问妇人脉法，与男子何异。答曰。女子二七天癸通。月事以时下。故其所重。全在冲任。冲任为精血之海。
其脉常随肝肾而行。故以左尺为命门。阴阳应象论云。阴阳者。血气之男女也。左右者。阴阳之道路也。盖天
道左旋而主阳气。地道右转而主
阴血。阴常从阳。为阳之守。故左尺反有命门之号。然阴禀多暴。脉多随气上章。阴性多郁。脉亦随气内 。
古人虽有女子右脉常盛。及女脉在关下之说。要非定论。其病惟经候胎产。异于男子。他无所殊也。若肾脉微
涩。或左手关后尺内脉浮。或肝脉沉而急。或尺脉滑而断绝不匀。皆经闭不调之候。如体弱之妇。脉常微弱。
但尺内按之不绝。便是有子。月断呕逆不食。六脉不病。亦为有子。所以然者。体弱而脉难显也。脉经曰。妇
人脉三部浮沉正等。按之不绝。无他病而不月者。妊子也。尺数而旺者亦然。经曰。何以知怀子之且生。身有病
而无邪脉也；又云。阴搏阳别。谓之有子。言尺内阴脉搏指。与寸口阳脉迥别。其中有阳象也。阴阳相KT
谷鹁。
故能有子。阴虚阳搏谓之崩。言尺内虚大弦数。皆内崩而血下。若消瘦喘息。月事不来者。二阳之病发心脾也
。妇人不月。脉来滑疾。重手按之散者。胎已三月也。和滑而代者。此二月余之胎息也。重手按之。滑疾而不
散者。五月也。妊娠四月。欲知男女法。古人悉以左尺滑大为男。右尺滑大为女。两尺俱滑大为双胎。然往往
有左寸动滑为男者。以经行血泻。阴常不满。故尺常不足。不可执于尺内滑大方为胎脉之例。经云。妇人手少阴
脉动甚者。妊子也。寸为阳位。故见动滑。则为血充而显阳象。左叶熊罴。右应鸾凰之兆。可预卜而无疑也。
凡妇人经水三月不来。诊其脉两寸浮大。两关滑利。两尺滑实而带数。此胎脉也。若有形而不动。或当脐下翕
翕微动。如抱瓮之状。按之冰冷。又两尺乍大乍小。乍有乍无。或浮或沉。或动或止。早暮不同者。乃鬼胎也。
须连视二三日乃见。宜补气活血。温养脾胃。则水行经自通矣。若脉来疾如风雨乱点。忽然而去。久之复来如
初者。是夜叉胎也。亦有左关之脉。指下见两歧而产夜叉者。总与平常之脉不类也。妊娠脉弱。防其胎堕。以
气血无养也。急宜补养。若弦急亦堕。是火盛也。孕妇脉沉细弦急。憎寒壮热。唇口俱青黑。是胎气损也。当
问胎动否。若不动。
反觉上抢心闷绝。按之冰冷者。当作死胎治之。妇人经断有躯。其脉弦者。后必大下。不成胎也。然有因病脉
弦。又当保胎为务。气旺则弦自退矣。妇人尺脉微迟为居经。月事三月一下。血气不足故也。妇人尺脉微弱而
涩。少腹恶寒。年少得之为无子。年大得之为绝孕。若因病而脉涩者。孕多难保。凡妊娠外感风邪。脉宜缓滑
流利。最忌虚涩躁急。虚涩则不固。躁急则热盛伤胎。多难治也。胎前下利。脉宜滑小。不宜洪数。洪数则防
其胎堕。堕后七日多凶。治疗之法。攻积必死。兜涩亦死。急宜伏龙肝汤。煎温养脾胃药。多有生者。凡
妊娠之脉。宜实大有力。忌沉细弦急虚涩。半产漏下。宜细小流连。忌急实断绝不匀。临产宜滑数离经。忌虚迟
弦细短涩。产后宜沉小微弱。忌急实洪数不调。新产伤阴。出血不止。尺脉不能上关者死。新产中风热病。脉
宜浮弱和缓。忌小急悬绝。崩漏不止。脉宜细小芤迟。忌虚涩数实。凡诊妇人室女伤寒热病。须问经事若何。
产后须问恶露多少。及少腹中有无结块。此大法也。
问：妇女的脉法，与男子有什么不同？
答：女子在十四岁左右天癸（指促进生殖机能成熟的物质）通畅，月经按时来潮。因此，诊脉的重点全在于冲脉和任脉。冲脉和任脉是精血汇聚的海源。
它们的脉象通常随着肝肾之气而行。所以以左尺脉作为命门（肾阳之根）。《阴阳应象大论》说：阴阳，指的是血气中的男女属性。左右，是阴阳运行的道路。大概天道向左旋转而主宰阳气，地道向右旋转而主宰阴血。阴常顺从阳，作为阳的守持者。所以左尺脉反而有命门的称号。然而阴气禀受容易暴烈，脉象多随气机上逆；阴性多郁结，脉象也随气机内陷。
