叔和《脉经》止论二十四种,若夫长短二脉,缺而不载;牢革二脉,混而不分;更有七至名极,即为疾
脉,是指下恒见者,又何可废乎?共得二十八脉,缕析而详为之辨,稍挟疑溷者,悉简其讹,从来晦蚀之
义,今始得而昭明;然皆考据典章,衷极理要,终不敢以凭臆之说,罔乱千秋也。
体象 浮在皮毛,如水漂木;举之有余,按之不足。
主病 浮脉为阳,其病在表。寸浮伤风,头疼鼻塞。左关
浮者,风在中焦。右关浮者,风痰在膈。尺部得之,下焦风热;小便不利,大便秘涩。
兼脉 无力表虚,有力表实。浮紧风寒,浮迟中风。浮数
风热,浮缓风湿。浮芤失血,浮短气病。浮洪虚热,浮虚暑惫。浮涩血伤,浮濡气败。
【按】浮之为义,如木之浮水面也。浮脉法天,轻清在上之象,在卦为干,在时为秋,在人为肺。
《素问》曰∶“其气来毛而中央坚,两旁虚,此为太过,病在外。其气来毛而微,此为不及,病在中。”
又曰∶“太过则气逆
而痛,不及则喘,少气而咳,上气见血。”又曰∶“肺脉厌厌聂聂,如落榆荚,曰肺平。肺脉不上不下,
如循鸡羽,曰肺病。肺脉来如物之浮,如风吹毛,曰肺死。”王叔和云∶“举之有余,按之不足”,最合
浮脉之义。黎氏以为如捻葱叶,则溷于芤脉矣。崔氏云∶“有表无里,有上无下”,则脱然
无根,又溷于散脉矣。伪诀云∶“寻之如太过”,是中候盛满,与浮之名义有何干涉乎?须知浮而盛大为洪,
浮而软大为虚,浮而柔细为濡,浮而无根为散,浮而弦芤为革,浮而中空为芤,毫厘疑似之间,相去便已千里,
可不细心体认哉!寸关尺俱浮,直上直下,或癫或痫,腰背强痛,不可俯仰,此督脉为病也。夫肺藏职秋金,
天地之气,至秋而降,且金性重而下沉,何以与浮脉相应耶!不知肺金虽沉,然所主者实阳气也,况处于至
高,为五脏六腑之华盖,轻清之用,与干天合德,故与浮脉相应耳。
王叔和在《脉经》中只论述了二十四种脉象,至于长脉和短脉,缺失未载;牢脉和革脉,混杂未能区分;更有七至(脉搏跳动极快)名为极脉,也就是疾脉,这是指下经常见到的脉象,又怎么可以废弃呢?共计得二十八种脉象,条理清晰地详细辨析它们,稍微夹杂疑惑混淆的,全部剔除其错误,向来晦涩不明的义理,现在开始得以昭示光明;然而这些都是考证依据经典文献,衷情于极致的医理要旨,最终不敢凭借主观臆测的说法,来扰乱千秋万代的医学传承。
体象:浮脉位于皮毛之间,如同木头漂浮在水面上;轻取(举)感觉有余,重按(按)感觉不足。
主病:浮脉属阳,其病位在表。寸部见浮脉为伤风,伴有头痛、鼻塞。左关部见浮脉,说明风邪在中焦。右关部见浮脉,说明风痰在膈间。尺部见到此脉,为下焦风热;小便不利,大便秘结涩滞。
兼脉:浮而无力为表虚,浮而有力为表实。浮紧脉为风寒,浮迟脉为中风。浮数脉为风热,浮缓脉为风湿。浮芤脉为失血,浮短脉为气病。浮洪脉为虚热,浮虚脉为暑天疲惫。浮涩脉为血伤,浮濡脉为气败。
【按语】浮脉的意义,就像木头漂浮在水面上一样。浮脉效法天道,具有轻清在上的象,在八卦中属于乾卦,在季节中对应秋季,在人体对应肺脏。《素问》说:“脉气来时像羽毛一样轻浮且中间坚实,两边虚弱,这叫做太过,病在外。脉气来时羽毛般轻浮但微弱,这叫做不及,病在内。”又说:“太过则气逆而疼痛,不及则气喘、少气而咳嗽,上气咳血。”又说:“肺脉柔和聂聂,像落下的榆荚,称为肺平(正常)。肺脉不上不下,像触摸鸡羽,称为肺病。肺脉来势像物体漂浮,像风吹毛发,称为肺死。”王叔和说:“轻取有余,重按不足”,最符合浮脉的意义。黎氏认为像捻葱叶,这就混淆于芤脉了。崔氏说:“有表无里,有上无下”,这就脱然无根,又混淆于散脉了。伪诀说:“寻之如太过”,这是中候盛满,与浮脉的名义有什么关系呢?必须知道浮而盛大的是洪脉,浮而软大的是虚脉,浮而柔细的是濡脉,浮而无根的是散脉,浮而弦芤的是革脉,浮而中空的是芤脉,毫厘疑似之间,相差便已千里,怎能不细心体认呢!寸、关、尺三部都浮,直上直下,或者癫狂或者痫证,腰背强痛,不能俯仰,这是督脉为病。肺脏职能对应秋金,天地之气,到了秋天就下降,而且金性沉重而下沉,为什么与浮脉相应呢?不知道肺金虽然沉降,然而所主的其实是阳气,况且肺处于最高位置,作为五脏六腑的华盖,轻清的作用,与乾天合德,所以与浮脉相应罢了。
Wang Shuhe in *Mai Jing* (Pulse Classic) only discusses twenty-four types of pulses. As for the Chang (Long) pulse and Duan (Short) pulse, they are missing and not recorded; the Lao (Firm) pulse and Ge (Leather) pulse are mixed and not distinguished; furthermore, there is the Ji (Extreme) pulse, characterized by seven or more beats per breath cycle, which is also known as the Ji (Rapid) pulse. This is a pulse frequently felt under the fingers, so how can it be discarded? In total, twenty-eight pulses are obtained. They are analyzed clearly and distinguished in detail. Those that are slightly confused or mixed with doubt are entirely corrected for errors. The meanings that have been obscure and dimmed for a long time are now beginning to be illuminated. However, all these are based on考证 (textual research) of classics, adhering strictly to the ultimate principles of medical theory. Finally, I dare not use subjective speculations to confuse the medical heritage of millennia.
