医宗曰。关前一分。人命之主。左为人迎。右为气口。关前一分者。寸关尺各有三部。共得九分。今日关前一分。
仍在关上。但在前之一分耳。故在为人迎。辨外因之风。以在关乃肝胆脉 。肝为脏。故曰人迎紧盛伤于风。右为
气口。辨内因之食。以右关乃脾胃脉。胃为水谷之海。脾为仓廪之官。故曰气口紧盛伤于食。勿以外因。兼求六气。勿
以内因。兼求七情也。或以前一分为寸上。岂有左寸之心。可以辨风。右寸之肺。可以辨食乎。
男子寸脉常盛。尺脉常弱。弱者少肾虚火旺反多盛也。女子寸脉常弱。尺脉常盛。盛者少阳盛阴虚反多弱也。又男
子之脉。左大为顺。女子之脉。右大为顺。
老弱之人。脉宜缓弱。过旺者病。少壮之人。脉宜充实。过弱者病。山甫以为犹有说焉。老者脉旺而非躁。此天禀
之浓。引年之叟也。名曰寿脉。若脉躁疾。有表无里。其死近矣。壮者脉细而和缓。三部平等。此天禀之静。清逸之士
也。各曰阴脉。若脉来细而劲直。前后不等。可与决死期矣。
瘦人脉健。肥人脉沉。瘦人多火。故脉健。肥人多湿。故脉沉。若瘦人火盛极则脉亦沉。治难见效。
中原之地。四时异气。居民之脉。亦因时异。春弦夏洪。秋毛冬石。脉与时违。皆名曰病。东夷之地。四时皆春。
其气暄和。民脉多缓。南夷之地。四时皆夏。其气蒸炎。民脉多大。西夷之地。四时皆秋。其气清肃。民脉多劲。北夷
之地。四时皆冬。其气凛冽。民脉多石。东南卑湿。其脉软缓。居于南巅。亦西北也。西北高燥。其脉刚劲。居于汗泽。
亦东南也。南人北脉。所禀必刚。北人南脉。所禀必柔。东西不同。可以类剖。
医宗说:关脉前一分,是生命的主宰。左手为人迎,右手为气口。所谓“关前一分”,是指寸、关、尺三部脉中,每一部都有上、中、下三候,合共九分。这里所说的“关前一分”,实际上仍在关脉之上,只是位于关脉前方的一小部分罢了。因此,左关前一分称为人迎,用于辨别外感风邪;因为左关对应肝胆脉,肝属于脏,所以说“人迎脉紧盛表示伤于风”。右关前一分称为气口,用于辨别内伤饮食;因为右关对应脾胃脉,胃是水谷之海,脾是仓廪之官,所以说“气口脉紧盛表示伤于食”。不要将外因(六淫)与六气混淆去求索病因,也不要将内因(七情)与七情混淆去求索病因。或许有人将“前一分为寸上”理解错误,难道左寸的心脉可以辨别风邪,右寸的肺脉可以辨别饮食吗?
男子的寸脉通常旺盛,尺脉通常虚弱;如果尺脉虚弱,往往是肾阴不足、虚火旺盛的表现,反而显得脉象盛大。女子的寸脉通常虚弱,尺脉通常旺盛;如果尺脉旺盛,往往是少阳之气盛、阴虚的表现,反而显得脉象虚弱。另外,男子的脉象以左侧脉大者为顺,女子的脉象以右侧脉大者为顺。
年老体弱的人,脉象宜缓和柔弱;如果脉象过旺,则是病态。年轻力壮的人,脉象宜充实有力;如果脉象过弱,则是病态。山甫对此还有进一步的阐述:老年人的脉象虽然旺盛但不躁动,这是先天禀赋浓厚、高寿老人的表现,称为“寿脉”。如果老年人脉象躁动疾速,浮取有而沉取无(有表无里),离死期就不远了。壮年人的脉象细密而和缓,寸关尺三部均衡,这是先天禀赋宁静、清闲高雅之士的表现,称为“阴脉”。如果脉象来势细弱却劲直有力,且寸关尺三部不均衡,就可以推断其死亡期限了。
瘦人的脉象多健劲,肥人的脉象多沉伏。瘦人多火,所以脉象健劲;肥人多湿,所以脉象沉伏。如果瘦人火气极盛,脉象也会变得沉伏,治疗难以见效。
中原地区,四季气候不同,居民的脉象也随季节变化。春季脉弦,夏季脉洪,秋季脉毛(浮),冬季脉石(沉)。脉象与季节气候相违背,都称为病态。东方夷地,四季如春,气候温暖平和,民众脉象多缓。南方夷地,四季如夏,气候湿热蒸腾,民众脉象大多数(大)。西方夷地,四季如秋,气候清肃凉爽,民众脉象多劲急。北方夷地,四季如冬,气候寒冷凛冽,民众脉象多石(沉实)。东南地区地势低洼潮湿,脉象软缓;居住在南方山顶的人,脉象也像西北方一样刚劲。西北地区地势高燥,脉象刚劲;居住在沼泽湿地的人,脉象也像东南方一样软缓。北方人出现南方脉象,说明其禀赋必然刚强;南方人出现北方脉象,说明其禀赋必然柔顺。东西方差异,可以据此类推分辨。
Yi Zong stated: The one-fen portion anterior to the Guan (Cun-Guan-Chi) pulse is the master of human life. The left side is Renying (Human Welcome), and the right side is Qikou (Qi Mouth). The "one-fen portion anterior to Guan" refers to the fact that each of the Cun, Guan, and Chi positions has three levels (upper, middle, lower), totaling nine fen. The "one-fen portion anterior to Guan" mentioned here actually remains above the Guan position, but specifically at the anterior one-fen segment. Therefore, the left anterior one-fen is called Renying, used to differentiate external wind pathogens; since the left Guan corresponds to the Liver and Gallbladder pulses, and the Liver is a Zang organ, it is said that "a tight and full Renying pulse indicates injury by wind." The right anterior one-fen is called Qikou, used to differentiate internal dietary injuries; since the right Guan corresponds to the Spleen and Stomach pulses, and the Stomach is the Sea of Water and Grain, while the Spleen is the Official of Granaries, it is said that "a tight and full Qikou pulse indicates injury by food." One should not confuse external causes (Six Excesses) with the Six Qi to seek etiology, nor should one confuse internal causes with the Seven Emotions to seek etiology. Some might mistakenly interpret the "anterior one-fen" as being above the Cun position; however, can the Heart pulse at the left Cun differentiate wind, or can the Lung pulse at the right Cun differentiate dietary injury?
