其有所云浮者,下指即显浮象,举之泛泛而流利,按之稍减而不空。凡芤大洪革,虚濡微散,皆
属浮类。不似虚脉按之不振,芤脉按之减小,濡脉绵软无力也。(语出张璐。又濒湖体状诗曰∶浮脉惟从肉上
行,如循榆荚似毛轻;三秋得令知无恙,久病逢之却可惊。又相类诗曰∶浮如木在水中浮,浮大中空乃是芤;
拍拍而浮是洪脉,来时虽盛去悠悠。浮脉轻平如捻葱,虚来迟大豁然空;浮而柔细方为濡,散似杨花无定踪。)
浮为虚损不足。凡风暑胀满不食,表热喘急等症,皆有上浮之义。若使浮而兼大,则为伤风;浮而兼紧,则为
伤寒;(张璐曰∶外感暴得,多见人迎浮盛。)浮而兼滑,则为宿食;浮而兼缓,则为湿滞;浮而兼芤,则为
失血;浮而兼数,则为风热;浮而兼洪,则为狂躁。然总不越有力无力,有神无神,以为区别。若使神力俱有,
是为有余,或为火发,或为气壅,或为热越,可类推也。神力俱无,是为不足,或为精衰,或为气损,可因明
也。岂可概指为表为热乎。(张景岳曰∶凡浮大弦硬之极,甚至四倍以上者,内经谓之关格,此非有神之谓,
乃真阴虚极,而阳亢无根,大凶兆也。林之翰曰∶浮脉须知主里。凡内虚之症,无不兼浮。如浮芤失血;浮革
亡血;内伤感冒,而见虚浮无力;痨瘵阴虚,而见浮大兼疾;火衰阳虚,而见浑浑革至,浮大有力。又如真阴
竭于下,孤阳浮于上,脉必浮大而无力,按之微细欲绝者,当益火之源。岂可以脉浮不审虚实,而妄用发表之
剂乎。)
那些被称为浮脉的,手指轻按即显现出浮象,轻取时感觉泛泛而流利,重按时力度稍减但脉形不空。凡是芤脉、大脉、洪脉、革脉、虚脉、濡脉、微脉、散脉,都属于浮脉类。它们不像虚脉那样重按无力不振,不像芤脉那样重按时脉管减小,也不像濡脉那样绵软无力。(这段话出自张璐。另外李时珍在《濒湖脉学》的体状诗中说道:浮脉只在肌肉表层运行,就像触摸榆荚或羽毛那样轻盈;在秋季得到这种脉象说明身体无恙,但在久病之人身上出现却令人惊恐。又在相类诗中说道:浮脉如同木头在水中漂浮,浮大中空的是芤脉;搏动拍击有力而浮的是洪脉,来势虽盛去势悠长的是……(注:此处原文诗句略有省略,意指洪脉或紧脉等对比,依文意理解为对洪脉的描述);浮脉轻取平和如捻葱叶,虚脉来得迟大而豁然中空;浮而柔细才是濡脉,散脉像杨花一样没有固定的踪迹。)浮脉主虚损不足。凡是风邪、暑邪导致的胀满、食欲不振,表热、气喘急促等症状,都有上浮的含义。如果浮脉兼见大脉,则是伤风;浮脉兼见紧脉,则是伤寒;(张璐说:外感病突然发作,多见其人迎穴处脉象浮盛。)浮脉兼见滑脉,则是宿食停滞;浮脉兼见缓脉,则是湿邪阻滞;浮脉兼见芤脉,则是失血;浮脉兼见数脉,则是风热;浮脉兼见洪脉,则是狂躁。然而总归不离有力与无力、有神与无神,以此作为区别。如果神气与力量俱有,这是有余证,或是火邪发作,或是气机壅滞,或是热邪外越,可以类推。如果神气与力量俱无,这是不足证,或是精髓衰败,或是元气受损,可以由此明了。怎么能一概指为表证或热证呢?(张景岳说:凡是浮大弦硬到了极点,甚至达到正常四倍以上的,《内经》称之为关格,这不属于有神的情况,而是真阴极度亏损,阳气亢盛而无根,是大凶的征兆。林之翰说:浮脉必须知道它主治里证。凡是内部虚损的疾病,无不兼见浮脉。如浮芤脉主失血;浮革脉主亡血;内伤感冒,见到虚浮无力;痨瘵阴虚,见到浮大兼疾速;火衰阳虚,见到浑浑革至,浮大有力。又如真阴在下枯竭,孤阳在上漂浮,脉必浮大无力,重按微细欲绝,应当补益火的源头。怎么能因为脉浮就不审察虚实,而妄用发表的药物呢?)
