(直看横推)
提纲要脉,不越浮、沉、迟、数、滑、涩六字,以足该表里阴阳、冷热虚实、风寒燥湿
腑气血也。盖浮为阳、为表;沉为阴、为里;迟为在脏,为冷、为虚、为寒;数为在腑,为热
、为燥、为实;滑为血有余;涩为气独滞。能于是缕晰以求之,而 疾莫能逃矣。顾浮沉以
举按轻重言,若洪、芤、弦、虚、濡、长、散,皆轻按而得之类,故统于浮;短、细、实、
伏、牢、革、代,皆重手而得之类,故统于沉。迟数以息至多少言,若微、弱、缓、结,皆
迟之类,故统于迟;紧、促、动,皆数之类,故统于数。至如滑虽似数,涩虽似迟;而其理
自殊,缘迟数以呼吸察其至数,滑涩则以往来察其形状,且滑涩二脉,多主气血故也,故此
二脉,虽无所统,亦平列于后,以为六纲云。
浮 浮以候表(其象轻手乃得,重手不见,动在肌肉以上。)
浮为风虚眩掉之候。阳脉浮,表热。阴脉浮,表虚。秋为正,肺脉宜,久病则忌。
左寸(伤风、发热、头疼、目眩、风痰。兼虚迟,心气不足、心神不安。兼散,心耗虚
烦。兼洪散,心热。)
左关腹胀。兼数,风热入肝经。兼促,怒气伤肝,心胸满逆。
左尺(膀胱风热,小便赤涩。兼芤,男子尿血。女子崩漏。兼迟,冷疝,脐下痛。)
右寸(肺感风寒,咳喘、鼻寒、清涕、自汗、体倦。兼洪,肺热而咳。兼迟,肺寒喘嗽
。)
右关(脾虚,中满不食。兼大涩,宿食。兼迟,脾胃虚。兼滑,痰饮。)
右迟(风邪客下焦,大便秘。兼数,下焦风热,大便秘。兼虚,元气不足。)
浮而有力为洪
(即大脉,又名钩脉。其象极大而数,按之满指,如群波之涌,来盛去衰,来大去长也
洪为经络大热,血气燔灼之候,夏为正,心脉宜。
血久嗽忌。形瘦多气者死。凡脉洪则病进。
(为表里皆热,为大小便秘,为烦,为口燥咽干。)
左寸(心经热,目赤、口疮、头疼痛、心内烦。)
左关(肝热,身痛、四肢浮热。)
左尺(膀胱热,小便赤涩。)
右寸(肺热,毛焦、唾粘、咽干。)
右关(胃热,反胃、呕吐、口干。兼紧,胸中胀满。)
右尺(腹满、大便难或下血。)
浮而无力为芤
(其象浮大而软,按之中有两边无,中空两边实,指下成窟,诊在浮举重按之间得之。)
芤为失血之候,大抵气有余血不足,血不足以载气,故虚而大,为芤之状。火犯阳经,
血上溢,火侵阴络,血下流,三部脉芤,久病生,卒病死。
左寸(心血妄行、吐衄。)
左关(胁间血气动,腹中瘀血、吐血,目暗而常昏。)
左尺(小便血、女子月事为病。)
右寸(胸有积血,或衄或呕。)
右关(肠痈瘀血,呕血不食。)
右尺(大便血。)
(古人云,前大后细,脱血也,夫前大后细,非芤而何。)
浮而端直为弦
(其象按之不移,举之应手,端直如新张弓弦之状。)
弦为血气收敛,为阳中伏阴,或经络间为寒所滞之候。弦紧数劲为太过,弦紧而细为不
及;
弦而软病轻,弦而硬病重;轻虚以滑者平,实滑如循长竿者病;劲急如新张弓弦者死。春为
正,肝脉宜,若肝木克土而至不食难治。疟病自弦。
(凡脉弦,为痛,为疟,为疝,为饮,为冷痹,为劳倦,为拘急,为寒热,为血虚盗汗
,为寒凝气结。兼数,劳疟。兼长,中有积滞。双弦,胁急痛。)
左寸(头疼、心惕、劳伤、盗汗、乏力。)
左关(胁肋痛、 癖。兼小,寒冷癖。兼紧,瘀血、疝瘕。)
左尺(小腹痛。兼滑,腰脚痛。)
右寸(肺经受风寒,咳嗽胸膈间有寒痰。)
右头(脾胃伤冷、宿食不化、心腹冷痛,又为饮。)
右尺(脐下急痛不安,下焦停水。)
浮而迟大为虚
(其象迟软散大,举按少力,豁然空,不能自固。)
虚为气血俱虚之候,气血虚则脉虚,主多在内不足之症,久病脉虚,多不治。
(凡脉虚,为伤暑,为虚烦,为自汗,为小儿惊风。)
寸(血不荣心、怔忡、恍惚、惊悸。)
关(腹胀、食不易化。)
尺(骨蒸、痿痹、精血亏损。)
浮而迟细为濡
(即软脉。其象虚软无力,应手细散,如绵絮之在水中,轻手相得,重手按之,即随手
而没。)
濡为气血两虚之候,亦主脾湿,病后产后可治,平人脉濡难治。
(凡脉濡,为疲损,为自汗,为痹,为下冷,为无血少气。)
左寸(心虚易惊、盗汗、短气。)
左关(荣卫不和、精神离散、体虚懒、少力。)
左尺(男伤精女脱血、小便数、自汗多。)
右寸(烘热憎寒、气乏体虚。)
右关(脾弱,食不化;胃虚,食不进。)
右尺(下元冷惫、肠虚泄泻。)
浮而迢亘为长
(其象不大不小,迢迢自若,指下有余,过于本位。)
长为气血皆有余之候,有三部之长,有一部之长,按之如牵绳,则病矣。长属肝,宜于
春,诊无病肝脉自见。
(凡脉长,为壮热,为癫痫,为阳毒内蕴,为三焦烦热,为阳明热甚。)
浮而虚大为散
(其象有表无里,有阴无阳,按之满指,散而不聚,来去不明,漫无根柢,如涣散不收
。)
散为气血耗散,脏腑气绝之候,在病脉主虚阳不敛,又主心气不足,大抵非佳兆也。心
浮大
而散,肺短涩而散,犹为平脉。若病脉见代散,必死。产妇脉散,临盆之兆,如未到产期,
必致堕胎。
寸(怔忡、雨汗。)
关(溢饮、 肿。)
尺(肾绝。)
沉 沉以候里(其象轻手不见,重手乃得,按至肌肉以下,着于筋骨之间。)
沉为阴逆阳虚之候,主阴经、主气、主水、主寒、主骨,太过病在外,不及病在内,冬
为正,女寸男尺俱宜。
(凡脉沉,为停饮,为癖瘕,为胁胀,为厥逆,为洞泄。兼细,少气。兼滑,宿食停滞
。兼迟,痼冷内寒。兼伏,霍乱吐泻。兼数,内热甚。兼弦,心腹冷痛。)
左寸(心内寒邪痛、胸中寒饮、胁痛。)
左关(伏寒在经,两胁刺痛。兼弦, 癖内痛。)
左尺(肾脏寒,腰背冷痛、小便浊而频、男为精冷女为血结。兼细,胫酸阴痒、溺有余
沥。)
右寸(肺冷,寒痰停蓄、虚喘少气。兼紧滑,咳嗽。兼细滑,骨蒸寒热、皮毛焦干。)
右关(胃中寒积,中满吐酸。兼紧,悬饮。)
右尺(病水,腰脚痛。兼细,下利、小便滑、脐下冷痛。)
沉而不及为短
(其象两头无,中间有,不及本位,应手而回。)
短为气不足以前导其血之候,俱主不及之病。短脉只见寸尺,若关部短,则上不通寸,
下
不能尺,是阴阳绝脉,必死,故关不诊短。短属肺,宜于秋,诊无病肺脉,其形自可见。
(凡脉短,为三焦气壅,为宿食不消。兼浮,血涩。兼沉,痞块。兼滑数,酒伤肠胃。)
寸(头痛。)
尺(腹痛。)
沉而微软为细
(其象小于微而常有,细直而软,指下寻之,往来如蚕丝状。)
细为血冷气虚不足以充之候,故主诸虚劳损,或湿侵腰肾,应病则顺,否则逆。吐衄得
之
生,春夏与少年不利,秋冬与老弱可治。忧劳过度者脉亦细,凡细脉,病俱在内、在下。
(凡脉细,为元气不足,乏力,无精,内外俱冷,痿弱,洞泄,为积,为痛。)
寸(呕吐。)
关(胃虚,腹胀。)
尺(丹田冷,泄痢、遗精。)
沉而弦长为实
(其象举按不绝,迢亘而长,不疾不徐,动而有力。)
实为三焦气满之候,俱主有余之病。
(凡脉实,为呕,为痛,为利,为气寒,为气聚,为食积、为伏阳在内。)
左寸(心中积热,口舌疮、咽喉痛。兼大,头面热风、烦躁、体痛、面赤。)
左关(腹胁痛满。兼浮大,肝盛,目暗、痛而赤色。)
左尺(少腹痛、小便涩。兼滑,茎中痛、淋沥不止、溺赤色。兼大,膀胱热结,小便难
。兼紧,腰脊疼痛。)
右寸(胸中热,痰嗽、烦满。兼浮,肺热,咽燥而疼、喘嗽、气壅。)
右关(伏阳蒸内、脾虚食少、胃气壅滞。兼浮,脾热,消中善饥、口干、劳倦。)
右尺(脐下痛、便难或时下利。)
沉极几无为伏
