Pulse fortune-telling method _ pulse divination

Introduction to pulse diagnosis, namely pulse-taking, commonly known as "pulse diagnosis", pulse diagnosis and diagnosis have a long history. Sima Qian recorded the contents of doctors' pulse diagnosis and treatment in Historical Records, and the "pulse diagnosis method" has been included in 1973 bamboo slips and silk books unearthed from Mawangdui Han Tomb in Changsha, Hunan. The first monograph of pulse science in China, Pulse Classic, was produced in Jin Dynasty, and the method and theory of pulse diagnosis are quite complete. The meaning of pulse condition is the image that pulse condition refers to. The generation of pulse condition is directly related to the fluctuation of heart, the rise and fall of heart qi, the smoothness of pulse and the profit and loss of qi and blood. Therefore, the heart and pulse are the main organs that form pulse conditions. Qi and blood are the material basis of pulse formation. At the same time, blood circulates throughout the body, and it goes round and round. In addition to the leading role of the heart, there must also be the coordination role of various organs: the lung is applied to the pulse and lung qi, so that the blood can be dispersed; Spleen governs blood, which is the source of qi and blood biochemistry. Only by nourishing and controlling spleen can blood run. Liver stores blood and regulates blood flow; Kidney storing essence can generate blood and transform qi, and kidney qi is the motive force of functional activities of various viscera. Therefore, it can reflect the comprehensive information of viscera, qi and blood, yin and yang of the whole body. When the zang-fu organs and qi and blood are diseased, pathological pulse conditions will inevitably appear, which has become an important pulse diagnosis method for diseases. The early pulse-cutting method is more complicated, and it is necessary to cut the pulse in the head, neck, hands and feet. In the future, it will be gradually simplified to just press the wrist pulse, which is called "Cunkou" diagnosis. Ancient doctors made many articles on this short pulse part. They divided this pulse, which is about one inch long, into three parts: inch, off and foot from the horizontal bar on the wrist.

The Cun, Guan and Chi of the left and right hands belong to different viscera, which can reflect the pathological changes of the corresponding viscera. Among them, the right inch reflects the lung, the right closes the spleen and stomach, and the right foot reflects the kidney (life gate); The left inch reflects the heart, the left customs reflects the liver, and the left ruler reflects the kidney and bladder.

After careful observation, it can be found that the far inch corresponds to the uppermost heart and lung (upper focus, respiratory and circulatory system) of the human body; The middle part corresponds to the liver and spleen and stomach (middle jiao, digestive system); The proximal ulna corresponds to the kidney and bladder (lower jiao, genitourinary system). In this way, the small "inch mouth" became a holographic window of human internal organs.

That's not enough. When cutting the pulse, you should use three different finger forces to press the pulse and gently press it on the skin to "float"; Press moderately hard until the muscles are "in the middle"; Press hard until the bones and muscles "sink". Inch, clearance and ruler have three stages, namely, floating, middle and sinking, which are collectively called "three orders and nine orders". The pulse conditions obtained by different manipulations have different clinical significance. Usually, if the pulse condition floats outside, the disease position will be shallow, and if it sinks inside, the disease position will be deep.

There are still many things to pay attention to when you feel the pulse. First of all, silence is needed, including the silence of the external environment and the silence of both doctors and patients. The patient should rest for a while before pulse-taking, and wait until it is quiet before pulse-taking. Before feeling the pulse, the doctor must meditate, adjust his breathing, completely concentrate on his fingers and press them carefully for more than one minute. When taking the pulse, the patient takes a sitting position or supine position, keeping his arms at the same level as his heart, and stretching his wrists and palms upward.

Secondly, doctors should use three designated positions in time, that is, first designate the middle part, and then adjust the density of three fingers according to the patient's height. If the patient is tall, his fingers should be sparse; Short people should have dense fingers, and children should use one finger (thumb) to pulse, regardless of three parts.

