关前弱脉阳道虚。关中有此气多疏。若在尺中阴气绝。酸疼引变上皮肤。
寸。阳位也。寸部见弱。谓之阳道虚。尺。阴位也。尺部见弱。谓之阴气绝。关。
阴阳交会之所也。关部见弱。谓之阴阳不相维。故曰气多疏也。然尺部
见弱。何以酸疼引变上皮肤也。尺以候肾。肾虚则病酸疼。尺所以候下
焦者。卫出下焦。卫气者。阳气也。所以温分肉。而实皮肤者也。尺部而见
弱。则阴气绝。而阳无所根据。则不能温分肉。而实皮毛。故酸疼引变于皮
肤之上也。
按脉经云。寸弱阳气虚。关弱无胃气。尺弱少血。又云。寸口脉弱。阳虚自
汗出而短气。宜服茯苓汤。内补散。适饮食消息。勿极劳。针胃管补之。又
云。关脉弱。胃气虚。胃中有客热。脉弱为虚热作病。其虽曰有热。不可大
攻之。热去则寒起止宜服竹叶汤。针胃管补之。又云。尺脉弱。阳气少。发
热骨烦。宜服前胡汤。干地黄汤。针关元补之。
又按仲景曰。假令尺脉弱。名曰阴不足。阳气下陷。入阴中而发热也。
云岐子曰。九道脉者。从天地九数之理说也。经曰。善言天者。必有应于人。
是以天有九星。地有九州。人有九脏。亦有九野。故立九道脉。以应天地阴
阳之法也。以长为干。清阳发腠理。以短为坤。浊阴归六腑。以虚为离。心中
惊则血衰。以促为坎。脉进则死。退则生。以结为兑。发在脐傍。以代为中上
主上中下三元正气。以牢为震。前后有水火相乘之气。以动为艮。主血山
衰。以细为异。主秋金有余。此九道脉。以应九脏九宫之法也。
九道脉
关前脉弱,表示阳气虚弱。关部出现这种脉象,说明气机多显疏泄不畅。若在尺部见到弱脉,则是阴气衰竭的表现,会导致酸痛并牵引变化至皮肤表面。
寸部属于阳位。在寸部见到弱脉,称为“阳道虚”。尺部属于阴位。在尺部见到弱脉,称为“阴气绝”。关部是阴阳交会的地方。在关部见到弱脉,称为阴阳相互维系的关系失调,所以说气机多显疏泄不畅。然而,尺部见到弱脉,为什么会出现酸痛并牵引变化至皮肤之上呢?尺部用来候察肾脏。肾虚则产生酸痛病症。尺部之所以用来候察下焦,是因为卫气出于下焦。卫气,属于阳气,作用是温煦肌肉腠理,并使皮肤致密坚固。如果尺部见到弱脉,就是阴气衰竭,阳气失去依附的根本,就不能温煦肌肉腠理,也不能使皮毛致密坚固,所以酸痛会牵引变化于皮肤之上。
按照《脉经》所说:寸部脉弱,是阳气虚;关部脉弱,是无胃气;尺部脉弱,是血少。又说:寸口脉弱,阳气虚导致自汗出且短气,适宜服用茯苓汤、内补散,通过调节饮食来调养,不要过度劳累,针刺胃管穴(指足三里或中脘等胃经穴位,此处泛指补益胃气之穴)以补法治疗。又说:关部脉弱,是胃气虚,胃中有客热。脉弱是由于虚热致病。虽然说是内有热,但不可用猛烈攻下的方法。热邪去除后寒症就会停止,适宜服用竹叶汤,针刺胃管穴以补法治疗。又说:尺部脉弱,是阳气少,出现发热、骨节烦扰的症状,适宜服用前胡汤、干地黄汤,针刺关元穴以补法治疗。
又按照张仲景所说:假如尺部脉弱,名叫“阴不足”,阳气下陷,进入阴分而发热。
云岐子说:九道脉,是从天地九数的道理来说明的。医经说:善于谈论天道的人,必定有对应于人道的表现。因此天有九星,地有九州,人有九脏,也有九野。所以设立九道脉,以对应天地阴阳的法度。以长脉为乾,清阳发散于腠理;以短脉为坤,浊阴归于六腑;以虚脉为离,心中受惊则血衰;以促脉为坎,脉势进则死,退则生;以结脉为兑,病变发于脐旁;以代脉为中宫之主,统摄上中下三元正气;以牢脉为震,前后有水火相乘之气;以动脉为艮,主血山衰败;以细脉为异,主秋金有余。这九道脉,以对应九脏九宫的法度。
The pulse at the Guan position (Cun-Guan-Chi) being weak indicates deficiency of Yang Qi. If this pulse is found at the Guan position, it suggests that Qi is often dispersed and unregulated. If a weak pulse is seen at the Chi position (Cun-Guan-Chi), it signifies the exhaustion of Yin Qi, leading to soreness and pain that radiates and alters the condition of the skin.