**Physical Manifestation**: The Fu (Floating) pulse is located at the skin and hair level, like wood floating on water. When lifted lightly (Ju), it feels abundant; when pressed heavily (An), it feels insufficient.
**Predominant Diseases**: The Fu pulse belongs to Yang, and the disease location is in the Exterior (Biao). A Fu pulse at the Cun (Inch) position indicates Wind Injury (Shang Feng), accompanied by headache and nasal congestion. A Fu pulse at the left Guan (Bar) position indicates Wind pathogen in the Middle Jiao (Middle Burner). A Fu pulse at the right Guan position indicates Wind-Phlegm in the Diaphragm area. If found at the Chi (Cubit) position, it indicates Wind-Heat in the Lower Jiao (Lower Burner); symptoms include difficult urination and constipation with dryness.
**Combined Pulses**: Fu pulse without strength indicates Deficiency of the Exterior; Fu pulse with strength indicates Excess of the Exterior. Fu-Jin (Floating-Tight) pulse indicates Wind-Cold; Fu-Chi (Floating-Slow) pulse indicates Wind Strike (Zhong Feng). Fu-Shu (Floating-Rapid) pulse indicates Wind-Heat; Fu-Huan (Floating-Lax) pulse indicates Wind-Dampness. Fu-Kou (Floating-Hollow) pulse indicates Blood Loss; Fu-Duan (Floating-Short) pulse indicates Qi Disease. Fu-Hong (Floating-Vast) pulse indicates Empty Heat; Fu-Xu (Floating-Deficient) pulse indicates Exhaustion from Summerheat. Fu-Se (Floating-Choppy) pulse indicates Blood Injury; Fu-Ru (Floating-Soft) pulse indicates Qi Failure.
[Commentary]: The meaning of the Fu pulse is like wood floating on the surface of water. The Fu pulse follows the Way of Heaven, presenting the image of lightness and clarity residing above. In the Eight Trigrams (Bagua), it corresponds to Qian (Heaven); in seasons, it corresponds to Autumn; in the human body, it corresponds to the Lung.
*Suzhou* (Su Wen) states: "When the qi comes feeling like feathers but firm in the center and empty on both sides, this is called 'Excess' (Tai Guo), indicating disease in the exterior. When the qi comes feeling feathery but weak, this is called 'Deficiency' (Bu Ji), indicating disease in the interior." It further states: "Excess leads to rebellious qi causing pain; deficiency leads to panting, shortness of breath, and coughing, with blood appearing in upper qi." It also states: "The Lung pulse, gentle and rustling, like falling elm seeds, is called Normal Lung Pulse. The Lung pulse, neither rising nor falling, like tracing a chicken feather, is called Diseased Lung. The Lung pulse coming like a floating object, or like wind blowing hair, is called Dead Lung Pulse."
Wang Shuhe said: "Abundant upon lifting, insufficient upon pressing," which best fits the meaning of the Fu pulse. Li Shi believed it was like rolling scallion leaves, which confuses it with the Kou (Hollow) pulse. Cui Shi said: "Having exterior but no interior, having upper but no lower," which implies being rootless, thus confusing it with the San (Scattered) pulse. The Pseudo-Mantra says: "Searching for it feels like excess," implying fullness at the middle depth, which has what relevance to the name and meaning of the Fu pulse? One must know that Fu and Vast (Hong) constitutes the Hong (Vast) pulse; Fu and Soft-Large constitutes the Xu (Deficient) pulse; Fu and Soft-Fine constitutes the Ru (Soft) pulse; Fu and Rootless constitutes the San (Scattered) pulse; Fu and String-Hollow constitutes the Ge (Leather) pulse; Fu and Hollow-in-the-center constitutes the Kou (Hollow) pulse. Between slight similarities and doubts, the difference is already a thousand miles. How can one not carefully perceive and recognize them!
If Cun, Guan, and Chi positions are all Fu, moving straight up and straight down, or if there is Mania (Dian) or Epilepsy (Xian), with stiffness and pain in the waist and back, unable to bend or extend, this is disease of the Du Mai (Governing Vessel).
The Lung organ's function corresponds to Metal of Autumn. The qi of heaven and earth descends in autumn. Moreover, the nature of Metal is heavy and sinks downward. Why does it correspond to the Fu pulse? It is unknown that although Lung Metal sinks, what it actually governs is Yang Qi. Furthermore, it resides at the highest position, serving as the Canopy over the five zang and six fu organs. Its function of lightness and clarity harmonizes with the virtue of Qian Heaven, therefore it corresponds to the Fu pulse.