脉经云。尺脉数恶寒。脐下热痛。尺主下部。今云脾热口臭。脾在中州。非尺所系。
阳微浮弱定心寒。阴滑〔食注脾家咎〕(经脉不调候。)
脉经曰。尺脉滑。血气实。妇人经脉不利。及尿血。食注脾咎。当诊于关上。
关前关后辨阴阳。察病根源应不朽。
此总结关前为阳名寸口以下之文也。脉经辨阴阳大法云。关前为阳。关后为阴。阳数吐血。阴
微下利。阳弦头痛。阴弦腹痛。阳微自汗。阴微自下。阳热口生疮。阴数加微必恶寒而烦躁不得眠。
阳微不能呼。阴微不能吸。今脉诀所述。或遵或违何也。洁古曰。阳弦为脉浮而弦。阴弦为脉沉而弦。
但言阴阳者。乃脉之浮沉也。经曰。浮为表。沉为里。非止寸口独浮尺独沉。尺寸俱有浮沉。今按
洁古论浮沉表里则是。而以论此段阴阳则非。盖脉经脉诀。皆以关前阳关后阴启之。中论脉证。后又
以关前关后辨阴阳结之。安可以浮沉论。
一息四至号平和。更加一至大无 。
素问曰。人一呼脉再动。一吸脉再动。呼吸定息。脉五动。闰以太息。命曰平人。难经曰。脉来。
一呼再至。不大不小。曰平。二经之言不同何也。盖难经因论损至之脉而概举也。故于至脉。则
云一呼再至。曰平。不言一吸者。举一使反三隅也。及后再举。则兼呼吸。总论。不大不小者。息
《脉经》说:尺部脉搏数且伴有恶寒,是脐下热痛。尺脉主要反映下部情况。现在文中说脾热导致口臭,脾位于中焦,不属于尺脉所主范围。
阳气微弱而浮弱,定是心寒;阴脉滑利(注:因饮食停滞导致脾脏过错)(这是经脉不调的征候)。
《脉经》说:尺脉滑,说明血气充实。妇女会出现月经不通畅,以及尿血、饮食停滞导致的脾脏过错等症状。应当诊察关部脉象。
关前与关后用以辨别阴阳,考察疾病根源就不会出错。
这是对前述“关前为阳,名为寸口”以下内容的总结。《脉经》辨别阴阳的大法说:关前为阳,关后为阴。阳脉数则吐血,阴脉微则下利;阳脉弦则头痛,阴脉弦则腹痛;阳脉微则自汗,阴脉微则自泄;阳热则口中生疮,阴脉数兼见微象必定恶寒且烦躁不得眠;阳脉微则不能呼气,阴脉微则不能吸气。如今《脉诀》所述内容,有的遵循经典,有的违背经典,为什么呢?李东垣(洁古)说:阳弦是指脉象浮而弦,阴弦是指脉象沉而弦。所谓阴阳,指的是脉象的浮沉。经典说:浮脉主表,沉脉主里。并不是只有寸口脉浮、尺部脉沉,尺寸两部都有浮沉变化。如今按照李东垣论述浮沉表里则是正确的,但用来论述这段关于阴阳的内容则是不对的。因为《脉经》和《脉诀》,都是以关前为阳、关后为阴来开头的,中间论述脉证,最后又以关前关后辨别阴阳来结束。怎么可以用浮沉来论述呢?
一呼一吸之间脉搏跳动四次称为平和脉,如果多一次则为大脉而无邪气困扰。
《素问》说:人每呼一次脉搏跳动两次,每吸一次脉搏跳动两次,呼吸交替定息时,脉搏共跳动五次,加上偶尔的深长呼吸(太息),这叫做平人(健康人)。《难经》说:脉来,每呼一次跳动两次,不大不小,这叫平脉。这两部经典的说法为什么不同呢?大概是因为《难经》在论述损脉和至脉时概括性地列举。所以在论及至脉时,只说每呼一次跳动两次叫平脉,没有提吸,这是举一反三的说法。等到后面再次列举时,就兼论呼吸,总括来说,不大不小的……
The *Mai Jing* (Pulse Classic) states: If the Chi pulse (Cun-Chi pulse at the wrist, reflecting lower body conditions) is rapid and accompanied by aversion to cold, it indicates heat and pain below the umbilicus. The Chi pulse primarily governs the lower part of the body. However, the text now mentions that spleen heat causes bad breath; the Spleen resides in the Middle Jiao (Central Region), which is not governed by the Chi pulse.
