趺阳脉迟而缓,胃气如经也。趺阳脉浮而数,浮则伤胃,数则动脾,此非本病,医特下之所为也。荣卫
内陷,其数先微,脉反但浮,其人必大便硬,气噫而除。何以言之?本以数脉动脾,其数先微,故知脾气不治,
大便硬,气噫而除。今脉反浮,其数改微,邪气独留,心中则饥,邪热不杀谷,潮热发渴,数脉当迟缓,脉因
前后度数如法,病者则饥。数脉不时,则生恶疮也。
经,常也。趺阳之脉,以候脾胃,故迟缓之脉为常。若脉浮数,则为医妄下,伤胃动脾,邪气乘虚内陷
也。邪在表则见阳脉,邪在里则见阴脉。邪在表之时,脉浮而数也,因下里虚,荣卫内陷,邪客于脾,以数则
动脾。今数先微,则是脾邪先陷于里也,胃虚脾热,津液干少,大便必硬。《针经》曰∶脾病善
噫,得后出余气,则快然而衰,今脾客邪热,故气噫而除。脾能消磨(医统本作“磨消”)水谷,今邪气独
留于脾,脾气不治,心中虽饥而不能杀谷也。脾主为胃行其津液,脾为热烁,故潮热而发渴
也。趺阳之脉,本迟而缓,因下之后,变为浮(医统本作“浮为”)数,荣卫内陷,数复改微,是脉因前后度
趺阳脉象迟而缓,这是胃气符合常道的表现。如果趺阳脉象浮而数,浮脉表示损伤了胃气,数脉表示扰动脾气,这并非疾病原本的状态,而是医生误用攻下法所造成的后果。营气和卫气因此内陷,原本的数脉先变得微弱,脉象反而只表现为浮,病人必定出现大便干硬、嗳气且症状缓解的情况。为什么这样说呢?本来是因为数脉扰动脾气,那数脉先前已经变得微弱,所以知道脾气功能失调,导致大便干硬,通过嗳气排出余气后感到舒适。现在脉象反而变浮,那数脉改为微弱,邪气独自留存,心中虽然感觉饥饿,但邪热不能消化食物,出现潮热和口渴的症状。数脉本应当转为迟缓,如果脉象的前后变化符合规律,病人就会感到饥饿。如果数脉不按时机消退,就会产生恶疮。
“经”,指常道。趺阳脉是用来候察脾胃的,所以迟缓的脉象属于正常情况。如果脉象浮数,则是医生妄用攻下法,损伤胃气并扰动脾气,邪气乘虚内陷。邪气在表则出现阳脉,邪气在里则出现阴脉。邪气在表的时候,脉象浮而数,因为误下导致里虚,营卫内陷,邪气客居于脾,因数脉而扰动脾气。现在数脉先变得微弱,说明脾部的邪气先陷入体内,胃虚脾热,津液干枯减少,大便必然干硬。《针经》说:脾病容易嗳气,得到排便或排气等余气排出后,就会畅快而病情减轻。现在脾脏遭受邪热侵袭,所以通过嗳气使症状缓解。脾能够消磨水谷,现在邪气独自留在脾,脾气无法治理,心中虽然饥饿但不能消化食物。脾主为胃输送津液,脾被热邪灼伤,所以出现潮热和口渴。趺阳脉本来迟而缓,因为经过攻下之后,变为浮数,营卫内陷,数脉又改为微弱,这是脉象前后变化的度数……
The pulse at the Fuyang (Stomach source point) is slow and moderate, indicating that the Stomach Qi conforms to the normal state. If the pulse at the Fuyang is floating and rapid, a floating pulse indicates injury to the Stomach Qi, and a rapid pulse indicates disturbance of the Spleen Qi. This is not the original disease but the result of the physician's inappropriate use of purgation. Ying (Nutritive) and Wei (Defensive) Qi have sunk inward; the rapidity was first diminished, and the pulse reverses to appear only floating. The patient will certainly experience hard stools and belching with subsequent relief. Why is this so? Originally, the rapid pulse disturbed the Spleen Qi, and since the rapidity had previously diminished, we know that Spleen Qi dysfunction has occurred, leading to hard stools. Belching allows residual Qi to exit, bringing comfort. Now, the pulse reverses to floating, and the rapidity changes to diminished. Pathogenic Qi remains alone. Although the heart/mind feels hungry, pathogenic heat cannot digest food, resulting in tidal fever and thirst. A rapid pulse should normally transform into a slow and moderate one. If the pulse's progression and regression follow the proper rules, the patient will feel hunger. If the rapid pulse does not subside at the appropriate time, malignant sores will arise.
"Jing" (Classic/Constant) refers to the constant or normal state. The Fuyang pulse is used to inspect the Spleen and Stomach; therefore, a slow and moderate pulse is considered normal. If the pulse is floating and rapid, it indicates the physician's reckless use of purgation, which injures the Stomach and disturbs the Spleen, allowing pathogenic Qi to sink inward due to deficiency. When pathogenic Qi is in the exterior, Yang pulses appear; when in the interior, Yin pulses appear. When pathogenic Qi is in the exterior, the pulse is floating and rapid. Due to internal deficiency caused by purgation, Ying and Wei Qi sink inward, and pathogenic Qi lodges in the Spleen, disturbing it via the rapid pulse. Since the rapidity diminishes first, it means Spleen pathogenic Qi has sunk inward first. With Stomach deficiency and Spleen heat, body fluids dry up and decrease, making stools inevitably hard. The *Zhen Jing* (Needle Classic) states: "Spleen disease predisposes to belching; after the discharge of residual Qi (via defecation or flatulence), one feels relieved and the condition subsides." Now, the Spleen is invaded by pathogenic heat, hence belching brings relief. The Spleen is responsible for processing water and grain. Now, pathogenic Qi remains solely in the Spleen, and Spleen Qi fails to govern properly; although there is a sensation of hunger in the heart/mind, food cannot be digested. The Spleen is responsible for transporting body fluids for the Stomach. When the Spleen is scorched by heat, tidal fever and thirst occur. The Fuyang pulse was originally slow and moderate, but after purgation, it changed to floating and rapid. Ying and Wei Qi sank inward, and the rapidity again changed to diminished. This concerns the degree of change in the pulse before and after...