古人虽然有女子右脉常盛，以及女脉在关下（关部以下）的说法，但这都不是定论。其病症唯独在月经、胎产方面，不同于男子，其他方面没有区别。如果肾脉微涩，或者左手关后尺内脉浮，或者肝脉沉而急，或者尺脉滑而断绝不均匀，都是经闭不调的征候。如体质虚弱的妇女，脉象常微弱，但尺内按之不绝，便是怀孕。月经停止且呕吐逆食，六脉无病态，也是怀孕。之所以这样，是因为体质虚弱而脉象难以显现。《脉经》说：妇人三部脉浮沉正常一致，按之不绝，没有其他疾病而月经不来的，是怀孕。尺脉数而旺盛的也是这样。《内经》说：怎么知道怀了孩子快要生产了？身体有病但没有邪脉；又说：阴脉搏动有力，与阳脉迥然不同，叫做怀孕。意思是尺内阴脉搏指有力，与寸口阳脉截然不同，其中含有阳象。阴阳相感合抱，所以能怀孕。阴虚阳搏叫做崩漏，意思是尺内脉虚大弦数，都是内里崩漏而下血。如果消瘦喘息，月经不来的，这是二阳（胃与大肠）的病发于心脾。妇女月经不来，脉来滑疾，重手按之散漫的，是胎儿已经三个月了。和缓滑利而代脉的，这是两个多月余的胎息。重手按之，滑疾而不散漫的，是五个月。妊娠四个月，想知道男女的方法，古人全部以左尺滑大为男，右尺滑大为女，两尺都滑大为双胎。然而往往有左寸动滑为男的，因为经期行血泻，阴常不满，所以尺脉常不足，不可拘泥于尺内滑大方为胎脉的例子。《内经》说：妇人手少阴脉动甚的，是怀孕。寸为阳位，所以见动滑，就是血充而显出阳象。左叶熊罴（喻男），右应鸾凰（喻女）的征兆，可以预先占卜而没有疑问。
凡是妇女经水三个月不来，诊其脉两寸浮大，两关滑利，两尺滑实而带数，这是胎脉。如果有形而不动，或者当脐下翕翕微动，像抱着瓮一样的形状，按之冰冷，又两尺脉乍大乍小，乍有乍无，或浮或沉，或动或止，早晚不同的，乃是鬼胎。必须连续观察两三天才能见到。宜补气活血，温养脾胃，则水液运行，经脉自然通畅。如果脉来疾速如风雨乱点，忽然而去，很久之后又回来如初的，是夜叉胎。也有左关之脉，指下见两歧而产夜叉的。总之与平常的脉不类似。妊娠脉弱，要防止胎堕，因为气血不能滋养。急宜补养。如果脉弦急也会堕胎，这是火盛。孕妇脉沉细弦急，憎寒壮热，唇口俱青黑，是胎气受损。应当问胎动否。如果不动，反而觉得上抢心闷绝，按之冰冷的，当作死胎治疗。妇女经断而有身孕，其脉弦的，后来必然大下血，不成胎。然而因病而脉弦，又应当以保胎为务。气旺则弦脉自退。妇女尺脉微迟为居经（指月经三月一行），月经三个月来一次，是血气不足的缘故。妇女尺脉微弱而涩，少腹恶寒，年少得的为无子，年长得的为绝孕。如果因病而脉涩的，怀孕多难保全。凡是妊娠外感风邪，脉宜缓滑流利，最忌虚涩躁急。虚涩则不固，躁急则热盛伤胎，多难治。胎前下利，脉宜滑小，不宜洪数。洪数则防其胎堕。堕后七日多凶险。治疗之法，攻积必死，兜涩（收敛固涩）亦死。急宜伏龙肝汤，煎温养脾胃药，多有生还的。凡是妊娠的脉，宜实大有力，忌沉细弦急虚涩。半产漏下，宜细小流连，忌急实断绝不匀。临产宜滑数离经（脉象离开常度），忌虚迟弦细短涩。产后宜沉小微弱，忌急实洪数不调。新产伤阴，出血不止，尺脉不能上关的死亡。新产中风热病，脉宜浮弱和缓，忌小急悬绝。崩漏不止，脉宜细小芤迟，忌虚涩数实。凡是诊察妇女室女伤寒热病，须问经事如何。产后须问恶露多少，及少腹中有无结块。这是大法。
Question: How does the pulse diagnosis for women differ from that of men?
