心脉搏坚而长,当病舌卷不能言;(搏,谓弦强搏击于手也。心脉搏坚而长者,肝邪乘心,脏气亏甚而
失和平之气也。手少阴脉,从心系上挟咽,故令舌卷不能言。搏击之脉,皆肝邪甚也。肝本属木,而何五
脏皆畏之?盖五脏皆以胃气为本,脉无胃气则死。凡木强者土必衰,脉搏者胃多败,故坚搏为诸脏所忌。
兹心脉搏坚而长者,以心脏之胃气不足而邪有余也。搏之微则邪亦微,搏之甚则几于真脏矣,故当以搏之微
甚而察病之浅深。夫五脏皆以胃气为本,搏坚皆为贼克之征,其本脏搏坚,亦自戕而自病也。)其 而散者,
当消环自已。(若证如前而脉则 散者,心气将和也。消,尽也。环,周也。谓期尽一周而病自已矣。)
肺脉搏坚而长,当病唾血;其 而散者,当病灌汗,至令不复散发也。(肺脉搏坚而长,邪乘肺也。肺系连喉,
故为唾血。若 而散则肺虚不敛,汗出如水,故云“灌汗”。汗多亡阳,故不可更为发散也。)肝脉搏坚而
长,色不青,当病坠若搏,因血在胁下,令人喘逆。其 而散色泽者,当病溢饮。溢饮者,渴暴多饮,
而易入肌皮肠胃之外也。(肝脉搏坚而长,肝自病也。脏病于中,色必外见,其色当青而不青者,以病不在
脏而在经也,必有坠伤。若由搏击,则血停胁下而气不利,故令人喘逆。若其 散则肝木不足,脾湿胜之,
湿在肌肤,故颜色光泽,病为溢饮。)胃脉搏坚而长,其色赤,当病折髀;其 而散者,当病食痹。(胃脉
搏坚,木乘土也,加之色赤,则阳明火盛,木火交炽,胃经必伤。阳明下行者,从气冲下髀,抵伏兔,故病髀
如折也。若 而散者,胃气本虚。阳明支别上行者,由大迎、人迎循喉咙,入缺盆
下膈,属胃络脾,故食即气逆滞闷不行,而为食痹。)脾脉搏坚而长,
其色黄,当病少气;其 而散,色不泽者,当病足胫肿,若水状也。(邪脉乘脾,脾气必衰,脾虚无以生血,
故本脏之色见于外。脾弱不能生肺,故为少气。若其 散而色不泽者,尤属脾虚。脾经之脉,从
拇指上内踝前廉,循 骨后,交出厥阴之前,故病足 肿。若水状者,以脾虚不能制水也。)肾脉搏坚而长,
其色黄而赤者,当病折腰;其 而散者,当病少血,至令不复也。(邪脉干肾,肾气必衰,其
色黄赤,为火土有余而肾水不足,故病腰如折也。若其 散,肾气本虚。肾主水以生化津液,今肾气不化,
故病少血。本原气衰,故令不能遽复。搏坚而长者,邪胜乎正,是谓“邪之所凑,其气必虚”也。 而散者,
本原不足,是谓“正气夺则虚”也。一以有邪而致虚,一以无邪而本虚,虚虽若一,而病本不同。)心脉急,
病心疝,少腹当有形。(心为牡脏,小肠为使,气本属阳,今脉紧急,阴寒胜也,以阳脏而为阴胜,故病心疝。
心疝者,形在少腹,而实以寒乘少阴所致。)而胃脉实则胀,虚则泄。(实为邪有余,故胀满;虚为正不足,故
泄利。心为君主,胃为水谷之海,故重揭其义以明之。)夫脉者,血之府也,(府,聚也,府库之谓也。血
必聚于经脉之中,故脉实血实,脉虚血虚也。然此“血”字,实兼气为言,非独指在血也。脉之盛衰,所以
统候血气之虚实、有余不足也。)长则气治,(气充和也。)短则气病,(气不足也。)数则烦心,(火热甚也。)大则
病进,(邪方张也。)上盛则气高,(寸为上,上盛者,邪壅于上也。气高者,喘满之谓。)下盛则气胀,
(关、尺为下,下盛者,邪滞于下,故腹为胀满。)代则气衰,(脉多更改不常者曰代,气虚无主也。)
细则气少,(脉来微细,正气不足也。)涩则心痛。(涩为血少气滞,故为心痛。)浑浑革至如涌泉,病
进而色弊,绵绵其去如弦绝,死。(浑浑,浊乱不明也。革至,如皮革之坚硬也。涌泉,其来 无序,但出
不返也。若得此脉而病加日进,色加憔弊,甚至绵绵如泻漆,及如弓弦之断绝者,皆
真气已竭,故死。)粗大者,阴不足,阳有余,为热中也。(粗大
者,浮洪之类,阳实阴虚,故为内热。)来疾去徐,上实下虚,为厥巅疾。(来疾者,其来急也;去徐者,
其去缓也;上实者,寸盛也;下虚者,尺弱也。皆阳强之脉,故为阳厥、顶巅之疾。夫察脉须识上、下、来、
去、至、止六字,不明此六字,则阴、阳、虚、实不别也。上者为阳,来者为阳,至者为阳,下者为阴,去
者为阴,止者为阴。上者自尺部上于寸口,阳生于阴也;下者自寸口下于尺部,阴生于阳也;来者自骨肉之
分而出于皮肤之际,气之升也;去者自皮肤之际而还于骨肉之分,气之降也。应曰至,息曰止也。)来徐去
疾,上虚下实,为恶风也。故中恶风者,阳气受也。(来之徐,上之虚者,皆阳不足也。阳受风气,故阳
虚者必恶风,而恶风之中人,亦必阳气受之也。恶,上去声,下入声。)有脉俱沉细数者,少阴厥也。(沉细
者,肾之脉体也。兼数则热,阴中有火也,故为少阴之阳厥。)沉细数散者,寒热也。(沉细为阴,数散
为阳。阴脉数散,阴不固也,故或入之阴,或出之阳,而为往来寒热。浮而散者,为 仆。(浮者阴不足,
散者神不守,浮而散者阴气脱,故为 仆也。 ,雄绢切,眩晕也。)诸浮不躁者皆在阳,则为热,其
有躁者在手。(脉浮为阳,而躁则阳中之阳,故但浮不躁者,皆属阳脉,未免为热。若浮而兼躁,乃为阳极,
故当在手。在手者阳中之阳,谓手三阳经也。此与人迎一盛,病在足少阳;一盛而躁,病在手少阳之义同。)
诸细而沉者皆在阴,则为骨痛,其有静者在足。(沉细为阴,而静则阴中之阴,故脉但沉细者病在阴分,当
为骨痛,若沉细而静,乃为阴极,故当在足。在足者,阴中之阴,谓足三阴经也。)数动一代者,病在阳
之脉也,泄及便脓血。(数动者,阳脉也。数动一代者,阳邪伤其血气也。故为泄及便脓血。)诸过者切之,
涩者阳气有余也,滑者阴气有余也。(脉失其常曰过,可因切而知也。阳有余则血少,故脉涩;阴
有余则血多,故脉滑。)阳气有余为身热无汗,阴气有余为多汗身寒,(阳有余者,阴不足也,故
身热无汗;阴有余者,阳不足也,故多汗
身寒,以汗本属阴也。)阴阳有余则无汗而寒。(阳余无汗,以表实也;阴余身寒,以阴盛也;阴阳有余,
阴邪实表之谓也。)推而外之,内而不外,有心腹积也;(此下言察病之法,当推求于脉,以决其疑似也。凡
病若在表,而欲求之于外矣,然脉则沉迟不浮,是在内而非外,故知其心腹之有积也。)推而内之,外而不
内,身有热也;(凡病若在里,而欲推求于内矣,然脉则浮数不沉,是在外而非内,故知其身之有热也。)
推而上之,上而不下,腰足清也;(凡推求于上部,然脉止见于上,而下部则弱,此以有升无降,上实下虚,
故腰足为之清冷也。)推而下之,下而不上,头项痛也。(凡推求于下部,然脉止见于下,而上部则亏,
此以有降无升,清阳不能上达,故为头项痛也;或以阳虚而阴凑之,亦为头项痛也。当外而不外,病在内;
当内而不内,病在外。上、下亦如之。)按之至骨,脉气少者,腰脊痛而身有痹也。(按之至骨,沉阴胜
也。脉气少者,血气衰也。正气衰而阴气盛,故为是病痹。)关格之脉,人迎一盛病在少阳,二盛病在太阳,
三盛病在阳明,四盛以上为格阳。(人迎,足阳明胃脉也,在颈下挟结喉旁一寸五分。一盛、二盛,犹言一
倍、二倍,谓以人迎、寸口相较,或此大于彼,或彼大于此,有三倍、四倍之殊也。寸口主中,人迎主外,
两者相应,俱往俱来,若引绳大小齐等,春夏人迎微大,秋冬寸口微大,如是者命曰“平人”,故人迎、
寸口而至于盛衰相倍者,乃不免于病矣。然人迎候阳,故一盛为少阳,胆与三焦也;二盛在太阳,膀胱、小
肠也;三盛在阳明,胃与大肠也;四盛以上者,以阳脉盛极而阴无以通,故曰“格阳”。)寸口一盛病在厥阴,
二盛病在少阴,三盛病在太阴,四盛以上为关阴。(寸口,手太阴肺脉也。寸口候阴,故一盛在厥阴,肝与
心主也;二盛在少阴,心与肾也;三盛在太阴,脾与肺也;四盛以上者,以阴脉盛极而阳无以交,故曰
“关阴”。)人迎与寸口俱盛四倍以上为关格,关格之脉羸,不能极于天地之精气则死矣。(俱盛四倍以上,
谓盛于平常之脉四倍也。物不
可以过盛,盛极则败。凡脉盛而至于关格者,以阴阳离绝,不能相营,故致羸败极尽也。精气,天禀也,
言不能尽其天年而夭折也。邪在腑则阳脉不和,阳脉不和则气留之,气留之则阳气盛矣,阳气太盛则阴不利,
阴脉不利则血留之,血留之则阴气盛矣,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”,阴阳俱盛不得相荣,故曰“关格”。关格者,不得尽期而死也。世人病此不少,历代医师相传谬
甚。夫所谓关格者,阴阳痞绝,不相营运,乖羸离败之候也。故人迎独盛者,病在三阳之腑也,寸口独盛者,
病在三阴之脏也。或见于人迎,或见于气口,皆孤阳之逆候,实真阴之败竭也。无阴则无根,而孤阳浮露于外
耳。凡犯此者,必死无疑,是皆酒色伤精所致。又以人迎在头,系阳明表脉,故人迎倍大者曰“格阳”;
寸口在手,系太阴里脉,故寸口倍大者曰“关阴”;阴阳互极,抗拒不通,故名“关格”,不可易也。
若在尺为关,在寸为格,关则不得小便,格则吐逆,特言膈食与癃闭耳,非此之谓也。)反四时者,有
余为精,不足为消。(此言四时阴阳,脉之相反者,亦为关格也,夫春夏人迎微大,秋冬寸口微大,如是
者命曰“平人”,以人迎为阳脉而主春夏,寸口为阴脉而主秋冬也。若其反者,春夏气口当不足而反有余,
秋冬人迎当不足而反有余,此邪气之有余,有余者反为精也;春夏人迎当有余而反不足,秋冬寸口当有余
而反不足,此血气之不足,不足者日为消也。)应太过,不足为精;应不足,有余为消。阴阳不相应,病名曰
关格。(如春夏人迎应太过而寸口之应不足者反有余而为精,秋冬寸口应太过而人迎之应不足者反有余而为
精,是不足者为精也;春夏寸口应不足而人迎应有余者反不足而为消,秋冬人迎应不足而寸口应有余者反
不足而为消,是有余者为消也。应不足而有余者,邪之日盛,应有余而不足者,正必日消,是为阴阳相反,气
不相营,亦名“关格”。)妊娠之脉,妇人手少阴脉动甚者,妊子也。(手少阴,心脉也。上附上,左外
以候心,故心脉当诊于左寸。动甚者,流利滑动也。心生血,血王乃能胎,妇人心
脉动甚者,血王而然,故当妊子。)阴搏阳别,谓之有子。(阴,如前手少阴也,或兼足少阴而言亦可。盖
心主血,肾主子宫,皆胎孕之所主也。搏,搏击于手也。阳别者,言阴脉搏手,似乎阳邪,然其鼓动滑利,
本非邪脉,盖以阴中见阳而别有和调之象,是谓“阴搏阳别”也。尺中之脉按之不绝,无他病而不月者,妊也。
古人男女皆称子,非男曰子而女则否也。男女之别,须审阴阳。右寸盛,阴状多,主女;左尺盛,阳状多,
主男。以左右分阴阳,则左为阳,右为阴;以尺寸分阴阳,则寸为阳,尺为阴;以脉体分阴阳,则鼓搏沉实
为阳,虚弱浮涩为阴。犹当察孕妇之强弱老少,及平日之偏左偏右,尺寸之素强素弱,庶足以尽其诊也。)
肝满、肾满、肺满皆实即为肿。(满,邪气壅滞而为胀满也。此言肝、肾、肺经皆能为满,若其脉实,当
为浮肿。)肺之壅,喘而两 满。(肺居膈上,其系横出腋下,故肺壅则喘而两 满。 ,腋下胁也。)
肝壅,两 满,卧则惊,不得小便。(肝经之脉,环阴器,布胁肋,故肝壅则两 满而不得小便。肝主惊骇,
卧则气愈壅,故多惊也。)肾壅, 下至少腹满,胫有大小,髀 大、跛、易、偏枯。(肾脉循
内踝之后,上 ,出 内廉,上股内,属肾络膀胱而上行,故肾经壅则 下至少腹胀满也。足胫或肿或消,
是谓大小。自髀至 ,或为大,或为跛,或掉易无力,或偏枯不用,是皆肾经壅滞,不能营运所致。髀,音皮。
,音杭。)心脉满大,痫螈筋挛。(心脉满大,火有余也。心主血,脉火盛则血涸,故痫螈而筋挛。痫,癫
痫也。螈,抽搐也。挛,拘挛也。)肝脉小急,痫螈筋挛。(肝藏血,小为血不足,急为邪有余,故为是
病。夫痫螈筋挛,病一也,而心肝二经皆有之,一以内热,一以风寒,寒热不同,血衰一也,故同有是病。)
肝脉骛暴,有所惊骇,脉不至,若喑,不治自已。(骛,驰骤也。暴,急疾也。惊骇者,肝之病,故肝
脉急乱者,因惊骇而然,甚有脉不至而声喑者,以猝惊则气逆,逆则脉不通而肝经之脉循喉咙,故声喑
而不出也。然此特一时之气逆耳,气通则愈
