《脉要精微论》曰∶诊法常以平旦,阴气未动,阳气未散,饮食未进,经脉未盛,
络脉调匀,气血未乱,乃可诊有过之脉。(荣卫之气,昼则行阳,夜则行阴,至平旦皆会于寸口,故
诊脉以平旦为常。阴气正平而未动,阳气将盛而未散,饮食未进,虚实易明,经脉未盛,络脉调匀。气血未因动
作而扰乱,乃可诊有过之脉。过者,病也。)夫脉者,血之府也。(府,聚也。言血之多少皆聚见于经脉之中,
故曰∶脉实血实,脉虚血虚。)长则气治,短则气病;数则烦心,大则病进;(夫脉长为气和故治,短为
不足故病,数急为热故烦心,大为邪盛故病进。长脉者
往来长,短脉者往来短,数脉者往来急速,大脉者往来满大。)上盛则气高,下盛则气胀;代则气衰,
细则气少;涩则心痛。(上谓寸口,下谓尺中,盛谓盛满。代脉者,动而中止,不能自还。细脉者,动如
莠蓬。涩脉者,往来时不利而蹇涩也。)浑浑革至如涌泉,病进而色弊,绵绵其去如弦绝死。(浑
浑言脉气浊乱也。革至者,谓脉来弦而大,实而长也。如涌泉者,言脉汨汨,但出而不返也。绵绵,言微微似有,
而不甚应手也。如弦绝者,言脉卒断,如弦之绝去也。如此之脉,皆必死也。)
夫五脏者,身之强也。(脏安则神守,神守则身强,故曰身之强也。)头者,精明之府,头倾视
深,精神将夺矣。背者,胸中之府,背曲肩随,府将坏矣。腰者,肾之府,转摇不
能,肾将惫矣。膝者筋之府,屈伸不能,行则偻俯,筋将惫矣。骨者,髓之府,不能
久立,行则振掉,骨将惫矣。(皆以所居所由而为之府也。)得强则生,失强则死。(强谓中气强,固
以镇守也。此言五脏为身之强,而失强则死也。)
是知阴盛则梦涉大水恐惧,(阴为水,故梦涉水而恐惧。)阳盛则梦大火燔灼,(阳为火,故梦
大火而燔灼。)阴阳俱盛则梦相杀毁伤,(亦类交争之象。)上盛则梦飞,下盛则梦堕,(气上则梦上
故飞,气下则梦下故坠。)甚饱则梦予,(内有余故。)甚饥则梦取,(内不足故。)肝气盛则梦怒,(肝在志为
怒。)肺气盛则梦哭,(肺声哀故梦哭。)短虫多则梦聚众,(内多短虫,神梦应象。)长虫多则梦相击毁
伤。(长虫多则内不安,神躁扰,故梦是矣。)
《脉要精微论》说:诊脉通常选择在清晨(平旦),此时阴气尚未发动,阳气尚未耗散,饮食尚未摄入,经脉之气尚未充盛,络脉气血调和均匀,全身气血未因活动而紊乱,这样才能诊断出有异常的脉象。(荣卫之气,白天运行于阳分,夜晚运行于阴分,到了清晨都汇聚于寸口,所以诊脉以清晨为常规。此时阴气正平和而未发动,阳气将要充盛但未耗散,饮食尚未进入体内,虚实容易辨别,经脉之气尚未充盛,络脉气血调和。气血未因动作而扰乱,才能诊断出有病的脉象。所谓“过”,就是指病邪。)
脉,是血液汇聚的地方。(府,就是聚集的意思。意思是血液的多少都聚集显现于经脉之中,所以说:脉象实表示血实,脉象虚表示血虚。)脉长表示气机调畅,脉短表示气机有病;脉数表示心烦,脉大表示病情进展。(脉长是因为气和顺所以正常,脉短是因为不足所以生病,脉数急因为有热所以心烦,脉大因为邪气盛所以病情加重。长脉的特点是往来时间长,短脉的特点是往来时间短,数脉的特点是往来急速,大脉的特点是往来满大。)
寸口上部脉盛表示气逆上冲,下部脉盛表示腹部胀满;代脉表示气衰,细脉表示气少;涩脉表示心痛。(上部指寸口,下部指尺中,盛指脉象盛满。代脉的特点是跳动中途停止,不能自行恢复。细脉的特点是跳动微弱如莠蓬草。涩脉的特点是往来不畅且艰涩。)脉象浑浊混乱、坚实急促如同涌泉一样,病情会加重且面色败坏;脉象微弱似有若无、离去时像琴弦断裂一样,主死亡。(浑浑形容脉气浊乱。革至,是指脉来弦而大,实而长。如涌泉,是说脉势汨汨而来,只出不返。绵绵,是说脉象微微似有,但不甚应手。如弦绝,是说脉突然中断,像琴弦断裂一样。这样的脉象,都是必死的征象。)
