午夜片无码AB区在线播放APP

登錄
首頁 >> 中醫基礎常識 >> 中醫基礎

中醫脈象之弦脈

祝由(you)網 2023-11-13 13:05:31

弦(xian)脈(mo)亦是(shi)具有單因素的(de)脈(mo)象,它(ta)的(de)性質是(shi)脈(mo)形(xing)變(bian)化,特點是(shi)張(zhang)力增強,有的(de)亦有阻(zu)力增加的(de)情況及(ji)脈(mo)管變(bian)硬(ying)等,所以它(ta)給人的(de)指感是(shi)像琴弦(xian)、弓(gong)弦(xian)等繃直的(de)感覺。

弦(xian)脈(mo)(mo)(mo)在(zai)(zai)古(gu)(gu)醫籍中的(de)(de)(de)記載(zai)亦(yi)是(shi)(shi)(shi)(shi)較早的(de)(de)(de),它(ta)(ta)亦(yi)有(you)一個形(xing)成過程(cheng),在(zai)(zai)《內經(jing)》中開始(shi)是(shi)(shi)(shi)(shi)以季節脈(mo)(mo)(mo)出現(xian)的(de)(de)(de),而(er)且(qie)有(you)時(shi)只(zhi)是(shi)(shi)(shi)(shi)作為(wei)(wei)(wei)對(dui)春天脈(mo)(mo)(mo)的(de)(de)(de)一種形(xing)容(rong),至(zhi)于作為(wei)(wei)(wei)肝脈(mo)(mo)(mo)、肝的(de)(de)(de)絕脈(mo)(mo)(mo)之(zhi)說亦(yi)不(bu)(bu)(bu)(bu)可(ke)能是(shi)(shi)(shi)(shi)由于季節和(he)胃氣(qi)的(de)(de)(de)有(you)無引(yin)申出來(lai)的(de)(de)(de)。如:“……死(si)(si)肝脈(mo)(mo)(mo)來(lai),急(ji)益勁(jing),如新張弓弦(xian),日肝死(si)(si)。”“春脈(mo)(mo)(mo)如弦(xian)……”“真(zhen)肝脈(mo)(mo)(mo)至(zhi)中外(wai)急(ji),如循(xun)刀刃,責責然(ran)(ran),如按琴(qin)瑟弦(xian)。”(《素問·玉(yu)機(ji)真(zhen)臟(zang)(zang)論(lun)》)而(er)且(qie)與(yu)長、滑(hua)等(deng)脈(mo)(mo)(mo)的(de)(de)(de)界限尚(shang)不(bu)(bu)(bu)(bu)太清楚,如《素問·玉(yu)機(ji)真(zhen)臟(zang)(zang)論(lun)》說春脈(mo)(mo)(mo)是(shi)(shi)(shi)(shi):“其(qi)氣(qi)來(lai)軟弱,輕虛而(er)滑(hua),端直以長。”等(deng)等(deng)。到(dao)了(le)(le)《難(nan)經(jing)》上弦(xian)脈(mo)(mo)(mo)的(de)(de)(de)名(ming)稱就進一步(bu)確(que)定(ding)了(le)(le),它(ta)(ta)雖然(ran)(ran)引(yin)用(yong)的(de)(de)(de)基(ji)本上是(shi)(shi)(shi)(shi)《內經(jing)》之(zhi)文,但它(ta)(ta)的(de)(de)(de)提法(fa)(fa)已經(jing)是(shi)(shi)(shi)(shi)“春脈(mo)(mo)(mo)弦(xian)者(zhe)(zhe)”如何(he)如何(he)了(le)(le)。后人對(dui)此亦(yi)有(you)所分析,如《醫碥》上說:“古(gu)(gu)人有(you)時(shi)以長脈(mo)(mo)(mo)為(wei)(wei)(wei)弦(xian),如謂春脈(mo)(mo)(mo)弦(xian)而(er)言其(qi)軟弱直長是(shi)(shi)(shi)(shi)弦(xian)即長也(ye)。今(jin)后分二脈(mo)(mo)(mo)則弦(xian)自有(you)急(ji)勁(jing)之(zhi)意不(bu)(bu)(bu)(bu)僅(jin)長而(er)已。”實際分為(wei)(wei)(wei)二脈(mo)(mo)(mo)的(de)(de)(de)條件(jian)是(shi)(shi)(shi)(shi)長只(zhi)是(shi)(shi)(shi)(shi)個脈(mo)(mo)(mo)位問題,而(er)弦(xian)則為(wei)(wei)(wei)脈(mo)(mo)(mo)體(ti)的(de)(de)(de)一種形(xing)象。二者(zhe)(zhe)當然(ran)(ran)是(shi)(shi)(shi)(shi)不(bu)(bu)(bu)(bu)同的(de)(de)(de)。在(zai)(zai)《傷寒論(lun)·平脈(mo)(mo)(mo)法(fa)(fa)》上說:“弦(xian)者(zhe)(zhe)狀如弓弦(xian),按之(zhi)不(bu)(bu)(bu)(bu)移也(ye)。”《金(jin)匱要(yao)略(lve)》上有(you):“夫痙脈(mo)(mo)(mo),按之(zhi)緊如弦(xian),直上下行。”這(zhe)里的(de)(de)(de)緊是(shi)(shi)(shi)(shi)說脈(mo)(mo)(mo)形(xing)緊張不(bu)(bu)(bu)(bu)能理解為(wei)(wei)(wei)緊脈(mo)(mo)(mo)。至(zhi)此弦(xian)脈(mo)(mo)(mo)是(shi)(shi)(shi)(shi)確(que)立起來(lai)了(le)(le),而(er)且(qie)更廣泛(fan)地用(yong)于臨床,但《內經(jing)》、《難(nan)經(jing)》和(he)仲景(jing)都(dou)認為(wei)(wei)(wei)非常典型,亦(yi)即“純弦(xian)”脈(mo)(mo)(mo)是(shi)(shi)(shi)(shi)肝的(de)(de)(de)真(zhen)臟(zang)(zang)脈(mo)(mo)(mo),這(zhe)在(zai)(zai)《內經(jing)》中是(shi)(shi)(shi)(shi)屢見的(de)(de)(de)不(bu)(bu)(bu)(bu)具引(yin)。《難(nan)經(jing)》竟(jing)與(yu)《內經(jing)》相同,仲景(jing)亦(yi)說:“假(jia)令得純弦(xian)脈(mo)(mo)(mo)者(zhe)(zhe)死(si)(si)。”可(ke)見弦(xian)脈(mo)(mo)(mo)不(bu)(bu)(bu)(bu)但有(you)它(ta)(ta)自己獨特的(de)(de)(de)形(xing)象而(er)且(qie)程(cheng)度亦(yi)是(shi)(shi)(shi)(shi)非常重要(yao)的(de)(de)(de)。這(zhe)亦(yi)影(ying)響到(dao)后人對(dui)弦(xian)脈(mo)(mo)(mo)的(de)(de)(de)認識和(he)說解。

