浮不沉也。按之不足。轻举有余。满指浮上。曰浮。为风虚动之候。为胀。为风。为 。为满不食。为表热。为喘。
浮大伤风鼻塞。浮滑疾为宿食。浮滑为饮。左寸浮。主伤风发热。头疼目眩。及风痰。浮而虚迟。心气不足。心神不安。
浮散。心气耗。虚烦。浮而洪数。心经热。关浮。腹胀。浮而数。风热入肝经。浮而促。怒气伤肝。心胸逆满。尺浮。
膀胱风热。小便赤涩。浮而芤。男子小便血。妇人崩带。浮而迟。冷疝脐下痛。右寸浮。肺感风寒。咳喘清涕。自汗体
倦。浮而洪。肺热而咳。浮而迟。肺寒喘嗽。关浮。脾虚。中满不食。浮大而涩。为宿食。浮而迟。脾胃虚。尺浮。风
邪客下焦。大便秘。浮而虚。元气不足。浮而数。下焦风热。大便秘。(诸脉指下真形。与其主病。俱少所发明。读者当
以意测之。推见其本。乃为有得)
沉。不浮也。轻手不见。重手乃得。为阴逆阳郁之候。为实。为寒。为气。为水。为停饮。为 瘕。为胁胀。为厥
逆。为洞泄。沉细为少气。沉迟为痼冷。沉滑为宿食。沉伏为霍乱。沉而数内热。沉而迟内寒。沉而弦心腹冷痛。左寸
沉。心内寒邪为痛。胸中寒饮胁疼。关沉。伏寒在经。两胁刺痛。沉弦。癖内痛。尺沉。肾藏感寒。腰臂冷痛。小便浊
而频。男为精冷。女为血结。沉而细。胫 阴痒。溺有余沥。右寸沉。肺冷。寒痰停蓄虚喘少气。沉而紧滑。咳嗽。沉
细而滑。骨蒸寒热皮毛焦干。关沉。胃中寒积。中满吞酸。沉紧悬饮。尺沉。病水。腰脚疼。沉细下利。又为小便滑。
脐下冷痛。
迟。不及也。以至数言之。呼吸之间。脉仅三至。减于平。脉一至也。为阴胜阳亏之候。为寒。为不足。浮而迟表
有寒。沉而迟里有寒。居寸为气不足。居尺为血不足。气寒则缩。血寒则凝也。左寸迟。心上寒。精神多惨。关迟。筋
寒急手足冷。胁下痛。尺迟。肾虚便浊。女人不月。右寸迟。肺感寒。冷痰气短。关迟。中焦寒。及脾胃伤冷物不食。
沉迟为积。尺迟。为藏寒泄泻。小腹冷痛。腰脚重。
数。太过也。一息六至。过平脉两至也。为烦满。上为头疼上热。中为脾热口臭。胃烦呕逆。左为肝热目赤。右下
为小便黄赤大便秘涩。浮数表有热。沉数里有热也。
虚。不实也。散大而软。举按豁然。不能自固。气血俱虚之。诊也。为暑。为虚烦多汗。为恍惚多惊。为小儿惊风。
实。不虚也。按举不绝。迢迢而长。动而有力。不疾不迟。为三焦气满之候。为呕。为痛。为气寒。为气聚。为食
积。为利。为伏阳在内。左寸实。心中积热。口舌疮。咽疼痛。实大。头面热风烦燥。体痛面赤。关实。腹胁痛满。实
而浮大。肝盛。目暗赤痛。尺实。小腹痛。小便涩。实而滑。淋沥茎痛溺赤。实大。膀胱热。溺难。实而紧腰痛。右寸
实。胸中热。痰嗽烦满。实而浮。肺热。咽燥痛。喘咳气壅。关实。伏阳蒸内。脾虚食少。胃气滞。实而浮。脾热。消
中善饥。口干劳倦。尺实。脐下痛。便难。或时下痢。
洪。大而实也。举按有余。来至大而去且长。腾上满指。为荣络大热。血气燔灼之候。为表里皆热。为烦。为咽干。
为大小便不通。左寸洪。心经积热。眼赤口疮头痛内烦。关洪。肝热及身痛。四肢浮热。尺洪。膀胱热小便赤涩。右寸
洪。肺热毛焦。唾粘咽干。洪而紧。喘急关洪。胃热。反胃呕吐口干。洪而紧。为胀。尺洪。腹满。大便难或下血。
微。不显也。依稀轻细。若有若无。为气血俱虚之候。为虚弱。为泄。为虚汗。为崩漏败血不止。为少气。浮而微
者阳不足。必身恶寒。沉而微者阴不足。主藏寒下利。左寸微。心虚。忧惕。荣血不足。头痛胸痞。虚劳盗汗。关微。
胸满气乏。四肢恶寒拘急。尺微。败血不止。男为伤精尿血。女为血崩带下。右寸微。上焦寒痞。冷痰不化。中寒少气。
关微。胃寒气胀。食不化。脾虚噫气。心腹冷痛。尺微。藏寒泄泻脐。下冷痛。
弦。按之不移。举之应手端直如弓弦。为血气收敛。为阳中伏阴。或经络间为寒所滞为痛。为疟。为拘急。为寒热。
为血虚。为盗汗。为寒凝气结。为冷痹。为疝。为饮。为劳倦。弦数为劳疟。双弦胁急痛。弦长为积。左寸弦。头疼心
惕。劳伤盗汗乏力。关弦。胁肋痛 癖。弦紧为疝瘕。为瘀血。弦小寒癖。尺弦。少腹痛。弦滑脚痛。右寸弦。肺受寒。
咳嗽胸中有寒痰。关弦。脾胃伤冷宿食不化。心腹冷痛。又为饮。尺弦。脐下急痛不安。下焦停水。
缓。不紧也。往来纡缓。呼吸徐徐。以气血向衰。故脉体为之徐缓尔。为风。为虚。为痹。为弱。为疼。在上为项
强。在下为脚弱。浮缓沉缓。血气俱弱。左寸缓。心气不足。怔忡多忘。亦主项背急痛。关缓。风虚眩晕。腹胁气结。
尺缓。肾虚冷。小便数。女人月事多。右寸缓。肺气浮。言语短气。关缓。胃气虚弱。浮缓。脾气虚弱。不沉不浮。从
容和缓。乃脾家本脉也。尺缓下寒脚弱。风气秘滞。浮缓。肠风泄泻。沉缓。小腹感冷。
滑。不涩也。往来流利。如盘走珠。不进不退。为血实气壅之候。盖气不胜于血也。为呕吐。为痰逆。为宿食。为
经闭(滑而不断绝。经不闭。有断绝者。经闭)上为吐逆。下为气结。滑数为结热。左寸滑。心热。滑而实大。心惊舌
强。关滑肝热。头目为患尺滑。小便淋涩。尿赤。茎中痛。右寸滑。痰饮呕逆。滑而实。肺热。毛发焦。隔壅咽干。痰
晕目昏。涕唾粘。关滑。脾热。口臭。及宿食不化。吐逆。滑实。胃热。尺滑。因相火炎而引饮多。脐冷腹鸣或时下利。
妇人主血实气壅。月事不通。若和滑。为孕。
涩。不滑也。虚细而迟。往来难。三五不调。如雨沾沙。如轻刀刮竹然。为气多血少之候。为少血。为无汗。为血
