦脉归为阴，而王叔和独将弦脉归为阳，这是为什么呢？不知道张仲景论述的是伤寒病，是从体表逐渐传入体内，从外到内来说的，所以将弦脉视为阴；王叔和论述的是虚劳证，是从体内逐渐达于体表，从内到外来说的，所以将弦脉视为阳。然而弦脉主虚劳，所以诊察法则说：指下重按感觉不足，说明阴气不足；轻取感觉有余，说明阳气偏盛；脉象形状像筝弦，说明气血收敛；时常兼有数脉，说明阴虚而生内热。因此主治病症说是劳风乏力。既然叫“劳”，又为什么叫“风”呢？可能是因为过度用力或房事不节，导致肾汗排出，肾汗出则玄府（汗孔）开放，正气虚弱的地方，邪气必然侵袭，从而形成劳风乏力的证候。阴气不足则导致盗汗。凡是人的精血充足时，在内能渗入骨髓，在外能滋润肌肤。现在既被劳风所煎熬，在内无法充实骨髓，所以手足酸痛；在外无法滋润肌肤，所以皮肤毛发干枯憔悴。
按《脉经》记载：弦脉轻取似乎没有，重按时像弓弦一样坚硬。另一种说法是像拉开的弓弦，重按时位置不移。又说沉紧的脉象称为弦。经典中说：弦数脉多见于疟疾。又说疟疾的脉象自然呈弦象。弦数脉多属热证，弦迟脉多属寒证。弦脉主痛痹和风疰（一种慢性消耗性疾病）。单侧弦脉主饮邪停聚，双侧弦脉则胁肋下拘急疼痛，病人怕冷发抖。又说弦而钩的脉象，胁下疼痛如刀刺，状如飞尸鬼注，病情危重可致死。经典又说：弦急脉主疝气和瘕积（腹内结块），小腹痛。又主癖病（腹内结块）。又说弦小脉主寒证。又说沉而弦的脉象主悬饮（胸胁间积水）和内痛。又说弦数脉伴有寒饮，冬夏两季都难治。又说弦而紧的脉象主胁痛，脏腑受伤且有瘀血。又说弦小紧的脉象，可以用攻下法治疗。又说弦迟脉，适宜用温药治疗。
又按《此事难知》记载：张仲景论述弦涩脉为阴，王叔和说弦涩脉为阳，这是什么意思？大抵上，弦脉对应东方，涩脉对应西方，以南北来划分阴阳。所以有阴阳的区别。涩脉本属燥火，弦脉本属水少。虽然有南北方位之分，总而言之，不离乎“诸数为热，诸迟为寒”的原则。张仲景和王叔和的说法原本出自两个不同的角度，并非相互违背，合起来看都是正确的。张仲景所说的，是指伤寒病从外部侵入；王叔和所说的，是指五脏病变从内部发出。伤寒从气分侵入，所以张仲景将弦脉视为阴，是从艮卦（东北方）向内，从外入内，先涉及太阳经。位在东北方。杂病从血分而出，所以王叔和将弦脉视为阳，是从巽卦（东南方）向外，从内出外，先涉及少阳经。位在东南方。
The five-string pulse belongs to Yang. Upon deep pressure, the force feels insufficient; upon light pressure, it feels abundant. Its shape resembles the strings of a zither (zheng). When it occasionally carries a rapid frequency, it is called the Wiry Pulse (Xian Mai, 弦脉). It primarily governs Labor-Wind disease, manifesting as fatigue, night sweats with profuse sweating, soreness and pain in the hands and feet, and dry, withered skin and hair.
