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MCH HC TNG HP

Tc gi: Hong Duy Tn

LI NI U

Trong lm sng thc nghim, i vi cc thy thuc YHCT, mt trong nhng yu t chn on c coi l kh nht, l vic xem mch. Mch tng (hnh th ca mch) va l thc ti ( s, bt c) nhng cng rt tru tng. Xt v tng ngha ca mch, mi loi mch c th ch mt loi bnh khc nhau. Ngoi ra mch cc v tr khc nhau cng biu hin bnh l khc nhau. Th d: Mch Trm (thuc Thn - Thy), nu v tr b xch bn tay tri ( b v ca Thn) th rt tt nhng nu v tr b thn tay tri (thuc Tm) li rt nguy him, v l biu hin ca thy khc ha, bnh nng hn... Mun hiu ti sao cng mch Trm, b v ny th tt, b v khc li xu... i hi phi hiu bit v y l...

Sch chuyn v mch bng ting Vit hin nay tng i rt t v ngay c trong cc sch gio khoa cng ch bn s qua v cc b mch, kh p ng c nhu cu ngy cng c chiu hng mun nghin cu su hn v YHCT (trong c mch hc).

Hin nay, vi s tin b ca khoa hc k thut, nhiu nc nghin cu v s dng mt s my chn on mch. Vi pht trin nh v bo ca khoa thng cng ngh thng tin, rt c th trong tng lai, vic s dng my mc thit b hin i thay th i bn tay ca thy thuc trong vic xem mch. Tuy nhin, vn cn n s kho lo, tinh t ca bn tay thy thuc trong vic xem mch. V vy, chng ti cng s gii thiu mt cch tng quan v nhng thit b hin i dng trong vic h tr ghi nhn mch. Cc chuyn gia v my tnh nhn xt rng, khi chng mua mt my tnh, ra khi ca, c th my ca chng ta b tt hu ri. Cc thit b chng ti gii thiu by gi, c th ch vi nm na thi s tr thnh tt hu, nhng hy vng s phn no em n cho ngi c mt s nt chm ph v vic ng dng cc thit b mi trong vic ghi nhn hnh sng mch.

V vy, trong tinh thn nghin cu, hc hi, chng ti c gng tng hp li cc sch mch (a s da theo cc sch mch bng ting Hn) xa v nay, sp xp li thnh h thng trong tng vn chuyn su v mch.

Ni dung ca tng mch c trin khai di 9 tiu :

1- i cng: Nu ln phn xut x hoc nh ngha v tng loi mch .

2- Mch tng: Cch m t hoc hnh v biu din ca cc mch theo cc sch chuyn khoa. Trong phn ny, chng ti gii thiu thm (nu c th) hnh v biu din ca cc mch theo nhng sch mch hin i: trnh by ng biu din mch qua cc dng sng, c o bng cc my tng i hin i, gip ngi c c c s so snh hoc d nhn xt v cc sng mch.

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3- Nguyn nhn pht sinh mch: Da theo quan im ca cc sch xa v nay, theo YHCT ln YHH. Th d: Nguyn nhn pht sinh ra mch PH:

+ Theo YHCT c th do t kh xm nhp vo 3 kinh dng bc bch mch kh ra ngoi...

+ Theo YHH c th do lng mu ca tim tng ra c tng ln...

Nhng quan nim tuy khc nhau gia hai nn YHCT v YHH c th gip ngi c hiu r hn v nguyn nhn pht sinh ra loi mch .

4- Mch ch bnh: Mi mch, ty tng b v (thn, quan xch) khc nhau, c th biu hin loi bnh chng khc nhau... Cc y gia, qua kinh nghim, ghi chp tng i kh y ... y, chng ti ch tng hp li v sp xp theo th t thi gian ca cc tc phm trch dn. Th d cng v mch PH, theo lch s phi k n sch Ni kinh T Vn ri n Thng hn lun, Kim qu...

5- Mch ch kim mch bnh: Mi mch, khi kt hp vi mch khc, c th em li ngha bnh l khc nhau. Th d: mch Ph Sc ch cm phong nhit nhng Ph Khn li ch cm phong hn...

6- Mch v tr liu: Qua kinh nghim, cc nh mch hc tng hp c cc phc iu tr cho tng loi mch, lm c s cho vic lp lun v nghin cu v mch.

7- Cc li bn v mch: Trnh by cc quan im ring ca cc sch v mch c uy tn, k c nhng li bnh lun, tranh ci... gip hiu su hn v ngha v ng dng ca cc loi mch trong nghin cu v tr liu.

8- Cc y n lin quan n mch: Nu nhng kinh nghim thc tin ca cc danh y v cng l cch hay nht hiu r hn v l lun v ng dng mch trong chn on v tr liu.

9- S lin h: (nu c) gia mch vi cc mch khc gip cho d nhn xt v d nh.

V ti liu c hn, s hiu bit c chng mc m ti v mch qu rng... chc chn trong lc bin son kh trnh khi thiu st, rt mong nhn c nhng kin ng gp vic bin son c tt p v hon ho hn.

Bin Ho, ngy 01 thng 04 nm 2006.

HONG DUY TN

A- i cng

Ch MCH theo nguyn ngha c th hiu l:

1- Ch Mch () mt bn l ch Huyt () mt bn l ch Phi () (l ngnh, l chi phi, nhnh), ni rng mch l mt phi, mt ngnh ca huyt, trong , huyt lu thng.

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2- () Mt bn l ch Huyt () mt bn l ch Vnh () l lu di, ni c mch (c huyt), cn mch th c th cn sng lu di (mt mch, mch khng p na l cht).

3- Mt bn l ch Nguyt (ng ra l b Nhc ) mt bn l ch (Vnh ) l lu di, ni c mch th sng lu ( khng cn mch th cht).

Nh vy, theo YHCT, mch l biu hin ca Kh, Huyt, lu hnh ngy m khp c c th con ngi.

Theo YHH, mch l ln sng p huyt, t tim chuyn ra ng mch, lan truyn di theo ng mch vi tc bnh thng l 9m/giy.

Theo YHCT, chn mch l thy thuc dng ngn tay ca mnh, bt mch ca ngi bnh phn bit mch tng ri kt hp vi cc php Vng (nhn), Vn (nghe), Vn (hi), chn on m dng biu l, hn nhit, h thc ca bnh chng.

Gi Tr Ca Vic Chn Mch

- Sch 'Trung y hc khi lun' ghi: "Chn on mch tng c th hiu r c s bin ha ca bnh t, theo m phn bit chng hu, mt khc li c th d c s thng hoc bin ca kh huyt, theo m suy on c s thnh suy ca chnh kh, lm cho thy thuc c th nm vng c chiu hng tiu trng trn lm sng".

- Thin 'Nghch thun' (Linh khu 55) ghi: "S thnh suy ca mch l xt bit c s h hoc thc, hu d hoc bt tc ca kh".

- Thin 'Phng thnh suy lun' (T vn 80) nu ln c th gi tr ca vic chn mch: "... em nhng tnh hnh t m xem xt c m tng hp li, suy tm s bin ha ca m dng, hiu r bnh tnh ca ng tng, rt ra c kt lun ng n ri cn c vo im ct yu ca h thc, ng chn, ng phn on".

B- Lch S Mch Hc

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- Cun sch c nht cp n mch l cun 'Ni kinh T vn' ( khong 200 - 300 nm trc Cng nguyn), ng k nht l cc thin: 'Mch yu tinh vi lun (T vn 17), Bnh nhn kh tng lun (T vn 18), Kinh mch bit lun (T vn 21), Mch gii ( T vn 49), Th thung dung lun (T vn 76)...

- Khong th k th 5 trc Cng nguyn, Tn Vit Nhn (Bin Thc) trong tc phm 'Nan kinh' ra 24 Nan (trong tng s 81 Nan) bn v mch.

- Th k 2-3 sau Cng nguyn, Trng Trng Cnh, trong sch 'Thng hn lun' v 'Kim qu ngc hm kinh' ghi li kinh nghim v nhn nh v tng loi mch v chng.

- Th k th 3, Vng Thc Ha ln u tin h thng ha ton b mch hc trong tc phm 'Mch kinh'.

- i nh Nguyn, c hai quyn sch v mch ng c ch n l:

1- 'Khit C ch Thc Ha mch hc' ca Trng Nguyn T (Trng Khit C) ch gii v sch mch ca Vng Thc Ha.

2- 'Mch chng ch chng' ca Chu an Kh bn v mch v chng.

- i nh Minh (1368) ti liu v mch c:

Chn gia chnh nhn ca L Trung T (L S Ti).

Mch l minh bin ca L Qu.

ch mch chng ph trng ca Trng Th Hin.

Tn H mch hc ca L Thi Trn.

Chn mch i ch ca Chc Nhc.

T chn php ca Trng Tam Dng.

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- i nh Thanh (1644) sch bn v mch c:

Mch hc hp bch ca Trm Kch.

Chn mch tam thp nh bin ca Qun Ngc Hnh.

Mch l v tham ca T Chi Tun.

Mch hc ch thch ca Vng Vn K.

Mch php nhin tri ca Tin Kinh Lun.

Mch chng iu bin ca H Chnh.

Tr t mch hu chng ca Du Chnh Tip.

T chn quyt vi ca Lm Chi Hn.

Hot nhn tm php chn thit knh ca Lu D Nhn.

- L S Ti (1624) cng dnh hn mt chng ('T Ngn Mch Quyt' trong sch 'Y tn tt c') bn v mch.

- Trng Cnh Nhc (1624) trong b 'Cnh Nhc ton th' cng c hn mt chng 'Mch thn' bn kh su v mch.

Th k 18 vi b 'Y tng kim gim' Ng Khim v cc cng s c hn mt tp 'T chn tm php yu quyt' bn v mch...

Qua th k 20, vi nhng tin b v khoa hc k thut, nhiu hc vin Trung Y ni ting nh Thng Hi, Bc Kinh, Qung Chu, Thnh ... dng cc thit b hin i o v ghi li c cc dng sng mch, ng thi cng nu ln c s tng quan gia mch v cc chc danh bnh l theo thut ng y hc hin i...

Ti Vit Nam, vo th k 18, Nguyn B Tnh (Tu Tnh) trong sch 'Hng ngha gic t y th' c nhiu ch bn v mch. V Hi Thng Ln ng, trong chng 'Y gia quan min' cng c hn mt phn bn v cc mch v cch xem mch...

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Ring sch chuyn v Mch ( ting Vit), c rt t:

Phng php xem mch ng phng ca Nguyn Vn Minh.

nh Ninh ti hc mch ca L c Thip.

Cm nang mch hc ca Nguyn Khc Nhn.

Mch l v phng dc ca Nguyn Hu Khai.

Sch dy xem mch ca Nguyn An Nhn, in 1942.

C- C CH CA MCH

a- Theo Y Hc C Truyn

- Thin 'Tuyn minh ng kh lun' (T vn 23) ghi: 'Tm ch mch', da vo cu ny, sch 'Mch hc ging ngha' gii thch nh sau: "Mch vi Tm c quan h vi nhau theo tng nhp th. Tm li c quan h mt thit vi ton b c th. V vy, c th b bnh chc chn s nh hng n mch".

- Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch l ph ca huyt, mch Trng th kh c trng, mch on th kh b bnh, mch Sc th tm phin, mch i th bnh ang tin trin...".

- Sch 'Mch hc ging ngha' gii thch ca thin 17 sch T vn nh sau: "Mch l ph ca huyt, Vinh kh da vo m i trong mch, V kh da vo m i ngoi. Mch theo kh i, huyt theo mch chy. Vinh V iu ha, kh v huyt thng ng, l ngi bnh thng".

b- Theo Y Hc Hin i

Qua nghin cu mt s mch YHCT bng cc thit b hin i, sch ' Tn bin Trung y hc khi yu'(1973), 'Trung y hc c s' (1974) v sch 'Trung y bin chng lun tr ging ngha' (1976) cng nhn nh: "Nhng lin quan v hnh nh in tim, ting tim ghi ng thi vi ng cong ng mch cnh v ng mch quay ni ln trng lc tng hoc gim ca mch... lm nh hng trc tip n s thay i hnh thi ca mch...

Nhng s thay i , hoc do bnh ca tim mch gy ra hoc do bnh ca ton thn tc ng n tim mch gy ra. Ngoi ra, yu t thn kinh, tm l, thi tit... cng c th nh hng n s thay i ca mch.

Th d: Khi theo di mch PH, cc tc gi nhn thy:

Mch PH c th pht sinh do:

Lng mu tim tng ra c tng ln.

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Sc co bp ca thnh mch km.

Hoc s thay i ca mch TRM c th do:

Lng mu tim tng ra bnh thng hoc h thp.

Cc mch mu ngoi bin co li...

D- CC B V CHN MCH

B v chn mch, theo cc sch xa, c nhiu cch khc nhau, c th tm vo ba cch sau:

1- Cch chn mch ton thn (Bin chn php), thin 'Tam b cu hu lun' (T vn 20) trnh by nh sau:

a- Thng b (u) chia l ba vng:

Thng b thng : ng mch hai bn trn (Thi dng) chn bnh kh cnh bn u.

Thng b trung: ng mch trc tai (tng ng vng huyt Nh mn) chn bnh v tai v mt.

Thng b h: ng mch hai bn m (tng ng vng huyt C liu) chn bnh ming v rng.

b- Trung B (Tay), chia lm ba vng:

Trung b thng: th Thi m (vng thn khu - huyt Thi uyn) chn bnh v Ph.

Trung b trung: th Thiu m ( vng huyt Thn mn - ch lm ln ch trong c tay, thng ngn tay t ln ) chn bnh v tng Tm.

Trung b h: th Dng minh (vng h khu - huyt Hp cc) chn bnh v kh trong ngc.

c- H b (Chn), chia lm ba vng:

H b thng: tc Quyt tm (vng huyt Ng l hoc Thi xung) chn bnh v tng Can.

H b trung: tc Thi m (vng huyt C mn hoc Xung dng) chn bnh v Ty, V, xem V kh.

H b h: tc Thiu m (vng huyt Thi kh) chn bnh v tng Thn.

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Hc THN QUAN XCH

Thuyt Phi Tri Phi Tri Phi Tri

Ni kinh Ph

Hung trung

Tm

Hung trung

V

T

Can

Cch

Thn Phc

Thn

Phc

Nan kinh

Ph,

i trng

Tm

Tiu trng

T

V

Can

m

Thn

Mnh mn

Thn

Bng quang

Mch kinh

Ph

i trng

Tm

Tiu trng

T

V

Can

m

Mnh mn

Bng quang

Thn

Bng quang

Thin kim

phng

Ph Tm T Can Thn Thn

Thi th t

nguyn c yu

Ph

Cch thng

Tm

Cch thng

T

Cch h

Can

Cch h

Mnh mn

Thn

L ng Vin

Ph

i trng

Tm

Tiu trng

T

V

Can

m

Mnh mn

3. Tiu

Thn

Bng quang

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Hot B Nhn

Ph . trng

Tm

Tiu trng

T

V

Can

m

3. Tiu

Tm bo

Thn

Bng quang

L Thi Trn

Ph

Hung trung

Tm

Chin trung

T

V

Can

m

Thn i

trng

Thn

Tiu trng

D Gia Ngn

Ph Tm T

V

Can

m

Thn

3. tiu

Tiu trng

Thn, B. quang

i trng

Y tn tt c

Ph

V trung

Tm

Chin trung

T

V

Can

m

Thn i

trng

Thn

Tiu trng

Cnh Nhc

ton th

Ph

Chin trung

Tm

Tm bo

T

V

Can

m

Mnh mn

3. Tiu

T. trng

Thn

B. quang

. trng

Y tng

kim gim

Hung trung.

