马云。从容。系古经篇名。见第二节。本篇。详示从容之义。故名篇。吴云。篇内论病情有难知者。帝示
雷公从人之容貌。而求合病情。其长其少其壮。容不类也。高云。圣人治病。循法守度。援物比类。从容中道。
帝以此理示诸雷公。故曰示从容。
及于比类 马云。观前后篇内。俱有比类。系古经篇名。然实以比方相类为义。
水所从行 吴云。水。谓五液也。此皆人之所生。指胆胃以下十四端而言。高云。五脏主藏精者。故
曰水。
治之过失 吴云。言五脏六腑七情五液。皆人所赖以生。治之者。恒有过有失也。张云。凡治过于病。
谓之过。治不
及病。谓之失。不得其中。皆治之过失也。志本。失。作矣。
子别试 吴云。别。谓往时也。张云。别试通者。谓素之所通也。其有未通者。当请问其所不知耳。
志云。别者。谓未通天道也。高云。既诵脉经。当于脉经辨别。而试通之。简按诸注义未稳。盖别试者。谓脉
经上下编之外。别有所通。试论之也。下文子言上下以对何也语。可见耳。
窈冥 熊音。窈。乌绞反。深也。吴云。窈冥者。义理玄妙。非书传之陈言也。
脾虚浮似肺 张云。脾本微软。病而虚浮。则似肺矣。肾本微沉。病而小浮。则似脾矣。肝本微弦。
病而急沉散。则似肾矣。脉有相类。不能辨之。则以此作彼。致于谬误。此皆工之不明。所以时多惑乱也。按
王氏曰。浮而缓云云。此详言五脏脉体。以明本节之义也。所以诊法有从部位察脏气者。有从脉体察脏气者。
得其义。则妙无不在。学人当于此而贯通焉。
从容得之 马云。若明从容篇比类之。则窈冥之妙传矣。吴云。从人之容色。而求病情。斯得之矣。
志云。从容者。天之道也。天道者。阴阳之道也。简按诗都人士笺云。从容。犹休燕也。正义云。休燕。闲暇
之处。中庸云。从容中道。圣人也。家语哀公问云。夫诚。不勉而中。不思而得。从容中道。圣人所以定体也。
广雅云。举动也。考数义。王以安缓释之。乃为允当。
怯然 熊音。怯。去劫反。畏也。
夫从容之谓也 吴云。帝言若是者。宜从其人之容貌。而合之病情也。张云。引经语也。如下文。
志云。此言经脉之当求之于气也。夫从容者。气之谓也。高云。比类者。同类相比。辨别其真。必从容而得之。
故曰。夫从容之谓也。
简按今从高注。
年少则求之于经 张云。年少者。每忽风寒劳倦。所受在经。简按志以年长年少年壮。为长女中女少
女。以为三阴之义。注义迂回。不可从。
夫浮而弦 张云。肾脉宜沉。浮则阴虚。水以生木。弦则气泄。故为肾之不足也。简按仲景云。弦则
为减。即此义也。
水道不行 张云。精所以成形。所以化气。水道不行。则形气消索。故怯然少气也。
一人之气病在一脏也 吴云。一人之气。病在一脏。一脏不再伤。故三脏俱行。不在法也。张云。凡
此皆一人之气。病在肾之一脏耳。即如上文雷公所问头痛者。以水亏火炎也。筋挛者。肾水不能养筋也。骨重
者。肾主骨也。哕噫者。肾脉上贯肝膈。阴气逆也。腹满者。水邪侮土也。时惊者。肾藏志。志失则惊也。不
嗜卧者。阴虚目不瞑也。病本于肾。而言三脏俱行。故非法也。志高义同。
三脏俱行 简按行字。诸家无解。盖谓病之行也。
此何物也 高云。此何故也。简按物训故。未见所据。
子所能治知亦众多 吴云。帝言子所能者。治所知之病。亦众人之所称欤。张云。言子之所能。余亦
知其多。但以此病为伤肺。则失之矣。简按张似是。
譬以鸿飞亦冲于天 吴云。譬之鸿飞。亦常冲天。然有时而下。不常高尔。张云虽所之任意。而终莫
能得其际。亦犹长空浩渺之难测耳。高云。粗工妄治而愈。是千虑一得。譬以鸿飞亦冲于天。简按张注似稍通。
冲。 同。
化之冥冥 马云。化字。恐当是托。世本讹也。吴云。变化于冥冥莫测之境。张同。志云。察造化之冥冥。
何必守经 吴云。何必执守经常哉。
去胃外归阳明也 吴云。去其胃腑。而外归阳明经也。
二火不胜三水 吴云。二火。犹言二阳。谓胃也。三水。犹言三阴。谓脾也。言太阴之气。外归阳明。
阳明不胜太阴。是以脉乱而失其常。常脉浮缓。今失而为浮大虚矣。高同。马张仍王。
由失以狂也 简按孟子。王由足用为善。由。与犹通。王注本此。高为从之义。非是。
经脉傍绝 张云。肺脏损坏。则治节不通。以致经脉有所偏绝。
是失吾过矣 吴云。是失二字为句。
名曰诊轻 吴张据太素。轻。作经。张云。明引形证。比量异同。以合从容之法。故名曰诊经。乃至
道之所在也。马志高从王注。恐非。
Ma Yun states: "Congrong" (Composure/Measured Approach) is the title of an ancient classic chapter, appearing in Section 2. This chapter elaborates on the meaning of "Congrong," hence its title "Shi Congrong" (Demonstrating the Measured Approach).
