长脉气平短脉气病细则气少大则病进此言长短细大脉之为病也长脉气畅故曰平短脉气促
故曰病细为正不足故气少也大为邪有余故病进也
浮长风痫沉短宿食血虚脉虚气实脉实此言长短虚实脉之为病也长类乎弦亦肝木之象也浮
则为风风木偏胜痫证作矣沉脉主里沉而兼短乃为宿食停留中气不运也脉为血府脉虚者血虚脉
由气行气实者脉实
洪脉为热其阴则虚细脉为湿其血则虚洪脉阳盛之象故当为热阳有余而阴不足故为阴虚细
为阴脉细小不振阴湿之候细又为血虚者盖脉以血为体耳
缓大者风缓细者湿缓涩血少缓滑内热此言缓脉兼诸脉之为病也空疏缓大风所至也缓慢濡
细湿所侵也缓而涩滞血必少也缓而滑疾内有热也
濡小阴虚弱小阳竭阳竭恶寒阴虚发热此言濡脉之为病也濡小之脉即所谓如帛浮水面有上
无下阴虚之候也弱小之脉体不充鼓阳竭之候也阳竭则阴乘阳故恶寒阴虚则阳乘阴故发热
阳微恶寒阴微发热男微虚损女微泻血此言微脉之为病也微脉按之如欲绝若有若无言其虚
极也寸微即阳虚而阴气上入于阳中故恶寒也尺微即阴虚而阳气下陷于阴中故发热也男人得此
不惟恶寒发热而且为虚损女人得此不惟恶寒发热而且为泻血
阳动汗出阴动发热为痛与惊崩中失血此言动脉之为病也动乃数脉见于关上下无头尾如豆
大厥厥动摇故阳虚者为阳动外卫不密而汗自出矣阴虚者为阴动内守不宁而热自发矣为痛为惊
者阴阳不和卫守两失其职而崩中失血有自来矣
长脉的脉气平和,短脉的脉气有病;脉象细弱表示正气不足、气血亏少,脉象宏大表示病势进展。这段话论述的是长、短、细、大四种脉象所主疾病的情况。长脉脉气通畅,所以称为“平”(正常);短脉脉气急促,所以称为“病”;细脉是因为正气不足,所以表现为气血少;大脉是因为邪气有余,所以表示病势进。
浮取而长的脉象主风痫,沉取而短的脉象主宿食;血虚则脉虚,气实则脉实。这段话论述的是长、短、虚、实四种脉象所主疾病的情况。长脉类似于弦脉,也是肝木之象。脉浮且长则为风邪所致,风木偏胜,导致痫证发作。沉脉主里证,沉而兼短,乃是宿食停滞中焦,中气不运的缘故。脉为血之府,脉虚者即为血虚;脉由气推动,气实则脉实。
洪脉主热证,若阴分则虚;细脉主湿证,其血分则虚。洪脉是阳盛之象,所以应当表现为热;阳气有余而阴气不足,所以表现为阴虚。细脉属于阴脉,细小不振,是阴湿的征候;细脉又主血虚,这是因为脉以血液为形体基础的缘故。
缓大而主的病证为风,缓细主的病证为湿,缓涩主血少,缓滑主内热。这段话论述的是缓脉兼见其他脉象所主疾病的情况。空疏而缓,是大风所至的表现;缓慢而濡细,是湿气所侵的表现;缓而涩滞,血液必然稀少;缓而滑疾,体内有热。
濡小脉主阴虚弱,弱小脉主阳气竭绝。阳气竭绝则恶寒,阴虚则发热。这段话论述的是濡脉所主疾病的情况。濡小之脉,就是所说的像帛漂浮在水面上,只有上面没有下面,这是阴虚的征候。弱小之脉,脉体不充盈鼓动,这是阳气竭绝的征候。阳气竭绝则阴气乘袭阳气,所以恶寒;阴虚则阳气乘袭阴分,所以发热。
阳气微则恶寒,阴气微则发热。男子出现微脉多为虚损,女子出现微脉多为泻血(下血)。这段话论述的是微脉所主疾病的情况。微脉按之似有若无,好像要断绝一样,形容虚损到了极点。寸口脉微,即是阳虚而阴气上入于阳位,所以恶寒;尺部脉微,即是阴虚而阳气下陷于阴位,所以发热。男子得到这种脉象,不仅恶寒发热,而且会导致虚损;女子得到这种脉象,不仅恶寒发热,而且会导致下血。
阳气动则汗出,阴气动则发热、疼痛与惊悸;崩中失血。这段话论述的是动脉所主疾病的情况。动脉是数脉的一种,见于关部上下,无头无尾,状如豆大,厥厥动摇。所以阳虚者为阳动,外卫不固密而汗自出;阴虚者为阴动,内守不宁静而热自发。出现疼痛和惊悸,是因为阴阳不和,卫气和营气都失去了职司,从而导致崩中和失血,这是由来已久的了。
The pulse of Chang (Long) has a peaceful qi, indicating normality; the pulse of Duan (Short) has diseased qi. A thin pulse indicates deficient qi and blood; a large pulse indicates the progression of disease. This passage discusses the diseases associated with the Long, Short, Thin, and Large pulses. The Long pulse has smooth and free-flowing qi, hence it is called "Ping" (normal); the Short pulse has hurried qi, hence it is called "Bing" (diseased). The Thin pulse arises from insufficient righteous qi, thus manifesting as scanty qi and blood. The Large pulse arises from excess pathogenic factors, thus indicating disease progression.
