心脉。浮大而散。
心合血脉。故心脉循血脉而行。持脉指法。如六菽之重。按至血脉而得者为浮。稍稍加力。
脉道粗者为大。又稍加力。脉道阔软者为散。余仿此。机按。菽。豆也。指按如六豆之重也。
肺脉。浮涩而短。
肺合皮毛。故脉循皮毛而行。持脉指法。如三菽之重。按至皮毛而得者为浮。稍稍加力。脉
道不利为涩。又稍加力。不及本位曰短。
肝脉。弦而长。
肝合筋。故肝脉循筋而行。持脉指法。如十二菽之重。按至筋。脉道与筝弦相似为弦。次稍
加力。脉道迢迢者为长。
脾脉。缓而大。
脾合肌肉。故脾脉循肌肉而行。持脉指法。如九菽之重。按至肌肉。如微风轻 柳梢之状。
为缓。次稍加力。脉道敦实者为大。
肾脉。沉而软滑。
肾合骨。故肾脉循骨而行。持脉指法。按至骨上而得者为沉。次重按之。脉道无力为软。
举指来疾。脉道流利者为滑。凡此五脏平脉。须要察之。久久成熟。一遇病脉。自然可晓。
经曰。先识经脉。而后识病脉。此之谓也。
(出诊脉须知。)
左寸。手太阳小肠脉。洪大而紧。(一云洪大而长。为受盛之官。名受盛之府。)
左关。足少阳胆脉。弦大而浮。(一云大而浮。一云乍数乍疏。乍短乍长。一云乍大乍小,乍
短乍长。与祟脉无异。何以区别。然两手三部皆然。方为祟脉。今独左手关部如此。则谓之胆脉。可也。
胆为中正之官。名清净之府。相火胆与风肝合。脉急则为惊。)
左尺。足太阳膀胱脉。洪滑而长。(膀胱为州都之官。名津液之府。寒水膀胱。与君火肾合。脉急
则为瘕。或曰心脉居午。谓之君火宜也。今肾脉居子。亦谓之君火何义。又命门脉为心主。
居亥。谓之相火宜也。今胆脉居寅。亦谓之相火。又何邪。内经天元纪论。鬼臾区曰。子午之岁。
上见少阴。巳亥之岁。上见厥阴。少阴所谓标也。厥阴所谓终也。厥阴之上。风气主之。少阴之上。
热气主之。少阳之上。相火主之。而释者谓午亥之岁为正化。子巳之岁为对化。由此言之。则心
肾皆可言君火。以其热气主之也。厥阴既主风气。而手厥阴命门不当以相火言。少阳既主其相火。
则胆与三焦为相火明矣。)
右寸。手阳明大肠脉。浮短而滑。(一云短而涩。为传道之官。名传道之府。)
右关。足阳明胃脉。浮长而滑。(一云浮大而短。为仓廪之官。名水谷之府。燥金胃与湿土脾合。)
右尺。手少阳三焦脉。洪散而急。(为决渎之官。名外府。机按。以上但言六腑脉状。而诊法
轻重内外。俱未及论。学人宜更考之。)
心脉。浮大而散。
心脏与血脉相合,所以心脉随着血脉运行。诊脉时的指法:力度如同六颗豆子的重量,按至血脉处能摸到的为“浮”脉。稍微增加力度,脉道粗大的为“大”脉。再稍微增加力度,脉道宽阔柔软的为“散”脉。其余脏腑的诊法仿照此例。徐机按语:菽,即豆类。指下的压力相当于六颗豆子的重量。
肺脉。浮涩而短。
肺脏与皮毛相合,所以脉象随皮毛而行。诊脉指法:力度如同三颗豆子的重量,按至皮毛处能摸到的为“浮”脉。稍微增加力度,脉道不畅的为“涩”脉。再稍微增加力度,脉搏达不到本位(正常深度)的为“短”脉。
肝脉。弦而长。
肝脏与筋相合,所以肝脉随筋而行。诊脉指法:力度如同十二颗豆子的重量,按至筋部,脉道形状像筝弦一样紧绷的为“弦”脉。接着稍微增加力度,脉道悠长不断的为“长”脉。
脾脉。缓而大。
脾脏与肌肉相合,所以脾脉随肌肉而行。诊脉指法:力度如同九颗豆子的重量,按至肌肉层,感觉像微风轻拂柳梢那样的柔和状态,即为“缓”脉。接着稍微增加力度,脉道敦厚坚实的为“大”脉。
肾脉。沉而软滑。
肾脏与骨相合,所以肾脉随骨而行。诊脉指法:按至骨头表面能摸到的为“沉”脉。接着重按,脉道无力的为“软”脉。抬起手指时脉搏来势急促,脉道流利的为“滑”脉。以上这五种五脏的正常脉象,必须仔细考察,久而久之熟练精通,一旦遇到病脉,自然就能明白。
经典说:先认识正常的经脉脉象,然后才能识别病脉,说的就是这个道理。
(出自《诊脉须知》。)
左寸口部位。手太阳小肠脉。洪大而紧。(另一种说法是洪大而长。小肠被称为受盛之官,名为受盛之府。)
左关部位。足少阳胆脉。弦大而浮。(另一种说法是大而浮;又一种说法是忽快忽慢,忽短忽长;还有一种说法是忽大忽小,忽短忽长。这与祟脉没有区别,如何区分呢?如果两手三部脉都这样,才称为祟脉。现在只有左手关部如此,那么称之为胆脉是可以的。胆被称为中正之官,名为清净之府。胆内寄相火,与风木之肝相合,脉象紧急则为惊悸。)
左尺部位。足太阳膀胱脉。洪滑而长。(膀胱被称为州都之官,名为津液之府。膀胱属寒水,与君火之肾相合,脉象紧急则形成瘕积。有人说:心脉位于午位,称为君火是适宜的。现在肾脉位于子位,也称为君火,这是什么意义?又说命门脉属于心主,位于亥位,称为相火是适宜的。现在胆脉位于寅位,也称为相火,又有什么邪义呢?《内经·天元纪大论》中,鬼臾区说:子年和午年,上见少阴脉;巳年和亥年,上见厥阴脉。少阴是所谓的标,厥阴是所谓的终。厥阴之上,风气主令;少阴之上,热气主令;少阳之上,相火主令。而解释者认为午年和亥年为正化,子年和巳年为对化。由此说来,心和肾都可以称为君火,因为它们由热气主令。厥阴既然主司风气,那么手厥阴心包络(此处原文误作命门,实指心包或相关理论争议)不应当以相火言说。少阳既然主司相火,那么胆和三焦作为相火所属是明确的。)
