寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Vessel

Maek

한글 맥  ·  Pinyin Mai

What the finger is listening for — the hour to take a pulse, the seven things a physician must do first, and the twenty-seven pulses with what each one means

脉

The pulse comes before the blood and qi, and the chapter takes that literally: 脉者血氣之先, the vessel is the forerunner of blood and qi, and a man may lose an arm or an eye and live, but let the pulse change a little and illness follows. The practical part begins with when and how. Take the pulse at dawn, before the yin has stirred or the yang scattered, before food has gone in — and before that, do seven things: still the mind, put outside thoughts away, even out your own breathing, then touch lightly at the skin for the bowels, press a little at the flesh for the stomach qi, and sink to the bone for the viscera. The rate is counted against the physician's own breath, four beats to a breath being normal, and the chapter gives the ladder down to death in both directions. Then the six positions and what each rules, the nine indicators taken at nine arteries of the body from the temples to the instep, and the twenty- seven pulses one at a time — each with how it feels under the finger and what it means, and then sorted again into those that resemble each other and those that are opposites. It closes with four formulas, fourteen simples and three needling methods, one of them for a patient whose pulse has gone altogether.

9.1 The Vessel Is the Forerunner of Blood and Qi 脉者血氣之先

9.1.1
Source원문

河間云, 脉者血氣之先, 斯論得之矣. 人身之脉, 血氣之所爲, 而不知所以周流不息者, 正乾道乾乾之意, 亦猶理之寓乎氣, 所以爲血氣之先. 先之一字, 厥有旨焉. 《綱目》

Translation영역
Hejian says: the vessel is the forerunner of blood and qi — this saying has it right. The vessel of a person's body is what the blood and qi make; yet that one does not know why it flows round without ceasing is just the sense of the Qian hexagram's unresting vigour, and is likewise as principle lodging in qi. That is why it is the forerunner of blood and qi; and in the one word forerunner there is a meaning.

Gangmok 綱目

9.1.2
Source원문

脉者, 先天一氣, 先天之靈, 非心淸氣定者不能察識. 醫者平時對先天圖靜坐調息, 觀氣往來, 庶可愉合. 《入門》

Translation영역
The vessel is the one qi of the prior heaven, the numinous thing of the prior heaven, and none but one whose mind is clear and qi settled can discern it. A physician should at ordinary times sit quietly before the prior-heaven diagram regulating his breath and watching the qi come and go; then he may come near to matching it.
Clinical note임상 주석
The instruction is to the physician, not the patient. Before the finger is any use the hand must be steady and the attention quiet, and the Immun prescribes sitting practice for it the way another chapter prescribes a decoction.

Immun 入門

9.1.3
Source원문

噫, 折一臂ㆍ瞽一目而不夭, 脉少有變則病患隨之, 可不愼哉. 《入門》

Translation영역
Alas — a man may break an arm or lose an eye and not die young; but let the pulse change a little and illness follows on it. How can one not be careful?
Clinical note임상 주석
The chapter's argument for its own importance, and it is a fair one: gross damage to the frame may be survived, while a small change in the pulse means something has gone wrong at the centre.

Immun 入門

9.2 The Graph for Vessel Has a Meaning 脉字有義

9.2.1
Source원문

榮行脉中, 衛何脉外. 脉者所以主宰榮衛, 而不可須臾失也. 從月從永, 謂得此可永歲月也. 古脉字從血從𠂢, 所以使氣血各依分派而行經絡也. 《入門》

Translation영역
The construction runs within the vessels and the defence outside them; the vessel is what governs construction and defence, and cannot be lost for a moment. The graph follows 月 and 永, meaning that having this one may lengthen one's years. The old graph for vessel followed 血 and 𠂢, because it makes the blood and qi each follow their own branch and run in the channels and networks.
Clinical note임상 주석
Both etymologies are read for what they teach. 𠂢 is the picture of a stream dividing, so the old graph 衇 says the blood runs in branches — which is what the character actually shows, and a rare case of the tradition's graph-glossing being sound.

Immun 入門

9.2.2
Source원문

脉者, 幕也. 如幕外之人而欲知幕內之事也. 《丹心》

Translation영역
The vessel is a curtain: it is like one outside the curtain wanting to know what goes on within.
Clinical note임상 주석
The best sentence in the chapter. A physician at the wrist is outside the curtain, and everything the rest of the chapter teaches is how to listen through it.

Dansim 丹心

9.3 There Is a Method for Taking the Pulse 診脉有法

9.3.1
Source원문

診法常以平旦, 陰氣未動, 陽氣未散, 飮食未進, 經脉未盛, 絡脉調勻, 氣血未亂, 故乃可診有過之脉. 切脉動靜而視精明, 察五色, 觀五臟有餘不足, 六府强弱, 形之盛衰, 以此參伍決死生之分. 《內經》

Translation영역
The method of examination is always at dawn, when the yin qi has not yet stirred and the yang qi not yet scattered, food and drink have not gone in, the channels are not yet full, the network vessels are evenly regulated and the blood and qi not yet disordered — therefore a pulse that is at fault can be discerned. Feel the pulse's movement and stillness and look at the brightness of the eyes, examine the five colours, observe the surplus and insufficiency of the five viscera, the strength and weakness of the six bowels and the flourishing or decline of the form; cross-check them by threes and fives and decide the division between life and death.
Clinical note임상 주석
參伍 — cross-checking by threes and fives. The Suwen does not let the pulse stand alone: it is read against the eyes, the complexion and the build, and only the four together decide anything.

Naegyeong 內經

9.3.2
Source원문

診法有七. 一者靜其心, 存其神也. 二者忘外意, 無私慮也. 三者勻呼吸, 定其氣也. 四者輕指於皮膚之間, 探其府脉也. 五者微重指於肌肉之間, 取其胃氣也. 六者沈指於筋骨之上, 取其藏脉也. 七者察病人脉息往來也. 《入門》

Translation영역
There are seven things in the method of examination. First, still the mind and keep the spirit within. Second, forget outward concerns and have no private thoughts. Third, even out the breathing and settle the qi. Fourth, lay the finger lightly at the skin and search out the bowel pulse. Fifth, press a little more at the flesh and take the stomach qi. Sixth, sink the finger to the sinew and bone and take the visceral pulse. Seventh, examine the coming and going of the patient's pulse and breath.
Clinical note임상 주석
Three things the physician does to himself and four to the patient, in that order. The three depths — skin, flesh, bone — are the whole of pulse technique, and the chapter puts them fourth, fifth and sixth because the first three must come first.

Immun 入門

9.3.3
Source원문

上古診法有二. 一者十二經動脉, 分三部候其藏府. 二者以氣口人迎決內外病因. 三者獨取寸口, 以決五藏六府之生死吉凶也. 《入門》

Translation영역
In high antiquity there were three methods of examination. First, the pulsating arteries of the twelve channels, divided into three regions to read the viscera and bowels. Second, using the Gigu and Inyeong to decide whether the cause of the disease is within or without. Third, taking the inch-opening alone to decide the life or death, the good or ill fortune of the five viscera and six bowels.
Clinical note임상 주석
Three historical methods, and the third — the wrist alone — is the one that won. The Nanjing's first difficulty argued for it, and the whole of later pulse diagnosis follows from that decision.

Immun 入門

9.3.4
Source원문

淸高貴客, 脉證兩憑. 勞苦麤人, 多憑外證. 傷寒陰陽證, 多從脉斷. 《入門》

Translation영역
For the refined and high-born, rely on pulse and signs together; for the labouring and coarse, rely mostly on the outward signs; in the yin and yang patterns of cold damage, decide mostly from the pulse.

