{"resource_id":10370,"title":"重订诊家直诀","format":"md","encoding":"utf-8","chapters":[{"id":"chapter-1","title":"重訂診家直訣序目","sections":[{"id":"chapter-1-section-1","title":"正文","paragraphs":["醫有四科，曰脈、曰證、曰藥、曰方，","知脈而後知證，知藥而後能方，故脈尤汲汲也。","拙著脈義簡摩，脈簡補義，診家直訣，辨脈平脈章句，凡四種。都十二卷，博採百家，參以已說，名雖四種，義實相承，卷帙既繁，脈絡難貫，專取一種，又苦弗完，茲特撮其要者，簡之又簡，別為此編，名曰重訂診家直訣，其篇目如左："]},{"id":"chapter-1-section-2","title":"【捲上】","paragraphs":[]},{"id":"chapter-1-section-3","title":"【一】指法總義","paragraphs":[]},{"id":"chapter-1-section-4","title":"【二】八法總義","paragraphs":[]},{"id":"chapter-1-section-5","title":"【三】微甚兼獨","paragraphs":[]},{"id":"chapter-1-section-6","title":"【四】二十四象會通","paragraphs":[]},{"id":"chapter-1-section-7","title":"【五】位數形勢","paragraphs":[]},{"id":"chapter-1-section-8","title":"【卷下】","paragraphs":[]},{"id":"chapter-1-section-9","title":"【一】獨取寸口本義","paragraphs":["【二】血氣形勢直解1"]},{"id":"chapter-1-section-10","title":"【三】說神","paragraphs":[]},{"id":"chapter-1-section-11","title":"【四】初診久按不同","paragraphs":["【五】脈有兩側"]},{"id":"chapter-1-section-12","title":"【六】脈有動搖","paragraphs":[]},{"id":"chapter-1-section-13","title":"【七】脈有內曲外曲","paragraphs":[]},{"id":"chapter-1-section-14","title":"【八】脈有變易無定","paragraphs":[]},{"id":"chapter-1-section-15","title":"【九】外診撮要","paragraphs":[]},{"id":"chapter-1-section-16","title":"【十】三關脈體通考","paragraphs":[]},{"id":"chapter-1-section-17","title":"【十一】左右表裡直解","paragraphs":[]},{"id":"chapter-1-section-18","title":"【十二】辨止","paragraphs":[]},{"id":"chapter-1-section-19","title":"【十三】單診總按不同","paragraphs":[]},{"id":"chapter-1-section-20","title":"【十四】脈有頭本","paragraphs":[]},{"id":"chapter-