伤寒死脉定难痊。阳病见阴端可怜。上气脉散为形损。耳聋浮涩命难全。谵言身热宜洪
大。
沉细而微寿不延。腹大泄利当微细。紧大而滑定归泉。吐衄若得沉细吉。浮大而牢叹逝川。
阴阳俱虚热不止。乍疏乍数命归天。如屋漏如雀啄来。如弹石去如解索。虾游鱼翔脉证乖。
转豆偃刀形候恶。下不至关阳气绝。上不至关阴气铄。代脉来时不用医。必定倾危难救药。
(一首集次见东垣医学发明)
中焦肺起脉之宗。出手大指之端冲。大肠即手起次指。上行环口交鼻里。胃经源又下鼻
交。
出足大指之端饶。脾脉就足指端上。注于心中少阴向。心经中之入掌循。手内端出小指行。
小肠从手小指起。上斜络于目内 。膀胱经就目内生。至足小指内侧停。肾脉动于小指下。
起注胸中过腹胯。心包出处又属胸。循手小指次指终。三焦向手次指侧。环走耳前目锐息。
胆家接生目锐傍。走足大指三毛间。足肝就起三毛际。注入肺中循不已。
(一首集次见内经骨空论等篇)
督脉起自下极 。并于脊里上风府。过脑额鼻入龈交。为阳脉海都纲要。任脉起于中极
底。
上腹循喉承浆里。阴脉之海妊所谓。冲脉出胞循脊中。从腹会咽络口唇。女人成经为血室。
脉并少阴之肾经。与任督本于阴会。三脉并起而异行。阳跷起足之跟里。循外踝上入风池。
阴跷内踝循喉嗌。本足阴阳脉别支。诸阴交起阴维脉。发足少阳筑宾郗。诸阳会起阳维脉。
太阳之 金门是。带脉周回季胁间。会于维道足少阳。所谓奇经之八脉。维系诸经乃顺常。
伤寒病出现死脉,病情确实难以痊愈。阳证见到阴脉的征象,预后非常可怜。气逆上冲且脉象散乱,说明形体已受损;耳聋且脉象浮涩,生命难以保全。说胡话(谵语)且身体发热,脉象应当洪大;若反而沉细微弱,寿命便不能延续。腹部胀大且腹泻,脉象应当微细;若脉象紧大而滑,必定死亡。吐血或鼻出血,若脉象沉细为吉兆;若脉象浮大而牢实,则叹息如逝水般离去(指死亡)。阴阳都虚弱却发热不止,脉象忽快忽慢,性命归天。脉象像屋漏滴水一样,像雀啄米一样,像弹石一样去势,像解绳索一样杂乱,像虾游、鱼翔一样脉证不符,像转豆、偃刀一样形态候象恶劣。脉气下不到关元穴,是阳气断绝;上不到人迎穴,是阴气枯竭。出现代脉时,不需要医生诊治,必定病情危重,危难中无法用药物挽救。
中焦肺气是脉气的宗主。脉气从手大拇指的端头冲出。大肠经起于手次指(食指),上行环绕口唇,交叉于鼻旁。胃经源头又下行至鼻旁,交于足大拇指的端头。脾脉就着足趾端向上,注入心中,流向少阴经。心经进入手掌循行,从手内侧端头出于小指。小肠经从手小指起,上行斜行联络于目内眦。膀胱经从目内眦生发,至足小指内侧停止。肾脉动于小指之下,起始注入胸中,经过腹部和胯部。心包出处也属于胸部,循行至手小指和次指的末端结束。三焦经向着手次指的侧面,环绕行走于耳前,到达目锐眦(外眼角)。胆家接生处位于目锐眦旁边,行走至足大拇指三毛之间。足肝经就起于三毛际,注入肺中循环不已。
督脉起自下极(会阴部),并行于脊柱内部,上风府穴。过脑部、额头、鼻子,进入龈交穴。它是阳脉之海的总纲要。任脉起于中极穴底部,沿腹部循行,经过喉咙至承浆穴。它是阴脉之海,所谓“妊”(孕育)。冲脉出自胞宫,循行于脊柱中,从腹部会合于咽喉,联络口唇。女子形成月经,称为血室。脉与少阴肾经并行。与任脉、督脉本源于阴交会。三脉并起而各行其道。阳跷脉起于足跟里,循行外踝向上进入风池穴。阴跷脉循行内踝,经过喉咙。它们是足阴阳经脉的别支。诸阴交起于阴维脉,发于足少阳经的筑宾穴作为郄穴。诸阳会起于阳维脉,太阳经的金门穴是其所在。带脉周回于季胁之间,会合于维道穴(属足少阳经)。这就是所谓的奇经八脉,维系诸经使之顺常。
The death pulse of cold damage is indeed difficult to cure. When a Yang disease presents with Yin signs, the prognosis is pitiful. Qi rebelling upward with a scattered pulse indicates damage to the form; deafness with a floating and choppy pulse makes life hard to preserve. Delirium accompanied by fever should present with a洪大 (Hongda, large and surging) pulse; if it is instead deep, fine, and minute, longevity will not extend. Abdominal distension with diarrhea should present with a micro-fine pulse; if the pulse is tight, large, and slippery, death is certain. Hematemesis or epistaxis with a deep and fine pulse is auspicious; a floating, large, and firm pulse sighs like a passing river (indicating death). If both Yin and Yang are deficient yet heat persists, and the pulse alternates between slow and rapid, life returns to heaven. The pulse resembles water dripping from a leaking roof, a sparrow pecking rice, stones being flicked away, ropes being untied, shrimp swimming, or fish gliding—where the pulse contradicts the symptoms. It resembles turning beans or an inverted knife—forms and prognoses are ominous. If the pulse qi does not reach below the Guan position, Yang Qi is exhausted; if it does not reach above the Renying position, Yin Qi is depleted. When the Dai pulse (intermittent pulse) arrives, no doctor is needed; the condition is definitely critical and dangerous, beyond rescue by medicine.
