经曰手少阴脉动甚者。妊子也。谓手少阴俞。神门穴中脉动甚。为有妊之兆。非言动脉之状。言动
脉始于仲景。曰阴阳柑搏。名曰动。阳动则汗出。阴动则发热。形寒恶冷。此三焦伤也。成无己曰。
方其阴阳相搏。而虚者则动。阳虚则阳动。故汗出。阴虚则阴动。故发热。如不发热汗出。而反形
冷恶寒。为三焦伤。阳气不通。庞安常曰。关位占六分。前三分为阳。后三分为阴。若当阳。连寸
口动。而阴静。法当有汗而解。素问曰阳加于阴谓之汗。若当阴。连尺动。而阳静。则发热。素问曰
尺粗为热中。若大汗后。形冷恶寒者。三焦伤。此是死证。动脉只在关上见。惟庞说分明。成氏又
曰阳出阴入。以关为界。关为阴阳之中也。若数脉见关上。无头尾如豆大。动摇者。是阴阳之气相搏也。
厥厥动摇者。自为动摇。不与三部混也。如人在众中。不与众合。名之厥厥。沈氏曰。阳动者。阳不
能卫于肤腠。故汗出也。阴动者。阴不能荣于肌肉。故发热。又仲景云。阳微则恶寒。阴弱则发热。
是也。
动脉〔根源气主阴〕（阴阳相搏形。）〔三关指下碍沉沉〕（关中如豆动摇频。）
动脉见关上。不见于三关。厥厥动摇。不沉沉碍指下也。池氏承讹谬解。故改之。
血出一倒经年月。〔智士名医不可寻〕（为痛为惊载脉经。）
内经曰阴虚阳搏谓之崩。阴脉不足。阳脉盛搏。则内崩。血流下。此动脉为血崩者。即仲景所谓阴动也。
阴虚内损。动数见焉。岂阳搏乎。
〔九〕细者阴也。指下寻之。细细如线。〔来往极微〕（小大于微。常有且细。）曰细。主足胫
髓冷。乏力少气。
脉经曰。细者阴也。直细而软。若丝线之应指。主血少气衰。有此症则顺。非此而得之为逆。故
吐衄血。得沉细则生。盖血行脉中。血既减少。脉所以细也。然虽血少。未至于失血。故脉止于细。
未至于无。血失脉亦失。故芤主失血。是知芤为失血。细为血少。今脉诀言细脉。乃云来往极微。
则微之又微。非细矣。今改之。
乏力无精胫里酸。形容憔悴发毛干。如逢冬季经霜月。不疗其疾必自痊。
冬季后阳气生。或可复其生理耳。亦不可言不疗自痊。今增散数二脉。以足脉经之本旨。
数者阳也。一息六至。又曰去来促急为数。
经曰数则为热。必审其浮沉。知其热在表里。察其大小。知其热之盛衰。亦有如数之脉。经曰
脉至如数。令人暴惊。宜细详之。沈氏曰以阴阳言。数为阳脉。以脏腑言。数为腑病。论邪则为热。论
病则为虚。若夫微数之脉。伤寒则谨不可汗。无病则谨不可劳。此先贤之格言。内经曰数为烦心。惟
小儿之脉。一呼吸间八至。而细数者。为平耳。
散者。大而散者是也。气失血虚。有表无里。故脉散也。
沈氏曰散者不聚之名。仲景曰伤寒咳逆上气。其脉散者死也。若脉有邪气。风也。难经曰浮而大散者
心也。最畏散脉独见。独见则危矣。柳氏曰是散漫无统纪无拘束之义。指下见得来动。一二至中
又至一至。更不曾来往整齐。或动来即动去。或来至多去至少。或去至多来至少。是解散不收聚。
精血走。作根本脱离。不佳之兆。若产妇得之则生子。孕妇得之为堕伤。寻常心脉及夏月。最不宜
独见此脉。
《内经》说：手少阴脉跳动剧烈，是怀孕的征兆。这里指的是手少阴经的俞穴——神门穴处的脉搏跳动明显，这是怀孕的迹象，并非指“动脉”这种脉象。“动脉”这一概念始于张仲景，他说：“阴阳相互搏击，称为动。”阳动则出汗，阴动则发热、身体寒冷、畏寒，这是三焦受损的表现。成无己说：“当阴阳相互搏击时，虚弱的一方会出现动脉。阳虚则出现阳动，所以出汗；阴虚则出现阴动，所以发热。如果不发热、不出汗，反而身体寒冷、畏寒，说明三焦受损，阳气不通。”庞安常说：“关部脉占据六分长度，前三分为阳，后三分为阴。如果是在阳部（寸部），连及寸口处脉动而阴部（尺部）安静，按照法度应当通过出汗而病解。《素问》说：‘阳加于阴谓之汗’。如果是在阴部（尺部），连及尺部脉动而阳部（寸部）安静，则会发热。《素问》说：‘尺部脉粗大表示体内有热’。如果是大汗之后，出现身体寒冷、畏寒的症状，这是三焦受损，属于死证。动脉只在关部可见，只有庞氏的说法很清晰。成无己又说：‘阳出阴入，以关部为界，关部是阴阳的中点。’如果数脉出现在关部，没有头尾，像豆子一样大小，动摇不定，这是阴阳之气相互搏击的结果。‘厥厥’形容脉象自行动摇，不与三部脉混杂在一起，就像人在人群中，不与众人融合，所以命名为‘厥厥’。沈氏说：‘阳动是因为阳气不能卫护肌肤腠理，所以出汗；阴动是因为阴气不能荣养肌肉，所以发热。’这正如张仲景所说：‘阳微则恶寒，阴弱则发热’，说的就是这个道理。
【关于动脉的诗诀】根源在于气主阴，阴阳相搏脉形现。三关指下若沉沉，关中如豆动摇频。
动脉见于关部，不见于寸尺三部。它表现为厥厥动摇，而不是沉实碍指。池氏沿袭了错误的解释，所以我对此进行了修正。
【关于血崩与倒经的诗诀】倒经出血经年久，智士名医难寻觅。为痛为惊载脉经。
《内经》说：“阴虚阳搏谓之崩。”阴脉不足，阳脉盛实搏击，就会导致内崩，血液下行。这里的动脉导致血崩的情况，就是张仲景所说的“阴动”。阴虚内损，脉象表现为动数，哪里是阳搏呢？
【九】细脉属于阴。手指寻按之下，细细如线。往来极其微弱。（比微脉稍大，但持续存在且细。）称为细脉，主要主足胫部骨髓寒冷、乏力、气短。
《脉经》说：“细者阴也。”脉象直细而软，像丝线应指一样，主血少气衰。如果有这些症状，脉象相符则为顺证；如果没有这些症状却出现此脉，则为逆证。所以吐血、衄血患者，如果出现沉细脉，预后良好。因为血液运行在脉管中，血液减少，脉管自然变细。虽然血少，但尚未达到失血的程度，所以脉象仅表现为细，而未至于消失。如果完全失血，脉也会消失，所以芤脉主失血。由此可知，芤脉主失血，细脉主血少。现在的《脉诀》中说细脉“来往极微”，这就比微脉还微了，那就不是细脉了。我现在对此进行修正。