(其象极重按之,至于透筋着骨,指下始觉隐隐然。)
伏为阴阳潜伏,关格闭塞之候,关前得之为阳伏,关后得之为阴伏,脉伏者不可发汗,
痛甚者脉必伏。
(凡脉伏,为积聚,为瘕 ,为霍乱,为水气,为食不消,为荣卫气闭而厥逆。)
左寸(心气不足、神不守常、忧郁。)
左关(血冷、腰脚痛、胁下寒气。)
左尺(肾寒精虚、瘕疝寒痛。)
右寸(胸中冷滞、寒痰积冷。)
右关(中脘积块作痛、脾胃间停滞痞积。)
右尺(脐下冷痛、下焦虚寒或痛、腹中痛冷、少腹痛。)
沉而有力为牢
(其象似沉似伏,实大而长,少弦,按之动而不移,若牢固然。)
牢为里实表虚,胸中气促,劳伤痿极之候。大抵牢脉近乎无胃气者,故为危殆之脉。如
失血人宜沉细,若浮大而牢,必死,以虚病反见实脉也。
(凡脉牢,为气居于表,为骨节疼痛。)
寸
关(木乘土而心腹寒疼。)
尺( 疝、 瘕。)
沉失常度为革
(其象沉伏实大,如按鼓皮一般。)
革为虚寒失血之候,其实即芤弦二脉相合之象,芤为虚,弦为寒,虚寒相搏,故主男子
亡血
失精,女子半产漏下,又为中风感湿之症。久病死,卒病生。脉来混浊变革,急如涌泉,出
而不反,病进而危,去如弦绝者死。
寸
关
尺
沉而更代为代
(其象动而中止,不能自还,因而复动,由是复止,寻之良久,乃复强起而动。)
代为脏气多衰,形容羸瘦,口不能言之候。若不病而羸瘦,脉代止,是一脏无气,他脏
代之
,必危;若因病而气血骤损,致元气卒不相绩,或风家痛家,只为病脉,故伤寒亦有心悸而
脉代者(复脉汤主之。)腹心疼亦有结涩止代不匀者,久痛之脉,不可准也;妊娠脉代,必怀
胎三月,代脉有生有死,非定为死脉,宜辨之。
(凡脉代,为腹痛,为便脓血,为泄利吐泻,为下元虚损。)
迟 迟以候脏(其象呼吸之间,脉仅三至,去来极慢。)
迟为阴盛阳虚之候,阳不胜阴,故脉来不及也。居寸为气不足,气寒则缩也;居尺为血
不足,血寒则凝也。
(凡脉迟,为寒,为虚。兼浮,表寒。兼沉,里寒。)
左寸(心上寒、精气多惨。)
左关(筋寒急、胁下痛、手足冷。)
左尺(肾虚便溺、女人不月。)
右寸(肺感寒、冷痰、气短。)
右关(中焦寒,脾胃伤冷物。不食,食不化。兼沉为积。)
右尺(脏寒泄泻、小腹冷痛、腰脚重。)
迟而细软为微
(其象极细而软,若有若无,多兼于迟,按之如欲绝。)
微为久虚血弱之候,又主阴寒或伤寒蓄热在里,脉道不利,亦微细濡弱,不可为寒者,
当以标本别之,总之气血微脉即微。
(凡脉微,为虚弱,为虚汗,为泄泻,为少气,为崩漏不止。兼浮,阳不足,必身恶寒
冷。兼沉,阴不足,必脏寒下利。)
左寸(心虚忧惕、荣血不足。)
左关(胸满气乏、四肢恶寒、拘急。)
左尺(男子伤精尿血,女子崩漏败血不止或赤白带下。)
右寸(上焦寒、痞痛、冷痰凝结不化、中寒少气。)
右关(胃寒气胀、食不能化、脾虚噫气、心腹冷痛。)
右尺(脏寒泄泻、脐下冷痛。)
迟而无力为弱
(其象极软而沉细,怏怏不前,无息以动,按之如欲绝,略举手即无。)
弱为阳陷入阴,精气不足之候,亦主筋。脉弱以滑,是有胃气,脉弱以涩,是为久病;
阳浮阴弱,应为血虚筋急、恶寒发热之病。老得之顺,壮得之逆。
(凡脉弱,为痼冷,为烘热,为泄精,为虚汗,为元气亏耗,为痿弱不前。)
左寸(阳虚心悸、自汗。)
左关(筋痿无力,女人主产后客风面肿。)
左尺(小便频数、肾元虚、耳鸣或聋、骨肉间酸疼。)
右寸(身冷多寒、胸中短气。)
右关(脾胃虚、食不化。)
右尺(下焦冷痛、大便滑泄不禁。)
迟而有力为缓
(其象比浮而稍大,似迟而小疾,一息四至,来往纡缓,呼吸徐徐。)
缓为气血向衰之候。若不沉不浮,从容和缓,乃脾家之正脉。四季亦为平脉,非时即病
。和缓而匀,无浮沉徐疾微弱之偏,即为胃气脉。
(凡脉缓,为风,为虚,为痹,为弱,为疼。在上为项强,在下为脚弱。兼浮,感风。
兼沉,血气弱。)
左寸(心气不足,怔忡、健忘。亦主项背拘急而痛。)
左关(风虚眩晕、腹胁气结。)
左尺(肾元虚冷、小便频数,女人主月事过多。)
右寸(肺气浮、言语短气。)
右关(胃弱、气虚。兼浮,脾虚。)
右尺(下寒脚弱、风气秘滞。兼浮,肠风泄泻。兼沉,小腹感冷。)
迟而时止为结
(其象来时迟缓,时一止,复又来。)
结为阴独盛而阳不能相入之候,此为阴脉之极。按之累累如循长竿曰阴结,蔼蔼如张车
(直看横推)
提纲领地把握脉象,不离浮、沉、迟、数、滑、涩这六个字,以此涵盖表里、阴阳、冷热、虚实、风寒燥湿以及腑气、气血等所有脉象。大概来说,浮脉属阳、主表证;沉脉属阴、主里证;迟脉主在脏、主冷、主虚、主寒;数脉主在腑、主热、主燥、主实;滑脉主血有余;涩脉主气独滞。能够在此细细辨析以求索,那么各种疾病就无处遁形了。至于浮沉是根据举(轻按)和按(重按)的轻重力度而言的,像洪、芤、弦、虚、濡、长、散这些脉象,都是轻按就能得知的类型,所以统归于浮脉;短、细、实、伏、牢、革、代这些脉象,都是重手按压才能得知的类型,所以统归于沉脉。迟数以呼吸的次数多少来区分,像微、弱、缓、结这些脉象,都属于迟脉一类,所以统归于迟脉;紧、促、动这些脉象,都属于数脉一类,所以统归于数脉。至于滑脉虽然看似数脉,涩脉虽然看似迟脉;但其道理自然不同,因为迟数和滑涩的区别在于:迟数是依靠呼吸来观察脉搏至数的快慢,而滑涩则是通过脉搏往来时的形态来观察,而且滑涩二脉多与气血有关,所以这两类脉象,虽然无法归入上述六纲统领,但也并列放在后面,作为六纲的补充。
浮脉
浮脉用来候察表证(其形象是轻手触摸即可感知,重手触摸则不明显,跳动位置在肌肉以上。)
浮脉是风邪侵袭或虚损导致眩晕、震颤的征候。阳脉见浮,主表热;阴脉见浮,主表虚。秋季脉象以浮为正常,肺脉见浮适宜,但久病患者忌见浮脉。
左寸部(伤风、发热、头痛、目眩、风痰。若兼见虚迟脉,主心气不足、心神不安。若兼见散脉,主心血耗散、虚烦。若兼见洪散脉,主心热。)
左关部(腹胀。若兼见数脉,主风热侵入肝经。若兼见促脉,主怒气伤肝,心胸满闷逆乱。)
左尺部(膀胱风热,小便赤涩。若兼见芤脉,男子主尿血,女子主崩漏。若兼见迟脉,主冷疝,脐下疼痛。)
右寸部(肺感风寒,咳嗽气喘、鼻寒、流清涕、自汗、身体疲倦。若兼见洪脉,主肺热而咳。若兼见迟脉,主肺寒喘嗽。)
右关部(脾虚,脘腹胀满不食。若兼见大涩脉,主宿食停滞。若兼见迟脉,主脾胃虚寒。若兼见滑脉,主痰饮。)
右尺部(风邪客居下焦,大便秘结。若兼见数脉,主下焦风热,大便秘结。若兼见虚脉,主元气不足。)
浮而有力为洪脉
(即大脉,又名钩脉。其形象极大且数,重按满指,如群波涌起,来势盛而去势衰,来时大去时长。)
洪脉是经络大热、血气燔灼的征候,夏季脉象以洪为正,心脉见洪适宜。久病咳嗽者忌见洪脉。形体消瘦且多气者见洪脉主死。凡是脉象洪大,表示病情进展。
(主表里皆热,大小便不通,心烦,口燥咽干。)
左寸部(心经热盛,目赤、口疮、头疼痛、心中烦闷。)
左关部(肝热,身体疼痛、四肢浮热。)
左尺部(膀胱热,小便赤涩。)
右寸部(肺热,毛发枯焦、唾粘、咽干。)
右关部(胃热,反胃、呕吐、口干。若兼见紧脉,主胸中胀满。)
右尺部(腹满、大便困难或便血。)
浮而无力为芤脉
(其形象浮大而软,重按中间空虚两边实,指下感觉成窟窿状,诊察时在轻举重按之间得到。)
