喘急疾而连属,不若累累之连珠也,其中微曲,不若循琅 之平和也。心脉如是,则心气不和,故曰心病。
若死心脉来,前诊则脉曲如钩,后则居而不动,其曲也如操带钩,无柔合之胃气,故曰心死。
平肺脉来,厌厌聂聂,如落榆英,曰肺平。秋以胃气为本,病肺脉来,不上不下,如循鸡羽,
曰肺病。死肺脉来,如物之浮,如
风吹毛,曰肺死。
厌,平声。厌厌聂聂,安静而轻小也。如落榆 ,轻薄而不虚也。此乃肺之平脉,肺主秋金,故秋以
胃气为本,不上不下,似浮非浮,似沉非沉,而非厌厌聂聂也。如循鸡羽,极轻极虚,不若榆
之落也,故曰肺病。如物之浮,虚而无根也。如风吹毛,散而不收也。脉无胃气,故曰肺死。
平肝脉来, 弱招招,如揭长竿末梢,曰肝平。春以胃气为本,病肝脉来,盈实而滑,如循长竿,
曰肝病。死肝脉来,急益劲,如新张弓弦,曰肝死。
弱招招,柔和而起伏也,如揭长竿末梢,应指而上下也,此乃肝之平脉。肝主春木,故春以胃
气为本,盈实而滑,不 弱矣。如循长竿,其体坚硬,不若末梢之上下矣。故曰肝病,急益劲者,
较之滑脉而且急,较之长竿而益劲,其劲急也,如新张之弓弦,无柔和之胃气,故曰肝死。
平脾脉来,和柔相离,如鸡践地,曰脾平。长夏以胃气为本,病脾脉来,实而盈数,如鸡举足,曰
脾病。死脾脉来,锐坚,如乌之喙,如乌之距,如屋之漏,如水之流,曰脾死。
喙,音诲,余篇同。和柔相离,本中土和柔之气,而离散于四旁也。如鸡践地,鸡足,四爪践地,
犹脾土和柔而濡润也。此脾之平脉,合于季土,故长夏以胃气为本,实而盈数,其脉牢固有余,
不和柔而四散也。如鸡举足,其脉拳而收敛,不如践地之舒布也,故曰脾病。锐坚,锐利坚固,不柔和也。
其锐也,如乌之喙,尖而不和,其坚也,如乌之距,着实而强,此脾土之不行也。其行,则
如屋之漏,点滴稀疏,如水之流,去而不返,夫脾土中和,刚势之极,散漫之极,皆为死脉,故曰脾死。
平肾脉来,喘喘累累如钩,按之而坚,曰肾平。冬以胃气为本,病肾脉来,如引葛,按之益坚,曰肾
病。死肾脉来,发如夺索,辟辟如弹石,曰肾死。
喘喘累累如钩,乃水中之生阳上升,其气喘喘,其象累累,其
生长如钩,从下而上,故按之而坚。此肾之平脉,合于冬水,故冬以胃气为本。如引葛,如引葛藤之上延,
散而且蔓,不若如钩之有本矣。按之益坚,乃石多胃少,沉实太过,不若按之而坚矣。发如
夺索,脉气之至,彼此牵引,如夺索然也。辟辟,来去不伦也,如弹石,园硬不软也。此但石无胃,故曰肾死。
肝见庚辛,死。心见壬癸,死。脾见甲乙,死。肺见丙丁,死。肾见戊己,死。是谓真脏见者,死。
旧本在臂多青脉段之下,今改正于此。计其五脏死期,逢十干相克而死。死肝脉见,则逢庚辛死,
金克木也。死心脉见,则逢壬癸死,水克火也。死脾脉见,则逢甲乙死,木克土也。死肺脉见,
则逢丙丁死,火克金也。死肾脉见,则逢戊己死,土克水也。是谓真脏见者死,犹云是即所谓但得真脏,
不得胃气者,则死也,且明五见,而属于真脏之见也。五脏四时之脉,皆以胃气为本,是知平
人气象,亦以胃气为本也。
喘急而连续不断,不像累累相连的珍珠那样圆润;脉象中微有弯曲,也不像抚摸琅玕玉那样平和。心脉呈现这种状态,说明心气不和,所以称为心病。
如果死心脉到来,初按时脉象弯曲如钩,随后则停滞不动,其弯曲程度如同拿着带钩的腰带,没有柔和的胃气,所以称为心死。
平肺脉到来时,脉势安和轻小,如同榆钱飘落,这叫做肺平。秋季脉象以胃气为本,病肺脉到来时,脉象不上不下,如同抚摸鸡羽,这叫做肺病。死肺脉到来时,脉象如同物体漂浮,又如同风吹羽毛,这叫做肺死。
“厌”读作平声。“厌厌聂聂”,形容脉象安静而轻小。如同榆钱飘落,轻薄但不虚浮。这是肺的平脉,肺主秋金,所以秋季脉象以胃气为本。不上不下,似浮非浮,似沉非沉,而不是那种安和轻小的脉象。如同抚摸鸡羽,极轻极虚,不如榆钱飘落那样有根,所以叫做肺病。如同物体漂浮,是虚而无根的表现。如同风吹羽毛,是散乱而不收敛的表现。脉中没有胃气,所以叫做肺死。
平肝脉到来时,脉势柔弱起伏,如同高举长竿的末梢摆动,这叫做肝平。春季脉象以胃气为本,病肝脉到来时,脉象充盈坚实而滑利,如同抚摸长竿,这叫做肝病。死肝脉到来时,脉势紧急且强劲,如同新拉开的弓弦,这叫做肝死。
“弱招招”,形容脉象柔和而有起伏。如同高举长竿的末梢,应指而上下摆动,这是肝的平脉。肝主春木,所以春季脉象以胃气为本。充盈坚实而滑利,就不柔弱了。如同抚摸长竿,脉体坚硬,不像竿梢那样上下柔和摆动。所以叫做肝病。紧急且强劲,比滑脉更急,比长竿更劲,其劲急之状,如同新张开的弓弦,没有柔和的胃气,所以叫做肝死。