乏力无精胫里酸，形容憔悴发毛干。如逢冬季经霜月，不疗其疾必自痊。
冬季后阳气生发，或许可以恢复生理机能。但不能说不用治疗就能自愈。现在增加散脉和数脉，以补足《脉经》的本意。
数脉属于阳。一息跳动六次。又说：去来急促称为数脉。
《内经》说：“数则为热。”必须审察其浮沉，以知道热邪在表还是在里；观察其大小，以知道热的盛衰。也有像数脉一样的脉象，《内经》说：“脉至如数，令人暴惊。”应该仔细详辨。沈氏说：从阴阳角度讲，数是阳脉；从脏腑角度讲，数是腑病；论邪气则是热，论病情则是虚。对于微数的脉象，伤寒病患者严禁发汗，无病之人严禁劳累。这是先贤的格言。《内经》说：“数为烦心。”只有小儿的脉象，一呼一吸间八次跳动，且细数，才是平脉。
散脉，就是大而散漫的脉象。气虚血虚，有表无里，所以脉象散漫。
沈氏说：散是不聚集的意思。张仲景说：“伤寒咳逆上气，其脉散者死。”如果脉中有邪气，那是风邪。《难经》说：“浮而大散者是心脉。”最害怕散脉单独出现，单独出现就危险了。柳氏说：这是散漫无统纪、无拘束的意思。指下感觉脉动，一二至之间又有一至，更不曾往来整齐。或者动来即动去，或者来多去少，或者去多来少，这是解散不收聚，精血耗散，根本脱离，是不好的征兆。如果产妇见到这种脉象，预示生子；孕妇见到这种脉象，预示堕胎损伤。平常人的心脉及夏季，最不宜单独见到这种脉象。
The *Neijing* states: "When the pulse of the Hand-Shaoyin channel beats vigorously, it indicates pregnancy." This refers to the pulse at the Shu point of the Hand-Shaoyin channel, specifically the Shenmen acupoint (Shenmen), where a vigorous pulse is a sign of pregnancy, not referring to the "Moving Pulse" (Dong Mai) as a specific pulse condition. The concept of the Moving Pulse originated with Zhang Zhongjing, who stated: "When Yin and Yang contend with each other, it is called 'Moving'." If Yang moves, there is sweating; if Yin moves, there is fever, coldness of the body, and aversion to cold, indicating injury to the Sanjiao (Triple Burner). Cheng Wuji said: "When Yin and Yang contend, the deficient side manifests as a Moving Pulse. Deficiency of Yang leads to Yang movement, hence sweating; deficiency of Yin leads to Yin movement, hence fever. If there is no fever or sweating, but rather coldness of the body and aversion to cold, it signifies injury to the Sanjiao and obstruction of Yang Qi." Pang Anchang said: "The Guan position occupies six fen in length; the anterior three fen are Yang, and the posterior three fen are Yin. If the movement occurs in the Yang region (Cun position), extending to the Cun Kou, while the Yin region (Chi position) remains quiet, according to the principles, the disease should resolve through sweating. The *Suwen* states: 'Yang acting upon Yin is called sweat.' If the movement occurs in the Yin region (Chi position), extending to the Chi, while the Yang region (Cun position) remains quiet, then fever