心脉浮大而散。肺脉浮涩而短。肝脉弦长而和。脾脉缓大而敦。肾脉沉软而滑。○又有
反关。脉在关后。必反其手诊之。当询其平日何如脉象。
男子阳为主。两寸常旺于尺。女子阴为主。两尺常旺于寸。乃其常也。反之者病。
经者。常也。医者一呼一吸。病者脉来四至。为和平之象。或问。以五至为闰息。如岁
运三年一闰。是我之息长。非彼之脉数也。
十二月大寒至二月春分。为初之气。厥阴风木主令。经曰。厥阴之至其脉弦。○春分至
小满。为二之气。少阴君火主令。经曰。少阴之至其脉钩。○小满至六月大暑。为三之气。
少阳相火主令。经曰。少阳之至大而浮。○大暑至八月秋分。为四之气。太阴湿土主令。经
曰。太阴之至其脉沉。○秋分至十月小雪。为五之气。阳明燥金主令。经曰。阳明之至短而
涩。○小雪至十二月大寒。为六之气。太阳寒水主令。经曰。太阳之至大而长。
按近时只遵春弦夏洪。秋毛冬石。四季之末和缓不忒之诀。然气之至有迟速。不必趋于
快捷方式。
(旧诀)
雀啄连来三五啄。(连连抟指。忽然止绝。少顷复来。如雀啄食。肝绝也。)屋漏半日一
点落。(如屋残漏下半时一滴。胃绝也。)弹石硬来寻即散。(沉于筋间。劈劈急硬如指弹石。
肾绝也。)搭指散乱如解索。(指下散乱。乍数乍疏。如索之解。脾绝也。)鱼翔似有亦似无。
(本不动而未强摇似有似无。如鱼之翔。心绝也。)虾游静中跳一跃。(浮于指下始则冉冉不
动。少焉而去。久之忽然一跃。进退难寻。如虾之游。大肠绝也。)更有釜沸涌如羹。(浮于
指下。有出无入。无复止数。如釜汤沸。肺绝也。)旦占夕死不须药。
心脉的脉象浮大而散。肺脉的脉象浮涩而短。肝脉的脉象弦长而柔和。脾脉的脉象缓大而敦厚。肾脉的脉象沉软而滑。○还有反关脉,脉位在关后,必须翻转手腕来诊察。应当询问患者平日的脉象特征。
男子以阳气为主,两寸脉常比尺脉旺盛。女子以阴气为主,两尺脉常比寸脉旺盛。这是正常的生理现象。反之则为病态。
“经”意为常规。医生一呼一吸之间,病人脉搏跳动四次,这是和平健康的征象。有人问:以五至为闰息(异常脉率),就像岁运三年一闰一样,是我的呼吸长了,并非病人的脉搏快。
从十二月大寒到二月春分,称为初之气,由厥阴风木主令。医经说:厥阴之至,其脉弦。○从春分到小满,称为二之气,由少阴君火主令。医经说:少阴之至,其脉钩。○从小满到六月大暑,称为三之气,由少阳相火主令。医经说:少阳之至,其脉大而浮。○从大暑到八月秋分,称为四之气,由太阴湿土主令。医经说:太阴之至,其脉沉。○从秋分到十月小雪,称为五之气,由阳明燥金主令。医经说:阳明之至,其脉短而涩。○从小雪到十二月大寒,称为六之气,由太阳寒水主令。医经说:太阳之至,其脉大而长。
按近世只遵循春弦、夏洪、秋毛、冬石,以及四季末月和缓无差的口诀。然而气的到来有迟有速,不必拘泥于快捷方式(固定模式)。
(旧诀)
雀啄连来三五啄。(连连搏指,忽然停止,片刻后又来,如麻雀啄食,为肝绝。)屋漏半日一点落。(如屋顶残漏,半时一滴,为胃绝。)弹石硬来寻即散。(沉在筋间,劈劈急硬如手指弹石,为肾绝。)搭指散乱如解索。(指下散乱,忽快忽慢,如绳索解开,为脾绝。)鱼翔似有亦似无。(本来不动却微微摇动,似有似无,如鱼游水,为心绝。)虾游静中跳一跃。(浮于指下,起初缓缓不动,一会儿离去,许久忽然一跃,进退难寻,如虾游动,为大肠绝。)更有釜沸涌如羹。(浮于指下,有出无入,没有止数,如锅汤沸腾,为肺绝。)早晨诊断晚上死亡,无需服药。
The heart pulse is floating, large, and scattered. The lung pulse is floating, choppy, and short. The liver pulse is wiry, long, and harmonious. The spleen pulse is moderate, large, and solid. The kidney pulse is deep, soft, and slippery. ○ There is also the "Fan Guan" (Reverse Gate) pulse, located behind the cun position; one must turn the hand over to examine it. It is necessary to inquire about the patient's usual pulse condition.