Ph

Chin trung.

Tm

T

V

Can

m

i trng Thn

Tiu trng

Bng quang

Thn

Chn gia khu

yu

Ph

i trng

Tm

Tiu trng.

Ph

V

Can m

T. bo

3 tiu

M.mn

Thn

Bquang

Vic chia lm ba vng (Tam b) v 9 khu (Cu hu) theo sch T vn trn l d tm cc mch mu phn (lp) nng (cn) ca ton thn, qua phn tch s bin ha v kh huyt trong c th con ngi suy hoc thnh. Hin nay trn lm sng t khi dng n.

Trong trng hp bnh nng hoc nguy him, ngi ta mi chn mch Xung dng ( xem v kh cn hoc mt, tin liu c vic dung np thuc hay khng ) hoc xem mch Thi kh d on sng (cn p) hoc cht (khng p na).

2- Cch Chn Mch Theo Tam B

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Theo sch 'Thng hn lun', c th ch xem mch tam (ba) b:

Nhn nghinh (ng mch c) chn v V kh.

Thn khu (ng mch tay quay - huyt Thi uyn) chn bnh ca 12 ng kinh.

Phu dng (ng mch mu bn chn - huyt Xung dng) chn v V kh.

3- Cch Chn Mch Thn Khu

Sch 'Nan Kinh', Nan th I cho rng, ch cn xem mch thn khu, v cng chia ra lm ba b: Thn, Quan v Xch. Mi b li chia ra lm ba hu: Ph, Trung v Trm, hp li cng thnh tam b cu hu. Ch dng mt b thn khu xem s thnh suy kh huyt ca ton thn.

gii Vn nn (Nan) I l: "12 kinh u c ng mch nhng ch xem mch thn khu chn on vic lnh d, sng cht ca lc ph, ng tng l th no?" Tn Vit Nhn tr li nh sau: "Thn Khu l ch i hi ca mch, l ng mch ca th Thi m... l chung th ca ng tng, lc ph, v vy, php chn phi ly thn khu. ( Thn khu gi, mch chi i hi, th Thi m chi mch ng d... Thn khu gi, ng tng lc ph chi s chung th, c php th thn khu d ).

Trong thin 'Ng tng bit lun' (T vn 11) Hong hi: "Kh khu ti sao li lm ch ring ca ng tng?" K B p: "V l b cha thc n, l ngun gc ca lc ph. Nh vy, tuy vic chn mch thn khu do sch Nan kinh xut nhng cng bt ngun t sch Ni kinh T Vn.

(Ghi ch: Vng Thc Ha trong sch 'Mch kinh' gi b thn bn tri l Nhn nghinh v b thn bn phi l Kh khu ).

E- MCH V TNG PH

Theo Nan th 18 (Nan kinh) th b v xem mch thn khu c chia lm ba b v c gi theo th t: Thn, Quan v Xch. Cc b v ny s tng ng vi Tng Ph trong c th.

Vic sp xp (nh v) cc b v tng ng vi cc tng ph ra sao c cc sch kinh in ghi chp li. Ty theo quan im ca mi tc gi, cch nh v c hi khc nhau v danh xng, nhng v c bn li rt ging nhau. ( Xem 'Biu ca cc hc thuyt v b v mch').

Cc hc thuyt trn, vic phn b v tr ca tng ph u da theo ca thin 'Mch yu tinh vi lun' (T vn 17) ch ring v tr ca i trng, Tiu trng v Tam tiu l c nhiu khc bit:

- Theo Vng Thc Ha trong sch 'Mch kinh' th: "Tiu trng tng ng vi Tm, v vy, Tiu trng b thn bn tri cng vi Tm, i trng biu l vi Ph, v vy, i trng b thn bn tay phi cng vi Ph. Tam tiu b Xch bn tay phi cng vi Mnh mn ha v Mnh mn ha v Tam tiu u l tng ha".

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- Theo Trng Cnh Nhc trong 'Cnh Nhc ton th' th Tiu trng b xch bn tay phi, cng v tr vi Mnh mn ha v ha Tiu trng gn vi ha Thn hn l ha Tm. Ngoi ra, Tiu trng cng tng thng vi Thn v Bng quang. i trng b xch bn tay tri, cng v tr vi Thn thy v kim (i trng) sinh thy (T hn).

- Theo L Thi Trn trong 'Tn H mch hc' th Tiu trng di Tm, v vy b xch bn tri. i trng di Ph, v vy b xch bn phi.

c bit Trng Cnh Nhc v L Thi Trn khng cp n Tam tiu (Xem thm chi tit trong biu ).

Nhn nh v vic phn b cc b v tng ph vi mch, Trn Tu Vin bnh lun nh sau: "i v Tiu trng trong sch Ni kinh khng cp n, cc nh (nghin cu) sau u theo l m da vo, (iu ny) khng th cu n, ch dng tham kho trong vic bin chng". L Thi Trn, trong sch 'Tn H mch hc' cng nhn nh: "Su b hai tay u l mch ca Ph, ch cn ly m chn on kh ca ng tng lc ph ch khng phi l v tr ca ng tng lc ph".

Hin nay, a s cc nh nghin cu chn dng theo hc thuyt ca L ng Vin nh sau:

TAY PHI TAY TRI

THN Ph

i trng

Tm

Tiu trng

QUAN T

V

Can

m

XCH Mnh mn

Tam tiu

Thn

Bng quang

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5- S Lin H Gia Cc B V Mch

Da theo c tnh sinh khc ca Ng hnh, p dng vo cch phn nh b v ca mch v tng ph theo L ng Vin, ta c:

+ Tng sinh:

Thn Thy (b xch tay tri) sinh Can Mc (Quan), Mc sinh Ha (Thn) v Ha (Mnh mn - xch bn phi) sinh T Th (Quan), T Th sinh Ph Kim (Thn).

TAY TRI TAY PHI

THN Tm Ha Ph Kim

QUAN

Can Mc T Th

XCH

Thn Thy Mnh mn (Ha)

+ Tng khc:

Nhn vo hng ngang, gia 2 tay phi v tri, v gia cc b v cng tn, ta thy c s tng khc: Tm Ha khc Ph Kim, Can Mc khc T Th, Thn Thy khc Mnh mn Ha.

TAY TRI TAY PHI

THN Tm Ha Ph Kim

QUAN Can Mc T Th

XCH Thn Thy Mnh Mn Ha

Nu nhn cho s thy: Ph Kim khc Can Mc, T Th khc Thn Thy v nh vy s c mt vng lin hp tng khc nh sau:

Tm Ha khc Ph Kim, Ph Kim khc Can Mc, Can Mc khc T Th, T Th khc Thn Thy, Thn Thy khc Mnh mn Ha, v vng tng khc c nh vy m tip din.

C l v vy m hnh thi nh v ny c nhiu ngi ch v chp nhn.

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Sch 'Y hc nhp mn' ca L Din din ca cc v tr ca tng ph nh sau:

"T Tm, Tiu trng, Can, m, Thn,

Hu Ph, a Trng, T, V, Mnh (Mn).

- Tm d Tiu trng c t thn

Can, m ng quy t quan nh,

Thn mch nguyn ti t xch trung,

Bng quang th ph thng tng ng.

- Ph d i trng c hu thn,

T, V mch tng hu quan nhn,

- Tm bo hu xch phi Tam tiu

Th vi s hc nhp mn quyt".

E. PHNG PHP CHN MCH

1- Thi gian xem mch

- Thin ' Mch yu tinh vi lun' (T vn 17) ghi: "Chn mch thng vo lc sng sm, m kh cha ng, dng kh cha tn, cha n ung g, kinh mch cha y, lc mch iu ha, kh huyt cha lon, do , c th tm thy mch bnh".

Tuy nhin, Ung Thch Sn, trong 'Thch Sn y n' nhn nh rng: "Nu gp bnh th bt c lc no cng c th chn mch, khng cn chn mch vo lc sng sm mi c".

- Trc khi chn mch, nn cho ngi bnh ngh mt lt cho kh huyt c iu ha.

- Khng nn xem mch khi ngi bnh n ung qa no, i qa hoc mi ung ru, i xa n m mt mi...

- Ngoi ra, ng tay o ngi bnh qu cht, hon cnh chung quanh n o... cng c th nh hng n vic chn mch.

2- T th lc xem mch

- Theo sch 'Trung y chn on hc ging ngha' th : "Ngi bnh nn ngi thng thn, t nhin hoc nm nga, cnh tay nn dui ra 2 bn, bn tay nga cho huyt mch lu thng tt v khng nh hng n mch".

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Sch 'Y tng kim gim' nu r: "Ngi bnh nm nghing th cnh tay pha di ln lm mch khng chy c. Nu co tay li th bn tay b b tc, mch khng lu thng. Nu xui tay th mu dn xung lm mch b tr, nu gi tay ln cao th kh chy ln m mch nhy. Nu co c th li th kh b nn m mch b g b. Nu ngi c ng th kh b nhiu lon m mch chy nhanh..."

Thy thuc nn ngi nghing i vi ngi bnh, dng tay tri chn mch tay phi ngi bnh v ngc li dng tay phi chn mch tay tri.

3- nh hi th

Thy thuc cn n nh hi th, gi vng tiu chun: 1 hi th ra, ht vo tng ng vi 4 ln mch p. Sau , cn c vo tiu chun ny, tp trung ch vo cc ngn tay ang t trn cc b v thm d mch tng v s mch m ca ngi bnh. Do , thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Phng php chn mch ct tm h tnh".

4- Cch t tay chn mch

- Sch 'Chn gia khu yu' trnh by cch t tay xem mch nh sau: "Khi t ngn tay xung, u tin t ngn tay gia vo b quan ( m trong ch xng cao - ngang vi li xng quay), ri t lun 2 ngn tay 2 (tr) v 4 (p t) pha trc v sau thnh 3 b mch. Ngn tay trc (trn) l b thn khu, ngn tay sau (di) l b xch. Nu cng tay ngi bnh di th t ngn tay tha, nu cng tay ngn th t cc ngn tay kht nhau".

- Sch 'Trung y hc khi lun' nhn mnh rng: "Khi t ngn tay (xem mch) cn phi u ngn tay bng nhau v mc cm gic ca da u cc ngn tay ang xem mch khng ging (nhy bn) nh nhau... v vy, khi cn chn mch, nn dng ch nh ( ch u ngn tay ni ln nh si ch) s, n".

- Sch 'Mch ngha gin ma' gii thch r hn nh sau: "Ba ngn tay ca ngi ta di ngn khng bng nhau, v vy phi 3 u ngn tay bng nhau, t ngn ny ngang t ngn kia mi c th chn mch c. Nhng da tht u 3 ngn tay th ngn tr nhy cm nht, ngn gia da dy, ngn th 4 li dy v km nhy cm hn. V vy, phi dng cnh ca u ngn tay nh si ch, gi l ch mc (mt ca ngn tay) n ln sng mch".

- Sch 'Trung y hc khi lun' cn lu rng: "iu quan trng hn na l khng nn da vo mch p u ngn tay ca mnh m nhn lm vi mch p ca ngi bnh, v u ngn tay ca thy thuc cng c ng mch. iu ny cn ch trn lm sng".

Sau khi t tay ng v tr v ng phng php, thy thuc phi bit vn dng nng lc nng nh v di chuyn ngn tay thm d mch tng.

Hot B Nhn, trong sch 'Chn gia khu yu' nu r: "Chn mch c 3 iu ch yu l C, n v Tm. Nh tay s mch gi l C, nng tay chn mch gi l n, khng nng khng nh, uyn chuyn tm kim gi l Tm".

Hin nay cc nh nghin cu mch hc nghing v cch sau:

15

+ S (Khinh) n: Bt u t (ng) ngn tay n mch ca ngi bnh chn bnh ph.

+ Trung n: n nh tay xung 1 cht bit v V kh.

+ Trm (Trng) n: n nng tay xung mt t chn bnh tng.

Cch chung, khi chn (xem) mch, nn:

Xem chung c 3 b (Tng khn) nhn nh v tnh hnh chung (thng c dng nht).

Xem ring tng b phn (n khn) nh gi ring tng c quan, tng ph.

Ngoi ra, theo cc nh mch hc th khi xem mch cn cn phi ch n 3 yu t l V kh, Thn v Cn.

1) V kh

Thin 'Bnh nhn kh tng lun' (T vn 18) ghi: "C V kh th sng, khng c V kh th cht", v vy, mch ly V kh lm gc.

Trng Cnh Nhc trong chng 'Mch thn' (Cnh Nhc ton th) trnh by v V kh nh sau: Mun xt din tin ca bnh tt hoc xu nn ly V kh lm ch. Cch xt ny v v kh nh sau: "Th d, hm nay mch cn ha hon m ngy mai li Huyn, Cp th bit rng t kh ang tin trin, t kh cng tin, bnh cng nng. Hoc hm nay mch rt Huyn, Cp nhng ngy mai li thy ha hon th bit l V kh n, V kh n th bnh nh dn. Nu nh trong chc lt m mi u thy mch Cp m sau Hon l V kh n, lc u Hon m sau Cp l V kh mt".

2) Thn

Sch 'Trung y chn on hc ging ngha' gii thch: "Gi l thn ca mch tc l mch i nhu ha. Th d nh bt c mch Vi Nhc th tuy l Vi Nhc nhng khng n mc v lc l c thn, hoc bt c mch Huyn Thc m trong ci Huyn Thc vn thy nhu ha, l c thn. Tm li, mch c V kh, c Thn u l c hin tng xung ha. C V kh l c Thn kh, v vy, trn lm sng, cch chn on V kh v Thn nh nhau".

3) Cn

- Sch 'Mch quyt' ghi: "Mch b thn v b quan tuy khng cn na nhng mch b xch vn cn, nhng bnh gp mch , khng lo cht".

- Sch 'Trung y chn on hc ging ngha' gii thch: "Mi hai kinh mch trong c th u nh ch ng kh ca Thn m pht sinh. Thn kh cn cng nh cy c gc (cn) cnh l tuy kh m gc cha kh th c hy vng sng c. Thn kh cha tuyt th mch nht nh c cn. Mch Trm chn tng Thn, b xch chn v Thn, mch b xch m Trm, c lc l du hiu mch c cn".

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- Hot B Nhn trong sch 'Chn gia khu yu' li cho rng khi chn mch phi ch n su yu t: Thng, H, Lai, Kh, Ch, Ch, ng vit: "Chn mch nn bit su ch: Thng, H, Lai, Kh, Ch, Ch, khng hiu su ch th khng phn bit c m dng h thc. Thng, Lai, Ch l dng; H, Ch l m. Thng l t b xch ln ti thn khu n b xch, m sinh dng, Lai l t trong tht xut ra ch trong da ngoi, s tng ln ca kh. Kh l t ch trong da ngoi tht i vo tht vo xng, s ging xung ca kh. ng l Ch, ngh l Ch".

- Sch 'Trung y chn on hc ging ngha' khi gii thch cu ny nhn xt: "Cu danh ngn su ch (Thng, H, Lai, Kh, Ch, Ch) ca Hot B Nhn, cc y gia ca cc thi i u cho rng tm c iu ct yu ca vic chn mch.

