长则指下迢迢,上溢鱼际,下通赤泽,过于本位,三部举按皆然。凡实牢弦紧,皆属长类。不似
大脉举之盛大,按之少力也。(语出张璐。又濒湖体状相类诗曰∶过于本位脉名长,弦则非然但满张;弦脉与
长争较远,良工尺度自能量。李士材曰∶状如长竿,直上直下,首尾相应,非若他脉上下参差首尾
不匀者也。)长为气治无病之象,(经曰∶长则气治。)然必长而和缓方为无病。若使长而浮盛,其在外感,
则为经邪方张;内损,则为阴气不足而脉上盛。至于风邪陷阴,脉应微涩;乃于阴脉微细之中,而忽兼有长脉,
是为热邪外发,而有将愈之兆矣,又岂可作病进之象乎。(仲景曰∶太阴中风,四肢烦疼,阳脉微阴脉涩而长
者为欲愈。)
短则寸上尺下,低于寸尺。凡微涩动结,皆属短类。不但小脉之三部皆小弱不振,伏脉之独伏
匿不前也。(语出张璐。又濒湖体状相类诗曰∶两头缩缩名为短,涩短迟迟细且难;短涩而浮秋喜见,三春为
贼有邪干。)短则止见尺寸。
若关中见短,则上不通寸为阳绝,下不通尺为阴绝矣,故关从无见短之理。(盛同文云∶关不见短。李士材曰∶
短脉只见于尺寸。然尺寸可短,依然落于阴绝阳绝矣;殊不知短脉非两头断绝也,特两头俯而沉下,中间突而
浮起,仍自贯通者也。)短为阳气不接,或中有痰气食积而成。然痰气食积阻碍气道,亦由阳气不力,始见阻
塞。故凡见有阻塞之症者,当于通豁之内加以扶气之品,使气治而豁自见矣。若使中无阻塞而脉见短隔,急当
用大温补以救垂绝,否则便尔不治矣。
长脉的特征是手指下感觉脉动悠长,向上超过鱼际穴部位,向下通达赤泽(尺泽穴附近),超出本位范围,在寸、关、尺三部无论轻取还是重按都是如此。凡是实脉、牢脉、弦脉、紧脉,都属于长脉的类别。这与大脉不同,大脉轻取时盛大有力,但重按时力量稍减。(这段话出自张璐。另外李时珍《濒湖脉学》中描述体状相似的诗说:超出本位的脉称为长脉,弦脉则不然,只是感觉饱满张开;弦脉与长脉相比距离较远,高明的医生自有标准来衡量。李士材说:长脉形状像长竿,直上直下,首尾相应,不像其他脉象上下参差、首尾不均匀。)长脉是气机调畅、无病的征象。(医经说:长脉代表气机调治。)但是必须长而和缓才算是无病。如果长脉兼见浮盛之象,在外感病中,说明外邪正盛;在内伤虚损中,则是阴气不足导致脉象上部盛实。至于风邪陷入阴分,脉象应当微涩;如果在阴脉微细之中,忽然兼见长脉,这是热邪向外发散的征兆,是有即将痊愈的迹象,又怎么可以看作是病情加重的表现呢?(张仲景说:太阴中风,四肢烦痛,阳脉微、阴脉涩而长的,是想要痊愈的表现。)
短脉的特征是寸部之上和尺部之下,低于正常的寸尺范围。凡是微脉、涩脉、动脉、结脉,都属于短脉的类别。这不同于小脉的三部皆小弱不振,也不同于伏脉的独自潜伏隐匿不前。(这段话出自张璐。另外李时珍《濒湖脉学》中描述体状相似的诗说:两头缩缩的名为短脉,涩短脉迟缓细微且困难;短涩而浮的脉象在秋季喜见,但在春三季出现则为贼邪干扰。)短脉只见于寸部和尺部。
如果在关部见到短脉,那么向上不通于寸部就是阳绝,向下不通于尺部就是阴绝了,所以关部从来没有见到短脉的道理。(盛同文说:关部不见短脉。李士材说:短脉只见于寸尺两部。然而寸尺若短,依然落入阴绝阳绝的境地;殊不知短脉并不是两头断绝,而是两头俯沉向下,中间突起浮起,仍然自身贯通的。)短脉是因为阳气不相接续,或者中有痰气、食积形成。但是痰气食积阻碍气道,也是由于阳气不力,才开始出现阻塞。所以凡是见到有阻塞症状的患者,应当在通豁的药物中加入扶助元气的药品,使气机调畅而豁通自然显现。如果中部没有阻塞而脉象出现短隔,应当紧急使用大温补的方法来挽救垂危的阳气,否则就会无法治愈了。
The *chang* (Long) pulse is characterized by a sensation of length under the fingers, extending upward beyond the *Yuchi* (L.I.10) area and downward toward the *Chize* (LU.5) region, exceeding its normal position. This is observed in all three positions (Cun, Guan, Chi) upon both light and heavy palpation. Pulses such as *Shi* (Full), *Lao* (Deep-Firm), *Xian* (Wiry), and *Jin* (Tight) all belong to the category of Long pulses. This differs from the *Da* (Large) pulse, which appears grand and forceful upon light palpation but loses some strength upon heavy pressure. (This passage is attributed to Zhang Lu. Additionally, Li Shizhen's poem on similar pulse characteristics states: "Exceeding the normal position defines the Long pulse; the Wiry pulse is not so, merely feeling full and distended; The distinction between Wiry and Long is far apart, measured accurately by skilled physicians." Li Shicaipoints out: "It resembles a long bamboo pole, straight up and down, with head and tail corresponding, unlike other pulses that are uneven at the top and bottom or irregular in head and tail.") A Long pulse indicates harmonious Qi and the absence of disease. (The Classics state: "A Long pulse signifies regulated Qi.") However, it must be Long and gentle/relaxed to truly indicate health. If the Long pulse is also floating and vigorous, in external contraction