凡诊脉须自寸口逐一部以中指头按之为法。初指下轻按得脉之者。乃胃脉也。更倍深下。按将至骨。方可缓缓放起
指头。脏脉也。若浮中沉。三候六部皆然。故谓之三部九候也。或以数多为轻重。次第按者非也。脉有阴阳之法者。由
呼出心与肺。吸入肾与肝。呼吸之间。脾受谷味。故五脏之脉。皆为气府为尺上关部见之而已。六部轻按得者。腑脉也。
属阳。次深按至中得之。乃胃脉。亦属阳。阳重按之深。属脏阴脉也。脾属土名中州。故其脉在中。此名阴阳之法。三
阴从天生。故以女关前为阴。关后为阳。女子阴盛而阳微。其脉在关下。
故寸沉而尺盛女子不可久吐。所以女得男脉为有余。在左则左病。在右则右病。
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迟(一息三至。应指轻缓。) 气血俱寒。 瘕沉积。
浮(按之不足。举之有余。) 阳实阴虚。
数(一息七至。去来促急。) 阳盛阴虚。燥热烦满。浮短。喘满不利。
虚(迟大而软。按之而绵。) 气血耗亡。夏伤暑 。浮长。风眩癫疾。
实(举按有力。不迟不疾。) 血气壅实。痛热带下。浮弦。痰饮发热。
缓(一息四至。去而带软。) 湿流气壅。或痹或痛。浮滑。停饮宿食。
紧(软如细线。转动紧搏。) 正气特弱。邪气作痛。浮紧。寒邪淋闭。
洪(来之至大。去之且长。) 荣卫壅塞。热盛躁狂。浮数。大腑秘涩。
细(按举往来。其重如丝。) 着湿凝涎。胫痰髓冷。浮缓。风湿不仁。
滑(起而有力。见源如珠。) 痰敛呕吐。气逆不和。浮洪。阳经发热。
涩(三五不调。涩如削竹。) 荣卫俱虚。或为湿痒。浮涩。积滞不消。
弦(如按琴弦。直气由绕。) 或寒或热。拘急饮冷。浮弦。伤饮气促。
弱(轻软沉细。按之欲绝。) 宿食不消。恶寒气满。代动而不来。复来更动。
结(来往急缓。时止更来。) 痰饮积遏。迷闷病痛。代不损部位。随应即死。
促(去来急缓。时止即来。) 脏热壅滞。痰饮不行。沉弱。虚劳客热。
芤(中软傍实。按无举有。) 阳实阴虚。气奔失血。沉缓。重着不仁。
微(轻虚细软。若有若无。) 荣卫不足。气痞虚寒。沉紧。不冷作痛。
动(胎肉如豆。动而不行。) 虚荣惊悸。股痛肉挛。沉滑。涎饮秽逆。
伏(举之虽无。而骨乃得。) 积聚痰癖。痞结不磨。沉细。体软无力。
长(过于本位。通流而长。) 浑身壮热。坐卧不安。沉涩。积冷不禁。
短(举时有数。不及本位。) 宿食不消。恶寒气满。沉濡。气怯自汗。
濡(轻轻而软。按之若无。) 虚惫寒热。痹弱羸怯。沉迟。虚寒痛冷。
牢(浮按有力。按之即无。) 着湿作肿。筋骨疼痛。沉实。瘀血癖积。
散(举按下时。散而无力。) 淫邪脱泄。精血耗亡。沉微。荣卫耗亡。
革(沉伏实大。如按鼓皮。) 邪气固结。真脱病危。沉(举之不足。按之有余。) 阴虚气滞血凝。
凡是诊察脉象,必须从寸口开始,逐一部位用中指指头按压作为规范。初下指时轻按而能感知到脉象的,是胃脉。再加倍深度下按,按至接近骨骼处,方可缓缓抬起指头,此时感知到的脉象是脏脉。如果在浮、中、沉三候和六部脉位上都是如此,所以称之为三部九候。有的人以次数多少来区分轻重层次进行依次按压,这是错误的。脉有阴阳的方法:呼气排出心与肺的气,吸气纳入肾与肝的气,在呼吸之间,脾接受水谷精微之气。因此五脏的脉象,都作为气的府库,在尺部以上关部显现出来。六部脉轻按所得的,是腑脉,属于阳;次深按至中部所得的,是胃脉,也属于阳;重按至深处所得的,属于脏阴脉。脾属土,名为中州,所以它的脉象位于中部。这叫做阴阳的方法。三阴由天生成,所以在女子脉诊中,关前为阴,关后为阳。女子阴气盛而阳气微弱,其脉象在关下。所以寸脉沉而尺脉盛。女子不可久用催吐法。所以女子得到男子般的脉象(即寸盛尺弱)为有余。脉象在左手则左半身有病,在右手则右半身有病。
迟脉(一息跳动三次,应指轻缓。)气血俱寒。瘕积沉积。
浮脉(按之感觉不足,举之感觉有余。)阳实阴虚。
数脉(一息跳动七次,去来急促急迫。)阳盛阴虚。燥热烦闷胀满。浮短。喘促胀满不利。
虚脉(迟大而软,按之绵软无力。)气血耗散亡失。夏季伤于暑邪。浮长。风眩癫疾。
实脉(举按有力,不迟不疾。)血气壅滞充实。痛症带下。浮弦。痰饮发热。
缓脉(一息跳动四次,去势带有柔软感。)湿气流动气机壅塞。或痹证或疼痛。浮滑。停饮宿食。
紧脉(软如细线,转动紧搏。)正气特别虚弱,邪气作痛。浮紧。寒邪淋闭。
洪脉(来势极大,去势且长。)营卫壅塞。热盛躁狂。浮数。大腑秘涩。
细脉(按举往来,其重如丝。)着湿凝涎。胫部痰髓冷。浮缓。风湿不仁。
滑脉(起而有力,见源如珠。)痰敛呕吐。气逆不和。浮洪。阳经发热。
涩脉(三五不调,涩如削竹。)营卫俱虚。或为湿痒。浮涩。积滞不消。
弦脉(如按琴弦,直气由绕。)或寒或热。拘急饮冷。浮弦。伤饮气促。
弱脉(轻软沉细,按之欲绝。)宿食不消。恶寒气满。代动而不来,复来更动。
结脉(来往急缓,时止更来。)痰饮积遏。迷闷病痛。代脉不损部位,随应即死。
促脉(去来急缓,时止即来。)脏热壅滞。痰饮不行。沉弱。虚劳客热。
芤脉(中软傍实,按无举有。)阳实阴虚。气奔失血。沉缓。重着不仁。
微脉(轻虚细软,若有若无。)营卫不足。气痞虚寒。沉紧。不冷作痛。
动脉(胎肉如豆,动而不行。)虚荣惊悸。股痛肉挛。沉滑。涎饮秽逆。
伏脉(举之虽无,而骨乃得。)积聚痰癖。痞结不磨。沉细。体软无力。
长脉(过于本位,通流而长。)浑身壮热。坐卧不安。沉涩。积冷不禁。
短脉(举时有数,不及本位。)宿食不消。恶寒气满。沉濡。气怯自汗。