Immun 入門

9.4 The Method of Laying the Finger 下指法

9.4.1
Source원문

凡初下指, 先以中指揣按得關脉掌後高骨謂之關也, 乃齊下前後二指, 是爲三部脉. 前指寸口也, 後指尺部也. 若人臂長則疎下指, 臂短則密下指. 先診寸口, 浮按消息之, 次中按消息之, 次重按消息之, 次上竟消息之, 次下竟消息之, 次推指外消息之, 次推指內消息之. 《綱目》

Translation영역
Whenever the finger is first laid on, press first with the middle finger to find the bar pulse the high bone behind the palm is called the bar, then set the two fingers before and behind it level with it — these are the three regions of the pulse. The front finger is the inch-opening and the back finger the cubit region. If the person's forearm is long, set the fingers wide; if short, set them close. Examine the inch-opening first: press at the surface and consider it, then press at the middle and consider it, then press heavily and consider it, then run up to the limit and consider it, then down to the limit and consider it, then push the finger outward and consider it, then push the finger inward and consider it.
Clinical note임상 주석
Seven movements at each position: three depths, two ends and two sides. The one detail a beginner most needs is here too — find the styloid process first with the middle finger and set the other two to it, wide or close according to the forearm.

Gangmok 綱目

9.4.2
Source원문

脉有三部, 分爲寸關尺, 每部各浮中沈三診, 合爲九候. 浮以診其府, 見六府之盛衰; 沈以診其藏, 見五藏死生盈虛; 中則診其胃氣. 盖胃爲水穀之海, 氣血之源, 有胃氣則生, 無胃氣則死故也. 《得效》

Translation영역
The pulse has three regions, divided as inch, bar and cubit; each region has three examinations at the surface, the middle and the depth, making nine indicators in all. The surface examines the bowels and shows the flourishing or decline of the six bowels; the depth examines the viscera and shows the life or death, fullness or emptiness of the five; the middle examines the stomach qi. For the stomach is the sea of water and grain and the source of blood and qi — with stomach qi there is life, without it death.
Clinical note임상 주석
有胃氣則生, 無胃氣則死 — the middle depth is the one that matters most. A pulse with stomach qi is soft and even under the finger whatever else it is doing, and 9.13 makes that the test of whether a seasonal pulse is healthy.

Deukhyo 得效

9.5 The Twelve Channels 十二經脉

9.5.1
Source원문

詳見鍼灸.

Translation영역
Treated in detail in the Acupuncture chapter.

Donguibogam · Maek

9.6 The Fifteen Network Vessels 十五絡脉

9.6.1
Source원문

詳見鍼灸.

Translation영역
Treated in detail in the Acupuncture chapter.

Donguibogam · Maek

9.7 The Eight Extraordinary Vessels 奇經八脉

9.7.1
Source원문

詳見鍼灸.

Translation영역
Treated in detail in the Acupuncture chapter.

Donguibogam · Maek

9.8 The Pulse's Beating Has a Standard 脉動有準

9.8.1
Source원문

人一呼脉再動, 一吸脉亦再動, 呼吸定息脉五動, 閏以太息, 命曰平人. 平人者, 不病也. 常以不病調病人, 醫不病, 故爲病人平息以調之爲法. 人一呼脉一動, 一吸脉一動, 曰少氣. 人一呼脉三動, 一吸脉三動而躁, 尺熱曰病溫, 尺不熱脉滑曰風, 脉澁曰痺. 《內經》

Translation영역
In a person, the pulse beats twice to one exhalation and twice again to one inhalation; over a settled breath the pulse beats five times, the fifth falling as the intercalary long breath — such a one is called a level person, and a level person is one who is not ill. One who is not ill is always used to measure the ill: the physician is not ill, and so it is the rule that he evens his own breathing for the patient and measures by it. Where the pulse beats once to an exhalation and once to an inhalation, it is called scant qi. Where it beats three times to an exhalation and three to an inhalation and is agitated, if the cubit skin is hot it is warm disease; if the cubit is not hot and the pulse slippery it is wind, and if rough, impediment.
Clinical note임상 주석
The physician's own breath is the clock. Four beats to a breath with a fifth now and then is normal; at about sixteen breaths a minute that comes to roughly seventy a minute, which is right. It is a workable method with nothing but attention.

Naegyeong 內經

9.8.2
Source원문

一息四至號平和, 更加一至大無痾, 三遲二敗冷危困, 六數七極熱生多, 八脫九死十歸墓, 十一十二絶魂瘥. 三至爲遲, 一二敗, 兩息一至死非怪. 《脉訣》

Translation영역
Four beats to a breath is called level and harmonious; one more does no great harm. Three is slow and two is failing — cold, critical and exhausted. Six is rapid and seven extreme, with much heat engendered. Eight is desertion, nine is death, ten is the grave; eleven and twelve, the soul is cut off. Three beats is slow, one or two is failing, and at one beat to two breaths death is no wonder.
Clinical note임상 주석
A ladder in both directions from four. Counted against a breath, eight beats is about 140 a minute and two is about 35 — and the verse's verdicts on each end are not far from what a modern clinician would say about those rates in a sick patient.

Maekgyeol 脉訣

9.8.3
Source원문

凡人病脉亦當病, 方爲相應. 如强健人脉病, 病人却有强健脉, 長人脉短, 短人脉長, 肥人脉瘦, 小人脉大, 皆相反也. 《脉訣》

Translation영역
Where a person is ill the pulse should be ill too, and then they correspond. Where a robust person has an ill pulse, or a sick person has a robust pulse; where a tall person's pulse is short or a short person's long; where a stout person's pulse is thin or a small person's large — all these are contrary.
Clinical note임상 주석
The rule of correspondence, and it cuts both ways: a strong pulse in a very sick patient is as much a warning as a weak one in a healthy patient. The Abdomen chapter's 3.4.3 used the same reasoning on a belly pain.

Maekgyeol 脉訣

9.9 The Inch-Opening Is the Great Meeting of the Vessels 寸口者脉之大要會

9.9.1
Source원문

人一呼脉行三寸, 一吸脉行三寸, 呼吸定息脉行六寸. 人一日一夜凡一萬三千五百息, 脉行三十度周於身, 漏水下百刻. 榮衛行陽二十五度, 行陰亦二十五度, 爲一周也. 故五十度復會於手太陰, 卽寸口也. 《入門》

Translation영역
To one exhalation the pulse travels three chon and to one inhalation three chon, so that over a settled breath it travels six chon. In one day and night a person breathes thirteen thousand five hundred times, and the pulse travels thirty circuits of the body while the water clock runs down its hundred marks. The construction and defence make twenty-five circuits in the yang and twenty-five in the yin, and that is one round; and so at the fiftieth circuit they meet again at the hand greater yin, which is the inch-opening.
Clinical note임상 주석
The arithmetic is why the wrist alone came to be enough: everything returns there once a full circuit is complete. The figures are schematic — 13,500 breaths a day is about nine a minute — but the reasoning is a closed circulation, argued sixteen centuries before Harvey.

Immun 入門

9.9.2
Source원문

五味入口, 藏於胃, 以養五藏氣, 氣口亦太陰也. 是以五藏六府之氣味, 皆出於胃, 變見於氣口. 氣口一名寸口也, 故獨取寸口以決人之生死吉凶也. 《內經》

Translation영역
The five flavours enter the mouth and are stored in the stomach to nourish the qi of the five viscera, and the Gigu too is the greater yin. Therefore the qi and flavours of the five viscera and six bowels all issue from the stomach and appear transformed at the Gigu. The Gigu is another name for the inch-opening, and so the inch-opening alone is taken to decide a person's life or death, good or ill fortune.