To learn pulse diagnosis, we must first understand the normal pulse condition. Normal pulse is called "flat pulse" and "normal pulse". The pulse rate is about 70-80 times per minute, the rhythm is regular, the pulse type is not thick or thin, not floating or sinking, not stiff or weak. However, normal pulse condition often changes with season, age, sex and physique. Such as spring, summer and autumn, the pulse is floating and strong; The pulse condition in winter is mostly submerged in water. The younger the age, the faster the pulse, the stronger the pulse of young and middle-aged people, and the weaker the pulse of the elderly; How long the high net is, the short net is short, the thin net is floating, and the fat net is heavy; How fast and strong is the pulse after satiety and emotional excitement, and how weak is the pulse when hungry. If you find the opposite pulse, such as winter pulse floating, fat net floating, fine net sinking, etc. , indicating abnormal pulse condition. ] Pulse diagnosis method and precautions 1, time

The best time to feel the pulse is early morning. Su Wen Yao Jing Wei pointed out: "The diagnosis method is often Ping Dan, Yin Qi does not move, Yang Qi does not disperse, the diet does not advance, the meridians are dissatisfied, the collaterals are evenly adjusted, and the qi and blood are not chaotic, so it can be diagnosed as having a pulse." Because the patient is not affected by various factors such as diet and morning activities, the internal and external environment is relatively quiet, and the qi and blood meridians are in a state of less interference, so it is easy to identify the pulse. But that doesn't mean you can't feel the pulse at other times. Wang Ji believes: "You can see a doctor at any time if you are sick, and you don't have to take Pingdan as a detention." Generally speaking, pulse diagnosis needs a quiet internal and external environment. Let the patient rest for a while before taking the pulse, so as to make the qi and blood calm, keep the clinic quiet, avoid the influence of the external environment and the fluctuation of the patient's mood, which is conducive to the doctor's understanding of the pulse condition. Under special circumstances, patients should be examined anytime and anywhere, and there is no need to stick to these conditions.

2. Body position

Ask the patient to take a sitting or lying position, with his arms flat, his heart almost at the same level, his wrist straight and his palm up, and put a pillow on the back of his wrist joint for pulse cutting. Incorrect posture will affect local blood circulation and pulse condition.

3. fingering

The doctor and the patient sit sideways, with the left hand holding the patient's right hand and the right hand holding the patient's left hand. When feeling the pulse downward, first press the middle finger on the inner side of the high metacarpal bone to close the pulse, then press the inch pulse with the index finger to close it again, and then press the ruler pulse with the ring finger to close the pulse. Three fingers should be arched and fingers should be flush. Touch the pulse with fingertips, which is more sensitive. The density of finger cloth should be adapted to the patient's body shape. Old people with long arms should have sparse fingers and short arms should be dense. After the positioning is accurate, the three-finger flat cloth presses the pulse forcefully at the same time, which is called total pressing. In order to focus on a pulse condition, you can also press a pulse condition with one finger, which is called single press. If it is an inch pulse, lift the middle finger and ring finger slightly; When feeling the pulse, the index finger and ring finger are slightly lifted; When diagnosing ulnar pulse, the index finger and middle finger are slightly raised, and the combination of total press and single press is often used in clinic.

The method of "one finger (thumb) determining pulse" can be used to diagnose pulse in children without subdividing three parts. Because children have short mouths, they are not allowed to specify three inches, and it is easy to cry and not cooperate.

4. Lift and press to find.

This is a technique to detect the pulse condition by using the weight and displacement of finger force during pulse diagnosis.

Hua Boren's "Physician's Summary" said: "There are three kinds of pulse: lifting, pressing and searching. Handle with care, press with your hands, neither light nor heavy, and ask for many blessings. At the beginning, take the pulse and wait gently, and you will see the pulse between your skin. This is also the yang qi and fu qi, and it is also the response of your heart and lungs. If the hand is heavy and the pulse is under the flesh, it is also the yin and the liver and kidney. It is neither light nor heavy, and it is taken from the middle vein, and its pulse should be between the flesh and blood, yin and yang are suitable, and the spleen and stomach are in harmony. If you can't see it in the floating, you will be blessed. If you can't see it, then Yin and Yang are hidden, and all three are the same. " Pressing lightly on the skin with your fingers is called lifting, also called floating or gently taking; Pressing the fingers between the bones and muscles with excessive force is called pressing, which is also called sinking or retracting; Finger force can be light or heavy, so it is called compromise. In addition, when the three veins are unique, it is necessary to gradually move the finger position and look inside and outside. The meaning of seeking is not the meaning of taking. So be sure to pay attention to the pulse changes between lifting, pressing and searching.

Step 5 be quiet

One breath is one breath. When feeling the pulse, the doctor should breathe naturally and evenly, and use one breath and the time of one breath to calculate the patient's pulse number, such as the late pulse number, which is counted as interest. In addition, doctors are also reminded to be open-minded and calm when taking the pulse, concentrate their thoughts and concentrate on understanding the pulse condition. "Su Wen pulse diagnosis should be refined" says: "Keep the pulse accurate and steady."