Answer: When a woman reaches fourteen years old, Tian Gui (the substance promoting reproductive maturation) becomes unblocked, and menstruation occurs on time. Therefore, the focus of pulse diagnosis lies entirely in the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). The Chong and Ren Mai are the seas of essence and blood.
Their pulses typically follow the Qi of the Liver and Kidney. Thus, the Left Chi (Left Distal) pulse is regarded as the Ming Men (Gate of Life, root of Kidney Yang). The *Treatise on the Correspondences of Yin and Yang* states: Yin and Yang refer to the male and female attributes within blood and Qi. Left and right are the pathways of Yin and Yang. Generally, the Way of Heaven rotates left and governs Yang Qi, while the Way of Earth rotates right and governs Yin Blood. Yin often follows Yang, serving as its guardian. Hence, the Left Chi pulse bears the title of Ming Men. However, Yin endowment tends to be violent, and the pulse often rises with Qi; Yin nature tends to stagnate, and the pulse also sinks inward with Qi.
Although ancients held that women's Right pulses are often vigorous, and that the female pulse resides below the Guan (Middle) position, these are not definitive conclusions. Their diseases differ from men only in menstruation, pregnancy, and childbirth; otherwise, there is no distinction. If the Kidney pulse is faint and choppy, or if the pulse inside the Left Chi (distal to the Guan) is floating, or if the Liver pulse is deep and rapid, or if the Chi pulse is slippery but irregularly intermittent, these are signs of amenorrhea and irregular menstruation. For women with weak constitutions whose pulses are often faint, if the Chi position remains unceasing upon pressure, it indicates pregnancy. If menstruation has ceased accompanied by vomiting and loss of appetite, yet the six pulses show no pathological signs, this also indicates pregnancy. This is because in weak constitutions, the pulse manifestations are difficult to reveal. The *Mai Jing* (Pulse Classic) states: If a woman's three positions (Cun, Guan, Chi) show floating and sinking consistency, remain unceasing upon pressure, and she has no other illness but lacks menstruation, she is pregnant. Similarly, if the Chi pulse is rapid and vigorous. The *Jing* (Classic) asks: How do we know that a pregnancy is near term? The body shows symptoms but without pathogenic pulses; it further states: "Yin pulsation distinct from Yang" signifies pregnancy. This means the Yin pulse at the Chi position beats forcefully against the fingers, distinctly different from the Yang pulse at the Cun (Distal) position, containing Yang characteristics. When Yin and Yang interact and combine, conception occurs. "Yin deficiency with Yang pulsation" refers to Bing Lou (metrorrhagia and metrostaxis), meaning the Chi pulse is deficient, large, wiry, and rapid, indicating internal collapse and bleeding. If emaciation and panting occur with amenorrhea, this is a disease of the Er Yang (Stomach and Large Intestine) originating from the Heart and Spleen. In women with amenorrhea, if the pulse is slippery and rapid, and disperses under heavy pressure, the fetus is three months old. If it is harmonious, slippery, and exhibits Dai Mai (intermittent pulse), the fetus is slightly over two months old. If it is slippery and rapid without dispersion under heavy pressure, it is five months. To determine the sex of the fetus at four months of gestation, ancients generally considered a slippery and large Left Chi as male, and a slippery and large Right Chi as female, with both Chi positions being slippery and large indicating twins. However, sometimes a moving and slippery Left Cun indicates a male. This is because during menstruation, blood is discharged, Yin is often insufficient, so the Chi pulse is frequently deficient. One cannot rigidly adhere to the rule that only a slippery and large Chi pulse indicates pregnancy. The *Jing* states: "If the Hand Shaoyin pulse moves vigorously, it indicates pregnancy." The Cun position is Yang; thus, seeing movement and slipperiness indicates sufficient blood revealing Yang characteristics. Signs resembling male (bear and tiger) on the left and female (phoenix) on the right can be predicted with certainty.