The Cun position (Cun-Guan-Chi) belongs to Yang. A weak pulse at the Cun position is termed "Deficiency of the Yang Path." The Chi position (Cun-Guan-Chi) belongs to Yin. A weak pulse at the Chi position is termed "Exhaustion of Yin Qi." The Guan position (Cun-Guan-Chi) is where Yin and Yang intersect. A weak pulse at the Guan position is termed "Yin and Yang failing to sustain each other," hence it is said that Qi is often dispersed. However, why does a weak pulse at the Chi position lead to soreness and pain radiating to the skin? The Chi position is used to observe the Kidneys. When the Kidneys are deficient, soreness and pain occur. The reason the Chi position observes the Lower Jiao is because Wei Qi (Defensive Qi) originates from the Lower Jiao. Wei Qi is a form of Yang Qi; its function is to warm the muscle tissue and consolidate the skin. If a weak pulse is seen at the Chi position, it means Yin Qi is exhausted, and Yang Qi has no foundation to rely upon. Consequently, it cannot warm the muscle tissue or consolidate the skin and hair follicles, thus causing soreness and pain to radiate and alter the condition of the skin.
According to the *Mai Jing* (Pulse Classic): A weak pulse at the Cun position indicates deficiency of Yang Qi; a weak pulse at the Guan position indicates absence of Stomach Qi; a weak pulse at the Chi position indicates insufficient Blood. It also states: A weak pulse at the Cunkou position, with deficiency of Yang Qi leading to spontaneous sweating and shortness of breath, is suitable for treating with Fuling Tang (Poria Decoction) and Neibu San (Internal Tonifying Powder). One should adjust diet and lifestyle, avoid excessive labor, and needle the Weiguan acupoint(s) using the tonification method. It further states: A weak pulse at the Guan position indicates deficiency of Stomach Qi and the presence of exogenous heat in the Stomach. A weak pulse arises from pathological changes due to deficient heat. Although there is heat, one must not use harsh purgative methods. Once the heat is cleared, the cold symptoms will cease. It is suitable to take Zhuye Tang (Bamboo Leaf Decoction) and needle the Weiguan acupoint(s) using the tonification method. It also states: A weak pulse at the Chi position indicates scarcity of Yang Qi, manifesting as fever and bone irritability. It is suitable to treat with Qianhu Tang (Peucedanum Decoction) or Gadihuang Tang (Rehmannia Decoction), and needle the Guanyuan acupoint using the tonification method.
Furthermore, according to Zhang Zhongjing: If the Chi pulse is weak, it is named "Insufficiency of Yin," where Yang Qi sinks downward and enters the Yin level, causing fever.
Yun Qizi stated: The Nine Pulse Categories are explained based on the principle of the number nine in Heaven and Earth. The Classics state: One who speaks well of Heaven must have correspondences in humanity. Therefore, Heaven has nine stars, Earth has nine provinces, humans have nine Zang organs, and there are also nine regions. Thus, the Nine Pulse Categories were established to correspond to the laws of Yin and Yang in Heaven and Earth. The Chang (Long) pulse represents Qian (Heaven); Clear Yang disperses into the interstices. The Duan (Short) pulse represents Kun (Earth); Turbid Yin returns to the Six Fu organs. The Xu (Empty) pulse represents Li (Fire); if the Heart is startled, Blood declines. The Cu (Rapid) pulse represents Kan (Water); if the pulse advances, death ensues; if it retreats, life prevails. The Jie (Knotted) pulse represents Dui (Lake); pathology manifests beside the umbilicus. The Dai (Intermittent) pulse represents the Center; it governs the upright Qi of the Upper, Middle, and Lower Triple Burners. The Lao (Deep-Firm) pulse represents Zhen (Thunder); there is an interaction of Water and Fire between front and back. The Dong (Moving) pulse represents Gen (Mountain); it governs the decline of the Blood Mountain. The Xi (Fine) pulse is considered distinct; it indicates excess Autumn Metal. These Nine Pulse Categories correspond to the laws of the Nine Zang organs and Nine Palaces.