浮似芤,芤则中断浮不断,浮似洪,力薄为浮浓者洪;浮似虚,轻手为浮无力虚。滑似动,滑珠朗朗动
混混(混混然无头尾;)滑似数,滑利往来数至多。实似革,革按不移实大长。弦似紧,弦言其力紧言象(弦
如张弓,紧如转索。)洪似
大,大按无力洪有力。微似涩,涩短迟细微如毛。沉似伏,伏极其沉深复深。缓似迟,缓比之迟仍小快。迟似
涩,迟息三至涩短难。弱似濡,濡力柔薄弱如无。结促代,结缓促数止无定,代歇有常命鲜回。散似大,散里全
无大翕翕(散形缓漫里全无,大则其中还翕翕。)
浮风芤血滑多痰,
浮主风者,风气浮荡也。芤主血虚,血属阴,阴道常乏,故中有间断也。滑主血多,随气壅上为痰。
实热弦劳紧痛关。
实主气,实有热,血随气行,气血俱热候也。弦主劳伤,气血拘敛。紧主邪搏,气血沸乱,故痛。
洪热微寒脐下积,
洪乃气血燔灼,表里热极。微乃气血虚寒,脐下冷积,作痛作泻。
沉因气痛缓肤顽。
沉为气郁疼痛。缓大非时得之,则气血不周,肌肤顽痹麻木。
涩则伤精阴败血,
涩乃精血枯燥,男子得之房劳伤精。女子有胎得之,胎中少血作痛;无孕得之,瘀血滞也。
又闻迟冷伏格关。
迟为阳虚里寒,外见冷症,伏乃阴阳潜伏,关格闭塞。
濡多自汗偏宜老,
濡主气血衰疲,阳虚自汗,老人气血已衰故宜。少壮得之,危。
弱脉精虚骨体酸。
弱由真精气虚极,骨髓空虚,故作酸痛。老人得之,亦无妨也。
长则气理短则病,
长乃气血有条理而不乱,滞缓则百病易治。短因气滞,或胃气衰少,诸病见短难治。
细气少兮代气衰。
细本元气不足,精血亦乏。代乃元气衰极,他脏代至,死脉也。
促为热极结为积,
促乃阳盛而阴不相济,热蓄于里也。结乃阴盛而阳不相入,内外邪滞为积。
虚惊动脱血频来。
虚乃气血俱虚,故多恍惚惊悸。动亦虚劳之脉,主脱漏崩中泄痢,血分之疾。
数则心烦大病进,
数亦热极脉也,主心烦发狂。大乃邪盛,气血虚不能制,故病进也。
革去精血亦奇哉。
革乃变易,血气去留常度,男子不交精泄,女子崩中漏下,有孕半产,真虚寒怪症脉也。
浮脉与芤脉相似,但芤脉中间有空缺感而浮脉连续不断;浮脉与洪脉相似,指力轻取为浮,指力重按充实有力者为洪;浮脉与虚脉相似,轻手即得为浮,无力者则为虚。滑脉与动脉相似,滑脉如珠滚动清晰可辨,动脉则混沌无头尾;滑脉与数脉相似,滑利往来流利,数脉至数较多。实脉与革脉相似,重按不移且大而长者为实;弦脉与紧脉相似,弦脉形容其张力如张开的弓,紧脉形容其形态如旋转的绳索。洪脉与大脉相似,重按无力为大,重按有力为洪。微脉与涩脉相似,涩脉短促迟缓,微弱如毛发般细微。沉脉与伏脉相似,伏脉比沉脉更深,需重按推筋着骨始得。缓脉与迟脉相似,缓脉比迟脉稍快一些。迟脉与涩脉相似,迟脉一息三至,涩脉短促难行。弱脉与濡脉相似,濡脉柔和无力,弱脉细软如无。结脉、促脉、代脉中,结脉缓慢而有间歇,促脉快速而有间歇且无规律,代脉有固定的歇止次数,预后不良难以恢复。散脉与大脉相似,散脉涣漫无根,内部完全空虚,大脉虽然外形宏大,但内部仍有搏动感(翕翕)。
浮脉主风证,因风气浮荡所致;芤脉主血虚,血属阴,阴脉常显不足,故脉象中有间断感;滑脉主痰湿,因气血壅盛上逆化为痰。实脉主气分热盛,气血俱热;弦脉主劳伤,气血拘急收敛;紧脉主邪气搏击,气血沸乱,故见疼痛。洪脉主热极,气血燔灼,表里皆热;微脉主寒,气血虚寒,脐下冷积,导致疼痛或腹泻。沉脉主气郁疼痛;缓脉若非应时出现,则提示气血运行不周,肌肤顽痹麻木。涩脉主精血亏损,男子多因房劳伤精;女子若有孕得此脉,因胎中血少而痛;若无孕得此脉,则为瘀血停滞。迟脉主阳虚里寒,外见冷症;伏脉主阴阳潜伏,关格闭塞。濡脉多见于自汗,因气血衰疲、阳虚所致,老人气血已衰故常见,若少壮之人得之则病情危重。弱脉主精虚,骨髓空虚,故身体酸痛,老人得之尚可,若年轻人得之则不佳。长脉主气血条理顺畅,滞缓则百病易治;短脉主气滞或胃气衰少,诸病见短脉难治。细脉主元气不足,精血亦乏;代脉主元气衰极,他脏之气来代,属死脉。促脉主热极,阳盛而阴不相济,热蓄于内;结脉主积聚,阴盛而阳不相入,内外邪气停滞形成积聚。虚脉主惊悸恍惚,因气血俱虚所致;动脉主虚劳及脱漏、崩中、泄痢等血分疾病。数脉主心烦发狂,为热极之象;大脉主邪气盛,气血虚弱不能制约邪气,故病情进展。革脉主精血亏耗,血气失去常度,男子可见精泄,女子可见崩中漏下或半产,属于真虚假寒的怪症脉象。
The floating pulse resembles the hollow pulse, but the hollow pulse has an interruption in the middle while the floating pulse is continuous. The floating pulse resembles the flooding pulse; light pressure yields the floating pulse, while heavy pressure yielding a full and forceful sensation indicates the flooding pulse. The floating pulse resembles the deficient pulse; obtaining it with light touch indicates floating, while lack of force indicates deficiency. The slippery pulse resembles the moving pulse; the slippery pulse rolls like pearls clearly, whereas the moving pulse is chaotic without head or tail. The slippery pulse resembles the rapid pulse; the slippery pulse flows smoothly and freely, while the rapid pulse has a high frequency. The solid pulse resembles the leathery pulse; pressing heavily without displacement, being large and long indicates the solid pulse. The wiry pulse resembles the tight pulse; "wiry" describes its tension like a drawn bow, while "tight" describes its shape like a twisting rope. The flooding pulse resembles the large pulse; lacking force upon heavy pressure indicates large, while having force indicates flooding. The minute pulse resembles the choppy pulse; the choppy pulse is short, slow, and fine like a hair. The deep pulse resembles the hidden pulse; the hidden pulse is extremely deep, requiring even deeper pressure than the deep pulse. The moderate pulse resembles the slow pulse; the moderate pulse is slightly faster than the slow pulse. The slow pulse resembles the choppy pulse; the slow pulse beats three times per respiration, while the choppy pulse is short and difficult to navigate. The weak pulse resembles the soggy pulse; the soggy pulse is soft and powerless, while the weak pulse is fine and soft as if non-existent. Among the knotted, rapid, and intermittent pulses: the knotted pulse is slow with irregular pauses; the rapid pulse is fast with irregular pauses; the intermittent pulse has regular pauses and a poor prognosis with little chance of recovery. The dispersed pulse resembles the large pulse; the dispersed pulse is scattered and rootless, completely empty inside, whereas the large pulse appears grand externally but still has internal pulsation (fluttering).