平脾脉到来时,脉势和柔而离散(指分布均匀),如同鸡脚踩地,这叫做脾平。长夏脉象以胃气为本,病脾脉到来时,脉象实而满数,如同鸡脚抬起,这叫做脾病。死脾脉到来时,脉势锐利坚固,如同乌鸦的嘴,如同乌鸦的爪距,如同屋顶漏雨(点滴稀疏),如同水流去而不返,这叫做脾死。
“喙”读作hui,其他篇章同此。和柔而离散,是本属中土的柔和之气,散布于四旁。如同鸡脚踩地,鸡足四爪着地,犹若脾土的和柔与濡润。这是脾的平脉,合于季夏之土,所以长夏脉象以胃气为本。实而满数,脉象牢固有余,不和柔也不向四周分散。如同鸡脚抬起,脉象拳缩而收敛,不像踩地那样舒展布散,所以叫做脾病。锐利坚固,不柔和。其锐利,如同乌鸦的嘴,尖削而不和缓;其坚固,如同乌鸦的爪距,着实而强硬,这是脾土之气不能运行的表现。其运行正常时,则如屋顶漏雨般点滴稀疏有序,如水流动般去而不返。脾土贵在中和,过于刚强或过于散漫,都是死脉,所以叫做脾死。
平肾脉到来时,脉势喘喘累累如钩,按之坚实,这叫做肾平。冬季脉象以胃气为本,病肾脉到来时,如同牵引葛藤,按之更加坚实,这叫做肾病。死肾脉到来时,脉势发如夺索(互相牵引),辟辟有声如同弹石,这叫做肾死。
喘喘累累如钩,是水中之生阳上升,其气喘喘,其形累累,其生长之势如钩,从下而上,所以按之坚实。这是肾的平脉,合于冬水,所以冬季脉象以胃气为本。如同牵引葛藤,像葛藤向上蔓延,散漫而无根基,不像如钩那样有本。按之更加坚实,是石多胃少,沉实太过,不像平脉那样按之坚实而有神。发如夺索,是脉气到来时,彼此牵引,如同争夺绳索。辟辟,形容脉来去无序,如同弹石,圆硬不软。这里只有石脉而没有胃气,所以叫做肾死。
肝脏病变见庚辛日(金日),则死。心脏病变见壬癸日(水日),则死。脾脏病变见甲乙日(木日),则死。肺脏病变见丙丁日(火日),则死。肾脏病变见戊己日(土日),则死。这就叫做真脏脉现,主死。
旧版将此段放在“臂多青脉”段落之下,现在改正于此。推算五脏的死期,是遇到天干相克的日子而死。死肝脉出现,则逢庚辛日死,因为金克木。死心脉出现,则逢壬癸日死,因为水克火。死脾脉出现,则逢甲乙日死,因为木克土。死肺脉出现,则逢丙丁日死,因为火克金。死肾脉出现,则逢戊己日死,因为土克水。这就叫做真脏脉现主死,也就是所谓只得到真脏脉,得不到胃气的,就会死亡。并且明确了五种真脏脉的出现都属于真脏脉的范畴。五脏在四季的脉象,都以胃气为本,由此可知平人的气象,也是以胃气为本的。
When the pulse is rapid and continuous without pause, it differs from the beads of a string of pearls (Lei Lei) which are connected yet distinct; its slight curvature differs from the smoothness felt when stroking Langgan jade. If the Heart pulse presents thus, it indicates that Heart Qi is disharmonious, hence termed Heart disease.
If the dying Heart pulse arrives, initially it feels curved like a hook, but subsequently remains stagnant and motionless. Its curvature is like handling a belt with a hook, lacking the softness of Stomach Qi, hence termed dying Heart.
The normal Lung pulse arrives gently and lightly, like elm seeds falling, this is called normal Lung. In autumn, Stomach Qi is fundamental. The diseased Lung pulse arrives neither rising nor sinking, like stroking a chicken feather, this is called Lung disease. The dying Lung pulse arrives floating like an object, or like wind blowing feathers, this is called dying Lung.