芤脉是失血的征候,大体上是气有余而血不足,血不足以承载气,所以脉象虚大,呈现芤脉的状态。火邪侵犯阳经,血液上溢;火邪侵扰阴络,血液下流。三部脉均见芤脉,久病者生,突发重病者死。
左寸部(心血妄行、吐血衄血。)
左关部(胁间血气动荡,腹中瘀血、吐血,目暗时常昏花。)
左尺部(小便出血、女子月经失常。)
右寸部(胸中有积血,或衄血或呕血。)
右关部(肠痈瘀血,呕血不食。)
右尺部(大便出血。)
(古人说,前大后细,是脱血之象,夫前大后细,不就是芤脉吗?)
浮而端直为弦脉
(其形象重按不移位,轻举应手指,端直如同新张开的弓弦之状。)
弦脉是血气收敛、阳中伏阴,或经络间被寒邪阻滞的征候。弦紧数劲为太过,弦紧而细为不及;
弦而软病轻,弦而硬病重;轻虚而滑者为平脉,实滑如摸长竿者为病脉;劲急如新张弓弦者主死。春季脉象以弦为正,肝脉见弦适宜,若肝木克土导致不食则难治。疟疾病脉自现弦象。
(凡脉弦,主痛、疟、疝、饮、冷痹、劳倦、拘急、寒热、血虚盗汗、寒凝气结。若兼见数脉,主劳疟。若兼见长脉,主中有积滞。双弦脉,主胁肋急痛。)
左寸部(头痛、心悸、劳伤、盗汗、乏力。)
左关部(胁肋痛、癖块。若兼见小脉,主寒冷癖。若兼见紧脉,主瘀血、疝瘕。)
左尺部(小腹痛。若兼见滑脉,主腰脚痛。)
右寸部(肺经受风寒,咳嗽胸膈间有寒痰。)
右关部(脾胃伤冷、宿食不化、心腹冷痛,又主水饮。)
右尺部(脐下急痛不安,下焦停水。)
浮而迟大为虚脉
(其形象迟软散大,轻举重按力量少,豁然空虚,不能自固。)
虚脉是气血俱虚的征候,气血虚则脉虚,主要主内不足的病症,久病脉虚,大多难以治愈。
(凡脉虚,主伤暑、虚烦、自汗、小儿惊风。)
寸部(血不荣心、怔忡、恍惚、惊悸。)
关部(腹胀、食物不易消化。)
尺部(骨蒸、痿痹、精血亏损。)
浮而迟细为濡脉
(即软脉。其形象虚软无力,应手细散,如棉絮在水中,轻手相得,重手按之,随即消失。)
濡脉是气血两虚的征候,也主脾湿,病后产后可治,平人脉濡难治。
(凡脉濡,主疲损、自汗、痹证、下冷、无血少气。)
左寸部(心虚易惊、盗汗、短气。)
左关部(营卫不和、精神离散、体虚懒怠、少力。)
左尺部(男子伤精女子脱血、小便频数、自汗多。)
右寸部(烘热憎寒、气乏体虚。)
右关部(脾弱,食不化;胃虚,食不进。)
右尺部(下元冷惫、肠虚泄泻。)
浮而迢亘为长脉
(其形象不大不小,迢迢自若,指下有余,超过本位。)
长脉是气血皆有余的征候,有三部长、有一部长,重按如牵绳,则为病脉。长脉属肝,适宜于春季,诊察无病之人肝脉自见。
(凡脉长,主壮热、癫痫、阳毒内蕴、三焦烦热、阳明热甚。)
浮而虚大为散脉
(其形象有表无里,有阴无阳,按之满指,散而不聚,来去不明,漫无根柢,如涣散不收。)
散脉是气血耗散、脏腑气绝的征候,在病脉中主虚阳不敛,又主心气不足,大体上不是好兆头。心脉浮大而散,肺脉短涩而散,尚且算作平脉。若病脉见代散,必死。产妇脉散,是临盆的征兆,如果未到产期出现,必然导致堕胎。
寸部(怔忡、雨汗。)
关部(溢饮、浮肿。)
尺部(肾绝。)
沉脉
沉脉用来候察里证(其形象轻手触摸不见,重手触摸才得,按至肌肉以下,着于筋骨之间。)
沉脉是阴逆阳虚的征候,主阴经、主气、主水、主寒、主骨,太过则病在外,不及则病在内,冬季脉象以沉为正,女性寸脉男性尺脉俱宜见沉。
(凡脉沉,主停饮、癖瘕、胁胀、厥逆、洞泄。若兼见细脉,主少气。若兼见滑脉,主宿食停滞。若兼见迟脉,主痼冷内寒。若兼见伏脉,主霍乱吐泻。若兼见数脉,主内热甚。若兼见弦脉,主心腹冷痛。)
左寸部(心内寒邪痛、胸中寒饮、胁痛。)
左关部(伏寒在经,两胁刺痛。若兼见弦脉,主癖块内痛。)
左尺部(肾脏寒,腰背冷痛、小便浊而频、男为精冷女为血结。若兼见细脉,主胫酸阴痒、溺有余沥。)
右寸部(肺冷,寒痰停蓄、虚喘少气。若兼见紧滑脉,主咳嗽。若兼见细滑脉,主骨蒸寒热、皮毛焦干。)
右关部(胃中寒积,中满吐酸。若兼见紧脉,主悬饮。)
右尺部(病水,腰脚痛。若兼见细脉,主下利、小便滑、脐下冷痛。)
沉而不及为短脉
(其形象两头无,中间有,不及本位,应手而回。)
短脉是气不足以前导其血的征候,都主不及的病症。短脉只见寸尺,若关部短,则上不通寸,下不能尺,这是阴阳绝脉,必死,所以关部不诊短脉。短脉属肺,适宜于秋季,诊察无病之人肺脉,其形自可见。
(凡脉短,主三焦气壅、宿食不消。若兼见浮脉,主血涩。若兼见沉脉,主痞块。若兼见滑数脉,主酒伤肠胃。)
寸部(头痛。)
尺部(腹痛。)
沉而微软为细脉
(其形象小于微脉而常有,细直而软,指下寻之,往来如蚕丝状。)
细脉是血冷气虚不足以充盛的征候,故主诸虚劳损,或湿邪侵扰腰肾,应病则顺,否则为逆。吐衄患者得此脉为生,春夏及少年不利,秋冬及老弱可治。忧劳过度者脉亦细,凡细脉,病都在内、在下。
(凡脉细,主元气不足、乏力、无精、内外俱冷、痿弱、洞泄、积聚、疼痛。)
寸部(呕吐。)
关部(胃虚,腹胀。)
尺部(丹田冷,泄痢、遗精。)
沉而弦长为实脉
(其形象举按不绝,迢亘而长,不疾不徐,动而有力。)
实脉是三焦气满的征候,都主有余的病症。
(凡脉实,主呕、痛、利、气寒、气聚、食积、伏阳在内。)
左寸部(心中积热,口舌疮、咽喉痛。若兼见大脉,主头面热风、烦躁、体痛、面赤。)
左关部(腹胁痛满。若兼见浮大脉,主肝盛,目暗、痛而赤色。)
左尺部(少腹痛、小便涩。若兼见滑脉,主茎中痛、淋沥不止、溺赤色。若兼见大脉,主膀胱热结,小便难。若兼见紧脉,主腰脊疼痛。)
右寸部(胸中热,痰嗽、烦满。若兼见浮脉,主肺热,咽燥而疼、喘嗽、气壅。)
右关部(伏阳蒸内、脾虚食少、胃气壅滞。若兼见浮脉,主脾热,消中善饥、口干、劳倦。)
右尺部(脐下痛、便难或时下利。)
沉极几无为伏脉
(其形象极重按之,至于透筋着骨,指下始觉隐隐然。)
伏脉是阴阳潜伏、关格闭塞的征候,关前得之为阳伏,关后得之为阴伏,脉伏者不可发汗,痛甚者脉必伏。
(凡脉伏,主积聚、瘕块、霍乱、水气、食不消、营卫气闭而厥逆。)
左寸部(心气不足、神不守常、忧郁。)
左关部(血冷、腰脚痛、胁下寒气。)
左尺部(肾寒精虚、瘕疝寒痛。)
右寸部(胸中冷滞、寒痰积冷。)
右关部(中脘积块作痛、脾胃间停滞痞积。)
右尺部(脐下冷痛、下焦虚寒或痛、腹中痛冷、少腹痛。)
沉而有力为牢脉
(其形象似沉似伏,实大而长,稍带弦象,重按动而不移,若牢固然。)
牢脉是里实表虚、胸中气促、劳伤痿极的征候。大体上牢脉近乎无胃气,故为危殆之脉。如失血人宜见沉细脉,若见浮大而牢脉,必死,因为虚病反见实脉。
(凡脉牢,主气居于表、骨节疼痛。)
寸部
关部(木乘土而心腹寒疼。)
尺部(疝、瘕。)
沉失常度为革脉
(其形象沉伏实大,如按鼓皮一般。)
革脉是虚寒失血的征候,其实即是芤脉和弦脉相合的形象,芤为虚,弦为寒,虚寒相搏,故主男子亡血失精,女子半产漏下,又主中风感湿之症。久病死,卒病生。脉来混浊变革,急如涌泉,出而不反,病进而危,去如弦绝者死。
寸部
关部
尺部
沉而更代为代脉
(其形象动而中止,不能自还,因而复动,由是复止,寻之良久,乃复强起而动。)
代脉是脏气多衰、形容羸瘦、口不能言的征候。若不病而羸瘦,脉代止,是一脏无气,他脏代之,必危;若因病而气血骤损,致元气卒不相续,或风家痛家,只为病脉,故伤寒也有心悸而脉代的(复脉汤主治)。腹心疼也有结涩止代不匀的,久痛的脉象,不可作为标准;妊娠脉代,必怀胎三月,代脉有生有死,非定为死脉,宜辨之。
