浮脉主表(病在外,)沉脉主里(病在内;)迟脉主脏(病为寒,)数脉主腑(病为热。)
五至四至为迟、为寒、为不足(浮迟外寒,沉迟内寒,有力实寒,无力虚寒;)
七至八至为数、为热、为太过(浮数表热,沉数里热,有力实热,无力虚热。)
浮而有力风热,无力阴虚;沉而有力痰食,无力气滞;迟而有力为痛,无力虚寒;数而有力实热,无力疮疡。
太渊一指定安危,六至中和五至亏。七八热多三四冷,浮沉迟数贵详推。有力为阳为实热,虚寒无力里何
疑。若能留意于中取,何致亡羊泣途岐。
浮而有力实兼风(风热皆阳,表之实也,)无力阴虚汗雨蒙(阴荣妄泄,表之虚也。)有力而沉痰食害(痰凝食滞,
结于里也,)沉沉无力气凝胸(气滞于中,不运化也。)迟而有力多为痛(浮迟外痛,沉迟内痛,)无力虚寒气血穷(气弱
血衰,至虚之候。)数脉热多终有力(数而有力,实热何疑,)疮痍无力热虚攻(阴血受伤,虚热所致。)
脉浮身热汗之松(阳邪居表,应从汗解,)沉细身凉莫强攻(无论表里,不堪攻伐。)咳嗽正嫌浮带数(浮缓为宜,
浮数大忌,)细沉肿胀定知凶(脾胃虚寒,愈不运化。)沉迟下痢方为吉(气血俱伤,最嫌洪数,)洪大偏宜痘疹逢(阴阳
充足,毒不能留。)腹痛不堪浮有力(三阴受病,浮则反常,)浮洪吐衄总无功(阳火太盛,阴血愈伤。)
陶节庵曰∶诊脉之要,无论浮沉迟数,但于有力无力中分。有力者为阳、为实、为热;无力者为阴、为虚、
为寒。至哉斯言也,后贤无忽!
浮脉主表证(病邪在体表),沉脉主里证(病邪在体内);迟脉主脏病(病性为寒),数脉主腑病(病性为热)。
脉搏跳动五至或四至为迟脉,主寒、主正气不足(浮迟脉主外寒,沉迟脉主内寒,脉有力属实寒,脉无力属虚寒);
脉搏跳动七至或八至为数脉,主热、主邪气太过(浮数脉主表热,沉数脉主里热,脉有力属实热,脉无力属虚热)。
脉象浮而有力主风热,无力主阴虚;脉象沉而有力主痰食积滞,无力主气机阻滞;脉象迟而有力主疼痛,无力主虚寒;脉象数而有力主实热,无力主疮疡。
通过太渊穴处的脉象可以判断安危,六至脉象平和,五至脉象显示亏虚。七八至脉象多热,三四至脉象多冷,浮、沉、迟、数四种脉象需要仔细推究。脉有力属于阳、属于实热,脉无力属于虚寒,对此有何怀疑呢?如果能留意于中取法(指诊脉时中等力度的按压力度),怎么会像迷路的人那样痛哭流涕呢?
脉浮而有力,实证兼有风邪(风热皆属阳,为表实证);脉浮无力,阴虚导致汗出如雨(阴液营血妄泄,为表虚证)。脉沉而有力,痰食为害(痰凝食滞,结聚于体内);脉沉而无力,气机凝滞于胸中(气滞于中焦,运化功能失常)。脉迟而有力,多为疼痛(浮迟主外痛,沉迟主内痛);脉迟无力,气血穷尽之虚寒证(气弱血衰,至极虚的状态)。数脉多热且终归有力(数而有力,实热无疑);疮疡脉象若无力,则为虚热所攻(阴血受伤,由虚热所致)。
脉浮身热,发汗则轻松缓解(阳邪居于体表,应当从汗解);脉沉细身凉,不要强行攻伐(无论表里,身体不堪受攻伐)。咳嗽正值浮带数的脉象是大忌(浮缓为宜,浮数大忌);脉细沉伴肿胀,定知预后凶险(脾胃虚寒,运化功能更差)。脉沉迟下痢方为吉兆(气血俱伤,最忌讳洪数脉);脉洪大偏宜痘疹出现之时(阴阳充足,毒邪不能滞留)。腹痛若见浮而有力的脉象则不堪忍受(三阴经受病,见浮脉反常);脉浮洪伴吐衄,治疗总无功(阳火太盛,阴血愈伤)。
陶节庵说:诊脉的要领,无论浮沉迟数,只要在有力无力的区分中把握即可。脉有力者为阳、为实、为热;脉无力者为阴、为虚、为寒。这话真是精辟啊,后世的贤者不可轻视!