Naegyeong 內經

9.10 The Diagram of the Six Positions 六部脉圖

9.10.1
Source원문

左手脉: 人迎ㆍ寸ㆍ關ㆍ尺 — 心火ㆍ肝木ㆍ腎水 — 小腸火ㆍ膽木ㆍ膀胱水. 右手脉: 氣口ㆍ寸ㆍ關ㆍ尺 — 大腸金ㆍ胃土ㆍ三焦火 — 肺金ㆍ脾土ㆍ命門火.

Translation영역
Left-hand pulse: Inyeong, inch, bar, cubit — heart fire, liver wood, kidney water — small intestine fire, gallbladder wood, bladder water. Right-hand pulse: Gigu, inch, bar, cubit — large intestine metal, stomach earth, triple burner fire — lung metal, spleen earth, life-gate fire.
Clinical note임상 주석
The chart reads as a grid. The left hand carries heart and small intestine at the inch, liver and gallbladder at the bar, kidney and bladder at the cubit; the right hand carries lung and large intestine at the inch, spleen and stomach at the bar, and the life gate with the triple burner at the cubit. Each position thus holds one viscus and its paired bowel, which is what makes six positions cover twelve organs. The diagram prints the bowels before the viscera on the right hand and after them on the left; the order on the page is not a claim about depth. Depth is the business of 9.17 and 9.18, where the viscera and the bowels are taken separately at the same positions, and of 9.12, which names the inch-front of each hand Inyeong and Gigu.

Donguibogam · Maek

9.11 The Six Pulses Interwoven as Yin and Yang 六脉陰陽錯綜

9.11.1
Source원문

左尺水生左關木, 左關木生左寸火, 左寸火接右尺火, 右尺火生右關土, 右關土生右寸金, 右寸金生左尺水. 生生之意不絶, 有子母之親也. 《入門》

Translation영역
The left cubit's water engenders the left bar's wood; the left bar's wood engenders the left inch's fire; the left inch's fire joins the right cubit's fire; the right cubit's fire engenders the right bar's earth; the right bar's earth engenders the right inch's metal; the right inch's metal engenders the left cubit's water. The sense of engendering upon engendering is unbroken, and there is the closeness of mother and child.
Clinical note임상 주석
The six positions arranged as a closed engendering cycle, so that the hand can be read round rather than position by position. The next two passages give the same six as restraint and as rank — three ways of reading one hand.

Immun 入門

9.11.2
Source원문

左寸火剋右寸金, 左關木剋右關土, 左尺水剋右尺火. 左剛右柔, 有夫婦之別也. 《入門》

Translation영역
The left inch's fire restrains the right inch's metal, the left bar's wood the right bar's earth, the left cubit's water the right cubit's fire. The left is firm and the right yielding, and there is the distinction of husband and wife.

Immun 入門

9.11.3
Source원문

左手屬陽, 右手屬陰. 左寸君火以尊而在上, 右尺相火以卑而在下, 有君臣之道也. 《入門》

Translation영역
The left hand belongs to yang and the right to yin. The left inch's sovereign fire, being honoured, is above; the right cubit's ministerial fire, being lowly, is below — and there is the way of sovereign and minister.

Immun 入門

9.12 The Inyeong and Gigu Pulses 人迎氣口脉

9.12.1
Source원문

左手關前曰人迎, 右手關前曰氣口. 兩關之後一分卽曰神門. 故脉法讚曰, 肝心出左, 脾肺出右, 腎與命門俱出尺部, 魂魄穀神皆見寸口. 《東垣》

Translation영역
Before the bar on the left hand is called Inyeong, and before the bar on the right hand Gigu; one fen behind both bars is called Sinmun. So the Praise of the Pulse Method says: liver and heart issue on the left, spleen and lung on the right, kidney and gate of life both issue at the cubit region, and the ethereal soul, corporeal soul, grain and spirit all appear at the inch-opening.

Dongwon 東垣

9.12.2
Source원문

關前一分, 人命之主. 左爲人迎, 右爲氣口, 神門決斷, 兩在關後. 故曰人迎緊盛傷於寒, 氣口緊盛傷於食. 此兩脉有內傷外感之辨也. 《脉贊》

Translation영역
One fen before the bar is the master of a person's life: on the left it is Inyeong, on the right Gigu; and Sinmun, which decides the matter, lies behind both bars. So it is said that where Inyeong is tight and exuberant there is damage by cold, and where Gigu is tight and exuberant there is damage by food — and in these two pulses lies the distinction between internal damage and external contraction.
Clinical note임상 주석
One comparison, and it decides the largest question in the Bogam's internal medicine: a fever from outside or from within. The Internal Damage chapter is built on it, and Dongwon's whole doctrine rests on being able to tell the two apart at the wrist.

Maekchan 脉贊

9.13 Inch, Bar and Cubit Together Make One Chon Nine Fen 寸關尺合一寸九分

9.13.1
Source원문

寸脉六分, 關脉六分, 其上三分入于寸內, 是陽得寸內九分, 陽數九也. 尺內七分, 關下三分入于尺內, 是陰得尺內一寸, 陰數十也. 終始一寸九分者, 此也. 《醫鑑》

Translation영역
The inch pulse is six fen and the bar pulse six fen, of which the upper three fen fall within the inch; so the yang has nine fen within the inch, and nine is the yang number. The cubit is seven fen, and three fen below the bar fall within the cubit; so the yin has one chon within the cubit, and ten is the yin number. From beginning to end it is one chon nine fen — such is the reason.

Uigam 醫鑑

9.14 The Twenty-Seven Pulses 二十七脉

9.14.1
Source원문

浮ㆍ芤ㆍ滑ㆍ實ㆍ弦ㆍ緊ㆍ洪爲七表脉. 微ㆍ沈ㆍ緩ㆍ澁ㆍ遲ㆍ伏ㆍ濡ㆍ弱爲八裏脉. 長ㆍ短ㆍ虛ㆍ促ㆍ結ㆍ代ㆍ牢ㆍ動ㆍ細爲九道脉. 又有數脉ㆍ大脉ㆍ散脉, 合爲二十七脉也. 《入門》

Translation영역
Floating, hollow, slippery, replete, stringlike, tight and surging are the seven surface pulses. Faint, sunken, moderate, rough, slow, hidden, soggy and weak are the eight interior pulses. Long, short, empty, skipping, bound, intermittent, firm, stirred and fine are the nine way pulses. There are also the rapid, the large and the scattered, making twenty-seven pulses in all.

Immun 入門

9.14.2
Source원문

浮, 陽脉也. 按之不足, 擧之有餘, 脉在肉上行也, 瞥瞥如羹上肌. 又曰泛泛浮浮, 如水漂木. 浮爲風爲虛. 浮而有力爲風, 無力爲虛. 又曰浮者, 風虛運動之候. 《入門》

Translation영역
Floating is a yang pulse. Pressed it is insufficient and lifted it is in surplus; the pulse runs above the flesh, glancing like the fat on a broth. It is also said: drifting and floating, like wood adrift on water. Floating means wind and means vacuity — floating with force is wind, without force is vacuity. It is also said: floating is the sign of wind vacuity in motion.
Clinical note임상 주석
如羹上肌 — like the fat floating on a soup. The whole of the twenty-seven is taught by images of this kind, because a pulse cannot be described except by comparison.

Immun 入門

9.14.3
Source원문

芤, 陽脉也. 浮大而軟, 按之中空傍實, 如按葱葉. 芤者, 葱葉也. 芤者, 失血之候, 爲吐衄便尿等血. 《入門》

Translation영역
Hollow is a yang pulse. It is floating, large and soft, and pressed it is empty in the middle and firm at the sides, like pressing a scallion leaf; 芤 is the scallion leaf. Hollow is the sign of blood lost — vomited or from the nose, in the stool or the urine.
Clinical note임상 주석
Firm at the edges and empty under the middle, exactly as a scallion leaf feels. It is the pulse of acute blood loss, and the Blood chapter relies on it.

