欲识病脉,先审平脉,诊法乃得。
举浮而软按差长,禀得肝经血气强。
脉形浮缓有力,招招如揭长竿,为禀木气,为血盛,为春令。
指下清圆不是滑,心神王相须明察。
脉形溜亮微软,累累如循琅 ,为禀火气,为神王,为夏令。
去来敦浓土德隆。
脉形中和且平,悠悠如鸡践地,为禀脾气,为真元健顺,为令长夏、四季。
和缓轻清肺气充。
脉形轻浮微涩,聂聂如落榆荚,为禀金气,为气治,为秋令。
脉济以匀寻到底,天赋一生资肾水。
脉形沉实平均,朗朗如绵裹砂石,为禀水气,为精足,为冬令。
入手迟微或者沉,钟灵端的在三阴。
脉形沉细有力,小驶于迟,为禀阴气,为老年,为秋冬令。
三阳毓秀君知否,春夏时令行寸口。
脉形似大,微弦,少缓于数,为禀阳气,为壮岁,为春夏令。
胃气只缘脉有神,反关诊亦等常人。
脉形阳刚不躁,阴柔有力,病甚而不空不散,为有胃气,医可十全八九。脉形不在尺寸,而在关后,曰反关。
位次虽异,诊则一也。李士材谓反关脉主贵,直可发噱。
连来三五为雀啄;
脉来三至五至一止,如鸟啄粟,未数粒辄惊顾少停,曰雀啄。心绝。旧注脉坚而锐,如鸡之 ,如鸟之喙,
脾绝。不知所谓。
半晌一至屋漏若;
脉来极迟极软,如雨歇漏滴,半日一点,曰屋漏。脾绝。
弹石来洪按即无;
脉来坚实迫指,切切如弹中人,曰弹石。肾绝。旧注脉劈劈如指弹石,是脉譬指、石譬肌肤语焉,而不详,
此之谓与。
散乱不伦疑解索;
脉来头绪纷纭,如已拆麻绳,散而不收。少焉一缕坚劲,如循刃,曰解索。肝绝。
鱼逝浮时倏而沉;虾游沉中浮几跃;
脉来或散或断,时浮时沉,如鱼戏水,曰鱼逝。形曲而跳,沉静中忽鼓数下而去,曰虾游。肺绝。
鼎沸浑似煮羹初;
脉来极数极躁,如煎羹烹水,涌涌无少息,曰鼎沸。阴绝。
乍绝忽苏曰灯落;
脉来大,是愁人,忽了了。可意如灯将烬复明,曰灯落。阳绝。又初持朗朗,已而大非,谓灯落。亦通。
八者见一觅天医,人间那得还魂药。
久病形神已脱,得斯八脉,虽上工无所用其伎。否则或有可救,无徒以一脉谬诊费人。
举指轻取浮而柔软,重按稍长,这是禀受肝经血气强盛的表现。
脉形浮缓且有力,跳动招展如同高举长竿,这是禀受木气,表示血盛,对应春季的时令。
指下感觉清圆流畅而非滑腻,心神王相(旺盛)的状态必须明察。
脉形溜亮微软,连续不断如同触摸美玉琅玕,这是禀受火气,表示神旺,对应夏季的时令。
去来敦厚浓重,体现土德兴隆。
脉形中和平稳,悠悠然如同鸡脚踩地,这是禀受脾气,表示真元健顺,对应长夏及四季的时令。
和缓轻清,肺气充盈。
脉形轻浮微涩,聂聂然如同榆树荚飘落,这是禀受金气,表示气治,对应秋季的时令。
脉象济以均匀,寻至底部,天赋一生资养肾水。
脉形沉实平均,朗朗然如同棉裹砂石,这是禀受水气,表示精足,对应冬季的时令。
入手感觉迟微或者沉,钟灵毓秀确实在于三阴。
脉形沉细有力,比迟脉稍快一点,这是禀受阴气,对应老年人,以及秋冬的时令。
三阳孕育秀气,你知道吗?春夏时令在寸口部施行。
脉形似大,微弦,比数脉稍缓,这是禀受阳气,对应壮年人,以及春夏的时令。
胃气的存在只因为脉有神气,即使是反关脉(桡动脉解剖位置异常),诊察也等同于常人。
脉形阳刚而不躁急,阴柔而有力,即使病情严重也不空散,这是有胃气的表现,医生可以治愈八九成。脉形不在寸关尺的标准位置,而在关后,称为反关脉。
位次虽然不同,但诊察原理是一样的。李士材说反关脉主贵,这简直令人发笑。
脉来三五次一止,如同雀鸟啄食;
脉来三次或五次出现一次停顿,像鸟啄米一样,还没啄几粒就惊恐回头少停,称为雀啄脉。这是心绝之象。旧注解说脉坚而锐,像鸡的喙,像鸟的嘴,不知所谓。这是脾绝之象。
半晌才来一次,如同屋漏滴水;
脉来极迟极软,像雨停后屋檐漏水,半天滴下一点,称为屋漏脉。这是脾绝之象。
弹石般洪大,重按即无;
脉来坚实迫指,切切然如同弹击中人,称为弹石脉。这是肾绝之象。旧注解说脉劈劈然如手指弹石头,是把脉比作指、石比作肌肤的说法,语焉不详,大概就是这个意思吧。
散乱无伦,怀疑是解索;
