Library

"Three Parts" refers to the Upper, Middle, and Lower sections. "Nine Probes" (Jiu Hou) refers to the three probes—Heaven, Earth, and Man—within each of the three sections. This is the intent of the classic text. Later generations interpreted "Three Parts" as the Cun, Guan, and Chi positions of the radial artery, employing Floating, Middle, and Sinking palpation techniques to differentiate syndromes and determine life and death.

The Yellow Emperor asked: ... I wish to hear about the supreme numbers of Heaven and Earth, how they correspond to human form and blood qi, and how to use them to distinguish life from death. What should be done?

Qibo replied: The supreme numbers of Heaven and Earth begin with One and end with Nine. (Note: Nine is the ultimate odd number.) One represents Heaven, Two represents Earth, Three represents Man. Multiplying by three yields nine, corresponding to the Nine Regions (Jiu Ye). Thus, humans have Three Parts, each with three probes, used to determine life and death, treat the hundred diseases, regulate deficiency and excess, and eliminate pathogenic disorders. (Note: See previous annotations for "Nine Regions".)

The Emperor asked: What are the Three Parts? Qibo said: There is a Lower Part, a Middle Part, and an Upper Part; each part has three probes. These three probes correspond to Heaven, Earth, and Man. One must guide the fingers to perceive them to grasp the truth. (Meaning: One must learn from a teacher.)

The Upper Part's Heaven probe is the arterial pulse on both sides of the forehead. (Located on both sides of the forehead, pulsating at the touch, where the Qi of the Foot-Shaoyang Gallbladder Meridian travels.) The Upper Part's Earth probe is the arterial pulse on both cheeks. (Located on both sides below the nostrils, near the boundary of the Juliao point, pulsating at the touch, where the Qi of the Foot-Yangming Stomach Meridian travels.) The Upper Part's Man probe is the arterial pulse in front of the ears. (Located in the depression in front of the ear, pulsating at the touch, where the Qi of the Hand-Shaoyang Sanjiao Meridian travels.)

The Middle Part's Heaven probe is the Hand-Taiyin Lung Meridian. (Referring to the Lung pulse, located at the Cun Kou in the wrist crease, known as Jingquan, pulsating at the touch.) The Middle Part's Earth probe is the Hand-Yangming Large Intestine Meridian. (Referring to the Large Intestine pulse, located between the metacarpal bones of the thumb and index finger, at the boundary of the Hegu point, pulsating at the touch.) The Middle Part's Man probe is the Hand-Shaoyin Heart Meridian. (Referring to the Heart pulse, located at the end of the styloid process of the ulna, at the boundary of the Shenmen point, pulsating at the touch.)

The Lower Part's Heaven probe is the Foot-Jueyin Liver Meridian. (Referring to the Liver pulse, located outside the pubic hairline, one and a half cun below the Yangshi point, in a depression, at the boundary of the Wuli point; taken while lying down, pulsating at the touch. For women, take Taichong, located two cun behind the root of the big toe in a depression.) The Lower Part's Earth probe is the Foot-Shaoyin Kidney Meridian. (Referring to the Kidney pulse, located in the depression behind the medial malleolus and above the calcaneus, at the boundary of the Taixi point, pulsating at the touch.) The Lower Part's Man probe is the Foot-Taiyin Spleen Meridian. (Referring to the Spleen pulse, located between the tendons on the upper calf, directly below Wuli at the boundary of the Jimen point; requires heavy compression to feel, pulsating at the touch. To observe Stomach Qi, take the Chongyang point on the dorsum of the foot, pulsating at the touch. Note: The Classic refers to both meridians and acupoints, not just the Cun-Guan-Chi positions; they should be observed separately.)

Therefore, the Lower Part's Heaven probe observes the Liver, its Earth probe observes the Kidney, and its Man probe observes the Qi of the Spleen and Stomach. (Since the Spleen and Stomach are connected by membranes, observing the Spleen also observes the Stomach.)

The Emperor asked: How are the Middle Part probes? Qibo said: They also have Heaven, Earth, and Man. Heaven observes the Lung, Earth observes the Qi of the Chest Center, (The Classic states the Intestines and Stomach share observation, so this observes the chest center), and Man observes the Heart.

The Emperor asked: How does one observe the Upper Part? Qibo said: It also has Heaven, Earth, and Man. Heaven observes the Qi of the Head and Horns, Earth observes the Qi of the Mouth and Teeth, and Man observes the Qi of the Ears and Eyes. (Note: The following paragraphs merely re-explain the preceding text without deep meaning.)