1-section-21","title":"【十五】脈有俯仰","paragraphs":[]},{"id":"chapter-1-section-22","title":"【十六】脈有無數細絲","paragraphs":[]},{"id":"chapter-1-section-23","title":"【十七】脈有起伏中途變易","paragraphs":["2"]},{"id":"chapter-1-section-24","title":"【捲上】","paragraphs":[]},{"id":"chapter-1-section-25","title":"【一】指法總義","paragraphs":["診脈之指法，見於經論者，曰舉、曰按、曰尋、曰推，曰初持，曰久按，曰單持，曰總按、無求子訊息七法。","曰上竟、下竟、曰內推、外推，曰浮按、中按、沉按，","更有：側指法，挽指法，輾轉指法，俯仰指法，","舉而覆按，按而復舉，是操縱指法，若是者，皆有舊論可考也。","至於私心所創穫，與得諸益友所訓示者，則又有移指法，直壓指法。","夫脈有四科，位、數、形、勢、而已。","（一）位者：浮、沉、尺、寸也","（二）數者：遲、數、促、結也","（三）形者：長、短、廣、狹、厚、薄、粗、細、剛、柔。猶算學家之有線面體也。","（四）勢者：斂、舒、伸、縮、進、退、起、伏、之有盛衰也，勢因形顯，","斂舒成形於廣狹，","伸縮成形於長短，","進退成形於前後，3","起伏成形於高下，","而盛衰則貫於諸勢之中，以為之綱者也，","此所謂脈之四科也。","指法即由此而辨，","曰舉法，以診高深也。","曰上下，以診長短也。","曰尋推，以診皮廣狹厚薄曲直也。","曰初持久按，以診遲數滑濇止代也。","曰單持總按，以診去來斷續也。","病者，氣口處骨肉不平，須用側指法，","病者，不能平臂而側置，須用挽指法，","俯仰者：三指輕重相畸也，","輾轉者：一指左右相傾也，","操縱者，舉按迭用，以察根氣之強弱，難經所謂按之耎，舉指來疾者此也","惟三指總按，橫度三關，三指縫中，各有其隙，若三部脈形不同，如寸濇尺滑，前小後大即，無由得其接續之真跡，昔有同學示以移指法4","，如先診三關，再略退半部，以食指加寸關之交，中指加關尺之交，終以有隙。而其真不見，後乃自創一指直壓之法，以食指直壓三關，而真象並露矣。","小兒脈位狹小，以食指橫度脈上，而展轉以診之。","【二】二十四象會通：","（一）浮沉：","以診氣之升降也，","陽不能降，則脈見於浮，","陰不能升，則脈見於沉，","前人每以脈之在浮在沉，與脈之能浮能沉相混，"]},{"id":"chapter-1-section-26","title":"能浮能沈乃高深之義也","paragraphs":["（二）遲數：","以診氣之躁靜也，","躁有因熱，有因燥，","靜有因寒，有因虛，","而皆有因鬱5","按內經：手躁足靜，與遲數不同，手經之道近，其氣至也迫，足經之道遠，其氣至也緩，故有躁靜之殊也。然先至者不能先去，必待後至者去，而始能與之俱去，故無遲數之異也。","滑伯仁謂：察脈須識上、下、去、來、至、止，","至止即察躁靜之事也，","察其停於下者之久暫，","又察其鼓於上者之久暫，","而陰陽噓吸之躁靜瞭然矣。","（三）強弱：","以診勢之盛衰也，","應指有力謂之強，","無力謂之弱，","前人每以脈形之軟硬，與脈勢之盛衰相混，","內經凡言脈之大小，多指動勢之盛衰也。","（四）剛柔：以診形之軟硬也，6","形軟有因血虛，有因溼熱，","形硬有因血實，有因風寒，"]},{"id":"chapter-1-section-27","title":"此即內經之所謂緩急也","paragraphs":["（五）滑濇：","以診形之枯潤也，","血有餘則脈滑，","血不足則脈濇，","然血由氣行，故亦可徵氣之盛衰雲，","氣血必有津已載之，始能推行滑利，","故內經以滑為陰有餘，濇為陽有餘，陰即津液也。","（六）斷續：","以診氣血之通塞盛衰也，","有形之斷續，長短是也，","有動之斷續，促結濇代是也，","此條專言動之斷續，","應指有力有神，屬於通塞，","無力無神，關於盛衰，7","亦有無力而有神者，微衰而兼塞也，","來去停勻，五十不代，謂之續，","參伍不調，有來有去，謂之斷。","其敗也，蝦遊，魚翔、屋漏，雀啄，","塞者血塞也，衰者氣衰也，敗者氣血俱敗也。","（七）長短：","以診氣之鬱暢也，氣暢則雖弱而亦長，氣鬱則雖強而亦短。","按氣有出入，有升降，出入橫也，升降直也，","風寒外束，氣出不利，脈來弦緊，","痰飲中結，氣升不利，脈來厥厥如豆，","是長短皆有氣鬱也，","經曰：長則氣治，短則氣病，亦言其大概而已。","（八）高深：","以診氣之噓吸也，此指來去之遠近，","所謂息之深深，達之覺覺者，氣之操縱也，","浮沈是陰陽噓翁之已然，","高深是陰陽噓翁之方然，8","一言氣之所在，一言氣之所至。","（九）厚薄：","以診血之盈虛也，","以形體言，非浮沉之謂也，","故有浮而厚，有沉而薄，","浮中沉三候俱有，按之不斷，謂之厚。","僅在一侯，按之即斷謂之薄。","（十）寬窄：","以診氣血之寒熱盈虛也，","氣熱則血漲，","氣寒則血消，","血實則氣充，"]},{"id":"chapter-1-section-28","title":"血虛則氣怯","paragraphs":["（一一）斂散：","以診氣之寒熱也，以兩旁之邊際言，非寬窄之謂也，","寬窄指脈體之大小，9","斂散指脈邊之清濁，","故氣寒血盈，寬而亦清，","氣熱血虛，窄而亦濁，","亦非剛柔之謂也，","一、剛柔指脈體之硬軟，","二、斂散指脈遲之緊松，","故血虛氣寒，軟而亦緊，","血實氣熱，硬而亦松，脈中有脊，而兩邊渾渾不清也。","（一二）粗細：","以診氣血之寒熱盈虛也，寬厚相搏謂之粗，窄薄相搏謂之細。","會通者，二十四象互相加乘，以求合於古脈，而診百病也，","如浮薄而硬，革也。","浮薄而耎，芤也。","浮厚而斂，弦也。","浮薄而散，微也。","長硬而斂，緊也。10","短耎而散，濡也。","高而數，促也。","深而遲，伏也。","短而剛強，動滑也。","斷而柔弱，結代也。","長厚硬斂，弦牢也。","長厚柔散，洪緩也。","是故：","芤、血虛也，","遲、氣寒也。","伏、氣閉也。","代散、氣脫也。","血弱虛微、氣血俱虛也。","細緊，氣血俱寒也。","革、陰盛於上也。","牢、陰盛於下也。","洪促、氣熱於氣分也。","動滑、氣熱於血分也。","浮數、氣熱於氣分也。11","沉遲、氣寒於血分也。","弦革、氣寒於氣分也。","緊結、氣結於血分也。","細、血中氣寒也。","緩、血中氣熱也。","長短、同有氣鬱。","氣橫於氣分則長。","氣結於血分則短也。","滑濇同有、血虛血實。","寒凝於血分則實而濇。","熱亢於氣分則虛而滑也。","而且寒極似熱，熱極似寒，實極似虛，虛極似實。","如滑主痰也，而痰亦見濇，","弦主"]}]}],"toc":[{"id":"chapter-1-section-1","chapter_title":"重訂診家直訣序目","section_title":"正文","is_available":true},{"id":"chapter-1-section-2","chapter_title":"重訂診家直訣序目","section_title":"【