微脉,极细而软,按之如欲绝,若有若无(《脉经》)。细而稍长(戴氏)。《素问》谓之小。气血微则脉微。
〔体状相类诗〕微脉轻微瞥瞥乎,按之欲绝有如无。微为阳弱细阴弱。细比于微略较粗。轻诊即见,重按如欲绝者,
微也。往来如线而常有者,细也。仲景曰∶脉瞥瞥如羹上肥者,阳气微;萦萦如蚕丝细者,阴气衰;长病得之死,卒病
得之生。
〔主病诗〕气血微兮脉亦微,恶寒发热汗淋漓。男为劳极诸虚候,女作崩中带下医。寸微气促或心惊,关脉微时胀
满形。尺部见之精血弱,恶寒消瘅痛呻吟。微主久虚血弱之病,阳微恶寒,阴微发热。《脉诀》云∶岁中日久为白带,
漏下多时骨亦枯。
紧脉,来往有力,左右弹人手(《素问》)。如转索无常(仲景),数如切绳(《脉经》),如纫 线(丹溪)。紧乃热为
寒束之脉,故急数如此,要有神气。《素问》谓之急。《脉诀》言∶寥寥入尺来。崔氏言∶如线,皆非紧状。或以浮紧为
弦,沉紧为牢,亦近似耳。
〔体状诗〕举如转索切如绳,脉象因之得紧名。总是寒邪来作寇,内为腹痛外身疼。
〔相类诗〕见弦、实。
〔主病诗〕紧为诸痛主于寒,喘咳风痫吐冷痰。浮紧表寒须发越,紧沉温散自然安。寸紧人迎气口分,当关心腹痛
沉沉。尺中有紧为阴冷,定是奔豚与疝疼。诸紧为寒为痛,人迎紧盛伤于寒,气口紧盛伤于食,尺紧痛居其腹。况乃疾
在其腹。中恶浮紧、咳嗽沉紧,皆主死。
微脉,极其细弱且柔软,重按时感觉快要消失,似有似无(出自《脉经》)。也有描述为细而稍长(戴氏观点)。《素问》中称之为“小”。气血虚弱则脉象表现为微。
〔体状相类诗〕微脉轻微,闪烁不定,重按似乎要断绝,好像没有一样。微脉代表阳气虚弱,细脉代表阴气虚弱。细脉比微脉略微粗一些。轻取即能感觉到,重按却感觉快要断绝的,是微脉。往来像线一样但持续存在的,是细脉。张仲景说:脉象闪烁如同汤面上漂浮的油花,这是阳气微弱;脉象缠绕如同蚕丝般细微,这是阴气衰败;久病出现此脉多主死亡,急病出现此脉尚有生机。
〔主病诗〕气血虚弱,脉象也随之微弱,出现怕冷发热、大汗淋漓的症状。男子出现此脉多为劳损至极及各种虚证候,女子出现此脉则需考虑崩漏及带下病的治疗。寸部见微脉,可能出现气短或心悸;关部脉微,身体会出现胀满形态;尺部见到微脉,表示精血虚弱,伴有怕冷、消瘦消渴、疼痛呻吟等症状。微脉主要主久病体虚、血弱的病症,阳气微则怕冷,阴气微则发热。《脉诀》中说:岁久日深会导致白带增多,漏下日久骨骼也会枯槁。
紧脉,往来有力,左右弹击手指(出自《素问》)。像转动绳索一样无常(张仲景观点),急促如同切绳(《脉经》观点),像穿线的针脚(朱丹溪观点)。紧脉是因为热被寒邪束缚所致,所以脉象紧急数动如此,但必须具有神气。《素问》称之为“急”。《脉诀》说:寥寥无几直达尺部。崔氏说:像线一样,这些都不是紧脉的真实形态。有人将浮紧脉误认为弦脉,沉紧脉误认为牢脉,这也只是近似而已。
〔体状诗〕轻取如同转动绳索,重按如同切绳,脉象因此得名紧。这总是因为寒邪入侵作祟,内部导致腹痛,外部导致身痛。
〔相类诗〕参见弦脉、实脉。
〔主病诗〕紧脉主要主各种由寒引起的疼痛,以及喘咳、风痫、吐出冷痰等症状。浮紧脉表示表寒,需要用发汗法发散;紧沉脉表示里寒,用温散法治疗自然安宁。寸部紧脉,人迎穴和气口穴可分别判断,应当关心心腹部的沉重疼痛。尺部出现紧脉表示阴寒内盛,必定是奔豚病和疝气疼痛。各种紧脉都表示寒邪和疼痛,人迎脉紧盛说明伤于寒邪,气口脉紧盛说明伤于饮食,尺脉紧说明疼痛位于腹部。况且疾病在腹部。中恶病出现浮紧脉、咳嗽病出现沉紧脉,都主死亡。
The Wei (Micro) pulse is extremely fine, thin, and soft; upon heavy pressure, it feels as if it is about to disappear, seeming to exist yet not exist (from *Mai Jing*). Some describe it as fine and slightly long (Dai's view). It is referred to as "Xiao" (Small) in the *Su Wen*. When Qi and Blood are deficient, the pulse appears as Wei.