The Three Parts each have Heaven, Earth, and Man. Three constitute Heaven, three constitute Earth, three constitute Man. Three times three equals nine. Nine divides into Nine Regions, which correspond to Nine Viscera. Thus, there are five Spirit Viscera (Shen Zang) and four Form Viscera (Xing Zang), totaling nine. (The five Spirit Viscera are: Liver stores Hun, Heart stores Shen, Spleen stores Yi, Lung stores Po, Kidney stores Zhi, because they house spiritual energy. The four Form Viscera are: 1. Head and Horns, 2. Ears and Eyes, 3. Mouth and Teeth, 4. Chest Center. Note: This section summarizes the preceding theory of Three Parts and Nine Probes. "Wei" means "corresponds to"; Nine Regions correspond to Nine Viscera. Carefully noted: Among the Upper Part's three probes, four Form Viscera occupy three; among the Middle Part's three probes, two Spirit Viscera and one Form Viscera occupy them; among the Lower Part's three probes, all are Spirit Viscera. However, doubts remain: Previously, the Middle Part's Earth was identified as the Hand-Yangming Meridian, annotated as the Large Intestine pulse. But when Qibo re-explained, he said Earth observes the Qi of the Chest Center, annotated as the Hand-Yangming meridian passing that area. The Hand-Yangming Large Intestine Meridian starts from the anterior shoulder, ascends to the vertebral junction, descends into the Clavicular Fossa, connects to the Lung, passes through the Diaphragm, and belongs to the Large Intestine. Although it mentions "passing through the diaphragm," it cannot be directly called the "Chest Center," which is doubt one. If referring to the coiled location of the Large Intestine, it is at the umbilicus, not the chest center, which is doubt two. Later, the summary of four Form Viscera includes "Chest Center," implying it is not an error. Previously, only Zang pulses were mentioned in the Three Parts, not Fu pulses, yet Hand-Yangming is a Fu pulse; perhaps this is an error, which is doubt three. Due to inconsistencies, this is preserved for future scholars.)

The Emperor asked: How does one observe [the condition]? Qibo said: First, measure the fatness or thinness of the body to adjust the deficiency or excess of Qi. Excess is drained; deficiency is tonified. ...

The Emperor asked: How does one determine life and death? Qibo said: A robust body with fine pulses, shortness of breath insufficient for respiration indicates danger. (Body and Qi are contradictory, so vital energy is extremely critical. "Danger" implies near-death but with potential for survival.) A emaciated body with large pulses and excessive Qi in the chest indicates death. (Such cases represent a mismatch between body and Qi. Note: "Robust body" means muscles are not wasted; "fine pulse" means weak and powerless. Because the pulse is fine, there is little Qi; because there is little Qi, respiration is insufficient. Such pulse-symptom patterns often appear in early-stage illnesses, likely due to innate weakness resulting in weak pulses. With aggressive tonification, survival is possible, hence "danger." If muscles are wasted and the pulse floats and becomes large, it indicates exhaustion of the True Origin. Excessive Qi in the chest indicates Yuan Qi detaching from its root. Such patterns in chronic patients lead to immediate death. Do new illnesses never present this way? Answer: Yes, if the pulse is large and floating, even with panting, it indicates Yin exhaustion and Yang floating. Avoid tonifying Qi; urgently use Yin-astringing herbs. If ineffective, add Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconite Root) to guide Qi to the Dantian. Unskilled physicians, unaware of this principle, mistakenly use Qi-moving herbs, hastening death. New and chronic illnesses share the same fatal outcome, differing only in whether the body is emaciated.)

When Body and Qi are harmonious, life prevails. When pulses are irregular and uncoordinated, disease exists. (Can refers to comparison; Wu refers to grouping. Note: Pulse rates are uneven.) If all Nine Probes are discordant, death occurs. (Note: Discordance means significant disparity in size and speed.) If half of the Three Parts' pulses are normal and half abnormal, treatment is still possible. If all are discordant, death ensues. If the pulses of Up, Down, Left, and Right respond like a pestle pounding rice, the disease is severe. If they are discordant and uncountable, death ensues. (Note: Up/Down refer to Cun/Chi; Left/Right refer to both hands, i.e., the Three Parts of both hands. Each part has three probes, totaling eighteen diagnoses. "Pestle pounding" means frequent beating against the hand, like adding a pestle to grain. Pulse methodology states: "Two beats per exhalation and two per inhalation is normal." Here, four beats per cycle are described. Three beats indicate deviation from the classic, four indicate depletion of essence, five indicate death, six indicate end of life, totaling twelve beats per cycle. If pulses are too fast to count, death is inevitable.) Even if the Middle Part's pulse is harmonious alone, if it mismatches other viscera, death occurs. If the Middle Part's pulse diminishes, death occurs. (Note: Middle Part refers to the Guan pulses. If Cun and Chi lose their norm, even if Guan is healthy, it constitutes discordance among the Nine Probes, leading to death. If only Guan is diseased and diminishing, even if Cun and Chi are healthy, it is also discordance. The text uses mutual explanation for clarity, not distinct meanings.) Sunken eyes indicate death. (Note: Sunken means deeply recessed. Essence of all five viscera converges in the eyes; sunken eyes indicate exhaustion of true essence, hence death. The annotation focusing solely on Taiyang is biased.)

The Emperor asked: How does one know the location of the disease? Qibo said: Observe the Nine Probes. The one that is uniquely small is diseased; uniquely large is diseased; uniquely rapid is diseased; uniquely slow is diseased; uniquely hot is diseased; uniquely cold is diseased; uniquely depressed is diseased. (...Pulse manifestations of the Seven Diagnoses indicate irregularity; based on unique differences, one identifies the disease.)

