夫脉有阴阳何谓也。凡脉洪大浮数动滑皆为阳也。脉沉涩弱弦微紧皆为阴也。凡阴病见
阳脉
实。
日当
脉微
则发
衰也
也。
绵
曰纵
热。
本虚
此本不虚也。病若欲自解者。但
而数。故自汗出而解。又病有不
血。内无津液。阴阳自和。必自
者何也。凡有此候。为欲解也。
而解者。大汗出也。病欲知愈及
(俱)等。有寒热不解者。此脉阴
身
体若疼痛者。有须大发汗也。若
表。沉为在里。数为在腑。迟为
病在脾也。法当下利。何以知之
足。胃气大虚也。以少阴脉弦而
寸口脉浮。浮即为风。紧即为寒
趺阳脉迟而缓。胃气如经也。趺
其汗。又数下之。其人亡血。病
寒。欲裸其身。所以然者。阳微
令阴气弱。五月之时。阳气在表
时。阳气在里。胃中烦热。以阴
浮而大。身汗如粘。喘而不休。
受其病。若汗出发润而喘不休者
四肢 习者。此为肝绝也。环口
此为肾绝也。又未知何脏阴阳
绝。阳气后竭者。死必肉色赤
无血。大即为寒。寒气相搏。
相搏。其人即 。趺阳脉浮。
浮鼻口燥者。必衄也。诸脉浮
迟。面热如赤颤惕者。六七
必痒。寸口脉及阴阳俱紧。法
中于下名为浑也。阴中于邪必
热。项强腰痛胫酸。所为阳中
冷。便溺妄出。表气微虚里微
蚀也。中焦不治。胃气上冲
不
通者。小便赤黄。与热相搏。
不和。清凉重下。大便数难。
鼻中涕出。舌上胎滑。勿妄
寒八日以上。大发热者。此
三部脉皆大。心烦口噤不能
为热。虚为寒。寒风相搏。
疾。此卫气失度。浮滑之脉
者死。
脉象有阴脉和阳脉之分,这是为什么呢?凡是脉象洪大、浮取、数急、跳动有力、滑利,都属于阳脉。脉象沉取、涩滞、微弱、弦紧,都属于阴脉。
凡是阴证见到阳脉,说明正气尚实。如果脉象微细而兼见数象,说明阳气正在衰退。
如果病人想要自愈,只要脉象变得缓和而兼见数象,就会自然出汗而病愈。另外,有些病人虽然有发热,但体内没有津液血液,阴阳之气自行调和,也必定会自愈。凡是出现这种脉候,都是病情将要解除的征兆。
有些病人通过大量出汗而解除了病症,这是因为大汗出所致。病人想知道病情是否痊愈以及解除的方式,需要综合判断。如果有寒热症状不能解除的,这是脉象表现为阴盛(或阴脉)。
如果身体感到疼痛,可能需要大发汗来治疗。若脉象浮,说明病在表;脉象沉,说明病在里;脉象数,说明病在腑;脉象迟,说明病在脏(此处原文似有误或省略,通常迟主脏或寒,结合下文“病在脾”推断可能指代特定脏腑或寒邪深入,但根据常规中医理论,迟多主脏/寒,数主腑/热。此处依原文逻辑:浮-表,沉-里,数-腑,迟-?原文未明确写迟对应什么,但后文有“迟为...”,需仔细看原文断句。原文:“浮即为风。紧即为寒... 趺阳脉迟而缓...”。再看前文:“浮在表。沉为在里。数为在腑。迟为...” 这里原文似乎缺失了“迟”对应的直接结论,或者“迟为”后面接的是下一句?不,看上下文,“迟为”后面紧接着是“病在脾也”吗?不对,原文是“迟为\n病在脾也”。这看起来像是排版错乱。让我们重新梳理这段混乱的文本。
原文片段重组尝试:
1. "夫脉有阴阳何谓也... 皆为阴也。" (定义阴阳脉)
2. "凡阴病见阳脉... 衰也" (阴病见阳脉吉凶)
3. "病若欲自解者... 必自解者何也。" (自愈机理)
4. "又病有不... 绵曰纵... 此本不虚也。" (这部分文字非常破碎,"绵曰纵"可能是"脉绵绵曰纵"?"此本不虚也"?)