痹痛。为伤精。女人有孕为胎痛。无孕为败血病。左寸涩。心神虚耗不安。及冷气心痛。关涩。肝虚血散。肋胀胁满。
身痛。尺涩男子伤精及疝。女人月事虚败。若有孕。主胎漏不安。右寸涩。脾弱不食。胃冷而呕。尺涩。大便涩。津液
不足。小腹寒。足胫逆冷。(经云。滑者伤热。涩者中雾露。)
长。不短也。指下有余。而过于本位。气血皆有余也。为阳毒内蕴三焦烦郁为壮热。
短。不长也。两头无。中间有。不及本位。气不足以前导其血也。为阴中伏阳。为三焦气壅。为宿食不消。
大。不小也。浮取之若浮而洪。沉取之大而无力。为血虚。气不能相入也。经曰大为病进。
小。不大也。浮沉取之。悉皆损小。在阳为阳不足。在阴为阴不足前大后小。则头疼目眩。前小后大。则胸满气短。
紧。有力而不缓也。其来劲急。按之长。举之若牵绳转索之状。为邪风激搏。伏于荣卫之间。为痛。为寒。浮紧为
伤寒身痛。沉紧为腹中有寒。为风痫。左寸紧头热目痛。舌强。紧而沉。心中气逆冷痛。关紧。心腹满痛。胁痛肋急。
紧而盛。伤寒浑身痛。紧而实。 癖。尺紧。腰脚脐下痛。小便难。右寸紧。鼻塞膈壅。紧而沉滑。肺实咳嗽。关紧。
脾寒腹痛吐逆。紧盛。腹胀伤食尺紧。下焦筑痛。
弱。不盛也。极沉细而软。怏怏不前 。按之欲绝未绝。举之即无。由精气不足。故脉萎弱而不振也。为元气虚耗。
为萎弱不前。为痼冷。为关热。为泄精。为虚汗。老得之顺。壮得之逆。左寸弱。阳虚。心悸自汗。关弱。筋痿无力。
妇人主产后客风面肿。尺弱。小便数。肾虚耳聋。骨内 痛。右寸弱。身冷多寒。胸中短气。关弱。脾胃虚。食不化。
尺弱。下焦冷痛。大便滑。
动。其状如大豆。厥厥摇动。寻之有。举之无。不往不来不离其处。多于关部见之。(当云只各见本关之上。)动为
痛。为惊。为虚劳体痛。为崩脱。为泄利。阳动则汗出。阴动则发热。
伏。不见也。轻手取之。绝不可见。重取之。附着于骨。为阴阳潜伏。关鬲闭塞之候。为积聚。为瘕疝。为食不消。
为霍乱。为水气。为荣卫气闭而厥逆。关前得之为阳伏。关后得之为阴伏。左寸伏。心气不足。神不守常。沉忧抑郁。
关伏。血冷。腰脚痛。及胁下有寒气。尺伏。肾寒精虚。疝瘕寒痛。右寸伏。胸中气滞。寒痰冷积。关伏。中脘积块作
痛。及脾胃停滞。尺伏。脐下冷痛。下焦虚寒。腹中痼冷。
促。阳脉之极也。脉来数。时一止。复来者。曰促。阳独盛而阴不能相和也。或怒气逆上。亦令脉促。为气粗。为
狂闷。为瘀血发狂。又为气。为血。为饮。为食。为痰。盖先以气热脉数而五者或一。有留滞乎。其间则因之而为促。
非恶脉也。虽然。加即死。退则生。亦可畏哉。
结。阴脉之极也。脉来缓。时一止。复来者。曰结。阴独盛而阳不能相入也。为 结。为七情所郁。浮结为寒邪滞
经。沉结为积气在内。又为气。为血。为饮。为食。为痰。盖先以气寒脉缓而五者或一留滞于其间。则因而为结。故张
长沙谓结促皆病脉。
芤。浮大而软。寻之中空旁实。旁有中无。诊在浮举重按之间。为失血之候。大抵气有余。血不足。血不能统气。
故虚而大。若芤之状也。左寸芤。主心血妄行。为吐。为衄。关芤。主胁间血气痛。或腹中瘀血。亦为吐血目暗。尺芤。
小便血。女人月事为病。右寸芤。胸中积血。为衄。为呕。关芤。肠痈。瘀血。及呕血不食。尺芤。大便血。又云前大
后细脱血也。非芤而何。
革(与牢脉互换)沉伏实大如鼓皮曰革。气血虚寒。革易常度也。妇人则半产漏下。男子则亡血失精。又为中风寒
湿之诊也。
濡。无力也。虚软无力。应手散细。如绵絮之浮水中。轻手乍来。重手即去。为血气俱不足之候。为少血。为无血。
为疲损。为自汗。为下冷。为痹。左寸濡。心虚。易惊。盗汗。短气。关濡。荣卫不和。精神离散。体虚少力。尺濡。
男为伤精。女为脱血。小便数。自汗。多 。右寸濡。关热憎寒。气乏体虚。关濡。脾软不化饮食。尺濡。下元冷惫。
肠虚泄泻。
牢。坚牢也。沉而有力。动而不移。为里实表虚。胸中气促。为劳伤。大抵其脉近乎无胃气者。故诸家皆以为危殆
之脉云。亦主骨间疼痛。气居于表。
疾。盛也。快于数而疾。呼吸之间脉七至。热极之脉也。在阳犹可。在阴为逆。(按疾言其至止之躁也。不必七至。
病主津虚气悍。非热也。)
细。微眇也。指下寻之。往来如线。盖血冷气虚。不足以充故也。为元气不足。乏力无精。内外俱冷。痿弱洞泄。
为忧劳过度。为伤寒。为积。为痛在内及在下。
代。更代也。动而中止。不能自还。因而复动。由是复止。寻之良久。乃复强起为代。主形容羸瘦。口不能言。若
不因病。而人羸瘦。其脉代止。是一藏无气。他藏代之。真危亡之兆也。若因病而气血骤损。以致元气不续。或风家痛
家。脉见止代。只为病脉。故伤寒家亦有心悸而脉代者。心痛亦有结涩止代不匀者。盖凡痛之脉。不可准也。又妊娠亦
有脉代者。此必二月余之胎也。
散。不聚也。有阳无阴。按之满指。散而不聚。来去不明。谩无根柢。为气血耗散。腑脏气绝。在病脉。主阴阳不
敛。又主心气不足。大抵非佳脉也。
浮脉,指脉位浅表,轻取即得,重按反而减弱。手指轻抬时感觉脉搏充盈于指下表层,称为浮脉。它是风邪侵袭或正气虚弱的征象,主胀满、风病、气滞、脘腹胀满且食欲不振、表热证以及喘证。
