肠痈实热滑数可知数而不热关脉芤虚微涩而紧未脓当下紧数脓成切不可下此言肠痈脉证
宜别也肠痈者肠内生痈也大肠小肠皆有之大抵得之不节饮食不适寒温久郁化热久热腐脓而痈
斯成矣如小腹肿痞皮急按之则痛小便数如淋或发热恶寒皆肠痈之候也肠痈系实热之证其脉滑
数可知脉若数而不热关脉必见芤虚无力脉若带微涩而紧者其痈尚未成脓可用下法脉若紧而且
数其
妇人之脉以血为本血旺易胎气旺难孕少阴动甚谓之有子尺脉滑利妊娠可喜滑疾不散胎必
三月但疾不散五月可别左疾为男右疾为女女腹如箕男腹如釜欲产之脉其至离经水下乃产未下
勿惊新产之脉缓滑为吉实大弦牢有证则逆此言妇人胎产脉证宜辨也男为阳女为阴阳主气阴主
血一定之理也故女人以血为本经脉调而血旺者易以成胎气脉旺必难成孕所以女人身肥胖者多
不生子以其脂肥而不能成孕故也少阴者肾脉也动甚者即阴搏阳则谓之有子若尺脉滑利者主有
妊故可喜即此滑利之脉应指疾而不散滑为血液敛结之象是为有胎三月矣若但疾而不散是从虚
渐实转为形体此妊娠五月之脉也其疾左胜于右是为男孕胎气钟于阳故左胜右胜于左是为女孕
胎气钟于阴故右胜更视其腹如箕者为女胎腹如釜者为男胎所谓女生外向男子负阴而抱阳其理
一也及其欲产之脉与平日忽异一旦欲落气血动荡胞胎迸裂自与经常离异而脉亦非平昔之状貌
矣然必有水先下俗谓之胞浆不尔犹未即下勿认为难产而惊讶也及其已产也气血两虚其脉宜缓
滑为吉兆也若脉实大弦牢非产后气血俱虚者所宜是皆相逆之脉设外有证又岂能顺乎
肠痈(肠道内形成的痈肿)表现为实热证,脉象滑数是可以推断的;如果脉数但体表不热,关脉呈现芤、虚、微、涩而紧的特征,说明脓液尚未形成,此时应当使用下法(泻下攻积);如果脉象紧且数,说明脓液已经形成,切不可使用下法。这是关于肠痈脉证的论述,需要加以辨别。所谓肠痈,就是肠道内部生痈。大肠和小肠都可能发生此病。大抵是因为饮食不节制,寒温不适,导致邪气长期郁结化热,久热腐肉成脓,从而形成痈肿。症状如小腹肿胀痞块,皮肤绷紧,按压则疼痛,小便频数像淋证一样,或者发热恶寒,这些都是肠痈的征候。肠痈属于实热证,其脉象滑数是显而易见的。如果脉数但身体不热,关脉必然出现芤、虚、无力的表现;如果脉象带微涩而紧,说明痈肿尚未成脓,可以使用下法;如果脉象紧而且数,说明脓已成熟,绝对不可以使用下法。
妇女的脉象以血为本,血液旺盛容易受孕,胎气旺盛难以怀孕。少阴脉(肾经脉)动甚,称为有子;尺脉滑利,是妊娠的可喜之象。脉象滑疾而不散,胎儿必定三个月了;如果脉象滑疾但不散,五个月时可以辨别性别。左脉滑疾为男,右脉滑疾为女。孕妇腹部形状如箕(宽平)的是女胎,如釜(圆凸)的是男胎。临产前的脉象与平日不同,一旦脉象离经(指脉位或脉律发生显著变化),羊水破裂即可生产;在羊水未破之前,不要惊慌。新产后的脉象,缓滑为吉兆,若脉实大弦牢且有病症,则为逆证。这是关于妇人胎产脉证的论述,需要仔细辨别。男子属阳,女子属阴,阳主气,阴主血,这是一定的道理。所以女人以血为本,经脉调和而血液旺盛的人容易受孕;如果脉象旺盛(指阳气过亢),反而难以怀孕。因此,身体肥胖的女人多不能生育,因为脂肪肥厚阻碍了受孕的原理。少阴指的是肾脉,搏动明显即“阴搏阳别”,称为有子。如果尺脉滑利,主有妊娠,所以是可喜之象。这种滑利的脉象应指疾速而不散,滑是血液敛结的象征,这是怀孕三个月的脉象。如果脉象仅疾速而不散,是从虚渐转为实,反映形体发育,这是怀孕五个月的脉象。如果左脉疾胜于右,是为男孕,因为胎气聚集于阳,所以左侧胜;如果右脉疾胜于左,是为女孕,因为胎气聚集于阴,所以右侧胜。还要观察腹部形状,如箕者为女胎,如釜者为男胎。所谓女生外向,男子负阴抱阳,其道理是一致的。等到临产的脉象,与平日突然不同,一旦想要分娩,气血动荡,胞胎迸裂,自然与平时的脉象不同,脉象也不再是平常的样子。然而必须有羊水先下,俗称胞浆,否则还不能立即生产,不要误认为是难产而惊讶。等到已经生产后,气血两虚,脉象宜缓滑,这是吉兆。如果脉象实大弦牢,这不是产后气血俱虚者应有的脉象,都是相逆的脉象,假如外部还有病症,又怎么能顺乎常理呢?
