【方歌】三至为迟六至数,四至为缓七至疾,缓止为结数止促,
动止难还代脉识。
【注】一呼一吸,谓之一息。一息三至,谓之迟脉。一息四至
,谓之缓脉。一息六至,谓之数脉。一息七至,谓之疾
脉。缓脉动时一止,谓之结脉。数脉动时一止,谓之促
脉。结促之脉,动而中止,不能自还,谓之代脉。凡脉
以至数而得名者,皆统于迟数。故以迟数为提纲,以统
缓、疾、结、促、代五脉也。
【方歌】滑脉如珠溜不定,涩脉滞涩往来艰,弦脉端直细且劲,
紧比弦粗劲且弹。来盛去衰洪脉是,细则如丝大豁然,
长脉迢迢短缩缩,如豆摇摇作动看。
【注】形状如珠,滑溜不定,谓之滑脉。往来滞涩,进退维艰
,谓之涩脉。状如弓弦,细而端直,按之且劲,谓之弦
脉。较弦则粗,按之劲,左右弹者,谓之紧脉。上来应
指而盛,下去减力而衰。谓之洪脉,脉形软直如丝者,
谓之细脉。脉形粗大豁然者,谓之大脉。来去迢迢而长
,谓之长脉。来去缩缩而短,谓之短脉。其形如豆,约
约动摇不移者,谓之动脉。凡脉以形状而得名者,皆统
于滑涩。故以滑涩为提纲,以统弦、紧、洪、细、大、
长、短、动八脉也。
【方歌】痈脉脉宜洪大数,若逢牢短化脓难,疽脉最宜沈与弱,
浮大且散命归泉。
【注】痈乃阳毒,应见阳脉。若洪大而数,则毒易溃。若见牢
短之脉,则为阴凝气少,故曰化脓难也。疽乃阴毒,脉
应见沈与弱,是为顺脉。若见浮大而散,则为阳脱气败
,故曰命归泉也。
【方歌】一息脉跳三次为迟脉,六次为数脉;四次为缓脉,七次为疾脉;脉动时有间歇停止为结脉,数脉中有间歇停止为促脉;脉动中止后难以自行恢复的,是代脉的特征。
【注】一次呼气与一次吸气合称为“一息”。在一息之间脉搏跳动三次,称为迟脉。在一息之间脉搏跳动四次,称为缓脉。在一息之间脉搏跳动六次,称为数脉。在一息之间脉搏跳动七次,称为疾脉。缓脉在搏动时出现一次停止,称为结脉。数脉在搏动时出现一次停止,称为促脉。结脉和促脉都是脉搏跳动中途停止,且不能自行恢复,这被称为代脉。凡是根据脉搏至数(次数)来命名的脉象,都统属于迟脉和数脉。因此以迟脉和数脉作为提纲,来统领缓、疾、结、促、代这五种脉象。
【方歌】滑脉像珠子一样滑动不定,涩脉往来艰涩不畅;弦脉端直而细且有力,紧脉比弦脉更粗劲且有弹指感。来势强盛去势衰弱的洪脉,细如丝线的大脉豁然开阔;长脉悠长,短脉短缩,动脉像豆子一样动摇不定。
【注】脉形像珠子一样光滑溜动而不定,称为滑脉。脉搏往来滞涩,进退艰难,称为涩脉。脉状像弓弦一样,细而端正挺直,按压时感觉强劲,称为弦脉。比弦脉更粗,按压时强劲,左右弹手的,称为紧脉。脉气上来应指强盛,下去减力而衰弱,称为洪脉。脉形柔软直细如丝线的,称为细脉。脉形粗大豁然开阔的,称为大脉。来去悠长而长的,称为长脉。来去短缩而短的,称为短脉。其形状像豆粒,摇摇动摇不移的,称为动脉。凡是根据脉象形状来命名的,都统属于滑脉和涩脉。因此以滑脉和涩脉作为提纲,来统领弦、紧、洪、细、大、长、短、动这八种脉象。
【方歌】痈的脉象适宜洪大数,如果遇到牢脉或短脉,则化脓困难;疽的脉象最适宜沉脉与弱脉,如果出现浮大且散的脉象,则性命难保。
【注】痈属于阳毒,应当见到阳脉。如果脉象洪大而数,则毒邪容易溃破排出。如果见到牢脉或短脉,则是阴气凝滞、正气不足的表现,所以说化脓困难。疽属于阴毒,脉象应当见到沉脉与弱脉,这是顺应的脉象。如果见到浮大且散的脉象,则是阳气脱失、正气败坏的表现,所以说性命垂危。
[Verse] Three beats per respiration constitute the Slower pulse (Chi Mai, 迟脉), six beats constitute the Rapid pulse (Shu Mai, 数脉); four beats constitute the Moderate pulse (Huan Mai, 缓脉), seven beats constitute the Hasty pulse (Ji Mai, 疾脉); a pause in the pulse beat is the Knotted pulse (Jie Mai, 结脉), a pause in the Rapid pulse is the Interrupted pulse (Cu Mai, 促脉); when the pulse stops and fails to return spontaneously, it is recognized as the Intermittent pulse (Dai Mai, 代脉).