The Nine Probes should correspond, being uniform up and down, without discordance. (Uniformity means consistency in speed and size.) If one probe lags, there is disease; if two lag, the disease is severe; if three lag, the disease is critical. "Lagging" means the responses are not simultaneous. (...Simultaneous means identical. Note: This applies to a single part. Non-simultaneous means the frequency of the later pulse does not match the earlier one.) Appearance of True Zang Pulses indicates death on the day of overcoming [the organ]. (Note: True Zang Pulses signify certain death. Death occurs on the day that overcomes the specific organ's element.)

When the Qi of the Foot-Taiyang Bladder Meridian ceases, the feet cannot flex or extend, and death involves upward staring of the eyes. (The Foot-Taiyang Bladder Meridian originates at the inner canthus, ascends to the vertex, enters the brain, exits to the nape, runs along the scapula,夹 spine to the loins. Branches descend through the buttocks, pass the hip joint, enter the popliteal fossa, run along the calf, to the lateral foot. When Taiyang Qi ceases, death presents thus. Note: Xin Zhengxiao states: "Zhenyao Jingzhong Lun records termination signs for all three Yang and Yin meridians; here only Foot-Taiyang is recorded, implying missing text.")

The Emperor asked: What about Winter Yin and Summer Yang? (Referring to time of death.) Qibo said: If all Nine Probes are sinking, fine, and suspended/extreme, it is Yin, ruling Winter, so death occurs at midnight. If pulses are full, rapid, panting, and numerous, it is Yang, ruling Summer, so death occurs at noon. (Positions are not fixed; extremes reverse. The principle of Qian and Kun: extreme Yin leads to dragon battle in the wild; extreme Yang leads to regret of the soaring dragon. Thus, extreme Yin/Yang pulses die at midnight/noon.) Therefore, Cold-Heat diseases cause death at dawn. (Wood is prosperous at dawn; Wood Qi transforms into Wind, so Cold-Heat diseases die during Wood's prosperity.) Heat-in-the-Middle and Heat diseases cause death at noon. (Extreme Yang.) Wind diseases cause death at dusk. (Mao-You opposition.) Water diseases cause death at midnight. (Water is prosperous.) Pulses that are suddenly sparse/slow or sudden/fast/diseased cause death during the Four Seasons' transition periods (Chen, Xu, Chou, Wei hours). (Earth Qi is dominant in these hours; Spleen Qi internally fails, causing death.) If flesh and muscle are exhausted, even if Nine Probes are harmonious, death occurs. (Also indicates body-Qi mismatch. Note: Humans consist of internal spirit and external flesh/muscle. When flesh/muscle waste away, spirit scatters without foundation. At this time, how could Nine Probes be harmonious? The Classic uses extreme language for emphasis.)

If the Seven Diagnoses appear, but the Nine Probes follow the norm, death does not occur. The "non-death" refers to Wind diseases and menstrual diseases (or long-term illnesses lasting over a month), which resemble Seven Diagnosis symptoms but are not truly so, hence no death. (Note: "Following norm" means pulse continuity. Pulse manifestations of Seven Diagnoses without change indicate illness but not necessarily death. Why no death? Wind disease pulses are typically rapid/large; chronic disease pulses are typically slow/small; they do not truly border death like the Seven Diagnoses imply. "Jing" means long-lasting, referring to illness exceeding a month; annotating it as menstruation is incorrect.) If Seven Diagnosis symptoms exist and pulse conditions also fail, death occurs, accompanied by hiccups and belching. (...Note: Violating Seven Diagnoses with chaotic Nine Probes guarantees death. Hiccups and belching occur due to severe disease disrupting Qi mechanism. Hiccups (Yue) are stomach disorders; Belching (Yi) are heart disorders, where Qi stagnates below and seeks to ascend.)

Rapid pulses indicate no disease (Qi is strong). Slow pulses indicate disease (Qi is insufficient). Pulses that do not flow indicate death (Qi and Blood are stagnant). Skin adhering tightly to bone indicates death (Flesh and blood are dry and solid).

The Emperor asked: How are treatable cases managed? Qibo said: Treat Jing diseases by treating the Jing; treat Luo diseases by treating the Luo (seeking pathological sites). (Note: Wang Bing's edition mentions Sun Luo blood; Jia Yi Jing omits "Sun Blood"; we follow Jia Yi Jing.) For body pain, treat the Jing and Luo. (Note: Wang Bing's edition mentions blood disease causing pain; Jia Yi Jing omits "blood disease"; we follow Jia Yi Jing.) For diseases caused by Odd Pathogens (Qi Xie), whose pulses differ, use Miao Ci (Needling opposite sides). (Miao Ci involves needling collateral vessels, treating left with right and right with left.) For emaciation with persistent pathogens, puncture with regulation/moderation. (...Pathogen Qi lingers, appearance wastes, symptoms do not shift; then adjust dosage and level, nourish, and puncture.) High pupils indicate Taiyang deficiency; upward staring indicates Taiyang exhaustion. This is key to determining life and death and must be carefully observed. (...This reiterates the signs of Taiyang Qi impending exhaustion and actual exhaustion.)