若浮而大,多为伤风导致鼻塞;浮而滑且快,多为宿食停滞;浮而滑,多为痰饮内停。左寸部见浮脉,主伤风发热、头痛目眩及风痰;若浮而虚迟,主心气不足、心神不宁。
若脉浮散,主心气耗损、虚烦不安;若浮而洪数,主心经有热。关部见浮脉,主腹胀;若浮而数,主风热侵入肝经;若浮而促(脉来急数时有间歇),主怒气伤肝,心胸逆满。尺部见浮脉,主膀胱风热,小便赤涩;若浮而芤(中空如葱管),男子主尿血,妇人主崩漏带下;若浮而迟,主冷疝,脐下疼痛。
右寸部见浮脉,主肺感风寒,咳嗽气喘、流清涕、自汗体倦;若浮而洪,主肺热咳嗽;若浮而迟,主肺寒喘嗽。关部见浮脉,主脾虚、中焦胀满且食欲不振;若浮大而涩,主宿食停滞;若浮而迟,主脾胃虚弱。尺部见浮脉,主风邪客于下焦,大便秘结;若浮而虚,主元气不足;若浮而数,主下焦风热,大便秘结。(关于各种脉象在指下的真实形态及其所主疾病,本书阐述较少,读者应当用心揣摩,推究其本源,这样才能有所收获。)
沉脉,与浮脉相反,轻手触摸不见,重手按压才能触及。它是阴气逆乱、阳气郁结的征象,主实证、寒证、气滞、水饮、痰饮停留、癥瘕积聚、胁肋胀满、厥逆、洞泄(严重腹泻)。
沉细脉主少气;沉迟脉主久寒之疾;沉滑脉主宿食;沉伏脉(极深难见)主霍乱;沉而数主内热;沉而迟主内寒;沉而弦主心腹冷痛。
左寸部见沉脉,主心受寒邪引起疼痛,胸中有寒饮导致胁痛;关部见沉脉,主寒邪潜伏在经络,两胁刺痛;若兼弦脉,主癖积内痛;尺部见沉脉,主肾脏感受寒邪,腰臂冷痛,小便浑浊频数,男子主精冷,女子主血结。若沉而细,主小腿内侧瘙痒,小便淋漓不尽。
右寸部见沉脉,主肺冷,寒痰停蓄导致虚喘少气;若沉而紧滑,主咳嗽;若沉细而滑,主骨蒸潮热,皮毛焦干。关部见沉脉,主胃中寒积,中焦胀满吞酸;若沉紧,主悬饮。尺部见沉脉,主水肿病,腰脚疼痛;若沉细,主下利,也主小便失禁,脐下冷痛。
迟脉,指至数不及正常标准。以呼吸计算,一呼一吸之间,脉搏仅跳动三次,比平脉减少一次。它是阴盛阳亏的征象,主寒证、虚证。
浮而迟,主表寒;沉而迟,主里寒。脉见于寸部,主气不足;见于尺部,主血不足。气寒则收缩,血寒则凝滞。
左寸部见迟脉,主心上寒,精神多凄惨;关部见迟脉,主筋寒拘急,手足冷,胁下痛;尺部见迟脉,主肾虚,小便浑浊,女子月经不行。
右寸部见迟脉,主肺感寒邪,冷痰气短;关部见迟脉,主中焦寒,以及因食用生冷食物导致的脾胃损伤、食欲不振;若沉迟,主积证;尺部见迟脉,主脏腑寒冷泄泻,小腹冷痛,腰脚沉重。
数脉,指至数超过正常标准。一息跳动六次,比平脉多两次。它主烦闷胀满。上部见数脉,主头疼、上热;中部见数脉,主脾热口臭、胃热烦呕;左侧见数脉,主肝热目赤;右侧下部见数脉,主小便黄赤、大便秘涩。
浮而数,主表热;沉而数,主里热。
虚脉,指不实。脉形散大柔软,轻取重按都感觉豁然空虚,不能固摄,是气血俱虚的表现。它主暑病、虚烦多汗、恍惚易惊、小儿惊风。
实脉,指不虚。轻取重按脉搏连续不断,悠长有力,跳动有力但不快不慢。它是三焦气满的征象,主呕吐、疼痛、气寒、气聚、食积、泄利、伏阳在内。
左寸部见实脉,主心中积热,口舌生疮,咽喉疼痛;若实大,主头面风热烦躁,身体疼痛面色红赤。关部见实脉,主腹胁痛满;若实而浮大,主肝气盛,目暗赤痛。尺部见实脉,主小腹痛,小便涩滞;若实而滑,主淋沥茎痛、尿赤;若实大,主膀胱热,排尿困难;若实而紧,主腰痛。
右寸部见实脉,主胸中热,痰嗽烦满;若实而浮,主肺热,咽燥痛,喘咳气壅。关部见实脉,主伏阳蒸腾于内,脾虚食少,胃气阻滞;若实而浮,主脾热,消谷善饥,口干劳倦。尺部见实脉,主脐下痛,大便难,或时下痢。
洪脉,指脉形大而实。轻取重按都有余感,脉来时势大力猛,去时漫长,充满指下。它是营络大热、血气燔灼的征象,主表里皆热、心烦、咽干、大小便不通。
左寸部见洪脉,主心经积热,眼赤口疮头痛内烦;关部见洪脉,主肝热及身痛,四肢浮热;尺部见洪脉,主膀胱热,小便赤涩。
右寸部见洪脉,主肺热,毛发焦枯,唾粘咽干;若洪而紧,主喘急。关部见洪脉,主胃热,反胃呕吐口干;若洪而紧,主胀满。尺部见洪脉,主腹满,大便难或下血。
微脉,指不明显。脉象依稀轻细,若有若无。它是气血俱虚的征象,主虚弱、泄泻、虚汗、崩漏败血不止、少气。
浮而微,主阳不足,必定身体恶寒;沉而微,主阴不足,主脏腑寒冷下利。
左寸部见微脉,主心虚,忧惧不安,营血不足,头痛胸痞,虚劳盗汗;关部见微脉,主胸满气乏,四肢恶寒拘急;尺部见微脉,主败血不止,男子主伤精尿血,女子主血崩带下。
右寸部见微脉,主上焦寒痞,冷痰不化,中寒少气;关部见微脉,主胃寒气胀,食物不化,脾虚噫气,心腹冷痛;尺部见微脉,主脏腑寒冷泄泻,脐下冷痛。
弦脉,指按之不移,轻举时应手端直如弓弦。它是血气收敛、阳中伏阴,或经络间被寒邪阻滞致痛的征象,主疟疾、拘急、寒热、血虚、盗汗、寒凝气结、冷痹、疝气、痰饮、劳倦。
弦数脉主劳疟;双弦脉主胁肋急痛;弦长脉主积证。
左寸部见弦脉,主头疼、心悸、劳伤盗汗乏力;关部见弦脉,主胁肋痛、癖积;若弦紧,主疝瘕、瘀血;若弦小,主寒癖。尺部见弦脉,主少腹痛;若弦滑,主脚痛。
右寸部见弦脉,主肺受寒,咳嗽胸中有寒痰;关部见弦脉,主脾胃伤冷,宿食不化,心腹冷痛,也主痰饮;尺部见弦脉,主脐下急痛不安,下焦停水。
