寸口脉弱而缓弱者阳气不足缓者胃气有余噫而吞酸食卒不下气填于膈上也
寸口脉弱而缓弱者阳气之不足缓者胃气之有余有余者胃气上逆壅满不降名为有余实则胃阳之不足也上脘壅滞则噫气
吞酸食卒不下浊气填塞于膈上也(吞酸者胃气痞塞乙木不得升达郁而为酸也)
寸口脉弱而迟弱者卫气微迟者营中寒营为血血寒则发热卫为气气微者心内饥饥而虚满不能食也
寸口脉弱而迟弱者卫气之微迟者营中寒营为血血寒则温气外泄而发热卫为气气微则心内空虚而若饥然阳虚气滞胃口
痞满虽饥而不能食也
趺阳脉伏而涩伏则吐逆水谷不化涩则食不得入名曰关格
趺阳脉伏而涩伏则胃虚不能化谷而吐逆涩则胃逆不能纳谷而食不得入名曰关格水谷不化而吐逆是反胃之病食不得入
而噎塞是膈噎之病伏者胃气之郁伏阳衰于下故不化谷涩者胃气之凝涩阴填于上故不纳食
寸口脉浮而大浮为虚大为实在尺为关在寸为格关则不得小便格则吐逆
寸口脉浮而大浮为虚大为实既虚而又实者人身之气实则清空而虚则痞塞所谓实则虚而虚则实也(子华子语)盖阴平
阳密则阳交于阴而不见浮大阴盛阳虚则阳泄于外而浮大见焉其浮者阳之内虚也其大者阳之外实也此脉在尺则阳气下陷而
为关在寸则阴气上逆而为格关者阴阂于下清气沉郁而不升也肝木一陷疏泄之令莫行故不得小便格者阳浮于上浊阴冲塞而
不降也胃土既逆受盛之官失职故吐逆也灵枢脉度阴气太盛则阳气不能荣也故曰关阳气太盛则阴气不能荣也故曰格以阳气
下降而化浊阴阴气上升而化清阳清阳升则水利而不癃浊阴降则谷入而不呕阴盛于下致阳陷而不升故肝气下郁而水不行阳
盛于上缘阴逆而不降故胃气上郁而食不下也
寸口脉象弱而缓,弱代表阳气不足,缓代表胃气有余。表现为嗳气和吞酸,食物突然无法咽下,气机堵塞在膈部上方。
寸口脉象弱而缓,弱是阳气不足的表现,缓是胃气有余的表现。所谓“有余”,是指胃气上逆,壅滞胀满而不能下降,名义上叫有余,实际上是胃阳的不足。上脘部位壅滞就会导致嗳气、吞酸、食物突然无法咽下,浊气填塞在膈部上方。(吞酸是因为胃气痞塞,乙木[肝木]不能升达,郁结而化为酸味。)
寸口脉象弱而迟,弱代表卫气微弱,迟代表营分有寒。营属于血,血寒则导致发热;卫属于气,气微弱则心中感觉饥饿,但伴有虚胀感,不能进食。
寸口脉象弱而迟,弱是卫气微弱的表现,迟是营分有寒的表现。营属于血,血寒则温气外泄而导致发热;卫属于气,气微弱则心中空虚而像饥饿一样,但因阳虚气滞,胃口痞满,虽然饥饿却不能进食。
趺阳脉象伏而涩,伏代表呕吐逆乱,水谷不能消化;涩代表食物无法进入,这叫做关格病。
趺阳脉象伏而涩,伏是因为胃虚不能消化谷物而导致呕吐逆乱;涩是因为胃气上逆不能纳受谷物而导致食物无法进入,这叫做关格病。水谷不化而呕吐逆乱,这是反胃的病证;食物无法进入而噎塞,这是膈噎的病证。伏脉是胃气郁伏,阳气衰于下部,所以不能消化谷物;涩脉是胃气凝涩,阴邪填塞于上部,所以不能纳受食物。
寸口脉象浮而大,浮代表虚,大代表实。脉象在尺部出现这种特征称为“关”,在寸部出现称为“格”。关则小便不通,格则呕吐逆乱。
寸口脉象浮而大,浮代表虚,大代表实。既虚又实的情况,人气实则清空而虚则痞塞,这就是所谓的“实表现为虚,虚表现为实”(子华子的话)。大概阴阳平和、阳气致密时,阳气交合于阴中而不显现浮大之象;阴盛阳虚时,阳气外泄而显现浮大之象。其浮,是阳气内部的虚弱;其大,是阳气外部的实象。这种脉象如果在尺部,则是阳气下陷而形成关格中的“关”;如果在寸部,则是阴气上逆而形成关格中的“格”。“关”是阴邪阻隔于下部,清气沉郁而不能上升,肝木一旦下陷,疏泄的功能就无法施行,所以小便不通。“格”是阳气浮越于上部,浊阴冲塞而不能下降,胃土既然上逆,受盛器官失职,所以发生呕吐逆乱。《灵枢·脉度》说:阴气太盛,则阳气不能荣养,所以叫“关”;阳气太盛,则阴气不能荣养,所以叫“格”。因为阳气下降才能化生浊阴,阴气上升才能化生清阳。清阳上升则水道通利而不癃闭,浊阴下降则饮食入胃而不呕吐。阴盛于下部导致阳气下陷而不能上升,所以肝气下郁而水液不行;阳盛于上部缘于阴气上逆而不能下降,所以胃气上郁而饮食不下。
The pulse at the Cun Kou (Cun Kou, radial artery location) is weak and slow. Weakness indicates insufficiency of Yang Qi (Yang Qi). Slowness indicates excess of Stomach Qi (Stomach Qi). Symptoms include belching and acid regurgitation, sudden inability to swallow food, and Qi stagnation filling the upper Diaphragm (Diaphragm).