(凡脉代,主腹痛、便脓血、泄利吐泻、下元虚损。)
迟脉
迟脉用来候察脏病(其形象呼吸之间,脉搏仅三至,去来极慢。)
迟脉是阴盛阳虚的征候,阳不胜阴,所以脉搏来不及。居寸部为气不足,气寒则缩;居尺部为血不足,血寒则凝。
(凡脉迟,主寒、主虚。若兼见浮脉,主表寒。若兼见沉脉,主里寒。)
左寸部(心上寒、精气多惨。)
左关部(筋寒急、胁下痛、手足冷。)
左尺部(肾虚便溺、女人不月。)
右寸部(肺感寒、冷痰、气短。)
右关部(中焦寒,脾胃伤冷物。不食,食不化。若兼见沉脉为积。)
右尺部(脏寒泄泻、小腹冷痛、腰脚重。)
迟而细软为微脉
(其形象极细而软,若有若无,多兼于迟,按之如欲绝。)
微脉是久虚血弱的征候,又主阴寒或伤寒蓄热在里,脉道不利,也见微细濡弱,不可单纯视为寒者,当以标本别之,总之气血微脉即微。
(凡脉微,主虚弱、虚汗、泄泻、少气、崩漏不止。若兼见浮脉,主阳不足,必身恶寒冷。若兼见沉脉,主阴不足,必脏寒下利。)
左寸部(心虚忧惕、荣血不足。)
左关部(胸满气乏、四肢恶寒、拘急。)
左尺部(男子伤精尿血,女子崩漏败血不止或赤白带下。)
右寸部(上焦寒、痞痛、冷痰凝结不化、中寒少气。)
右关部(胃寒气胀、食不能化、脾虚噫气、心腹冷痛。)
右尺部(脏寒泄泻、脐下冷痛。)
迟而无力为弱脉
(其形象极软而沉细,怏怏不前,无息以动,按之如欲绝,略举手即无。)
弱脉是阳陷入阴、精气不足的征候,也主筋。脉弱以滑,是有胃气,脉弱以涩,是为久病;阳浮阴弱,应为血虚筋急、恶寒发热之病。老人得之顺,壮年得之逆。
(凡脉弱,主痼冷、烘热、泄精、虚汗、元气亏耗、痿弱不前。)
左寸部(阳虚心悸、自汗。)
左关部(筋痿无力,女人主产后客风面肿。)
左尺部(小便频数、肾元虚、耳鸣或聋、骨肉间酸疼。)
右寸部(身冷多寒、胸中短气。)
右关部(脾胃虚、食不化。)
右尺部(下焦冷痛、大便滑泄不禁。)
迟而有力为缓脉
(其形象比浮脉稍大,似迟而小疾,一息四至,来往纡缓,呼吸徐徐。)
缓脉是气血向衰的征候。若不沉不浮,从容和缓,乃是脾家的正脉。四季亦为平脉,非时即病。和缓而匀,无浮沉徐疾微弱之偏,即为胃气脉。
(凡脉缓,主风、虚、痹、弱、疼。在上为项强,在下为脚弱。若兼见浮脉,主感风。若兼见沉脉,主血气弱。)
左寸部(心气不足,怔忡、健忘。亦主项背拘急而痛。)
左关部(风虚眩晕、腹胁气结。)
左尺部(肾元虚冷、小便频数,女人主月事过多。)
右寸部(肺气浮、言语短气。)
右关部(胃弱、气虚。若兼见浮脉,主脾虚。)
右尺部(下寒脚弱、风气秘滞。若兼见浮脉,主肠风泄泻。若兼见沉脉,主小腹感冷。)
迟而时止为结脉
(其形象来时迟缓,时一止,复又来。)
结脉是阴独盛而阳不能相入的征候,此为阴脉之极。按之累累如循长竿曰阴结,蔼蔼如张车
(Reading Vertically and Horizontally)
To grasp the pulse comprehensively, one need not go beyond the six characters: Floating (Fu), Sinking (Chen), Slow (Chi), Rapid (Shu), Slippery (Hua), and Choppy (Se). These six cover all aspects of exterior/interior, Yin/Yang, cold/heat, deficiency/excess, wind/cold/dryness/dampness, fu-organs/qi, and blood/qi. Generally speaking, Floating is Yang and indicates the Exterior; Sinking is Yin and indicates the Interior; Slow indicates involvement of the Zang organs, Cold, Deficiency, and Yin-Cold; Rapid indicates involvement of the Fu organs, Heat, Dryness, and Excess; Slippery indicates an excess of Blood; Choppy indicates stagnation of Qi alone. By meticulously analyzing these, no disease can escape detection. As for Floating and Sinking, they are defined by the lightness or heaviness of lifting (Ju) and pressing (An). Pulses such as Full (Hong), Scallion-Stalk (Kou), Bowstring (Xian), Empty (Xu), Soft (Ru), Long (Chang), and Scattered (San) are obtained with light pressure and thus are grouped under Floating. Pulses such as Short (Duan), Fine (Xi), Solid (Shi), Hidden (Fu), Firm (Lao), Drum-Taut (Ge), and Intermittent (Dai) are obtained with heavy pressure and thus are grouped under Sinking. Slow and Rapid are distinguished by the number of beats per breath. Pulses such as Minute (Wei), Weak (Ruo), Moderate (Huan), and Knotted (Jie) belong to the category of Slow. Pulses such as Tense (Jin), Urgent (Cu), and Moving (Dong) belong to the category of Rapid. Although Slippery may resemble Rapid, and Choppy may resemble Slow, their principles differ. Slow and Rapid are observed by counting beats relative to respiration, whereas Slippery and Choppy are observed by the shape and movement of the pulse wave. Furthermore, Slippery and Choppy are closely related to Qi and Blood. Therefore, although these two categories do not fit strictly into the six main groups, they are listed separately here as supplements to the six guidelines.