缓脉,指不紧张。脉来舒缓,呼吸徐徐。因为气血趋向衰弱,所以脉体徐缓。它主风病、虚证、痹证、弱证、疼痛。在上部主项强,在下部主脚弱。
浮缓或沉缓,主气血俱弱。
左寸部见缓脉,主心气不足,怔忡健忘,也主项背急痛;关部见缓脉,主风虚眩晕,腹胁气结;尺部见缓脉,主肾虚冷,小便频数,女子月经量多。
右寸部见缓脉,主肺气浮,言语短气;关部见缓脉,主胃气虚弱;若浮缓,主脾气虚弱;若不浮不沉,从容和缓,这是脾的本脉。尺部见缓脉,主下寒脚弱,风气秘滞;若浮缓,主肠风泄泻;若沉缓,主小腹感冷。
滑脉,指不涩。脉来流利,如盘走珠,不进不退。它是血实气壅的征象,盖因气不胜于血。它主呕吐、痰逆、宿食、经闭(若滑而不断绝,则经不闭;若有断绝者,则为经闭)。上部见滑脉主吐逆,下部见滑脉主气结。滑数脉主结热。
左寸部见滑脉,主心热;若滑而实大,主心惊舌强。关部见滑脉,主肝热,头目为患;尺部见滑脉,主小便淋涩,尿赤,茎中痛。
右寸部见滑脉,主痰饮呕逆;若滑而实,主肺热,毛发焦枯,膈壅咽干,痰晕目昏,涕唾粘。关部见滑脉,主脾热,口臭,以及宿食不化,吐逆;若滑实,主胃热。尺部见滑脉,主因相火炎上而引饮多,脐冷腹鸣或时下痢。
妇人见滑脉,主血实气壅,月事不通;若脉和滑,主怀孕。
涩脉,指不滑。脉象虚细而迟,往来艰难,三五不调,如雨沾沙,如轻刀刮竹。它是气多血少的征象,主少血、无汗、血痹痛、伤精。女人有孕见涩脉主胎痛,无孕见涩脉主败血病。
左寸部见涩脉,主心神虚耗不安,以及冷气心痛;关部见涩脉,主肝虚血散,肋胀胁满,身痛;尺部见涩脉,男子主伤精及疝,女子主月事虚败,若有孕,主胎漏不安。
右寸部见涩脉,主脾弱不食,胃冷而呕;尺部见涩脉,主大便涩,津液不足,小腹寒,足胫逆冷。(《内经》说:滑脉主伤热,涩脉主中雾露。)
长脉,指不短。指下有有余之感,超过本位。它是气血皆有余的表现。主阳毒内蕴,三焦烦郁,壮热。
短脉,指不长。两头无脉,中间有脉,不及本位。它是气不足以前导其血的表现。主阴中伏阳,三焦气壅,宿食不消。
大脉,指不小。浮取之似浮而洪,沉取之大而无力。它是血虚,气不能相入的表现。《内经》说:大为病进。
小脉,指不大。浮沉取之,都显得损小。在阳分主阳不足,在阴分主阴不足。前大后小,主头疼目眩;前小后大,主胸满气短。
紧脉,指有力而不缓和。脉来劲急,按之长,举之如牵绳转索之状。它是邪风激搏,伏于荣卫之间的表现。主疼痛、寒证。
浮紧主伤寒身痛;沉紧主腹中有寒,主风痫。
左寸部见紧脉,主头热目痛,舌强;若紧而沉,主心中气逆冷痛。关部见紧脉,主心腹满痛,胁痛肋急;若紧而盛,主伤寒浑身痛;若紧而实,主癖积。尺部见紧脉,主腰脚脐下痛,小便难。
右寸部见紧脉,主鼻塞膈壅;若紧而沉滑,主肺实咳嗽。关部见紧脉,主脾寒腹痛吐逆,紧盛主腹胀伤食;尺部见紧脉,主下焦筑痛。
弱脉,指不盛。极沉细而软,怏怏不前,按之欲绝未绝,轻举即无。由精气不足,故脉萎弱不振。它主元气虚耗,萎弱不前,久寒,关热,泄精,虚汗。老年人得此脉为顺,青壮年得此脉为逆。
左寸部见弱脉,主阳虚,心悸自汗;关部见弱脉,主筋痿无力,妇人主产后客风面肿;尺部见弱脉,主小便频数,肾虚耳聋,骨内疼痛。
右寸部见弱脉,主身冷多寒,胸中短气;关部见弱脉,主脾胃虚,食不化;尺部见弱脉,主下焦冷痛,大便滑。
动脉,其状如大豆,厥厥摇动,寻之有,举之无,不往不来不离其处,多见于关部。(应当说是只在各本关之上出现)。动脉主疼痛、惊恐、虚劳体痛、崩脱、泄利。阳动则汗出,阴动则发热。
伏脉,指不见。轻手取之,绝对看不见,重取之,附着于骨。它是阴阳潜伏,关鬲闭塞的征象,主积聚、瘕疝、食不消、霍乱、水气、荣卫气闭而厥逆。
关前得之为阳伏,关后得之为阴伏。
左寸部见伏脉,主心气不足,神不守常,沉忧抑郁;关部见伏脉,主血冷,腰脚痛,及胁下有寒气;尺部见伏脉,主肾寒精虚,疝瘕寒痛。
右寸部见伏脉,主胸中气滞,寒痰冷积;关部见伏脉,主中脘积块作痛,及脾胃停滞;尺部见伏脉,主脐下冷痛,下焦虚寒,腹中久寒。
促脉,是阳脉的极致。脉来数,时常有一次停顿,随后又跳动,称为促脉。这是阳独盛而阴不能相和的表现。或是怒气逆上,也会使脉促。它主气粗、狂闷、瘀血发狂,也主气、血、饮、食、痰的留滞。大概是因为先有气热脉数,然后这五种病理产物之一留滞其间,从而导致促脉。这不是恶脉。虽然如此,若脉象加剧则死,若脉象退减则生,也可畏惧啊。
结脉,是阴脉的极致。脉来缓,时常有一次停顿,随后又跳动,称为结脉。这是阴独盛而阳不能相入的表现。它主阴结,主七情所郁。浮结主寒邪滞经,沉结主积气在内。也主气、血、饮、食、痰的留滞。大概是因为先有气寒脉缓,然后这五种病理产物之一留滞于其间,从而导致结脉。所以张长沙说结脉和促脉都是病脉。
芤脉,指浮大而软,寻之中空旁实,旁有中无,诊察时在浮举重按之间发现。它是失血的征象。大体上是气有余,血不足,血不能统气,所以脉虚大,像芤草一样。
左寸部见芤脉,主心血妄行,为吐血、衄血;关部见芤脉,主胁间血气痛,或腹中瘀血,也为吐血目暗;尺部见芤脉,主小便血,女子月经病。
右寸部见芤脉,主胸中积血,为衄血、呕血;关部见芤脉,主肠痈、瘀血,及呕血不食;尺部见芤脉,主大便血。又说前大后细为脱血,如果不是芤脉是什么?