五脏,是身体强健的根本。(脏气安宁则神志守持,神志守持则身体强健,所以说身体强健源于此。)头,是精明之府,如果头低垂、眼窝深陷,说明精神即将耗竭。背,是胸中之府,如果背部弯曲、肩膀下垂,说明胸中之府即将败坏。腰,是肾之府,如果腰部转动摇动困难,说明肾气将衰竭。膝,是筋之府,如果屈伸困难,行走时弯腰驼背,说明筋将衰竭。骨,是髓之府,如果不能久站,行走时身体震颤摇晃,说明骨将衰竭。(这些都是根据脏腑所居之处及其功能关联而称为“府”的。)得到强健就能生存,失去强健就会死亡。(强指的是中气强盛,能够镇守固摄。这里说的是五脏构成了身体的强健,如果失去这种强健就会死亡。)
由此可知,阴气盛则梦见渡过大水并感到恐惧,(阴对应水,所以梦见涉水而恐惧。)阳气盛则梦见大火燃烧灼烧,(阳对应火,所以梦见大火而灼烧。)阴阳俱盛则梦见互相杀戮毁伤,(这也是阴阳交争的象征。)上部气盛则梦见飞翔,下部气盛则梦见坠落,(气向上则梦向上故飞,气向下则梦向下故坠。)吃得很饱则梦见给予别人东西,(体内有余的缘故。)非常饥饿则梦见向别人索取东西,(体内不足的缘故。)肝气盛则梦见发怒,(肝在情志上对应怒。)肺气盛则梦见哭泣,(肺的声音哀怨所以梦见哭。)体内短虫多则梦见聚集众人,(体内短虫多,神志梦境应验其象。)体内长虫多则梦见互相击打毁伤。(长虫多则体内不安宁,神志躁扰,所以梦见这些景象。)
The *Ling Shu: Mai Yao Jing Wei Lun* states: Pulse diagnosis is usually performed at dawn (Pingdan). At this time, Yin Qi has not yet stirred, Yang Qi has not yet dispersed, food and drink have not been ingested, the Jing Mai (Primary Meridians) are not yet full, the Luo Mai (Collaterals) are harmonious and even, and the Qi and Blood are not yet disturbed. Only then can abnormal pulses be diagnosed. (Ying Wei Qi [Nutritive and Defensive Qi] travels through the Yang aspects during the day and the Yin aspects at night, converging at the Cun Kou (Radial Artery) by dawn; therefore, dawn is the standard time for pulse diagnosis. Yin Qi is peaceful and unstirred, Yang Qi is about to become abundant but not yet dispersed, no food has entered, making deficiency and excess easy to distinguish, Jing Mai Qi is not yet full, and Luo Mai Qi is harmonious. Qi and Blood are not disturbed by movement, allowing for the diagnosis of pathological pulses. "Guo" refers to disease.)