Whenever a woman's menses have been absent for three months, if the pulse shows floating and large Cun positions, slippery and smooth Guan positions, and slippery, solid, and slightly rapid Chi positions, this is a fetal pulse. If there is form but no movement, or slight movement below the navel like holding a urn, feeling cold to touch, and the bilateral Chi pulses fluctuate between large and small, present and absent, floating and sinking, moving and stopping, varying morning and evening, this is a Ghost Fetus (ectopic or abnormal pregnancy). Continuous observation for two to three days is required to confirm. Treatment should involve tonifying Qi and invigorating blood, warming and nourishing the Spleen and Stomach, so that fluid metabolism proceeds and meridians clear naturally. If the pulse comes rapidly like chaotic raindrops, suddenly disappearing and returning after a long time, this is a Yaksha Fetus. There are also cases where the Left Guan pulse feels bifurcated under the fingers, leading to the birth of a Yaksha. In all such cases, the pulse differs significantly from normal. A weak pulse during pregnancy warns of miscarriage due to lack of Qi and Blood nourishment; urgent tonification is needed. A wiry and rapid pulse may also lead to miscarriage, indicating excessive Fire. If an pregnant woman's pulse is deep, fine, wiry, and rapid, accompanied by aversion to cold and high fever, with blue-black lips and mouth, the fetal Qi is damaged. One must ask if the fetus is moving. If there is no movement, but instead a sensation of upward rushing causing chest oppression and syncope, with a cold abdomen upon palpation, treat as a Dead Fetus. If a woman has amenorrhea with pregnancy but the pulse is wiry, heavy bleeding will likely follow, resulting in failure to sustain the pregnancy. However, if the wiry pulse is due to illness, preserving the fetus is paramount; when Qi becomes robust, the wiry quality will recede. A faint and slow Chi pulse in women is called Ju Jing (menstruation occurring once every three months), caused by insufficiency of Qi and Blood. A weak and choppy Chi pulse with cold intolerance in the lower abdomen indicates infertility in young women and barrenness in older women. If the choppy pulse is due to illness, maintaining pregnancy is difficult. In pregnancy complicated by external Wind pathogen, the pulse should be slow, slippery, and fluent; deficiency-choppy and restless-rapid pulses are most contraindicated. Deficiency-choppy implies instability, while restless-rapid implies excessive heat damaging the fetus, making treatment difficult. For diarrhea before delivery, the pulse should be slippery and small, not full and rapid; a full and rapid pulse warns of miscarriage, which is often fatal within seven days post-miscarriage. Treatment involving purging accumulation leads to death, as does using astringents. Urgently use Fulong Gan Decoction (Dragon's House Soil Decoction) to decoct medicines that warm and nourish the Spleen and Stomach; many survive. Generally, the pulse in pregnancy should be substantial, large, and forceful; deep, fine, wiry, rapid, deficient, and choppy pulses are contraindicated. For spontaneous abortion and dripping bleeding, the pulse should be fine and lingering; rapid, substantial, and irregularly intermittent pulses are contraindicated. At labor, the pulse should be slippery, rapid, and deviating from the regular course; deficient, slow, wiry, fine, short, and choppy pulses are contraindicated. Postpartum, the pulse should be deep, small, and faint; rapid, substantial, full, and rapid irregular pulses are contraindicated. In new postpartum yin injury with continuous bleeding, if the Chi pulse cannot reach the Guan position, it is fatal. In new postpartum wind-heat disease, the pulse should be floating, weak, and harmonious; small, rapid, and suspended-extreme pulses are contraindicated. For persistent metrorrhagia and metrostaxis, the pulse should be fine, small, hollow, and slow; deficient, choppy, rapid, and substantial pulses are contraindicated. Whenever diagnosing Shang Han (Cold Damage) or febrile diseases in unmarried women, one must inquire about menstrual status. Postpartum, one must inquire about the amount of Lochia (postpartum discharge) and whether there are masses in the lower abdomen. These are the general principles.