Sch 'Trung y chn on hc ging ngha' gii thch v cc yu quyt chn mch ca Hot B Nhn nh sau:

Thng, H l ch mch ch thng sut t b xch n b thn, ch chn st 1 b m phi ch n tnh hnh c ba b thn, quan, xch nh chng 'Bnh mch php' (Thng hn lun) ghi: " b thn, mch H khng n b quan l du hiu dng tuyt, b xch, mch Thng khng ti b quan l m b tuyt".

Lai, Kh l ch s thng ging ca mch. Thng ging khng cp bch, nh nhng, iu ha l mch tng ca mch khng c bnh. Mch Lai m Tt, mch Kh m T l du hiu trn thc di h ( hoc trong h ngoi thc). Mch Lai m T, Mch Kh m Tt l du hiu trn h di thc (hoc ngoi h trong thc).

'Ch Ch' l ch vo ch v trong thi gian ngn hay di ca cc b mch. Ch chn mch n, thi gian ngn hoc di ca cc b mch. Ch thi gian ngn di b thng c th xt s thnh suy ca chn dng bin v yu mch ca chn m. Ch thi gian di ngn b h c th xt s thnh suy ca chn m bin v s mch yu ca chn dng".

Ng Hc Cao nhn xt: "Mch c thng h l m dng tng sinh, bnh tuy nng cng khng cht. Mch c lai, kh l biu l giao ha, bnh tuy nng ri cng khi. Mch khng c Thng, H, lai, kh th cht gn ngy".

5- Bin Lun V Mch

Theo sch 'Trung y chn on hc ging ngha' th khi bin lun v mch cn ch n hai yu t chnh l:

1- Khng nn cu n v tnh cht c th ca tng mch.

Th d: Khi ni n biu l phi quy v mch Ph, nhit l Sc, l l Trm, hn l Tr, mch Huyn, Cng l Thc; T, Vi l H... tuy nhin, phi cn lu n cc yu t chn, gi.

Bn v vn ny, Trng Cnh Nhc trong chng 'Mch thn' ca b 'Cnh Nhc ton th' gii thch nh sau: "Mch Ph tuy thuc v biu nhng h m h, huyt thiu, kh trung tiu suy tn s thy mch Ph m v lc, v vy, khng th cho rng mch Ph hon

17

ton lin h vi phn biu. Mch Trm tuy thuc v phn l nhng h ngoi t mi cm m vo su th hn t b ly kinh lc, mch kh khng thng t c, s thy mch Trm, v vy, khng th cho rng mch Trm hon ton thuc v phn l. Mch Sc l nhit, nhng chn nhit cha hn l Sc. Chng h tn, m dng u b khn qun, kh huyt hn lon, h nhiu, mch Sc cng nhiu, v vy khng th ni l Sc hon ton thuc nhit c. Tr l hn nhng bnh thng hn, t kh mi lui, nhit cha ht, mch phn nhiu l Tr Hot, v vy ng cho rng Tr hon ton l hn. Huyn, Cng thuc thc nhng chn m, v kh h qu v cc chng m dng quan cch (b ngn tr), mch s Huyn, Cng, v vy Huyn cng khng hn l Thc. Mch Vi, T thuc h trng hp b au qu, kh b b, vinh v b ng tr khng thng, mch s phi n np (Phc), v vy mch Phc khng phi hon ton l H... t c th suy ra... trong cc mch u c vn ".

2- S khc nhau lc mi t tay vo mch v lc xem mch mt lc tht lu

C khi mch mi xem v xem mt lc lu c s khc bit. Th d: Lc mi xem thy mch ni to, xem mt lc thy mch chm lng. Hoc mi xem thy mch mm nhn, xem lu li thy bt di tay. C khi lc u thy mch Huyn, mt lc sau li l Hon.

Bn v vn ny, Trng ng trong chng 'Vn s chn cu n bt ng thuyt' (Chn tng tam mui) nhn nh rng: "Khi chn mch loi khch t bo bnh m mch Ph l ng. Nu bnh lu, sc h tn, nn chn cn kh lm gc. Nu thy Ph, i, n tay lu thy chm mt, l hin tng chnh kh qu h, khng cn hi l bnh lu hoc mi nhim, tuy rng chng m thy nng nhiu, phin nhiu do chnh kh suy khng t ch c m h dng thot ra ngoi. Khi mi xem mch thy Nhu, Nhuyn, bt u thy bt di tay l du hiu bnh phn l, phn biu khng bnh. Khng phi tng kh b th thng th l kin tch n phc bn trong, trng hp ny khng th cho l mch Trm m lm l b h hn. Mi xem thy mch hi Huyn, xem lu li thy ha hon, h bnh lu th sp khi, kh huyt tuy km nhng tng kh cha bi. Cch chung, mch ca ngi bnh lc mi t tay vo tuy thy v lc hoc Huyn T, khng ha hon, xem lu trn mi ch li thy iu ha dn, th bnh c th cha. Nu mi xem mch thy ha hon nhng xem lu li thy Vi, Sc khng ng tay hoc dn dn Huyn, cng ( ngnh) th bnh kh cha".

6- B Mch Theo Chng - B Chng Theo Mch

(X Mch Tng Chng - X Chng Tng Mch)

Thng thng th mch v chng tng ng vi nhau, nhng c nhiu trng hp mch v chng li khng i i vi nhau nh dng chng m li thy mch m hoc m chng m thy mch dng... Sch ' Y bin' gii thch r nh sau: "Phm bnh m mch v chng khng hp th mt bn tht, mt bn gi, cn phn bit k. Nh bn ngoi tuy phin nhit m thy mch Vi, Nhc th h ha, h tng, li chu c cng pht sao?. Nn theo mch m cha chng chn h ch khng theo chng l gi tng. Hoc trng hp bnh vn khng c phin nhit m thy mch Hng, Sc th khng phi l ha t. Bnh vn khng c trng y, tr m thy mach Huyn, Cng th khng phi l chng thc bn trong. Khng nhit, khng trng li c th chu c php t hay sao?. Nn theo chng h ch khng theo mch gi thc... Nu l t lm thng tn bn trong hoc thc tr, kh tr m bng trn

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au tht n ni mch Trm, Phc hoc Xc hoc Kt, l t b tc kinh lc gy ra. c chng thc lm cn c th mch h tc l ga, trng hp ny nn theo chng ch khng theo mch. Hoc nh bnh thng hn, tay chn ga lnh, rt run m mch thy Hot, Sc, l do ni nhit lm cch m. Lm sao c th bit c? V bnh truyn t kinh ny sang kinh khc ch khng phi trc trng m kinh, t chng nhit chuyn sang hn. c mch Sc, Hot lm cn c th ngoi chng l gi h, cng theo mch ch khng theo chng vy".

Trng hp no nn b mch m theo chng, L c Thip trong sch ' nh Ninh ti hc mch' nhn nh:

Nn b mch theo chng trong cc trng hp sau:

- Nhng bnh m nhn xt v mch kh chnh xc nh nhng ngi khng th ch cn c vo mch hoc nhng ngi khng c b mch xem.

- Nhng ngi thanh cao, 2 tay thng khng c mch, nu c th mch i rt m du, nh nhng, b nh.

- Nhng ngi mch tay tri thng rt nh hn tay phi hoc ngc li.

- Nhng ngi c mch 'Phn quan'.

- Nhng ngi khng may b ct mt hoc c hai tay.

- Nhng ngi b thng ngay v tr xem mch.

G- QUAN H GIA MCH

VI NHN T TRONG NGOI

1- Quan H Gia Mch V Ng Hnh

Dng ng hnh p dng vo mch ta thy:

Tay Bn TRI: Thn thy (b xch) sinh Can mc (quan), can mc sinh Tm ha ( thn).

Tay Bn PHI: Mnh mn ha (b xch) sinh T th (quan), t th sinh Ph kim (thn).

2- Mch V Kh Huyt

Xt v kh huyt vi mch ta c:

+ Bn tri thuc Huyt: Thn, Can v Tm. Thn (tng tinh, tinh sinh huyt ) - Can tng huyt - Tm ch huyt.

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+ Bn phi thuc Kh: Mnh mn (Tam tiu), T v Ph. T l trung kh - Mnh mn l ni cha nguyn kh - Tam tiu l ng dn kh - Ph ch kh. V vy, mch bn phi lin h vi kh.

TAY PHI TAY TRI

KH HUYT

Mnh mn (Tam tiu), T, Ph. Thn, Can v Tm

3- Quan H Gia Mch V Ma

Mi ma ng vi mt tng nht nh, d ma cng chi phi ton th cc mch khc trong sut thi gian .

+ Ma Xun: Mch Huyn.

Cy ci xanh tt vo ma ny, mu xanh ng vi mu ca Can, do c mch Huyn (mch ca Can).

Ma xun dng kh bt u pht (Thiu dng) nhng kh lnh vn cha ht, kh c cn c hin tng c thc, v vy mch tng thy u thng m di, ging nh giy n (Huyn).

+ Ma H: Mch Hng.

Cy ci ln ln, sc nng ca ma h bng ln, thiu t vn vt nh la bng ln (Hng).

Vo ma ny, vn vt ti tt, thnh vng, mch n th thnh m i th suy, v vy sch 'Ni kinh' gi l mch Cu.

+ Ma Thu: Mch Mao.

Mi vt bt u thu li, l cy kh i v rng ging nh lng, do mch ca ma thu l mch Mao.

Thi im ny, dng kh bt u suy, th mch gim ch thy Ph. Sch 'Ni kinh' gi l mch Mao l hnh dung th mch n ng di tay thy nh nh lng (Mao).

+ Ma ng: Mch Thch.

Mi vt thu gi li, tng tr tt c kh nng mnh m ca mnh sng qua ci lnh gi, v vy, mch ca ma ng l mch Thch.

Ma ng vn vt b tng, th n ca mch kh trm m c sc bt vo ngn tay, sch 'Ni kinh' gi l mch Thch l hnh dung mch n ng vo tay c lc cng nh cc (Thch).

+ T Qu: T qu l chuyn tip gia cc ma, v vy thng mang c tnh n ha, do mch ca T qu l mch Hon.

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4- Quan H Gia Mch V Lc Dm (Ngoi T)

Hn lm hi (thng) Thn v vy c mch Khn.

Th lm hi (thng) Tm v vy c mch H.

To lm hi (thng) Ph v vy c mch Sp.

Thp lm hi (thng) T v vy c mch Nhu.

Phong lm hi (thng) Can v vy c mch Ph.

Nhit lm hi (thng) Tm bo v vy c mch Nhc.

5- Mch V Tht Tnh (Ni Nhn)

H thng (lm hi) Tm gy nn mch H.

T thng T gy nn mch Kt.

u thng Ph gy nn mch Sp.

N thng Can gy nn mch Nhu.

Khng thng Thn gy nn mch Trm.

Kinh thng m gy nn mch ng.

Bi thng Tm bo gy nn mch Khn.

6- Mch V Nam N

- Sch 'Thin kim phng' ghi: "Mch ca ph n thng nhu nhc ( yu) hn mch ca nam gii".

- Sch 'Y hc nhp mn' ghi: "Xem mch 'Nam t N hu'. Xem mch, phi nam xem bn tay tri (lm chnh), phi n xem bn tay phi (lm chnh). Sch ' nh Ninh ti hc mch' gii thch ca cu ny nh sau: "Xem mch phi nam, mch tay tri (dng) mnh hn tay phi (m) l dng nhiu hn m l thun. Ngc li, mch tay phi m mnh hn tay tri l m nhiu hn dng khng thun, tc l ngi nam b m thnh dng suy. Xem mch ngi n, mch tay phi (m) mnh hn tay tri ( dng) l m nhiu hn dng l thun. Ngc li, nu mch tay tri mnh hn tay phi l dng nhiu hn m khng thun, tc l ngi n b dng thnh m suy. Nh vy, vic xem 'Nam t N hu' ch yu ch xem m dng thun hoc nghch i vi ngi ch khng nht thit phi theo ng quy cch trn.

iu ch yu trong cu 'Nam t n hu' l ch vo hai b xch ca c nam ln n.

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+ 'Nam d t xch nhi tng tinh' hoc 'Nam d t xch vi tinh ph' ( Nam tng tr tinh kh b xch bn tay tri). Xem mch ngi nam, nu b xch tay tri ha hon, c lc th bit rng ngi tinh kh sung mn, khe mnh. Nu b xch tay tri Trm, Vi v lc th khng khe...

+ 'N d hu xch nhi bo h' hoc 'N d hu xch vi huyt hi' ( N lin h vi bo thai v cha huyt b xch). Xem mch ngi n, nu b xch tay phi ha hon, c lc th bit rng t cung v huyt ca h tt. Nu b xch tay phi Trm, Vi v lc th khng khe.

H- PHN LOI MCH

C nhiu cch phn chia cc loi mch, ty quan im ca cc tc gi hoc cc trng phi. Trong ti liu ny, rng ng tham kho, chmg ti trnh by cc cch phn chia mch theo cc trng phi ln d nghin cu:

- Theo 'Ni kinh' (c coi l c nht): Sch 'Y nguyn' ghi: "Tinh xc ca php chn mch khng ai hn sch 'Ni kinh'. Ni kinh ly 8 mch PH, TRM, HON, CP, I, TIU, HOT, SC bin v biu, l, hn, nhit, h, thc, thun, nghch, (v) mi mch Ph l bnh dng, mi mch Trm l bnh m, mi mch Cp th phn nhiu hn, mi mch Hon th phn nhiu nhit. Mch i nhiu kh huyt, mch Tiu th kh huyt u t. Hot l dng kh thnh, Sc l m huyt b thiu. Tc l trong 8 mch phn ra lm 3 mc tng phn nhau(nh loi Ph, Trm, Hot, Sc), nhiu t ( nh loi hi Ph, Ph nhiu, hi Trm, Trm nhiu), huyn tuyt (nh loi thi qu n cp 3, cp 4 hoc bt cp ch 1 ch, 2 ch, mt hn... ) xt bnh tin thoi, thun nghch, sng cht, li khng tinh v gn hay sao?"

- Thin 'Bt mch yu ch vi cng" trong 'Cnh Nhc ton th' chia 28 mch ra lm 8 loi mch chnh l Ph, Trm, Tr, T, Sc, i, on, Trng cn 20 mch kia th quy np vo vi 8 mch chnh ny, gi l kim mch.

- Sch 'Lc mch cng lnh' ca Hot Th li ly 6 mch lm gc: Ph, Trm, Tr, Sc, Hot, Sp theo bng di y:

1- Nhm Mch PH gm 6 mch:

Trm m rt hu lc, nh vo da trng l mch CCH.

Ph m v lc, nh la ngm trong nc l mch NHU.

Ph, Trm hu lc, mch chc di tay l mch THC.

Ph, Trm u v lc, np di tay thoang thong l H.

Ph, Trm, i, gia rng ngoi chc nh ng l hnh l mch KHU.

2- Nhm Mch TRM gm 5 mch:

Trm m rt c lc, tay st xng mi thy l PHC.

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Trm, rt c lc, gia khong Trm v Ph l mch LAO.

Trm m khng c lc, tm k mi thy l mch NHC.

Mt hi th 4 ln l mch HON.

