浮紧弦迟属风寒。升之散之气自完。
弦数浮洪风热认。药用收降病自安。
浮弦小涩如丝线。风燥药宜降润施。
浮而平渗来归指。风湿升散加参主。
小涩无力寒燥伤。温润之药端可与。
洪盛而涩乃燥热。降药润药当急取。
平润革迟为寒湿。升燥之药为第一。
渗润洪数为湿热。苦寒药饵宜用急。
枯涩小涩乃火燥。滋润之药用之可。
数而无力寒火观。甘补温药俱勿少。
数而有力热火功。苦寒之药正相同。
亦有湿盛火俱下。寒火之脉认宜真。
有见表滞里表实。此脉莫把热认之。
分明寒郁热难发。发散寒邪热自驱。
又有表数里无力。阴盛格阳正此期。
温内更加敛表药。阴阳和时脉自如。
积滞之脉自沉伏。流注如珠或结芤。
血积有形按不散。气积按有寻却无。
按滑如苔名痰积。食积惟在右关系。
气口紧盛食积新。关若伏兮食多日。
食不下兮气口滑。食不化兮气口滞。
大凡痛脉多属阴。阳脉即散痛难成。
亦有火热来作痛。外由阴郁故来侵。
夫人身之有五脏六腑。俱静而不能自动。惟脾一脏。时时能动。磨掣水谷。以司变化。
故五脏
六腑之系于脾者。由万物禀育于土也。若脾有病。则不能以养百脉。凡各脏有病。或各腑有
病。亦不能不干累于脾。凡各脏腑有病。内则病气干于脾之脏。外有脉气见于脾之部。故
有诸中。必形诸外。形诸外。则有所据。是以看脾为之关钥。凡诊脉稍有疑难。随将脾部下
指。看是甚体。真切一照。即知病脉见。于某部遂将这部移指去寻。又当体认。十八脉状响
应如神。世莫如此。实玄窍也照法参究。抄录于后。
\r右手表里图形\ps48a5.bmp\r
表三焦手少阳经 表胃脉足阳明经 表大肠手阳明经
里命门(又半表半里心包络厥阴络具右尺)
里脾脉(当作三层看诊足太阴脾经)
里肺脉手太阴肺经
右手经络诀
寸表大肠手阳明经
寸里肺脉手太阴经
关表胃脉足阳明经
关里脾脉足太阴经
尺表三焦手少阳经
尺半表半里心包络厥阴经
尺里命门
\r左手表里图形\ps48a6.bmp\r
表膀胱脉足太阳经 表胆脉足少阳经 表小肠脉手太阳经
寸表小肠手太阳经
寸里心脉手少阴心经
关表胆脉足少阳胆经
关里肝脉足厥阴肝经
尺表膀胱足太阳膀胱经
尺里肾脉足少阴肾经
里心脉手少阴心经
里肝脉足厥阴肝经
里肾脉足少阴肾经
\r详症脉照图\ps48a7.bmp\r
假如。经脉者。若十二月也。络脉者。若三百六十日也。
孙脉者。若四千三百二十时也。人亦如一小天地。于此则可见矣。
\r输经络孙图\ps48a8.bmp\r
浮脉、紧脉、弦脉、迟脉属于风寒证。使用升散之法,气机自然恢复完整。
弦脉、数脉、浮脉、洪脉可辨为风热证。药用收敛降逆之品,病自安宁。
浮脉、弦脉、小脉、涩脉如丝线般细弱,此为风燥证,用药宜用降润之法。
浮脉而平和渗利,指下感觉归拢,此为风湿证,宜用升散法并加人参为主药。
脉小、涩且无力,是寒邪与燥邪所伤,温润的药物才适宜使用。
脉象洪盛而涩,乃是燥热证,应当急取降火润燥的药物。
脉象平润、革脉、迟脉,属于寒湿证,升阳燥湿的药物是第一选择。
脉象渗利、润、洪、数,属于湿热证,苦寒药物宜紧急使用。
脉象枯涩、小涩,乃是火燥证,滋润的药物使用即可。
脉数而无力,需观察是寒证还是火证,甘补温性的药物都不能缺少。
脉数而有力,是热火之功,苦寒药物正相适宜。
也有湿盛与火俱下的情况,辨别寒火之脉应当真实准确。
有表现为表证阻滞、里证实满的,此脉象不要误认为是热证。
分明是寒邪郁结导致热难发散,发散寒邪则热自驱除。
又有表脉数而里脉无力的,这是阴盛格阳证,正处于此时期。
温补内部更加收敛表气的药物,阴阳调和时脉象自然自如。
积滞病的脉象多沉伏,流注病脉象如珠滚动或出现结脉、芤脉。
血积有形,按压不散;气积按压时有感觉却随即消失。
按之滑利如苔状,名为痰积;食积主要在右手关部有所关联。
气口(寸口)紧盛,是新近食积;关脉若伏匿,则是食积日久。
饮食不下,气口脉滑;饮食不化,气口脉滞。
大凡痛证脉象多属阴,阳脉即散则痛难以形成。
也有火热来作痛的,外因由阴郁故而来侵袭。
人身的五脏六腑,都是静止而不能自动的,只有脾这一脏,时时能够运动,磨碎水谷,以主持变化。
所以五脏六腑系属于脾,是因为万物禀受土气而孕育。如果脾有病,就不能滋养百脉。凡是各脏有病,或各腑有病,也不能不牵连到脾。凡是各脏腑有病,内则病气干扰脾脏,外则有脉气显现于脾的部位。所以有诸内,必形诸外。形诸外,就有依据。因此看脾脉作为关键钥匙。凡是诊脉稍有疑难,随即在脾脉部位下指,看是什么脉象体貌,真切一照,就知道病脉出现在哪一部,于是将手指移到那部去寻查,又当体认十八种脉象的响应,灵验如神,世间没有比这更好的了,确实是玄妙窍诀。照脉方法参究,抄录于后。
[右手表里图形]
表:三焦经(手少阳经)、胃脉(足阳明经)、大肠经(手阳明经)
里:命门(又半表半里心包络、厥阴络具于右尺)
里:脾脉(当作三层看诊,足太阴脾经)
里:肺脉(手太阴肺经)
右手经络诀:
寸部表:大肠经(手阳明经)
寸部里:肺脉(手太阴经)
关部表:胃脉(足阳明经)
关部里:脾脉(足太阴经)
尺部表:三焦经(手少阳经)
尺部半表半里:心包络(厥阴经)
尺部里:命门