6. Fifty moves

Every time I feel my pulse, I will feel 50 times. In other words, every time you press the pulse, the pulse on each side should not be less than 50 times. Its significance lies in: on the one hand, we can know whether there is knot, generation and pulse acceleration when the pulse beats fifty times. If necessary, it can be extended to 50 pulses for the second or third time, always aiming at pulse identification, so it is appropriate to wait for 3 ~ 5 minutes each time; On the other hand, he also reminded the doctor not to draw three strokes and two strokes hastily when taking the pulse. Zhang Zhongjing said, "If the number of strokes is less than 50 and the diagnosis is unknown in the short term, there is no such thing as waiting for nine times ... It is really difficult for my husband from ruin." [Edit this paragraph] Pingmai 1, features

Flat pulse is the pulse condition of normal people. Su Wen's "Ren Ping's Meteorology" said: "When a person breathes a pulse, he will move again. When he breathes a pulse, he will move five times and breathe for a long time, hence the name Ren Ping. Even people are not sick." The shape of the flat pulse is three pulses, one pulse and four pulses (leap is five to five, equivalent to 72-80 times/minute), which is neither floating nor sinking, neither too big nor too small, calm and gentle, soft and powerful, with the same rhythm, and the ruler pulse has a certain intensity, which changes normally with different physiological activities and climate environment. Pingmai has three characteristics: stomach, spirit and root.

(1) Stomach and stomach are the sea of water and grain, the foundation of the day after tomorrow and the source of qi and blood for human health. People's life and death depend on the existence of stomach qi. As the saying goes, "if you have stomach qi, you will be born, and if you don't have stomach qi, you will die." Therefore, the pulse condition is also stomach-qi-based, and there are many ancient sayings. For example, "Lingshu Zhong Shi" said: "Evil spirits are also tight and sick, and the valley spirit is also warm." Or take it from the middle to wait for stomach qi. Generally speaking, the average person's pulse is not floating, not heavy, not fast, not slow, calm and gentle, and the rhythm is consistent, so that they have stomach gas. Even the pulse of illness, regardless of the ups and downs, has an image of Xu He, that is, stomach gas. Investigating the rise and fall of stomach qi has certain clinical significance in judging the advance and retreat of diseases.

(2) The pulse of the spirit is precious, the heart controls the blood to store the spirit, the pulse is the blood mansion, the qi and blood are full, the mind is healthy and vigorous, the pulse condition is natural, and the pulse shape is soft and powerful, even if the pulse is weak, it will not be completely weak. String solid pulse, which still has a soft image, is a god. In a word, the same pulse of stomach and spirit is a sign of harmony, so is the same pulse of stomach and spirit.

(3) The kidney is the innate foundation, and it is the motive force of the functional activities of human viscera. Sufficient kidney qi, reflected in the pulse condition, is to have roots, enough to wait for the kidney, enough to wait for the kidney, that is, the pulse condition with roots is strong. If the kidney qi is still there, the congenital foundation is still there, and the feet are still visible, there is still vitality, just as the pulse formula says: "inch."

2. Physiological changes of flat pulse.

(1) Due to the influence of climate, the flat pulse changes to spring, summer, floating, winter and sinking. Although the yang rises in spring, the cold is not completely removed and the qi is restrained, so the pulse is slightly chordal. In summer, the yang is strong, and the pulse is strong and flaccid, so the pulse is slightly broad. In autumn, the yang is about to converge, and the pulse condition drops, as light as hair, so the pulse is slightly floating. In winter, the yang is hidden, the pulse is heavy, and the fingers are beating.

(2) Geographical environment Geographical environment will also affect the pulse condition. The south is located in low-lying, warm climate, moist air and slow and sparse human muscles, so the pulse is soft or slightly counted; In the north, the terrain is high, the air is dry, the climate is cold, and human muscles are tight, so the pulse is heavy and firm.

(3) Generally speaking, the pulse condition of both men and women is slightly weaker and faster than that of men. When a woman is pregnant after marriage, her pulse often slips and rushes.

(4) The younger the age, the faster the pulse, and the baby's pulse is 120 ~ 140 times per minute; For children aged five or six, the pulse rate is 90 ~ 1 10 times per minute; With the increase of age, the pulse will gradually ease. Young people are strong and have a strong pulse; The old man is weak in qi and blood, weak in energy and weak in pulse.

