{"resource_id":15236,"title":"脉确","format":"md","encoding":"utf-8","chapters":[{"id":"chapter-1","title":"脈確","sections":[{"id":"chapter-1-section-1","title":"《脈確》  清 黃蘊兮","paragraphs":[]},{"id":"chapter-1-section-2","title":"序","paragraphs":[]},{"id":"chapter-1-section-3","title":"脈原","paragraphs":[]},{"id":"chapter-1-section-4","title":"脈名","paragraphs":[]},{"id":"chapter-1-section-5","title":"脈類","paragraphs":["寸關尺臟腑部位"]},{"id":"chapter-1-section-6","title":"診法","paragraphs":[]},{"id":"chapter-1-section-7","title":"平脈","paragraphs":[]},{"id":"chapter-1-section-8","title":"病脈","paragraphs":[]},{"id":"chapter-1-section-9","title":"主諸病脈","paragraphs":[]},{"id":"chapter-1-section-10","title":"可治病脈","paragraphs":[]},{"id":"chapter-1-section-11","title":"諸可治病脈","paragraphs":[]},{"id":"chapter-1-section-12","title":"死脈","paragraphs":[]},{"id":"chapter-1-section-13","title":"諸病死脈","paragraphs":["奇經"]},{"id":"chapter-1-section-14","title":"內經切脈之圖","paragraphs":["浮","洪"]},{"id":"chapter-1-section-15","title":"虛","paragraphs":["芤革","散","微","沉牢","伏","實","遲","緩","數","結","促","代","弦","緊","長","短","細","澀","滑","動"]},{"id":"chapter-1-section-16","title":"胎脈","paragraphs":[]},{"id":"chapter-1-section-17","title":"附送戴原禮還浦陽序","paragraphs":[]},{"id":"chapter-1-section-18","title":"贈醫師葛某序","paragraphs":[]},{"id":"chapter-1-section-19","title":"贈醫師賈某序","paragraphs":[]},{"id":"chapter-1-section-20","title":"序","paragraphs":["石陽黃韞兮。著脈確一書。或從而叩其義。韞兮曰。醫憑乎脈。而脈衰乎理。從來醫家論脈。不患其言之無理。而患其言之於理甚精。以之測病。而所謂精者。終未確也。夫脈以測病。不確豈能無誤。浮游沉塞。起伏傳變。全寄之乎三指。輕輒重按。反覆呼吸。實有毫釐千里之判。微乎渺乎。確誠未易言矣。於脈學。究心已久。嘗以軒岐之經為主。","而於諸賢論脈之書。採其理之的然可信者。而據以為確。間有未的。則證之於經。復出己意。以旁探博求。其所謂確者。","第識見有限。竊恐自以為確。而終未必其能確也。倘高明於其未確者。更加校正。則幸甚矣。韞兮之言若此。歲壬戌餘以母病。延之來淮。出視是書。山陽醫士李鑄九見之。深為折服。晚年其學益進。餘復攜其帙至真洲。以示李喬年。喬年亦世醫也。謂餘曰。是書實足發矇啟。先生既刊行傷寒論翼矣。