[左手表里图形]
表:膀胱脉(足太阳经)、胆脉(足少阳经)、小肠脉(手太阳经)
寸部表:小肠经(手太阳经)
寸部里:心脉(手少阴心经)
关部表:胆脉(足少阳胆经)
关部里:肝脉(足厥阴肝经)
尺部表:膀胱(足太阳膀胱经)
尺部里:肾脉(足少阴肾经)
里:心脉(手少阴心经)
里:肝脉(足厥阴肝经)
里:肾脉(足少阴肾经)
[详症脉照图]
假如说,经脉如同十二月,络脉如同三百六十日,孙脉如同四千三百二十时辰。人也如同一个小天地,于此可见矣。
[输经络孙图]
Floating (Fu), tight (Jin), wiry (Xian), and slow (Chi) pulses belong to wind-cold syndrome. Using ascending and dispersing methods, the Qi naturally becomes complete.
Wiry (Xian), rapid (Shu), floating (Fu), and surging (Hong) pulses are recognized as wind-heat syndrome. Medicinals for astringing and descending bring peace to the disease.
Floating (Fu), wiry (Xian), small (Xiao), and choppy (Se) pulses like silk threads indicate wind-dryness; medicinals should be applied with descending and moistening methods.
A floating (Fu) pulse that is level and permeable, returning to the fingers, indicates wind-dampness; ascending and dispersing methods with Ginseng Radix et Rhizoma (Renshen, 人参) as the main agent are appropriate.
Small (Xiao), choppy (Se), and forceless pulses indicate injury by cold and dryness; warming and moistening medicinals are suitable.
A surging (Hong) and forceful yet choppy (Se) pulse indicates dryness-heat; descending and moistening medicinals should be urgently obtained.
A level (Ping), moist (Run), leathery (Ge), and slow (Chi) pulse indicates cold-dampness; ascending and drying medicinals are the first choice.
Permeable (Shen), moist (Run), surging (Hong), and rapid (Shu) pulses indicate damp-heat; bitter-cold medicinals should be used urgently.
Withered (Ku) and choppy (Se), or small (Xiao) and choppy (Se) pulses indicate fire-dryness; moistening medicinals can be used.
A rapid (Shu) but forceless pulse requires observation of whether it is cold-fire; sweet-tonifying and warming medicinals should not be lacking.
A rapid (Shu) and forceful pulse indicates heat-fire efficacy; bitter-cold medicinals are exactly appropriate.
There are also cases where dampness is excessive and fire is below; recognizing cold and fire pulses must be accurate.
When there is exterior stagnation and interior excess, this pulse should not be mistaken for heat.