Immun 入門

9.14.4
Source원문

滑, 陽脉也. 按之累累如珠, 往來疾速. 又曰往來流利, 應指圓滑如珠. 滑爲多痰. 滑者, 血實氣壅之候. 滑而不斷絶者, 經不閉也; 其有斷絶者, 經閉也. 盖滑主月經閉也. 《入門》

Translation영역
Slippery is a yang pulse. Pressed it comes one after another like beads, coming and going swiftly; it is also said to come and go smoothly, answering the finger round and slippery as a pearl. Slippery means much phlegm, and is the sign of blood replete and qi congested. Slippery without breaking off means the menses are not blocked; where it breaks off, they are blocked — for slippery governs blockage of the menses.

Immun 入門

9.14.5
Source원문

實, 陽脉也. 擧按皆有力, 隱指愊愊然, 浮中沈皆有力曰實. 又曰健而有力. 實者, 三焦氣滿之候. 又曰實爲熱爲吐. 《入門》

Translation영역
Replete is a yang pulse. Lifted or pressed it has force, pushing back under the finger; forceful at the surface, the middle and the depth alike is called replete. It is also said to be vigorous and forceful. Replete is the sign of the three burners' qi being full; it is also said that replete means heat and means vomiting.

Immun 入門

9.14.6
Source원문

弦, 陽脉也. 勁直以長如弦. 又曰擧之無有, 按之如弓弦狀. 弦者, 氣血收斂不舒之候. 又曰弦脉爲勞, 爲寒熱瘧, 爲拘急痛, 偏弦爲飮. 最難調治者弦脉也. 弦爲肝脉, 肝木剋脾土, 五藏俱傷故也. 《丹心》

Translation영역
Stringlike is a yang pulse: taut, straight and long like a bowstring. It is also said that lifted there is nothing and pressed it is like a bowstring. Stringlike is the sign of the blood and qi drawn in and not stretched out. It is also said that a stringlike pulse means taxation, means cold and heat and malaria, means cramping and pain, and stringlike on one side means rheum. The hardest of all to regulate and treat is the stringlike pulse: stringlike is the liver's pulse, and the liver's wood restrains the spleen's earth, so all five viscera are damaged.
Clinical note임상 주석
最難調治者弦脉也 — the stringlike pulse is the hardest of all to treat. Danxi's reason is the five-phase one, but the observation behind it is that a taut pulse means a patient wound tight, and that is slow to unwind whatever is given.

Immun 入門 · Dansim 丹心

9.14.7
Source원문

緊, 陽脉也. 數而有力爲緊. 又曰擧按急數, 指下如牽繩轉索之狀. 緊如切繩狀, 誠得之. 緊者, 風寒激搏伏於陽脉絡之候. 又曰弦緊爲傷寒. 又曰人迎緊盛傷於寒, 氣口緊盛傷於食. 《丹心》

Translation영역
Tight is a yang pulse: rapid and forceful is tight. It is also said that lifted or pressed it is urgent and rapid, and under the finger it is like a rope being drawn and twisted. That tight is like cutting a rope catches it exactly. Tight is the sign of wind cold striking violently and lying hidden in the yang channels and networks. It is also said that stringlike and tight means cold damage; and that Inyeong tight and exuberant is damage by cold, Gigu tight and exuberant damage by food.

Dansim 丹心

9.14.8
Source원문

洪, 陽脉也. 指下洪大有力, 如洪水波浪, 卽鉤脉也. 極大滿指曰洪, 卽大脉也. 洪者, 榮衛大熱血氣燔灼之候. 又曰洪爲熱爲脹. 《丹心》

Translation영역
Surging is a yang pulse: under the finger it is flooding, large and forceful, like the waves of a flood — that is, the hook pulse. Extremely large and filling the finger is called surging, and that is the large pulse. Surging is the sign of great heat in construction and defence, the blood and qi scorching. It is also said that surging means heat and means distension.

Dansim 丹心

9.14.9
Source원문

微, 陰脉也. 若有若無, 極細而軟, 無浮沈之別曰微. 微如細絲, 時或欲絶. 微者, 血氣俱虛之候. 《丹心》

Translation영역
Faint is a yin pulse: as though there and as though not, extremely fine and soft, with no distinction of surface or depth — this is called faint. Faint is like a fine thread, and at times seems about to cease. Faint is the sign of blood and qi both vacuous.

Dansim 丹心

9.14.10
Source원문

沈, 陰脉也. 輕手不見, 重手乃得曰沈. 沈若爛綿, 尋之至骨. 沈者, 陰氣厥逆陽氣不舒之候. 《丹心》

Translation영역
Sunken is a yin pulse: not found with a light hand and only got with a heavy one is called sunken. Sunken is like sodden cotton wool, sought right down to the bone. Sunken is the sign of the yin qi counterflowing and the yang qi not stretching out.

Dansim 丹心

9.14.11
Source원문

緩, 陰脉也. 一息四至, 往來和緩, 少駃於遲. 又曰擧按大而慢. 緩者, 衛氣有餘榮氣不足之候. 《丹心》

Translation영역
Moderate is a yin pulse: four beats to a breath, coming and going harmonious and easy, a little quicker than slow. It is also said that lifted or pressed it is large and unhurried. Moderate is the sign of the defence qi in surplus and the construction qi insufficient.

Dansim 丹心

9.14.12
Source원문

澁, 陰脉也. 細而遲, 往來難且散, 或一止復來. 又曰往來澁滯, 如雨沾沙, 如輕刀刮竹狀. 濇與澁同. 澁者, 氣多血少之候. 又曰澁爲精竭血枯. 《丹心》

Translation영역
Rough is a yin pulse: fine and slow, coming and going with difficulty and scattering, and sometimes stopping once and coming again. It is also said that it comes and goes roughly and stickingly, like rain wetting sand, like a light blade scraping bamboo. 濇 and 澁 are one word. Rough is the sign of much qi and little blood; it is also said that rough means the essence exhausted and the blood withered.
Clinical note임상 주석
如輕刀刮竹 — like a light knife scraping along bamboo, catching and slipping. Of all the twenty-seven images this is the one that most nearly teaches the feel, and every later pulse book keeps it.

Dansim 丹心

9.14.13
Source원문

遲, 陰脉也. 一息三至, 去來極遲, 隨浮沈而見曰遲. 遲者, 陰盛陽虛之候. 遲爲虛寒. 《丹心》

Translation영역
Slow is a yin pulse: three beats to a breath, going and coming very slowly, appearing whether at the surface or the depth — this is called slow. Slow is the sign of yin exuberant and yang vacuous; slow means vacuity cold.

Dansim 丹心

9.14.14
Source원문

伏, 陰脉也. 伏者, 脉行筋下也. 輕手取之絶不可見, 重手取亦不得, 必推開筋附着於骨乃得見也. 又曰沈至極曰伏. 伏潛於骨, 重按乃得. 伏者, 陰陽潛伏關格閉塞之候. 又曰伏爲積聚停痰蓄水. 《丹心》

Translation영역
Hidden is a yin pulse: hidden means the pulse runs beneath the sinew. Taken with a light hand it cannot be seen at all, and taken with a heavy hand it is still not got; one must push the sinew aside and press against the bone before it can be found. It is also said that sunken at its extreme is called hidden. Hidden lies concealed at the bone and is got only on heavy pressure. Hidden is the sign of yin and yang lying concealed with block and repulsion shutting the way; it is also said that hidden means accumulations, lodged phlegm and amassed water.