革脉(与牢脉互换位置讨论),指沉伏实大如鼓皮曰革。它是气血虚寒,革易常度的表现。妇人主半产漏下,男子主亡血失精,也主中风寒湿的诊断。
濡脉,指无力。虚软无力,应手散细,如棉絮浮在水中,轻手乍来,重手即去。它是血气俱不足的征象,主少血、无血、疲损、自汗、下冷、痹证。
左寸部见濡脉,主心虚,易惊,盗汗,短气;关部见濡脉,主营卫不和,精神离散,体虚少力;尺部见濡脉,男子主伤精,女子主脱血,小便频数,自汗,多梦。
右寸部见濡脉,主关热憎寒,气乏体虚;关部见濡脉,主脾软不化饮食;尺部见濡脉,主下元冷惫,肠虚泄泻。
牢脉,指坚牢。脉沉而有力,动而不移。它是里实表虚,胸中气促,劳伤的表现。大体上这种脉接近无胃气,所以各家都认为它是危殆之脉。它也主骨间疼痛,气居于表。
疾脉,指盛。比数脉更快,一息跳动七次,是热极的脉象。在阳分尚可,在阴分为逆。(按:疾言其至止之躁动,不必一定是七至,病主津虚气悍,不一定是热。)
细脉,指微眇。指下寻之,往来如线。盖因血冷气虚,不足以充脉所致。它主元气不足,乏力无精,内外俱冷,痿弱洞泄,忧劳过度,伤寒,积证,痛在内及在下。
代脉,指更代。动而中止,不能自还,因而复动,由此复止,寻之良久,乃复强起为代。它主形容羸瘦,口不能言。如果不因病,而人羸瘦,其脉代止,是一脏无气,他脏代之,真是危亡的征兆。如果因病而气血骤损,以致元气不续,或风家、痛家,脉见止代,只为病脉。所以伤寒家也有心悸而脉代的,心痛也有结涩止代不匀的。大概凡是疼痛的脉,不可作为准绳。另外妊娠也有脉代的,这必是二月余的胎。
散脉,指不聚。有阳无阴,按之满指,散而不聚,来去不明,漫无根柢。它是气血耗散,腑脏气绝的表现。在病脉中,主阴阳不敛,也主心气不足。大体上不是好脉。
The floating pulse is superficial, becoming weaker upon heavy pressure. When the fingers lightly lift, the pulse feels full at the surface of the finger pads; this is called the Floating Pulse (Fu Mai). It indicates a pattern of wind invasion or deficiency, manifesting as distension, wind diseases, qi stagnation, abdominal fullness with poor appetite, exterior heat, and wheezing.
If the pulse is floating and large, it often indicates wind injury causing nasal congestion; if floating, slippery, and rapid, it suggests retained food; if floating and slippery, it suggests fluid retention. A floating pulse at the left Cun position primarily indicates wind injury with fever, headache, dizziness, and wind-phlegm. If floating, deficient, and slow, it indicates insufficient heart qi and restless mind.
A floating and scattered pulse indicates consumption of heart qi and empty vexation. If floating, surging, and rapid, it indicates heat in the Heart Channel. At the Guan position, a floating pulse indicates abdominal distension; if floating and rapid, it indicates wind-heat invading the Liver Channel; if floating and choppy (Cu), it indicates liver qi rebellion due to anger, causing chest and epigastric fullness. At the Chi position, a floating pulse indicates wind-heat in the Bladder, with red, scanty urine. If floating and hollow (Kou), men may have hematuria, while women may have metrorrhagia and leukorrhea. If floating and slow, it indicates cold hernia with pain below the umbilicus.
At the right Cun position, a floating pulse indicates lung exposure to wind-cold, with cough, wheezing, clear nasal discharge, spontaneous sweating, and fatigue. If floating and surging, it indicates lung heat with cough. If floating and slow, it indicates lung cold with wheezing and cough. At the Guan position, a floating pulse indicates spleen deficiency, middle jiao fullness, and poor appetite; if floating, large, and choppy, it indicates retained food; if floating and slow, it indicates spleen and stomach deficiency. At the Chi position, a floating pulse indicates wind pathogen lodging in the lower jiao with constipation; if floating and deficient, it indicates insufficiency of primordial qi; if floating and rapid, it indicates wind-heat in the lower jiao with constipation. (Regarding the true shapes of various pulses under the fingers and their corresponding diseases, this text offers little explanation. Readers should use their judgment to infer the root causes to gain true understanding.)
The sinking pulse (Chen Mai) is opposite to floating; it is not visible with light touch but can be felt with heavy pressure. It indicates rebellion of yin and depression of yang, manifesting as excess patterns, cold patterns, qi stagnation, water retention, phlegm-fluid retention, masses, hypochondriac distension, reversal cold, severe diarrhea, shortness of breath (if fine), chronic cold (if slow), retained food (if slippery), cholera (if hidden/deeply sunken), internal heat (if rapid), internal cold (if slow), and cold pain in the heart and abdomen (if wiry).
At the left Cun position, a sinking pulse indicates cold pathogen in the heart causing pain, and cold-fluid in the chest causing hypochondriac pain. At the Guan position, it indicates latent cold in the meridians causing stabbing pain in both hypochondria; if wiry, it indicates internal pain from accumulations. At the Chi position, it indicates kidney exposure to cold, causing cold pain in the waist and arms, turbid frequent urination, cold sperm in men, and blood coagulation in women. If fine, it indicates itching in the shins and dribbling urination.