3- Nhm Mch SC gm 4 mch:

Mch Sc b quan, khng c u ui l mch NG.

Mch Sc, thng dng li ri li i tip l mch XC.

7 - 8 ln n l mch TT.

4- Nhm Mch TR gm 4 mch:

Khi Tr, khi Sc, dng li c s nht nh l mch I (i).

n khng u s, tay thy Ph m tn lon l TN.

Mch Hon m c khi ng li l mch KT.

5- Nhm Mch HOT gm 6 mch:

Nh tay vo dy n l mch HUYN.

i li nh xon dy l mch KHN.

Khng to khng nh nh vt cn cu di l mch TRNG.

n thnh i suy, n to i di l mch HNG.

Nh hnh ht u, ng tay vo xung ngay l mch ON.

6- Nhm Mch SP gm 3 mch:

Rt nh m mm, n tay vo mun tuyt l mch VI.

Nh mch Vi m r hn l mch T.

L S Ti trong thin 'T mch cng lnh' li ch quy v 4 mch chnh, gi l T i mch: Ph, Trm, Tr, Sc.

- L Hu Trc trong tp 'Y gia quan min' (Hi thng y tn tm lnh) li chia mch theo M DNG:

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+ Nhm Dng, c 7 mch: Ph, Hng, Hot, Thc, Huyn, Khn, Hng gi l Tht biu mch.

+ Nhm m, c 8 mch: Vi, Trm, Tr, Hon, Sc, Phc, Nhu v Nhc gi l Bt l mch.

Nhm cn li gi l Cu o mch (9 mch) gm: Trng, on, H, Kt, i (i), Xc, Tn, ng, T.

- Sch 'Tn bin Trung y hc khi yu' chia mch ra lm 6 loi gm:

+ Loi mch Ph (c 6 mch): Ph, Hng, Nhu, Tn, Khu, Cch.

+ Loi mch Trm (c 5 mch): Trm, Phc, Nhc, Lao, Huyn.

+ Loi mch Sc (4 mch): Sc, Xc, Tt, ng.

+ Loi mch Tr (4 mch): Tr, Hon, Sp, Kt.

+ Loi mch H (5 mch): H, T, Vi, i (i), on.

+ Loi mch Thc (4 mch): Thc, Hot, Khn, Trng.

BNG PHN LOI TNH CHT MCH YHCT

(Theo sch 'Tn bin Trung y hc khi yu')

Hnh Thc Tnh Cht Loi Mch Ngha Cch Phn Bit

V v tr nng su.

Sng mch ni ln trn hoc chm.

Ph

Trm

phn bit bnh biu

hoc l.

n kh, va, mnh mi thy.

V cng p.

Xem chn ng mch mnh, yu.

H

Thc

nhn ra s thnh suy

ca t v chnh kh.

Mch p c lc hoc khng c

lc.

V tc mch p.

Tn s mch

nhanh hoc chm.

Tr

Sc

nhn ra chng hn hoc nhit.

Phn bit theo hi th thy

thuc hoc ng h.

V nhp p.

Mch p u hay khng.

Kt

Xc

i (i)

nhn ra kh c lu

thng hoc khng.

Theo mc p u hoc khng

u.

V th tch mch.

Sng mch ln hay

nh.

Hng (i)

T (Tiu)

nhn ra kh huyt suy hoc

Theo th to hoc nh ca mch.

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thnh.

V hnh thi sng

mch.

a- p lu lot,

sng mch r, u.

Hot

Sp

nhn ra tng trng thi bnh l

ca tng ph kh

huyt , m tr.

Qua cm gic v

tng hnh th ca cc sng mch.

b- di, yu.

c- cng, cng.

Trng, on,

Huyn, Khn,

Tn.

MCH V HIN I HO VIC CHN MCH

i vi YHCT, thng thy thuc tay vo cc b v quy nh xem mch, t , da vo kinh nghim, kin thc ca thy thuc xc nh ra cc loi mch v cc tng ph lin h cng nh bnh l tng ng, y l iu m khng phi thy thuc no cng c th lm c mt cch chnh xc v ng tin. V vy, lm cch no c th ghi nhn li cc biu tng ca mch d theo di v c tnh hin i, chnh xc hn, l iu m cc nh nghin cu mch v ang ch tm.

Trong ngnh tim mch, ghi li hot ng ca tim mch, ngi ta c cc thit b in tm , tm thanh , tnh mch , ng mch Qua phng php ghi ng mch , c th thu c hnh nh ca cc loi mch YHCT gip cho vic nhn nh, phn bit mch YHCT thm d dng v r rng hn.

Ti Trung quc, ghi hnh thi mch YHCT, cc thy thuc thng dng my ng mch k (sphygmograph), Php c loi my nh ng mch loi k (photo-sphymographe lectronique) t sng ch ly.

Ti Vit Nam, ri rc c nhiu thy thuc t my m dng Osiloscope, mt loi dng ghi sng ca cc my xung in, t dng vo vic kim tra sng ca mch, tuy nhin loi sng ny khng mnh i vi sng in ni con ngi, do hiu qu khng cao. Mi n nm 1980, nhm ca bc s L Nguyn Khnh, ln u tin dng my in tm thanh c ng k (electro phono cardio mecanograph (c trang b phng thm d huyt ng ca bnh vin Bch Mai - H Ni) ghi li ng biu din ca mch hc YHCT. y l loi my c th ghi c hnh th loi mch bt c c tay ngi bnh ti v tr mch tay quay (ni cc thy thuc bt mch), ng thi ghi thm c c ng mch cnh , in tm v in thanh ca bnh nhn trn mt bng giy cng mt lc.

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T th k 17, Vng K trong sch 'Tam ti hi', c l da vo s cm nhn c th ha 15 loi mch bng hnh v n gin, nhng c th coi l bc u cc thy thuc ch n hnh nh biu hin ca mch. Ti Trung quc, t nm 1970 cc nh nghin cu v mch tp trung nghin cu v ghi li hnh nh biu th ca tt c cc loi mch kinh in bng cc thit b tng i hin i vo lc . Tuy nhin, bo m cng vic c thun li v chnh xc, trc khi ghi li hnh nh ca mch, cc nh nghin cu mi nhng lo y c kinh nghim cao v bt mch hi chn v nht tr a ra kt lun v tn mch trc, sau mi dng my ghi ng mch (sphygmograph) ti ng mch quay ca bnh nhn ghi li thnh ng cong biu din ca loi mch . y l mt cng vic c ngha ht sc to ln trong vic h thng ho, hin i ho vic ghi li cc ng biu din ca mch YHCT, to bc ngoc cho vic nghin cu v hin i ho mch YHCT.

Cui th k 20, chng ta chng kin bc nhy vt kh tng tng c ca ngnh cng ngh thng tin vi nhng thit b 'siu x l', chc chn s c nhiu bc tin trong vic nghin cu v hnh nh biu th ca sng mch YHCT.

Mt s hnh nh biu th mch ca Trung quc (trch trong 'Trung Quc Mch Chn Hc' Nxb Thin Tn, nm 2001).

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HUYT NG CA NG CONG NG MCH CNH V NG MCH QUAY

ng mch cnh v ng cong biu din ng mch quay l hnh nh ca lung sng mch pht ra t tht tri v ng mch ch truyn ln n ng mch cnh v ra n ng mch quay. Trong hnh v ca mt sng mch, im C l ch ng cong ng mch bt u un vt ln, nh du lc sng mch khi u s phun mu ca tht tri truyn ln n ng mch cnh v ra n ng mch quay.

Ni ngi bnh thng, thi gian trung bnh t ting tim th nht (ng van 2 l) cho n khi sng mch n c im C ng mch cnh l 80m giy (0.080 giy) v thi gian trung bnh t im C ng mch cnh n im C ng cong ng mch quay l 80m giy (thi gian trung bnh t ch ng cong ng mch ch bt u un vt ln cho n khi sng mch n c im C ng mch cnh l 30m giy). V vy, trong hnh v mi thy c hin tng x dch mt t gia cc ng cong biu din ca ng mch quay v ng mch cnh c ghi ng thi vi in tm v tm thanh .

Sng mch truyn t ng mch ch ln cho n cc ng mch ngi bin c nhng thay i hi khc nhau tng ni, v vy hnh dng ng mch cnh c hi khc hnh dng ca ng biu din ng mch quay mt t.

ng cong biu din ng mch no cng gm c 2 nhnh : Nhnh anacrot t chn mch i ln n nh mch v nhnh catacrot t nh mch r xung chn mch.

Nhnh anacrot : T im C, sng mch un vt ln nhanh v nh, n im D l im cao nht ca sng mch tnh t chn mch, hnh thnh nhnh ancacrot. Sng mch truyn ra ngoi bin cng xa bao nhiu th nhnh ancarrot cng dc. V vy, trong hnh v, nhnh ancarot ng mch quay dc hn nhnh ancarot ng mch cnh.

nh mch : L im cao nht ca ng mch cnh hoc ca ng cong biu din ng mch quay. Hnh nh nh mch c th khc nhau (nhn hoc trn hoc i hi ngang theo hnh cao nguyn v.v) tu tng dng sng mch.

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Nhnh catarot : T nh (thuc thi gian tng mu tm thu), sng mch r xung t dc hn nhnh ancarot n tn im C ca chn mch, hnh thnh nhnh catarot. Nhnh catacrot trn ng r xung b lm vo thnh mt ci mc gi l mc dicrot, ni b lm vo thng r nt nhng cng c khi rt t r nt, nh du vo chnh lc van ng mch ch khp li, kt thc phun mu.

Tip ngay mc dicrot l sng di dicrot, ch yu to bi cc lung sng di li t ngoi bin ngay sau lc van ng mch ch khp li. Sng di dicrot c th nh ln cao nhiu hoc t tu tng dng sng.

Chn mch : L ng ngang ni lin im bt u i ln ca nhnh anacrot n im tn cng i xung ca nhnh catacrot.

Nu in tm , tm thanh c ghi ng thi vi ng mch cnh v ng biu din ng mch quay th c th ghi c ton thi gian tm thu in c hc. Trong hnh v, ton thi gian tm thu in c hc l qung QT2. bt u t khi im ca kh cc tht, tc l sng Q ca in tm (hoc sng R nu khng c sng Q) cho n mc kt thc ting tim th hai (T2).

Ton thi gian tm thu in c hc gm c 2 thi gian tip theo nhau : Thi gian tin tng mu v thi gian tng mu.

Thi gian tin tng mu l giai on u ca thi k tm thu : lc tm tht co nhng van t chim cha m, mu cha phun ra, th tch tht tri cha thay i. Trong hnh v, thi gian tin tng mu l hiu s ca qung QT2 tr i qung CI' (QT2 - CI').

Thi gian tin tng mu phn nh s co bp ca tht tri.

Thi gian tng mu : L giai on th hai ca thi k tm thu, bt u t lc mu phun ra khi tht tri cho n khi ht phun. Trong hnh v, trn ng mch cnh v trn ng biu din ca ng mch quay, l qung CI'.

Thi gian tng mu t l nghch vi tn s tim v t l thun vi th tch mu c tng ra, v vy, mun cho n c gi tr chn on, phi sa theo tn s tim bng cch o ly tr s tuyt i qung CI' v qung RR lin trc n (tc l thi gian chu chuyn tim trc ri tnh theo cng thc Wood :

Thi gian tng mu sa:

c gi tr chn on mc chnh xc cao, ngi ta thng tnh thi gian tin tng mu QT2 - CI' v thi gian tng mu tm thu CI' 5 - 6 nht bp tim lin tip ri ly trung bnh cng v cho bng giy ghi chy vi tc tht nhanh.

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Sng p v Sng Tro : Trn ng biu din ng mch quay v ng mch cnh thuc qung CI' ca thi gian tng mu, thng xut hin 2 sng chnh m nh ca sng ny c th cao hn nh ca sng kia. Sng u tin c gi l sng p, sng th hai c gi l sng tro. Gia 2 nh ca sng p v sng tro, mch c th i ln hoc i xung hoc i hi ngang theo hnh nh cao nguyn.

Thi gian nh l thi gian ln ht ca nhnh ancarot, tc thi gian sng mch t im C chn mch un vt ln, t n nh cao nht ti sng p hoc sng tro. Trong hnh v,

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thi gian nh l qung C ng mch cnh cng nh ng biu din ng mch quay.

C nhiu trng hp do thi gian ln ht ca nhnh ancarot rt kh chnh xc, th d nh nhng ngi bnh thng c nh cong qu nhiu hoc nhng ngi hp ng mch ch c ng cong dng mo g hoc trng hp gia 2 nh sng p v sng tro, mch i ngang theo hnh cao nguyn V vy, thng dng thi gian na nh chnh xc hn thi gian nh.

Thi gian na nh l thi gian ln na chng ca nhnh anacrot, tc thi gian sng mch t im C chn mch un vt ln t n na chiu cao ton b ca ng mch cnh hoc ca ng biu din ng mch quay. Trong hnh v, thi gian na nh l qung CN.

Thng s huyt ng l t s % gia thi gian tng mu v thi gian tin tng mu

TSH = TGTM TGTTM

Qua thng s huyt ng b gim nhiu hoc t, c th nh gi c mc suy tim nh hoc nng, ch yu v mc suy tht tri.

Trng hp thng s huyt ng tng cao nh trong trng hp cng tuyn gip, do TGTM tng cao m TSH tng cao, cng l bnh l v mt huyt ng.

PHNG PHP GHI MCH YHCT QUA MY IN TM THANH C NG K CA VIT NAM.

Ti Vit Nam, nhm nghin cu ca bc s L Nguyn Khnh, nghin cu p dng my in tm thanh c ng k ghi li mt s mch chnh thng gp ca YHCT phc v cng tc nghin cu hin i ho mch YHCT. Nhng cng trnh ny c gii thiu trong quyn sch 'Kt hp Y hc dn tc vi Y hc hin i trong lm sng' (Nxb Y hc 1982).

Dng c dng kho st l my in tm thanh c ng k Mingograf ca hng Elema - Schonander (Thu in), t ti phng thm d huyt ng ca bnh vin Bch Mai.

ng biu din ng mch quay c ghi ng thi vi ng mch cnh , in tm v tm thanh .

u d tm thanh t ti lin sn III bn tri v ghi cc di tn s theo chng trnh ca my, t thp, trung bnh n cao, ghi song song vi in tm o trnh ngoi bin D2.

u d ng mch quay t ti v tr quy nh bt mch YHCT ti c tay. u d ng mch cnh t ti v tr YHH thng t, c, ti b sn gip.

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Hai u d ng mch quay v ng mch cnh bng cht p in titanat baryum, chuyn cc xung ng ca ng mch cnh v ng mch quay qua my. Cc xung ng c kim phun mc Mingograf ghi thnh ng cong ng mch trn giy Minograf vi tc thng nht l 50mm/giy v khuych i thng nht l 1 milivolt cho tt c 123 bn ng mch . Hnh nh ng mch quay v ng mch cnh u c ghi bn tri c th. Cc ng cong ng mch v tm thanh , in tm u c theo di trn mn in sng v ch c ghi ln giy khi c dng thch hp.

Xem chi tit cc dng mch tng loi mch.

Sau mt thi gian nghin cu vic ghi li mch qua my, cc nh nghin cu a ra nhn nh nh sau:

+ Cch chung, mt loi mch YHCT c th gp nhiu bnh khc nhau, ngay c ni c th bnh thng, kho mnh.