The Mai (Vessel/Meridian) is the residence where blood gathers. (Residence means gathering. This implies that the quantity of blood is manifested within the vessels; thus, a full pulse indicates full blood, and a deficient pulse indicates deficient blood.) A long pulse indicates regulated Qi; a short pulse indicates diseased Qi; a rapid pulse indicates vexation of the heart; a large pulse indicates the progression of disease. (A long pulse reflects harmonious Qi and thus normality; a short pulse reflects insufficiency and thus disease; a rapid and urgent pulse reflects heat and thus heart vexation; a large pulse reflects excess pathogenic factors and thus disease progression. The characteristic of a Long Pulse is its extended duration in both incoming and outgoing phases; a Short Pulse is brief; a Rapid Pulse is swift; a Large Pulse is expansive and full.)
Excess in the upper portion (Cun position) indicates rebellious Qi rising; excess in the lower portion (Chi position) indicates abdominal distension. A Dai Pulse (Intermittent Pulse) indicates Qi decline; a Xi Pulse (Fine/Thready Pulse) indicates Qi scarcity; a Se Pulse (Choppy Pulse) indicates heart pain. (Upper refers to the Cun position, lower to the Chi position; "excess" refers to a full pulse condition. The Dai Pulse stops temporarily and cannot recover immediately. The Xi Pulse beats faintly like weed fluff. The Se Pulse is unsmooth and hesitant in its flow.) If the pulse is turbid, firm, and urgent like a gushing spring, the disease will progress and the complexion will deteriorate. If the pulse is faint, barely perceptible, and leaves like a broken string, death ensues. (Turbid describes chaotic Qi. "Ge Zhi" refers to a pulse that is wiry, large, solid, and long. "Like a gushing spring" describes a pulse that rushes forth without returning. "Mian Mian" describes a faint pulse barely felt. "Like a broken string" describes a sudden cessation of the pulse, akin to a snapped string. Such pulses indicate inevitable death.)
The Zang Organs are the foundation of the body's strength. (When Zang organs are tranquil, Shen [Spirit] is retained; when Shen is retained, the body is strong.) The head is the residence of clarity and spirit; if the head droops and eyes are sunken, the spirit is being depleted. The back is the residence of the chest; if the back is curved and shoulders sag, the residence of the chest is failing. The waist is the residence of the Kidneys; if turning and shaking the waist is difficult, the Kidneys are becoming exhausted. The knees are the residence of the sinews; if flexion and extension are difficult, and walking requires stooping, the sinews are becoming exhausted. The bones are the residence of the marrow; if one cannot stand for long and trembles while walking, the bones are becoming exhausted. (These are called "residences" based on their location and functional association.) Retaining strength leads to life; losing strength leads to death. (Strength refers to robust Middle Qi that stabilizes and guards. This passage emphasizes that the Zang organs constitute the body's strength; losing this strength results in death.)
From this, we know that excess Yin leads to dreams of crossing large waters with fear. (Yin corresponds to water, hence dreaming of wading through water and feeling fear.) Excess Yang leads to dreams of great fire burning and scorching. (Yang corresponds to fire, hence dreaming of fire and scorching.) Excess of both Yin and Yang leads to dreams of killing and injuring each other. (This symbolizes the struggle between Yin and Yang.) Excess in the upper part leads to dreams of flying; excess in the lower part leads to dreams of falling. (Qi ascending leads to dreams of going up/flying; Qi descending leads to dreams of going down/falling.) Being very full leads to dreams of giving things away. (Due to internal surplus.) Being very hungry leads to dreams of taking things. (Due to internal deficiency.) Excess Liver Qi leads to dreams of anger. (The Liver governs anger.) Excess Lung Qi leads to dreams of crying. (The sound of the Lung is mournful, hence dreaming of crying.) Abundance of short parasites leads to dreams of gathering crowds. (Internal presence of many short parasites manifests in spiritual dreams.) Abundance of long parasites leads to dreams of fighting and injuring each other. (Many long parasites cause internal unrest and mental agitation, leading to such dreams.)