《脈(mo)經》所(suo)提出的(de)弦(xian)(xian)(xian)(xian)脈(mo)脈(mo)形(xing)是(shi):“舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有,按之(zhi)(zhi)(zhi)如弓弦(xian)(xian)(xian)(xian)狀(zhuang)(一日(ri)如張弓弦(xian)(xian)(xian)(xian),按之(zhi)(zhi)(zhi)不(bu)移,又(you)日(ri)浮(fu)緊為(wei)(wei)弦(xian)(xian)(xian)(xian))。”如弓弦(xian)(xian)(xian)(xian)狀(zhuang)是(shi)確定不(bu)說的(de)。但舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有,和(he)浮(fu)緊為(wei)(wei)弦(xian)(xian)(xian)(xian)之(zhi)(zhi)(zhi)說卻可商(shang)。因為(wei)(wei)弦(xian)(xian)(xian)(xian)是(shi)脈(mo)形(xing)的(de)變化,它與脈(mo)位(浮(fu)、中(zhong)、沉(chen))沒有關系,實踐(jian)中(zhong)浮(fu)弦(xian)(xian)(xian)(xian)的(de)脈(mo)亦不(bu)少(shao),所(suo)以(yi)說舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有是(shi)不(bu)恰當的(de)。對(dui)此后人亦有所(suo)論議如李時珍說:“或以(yi)浮(fu)緊為(wei)(wei)弦(xian)(xian)(xian)(xian),況緊為(wei)(wei)牢(lao)亦近(jin)(jin)似耳。”說近(jin)(jin)似當然是(shi)不(bu)準確的(de)。《脈(mo)確》說:“《脈(mo)經》謂(wei)弦(xian)(xian)(xian)(xian)脈(mo)‘舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有’按瘧脈(mo)有浮(fu)弦(xian)(xian)(xian)(xian)者,未嘗舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有也(ye),即《脈(mo)經》傷(shang)寒(han)條中(zhong)亦有陽明(ming)中(zhong)風(feng)脈(mo)浮(fu)弦(xian)(xian)(xian)(xian)之(zhi)(zhi)(zhi)語,則謂(wei)弦(xian)(xian)(xian)(xian)脈(mo)舉(ju)之(zhi)(zhi)(zhi)無(wu)(wu)有,疑其誤(wu)也(ye)。”浮(fu)緊為(wei)(wei)弦(xian)(xian)(xian)(xian)之(zhi)(zhi)(zhi)說出自仲景《傷(shang)寒(han)論·平脈(mo)法(fa)》原文是(shi):“脈(mo)浮(fu)而緊者,名(ming)日(ri)弦(xian)(xian)(xian)(xian)也(ye)。”這個說法(fa)王叔和(he)亦恐未盡同意(yi),所(suo)以(yi)沒有放(fang)在正文,而在又(you)日(ri)里提出說弦(xian)(xian)(xian)(xian)一定要出現(xian)在浮(fu)的(de)部(bu)位和(he)前而的(de)不(bu)能(neng)出現(xian)在浮(fu)的(de)部(bu)位是(shi)一樣的(de)不(bu)適當,至(zhi)于緊亦不(bu)應(ying)當理解為(wei)(wei)緊脈(mo)。