+ Nhng lin quan v hnh nh in tim, ting tim ghi, ng thi vi ng cong ng mch cnh v ng mch quay ni ln sc co bp mnh hay yu, u hay khng u ca tim, ni ln trng lc tng hoc gim ca mch lm nh hng trc tip n s thay i hnh thi mch YHCT, m nhng s thay i hoc do bnh ca tim gy ra hoc do bnh ca ton thn tc ng n tim mch gy ra. Ngoi ra, yu t thn kinh tm l hoc yu t thi tit ngoi lai cng c th lm thay i hnh thi mch YHCT.

Da vo nhng kho st ca biu mch c th nhn thy rng khng th ch c bt mch m c th chn on ra mt bnh no tht chi tit c th nh nhiu ngi t trc n nay vn nhn nh. Mt loi mch YHCT khng c trng cho mt bnh ring bit no c. Mch ch l mt biu hin, phi kt hp vi rt nhiu biu hin khc ca ton thn mi c th cho bit c chng no thuc trng thi bnh thng hoc bnh l.

S phn bit c mt cch khch quan c th mt s loi mch YHCT thng gp qua cc nhn nh sau y trn mt dng cong ng mch:

+ S thay i v thi gian nh v thi gian nh.

+ S thay i v t l gia chiu cao nh mch vi chiu cao mc dicrot v vi chiu cao sng dicrot.

+ S thay i v hnh thi sng p v sng tro.

+ S thay i v khong cch RR gia hai nht bp tim di hay ngn.

+ S thay i v cc khong gia RR nhiu nht bp tim lin tip u hay khng u.

ng mch gip thy r c tng nt ca loi mch YHCT hn l bt mch, nht l i vi nhng ngi cha c nhiu kinh nghim v bt mch. Nu c c bng ghi ng mch sau khi bt mch vn c li v nm c hnh thi mch qua xc gic ca u ngn tay ca thy thuc vn c nhng kh khn nht nh trong nhng loi mch cng chung mt gc.

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Hn na, vic nhn nh hnh thi mch YHCT qua bt mch kh lng khch quan c bng vic nhn nh qua ng mch , v trong lc bt mch, khng th no loi tr c yu t ch quan ca thy thuc.

Mt s mch c ghi bng my ca nhm nghin cu Vit Nam (xem thm m t chi tit tng mch):

Mch Hng

Mch Hot

Mch Huyn Mch Ph

MCH Y HC C TRUYN

D trong cc sch kinh in nu ln 27 - 28 mch, nhng kinh nghim thc tin khm bnh lm sng a s cc thy thuc cho bit rng trong tng s 28 loi Mch ngi xa truyn li, c mt s mch k ra rt t gp. V vy cc sch ph bin v ng y hin nay Trung quc nh 'Trung y hc c s', 'Tn bin Trung y hc khi yu', 'Trung y bin chng lun tr ging ngha' lc b bt mt s mch t gp, ch nhc n khong 15 - 18 loi mch thng gp.

Tuy nhin, phc v cng tc nghin cu, chng ti s gii thiu y cc mch (28 mch) vi nhng chi tit tng i k v su v tng loi mch.

Nhng mch no c th c c cc hnh v, hnh ghi bng my, chng ti cng s gi thiu c th c ci nhn hin i hn v mch l ca ng y.

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MCH CCH

( - Leather Poulse - Pouls Separe Void - Tight Pulse )

A- i cng

- Chng 'Bnh mch php'(Thng hn lun) v chng 'Huyt t h lao bnh mch chng tnh tr' (Kim qu yu lc) ghi: "Mch Huyn m i. Huyn tc l gim, i tc l Khu. Gim tc l hn, Khu l h. H hn tng bc gi l mch Cch".

- Sch 'Tam nhn phng' ghi: "Cch l y, l cp".

- "Cch l da thuc, ni tng mch c kt khng di ng".

B- Hnh tng mch Cch

- Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch Cch n cun cun nh sui chy".

- Chng 'Mch hnh trng ch h b quyt' (Mch kinh) ghi: "Mch Cch ging nh Trm, Phc, Thc, i m Trng, hi Huyn".

- Sch 'Tn H mch hc' ghi: "T Xun Ph ni rng Cch l da thuc, l Ph, Huyn, i, H, nh n tay ln da trng".

- Chng 'Chnh mch ton th' (C kim y thng) ghi : "Mch Cch l da thuc, l Ph, Huyn, i, H, nh n tay ln da trng, trong h, ngoi cp".

- Sch 'Trung y hc khi lun' ghi: "Mch Cch... ln m Huyn, Cp, t nh tay thy ngay, n xung th khng thy, nh n tay vo da trng, ngoi cng trong rng".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch Cch i ni m dn vo tay, trong rng ngoi cng, nh ln mt trng".

- Sch 'The web that has no weaver' ghi: "Mch Cch l s kt hp gia mch Huyn v Ph, c hnh dng nh mch rng, ging nh da trng".

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HNH V BIU DIN MCH CCH

Sch 'Mch chn' ghi li Hnh v biu th mch Cch:

C- Nguyn Nhn Pht Sinh Mch Cch

- Sch 'Trung y chn on hc ging ngha' gii thch: "Mch Cch... do kh h khng kin c, tinh huyt khng tng c, lm cho kh khng c ch da m ph vit ra ngoi".

- Sch 'Trung y chn on hc' ghi : "Mch Cch l s tng hp gia mch Huyn v Khng, do tinh huyt bn trong b h, kh khng gi c m ph vit ra ngoi ".

D- Mch Cch ch bnh

- Chng 'Huyt t h lao' (Kim qu yu lc) ghi: "Mch cch... n b th xy thai, n ng th mt tinh, mt huyt, n b th non, rong huyt, bng huyt".

THN QUAN XCH Chn gia chnh nhn

. Tm huyt h thng (Tri).

. Kim suy, kh ng (Phi).

. Sn h (Tri).

. Bn trn h, au.

Tinh long (Tri).

. Sinh non, lu h (Phi)

Mch quyt hi bin

. Tm huyt h thng (Tri).

. Kim suy, kh ng (Phi).

. Sn h (Tri).

. Bn trn h, au.

Tinh long (Tri).

. Sinh non, lu h (Phi)

Mch quyt khi ngn ch thch

. Tm huyt h thng (Tri).

. Kim suy, kh ng (Phi).

. Sn h (Tri).

. Th h, mc ng (Phi).

Tinh long (Tri).

. Sinh non, lu h (Phi)

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Mch hc xin vi

. Ngc bt rt, hi th ngn, hi hp, au tht ngc, tm phin (Tri).

. Ho, kh th, kh ngn khng , m nhiu (Phi).

Hng sn bn phi trng au, tm phin, khng mun n ung (Tri).

. Bng trng y, n t, tiu ho tr tr, d dy au (Phi).

. Lng au, di tinh, to tinh, tit tinh, mt ng, tiu nhiu, hay qun (Tri).

. Bng trng, mt mi, bng lu, sinh non, lng au (Phi).

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch Cch... mt mu, mt tinh, non, bng huyt, rong huyt".

-Sch 'Mch hc ging ngha' ghi: "Mch cch ch biu hn, trung h, xy thai, lu h, n ng th mt tinh, huyt".

T Thn CCH

Tm h, au.

Hu Thn CCH

Ph h, kh ng tr.

T Quan CCH

Sn H.

Hu Quan CCH

T h, d dy au.

T Xch CCH

Di tinh.

Hu Xch CCH

Xy thai, lu h.

E - Mch Cch kim mch bnh

- Sch 'Mch hc ging ngha' ghi : Cch m ph cng l biu t cc thnh. Cch m Hon, khng c thn l m kh tiu tan, kh cha.

F- Mch Cch v cc li bn

- Sch 'Chn gia chnh nhn' ghi: "Mch Cch hnh tng nh da thuc, l biu t c tha m trong th khng , ging nh da trng, ngoi th cng cht, trong th rng h n nh tay thy Huyn i, trong th kh huyt suy yu, v vy tng mch rng nh vy".

- Chng 'Bin mch hnh cp bin ha s ch bnh chng php' ( Ton sinh ch m) ghi: "Tng mch Cch n cun cun nh sui chy l ni mch i m khng tr li, l m kh cch dng cng l mch Dt, v vy mch kh i t b Xch ra, ln n Ng t, cng gi l ly kinh, l khng c cn bn vy".

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- Sch 'Tn H mch hc' ghi: "Cc sch vit v mch u cho mch Cch l mch Lao, v vy, h ghi l mch Lao th khng ghi mch Cch hoc c mch Lao th khng ghi mch Cch, ln ln khng phn bit. l v chng bit rng mch Cch th Ph, mch Lao th Trm, mch Cch th H, mch Lao th Thc, hnh chng u khc nhau vy".

- Sch 'Mch hc ging ngha' ghi: "Xt cc li trch dn v mch Cch trong sch 'Kim qy yu lc' v sch 'Tam nhn phng' th bit l khc phn biu Thc, l L H t thy mch Cch".

- Sch 'Hong hn y hc' ghi: "Xt rng c Trng Cnh ni: "Mch Huyn m i. Huyn c ngha l st km, i c ngha l rng gia, st km th l hn, rng gia l h. H vi hn xung t nhau, gi l mch Cch. n b c chng tiu sn, rong huyt, n ng th mt tinh, mt mu. Xem th th nhng iu lm ca ng L Thi Trn v cc y gia r lm, khng cn nghi ng g na".

Bi ca mch CCH (Trung y chn on hc ging ngha)

Mch tng: Cch nh da trng thng cng,

Ch bnh : Khu Huyn hp tng, mch rng hn h.

N bng lu non ?,

Nam th di mng dinh h chng lm.

Tng loi: Cch kim khn hng ph ln,

Cch h lao thc phi nn r rng.

Cch l khu li i huyn,

Khu ch tht huyt, Cch bn huyt h.

Bi ca mch CCH (Chn gia chnh nhn)

Mch tng: Mch Cch ta cng phi hay,

Mch i ph i v nay cp huyn.

Nh da mt trng s lu,

Nh th thy mch, n lin mt ngay.

Ch bnh: Mch Cch ch bnh s bn,

Hoc ch biu hn hoc thuc trung h.

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T thn au tm huyt suy,

Hu thn kh ng Ph suy m.

T quan Cch ch bn, l,

Hu quan au bng thc l T h.

T xch tinh kit khng ng,

Hu xch mch Cch n gi t vong.

N nhn mch Cch bo cng,

non, rong huyt, quyt khng cn ng.

MCH I

( - Huge (Big) Pulse - Pouls Grand )

A- i cng

- i l to ln.

- Trong sch 'Ni kinh T Vn' c n 7 thin nhc n mch i nhng trong sch Mch kinh li t ghi v mch i.

B- Hnh tng mch i

- Chng 'S truyn tam thp nh tc' (Chn tng tam mui) ghi : "Mch i trn y, ng di ngn tay ln bnh thng".

- Sch 'Trung y chn on hc' ghi :"Mch i, rng v to khc thng, ch khng cun cun nh mch Hng m thi".

- Sch 'ng y lc kho' ghi : "Mch i... tay thy nh trn y nhng n tay li thy mch i khng c sc".

- Sch 'nh Ninh ti hc mch' ghi : "Mch i... sc mnh i ph n th nh nc ni ln trn y di ngn tay m trm n th li lan rng ra m mm yu i, tc l ph n th hu lc cn trm n th v lc".

HNH V BIU DIN MCH I

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- Sch 'Mch chn' biu din hnh v mch i:

( So snh vi mch Vi)

C- Mch i ch bnh

- Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch i l bnh nng thm. Tng mch th, i l m khng , dng c d, s gy nn chng nng (nhit) trung tiu".

- Thin 'Ngc c chn tng lun' (T vn 19) ghi: "Tiu chy m mch i... kh cha".

- Thin 'Bnh nng lun' (T vn 46) ghi: "Ph kh thnh th mch i, mch i th khng th nm nga".

- Thin 'i k lun' (T vn 48) ghi: "Mch Tm y, i s pht ra chng gin khit, gn co qup".

- Chng 'Bin mch php' (Thng hn lun) ghi: "Cc mch i, Ph, Sc, ng, Hot, gi l cc mch Dng, bnh m thy mch dng th sng".

- Chng 'Tr tt on trng tp mch' (Mch kinh) ghi: "Mch i l huyt v kh u thnh. Mch thy i m cng l huyt kh u thc".

- Chng 'Bin tam b cu hu mch chng' (Mch kinh) ghi: "Mch b quan Ph m i l phong V, gy ra h ming, so vai m th, v qun kh chu, n vo th mun nn".

- Chng 'Chm o ngoi su tng x' (Gip t) ghi: "Mch m i l au t".

- Chng 'Tc yu hnh chn bnh hu lai thng bt lai thng i lun' ( Gip t) ghi: "Hnh th sung mn m thy mch i cng l thun".

- Sch 'ng y lc kho' ghi: "Mch i ch t kh thnh, chnh kh suy. Bnh thy mch i l bnh sp pht nng. Bnh mi b m thy i l thuc thc, bnh lu ngy thy mch i thuc H".

- Sch 'Mch hc ging ngha' ghi: "Mch i ch t nhit cm nng, thp nhit, tch kh, ho suyn, trng tit, kh a nghch ln lm mt b ph, h lao ni thng".

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T Thn I

Tm phin, phong nhit, kinh s.

Hu Thn I

Kh nghch, mt ph, ho suyn.

T Quan I

Sn kh, phong huyn.

Hu Quan I

Tch kh, v thc, bng y.

T Xch I

Thn t.

Hu Xch I

Tiu , to bn.

B- Mch i kim mch bnh

- Thin 'Ng tng sinh thnh lun' (T vn 10) ghi: "Mch T hin n th mch i m h l trong bng c tch kh, nu c quyt kh th gi l quyt sn. Nam n cng mt chng trng nh nhau, do chn tay ang ra m hi m gp gi. Mch thn hin n th trn cng m i, l c tch kh vng gia bng di vi tin m, gi l chng thn t, b chng ny l do tm gi nc lnh xong m i nm ngay".

- Thin 'Bnh nhn kh tng lun' (T vn 18) ghi: "Mch Thi dng n th Hng, i m Trng... Mch Dng minh n th Ph, i m on".

- Thin 'Ngc c chn tng lun' (T vn 19) ghi; "Mch chn tng ca Ph hin ra th i m H, nh cm lng chim pht vo da, sc mt trng , khng bng, lng tc rng th cht".

- Thin 'Tam b cu hu lun' (T vn 20) ghi: "Thn hnh gy, mch i trong ngc hi nghn th cht m ra ln m v mu l th no? K B p: "Mch Tuyt th cht, mch Hot i th sng". Cn chng trng tit m c th khng nng, mch khng tuyt th sao? K B p: "Nu mch Hot i th sng, mch Sp th cht. Nn theo tng tng bit ngy cht". Bnh bin th nh th no? K B p: "Tng mch thy i m Hot th lu ngy cng khi". Chng tiu th h thc th no? K B p: "Tng mch thc m i th bnh d lu ngy cng cha c".

- Thin 'i k lun' (T vn 48) ghi; "Mch ca Thn i m Cp, Trm, mch ca Can i, Cp m Trm u l chng sn".