At the right Cun position, a sinking pulse indicates lung cold, with cold-phlegm retention causing deficiency wheezing and shortness of breath; if tight and slippery, it indicates cough; if fine and slippery, it indicates bone-steaming tidal fever with dry skin and hair. At the Guan position, it indicates cold accumulation in the stomach, middle jiao fullness, and acid regurgitation; if tight, it indicates suspended fluid. At the Chi position, it indicates edema with back and leg pain; if fine, it indicates diarrhea or urinary incontinence with cold pain below the umbilicus.
The slow pulse (Chi Mai) refers to a rate below normal. In terms of respiration, the pulse beats only three times per breath cycle, one beat less than the normal pulse. It indicates excess yin and deficiency of yang, manifesting as cold and deficiency patterns. Floating and slow indicates exterior cold; sinking and slow indicates interior cold. Located at the Cun, it indicates qi deficiency; located at the Chi, it indicates blood deficiency. Cold in qi causes contraction; cold in blood causes coagulation.
At the left Cun position, a slow pulse indicates cold in the upper heart, with a melancholic spirit. At the Guan position, it indicates cold in the sinews causing stiffness and cold hands and feet, with pain below the hypochondria. At the Chi position, it indicates kidney deficiency with turbid urine and amenorrhea in women.
At the right Cun position, a slow pulse indicates lung exposure to cold, with cold-phlegm and shortness of breath. At the Guan position, it indicates middle jiao cold and spleen/stomach damage from cold foods leading to anorexia; if sinking and slow, it indicates accumulations. At the Chi position, it indicates visceral cold with diarrhea, cold pain in the lower abdomen, and heaviness in the waist and legs.
The rapid pulse (Shu Mai) refers to a rate exceeding normal, beating six times per breath cycle, two beats more than the normal pulse. It manifests as vexation and fullness. Upper rapidity indicates headache and upper heat; middle rapidity indicates spleen heat with bad breath and stomach heat with vexation and vomiting; left rapidity indicates liver heat with red eyes; lower right rapidity indicates yellow-red urine and constipation. Floating and rapid indicates exterior heat; sinking and rapid indicates interior heat.
The deficient pulse (Xu Mai) is not solid. It is scattered, large, and soft, feeling hollow upon both light and heavy pressure, unable to hold firm. It indicates dual deficiency of qi and blood, manifesting as summerheat, empty vexation with profuse sweating, mental confusion with fright, and pediatric convulsions.
The excessive pulse (Shi Mai) is not deficient. The pulse continues uninterrupted upon both light and heavy pressure, long and forceful, neither fast nor slow. It indicates fullness of qi in the Triple Burner, manifesting as vomiting, pain, cold qi, qi aggregation, food retention, diarrhea, and latent yang inside.
At the left Cun position, an excessive pulse indicates accumulated heat in the heart, mouth/tongue sores, and sore throat; if large and excessive, it indicates wind-heat on the head/face with vexation, body pain, and red face. At the Guan position, it indicates abdominal and hypochondriac pain/fullness; if excessive and floating-large, it indicates liver excess with dim vision and red painful eyes. At the Chi position, it indicates lower abdominal pain and dysuria; if excessive and slippery, it indicates strangury with penile pain and red urine; if large and excessive, it indicates bladder heat with difficult urination; if excessive and tight, it indicates lower back pain.
At the right Cun position, an excessive pulse indicates heat in the chest, phlegm-cough with vexation and fullness; if excessive and floating, it indicates lung heat with dry sore throat and oppressive cough. At the Guan position, it indicates latent yang steaming internally, spleen deficiency with poor appetite, and stomach qi stagnation; if excessive and floating, it indicates spleen heat with polyphagia, dry mouth, and fatigue. At the Chi position, it indicates pain below the umbilicus, difficulty defecating, or occasional diarrhea.
The surging pulse (Hong Mai) is large and solid. It feels abundant upon both light and heavy pressure, coming forcefully and going long, filling the finger pads. It indicates great heat in the Ying collaterals and blazing blood/qi, manifesting as heat in both interior and exterior, vexation, dry throat, and obstruction of urination and defecation.
At the left Cun position, a surging pulse indicates accumulated heat in the Heart Channel, with red eyes, mouth sores, headache, and internal vexation. At the Guan position, it indicates liver heat with body pain and floating heat in the limbs. At the Chi position, it indicates bladder heat with red, scanty urine.
At the right Cun position, a surging pulse indicates lung heat with dry skin, sticky saliva, and dry throat; if surging and tight, it indicates急促 wheezing. At the Guan position, it indicates stomach heat with reverse flow vomiting and dry mouth; if surging and tight, it indicates distension. At the Chi position, it indicates abdominal fullness, difficult defecation, or bloody stool.
The minute pulse (Wei Mai) is indistinct. It is faint, thin, seeming to exist yet not. It indicates dual deficiency of qi and blood, manifesting as weakness, diarrhea, spontaneous sweating, unstoppable bleeding from broken blood, and shortness of breath. Floating and minute indicates insufficient yang,必然 accompanied by aversion to cold; sinking and minute indicates insufficient yin, indicating visceral cold with diarrhea.
At the left Cun position, a minute pulse indicates heart deficiency, fearfulness, insufficient Ying blood, headache, chest stuffiness, consumptive night sweats. At the Guan position, it indicates chest fullness, qi exhaustion, cold aversion, and limb stiffness. At the Chi position, it indicates unstoppable broken blood, seminal emission with hematuria in men, and metrorrhagia/leukorrhea in women.
At the right Cun position, a minute pulse indicates upper jiao cold stuffiness, untransformed cold-phlegm, middle jiao cold with shortness of breath. At the Guan position, it indicates stomach qi cold with distension, undigested food, spleen deficiency with belching, and cold pain in the heart/abdomen. At the Chi position, it indicates visceral cold with diarrhea and cold pain below the umbilicus.
The wiry pulse (Xian Mai) does not move when pressed; upon lifting, it feels straight and taut like a bowstring. It indicates convergence of blood and qi, latent yin within yang, or cold stagnation in the meridians causing pain. It manifests as malaria, stiffness, alternating cold and fever, blood deficiency, night sweats, cold coagulation with qi knotting, cold bi syndrome, hernia, fluid retention, and overwork. Wiry and rapid indicates labor malaria; double wiry indicates acute hypochondriac pain; wiry and long indicates accumulations.
At the left Cun position, a wiry pulse indicates headache, palpitations, consumptive night sweats, and fatigue. At the Guan position, it indicates hypochondriac pain and accumulations; if wiry and tight, it indicates hernia/masses and blood stasis; if wiry and small, it indicates cold accumulations. At the Chi position, it indicates lower abdominal pain; if wiry and slippery, it indicates foot pain.
At the right Cun position, a wiry pulse indicates lung exposure to cold, cough with cold-phlegm in the chest. At the Guan position, it indicates spleen/stomach damage from cold, undigested retained food, cold pain in the heart/abdomen, and fluid retention. At the Chi position, it indicates urgent pain below the umbilicus and water retention in the lower jiao.