弦(xian)(xian)(xian)(xian)脈(mo)(mo)歷代(dai)各(ge)家(jia)的(de)形(xing)容(rong)基本(ben)上是(shi)(shi)一(yi)致的(de),例(li)如《諸病(bing)(bing)源候論》說(shuo):“按(an)(an)之(zhi)如琴瑟(se)弦(xian)(xian)(xian)(xian),三關通病(bing)(bing),梗(geng)梗(geng)無有(you)屈撓名日(ri)弦(xian)(xian)(xian)(xian)。”這(zhe)里(li)的(de)病(bing)(bing)字(zi)不(bu)應(ying)理解為(wei)疾(ji)病(bing)(bing),而是(shi)(shi)指(zhi)脈(mo)(mo)的(de)這(zhe)種弦(xian)(xian)(xian)(xian)的(de)變化。《察病(bing)(bing)指(zhi)南(nan)》說(shuo):“勁(jing)急如弦(xian)(xian)(xian)(xian)弓弦(xian)(xian)(xian)(xian)。”《診家(jia)樞要》說(shuo):“按(an)(an)之(zhi)不(bu)移(yi),舉之(zhi)應(ying)手,端(duan)直如絲弦(xian)(xian)(xian)(xian)。”《脈(mo)(mo)訣刊誤》說(shuo):“指(zhi)下左右皆無,從(cong)前(qian)中后,直過挺(ting)然于指(zhi)下,日(ri)弦(xian)(xian)(xian)(xian)。”《瀕湖脈(mo)(mo)學(xue)》說(shuo):“弦(xian)(xian)(xian)(xian)脈(mo)(mo)端(duan)直以長,如張弓弦(xian)(xian)(xian)(xian),按(an)(an)之(zhi)不(bu)移(yi),綽(chuo)綽(chuo)如按(an)(an)琴瑟(se)弦(xian)(xian)(xian)(xian),狀若箏弦(xian)(xian)(xian)(xian),從(cong)中直過,挺(ting)然指(zhi)下。”各(ge)家(jia)語(yu)氣形(xing)容(rong)雖微有(you)不(bu)同,但基本(ben)一(yi)致,尤其(qi)是(shi)(shi)李時(shi)珍的(de)說(shuo)法(fa)匯合了(le)前(qian)人(ren)正(zheng)確的(de)說(shuo)法(fa)更為(wei)全面.其(qi)他和以后各(ge)家(jia)之(zhi)說(shuo)或繁或簡大抵不(bu)出這(zhe)個范圍。