- Thin 'iu kinh lun' (T vn 62) ghi: "m thnh sinh ni hn l th no? K B p: "Quyt kh nghch ln, hn kh tch trong ngc m khng t ra c th n kh s tiu i m ch cn c hn kh, huyt do m ngng ng li. Ngng ng li th mch khng thng, lm cho tng mch thnh, i m Sc, cho nn lnh trong".

- Nan th 7 (Nan kinh) ghi: "Kinh vn c ghi: 'Mch ca Thiu dng n th Ph, i, khi Tiu khi on, khi Trng. Mch ca Dng minh n th Ph, i m on. Mch Thi dng n th Hng, i m Trng. Mch Thi m n th Khn, i m Trng".

- Chng 'Bin mch php' (Thng hn lun) ghi: "Mch Huyn m i. Huyn tc l gim, i tc l Hng. Gim l hn, Hng l h. Hn v H tng bc gi l Cch. n b gp

39

mch ny th lu h, xy thai, n ng th vong huyt, tht (mt) tinh. Mch thn khu Ph, i... Ph l v huyt, i l hn, hn kh tng bc gy ra bng si".

- Chng 'Bnh mch php' (Thng hn lun) ghi: "Mch thn khu Ph m i. Ph l h, i l thc, (mch ny) thy b thn l chng "Cch", thy b xch l chng 'Quan'. Quan th khng tiu c, Cch th i ngc".

- Chng 'Thng hn l' (Thng hn lun) ghi: "Phm bnh huyt m thy mch ng Sc, sau khi ung thuc mch li Tr, mch Ph, i gim thnh Tiu, trc ang ng sau li yn tnh th l triu chng sp khi. Ni xm, c th nng mch Ph, i, chn tay m th sng. Nu lnh nghch th thy mch Trm, T, khng qu 1 ngy th cht".

- Chng 'Tr tt on trng tp mch' (Mch kinh) ghi: "Mch Hng, i, khn cp l bnh ang tin nhanh bn ngoi, u au, pht st, nht sng. Mch b thn i m b xch li Tiu l u au, mt hoa. Mch b thn Tiu m b xch li i l ngc y, ht hi".

- Chng 'Bnh tam quan bnh hu tnh tr nghi' (Mch kinh) ghi: "Mch thn khu Hng i th ngc sn y tc".

- Chng 'Bnh tp bnh mch' (Mch kinh) ghi: "Mch i, Ph, Hng, Trng l chng phong huyn, in tt".

- Chng 'Bin Thc m dng mch php' (Mch kinh) ghi: "Mch ca Thi dng th Hng, i m Trng. Mch ca Thiu dng th khi on khi Trng, khi i khi Tiu, mch ca Dng minh th Hng, i m Ph".

- Chng 'Kinh mch - Phn thng' (Gip t) ghi: "Mch kh nhn nghinh i, Khn m Ph l bnh nng thm, bn ngoi... bnh tng, thy mch Trm, i th d cha. Nu b thn thy mch Tiu l nghch. Bnh ph, thy mch Ph m i th d khi... thy mch Hot, i m li i, Trng l bnh t bn ngoi xm nhp vo".

- Sch 'Mch hc ging ngha' ghi:

Mch i m Ph l h hoc biu b nhit.

Mch i m Trm l phn l b nhit, bnh Thn.

Mch i m Huyn l nng lnh.

Mch i m Nhu l h nhit.

Mch i m Hon l thp nhit.

Mch i m Hng l V b thc.

Mch i m Thc l c tch kh.

40

E - Mch i v tr liu

- Chng 'Bin thi dng bnh mch chng tnh tr' (Thng hn lun) ghi: "Sau khi ung bi 'Qu chi thang' ( Qu chi, Bch thc, Cam tho, Sinh khng, i to), m hi ra nhiu ri m phin kht vn khng gim, mch Hng, i th cho ung bi 'Bch h thang' (Thch cao, Tri mu, Ngnh m) thm Nhn sm. - Chng kt hung, thy mch Ph, i th khng th dng php h cha c".

- Chng 'Ph nuy, Ph ung bnh mch chng tnh tr' (Kim qu yu lc) ghi: "Ho m hi a ngc ln l chng ph trng, mt nh li ra, mch Ph i, cho ung bi 'Vit t gia bn h thang' ( Ma hong, Thch cao, Cam tho, Sinh khng, To, Bn h)".

- Chng 'Phc mn hn sn bnh mch chng tnh tr' ( Kim qu yu lc) ghi: "Mch thn khu Ph m i, n tay xung li thy Sp, b xch th Vi m Sp, bit l chng n khng tiu, cho ung bi 'i tha kh thang' ( i hong, Ch thc, Hu phc, Mang tiu)".

G - Mch i qua cc li bn

- Chng 'S truyn tam thp nh tc' (Chn tng tam mui) ghi: "... Phm mch i m Sc thnh c lc u l thc nhit. Nh mch nhn nghinh, kh khu thy i, Khn m Ph l bnh nng thm, bn ngoi. Mch kh khu hi i l ngi bnh thng. Mch i cng m Sp l bnh trng. Mch i thy ph n cho con b l s b trng phong nhit. Ngi bnh suyn, so vai m th, nu thy mch Thc, i m Hon th sng, thy mch Cp th cht. Sau khi sinh, mch nn thy Tiu, rt k Thc, i, Trng hp thy suyn so vai m th l t kh bo ngc th li cn thy mch Thc i m Hon th mi hp vi chng bnh... Nu Thc, i cp l t thng, chnh suy. Thng hn nhit bnh m thy ni xm, phin kht, mch Thc i, tuy bnh nng vn d cha. Sau khi ra m hi m nng khng bt, mch li to, Tt, Thc, i th cht. n bnh m st cao, khng ra m hi c, mch li Sc, Cp, i l cht. Nu thy T, Tiu, H, Sp cng cht. Quyt m bnh m kit l, mch i l h. Thy m chng m li st cao, mch H, i, v lc l bin chng. Nguyn kh khng m pht nng, mch i m H l thng. Chng h lao m mch i l huyt h kh thnh. Sch 'Kim qy' c ghi: "n ng bnh thng m thy c mch i l h lao", kh c tha tc l ha vy. V vy ngi bnh trong ngc hi b mch i hoc l bnh lu ngy, kh suy, mch i u l triu chng ca m dng ly tuyt"... Mch i trn y, ng di ngn tay ln hn bnh thng, khng ging nh mch Trng ch di m khng ln, mch Hng th li va ln m va Sc".

- Sch 'Mch hc ging ngha' ch gii li ghi ca sch ' Chn tng tam mui' v mch i nh sau: "Mch i l ni hnh th mch nh, ln, ln hn mch Tiu. Nu ni l 'Trn y ng di ngn tay' th cha chc ng ".

- Sch 'nh Ninh ti hc mch' ghi: "Mch i ch bnh ang pht nng - v kh huyt suy khng sc ch ng t kh, t kh mnh hn kh huyt th bnh pht nng".

41

H- Cc Y n Mch i

Y n Mch Bn Tri I

( Trch trong 'Ni khoa hc' ca Vin Trung y Thng Hi)

"Vng XX. Sau khi b th huyt, m phn cha phc hi vi lm vic mt nhc, dng kh bc ln lm hoa mt, chng mt, tay chn t di, hi hp khng yn, ang ng c cn nng t ngt, m hi t ra,mch bn tri i".

iu tr: Dng huyt, khu phong, dc m, tim dng.

Cho dng: Sinh a 16g, A giao (chu) 12g, N trinh t 12g, Mit Gip 20g, Cu ng 12g, Bch thc (sng) 8g, Mu l 201g, Cc hoa 6g, n b 6g, H th ( ch) 12g.

Khm ln 2: Hi chng mt hoa mt, ng vn git mnh, pht st, ra m hi, hi hp, ng km. y l du hiu mt huyt, phn m b tn thng, mt nhc lm cho dng kh b ng, dng kh cha thu v.

Cch cha: Lim m, tim dng.

Cho dng: Quy bn 20g, Sinh a 16g, N trinh t 12g, Mit gip (sng) 20g, Tiu mch 20g, Mu l 20g, Bch thc (sng) 12g, V u en 12g, Toan To nhn ( sao ) 8g, Thanh cao 12g.

Khm ln 3: Ht hoa mt chng mt, ng yn, m hi ngng ra, n kh hn, dng kh hi phc dn, mi tnh trng phc tp g c gn ht. Tip tc iu tr theo hng c, bnh khi".

Y n Mch I, Huyn, Sc

(Trch trong 'Lm chng y n bt k')

"Kinh Kha Tra Tiu Sn c ngi con gi ln b b kinh lu, gn y pht sinh ra chng nng m trong xng (ct chng), n t, dng nhiu thuc nhng khng bt. Ti ni rng: "Mch, i, Huyn, Sc l do m h, huyt kh ro, ha bo lc thnh ln v ung nhiu thuc dng v n b qu lm cho ha bng ln, thy b kit, chn m b t chy v vy huyt b kh m gy ra b kinh". Dng bi 'Thanh ct tn' (Si h, Sinh a, Nhn sm, Phng phong, Thc a, Tn cu, Xch Phc linh, Hong lin, Bc h (l ), trc ht l thanh

42

c, lm cho xng ht lao nhit, sau mi dng php hot huyt iu kinh. Ung lin tc 10 thang thy c kt qu lin cho dng bi 'Bt v tiu dao tn' ( ng quy, Xuyn khung, Thc dc, Thc a, Sinh a, an sm, Huyn h, n b, Hng ph, Trn b, Bch trut, Sa nhn, Hng lam hoa ) v bi 'Trch lan thang' (Trch lan, ng quy, Thc dc, Chch tho). Mi ngy theo chng m i phng.

iu tr 2 thng, cc chng u bt, ch cn chng kinh nguyt khng thng. Dng bi sau: B t nhn, Ngu tt, Quyn b, Trch lan dip, Tc on, Thc a, Quy v, Xch thc, A giao, an sm, Din h sch, Lu k n, Hng hoa. Tt c tn thnh bt. Dng cao ch mu luyn mt lm vin, to bng ht Ng ng. Ung mi ln 3 - 5 vin vi nc nng, lc bng i. Ngy 2 ln. Ung 3 thng, khng nhng huyt hot kinh hnh m c th, kh lc, n ung li nh thng".

Y n Mch I, Sc

(Trch trong 'Thin gia diu phng)

"M X... cng nhn. Ho khc ra mu gn 4 ngy. Trc khi vo vin, trong 12 gi i ra mu 3 ln, khong 1 lt. Km st, au vng u, ngc tc, mt mi, khng c sc. Khm thy tnh trng ngi bnh trm trng, gy yu, h mt trng su kt mc sung huyt, ting phi bn phi trm th rt, ting g c, tim p yu. Chp X. quang xc nh phi b thm nhim c 2 phn trn. Xt nghim mu: Huyt sc t: 80%, Hng cu: 3.900.000/mm 3. Chn on lm sng: lao phi c 2 bn c ho ra mu t. Sau khi vo vin dng thuc cm mu, trn tnh, chng lao v truyn mu. Tuy dng nhiu bin php nhng vn ho ra mu, li mt thm 1.000ml na. Hng kh, ming kht, g m , trng mt , tiu kh, to bn. Mch i m Sc. Xc nh l chng th huyt do nhit. Khng nhng huyt nhit ha thnh m cn lm tn thng tn dch. V vy, ngng dng tt c cc thuc ty y, ch cn dng sinh t K, ch cho ung bi 'Ch huyt m' ( Sinh a (ti), Hong cm, Sn chi (sao en), i k, Tiu k, Hn lin tho, Thc qun, Gi thch (sng), Long ct (sng), Mu l (sng), Tin hc tho, B hong (sao), Thin tho (than), A giao, Tam tht (phn), thm Thch cao (sng) 60g, Nguyn sm 12g, Mch mn 12g). Sc ung ngui. Sau khi ung thuc, bt ho ra mu. Sau 12 gi ch ra mt 400ml, Lc , tuy thy ha b khng (c) ch nhng mch li chuyn sang H m Sc, th ngn m yu. S rng kh theo huyt m thot ra ngoi. Mt khc v mch c v Sc, khi ha cn cha tt, nu nh hon ton i dng thuc loi n, ch kh, c thot th li s rng sau khi thot kh, ha s tr li. V vy, u tin cho dng bi 'c sm thang' b kh c thot sau li dng 1 thang 'Ch huyt m', thang ny c thm Nhn sm, trong Sinh a, Hong cm, i k, Tiu k ( u sao thnh than). ng thi c phi hp chch tnh mch 50mg Cortison, truyn 250ml mu. Vi gi sau, tuy c ra mu ln na nhng ch mt cha n 120ml mu. Sau khng cn ra mu t na. Nh vy, trong vng 24 gi khng ch c chng ho ra mu t. Hm sau, tnh trng ngi bnh kh dn ln..."

MCH I ( I )

( - Intermittent Pulse - Pouls Changeant)

43

A - i cng

- Chng 'Bin Thi dng bnh mch chng tnh tr' ( Thng hn lun) ghi: "Mch kh n ng, ngng ri li tip, gi l i, thuc m".

- Sch 'Mch hc ging ngha' ghi: "i c ngha l thay i, mch bnh thng m bt thnh lnh thy Nhuyn, Nhc hoc lc sc lc s, u gi l mch i ( i )".

B - Hnh tng mch i

- Chng 'Hnh trng ch h b quyt'(Mch kinh) ghi: "Mch i n Sc, ngng ri li tip".

- Sch 'Trung y hc khi lun' ghi: "Mch i thay i, c my ln n th ngng li 1 ln, khng tr li c, lu lu li thy ng".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch n ng ri li ngng, ri khng tip tc ngay, lu lu mi li ng, ngng c s nht nh".

HNH V BIU TH MCH I

Sch 'Mch chn' biu th hnh v mch i:

C - Nguyn nhn pht sinh mch i

- Sch 'Chn gia khu yu' gii thch: "Mch i l do mt tng khng cn kh, v th tng khc phi thay... Hoc do kh huyt b tn thng lm cho nguyn kh b t on".

- Sch 'Tn bin Trung y hc khi yu' ghi: " ngi bnh c mch i, khi ghi in tm thy c hnh nh bloc nh thp cp 2 hoc hnh nh nhp i, nhp ba. Ng c Digitalin c th pht sinh ra mch i'.

- Sch 'Trung y chn on hc ging ngha' vit: "Sch Ni kinh dy rng mch i l tng kh suy vi hoc l du hiu ca T kh thot tuyt. Nhng nhng chng phong, chng au, tht tnh, kinh s hoc b vp ng tn thng m thy mch i v bnh m mch kh khng

44

tip ni, cho nn mch thy thnh thong li ngng li. Ph n c thai i khi cng thy mch i. Cc iu ny khc vi mch i ca tng kh suy vi hoc mt tng no b mt kh, khng th cho l bnh nguy c'.

D - Mch i ch bnh

- Thin 'Cm phc' (Linh khu) ghi: " Mch i (i) th lc au lc khng".

- Chng 'Kinh mch - Phn thng' (Gip t kinh) ghi: "i th khi hn khi nhit, trn nhit di hn".

- Chng 'Lc kinh th bnh pht thng hn nhit bnh trung' (Gip t) ghi: "Bnh nhit m thy mch i (i), mt ngy th cht".

- Sch 'Chn gia chnh nhn' ghi: "Mch i ch v tng kh suy yu, T th qu h, nn ma, tiu chy, trng hn khng n c m au bng".