右寸口部位。手阳明大肠脉。浮短而滑。(另一种说法是短而涩。大肠被称为传道之官,名为传道之府。)
右关部位。足阳明胃脉。浮长而滑。(另一种说法是浮大而短。胃被称为仓廪之官,名为水谷之府。燥金之胃与湿土之脾相合。)
右尺部位。手少阳三焦脉。洪散而急。(三焦被称为决渎之官,名为外府。徐机按语:以上只讲了六腑的脉象特征,而诊脉时轻重深浅的方法都没有涉及,学习者应该进一步考证。)
Heart pulse. Floating, large, and scattered (San).
The Heart harmonizes with the blood vessels; therefore, the Heart pulse travels along the blood vessels. The finger technique for holding the pulse: apply pressure equivalent to the weight of six beans (Shu). Pressing until the pulse is felt at the level of the blood vessels constitutes the "Floating" (Fu) pulse. Slightly increasing the pressure, a coarse pulse channel constitutes the "Large" (Da) pulse. Increasing the pressure slightly again, a broad and soft pulse channel constitutes the "Scattered" (San) pulse. The rest follow this pattern. Note by Xu Ji: Shu refers to beans. The finger pressure is equivalent to the weight of six beans.
Lung pulse. Floating, choppy (Se), and short.
The Lung harmonizes with the skin and hair; therefore, the pulse travels along the skin and hair. The finger technique for holding the pulse: apply pressure equivalent to the weight of three beans. Pressing until the pulse is felt at the level of the skin and hair constitutes the "Floating" (Fu) pulse. Slightly increasing the pressure, an obstructed pulse flow constitutes the "Choppy" (Se) pulse. Increasing the pressure slightly again, a pulse that does not reach its proper depth constitutes the "Short" (Duan) pulse.
Liver pulse. Wiry (Xian) and long.
The Liver harmonizes with the tendons; therefore, the Liver pulse travels along the tendons. The finger technique for holding the pulse: apply pressure equivalent to the weight of twelve beans. Pressing to the level of the tendons, a pulse channel resembling the string of a zither constitutes the "Wiry" (Xian) pulse. Subsequently, slightly increasing the pressure, a pulse channel that is continuous and distant constitutes the "Long" (Chang) pulse.
Spleen pulse. Moderate (Huan) and large.
