夫寸关尺者,脉之位也;浮沉滑涩者,脉之体也。奠位分体、指文语证者,诊脉之要道
《脉经》曰∶大凡诊候,两手三部脉滑而迟,不浮不沉,不长不短,去来齐等者,无病也。
寸口脉浮者,伤风也;紧者,伤寒也;弦者,伤食也。浮而缓者,中风也;浮而数者,
也;浮而紧者,膈上寒,胁下冷冻饮料也。沉而紧者,心下寒而积痛;沉而弱者,虚损也。缓而
迟者,虚寒也。微弱者,血气俱虚也。弦者头痛,心下有水也;双弦者,两胁下痛也。偏绝
者,不遂也;俱绝者,不治也。 如羹上肥者,阳气微也;连连如蜘蛛丝者,阳气衰也。
关主中焦,胸腹中事。去来徐而缓者,无病也。浮者,腹满而不欲食,胃虚胀也;滑者
在胃也;数者热结中焦也;沉伏者中焦水气,或呕逆而吞酸也;弱者胃气虚也,虽有虚热,
不可大攻,须防热去则生寒也,牢而实者,腹满响响,噎塞而不通,或复大痛;涩者气逆也
,芤则泻血,涩坚大实,按之不减而有力者,中焦实有结伏在胃也;微浮者,积热不消,
蛔动心悸也。
尺主下焦,腰肾膝胫足中事也。尺脉浮者,风热小便难也;沉者,腰背痛而肾气不足;
,脐下热痛,小便赤色而恶寒也;迟者,下焦寒而阴虚也;紧者,脐下小腹急痛也;缓者,
脚弱下肿而痿痹也;弱者,下冷而肾气衰也;软者,脚不收而风痹,小便难也;伏者,小腹
痛而疝瘕,谷不化也;细者,溏泄而下冷也;芤者,小便涩血而下虚也;牢而小者,足膝寒
痹,脚下隐隐疼痛也;细而急者,筋挛不能行也;来而断绝者,男子小腹有滞气也,妇人月
水不利也。
寸、关、尺是脉诊的部位;浮、沉、滑、涩是脉象的特征。确定部位、分辨脉象特征、通过指下的感觉来论述病证,这是诊察脉搏的关键方法。
《脉经》说:大凡诊察候脉,两手三部脉象滑利而迟缓,不浮不沉,不长不短,来去均匀一致的,是没有病的。
寸口脉象浮的,是伤风;紧的,是伤寒;弦的,是伤食。浮而缓的,是中风;浮而数的,是(原文此处缺字,据上下文推测可能为热或相关证候,但依规则不增添内容,故略过或视为缺失);浮而紧的,是膈上有寒,胁下有冷积。沉而紧的,是心下寒冷且有积聚疼痛;沉而弱的,是虚损。缓而迟的,是虚寒。微弱的是气血俱虚。弦的,主头痛,心下有停水;双侧皆弦的,两胁下疼痛。一侧脉绝的,肢体不遂;双侧皆绝的,属不治之症。像羹汤上面漂浮的油花那样轻浮无根的,是阳气微弱;连续不断如蜘蛛丝那样细弱欲绝的,是阳气衰败。
关部脉主要反映中焦的情况,即胸腹中的病变。来去徐缓的,没有病。浮的,腹部胀满且不想进食,是胃气虚弱导致的胀满;滑的,病位在胃;数的,是中焦有热结;沉伏的,是中焦有水气,或者呕吐逆气且吞酸;弱的,是胃气虚弱,虽然可能有虚热,但不可猛烈攻伐,必须防止热邪去除后产生寒证;牢而实的,腹部胀满且肠鸣有声,噎塞不通,或者再次出现剧烈疼痛;涩的,是气机逆乱;芤的,是便血;涩而坚大实,按压不减且有力的,是中焦实在有结滞伏留于胃中;微浮的,是积热不消,蛔虫扰动导致心悸。
尺部脉主要反映下焦的情况,即腰、肾、膝、胫、足等部位的病变。尺脉浮的,是风热导致小便困难;沉的,是腰背疼痛且肾气不足;(原文此处缺字),脐下热痛,小便颜色红赤且怕冷;迟的,是下焦寒而阴虚;紧的,是脐下小腹急痛;缓的,是脚弱下肢肿胀且痿痹;弱的,是下部寒冷且肾气衰败;软的,是脚不能收持且患风痹,小便困难;伏的,是小腹痛且有疝瘕,食物不消化;细的,是溏泄且下部寒冷;芤的,是小便涩痛带血且下部虚损;牢而小的,是足膝寒痹,脚下隐隐作痛;细而急的,是筋脉拘挛不能行走;来势中断绝的,男子是小腹有滞气,女子是月经不畅。
Cun (Inch), Guan (Bar), and Chi (Foot) are the positions of pulse diagnosis; Fu (Floating), Chen (Sinking), Hua (Slippery), and Se (Choppy) are the characteristics of the pulse body. Establishing positions, distinguishing pulse bodies, and discussing syndromes through finger sensations is the essential method for pulse diagnosis.
