中虛心痛 What Each Pulse Declares
夫左寸強而緊者,中虛心痛也;關濇而緩者,汗出肌麻也;尺芤而沉者,小便赤而大便帶血也。右手寸脈浮而滑者,內結經閉也;關遲而結者,宿食留飲也;尺數而牢者,煩滿虛寒相持也。夫左寸强而紧者,中虚心痛也;关濇而缓者,汗出肌麻也;尺芤而沉者,小便赤而大便带血也。右手寸脉浮而滑者,内结经闭也;关迟而结者,宿食留饮也;尺数而牢者,烦满虚寒相持也。
逐句解 Line by line
"Now, where the left cùn is forceful and taut, the centre is depleted and the heart pains; where the guān is rough and slack, there is sweating and numbness of the flesh; where the chǐ is hollow and sunken, the water passes red and the stool carries blood.
Same six pulses, second time round, with a condition hung on each. The pattern is the oldest one in Chinese exposition: 夫 to open, then a topic marked with 者, then the verdict marked with 也. Three of them in a row, all built the same way. 夫 is fú in that opening use — a throat-clearing "now, then" — and not the fū of 夫人, a lady, which this chapter will need later when the demon sends for one.
"Where the right cùn is floating and slippery, there is binding within and the channels are stopped; where the guān is slow and knotted, food lodges undigested and drink stands; where the chǐ is rapid and firm, vexation and fullness contend with depletion and cold."
And the right hand again, to the same formula. 數 is shuò once more. 宿 is sù, kept overnight — so 宿食 is food that has sat undigested. 相 is xiāng, mutually, which makes 相持 two conditions gripping each other in a deadlock, neither able to give way.
Now the same six pulses again, this time with a condition hung on each. The second recital shortens the first as it goes — 左手寸脈 becomes 左寸, and the 且 of 芤且沉 becomes 而 — so you are carried through the argument instead of being made to hold two lists at once.
None of the medicine here is invented. The pulse qualities, the paired stations, the conditions read off them all come from the standing vocabulary of Chinese diagnosis, and a Ming reader with any schooling would have found the passage competent rather than fanciful. That soundness is what makes the joke possible later. The frame has to hold before the contents can be absurd.