Clearly, cold constraint makes heat difficult to emit; dispersing cold pathogens drives away the heat naturally.
Again, a rapid (Shu) exterior pulse with a forceless interior pulse indicates Yin excess repelling Yang, occurring at this time.
Warming the interior combined with astringing exterior medicinals allows Yin and Yang to harmonize, and the pulse becomes natural.
Pulses of accumulation and stagnation are naturally deep and hidden (Chen Fu); flowing injections resemble pearls or present knotted (Jie) or hollow (Kou) pulses.
Blood accumulation has form and does not disperse upon pressing; Qi accumulation feels present upon pressing but vanishes when seeking further.
Pressing smoothly like moss is named Phlegm Accumulation; Food Accumulation relates primarily to the right Guan position.
Tight and surging Qi Kou (Cunkou) indicates recent food accumulation; if the Guan pulse is hidden, it indicates long-standing food accumulation.
Inability to swallow food corresponds to a slippery (Hua) Qi Kou pulse; inability to digest food corresponds to a stagnant Qi Kou pulse.
Generally, pain pulses mostly belong to Yin; if Yang pulses scatter, pain is hard to form.
There are also pains caused by fire-heat, externally invading due to Yin constraint.
The five Zang organs and six Fu organs of the human body are all static and cannot move spontaneously. Only the Spleen organ moves constantly, grinding water and grain to manage transformation.
Therefore, the connection of the five Zang and six Fu organs to the Spleen is because all things are nurtured by Earth. If the Spleen is diseased, it cannot nourish the hundred vessels. If any Zang or Fu organ is diseased, it inevitably affects the Spleen. For diseases in any Zang or Fu, internally the pathogenic Qi interferes with the Spleen organ, and externally the pulse Qi appears in the Spleen's region. Thus, what exists inside must manifest outside. Manifesting outside provides a basis. Therefore, examining the Spleen serves as the key. Whenever pulse diagnosis is slightly difficult, immediately press on the Spleen region to observe the pulse morphology. A precise examination reveals which region shows the pathological pulse; then shift the finger to that region to search again, recognizing the responses of the eighteen pulse types, effective as if divine. Nothing in the world surpasses this; it is truly a profound secret. The method of examination is studied and copied below.
[Right Hand Table-Inside Diagram]
Exterior: Sanjiao Meridian (Hand-Shaoyang), Stomach Pulse (Foot-Yangming), Large Intestine Meridian (Hand-Yangming)
Interior: Mingmen (also Half-Exterior/Half-Interior Pericardium Meridian, Jueyin Collateral located at Right Chi)
Interior: Spleen Pulse (Viewed as three layers, Foot-Taiyin Spleen Meridian)
Interior: Lung Pulse (Hand-Taiyin Lung Meridian)
Right Hand Meridian Formula:
Cun Position Exterior: Large Intestine Meridian (Hand-Yangming)
Cun Position Interior: Lung Pulse (Hand-Taiyin)
Guan Position Exterior: Stomach Pulse (Foot-Yangming)
Guan Position Interior: Spleen Pulse (Foot-Taiyin)
Chi Position Exterior: Sanjiao Meridian (Hand-Shaoyang)
Chi Position Half-Exterior/Half-Interior: Pericardium Meridian (Jueyin)
Chi Position Interior: Mingmen
[Left Hand Table-Inside Diagram]
Exterior: Bladder Pulse (Foot-Taiyang), Gallbladder Pulse (Foot-Shaoyang), Small Intestine Pulse (Hand-Taiyang)
Cun Position Exterior: Small Intestine Meridian (Hand-Taiyang)
Cun Position Interior: Heart Pulse (Hand-Shaoyin Heart Meridian)
Guan Position Exterior: Gallbladder Pulse (Foot-Shaoyang Gallbladder Meridian)
Guan Position Interior: Liver Pulse (Foot-Jueyin Liver Meridian)
Chi Position Exterior: Bladder (Foot-Taiyang Bladder Meridian)
Chi Position Interior: Kidney Pulse (Foot-Shaoyin Kidney Meridian)
Interior: Heart Pulse (Hand-Shaoyin Heart Meridian)
Interior: Liver Pulse (Foot-Jueyin Liver Meridian)
Interior: Kidney Pulse (Foot-Shaoyin Kidney Meridian)
[Detailed Symptom Pulse Diagram]
Suppose that Jing Mai (Main Vessels) are like twelve months, Luo Mai (Collaterals) are like three hundred and sixty days, and Sun Mai (Sun Vessels) are like four thousand three hundred and twenty hours. Humans are also like a small heaven and earth, which can be seen here.
[Acupoint Meridian Sun Diagram]