The *Mai Jing* (Pulse Classic) states: Generally speaking, when examining the pulses, if the three sections of both hands are slippery yet slow, neither floating nor sinking, neither long nor short, and coming and going uniformly, there is no disease.
If the Cun Kou (Radial Artery at the wrist) pulse is floating, it indicates Wind Injury (Shang Feng); if tight, it indicates Cold Damage (Shang Han); if wiry (Xian), it indicates Food Retention (Shang Shi). If floating and moderate, it indicates Stroke-Wind (Zhong Feng); if floating and rapid, [text missing]; if floating and tight, it indicates Cold above the diaphragm and cold accumulation below the hypochondrium. If sinking and tight, it indicates Cold in the epigastrium with accumulated pain; if sinking and weak, it indicates Deficiency and Damage (Xu Sun). If moderate and slow, it indicates Deficient-Cold. If faint and weak, it indicates deficiency of both Qi and Blood. If wiry, it indicates headache and water retention in the epigastrium; if bilateral pulses are wiry, it indicates pain below both hypochondria. If one side is absent, it indicates hemiplegia or limb paralysis; if both sides are absent, it is an untreatable condition. Like fat floating on soup, it indicates slight Yang Qi; continuous like a spider's thread, it indicates declining Yang Qi.
The Guan position governs the Middle Jiao (Middle Burner), concerning matters of the chest and abdomen. If coming and going slowly and moderately, there is no disease. If floating, it indicates abdominal fullness and loss of appetite, which is stomach deficiency causing distension; if slippery, the pathology is in the Stomach; if rapid, it indicates Heat binding in the Middle Jiao; if sinking and hidden, it indicates Water Qi in the Middle Jiao, or vomiting, regurgitation, and acid reflux; if weak, it indicates Stomach Qi deficiency. Although there may be deficient heat, strong purgation must not be used, as one must guard against the generation of Cold after the Heat is removed. If firm and solid, it indicates abdominal fullness with borborygmus, dysphagia and obstruction, or recurrent severe pain; if choppy, it indicates rebellious Qi; if knifelike (Kou), it indicates bleeding from the bowels; if choppy, hard, large, and solid, unyielding to pressure and forceful, it indicates substantial stagnation and entrapment in the Stomach within the Middle Jiao; if slightly floating, it indicates unresolved accumulated heat and restless roundworms causing palpitations.
The Chi position governs the Lower Jiao (Lower Burner), concerning matters of the waist, Kidneys, knees, shins, and feet. If the Chi pulse is floating, it indicates Wind-Heat causing difficult urination; if sinking, it indicates lower back pain and insufficient Kidney Qi; [text missing], it indicates heat and pain below the umbilicus, dark red urine, and aversion to cold; if slow, it indicates Lower Jiao Cold and Yin deficiency; if tight, it indicates acute pain in the lower abdomen below the umbilicus; if moderate, it indicates weak legs, lower limb edema, and flaccid bi-syndrome; if weak, it indicates cold below and declining Kidney Qi; if soft, it indicates inability to support the feet, wind-bi syndrome, and difficult urination; if hidden, it indicates lower abdominal pain, hernia masses (Shan Jia), and undigested food in stool; if fine, it indicates loose stools and cold below; if knifelike, it indicates painful and bloody urination with lower deficiency; if firm and small, it indicates cold-bi in the feet and knees with dull pain under the feet; if fine and rapid, it indicates tendon spasms preventing walking; if the pulse comes and then cuts off, it indicates stagnant Qi in the lower abdomen for men, and irregular menstruation for women.