The floating pulse governs wind syndromes, caused by the floating and荡漾 nature of wind qi. The hollow pulse governs blood deficiency; blood belongs to Yin, and Yin pulses often appear deficient, hence the sensation of interruption. The slippery pulse governs phlegm-dampness, resulting from qi and blood surging upward and transforming into phlegm. The solid pulse governs excess heat in the Qi level, indicating both Qi and Blood are hot. The wiry pulse governs labor injury, where Qi and Blood are constrained and tightened. The tight pulse governs pathogenic struggle, causing Qi and Blood to boil and disorder, leading to pain. The flooding pulse governs extreme heat, where Qi and Blood are blazing, indicating extreme heat in both exterior and interior. The minute pulse governs cold, indicating Qi and Blood deficiency and cold, with cold accumulation under the umbilicus causing pain or diarrhea. The deep pulse governs Qi stagnation and pain. If the moderate pulse appears out of season, it indicates uneven circulation of Qi and Blood, leading to stiff, numb skin and muscles. The choppy pulse governs essence and blood depletion; men often suffer this due to sexual exhaustion damaging essence. If women have pregnancy and present this pulse, it indicates insufficient blood in the fetus causing pain; if not pregnant, it indicates stagnant blood stasis. The slow pulse governs Yang deficiency and interior cold, manifesting externally as cold symptoms. The hidden pulse governs the hiding of Yin and Yang, with obstruction of Guan-Ge (gate and barrier) mechanisms. The soggy pulse is common in spontaneous sweating due to Qi and Blood fatigue and Yang deficiency; it is suitable for the elderly whose Qi and Blood are already declining, but dangerous for young and strong individuals. The weak pulse governs essence deficiency, with empty bone marrow causing soreness and ache; acceptable for the elderly, but concerning for others. The long pulse governs orderly Qi and Blood; if sluggish, hundred diseases are easy to treat. The short pulse governs Qi stagnation or decline of Stomach Qi; diseases presenting with a short pulse are difficult to treat. The fine pulse governs insufficiency of Yuan Qi and lack of essence and blood. The intermittent pulse governs extreme decline of Yuan Qi, where other Zang organs send their Qi to substitute, indicating a death pulse. The rapid pulse governs extreme heat, where Yang is excessive and Yin cannot assist, with heat accumulating internally. The knotted pulse governs accumulations, where Yin is excessive and Yang cannot enter, with external and internal pathogenic stagnation forming masses. The deficient pulse governs fright and palpitations due to joint deficiency of Qi and Blood. The moving pulse governs deficiency-wasting and hemorrhagic disorders such as leakage, metrorrhagia, and dysentery, which are Blood-level diseases. The rapid pulse governs heart vexation and madness, indicating extreme heat. The large pulse governs excess pathogens; when Qi and Blood are too weak to control them, the disease progresses. The leathery pulse governs loss of essence and blood, where Qi and Blood deviate from normal patterns; men may experience seminal emission, women may experience metrorrhagia, leukorrhea, or miscarriage, representing a strange pulse of true deficiency and false cold.