[Poem on Form and Similarities] The Wei pulse is slight and flickering; under heavy pressure, it seems to vanish, appearing non-existent. Wei indicates deficiency of Yang, while Xi (Fine) indicates deficiency of Yin. Xi is slightly coarser than Wei. If felt lightly but feels like it is about to cease under heavy pressure, it is Wei. If it flows back and forth like a thread but remains constant, it is Xi. Zhang Zhongjing stated: A pulse that flickers like fat floating on soup surface indicates weak Yang Qi; a pulse that winds like silk threads indicates declining Yin Qi. In chronic diseases, this pulse portends death; in acute diseases, it suggests survival.
[Poem on Main Diseases] When Qi and Blood are deficient, the pulse also becomes micro; symptoms include aversion to cold, fever, and profuse sweating. In men, it signifies extreme exhaustion and various deficiency syndromes; in women, it indicates conditions such as metrorrhagia and leukorrhea requiring treatment. At the Cun position, a Wei pulse may present with shortness of breath or palpitations; at the Guan position, a Wei pulse manifests as abdominal distension and fullness; at the Chi position, it indicates weakness of essence and blood, accompanied by aversion to cold, emaciation, thirst, pain, and groaning. Wei primarily governs diseases of chronic deficiency and weak blood. Weak Yang leads to aversion to cold, while weak Yin leads to fever. *Mai Jue* states: Prolonged duration can lead to excessive white leukorrhea, and prolonged leakage causes the bones to wither.
The Jin (Tight) pulse is forceful in its coming and going, striking the fingers from both sides (from *Su Wen*). It resembles a twisting rope, changing constantly (Zhang Zhongjing), rapid like cutting a rope (*Mai Jing*), or like stitches on a needle (Zhu Danxi). The Jin pulse arises because heat is constrained by cold pathogens, resulting in such urgency and rapidity, yet it must retain Shen Qi (Spirit/Energy). *Su Wen* refers to it as "Ji" (Urgent). *Mai Jue* says: Rarely reaching the Chi position. Cui Shi said: Like a thread. These descriptions do not accurately depict the Jin pulse. Some mistakenly identify floating-tight as Xian (Wiry) and sinking-tight as Lao (Deep-Firm), which are only approximate.
[Poem on Form] Light pressure feels like a twisting rope, heavy pressure feels like cutting a rope; thus the pulse obtains the name Jin. This is always caused by the invasion of Cold Pathogens, leading to abdominal pain internally and body pain externally.
[Poem on Similarities] See Xian (Wiry) and Shi (Excess).
[Poem on Main Diseases] Jin primarily governs pain due to Cold, as well as wheezing, coughing, wind-stroke epilepsy, and vomiting of cold phlegm. Floating-Jing indicates exterior cold, requiring diaphoresis (sweating method); Sinking-Jin indicates interior cold, which will naturally resolve with warming and dispersing methods. At the Cun position, differences between Renying and Qikou acupoints should be noted, concerning heavy pain in the heart and abdomen. Jin at the Chi position indicates Yin-Cold, definitely pointing to Ben Tun (Rushing Tumor) and Hernia pain. All Jin pulses indicate Cold and Pain. Renying pulse tight and excess indicates injury by Cold; Qikou pulse tight and excess indicates injury by food stagnation; Chi pulse tight indicates pain located in the abdomen. Furthermore, if the disease is in the abdomen. In Zhong E (Sudden Evil) presenting with Floating-Jin, or coughing presenting with Sinking-Jin, both portend death.