Wu Yun states: The chapter discusses cases where the disease condition is difficult to ascertain. The Emperor instructs Lei Gong to observe the patient's demeanor and appearance to seek concordance with the disease state. Whether the patient is elderly, young, or in their prime, their physical manifestations are not uniform.
Gao Yun states: When sages treat diseases, they follow laws and standards, draw analogies from objects, and adhere to the Mean. The Emperor demonstrated this principle to Lei Gong; therefore, it is called "Shi Congrong."
Regarding Bilie (Analogy by Similarity): Ma Yun states: Throughout previous and subsequent chapters, "Bilie" appears as a chapter title of ancient classics. However, its actual meaning lies in analogy and similarity.
Water's Pathway: Wu Yun states: "Water" refers to the Five Fluids (sweat, nasal mucus, tears, saliva, and drool). These are essential for human life, referring here to fourteen aspects ranging from the Gallbladder to the Stomach. Gao Yun states: The Zang organs store essence; thus, they are referred to as "Water."
Errors in Treatment: Wu Yun states: The Six Fu organs, Seven Emotions, and Five Fluids are all relied upon for life. In treatment, there are often errors of excess or deficiency. Zhang Yun states: Treatment that exceeds the needs of the disease is called "Guo" (Excess); treatment that falls short is called "Shi" (Deficiency/Miss). Failing to achieve balance constitutes an error in treatment. Zhiben suggests "Shi" is interchangeable with "Yi" (error).
Test Separately: Wu Yun states: "Bie" refers to the past. Zhang Yun states: "Testing what is already understood" refers to knowledge already mastered in the *Suwen*. For what is not yet understood, one should ask about the unknown. Zhi Yun states: "Bie" refers to not yet understanding the Heavenly Dao. Gao Yun states: Having recited the Pulse Classic, one should distinguish within it and attempt to comprehend it. Jian An notes: None of these annotations are entirely satisfactory. Likely, "Bie Shi" means there is additional understanding beyond the upper and lower sections of the Pulse Classic, which one should attempt to discuss. This is evident from Lei Gong's later question regarding the upper and lower sections.
Yaoming (Profound and Obscure): Xiong Yin notes: "Ya" is pronounced 'wu jiao fan,' meaning deep/profound. Wu Yun states: "Yaoming" refers to profound and subtle principles, not merely stale words from books.
Spleen Deficiency Floating Resembles Lung: Zhang Yun states: The Spleen pulse is naturally soft. If diseased and deficient-floating, it resembles the Lung pulse. The Kidney pulse is naturally slightly deep; if diseased and slightly floating, it resembles the Spleen pulse. The Liver pulse is naturally slightly wiry; if diseased and urgent/deep/scattered, it resembles the Kidney pulse. Pulses can be similar; failure to distinguish them leads to mistaking one for another, causing errors. This stems from the physician's lack of clarity, leading to confusion. Wang Bing's commentary details pulse characteristics like "floating and slow" to explain the nature of the Five Zang pulses, clarifying this section. Diagnostic methods include observing organ qi via location or pulse morphology. Mastering these allows for comprehensive understanding. Students should integrate these concepts here.
Acquiring Congrong: Ma Yun states: By understanding the analogies in the *Congrong* chapter, the subtleties of *Yaoming* can be transmitted. Wu Yun states: By following the person's demeanor to seek the disease condition, one attains the truth. Zhi Yun states: "Congrong" is the Way of Heaven. The Way of Heaven is the Way of Yin and Yang. Jian An notes: The commentary on *Shi Jing* states "Congrong" is akin to "Xiuyan" (leisurely ease). The *Zhengyi* states "Xiuyan" means leisure. *Zhong Yong* states: "Congrong zhong dao, sheng ren ye" (Acting with composure in accordance with the Mean is the way of the Sage). *Kongzi Jiayu* states: "Sincerity... acts with composure according to the Mean, which establishes the Sage's substance." *Guangya* defines "Congrong" as movement/conduct. Considering these definitions, Wang Bing's interpretation of "an huan" (calm and slow) is most appropriate.
Qieran (Timidly/Fearfully): Xiong Yin notes: "Qie" is pronounced 'qu jie fan,' meaning fear/timid.