The pulse at the Cun Kou is weak and slow. Weakness signifies insufficiency of Yang Qi. Slowness signifies excess of Stomach Qi. The so-called "excess" refers to Stomach Qi reversing upward, causing obstruction, fullness, and failure to descend; nominally called excess, it is actually an insufficiency of Stomach Yang Qi. Obstruction in the Shang Wan (Shang Wan, upper epigastrium) leads to belching and acid regurgitation. Food suddenly cannot be swallowed, and turbid Qi fills the upper Diaphragm. (Acid regurgitation occurs because Stomach Qi is obstructed, preventing Yi Mu [Liver Wood] from ascending and transforming into sourness due to stagnation.)
The pulse at the Cun Kou is weak and delayed. Weakness indicates slight Wei Qi (Wei Qi, Defensive Qi). Delay indicates Cold in Ying (Ying, Nutritive Qi). Ying belongs to Blood; when Blood is cold, fever occurs. Wei belongs to Qi; when Qi is slight, there is a sensation of hunger in the heart, accompanied by deficiency-fullness, leading to an inability to eat.
The pulse at the Cun Kou is weak and delayed. Weakness indicates slight Wei Qi. Delay indicates Cold in Ying. Ying belongs to Blood; when Blood is cold, Warm Qi leaks outward, causing fever. Wei belongs to Qi; when Qi is slight, the heart feels empty and resembles hunger. However, due to Yang deficiency and Qi stagnation, the stomach opening is obstructed and full; although hungry, one cannot eat.
The pulse at the Fu Yang (Fu Yang, dorsalis pedis artery location) is hidden and choppy. Hidden indicates vomiting and reversal, with undigested food and water. Choppy indicates that food cannot enter. This is named Guan Ge (Guan Ge, Obstruction and Reversal syndrome).
The pulse at the Fu Yang is hidden and choppy. Hidden indicates Stomach deficiency failing to transform grain, leading to vomiting and reversal. Choppy indicates Stomach Qi reversing upward, failing to accept grain, so food cannot enter. This is named Guan Ge. Undigested food and water leading to vomiting and reversal is the disease of Fan Wei (Fan Wei, Regurgitation/Reversal Stomach). Food unable to enter with choking and blockage is the disease of Ge Ye (Ge Ye, Diaphragmatic Dysphagia). The hidden pulse represents stagnant Stomach Qi, with Yang Qi declining below, thus failing to transform grain. The choppy pulse represents condensed and rough Stomach Qi, with Yin filling above, thus failing to accept food.
The pulse at the Cun Kou is floating and large. Floating indicates deficiency; Large indicates excess. If this appears at the Chi (Chi, distal radial pulse position), it is Guan (Guan, Obstruction); if at the Cun (Cun, proximal radial pulse position), it is Ge (Ge, Reversal). Guan results in inability to urinate; Ge results in vomiting and reversal.
The pulse at the Cun Kou is floating and large. Floating indicates deficiency; Large indicates excess. When both deficiency and excess are present, Qi in the body becomes clear and empty when excessive, and obstructed when deficient. This is what Zi Hua Zi said: "Excess manifests as deficiency, deficiency manifests as excess." Generally, when Yin is balanced and Yang is dense, Yang intersects with Yin without showing floating or large characteristics. When Yin is excessive and Yang is deficient, Yang leaks outward, showing floating and large characteristics. The floating aspect indicates internal deficiency of Yang; the large aspect indicates external excess of Yang. If this pulse is at the Chi position, Yang Qi sinks downward, forming Guan. If at the Cun position, Yin Qi reverses upward, forming Ge. Guan means Yin obstructs below, Qing Qi (Clear Qi) sinks and stagnates without ascending. Once Liver Wood sinks, its command of Shu Xie (Shu Xie, dispersing and draining) cannot act, resulting in inability to urinate. Ge means Yang floats above, Turbid Yin rushes and blocks without descending. Since Stomach Earth has reversed, its official function of receiving and storing fails, resulting in vomiting and reversal. The *Ling Shu: Mai Du* states: "When Yin Qi is too excessive, Yang Qi cannot nourish," hence Guan. "When Yang Qi is too excessive, Yin Qi cannot nourish," hence Ge. Because Yang Qi descends to transform Turbid Yin, and Yin Qi ascends to transform Clear Qi: Clear Qi ascending ensures smooth water passage without retention; Turbid Yin descending ensures food intake without vomiting. Excessive Yin below causes Yang to sink and fail to ascend, so Liver Qi sinks downward and water does not flow. Excessive Yang above, due to Yin reversing and failing to descend, causes Stomach Qi to stagnate upward and food to fail to go down.