曷極付剞劂。附之於後俾得表裡印證。厥功豈不偉哉。餘曰諾。因次述其語。以弁簡端。","乾隆丙寅小春歙州程識"]},{"id":"chapter-1-section-21","title":"脈原","paragraphs":["氣口者。手太陰肺經之動脈。而五臟六腑之氣。於此候之也。蓋人以氣生。營衛之氣。先天也。水谷之氣。後天也。","先天后天之氣。脈皆主之。故飲入於胃。其精氣。自脾歸肺。食入於腎。其精氣。自心歸肺。肺布飲食之精氣於諸臟腑。","而後血氣充。營衛調。諸臟腑之氣。各隨其經。同營衛之氣。而呼吸朝之於肺。故手太陰肺經。乃諸臟腑之氣所聚也。","聖人於氣口。候其盛衰。洩天地化育莫測之秘。豈不神乎。"]},{"id":"chapter-1-section-22","title":"脈名","paragraphs":["王叔和脈經。有浮、芤、洪、涓、數、促、弦、緊、沉、伏、革、實、微、澀、細、、弱、虛、散、緩、遲、結、代、動二十四名。叔和以後諸家。又增長短、牢、疾、大、小共三十名。按察病以脈。必辨之精確。而後見之明。不至遊疑而無主。據經之論脈。不止三十名。如鼓、搏、喘、橫之類。今亦未窺其奧。不敢採入。即三十名。尚有可測者。","如脈經。謂浮細為。沉細為弱。是以浮細辨。弱以沉細辨也。然經曰。長夏胃微弱曰平。使弱皆細脈。細則氣少。經何以謂為長夏之平脈乎。又曰。弱有石曰冬病。石沉脈也。弱而沉。是水之侮土也。使脈果以浮細辨。經何謂以沉言乎。由是觀之。凡脈柔而無力者。概謂之弱。非浮細沉細之謂。今以弱附於細。以存其舊也。仲景曰。","弦則為寒。芤則為虛。虛寒相搏。此名曰革。男子亡血失精。女子半產漏下。據此則革脈。即芤之兼弦者。芤主陰虛病。","革亦主陰虛病。今以革附於芤也。沉伏實大。千金翼謂之牢。主寒主痛。是即沉脈而有力者。今附於沉。經一脈有數名者。如秋脈謂之毛。又謂之浮。非二脈也。是疾脈即數。大即洪。小即細也。今刪弱革牢疾大小七名。定為二十三脈。","蓋脈以候病。其可去輒者。不加詳辨。則名目愈多。脈理愈晦。故不敢避僭妄之譏也。"]},{"id":"chapter-1-section-23","title":"脈類","paragraphs":["脈者。陰陽之氣也。有浮即有沉。有大即有小。有遲即有數。故吳草廬。滑伯仁。李瀕湖。皆以對待編之。今欲其易於分別。凡以浮辨者為一類。以沉辨者為一類。以浮沉合辨者為一類。不以浮沉辨。而以至數辨者為一類。不以浮沉至數辨。而以形辨者為一類。","寸關尺臟腑部位","經。尺內兩旁。則季脅也。（肋骨盡處名季脅）尺外以候腎。尺內以候腹。中附上。（越人謂之關）左外以候肝。內以候膈。右外以候胃。內以候脾。上附上。（越人謂之寸口）右外以候肺。內以候胸中。左外以候心。內以候膻中。（膻中在兩乳之間）前以候前。後以候後。上竟上者。（關以上）胸喉中事也。下竟下者。（關以下）少腹腰股。膝脛足中事也。推而外之。內而不外。（外浮也內沉也）心腹疾也。推而內之。外而不內。身有熱也。推而上之。上而不下。腰足清也。推而下之。下而不上。頸項痛也。按之至骨。脈氣少者。腰脊痛而有痺也。","脈經。從魚際至高骨。卻行一寸。其中名曰寸口。從寸至尺。名曰尺澤。故曰尺寸。寸後尺前。名曰關。陽出陰入。","以關為界。陽出三分。陰入三分。故曰三陽三陰。陽生於尺。動於寸。陰生於寸。動於尺。寸主上焦。頭及皮毛竟手。","關主中焦。腹及腰。尺主下焦。少腹即足。","經於寸關尺分部以候五臟。而六腑止及腎者。蓋五臟先天之氣。賴後天水谷之氣以養之也。餘腑不及者。統於髒也。","蓋腎開竅於二陰。小腸膀胱屬前陰。大腸屬後陰。則腎統乎大腸小腸膀胱也。膽附於肝。則肝統乎膽也。三焦不統於髒。","故於寸內候胸中。關內候膈。尺內候腹。胸中上焦也。膈中焦也。腹下焦也。且五臟者。身之主也。外則耳目鼻口。四肢皮毛肌肉。內則筋骨脈絡。氣血精神魂魄。皆其所司也。故人之一身皆可病。而病入髒者死。見真髒脈者死。此所以經之論脈。惟詳五臟也。四時之脈。有胃氣者生。無胃氣者死。此所以經之論脈。而六腑止及胃也。","經論脈。不以六腑配五臟。而王叔和脈經。以心與小腸。候在左寸。肺與大腸。候在右寸。肝膽候在左關。脾胃候在右關。腎與膀胱。候在左尺。又謂左尺屬腎。