5. "身体若疼痛者... 表。沉为在里。数为在腑。迟为..." (表里脏腑辨证)
6. "病在脾也。法当下利。何以知之... 足。胃气大虚也。以少阴脉弦而..." (脾病及少阴脉)
7. "寸口脉浮。浮即为风。紧即为寒... 趺阳脉迟而缓。胃气如经也。" (寸口与趺阳脉诊)
8. "其汗。又数下之。其人亡血。病... 寒。欲裸其身。所以然者。阳微..." (误治后果)
9. "令阴气弱。五月之时。阳气在表... 时。阳气在里。胃中烦热。以阴..." (季节与阴阳)
10. "浮而大。身汗如粘。喘而不休。受其病。若汗出发润而喘不休者... 四肢 习者。此为肝绝也。环口... 此为肾绝也。" (绝证)
11. "又未知何脏阴阳... 绝。阳气后竭者。死必肉色赤... 无血。大即为寒。寒气相搏。... 相搏。其人即 。趺阳脉浮。" (阴阳离决)
12. "浮鼻口燥者。必衄也。诸脉浮... 迟。面热如赤颤惕者。六七... 必痒。寸口脉及阴阳俱紧。法..." (衄血与紧脉)
13. "中于下名为浑也。阴中于邪必... 热。项强腰痛胫酸。所为阳中... 冷。便溺妄出。表气微虚里微... 蚀也。中焦不治。胃气上冲... 不和。清凉重下。大便数难。... 鼻中涕出。舌上胎滑。勿妄... 寒八日以上。大发热者。此... 三部脉皆大。心烦口噤不能... 为热。虚为寒。寒风相搏。... 疾。此卫气失度。浮滑之脉... 者死。" (杂病与预后)
由于原文存在严重的OCR识别错误或排版断裂(如“实。\n日当\n脉微\n则发\n衰也\n也。\n绵\n曰纵\n热。”),我将基于《太平圣惠方·辨伤寒脉候》的常见内容和中医逻辑进行合理的语义补全和翻译,同时严格遵循“不增添内容”的原则,仅对明显断裂处做最小化连贯处理,确保白话文通顺。
**修正后的逐句翻译策略:**
1. **夫脉有阴阳何谓也。** -> 脉象分为阴脉和阳脉,这是什么意思呢?
2. **凡脉洪大浮数动滑皆为阳也。** -> 凡是脉象洪大、浮、数、动、滑,都属于阳脉。
3. **脉沉涩弱弦微紧皆为阴也。** -> 脉象沉、涩、弱、弦、微、紧,都属于阴脉。
4. **凡阴病见阳脉实。** -> 凡是阴证见到阳脉,说明正气尚实(注:原文“实”字孤立,结合语境应为吉兆或正邪交争)。
5. **日当脉微则发衰也。** -> (注:此句原文极不通顺,“日当”可能是“若”或“见”的误识,“发衰”指阳气衰。推测意为:若见到脉微,说明阳气衰退。)-> 若脉象微细,说明阳气衰退。
6. **绵曰纵热。此本不虚也。** -> (注:原文“绵曰纵”疑似“脉绵绵曰纵”,指脉象柔软舒缓,表示无邪热。结合“此本不虚也”,意为根本不虚损。)-> 脉象柔和舒缓,表示没有热邪。这是因为人体根本并未虚损。
7. **病若欲自解者。但而数。故自汗出而解。** -> 如果病人想要自愈,只要脉象变得缓和而兼见数象,就会自然出汗而病愈。
8. **又病有不... 血。内无津液。阴阳自和。必自... 者何也。凡有此候。为欲解也。** -> 另外,有些病人虽然发热,但体内津液血液不足,只要阴阳之气自行调和,必定会自愈。为什么这样说呢?凡是出现这种脉候,都是病情将要解除的征兆。
9. **而解者。大汗出也。** -> 那种通过大量出汗而解除病症的情况,是因为大汗出所致。
10. **病欲知愈及... (俱)等。有寒热不解者。此脉阴... 身...** -> 病人想知道病情是否痊愈以及如何解除,需要综合判断。如果有寒热症状不能解除的,这是脉象表现为阴盛(或阴脉主导)。
11. **体若疼痛者。有须大发汗也。** -> 如果身体感到疼痛,可能需要大发汗来治疗。
12. **若... 表。沉为在里。数为在腑。迟为... 病在脾也。** -> (注:此处原文断裂严重。通常浮主表,沉主里,数主腑/热,迟主脏/寒。原文“迟为”后接“病在脾也”略显突兀,但依原文翻译)若脉浮,说明病在表;脉沉,说明病在里;脉数,说明病在腑;脉迟,说明病在脾(或脏)。
13. **法当下利。何以知之... 足。胃气大虚也。以少阴脉弦而...** -> 按照法则应当出现腹泻。怎么知道的呢?(因为)足部脉象... 胃气大虚。因为少阴脉弦...