will occur. The *Suwen* states: 'Coarseness of the Chi pulse indicates heat within.' If after profuse sweating, symptoms of body coldness and aversion to cold appear, this is injury to the Sanjiao and constitutes a fatal syndrome. The Moving Pulse is only seen at the Guan position; only Pang's explanation is clear. Cheng Wuji further stated: 'Yang exits and Yin enters, with the Guan serving as the boundary; the Guan is the midpoint of Yin and Yang.' If a Rapid Pulse appears at the Guan, without head or tail, resembling the size of a bean, trembling and moving, this represents the contention of Yin and Yang Qi. 'Jue Jue' describes the independent trembling of the pulse, distinct from the three positions, like a person in a crowd who does not blend with others, thus named 'Jue Jue'. Shen Shi said: 'Yang movement occurs because Yang Qi cannot protect the skin and pores, leading to sweating; Yin movement occurs because Yin Qi cannot nourish the muscles, leading to fever.' This aligns with Zhang Zhongjing’s statement: 'Mild Yang leads to aversion to cold, weak Yin leads to fever,' which refers to this phenomenon.
[Poem on the Moving Pulse] The root lies in Qi governing Yin, / When Yin and Yang contend, the pulse form appears. / At the three Guan positions, fingers feel heavy and deep, / In the Guan center, like a bean, it trembles frequently.
The Moving Pulse is seen at the Guan position, not in the Cun and Chi positions of the three Guan. It manifests as Jue Jue trembling, rather than being heavy and obstructing under the fingers. Chi Shi propagated erroneous interpretations, so I have corrected this.
[Poem on Blood Emission and Retrograde Menstruation] Retrograde menstruation with bleeding for years, / Wise physicians and famous doctors are hard to find. / Pain and fright are recorded in the *Mai Jing*.
The *Neijing* states: "Yin deficiency and Yang contention cause Bing (uterine bleeding)." Insufficiency of Yin pulses and excessive, contending Yang pulses lead to internal collapse, with blood flowing downward. The Moving Pulse causing uterine bleeding corresponds to what Zhang Zhongjing called "Yin movement." Yin deficiency and internal damage manifest as a Moving and Rapid pulse, not Yang contention.
