阳脉浮大而濡阴脉浮大而濡阴脉与阳脉同等者名曰缓也
寸为阳尺为阴尺寸浮大而柔濡上下同等不至偏虚彼此不争是以安缓也
问曰翕奄沉名曰滑何谓也师曰沉为纯阴翕为正阳阴阳合和故令脉滑关尺自平阳明脉微沉饮食自可少阴脉微滑滑者紧
之浮名也此为阴实其人必股内汗出阴下湿也
翕者浮动之意脉正浮动忽然而沉其名曰滑沉为纯阴翕为正阳阳升于寸则为浮阴降于尺则为沉阴阳和合故令或浮或沉
而脉滑如是者关尺之脉必自均平也关为阴阳之交浮沉之中关平则阴阳和合而为滑尺平则沉而不滑也(关平则滑尺平则沉
关不平则沉尺不平则滑)若使关不平阳明脉微沉阴气稍盛矣而未至大盛食饮犹自可也尺不平少阴脉微滑虽称曰滑其实乃
紧而浮之名也此为肾家之阴实不能温升肝木木气郁动故令脉滑非阴阳和合之滑也肝气郁动于下焦不遂其发生之性风木疏
泄其人必股内汗出阴器之下常湿也
脉浮而紧者名曰弦也弦者状如弓弦按之不移也脉紧者如转索无常也
紧为寒脉伤寒则脉紧以寒性闭藏而不发也冬时寒盛水冰地坼脉紧之义也肾主蛰藏故尺脉沉紧及关而浮紧变为弦便是
春木发生之象弦虽按之不移然紧中带浮已非沉紧之形如转索之不息者矣上章紧之浮名也具此弦意尺本沉紧而忽然滑者则
不专于沉兼有浮升之状是弦见于尺弦应在关而见于尺者木欲升而不能升也故名滑而不名弦及其渐升于关则阴阳相半浮紧
两平不曰紧曰滑直名曰弦矣
阳脉(指寸部脉)浮大而濡软,阴脉(指尺部脉)也浮大而濡软,阴脉与阳脉形态同等者,称为缓脉。
寸部属阳,尺部属阴。尺寸两部脉象都浮大且柔和濡软,上下程度相等,没有偏虚之处,彼此不相互争斗,所以表现为安和舒缓的脉象。
问:脉象忽而聚合浮起、忽而沉下,称为滑脉,这是什么意思呢?老师说:沉脉属于纯阴,浮脉(翕)属于正阳,阴阳和谐交融,所以使脉象呈现滑利之态。如果关部和尺部的脉象自然平和,阳明经的脉象微沉,饮食功能就会正常;少阴经的脉象微滑,滑脉其实是紧脉的一种浮象表现。这属于阴气充实的病证,患者必然大腿内侧出汗,阴部下方潮湿。
“翕”是浮动的意思,脉象正在浮动时忽然沉下,这种脉象称为滑脉。沉脉属于纯阴,浮脉(翕)属于正阳。阳气上升于寸部则表现为浮脉,阴气下降于尺部则表现为沉脉。阴阳和谐交融,所以脉象或浮或沉而呈现出滑利的特点。像这样的情况,关部和尺部的脉象必然自会均平。关部是阴阳交汇之处,也是浮沉之中,关部平和则阴阳和谐交融而形成滑脉;尺部平和则脉沉而不显滑利。(注:若关部平和则脉滑,若尺部平和则脉沉;若关部不平则脉沉,若尺部不平则脉滑。)假如关部不平,阳明脉微沉,阴气稍盛,但还未到大盛的程度,饮食尚且正常。假如尺部不平,少阴脉微滑,虽然称为滑脉,其实乃是紧脉兼有浮象的名称。这属于肾家阴气实盛,不能温升肝木,导致肝气郁结而动,所以出现脉滑,但这并非阴阳和谐交融的滑脉。肝气在下焦郁结动摇,不能顺遂其生发的本性,风木之气疏泄失常,患者必然大腿内侧出汗,阴器之下经常潮湿。
脉象浮而紧的,称为弦脉。弦脉的形状像弓弦一样,按下去不移位。脉象紧的,像转动绳索一样无常变化。
紧脉主寒邪,伤寒病则脉象紧,因为寒性闭藏而不发散。冬季寒气旺盛,水结冰、地裂开,这就是紧脉的含义。肾主蛰伏闭藏,所以尺脉沉紧,到了关部变为浮紧,进而转变为弦脉,这是春季木气生发的征象。弦脉虽然按之不移,但在紧中带浮,已经不再是沉紧的形态,也不像转索那样不停歇了。上一章提到的“紧之浮”,具备这种弦脉的意思。尺部原本沉紧,忽然变得滑利,那么就不专主于沉,兼有浮升的状态,这是弦脉见于尺部。弦脉本应在关部出现却见于尺部,说明木气想要升发而不能升发,所以命名为滑而不是弦。等到脉象逐渐升至关部,则阴阳各半,浮与紧两相平衡,不再称为紧,也不再称为滑,直接称为弦脉了。
The Yang pulse (pulse at the Cun position) is floating, large, and soft; the Yin pulse (pulse at the Chi position) is also floating, large, and soft. When the Yin pulse and the Yang pulse are of equal magnitude, it is named Huan pulse (Slow/Relaxed Pulse).