A floating and long pulse governs wind epilepsy; a sinking and short pulse governs retained food. Blood deficiency results in a deficient pulse; Qi excess results in an excess pulse. This passage discusses the diseases associated with the Long, Short, Deficient, and Excess pulses. The Long pulse resembles the Xian (Wiry) pulse and is also a manifestation of Liver Wood. Floating indicates Wind; when Wind-Wood prevails excessively, epilepsy occurs. Sinking pulses govern interior syndromes; sinking combined with shortness indicates retained food stagnating in the middle jiao, causing dysfunction of Middle Qi. The pulse is the mansion of Blood; a deficient pulse signifies Blood deficiency. The pulse moves by Qi; excess Qi manifests as an excess pulse.
The Hong (Surging) pulse indicates Heat, implying Yin deficiency if present in the Yin aspect. The Xi (Fine/Thin) pulse indicates Dampness, implying Blood deficiency. The Hong pulse is a sign of Yang excess, therefore it corresponds to Heat; excess Yang and insufficient Yin result in Yin deficiency. The Xi pulse belongs to Yin pulses; it is fine, small, and unresisting, representing a sign of Yin-Dampness. Furthermore, the Xi pulse indicates Blood deficiency because the pulse takes Blood as its substance.
A Huan (Slow/Lax) and large pulse indicates Wind; a Huan and fine pulse indicates Dampness; a Huan and Se (Choppy) pulse indicates little Blood; a Huan and Hua (Slippery) pulse indicates internal Heat. This passage discusses the diseases associated with the Huan pulse combined with other pulses. Hollow and lax indicates the arrival of strong Wind. Slow and moist/fine indicates invasion by Dampness. Huan and choppy indicates that Blood must be scarce. Huan and slippery/fast indicates internal Heat.
Ru (Soggy) and Xiao (Small) pulses indicate Yin deficiency and weakness; Ruo (Weak) pulses indicate exhaustion of Yang. Exhaustion of Yang causes aversion to cold; Yin deficiency causes fever. This passage discusses the diseases associated with the Ru pulse. The Ru and Xiao pulse is described as floating on the water surface like silk, having no depth below; this is a sign of Yin deficiency. The Ruo pulse lacks fullness and distending power, which is a sign of Yang exhaustion. When Yang exhausts, Yin overcomes Yang, leading to aversion to cold. When Yin is deficient, Yang invades Yin, leading to fever.
Yang deficiency (Wei pulse) causes aversion to cold; Yin deficiency (Wei pulse) causes fever. In men, a Wei (Microscopic/Faint) pulse indicates deficiency and damage; in women, it indicates bleeding from the lower orifices (hematochezia/menorrhagia). This passage discusses the diseases associated with the Wei pulse. The Wei pulse feels as if it is about to disappear, existing only faintly, describing extreme deficiency. A Wei pulse at the Cun (Cun position) indicates Yang deficiency with Yin Qi ascending into the Yang region, causing aversion to cold. A Wei pulse at the Chi (Chi position) indicates Yin deficiency with Yang Qi sinking into the Yin region, causing fever. Men presenting with this pulse not only experience aversion to cold and fever but also suffer from deficiency damage. Women presenting with this pulse not only experience aversion to cold and fever but also suffer from bleeding.
Yang movement (Dong pulse) causes sweating; Yin movement causes fever, pain, and fright. It can also lead to metrorrhagia (Beng Zhong) and blood loss. This passage discusses the diseases associated with the Dong (Moving) pulse. The Dong pulse is a type of Shu (Rapid) pulse appearing above and below the Guan (Guan position), without head or tail, resembling a bean in size, trembling vigorously. Therefore, in cases of Yang deficiency, it is Yang movement; the exterior defense is not secure, leading to spontaneous sweating. In cases of Yin deficiency, it is Yin movement; the interior retention is restless, leading to spontaneous fever. Pain and fright occur because Yin and Yang are disharmonious, and both Wei (Defensive) and Ying (Nutritive) functions lose their duties, thereby leading to metrorrhagia and blood loss, which has been developing for some time.