弦为少阳,缓为阳明,洪为太阳,三阳也。微为少阴,迟为厥阴,沉为太阴,三阴也。
脉有一阴一阳,一阴二阳,一阴三阳。有一阳一阴,一阳二阴,一阳三阴。如此言之,寸口
有六脉俱动耶。然《经》言∶如此者,非有六脉俱动也,谓浮、沉、长、短、滑、涩也。凡
脉浮、滑、长者,阳也。沉、涩、短者,阴也。所以言一阴一阳者,谓脉来沉而滑也。一阴
二阳者,脉来沉滑而长也。一阴三阳者,谓脉来浮滑而长,时一沉也。所以言一阳一阴者,
谓脉来浮而涩也。一阳二阴者,谓脉来长而沉涩也。一阳三阴者,谓脉来沉涩而短,时一浮
也,各以其经所在,言病之逆顺也。
脉有阳盛阴虚,阴盛阳虚,何谓也?然浮之损小,沉之实大,故云∶阴盛阳虚。 沉之
损小,浮之实大,故曰∶阳盛阴虚,是谓阴阳虚实之意也。 凡脉浮、大、数、动、长、滑
,阳也。沉、涩、弦、弱、短、微,阴也。阳病见阴脉者,逆也,主死。阴病见阳脉者,顺
也,主生。 关前为阳,关后为阴。阳数即吐,阴微即下。阳弦则头痛,阴弦则腹痛,根据阴
阳察病也。 又尺脉为阴,阴脉常沉而迟。寸关为阳,阳脉但浮而速。 尺脉上不至关为阴
绝,寸脉下不至关为阳绝,阴绝而阳微,死不治。 呼为表属腑,吸为里属脏。阳微不能呼,
阴微不能吸。 呼吸不足,胸中短气。 弱反在关,濡反在巅。微在其上,涩反在下。微即
阳气不足,沾热汗出。涩即无血,厥而且寒。 诸腑脉为阳,主热。诸脏脉为阴,主寒。阳
微则汗,阴浮自下。(《脉经》作阴微。) 阳数,口生疮。阴数加微,必恶寒烦扰,而不得
眠。 阳芤吐血(《脉经》作阳数则吐血。) 阴芤下血(《脉经》作阴涩则下血)。无阳则厥,
无阴则呕。 寸口脉浮大而疾者,名曰阳中之阳,病苦烦满身热,头痛,腹中热, 寸口脉
沉细者,名曰阳中之阴,病苦悲伤不乐,恶闻人声,少气,时汗出,阴气不通(不通一作并),
臂不能举。(《巢氏病源》作臂偏不举。) 尺脉沉细者,名曰阴中之阴,病苦两胫酸疼,不
能久立,阴气衰,小便余沥,阴下湿痒。 尺脉滑而浮大者,名曰阴中之阳,病苦小腹痛满,
不能溺,溺即阴中痛,大便亦然。 尺脉牢而长,关上无有,此为阴干阳,其人苦两胫重,
小腹引腰痛。 寸口壮大,尺中无有,此为阳干阴,其人苦腰背痛
人有三虚三实者,何谓也?然有脉之虚实,有病之虚实,有诊之虚实。脉之虚实者,脉
来濡者,虚。牢者,实也。病之虚实者,出者为虚,入者为实。言诸者为虚,不言者为实。
缓者为虚,急者为实也。诊之虚实者,痒者为虚,痛者为实。外痛内快为外实内虚,内痛外
快为内实外虚,故曰∶虚实也。 问曰∶何谓虚实?答曰∶邪气盛则实,精气夺则虚。何谓
重
五实。 脉细皮寒,气少,泄痢注前后,饮食不入,为五虚也。
弦脉对应少阳,缓脉对应阳明,洪脉对应太阳,这三者属于三阳经。微脉对应少阴,迟脉对应厥阴,沉脉对应太阴,这三者属于三阴经。
脉象有一阴一阳、一阴二阳、一阴三阳的情况;也有一阳一阴、一阳二阴、一阳三阴的情况。像这样说来,寸口(手腕桡动脉处)难道有六条脉同时跳动吗?然而《内经》说:并非真的有六条脉同时跳动,而是指浮脉、沉脉、长脉、短脉、滑脉、涩脉这六种脉象特征。凡是脉象表现为浮、滑、长的,属于阳;表现为沉、涩、短的,属于阴。所以所说的“一阴一阳”,是指脉来势沉而滑。“一阴二阳”,是指脉来势沉、滑且长。“一阴三阳”,是指脉来势浮、滑且长,偶尔出现一次沉象。所说的“一阳一阴”,是指脉来势浮而涩。“一阳二阴”,是指脉来势长而沉、涩。“一阳三阴”,是指脉来势沉、涩且短,偶尔出现一次浮象。根据这些脉象所在的经络部位,来判断疾病的顺逆。