脉来头绪纷纭,像已拆开的麻绳,散乱不收。过了一会儿一缕坚劲,如同触摸刀刃,称为解索脉。这是肝绝之象。
鱼逝浮时倏而沉;虾游沉中浮几跃;
脉来或散或断,时而浮时而沉,像鱼戏水,称为鱼逝脉。形体弯曲而跳跃,在沉静中忽然鼓动几下然后离去,称为虾游脉。这是肺绝之象。
鼎沸浑似煮羹初;
脉来极数极躁,像煎煮羹汤烧水,涌涌不停息,称为鼎沸脉。这是阴绝之象。
乍绝忽苏叫做灯落;
脉来宏大,让人发愁,忽然清晰明了。可意会得像灯将熄灭又复明,称为灯落脉。这是阳绝之象。另外,初持脉时朗朗有力,后来变得大而无根,称为灯落脉,也通顺。
这八种脉象见到一种就要寻找天医了,人间哪有还魂药。
久病之人形神已经脱失,得到这八种脉象,即使是最高明的医生也无计可施。否则或许还有可救的机会,不要仅仅因为一种脉象就错误诊断,浪费人力物力。
To identify pathological pulses, one must first examine the normal pulse (Ping Mai), so that diagnostic methods may be accurate.
Lifting the finger reveals a floating and soft quality, while pressing slightly longer; this indicates strong Liver channel Qi and Blood constitution.
The pulse shape is floating, slow, and forceful, moving expansively like holding up a long pole. This reflects Wood Qi, abundant Blood, and corresponds to the Spring season.
Under the fingers, it feels clear and round, not slippery; the Wang Xiang (Prosperous Phase) of the Heart Spirit must be clearly observed.
The pulse shape is smooth, bright, soft, and weak, continuous like touching fine jade (Langgan). This reflects Fire Qi, prosperous Spirit, and corresponds to the Summer season.
Coming and going are thick and dense, demonstrating the prosperity of Earth Virtue.
The pulse shape is moderate, neutral, and flat, leisurely like a chicken stepping on the ground. This reflects Spleen Qi, healthy and smooth True Yuan, and corresponds to the Late Summer and the four seasons.
Harmonious, slow, light, and clear, Lung Qi is full.
The pulse shape is lightly floating with slight choppy qualities, rustling like falling elm seeds. This reflects Metal Qi, regulated Qi, and corresponds to the Autumn season.