The moderate pulse (Huan Mai) is not tight. It comes slowly and leisurely, matching the breathing rhythm. Due to declining qi and blood, the pulse body becomes slow. It indicates wind, deficiency, bi syndrome, weakness, and pain. Upper moderate indicates neck stiffness; lower moderate indicates weak legs. Floating-moderate or sinking-moderate indicates dual deficiency of qi and blood.
At the left Cun position, a moderate pulse indicates insufficient heart qi, palpitations, forgetfulness, and neck/back stiffness. At the Guan position, it indicates wind-deficiency vertigo and qi knotting in the abdomen/hypochondria. At the Chi position, it indicates kidney cold, frequent urination, and heavy menstruation in women.
At the right Cun position, a moderate pulse indicates floating lung qi and shortness of speech. At the Guan position, it indicates weak stomach qi; if floating-moderate, it indicates weak spleen qi. If neither floating nor sinking, gentle and moderate, it is the native pulse of the spleen. At the Chi position, it indicates lower cold, weak legs, and wind-induced constipation; if floating-moderate, it indicates intestinal wind diarrhea; if sinking-moderate, it indicates cold in the lower abdomen.
The slippery pulse (Hua Mai) is not choppy. It flows smoothly, like pearls rolling in a plate, neither advancing nor retreating. It indicates excess blood and congested qi, where qi cannot overcome blood. It manifests as vomiting, rebellious phlegm, retained food, and amenorrhea (if slippery and uninterrupted, menses are not blocked; if interrupted, it is amenorrhea). Upper slipperiness indicates vomiting/rebellion; lower slipperiness indicates qi knotting. Slippery and rapid indicates knotted heat.
At the left Cun position, a slippery pulse indicates heart heat; if slippery and excessive-large, it indicates heart fright and stiff tongue. At the Guan position, it indicates liver heat affecting the head and eyes. At the Chi position, it indicates strangury, red urine, and penile pain.
At the right Cun position, a slippery pulse indicates phlegm-fluid with vomiting/rebellion; if slippery and excessive, it indicates lung heat with dry skin, chest obstruction, dry throat, phlegm-dizziness, blurred vision, and sticky sputum. At the Guan position, it indicates spleen heat, bad breath, undigested retained food, and vomiting/rebellion; if slippery and excessive, it indicates stomach heat. At the Chi position, it indicates excessive drinking due to ministerial fire flaring, cold umbilicus, borborygmus, or occasional diarrhea. In women, it indicates blood excess and qi congestion with amenorrhea; if gentle and slippery, it indicates pregnancy.
The choppy pulse (Se Mai) is not slippery. It is deficient, fine, and slow, flowing with difficulty, irregular every three or five beats, like rain soaking sand or a light knife scraping bamboo. It indicates excess qi and deficient blood, manifesting as blood deficiency, absence of sweating, blood-bi pain, and seminal emission. In pregnant women, it indicates fetal pain; in non-pregnant women, it indicates broken blood disease.
At the left Cun position, a choppy pulse indicates depletion of heart spirit causing restlessness and cold qi heart pain. At the Guan position, it indicates liver deficiency with dispersed blood, rib distension, hypochondriac fullness, and body pain. At the Chi position, it indicates seminal emission and hernia in men, and menstrual deficiency/failure in women; if pregnant, it indicates threatened miscarriage.
At the right Cun position, a choppy pulse indicates weak spleen with anorexia and cold stomach with vomiting. At the Chi position, it indicates difficult defecation, insufficient fluids, cold lower abdomen, and cold calves/shins. (The Classic states: Slippy indicates heat injury; Choppy indicates mist/dew invasion.)
The long pulse (Chang Mai) is not short. It feels abundant under the fingers, extending beyond its normal position. It indicates excess in both qi and blood, manifesting as internal accumulation of yang toxin, triple burner vexation, and high fever.
The short pulse (Duan Mai) is not long. It is absent at both ends and present only in the middle, failing to reach its normal position. It indicates insufficient qi to guide blood, latent yang within yin, triple burner qi congestion, and undigested retained food.
The large pulse (Da Mai) is not small. Upon light palpation, it resembles floating and surging; upon deep palpation, it is large but forceless. It indicates blood deficiency where qi cannot enter. The Classic states: Large indicates disease progression.
The small pulse (Xiao Mai) is not large. Upon both light and deep palpation, it appears diminished. In the yang aspect, it indicates yang deficiency; in the yin aspect, it indicates yin deficiency. Large front and small back indicate headache and dizziness; small front and large back indicate chest fullness and shortness of breath.
The tight pulse (Jin Mai) is forceful and not relaxed. It comes swiftly and tightly, feeling long upon pressing and like pulling a rope upon lifting. It indicates evil wind clashing and lodging between Ying and Wei, manifesting as pain and cold. Floating-tight indicates cold damage with body pain; sinking-tight indicates cold in the abdomen and wind epilepsy.
At the left Cun position, a tight pulse indicates head heat, eye pain, and stiff tongue; if tight and sinking, it indicates rebellious cold pain in the heart. At the Guan position, it indicates heart/abdominal fullness/pain and hypochondriac pain/stiffness; if tight and flourishing, it indicates cold damage with whole-body pain; if tight and excessive, it indicates accumulations. At the Chi position, it indicates pain in the waist, legs, and below the umbilicus, with difficult urination.
At the right Cun position, a tight pulse indicates nasal congestion and chest obstruction; if tight, sinking, and slippery, it indicates lung excess with cough. At the Guan position, it indicates spleen cold with abdominal pain and vomiting; if tight and flourishing, it indicates abdominal distension from food injury. At the Chi position, it indicates pounding pain in the lower jiao.
The weak pulse (Ruo Mai) is not flourishing. It is extremely sinking, fine, and soft, sluggish, nearly disappearing upon pressing but vanishing upon lifting. It results from insufficiency of essence and qi, causing the pulse to be withered and unvigorous. It indicates depletion of primordial qi, withering/sluggishness, chronic cold, guan-heat, seminal emission, and spontaneous sweating. In the elderly, it is favorable; in the young, it is unfavorable.
At the left Cun position, a weak pulse indicates yang deficiency, palpitations, and spontaneous sweating. At the Guan position, it indicates sinew withering and weakness, and postpartum wind swelling in women. At the Chi position, it indicates frequent urination, kidney deficiency deafness, and bone pain.
At the right Cun position, a weak pulse indicates cold body with aversion to cold and shortness of breath in the chest. At the Guan position, it indicates spleen/stomach deficiency with undigested food. At the Chi position, it indicates lower jiao cold pain and slippery stool.