右為子戶。名曰三焦。又謂腎與命門。俱出尺部。其書前後。多自相矛盾。疑不盡出於叔和。世但闢高陽生脈訣。而不知脈訣。亦實本於脈經也。至右尺主三焦命門之誤。李瀕湖辨之詳矣。","經論脈不及腑。腑病何以候之耶。曰。腑病辨之於症。而以髒脈。候內外之因。假如頭角耳前後痛。往來寒熱。此膽經之病症也。而肝脈浮緊。則膽經之風寒。肝脈弦數。則膽經之痰火也。假如胸中脹悶。上焦之病症也。而肺脈滑數。","則上焦之痰火。肺脈沉遲。則上焦之寒氣也。","寸關尺。經有外候內候之說。王太僕曰。外謂外側。內謂內側。李士材曰。外謂前半部。內謂後半部。二說皆有可議者。試即尺論之。外以候腎。內以候腹。假令腎病腹不痛。而其脈外側見病脈。內側見平脈乎。前半部見病脈。後半部見平脈乎。即使如此。而一指舉按之間。所謂外側內側。前半後半之界。能劃然清乎。今據經曰。推而外之。內而不外。有心腹積也。推而內之。外而不內。身有熱也。外指浮。內指沉。沉而不浮。故有心腹積。浮而不沉。故身有熱。","由是觀之。則所謂外候內候。指沉浮而言也明矣。蓋五"]}]}],"toc":[{"id":"chapter-1-section-1","chapter_title":"脈確","section_title":"《脈確》  清 黃蘊兮","is_available":true},{"id":"chapter-1-section-2","chapter_title":"脈確","section_title":"序","is_available":true},{"id":"chapter-1-section-3","chapter_title":"脈確","section_title":"脈原","is_available":true},{"id":"chapter-1-section-4","chapter_title":"脈確","section_title":"脈名","is_available":true},{"id":"chapter-1-section-5","chapter_title":"脈確","section_title":"脈類","is_available":true},{"id":"chapter-1-section-6","chapter_title":"脈確","section_title":"診法","is_available":true},{"id":"chapter-1-section-7","chapter_title":"脈確","section_title":"平脈","is_available":true},{"id":"chapter-1-section-8","chapter_title":"脈確","section_title":"病脈","is_available":true},{"id":"chapter-1-section-9","chapter_title":"脈確","section_title":"主諸病脈","is_available":true},{"id":"chapter-1-section-10","chapter_title":"脈確","section_title":"可治病脈","is_available":true},{"id":"chapter-1-section-11","chapter_title":"脈確","section_title":"諸可治病脈","is_available":true},{"id":"chapter-1-section-12","chapter_title":"脈確","section_title":"死脈","is_available":true},{"id":"chapter-1-section-13","chapter_title":"脈確","section_title":"諸病死脈","is_available":true},{"id":"chapter-1-section-14","chapter_title":"脈確","section_title":"內經切脈之圖","is_available":true},{"id":"