候病所在,逐部诊视。合位应时,软滑者吉。(合位,如肺应皮毛,心应血脉,脾应肌肉,
肝筋肾骨之类是也。应时,如春弦夏钩秋毛冬石四季软滑是也。软滑如经云∶脉弱以滑,是有胃
气也。)病脉反之,大小独异,上下之至异同,候分统属为式。六部脉属五脏,应乎五行之气。
气同则合上达,惟水不趋,气异俱有阴阳升降之义。(如左寸主心属火,气同则合上炎,气异则
分阴阳。右寸主肺属金,气同则合上光,气异则分明暗。左关主肝属木,气同则合上达,气异则
分春秋。右关主脾属土,气同则合上升,气异则分寒温。两尺主肾属水,气同则合下流,气异则
分溢覆。)故脉前后状同,统候兼主其一,寸关病在前候,两尺病在后取。(如左寸前以候心,
后候膻中,右寸前以候肺,后候胸中。左关前候肝胆,后以候膈。右关前以候胃,后候脾宫。两
尺前以候肾,后候腹中之类是也。)前后之状异者,属候歧之为二,上至病在前候,下至病在后
位,前后互见和乖,乖病和平,前后同中有异,异者病拟。(如上下之至俱弦或弦兼涩,则取兼
涩之候为病。)前后强弱相同,尤者之候病,及前阳后阴候病,阴降阳升。前溢后覆出部,升降
仿此。洪细长短,濡芤滑涩,统中未详,属相出入,统属兼审。浮沉虚实,浮表经脉,皮毛腠理,
四肢百节,头面背膂。沉里口舌,咽喉骨髓,五脏六腑,大便小水。两傍外内,亦分表里,侵外
身热,侵内积滞。(经云∶推而内之,外而不内,身有热也。推而外之,内而不外,有心腹积也。
是已。)虚为不足,痒麻泻痿。实为有余,胀壅痛秘。统常属变,法稽经旨,附以管窥,条陈大
意。(汪氏诊候。)
To diagnose the location of the disease, one must examine the pulse section by section. If the pulse corresponds to the organ position and complies with the season, appearing soft and slippery (soft and smooth), it is auspicious. ("Corresponding to position" refers to such correspondences as the Lung corresponding to skin and hair, the Heart to blood vessels, the Spleen to muscles, the Liver to sinews, and the Kidney to bones. "Complying with the season" refers to such seasonal pulses as the Wiry (Xian) pulse in Spring, the Hook (Gou) pulse in Summer, the Hairy (Mao) pulse in Autumn, the Stone (Shi) pulse in Winter, and the soft and slippery pulse present in all four seasons. A soft and slippery pulse indicates the presence of Stomach Qi (Wei Qi), as stated in the classics: "A pulse that is weak yet slippery indicates the presence of Stomach Qi.") Conversely, pathological pulses differ, showing unique variations in size and differences in the arrival of Qi at the Cun, Guan, and Chi positions. Diagnosis should follow the pattern of hierarchical classification and attribution.
The six pulse positions belong to the Five Zang Organs and correspond to the Qi of the Five Elements. When the Qi nature is identical, it ascends and reaches upward; only Water Qi does not tend upward. When Qi natures differ, there is a principle of Yin descending and Yang ascending. (For example, the Left Cun position governs the Heart, belonging to Fire. When Qi is identical, it flares upward; when different, it distinguishes Yin and Yang. The Right Cun position governs the Lung, belonging to Metal. When Qi is identical, it shines upward; when different, it distinguishes brightness and darkness. The Left Guan position governs the Liver, belonging to Wood. When Qi is identical, it grows upward; when different, it distinguishes Spring and Autumn. The Right Guan position governs the Spleen, belonging to Earth. When Qi is identical, it rises upward; when different, it distinguishes Cold and Warmth. Both Chi positions govern the Kidneys, belonging to Water. When Qi is identical, it flows downward; when different, it distinguishes overflowing or submerging.) Therefore, if the pulse characteristics before and after are similar, they are jointly attributed to one aspect in unified diagnosis. If the pathology is at the Cun and Guan positions, the disease is located in the anterior (superficial/exterior) aspect; if the pathology is at both Chi positions, the disease is sought in the posterior (deep/internal) aspect. (For instance, the anterior aspect of the Left Cun diagnoses the Heart, while the posterior aspect diagnoses the Danzhong area; the anterior aspect of the Right Cun diagnoses the Lung, while the posterior aspect diagnoses the chest cavity; the anterior aspect of the Left Guan diagnoses the Liver and Gallbladder, while the posterior aspect diagnoses the diaphragm; the anterior aspect of the Right Guan diagnoses the Stomach, while the posterior aspect diagnoses the Spleen palace; the anterior aspect of both Chis diagnoses the Kidneys, while the posterior aspect diagnoses the abdomen, etc.)
If the pulse characteristics before and after differ, the diagnostic targets diverge into two: Qi arriving from above indicates disease in the anterior aspect, while Qi arriving from below indicates disease in the posterior aspect. If the anterior and posterior pulses show both harmony and discord, the discordant aspect indicates disease, while the harmonious aspect indicates health. If the anterior and posterior pulses are largely similar but contain differences, the differing aspects are used to predict the disease. (For example, if both upper and lower pulses are Wiry or Wiry combined with Choppy, the Choppy aspect is taken as the pathological sign.) If the strength of the anterior and posterior pulses is the same, special attention should be paid to the pulse signs indicating disease. Regarding the method of diagnosing disease via anterior Yang and posterior Yin, it follows the principle of Yin descending and Yang ascending. If the pulse overflows anteriorly and submerges posteriorly, extending beyond the pulse position, the principles of ascent and descent apply similarly. For pulses such as Surging (Hong), Fine (Xi), Long, Short, Soft (Ru), Hollow (Kou), Slippery, and Choppy, if not detailed in the unified examination, they represent variations of mutual entry and exit, requiring comprehensive review of their hierarchical attribution.
Regarding Floating (Fu) and Sinking (Chen), Deficiency (Xu) and Excess (Shi): Floating pulses indicate exterior conditions involving meridians, skin and hair, interstices, limbs, joints, head, face, and back. Sinking pulses indicate interior conditions involving the mouth and tongue, throat, bone marrow, Five Zang and Six Fu organs, stool, and urine. The lateral aspects also distinguish between exterior and interior: invasion of the exterior causes body heat, while invasion of the interior leads to accumulation and stagnation. (The classics state: "Pushing inward, if the Qi remains exterior and does not enter, there is body heat. Pushing outward, if the Qi remains interior and does not emerge, there is accumulation in the heart or abdomen." This is correct.) Deficiency indicates insufficiency, manifesting as itching, numbness, diarrhea, and flaccidity. Excess indicates surplus, manifesting as distension, obstruction, pain, and constipation. These rules integrate constant methods with variable changes, adhering to the principles of the classics, supplemented by personal insights, and systematically presenting the main ideas. (Diagnosis by Mr. Wang.)