心脉脉搏坚实而长,应当发生舌体卷缩、不能言语的病症;(搏,是指脉象弦强有力,搏击于指下。心脉搏坚而长的,是肝木之邪侵犯心脏,导致脏气极度亏虚,失去了平和之气。手少阴心经的经脉,从心系向上夹着咽喉走,所以会导致舌体卷缩、不能言语。搏击有力的脉象,都是肝邪严重的表现。肝本属木,为什么五脏都畏惧它呢?大概是因为五脏都以胃气为根本,脉中没有胃气就会死亡。凡是木气过旺,土气必然衰弱,脉搏搏击有力,说明胃气大多败坏,所以脉象坚硬搏击是各脏腑所忌讳的。现在心脉搏坚而长,是因为心脏的胃气不足而邪气有余。搏动轻微则邪气也轻微,搏动严重则接近真脏脉了,所以应当根据搏动的轻重来察知病情的深浅。大凡五脏都以胃气为根本,脉象搏坚都是贼邪克伐的征象,即使是本脏脉象搏坚,也是自我损伤而生病。)如果脉象散乱无根,应当在一个月左右自愈。(如果证候像前面所说的那样,但脉象却散乱无根的,说明心气将要调和。消,是尽的意思。环,是周的意思。意思是说期限满一周(指一个月)疾病就会自然痊愈。)
肺脉脉搏坚实而长,应当发生唾血的病症;如果脉象散乱无根,应当发生灌汗症,至今不能再使用发汗的方法治疗。(肺脉搏坚而长,是邪气侵犯肺脏。肺系连接喉咙,所以会发生唾血。如果脉象散乱无根则是肺气虚弱不能收敛,汗出如水,所以说“灌汗”。汗多会亡失阳气,所以不可以再给予发散的治疗。)
肝脉脉搏坚实而长,面色不青,应当发生因坠落或殴打导致的伤痛,因为血液停滞在胁下,令人气喘逆乱。如果脉象散乱且色泽润泽,应当发生溢饮症。溢饮症,是口渴突然大量饮水,水液容易流入肌肉皮肤和肠胃之外。(肝脉搏坚而长,是肝脏自病。内脏有病,面色必定外现,其色应当发青而不发青的,是因为病不在脏而在经络,一定有坠伤。如果是由于殴打,则血液停滞在胁下而气机不利,所以令人气喘逆乱。如果脉象散乱则是肝木不足,脾湿胜之,湿气在肌肤,所以颜色光泽,病为溢饮。)
胃脉脉搏坚实而长,面色赤红,应当发生髋部疼痛如折断般的病症;如果脉象散乱无根,应当发生食痹症。(胃脉搏坚,是木邪乘袭土脏,加上面色赤红,则阳明火气旺盛,木火交相炽盛,胃经必然受伤。阳明经下行的部分,从气冲穴下行至髀部,抵达伏兔穴,所以病发时髀部感觉像折断一样。如果脉象散乱无根,则是胃气本来虚弱。阳明经的支别上行的部分,由大迎穴、人迎穴沿着喉咙,进入缺盆,向下穿过膈肌,属于胃络于脾,所以进食后气逆滞闷不通畅,从而形成食痹。)
脾脉脉搏坚实而长,面色黄,应当发生气少的病症;如果脉象散乱且面色不润泽,应当发生足胫肿胀,像水肿一样的病症。(邪脉侵犯脾脏,脾气必然衰败,脾虚无以生血,所以本脏的颜色显露于外。脾弱不能生肺,所以发生气少。如果脉象散乱且面色不润泽,更是属于脾虚。脾经的脉络,从拇指沿内踝前缘,循行经过腓骨后面,交出厥阴肝经之前,所以病发时足胫肿胀。像水肿一样的,是因为脾虚不能制约水湿的缘故。)
肾脉脉搏坚实而长,面色黄而赤红,应当发生腰部疼痛如折断般的病症;如果脉象散乱无根,应当发生血少的病症,至今不能恢复。(邪脉干扰肾脏,肾气必然衰败,其面色黄赤,是火土有余而肾水不足,所以病发时腰部像折断一样。如果脉象散乱,则是肾气本来虚弱。肾主水以生化津液,现在肾气不化,所以病发血少。本源元气衰败,所以令其不能迅速恢复。脉象搏坚而长,是邪气胜过正气,这就是所说的“邪之所凑,其气必虚”。脉象散乱无根,是本原不足,这就是所说的“正气夺则虚”。一种是因为有邪气而导致虚损,一种是因为无邪气而本体虚弱,虚损虽然看似相同,但病本不同。)
心脉紧急,病发心疝,小腹部应当有有形之物。(心为牡脏,小肠为之使,气本属阳,现在脉象紧急,是阴寒胜也,以阳脏而为阴寒所胜,所以病发心疝。心疝,是指形体在小腹部,但实际上是由寒邪乘袭少阴所致。)
胃脉实则为胀满,虚则为泄泻。(实是邪气有余,所以胀满;虚是正气不足,所以泄利。心为君主之官,胃为水谷之海,所以再次揭示其义理以阐明道理。)
大凡脉,是血液汇聚的地方,(府,是聚集的意思,即府库之称。血液必须汇聚在经脉之中,所以脉实则血实,脉虚则血虚。然而这个“血”字,实际上兼带气而言,不仅仅指血。脉象的盛衰,是用来总括候察血气虚实、有余不足的。)
脉长则气机调治,(气充盛调和。)脉短则气机有病,(气不足。)脉数则心烦,(火热甚盛。)脉大则病情进展,(邪气正嚣张。)上部脉盛则气逆喘满,(寸口为上,上部脉盛,是邪气壅滞于上。气高,是指喘满。)下部脉盛则腹部胀满,(关、尺为下,下部脉盛,是邪气滞留于下,所以腹部胀满。)脉代则气衰,(脉象多次更改不常叫做代,气虚无主。)脉细则气少,(脉来微细,正气不足。)脉涩则心痛。(涩是血少气滞,所以发生心痛。)
脉象浑浑乱如涌泉般急促而至,病情进展且面色憔悴,脉去绵绵如弓弦断绝,主死。(浑浑,是浊乱不明。革至,像皮革一样坚硬。涌泉,其来无序,只有出没有返。如果得到这种脉象而病情日益加重,面色更加憔悴,甚至脉去绵绵如泻漆,以及像弓弦断绝的样子,都是真气已经竭尽,所以死亡。)
脉象粗大,是阴不足阳有余,属于热中症。(粗大,是浮洪之类,阳实阴虚,所以为内热。)
脉来急去缓,上部实下部虚,是厥逆和巅顶部的疾病。(来疾,是脉来急迫;去徐,是脉去缓慢;上实,是寸脉盛;下虚,是尺脉弱。这些都是阳强盛的脉象,所以为阳厥、顶巅之疾。诊察脉象必须识得上下、来去、至止六个字,不明白这六个字,就无法辨别阴阳、虚实。上者为阳,来者为阳,至者为阳,下者为阴,去者为阴,止者为阴。上者是从尺部上行到寸口,阳生于阴;下者是从寸口下行到尺部,阴生于阳;来者是从骨肉之分出于皮肤之际,是气的上升;去者是从皮肤之际还于骨肉之分,是气的下降。应叫至,息叫止。)
脉来缓去急,上部虚下部实,是恶风症。所以感受恶风的,是阳气受邪。(来之徐,上之虚者,都是阳气不足。阳受风气,所以阳虚的人一定恶风,而恶风侵入人体,也一定是阳气受邪。恶,上声读wù,下声读è。)
脉象都沉细数的,是少阴厥逆。(沉细,是肾的脉象特征。兼见数脉则有热,阴中有火,所以为少阴的阳厥。)
脉象沉细数而散的,是寒热往来。(沉细为阴,数散为阳。阴脉数散,阴气不固,所以有时入于阴,有时出于阳,而发生往来寒热。)
