体象 濡脉细软,见于浮分;举之乃见,按之即空。
濡者,即软之象也。必在浮候见其细软,若中候沉候,不可得而见也。叔和比之“帛浮水面”,时珍比之
“水上浮沤”,皆状其随手而没之象也。
主病 濡主阴虚,髓竭精伤。左寸濡者,健忘惊悸。濡在左关,血不荣筋。左尺得濡,精血枯损。
右寸濡者,腠虚自汗。濡在右关,脾虚湿侵。右尺得濡,火败命倾。
按浮主气分,浮取之而可得,气犹未败;沉主血分,沉按之而如无,此精血衰败。在久病老年之人,尚未
至于必绝,为其脉与证合也;若平人及少壮及暴病见之,名为无根之脉,去死不远。叔和言“轻手相
得,按之无有。”伪诀反言“按之似有举之无。”悖戾一至于此耶!且按之则似有,举之则还无,是弱脉
而非濡脉矣。濡脉之浮软,与虚脉相类,但虚脉形大而濡脉形小也。濡脉之细小,与弱脉相类,但弱在
沉分而濡在浮分也。濡脉之无根,与散脉相类,但散脉从浮大而渐至于沉,濡脉从浮小而渐至于不
见也;从大而至沉者全凶,从小而之无者为吉凶相半也。又主四体骨蒸,盖因肾气衰绝,水不胜火耳。
体象 弱脉细小,见于沉分;举之则无,按之乃得。
沉而且细且小,体不充,势不鼓也。
主病 弱为阳陷,真气衰弱。左寸弱者,惊悸健忘。弱在左关,木枯挛急。左尺得弱,涸流可征。
右寸弱者,自汗短气。弱在右关,水谷之 。右尺得弱,阳陷可验。
夫浮以候阳,阳主气分,浮取之而如无,则阳气衰微,确然可据。夫阳气者,所以卫外而为固者也;亦以
营运三焦,熟腐五谷者也。柳氏曰∶“气虚则脉弱。寸弱阳虚,尺弱阴虚,关弱胃虚。弱脉呈形,而阴霾已
极,自非见 ,而阳何以复耶?”《素问·玉机真藏论》曰∶“脉弱以滑,是有胃气。脉弱以涩,是为久病。”
愚谓弱堪重按,阴犹未绝;若兼涩象,则气血交败,生理灭绝矣。仲景云∶“阳陷入阴,当恶寒发热,久病
及衰年见之,犹可维援;新病及少壮得之,不死安待!”
按《脉经》曰∶“弱脉极软而沉细,按之乃得,举手无有。”何其彰明详尽也。伪诀谓“轻手而得”,明与叔
和相戾,且是濡脉之形,而非弱脉之象。因知伪诀误以濡脉为弱,弱脉为濡,其卤莽特甚。即黎氏浮沤
之譬,亦踵高阳之弊,不可不详加考据也。
【体象】濡脉的形态细软,出现在浮取部位;轻举手指即可触及,重按则感觉空虚无物。
濡脉,就是柔软的形象。必须在浮候(轻取)时见到其细软之象,如果在中候(中取)和沉候(重取)时,就无法见到了。王叔和将其比喻为“丝绸漂浮在水面”,李时珍将其比喻为“水上浮泡”,都是形容它随手按压就消失不见的形象。
【主病】濡脉主要主阴虚证,髓海枯竭、精气损伤。左寸部出现濡脉,表现为健忘、惊悸。濡脉出现在左关部,表示血液不能滋养筋脉。左尺部出现濡脉,表示精血枯损。右寸部出现濡脉,表示腠理疏松、自汗出。濡脉出现在右关部,表示脾虚湿邪侵袭。右尺部出现濡脉,表示命门火衰、生命垂危。
一般来说,浮脉主气分病变,轻取可得,说明气尚未败坏;沉脉主血分病变,重按若无,说明精血衰败。对于久病或老年患者,虽然出现这种脉象,但尚未至于必死无疑,这是因为脉象与症状相符;如果是健康人、年轻人或突发疾病的人出现这种脉象,称为无根之脉,离死亡不远了。王叔和说:“轻手相得,按之无有。”而伪托的《脉诀》反而说:“按之似有,举之无。”违背常理到了这种地步!而且如果按之似乎有,举之反而无,这是弱脉而不是濡脉了。濡脉的浮软,与虚脉相似,但虚脉形态大而濡脉形态小。濡脉的细小,与弱脉相似,但弱脉在沉分出现而濡脉在浮分出现。濡脉的无根,与散脉相似,但散脉是从浮大逐渐变为沉伏,濡脉是从浮小逐渐变为看不见;从大而至沉者全凶,从小而至无者为吉凶参半。另外,濡脉也主四肢骨蒸热,这是因为肾气衰绝,水不能制火所致。
【体象】弱脉的形态细小,出现在沉取部位;轻举手指则无,重按才能触及。
沉而且细而且小,脉体不充盈,脉势不鼓动。
【主病】弱脉主阳气下陷,真气衰弱。左寸部出现弱脉,表现为惊悸、健忘。弱脉出现在左关部,表示肝木干枯、筋脉拘挛。左尺部出现弱脉,表示肾水枯竭可征。右寸部出现弱脉,表现为自汗、短气。弱脉出现在右关部,表示脾胃虚弱、运化无力。右尺部出现弱脉,表示阳气下陷可以验证。