濡脉(轻轻而软,按之若无。)虚惫寒热。痹弱羸怯。沉迟。虚寒痛冷。
牢脉(浮按有力,按之即无。)着湿作肿。筋骨疼痛。沉实。瘀血癖积。
散脉(举按下时,散而无力。)淫邪脱泄。精血耗亡。沉微。营卫耗亡。
革脉(沉伏实大,如按鼓皮。)邪气固结。真脱病危。
沉脉(举之不足,按之有余。)阴虚气滞血凝。
Whenever palpating the pulse, one must start from the Cun Kou (Radial Artery Pulse Position) and press each position sequentially with the tip of the middle finger as the standard. When the finger first presses lightly and the pulse is perceived, it is the Stomach Pulse. Pressing deeper, doubling the depth until approaching the bone, and then slowly lifting the finger tip reveals the Zang Pulse. If this pattern holds true for the Floating, Middle, and Deep levels across all six positions, it is referred to as the Three Regions and Nine Hearsings. Some people incorrectly distinguish layers by counting frequency and pressing in sequence. There is a method of Yin and Yang in pulses: Exhalation expels Qi from the Heart and Lungs; inhalation draws Qi into the Kidneys and Liver. Between breaths, the Spleen receives the essence of grains. Therefore, the pulses of the five Zang organs serve as the reservoirs of Qi and are manifested above the Chi position at the Guan position. The pulse obtained by light pressure in the six positions is the Fu Pulse, which belongs to Yang. The pulse obtained by moderate deep pressure at the middle level is the Stomach Pulse, also belonging to Yang. The pulse obtained by heavy deep pressure belongs to the Yin pulses of the Zang organs. The Spleen belongs to Earth and is named the Central Province, so its pulse is located in the middle. This is called the method of Yin and Yang. The three Yins are generated from Heaven; thus, in female pulse diagnosis, the area anterior to the Guan is Yin, and the area posterior to the Guan is Yang. Women have abundant Yin and weak Yang, so their pulse is found below the Guan. Therefore, the Cun pulse is deep and the Chi pulse is vigorous. Women should not undergo prolonged emesis therapy. Thus, if a woman presents with a male-like pulse (strong Cun, weak Chi), it indicates excess. If the abnormality is on the left, the disease is on the left side; if on the right, the disease is on the right side.
Chi Pulse (Three beats per respiration, feeling light and slow.) Cold in both Qi and Blood. Accumulation of masses.