Cun belongs to Yang, and Chi belongs to Yin. Both the Cun and Chi positions exhibit a floating, large, and soft/moderate quality. The upper and lower parts are equal in degree, without deficiency on either side, and do not contend with each other; thus, the pulse is peaceful and relaxed.
Question: What does it mean when the pulse suddenly gathers and floats then sinks, called Hua pulse (Slippery Pulse)? The Master said: Sinking (Chen) represents pure Yin, while gathering/floating (Xi) represents correct Yang. When Yin and Yang harmonize and blend, the pulse becomes slippery. If the Guan and Chi pulses are naturally balanced, and the Yangming pulse is slightly sinking, digestion will be normal. If the Shaoyin pulse is slightly slippery, note that "slippery" here actually refers to a floating manifestation of a Tight pulse. This indicates an excess of Yin within the interior. The patient will inevitably experience sweating inside the thighs and dampness below the yin organs.
"Xi" implies a floating sensation. When the pulse is floating and suddenly sinks, this is termed Slippery. Sinking is pure Yin; Xi (floating) is correct Yang. When Yang Qi ascends to the Cun position, it manifests as Floating; when Yin Qi descends to the Chi position, it manifests as Sinking. When Yin and Yang harmonize, the pulse may float or sink yet still exhibit a slippery character. In such cases, the Guan and Chi pulses must naturally be balanced. The Guan position is the intersection of Yin and Yang and the midpoint between floating and sinking. If Guan is balanced, Yin and Yang harmonize to create a Slippery pulse; if Chi is balanced, the pulse sinks without appearing slippery. (Note: If Guan is balanced, the pulse is slippery; if Chi is balanced, the pulse is sinking. If Guan is unbalanced, the pulse sinks; if Chi is unbalanced, the pulse is slippery.) If Guan is unbalanced, the Yangming pulse is slightly sinking, indicating Yin Qi is slightly excessive but not severely so; digestion remains acceptable. If Chi is unbalanced, the Shaoyin pulse is slightly slippery. Although called "slippery," it is essentially a Tight pulse with a floating quality. This signifies Kidney Yin Excess, which fails to warm and ascend Liver Wood, causing Liver Qi to stagnate and move. Thus, the pulse appears slippery, but this is not the harmony of Yin and Yang. Instead, Liver Qi stagnates and agitates in the Lower Jiao, failing to fulfill its generating nature. The Wind-Wood Qi loses its proper dispersing function. Consequently, the patient experiences sweating inside the thighs and chronic dampness below the genitalia.
A pulse that is Floating and Tight is named Xian pulse (Wiry Pulse). The Wiry pulse feels like a bowstring; pressing it does not shift. A Tight pulse feels like a twisting rope, constantly changing.
Tightness indicates Cold. In Cold Damage (Shanghan), the pulse is tight because Cold has the nature of closure and storage, preventing dispersion. In winter, when Cold is severe, water freezes and the earth cracks; this illustrates the meaning of the Tight pulse. The Kidney governs hibernation and storage; therefore, the Chi pulse is Sinking and Tight. As it reaches the Guan position and becomes Floating and Tight, transforming into a Wiry pulse, this represents the sprouting phenomenon of Spring Wood. Although the Wiry pulse is firm upon pressure, it contains Floating within the Tightness, differing from the Sinking-Tight form, and lacks the ceaseless twisting motion of a Tight pulse. The "Floating of Tightness" mentioned in the previous chapter embodies this Wiry intent. If the Chi pulse, originally Sinking and Tight, suddenly becomes Slippery, it no longer solely indicates Sinking but also shows a Floating-ascending state. This is the Wiry pulse appearing at the Chi position. Since the Wiry pulse should appear at the Guan position but appears at Chi, it indicates that Wood Qi desires to ascend but cannot. Hence, it is named Slippery rather than Wiry. As the pulse gradually ascends to the Guan position, Yin and Yang become half-and-half, and Floating and Tight balance each other. It is no longer called Tight or Slippery, but directly named Wiry.