弦(xian)(xian)(xian)脈是(shi)脈形(xing)的(de)(de)(de)變化,在(zai)古人(ren)(ren)亦(yi)只能用(yong)(yong)客觀事(shi)物來形(xing)容反映它(ta)(ta),所以(yi)形(xing)象比(bi)擬之說(shuo)是(shi)比(bi)較(jiao)多,而主要的(de)(de)(de)在(zai)《內經》里(li)就(jiu)(jiu)有很多,尤其是(shi)具體到(dao)不同(tong)程(cheng)度時(shi)就(jiu)(jiu)要更明顯。例如(ru)(ru)(ru)在(zai)季(ji)(ji)節脈里(li)它(ta)(ta)就(jiu)(jiu)起(qi)碼分(fen)成三種,一是(shi)有胃氣的(de)(de)(de)即正(zheng)常季(ji)(ji)節脈的(de)(de)(de)弦(xian)(xian)(xian),是(shi)“軟弱招招,如(ru)(ru)(ru)揭長(chang)(chang)竿末(mo)梢”;二是(shi)病(bing)脈弦(xian)(xian)(xian)是(shi)“盈實而滑,如(ru)(ru)(ru)循長(chang)(chang)竿”;三是(shi)死(si)脈弦(xian)(xian)(xian)是(shi)“急益勁(jing),如(ru)(ru)(ru)新張弓(gong)弦(xian)(xian)(xian)”(見于《索同(tong)一平(ping)人(ren)(ren)氣象論》)。《素問·玉機真臟論》說(shuo):“真肝脈至(zhi),中外急,如(ru)(ru)(ru)循刀力,責責然,如(ru)(ru)(ru)按琴瑟弦(xian)(xian)(xian),”等等。后人(ren)(ren)書中多半用(yong)(yong)琴瑟弦(xian)(xian)(xian),弓(gong)弦(xian)(xian)(xian)為喻,《脈訣》提出“箏弦(xian)(xian)(xian)”,《瀕湖(hu)脈學》亦(yi)引用(yong)(yong),另外周學海氏在(zai)《診家(jia)直訣》中說(shuo):“浮厚(hou)而斂,弦(xian)(xian)(xian)也。”雖然不是(shi)用(yong)(yong)客觀形(xing)象來描述(shu)的(de)(de)(de),但這個斂字(zi)卻反映了脈管張力增強的(de)(de)(de)神態,在(zai)當時(shi)亦(yi)是(shi)難(nan)得的(de)(de)(de)。

