二沉者阴也。指下寻之似有。举之全无。缓度三关。状若烂绵曰沉。主气胀
两胁。手足时冷。
沉者。阴水也。水性沉下。寻之似有。举之全无。水之性也。水性漂流。缓度
三关。水之状也。水性濡 。状若烂绵。水之形也。然水性阴冷。冷则生气。
故气胀两胁。而手足时冷也。
按脉经云。沉脉举之不足。按之有余。一曰重按之乃得。经云。沉为水为
实。又为鬼疰。
按之似有举还无。气满三焦脏腑虚。冷热不调三部壅。通肠健胃始能除。
夫沉脉主气。为诸阴之首。今云按之似有举还无。是沉而无力也。刘氏
曰。沉而无力为气。假令其人冷热调和。则脏腑充实。而上中下三焦之
气。自然和畅。而无壅滞之患矣。今因冷热不调。则卫气不得行于阳分。
卫气不行于阳分。则三焦之气满。而脏腑虚矣。治之者。当用辛温之药
利之。以通其肠。复用温补之药和之。以健其胃。肠胃之气宣通。则三部
之气条达。使卫气复行于阳分。而脉道自无沉匿矣。
按经云。沉而迟。腹藏有冷病。又云。脉来沉沉泽泽。四肢不仁。而重土祟。
又云。沉而滑为下血。亦为背膂痛。千金方作下重。
寸脉沉兮胸有痰。
寸部所以候胸中者。今寸部见沉。是为水气泛而为痰矣。
按千金方云。寸口脉沉而滑者。胸中有水气。面目肿。有微热。为风水。又
云。寸口脉沉。大而滑。沉即为血实。滑即为气实。血气相搏。入脏即死。入
腑即愈。脉经云。寸口沉胸中痛引背。又云寸口脉沉。胸中引胁痛。胸中
有水气。宜服泽漆汤。针巨阙泻之。又云。寸口脉沉。胸中短气。又云。寸口
脉沉而坚者。病在中。又云。寸口脉沉而弱者。曰寒。又云寸口脉沉而弱
者。发必堕落。又云。寸口脉沉而紧。若心下有寒。时痛。有积聚。又云。寸口
脉沉而喘者。寒热。
当关气短痛难堪。
关所以候腹中者。中气温和。则舒畅而无痞满疼痛之患矣。今关中而
见沉。则为腹中有冷气。腹中有冷气。则闭塞而不通。闭塞而不通。则腹
中疼痛。呼吸不利。而气短难堪矣。
按脉经云。关上沉。心痛。上吞酸。又云。关脉沉。心下有冷气。苦满吞酸。宜
服白薇茯苓丸。针胃管补之。
若在尺中腰脚重。小便稠数色如泔。
尺部者。阴部也。所以候肾与三焦膀胱者。左肾主水。右肾主火。膀胱为
水。三焦为火。故水火既济。阴阳相维。而后腰脚得以便利。水道得以澄
清。今尺中而见沉脉。是有阴而无阳。有水而无火。致使阳气不行。则腰
脚重滞。决渎失职。而小便如泔矣。
按脉经云。尺中沉。引背痛。又云。尺脉沉。腰背痛。宜服肾气丸。针京门补
之。
沉脉属于阴脉。手指轻取时感觉若有若无，重按反而消失。脉搏缓慢通过寸、关、尺三部，形态像腐烂的棉絮一样，这就是沉脉。它主要主气胀病，表现为两胁部胀满，手足时常发冷。
沉脉对应五行中的水，属阴。水的性质是下沉的，所以轻取似有，重按反无，这是水的本性。水流流动的特性，体现在脉搏缓慢通过三部，这是水的动态表现。水性湿润濡软，脉象像腐烂的棉絮，这是水的形态表现。然而水性属阴且寒冷，寒则容易生寒气，所以导致两胁气胀和手足时常发冷。
根据《脉经》记载：沉脉轻取不足，重按有余。另一种说法是必须重按才能触及。经典中说：沉脉主水饮，也主实证，还主鬼疰（一种传染性或精神类疾病）。
重按时似乎有脉动，轻举时脉象又消失，这是气机壅满三焦而脏腑虚弱的表现。冷热不调导致三部脉气壅滞，只有通利肠道、健运脾胃才能消除病症。
沉脉主气，为诸阴脉之首。现在说“重按似有，轻举还无”，说明沉脉而无力。刘氏说：沉而无力主气病。假如一个人冷热调和，那么脏腑充实，上、中、下三焦的气机自然和畅，就不会有壅滞的隐患。如今因为冷热不调，卫气不能运行于阳分。卫气不在阳分运行，就会导致三焦之气壅满，而脏腑虚弱。治疗时，应当使用辛温的药物来利导气机，以通利肠道；再复用温补的药物来调和，以健运脾胃。肠胃之气宣通后，三部脉气就会条达顺畅，使卫气重新运行于阳分，脉道自然就不再沉匿了。
根据经典记载：沉而迟的脉象，表明腹脏有冷病。又说：脉来深沉润泽，四肢麻木不仁，这可能是由于邪祟所致。又说：沉而滑的脉象，主下部出血，也主背部脊柱疼痛，《千金方》中记作“下重”（肛门坠胀感）。
寸口脉沉，说明胸中有痰饮。
寸部是用来诊察胸中情况的。现在寸部出现沉脉，这是水气泛滥化为痰饮的表现。
根据《千金方》记载：寸口脉沉而滑，说明胸中有水气，面目浮肿，伴有轻微发热，这是风水病。又说：寸口脉沉大而滑，沉代表血实，滑代表气实。血气和搏结，侵入五脏则死，侵入六腑则愈。《脉经》说：寸口脉沉，胸中痛牵引至背部。又说：寸口脉沉，胸中牵引胁肋疼痛，胸中有水气，适宜服用泽漆汤，针刺巨阙穴并采用泻法。又说：寸口脉沉，胸中短气。又说：寸口脉沉而坚，病在体内。又说：寸口脉沉而弱，称为寒证。又说：寸口脉沉而弱，头发必定脱落。又说：寸口脉沉而紧，如果心下有寒，时常疼痛，且有积聚。又说：寸口脉沉而喘急，主寒热病。
关部脉沉，气短疼痛难以忍受。
关部是用来诊察腹中情况的。中气温和，就会舒畅而没有痞满疼痛的隐患。现在关部见到沉脉，说明腹中有冷气。腹中有冷气，就会闭塞不通。闭塞不通，就会导致腹中疼痛，呼吸不利，气短难以忍受。