Fu Pulse (Insufficient upon pressing, excessive upon lifting.) Excess Yang and Deficient Yin.
Shu Pulse (Seven beats per respiration, coming and going rapidly.) Excess Yang and Deficient Yin. Dryness, heat, vexation, and fullness. Floating and short. Panting and fullness with difficulty.
Xu Pulse (Slow, large, and soft,绵软 upon pressing.) Consumption and loss of Qi and Blood. Summer-heat injury in summer. Floating and long. Wind-induced vertigo and epilepsy.
Shi Pulse (Forceful upon lifting and pressing, neither slow nor rapid.) Stagnation and excess of Blood and Qi. Pain with leukorrhea. Floating and wiry. Phlegm-fluid retention with fever.
Huan Pulse (Four beats per respiration, departing with a soft sensation.) Dampness flowing and Qi stagnation. Bi syndrome or pain. Floating and slippery. Retained fluids and undigested food.
Jin Pulse (Soft like a fine thread, tight and pulsating upon rotation.) Special weakness of Healthy Qi, pain caused by Pathogenic factors. Floating and tight. Cold pathogen causing strangury and retention.
Hong Pulse (Coming is extremely large, going is long.) Obstruction of Ying and Wei. Excessive heat causing restlessness and mania. Floating and rapid. Constipation of the Large Intestine.
Xi Pulse (Moving upon pressing and lifting, heavy like a silk thread.) Dampness adhering and saliva congealing. Cold phlegm and marrow in the shins. Floating and slow. Wind-dampness causing numbness.
Hua Pulse (Rising with force, appearing like pearls at the source.) Vomiting due to phlegm constriction. Rebellious Qi and disharmony. Floating and surging. Fever in the Yang meridians.
Se Pulse (Irregular rhythm of three or five, rough like scraping bamboo.) Deficiency of both Ying and Wei. Or dampness-induced itching. Floating and choppy. Accumulation and stagnation failing to resolve.
Xian Pulse (Like pressing a zither string, straight Qi winding around.) Either cold or heat. Spasm and drinking cold liquids. Floating and wiry. Injury from fluid retention causing rapid breathing.
Ruo Pulse (Light, soft, deep, and fine, seeming to vanish upon pressing.) Undigested food retention. Aversion to cold, Qi fullness. Dai pulse moving but not arriving, arriving again with movement.
Jie Pulse (Coming and going alternating between rapid and slow, pausing intermittently.) Phlegm-fluid accumulation and obstruction. Confusion and painful diseases. Dai pulse without positional damage, death follows immediately.
Cu Pulse (Coming and going alternating between rapid and slow, pausing then returning.) Heat stagnation in Zang organs. Phlegm-fluid failure to circulate. Deep and weak. Deficiency consumption with external heat.
Kou Pulse (Soft in the center, firm on the sides, absent upon pressing, present upon lifting.) Excess Yang and Deficient Yin. Qi rushing and blood loss. Deep and slow. Heavy sensation and numbness.
Wei Pulse (Light, deficient, fine, and soft, seeming to exist and not exist.) Insufficiency of Ying and Wei. Qi痞 (epigastric fullness) and deficiency-cold. Deep and tight. Pain without cold sensation.
Dong Pulse (Like a bean-shaped mass, moving but not traveling.) Deficient Ying causing fright and palpitations. Thigh pain and muscle cramps. Deep and slippery. Saliva-fluid and foul rebellion.
Fu Pulse (Not felt upon lifting, but obtained when pressing to the bone.) Accumulations, masses, and phlegm-parasites. Epigastric knotting and indigestion. Deep and fine. Body softness and weakness.
Chang Pulse (Extending beyond its normal position, flowing smoothly and long.) Generalized high fever. Restlessness in sitting and lying. Deep and choppy. Uncontrollable accumulated cold.
Duan Pulse (Felt occasionally upon lifting, not reaching its normal position.) Undigested food retention. Aversion to cold, Qi fullness. Deep and soggy. Qi timidity and spontaneous sweating.
Ru Pulse (Lightly soft, seeming absent upon pressing.) Deficiency exhaustion with alternating cold and heat. Bi weakness and emaciation. Deep and slow. Deficiency-cold and painful cold.
Lao Pulse (Forceful upon floating pressure, disappearing upon deep pressure.) Dampness causing swelling. Bone and tendon pain. Deep and solid. Blood stasis and mass accumulation.
San Pulse (Scattered and powerless upon lifting and pressing.) Deviant pathogens causing leakage. Consumption and loss of Essence and Blood. Deep and minute. Exhaustion of Ying and Wei.
Ge Pulse (Deep, hidden, solid, and large, like pressing a drum skin.) Pathogenic factors firmly bound. True collapse and critical illness.
Chen Pulse (Insufficient upon lifting, excessive upon pressing.) Deficient Yin, Qi stagnation, and Blood coagulation.