[Commentary] One exhalation and one inhalation are collectively termed one respiration (Yi Xi, 一息). If the pulse beats three times per respiration, it is called the Slower pulse. If it beats four times, it is called the Moderate pulse. If it beats six times, it is called the Rapid pulse. If it beats seven times, it is called the Hasty pulse. When the Moderate pulse exhibits a single pause during its beat, it is called the Knotted pulse. When the Rapid pulse exhibits a single pause during its beat, it is called the Interrupted pulse. Both the Knotted and Interrupted pulses involve a cessation of the beat that cannot recover spontaneously; this is termed the Intermittent pulse. All pulse types named according to their frequency (Zhi Shu, 至数) are subsumed under the Slower and Rapid pulses. Therefore, Slower and Rapid pulses serve as the outline to govern the five pulse types: Moderate, Hasty, Knotted, Interrupted, and Intermittent.
[Verse] The Slippery pulse (Hua Mai, 滑脉) resembles a rolling pearl, moving unpredictably; the Choppy pulse (Se Mai, 涩脉) is stagnant and difficult in its coming and going; the Wiry pulse (Xian Mai, 弦脉) is straight, thin, and forceful; the Tight pulse (Jin Mai, 紧脉) is coarser, more forceful, and springy compared to the Wiry pulse. The Surging pulse (Hong Mai, 洪脉) is strong upon arrival and weak upon departure; the Fine pulse (Xi Mai, 细脉) is like a silk thread; the Large pulse (Da Mai, 大脉) is broad and open. The Long pulse (Chang Mai, 长脉) extends far, while the Short pulse (Duan Mai, 短脉) is contracted; the Moving pulse (Dong Mai, 动脉) resembles a bean, trembling and shifting.
[Commentary] A shape resembling a pearl, smooth and rolling without stability, is called the Slippery pulse. Stagnant and difficult in both advance and retreat, it is called the Choppy pulse. Resembling a bowstring, thin, straight, and firm upon pressure, it is called the Wiry pulse. Coarser than the Wiry pulse, firm upon pressure, and flicking to the left and right, it is called the Tight pulse. Strong upon arrival and weakening upon departure, it is called the Surging pulse. Soft, straight, and fine like a silk thread, it is called the Fine pulse. Broad and expansive in form, it is called the Large pulse. Extending far in both arrival and departure, it is called the Long pulse. Contracted in both arrival and departure, it is called the Short pulse. Its shape resembles a bean, trembling yet immobile, it is called the Moving pulse. All pulse types named according to their morphology are subsumed under the Slippery and Choppy pulses. Therefore, Slippery and Choppy pulses serve as the outline to govern the eight pulse types: Wiry, Tight, Surging, Fine, Large, Long, Short, and Moving.
[Verse] For Carbuncle (Yong, 痈), the pulse should be Surging, Large, and Rapid; if a Firm (Lao, 牢) or Short pulse is encountered, pus formation will be difficult. For Ulcer (Ju, 疽), the pulse should ideally be Deep (Chen, 沉) and Weak (Ruo, 弱); if a Floating (Fu, 浮), Large, and Scattered (San, 散) pulse appears, death is imminent.
[Commentary] Carbuncle is a Yang toxin and should present with Yang pulses. If the pulse is Surging, Large, and Rapid, the toxin can easily suppurate and discharge. If a Firm or Short pulse is seen, it indicates Yin stagnation and Qi deficiency, hence pus formation is difficult. Ulcer is a Yin toxin, and the pulse should present as Deep and Weak, which constitutes a favorable (Shun, 顺) pulse. If a Floating, Large, and Scattered pulse is observed, it indicates Yang collapse and Qi exhaustion, hence life is at risk.