浮脉用来候阳,阳主气分,轻取若无,则阳气衰微,确实可信。阳气,是用来卫护体表并固摄津液的;也是用来营运三焦、腐熟五谷的。柳氏说:“气虚则脉弱。寸部弱为阳虚,尺部弱为阴虚,关部弱为胃虚。弱脉呈现这种形态,说明阴寒之气已极盛,如果不是见到阳气来复,阳气怎么能恢复呢?”《素问·玉机真藏论》说:“脉弱而滑,是有胃气。脉弱而涩,是久病。”我认为弱脉可以重按,说明阴气尚未绝灭;如果兼见涩象,则气血交相败坏,生理机能灭绝了。张仲景说:“阳气陷入阴分,应当恶寒发热,久病及衰老之年见到此脉,还可以挽救;新病及年轻力壮之人得到此脉,不死又等待什么呢!”
按《脉经》说:“弱脉极软而沉细,按之乃得,举手无有。”多么明白详尽啊!伪托的《脉诀》说“轻手而得”,明显与王叔和的说法相违背,而且这是濡脉的形态,而不是弱脉的形象。由此可知,伪托的《脉诀》错误地将濡脉当作弱脉,将弱脉当作濡脉,其粗疏荒谬特别严重。即使是黎氏用浮沤作比喻,也是沿袭高阳生的弊病,不可不详加考证。
[Physical Characteristics] The Ru (Soft) pulse is fine and soft, appearing in the floating position; it can be felt with light pressure but feels empty upon heavy pressure.
Ru means the image of softness. It must be observed as fine and soft at the floating level (light pressure); it cannot be seen at the middle level (moderate pressure) or deep level (heavy pressure). Wang Shuhe compared it to "silk floating on water," and Li Shizhen compared it to "bubbles floating on water," both describing its characteristic of disappearing upon pressing.
[Indications] The Ru pulse primarily indicates Yin deficiency, exhaustion of marrow, and injury to essence. A Ru pulse at the left Cun position indicates forgetfulness and palpitations. A Ru pulse at the left Guan position indicates blood failing to nourish the tendons. A Ru pulse at the left Chi position indicates withered and damaged essence and blood. A Ru pulse at the right Cun position indicates loose interstices and spontaneous sweating. A Ru pulse at the right Guan position indicates Spleen deficiency with dampness invasion. A Ru pulse at the right Chi position indicates failure of Mingmen fire and impending death.