The Spleen harmonizes with the muscles; therefore, the Spleen pulse travels along the muscles. The finger technique for holding the pulse: apply pressure equivalent to the weight of nine beans. Pressing to the level of the muscles, feeling like the gentle sway of willow branches in a light breeze constitutes the "Moderate" (Huan) pulse. Subsequently, slightly increasing the pressure, a solid and substantial pulse channel constitutes the "Large" (Da) pulse.
Kidney pulse. Deep (Chen), soft, and slippery (Hua).
The Kidney harmonizes with the bones; therefore, the Kidney pulse travels along the bones. The finger technique for holding the pulse: pressing until the pulse is felt on top of the bone constitutes the "Deep" (Chen) pulse. Subsequently, pressing heavily, a pulse channel lacking strength constitutes the "Soft" (Ruan) pulse. Lifting the fingers, if the pulse comes swiftly and the pulse channel flows smoothly, it constitutes the "Slippery" (Hua) pulse. For these five normal pulses of the Zang organs, one must observe them carefully. Through prolonged practice and mastery, upon encountering pathological pulses, their nature will naturally become clear.
The Classics state: First recognize the normal meridional pulses, then recognize the pathological pulses. This is what is meant.
(From "Prerequisites for Pulse Diagnosis".)
Left Cun position. Hand-Taiyang Small Intestine pulse. Surging (Hong), large, and tight. (Another view says surging, large, and long. It is called the Official of Reception and Storage, named the Fu organ of Reception and Storage.)
Left Guan position. Foot-Shaoyang Gallbladder pulse. Wiry, large, and floating. (Another view says large and floating; another says intermittent speed, intermittent length; yet another says fluctuating size, fluctuating length. This is indistinguishable from a Gui pulse. How to distinguish? If both hands and all three positions exhibit this, it is termed a Gui pulse. Since only the left Guan position exhibits this now, it may be called the Gallbladder pulse. The Gallbladder is the Official of Uprightness, named the Fu organ of Purity. The Ministerial Fire within the Gallbladder combines with the Wind-Liver. A tense pulse indicates fright.)
Left Chi position. Foot-Taiyang Bladder pulse. Surging, slippery, and long. (The Bladder is the Official of the Capital, named the Fu organ of Fluids. The Bladder belongs to Cold Water and combines with the Ministerial Fire-Kidney. A tense pulse indicates mass accumulation. Some say: The Heart pulse resides in the Wu position, so calling it Ministerial Fire is appropriate. Now the Kidney pulse resides in the Zi position, also called Ministerial Fire, what is the meaning? Also, the Mingmen pulse belongs to the Heart Master, residing in the Hai position, so calling it Ministerial Fire is appropriate. Now the Gallbladder pulse resides in the Yin position, also called Ministerial Fire, what is the heresy? In the "Tianyuanji Lun" chapter of the Neijing, Gui Yuqu said: In Zi and Wu years, the upper manifestation is Shaoyin. In Si and Hai years, the upper manifestation is Jueyin. Shaoyin is the so-called Biao (Mark); Jueyin is the so-called Zhong (End). Above Jueyin, Wind Qi governs. Above Shaoyin, Heat Qi governs. Above Shaoyang, Ministerial Fire governs. Interpreters state that Wu and Hai years are Zheng Hua (Direct Transformation), while Zi and Si years are Dui Hua (Counter Transformation). From this perspective, both Heart and Kidney can be called Ministerial Fire, as they are governed by Heat Qi. Since Jueyin governs Wind Qi, the Hand-Jueyin [Pericardium/Mingmen controversy] should not be spoken of as Ministerial Fire. Since Shaoyang governs Ministerial Fire, it is clear that the Gallbladder and Sanjiao belong to Ministerial Fire.)
Right Cun position. Hand-Yangming Large Intestine pulse. Floating, short, and slippery. (Another view says short and choppy. It is called the Official of Transmission, named the Fu organ of Transmission.)
Right Guan position. Foot-Yangming Stomach pulse. Floating, long, and slippery. (Another view says floating, large, and short. It is called the Official of Granaries, named the Fu organ of Water and Grain. The Dry Metal-Stomach combines with the Damp Earth-Spleen.)
Right Chi position. Hand-Shaoyang Sanjiao pulse. Surging, scattered, and urgent. (It is called the Official of Irrigation, named the Outer Fu. Note by Xu Ji: The above only describes the pulse characteristics of the Six Fu organs, without discussing the methods of depth and pressure in diagnosis. Students should investigate further.)