Dansim 丹心

9.14.15
Source원문

濡, 陰脉也, 卽軟脉也. 極軟而浮細, 輕手乃得, 不任尋按曰濡. 軟而無力也. 濡者, 血氣俱不足之候. 又曰爲亡血爲自汗. 《丹心》

Translation영역
Soggy is a yin pulse, that is the soft pulse: extremely soft, floating and fine, got only with a light hand and not standing up to being sought by pressure — this is called soggy. It is soft and without force. Soggy is the sign of blood and qi both insufficient; it is also said to mean blood lost and spontaneous sweating.

Dansim 丹心

9.14.16
Source원문

弱, 陰脉也. 極軟而沈細, 按之如欲絶, 沈而無力. 弱乃六極之脉. 老人則爲順, 少壯則爲逆. 脉弱者無陽, 又主客風面腫. 《丹心》

Translation영역
Weak is a yin pulse: extremely soft, sunken and fine, and pressed it seems about to cease — sunken and without force. Weak is the pulse of the six exhaustions. In the old it is favourable, in the young and strong it is contrary. A weak pulse means there is no yang, and it also governs visiting wind with a swollen face.
Clinical note임상 주석
老人則爲順, 少壯則爲逆 — favourable in the old, contrary in the young. The same finding read two ways according to whose wrist it is, which is 9.8.3's rule of correspondence applied.

Dansim 丹心

9.14.17
Source원문

長, 陽脉也. 按之洪大而長, 出於本位, 三關通度. 氣血俱有餘也. 長爲陽毒, 主三焦熱及渾身壯熱. 又曰長而緩者, 胃脉也, 百病皆愈, 盖長則氣治也. 《丹心》

Translation영역
Long is a yang pulse: pressed it is surging, large and long, reaching beyond its own position and passing through all three bars. It means the blood and qi are both in surplus. Long means yang toxin and governs heat of the three burners and vigorous fever of the whole body. It is also said that long and moderate is the stomach pulse, and that then every disease heals — for when it is long the qi is well ordered.

Dansim 丹心

9.14.18
Source원문

短, 陰脉也. 兩頭無中間有, 不及本位曰短. 爲心腹痛, 爲宿食, 爲氣鬱. 又曰諸病脉短皆難治, 盖短則氣病無胃氣故也. 《丹心》

Translation영역
Short is a yin pulse: absent at both ends and present in the middle, not reaching its own position — this is called short. It means pain of heart and abdomen, food lodged overnight, and depressed qi. It is also said that in any disease a short pulse is hard to treat, for short means the qi is diseased and there is no stomach qi.

Dansim 丹心

9.14.19
Source원문

虛, 陰脉也. 遲大而軟, 輕擧指下豁然而空. 又曰尋之不足, 擧之有餘. 虛者, 血氣俱虛之候. 又曰虛爲傷暑之脉. 《丹心》

Translation영역
Empty is a yin pulse: slow, large and soft, and lifting the finger lightly it is suddenly hollow beneath. It is also said that sought it is insufficient and lifted it is in surplus. Empty is the sign of blood and qi both vacuous; it is also said that empty is the pulse of summerheat damage.

Dansim 丹心

9.14.20
Source원문

促, 陽脉也. 來去數, 時一止復來. 又曰尋之極數. 促爲怒厥, 熱極. 老人及久病得之, 非福. 《丹心》

Translation영역
Skipping is a yang pulse: coming and going rapidly, stopping once at times and coming again. It is also said that sought it is extremely rapid. Skipping means rage reversal, extreme heat; got in the old or the long ill, it is no blessing.

Dansim 丹心

9.14.21
Source원문

結, 陰脉也. 往來遲緩, 時一止復來. 又曰指下聚而却還曰結. 結爲陰盛, 爲積聚. 《丹心》

Translation영역
Bound is a yin pulse: coming and going slow and easy, stopping once at times and coming again. It is also said that gathering under the finger and then returning is called bound. Bound means yin exuberant and means accumulations.
Clinical note임상 주석
Skipping and bound differ only in rate — a fast pulse that drops beats and a slow one that does. Both are irregular beats, and the tradition tells them apart the way a clinician does, by counting first.

Dansim 丹心

9.14.22
Source원문

代, 陰脉也. 動而中止, 不能自還, 因而復動, 由是復止, 尋之良久乃復强起曰代. 又曰動中一止, 停久乃還. 代者, 更代也, 止歇有定數, 未比促結止而不定. 代者, 藏氣絶危亡之脉也. 代爲脾元氣衰. 《丹心》

Translation영역
Intermittent is a yin pulse: it beats and stops midway, cannot return of itself, and thereupon beats again and so stops again; sought for a good while it then rises strongly once more — this is called intermittent. It is also said that it stops once in the midst of beating and returns only after a long pause. 代 means taking turns: the stopping and resting has a fixed number, unlike skipping and bound, which stop without regularity. Intermittent is the pulse of the visceral qi cut off and of mortal danger; intermittent means the spleen's origin qi has declined.
Clinical note임상 주석
止歇有定數 — the pause comes at a fixed count. That is the distinction that matters: a regularly dropped beat is read as grave where an irregular one is not, and the chapter's own formula for it, Jagamcho-tang, is still prescribed for arrhythmia.

Dansim 丹心

9.14.23
Source원문

牢, 卽革脉也, 陽脉也. 沈而有力, 動而不移曰牢. 牢比弦緊轉堅而勁. 寒虛相搏則革. 婦人則半産崩漏, 男子則亡血失精. 《丹心》

Translation영역
Firm is the drumskin pulse, and a yang pulse: sunken and forceful, beating and not shifting, is called firm. Firm is harder and more taut than stringlike and tight. Where cold and vacuity strike against each other there is the drumskin pulse: in a woman it means miscarriage and flooding, in a man loss of blood and loss of essence.

Dansim 丹心

9.14.24
Source원문

動, 陰脉也. 數脉見於關上, 上下無頭尾, 大如豆, 厥厥然動搖, 名曰動. 又曰不往不來, 不離其處, 多於關部見之. 動者, 陰陽氣相搏耳, 陰陽和則脉不動也. 陰陽相搏名曰動. 陽動則陽虛, 故汗出; 陰動則陰虛, 故發熱. 又曰動爲驚爲痛爲血痢爲崩漏. 《丹心》

Translation영역
Stirred is a yin pulse: a rapid pulse appearing at the bar, with no head or tail above or below, as large as a bean, quivering and shaking — this is named stirred. It is also said that it neither goes nor comes and does not leave its place, and is mostly seen at the bar position. Stirred is simply the yin and yang qi striking against each other; when yin and yang are harmonious the pulse does not stir. Yin and yang striking each other is named stirred: where the yang stirs, the yang is vacuous and so sweat comes out; where the yin stirs, the yin is vacuous and so there is fever. It is also said that stirred means fright, means pain, means bloody dysentery and means flooding.

Dansim 丹心

9.14.25
Source원문

細, 陰脉也. 較微脉差大耳. 細如一線, 小而有力. 又曰細細如絲, 來往極微. 細爲精血不足, 脛痠髓冷. 又曰細爲氣少. 《丹心》

Translation영역
Fine is a yin pulse, only a little larger than the soft and faint pulses. Fine as a single thread, small but with force. It is also said to be as fine as silk, coming and going very slightly. Fine means the essence and blood insufficient, with cramping shins and cold marrow; it is also said that fine means scant qi.

Dansim 丹心

9.14.26
Source원문

數, 陽脉也. 一息六至, 去來促急. 又曰過平脉兩至曰數. 數爲心煩. 數而有力爲熱, 無力爲瘡. 《丹心》

Translation영역
Rapid is a yang pulse: six beats to a breath, going and coming hurried and urgent. It is also said that two beats beyond the level pulse is called rapid. Rapid means vexation of the heart; rapid with force means heat, without force means sores.