chapter-1-section-15","chapter_title":"脈確","section_title":"虛","is_available":true},{"id":"chapter-1-section-16","chapter_title":"脈確","section_title":"胎脈","is_available":true},{"id":"chapter-1-section-17","chapter_title":"脈確","section_title":"附送戴原禮還浦陽序","is_available":true},{"id":"chapter-1-section-18","chapter_title":"脈確","section_title":"贈醫師葛某序","is_available":true},{"id":"chapter-1-section-19","chapter_title":"脈確","section_title":"贈醫師賈某序","is_available":true},{"id":"chapter-1-section-20","chapter_title":"脈確","section_title":"序","is_available":true},{"id":"chapter-1-section-21","chapter_title":"脈確","section_title":"脈原","is_available":true},{"id":"chapter-1-section-22","chapter_title":"脈確","section_title":"脈名","is_available":true},{"id":"chapter-1-section-23","chapter_title":"脈確","section_title":"脈類","is_available":true}],"plain_text":"# 脈確\n## 《脈確》  清 黃蘊兮\n## 序\n## 脈原\n## 脈名\n## 脈類\n寸關尺臟腑部位\n## 診法\n## 平脈\n## 病脈\n## 主諸病脈\n## 可治病脈\n## 諸可治病脈\n## 死脈\n## 諸病死脈\n奇經\n## 內經切脈之圖\n浮\n洪\n## 虛\n芤革\n散\n微\n沉牢\n伏\n實\n遲\n緩\n數\n結\n促\n代\n弦\n緊\n長\n短\n細\n澀\n滑\n動\n## 胎脈\n## 附送戴原禮還浦陽序\n## 贈醫師葛某序\n## 贈醫師賈某序\n## 序\n石陽黃韞兮。著脈確一書。或從而叩其義。韞兮曰。醫憑乎脈。而脈衰乎理。從來醫家論脈。不患其言之無理。而患其言之於理甚精。以之測病。而所謂精者。終未確也。夫脈以測病。不確豈能無誤。浮游沉塞。起伏傳變。全寄之乎三指。輕輒重按。反覆呼吸。實有毫釐千里之判。微乎渺乎。確誠未易言矣。於脈學。究心已久。嘗以軒岐之經為主。\n而於諸賢論脈之書。採其理之的然可信者。而據以為確。間有未的。則證之於經。復出己意。以旁探博求。其所謂確者。\n第識見有限。竊恐自以為確。而終未必其能確也。倘高明於其未確者。更加校正。則幸甚矣。韞兮之言若此。歲壬戌餘以母病。延之來淮。出視是書。山陽醫士李鑄九見之。深為折服。晚年其學益進。餘復攜其帙至真洲。以示李喬年。喬年亦世醫也。謂餘曰。是書實足發矇啟。先生既刊行傷寒論翼矣。曷極付剞劂。附之於後俾得表裡印證。厥功豈不偉哉。餘曰諾。因次述其語。以弁簡端。\n乾隆丙寅小春歙州程識\n## 脈原\n氣口者。手太陰肺經之動脈。而五臟六腑之氣。於此候之也。蓋人以氣生。營衛之氣。先天也。水谷之氣。後天也。\n先天后天之氣。脈皆主之。故飲入於胃。其精氣。自脾歸肺。食入於腎。其精氣。自心歸肺。肺布飲食之精氣於諸臟腑。\n而後血氣充。營衛調。諸臟腑之氣。各隨其經。同營衛之氣。而呼吸朝之於肺。故手太陰肺經。乃諸臟腑之氣所聚也。\n聖人於氣口。候其盛衰。洩天地化育莫測之秘。豈不神乎。\n## 脈名\n王叔和脈經。有浮、芤、洪、涓、數、促、弦、緊、沉、伏、革、實、微、澀、細、、弱、虛、散、緩、遲、結、代、動二十四名。