Intestinal abscess (an abscess formed within the intestines) presents as a excess-heat syndrome, and a slippery and rapid pulse is indicative. If the pulse is rapid but there is no fever, and the Guan position pulse exhibits characteristics of hollow (Kou), deficiency, minute, choppy, and tight, it indicates that pus has not yet formed; in this case, purgation should be employed. If the pulse is both tight and rapid, it indicates that pus has formed, and purgation must absolutely be avoided. This discusses the pulse manifestations of intestinal abscess, which require differentiation. Intestinal abscess refers to an abscess forming inside the intestines. It can occur in both the Large Intestine and the Small Intestine. Generally, it arises from irregular diet and improper exposure to cold or heat, leading to long-term stagnation transforming into heat. Prolonged heat causes tissue corruption and pus formation, resulting in an abscess. Symptoms include swelling and fullness in the lower abdomen, tense skin with pain upon palpation, frequent urination resembling strangury, or fever and aversion to cold; these are all signs of intestinal abscess. Intestinal abscess belongs to the category of excess-heat syndromes, and its slippery and rapid pulse is evident. If the pulse is rapid but the body is not hot, the Guan position pulse will necessarily appear hollow, deficient, and weak. If the pulse is minute, choppy, and tight, the abscess has not yet matured into pus, and purgative methods may be used. If the pulse is tight and rapid, pus has formed, and purgation is strictly contraindicated.
The female pulse is rooted in Blood. Abundant Blood facilitates conception, while vigorous Fetal Qi makes pregnancy difficult. Vigorous movement of the Shao Yin pulse (the Kidney meridian pulse) is called "having a child." A slippery and smooth Chi position pulse is a favorable sign of pregnancy. A slippery and rapid pulse that does not scatter indicates the fetus is likely three months old. If the pulse is rapid but does not scatter, gender can be distinguished at five months. A rapid pulse on the left indicates a male fetus; a rapid pulse on the right indicates a female fetus. An abdomen shaped like a wide basket suggests a female fetus; one shaped like a pot suggests a male fetus. The pulse before labor differs from the usual pattern. Once the pulse deviates from the regular pattern ("Li Jing") and amniotic fluid breaks, delivery occurs. Do not panic before the fluid breaks. For postpartum women, a slow and slippery pulse is auspicious; a solid, large, wiry, or firm pulse with pathological signs is adverse. This section discusses the pulse manifestations of female pregnancy and childbirth, requiring careful differentiation. Males belong to Yang, females to Yin; Yang governs Qi, and Yin governs Blood. This is a fixed principle. Therefore, women are rooted in Blood; those with harmonized meridians and abundant Blood conceive easily. However, if the pulse is excessively vigorous (indicating hyperactive Yang), pregnancy is difficult. Thus, obese women often fail to conceive because excessive fat impedes conception. "Shao Yin" refers to the Kidney pulse; vigorous movement, described as "Yin bounding and distinguishing from Yang," indicates pregnancy. A slippery and smooth Chi position pulse signifies pregnancy and is auspicious. This slippery and smooth pulse, felt as rapid and non-scattering, reflects the gathering of Blood essence, indicating a three-month pregnancy. If the pulse is merely rapid without scattering, it transitions from deficiency to excess, reflecting fetal development, characteristic of a five-month pregnancy. If the left pulse is more rapid than the right, it indicates a male fetus, as Fetal Qi gathers in Yang, making the left side predominant. If the right pulse is more rapid than the left, it indicates a female fetus, as Fetal Qi gathers in Yin, making the right side predominant. One should also observe the abdomen: basket-shaped for female, pot-shaped for male. The saying "females look outward, males carry Yin and embrace Yang" follows the same logic. When labor approaches, the pulse suddenly differs from the norm. As delivery begins, Qi and Blood become turbulent, and the gestational sac ruptures, causing the pulse to change from its usual appearance. However, amniotic fluid (commonly called "bao shuang") must break first; otherwise, immediate delivery will not occur. Do not mistake this for dystocia and panic. After delivery, Qi and Blood are both deficient, so a slow and slippery pulse is auspicious. A solid, large, wiry, or firm pulse is inappropriate for the postpartum state of Qi and Blood deficiency and represents an adverse pulse. If external pathological signs are present, how can the condition remain compliant?