捲上】","is_available":true},{"id":"chapter-1-section-3","chapter_title":"重訂診家直訣序目","section_title":"【一】指法總義","is_available":true},{"id":"chapter-1-section-4","chapter_title":"重訂診家直訣序目","section_title":"【二】八法總義","is_ava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重訂診家直訣序目\n醫有四科，曰脈、曰證、曰藥、曰方，\n知脈而後知證，知藥而後能方，故脈尤汲汲也。\n拙著脈義簡摩，脈簡補義，診家直訣，辨脈平脈章句，凡四種。都十二卷，博採百家，參以已說，名雖四種，義實相承，卷帙既繁，脈絡難貫，專取一種，又苦弗完，茲特撮其要者，簡之又簡，別為此編，名曰重訂診家直訣，其篇目如左：\n## 【捲上】\n## 【一】指法總義\n## 【二】八法總義\n## 【三】微甚兼獨\n## 【四】二十四象會通\n## 【五】位數形勢\n## 【卷下】\n## 【一】獨取寸口本義\n【二】血氣形勢直解1\n## 【三】說神\n## 【四】初診久按不同\n【五】脈有兩側\n## 【六】脈有動搖\n## 【七】脈有內曲外曲\n## 【八】脈有變易無定\n## 【九】外診撮要\n## 【十】三關脈體通考\n## 【十一】左右表裡直解\n## 【十二】辨止\n## 【十三】單診總按不同\n## 【十四】脈有頭本\n## 【十五】脈有俯仰\n## 【十六】脈有無數細絲\n## 【十七】脈有起伏中途變易\n2\n## 【捲上】\n## 【一】指法總義\n診脈之指法，見於經論者，曰舉、曰按、曰尋、曰推，曰初持，曰久按，曰單持，曰總按、無求子訊息七法。\n曰上竟、下竟、曰內推、外推，曰浮按、中按、沉按，\n更有：側指法，挽指法，輾轉指法，俯仰指法，\n舉而覆按，按而復舉，是操縱指法，若是者，皆有舊論可考也。\n至於私心所創穫，與得諸益友所訓示者，則又有移指法，直壓指法。\n夫脈有四科，位、數、形、勢、而已。\n（一）位者：浮、沉、尺、寸也\n（二）數者：遲、數、促、結也\n（三）形者：長、短、廣、狹、厚、薄、粗、細、剛、柔。猶算學家之有線面體也。\n（四）勢者：斂、舒、伸、縮、進、退、起、伏、之有盛衰也，勢因形顯，\n斂舒成形於廣狹，\n伸縮成形於長短，\n進退成形於前後，3\n起伏成形於高下，\n而盛衰則貫於諸勢之中，以為之綱者也，\n此所謂脈之四科也。\n指法即由此而辨，\n曰舉法，以診高深也。\n曰上下，以診長短也。\n曰尋推，以診皮廣狹厚薄曲直也。\n曰初持久按，以診遲數滑濇止代也。\n曰單持總按，以診去來斷續也。\n病者，氣口處骨肉不平，須用側指法，\n病者，不能平臂而側置，須用挽指法，\n俯仰者：三指輕重相畸也，\n輾轉者：一指左右相傾也，\n操縱者，舉按迭用，以察根氣之強弱，難經所謂按之耎，舉指來疾者此也\n惟三指總按，橫度三關，三指縫中，各有其隙，若三部脈形不同，如寸濇尺滑，前小後大即，無由得其接續之真跡，昔有同學示以移指法4\n，如先診三關，再略退半部，以食指加寸關之交，中指加關尺之交，終以有隙。而其真不見，後乃自創一指直壓之法，以食指直壓三關，而真象並露矣。\n小兒脈位狹小，以食指橫度脈上，而展轉以診之。\n【二】二十四象會通：\n（一）浮沉：\n以診氣之升降也，\n陽不能降，則脈見於浮，\n陰不能升，則脈見於沉，\n前人每以脈之在浮在沉，與脈之能浮能沉相混，\n## 能浮能沈乃高深之義也\n（二）遲數：\n以診氣之躁靜也，\n躁有因熱，有因燥，\n靜有因寒，有因虛，\n而皆有因鬱5\n按內經：手躁足靜，與遲數不同，手經之道近，其氣至也迫，足經之道遠，其氣至也緩，故有躁靜之殊也。