窃闻人有是病,即有是脉,此大概言之。其得心应手全在审视,未必专尚乎诊也。如病目必视其症为外为内,
必审其何因而致,所伤之风邪在何脏腑,得其情而后切以印可,治无不当。但诊惟外之手,即欲理会方药,不以
人性命为儿戏耶?语曰∶学医人费解皆脉之使之也。间亦有切而知者,仅谓之巧中。然施于本经,十失八九。盖
医门之事,目与五行最为亲切,药之优劣当面定夺,万难藏拙,非比别病之无对症,而可以横口不根,夸张脉理。
试匿青盲妇,令当家诊之,其上、下、来、去、至、止,曷常于平人迥异?诳以赤肿必作风热处
方。讵知目不能治,而身之元无恙耶?是故舍可见可闻之耳目,而凭一无形无影之手指,其症候必猜度拟议之,
而用药亦猜度拟议之药尔。庸医误人,孰有甚于此者!李时珍曰∶医病两家咸以脉为首务,不知脉乃四诊之末,
上士欲会其全,非备四诊不可。孙思邈亦曰∶未诊先问,最为有准。是则百病之不可恃乎脉也明矣,况目乎?不
宁维是,夫人百骸九窍,皆丝脉联系以通血气,自项至踵,周流不息。凡骨节之间皆有之,但手腕较着,以便诊
耳,未必十二经络左右平分,分则尽总于此,一寸二寸,如发如缕,似气非筋之脉。即使尽总于此,病患之臂有
长短,医人之指有大小,倘前后失序,不几以神门为尺,以人迎气为关耶?病患之脉有常变,医人之气有疾徐,
倘呼吸不匀,不几以三至为急,以五至六至为缓耶?前人不计及比,漫演为奇经,为太素,为广经、孙输络,为
状尖、圆、长、短、扁,为辨高、章、纲、 、卑、损,愈阐愈凿,愈凿愈元,而脉之本源尽失。孟子曰∶道在
迩而求诸远,事在易而求诸难,此之谓也。呜呼!之数人者,妄出一己之私见,以欺天下后世之耳目。而索隐行
怪之徒,神其说以射利,至今习俗成风,虽儒医亦用而术。屡欲条陈荒谬,以靖流弊,恐世人以假遇假,实论相
参,则是非争起。且谓医家之诊切,犹兵家之旗鼓。夫旗鼓何助于战,乃所以扬威陷阵者,端赖此耳。又子从事
渔猎,而废网罗之具,是自败其道也,姑仍旧本而已。至若《太素》一书,务必屏绝。盖医家以岐黄为祖,所论
脉不过察病情、决生死,未有所谓《太素》也。神明如仓公、扁鹊、仲景、叔和,亦无所谓《太素》也。彼何人
斯?不惟测人之病情,而能占人之穷通,不惟决人之死生,而能知人之祸福,异端之说,攻之斯害,岂特载鬼一
车,徒令人狐惑已也。爰立斯
论,并商订脉体诊诀于后,读者不病其简,不责以狂,虚心周虑而转应之,自然不尚乎脉,自然巧合于脉。大概
言有是病,大概即有是脉。
I have heard that when a person has a certain disease, there is a corresponding pulse; this is a general statement. However, for a physician to achieve proficiency and ease in treatment, it relies entirely on careful observation (inspection), and does not necessarily depend solely on pulse diagnosis. For instance, when treating eye diseases, one must observe whether the symptoms are external or internal, determine the etiology, identify which Zang-Fu organs are affected by the pathogenic wind-evil, and only after understanding these conditions should pulse palpation be used to verify them, ensuring appropriate treatment. If one merely palpates the pulse at the wrist yet attempts to prescribe herbal formulas, is this not treating human life as a trivial matter? It is said: "Those who study medicine find it difficult to comprehend, largely due to being misled by pulse theory." Occasionally, some may diagnose correctly through pulse palpation alone, but this can only be called "coincidental accuracy" (accidental hit). However, applying this method to ophthalmology results in eight or nine errors out of ten. This is because, within the medical field, the eyes are most intimately connected with the Five Elements theory. The quality of herbs must be determined face-to-face, making it difficult to hide incompetence, unlike other diseases where one might speak without basis and exaggerate pulse theories. Suppose we pretend there is a patient with Qingmang (blindness), and ask their family member to take their pulse. Would the pulse's upward/downward, coming/going, arriving/stopping characteristics truly differ significantly from those of a healthy person? If one falsely claims that redness and swelling are caused by Wind-Heat and prescribes accordingly, who would know that while the eye condition remains untreated, the body's vital essence remains unharmed? Therefore, abandoning the visible and audible senses (Inspection and Auscultation/Olfaction) to rely on invisible fingers for pulse taking means that symptom assessment becomes speculative, and medication choices become speculative as well. Are there any greater errors committed by mediocre physicians than this? Li Shizhen stated: "Both doctors and patients prioritize pulse diagnosis, unaware that pulse taking is merely the last of the Four Diagnostic Methods. A superior physician seeking comprehensive knowledge must employ all four methods." Sun Simiao also said: "Inquiring before diagnosing is the most accurate approach." Thus, it is clear that hundred diseases cannot rely solely on pulse diagnosis, let alone eye diseases. Furthermore, the human body's bones and orifices are interconnected by meridians to circulate Qi and Blood, flowing continuously from the neck to the heels. Meridians exist at every joint, but they are most prominent at the wrist for diagnostic convenience. They are not necessarily divided equally between left and right; if they were, all twelve meridians would converge here. These pulses, measuring one or two cun, thin as hair or thread, resembling Qi rather than tendons—even if they all converged here—patients' arms vary in length, and physicians' fingers vary in size. If the sequence is disordered, would one not mistake Shenmen (HT7) for the Chi position, and Renying (ST9) for the Guan position? Patients' pulses vary, and physicians' breathing rates differ. If respiration is uneven, would one not mistake three beats per breath for a rapid pulse, and five or six beats for a slow pulse? Predecessors failed to consider these factors, arbitrarily elaborating concepts such as Extraordinary Vessels, Taisu (Supreme Purity), Guangjing, Sunshuluo, and shapes like sharp, round, long, short, flat, and classifications like high, zhang, gang, bei, sun. The more they elaborated, the more far-fetched it became, until the original source of pulse theory was completely lost. Mencius said: "The Way is near, yet sought from afar; matters are easy, yet sought as difficult." This describes the situation. Alas! These individuals, acting on personal prejudices, deceive the world and future generations. Those who pursue obscure and bizarre theories spiritualize these claims to profit, and this custom has become prevalent, even adopted by Confucian physicians. I have repeatedly wished to expose these absurdities to stop the malpractice, fearing that people might confuse falsehood with truth, leading to disputes over right and wrong. Moreover, comparing a physician's pulse diagnosis to a military commander's flags and drums is flawed. Flags and drums do not help in battle; they are used to display majesty and charge into enemy lines. Relying solely on them is like engaging in fishing while discarding nets; it is self-defeating. One should stick to the fundamental principles. As for the book *Taisu*, it must be rejected. Physicians revere Huangdi and Qibo as ancestors; their discussions on pulse aim only to assess disease conditions and determine life and death, with no mention of *Taisu*. Even divine figures like Cang Gong, Bian Que, Zhang Zhongjing, and Wang Shuhe had no concept of *Taisu*. Who were these people? Not only did they speculate on disease conditions but also predict fortune and misfortune, determining life and death while knowing blessings and curses. Such heterodox teachings are harmful even to critique; they are akin to recording a cart full of ghosts, merely causing confusion and anxiety. Therefore, I establish this treatise and discuss pulse morphology and diagnostic rules below. Readers should not complain of its brevity nor accuse me of arrogance. By thinking carefully and responding flexibly, one will naturally not overly rely on pulse diagnosis, yet naturally align with pulse principles. Generally speaking, where there is a disease, there is generally a corresponding pulse.