《素问·平人气象》于人以胃气为本后,独言三阳之脉,不及三阴。林亿以为阙文,引
《难
经》吕广说补之。泉案∶三阴之脉行五脏,经于三阳脉后,即言五脏脉,五脏即三阴也。文
与《灵·经脉》六阳气俱绝、五阴气俱绝,及《素·经终》六阳、五阴之终例同。盖分手足
言之,则六阳;浑举之,则三阳;统言之,则五脏称五阴经。实核之,则五脏言各有当,非
一端也。三阳主躯壳,与《脉经》时脉之六经必兼三阴者,相似而不同。《难经》所言,亦
系时脉,其动摇几分云云,不可执以例此。五脏主躯内,兼主时,故五脏平脉与四时脉同。
然四时脉通主一身,五脏脉专主一脏,故病脉、死脉之象,则与玉机所云太过不及者不同。
读《灵》、《素》常须识此,勿令误也。林校殊未审。
仲景生于南阳,官于长沙,医于京洛。今案其地,皆非北方郡县,而洛称中土尤着。仲
景是
书,将为前圣集大成,为后世立大法,而斤斤一隅之见,何以为仲景?且历东西晋、南北朝
及隋唐,其间建都若邺、若金陵、若长安,几于五方无定。而《外台》所采诸家,半皆当时
士大夫在京师者,其尊仲景方,至于天下附应,及宋许白沙当南渡时,去仲景千有余年,而
伤寒九十论中,所纪证治,若合符节。可见通人之学,不以方隅限也。其所谓伤寒病则恶
寒、体痛、呕逆而已,并不大重,何异之有?若以其处方太峻,则古权量不及今之十一,有
《千金》可证,又何异之有?夫天下事,果有二千年来,五方通行,末几而止宜一方者乎?人
亦自求所以知仲景者可耳!
按《河南通志》云∶张机涅阳人。涅阳,即南阳郡之属县名,非有异也。惟张松北见曹
操,
以川中医有仲景为夸(见《方氏条辨》自序,)则与此异。岂仲景曾入蜀为医欤?要之,蜀亦
西南方也。
In the *Suwen: Pingren Qixiang Lun* (Plain Questions: Treatise on the Pulse of a Healthy Person), after stating that "the human body takes Stomach Qi as its foundation," it exclusively discusses the pulses of the Three Yang meridians and omits those of the Three Yin meridians. Lin Yi considered this to be a lacuna in the text and cited the commentary by Lu Guang from the *Nanjing* (Classic of Difficult Issues) to supplement it. My research indicates: The pulses of the Three Yin meridians circulate through the Five Zang organs. Following the discussion of the Three Yang pulses, the text immediately proceeds to discuss the pulses of the Five Zang organs; the Five Zang organs are essentially the Three Yin. This textual structure is consistent with the accounts in the *Lingshu: Jingmai* (Spiritual Pivot: Meridians) regarding the exhaustion of the Qi of the Six Yang and the Five Yin, as well as the examples of the termination of the Six Yang and Five Yin found in the *Suwen*. Generally speaking, when distinguishing between hand and foot, they are called the Six Yang; when speaking broadly, they are called the Three Yang; and when discussing them comprehensively, the Five Zang organs are referred to as the Five Yin meridians. Upon strict examination, the discussions regarding the Five Zang organs each have their appropriate context and are not limited to a single fixed pattern. The Three Yang meridians primarily govern the body surface and exterior, which is similar to but distinct from the situation in the *Maijing* (Pulse Classic), where the six meridians discussed in relation to seasonal pulses must include the Three Yin. What is described in the *Nanjing* also pertains to seasonal pulses, specifically mentioning degrees of pulse fluctuation; such descriptions cannot be rigidly applied to analogize this specific text. The Five Zang organs primarily govern the internal viscera while also relating to the four seasons; therefore, the normal pulses (Ping Mai) of the Five Zang organs correspond with the seasonal pulses. However, since seasonal pulses generally govern the entire body, whereas the pulses of the Five Zang organs specifically govern individual organs, the manifestations of pathological and terminal pulses differ from the concepts of excess and deficiency (Tai Guo and Bu Ji) described in the *Suwen: Yuji Zhenzang Lun* (Treatise on the True Visceral Pulses). When reading the *Lingshu* and *Suwen*, one must always recognize this distinction to avoid error. Lin Yi’s collation was indeed insufficiently rigorous.
Zhang Zhongjing was born in Nanyang, served as an official in Changsha, and practiced medicine in the capital region of Luoyang. Examining these locations today, none are in the northern commanderies, and Luoyang is notably regarded as the Central Plains (Zhongtu). Zhang Zhongjing’s work aimed to synthesize the achievements of past sages and establish fundamental principles for future generations. If one were to adhere to narrow, regional perspectives, how could one truly understand Zhang Zhongjing? Furthermore, throughout the Western and Eastern Jin dynasties, the Northern and Southern Dynasties, as well as the Sui and Tang dynasties, capitals were established in various places such as Ye, Jinling, and Chang’an, indicating that there was no fixed capital across the five directions. The medical works collected in the *Waitai Miyao* (External Cabinet Essential Prescriptions) were mostly authored by scholars who were in the capital at the time. Their reverence for Zhang Zhongjing’s formulas led to widespread emulation across the realm. Even during the Southern Song dynasty, when Xu Shuwei (styled Basha) lived more than a thousand years after Zhang Zhongjing, his *Shanghan Jiushi Lun* (Ninety Cases of Cold Damage Pathology) recorded diagnoses and treatments that matched Zhang’s methods perfectly. This demonstrates that the scholarship of enlightened individuals is not confined by geographical boundaries. The cold damage disease he described involved merely aversion to cold, body pain, and vomiting or regurgitation; it was not particularly severe, so what is the difference? If one argues that his prescriptions were too potent, it must be remembered that ancient weights and measures were less than one-tenth of modern standards, as evidenced by the *Qianjin Yaofang* (Essential Prescriptions Worth a Thousand Gold); thus, what is the difference? Are there not matters in the world that were universally applicable for two millennia but later became suitable only for a specific region? People should simply seek to understand Zhang Zhongjing on their own terms!
According to the *Henan Tongzhi* (General Gazetteer of Henan): Zhang Ji (Zhang Zhongjing) was from Nieyang. Nieyang was a county subordinate to the Nanyang Commandery, with no discrepancy. However, Zhang Song, upon visiting Cao Cao in the north, boasted about having Zhang Zhongjing among the physicians in Sichuan (as seen in the preface of *Fangshi Tiaobian*), which differs from this account. Did Zhang Zhongjing ever practice medicine in Shu? In any case, Shu is also located in the southwest.