脉象有阳盛阴虚、阴盛阳虚,这是什么意思呢?如果轻取(浮取)脉象损小,重取(沉取)脉象实大,所以说:阴盛阳虚。如果重取脉象损小,轻取脉象实大,所以说:阳盛阴虚。这就是阴阳虚实的意思。
凡是脉象浮、大、数、动、长、滑的,属于阳;脉象沉、涩、弦、弱、短、微的,属于阴。阳病见到阴脉,是逆证,主死;阴病见到阳脉,是顺证,主生。
关前(寸部)为阳,关后(尺部)为阴。阳脉数则呕吐,阴脉微则泄泻。阳脉弦则头痛,阴脉弦则腹痛,这是根据阴阳来诊察疾病。
另外,尺脉属阴,阴脉通常沉而迟。寸部和关部属阳,阳脉通常浮而速。尺脉不上行至关部,称为阴绝;寸脉下不至关部,称为阳绝。阴绝而阳气微弱,是死证,无法治疗。
呼气属表,关联腑;吸气属里,关联脏。阳气微弱则不能充分呼气,阴气微弱则不能充分吸气。呼吸不足,会导致胸中短气。
弱脉反见于关部,濡脉反见于巅顶(此处指脉位异常或特定部位),微脉见于上部,涩脉反见于下部。微脉表示阳气不足,伴有发热汗出。涩脉表示无血,导致四肢厥冷且寒。
所有腑的脉象属阳,主热证。所有脏的脉象属阴,主寒证。阳脉微弱则出汗,阴脉浮起自下焦。(《脉经》作阴脉微弱。)阳脉数,口中生疮。阴脉数兼见微脉,必定恶寒烦躁,无法入睡。阳脉芤则吐血(《脉经》作阳脉数则吐血)。阴脉芤则便血(《脉经》作阴脉涩则便血)。没有阳气则四肢厥冷,没有阴液则呕吐。
寸口脉浮大而疾速的,称为阳中之阳,病人苦于烦闷、全身发热、头痛、腹中热。寸口脉沉细的,称为阳中之阴,病人苦于悲伤不乐、厌恶听到人声、气短、时常出汗、阴气不通畅(不通一作并),手臂不能举起。(《诸病源候论》作手臂偏侧不能举起。)
尺脉沉细的,称为阴中之阴,病人苦于两小腿酸痛,不能久站,阴气衰弱,小便淋漓不尽,外阴潮湿瘙痒。
尺脉滑而浮大的,称为阴中之阳,病人苦于小腹胀满,不能排尿,排尿时尿道疼痛,大便亦然。
尺脉牢而长,关部没有这种脉象,这是阴邪侵犯阳位,病人苦于两小腿沉重,小腹牵引腰痛。
寸口脉盛大,尺部没有这种脉象,这是阳邪侵犯阴位,病人苦于腰背痛。
人有三种虚证和三种实证,是什么意思呢?这里有脉象的虚实、病症的虚实、诊察的虚实。脉象的虚实:脉来柔软无力的是虚,脉来坚实有力的是实。病症的虚实:向外排出的是虚,向内侵入的是实。说话多的是虚,不说话的是实。脉势缓和的是虚,脉势紧急的是实。诊察的虚实:痒的是虚,痛的是实。外部痛内部舒适为外实内虚,内部痛外部舒适为内实外虚,所以称为虚实。
Xian (Wiry) pulse corresponds to Shaoyang (Lesser Yang), Huan (Moderate/Slack) pulse corresponds to Yangming (Bright Yang), Hong (Surging) pulse corresponds to Taiyang (Greater Yang); these three belong to the Three Yang meridians. Wei (Fine/Micro) pulse corresponds to Shaoyin (Lesser Yin), Chi (Slow) pulse corresponds to Jueyin (Terminal Yin), Chen (Deep) pulse corresponds to Taiyin (Greater Yin); these three belong to the Three Yin meridians.