然先至者不能先去，必待後至者去，而始能與之俱去，故無遲數之異也。\n滑伯仁謂：察脈須識上、下、去、來、至、止，\n至止即察躁靜之事也，\n察其停於下者之久暫，\n又察其鼓於上者之久暫，\n而陰陽噓吸之躁靜瞭然矣。\n（三）強弱：\n以診勢之盛衰也，\n應指有力謂之強，\n無力謂之弱，\n前人每以脈形之軟硬，與脈勢之盛衰相混，\n內經凡言脈之大小，多指動勢之盛衰也。\n（四）剛柔：以診形之軟硬也，6\n形軟有因血虛，有因溼熱，\n形硬有因血實，有因風寒，\n## 此即內經之所謂緩急也\n（五）滑濇：\n以診形之枯潤也，\n血有餘則脈滑，\n血不足則脈濇，\n然血由氣行，故亦可徵氣之盛衰雲，\n氣血必有津已載之，始能推行滑利，\n故內經以滑為陰有餘，濇為陽有餘，陰即津液也。\n（六）斷續：\n以診氣血之通塞盛衰也，\n有形之斷續，長短是也，\n有動之斷續，促結濇代是也，\n此條專言動之斷續，\n應指有力有神，屬於通塞，\n無力無神，關於盛衰，7\n亦有無力而有神者，微衰而兼塞也，\n來去停勻，五十不代，謂之續，\n參伍不調，有來有去，謂之斷。\n其敗也，蝦遊，魚翔、屋漏，雀啄，\n塞者血塞也，衰者氣衰也，敗者氣血俱敗也。\n（七）長短：\n以診氣之鬱暢也，氣暢則雖弱而亦長，氣鬱則雖強而亦短。\n按氣有出入，有升降，出入橫也，升降直也，\n風寒外束，氣出不利，脈來弦緊，\n痰飲中結，氣升不利，脈來厥厥如豆，\n是長短皆有氣鬱也，\n經曰：長則氣治，短則氣病，亦言其大概而已。\n（八）高深：\n以診氣之噓吸也，此指來去之遠近，\n所謂息之深深，達之覺覺者，氣之操縱也，\n浮沈是陰陽噓翁之已然，\n高深是陰陽噓翁之方然，8\n一言氣之所在，一言氣之所至。\n（九）厚薄：\n以診血之盈虛也，\n以形體言，非浮沉之謂也，\n故有浮而厚，有沉而薄，\n浮中沉三候俱有，按之不斷，謂之厚。\n僅在一侯，按之即斷謂之薄。\n（十）寬窄：\n以診氣血之寒熱盈虛也，\n氣熱則血漲，\n氣寒則血消，\n血實則氣充，\n## 血虛則氣怯\n（一一）斂散：\n以診氣之寒熱也，以兩旁之邊際言，非寬窄之謂也，\n寬窄指脈體之大小，9\n斂散指脈邊之清濁，\n故氣寒血盈，寬而亦清，\n氣熱血虛，窄而亦濁，\n亦非剛柔之謂也，\n一、剛柔指脈體之硬軟，\n二、斂散指脈遲之緊松，\n故血虛氣寒，軟而亦緊，\n血實氣熱，硬而亦松，脈中有脊，而兩邊渾渾不清也。\n（一二）粗細：\n以診氣血之寒熱盈虛也，寬厚相搏謂之粗，窄薄相搏謂之細。\n會通者，二十四象互相加乘，以求合於古脈，而診百病也，\n如浮薄而硬，革也。\n浮薄而耎，芤也。\n浮厚而斂，弦也。\n浮薄而散，微也。\n長硬而斂，緊也。10\n短耎而散，濡也。\n高而數，促也。\n深而遲，伏也。\n短而剛強，動滑也。\n斷而柔弱，結代也。\n長厚硬斂，弦牢也。\n長厚柔散，洪緩也。\n是故：\n芤、血虛也，\n遲、氣寒也。\n伏、氣閉也。\n代散、氣脫也。\n血弱虛微、氣血俱虛也。\n細緊，氣血俱寒也。\n革、陰盛於上也。\n牢、陰盛於下也。\n洪促、氣熱於氣分也。\n動滑、氣熱於血分也。\n浮數、氣熱於氣分也。11\n沉遲、氣寒於血分也。\n弦革、氣寒於氣分也。\n緊結、氣結於血分也。\n細、血中氣寒也。\n緩、血中氣熱也。\n長短、同有氣鬱。\n氣橫於氣分則長。\n氣結於血分則短也。\n滑濇同有、血虛血實。\n寒凝於血分則實而濇。\n熱亢於氣分則虛而滑也。\n而且寒極似熱，熱極似寒，實極似虛，虛極似實。\n如滑主痰也，而痰亦見濇，\n弦主","is_preview":true,"preview_page_limit":10}