The five-string pulse belongs to Yang, which is Yang Wood. What is Yang Wood? It is the Wood of Shaoyang (Lesser Yang). Shaoyang governs the ascending command of spring. Therefore, the spring pulse is wiry. In Taiyang-Shaoyang syndrome (Shaoyang syndrome of Cold Damage), the pulse is also wiry. Thus, we know that the wiry pulse belongs to Yang. Some say that Zhang Zhongjing classified the wiry pulse as Yin, while Wang Shuhe alone classified it as Yang. Why? It is unknown that Zhang Zhongjing discussed Cold Damage (Shanghan), describing the progression from the exterior gradually entering the interior, from outside to inside; hence, he regarded the wiry pulse as Yin. Wang Shuhe discussed consumptive diseases (Lao Zheng), describing the progression from the interior gradually reaching the exterior, from inside to outside; hence, he regarded the wiry pulse as Yang. However, since the wiry pulse indicates consumption/labor, the palpation method states: "Insufficient upon deep pressure" indicates Yin insufficiency; "Abundant upon light pressure" indicates Yang excess; "Shape like zither strings" indicates the contraction of Qi and Blood; "Occasionally rapid" indicates internal heat generated by Yin deficiency. Therefore, the governing diseases are stated as labor-wind and fatigue. Since it is called "labor," why is it also called "wind"? This may be due to excessive physical exertion or sexual indiscretion, causing Kidney sweat to emerge. When Kidney sweat emerges, the Yuan Fu (pores) open. Where there is deficiency, pathogenic factors inevitably converge, thus forming the syndrome of labor-wind and fatigue. Yin insufficiency leads to night sweats. Normally, when Essence and Blood are sufficient, they penetrate into the Marrow internally and moisten the Skin and Hair externally. Now, having been scorched by labor-wind, internally there is no capacity to fill the Marrow, resulting in soreness and pain in the hands and feet; externally there is no capacity to moisten the Skin and Hair, resulting in dry and withered integument.
According to the *Mai Jing* (Pulse Classic): The wiry pulse seems absent upon light pressure but feels hard like a bowstring upon deep pressure. Another description says it is like a drawn bowstring, remaining fixed upon pressure. It is also said that a deep and tight pulse is wiry. The classics state: "Wiry and rapid pulses indicate Malaria." It is also said: "The pulse of malaria is naturally wiry." Wiry-rapid pulses indicate Heat; wiry-slow pulses indicate Cold. The wiry pulse governs Painful Obstruction (Tong Bi) and Feng Zhu (a chronic wasting disease). A unilateral wiry pulse indicates Fluid retention (Yin); bilateral wiry pulses indicate hypochondriac stiffness, urgency, and pain, accompanied by aversion to cold and shivering. It is also said that a wiry and hook-like pulse causes stabbing pain under the hypochondrium, resembling Fei Shi (flying corpse/ghost affliction), leading to critical illness and death. The classics further state: "Wiry and urgent pulses indicate Hernia and Jia masses (abdominal lumps) with lower abdominal pain." It also governs Pi diseases (abdominal masses). It is also said: "Wiry and small pulses indicate Cold." It is also said: "Deep and wiry pulses indicate Xuan Yin (fluid retention in the chest/hypochondrium) and internal pain." It is also said: "Wiry-rapid pulses with cold-fluid retention are difficult to treat in both winter and summer." It is also said: "Wiry and tight pulses indicate hypochondriac pain, organ injury, and blood stasis." It is also said: "Wiry-small-tight pulses can be treated with purgatives." It is also said: "Wiry-slow pulses are suitable for warm herbs."
Furthermore, according to *Ci Nan Zhi* (Difficulties of the Matter): Zhang Zhongjing discusses wiry and choppy pulses as Yin, while Wang Shuhe states wiry and choppy pulses as Yang. What is the meaning? Generally, the wiry pulse corresponds to the East, and the choppy pulse to the West, divided by North and South. Hence, there is a distinction between Yin and Yang. The choppy pulse essentially belongs to Dryness-Fire, while the wiry pulse essentially belongs to deficient Water. Although there is a division of North and South, in summary, it does not depart from the principle that "all rapid pulses indicate Heat, all slow pulses indicate Cold." The theories of Zhang Zhongjing and Wang Shuhe originate from two different approaches and do not contradict each other; considered together, both are correct. Zhang Zhongjing's statement refers to Cold Damage entering from the exterior; Wang Shuhe's statement refers to the Five Viscera manifesting from the interior. Cold Damage enters via Qi; therefore, Zhang Zhongjing regards the wiry pulse as Yin, moving from Gen (Northeast) inward, from exterior to interior, first involving the Taiyang channel. Its position is in the Northeast. Miscellaneous diseases exit via Blood; therefore, Wang Shuhe regards the wiry pulse as Yang, moving from Xun (Southeast) outward, from interior to exterior, first involving the Shaoyang channel. Its position is in the Southeast.