There are pulses characterized by one Yin and one Yang, one Yin and two Yangs, one Yin and three Yangs; as well as one Yang and one Yin, one Yang and two Yins, one Yang and three Yins. Speaking in this manner, does it mean that there are six pulses beating simultaneously at the Cun Kou (Inch Port, radial artery)? However, the *Classic* states: It does not mean that six pulses beat simultaneously, but refers to the six pulse qualities: Fu (Floating), Chen (Deep), Chang (Long), Duan (Short), Hua (Slippery), and Se (Choppy). Generally, pulses that are Fu, Hua, or Chang belong to Yang; those that are Chen, Se, or Duan belong to Yin. Therefore, "one Yin and one Yang" refers to a pulse that is Chen and Hua. "One Yin and two Yangs" refers to a pulse that is Chen, Hua, and Chang. "One Yin and three Yangs" refers to a pulse that is Fu, Hua, and Chang, occasionally presenting a Chen quality. "One Yang and one Yin" refers to a pulse that is Fu and Se. "One Yang and two Yins" refers to a pulse that is Chang, Chen, and Se. "One Yang and three Yins" refers to a pulse that is Chen, Se, and Duan, occasionally presenting a Fu quality. Based on the meridian location of these pulses, one determines the favorable or unfavorable nature of the disease.
Pulses exhibit conditions of Excess Yang and Deficient Yin, or Excess Yin and Deficient Yang. What do these mean? If the pulse appears diminished and small upon superficial palpation (Fu), but solid and large upon deep palpation (Chen), it is said to be: Excess Yin and Deficient Yang. If the pulse appears diminished and small upon deep palpation (Chen), but solid and large upon superficial palpation (Fu), it is said to be: Excess Yang and Deficient Yin. This defines the meaning of Yin-Yang Excess-Deficiency.
Generally, pulses that are Fu, Da (Large), Shu (Rapid), Dong (Agitated), Chang, or Hua belong to Yang; pulses that are Chen, Se, Xian, Ruo (Weak), Duan, or Wei belong to Yin. When a Yang disease presents with Yin pulses, it is a counter-flow (Ni) condition, indicating death. When a Yin disease presents with Yang pulses, it is a smooth flow (Shun) condition, indicating life.
The area anterior to the Guan (Bar) pulse position is Yang; the area posterior to the Guan is Yin. A Yang pulse that is Shu (Rapid) indicates vomiting; a Yin pulse that is Wei (Micro) indicates diarrhea. A Yang pulse that is Xian (Wiry) indicates headache; a Yin pulse that is Xian (Wiry) indicates abdominal pain. This is diagnosing disease based on Yin and Yang.
Furthermore, the Chi (Cubit) pulse belongs to Yin, and Yin pulses are typically Chen (Deep) and Chi (Slow). The Cun (Inch) and Guan (Bar) positions belong to Yang, and Yang pulses are typically Fu (Floating) and Su (Fast). If the Chi pulse does not extend up to the Guan position, it is called Yin Absolute Absence (Yin Jue); if the Cun pulse does not extend down to the Guan position, it is called Yang Absolute Absence (Yang Jue). If Yin is absolutely absent and Yang is weak, it is a fatal condition that cannot be treated.