Dansim 丹心

9.14.27
Source원문

大, 陽脉也. 大卽洪之別名也. 大爲病進, 爲血虛. 《丹心》

Translation영역
Large is a yang pulse; large is another name for surging. Large means the disease is advancing, and means blood vacuity.

Dansim 丹心

9.14.28
Source원문

散, 陽脉也. 擧之則似浮而散大無力, 按之則滿指散而不聚, 來去不明, 漫無根柢. 渙漫不收, 其脉爲散. 散乃將死之脉, 散而不聚, 命亦危矣. 《丹心》

Translation영역
Scattered is a yang pulse: lifted it seems floating but is scattered and large without force; pressed it fills the finger, scattered and not gathering, its coming and going unclear, spread out with no root. Dissipated and not drawn in — such a pulse is scattered. Scattered is the pulse of one about to die: scattered and not gathering, the life too is in danger.
Clinical note임상 주석
漫無根柢 — spread out with no root. The chapter ends its twenty-seven on the pulse it calls the pulse of dying, and the absence of a root — nothing left when the finger presses — is what every grave pulse in the book has in common.

Dansim 丹心

9.15 Pulses That Resemble One Another 相類脉

9.15.1
Source원문

浮與芤相類浮則不端, 芤則中斷. 弦與緊相類弦如弓弦, 緊如轉索. 滑與數相類滑往來流利, 數一息六至. 牢與實相類牢沈而有力, 實浮而有力. 沈與伏相類沈重手乃得, 伏着骨乃得. 微與澁相類微脉如毛, 澁則細遲. 軟與弱相類軟則浮細, 弱則沈細. 緩與遲相類緩脉少駃, 遲則尤緩. 又曰浮似虛輕手爲浮, 無力爲虛. 滑似動滑度三關, 動只在一處. 《三因》

Translation영역
Floating resembles hollow floating is not broken, hollow is empty in the middle. Stringlike resembles tight stringlike is like a bowstring, tight like a twisting rope. Slippery resembles rapid slippery comes and goes smoothly, rapid is six beats to a breath. Firm resembles replete firm is sunken and forceful, replete is floating and forceful. Sunken resembles hidden sunken is got with a heavy hand, hidden only against the bone. Faint resembles rough the faint pulse is like a hair, rough is fine and slow. Soft resembles weak soft is floating and fine, weak is sunken and fine. Moderate resembles slow moderate is a little quicker, slow is slower still. It is also said that floating is like empty a light hand finds floating, without force it is empty, and slippery like stirred slippery passes through all three bars, stirred stays in one place.
Clinical note임상 주석
Ten pairs, each separated by one feature given in a half-line. It is the most useful page in the chapter for anyone actually learning: the pulses are not learnt one at a time but against the one they can be confused with.

Samin 三因

9.16 Pulses That Are Opposites 相反脉

9.16.1
Source원문

浮與沈相反浮主表, 沈主裏. 遲與數相反遲主寒, 數主熱. 虛與實相反虛主不足, 實主有餘. 洪與細相反洪主血氣多, 細主血氣少. 滑與澁相反滑主血實, 澁主氣實. 緩與緊相反緩主熱, 緊主寒. 結與促相反結主陰盛, 促主陽盛. 强革與濡弱相反强革主虛寒, 濡弱主虛熱. 《三因》

Translation영역
Floating and sunken are opposites floating governs the exterior, sunken the interior. Slow and rapid are opposites slow governs cold, rapid heat. Empty and replete are opposites empty governs insufficiency, replete surplus. Surging and fine are opposites surging governs much blood and qi, fine little. Slippery and rough are opposites slippery governs blood replete, rough qi replete. Moderate and tight are opposites moderate governs heat, tight cold. Bound and skipping are opposites bound governs yin exuberant, skipping yang exuberant. Hard and drumskin are opposite to soggy and weak hard and drumskin govern vacuity cold, soggy and weak vacuity heat.
Clinical note임상 주석
The four cardinal pairs come first — surface against interior, cold against heat, insufficiency against surplus — and those three axes are the eight principles as they appear at the wrist.

Samin 三因

9.17 The Pulses of the Five Viscera 五臟脉

9.17.1
Source원문

內經曰, 五脉應象. 肝脉弦, 心脉鉤一作洪, 脾脉代一作緩, 肺脉毛一作澁, 腎脉石一作沈.

Translation영역
The Neijing says: the five pulses answer to their images. The liver's pulse is stringlike, the heart's hooked one version says surging, the spleen's intermittent one version says moderate, the lung's downy one version says rough, the kidney's stony one version says sunken.

Naegyeong 內經

9.17.2
Source원문

心之平脉浮大而數, 肝之平脉弦細而長, 腎之平脉沈濡而滑, 肺之平脉浮短而澁, 脾之平脉和緩而大. 《入門》

Translation영역
The heart's level pulse is floating, large and rapid; the liver's stringlike, fine and long; the kidney's sunken, soggy and slippery; the lung's floating, short and rough; the spleen's harmonious, moderate and large.

Immun 入門

9.18 The Pulses of the Six Bowels 六腑脉

9.18.1
Source원문

小腸脉微洪, 大腸脉微澁, 膀胱脉微沈, 膽脉微弦急, 胃脉微緩. 此乃府與藏合, 氣同氣相求, 斯有得其近似者矣. 《直指》

Translation영역
The small intestine's pulse is slightly surging, the large intestine's slightly rough, the bladder's slightly sunken, the gallbladder's slightly stringlike and urgent, the stomach's slightly moderate. This is the bowel joining with its viscus, like qi seeking like qi, and so one gets something close to it.
Clinical note임상 주석
Each bowel's pulse is its paired viscus's pulse made slighter — 微, a shade of the same thing. It is why the surface depth reads the bowels and the deep reads the viscera at 9.4.2.

Jikji 直指

9.19 The Pulses of the Four Seasons 四時脉

9.19.1
Source원문

春肝脉來, 軟弱輕虛而滑, 端直以長, 故曰弦. 夏心脉來, 來盛去衰, 故曰鉤一作洪. 秋肺脉來, 輕虛而浮, 來急去散, 故曰浮一作澁. 冬腎脉來, 來沈以搏, 故曰營一作石. 四季脾脉來, 和緩而大. 《內經》

Translation영역
In spring the liver's pulse comes soft, weak, light, empty and slippery, straight and long — hence it is called stringlike. In summer the heart's pulse comes full and goes away declining — hence hooked one version says surging. In autumn the lung's pulse comes light, empty and floating, coming urgently and going scattered — hence floating one version says rough. In winter the kidney's pulse comes sunken and striking — hence營 one version says stony. In the last month of each season the spleen's pulse comes harmonious, moderate and large.

Naegyeong 內經

9.19.2
Source원문

肝弦ㆍ心洪ㆍ肺澁ㆍ腎沈ㆍ脾緩者, 本藏脉也. 然春微弦ㆍ夏微洪ㆍ秋微毛ㆍ冬微石, 俱帶和緩, 是有胃氣, 無病也. 《入門》

Translation영역
Liver stringlike, heart surging, lung rough, kidney sunken and spleen moderate are the pulses of the viscera themselves. But in spring slightly stringlike, in summer slightly surging, in autumn slightly downy and in winter slightly stony, all carrying a harmonious ease — that is having stomach qi, and there is no disease.
Clinical note임상 주석
俱帶和緩 — all carrying a harmonious ease. The seasonal pulse is normal only if it is a shade of its type and soft underneath; a frankly stringlike spring pulse with no give in it is the liver's disease, not the season's.

