体象 短脉涩小,首尾俱俯;中间突起,不能满部。
主病 短主不及,为气虚症。短居左寸,心神不定。短见
右寸,肺虚头痛。短在左关,肝气有伤。短在右关,膈间为殃。左尺见短,少腹必疼。右尺见短,真火不隆。
【按】短之为象,两头沉下,而中间独浮也。在时为秋,在人为肺。肺应秋金,天地之气,至是而收
敛,人身一小天地,故畜缩之象相应,而短脉见也。《内经》曰∶“短则气病。”盖以气属阳,主乎充沛,
若短脉独见,气衰之确兆也。然肺为主气之脏,偏与短脉相应,则又何以说也。《素问》曰∶“肺之平脉,
厌厌聂聂,如落榆荚。”则短中自有和缓之象,气仍治也。若短而沉且涩,而谓气不病可乎!高阳生以短脉
为中间有,两头无,为不及本位。尝衷之以至理,而知其说不能无弊也。盖脉以贯通为义,
一息不运,则机缄穷,一毫不续,则穹壤判,岂有断绝不通之理哉!假使上不贯通,则为阳绝,下不贯通,
则为阴绝,俱为必死之脉矣。戴同父亦悟及此,而云短脉只宜见于尺寸,若关中见短,是上不通寸,下不通尺,
为阴阳绝脉而必死。据同父之说,极为有见。然尺与寸可短,依然落于阴绝阳绝矣,非两头断绝也。特两头俯
而沉下,中间突而浮起,仍自贯通者也。叔和云∶“应指而回,不能满部”,亦非短脉之合论也。
李时珍曰∶“长脉属肝,宜于春;短脉属肺,宜于秋。但诊肺肝,则长短自见。”故
知非其时、非其部,即为病脉也。
【脉象特征】短脉的形态是涩而细小,脉动的首部和尾部都向下沉伏;中间部分突起,不能充满整个寸口部位。
【主病】短脉主要主气不足,属于气虚证。短脉出现在左寸部,提示心神不定。短脉出现在右寸部,提示肺气虚引起的头痛。短脉出现在左关部,提示肝气受损。短脉出现在右关部,提示膈间发生病变。左尺部出现短脉,少腹部必然疼痛。右尺部出现短脉,命门真火不旺盛。
【按语】短脉的形象,是两头下沉,而中间独自浮起。在季节上对应秋季,在人体脏腑上对应肺脏。肺对应秋天的金气,天地之气在这个时候收敛,人身是小天地,所以呈现出收缩的形象相应,因此出现短脉。《内经》说:“短则气病。”大概是因为气属于阳,主充沛,如果单独见到短脉,是气衰弱的明确征兆。然而肺是主气的脏器,偏偏与短脉相应,这又怎么解释呢?《素问》说:“肺的正常脉象,柔和轻灵,像落下的榆荚。”那么短脉中自然包含和缓之象,说明气机仍然调和。如果短脉兼见沉且涩,能说气没有病吗!高阳生认为短脉是中间有脉动,两头没有,是不及本位。我曾用至理来推敲,知道他的说法不能没有弊端。因为脉以贯通为意义,一息之间如果不运行,则生机穷尽,一丝一毫不连续,则天地判分,哪里有断绝不通的道理呢!假使上部不贯通,就是阳绝,下部不贯通,就是阴绝,都是必死的脉象。戴同父也领悟到这一点,他说短脉只应该见于尺寸两部,如果在关部见到短脉,这是上不通寸,下不通尺,是阴阳绝脉而必死。根据戴同父的说法,非常有见解。然而尺与寸可以短,依然落入阴绝阳绝的范畴,并不是两头断绝。特别是两头俯伏而下沉,中间突起而浮起,仍然是贯通的。王叔和说:“应指而回,不能满部”,也不是对短脉的正确论述。李时珍说:“长脉属肝,适宜于春季;短脉属肺,适宜于秋季。只要诊察肺和肝,长短脉自然显现。”所以知道如果不是其时、不是其部,就是病脉。
[Pulse Image] The morphology of the Duan Mai (Short Pulse) is choppy and small; both its beginning and end sink downward, while the middle part protrudes, failing to fill the entire Cun-Kou (radial pulse position).
[Main Diseases] The Duan Mai primarily indicates insufficiency, manifesting as Qi Deficiency Syndrome. When the Duan Mai appears in the Left Cun position, it suggests unsettled Heart Spirit. When seen in the Right Cun position, it indicates headache due to Lung Qi deficiency. In the Left Guan position, it signifies injury to Liver Qi. In the Right Guan position, it portends pathology in the diaphragm area. If the Duan Mai is observed at the Left Chi position, pain in the lower abdomen is certain. If seen at the Right Chi position, it indicates that the True Fire (Mingmen Fire) is not flourishing.
[Commentary] The image of the Duan Mai is characterized by sinking ends and a distinctly floating middle. In terms of seasons, it corresponds to Autumn; in terms of human organs, it corresponds to the Lung. The Lung corresponds to the Metal of Autumn; the Qi of Heaven and Earth converges and gathers at this time. Since the human body is a microcosm, the image of contraction corresponds accordingly, resulting in the appearance of the Duan Mai. The *Neijing* states: "Shortness indicates Qi pathology." This is because Qi belongs to Yang and is characterized by abundance. If the Duan Mai appears alone, it is a definitive sign of Qi decline. However, since the Lung is the organ governing Qi, why does it specifically correspond to the Duan Mai? The *Suwen* states: "The normal pulse of the Lung is gentle and light, like falling elm seeds." Thus, within the shortness lies an image of harmony and slowness, indicating that Qi remains regulated. But if the pulse is short, deep, and choppy, can one claim that Qi is not diseased? Gao Yangsheng described the Duan Mai as having a pulse in the middle but none at the ends, representing being below the standard position. Upon reflecting on this with profound reasoning, I found flaws in his theory. The essence of the pulse is continuity; if circulation ceases for even one breath, the mechanism of life exhausts; if there is the slightest discontinuity, heaven and earth are separated. How could there be a state of absolute interruption? If the upper part is not connected, it constitutes Yang Extinction; if the lower part is not connected, it constitutes Yin Extinction; both are fatal pulses. Dai Tongfu also realized this, stating that the Duan Mai should only appear in the Cun and Chi positions. If seen in the Guan position, it means lack of connection upward to the Cun and downward to the Chi, constituting Yin-Yang Extinction and leading to death. Dai's view is highly insightful. However, even if Cun and Chi are short, they still fall under Yin/Yang Extinction, rather than a complete severance of the two ends. Specifically, the two ends sink while the middle rises, yet the pulse remains continuous. He Chaohe stated: "Rebounding upon palpation, failing to fill the position," which is not an accurate generalization of the Duan Mai. Li Shizhen said: "The Chang Mai (Long Pulse) belongs to the Liver and is suitable for Spring; the Duan Mai belongs to the Lung and is suitable for Autumn. By examining the Lung and Liver, the long and short pulses will naturally become apparent." Therefore, we know that if the pulse appears out of season or in an inappropriate position, it is a pathological pulse.