Exhalation relates to the Exterior and the Fu organs; inhalation relates to the Interior and the Zang organs. If Yang Qi is weak, exhalation is impaired; if Yin Essence is weak, inhalation is impaired. Insufficient respiration leads to shortness of breath in the chest.
A Ruo (Weak) pulse appearing at the Guan position, a Ru (Soggy) pulse appearing at the peak (referring to abnormal location), a Wei (Micro) pulse appearing above, and a Se (Choppy) pulse appearing below: Wei indicates insufficiency of Yang Qi, accompanied by heat and sweating. Se indicates lack of Blood, leading to cold limbs and chill.
All Fu organ pulses belong to Yang and govern Heat syndromes. All Zang organ pulses belong to Yin and govern Cold syndromes. Weak Yang pulses lead to sweating; Floating Yin pulses originate from below. (*Mai Jing* reads: Weak Yin pulses). Rapid Yang pulses lead to mouth sores. Rapid Yin pulses combined with Micro indicate aversion to cold, restlessness, and insomnia. Hollow Yang pulses (Kou) lead to hematemesis (*Mai Jing* reads: Rapid Yang pulses lead to hematemesis). Hollow Yin pulses (Kou) lead to lower bleeding (*Mai Jing* reads: Choppy Yin pulses lead to lower bleeding). Absence of Yang leads to cold extremities; absence of Yin leads to vomiting.
If the Cun Kou pulse is Fu, Da, and Ji (Rapid), it is named Yang within Yang. The patient suffers from irritability, generalized fever, headache, and internal heat. If the Cun Kou pulse is Chen and Xi (Fine), it is named Yin within Yang. The patient suffers from sorrow and unhappiness, aversion to human voices, shortness of Qi, occasional sweating, and obstruction of Yin Qi (or integration), with inability to raise the arm. (*Bing Yuan* reads: inability to raise the arm laterally).
If the Chi pulse is Chen and Xi, it is named Yin within Yin. The patient suffers from soreness and pain in both calves, inability to stand for long periods, decline of Yin Qi, dribbling urine, and dampness and itching in the genital region.
If the Chi pulse is Hua and Fu, Da, it is named Yang within Yin. The patient suffers from fullness and pain in the lower abdomen, inability to urinate, pain in the urethra during urination, and similar issues with defecation.
If the Chi pulse is Lao (Firm) and Chang, without such a pulse at the Guan position, this is Yin invading Yang. The patient suffers from heaviness in both calves and lower abdominal pain radiating to the lower back.
If the Cun Kou pulse is Zhuang Da (Strong and Large), without such a pulse at the Chi position, this is Yang invading Yin. The patient suffers from pain in the waist and back.
Humans have three types of Deficiency and three types of Excess. What does this mean? There is pulse Excess-Deficiency, disease Excess-Deficiency, and diagnostic Excess-Deficiency. Pulse Excess-Deficiency: A pulse that is Ru (Soft) is Deficient; a pulse that is Lao (Firm) is Excess. Disease Excess-Deficiency: Outward discharge indicates Deficiency; inward invasion indicates Excess. Speaking excessively indicates Deficiency; silence indicates Excess. A slow/moderate pulse indicates Deficiency; a rapid/tense pulse indicates Excess. Diagnostic Excess-Deficiency: Itching indicates Deficiency; pain indicates Excess. External pain with internal comfort is External Excess and Internal Deficiency; internal pain with external comfort is Internal Excess and External Deficiency. Thus, it is called Excess-Deficiency.
Question: What are Excess and Deficiency? Answer: When pathogenic factors are vigorous, it is Excess; when vital essence is depleted, it is Deficiency. What are the Five Excesses?
[Note: The text provided ends abruptly after asking about Five Excesses, then lists Five Deficiencies.]
Pulse is Fine, skin is cold, Qi is scanty, diarrhea and dysentery affect both bowels, and food/drink cannot enter; this is called the Five Deficiencies.