《脉经》曰∶七诊者,一静其心,存其神也;二忘外意,
无思虑也;三均呼吸,定其气也;四轻指于皮肤之间;探其腑脉也;五稍重指于肌肉之际,取其胃气也;六再
重指于骨上,取其脏脉也;七详察脉之往来也。据《脉经》所说,指临时言。以余诀之,用功不在临时,而在平
时。平居一室之中,内以养己,恬静虚无,一存其神,二忘其虑,三均其呼吸。沉潜于脉理之场,从容于脉理
之圃。将心所存之神,意所忘之虑,鼻所出入之呼吸,尽附指头。不以心所存之神为存;而以指所存之神为存
;不以意所忘之虑为忘,而以指所忘之虑为忘;不以鼻所出入之呼吸为呼吸,而以指所出入之呼吸为呼吸。以
之探脏腑,取胃气,察脉之往来,无论燕居间暇,即造次之时,颠沛之际,得之于手,应之于心矣!盖手中有
脉,而后可以诊他人之脉。若平时未及揣摩,徒事口耳之学,临时从七诊分晰,心中了了,指下难明。况医常仓
卒,病值危急,又何以尽七诊之法,而一无遗漏也乎?!
寸、关、尺为三部,一部各有浮、中、沉三候。轻手得之曰举,候浮脉也;重手取之曰按,候沉脉也;不
轻不重,委屈求之曰寻,候中脉也。三而三之为九也。浮以候表,头面皮毛外感之病也;沉以候里,脏腑骨髓
内伤之病也;中以候中。中者,无过不及,非表非里,至数从容,无病可议。古帝王传心之要,所为以一中括
天地之道而立斯人身心性命
之宗者,此也。古人以之为心传,吾人亦以之征心得。盖中与和通,谓其和缓而不邻于躁也;中与庸近,谓其
平庸而不涉于偏也。其见诸脉,胃气居中,则生机之应也。定之以中,而浮沉朗若观火,三部九候无不了然。
《脉经》说:七诊的方法,第一是使内心安静,精神集中;第二是忘却外界杂念,没有思虑;第三是调节呼吸均匀,安定气息;第四是指力轻放在皮肤之间,以探查腑脉;第五是指力稍重放在肌肉之间,以获取胃气;第六是指力再加重按在骨上,以获取脏脉;第七是详细观察脉搏的来去变化。根据《脉经》的说法,这是指诊脉时的临时操作。依我个人的心得总结,用功的关键不在诊脉的临时时刻,而在平时的修养。平时独居室内,向内修养自身,保持恬静虚无的状态,第一要保存精神,第二要忘却思虑,第三要调节呼吸均匀。沉潜于脉理的领域,从容地遨游于脉理的花园。将心中所存的精神、意念所忘的思虑、鼻子所出入的呼吸,全部依附在手指尖上。不是以心中所存的精神为存在,而是以指尖所感知到的精神为存在;不是以意念所忘的思虑为遗忘,而是以指尖所排除的思虑为遗忘;不是以鼻子所出入的呼吸为呼吸,而是以指尖所感知的呼吸为呼吸。凭借这种方法去探查脏腑、获取胃气、观察脉搏的来去,无论是在闲暇独处时,还是在匆忙急迫之时、颠沛流离之际,都能做到手上有感觉,心中有回应!只有手中掌握了脉象的感觉,然后才可以诊断他人的脉象。如果平时没有经过揣摩练习,只从事口头耳闻的学习,到了临时才从七诊方法中分析分辨,虽然心里明白,但手指下却难以准确辨别。况且医生经常面临仓促的情况,病人正值危急时刻,又怎么能完全运用好七诊的方法而毫无遗漏呢?