脉象浮而散的,是眩晕仆倒。(浮者阴不足,散者神不守,浮而散者是阴气脱失,所以发生眩晕仆倒。 ,音雄绢切,眩晕。)
所有浮脉但不躁动的,病都在阳分,则为热证,如果有躁动的在手经。(脉浮为阳,而躁则是阳中之阳,所以只有浮而不躁的,都属于阳脉,未免为热。如果浮而兼躁,乃是阳极,所以病当在手经。在手者,是阳中之阳,指手三阳经。这与与人迎脉比较,一盛病在足少阳;一盛而躁,病在手少阳的意义相同。)
所有细而沉的脉,病都在阴分,则为骨痛,如果有静象的在足经。(沉细为阴,而静则是阴中之阴,所以脉只沉细的病在阴分,应当为骨痛,如果沉细而静,乃是阴极,所以病当在足经。在足者,是阴中之阴,指足三阴经。)
脉数动而一代的,病在阳分的脉,发生泄泻及便脓血。(数动者,是阳脉。数动一代者,是阳邪伤了血气。所以发生泄泻及便脓血。)
所有异常的脉都要切按,涩脉是阳气有余,滑脉是阴气有余。(脉失去常态叫做过,可以通过切脉而知晓。阳有余则血少,所以脉涩;阴有余则血多,所以脉滑。)
阳气有余表现为身热无汗,阴气有余表现为多汗身寒,(阳有余者,阴不足,所以身热无汗;阴有余者,阳不足,所以多汗身寒,因为汗本属阴。)阴阳都有余则无汗且身寒。(阳有余无汗,是因为表实;阴有余身寒,是因为阴盛;阴阳有余,是指阴邪充实于体表。)
推求脉象向外,脉象沉迟不浮,是有心腹积聚;(这里以下讲的是诊察疾病的方法,应当通过推求脉象来决断疑似。凡是病如果在表,想要从外部求察,然而脉象却沉迟不浮,是在内而不是在外,所以知道有心腹的积聚。)
推求脉象向内,脉象浮数不沉,是身体有热。(凡是病如果在里,想要推求于内部,然而脉象却浮数不沉,是在外而不是在内,所以知道身体有热。)
推求脉象向上,脉象仅见于上部而下部弱,是腰足清冷。(凡是推求于上部,然而脉象只见于上部,而下部则弱,这是有升无降,上实下虚,所以腰足为之清冷。)
推求脉象向下,脉象仅见于下部而上部亏,是头项痛。(凡是推求于下部,然而脉象只见于下部,而上部则亏,这是有降无升,清阳不能上达,所以为头项痛;或者因为阳虚而阴气凑集,也为头项痛。应当浮而不应浮的,病在内;应当沉而不应沉的,病在外。上下的情况也是如此。)
按脉至骨,脉气微弱的,是腰脊痛且身体有痹症。(按之至骨,是沉阴胜。脉气少,是血气衰。正气衰而阴气盛,所以发生这些痹症。)
关格的脉象,人迎脉大一倍病在少阳,大二倍病在太阳,大三倍病在阳明,大四倍以上为格阳。(人迎,是足阳明胃脉,在颈部结喉旁一寸五分。一盛、二盛,犹言一倍、二倍,是说用人迎、寸口相比,或者此大于彼,或者彼大于此,有三倍、四倍的差别。寸口主中,人迎主外,两者相应,俱往俱来,像拉绳一样大小齐等,春夏人迎微大,秋冬寸口微大,像这样叫做“平人”,所以人迎、寸口至于盛衰相倍,才不免于病。然而人迎候阳,所以一盛为少阳,胆与三焦;二盛在太阳,膀胱、小肠;三盛在阳明,胃与大肠;四盛以上,是因为阳脉盛极而阴无以通,所以叫“格阳”。)
寸口脉大一倍病在厥阴,大二倍病在少阴,大三倍病在太阴,大四倍以上为关阴。(寸口,是手太阴肺脉。寸口候阴,所以一盛在厥阴,肝与心主;二盛在少阴,心与肾;三盛在太阴,脾与肺;四盛以上,是因为阴脉盛极而阳无以交,所以叫“关阴”。)
人迎与寸口都盛大四倍以上为关格,关格的脉象羸弱,不能穷尽天地精气就会死亡。(俱盛四倍以上,是说比平常的脉盛大四倍。事物不可以过盛,盛极则败。凡是脉盛至于关格的,是因为阴阳离绝,不能相互营运,所以导致羸败极尽。精气,是天禀赋,意思是不能尽其天年而夭折。邪在腑则阳脉不和,阳脉不和则气留滞,气留滞则阳气盛,阳气太盛则阴不利,阴脉不利则血留滞,血留滞则阴气盛,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”,阴阳俱盛不得相荣,所以叫“关格”。关格者,不能尽期而死。世人患此病不少,历代医师相传谬误很多。所谓关格,是阴阳痞绝,不相营运,乖离羸败的征候。所以人迎独盛的,病在三阳之腑;寸口独盛的,病在三阴之脏。或见于人迎,或见于气口,都是孤阳的逆候,实际上是真阴的败竭。无阴则无根,而孤阳浮露于外。凡是犯此病的,必死无疑,这都是酒色伤精所致。又因人迎在头部,系阳明表脉,所以人迎倍大的叫“格阳”;寸口在手上,系太阴里脉,所以寸口倍大的叫“关阴”;阴阳互极,抗拒不通,所以名叫“关格”,不可改变。如果在尺部为关,在寸部为格,关则小便不通,格则呕吐逆反,这只是说膈食与癃闭罢了,不是指这里的关格。)
反四时的脉象,有余为精,不足为消。(这里讲四时阴阳,脉象相反的,也是关格。春夏人迎微大,秋冬寸口微大,像这样叫做“平人”,因为人迎为阳脉而主春夏,寸口为阴脉而主秋冬。如果相反,春夏气口应当不足反而有余,秋冬人迎应当不足反而有余,这是邪气的有余,有余者反为精;春夏人迎应当有余反而不足,秋冬寸口应当有余反而不足,这是血气的不足,不足者日为消。)
应当太过而不足的是精;应当不足而有余的是消。阴阳不相应,病名曰关格。(如春夏人迎应太过而寸口应不足的反而是有余而为精,秋冬寸口应太过而人迎应不足的反而是有余而为精,这是不足者为精;春夏寸口应不足而人迎应有余的反而是不足而为消,秋冬人迎应不足而寸口应有余的反而是不足而为消,这是有余者为消。应不足而有余者,是邪气日益盛,应有余而不足者,是正气必日消,这是阴阳相反,气不相营,也叫“关格”。)
妊娠的脉象,妇人手少阴脉动甚的,是怀孕。(手少阴,是心脉。上附上,左外侧以候心,所以心脉应当诊于左寸。动甚,是流利滑动。心生血,血旺乃能胎,妇人心脉动甚的,是血旺而然,所以应当怀孕。)
