呼为阳以应天,脉再动以应春夏;吸为阴以应地,脉再动以应冬秋。
气出为呼,入为吸。再,两次也。动,至也。
或闰以太息而又一动者,以应长夏脾土,故一息四至、五至皆为和平。
太息,言呼吸或有长者也。长夏,六月也。和平,言为平人不病之脉。
谓一岁四时俱备也。五至以上曰数,不满四至曰迟。数过备者死,不及一至者亦死。
数为热,迟为寒。过备,八至之上也。是以平人之息,合病患之脉也。
故经曰∶常以不病调病患。由是小儿八至为和平,十至有热,六至为病寒也。自六岁以下,通曰
以此三岁之法。人小则脉如数,长短亦然。
浮、芤、滑、实、弦、紧、洪,此名七表,为阳。少阳之数为七。
浮脉者,轻手乃得,重按之不见。脉见诸阳为表热,诸阴为表寒。
脉动于肌肉之上也,浮,属阳,为病在表,一名腑病。或伤风自汗,脉浮为表热,迟缓之阴者,表寒。
芤脉者,浮大而软,按之中央虚,两边实也。
芤主热甚失血,寸芤则吐血,微则衄,甚则俱出。关芤则胸痈下血。尺芤则大便血,微则小便血,甚则俱下。
滑脉者,不涩也,多与实、数相兼,则为病热。或亡液、血衰,虽热而反涩
也;或滑兼迟,则为病寒;平而滑者,肾之本脉。
实脉大而长,浮沉皆得而数,阳热也。
弦脉者,软虚而滑,端直而长也。弦主于风,或如琴弦,或如张弓者,弦之太过也。
紧者不缓也,或如转索,或如切绳者,紧之太过也。
紧脉主痛,多与实、数相兼,则为热痛;或短、紧、微、细,阴脉相兼者,寒痛也。
洪脉者,极大而数。举、按者,指实热之极甚者也。
呼气称为阳,以对应天道;脉搏跳动两次以对应春夏季节。吸气称为阴,以对应地道;脉搏跳动两次以对应秋冬季节。
气向外排出为呼,向内吸入为吸。“再”意为两次。“动”意为至(次)。
如果偶尔因深长呼吸(太息)而多跳动一次,这是为了对应长夏季节的脾土,所以一息之间脉跳四至、五至都属于平和无病的脉象。
“太息”,指呼吸有时会有延长的情况。“长夏”,指农历六月。“和平”,指健康人没有疾病的脉象。
这表示一年中的四季都具备在内了。脉跳五次以上称为数脉,不满四次称为迟脉。超过正常限度太多的会死亡,少于一次的也会死亡。
数脉主热证,迟脉主寒证。过备,指八至以上。因此,健康人的呼吸与病人的脉象是相互对应的。
所以医经说:应当用健康人的标准来衡量病人。由此可知,小儿八至为平和脉,十至为有热,六至为病寒。自六岁以下,通称以此三岁之法的标准。人体小则脉象如数脉,脉管的长短也是如此。
浮、芤、滑、实、弦、紧、洪,这被称为七表脉,属于阳脉。少阳之数对应七。
浮脉,轻取即可触及,重按反而不明显。脉象见于诸阳经主表热,见于诸阴经主表寒。
脉动在肌肉之上,浮脉属阳,主病在体表,又称腑病。如果是伤风自汗,脉浮主表热;如果是迟缓的阴脉,则主表寒。
芤脉,浮大且软,重按时中间空虚,两边实感明显。
芤脉主热盛导致失血,寸口出现芤脉则吐血,轻微则鼻衄,严重则两者皆出。关部出现芤脉则胸中痈肿或下血。尺部出现芤脉则大便出血,轻微则小便出血,严重则两者皆下。
滑脉,不涩滞,常与实脉、数脉兼见,则为热病。或者是津液耗亡、血虚衰少,虽有热象反而表现为涩脉;或者滑脉兼见迟脉,则为寒病;平和而滑的,是肾的本脉。
实脉大而长,浮取沉取都能得到,且脉率快,属阳热证。
弦脉,柔软虚滑,端正直长。弦脉主风邪,有的像琴弦,有的像拉开的弓,这是弦脉太过亢盛的表现。
紧脉,不舒缓,有的像旋转的绳索,有的像被切割的绳子,这是紧脉太过亢盛的表现。
紧脉主痛证,常与实脉、数脉兼见,则为热痛;或者短、紧、微、细等阴脉兼见,则为寒痛。
洪脉,极大且数。举按之下,指下感觉实热至极。
Exhalation is termed Yang, corresponding to Heaven; the pulse beats twice to correspond to Spring and Summer. Inhalation is termed Yin, corresponding to Earth; the pulse beats twice to correspond to Autumn and Winter.