在(zai)(zai)(zai)弦(xian)脈(mo)(mo)(mo)(mo)的(de)(de)說(shuo)(shuo)解(jie)(jie)中(zhong)存在(zai)(zai)(zai)幾個問題(ti),一是(shi)緊(jin)(jin)(jin)(jin)(jin)的(de)(de)問題(ti),由(you)于仲(zhong)景提:“緊(jin)(jin)(jin)(jin)(jin)如(ru)(ru)(ru)弦(xian)”、“浮(fu)而(er)(er)緊(jin)(jin)(jin)(jin)(jin)”等,《脈(mo)(mo)(mo)(mo)經(jing)(jing)》亦(yi)引用過(guo),所以(yi)后人(ren)就(jiu)(jiu)有(you)人(ren)在(zai)(zai)(zai)說(shuo)(shuo)解(jie)(jie)弦(xian)脈(mo)(mo)(mo)(mo)時用緊(jin)(jin)(jin)(jin)(jin)這個條件,這應當是(shi)不當的(de)(de)理(li)由(you)見(jian)前文所述,揭到(dao)緊(jin)(jin)(jin)(jin)(jin)的(de)(de)書(shu)如(ru)(ru)(ru)《千金方》、《活人(ren)書(shu)》引了《脈(mo)(mo)(mo)(mo)經(jing)(jing)》全文,崔氏(shi)《脈(mo)(mo)(mo)(mo)訣》說(shuo)(shuo):“小緊(jin)(jin)(jin)(jin)(jin)為(wei)弦(xian)。”又說(shuo)(shuo):“弦(xian)如(ru)(ru)(ru)張弦(xian),緊(jin)(jin)(jin)(jin)(jin)如(ru)(ru)(ru)細線(xian)。”可(ke)見(jian)小緊(jin)(jin)(jin)(jin)(jin)與弦(xian)的(de)(de)緊(jin)(jin)(jin)(jin)(jin)亦(yi)不是(shi)緊(jin)(jin)(jin)(jin)(jin)脈(mo)(mo)(mo)(mo)而(er)(er)為(wei)緊(jin)(jin)(jin)(jin)(jin)張的(de)(de)意(yi)(yi)思。《外科精義(yi)》說(shuo)(shuo):“弦(xian)脈(mo)(mo)(mo)(mo)之(zhi)診,按(an)之(zhi)則(ze)緊(jin)(jin)(jin)(jin)(jin)而(er)(er)弦(xian),其似緊(jin)(jin)(jin)(jin)(jin)者,謂弦(xian)如(ru)(ru)(ru)按(an)弦(xian)而(er)(er)不移(yi),緊(jin)(jin)(jin)(jin)(jin)如(ru)(ru)(ru)切繩而(er)(er)轉(zhuan)動(dong),以(yi)此(ci)為(wei)異。”可(ke)見(jian)齊(qi)德之(zhi)亦(yi)并不認為(wei)弦(xian)脈(mo)(mo)(mo)(mo)里有(you)緊(jin)(jin)(jin)(jin)(jin)脈(mo)(mo)(mo)(mo)的(de)(de)成分,其意(yi)(yi)亦(yi)是(shi)緊(jin)(jin)(jin)(jin)(jin)張。《脈(mo)(mo)(mo)(mo)決指(zhi)掌》與《丹(dan)溪手(shou)鏡》都(dou)提到(dao)緊(jin)(jin)(jin)(jin)(jin)或(huo)(huo)與勁(jing)急之(zhi)意(yi)(yi)重復或(huo)(huo)引用仲(zhong)景浮(fu)緊(jin)(jin)(jin)(jin)(jin)之(zhi)文都(dou)沒有(you)什么新意(yi)(yi)。后來(lai)諸家只(zhi)有(you)《醫碥》上(shang)提到(dao):“似深而(er)(er)略遜,但稍見(jian)抗指(zhi)即是(shi),不若緊(jin)(jin)(jin)(jin)(jin)之(zhi)搏手(shou)。”此(ci)說(shuo)(shuo)在(zai)(zai)(zai)概念上(shang)卻不清楚(chu),因(yin)為(wei)弦(xian)和緊(jin)(jin)(jin)(jin)(jin)不單是(shi)力(li)度問題(ti),它們的(de)(de)形象亦(yi)是(shi)不同的(de)(de),如(ru)(ru)(ru)按(an)《醫碥》的(de)(de)說(shuo)(shuo)法有(you)力(li)的(de)(de)弦(xian)脈(mo)(mo)(mo)(mo)就(jiu)(jiu)都(dou)成為(wei)緊(jin)(jin)(jin)(jin)(jin)脈(mo)(mo)(mo)(mo)了,這是(shi)不對(dui)的(de)(de),這種說(shuo)(shuo)法可(ke)能還要(yao)比(bi)何氏(shi)早,因(yin)為(wei)在(zai)(zai)(zai)李(li)時珍的(de)(de)《脈(mo)(mo)(mo)(mo)學》上(shang)已經(jing)(jing)有(you)“緊(jin)(jin)(jin)(jin)(jin)言其力(li)弦(xian)言象”之(zhi)說(shuo)(shuo)。

