脉有七诊曰浮中沉上下左右消息求寻又有九候举按轻重三部浮沉各候五动寸候胸上关候
膈下尺候于脐下至跟踝左脉候左右脉候右病随所在不病者否浮为心肺沉为肾肝脾胃中州浮沉
之间心脉之浮浮大而散肺脉之浮浮涩而短肝脉之沉沉而弦长肾脉之沉沉实而濡脾胃属土脉宜
和缓命为相火左寸同断此言脉有七诊九候之法也七诊者与皮毛相得曰浮按之至骨曰沉中则在
浮沉之间上下即寸与尺此概两手六部而言也左右左手右手也是谓七诊言能消息细求错综审别
则上下表里之病无遁情矣又(素问三部九候论云)独小者病独大者病独疾者病独迟者病独热
者
病独寒者病独陷下者病亦谓之七诊但与本文七诊之义不同当参看九候者言脉分三部三部中各
有浮中沉是谓九候九候之情形非举按轻重不能得也其候以五动为准寸候胸上至头之有疾
关候膈下至脐之有疾尺候脐下至足之有疾左脉候身之左右脉候身之右病随脉之所在而见不病
则脉不应也与前七诊大同小异心肺居上脉应浮肝肾居下脉应沉脾胃居心肺肝肾之间谓之中州
脉亦应在浮沉之间心肺同一浮也但浮大而散者象夏火故属心浮涩而短者象秋金故属肺肝肾同
一沉也但沉而弦长者象春木故属肝沉实而濡者象冬水故属肾脉和而缓自有一种舒徐冲融气象
土之性也脾胃宜之命门右肾固含相火然终不能离火位故与左寸同断
脉诊有七种诊法,称为浮、中、沉、上、下、左、右。通过仔细推敲和探寻来辨别病情。又有九候之法,通过举按手法的轻重,在寸、关、尺三部分别候察浮、中、沉三种脉象,各候察五次搏动。寸部候察胸以上部位的病变,关部候察膈以下至脐部的病变,尺部候察脐以下至足跟踝部的病变。左侧脉象反映身体左侧的病变,右侧脉象反映身体右侧的病变。疾病随脉象出现的部位而定,没有病变的部位脉象则无异常表现。
浮脉主心肺病,沉脉主肾肝病,脾胃位于中州(中央),其脉象应在浮与沉之间。心脉之浮,表现为浮大而散;肺脉之浮,表现为浮涩而短。肝脉之沉,表现为沉而弦长;肾脉之沉,表现为沉实而濡。脾胃属土,脉象宜和缓。命门为相火,其脉象与左寸脉同断。这是论述脉诊有七诊和九候的方法。
所谓七诊,是指脉气与皮毛相合称为浮,重按至骨称为沉,中取则在浮与沉之间。上下即指寸部和尺部。这是概略地讲述两手六部的脉象。左右即左手和右手。这就是所谓的七诊。如果能仔细推敲、细细寻求、错综审别,那么上下表里的病情就无所遁形了。
另外,《素问·三部九候论》中说:脉独小者为病,独大者为病,独疾者为病,独迟者为病,独热者为病,独寒者为病,独陷下者为病。这也称为七诊,但与本文七诊的含义不同,应当参看。
所谓九候,是说脉分三部,每部中各有浮、中、沉,这就叫九候。九候的情形,非通过举按轻重的操作不能得知。其候察以五次搏动为准。寸部候察胸部以上至头部的疾病,关部候察膈下至脐部的疾病,尺部候察脐下至足部的疾病。左侧脉象反映身体左侧,右侧脉象反映身体右侧。疾病随脉象所在之处而显现,若无疾病,则脉象不应现病态。这与前文所述的七诊大同小异。
心肺居于上部,脉象应浮;肝肾居于下部,脉象应沉;脾胃居于心肺与肝肾之间,称为中州,脉象也应在浮与沉之间。心肺同属浮脉,但浮大而散者象征夏季之火,故归属于心;浮涩而短者象征秋季之金,故归属于肺。肝肾同属沉脉,但沉而弦长者象征春季之木,故归属于肝;沉实而濡者象征冬季之水,故归属于肾。脉象和缓从容,自有一种舒徐冲融的气象,这是土的性情,脾胃适宜这种脉象。命门位于右肾,固然含有相火,但最终不能脱离火位,故其脉象与左寸脉同断。
There are seven pulse diagnoses, known as Floating (Fu), Middle (Zhong), Deep (Chen), Upper (Shang), Lower (Xia), Left (Zuo), and Right (You). By carefully deliberating and seeking, one can discern the condition. There is also the Nine Palpations (Jiu Hou) method: by varying the pressure of lifting and pressing, one examines the Floating, Middle, and Deep pulses at the Cun (Inch), Guan (Bar), and Chi (Cubit) positions respectively, observing five beats for each. The Cun position palpates diseases in the chest and above; the Guan position palpates diseases from below the diaphragm to the navel; the Chi position palpates diseases from below the navel to the heel and ankle. The left pulse reflects conditions on the left side of the body, and the right pulse reflects conditions on the right side. Diseases manifest according to the location of the pulse changes; areas without disease show no abnormal pulse responses.