Generally, a floating pulse relates to the Qi aspect; being detectable with light pressure suggests that Qi has not yet failed. A deep pulse relates to the Blood aspect; feeling absent upon heavy pressure suggests the decline of essence and blood. In cases of chronic illness or in the elderly, although this pulse appears, it does not necessarily mean imminent death, because the pulse matches the symptoms. However, if seen in healthy individuals, the young and vigorous, or in acute illnesses, it is called a Rootless Pulse, indicating that death is near. Wang Shuhe stated, "Felt with light hand, absent upon pressing." Conversely, the spurious *Mai Jue* states, "Seems present upon pressing, absent upon lifting." How contrary to reason! Moreover, if it seems present upon pressing but absent upon lifting, this is the Ruo (Weak) pulse, not the Ru pulse. The floating softness of the Ru pulse is similar to the Xu (Deficient) pulse, but the Xu pulse is large in form while the Ru pulse is small. The fineness of the Ru pulse is similar to the Ruo pulse, but the Ruo pulse appears in the deep position while the Ru pulse appears in the floating position. The rootlessness of the Ru pulse is similar to the San (Scattered) pulse, but the San pulse goes from floating-large to gradually deep, whereas the Ru pulse goes from floating-small to gradually invisible; going from large to deep is entirely ominous, while going from small to invisible is half auspicious and half ominous. Additionally, the Ru pulse also governs bone-steaming heat in the four limbs, caused by the exhaustion of Kidney Qi, where Water fails to control Fire.
[Physical Characteristics] The Ruo (Weak) pulse is fine and small, appearing in the deep position; it is absent upon light pressure but felt upon heavy pressure.
It is deep, fine, and small; the body is not full, and the momentum does not surge.
[Indications] The Ruo pulse indicates sinking of Yang and weakness of true Qi. A Ruo pulse at the left Cun position indicates palpitations and forgetfulness. A Ruo pulse at the left Guan position indicates dry Liver Wood and tendon spasms. A Ruo pulse at the left Chi position indicates dried-up flow (Kidney Yin/Essence depletion). A Ruo pulse at the right Cun position indicates spontaneous sweating and shortness of breath. A Ruo pulse at the right Guan position indicates deficiency in processing food and drink. A Ruo pulse at the right Chi position confirms the sinking of Yang.
Floating pulse is used to examine Yang; Yang governs the Qi aspect. If it is absent upon light pressure, then Yang Qi is severely deficient, which is undeniable. Yang Qi serves to protect the exterior and consolidate; it also circulates through the Triple Burner and ripens the five grains. Liu said: "Qi deficiency leads to a weak pulse. Weakness at Cun indicates Yang deficiency, at Chi indicates Yin deficiency, at Guan indicates Stomach deficiency. When the Ruo pulse presents this form, Yin pathogens are extremely abundant; unless Yang returns, how can Yang recover?" The *Su Wen · Yu Ji Zhen Zang Lun* states: "A pulse that is weak and slippery indicates the presence of Stomach Qi. A pulse that is weak and choppy indicates a chronic illness." I believe that the Ruo pulse can be pressed heavily, suggesting that Yin has not yet perished; if accompanied by a Choppy (Se) quality, then Qi and Blood are mutually failing, and physiological life is extinguished. Zhang Zhongjing said: "When Yang sinks into Yin, there should be aversion to cold and fever. Seen in chronic illness and old age, it can still be supported; seen in new illness and youth, death is inevitable!"
According to the *Mai Jing*: "The Ruo pulse is extremely soft, deep, and fine; it is obtained only upon pressing and is absent upon lifting." How clear and detailed! The spurious *Mai Jue* claims it is "obtained with light hand," which clearly contradicts Wang Shuhe. Furthermore, this describes the form of the Ru pulse, not the image of the Ruo pulse. Thus, we know that the spurious *Mai Jue* mistakenly identified the Ru pulse as Ruo and the Ruo pulse as Ru, showing extreme carelessness. Even Li's metaphor of floating bubbles follows the errors of Gao Yangsheng and requires careful verification.