diseases, it indicates that pathogenic factors are flourishing; in internal deficiency damage, it indicates insufficient Yin Qi leading to an excess of pulse energy in the upper part. Regarding wind pathogens sinking into the Yin aspect, the pulse should be slightly choppy (*Se*) and fine; if a Long pulse suddenly appears amidst these fine and subtle Yin pulses, it signifies the outward emission of heat pathogens and is a sign of impending recovery. How could this be interpreted as a sign of disease progression? (Zhang Zhongjing stated: "In Taiyin Wind Strike, with vexing pain in the four limbs, if the Yang pulse is slight, the Yin pulse is choppy and Long, it indicates impending recovery.")
The *duan* (Short) pulse is characterized by being lower than the normal range at both the Cun (inch) and Chi (cubit) positions. Pulses such as *Wei* (Minute), *Se* (Choppy), *Dong* (Surging), and *Jie* (Knotted) all belong to the category of Short pulses. This is distinct from the *Xiao* (Small) pulse, where all three positions are weak and unvigorous, and from the *Fu* (Deep) pulse, which hides and does not advance. (This passage is attributed to Zhang Lu. Additionally, Li Shizhen's poem states: "Shrinking at both ends is named Short; Choppy and Short are slow, fine, and difficult; A Choppy-Short-Floating pulse is favorable in Autumn, but in the three Spring months, it indicates evil invasion.") A Short pulse is seen only at the Cun and Chi positions.
If a Short pulse is seen at the Guan (bar) position, it means there is no connection upward to the Cun, constituting Yang Extinction, and no connection downward to the Chi, constituting Yin Extinction. Therefore, there is no rationale for a Short pulse to appear at the Guan position. (Sheng Tongwen said: "The Guan position does not show a Short pulse." Li Shicaipointed out: "The Short pulse is seen only at the Cun and Chi positions. However, if Cun and Chi are short, they still fall into Yin and Yang Extinction; one must not know that the Short pulse is not severed at both ends, but rather sinks downward at the ends while bulging upward in the middle, remaining internally connected.") A Short pulse results from the disconnection of Yang Qi, or from the accumulation of Phlegm-Qi or Food Stagnation in the interior. However, the obstruction of the Qi pathway by Phlegm-Qi or Food Stagnation occurs because Yang Qi is insufficient, leading to blockage. Therefore, for patients presenting with symptoms of obstruction, one should add Qi-tonifying herbs within the formula for unblocking and draining, so that when Qi becomes regulated, the unblocking will naturally manifest. If there is no interior obstruction but the pulse shows a Short and interrupted quality, urgent use of major warming and tonifying methods is required to save the perishing Yang Qi; otherwise, the condition will be incurable.