阴搏阳别,叫做有子。(阴,如前述的手少阴,或者兼足少阴来说也可以。盖心主血,肾主子宫,都是胎孕所主的部位。搏,是搏击于指下。阳别者,是说阴脉搏手,似乎阳邪,但其鼓动滑利,本来不是邪脉,盖因为阴中见阳而别有和调之象,这叫“阴搏阳别”。尺中的脉按之不绝,没有其他病而月经不来的,是怀孕。古人男女都称子,不是男叫子女就不叫。男女的区别,须审阴阳。右寸盛,阴状多,主女;左尺盛,阳状多,主男。以左右分阴阳,则左为阳,右为阴;以尺寸分阴阳,则寸为阳,尺为阴;以脉体分阴阳,则鼓搏沉实为阳,虚弱浮涩为阴。还应当察看孕妇的强弱老少,及平日偏左偏右,尺寸的素强素弱,才足以穷尽诊察的道理。)
肝满、肾满、肺满皆实即为肿。(满,是邪气壅滞而为胀满。这里说肝、肾、肺经都能为满,如果脉实,应当为浮肿。)
肺之壅,喘而两腋下满。(肺居膈上,其系横出腋下,所以肺壅则喘而两腋下满。 ,腋下胁也。)
肝壅,两腋下满,卧则惊,不得小便。(肝经的脉络,环绕阴器,布散胁肋,所以肝壅则两腋下满而不得小便。肝主惊骇,卧则气愈壅,所以多惊。)
肾壅, 下至少腹满,胫有大小,髀 、跛、易、偏枯。(肾脉循内踝之后,上 ,出 内廉,上股内,属肾络膀胱而上行,所以肾经壅则 下至少腹胀满也。足胫或肿或消,是谓大小。自髀至 ,或为大,或为跛,或掉易无力,或偏枯不用,是皆肾经壅滞,不能营运所致。髀,音皮。 ,音杭。)
心脉满大,痫螈筋挛。(心脉满大,是火有余。心主血,脉火盛则血涸,所以痫螈而筋挛。痫,癫痫。螈,抽搐。挛,拘挛。)
肝脉小急,痫螈筋挛。(肝藏血,小为血不足,急为邪有余,所以是病。夫痫螈筋挛,病是一样的,但心肝二经都有,一个以内热,一个以风寒,寒热不同,血衰是一样的,所以同有此病。)
肝脉骛暴,有所惊骇,脉不至,若喑,不治自已。(骛,驰骤。暴,急疾。惊骇者,是肝病,所以肝脉急乱的,因惊骇而然,甚至有脉不至而声喑的,因为猝惊则气逆,逆则脉不通而肝经的脉络循喉咙,所以声喑而出不来。然而这只是暂时的气逆而已,气通则愈)
When the Heart pulse is firm and long, one should expect pathology of tongue retraction and inability to speak; (Firm refers to a string-taut and forceful pulse beating against the fingers. A Heart pulse that is firm and long indicates Liver pathogenic factors invading the Heart, causing severe deficiency of Zang Qi and loss of harmonious Qi. The Hand-Shaoyin meridian ascends from the Heart system and flanks the pharynx, thus causing tongue retraction and inability to speak. Forceful pulses all indicate severe Liver pathogenic factors. The Liver belongs to Wood, yet why do all five Zang organs fear it? This is because all five Zang organs rely on Stomach Qi as their root; if the pulse lacks Stomach Qi, death ensues. Wherever Wood is excessive, Earth must be deficient; where the pulse is forceful, Stomach Qi is often ruined. Therefore, a firm and forceless pulse is taboo for all Zang organs. Now, a Heart pulse that is firm and long occurs because Heart Stomach Qi is insufficient while pathogenic factors are in excess. If the pulsation is slight, the pathogen is slight; if severe, it approaches the True Zang pulse. Thus, one should assess the depth of disease based on the severity of pulsation. Generally, all five Zang organs take Stomach Qi as their root; a firm pulse is a sign of hostile overacting. Even if the pulse of the affected Zang itself is firm, it represents self-injury and self-pathology.) If the pulse is scattered, the condition will resolve spontaneously within one cycle (one month). (If the symptoms are as described above but the pulse is scattered, Heart Qi is about to harmonize. "Xiao" means complete/end; "Huan" means cycle/week. It means that after one cycle, the disease will heal itself.)