Floating Pulse
The Floating pulse is used to diagnose Exterior conditions (Its image is perceived with light touch but disappears with heavy pressure; the pulsation is located above the muscle layer.)
A Floating pulse indicates Wind invasion or Deficiency leading to dizziness and tremors. A Yang-type Floating pulse indicates Exterior Heat; a Yin-type Floating pulse indicates Exterior Deficiency. In Autumn, Floating is considered normal, and it is suitable for the Lung pulse, but it is contraindicated in chronic diseases.
Left Cun position (Wind-cold injury, fever, headache, dizziness, Phlegm-Wind. If accompanied by Deficient-Slow, it indicates Heart Qi Deficiency and unsettled Mind. If accompanied by Scattered, it indicates Heart Blood consumption and empty irritability. If accompanied by Full-Scattered, it indicates Heart Heat.)
Left Guan position (Abdominal distension. If accompanied by Rapid, it indicates Wind-Heat entering the Liver channel. If accompanied by Urgent, it indicates anger injuring the Liver, causing chest fullness and rebellious Qi.)
Left Chi position (Bladder Wind-Heat, red and scanty urination. If accompanied by Scallion-Stalk, men have hematuria, women have metrorrhagia. If accompanied by Slow, it indicates Cold Hernia and pain below the umbilicus.)
Right Cun position (Lung affected by Wind-Cold, coughing and wheezing, nasal coldness, clear rhinorrhea, spontaneous sweating, fatigue. If accompanied by Full, it indicates Lung Heat causing cough. If accompanied by Slow, it indicates Lung Cold causing wheezing and cough.)
Right Guan position (Spleen Deficiency, abdominal fullness and loss of appetite. If accompanied by Large-Choppy, it indicates retained food. If accompanied by Slow, it indicates Spleen-Stomach Deficiency. If accompanied by Slippery, it indicates Phlegm-Fluid retention.)
Right Chi position (Wind pathogen lodging in the Lower Jiao, constipation. If accompanied by Rapid, it indicates Lower Jiao Wind-Heat and constipation. If accompanied by Deficient, it indicates Yuan Qi Deficiency.)
Full Pulse (Hong)
When Floating is forceful, it is called Full (Hong).
(It is also known as the Large pulse or Hook pulse. Its image is large and rapid, filling the fingers upon heavy pressure, like surging waves, coming strongly and departing weakly, large on arrival and long on departure.)
The Full pulse indicates excessive Heat in the collaterals and burning of Qi and Blood. It is normal in Summer and suitable for the Heart pulse. It is contraindicated in chronic cough. For emaciated individuals with abundant Qi, it indicates death. A Full pulse generally signifies disease progression.
(It indicates Heat in both Interior and Exterior, constipation or urinary difficulty, irritability, dry mouth and throat.)