The floating pulse (Fú Mài, Floating Pulse) governs exterior syndromes (pathogens located in the body surface), and the deep pulse (Chén Mài, Deep Pulse) governs interior syndromes (pathogens located within the body); the slow pulse (Chí Mài, Slow Pulse) governs Zang organ diseases (pathogenic nature is cold), and the rapid pulse (Shuò Mài, Rapid Pulse) governs Fu organ diseases (pathogenic nature is heat).
A pulse rate of five or four beats per breath cycle is classified as a slow pulse, indicating cold and deficiency (Floating-slow indicates exterior cold, Deep-slow indicates interior cold, forceful indicates excess cold, and feeble indicates deficiency cold);
A pulse rate of seven or eight beats per breath cycle is classified as a rapid pulse, indicating heat and excess (Floating-rapid indicates exterior heat, Deep-rapid indicates interior heat, forceful indicates excess heat, and feeble indicates deficiency heat).
A floating pulse that is forceful indicates wind-heat, while one that is feeble indicates Yin deficiency; a deep pulse that is forceful indicates phlegm and food retention, while one that is feeble indicates Qi stagnation; a slow pulse that is forceful indicates pain, while one that is feeble indicates deficiency-cold; a rapid pulse that is forceful indicates excess heat, while one that is feeble indicates sores and ulcers.
Assessing safety and danger through the Taiyuan acupoint (Taiyuan, LU9) pulse: six beats per cycle indicate harmony, while five beats indicate deficiency. Seven to eight beats indicate excessive heat, three to four beats indicate excessive cold; the characteristics of floating, deep, slow, and rapid pulses require careful deduction. Forceful pulses belong to Yang, excess, and heat; feeble pulses belong to deficiency-cold, leaving no room for doubt. If one pays attention to the intermediate pressure technique (Zhong Qu), how could one end up weeping at the crossroads of being lost?
A floating pulse that is forceful indicates excess combined with wind (wind-heat are both Yang, representing an exterior excess syndrome); a floating pulse that is feeble indicates Yin deficiency with profuse sweating (Yin and Ying fluids leaking recklessly, representing an exterior deficiency syndrome). A deep pulse that is forceful indicates harm from phlegm and food (phlegm condensation and food stagnation knotting in the interior); a deep pulse that is feeble indicates Qi stagnation in the chest (Qi stagnating in the middle Jiao, failing to transform and transport). A slow pulse that is forceful mostly indicates pain (floating-slow indicates exterior pain, deep-slow indicates interior pain); a slow pulse that is feeble indicates exhaustion of Qi and Blood due to deficiency-cold (weak Qi and depleted Blood, a state of extreme deficiency). The rapid pulse usually involves heat and ends up being forceful (rapid and forceful leaves no doubt about excess heat); sores and ulcers with a feeble pulse indicate attack by deficiency heat (Yin blood injured, caused by deficiency heat).
When the pulse is floating and the body is hot, sweating brings relief (Yang pathogens reside in the exterior and should be resolved through sweating); when the pulse is deep and fine and the body is cool, do not forcibly attack (regardless of exterior or interior, the body cannot withstand purgative or attacking methods). Coughing accompanied by a floating and rapid pulse is highly undesirable (floating and moderate is suitable, floating and rapid is taboo); a deep and fine pulse with swelling definitely indicates a poor prognosis (Spleen and Stomach deficiency-cold leads to further failure of transformation and transport). A deep and slow pulse with dysentery is auspicious (both Qi and Blood are injured, and a洪大 pulse [Hong Da, Surging and Large] is most feared); a洪大 pulse is favorable during the occurrence of smallpox/rash (Yin and Yang are sufficient, preventing pathogenic toxins from lingering). Abdominal pain with a floating and forceful pulse is intolerable (diseases of the Three Yin meridians manifesting with a floating pulse is abnormal); a floating and洪大 pulse with vomiting blood or nosebleeds renders treatment ineffective (excessive Yang fire causes further injury to Yin blood).
Tao Jian'an said: The key to pulse diagnosis lies in distinguishing between forceful and feeble, regardless of whether the pulse is floating, deep, slow, or rapid. A forceful pulse belongs to Yang, excess, and heat; a feeble pulse belongs to Yin, deficiency, and cold. These words are truly profound; later generations must not neglect them!