When the Lung pulse is firm and long, spitting blood should occur; if the pulse is scattered, one should suffer from "pouring sweat" (profuse sweating), and dispersing methods should no longer be used. (A Lung pulse that is firm and long indicates pathogenic factors invading the Lung. The Lung system connects to the larynx, hence spitting blood occurs. If the pulse is scattered, Lung Qi is deficient and cannot consolidate, leading to sweat pouring out like water, hence called "pouring sweat". Profuse sweating leads to loss of Yang Qi, so dispersing treatments are contraindicated.)
When the Liver pulse is firm and long, but the complexion is not green, one should suffer from trauma such as falling or beating, with blood stasis under the hypochondrium causing wheezing and counterflow qi. If the pulse is scattered and the complexion is lustrous, one should suffer from overflowing drink (Yi Yin). Overflowing drink is characterized by sudden thirst and excessive drinking, where fluids easily enter outside the muscles, skin, and intestines/stomach. (A Liver pulse that is firm and long indicates a primary Liver disorder. Internal Zang diseases manifest externally in color; if the color should be green but is not, it indicates the disease is in the meridians rather than the Zang, likely due to trauma. If caused by beating, blood stagnates under the hypochondrium and Qi movement is obstructed, causing wheezing and counterflow. If the pulse is scattered, Liver Wood is deficient, allowing Spleen Dampness to prevail. Dampness in the skin/muscles results in a lustrous complexion, diagnosing Overflowing Drink.)
When the Stomach pulse is firm and long, and the complexion is red, one should suffer from hip pain as if broken; if the pulse is scattered, one should suffer from food obstruction (Shi Bi). (Stomach pulse firmness indicates Wood overacting on Earth; added redness implies excessive Yangming Fire, with Wood and Fire blazing together, injuring the Stomach meridian. The descending branch of Yangming runs from Qichong down to the thigh, reaching Futu, hence hip pain feels like breaking. If the pulse is scattered, Stomach Qi is originally deficient. The ascending branch of Yangming goes from Daying and Renying along the throat, enters Quepen, descends through the diaphragm, belongs to the Stomach and connects to the Spleen. Thus, after eating, Qi reverses and stagnates, causing food obstruction.)
When the Spleen pulse is firm and long, and the complexion is yellow, one should suffer from shortness of breath; if the pulse is scattered and the complexion is not lustrous, one should suffer from edema of the lower legs resembling water retention. (Pathogenic pulses invading the Spleen cause Spleen Qi decline. Spleen deficiency fails to generate Blood, so the organ's color appears externally. Spleen weakness fails to generate Lung Qi, causing shortness of breath. If the pulse is scattered and the complexion lacks luster, it further confirms Spleen deficiency. The Spleen meridian ascends from the big toe along the medial malleolus, behind the fibula, crossing anterior to the Jueyin meridian, hence lower leg swelling. Resembling water retention is due to Spleen deficiency failing to control Water.)
When the Kidney pulse is firm and long, and the complexion is yellow-red, one should suffer from back pain as if broken; if the pulse is scattered, one should suffer from blood deficiency, unable to recover. (Pathogenic pulses interfering with the Kidney cause Kidney Qi decline. Yellow-red complexion indicates excess Fire/Earth and insufficient Kidney Water, hence back pain like breaking. If the pulse is scattered, Kidney Qi is originally deficient. The Kidney governs Water to transform fluids; now Kidney Qi fails to transform, causing blood deficiency. Original Qi decline prevents rapid recovery. Firm and long pulses indicate Pathogen overcoming Righteous Qi, i.e., "Where pathogen gathers, Qi is deficient." Scattered pulses indicate original insufficiency, i.e., "When Righteous Qi is depleted, there is deficiency." One is deficiency caused by pathogen; the other is inherent deficiency without pathogen. Though both are deficiency, the root causes differ.)
When the Heart pulse is tense, Heart Hernia occurs, with palpable masses in the lower abdomen. (The Heart is a Yang organ, with the Small Intestine as its envoy. Qi is inherently Yang, but a tense pulse indicates Yin-Cold excess. A Yang organ overcome by Yin leads to Heart Hernia. Heart Hernia presents as masses in the lower abdomen, actually caused by Cold invading Shaoyin.)
Stomach pulse excess leads to distension; deficiency leads to diarrhea. (Excess is pathogenic surplus, causing distension; deficiency is righteous insufficiency, causing diarrhea. The Heart is the Sovereign, the Stomach is the Sea of Water and Grain; thus, these principles are reiterated to clarify them.)
Pulse is the residence of Blood. (Residence means gathering place/storehouse. Blood gathers in the meridians, so pulse excess reflects Blood excess, and pulse deficiency reflects Blood deficiency. However, this "Blood" term actually includes Qi, referring not only to Blood. Pulse vigor/witheredness comprehensively monitors the excess/deficiency and surplus/insufficiency of Blood and Qi.)
Long pulse indicates regulated Qi. (Qi is abundant and harmonious.) Short pulse indicates diseased Qi. (Qi is insufficient.) Rapid pulse indicates vexation in the Heart. (Fire-Heat is excessive.) Large pulse indicates advancing disease. (Pathogen is flourishing.) Upper excess indicates high Qi (wheezing/fullness). (Cun position is upper; upper excess means pathogen stagnating above. High Qi refers to wheezing and fullness.) Lower excess indicates abdominal distension. (Guan and Chi positions are lower; lower excess means pathogen stagnating below, causing abdominal distension.) Dai (intermittent) pulse indicates Qi decline. (Pulse changing frequently is called Dai; Qi is deficient and lacks mastery.) Fine pulse indicates little Qi. (Pulse coming slightly and finely indicates insufficient Righteous Qi.) Choppy pulse indicates Heart pain. (Choppy indicates Blood deficiency and Qi stagnation, hence Heart pain.)
Chaotic,革 (leather-like) pulse arriving like a gushing spring, with disease advancing and complexion deteriorating; lingering departure like a broken string, indicates death. (Chaotic means turbid and unclear. Ge arrival is hard like leather. Gushing spring means irregular arrival, only outgoing without returning. Obtaining this pulse with worsening disease and sallow complexion, or lingering departure like leaking lacquer or a broken bowstring, indicates exhaustion of True Qi, hence death.)
Coarse/large pulse indicates Yin insufficiency and Yang excess, constituting Heat in the Middle. (Coarse/large refers to Floating/Hong types; Yang excess and Yin deficiency lead to internal heat.)