The Lung Qi of the Middle Jiao is the ancestor of pulses. Pulse Qi emerges from the tip of the thumb on the hand. The Large Intestine meridian starts at the second finger of the hand, ascends around the mouth, and crosses into the nose. The Stomach meridian source descends again from the nose, crossing at the tip of the big toe of the foot. the Spleen meridian rises from the tip of the toes, injects into the heart, and flows toward the Shaoyin meridian. The Heart meridian enters the palm and circulates, emerging from the medial end of the hand along the little finger. the Small Intestine meridian starts from the little finger of the hand, ascends obliquely to connect with the inner canthus of the eye. the Bladder meridian originates from the inner canthus, stopping at the medial side of the little toe of the foot. the Kidney meridian moves under the little toe, starting to inject into the chest, passing through the abdomen and hips. the Pericardium meridian originates in the chest, circulating to the ends of the little and second fingers of the hand. the Sanjiao (Triple Burner) meridian goes to the lateral side of the second finger of the hand, circling before the ear and reaching the outer canthus. the Gallbladder meridian originates beside the outer canthus, walking to the space among the three hairs on the big toe of the foot. the Liver meridian of the foot starts at the junction of the three hairs, injects into the Lung, and circulates endlessly.
the Du meridian originates from the lower extremity (Huiyin), runs parallel within the spinal column, passes through Fengfu. It goes over the brain, forehead, and nose, entering the Yinjiao acupoint. It is the general outline of the Sea of Yang meridians. the Ren meridian originates from the bottom of Zhongji, follows the abdomen, passes through the throat to Chengjiang. It is the Sea of Yin meridians, so-called for "Ren" (gestation). the Chong meridian exits the uterus, follows the middle of the spine, meets the throat from the abdomen, and connects to the lips. In women, it forms the menstrual cycle, known as the Blood Chamber. The pulse runs parallel with the Shaoyin Kidney meridian. It originates from the intersection of Yin with the Ren and Du meridians. These three meridians rise together but travel separately. the Yang Qiao meridian starts inside the heel of the foot, follows the lateral malleolus upward into Fengchi. the Yin Qiao meridian follows the medial malleolus, passing through the throat. They are branch vessels of the Foot Yin and Yang meridians. All Yin intersections start from the Yin Wei meridian, originating at the Xi-cleft point Zhubin of the Foot Shaoyang meridian. All Yang intersections start from the Yang Wei meridian, located at Jinmen of the Taiyang meridian. the Dai meridian circles between the costal region and hypochondrium, meeting at Weidao (Foot Shaoyang). This is what is called the Eight Extraordinary Vessels, maintaining the various meridians to ensure normal flow.