(5) For tall people, the pulse appears for a long time; Short people have shorter veins. Thin people have thin muscles and often floating veins; Obese people have thick subcutaneous fat and often have a heavy pulse. All common six-pulse deep and thin, but asymptomatic, is called six-yin pulse; Six-pulse flood is equal, but asymptomatic, which is called six-yang pulse.

(6) The pulse condition changes with the temporary mental stimulation of emotions, such as sadness and slow pulse when you are happy, rapid pulse when you are angry, and chaotic pulse when you are shocked. When your mood calms down, your pulse will return to normal.

(7) After strenuous exercise and long journey, the pulse is more intense, and after people fall asleep, the pulse is slower, and the pulse of mental workers is weaker than that of manual workers.

(8) How strong the pulse after drinking is after eating; When you are hungry, your pulse is a little slow and weak.

In addition, there are some people whose pulse condition is not seen at the mouth of the inch, but inclined from the foot to the back of the hand, named oblique flying pulse; If the pulse appears on the back of Cunkou, which is called anti-Guan pulse, and also appears in other parts of the wrist, it is a physiologically specific pulse position, that is, the variation of the anatomical position of radial artery, which does not belong to the diseased pulse. [Edit this paragraph] The common abnormal pulse condition is floating pulse, which is a kind of superficial pulse that appears in the part where the pulse condition appears. If you take it lightly, you will become weak. In general, it is suggested that the pathogenic factors are in the table. A strong pulse is superficial, while a weak pulse is superficial.

Sinking pulse is a pulse with deep pulse condition, which cannot be taken lightly. You can see it by pressing it again. Usually, the interior syndrome is the main one, and the heavy and powerful one is the interior syndrome, and the heavy and weak one is the interior deficiency syndrome.

Late pulse, slow pulse, less than 60 times per minute. Cold syndrome will slow down blood flow because of cold. The late strong is cold accumulation syndrome, and the late weak is yang deficiency syndrome.

Count the pulse, the pulse comes quickly, more than 90 times per minute, and it comes and goes in a hurry. Multi-dominant heat syndrome, because heat can speed up blood flow, the excess heat syndrome is strong and the weak heat syndrome is weak.

Veins, also called venules, are thin and weak, but they should be obvious. It is the image of dampness syndrome and deficiency syndrome. It is due to dampness blocking meridians or deficiency of qi and blood, which can not fill the pulse.

The flood pulse is broad and powerful, and it comes and goes like a flood. Empirical study on excess heat of most main pathogens.

String pulse, the pulse-shaped end is straight, such as pressing the string. Common in patients with hepatobiliary diseases, phlegm retention syndrome and pain syndrome.

Pulse slippery, pulse flowing (slippery), such as walking beads. It is a syndrome of excess heat, phlegm retention, eating disorder or pregnancy pulse.

The pulse is astringent and difficult, such as scraping bamboo with a light knife. It is the expression of qi stagnation and blood stasis and deficiency of essence and blood.

Deficiency of pulse, weakness in lifting and pressing three pulses, and faint peristalsis under the finger are the general names of all weak pulses. It is a sign of deficiency syndrome, mainly qi deficiency or both qi and blood deficiency.

Real pulse, three powerful pulses, strong pulse, is the floorboard of all powerful pulses. This is an empirical image, which shows that the evil spirit is true and healthy.

Pulse acceleration, pulse knot acceleration and pulse generation are all abnormal rhythms and intermittent pulses. Pulse acceleration refers to rapid pulse number and irregular interval. Strong pulse is the syndrome of hyperactivity of yang heat, while weak pulse is mostly the phenomenon of qi deficiency falling off. The pulse condition is slow and irregular, and the main symptoms are mostly yin deficiency, qi stagnation, cold phlegm and blood stasis. Pulses are generated at slow and regular intervals with long intervals. It is a syndrome of decreased dirty qi or qi stagnation and blood stasis.

