石阳黄韫兮。着脉确一书。或从而叩其义。韫兮曰。医凭乎脉。而脉衰乎理。从来医家论脉。不患其言之无理。而
患其言之于理甚精。以之测病。而所谓精者。终未确也。夫脉以测病。不确岂能无误。浮游沉塞。起伏传变。全寄之乎
三指。轻辄重按。反复呼吸。实有毫厘千里之判。微乎渺乎。确诚未易言矣。 于脉学。究心已久。尝以轩岐之经为主。
而于诸贤论脉之书。采其理之的然可信者。而据以为确。间有未的。则证之于经。复出己意。以旁探博求。其所谓确者。
第识见有限。窃恐自以为确。而终未必其能确也。倘高明于其未确者。更加校正。则幸甚矣。韫兮之言若此。岁壬戌余
以母病。延之来淮。出视是书。山阳医士李铸九见之。深为折服。晚年其学益进。余复携其帙至真洲。以示李乔年。乔
年亦世医也。谓余曰。是书实足发蒙启 。先生既刊行伤寒论翼矣。曷极付剞劂。附之于后俾得表里印证。厥功岂不伟
哉。余曰诺。因次述其语。以弁简端。
乾隆丙寅小春歙州程 识
气口者。手太阴肺经之动脉。而五脏六腑之气。于此候之也。盖人以气生。营卫之气。先天也。水谷之气。后天也。
先天后天之气。脉皆主之。故饮入于胃。其精气。自脾归肺。食入于肾。其精气。自心归肺。肺布饮食之精气于诸脏腑。
而后血气充。营卫调。诸脏腑之气。各随其经。同营卫之气。而呼吸朝之于肺。故手太阴肺经。乃诸脏腑之气所聚也。
圣人于气口。候其盛衰。泄天地化育莫测之秘。岂不神乎。
Huang Yunxi of Shiyang authored the book *Mai Que* (Pulse Certainty). Someone subsequently inquired about its principles. Yunxi replied: Physicians rely on pulse diagnosis, yet pulse studies have declined due to a lack of sound reasoning. Historically, physicians discussing pulses do not worry that their statements lack logic, but rather worry that their reasoning is overly subtle. When using such so-called "subtlety" to predict diseases, it ultimately fails to be certain. Since pulses are used to predict diseases, if they are not accurate, how can errors be avoided? Floating, sinking, rising, falling, and transmission/variation are all perceived through three fingers. Pressing lightly then heavily, repeatedly observing respiration, there is indeed a distinction as vast as a hair's breadth versus a thousand miles. Pulses are subtle and elusive; certifying them is certainly not easy.
I have devoted myself to pulse studies for a long time. I took the classics of Huangdi (Yellow Emperor) and Qibo (Grand Duke Qi) as the main basis, and from books on pulse theory by various sages, I selected those with clear and credible principles as my standard for certainty. Where things were not entirely clear, I verified them against the classics and added my own insights, exploring broadly and seeking widely. What I call "certainty" is limited by my knowledge; I fear that what I consider certain may not ultimately be so. If scholars of superior insight could correct the uncertain parts, it would be most fortunate. Such was Yunxi's statement. In the Renxu year, owing to my mother's illness, I invited him to Huai'an. He presented this book to me. Li Zhujiu, a medical practitioner from Shanyang, saw it and was deeply convinced. In his later years, his learning advanced further. I again brought the manuscript to Zhenzhou and showed it to Li Qiaonian. Qiaonian was also a hereditary physician. He said to me: "This book is truly sufficient to enlighten the ignorant. Since you have already published *Shanghan Lun Yi* (Wings to the Treatise on Cold Damage), why not have it printed and attached afterwards, so that internal and external aspects can verify each other? Would not the merit be great?" I agreed. Therefore, I recorded and stated his words, placing them at the beginning of the volume.
Recorded by Cheng of Shézōu in the early winter of the Bingyin year of the Qianlong reign.
The Qi Kou (Vital Gate), which is the arterial point of the Hand-Taiyin Lung Meridian, is where the Qi of the five zang and six fu organs is observed. Generally, humans live by Qi. The Ying and Wei (Defensive) Qi originate from the congenital (pre-heavenly), while the Qi of water and grain originates from the acquired (post-heavenly). Both congenital and acquired Qi are governed by the pulse. Thus, when drink enters the stomach, its essence travels from the Spleen to the Lung; when food enters the Kidney (Note: Text says Kidney, though physiologically usually Stomach/Spleen context applies, translating literally here), its essence travels from the Heart to the Lung. The Lung distributes the essence of food and drink to all organs, after which Blood and Qi become abundant, and Ying and Wei Qi are harmonized. The Qi of all organs follows its respective meridian, joining with Ying and Wei Qi to converge upon the Lung during respiration. Therefore, the Hand-Taiyin Lung Meridian is the gathering place of the Qi of all organs. The Sages observe the excess or deficiency of Qi at the Qi Kou, revealing the unfathomable secrets of Heaven and Earth's nurturing power. Is this not miraculous?