- Sch 'Trung y khi lun' ghi: "Mch i ch tng kh suy bi. Bnh thy mch i l nguy".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch i ch tng kh suy vi, chng phong, chng au, tht tnh s hi, t ng tn thng. Mch i l tng kh suy yu hoc l du hiu ca T kh thot".

- Sch 'Mch hc ging ngha' ghi: "Mch i ch tng kh suy yu, T h hn khng n c, nn ma, tiu chy, bng au".

T Thn I

Hi hp.

Hu Thn I

Kh suy.

T Quan I

Hng sn au d di.

Hu Quan I

T suy, bng trng.

T Xch I

Chn lnh.

Hu Xch I

Dng tuyt.

- Chng 'Y gia quan min' (Hi thng y tn tm lnh) ghi: "Mch i ( i) ch kh b hao tn".

- Sch 'nh Ninh ti hc mch' ghi: "Mch i (i) ch tng kh suy. Nguyn kh ca 1 tng no suy. Nguyn kh ca tng khc phi n thay vo . Tc l 1 tng tuyt kh, dn dn s n ti khc b tuyt kh. Mch ny l cht".

E - Mch i (i ) kim mch bnh

- Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch Sc m ng, thnh thong li i l bnh phn dng, tiu chy hoc i tin ra m, mu".

45

- Thin 'Tam b cu hu lun' (T vn 20) ghi: "Mch i m Cu (Hng ) l bnh lc mch".

- Chng 'Kinh mch' [Phn Thng] (Gip t) ghi: "Tng mch thy Hot, i (ln) m li i (i), Trng l bnh t ngoi xm nhp vo".

- Sch ' Mch hc ging ngha' ghi:

Mch

i (i)

Mch phi Biu hin

Hng Bnh lc mch.

Sc Tiu tiu ra mu m.

Tr Hon T kh tuyt.

Trm T Tiu chy, kit l.

Vi T Tn dch kh kit.

G - Mch i (i) v tr liu

- Chng 'Bin Thi dng bnh mch chng tnh tr' ( Thng hn lun) ghi: "Thng hn m mch Kt, i (i), hi hp, cho ung bi Chch Cam tho thang ( Chch tho, Nhn sm, A giao, Sinh a, Mch mn, Ma nhn, Qu chi, Sinh khng).

H - Mch i qua cc li bn

- Chng 'Mch m dng loi thnh' (Chn gia khu yu) ghi: "Mch i ( i) ch v hnh th gy m, do mt tng v kh , v vy tng khc thay i, l triu chng nguy vy. Nu do bnh m kh b tn thng lm cho nguyn kh b t on, hoc do phong, do au m thy mch i, th ch l mch bnh. V vy, bnh thng hn thy hi hp m mch i (i), vng tim au, cng thy c mch Kt, Sp m i khng u. n b c thai thy mch i (i) l thai c hn 2 thng".

- Sch 'Chn gia chnh nhn' ghi: " Mch p 2 ln ri ngng, ri li tip: 3 - 4 ngy sau s cht. Mch p 4 ln, ngng ri tip: 6 - 7 ngy th s cht".

- Sch ' Mch hc ging ngha' ghi: "Xem mch chn bnh th 5 ch ( ln p) lm chun, nu trong khong thi gian khng ngng ngh, gin on, l mch ca ngi bnh thng, khng bnh. Nu ang p m bt thnh lnh ngng 1 lt li p tip th bit l tng kh suy, kh v huyt khng lin h c vi nhau, l mch i (i). 'Nu khng bnh m gy m, mch i th rt nguy him".

Bi ca MCH I (m) (Tn H mch hc)

Th trng: Mch i ang i bng ngng,

Lu lu li thy mch bng ni ln.

Ngi m may cha c yn,

46

Ngi thng mch y tt nhin chng lnh.

Tng loi: Xc i mau c lc ngng,

i chm m dng mch Kt chng sai.

i th ngng, chng li ngay,

Kt sinh, i t hai loi khc nhau.

Ch bnh: Mch i do tng kh suy,

H nguyn suy th kit ly bng au,

T h th t ng lo,

Gi cha ba thng chi sao c m...

Bi ca MCH I (Chn gia chnh nhn)

Mch tng: i l c i thay,

ang i ngng li khng hay tr v.

S ngng gi ng nh y,

Ngng lu ri mch li i theo l.

Ch bnh: i th ch tng kh suy,

Bnh m mch i th nguy lm ri.

Th t T bi hoi ri,

Khng n, au bng ai ngi cu cho.

Mch i hai ng mt ngng,

Ba bn ngy cht tng nghim thay.

Mch bn ng mt ngng y,

Ch 6, 7 ngy l cht chng sai.

Suy ra theo th t ny,

Vi trong kinh ch thc nay khng lm.

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Y n Mch I

(Trch trong 'Chn gia chnh nhn')

"Hong Qu Nham, tim thng b au, n t, mch p 2 ln th ngng, lt sau mi p tip. C thy thuc h Tr ni: " Kh ca ng tng khng n (tc l mch i) s cht trong sm ti". Ti ni: "Ngi xa ni rng au d di th thng thy mch I', v c thm rng : "Ngi tr tui m thy mch i th cht, ln tui thy mch i th sng". Ngi bnh ny, tui cao m vng ngc bng li au, do , tuy thy mch i nhng cng khng ng lo. Qu nhin sau 2 tun iu tr th bnh khi. l, thy thuc m khng c rng, hiu nhiu th kh m nm c l bin ha ca mch vy!".

Y n Mch i

(Trch trong 'C kim y n')

"ng Lc Phng B, gn 70 tui, nhn gp tit ma ng tri nng bc khc thng, cm nhim kh tri ma, pht ho. Thy thuc lc u cho ung 'Khung t tn' ( Xuyn khung, T dip, Ch xc, Ct cnh, Si h, Bn h, Trn b, Phc linh, Can ct, Chch tho ) lm cho m hi ra khng ngng v ho lin tc khng ngh. n ung khng c, nm m man hn 1 tun. Ngi nh lo s, cho mi c Lc Tiu Ngu n khm bnh. C xem mch thy 6 mch Ph, i v lc. Nhn dng php m mch nhy 50 ng, thy c 20 -30 ci nhy ng thng ngng ngh ri li nhy li. C ni rng: Bnh ny nguyn v tui gi sinh mt nhc, t l c vi t, nay ch nn nng ly chnh kh cho thm mnh sc, lt qua cn bnh, sao li lm m cho thuc pht hn (lm cho ra m hi). D bnh m man, th gp, chng ny cha c th khi c nhng ri khng ngoi 3 nm na ngi bnh cng cht. Lc , c cho ung bi 'B kh dng vinh thang' ( Bch trut, Thc a, Hc khng, Chch tho, Hong k, Trn b, ng quy, Nhn sm, Xuyn khung ), thm To nhn tr sc, T b dip, Tang bch b, T t v Thch hc ging kh, nh suyn. Ung c 2 thang th ht m hi. Ung 2 thang th ht ho. Ung n 15 thang th khi. Nhng khng y 3 nm sau, c c tin ngi bnh cht".

MCH ON

( - Short Pulse - Pouls Court)

A- i cng

- Chng 'Cu o mch' (Mch kinh) ghi: " Mch i di tay, thy khng n bn v (v tr ca mch), gi l mch on'.

- Chng 'Cu o' (Mch quyt san ng) ghi: "Mch b xch, thn u tht li, gn b quan thy mt na, nh con ra rt u, rt ui, l m dng khng n bn v, v vy gi l mch on".

48

- Cao Dng Sinh trong sch 'Mch quyt' ni : "Mch on thuc m mch, mc ngn, khng n c bn v, gi l on".

B- Hnh tng mch on

- Sch 'Mch quyt san ng' ghi : "Mch on, ging nh con ra nm phc, co u co ui".

- Sch 'Y bin' ghi : Mch on, ngn, khng n c v ca 3 b".

- Sch 'Trung y hc khi lun' ghi: "Mch ngn m Sp, nh, u ui nh khng c, gia ni ln, khng y b v".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch on, u ui u ngn, khng cng b v".

HNH V BIU DIN MCH ON

- Sch 'Mch chn'(M.Kinh) biu din hnh v mch on nh sau:

C- Nguyn nhn pht sinh mch on

- Thin 'Mch yu tinh vi lun' (T vn 17) ghi: "Mch on... do kh khng c iu ha, h th thuc Ph, thc th thuc v V".

- Chng 'Cu o' (Mch quyt san ng) ghi: "Mch on... do m dng khng n bn v".

- Sch 'Chn tng tam mui' ghi: "V kh ng tc khng thng u c cc mch, hoc do m kh, n khng tiu lm tr ngi ng vn hnh ca kh, v vy thy mch on. Cng c khi do dng kh khng thng".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch on l v kh b h khng sc dn huyt. Hoc do huyt tr, kh ut hoc m tr kh ut, hoc m tr thc tch lm cho kh o v mch kh khng thng cng thy mch on".

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- Sch 'Trung y chn on hc" ghi : "Mch on m c lc, ch kh thc, do kh b ut hoc kh ca Tam tiu b , hoc do m, thc n ngn tr honh cch m gy ra mch on".

D- Mch on ch bnh

- Thin 'Bnh nhn kh tng lun' (T vn) ghi: "Mch thn khu ng vo ngn tay l on th u au".

- Chng 'Bin Dng minh mch chng tnh tr' (Thng hn lun) ghi: "M hi ra nhiu m li pht hn, thy triu chng vong dng, ni xm, mch on th cht".

- Sch 'Tn H mch hc' ghi: "Mch b thn on l u au, b xch on th bng au".

- Sch 'Chn gia khu yu' ghi : "Mch on... thuc m trung phc dng, ch kh ca Tam tiu b tc, n ung khng tiu".

- Sch 'Y bin' ghi : "Mch on ch kh b h".

- Sch 'Trung y hc khi lun' ghi: " Mch on thy chng bt tc, nguyn kh h suy '.

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch on, nu hu lc th ch v kh b ut, nu v lc th ch v kh b tn thng".

- Sch 'Mch hc ging ngha' ghi: "Mch on ch hi th ngn, huyt h, Ph h, n khng tiu, m hi ra nhiu, dng kh b vong".

Hu Thn ON

Ph h, u au.

T Thn ON

Tm thn, bt tc.

Hu Quan ON

V qun y, tc, khng thng.

T Quan ON

Ph kh, tn thng.

Hu Xch ON

Chn dng suy yu.

T Xch ON

Bng di au.

E - Mch on kim mch bnh

- Chng 'Tp bnh mch' (Mch kinh) ghi: "Mch Ph, on l Ph b tn thng, cc kh u t, khng qu 1 nm th cht. Mch on m Sc th tim au, bun bc".

- Sch 'Mch hc tp yu' ghi: "Mch Xc, on m Sc l do c kh phm vo Tm, mch o b qun bch m ra, l chng cht".

- Sch 'Mch quyt san ng' ghi : "Ph m on th doanh v khng hnh, Trm m on l tng ph c b khi, tr".

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- Sch 'Mch hc ging ngha' ghi:

Mch on

Phi mch Ch bnh

Sc Tim au, bun bc.

Hot, Sc Do ung ru lm hi thn tr.

Ph Huyt b sp tre, Ph b tn thng.

Trm B kt.

- Sch 'Trung y chn on hc' ghi : " Mch on m Ph l Ph kh b h hoc huyt b sp, on m Sp l Tm kh b h hoc Tm mch b tr, on m Trm l c b khi, on m Tr l h hn".

G- Mch on qua cc li bn

- Sch 'Thin kim phng' ghi: "... Thy v qun kh chu, suyn th khng ngng hoc ra m hi trng nhiu ln, hoc lc nng, lc lnh, mch Xc, on m Sc nn ma khng cm th cht".

- Sch 'Tn H mch hc' ghi: "Mch on th ch thy 2 b xch v thn. on m Hot l do ung ru lm hi thn. on m Ph l huyt b tr. on m Trm l c b khi. b thn on th u au, b xch on th bng au".

- Sch 'Chn gia chnh nhn' ghi: "Mch on ng vi thi lnh l ma thu, ng vi ngi Ph. Ph ng vi ma thu, kim, thu lim kh ca tri t, tng mch ng theo, v vy thy mch on. Sch 'Ni kinh' c ghi: "Mch on th kh b bnh" l v kh thuc dng m sung mn Ph, v vy, nu ch thy mch on th l triu chng ca kh b suy yu. Nu on m thy ha hon l kh vn cn thnh. Nu on m Trm Sc th kh mi b suy. Cao Dng Sinh ni: "Mch on th ch c gia m khng c 2 u, l bt cp bn v". Xt thy (cu ny) l khng ng v mch phi qun thng, nu trong 1 hi th m mch kh khng lin tc th sinh c phi tuyt, c l no m dt on khng thng c sao? Nu trn khng thng l dng b tuyt u l mch m nu thy th phi cht vy".

- Sch 'Chn tng tam mui' ghi: "Sch 'Ni kinh' ghi: "Mch on th kh b bnh" l do V kh b ng tc khng thng u c cc mch, hoc do m kh hoc thc n khng tiu tch cha li lm tr ngi dng kh, v vy tng mch thy on, Sc, Kt, Xc, cng c khi do dng kh khng m thy mch on. Mch thn khu ng vo ngn tay thy on th u au vy. Trng Trng Cnh cng ni: "M hi ra nhiu m li pht hn lm cho dng kh b vong, ni xm, mch on th cht, mch ha hon th sng". i ng Ph ni: "Mch on ch tm thy 2 b xch, thn... b quan khng c l thy mch on c. Nu chp vo 6 b mch th s mt i ngha ca mch on vy".

- Sch 'Mch hc tp yu' ghi: "Nu thy mch on Xc th ng s lm".

- Sch 'Y thut' ghi: "Mch on cng mt loi vi mch ng nhng suy yu hn. Mch ng c hnh tng Hot m Sc, mch on c hnh tng Sc m Tr".

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- Sch 'Mch quyt san ng' ghi: "Nu b quan m on, trn l thn, xung khng n quan, di l xch, ln khng n quan l mch ca m dng b ly tuyt, s cht m khng cha c, v vy, b quan khng dng mch on xem bnh".

- Sch 'Hong hn y hc' ghi: "Xt sch 'Thin kim phng' bn v bnh cc kh rng: thp ngc au tht, th suyn khng ngng hoc m hi t ra, hoc lc nng lc lnh, thy mch on, Xc m Sc, nn khng cm l bnh cht v mch on m Sc. Nghim rng khi xem cho ngi bnh thy c mch on m Sc, Tt, l c kh xung (xng ) ln tim, n ni mch o b qun bch, l bnh cht. Nh vy th mch on rt ng s, v vy chp thm vo y".

Bi ca MCH ON (m) (Tn H mch hc)

Th trng: on thng b ngn 2 u,

Tng loi: Sp, on, Tr, T d hu gian nan,

on ph, thu (ma) gp th nn,

Ba xun m thy t can (phm) chng lnh.

Ch bnh: on th xch thn thi,

on l Hot Sc ru ri thn thng,

Ph huyt (sp) Trm b phi tng,

Thn ch u nhc, xch thng bng au.

Bi Ca MCH ON (Chn gia chnh nhn)

Mch tng: Li xem mch on th no?

Mch kim sp tiu, khng u khng ui.

Ch thy khong gia thi,

Phi nn suy xt hn hoi mi tng.