根据《脉经》记载：关上脉沉，心痛，向上泛吐酸水。又说：关脉沉，心下有冷气，苦于胀满吞酸，适宜服用白薇茯苓丸，针刺胃管穴并采用补法。
如果在尺部见到沉脉，腰脚沉重，小便频数且浑浊如米泔水。
尺部是阴部，用来诊察肾与三焦、膀胱的情况。左肾主水，右肾主火，膀胱属水，三焦属火。所以水火既济，阴阳相互维系，之后腰脚才能便利，水道才能清澈。现在尺部见到沉脉，是有阴而无阳，有水而无火。致使阳气不能运行，导致腰脚沉重滞涩，决渎（疏通水道）失职，从而小便浑浊如米泔水。
根据《脉经》记载：尺中脉沉，牵引背痛。又说：尺脉沉，腰背痛，适宜服用肾气丸，针刺京门穴并采用补法。
Chen (Deep) pulse belongs to Yin. Under the fingers, it feels as if present when lightly pressed, but completely absent when lifted. It moves slowly through the three positions (Cun, Guan, Chi), resembling rotten cotton in texture; this is the Chen pulse. It primarily indicates Qi distension, manifesting as fullness in both hypochondria and coldness of the hands and feet from time to time.
Chen corresponds to Water in the Five Elements and is Yin. The nature of water is to sink downwards; thus, it feels as if present upon light palpation but vanishes upon lifting, which is the intrinsic nature of water. The flowing characteristic of water is reflected in the pulse moving slowly through the three positions, representing the dynamic state of water. The moistening and soft nature of water manifests as a texture resembling rotten cotton, representing the form of water. However, water nature is Yin and cold; coldness generates Qi stagnation, hence leading to Qi distension in the hypochondria and intermittent coldness of the extremities.
According to the *Mai Jing* (Pulse Classic): "The Chen pulse is insufficient upon light lifting but abundant upon heavy pressing." Another view states that it can only be felt with heavy pressure. The classics state: "Chen indicates Water retention and Excess patterns," and also refers to "Gui Zhu" (a type of infectious or spirit-related disease).
"Heavy pressing seems to have it, light lifting makes it vanish": This indicates Qi fullness in the San Jiao (Triple Burner) and deficiency of the Zang-Fu organs. Imbalance of Cold and Heat causes obstruction in the three positions; only by unblocking the intestines and strengthening the stomach can the condition be cured.
