凡欲诊脉。先调自气。压取病患息。以候其迟数过与不及。所谓以我医彼。知与神会。
则莫
凡诊脉须先识脉息两字。脉者血也。息者气也。脉不自动。为气使然。所谓长则气治。
短则
凡诊须识人迎气口。以辨内外因。其不与人迎气口相应。为不内外因。所谓关前一分。
人命
凡诊须先识五脏六经本脉。然后方识病脉。岁主脏者。气候逆传。阴阳有时。与脉为异。
此
凡诊须认取二十四字名状。与关前一分相符。推说证状。与病者相应。使无差忒。庶可
根据
经云。常以平旦。阴气未动。阳气未散。饮食未进。经脉未盛。络脉调匀。乃可诊有过
之脉
岂待
可以
为人迎
经常。
表者。
状不同
人命
怒则激
方乃不
文藻
故知
内。
精
而论
如垩
炭。
盛则
谵
所谓六腑强弱。以候形之盛衰者。头者精明之府。头倾视深。精神夺矣。背者胸之府。背曲
肩随。胸将坏矣。腰者肾之府。转摇不能。肾将惫矣。膝者筋之府。曲伸不能。筋将惫矣。
骨者髓之府。行则振掉。骨将惫矣。仓廪不藏者。肠胃不固也。水泉不止者。膀胱不藏也。
得强者生。失强者死。此等证医者要问。在脉难明。惟证易辨。是故圣人垂教。学人宜兼明
之。不可忽也。
凡是想要诊脉,先要调整自己的气息。按压并观察病人的呼吸,以候察其脉搏的迟、数以及是否超过或不及正常范围。这就是所谓的“以我之医道治彼之病患”,做到心知与神会相通。
凡是诊脉必须先认识“脉”和“息”这两个字。脉,指的是血;息,指的是气。脉不会自己跳动,是因为气的推动所致。所谓“脉长则气机调畅”。
凡是诊脉必须识别人迎穴和气口穴,以辨别内因和外因。如果脉象不与人迎、气口相应,则属于不内外因。所谓关前一分(寸部),关乎人的性命。
凡是诊脉必须先认识五脏六经的本脉,然后才能认识病脉。岁运主脏者,气候逆传,阴阳有时,脉象与之不同。
凡是诊脉必须认取二十四种脉象的名称和形态,并与关前一分相符,推演说证状,与病人情况相应,使无差错,才可以作为依据。
经文说:常在平旦(清晨)时分,阴气未动,阳气未散,饮食未进,经脉未盛,络脉调匀,这时才可以诊察有过之脉。
岂待……可以……为人迎经常。表者……状不同……人命……怒则激……方乃不……文藻……故知……内……精……而论……如垩……炭……盛则……谵……
所谓六腑强弱,是用来候察形体盛衰的。头是精明之府,头低垂、眼窝深陷,精神已夺失。背是胸之府,背部弯曲、肩膀下垂,胸将坏败。腰是肾之府,转动摇晃不能,肾将疲惫。膝是筋之府,屈伸不能,筋将疲惫。骨是髓之府,行走时振颤掉摇,骨将疲惫。仓廪不藏(指泄泻不止),是肠胃不固。水泉不止(指小便失禁),是膀胱不藏。得强者生,失强者死。这些证候医生一定要询问,在脉象上难以明确,只有证候容易辨别。所以圣人垂教,学人应当兼明之,不可忽视。
Whenever one wishes to diagnose the pulse, one must first regulate one's own breath. Press and observe the patient's respiration to await whether it is slow (Chi), rapid (Shu), excessive, or insufficient. This is what is meant by "using my medical approach to treat that patient," achieving a convergence of knowledge and spirit.
Diagnosing the pulse requires first understanding the terms "pulse" (Mai) and "respiration" (Xi). Pulse refers to blood; respiration refers to Qi. The pulse does not move on its own but is driven by Qi. It is said that "a long pulse indicates regulated Qi."
Diagnosis requires recognizing the Renying (Human Welcome acupoint) and Qikou (Qi Mouth pulse position) to differentiate internal and external causes. If the pulse does not correspond with Renying and Qikou, it belongs to non-internal, non-external causes. The area one cun anterior to the crease (Guanqian Yifen) concerns human life.
Diagnosis requires first knowing the fundamental pulses of the Five Zang organs and Six Meridians before identifying pathological pulses. When the annual influence governs the Zang organs, climatic changes transmit in reverse; Yin and Yang have their times, differing from the pulse.
Diagnosis requires recognizing the names and characteristics of twenty-four pulse types, ensuring they correspond with the Guanqian Yifen, deducing symptoms, and matching them with the patient's condition to avoid errors, thereby serving as a basis.
The Classic states: One should usually diagnose at dawn (Pingdan), when Yin Qi has not yet stirred, Yang Qi has not yet dispersed, food and drink have not been consumed, the Jing Mai are not yet full, and the Luo Mai are balanced. Only then can one diagnose abnormal pulses.
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The strength and weakness of the Six Fu organs are used to observe the flourishing and declining state of the physical form. The head is the mansion of clarity and intelligence; if the head droops and the eyes are sunken, the spirit has been depleted. The back is the mansion of the chest; if the back is curved and shoulders sag, the chest is about to fail. The waist is the mansion of the Kidney; if turning and shaking are impossible, the Kidney is about to be exhausted. The knees are the mansion of sinews; if bending and extending are impossible, the sinews are about to be exhausted. The bones are the mansion of marrow; if walking causes trembling and shaking, the bones are about to be exhausted. Inability to store contents (referring to diarrhea) indicates insecurity of the intestines and stomach. Unceasing water springs (referring to urinary incontinence) indicates inability of the Bladder to store. Gaining strength leads to life; losing strength leads to death. These syndromes must be asked about by the physician; they are difficult to clarify through pulse alone but easy to identify through symptoms. Therefore, the Sages imparted teachings, and students should understand them comprehensively and not neglect them.