不(bu)過(guo)(guo)宋元以(yi)下絕大多數(shu)的(de)(de)脈(mo)(mo)(mo)(mo)學書(shu)籍已經不(bu)再提(ti)緊這個(ge)(ge)條件了,應當說(shuo)(shuo)(shuo)(shuo)是(shi)(shi)(shi)在理論(lun)上(shang)和(he)實踐上(shang)都予(yu)以(yi)否(fou)定了,亦丘可以(yi)說(shuo)(shuo)(shuo)(shuo)分清(qing)了弦(xian)(xian)脈(mo)(mo)(mo)(mo)和(he)緊脈(mo)(mo)(mo)(mo)的(de)(de)界限、性質和(he)形(xing)象。一(yi)(yi)是(shi)(shi)(shi)滑(hua)的(de)(de)問題(ti)(ti),《內經》等書(shu)對春脈(mo)(mo)(mo)(mo)有(you)(you)輕(qing)虛而滑(hua)等說(shuo)(shuo)(shuo)(shuo)解,后(hou)人亦有(you)(you)的(de)(de)將滑(hua)列人弦(xian)(xian)脈(mo)(mo)(mo)(mo)的(de)(de)條件這是(shi)(shi)(shi)不(bu)必要(yao)的(de)(de)。因為(wei)彼時是(shi)(shi)(shi)用輕(qing)虛而滑(hua)形(xing)容那(nei)個(ge)(ge)“長竿末梢”具體(ti)到后(hou)來(lai)成熟的(de)(de)弦(xian)(xian)脈(mo)(mo)(mo)(mo)脈(mo)(mo)(mo)(mo)形(xing)就是(shi)(shi)(shi)不(bu)必要(yao)的(de)(de)了,提(ti)出(chu)滑(hua)的(de)(de)書(shu)有(you)(you)《脈(mo)(mo)(mo)(mo)訣匯辨》、《診家正眼》、《四診抉微》、《脈(mo)(mo)(mo)(mo)訣啟(qi)悟注釋》等書(shu),這是(shi)(shi)(shi)一(yi)(yi)種無謂(wei)的(de)(de)復(fu)古(gu)風氣(qi)(qi)并不(bu)實際。另外如(ru)《脈(mo)(mo)(mo)(mo)訣》說(shuo)(shuo)(shuo)(shuo):“時時帶(dai)數(shu)。”《壽世保元》說(shuo)(shuo)(shuo)(shuo):“數(shu)而有(you)(you)力(li)為(wei)弦(xian)(xian)。”當然是(shi)(shi)(shi)錯誤的(de)(de),而且.不(bu)必再分析辯解了。一(yi)(yi)是(shi)(shi)(shi)后(hou)世請家有(you)(you)時對弦(xian)(xian)脈(mo)(mo)(mo)(mo)形(xing)容太過(guo)(guo),這里(li)有(you)(you)一(yi)(yi)個(ge)(ge)平衡問題(ti)(ti),例如(ru)《景岳全書(shu)》說(shuo)(shuo)(shuo)(shuo):“按(an)之(zhi)(zhi)(zhi)不(bu)移,硬如(ru)弓(gong)弦(xian)(xian)高鼓峰(feng)的(de)(de)《四明心法(fa)》上(shang)說(shuo)(shuo)(shuo)(shuo):“弦(xian)(xian)如(ru)弓(gong)弦(xian)(xian)之(zhi)(zhi)(zhi)弦(xian)(xian),按(an)之(zhi)(zhi)(zhi)勒(le)指(zhi)(zhi),胃氣(qi)(qi)將絕,五臟(zang)無土,術氣(qi)(qi)太甚,即(ji)真臟(zang)脈(mo)(mo)(mo)(mo)也(ye),凡(fan)病(bing)脈(mo)(mo)(mo)(mo)見之(zhi)(zhi)(zhi)即(ji)兇(xiong),與(yu)滑(hua)相(xiang)反。”《三指(zhi)(zhi)禪(chan)》說(shuo)(shuo)(shuo)(shuo):“弦(xian)(xian)脈(mo)(mo)(mo)(mo)似(si)長(長作(zuo)張,動詞)弓(gong)。”說(shuo)(shuo)(shuo)(shuo):“脈(mo)(mo)(mo)(mo)而弦(xian)(xian),脈(mo)(mo)(mo)(mo)之(zhi)(zhi)(zhi)有(you)(you)力(li)者(zhe)也(ye),雄姿猛態,可以(yi)百(bai)鈞。”形(xing)容太過(guo)(guo)的(de)(de)原因一(yi)(yi)是(shi)(shi)(shi)個(ge)(ge)人認識上(shang)的(de)(de)不(bu)同,一(yi)(yi)是(shi)(shi)(shi)古(gu)人本有(you)(you)不(bu)同程度的(de)(de)弦(xian)(xian)脈(mo)(mo)(mo)(mo)之(zhi)(zhi)(zhi)說(shuo)(shuo)(shuo)(shuo),最重(zhong)的(de)(de)即(ji)所謂(wei)純(chun)弦(xian)(xian)無胃氣(qi)(qi)的(de)(de)脈(mo)(mo)(mo)(mo)是(shi)(shi)(shi)絕脈(mo)(mo)(mo)(mo),但(dan)在說(shuo)(shuo)(shuo)(shuo)解弦(xian)(xian)脈(mo)(mo)(mo)(mo)時不(bu)應將最嚴重(zhong)的(de)(de)弦(xian)(xian)脈(mo)(mo)(mo)(mo)定為(wei)一(yi)(yi)般性的(de)(de)指(zhi)(zhi)標,那(nei)樣顯然是(shi)(shi)(shi)與(yu)臨床最常見的(de)(de)弦(xian)(xian)脈(mo)(mo)(mo)(mo)是(shi)(shi)(shi)不(bu)適(shi)合(he)的(de)(de),對此應當在一(yi)(yi)般解釋的(de)(de)基礎上(shang)說(shuo)(shuo)(shuo)(shuo)明,弦(xian)(xian)脈(mo)(mo)(mo)(mo)有(you)(you)程度的(de)(de)差別(bie),如(ru)果出(chu)現“純(chun)弦(xian)(xian)”則提(ti)示胃氣(qi)(qi)將絕病(bing)情嚴重(zhong)較(jiao)為(wei)合(he)理。