The pulse is balanced and even, reaching down to the root; Heaven endowed life nourishes Kidney Water.
The pulse shape is deep, solid, and average, clear like sand wrapped in cotton. This reflects Water Qi, sufficient Essence, and corresponds to the Winter season.
Upon starting, it feels slow, minute, or deep; spiritual endowment truly lies in the Yin channels.
The pulse shape is deep, thin, and forceful, slightly faster than the Slow pulse. This reflects Yin Qi, corresponds to the elderly, and to the Autumn and Winter seasons.
Do you know how the Three Yang channels nurture elegance? The Cun Kou position operates during Spring and Summer.
The pulse shape appears large, slightly wiry, and slower than the Rapid pulse. This reflects Yang Qi, corresponds to adults in their prime, and to the Spring and Summer seasons.
The presence of Stomach Qi is due to the Spirit in the pulse. Even with a Reversed Guan pulse (Radial artery anomaly), diagnosis is equivalent to that of normal individuals.
The pulse shape is Yang-gang but not irritable, Yin-soft yet forceful. Even in severe illness, it is neither empty nor scattered; this indicates the presence of Stomach Qi, and the physician can achieve eight or nine successes out of ten. If the pulse form is not at the standard Cun, Guan, Chi positions but behind the Guan, it is called the Reversed Guan pulse.
Although the position differs, the diagnostic principle remains the same. Li Shicai’s claim that the Reversed Guan pulse signifies nobility is laughable.
Coming three or five times then stopping, like a sparrow pecking;
The pulse comes three or five times before a pause, like a bird pecking millet, startling and pausing after just a few grains; this is called Sparrow Pecking Pulse. It indicates Heart Extinction. Old annotations describe it as firm and sharp, like a chicken's beak or a bird's bill, which is nonsensical. This indicates Spleen Extinction.
Once every half day, like a leaking roof;
The pulse comes extremely slowly and softly, like rainwater dripping from a leaky roof after the rain stops, once every half day; this is called Leaking Roof Pulse. It indicates Spleen Extinction.
Like striking stone, surging but vanishing upon pressure;
The pulse comes firm and hard against the finger, crisp like striking a person; this is called Striking Stone Pulse. It indicates Kidney Extinction. Old annotations describe it as cracking like fingers striking stone, comparing the pulse to the finger and the stone to the skin, which is vague and unclear, likely referring to this concept.
Scattered and disordered, resembling untying a rope;
The pulse comes chaotic, like an untied hemp rope, scattered and unrestrained. After a moment, a single strand becomes firm and tough, like touching a blade; this is called Untying Rope Pulse. It indicates Liver Extinction.
Fish departing, floating then suddenly sinking; shrimp swimming, rising from depth with a few leaps;
The pulse comes either scattered or interrupted, sometimes floating, sometimes sinking, like fish playing in water; this is called Fish Departing Pulse. The shape is curved and jumping, suddenly pulsating a few times amidst stillness before leaving; this is called Shrimp Swimming Pulse. It indicates Lung Extinction.
Boiling like a pot of soup just beginning to cook;
The pulse comes extremely rapid and irritable, like boiling soup or water, surging without any rest; this is called Boiling Cauldron Pulse. It indicates Yin Extinction.
Suddenly extinct then revived, called Lamp Falling;
The pulse comes large, causing distress, then suddenly clear and distinct. It can be interpreted as a lamp about to go out suddenly flaring up again; this is called Lamp Falling Pulse. It indicates Yang Extinction. Alternatively, if the pulse is initially clear and strong but later becomes large and rootless, it is also called Lamp Falling, which is also acceptable.
If one of these eight pulses appears, seek a heavenly doctor; where in the human world is there a soul-returning medicine?
For chronic illnesses where form and spirit have already detached, obtaining any of these eight pulses means that even the highest skilled physicians have no technique to employ. Otherwise, there might be hope for rescue; do not merely misdiagnose based on a single pulse, wasting people's efforts.