Immun 入門

9.20 What Inch, Bar and Cubit Govern 寸關尺所主

9.20.1
Source원문

脉有三部, 卽寸關尺也. 一部有浮中沈三診, 是爲九候也. 上部法天, 主胸以上至頭之有疾; 中部法人, 主膈下至臍之上有疾; 下部法地, 主臍以下至足之有疾. 《難經》

Translation영역
The pulse has three regions — the inch, the bar and the cubit — and each region has three examinations at surface, middle and depth, which make the nine indicators. The upper region takes heaven as its model and governs disease from the chest upward to the head; the middle region takes man as its model and governs disease from below the diaphragm to above the navel; the lower region takes earth as its model and governs disease from the navel down to the feet.

Nangyeong 難經

9.21 The Nine Indicators of the Body 人身九候脉

9.21.1
Source원문

黃帝曰, 何謂三部. 岐伯曰, 有下部, 有中部, 有上部, 部各有三候. 三候者, 有天有地有人也. 上部天, 兩額之動脉, 以候頭角之氣; 上部地, 兩頰之動脉, 以候口齒之氣; 上部人, 耳前之動脉, 以候耳目之氣.

Translation영역
The Yellow Emperor said: what are the three regions? Qi Bo said: there is a lower region, a middle region and an upper region, and each region has three indicators — heaven, earth and man. The upper region's heaven is the pulsating artery at the two temples, which reads the qi of the head and its corners; the upper region's earth is the artery at the two cheeks, which reads the qi of mouth and teeth; the upper region's man is the artery before the ear, which reads the qi of ears and eyes.

Naegyeong 內經

9.21.2
Source원문

中部天, 手太陰也太淵穴, 以候肺; 中部地, 手陽明也合谷穴, 以候胸中之氣; 中部人, 手少陰也神門穴, 以候心.

Translation영역
The middle region's heaven is the hand greater yin the point Taeyeon, which reads the lung; the middle region's earth is the hand yang brightness the point Hapgok, which reads the qi within the chest; the middle region's man is the hand lesser yin the point Sinmun, which reads the heart.

Naegyeong 內經

9.21.3
Source원문

下部天, 足厥陰也太衝穴, 以候肝; 下部地, 足少陰也太谿穴, 以候腎; 下部人, 足太陰也衝陽穴, 以候脾胃之氣.

Translation영역
The lower region's heaven is the foot reverting yin the point Taechung, which reads the liver; the lower region's earth is the foot lesser yin the point Taegye, which reads the kidney; the lower region's man is the foot greater yin the point Chungyang, which reads the qi of spleen and stomach.
Clinical note임상 주석
Nine arteries that can actually be felt: temporal, facial, preauricular, radial, the first dorsal interosseous, ulnar, and at the foot the dorsalis pedis and posterior tibial. The older method before the wrist alone, and every one of the nine is a real pulse a hand can find.

Naegyeong 內經

9.21.4
Source원문

察九候, 獨小者病, 獨大者病, 獨疾者病, 獨遲者病, 獨熱者病, 獨寒者病, 獨陷下者病.

Translation영역
Examining the nine indicators: where one alone is small there is disease; where one alone is large, disease; one alone swift, disease; one alone slow, disease; one alone hot, disease; one alone cold, disease; one alone sunken and fallen, disease.
Clinical note임상 주석
獨 — the one that is alone, the odd one out. The nine are compared with each other rather than against a standard, and whichever differs from its fellows marks the place. It is a sound method and needs no memory of what normal feels like.

Naegyeong 內經

9.21.5
Source원문

九候之相應也, 上下若一, 不得相失. 一候後則病, 二候後則病甚, 三候後則病危. 厥謂後者, 應不俱也. 三部九候皆相失者死, 上下左右相失不可數者死. 《內經》

Translation영역
The nine indicators answer one another: above and below they are as one and must not fall out with each other. Where one indicator lags, there is disease; where two lag, the disease is severe; where three lag, the disease is critical. By lagging is meant that they do not answer together. Where the three regions and nine indicators all fall out with one another, death; where above and below, left and right fall out beyond counting, death.

Naegyeong 內經

9.22 Medicines for Diseases of the Pulse 脉病藥餌

9.22.1
Source원문

止代脉見, 宜服灸甘草湯ㆍ人參黃芪湯. 脉虛軟, 宜服茯神湯ㆍ補氣湯.

Translation영역
Where a stopping or intermittent pulse appears, Mix-Fried Licorice Decoction and Ginseng and Astragalus Decoction should be taken. Where the pulse is vacuous and soft, Poria with Pine Root Decoction and Supplement the Qi Decoction should be taken.
Clinical note임상 주석
The chapter's whole therapeutics: two formulas for a pulse that drops beats and two for a pulse with no strength. Both pairs supplement — nothing here drains, because a pulse at fault is read as something missing.

Donguibogam · Maek

9.22.2
Source원문

一名復脉湯. 脉結代者, 血氣虛弱不能相續也; 心動悸者, 眞氣虛也. 成無己云, 補可去弱, 人參ㆍ大棗之甘以補不足之氣; 桂枝ㆍ生薑之辛以益正氣. 五藏痿弱, 榮衛涸流, 濕劑所以潤之, 故用麻仁ㆍ阿膠ㆍ麥門冬ㆍ地黃之甘, 潤經益血復脉通心是也. 《東垣》

Translation영역
It is also called Restore the Pulse Decoction. A bound or intermittent pulse is the blood and qi vacuous and weak and unable to continue one beat to the next; palpitation of the heart is the true qi vacuous. Cheng Wuji says: supplementing can remove weakness — the sweetness of ginseng and jujube supplements the insufficient qi, and the acridity of cinnamon twig and fresh ginger boosts the right qi. Where the five viscera are wilted and weak and the construction and defence have run dry, moistening preparations are what wet them; hence the sweetness of hemp seed, ass-hide glue, ophiopogon and rehmannia, moistening the channels, boosting the blood, restoring the pulse and freeing the heart.
Clinical note임상 주석
復脉湯 — Restore the Pulse Decoction, Zhongjing's name for it, and the indication is precisely a dropped beat with palpitation. It is still given for arrhythmia under this name, and the reasoning quoted here is why: the beat fails because there is not enough to carry it.

Dongwon 東垣

9.23 Simple Medicinals 單方

9.23.1
Source원문

凡十四種.

Translation영역
Fourteen kinds in all.

Donguibogam · Maek

9.23.2
Source원문

乾地黃 通血脉, 補血脉. 或丸服, 或釀酒久服尤佳. 《本草》

Translation영역
Dried rehmannia (乾地黃): Frees the blood vessels and supplements the blood vessels. Taken as pills, or brewed into wine and taken over a long time — better still.
Clinical note임상 주석
The simples of the Vessels chapter are unlike any others in the book, because the complaint they treat is not a symptom: twelve of the fourteen are for 十二經脉, the twelve channels, taken to keep the conduits open rather than to relieve anything. There is nothing to feel and nothing to watch for, which makes this the most purely theoretical section in the Bogam — and, read another way, the most ordinary, since what it recommends is jujubes, lotus seed, mung beans and a cup of warm wine.

Boncho 本草

9.23.3
Source원문

甘草 治脉結代心動悸. 甘草 灸, 二兩, 剉, 水三升煎至半, 分三服. 《本草》

Translation영역
Licorice (甘草): Treats a bound or intermittent pulse with the heart stirring and palpitating. Roasted licorice 2 nyang, cut up, decocted in 3 seung of water down to half, divided into three doses.
Clinical note임상 주석
脉結代, a bound or intermittent pulse, with palpitations — this is the one entry in the section that names a finding a practitioner could check, and the finding is an arrhythmia. The prescription is the kernel of 炙甘草湯, the Roasted Licorice Decoction, which is still the formula reached for in an irregular pulse with palpitations. Licorice in quantity causes potassium loss and raises blood pressure, which in an arrhythmic patient is the wrong direction; a persistently irregular pulse needs an ECG.