"Yan" is pronounced level tone. "Yan Yan Nie Nie" describes a quiet and light/small quality. Like falling elm catkins, it is light and thin but not empty. This is the normal Lung pulse. Lung governs Autumn Metal, therefore in autumn, Stomach Qi is fundamental. Neither rising nor sinking, seemingly floating but not truly floating, seemingly deep but not truly deep, rather than being gentle and light. Like stroking a chicken feather, extremely light and deficient, unlike the falling elm catkins, hence called Lung disease. Floating like an object indicates emptiness without root. Like wind-blown feathers indicates scattering without gathering. A pulse without Stomach Qi is called dying Lung.
The normal Liver pulse arrives weak and swaying, like the tip of a long pole held high, this is called normal Liver. In spring, Stomach Qi is fundamental. The diseased Liver pulse arrives full, solid, and slippery, like stroking a long pole, this is called Liver disease. The dying Liver pulse arrives urgent and increasingly stiff, like a newly drawn bowstring, this is called dying Liver.
"Wei Zhao Zhao" describes a soft and undulating quality. Like the tip of a long pole held high, responding to the finger by moving up and down, this is the normal Liver pulse. Liver governs Spring Wood, therefore in spring, Stomach Qi is fundamental. Full, solid, and slippery means it is no longer weak. Like stroking a long pole, the body is hard, unlike the swaying tip. Hence called Liver disease. Urgent and increasingly stiff means compared to the slippery pulse it is more urgent, and compared to the long pole it is stiffer. Its stiffness is like a newly tensioned bowstring, lacking the softness of Stomach Qi, hence called dying Liver.