Men are dominated by Yang Qi; the two Cun positions are often more vigorous than the Chi positions. Women are dominated by Yin Qi; the two Chi positions are often more vigorous than the Cun positions. This is the normal state. Deviation from this indicates disease.
"Jing" (Classic/Standard) means constancy. When a doctor inhales and exhales once, and the patient's pulse beats four times, this is an image of harmony and health. One might ask: considering five beats per breath as a "leap breath" (abnormal rate), similar to the leap year every three years in astronomical cycles, does this mean my breath is longer, not that the patient's pulse is rapid?
From Great Cold in the 12th month to Spring Equinox in the 2nd month is the First Qi, governed by Jueyin Wind-Wood. The Classic states: "When Jueyin arrives, its pulse is wiry." ○ From Spring Equinox to Grain Full in the 4th month is the Second Qi, governed by Shaoyin Ministerial Fire. The Classic states: "When Shaoyin arrives, its pulse is hook-like." ○ From Grain Full to Great Heat in the 6th month is the Third Qi, governed by Shaoyang Ministerial Fire. The Classic states: "When Shaoyang arrives, its pulse is large and floating." ○ From Great Heat to Autumn Equinox in the 8th month is the Fourth Qi, governed by Taiyin Damp-Earth. The Classic states: "When Taiyin arrives, its pulse is deep." ○ From Autumn Equinox to Light Snow in the 10th month is the Fifth Qi, governed by Yangming Dry-Metal. The Classic states: "When Yangming arrives, its pulse is short and choppy." ○ From Light Snow to Great Cold in the 12th month is the Sixth Qi, governed by Taiyang Cold-Water. The Classic states: "When Taiyang arrives, its pulse is large and long."
Note: In recent times, only the formulas of Spring Wiry, Summer Flood-like, Autumn Hairy, Winter Stone-like, and the moderate and unerring pulse at the end of each season are followed. However, the arrival of Qi has its speed; one need not rush to rigid conventions.
(Old Rhyme)
Sparrow pecking comes three or five pecks continuously. (Pulsating against the fingers continuously, suddenly stopping, then returning after a while, like a sparrow pecking food; indicates Liver Exhaustion.)
House leak drops one point half a day later. (Like a drop from a leaking roof every half hour; indicates Stomach Exhaustion.)
Striking stone hard then immediately scatters. (Deep within the tendons, sharp and hard like a finger striking a stone; indicates Kidney Exhaustion.)
Fingers feel scattered like an untied rope. (Scattered under the fingers, sometimes rapid, sometimes slow, like a rope coming undone; indicates Spleen Exhaustion.)
Fish swimming seems present yet absent. (Originally still but slightly shaking, seeming present yet absent, like a fish swimming; indicates Heart Exhaustion.)
Shrimp swimming jumps once in stillness. (Floating under the fingers, initially moving slowly and still, then departing; after a long time, suddenly jumps once, difficult to track advancing or retreating, like a shrimp swimming; indicates Large Intestine Exhaustion.)
Furthermore, cauldron boiling surges like soup. (Floating under the fingers, emerging without returning, with no countable rhythm, like boiling water in a cauldron; indicates Lung Exhaustion.)
Diagnosed in the morning, dead by evening; no medicine needed.