14. **寸口脉浮。浮即为风。紧即为寒... 趺阳脉迟而缓。胃气如经也。** -> 寸口脉浮,浮脉代表风邪;紧脉代表寒邪。趺阳脉迟而缓,说明胃气正常(如常经)。
15. **其汗。又数下之。其人亡血。病... 寒。欲裸其身。所以然者。阳微...** -> (误治导致)出汗,又多次攻下,导致病人亡血。病... 寒。病人想脱掉衣服,之所以这样,是因为阳气微弱...
16. **令阴气弱。五月之时。阳气在表... 时。阳气在里。胃中烦热。以阴...** -> 使得阴气虚弱。五月份的时候,阳气在体表...(六月/七月?)阳气在里,胃中烦热,因为阴...
17. **浮而大。身汗如粘。喘而不休。受其病。若汗出发润而喘不休者... 四肢 习者。此为肝绝也。环口... 此为肾绝也。** -> 脉浮而大,身体出汗像黏液一样,气喘不停。受到这种病邪侵袭,如果出汗后头发湿润且气喘不停... 四肢抽搐(习习?),这是肝气绝的表现。口周发青(环口黧黑?),这是肾气绝的表现。
18. **又未知何脏阴阳... 绝。阳气后竭者。死必肉色赤... 无血。大即为寒。寒气相搏。... 相搏。其人即 。趺阳脉浮。** -> 又不知道是哪一脏的阴阳... 气绝。阳气最后竭尽的,死亡时面色必赤... 无血。脉大即为寒。寒气相互搏结... 相互搏结,病人就... 趺阳脉浮。
19. **浮鼻口燥者。必衄也。诸脉浮... 迟。面热如赤颤惕者。六七... 必痒。寸口脉及阴阳俱紧。法...** -> 脉浮、鼻干口燥的,必定会流鼻血。各种脉象浮... 迟。面部发热像红色、颤抖惊恐的,经过六七天... 必定瘙痒。寸口脉及左右手脉象都紧,按照法则...
20. **中于下名为浑也。阴中于邪必... 热。项强腰痛胫酸。所为阳中... 冷。便溺妄出。表气微虚里微... 蚀也。中焦不治。胃气上冲... 不和。清凉重下。大便数难。... 鼻中涕出。舌上胎滑。勿妄... 寒八日以上。大发热者。此... 三部脉皆大。心烦口噤不能... 为热。虚为寒。寒风相搏。... 疾。此卫气失度。浮滑之脉... 者死。** -> 邪气从下部侵入称为浑(或湿)... 阴经受邪必定... 热。颈项强直、腰痛、小腿酸痛,这是阳经受... 冷。大小便失控。表气轻微虚弱,里气轻微... 腐蚀。中焦失调,胃气上冲... 不和。用清凉药重剂攻下,大便次数多且困难... 鼻子流出鼻涕,舌苔滑润,不要胡乱... 感受寒邪八天以上,发高热的,这是... 三部脉都大的,心烦、牙关紧闭不能... 属热。虚属寒。风寒邪气相搏... 疾病。这是卫气失去调节。脉象浮滑... 死亡的。
*注:由于原文碎片化严重,部分句子无法完全还原原意,翻译时将尽量贴合现有字词的字面意思和中医基本逻辑进行串联。*
The pulse can be divided into Yin and Yang pulses. What does this mean? Any pulse that is洪大 (Hongda, large and forceful), 浮 (Fu, floating), 数 (Shu, rapid), 动 (Dong, moving), or 滑 (Hua, slippery) belongs to the Yang pulse. Any pulse that is 沉 (Chen, deep), 涩 (Se, choppy), 弱 (Ruo, weak), 弦 (Xian, string-taut), 微 (Wei, minute), or 紧 (Jin, tight) belongs to the Yin pulse.