The normal Spleen pulse arrives harmonious and soft, discrete yet balanced, like a chicken treading on the ground, this is called normal Spleen. In late summer, Stomach Qi is fundamental. The diseased Spleen pulse arrives solid, full, and rapid, like a chicken lifting its foot, this is called Spleen disease. The dying Spleen pulse arrives sharp and firm, like the beak of a crow, like the spur of a crow, like water leaking from a roof, or like flowing water going away and not returning, this is called dying Spleen.
"Hui" is pronounced hui, same as in other chapters. Harmonious and soft yet discrete refers to the harmonious Qi of Central Earth dispersing to the four directions. Like a chicken treading on the ground, with four claws touching the earth, resembling the harmony and moistness of Spleen Earth. This is the normal Spleen pulse, corresponding to the Earth of the final season, therefore in late summer, Stomach Qi is fundamental. Solid, full, and rapid indicates the pulse is firm and excessive, lacking harmony and dispersion. Like a chicken lifting its foot, the pulse is contracted and convergent, unlike the spreading nature of treading. Hence called Spleen disease. Sharp and firm means sharp and solid, lacking softness. Its sharpness is like the crow's beak, pointed and unharmonious; its firmness is like the crow's spur, substantial and strong. This indicates the failure of Spleen Earth Qi. When functioning normally, it is like roof leaks (sparse and orderly drops) or flowing water (going forth and not returning). Spleen Earth values moderation; extremes of rigidity or dissipation are both dying pulses, hence called dying Spleen.
The normal Kidney pulse arrives panting and cumulative like a hook, firm upon pressure, this is called normal Kidney. In winter, Stomach Qi is fundamental. The diseased Kidney pulse arrives like pulling a vine, becoming firmer upon pressure, this is called Kidney disease. The dying Kidney pulse arrives like competing for a rope, crackling like striking stones, this is called dying Kidney.
Panting and cumulative like a hook represents the ascending Yang within Water. Its Qi pants, its form is cumulative, its growth resembles a hook, rising from below, hence firm upon pressure. This is the normal Kidney pulse, corresponding to Winter Water, therefore in winter, Stomach Qi is fundamental. Like pulling a vine, extending upwards like grapevines, scattered and蔓 (spreading), unlike the hook which has a root. Becoming firmer upon pressure indicates Stone-like pulse with little Stomach Qi, excessively deep and solid, unlike the firmness of the normal pulse. Competing for a rope indicates the pulse Qi arriving, pulling against each other like a tug-of-war. "Pi Pi" describes irregular arrival and departure, like striking stones, round and hard without softness. Here there is only Stone pulse without Stomach Qi, hence called dying Kidney.
When Liver pathology appears on Geng/Xin days (Metal days), death occurs. When Heart pathology appears on Ren/Gui days (Water days), death occurs. When Spleen pathology appears on Jia/Yi days (Wood days), death occurs. When Lung pathology appears on Bing/Ding days (Fire days), death occurs. When Kidney pathology appears on Wu/Ji days (Earth days), death occurs. This is called the appearance of the True Viscera pulse, indicating death.
In old editions, this passage was placed under the section regarding blue veins on the arm; it is now corrected here. Calculating the timing of death for the five Zang organs, death occurs when encountering Heavenly Stems that overcome them. When the dying Liver pulse appears, death occurs on Geng/Xin days, because Metal overcomes Wood. When the dying Heart pulse appears, death occurs on Ren/Gui days, because Water overcomes Fire. When the dying Spleen pulse appears, death occurs on Jia/Yi days, because Wood overcomes Earth. When the dying Lung pulse appears, death occurs on Bing/Ding days, because Fire overcomes Metal. When the dying Kidney pulse appears, death occurs on Wu/Ji days, because Earth overcomes Water. This is called the appearance of the True Viscera pulse indicating death, meaning that obtaining only the True Viscera pulse without Stomach Qi leads to death. It clarifies that these five appearances belong to the category of True Viscera pulse. The pulses of the five Zang organs in the four seasons all take Stomach Qi as their foundation; thus it is known that the condition of a healthy person also takes Stomach Qi as the foundation.