摘要：在浩瀚的中医历史长河中，有这样一位医术精湛、学识渊博的名医——周学海。他以其对脉学的深刻研究和独到见解，为后世留下了宝贵的医学遗产，其中，《脉学四种》更是被誉为中医脉学的瑰宝。今天，让我们一同走进周学海的医学世界，探索他关于男女脉象之辨的深刻洞见。
在浩瀚的中医历史长河中，有这样一位医术精湛、学识渊博的名医——周学海。他以其对脉学的深刻研究和独到见解，为后世留下了宝贵的医学遗产，其中，《脉学四种》更是被誉为中医脉学的瑰宝。今天，让我们一同走进周学海的医学世界，探索他关于男女脉象之辨的深刻洞见。
一、脉学泰斗，周学海的贡献
周学海，清代名医，他对脉学的研究堪称炉火纯青。在《脉学四种》中，他不仅系统总结了历代医家对脉象的阐释，更结合自己的临床实践经验，对妇人常脉进行了深入剖析。他的著作，如同一盏明灯，照亮了中医脉学的探索之路。
二、男女脉象，差异何在？
在周学海看来，男女脉象的差异，源于体质与性情的根本不同。他引用了孙思邈《千金翼方》中的观点：“凡妇人脉，常欲濡弱于丈夫也。”这句话，道出了男女脉象差异的核心——女子体静气阴，脉象自然偏于沉静、柔软。
他进一步解释说，脉象的大小、缓急，与人的性气质地息息相关。女子体柔气静，脉象往往略沉而静，形态柔软为佳。若某一部脉象出现异常，往往与先天禀赋有关，需仔细辨别，以免误诊。
三、气血理论，诠释脉象差异
周学海不仅擅长从体质性情分析脉象，更善于运用气血理论来解释男女脉象的差异。他认为，妇人以血为本，血盛则脉盛，故女子脉象多左手偏盛、偏大，因为左手脉象多主血。而男子则气盛，脉象多右手偏盛，因为右手脉象多主气。
他还用阴阳升降理论来解释脉之来往态势。男左女右，象征着阳降阴升。因此，女子右手脉象偏盛，男子左手脉象偏盛，这是阴阳升降在脉象上的体现。
四、禀赋脉与本脉，个体差异的奥秘
周学海强调，每个人的脉象都受到先天禀赋的影响，这被称为“禀赋脉”或“本脉”。他引用了《脉经》中的观点，如“寡妇室女脉濡弱”、“女子尺强寸弱”，这些都是因气血、体质、性情不同而形成的“本脉”。
然而，他并不认为女子脉象必然盛于尺部。他批判了“形体虚实论”中关于女子脉象盛于尺部的说法，认为无论男女，只要肾中精气旺盛，其脉象都会在尺部表现出充盛之象。
五、生动案例，彰显脉学智慧
为了更好地说明男女脉象的差异，周学海在著作中穿插了许多生动的案例。有一次，他遇到一位年轻女子，脉象沉而有力，左手脉象尤为明显。他根据气血理论，判断该女子血气旺盛，身体健康。果然，经过进一步询问，得知该女子平时喜好运动，体质强健，与他的判断不谋而合。
六、结语：脉学之光，照亮医学之路
周学海对男女脉象之辨的深刻洞见，不仅丰富了中医脉学的理论体系，更为后世医者提供了宝贵的临床指导。他的医学智慧，如同一盏明灯，照亮了中医探索之路，让我们在传承与创新中，不断前行。
在今天这个科技日新月异的时代，周学海的医学思想依然闪耀着智慧的光芒。他提醒我们，医学不仅仅是科学，更是人文与艺术的结合。在追求技术精进的同时，更要关注患者的个体差异，用一颗慈悲之心去感受每一个生命的脉动。
作者简介：梁世杰 中医高年资主治医师，本科学历，从事中医临床工作24年，积累了较丰富的临床经验。师从首都医科大学附属北京中医院肝病科主任医师、著名老中医陈勇，侍诊多载，深得器重，尽得真传！擅用“商汤经方分类疗法”、专病专方结合“焦树德学术思想”“关幼波十纲辨证”学术思想治疗疑难杂症为特色。现任北京树德堂中医研究院研究员，北京中医药薪火传承新3+3工程—焦树德门人（陈勇）传承工作站研究员，国际易联易学与养生专委会常务理事，中国中医药研究促进会焦树德学术传承专业委员会委员，中国药文化研究会中医药慢病防治分会首批癌症领域入库专家。荣获2020年中国中医药研究促进会仲景医学分会举办的第八届医圣仲景南阳论坛“经方名医”荣誉称号。2023年首届京津冀“扁鹊杯”燕赵医学研究主题征文优秀奖获得者。事迹入选《当代科学家》杂志、《中华英才》杂志。
Zhou Xuehai, a famous doctor in the Qing Dynasty: The difference between pulse signs and men and women
In the long history of traditional Chinese medicine, there is such a renowned medical practitioner with great skill and knowledge - Zhou Xuehai. He left a valuable medical legacy for succeeding generations with his profound research and unique insights into pulse therapy, among which, The Four Types of Pulse Therapy is known as the treasure of traditional Chinese pulse theory. Today, let's step into the world of Zhou Xuehai's medicine and explore his profound insight into the difference between male and female pulse signals.