Rapid arrival and slow departure, Upper excess and Lower deficiency, indicate Jue and top-of-head disorders. (Rapid arrival means urgent coming; slow departure means slow going; Upper excess means Cun pulse strong; Lower deficiency means Chi pulse weak. These are Yang-strong pulses, hence Yang Jue and vertex disorders. Examining pulse requires understanding Up/Down, Arrival/Departure, To/Stop. Without knowing these six characters, Yin/Yang and Deficiency/Excess cannot be distinguished. Up is Yang, Arrival is Yang, To is Yang; Down is Yin, Departure is Yin, Stop is Yin. Up moves from Chi to Cun, Yang born from Yin; Down moves from Cun to Chi, Yin born from Yang. Arrival emerges from muscle-bone junction to skin surface, Qi ascending; Departure returns from skin to muscle-bone, Qi descending. Response is To, Breath is Stop.)
Slow arrival and rapid departure, Upper deficiency and Lower excess, indicate aversion to wind. Those suffering from aversion to wind have received Wind in their Yang Qi. (Slow arrival and Upper deficiency both indicate Yang insufficiency. Yang receives Wind, so Yang deficiency causes aversion to wind, and invasion by aversion to wind affects Yang Qi.)
Pulses all deep, fine, and rapid indicate Shaoyin Jue. (Deep and fine are Kidney pulse characteristics. Combined with rapid, it indicates heat within Yin, hence Shaoyin Yang Jue.)
Deep, fine, rapid, and scattered pulse indicates alternating cold and fever. (Deep/fine is Yin; rapid/scattered is Yang. Yin pulse rapid/scattered means Yin is not secure, entering Yin or exiting Yang, causing alternating cold and fever.)
Floating and scattered pulse indicates dizziness and collapse. (Floating indicates Yin insufficiency; scattered indicates Spirit not guarding. Floating and scattered indicates Yin Qi depletion, hence dizziness/collapse.)
All floating but not restless pulses belong to Yang, indicating Heat; if restless, it is in the Hand meridians. (Floating is Yang; restlessness is Yang within Yang. Only floating without restlessness belongs to Yang pulse, inevitably Heat. Floating with restlessness is extreme Yang, hence Hand meridians. Hand meridians are Yang within Yang, referring to the three Hand-Yang meridians. This aligns with comparing with Renying: one excess in Foot Shaoyang; one excess with restlessness in Hand Shaoyang.)
All fine and deep pulses belong to Yin, indicating bone pain; if quiet, it is in the Foot meridians. (Deep/fine is Yin; quiet is Yin within Yin. Only deep/fine pulse indicates disease in Yin branch, causing bone pain. Deep/fine with quietness is extreme Yin, hence Foot meridians. Foot meridians are Yin within Yin, referring to the three Foot-Yin meridians.)
Rapid, moving, and intermittent pulse indicates disease in Yang pulse, with diarrhea and pus/blood in stool. (Rapid/moving are Yang pulses. Rapid/moving with intermittence indicates Yang pathogen injuring Blood/Qi, hence diarrhea and pus/blood in stool.)
All abnormal pulses should be palpated; choppy pulse indicates Yang excess, slippery pulse indicates Yin excess. (Deviation from normal is "Guo", known by palpation. Yang excess leads to Blood deficiency, hence choppy pulse; Yin excess leads to Blood abundance, hence slippery pulse.)
Yang excess manifests as body heat and no sweat; Yin excess manifests as profuse sweat and cold body. (Yang excess means Yin insufficiency, hence body heat/no sweat; Yin excess means Yang insufficiency, hence profuse sweat/cold body, as sweat belongs to Yin.) Yin and Yang both excess leads to no sweat and cold. (Yang excess no sweat is due to exterior excess; Yin excess cold is due to Yin prosperity; Yin/Yang both excess means Yin pathogen solidifying the exterior.)
Pushing outward (examining superficially), if internal but not external, there are accumulations in Heart/Abdomen. (This section discusses diagnostic methods via pulse pushing. If disease is in Exterior but seeking externally, yet pulse is deep/slow/not floating, it is Internal not External, indicating Heart/Abdominal accumulation.)
Pushing inward (examining deeply), if external but not internal, the body has heat. (If disease is in Interior but seeking internally, yet pulse is floating/rapid/not deep, it is External not Internal, indicating body heat.)
Pushing upward, if upper but not lower, waist and feet are cold. (Seeking upper part, but pulse only seen upper and lower weak, this is ascent without descent, Upper excess/Lower deficiency, hence cold waist/feet.)
Pushing downward, if lower but not upper, head and neck hurt. (Seeking lower part, but pulse only seen lower and upper deficient, this is descent without ascent, Clear Yang cannot ascend, hence head/neck pain; or due to Yang deficiency with Yin encroachment, also head/neck pain. Should be external but not external, disease is internal; should be internal but not internal, disease is external. Same for up/down.)
Pressing to bone, if pulse Qi is slight, there is low back/spine pain and bi syndrome. (Pressing to bone indicates Deep Yin excess. Slight pulse Qi indicates Blood/Qi decline. Righteous Qi decline and Yin excess cause these bi syndromes.)
Guan Ge pulse: Renying one excess disease in Shaoyang, two excess in Taiyang, three excess in Yangming, four excess and above is Ge Yang. (Renying is Foot-Yangming Stomach pulse, 1.5 cun lateral to thyroid cartilage. One/Two excess means one/two times larger compared to Cunkou. Cunkou governs Interior, Renying governs Exterior. They should correspond equally like a rope. Spring/Summer Renying slightly large, Autumn/Winter Cunkou slightly large is "Ping Ren" (Healthy Person). Deviations indicate disease. Renying monitors Yang: one excess is Shaoyang (Gallbladder/San Jiao); two excess is Taiyang (Bladder/Small Intestine); three excess is Yangming (Stomach/Large Intestine); four excess and above, Yang pulse extreme and Yin cannot pass, called "Ge Yang".)
Cunkou one excess disease in Jueyin, two excess in Shaoyin, three excess in Taiyin, four excess and above is Guan Yin. (Cunkou is Hand-Taiyin Lung pulse. Cunkou monitors Yin: one excess is Jueyin (Liver/Pericardium); two excess is Shaoyin (Heart/Kidney); three excess is Taiyin (Spleen/Lung); four excess and above, Yin pulse extreme and Yang cannot interact, called "Guan Yin".)