寸、关、尺称为三部,每一部又有浮、中、沉三种候法。轻手取到脉象叫做“举”,是候察浮脉;重手取到脉象叫做“按”,是候察沉脉;不轻不重,委婉寻找到脉象叫做“寻”,是候察中脉。三乘以三成为九种候法。浮脉用来候察表证,即头面皮毛感受外邪的疾病;沉脉用来候察里证,即脏腑骨髓内部受损的疾病;中脉用来候察半表半里或平和之象。所谓“中”,是不偏不倚,既非表也非里,脉率从容和缓,表示没有疾病可议论。古代帝王传授心法的要领,之所以用“中”这一概念概括天地之道,并确立人类身心性命的根本,就是这个道理。古人将其作为心传,我们也通过它来验证心得。所谓“中”与“和”相通,是说它和缓而不接近急躁;“中”与“庸”相近,是说它平庸而不涉及偏颇。体现在脉象上,胃气居于中位,就是生机的表现。以“中”为标准来确定,那么浮脉和沉脉就清晰得像看火一样明亮,三部九候就没有不明了的了。
The *Mai Jing* (Pulse Classic) states: The seven examinations are: first, still the mind and preserve the spirit; second, forget external distractions and eliminate thoughts; third, equalize the breathing to stabilize the qi; fourth, apply light finger pressure between the skin to explore the fu-organ pulses; fifth, apply slightly heavier pressure at the muscle level to obtain the stomach qi; sixth, press further down to the bone to obtain the zang-organ pulses; seventh, carefully observe the coming and going of the pulse. According to the *Mai Jing*, these refer to the temporary actions during pulse diagnosis. Based on my own experience, the effort lies not in the moment of diagnosis, but in daily cultivation. When living quietly indoors, one cultivates oneself inwardly, maintaining tranquility and emptiness: first preserving the spirit, second forgetting thoughts, third equalizing the breath. One immerses oneself in the realm of pulse principles and moves leisurely within the garden of pulse theory. The spirit preserved in the mind, the thoughts forgotten by intention, and the breath entering and exiting through the nose should all be attached to the fingertips. Not regarding the spirit preserved in the mind as the true preservation, but regarding the spirit perceived by the fingertips as the preservation; not regarding the thoughts forgotten by intention as true forgetting, but regarding the thoughts excluded by the fingertips as forgetting; not regarding the breath entering and exiting through the nose as the breath, but regarding the breath perceived by the fingertips as the breath. Using this method to explore zang and fu organs, obtain stomach qi, and observe the pulse's movement, whether in leisure or in haste, even in times of turmoil, one achieves sensation in the hand and response in the heart! Only when one has mastered the pulse in the hand can one diagnose the pulses of others. If one has not practiced and pondered during ordinary times, relying merely on oral and auditory learning, and only analyzes according to the seven examinations at the moment of diagnosis, although the mind may understand, the fingers will struggle to clarify. Moreover, doctors often face urgent situations where patients are critical; how then can one fully apply the methods of the seven examinations without omission?
Cun (Inch), Guan (Bar), and Chi (Cubit) constitute the three positions. Each position has three depths: floating (Fu), middle (Zhong), and deep (Chen). Light pressure to feel the pulse is called "Ju" (Lifting), used to examine the floating pulse; heavy pressure to feel the pulse is called "An" (Pressing), used to examine the deep pulse; neither light nor heavy, seeking gently with a curved finger motion is called "Xun" (Seeking), used to examine the middle pulse. Three multiplied by three equals nine. The floating pulse examines exterior conditions, such as diseases caused by external pathogens affecting the head, face, skin, and hair; the deep pulse examines interior conditions, such as internal injuries to the zang and fu organs and bone marrow; the middle pulse examines the middle state. The "middle" implies no excess or deficiency, neither exterior nor interior, with a leisurely pulse rate, indicating no disease. This is the essential secret transmitted from heart to heart by ancient emperors, using the concept of "Zhong" (Middle/Center) to encompass the Way of Heaven and Earth, and establishing the foundation for human body, mind, and life. The ancients treated it as a mental transmission, and we too use it to verify our insights. "Zhong" connects with "He" (Harmony), meaning it is gentle and not prone to agitation; "Zhong" is close to "Yong" (Constant/Ordinary), meaning it is moderate and not biased. Manifested in the pulse, if Stomach Qi resides in the middle, it indicates vitality. By fixing the standard on the "middle," the floating and deep pulses become clear as fire, and the three positions and nine depths are fully understood.