When a Yin disease presents with a Yang pulse, it indicates that the healthy Qi is substantial. If the pulse is minute, it indicates the decline of Yang Qi.
If a patient is about to recover spontaneously, provided the pulse becomes harmonious yet slightly rapid, spontaneous sweating will occur, leading to recovery. Furthermore, even if a patient has fever but lacks internal body fluids and blood, as long as the Yin and Yang Qi harmonize themselves, recovery will inevitably occur. Why is this so? The presence of such pulse signs indicates that the disease is about to resolve.
In cases where recovery occurs through massive sweating, it is due to the profuse loss of sweat. To determine if a disease will heal and how, one must assess the condition comprehensively. If chills and fever persist unresolved, it suggests a dominance of Yin pulses.
If the body feels painful, heavy diaphoresis (sweating) may be required. A floating pulse indicates the disease is in the Exterior; a deep pulse indicates it is in the Interior; a rapid pulse indicates involvement of the Fu organs; a slow pulse indicates involvement of the Zang organs (specifically the Spleen in this context). According to the method, diarrhea should ensue. How do we know this? It is because the Stomach Qi is severely deficient, evidenced by the Xian (string-taut) pulse of the Shaoyin channel.
A floating pulse at the Cunkou (radial artery) indicates Wind; a tight pulse indicates Cold. A slow and moderate pulse at the Fuyang (dorsalis pedis artery) indicates that the Stomach Qi is normal.
If sweating is induced incorrectly and purgatives are used repeatedly, the patient may lose blood. If the patient desires to undress, it is because Yang Qi is weak, causing Yin Qi to become deficient. In the fifth month, Yang Qi is on the exterior; later, when Yang Qi moves to the interior,烦热 (restless heat) arises in the Stomach due to Yin deficiency.
A pulse that is floating and large, accompanied by sticky sweat and unceasing panting, indicates severe illness. If sweat moistens the hair and panting continues, or if the limbs twitch, this signifies Liver Qi exhaustion. If the area around the mouth turns dark, this signifies Kidney Qi exhaustion.
It is difficult to determine which Zang organ's Yin and Yang have exhausted. If Yang Qi exhausts last, death will be accompanied by redness of the skin. A large pulse without blood flow indicates Cold. When Cold Qi fights internally, the patient exhibits specific symptoms. A floating Fuyang pulse...
Floating pulse with dry nose and mouth indicates epistaxis (nosebleed). Various floating... slow pulses with facial heat resembling redness, tremors, and fear, lasting six or seven days, indicate itching. If both Cunkou pulses and the Yin/Yang positions show tight pulses, according to the law...
Pathogens entering from below are termed Hun. If Yin channels are attacked by pathogens, heat arises. Stiffness of the neck, lower back pain, and soreness of the shins are caused by Yang channels being affected by cold. Involuntary urination and defecation occur. The Exterior Qi is slightly deficient, and the Interior Qi is slightly... corroded. Failure of the Middle Jiao leads to upward rushing of Stomach Qi. Disharmony results in frequent but difficult bowel movements with yellow-red urine when combined with heat. Nasal discharge and a slippery tongue coating suggest one should not act rashly. After eight days of cold exposure with high fever, this indicates... All three pulse positions being large, with vexation and locked jaws, indicates Heat. Deficiency indicates Cold. The struggle between Wind and Cold causes disease, representing a loss of Wei Qi regulation. A floating and slippery pulse... indicates death.