Qi moving out is exhalation, moving in is inhalation. "Zai" means two times. "Dong" means arrival (beat).
If occasionally there is an extra beat due to a deep sigh (Tai Xi), this corresponds to the Spleen Earth of Late Summer. Therefore, four or five beats per respiration are considered harmonious and healthy.
"Tai Xi" refers to breathing that may sometimes be prolonged. "Late Summer" refers to the sixth lunar month. "Harmonious" refers to the pulse of a healthy person without disease.
This signifies that the four seasons of the year are all present. More than five beats is termed Shu (Rapid); fewer than four beats is termed Chi (Slow). Exceeding the normal limit significantly leads to death; falling short by one beat also leads to death.
Shu indicates Heat; Chi indicates Cold. "Guo Bei" refers to eight beats or more. Thus, the breath of a healthy person correlates with the pulse of a patient.
Therefore, the Classics state: Use the standard of the non-diseased to evaluate the diseased. From this, it follows that for children, eight beats is harmonious, ten beats indicates Heat, and six beats indicates Cold disease. For those under six years old, this method of three-year-olds is generally applied. Smaller bodies have pulses resembling Rapid pulses, and the length/shortness of vessels is similar.
Fu (Floating), Kou (Hollow), Hua (Slippery), Shi (Full), Xian (Wiry), Jin (Tight), Hong (Surging) are named the Seven Superficial Pulses, belonging to Yang. The number associated with Shaoyang is seven.
The Fu pulse can be felt with light pressure but disappears with heavy pressure. When appearing in Yang meridians, it indicates Exterior Heat; when appearing in Yin meridians, it indicates Exterior Cold.
The pulse moves above the muscle layer. Fu belongs to Yang and indicates disease in the Exterior, also known as Zang-Fu disease. If caused by Wind injury with spontaneous sweating, Fu indicates Exterior Heat; if it is a slow and delayed Yin pulse, it indicates Exterior Cold.
The Kou pulse is floating, large, and soft; pressing the center reveals emptiness while the sides feel solid.
Kou primarily indicates severe Heat leading to blood loss. A Kou pulse at the Cun position indicates hematemesis; mild cases indicate epistaxis; severe cases involve both. At the Guan position, it indicates chest abscess or lower bleeding. At the Chi position, it indicates rectal bleeding; mild cases indicate hematuria; severe cases involve both.
The Hua pulse is not choppy. It often accompanies Shi and Shu pulses, indicating Heat disease. Alternatively, if fluids are depleted or Blood is deficient, despite Heat, the pulse may paradoxically appear Choppy. If Hua accompanies Chi, it indicates Cold disease. A harmonious and slippery pulse is the intrinsic pulse of the Kidney.
The Shi pulse is large and long, palpable at both superficial and deep levels, and rapid, indicating Yang Heat.
The Xian pulse is soft, void, and slippery, straight and long. Xian governs Wind. Some resemble a lute string, others like a drawn bow; these represent excessive Xian.
Jin means not relaxed. Some resemble twisting ropes, others like cut cords; these represent excessive Jin.
Jin pulse governs Pain. Often accompanying Shi and Shu, it indicates Hot Pain. If accompanied by short, tight, faint, or thin Yin pulses, it indicates Cold Pain.
The Hong pulse is extremely large and rapid. Upon lifting and pressing, the fingers perceive extreme excess Heat.