When Yang Qi is faint and floating-weak, it definitively indicates Heart Cold; when the Yin pulse is slippery (note: due to food retention causing fault in the Spleen organ system) (this is a sign of irregular meridian patterns).
The *Mai Jing* states: A slippery Chi pulse indicates substantial Blood and Qi. In women, this may manifest as irregular menstruation, hematuria (blood in urine), or food retention causing faults in the Spleen function. One should examine the Guan pulse (pulse position at the midpoint of the wrist).
Distinguishing Yin and Yang between the anterior (Guan-Qian) and posterior (Guan-Hou) parts allows one to investigate the root cause of disease without error.
This summarizes the preceding text regarding "the anterior part of the Guan is Yang, named Cun Kou." The general principle for distinguishing Yin and Yang in the *Mai Jing* states: The anterior part of the Guan is Yang, and the posterior part is Yin. A rapid Yang pulse leads to hematemesis (vomiting blood); a faint Yin pulse leads to diarrhea; a wiry Yang pulse leads to headache; a wiry Yin pulse leads to abdominal pain; a faint Yang pulse leads to spontaneous sweating; a faint Yin pulse leads to spontaneous leakage/diarrhea; Yang Heat causes sores in the mouth; if the Yin pulse is rapid yet faint, it inevitably causes aversion to cold, irritability, and insomnia; a faint Yang pulse makes exhalation difficult; a faint Yin pulse makes inhalation difficult. Why does the content described in the *Mai Jue* (Song of Pulse Diagnosis) sometimes follow and sometimes violate these classics? Li Dongyuan (Jiegu) stated: "Yang wiry" refers to a pulse that is floating and wiry, while "Yin wiry" refers to a pulse that is deep and wiry. When referring to Yin and Yang here, it denotes the floating and deep nature of the pulse. The Classics state: Floating pulses indicate Exterior conditions, and deep pulses indicate Interior conditions. It is not the case that only the Cun Kou (anterior) pulse floats and only the Chi pulse sinks; both Cun and Chi positions have floating and deep variations. Therefore, following Li Dongyuan's discussion on floating/deep and Exterior/Interior is correct, but applying it to this specific passage on Yin/Yang is incorrect. This is because both the *Mai Jing* and the *Mai Jue* begin by establishing "Anterior Guan is Yang, Posterior Guan is Yin," discuss pulse-symptom correlations in the middle, and conclude with distinguishing Yin and Yang via the anterior/posterior Guan. Thus, one cannot interpret this section merely through floating and deep pulses.
Four beats per respiration cycle are termed a Harmonious (Ping) pulse; adding one more beat constitutes a Large pulse without pathogenic interference.
The *Su Wen* (Basic Questions) states: With each exhalation, the pulse moves twice; with each inhalation, the pulse moves twice. At the pause between breaths, the pulse moves five times. Occasionally, a deeper breath (Tai Xi) accounts for the extra movement. This is called a Ping Ren (Healthy Person). The *Nan Jing* (Classic of Difficult Issues) states: When the pulse comes, moving twice per exhalation, neither too large nor too small, it is called a Ping pulse. Why do these two classics differ? This is likely because the *Nan Jing*, when discussing Sun (Damaging) and Zhi (Excessive) pulses, provides a generalized summary. Thus, when discussing Zhi pulses, it states that two movements per exhalation are normal, omitting mention of inhalation to allow for inference from one example. Later, when reiterating, it includes both respiration. Summarizing, "neither too large nor too small"...