Those referred to as *Fu Mai* (Floating Pulse) reveal a floating image immediately upon light pressure; when lifted lightly, it feels superficial and smooth, and when pressed heavily, the force decreases slightly but does not feel empty. All pulses such as *Kou Mai* (Hollow Pulse), *Da Mai* (Large Pulse), *Hong Mai* (Surging Pulse), *Ge Mai* (Leather Pulse), *Xu Mai* (Deficiency Pulse), *Ru Mai* (Soggy Pulse), *Wei Mai* (Minute Pulse), and *San Mai* (Scattered Pulse) all belong to the category of floating pulses. They differ from *Xu Mai* (Deficiency Pulse), which fails to resonate upon heavy pressing; from *Kou Mai* (Hollow Pulse), which diminishes in size upon heavy pressing; and from *Ru Mai* (Soggy Pulse), which is soft and powerless. (This passage is attributed to Zhang Lu. Additionally, Li Shizhen’s poem in *Binhu Tizhuang Shi* states: "The Floating pulse moves only along the flesh, like touching elm seeds or light feathers; obtaining this pulse in the third autumn month indicates health, but encountering it in chronic illness is alarming." His poem on similar pulses states: "Floating resembles wood floating in water; large and hollow in the middle is Kou (Hollow); beating and floating is Hong (Surging); coming vigorously but departing leisurely [refers to Hong/Surging]; Floating pulse is light and level like rolling scallion stems; Xu (Deficiency) comes late and large, suddenly empty; Floating with softness and thinness is Ru (Soggy); San (Scattered) resembles willow catkins without fixed traces.") The Floating pulse indicates deficiency and insufficiency. Symptoms such as distension and anorexia caused by Wind or Summerheat, and exterior heat with panting and urgency, all carry the meaning of floating upward. If the Floating pulse is accompanied by Large, it indicates Wind Injury; if accompanied by Tight, it indicates Cold Damage; (Zhang Lu stated: In acute external contractions, the Renying pulse often appears floating and vigorous.) If accompanied by Slippery, it indicates retained food; if accompanied by Slow, it indicates dampness stagnation; if accompanied by Hollow, it indicates blood loss; if accompanied by Rapid, it indicates Wind-Heat; if accompanied by Surging, it indicates mania and restlessness. However, the distinction ultimately lies in whether the pulse is Forceful or Forceless, and whether it has Spirit or lacks Spirit. If both Spirit and Force are present, it indicates Excess, which may be due to Fire flare-up, Qi stagnation, or Heat escaping outward, which can be inferred analogously. If both Spirit and Force are absent, it indicates Deficiency, which may be due to essence depletion or Qi damage, which can be understood clearly. How can one generally categorize it merely as Exterior or Heat? (Zhang Jingyue stated: When Floating, Large, Wiry, and Hard reach extreme levels, even exceeding four times the normal rate, the *Neijing* calls this Guan Ge (Blockage and Reflux). This is not what is meant by having Spirit; rather, it signifies extreme depletion of True Yin with unrooted Yang hyperactivity, a dire omen. Lin Zhihan stated: One must understand that the Floating pulse governs Interior conditions. All internal deficiency syndromes are accompanied by Floating. For example, Floating-Hollow indicates blood loss; Floating-Leather indicates loss of blood; internal injury with cold-dampness presents as weak and floating; tuberculosis with Yin deficiency presents as Large and Rapid; fire decline and Yang deficiency present as chaotic and leather-like, Floating and Large yet Forceful. Furthermore, when True Yin is exhausted below and solitary Yang floats above, the pulse must be Floating, Large, and Forceless, becoming minute and nearly imperceptible upon heavy pressing; in such cases, one should tonify the source of Fire. How can one blindly use exterior-releasing formulas simply because the pulse is Floating without assessing Deficiency or Excess?)