Left Cun (Heart Channel Heat, red eyes, mouth ulcers, headache, internal irritability.)
Left Guan (Liver Heat, body pain, floating heat in limbs.)
Left Chi (Bladder Heat, red and scanty urination.)
Right Cun (Lung Heat, dry hair, sticky saliva, dry throat.)
Right Guan (Stomach Heat, regurgitation, vomiting, dry mouth. If accompanied by Tense, it indicates chest fullness.)
Right Chi (Abdominal fullness, difficult defecation or bloody stool.)
Scallion-Stalk Pulse (Kou)
When Floating is weak, it is called Scallion-Stalk (Kou).
(Its image is floating, large, and soft. Upon heavy pressure, the center is empty while the sides are solid, feeling like a hollow pit under the finger. It is detected between light lifting and heavy pressing.)
The Scallion-Stalk pulse indicates blood loss. Generally, there is excess Qi but deficient Blood; since Blood cannot carry Qi, the pulse appears vacuous and large. Fire invading Yang channels causes upper bleeding; Fire invading Yin collaterals causes lower bleeding. If all three positions show Scallion-Stalk, chronic patients survive, while acute patients die.
Left Cun (Reckless flow of Heart Blood, hematemesis and epistaxis.)
Left Guan (Blood-Qi disturbance in hypochondrium, abdominal blood stasis, hematemesis, dim vision and frequent fainting.)
Left Chi (Hematuria, menstrual disorders in women.)
Right Cun (Accumulated blood in chest, either epistaxis or hematemesis.)
Right Guan (Intestinal abscess with blood stasis, hematemesis and anorexia.)
Right Chi (Hematochezia.)
(The ancients said: "Large at the front, thin at the back" indicates blood loss. Is this not exactly the Scallion-Stalk pulse?)
Bowstring Pulse (Xian)
When Floating is straight and rigid, it is called Bowstring (Xian).
(Its image does not shift upon pressing, responds to lifting, and is straight like a newly strung bowstring.)
The Bowstring pulse indicates contraction of Qi and Blood, Yin hidden within Yang, or stagnation of Cold in the collaterals. Tense, Rapid, and forceful Bowstring indicates excess; Tense, fine, and slow indicates deficiency. Soft Bowstring indicates mild disease; hard Bowstring indicates severe disease. Light, vacuous, and slippery indicates health; solid and slippery like touching a long bamboo pole indicates disease; tense and urgent like a new bowstring indicates death. It is normal in Spring and suitable for the Liver pulse. If Liver Wood overacts on Earth causing anorexia, it is difficult to treat. Malaria pulses naturally present as Bowstring.
(Generally, Bowstring pulse indicates Pain, Malaria, Hernia, Fluid retention, Cold Bi, fatigue, spasm, alternating chills and fever, Blood Deficiency with night sweats, Cold congealing Qi stagnation. If accompanied by Rapid, it indicates Labor Malaria. If accompanied by Long, it indicates internal stagnation. Double Bowstring indicates hypochondriac tension and pain.)
Left Cun (Headache, palpitations, fatigue, night sweats, weakness.)
Left Guan (Hypochondriac pain, Pi masses. If accompanied by Small, it indicates Cold Pi. If accompanied by Tense, it indicates Blood Stasis and Jian masses.)
Left Chi (Lower abdominal pain. If accompanied by Slippery, it indicates waist and leg pain.)
Right Cun (Lung channel affected by Wind-Cold, cough with cold Phlegm in chest and diaphragm.)
Right Guan (Spleen-Stomach damaged by Cold, undigested food, cold pain in heart and abdomen, also indicates Fluid retention.)
Right Chi (Urgent pain below umbilicus with restlessness, Water retention in Lower Jiao.)
Empty Pulse (Xu)
When Floating is Slow and Large, it is called Empty (Xu).
(Its image is Slow, soft, scattered, and large. With little force in lifting or pressing, it feels suddenly empty and unstable.)
The Empty pulse indicates simultaneous Deficiency of Qi and Blood. Vacuous Qi and Blood result in a vacuous pulse, primarily indicating internal insufficiency. Chronic diseases with Empty pulses are mostly incurable.
(Generally, Empty pulse indicates Summerheat injury, empty irritability, spontaneous sweating, pediatric convulsions.)
Cun position (Blood failing to nourish the Heart, palpitations, trance, fright.)
Guan position (Abdominal distension, indigestion.)
Chi position (Bone-steaming fever, flaccidity and numbness, depletion of Essence and Blood.)
Soft Pulse (Ru)
When Floating is Slow and Fine, it is called Soft (Ru).
(It is also known as the Soft pulse. Its image is vacuous, soft, and powerless, fine and scattered upon response, like cotton wool in water. It is felt with light touch but disappears immediately upon heavy pressure.)
The Soft pulse indicates dual Deficiency of Qi and Blood, and also indicates Spleen Dampness. It is treatable after illness or postpartum, but difficult to treat if found in healthy individuals.
(Generally, Soft pulse indicates exhaustion, spontaneous sweating, Bi syndrome, lower cold, lack of Blood and Qi.)
Left Cun (Heart Deficiency with easy fright, night sweats, shortness of breath.)
Left Guan (Disorder of Ying and Wei, dispersion of Spirit, physical weakness and lethargy, lack of strength.)
Left Chi (Essence injury in men, Blood loss in women, frequent urination, excessive sweating.)
Right Cun (Hot flashes with aversion to cold, lack of Qi and physical weakness.)
Right Guan (Spleen weakness, indigestion; Stomach Deficiency, poor appetite.)
Right Chi (Cold and exhaustion of Lower Origin, intestinal Deficiency with diarrhea.)
Long Pulse (Chang)
When Floating extends continuously, it is called Long (Chang).
(Its image is neither too large nor too small, extending naturally, feeling abundant under the finger, exceeding its normal position.)
The Long pulse indicates excess of both Qi and Blood. Whether present in all three positions or just one, if it feels like pulling a rope upon pressure, it indicates disease. Long belongs to the Liver and is suitable in Spring; in healthy individuals, the Liver pulse naturally appears Long.
(Generally, Long pulse indicates high fever, epilepsy, internal accumulation of Yang-Toxin, irritability and heat in the Three Jiao, severe Yangming Heat.)
Scattered Pulse (San)
When Floating is Vacuous and Large, it is called Scattered (San).
(Its image has surface but no depth, Yin but no Yang. Filling the fingers upon pressure, it is scattered and uncollected, unclear in arrival and departure, rootless, like dissipation without restraint.)
The Scattered pulse indicates consumption and dispersion of Qi and Blood, and extinction of Zang-Fu Qi. In pathological pulses, it indicates failure of vacuous Yang to consolidate, and also Heart Qi Deficiency. Generally, it is an ill omen. Heart pulse being Floating, Large, and Scattered, or Lung pulse being Short, Choppy, and Scattered, can still be considered normal pulses. However, if a pathological pulse shows Intermittent and Scattered characteristics, death is certain. Scattered pulse in pregnant women indicates impending labor; if occurring before term, it leads to miscarriage.
Cun position (Palpitations, profuse sweating.)
Guan position (Overflowing fluid retention, edema.)
Chi position (Kidney extinction.)
Sinking Pulse
The Sinking pulse is used to diagnose Interior conditions (Its image is not perceived with light touch but only with heavy pressure, reaching down to below the muscles, resting between tendons and bones.)
The Sinking pulse indicates reversal of Yin and Deficiency of Yang. It governs Yin channels, Qi, Water, Cold, and Bones. Excess indicates disease in the Exterior; deficiency indicates disease in the Interior. It is normal in Winter. For women, the Cun position should be Sinking; for men, the Chi position should be Sinking.