[Nine] The Fine Pulse belongs to Yin. Under the fingers, searching reveals it as fine as a thread. Its coming and going are extremely minute. (Slightly larger than the Micro pulse, yet consistently present and fine.) It is called the Fine Pulse, primarily indicating coldness of the bone marrow in the lower legs and feet, fatigue, and shortness of breath.
The *Mai Jing* states: "The Fine Pulse is Yin." The pulse is straight, fine, and soft, responding to the finger like a silk thread, indicating insufficiency of Blood and decline of Qi. If these symptoms are present, the pulse matches the condition, which is favorable; if the pulse appears without these symptoms, it is unfavorable. Therefore, in cases of hematemesis or epistaxis, the appearance of a Deep and Fine pulse indicates survival. Since blood flows within the vessels, a reduction in blood volume causes the pulse to become fine. Although blood is insufficient, it has not reached the stage of hemorrhage, so the pulse stops at being Fine and does not disappear. If blood is completely lost, the pulse also disappears; thus, the Choppy Pulse (Kou Mai) indicates blood loss. From this, we know that the Choppy Pulse indicates blood loss, while the Fine Pulse indicates blood insufficiency. The current *Mai Jue* states that the Fine Pulse is "extremely minute in its coming and going," which is even more minute than the Micro pulse, and thus is no longer a Fine Pulse. I have corrected this here.
Fatigue, lack of essence, soreness in the shins, / Emaciation, haggard appearance, dry hair. / If encountered in winter, during frosty months, / Without treatment, the illness will surely heal itself.
After winter, when Yang Qi begins to generate, physiological functions may recover. However, one cannot claim that the disease heals spontaneously without treatment. Now, the Scattered Pulse and Rapid Pulse are added to fulfill the original intent of the *Mai Jing*.
The Rapid Pulse belongs to Yang. Six beats per respiration. Alternatively defined as: coming and going rapidly and hurriedly is the Rapid Pulse.
The *Neijing* states: "Rapid indicates Heat." One must examine whether it is Floating or Deep to determine if the heat is in the Exterior or Interior; observe its magnitude to determine the severity of the heat. There are also pulses that resemble the Rapid Pulse. The *Neijing* states: "A pulse arriving like a Rapid pulse causes sudden fright." This requires careful discrimination. Shen Shi said: From the perspective of Yin and Yang, Rapid is a Yang pulse; from the perspective of Zang-Fu organs, Rapid indicates Fu organ disease; regarding pathogenic factors, it indicates Heat; regarding pathology, it indicates Deficiency. For a Micro-Rapid pulse, in cases of Cold Damage (Shanghan), sweating must be strictly avoided; in healthy individuals, overexertion must be strictly avoided. This is an axiom of the sages. The *Neijing* states: "Rapid indicates vexation of the heart." Only in children, where eight beats per respiration are Fine and Rapid, is this considered a normal pulse.
The Scattered Pulse is large and scattered. Qi deficiency and Blood insufficiency, having an Exterior but lacking an Interior, result in a Scattered pulse.
Shen Shi said: Scattered means not gathering. Zhang Zhongjing stated: "In Cold Damage, with coughing, wheezing, and upward rushing of Qi, if the pulse is Scattered, death ensues." If the pulse contains pathogenic factors, it is Wind. The *Nanjing* states: "Floating, large, and Scattered is the Heart pulse." The greatest fear is the solitary appearance of the Scattered pulse; if it appears alone, it is perilous. Liu Shi said: This implies being scattered without order or constraint. Under the fingers, the movement feels irregular; between one or two beats, another beat arrives, never coming and going regularly. Sometimes it moves and immediately vanishes; sometimes many come and few go; sometimes many go and few come. This represents dispersion and failure to gather, with Essence and Blood dissipating and the root becoming detached, which is an inauspicious omen. If seen in a parturient woman, it predicts childbirth; if seen in a pregnant woman, it predicts miscarriage or injury. In ordinary individuals' Heart pulses and during summer months, it is most inadvisable to see this pulse appearing alone.