另(ling)外,正(zheng)如《三指禪》所說(shuo):“脈(mo)(mo)而(er)(er)弦(xian),脈(mo)(mo)之有(you)(you)力(li)(li)(li)(li)者(zhe)也(ye)。”弦(xian)脈(mo)(mo)確是(shi)(shi)一(yi)個代表(biao)力(li)(li)(li)(li)度的(de)(de)(de)脈(mo)(mo),在多因素的(de)(de)(de)脈(mo)(mo)象中(zhong),有(you)(you)力(li)(li)(li)(li)的(de)(de)(de)脈(mo)(mo)如實、牢等脈(mo)(mo)都具有(you)(you)弦(xian)的(de)(de)(de)因素,又如芤脈(mo)(mo)是(shi)(shi)個有(you)(you)邊(bian)無中(zhong)中(zhong)空(kong)(kong)的(de)(de)(de)脈(mo)(mo),但(dan)(dan)如為表(biao)面有(you)(you)較(jiao)強力(li)(li)(li)(li)度,但(dan)(dan)仍然(ran)中(zhong)空(kong)(kong)則(ze)需要芤與弦(xian)相合在一(yi)起(qi)才能形成,即所謂革脈(mo)(mo)。見(jian)在任何隋況下弦(xian)脈(mo)(mo)都是(shi)(shi)表(biao)現為有(you)(you)力(li)(li)(li)(li)的(de)(de)(de)。當然(ran)亦(yi)可(ke)以見(jian)到弦(xian)而(er)(er)無力(li)(li)(li)(li)的(de)(de)(de)脈(mo)(mo),那是(shi)(shi)屬于雖然(ran)張力(li)(li)(li)(li)略強但(dan)(dan)阻力(li)(li)(li)(li)不(bu)強脈(mo)(mo)管(guan)亦(yi)無變硬等條(tiao)件的(de)(de)(de)一(yi)種弦(xian)象,而(er)(er)典型的(de)(de)(de)弦(xian)脈(mo)(mo)正(zheng)如古人(ren)所說(shuo)是(shi)(shi)有(you)(you)力(li)(li)(li)(li)的(de)(de)(de)、硬的(de)(de)(de)。