Renying and Cunkou both four times excess is Guan Ge. Guan Ge pulse is emaciated; unable to exhaust Heaven-Earth Essence, death ensues. (Both four times excess means four times larger than normal. Things cannot be excessively excessive; extreme excess leads to ruin. Guan Ge pulse indicates Yin-Yang separation, unable to nourish each other, leading to emaciation. Essence is heavenly endowment; unable to reach full lifespan means premature death. Pathogen in Fu makes Yang pulse discordant, Qi stagnates, Yang becomes excessive. Excessive Yang hinders Yin, Blood stagnates, Yin becomes excessive. Excessive Yin hinders Yang from nourishing, called "Guan". Excessive Yang hinders Yin from nourishing, called "Ge". Yin/Yang both excessive and unable to nourish is "Guan Ge". Guan Ge patients die before their time. Many people suffer this;历代 physicians transmit errors. Guan Ge is Yin-Yang blockage, non-interaction, deviation/emaciation signs. Renying alone excess: disease in Three Yang Fu. Cunkou alone excess: disease in Three Yin Zang. Seen in Renying or Qikou, both are solitary Yang rebellion, true Yin exhaustion. No Yin means no root, solitary Yang floats externally. All who contract this die surely, caused by wine/sex damaging essence. Renying at head, Yangming exterior pulse; double size is "Ge Yang". Cunkou at hand, Taiyin interior pulse; double size is "Guan Yin". Yin/Yang extreme opposition, blocking communication, named "Guan Ge". If Guan at Chi, Ge at Cun: Guan is urinary retention, Ge is vomiting/regurgitation. This specifically refers to dysphagia and strangury, not the Guan Ge discussed here.)
Reversing Four Seasons: Excess is Jing (Essence/Substance), Insufficiency is Xiao (Consumption). (This discusses Four Seasons Yin-Yang, opposite pulses are also Guan Ge. Spring/Summer Renying slightly large, Autumn/Winter Cunkou slightly large is Healthy Person. Renying is Yang/Spring-Summer; Cunkou is Yin/Autumn-Winter. If reversed: Spring/Summer Cunkou should be insufficient but is excess (pathogen excess, excess becomes Jing); Autumn/Winter Renying should be insufficient but is excess (pathogen excess, excess becomes Jing). Spring/Summer Renying should be excess but is insufficient (Blood/Qi insufficiency, insufficiency becomes Xiao); Autumn/Winter Cunkou should be excess but is insufficient (Blood/Qi insufficiency, insufficiency becomes Xiao).)
Should be excessive but insufficient is Jing; should be insufficient but excessive is Xiao. Yin-Yang not corresponding, disease named Guan Ge. (e.g., Spring/Summer Renying should be excessive, Cunkou should be insufficient but is excess -> Jing; Autumn/Winter Cunkou should be excessive, Renying should be insufficient but is excess -> Jing. This is insufficiency becoming Jing. Spring/Summer Cunkou should be insufficient, Renying should be excess but is insufficient -> Xiao; Autumn/Winter Renying should be insufficient, Cunkou should be excess but is insufficient -> Xiao. This is excess becoming Xiao. Should be insufficient but is excess: Pathogen daily increases. Should be excess but is insufficient: Righteous Qi daily decreases. This is Yin-Yang opposite, Qi not nourishing, also named "Guan Ge".)
Pregnancy pulse: Woman's Hand-Shaoyin pulse moving vigorously indicates pregnancy. (Hand-Shaoyin is Heart pulse. Upper/Cun, left exterior monitors Heart, so Heart pulse diagnosed at Left Cun. Vigorous movement means smooth/sliding. Heart generates Blood; Blood prosperity enables conception. Woman's Heart pulse vigorous means Blood prosperity, hence pregnancy.)
Yin Bo Yang Bie is called having a child. (Yin refers to Hand-Shaoyin mentioned earlier, or combined with Foot-Shaoyin. Heart governs Blood, Kidney governs Uterus, both govern conception. Bo means beating against fingers. Yang Bie means Yin pulse beats strongly, seeming like Yang pathogen, but its sliding nature is not pathological. It shows Yang within Yin with harmonious signs, called "Yin Bo Yang Bie". Chi pulse unceasing when pressed, no other disease, amenorrhea indicates pregnancy. Ancients called both male and female children "Zi". Gender distinction requires Yin-Yang analysis. Right Cun excess, Yin signs more, predicts female; Left Chi excess, Yang signs more, predicts male. Left/Right divides Yin/Yang (Left Yang, Right Yin); Cun/Chi divides Yin/Yang (Cun Yang, Chi Yin); Pulse form divides Yin/Yang (Beating/Deep/Firm Yang, Weak/Floating/Choppy Yin). Also observe pregnant woman's strength/age, habitual left/right bias, Cun/Chi baseline strength, to fully master diagnosis.)
Liver Man, Kidney Man, Lung Man all Excess result in edema. (Man means pathogenic stagnation causing distension. Liver/Kidney/Lung meridians can cause Man; if pulse is Excess, edema occurs.)
Lung Yong (Obstruction): Wheezing and fullness in both axillae. (Lung sits above diaphragm, system extends horizontally to axillae, hence Lung obstruction causes wheezing and axillary fullness. , Axilla/hypochondrium.)
Liver Yong: Fullness in both axillae, waking startled, inability to urinate. (Liver meridian circles genitalia, spreads to hypochondrium, hence Liver Yong causes axillary fullness and urinary retention. Liver governs fright; lying down increases Qi stagnation, hence frequent startling.)
Kidney Yong: From to lower abdomen full, calves varying in size, thigh , limp, tremulous, hemiplegia. (Kidney meridian follows posterior medial malleolus, ascends , exits medial aspect, goes up inner thigh, belongs to Kidney, connects Bladder, ascends. Hence Kidney Yong causes to lower abdomen fullness. Calves swollen or atrophied are "large/small". Thigh to , large or limp, or tremulous/weak, or hemiplegia, all due to Kidney meridian stagnation failing to circulate. Pi, sound pi. , sound hang.)
Heart pulse Man Da: Epilepsy, convulsions, tendon cramping. (Heart pulse Man Da indicates Fire excess. Heart governs Blood; pulse Fire excess depletes Blood, hence epilepsy/convulsions/tendon cramping. Dianxian is epilepsy. Yuan is convulsion. Luan is cramping.)
Liver pulse Xiao Ji: Epilepsy, convulsions, tendon cramping. (Liver stores Blood; Xiao is Blood insufficiency; Ji is Pathogen excess, hence this disease. Epilepsy/convulsions/cramping is one disease, occurring in both Heart and Liver. Heart due to internal heat, Liver due to Wind-Cold. Cold/Heat differ, but Blood decline is same, hence same disease.)
Liver pulse Wu Bao (wild/rapid): Due to fright/startle, pulse may cease, or aphonia, heals spontaneously without treatment. (Wu means galloping/rushing. Bao means rapid. Startle is Liver disease, hence Liver pulse rapid/chaotic due to startle. Severe cases pulse ceases or voice lost. Sudden startle causes Qi reversal, reversal blocks pulse. Liver meridian follows throat, hence aphonia. This is temporary Qi reversal; once Qi flows, it heals.)