叔和以後諸家。又增長短、牢、疾、大、小共三十名。按察病以脈。必辨之精確。而後見之明。不至遊疑而無主。據經之論脈。不止三十名。如鼓、搏、喘、橫之類。今亦未窺其奧。不敢採入。即三十名。尚有可測者。\n如脈經。謂浮細為。沉細為弱。是以浮細辨。弱以沉細辨也。然經曰。長夏胃微弱曰平。使弱皆細脈。細則氣少。經何以謂為長夏之平脈乎。又曰。弱有石曰冬病。石沉脈也。弱而沉。是水之侮土也。使脈果以浮細辨。經何謂以沉言乎。由是觀之。凡脈柔而無力者。概謂之弱。非浮細沉細之謂。今以弱附於細。以存其舊也。仲景曰。\n弦則為寒。芤則為虛。虛寒相搏。此名曰革。男子亡血失精。女子半產漏下。據此則革脈。即芤之兼弦者。芤主陰虛病。\n革亦主陰虛病。今以革附於芤也。沉伏實大。千金翼謂之牢。主寒主痛。是即沉脈而有力者。今附於沉。經一脈有數名者。如秋脈謂之毛。又謂之浮。非二脈也。是疾脈即數。大即洪。小即細也。今刪弱革牢疾大小七名。定為二十三脈。\n蓋脈以候病。其可去輒者。不加詳辨。則名目愈多。脈理愈晦。故不敢避僭妄之譏也。\n## 脈類\n脈者。陰陽之氣也。有浮即有沉。有大即有小。有遲即有數。故吳草廬。滑伯仁。李瀕湖。皆以對待編之。今欲其易於分別。凡以浮辨者為一類。以沉辨者為一類。以浮沉合辨者為一類。不以浮沉辨。而以至數辨者為一類。不以浮沉至數辨。而以形辨者為一類。\n寸關尺臟腑部位\n經。尺內兩旁。則季脅也。（肋骨盡處名季脅）尺外以候腎。尺內以候腹。中附上。（越人謂之關）左外以候肝。內以候膈。右外以候胃。內以候脾。上附上。（越人謂之寸口）右外以候肺。內以候胸中。左外以候心。內以候膻中。（膻中在兩乳之間）前以候前。後以候後。上竟上者。（關以上）胸喉中事也。下竟下者。（關以下）少腹腰股。膝脛足中事也。推而外之。內而不外。（外浮也內沉也）心腹疾也。推而內之。外而不內。身有熱也。推而上之。上而不下。腰足清也。推而下之。下而不上。頸項痛也。按之至骨。脈氣少者。腰脊痛而有痺也。\n脈經。從魚際至高骨。卻行一寸。其中名曰寸口。從寸至尺。名曰尺澤。故曰尺寸。寸後尺前。名曰關。陽出陰入。\n以關為界。陽出三分。陰入三分。故曰三陽三陰。陽生於尺。動於寸。陰生於寸。動於尺。寸主上焦。頭及皮毛竟手。\n關主中焦。腹及腰。尺主下焦。少腹即足。\n經於寸關尺分部以候五臟。而六腑止及腎者。蓋五臟先天之氣。賴後天水谷之氣以養之也。餘腑不及者。統於髒也。\n蓋腎開竅於二陰。小腸膀胱屬前陰。大腸屬後陰。則腎統乎大腸小腸膀胱也。膽附於肝。則肝統乎膽也。三焦不統於髒。\n故於寸內候胸中。關內候膈。尺內候腹。胸中上焦也。膈中焦也。腹下焦也。且五臟者。身之主也。外則耳目鼻口。四肢皮毛肌肉。內則筋骨脈絡。氣血精神魂魄。皆其所司也。故人之一身皆可病。而病入髒者死。見真髒脈者死。此所以經之論脈。惟詳五臟也。四時之脈。有胃氣者生。無胃氣者死。此所以經之論脈。而六腑止及胃也。\n經論脈。不以六腑配五臟。而王叔和脈經。以心與小腸。候在左寸。肺與大腸。候在右寸。肝膽候在左關。脾胃候在右關。腎與膀胱。候在左尺。又謂左尺屬腎。右為子戶。名曰三焦。又謂腎與命門。俱出尺部。其書前後。多自相矛盾。疑不盡出於叔和。世但闢高陽生脈訣。而不知脈訣。亦實本於脈經也。至右尺主三焦命門之誤。李瀕湖辨之詳矣。\n經論脈不及腑。腑病何以候之耶。曰。腑病辨之於症。而以髒脈。候內外之因。假如頭角耳前後痛。往來寒熱。此膽經之病症也。而肝脈浮緊。則膽經之風寒。肝脈弦數。則膽經之痰火也。假如胸中脹悶。上焦之病症也。而肺脈滑數。\n則上焦之痰火。肺脈沉遲。則上焦之寒氣也。\n寸關尺。經有外候內候之說。王太僕曰。外謂外側。內謂內側。李士材曰。外謂前半部。內謂後半部。二說皆有可議者。試即尺論之。外以候腎。內以候腹。假令腎病腹不痛。而其脈外側見病脈。內側見平脈乎。前半部見病脈。後半部見平脈乎。即使如此。而一指舉按之間。所謂外側內側。前半後半之界。能劃然清乎。今據經曰。推而外之。內而不外。有心腹積也。推而內之。外而不內。身有熱也。外指浮。內指沉。沉而不浮。故有心腹積。浮而不沉。故身有熱。\n由是觀之。則所謂外候內候。指沉浮而言也明矣。蓋五","is_preview":true,"preview_page_limit":10}