1、弦脈(mo)為具有獨立意(yi)義之單因素脈(mo)象。

2、弦脈的指(zhi)感(gan)是(shi)脈管繃直挺然(ran)指(zhi)下(xia)按之(zhi)不移,端(duan)直以長。

3、弦(xian)(xian)(xian)脈的客觀形象描述是(shi)很重(zhong)要的,如狀如弓弦(xian)(xian)(xian),琴瑟弦(xian)(xian)(xian)、箏弦(xian)(xian)(xian)、絲弦(xian)(xian)(xian)等(deng)等(deng)。

4、弦脈原(yuan)則上是代表(biao)力度(du)強的(de)脈象(xiang)(xiang),它(ta)可(ke)以與(yu)其他脈象(xiang)(xiang)或因素組合(he)成某些(xie)有力的(de)復合(he)性(xing)質的(de)脈象(xiang)(xiang),如實、牢等(deng)(deng)脈或在某些(xie)復合(he)因索的(de)脈象(xiang)(xiang)中表(biao)現(xian)力度(du)如革脈等(deng)(deng)。

本文地址://n85e38t.cn/jichu/105258.html.

聲明: 我(wo)們致力于保護(hu)作(zuo)者(zhe)版(ban)權,注(zhu)重(zhong)分(fen)(fen)享,被刊用文章因無法(fa)(fa)核實(shi)真實(shi)出處,未能及時與作(zuo)者(zhe)取得聯(lian)系,或有版(ban)權異議的(de),請聯(lian)系管理(li)員,我(wo)們會(hui)立即(ji)處理(li),本站部分(fen)(fen)文字與圖片(pian)資源(yuan)來自(zi)于網絡,轉載是出于傳遞更多信息之目的(de),若有來源(yuan)標注(zhu)錯誤(wu)或侵犯(fan)了您(nin)的(de)合法(fa)(fa)權益,請立即(ji)通知我(wo)們(管理(li)員郵(you)箱:),情(qing)況屬(shu)實(shi),我(wo)們會(hui)第一時間(jian)予以刪(shan)除,并同時向您(nin)表示歉意,謝(xie)謝(xie)!

上(shang)一篇:

下一篇:

相關文章