Ch bnh: Mch on ch bnh ni qua,

Ch chng bt cp hoc l kh h.

T thn on thn m h,

Hu thn on thuc Ph h au u,

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T quan thng Can kh sao ?

Hu quan cch mc khi au tc y.

T xch bng di au thay,

Hu xch on ry chn ha suy vi.

H- CC Y N MCH ON

Y n Mch B Thn Hai Tay u ON Nhc

(Trch trong 'Tn Vn Vin y n')

"Mt ph n b au nhc c c th. St m ra m hi nhiu, tinh thn m mui nh say ru, nm khng dy c, mch b thn c 2 tay u on, Nhc, 2 tay u Sc m v lc. y l do mt nhc qu sc gy ra. Cho ung Hong k 12g, Bch thc 16g, Cam tho 6g, Qu b 3,2g, ng quy 4g, Thch hc 8g, ung 1 thang th ht au, bt nng, khng ra m hi na, ch cn mt mi khng dy c. Dng phng thuc c, thm Nhn sm v Trn b. Ung 2 thang th khi".

MCH HON

( - Moderate Pulse - Pouls Retarde )

A- i cng

- Chng 'Bnh mch php' (Thng hn lun) ghi: "V kh ha gi l Hon.

- m mch v dng mch iu ha gi l Hon".

- Sch 'Thin kim dc' ghi: "n tay thy mch vn y nguyn gi l Hon".

- Sch 'Y hc nhp mn' ghi: "Hon l ha hon "

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B- Hnh tng mch Hon

- Chng 'Mch hnh trng ch h b quyt' (Mch kinh) ghi: "Hon qua li cng chm, nhanh hn Tr mt t".

-Sch 'Tn H mch hc' ghi : "Mch Hon, 1 hi th 4 ch, n si t di tay...".

- Sch 'Chn gia khu yu' ghi: "Hon l khng cp bch, qua li thong th".

- Sch 'Trung y hc khi lun' ghi: "Mch Hon i khoan ha, u n, s mch p khng thay i my".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch Hon, 1 hi th 4 ch, i li khoan thai".

HNH V BIU TH MCH HON

- Sch 'Mch chn' ghi hnh v mch Hon nh sau:

- Sch 'Tam ti hi' v sch ' ch Nan kinh mch quyt' ghi hnh v biu din mch Hon:

- Sch 'Kt hp YHCT vi YHH trong lm sng' ghi: "Mch Hon thuc loi tn s trung bnh t 60 - 80 ln / pht".

54

C- Nguyn nhn pht sinh mch Hon

- Chng 'Y gia quan min' (Hi thng y tn tm lnh) ghi: "Kh huyt u h v vy mch n thong th [Hon]".

- Sch 'Trung y chn on hc ging ngha' ghi: "T thuc th m ch thp, kh c b thp t m khn n v vy thy mch Hon".

- Sch 'Trung y chn on hc' gii thch : "Do kh c b thp t dnh li gy nn. T V h yu, m T V l ngun ca kh huyt, kh huyt bt tc, khng vn hnh c, kt li gy nn mch Hon"

D- Mch Hon ch bnh

- Chng 'Thng hn l' (Thng hn lun) ghi: "Mch b xch v thn m u v Hon th bnh Quyt m".

- Chng 'Bin thi dng mch chng tnh tr' (Thng hn lun) ghi: "Thi dng bnh, mch b thn Hon, b quan Ph, b xch Thc, pht st, ra m hi s lnh, khng nn ma, ch thy mch Vi, Hon, y tc, l do thy thuc s dng php h gy ra".

- Chng 'Bin Thi m mch chng tnh tr' (Thng hn lun) ghi: "Thng hn, mch Ph Hon, b phu mt cm gic l phong hn c nhc", "Mch b quan Hon, bing n l do V kh khng iu ha, T kh khng . Mch b xch Hon th chn yu, tiu tin khng thng".

- Chng 'Bnh tam quan mch chng tnh nghi' (Mch kinh) ghi: "Mch thn khu Hon, b phu mt cm gic l phong hn c nhc". "Mch b quan Hon, bing n l do v kh khng iu ha, T kh khng . Mch b xch Hon th chn yu, tiu tin khng thng".

- Chng 'Bnh tp bnh' (Mch kinh) ghi: "Mch Hon l h".

- Sch 'Gip t' ghi: "Mch Hon l nhit nhiu".

- Sch 'Chn gia khu yu' ghi: "Mch Hon l phong, l h, l t, l yu, l au, trn l gy cng, di l chn yu. Mch b thn bn tri Hon l Tm kh khng , hi hp, hay qun, gy v lng au cp. - Mch b quan (tri) Hon l phong h, chng mt, kh kt bng sn. - Mch b xch (tri) Hon l Thn h hn, tiu kh, kinh nguyt ra nhiu. - Mch b thn (phi) Hon l Ph kh ph ln, th ngn. - Mch b quan (phi) Hon l V kh h yu. - Mch b xch (phi) Hon l chn lnh yu, phong b, kh tr".

- Sch 'Tn H mch hc' ghi: "Mch Hon l phn vinh (huyt) b suy m phn v (kh) li d, l phong hoc thp hoc T h, trn l gy cng au, di l chn t bi".

55

- Sch 'Trung y hc khi lun' ghi: "Mch Hon ch bnh do thp t gy ra".

- Sch 'Trung y chn on hc ging ngha' ghi: "Mch Hon ch bnh v thp".

- Sch 'Mch hc ging ngha' ghi: "Mch Hon ch v phong thp, trng phong, au nhc, hoa mt, chng mt, h nhc, ung nht, tiu kh".

T Thn HON

Tm kh khng .

Hu Thn HON

Thng phong.

T Quan HON

Can h.

Hu Quan HON

T thp.

T Xch HON

m h.

Hu Xch HON

Dng suy.

F- Mch Hon kim mch bnh

- Thin Bnh nhn kh tng lun (T vn) ghi: Mch Hon m Hot l chng nhit bn trong. - Chng Bin thi dng mch chng tnh tr (Thng hn lun) ghi: Thng hn mch Ph Hon, mch Vi Hon l bnh sp khi. - Chng Trng phong lch tit bnh mch chng tnh tr (Kim qu yu lc) ghi: Mch thn khu Tr m Hon, Tr l hn, Hon l h. Phn vinh thy mch Hon l ung huyt, v thy mch Hon l trng phong . - Chng Hong n bnh mch chng tnh tr (Kim qu yu lc) ghi: Mch thn khu Ph m Hon, ph l phong, Hon l chng t. - Sch Mch ng ghi: Mch Ph m Hon l v kh b tn thng, Trm m Hon l vinh kh suy yu. - Sch Chn gia chnh nhn ghi: Mch Ph Hon l thng phong, Trm Hon l hn thp. Hon i l phong h. Hon T l thp t. Hon Nhc l kh h . - Sch Chn gia khu yu ghi: Mch Ph Hon hoc Trm Hon l kh huyt suy yu. - Sch Mch hc ging ngha ghi:

Mch Hon

Phi mch Ch tr

Ph Thng phong phn biu.

Trm Thp t.

Hot Nng trong.

Sp Huyt h.

Trm, T v lc Dng h.

G- Mch Hon v iu tr

56

- Chng 'Bin Thi dng mch chng tnh tr' (Thng hn lun) ghi: "Thng hn mch Ph Hon, c th khng au m ch nng n, c khi nh bt, khng c chng ca Thiu m, dng bi 'i thanh long thang' ( Ma hong, Hnh nhn, Thch cao, Cam tho, Qu chi) pht hn".

- Chng 'Y gia quan min' (Hi thng y tn tm lnh) ghi: "Mch b thn Hon l c gy cng, cho ung bi 'Tr thp thang' ( Phc linh, Can ct, Bch trut, Chch tho). - Mch b quan (tri) Hon: Can h thp thnh. B quan (phi) Hon: T thp qu nhiu. Nn cho ung bi 'Nht kh thang' hoc bi 'Kin trung thang' ( Hong k, Nhn sm, Qu, Bch thc, ng quy). Kh kt trong bng khng dui ra c, cho ung bi 'n bch thang' ( T uyn, Ng th du, Xng b, Si h, Hu phc, Ct cnh, To gic, u, Phc linh, Qu tm, Hong lin, Thc tiu, Ba u, Sinh khng ). Mch t xch Hon l hn, trng h, nm m thy ma qu, cho ung bi 'Ng linh tn' (Tr linh, Trch t, Bch trut, Phc linh, Qu chi) thm Thng trut.

H- Mch Hon qua cc li bn

- Sch 'Mch ng' ghi: "Cc b mch thy Hon l khng v mch kh khng bt ln vy".

- Chng 'Mch thn' (Cnh Nhc ton th) ghi: Mch Hon c m dng c 3 ngha:

Mt l mch kh thong dong, ha hon, l mch kh ca ngi bnh thng.

Hai l Hot m i l thc nhit nh sch Ni kinh ghi: "Mch Hon m Hot l nng trong".

Ba l Hon m Tr T l h hn.

Nu thc nhit th phi l Hon m kim i c lc, l phin nhit, ming hi, bng y, ung nht, i tiu tin khng thng hoc thng hn, n ngc mi khi m d nhit cha ht th thng thy mch ny. Nu h hn th phi Hon m kim Tr, T, l dng h, s lnh, au nhc, chng mt, hi hp, hay qun, n ung khng tiu, tiu chy, tiu sng phn, thn tinh hn, tiu nhiu, n b th kinh nguyt b b, thiu, mt mu. Phm cc chng sang c, trng phong, sn hu m gp mch Hon u l sp khi".

- Chng 'S truyn tam thp nh tc' (Chn gia khu yu) ghi: "Thi dng bnh pht st, u au, m hi t ra, mch Ph Hon l do phong t lm hi phn v biu. Mch Hon l gc ca T, tt phi ha hon, c thn, l triu chng T kh sung mn. Nu Hon nhiu m Nhc l T kh khng . Hon m hot li l V kh xung ha. Ngi xa cho mch Hon l thng phong. - Trm Hon l hn thp. - Hon i l phong h. - Hon Trm l c thp trong m".

- Sch 'Mch ng'' ghi: "Mch Hon ch bnh, c Hon ca Tr, Nhc. Hon Tr l thng thp. - Hon Nhc l kh h. - Hon kim Sc l huyt h. - Ph Hon l phong thng kinh lc. - Trm Hon l thp thng tng phu. - Hng Hon l thp nhit. - T Hon l hn thp. Cn c m h thy mch Ph Hng v lc m Hon, dng h th Trm T v lc m Hon. Nu thy mch Huyn b v ca th (hu quan), mch Hon b v ca thy (t

57

xch) l trng thi mch khc. Khi gp mch ny cng phi xem xt V kh t hoc nhiu bt nhy cao hoc thp, qua li chm hoc mau th mi nm c bnh tnh".

- Sch 'Mch hc ging ngha' ghi: "Hot B Nhn hnh dung mch kh th th, ha hon l rt ng, cn Vng Thc Ha cho rng: "Mch Hon qua li cng chm" th cha n".

Bi ca Mch HON (m) (Tn H mch hc)

Th trng: Mch hon bn ch khoan ha,

Nh cnh dng liu la gi xun.

Bit mch c lc c thn,

Thung dung ha hon y phn khoe vui.

Tng loi: Mch i 3 ch l Tr,

Mch Hon th Tr cn c cht nhanh.

Ch bnh: Hon mch v thnh dinh suy,

Hoc phong, hoc thp, hoc l T h.

Chn bi lit, c cng ,

Cng theo i, tiu, trm, ph m chia.

Thn Hon lng gy c phong,

Quan Hon chong vng li cng V h.

Xch Hon khp khnh chn co,

Hoc l phong b hoc nhu tit ry.

Bi ca Mch HON (Chn gia chnh nhn)

Mch tng: Mch Hon ng tay khoan ha,

Mt tc bn ch tht l u thay.

Suy xem th tng mch ny,

Nh cnh dng liu gi lay nh nhng.

Ch bnh: Hon khng ch ring bnh chi,

58

Mun on chng th kim mch mi xong.

Kim mch: Mch ph Hon y thng phong,

Trm Hon hn thp, ta khng cn ng.

Mch Hon i y phong h,

Mch m Hon t thp t r rng.

Hon sp T h phi chng?

Mch m Hon nhc on rng kh h.

T thn ph Hon phong t,

Hu thn sp Hon y l T (huyt) h,

T quan ph Hon can phong,

Hu quan trm Hon thp xng hi T.

T xch Hon sp tinh khuy,

Hu xch Hon t dng suy lm ri.

I- CC Y N MCH HON

Y n Mch HON i V Lc

(Trch trong 'Lc Th tam th y nhim')

"Lc Thin Ngu cha mt ngi gi tn l Ng Nan Khu, ng ny vo khong thng 8, sau khi no say li nhp phng, qua ngy hm sau pht i l, 1 ngy i tiu c trm ln, trng ln ln, trong bng au ngm, tay chn lnh. Xem mch th thy Hon, i v lc, 2 b xch cng Nhc. Ti ni, chng ny phi nn b v cho toa c v Nhn sm, Nhc qu. Cc con ca ngi bnh thy u s hi ni rng khng c tch tr th khng thnh chng l, nay mi c 1-2 ngy m dng thuc b sao? Bt c d ti mi cho ung bi 'iu kh dng vinh thang' nhng bnh tnh cng chng tng hoc gim. Hm sau ti xem li, ni rng phi nn dng b gp. Trong nh li tranh ci v khng chu dng, bnh tnh cng khng thuyn gim. Nhn dp ti c ngi mi, nn ngi nh ngi bnh i mi thy thuc khc. Thy ny cho ung cc v nh Hong cm, Hong lin, Tn lang, Mc hng... th bng au d nh ct, chn lnh nh bng, ra m hi lnh, thiu hi khng th, thc n n vo th i tin ra ht... n na m cho ngi nh n mi ti. n xem thy ngi bnh khng t xoay tr c, i tin nh chy mu, bnh tnh rt nguy him, nhng cn may l mch v thn kh cha tuyt. Lin cho ung 'Nhn sm ph t l trung thang' ( Bch trut, Chch tho, Nhn sm, Can khng, Ph t) thm Nhc qu. Ung 1 thang th bng bt au, thm my

59

thang th chn m, i tin ngng; Li dng n 2 cn (1.280g) Nhn sm th mi khi, ru v tc u rng".

Y n 6 Mch u HON

(Trch trong 'Lc Th tam th y nhim').

"Lc Thin Ngu cha mt ngi bnh tn l Ng Tn Trai, ngi mp m thng hay ung ru,v qun thng au nay li thy au cc khp, na ngi pha di nng hn. C thy thuc cho l phong, cho dng bi 'S quc cng tu', th lc au lc bt. Li thy lu ngy khng bt, cho l do tinh huyt khng m ra, li cho dng H trng, H xa... th ch au li sng ln. Lc mi mi ti xem bnh. Xem mch th thy 6 b u Hon m b quan li hi Huyn. Ti lin ni rng: Xem mch th thy y l do m thp, khng thy phong cng chng thy h. Thuc cha phong tuy khng tr thp nhng li hnh kh, v vy c lc bt. Nu cho l h chng ri t b tc l lm cho ng tr thm, nh vy khng nng thm sao c? Cch cha, trc ht l dng thuc hon thanh m tch trung cung, sau dng thuc than