(Generally, Sinking pulse indicates Fluid retention, Pi-Jian masses, hypochondriac distension, cold extremities, watery diarrhea. If accompanied by Fine, it indicates shortness of Qi. If accompanied by Slippery, it indicates retained food. If accompanied by Slow, it indicates chronic internal Cold. If accompanied by Hidden, it indicates cholera-like vomiting and diarrhea. If accompanied by Rapid, it indicates severe internal Heat. If accompanied by Bowstring, it indicates cold pain in heart and abdomen.)
Left Cun (Internal Cold pain in Heart, cold-fluid retention in chest, hypochondriac pain.)
Left Guan (Hidden Cold in channels, stabbing pain in both hypochondria. If accompanied by Bowstring, it indicates internal pain from Pi masses.)
Left Chi (Kidney Cold, cold pain in lower back, turbid and frequent urination, seminal emission in men, Blood coagulation in women. If accompanied by Fine, it indicates sore calves, genital itching, and dribbling urine.)
Right Cun (Lung Cold, accumulation of cold Phlegm, asthmatic breathing with shortness of breath. If accompanied by Tense-Slippery, it indicates cough. If accompanied by Fine-Slippery, it indicates bone-steaming fever/chills, dry and scorched skin/hair.)
Right Guan (Cold accumulation in Stomach, abdominal fullness and acid regurgitation. If accompanied by Tense, it indicates Hanging Fluid.)
Right Chi (Water disease, pain in waist and legs. If accompanied by Fine, it indicates diarrhea, slippery urination, cold pain below umbilicus.)
Short Pulse (Duan)
When Sinking is insufficient, it is called Short (Duan).
(Its image lacks ends but has a middle, failing to reach its proper position, rebounding upon touch.)
The Short pulse indicates insufficient Qi to guide Blood, primarily indicating deficiency conditions. Short pulse is seen only in Cun and Chi positions. If the Guan position is Short, it means Qi cannot connect upward to Cun or downward to Chi, representing an extinction of Yin and Yang pulse, which indicates death. Therefore, Guan is not diagnosed for Short pulse. Short belongs to the Lung and is suitable in Autumn; in healthy individuals, the Lung pulse naturally appears Short.
(Generally, Short pulse indicates Qi congestion in the Three Jiao, undigested food. If accompanied by Floating, it indicates stagnant Blood. If accompanied by Sinking, it indicates痞 masses. If accompanied by Slippery-Rapid, it indicates alcohol damage to intestines and stomach.)
Cun position (Headache.)
Chi position (Abdominal pain.)
Fine Pulse (Xi)
When Sinking is slightly soft, it is called Fine (Xi).
(Its image is smaller than Minute but constant, straight and soft. Seeking under the finger, it comes and goes like silk threads.)
The Fine pulse indicates deficiency of Cold Blood and vacuous Qi unable to fill the vessels, thus governing various deficiency consumptions, or Dampness invading waist and Kidneys. It is favorable if corresponding to disease, otherwise unfavorable. It indicates survival in hematemesis/epistaxis, but is unfavorable in Spring/Summer for youths, and treatable in Autumn/Winter for elderly/weak. Overwork also results in Fine pulse. Generally, Fine pulse indicates disease in the Interior and Lower parts.
(Generally, Fine pulse indicates deficiency of Yuan Qi, weakness, lack of Essence, cold inside and out, flaccidity, watery diarrhea, accumulations, pain.)
Cun position (Vomiting.)
Guan position (Stomach Deficiency, abdominal distension.)
Chi position (Cold in Dantian, dysentery, spermatorrhea.)
Solid Pulse (Shi)
When Sinking is Bowstring and Long, it is called Solid (Shi).
(Its image does not cease upon lifting or pressing, extends continuously, neither fast nor slow, moving with force.)
The Solid pulse indicates fullness of Qi in the Three Jiao, primarily indicating excess conditions.
(Generally, Solid pulse indicates vomiting, pain, diarrhea, Cold Qi, Qi aggregation, food retention, latent Yang inside.)
Left Cun (Accumulated Heat in Heart, mouth/tongue sores, sore throat. If accompanied by Large, it indicates Wind-Heat in head/face, irritability, body pain, flushed face.)
Left Guan (Abdominal and hypochondriac pain/fullness. If accompanied by Floating-Large, it indicates Liver Excess, dim vision, painful redness.)
Left Chi (Lower abdominal pain, scanty urination. If accompanied by Slippery, it indicates pain in urethra, continuous dripping, red urine. If accompanied by Large, it indicates Bladder Heat obstruction, difficult urination. If accompanied by Tense, it indicates lumbar spine pain.)
Right Cun (Heat in chest, phlegmy cough, irritability/fullness. If accompanied by Floating, it indicates Lung Heat, dry/painful throat, wheezing/cough, Qi congestion.)
Right Guan (Latent Yang steaming internally, Spleen Deficiency with poor appetite, Stomach Qi stagnation. If accompanied by Floating, it indicates Spleen Heat, excessive hunger, dry mouth, fatigue.)
Right Chi (Pain below umbilicus, difficult defecation or occasional diarrhea.)
Hidden Pulse (Fu)
When Sinking is extreme and nearly absent, it is called Hidden (Fu).
(Its image requires extreme heavy pressure, penetrating to tendons and bones, before a faint sensation is felt under the finger.)
The Hidden pulse indicates latent Yin and Yang, and blockage of Guan-Ge. Obtained anterior to Guan indicates latent Yang; obtained posterior to Guan indicates latent Yin. Patients with Hidden pulse should not be treated with sweating methods. Severe pain often results in Hidden pulse.
(Generally, Hidden pulse indicates accumulations, Jian masses, cholera, Water Qi, undigested food, closure of Ying-Wei Qi leading to cold extremities.)
Left Cun (Heart Qi Deficiency, unsettled Spirit, depression.)
Left Guan (Cold Blood, pain in waist/legs, Cold Qi under hypochondrium.)
Left Chi (Kidney Cold with Essence Deficiency, cold pain from Jian/Hernia.)
Right Cun (Cold stagnation in chest, accumulation of cold Phlegm.)
Right Guan (Pain from masses in Zhongwan, stagnation and痞 accumulation in Spleen-Stomach.)
Right Chi (Cold pain below umbilicus, Lower Jiao Deficiency-Cold or pain, cold abdominal pain, lower abdominal pain.)
Firm Pulse (Lao)
When Sinking is forceful, it is called Firm (Lao).
(Its image resembles Sinking and Hidden, solid, large, and long, slightly Bowstring. Upon heavy pressure, it moves but does not shift, appearing firm.)
The Firm pulse indicates Interior Excess with Exterior Deficiency, shortness of breath in chest, and extreme fatigue/flaccidity from overstrain. Generally, Firm pulse approaches having no Stomach Qi, thus indicating a critical condition. Patients with blood loss should have Sinking-Fine pulses; if Floating-Large and Firm appear, death is certain, as Excess pulse appears in Deficiency disease.
(Generally, Firm pulse indicates Qi residing in the Exterior, joint pain.)
Cun position
Guan position (Wood overacting on Earth causing cold pain in heart and abdomen.)
Chi position (Hernia, Jian masses.)
Drum-Taut Pulse (Ge)
When Sinking loses its regular measure, it is called Drum-Taut (Ge).
(Its image is Sinking, Hidden, solid, and large, like pressing a drum skin.)