There are many pulse conditions, and the above is the most important. In the clinical treatment of traditional Chinese medicine, besides observing, smelling and asking questions, pulse-taking is also very important. Sun Simiao, a famous doctor in the Tang Dynasty, said: "People have a pulse, which is also a great medical undertaking. How can he be a doctor if he doesn't study hard? " ! "Pulse often plays a decisive role in syndrome differentiation. [Edit this paragraph] The relationship between pulse conditions and diseases Of course, the etiology and pathological changes of diseases are very complicated, so the pulse conditions seen in clinic are often very complicated, and two or more pulse conditions often appear together, such as floating, late, slippery and astringent. There is also the consistency and inconsistency of pulse conditions. If they are inconsistent, it is necessary to decide whether to give up the symptoms or give up the symptoms. In addition, pulse diagnosis is not difficult in theory, but in practice, it is not a day's work to determine what pulse condition it is and explain the relationship between pulse condition and disease. The ancients said: "The pulse is subtle and beyond words. It's hard to understand when you're in your heart. "Without years of repeated practice, careful experience, careful understanding and comparison, it is impossible to truly master pulse diagnosis.

Eight strange meridians are the general names of Du meridian, Ren meridian, Chong pulse, Dai pulse, Yin meridian, Yang meridian, Yin qiao pulse and Yang qiao pulse. They are different from the twelve meridians, because they are not directly connected with zang-fu organs and have no exterior-interior relationship, so they are called "strange classics". The Du Meridian, Ren Meridian and Chong Meridian of the Eight Veins all originate from cells and come from perineum, which is called "one source and three branches", in which the Du Meridian runs in the middle of the back and goes up on the head and face; Ren meridian runs in the middle of chest and abdomen, reaching chin; The chong pulse is parallel to the kidney meridian of the foot with little yin and surrounds the mouth and lips. The vein begins under the flank and surrounds the waist. The Yin-stomach pulse starts from the inside of the calf, goes up along the inside of the calf and thigh, and joins Ren-pulse at the throat. Yangwei meridian starts from the outside of tarsal bone, goes up along the outside of leg and knee, and meets Du meridian at the back of neck. The oblique pulse starts from the inside of the heel, goes up along the meridian with insufficient foot yin and qi, and intersects with the oblique pulse of the heel yang until the corner of the eye intersects. Yangqiao pulse starts from the outside of the heel, goes up with the meridian of foot sun, meets Yinqiao pulse in the inner canthus, goes up along the meridian of foot sun, and meets the meridian of foot shaoyang at the back of the neck.

Eight strange meridians crisscross between the twelve meridians, and their functions are mainly reflected in two aspects. First, communication between the twelve meridians. Eight strange meridians connect meridians with similar positions and functions, so as to control the qi and blood of meridians and coordinate yin and yang. Du meridian is related to six yang meridians, which is called "the sea of yang meridians" and has the function of regulating the qi of yang meridians throughout the body. Ren meridian is related to six yin meridians, which is called "the sea of yin meridians" and has the function of regulating the qi of all yin meridians in the whole body; Pulse flushing is related to Ren meridian, Du meridian, Foot Yangming meridian and Foot Shaoyin meridian, so it is called "Sea of the twelve meridians" and "Sea of Blood", which has the function of storing the twelve meridians's qi and blood. Vein constraint connects all the foot meridians of the longitudinal trunk; Yin-yang meridians connect Yin meridians and Yang meridians, which are in charge of the exterior and interior of the whole body respectively; Qiao Mai of Yin and Yang is in charge of the movement of Yang and the quietness of Yin, and is responsible for the movement of lower limbs and insomnia. Secondly, the eight strange meridians can regulate the accumulation and infiltration of the twelve meridians's qi and blood. When the twelve meridians and zang-fu organs are full of qi and blood, the eight strange meridians can be accumulated, and when human functional activities need it, the eight strange meridians can be supplied by infiltration irrigation.

The acupoints of the six meridians of Chong, Dai, Qiao and Wei all belong to the twelve meridians and Rendu, but Rendu has its own acupoints, so compared with the twelve meridians, it is collectively called "Fourteen Classics". Fourteen meridians have certain routes, symptoms and acupoints, which are the main components of the meridian system and the basis of clinical acupuncture treatment and drug meridian tropism.

People who have seen Chinese medicine often see doctors feel the pulse of patients first, which is called pulse-taking in textbooks. At the same time, the doctor will first look at the patient's "movement" and "quietness", that is, the patient's "spirit", and then observe the patient's complexion, and distinguish whether the disease belongs to "Yin" or "Yin" through the brightness of the complexion, the late pulse and the cold temperature of the skin. Through the thickness of tongue coating and the ups and downs of pulse condition, we can find out the "exterior and interior" of the disease, and distinguish the "excess and deficiency" of the patient through the strength of pulse condition. The "eight programs" are clear, and the zang-fu organs and meridians to which the disease belongs are further distinguished through the patient's chief complaint. Based on this dialectic, treatment.