I. The Sword of Compass, the Contribution of Zhou Xuehai
Zhou Xuehai was a famous doctor in the Qing Dynasty. His research on pulse therapy was as pure as the fire. In "The Four Types of Pulseology," he not only systematically summarized the interpretation of pulse signs by various generations of medical practitioners, but also applied his own clinical practice experience to conduct an in-depth analysis of women's common veins. His writings, like a bright light, illuminated the path of exploration of Chinese traditional meridian medicine.
II. What are the differences between male and female pulse patterns?
In the view of Zhou Xuehai, the difference between the pulse patterns of men and women stems from fundamental differences in physical characteristics and temperament. He quoted Sun Simian's "The Wing of a thousand Gentlemen" as saying: "Women often want to be weaker than their husbands in their connections." This phrase reveals the core of the difference between male and female pulse patterns - a woman's body is restless, and her pulse is naturally more quiet and soft.
He further explained that the size and urgency of a pulse are closely related to a person's sexual temperament. A woman's body is soft and calm, her pulse is often slightly calm and her form is better soft. If an abnormality occurs in a particular pulse, it is often related to congenital gifts, and it needs to be distinguished carefully to avoid misdiagnosis.
III. Aspiration theory, interpreting pulse differences
Zhou Xuehai is not only adept at analyzing pulse patterns from physical and temperament, but also very good at applying the theory of qi and blood to explain the differences between male and female pulse signals. He believed that a woman is based on blood, and a greater blood increases her pulse, so a woman's pulse tends to be larger and larger in the left hand, because the left hand tends to dominate blood. The man, on the other hand, has a strong breath and more pulse patterns in the right hand, because the right hand pulse often serves the air.
He also used the theory of yin and yang rising and falling to explain the flow of the pulse. Men are left and women are right, which symbolizes the fall of the sun and the rise of the shade. Therefore, the right hand of women has a strong pulse, and the left hand of men has a greater pulse, which is the manifestation of yin and yang rising and falling in the pulse.
IV. Endowments and veins, the mystery of individual differences
Zhou Xuehai emphasized that each person's pulse is influenced by their innate endowment, which is known as the "endowment pulse" or "original pulse." He cited points from the meridian scriptures, such as "women in the widow's room have weak meridians," and "women have strong feet and weak inches," which are "basic meridians" formed by differences in blood and blood, physique, and temperament.
However, he did not believe that a woman's pulse must be larger than the foot. He criticized the claim in the "corporeal myth" that women's pulse appears to be abundant in the femur, arguing that both men and women show signs of fullness in the femurs as long as the kidneys are filled with sperm.
V. A vivid case that demonstrates vascular wisdom
In order to better illustrate the differences between male and female pulse patterns, Zhou Xuehai intersperses many vivid cases in his work. On one occasion, he met a young woman whose pulse was heavy and strong, especially on her left hand. Based on the theory of qi and blood, he judged that the woman had strong blood and was in good health. Indeed, after further inquiry, it was learned that the woman was usually physically active and physically strong, which fit his judgment.
VI. CONCLUSIONS: The light of acupuncture illuminates the path of medicine
Zhou Xuehai's profound insight into the difference between male and female pulse patterns not only enriched the theoretical system of traditional Chinese pulse theory, but also provided valuable clinical guidance for future generations of practitioners. His medical wisdom is like a bright light that illuminates the path of exploration of traditional Chinese medicine, allowing us to keep moving forward in inheritance and innovation.
In today's era of rapid technological change, Zhou Xuehai's medical thinking still shines with wisdom. He reminds us that medicine is not just a science, but a combination of humanities and art. While pursuing technical refinement, we must pay more attention to the individual differences of patients, and feel the pulses of every life with a compassionate heart.
Author Bio: Liang Shijie is a senior medical practitioner in traditional Chinese medicine with an undergraduate degree. He has been engaged in traditional medicine clinical work for 24 years and has accumulated a wealth of clinical experience. Following Chen Yong, chief physician of liver disease at Beijing Traditional Medicine Hospital, affiliated with Capital Medical University, and renowned old Chinese medicine, he has been treated for many years and received great attention. He specializes in the treatment of difficult diseases using "conversational traditional therapy" and special treatments combined with the academic ideas of Jiao Shude and Guan Yubo's ten-level diagnosis.He is currently a researcher at the Shude Tang TCM Research Institute in Beijing, a fellow at the new 3 + 3 project of traditional Chinese medicine flame inheritance in Beijing - a scholar at the inheritance workstation of Jiao Shude's protégés (Chen Yong),He is a standing committee member of the International Expert Committee on E-learning and Health Care, a member of the Jiao Shude Academic Heritage Special Committee of the Chinese Association for the Advancement of Chinese Medicine Research, and the first cancer specialist to be included in the chapter of the Chinese Pharmaceutical Culture Research Association. Won the 2020 China Association for the Promotion of Traditional Chinese Medicine Zhongjing Medical Branch held the eighth session of the Medical Saint Zhongjing Nanyang Forum "Classic Prescription Famous Doctor" honorary title. The winner of the first Beijing-Tianjin-Hebei "Pingui Cup" Yanzhao Medical Research Essay Award in 2023. His work was featured in the journal Current Scientist and the journal Chinese Talent.
来源：首都专家梁世杰一点号