In men, the Cun pulse is typically vigorous, while the Chi pulse is typically weak; if the Chi pulse is weak, it often indicates Kidney Yin deficiency with hyperactive fire, which may paradoxically present as a seemingly vigorous pulse. In women, the Cun pulse is typically weak, while the Chi pulse is typically vigorous; if the Chi pulse is vigorous, it often indicates Shaoyang Qi excess with Yin deficiency, which may paradoxically present as a seemingly weak pulse. Furthermore, for men, a larger pulse on the left side is considered favorable (Shun); for women, a larger pulse on the right side is considered favorable.
For elderly and weak individuals, the pulse should be slow and weak; if it is overly vigorous, it indicates disease. For young and robust individuals, the pulse should be full and solid; if it is overly weak, it indicates disease. Shan Fu offered further commentary: An elderly person's pulse may be vigorous but not restless/agitated; this indicates strong congenital endowment and represents a long-lived elder, termed a "Longevity Pulse." If an elderly person's pulse is agitated and rapid, appearing superficially but lacking depth (superficial without interior root), death is near. A robust person's pulse should be fine, smooth, and harmonious, with equal balance across the three positions (Cun, Guan, Chi); this indicates a tranquil congenital endowment and represents a refined and leisurely scholar, termed a "Yin Pulse." If the pulse comes in finely but is stiff and straight, with inequality between the anterior and posterior positions, one can determine the time of death.
Thin individuals have vigorous pulses, while obese individuals have deep pulses. Thin individuals tend to have more Fire, hence their pulses are vigorous; obese individuals tend to have more Dampness, hence their pulses are deep. However, if a thin individual's Fire pathogen becomes extremely excessive, the pulse may also become deep, making treatment difficult to achieve effective results.
In the Central Plains region, the four seasons bring different Qi, and residents' pulses vary accordingly with the seasons: String-like (Xian) in Spring, Surging (Hong) in Summer, Feather-light (Mao) in Autumn, and Stone-deep (Shi) in Winter. Pulses that contradict the seasonal climate are all named as pathological. In the Eastern Yi lands, the four seasons resemble Spring; the Qi is warm and harmonious, so people's pulses are mostly slow/harmonious (Huan). In the Southern Yi lands, the four seasons resemble Summer; the Qi is steaming and scorching, so people's pulses are mostly large/vigorous (Da). In the Western Yi lands, the four seasons resemble Autumn; the Qi is clear and austere, so people's pulses are mostly stiff/forceful (Jin). In the Northern Yi lands, the four seasons resemble Winter; the Qi is biting cold, so people's pulses are mostly stone-deep (Shi). Southeastern regions are low and damp; their pulses are soft and slow. Those residing on southern peaks also exhibit pulses similar to those of the Northwest (stiff). Northwestern regions are high and dry; their pulses are stiff and forceful; those residing in marshy areas also exhibit pulses similar to those of the Southeast (soft). Northerners presenting with Southern-type pulses must have inherently rigid constitutions; Southerners presenting with Northern-type pulses must have inherently soft constitutions. Differences between East and West can be classified and understood through such analogies.