The Meaning of Congrong: Wu Yun states: The Emperor says that in such cases, one should follow the person's demeanor to align with the disease condition. Zhang Yun states: This quotes a classic. See below. Zhi Yun states: This refers to seeking Qi in the meridians. "Congrong" refers to Qi. Gao Yun states: "Bilie" involves comparing similar things to discern truth, which must be done with composure. Hence, "This is what is meant by Congrong." Jian An adopts Gao's note.
For the Young, Seek in the Meridians: Zhang Yun states: Young people often neglect wind-cold and fatigue; the pathogen resides in the meridians. Jian An notes: Zhi Gao interprets old, strong, and young as representing Elder, Middle, and Younger Daughters (Three Yin), which is convoluted and should not be followed.
Floating and Wiry: Zhang Yun states: The Kidney pulse should be deep. Floating indicates Yin deficiency. Water generates Wood; wiry indicates Qi leakage. Thus, it signifies Kidney insufficiency. Jian An notes: Zhang Zhongjing states "Wiry implies reduction," which aligns with this meaning.
Water Pathways Do Not Flow: Zhang Yun states: Essence forms the body and transforms into Qi. If water pathways do not flow, form and Qi diminish, resulting in timidity and shortness of breath.
One Person's Qi Disease Lies in One Zang Organ: Wu Yun states: One person's Qi disease affects one Zang organ. A Zang organ is not injured twice; thus, the Three Zang organs function together, outside standard rules. Zhang Yun states: All this concerns one person's Qi, diseased in the single Kidney organ. As asked by Lei Gong earlier: Headache is due to Water deficiency and Fire flaring; tendon cramping is due to Kidney Water failing to nourish tendons; heavy bones are due to Kidney governing bones; hiccup/belching is due to Kidney meridian passing through Liver/Diaphragm with inverted Yin Qi; abdominal fullness is due to Water evil insulting Earth; frequent fright is due to Kidney storing Zhi (Will), and loss of Zhi causes fright; aversion to sleep is due to Yin deficiency preventing eye closure. The root is Kidney, yet speaking of Three Zang organs functioning together is irregular. Zhi Gao agrees.
Three Zang Organs Function Together: Jian An notes: No experts explain "Xing" (function/move). It likely refers to the progression of the disease.
What is this thing?: Gao Yun states: What is the cause? Jian An notes: Interpreting "Wu" as "Gu" (cause) lacks evidence.
Your Capable Treatments Are Numerous: Wu Yun states: The Emperor asks if your capable treatments are merely those praised by the masses. Zhang Yun states: I know your capabilities are many. But if you think this disease injures the Lung, you are mistaken. Jian An notes: Zhang's view seems reasonable.
Like a Wild Goose Flying to the Sky: Wu Yun states: Like a wild goose flying, it may reach the sky, but sometimes descends, not always high. Zhang Yun states: Although its destination is arbitrary, its limits cannot be predicted, just as the vast sky is hard to fathom. Gao Yun states: A crude physician treating recklessly might cure by chance, like a wild goose occasionally reaching the sky (a lucky guess among many thoughts). Jian An notes: Zhang's annotation is more coherent. "Chong" is synonymous with upward movement.
Transformation in the Obscure: Ma Yun states: "Hua" (transform) might be a typo for "Tuo" (entrust/rely on) in some editions. Wu Yun states: Transformation occurs in the obscure and unpredictable realm. Zhang agrees. Zhi Yun states: Observing the mysteries of creation.
Why Must One Adhere to Classics?: Wu Yun states: Why must one rigidly adhere to constant methods?
Leaving the Stomach to Return to Yangming: Wu Yun states: Departing the Stomach Fu organ, it returns externally to the Yangming Meridian.
Two Fires Cannot Overcome Three Waters: Wu Yun states: "Two Fires" refers to "Two Yang," i.e., the Stomach. "Three Waters" refers to "Three Yin," i.e., the Spleen. It describes Taiyin Qi returning externally to Yangming. Yangming cannot overcome Taiyin, causing the pulse to become chaotic and lose its normal rhythm. The normal pulse is floating and slow; now it has lost this, becoming floating, large, and empty. Gao agrees. Ma and Zhang follow Wang Bing.
From Error Comes Madness: Jian An notes: In *Mencius*, "Wang you zu yong wei shan," "You" is interchangeable with "You" (like/as). Wang Bing follows this. Gao's interpretation as "following" is incorrect.
Meridians Severed Laterally: Zhang Yun states: Damage to the Lung organ obstructs regulation, causing meridians to be partially severed.
This Is My Mistake: Wu Yun states: "Shi Shi" (This mistake) forms a sentence.
Named Diagnosis Jing (Classic/Standard): Wu and Zhang, based on *Tai Su*, read "Qing" as "Jing." Zhang Yun states: Clearly citing physical signs, comparing similarities and differences to conform to the method of Congrong, thus named "Zhen Jing" (Diagnosing the Classic), which is the abode of the Great Dao. Ma, Zhi, and Gao follow Wang Bing, which is likely incorrect.