问曰。濡弱何以反适十一头。师曰。五脏六腑相乘。故十一。问曰。何以知乘腑。何以知乘脏。
师曰。诸阳浮数为乘腑。诸阴迟涩为乘脏也。
此段言脉之通于脏腑。凡邪之乘。因乎脉之虚。所以通结辨脉平脉二篇之义也。
濡弱。言气血。气无形。血如水。皆软细之物。非指病脉为濡弱。凡人脉皆如此也。适。往也。
反。来也。反适。即往来义。头。即处字之意。十一头。原文自明之。言相乘表里之谓也。五脏六
腑。皆阴阳相配为表里。而以三焦统之。成十二经。又分上中下为三。上焦心肺二脏。配以心包
络一腑。即身里上段之大膜。而就其包裹心者主之。包心络者。不止包心。通于全里。遂更通于表
矣。中焦肝脾二脏。配以胃胆二腑。两胁之间。胃肠之际。又有脂膜以连之。胃之下口。通于中焦
Question: Why does the "Ru Ruo" (soft and weak) pulse correspond to eleven locations? The Master replied: The five zang organs and six fu organs interact through mutual overacting (excessive control in the Five Phases), hence there are eleven. Another question was asked: How can one know if the pathogen has invaded the fu organs, or if it has invaded the zang organs?
The Master replied: When yang pulses present as floating and rapid, it indicates invasion of the fu organs; when yin pulses present as slow and choppy, it indicates invasion of the zang organs.
This passage discusses the correspondence between pulses and the zang-fu organs. Pathogenic invasion occurs taking advantage of pulse deficiency; thus, it connects the principles of the "Chapter on Distinguishing Pulses" and the "Chapter on Calming Pulses."
"Ru Ruo" refers to the state of Qi and Blood. Qi is formless, and Blood is like water; both are soft and subtle entities. This does not refer to a pathological "Ru Ruo" pulse type, but rather states that normal human pulses generally possess these characteristics. "Shi" means to go or proceed. "Fan" means to return or come. "Fan Shi" implies coming and going. "Tou" means location or place. "Eleven Tou" is explained in the original text as referring to the mutual overacting relationship between exterior and interior organs. The five zang and six fu organs are paired by Yin and Yang to form exterior-interior relationships, governed by the San Jiao (Triple Burner), forming the twelve meridians. These are further divided into Upper, Middle, and Lower Jiao. The Upper Jiao includes the Heart and Lung zang organs, paired with the Pericardium (Xin Bao Luo) fu organ, which corresponds to the large membrane in the upper internal body, primarily enveloping and governing the Heart. The Pericardium not only envelopes the Heart but also communicates throughout the entire interior, thereby extending to the exterior. The Middle Jiao includes the Liver and Spleen zang organs, paired with the Stomach and Gallbladder fu organs. Between the two hypochondria and amidst the intestines and stomach, there are fatty membranes connecting them. The lower opening of the Stomach connects to the Middle Jiao.