A Floating pulse indicates Heart and Lung disorders; a Deep pulse indicates Kidney and Liver disorders. The Spleen and Stomach reside in the Central Region (Zhong Zhou), and their pulse should be between Floating and Deep. The Heart pulse when Floating appears large and scattered (Da San); the Lung pulse when Floating appears choppy and short (Se Duan). The Liver pulse when Deep appears wiry and long (Xian Chang); the Kidney pulse when Deep appears solid and soft (Shi Ru). The Spleen and Stomach belong to Earth, and their pulse should be harmonious and moderate (He Huan). The Ming Men (Gate of Life) represents Ministerial Fire, and its pulse is diagnosed similarly to the Left Cun position. This describes the methods of the Seven Diagnoses and Nine Palpations in pulse reading.
The so-called Seven Diagnoses refer to: pulse qi merging with the skin and hair is called Floating; pressing deeply to the bone is called Deep; middle palpation lies between Floating and Deep. "Upper and Lower" refers to the Cun and Chi positions. This generally discusses the six positions of both hands. "Left and Right" refers to the left and right hands. These are the Seven Diagnoses. If one can carefully deliberate, seek meticulously, and analyze comprehensively, then the conditions of the interior and exterior, upper and lower will not escape detection.
Furthermore, the *Su Wen* (Basic Questions) chapter on "Three Parts and Nine Palpations" states: A pulse that is uniquely small indicates disease; uniquely large indicates disease; uniquely rapid indicates disease; uniquely slow indicates disease; uniquely hot indicates disease; uniquely cold indicates disease; uniquely sunken indicates disease. This is also called the Seven Diagnoses, but it differs in meaning from the Seven Diagnoses in this text and should be consulted together.
The so-called Nine Palpations means that the pulse is divided into three parts (Cun, Guan, Chi), and each part has Floating, Middle, and Deep aspects, which constitutes the Nine Palpations. The nuances of the Nine Palpations cannot be obtained without varying the pressure of lifting and pressing. The observation is based on five beats. The Cun position palpates diseases from the chest up to the head; the Guan position palpates diseases from below the diaphragm to the navel; the Chi position palpates diseases from below the navel to the feet. The left pulse reflects the left side of the body, and the right pulse reflects the right side. Diseases manifest where the pulse changes; if there is no disease, the pulse does not reflect pathological signs. This is largely similar to the previously mentioned Seven Diagnoses.
The Heart and Lungs reside in the upper part, so their pulse should be Floating; the Liver and Kidneys reside in the lower part, so their pulse should be Deep; the Spleen and Stomach reside between the Heart/Lungs and Liver/Kidneys, called the Central Region, so their pulse should also be between Floating and Deep. Both Heart and Lungs correspond to the Floating pulse, but Floating, Large, and Scattered symbolizes the Fire of Summer, thus belonging to the Heart; Floating, Choppy, and Short symbolizes the Metal of Autumn, thus belonging to the Lung. Both Liver and Kidneys correspond to the Deep pulse, but Deep, Wiry, and Long symbolizes the Wood of Spring, thus belonging to the Liver; Deep, Solid, and Soft symbolizes the Water of Winter, thus belonging to the Kidney. A pulse that is harmonious and moderate possesses a relaxed and integrated atmosphere, which is the nature of Earth, suitable for the Spleen and Stomach. The Ming Men, located in the right Kidney, inherently contains Ministerial Fire, but ultimately cannot depart from the Fire position, so its pulse is diagnosed identically to the Left Cun position.