The Drum-Taut pulse indicates Deficiency-Cold and blood loss. It is essentially a combination of Scallion-Stalk (Deficiency) and Bowstring (Cold) pulses. The interaction of Deficiency and Cold indicates seminal emission/blood loss in men, and miscarriage/metrorrhagia in women, also indicating Wind-stroke and Dampness invasion. Chronic patients die; acute patients survive. If the pulse becomes turbid and changing, urgent like a gushing spring, exiting without returning, the disease progresses critically. If departing like a breaking string, death occurs.
Cun position
Guan position
Chi position
Intermittent Pulse (Dai)
When Sinking changes periodically, it is called Intermittent (Dai).
(Its image stops during movement, cannot return spontaneously, then moves again, stopping repeatedly. After searching for a long time, it rises forcefully and moves again.)
The Intermittent pulse indicates decline of Zang Qi, emaciation, and inability to speak. If not diseased but emaciated with intermittent pulse, it indicates one Zang lacking Qi, replaced by others, which is critical. If due to disease causing sudden loss of Qi and Blood, leading to abrupt discontinuity of Yuan Qi, or in cases of Wind/Pain, it is merely a pathological pulse. Thus, Taiyang disease may have palpitations with intermittent pulse (treated with Fumu Tang). Abdominal heart pain may also have irregular Knotted/Choppy/Intermittent pulses; chronic pain pulses are not standard. Intermittent pulse in pregnancy indicates three months gestation. Intermittent pulse can indicate life or death, not necessarily death, so differentiation is required.
(Generally, Intermittent pulse indicates abdominal pain, pus and blood in stool, diarrhea/vomiting, deficiency of Lower Origin.)
Slow Pulse (Chi)
The Slow pulse is used to diagnose Zang organ diseases (Its image shows only three beats per breath, arriving and departing very slowly.)
The Slow pulse indicates Excess of Yin and Deficiency of Yang. Yang cannot overcome Yin, hence the pulse is slow. At Cun position, it indicates Qi Deficiency and Cold Qi contraction; at Chi position, it indicates Blood Deficiency and Cold Blood coagulation.
(Generally, Slow pulse indicates Cold and Deficiency. If accompanied by Floating, it indicates Exterior Cold. If accompanied by Sinking, it indicates Interior Cold.)
Left Cun (Cold in Upper Heart, miserable Jing-Essence.)
Left Guan (Cold tendons with urgency, pain under hypochondrium, cold hands and feet.)
Left Chi (Kidney Deficiency affecting urination, amenorrhea in women.)
Right Cun (Lung affected by Cold, cold Phlegm, shortness of breath.)
Right Guan (Middle Jiao Cold, Spleen-Stomach damaged by cold foods. Anorexia, indigestion. If accompanied by Sinking, it indicates accumulation.)
Right Chi (Zang Cold with diarrhea, cold pain in lower abdomen, heavy waist and legs.)
Minute Pulse (Wei)
When Slow is Fine and Soft, it is called Minute (Wei).
(Its image is extremely fine and soft, seemingly present or absent, often accompanying Slow. Upon pressure, it feels near extinction.)
The Minute pulse indicates chronic Deficiency and weak Blood, also indicating Yin-Cold or latent Heat from Cold damage in the Interior causing obstructed vessel pathways. It may also appear Minute, Fine, Soft, and Weak. One must distinguish based on root and branch, not solely attribute it to Cold. Ultimately, Minute pulse reflects minute Qi and Blood.
(Generally, Minute pulse indicates weakness, empty sweating, diarrhea, shortness of breath, unstoppable metrorrhagia. If accompanied by Floating, it indicates Yang Deficiency with aversion to cold. If accompanied by Sinking, it indicates Yin Deficiency with Zang Cold and diarrhea.)
Left Cun (Heart Deficiency with worry/fright, deficiency of Ying Blood.)
Left Guan (Chest fullness, lack of Qi, aversion to cold in limbs, spasms.)
Left Chi (Seminal emission/hematuria in men, unstoppable metrorrhagia/bad blood or red/white leukorrhea in women.)
Right Cun (Upper Jiao Cold,痞 pain, condensation of cold Phlegm, Middle Cold with shortness of breath.)
Right Guan (Stomach Cold with distension, inability to digest food, Spleen Deficiency with belching, cold pain in heart and abdomen.)
Right Chi (Zang Cold with diarrhea, cold pain below umbilicus.)
Weak Pulse (Ruo)
When Slow is powerless, it is called Weak (Ruo).
(Its image is extremely soft, Sinking, and Fine, lagging behind, lacking breath-driven movement. Upon pressure, it feels near extinction, disappearing even with slight lifting.)
The Weak pulse indicates Yang sinking into Yin and deficiency of Essence/Qi, also governing tendons. Weak pulse with Slipperiness indicates presence of Stomach Qi; Weak pulse with Choppy indicates chronic disease. Floating Yang and Weak Yin indicate Blood Deficiency with tendon tension, aversion to cold, and fever. It is favorable for the elderly, unfavorable for the vigorous.
(Generally, Weak pulse indicates chronic Cold, hot flashes, seminal emission, empty sweating, depletion of Yuan Qi, flaccidity and inability to advance.)
Left Cun (Yang Deficiency with palpitations, spontaneous sweating.)
Left Guan (Tendon flaccidity and weakness, postpartum facial swelling from external Wind in women.)
Left Chi (Frequent urination, Kidney Origin Deficiency, tinnitus or deafness, soreness/pain in bones and flesh.)
Right Cun (Cold body with frequent chills, shortness of breath in chest.)
Right Guan (Spleen-Stomach Deficiency, indigestion.)
Right Chi (Lower Jiao cold pain, involuntary slippery diarrhea.)
Moderate Pulse (Huan)
When Slow is forceful, it is called Moderate (Huan).
(Its image is slightly larger than Floating, seemingly Slow but slightly quick, four beats per breath, coming and going leisurely, with slow respiration.)
The Moderate pulse indicates declining Qi and Blood. If neither Sinking nor Floating, but calm and moderate, it is the correct pulse of the Spleen. It is also a normal pulse in all four seasons; outside these times, it indicates disease. Harmonious, even, without bias of Floating/Sinking, Slow/Fast, or Weak/Strong, it represents the Stomach Qi pulse.
(Generally, Moderate pulse indicates Wind, Deficiency, Bi, weakness, pain. Upper body indicates neck stiffness; lower body indicates weak legs. If accompanied by Floating, it indicates Wind invasion. If accompanied by Sinking, it indicates weak Qi and Blood.)
Left Cun (Heart Qi Deficiency, palpitations, forgetfulness. Also indicates neck/back tension and pain.)
Left Guan (Wind-Deficiency dizziness, Qi knot in abdomen/hypochondrium.)
Left Chi (Kidney Origin Deficiency-Cold, frequent urination, excessive menstruation in women.)
Right Cun (Floating Lung Qi, shortness of speech.)
Right Guan (Stomach weakness, Qi Deficiency. If accompanied by Floating, it indicates Spleen Deficiency.)
Right Chi (Lower Cold with weak legs, Wind-Qi constipation. If accompanied by Floating, it indicates Intestinal Wind diarrhea. If accompanied by Sinking, it indicates Cold in lower abdomen.)
Knotted Pulse (Jie)
When Slow has occasional pauses, it is called Knotted (Jie).
(Its image arrives slowly, pauses occasionally, then resumes.)
The Knotted pulse indicates exclusive Excess of Yin with Yang unable to enter, representing the extreme of Yin pulses. Pressing firmly like touching a long bamboo pole indicates Yin Knot, while [text cuts off]