The Chen pulse governs Qi and is the head of all Yin pulses. The description "heavy pressing seems to have it, light lifting makes it vanish" indicates a Chen pulse without force. Mr. Liu stated: "Chen without force indicates Qi pathology." If a person's Cold and Heat are harmonious, the Zang-Fu organs will be substantial, and the Qi of the Upper, Middle, and Lower San Jiao will flow smoothly without obstruction. Now, due to the imbalance of Cold and Heat, the Wei Qi (Defensive Qi) cannot circulate in the Yang aspect. Since Wei Qi does not circulate in the Yang aspect, the Qi of the San Jiao becomes full, while the Zang-Fu become deficient. In treatment, acrid-warm herbs should be used to promote circulation and unblock the intestines, followed by warm-tonifying herbs to harmonize and strengthen the stomach. Once the Qi of the stomach and intestines is unblocked and circulating, the Qi in the three positions will become smooth and free-flowing, allowing Wei Qi to re-enter the Yang aspect, and the pulse vessels will naturally cease to hide deeply.
According to the classics: "Chen and slow indicate cold diseases in the abdominal viscera." Also: "A pulse that comes deep and moist indicates numbness of the four limbs, possibly due to evil influences." Also: "Chen and slippery indicate bleeding from the lower orifices, or pain in the back and spine; the *Qian Jin Fang* records this as 'heaviness in the lower region'."
If the Cun position is Chen, there is phlegm in the chest.
The Cun position is used to inspect the chest. If the Cun position presents a Chen pulse, it indicates that Water Qi has overflowed and transformed into Phlegm.
According to the *Qian Jin Fang*: "If the Cun Kou pulse is Chen and slippery, there is Water Qi in the chest, facial swelling, slight fever, indicating Feng Shui (Wind-Water edema)." Also: "If the Cun Kou pulse is Chen, large, and slippery, Chen indicates Blood excess, and Slippery indicates Qi excess. When Blood and Qi contend and enter the Zang organs, death ensues; if they enter the Fu organs, recovery occurs." The *Mai Jing* states: "Cun Kou Chen indicates chest pain radiating to the back." Also: "Cun Kou Chen indicates chest pain radiating to the hypochondria, with Water Qi in the chest; Ze Qi Tang is suitable, and needle Juque with reducing method." Also: "Cun Kou Chen indicates shortness of breath in the chest." Also: "Cun Kou Chen and firm indicates disease within." Also: "Cun Kou Chen and weak indicates Cold." Also: "Cun Kou Chen and weak indicates hair loss." Also: "Cun Kou Chen and tight, if there is Cold under the heart, causing periodic pain and accumulation." Also: "Cun Kou Chen and panting indicates alternating Cold and Heat."
At the Guan position, Qi is short and pain is unbearable.
The Guan position is used to inspect the abdomen. If the middle Qi is mild and harmonious, there will be no discomfort of fullness or pain. If a Chen pulse appears at the Guan position, it indicates Cold Qi in the abdomen. Cold Qi in the abdomen causes blockage and obstruction. Obstruction leads to abdominal pain, difficulty in breathing, and unbearable shortness of breath.
According to the *Mai Jing*: "Guan Shang Chen indicates heart pain and acid regurgitation." Also: "Guan Mai Chen indicates Cold Qi under the heart, bitter fullness, and acid regurgitation; Bai Wei Fu Ling Wan is suitable, and needle Weiguan with reinforcing method."
If the Chi position shows Chen, the waist and legs feel heavy, and urination is frequent and turbid like rice washings.
The Chi position is the Yin position, used to inspect the Kidneys, San Jiao, and Bladder. The Left Kidney governs Water, the Right Kidney governs Fire; the Bladder belongs to Water, and the San Jiao belongs to Fire. Thus, when Water and Fire interact and Yin and Yang sustain each other, the waist and legs remain agile, and the water passages remain clear. If a Chen pulse appears at the Chi position, it indicates Yin without Yang, Water without Fire. This prevents the Yang Qi from circulating, resulting in heaviness and stiffness of the waist and legs, failure of the Jue Du (water pathways) to function properly, and urine becoming turbid like rice washings.
According to the *Mai Jing*: "Chi Zhong Chen indicates pain radiating to the back." Also: "Chi Mai Chen indicates lumbar and back pain; Shen Qi Wan is suitable, and needle Jingmen with reinforcing method."