The moving pulse (Dong Mai) resembles a soybean, trembling vigorously. It is felt upon searching but not upon lifting, staying in place without moving forward or backward, mostly seen at the Guan position (specifically above each respective Guan). It indicates pain, fright, consumptive body pain, metrorrhagia/prolapse, and diarrhea. Yang-moving indicates sweating; yin-moving indicates fever.
The hidden pulse (Fu Mai) is invisible. It is absolutely unseen with light touch but felt attached to the bone with heavy pressure. It indicates latent yin and yang, closure of the diaphragm/gates, manifesting as accumulations, hernias, undigested food, cholera, water qi, and reversal cold due to Ying-Wei closure. Obtained before the Guan, it is yang-hidden; obtained after the Guan, it is yin-hidden.
At the left Cun position, a hidden pulse indicates insufficient heart qi, unsettled spirit, and deep sorrow/depression. At the Guan position, it indicates cold blood, back/leg pain, and cold qi in the hypochondria. At the Chi position, it indicates kidney cold with deficient essence and cold pain from hernias/masses.
At the right Cun position, a hidden pulse indicates qi stagnation in the chest and cold-phlegm/cold accumulation. At the Guan position, it indicates painful masses in the middle jiao and spleen/stomach stagnation. At the Chi position, it indicates cold pain below the umbilicus, lower jiao deficiency-cold, and chronic cold in the abdomen.
The choppy-rapid pulse (Cu Mai) is the extreme of yang pulses. The pulse is rapid but occasionally stops before resuming. It indicates exclusive excess of yang with inability of yin to harmonize, or qi rebellion due to anger. It manifests as rough breathing, mania/vexation, blood stasis with madness, and stagnation of qi, blood, fluid, food, or phlegm. Generally, prior heat causes rapidity, and if one of the five stagnations remains, it leads to the Cu pulse. It is not necessarily a malignant pulse. However, if it worsens, death ensues; if it recedes, life is preserved. It is indeed formidable.
The knotted pulse (Jie Mai) is the extreme of yin pulses. The pulse is slow but occasionally stops before resuming. It indicates exclusive excess of yin with inability of yang to enter. It indicates yin knotting and depression from seven emotions. Floating-knotted indicates cold pathogen stagnating in meridians; sinking-knotted indicates accumulated qi inside. It also involves stagnation of qi, blood, fluid, food, or phlegm. Generally, prior cold causes slowness, and if one of the five stagnations remains, it leads to the Jie pulse. Thus, Zhang Zhongjing stated that both Jie and Cu are pathological pulses.
The scallion-stalk pulse (Kou Mai) is floating, large, and soft. Searching reveals emptiness in the center and solidity on the sides. It is diagnosed between light lifting and heavy pressing. It indicates blood loss. Generally, there is excess qi and deficient blood; blood fails to control qi, resulting in a vacuous, large pulse resembling a scallion stalk.
At the left Cun position, a Kou pulse indicates reckless bleeding from heart blood, manifesting as hematemesis or epistaxis. At the Guan position, it indicates blood/qi pain in the hypochondria, intra-abdominal blood stasis, hematemesis, and dim vision. At the Chi position, it indicates hematuria and menstrual disorders in women.
At the right Cun position, a Kou pulse indicates accumulated blood in the chest, manifesting as epistaxis or hematemesis. At the Guan position, it indicates intestinal abscess, blood stasis, hematemesis, and anorexia. At the Chi position, it indicates hematochezia. It is also said that large front and small back indicate blood loss; if not Kou, then what?
The drum-skin pulse (Ge Mai) (interchanged with Lao pulse) is sinking, hidden, excessive, and large, like a drum skin. It indicates deficiency-cold of qi and blood, altering the normal pulse quality. In women, it indicates miscarriage and dripping bleeding; in men, it indicates blood loss and seminal emission. It also indicates diagnosis of wind-stroke, cold, and dampness.
The soggy pulse (Ru Mai) is forceless. It is deficient, soft, and forceless, feeling scattered and fine like cotton floating in water. It comes lightly but disappears heavily. It indicates dual deficiency of blood and qi, manifesting as blood deficiency, absence of blood, debility, spontaneous sweating, lower cold, and bi syndrome.
At the left Cun position, a Ru pulse indicates heart deficiency, easy fright, night sweats, and shortness of breath. At the Guan position, it indicates disharmony of Ying and Wei, scattered spirit, and physical weakness. At the Chi position, it indicates seminal emission in men and blood loss in women, with frequent urination, spontaneous sweating, and dreams.
At the right Cun position, a Ru pulse indicates guan-heat with aversion to cold, qi exhaustion, and physical weakness. At the Guan position, it indicates soft spleen unable to transform food. At the Chi position, it indicates cold exhaustion of the lower origin and intestinal deficiency diarrhea.
The firm pulse (Lao Mai) is firm and solid. It is sinking and forceful, unmoving. It indicates interior excess and exterior deficiency, shortness of breath in the chest, and consumptive injury. Generally, this pulse approaches having no Stomach Qi, so all schools consider it a critical pulse. It also indicates interosseous pain, with qi residing in the exterior.
The hurried pulse (Ji Mai) is flourishing. It is faster than the rapid pulse, beating seven times per breath cycle. It is the pulse of extreme heat. In the yang aspect, it is acceptable; in the yin aspect, it is unfavorable. (Note: Ji refers to the agitation of the pulse beats, not necessarily seven beats; the pathology is fluid deficiency and fierce qi, not necessarily heat.)
The fine pulse (Xi Mai) is subtle. Under the fingers, it flows like a thread. This is due to cold blood and deficient qi failing to fill the vessels. It indicates insufficiency of primordial qi, fatigue, lack of essence, cold inside and out, wasting-thirst, severe diarrhea, excessive worry/labor, cold damage, accumulations, and pain inside or below.
The intermittent pulse (Dai Mai) indicates replacement. The pulse moves then stops, unable to return on its own, resuming motion, then stopping again. After searching for a long time, it rises strongly again. It indicates emaciation and inability to speak. If not caused by disease, but the person is emaciated with an intermittent pulse, it indicates one viscera lacks qi, replaced by others, a true sign of peril and death. If caused by disease with sudden loss of qi and blood leading to discontinuity of primordial qi, or in wind/pain cases, the intermittent pulse is merely a pathological pulse. Thus, in cold damage, palpitations may present with Dai pulse; in heart pain, Jie, Se, stop, and Dai may be irregular. Generally, pulses in pain conditions are not reliable standards. Also, pregnancy may present with Dai pulse, specifically around two months of gestation.
The scattered pulse (San Mai) is not gathered. It has yang but no yin. Upon pressing, it fills the fingers but is scattered and not gathered. Its coming and going are unclear, lacking roots. It indicates dispersion of qi and blood, and extinction of viscera qi. In pathological pulses, it indicates failure of yin and yang to converge and insufficient heart qi. Generally, it is not a favorable pulse.