Boncho 本草

9.23.4
Source원문

牛膝 助十二經脉. 煎服之, 或釀酒服尤佳. 《本草》

Translation영역
Achyranthes (牛膝): Assists the twelve channels. Decoct it and take, or brew it into wine and take — better still.

Boncho 本草

9.23.5
Source원문

通草 通利九竅血脉, 且通諸經脉壅不通之氣. 煎湯飮之. 《本草》

Translation영역
Rice-paper plant (通草): Frees and disinhibits the nine orifices and the blood vessels, and frees the qi where the channels are congested and will not pass. Decoct it and drink.
Clinical note임상 주석
通草, the drug whose name means to free what is blocked, in the chapter about conduits — the fit is so neat that the entry barely needs an argument. It is the same drug the Breast chapter gives for milk that will not come and the Dreams chapter for jaundice with drowsiness, and in each the reasoning is the name.

Boncho 本草

9.23.6
Source원문

燕覆子 通十二經脉. 可常食之. 《本草》

Translation영역
Akebia fruit (燕覆子): Frees the twelve channels. It may be eaten regularly.

Boncho 本草

9.23.7
Source원문

防己 通行十二經脉. 水煎服之. 《湯液》

Translation영역
Stephania (防己): Frees and moves the twelve channels. Decoct it in water and take.
Clinical note임상 주석
**A caution the Bogam could not give:** the name 防己 has covered several unrelated plants, and one of them, Aristolochia fangchi, caused an epidemic of kidney failure and urothelial cancer in Belgium in the 1990s when it was substituted in a slimming preparation. Aristolochic acid is a nephrotoxin and a Group 1 carcinogen. Only a correctly identified Stephania or Sinomenium article is acceptable, and the substitution risk is the reason this drug is restricted in many jurisdictions.

Tangaek 湯液

9.23.8
Source원문

何首烏 氣雄壯, 通十二經絡. 末服丸服幷佳. 《入門》

Translation영역
Fleeceflower root (何首烏): Its qi is bold and vigorous, and it frees the twelve channels and network vessels. Powdered or pilled, both are good.
Clinical note임상 주석
**A caution the Bogam could not give:** fleeceflower root is a recognized cause of drug-induced liver injury, and the raw root is the more hepatotoxic form. It should not be taken in the long courses this section implies without liver monitoring.

Immun 入門

9.23.9
Source원문

大棗 助十二經脉. 煎湯常飮佳. 味甘補經不足, 以緩陰血, 血緩脉生, 故能助十二經脉. 《湯液》

Translation영역
Jujube (大棗): Assists the twelve channels. Decocted and drunk regularly it is good. Its flavour is sweet, and it supplements an insufficiency of the channels, thereby relaxing the yin blood; when the blood is relaxed the vessel is engendered, and so it is able to assist the twelve channels.
Clinical note임상 주석
血緩脉生 — when the blood is relaxed the vessel is engendered. The one entry in the section that spells out its reasoning from flavour to action to result, and it is the clearest statement of why the sweet drugs belong in a chapter about conduits: sweetness relaxes, a relaxed blood fills the vessel, a filled vessel is a living one.

Tangaek 湯液

9.23.10
Source원문

蓮子 利益十二經脉血氣. 煎湯常飮, 或爲末煮粥常服尤佳. 《本草》

Translation영역
Lotus seed (蓮子): Disinhibits and boosts the blood and qi of the twelve channels. Decocted and drunk regularly, or powdered and boiled into a gruel and taken regularly — better still.

Boncho 本草

9.23.11
Source원문

酒 通血脉, 爲百藥之先. 溫服微醺爲妙. 《本草》

Translation영역
Wine (酒): Frees the blood vessels, and is first among the hundred medicines. Taken warm, to the point of being slightly tipsy — excellent.
Clinical note임상 주석
爲百藥之先, first among the hundred medicines — the Bogam's judgement on alcohol, and it is worth setting beside what it says elsewhere, where the Internal Damage chapter devotes whole sections to the harms of drink. The two are not in contradiction in the book's own terms: wine opens the vessels, and that is exactly why it is dangerous. 微醺, slightly tipsy, is the dose, and there is no safe level of alcohol for cancer risk; a warm cup to move the blood is not a prescription anyone should write today.

Boncho 本草

9.23.12
Source원문

菉豆 行十二經脉. 水煎服, 或煮粥服之. 《本草》

Translation영역
Mung bean (菉豆): Moves the twelve channels. Decoct it in water and take, or boil it into a gruel and take.

Boncho 本草

9.23.13
Source원문

苦苣 調十二經脉. 可常食之. 《本草》

Translation영역
Endive (苦苣): Regulates the twelve channels. It may be eaten regularly.

Boncho 本草

9.23.14
Source원문

黃狗肉 補血脉. 和五味煮爛, 空腹食之. 《本草》

Translation영역
Yellow dog meat (黃狗肉): Supplements the blood vessels. Dress it with the five flavours, boil it soft and eat it on an empty stomach.
Clinical note임상 주석
Recorded as the Bogam gives it. The slaughter of dogs for meat is prohibited in Korea under the 2024 act, with the ban taking full effect in 2027.

Boncho 本草

9.23.15
Source원문

石膏 善能去脉數. 病退而脉數不退, 可煎湯服之. 《東垣》

Translation영역
Gypsum (石膏): Is good at removing a rapid pulse. Where the illness has receded but the rapid pulse has not, decoct it and take.
Clinical note임상 주석
病退而脉數不退 — the illness has gone but the pulse is still racing. The section ends on its one piece of real clinical observation, and it is a good one: a tachycardia that outlasts a fever is a sign to attend to, and in modern terms it points at dehydration, anaemia, thyroid disease, or an infection that has not in fact resolved. Li Dongyuan read it as residual heat and gave his cooling mineral for it. Fourteen simples, twelve of them for the channels in general and only these last two for anything a hand on the wrist could find.

Dongwon 東垣

9.24 Acupuncture and Moxibustion 鍼灸法

9.24.1
Source원문

傷寒六脉俱無, 取復溜補之, 大回六脉ㆍ合谷ㆍ中極ㆍ支溝ㆍ巨闕ㆍ氣衝, 灸七壯. 《綱目》

Translation영역
In cold damage where all six pulses are absent, take Bongnyu (復溜, KI7) supplement it; it greatly brings back the six pulses, Hapgok (合谷, LI4), Junggeuk (中極, CV3), Jigu (支溝, TE6), Geogwol (巨闕, CV14) and Gichung (氣衝, ST30), with seven cones of moxa.

Gangmok 綱目

9.24.2
Source원문

又氣海多灸之. 《海藏》

Translation영역
Also moxa Gihae (氣海, CV6) freely.

Haejang 海藏

9.24.3
Source원문

乾嘔不止, 四肢厥冷, 脉絶, 灸間使三十壯, 此回生起死之法也. 《得效》

Translation영역
Where dry retching does not stop, the four limbs are cold with reversal and the pulse is cut off, moxa Gansa (間使, PC5) thirty cones — this is a method of bringing back the living from the dead.
Clinical note임상 주석
回生起死 — bringing the living back from the dead. Thirty cones at Gansa, on the pericardium channel of the forearm, for a patient who is cold, vomiting and has no pulse. It is the chapter's last line, and the only treatment in it aimed at someone past the reach of a decoction.

Deukhyo 得效

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Outer Form, Volume 3, Vessel chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.