脉者。阴阳之气也。有浮即有沉。有大即有小。有迟即有数。故吴草庐。滑伯仁。李濒湖。皆以对待编之。今欲其
易于分别。凡以浮辨者为一类。以沉辨者为一类。以浮沉合辨者为一类。不以浮沉辨。而以至数辨者为一类。不以浮沉
至数辨。而以形辨者为一类。
经。尺内两旁。则季胁也。（肋骨尽处名季胁）尺外以候肾。尺内以候腹。中附上。（越人谓之关）左外以候肝。内
以候膈。右外以候胃。内以候脾。上附上。（越人谓之寸口）右外以候肺。内以候胸中。左外以候心。内以候膻中。（膻
中在两乳之间）前以候前。后以候后。上竟上者。（关以上）胸喉中事也。下竟下者。（关以下）少腹腰股。膝胫足中事
也。推而外之。内而不外。（外浮也内沉也）心腹疾也。推而内之。外而不内。身有热也。推而上之。上而不下。腰足清
也。推而下之。下而不上。颈项痛也。按之至骨。脉气少者。腰脊痛而有痹也。
脉经。从鱼际至高骨。却行一寸。其中名曰寸口。从寸至尺。名曰尺泽。故曰尺寸。寸后尺前。名曰关。阳出阴入。
以关为界。阳出三分。阴入三分。故曰三阳三阴。阳生于尺。动于寸。阴生于寸。动于尺。寸主上焦。头及皮毛竟手。
关主中焦。腹及腰。尺主下焦。少腹即足。
经于寸关尺分部以候五脏。而六腑止及肾者。盖五脏先天之气。赖后天水谷之气以养之也。余腑不及者。统于脏也。
盖肾开窍于二阴。小肠膀胱属前阴。大肠属后阴。则肾统乎大肠小肠膀胱也。胆附于肝。则肝统乎胆也。三焦不统于脏。
故于寸内候胸中。关内候膈。尺内候腹。胸中上焦也。膈中焦也。腹下焦也。且五脏者。身之主也。外则耳目鼻口。四
肢皮毛肌肉。内则筋骨脉络。气血精神魂魄。皆其所司也。故人之一身皆可病。而病入脏者死。见真脏脉者死。此所以
经之论脉。惟详五脏也。四时之脉。有胃气者生。无胃气者死。此所以经之论脉。而六腑止及胃也。
经论脉。不以六腑配五脏。而王叔和脉经。以心与小肠。候在左寸。肺与大肠。候在右寸。肝胆候在左关。脾胃候
在右关。肾与膀胱。候在左尺。又谓左尺属肾。右为子户。名曰三焦。又谓肾与命门。俱出尺部。其书前后。多自相矛
盾。疑不尽出于叔和。世但辟高阳生脉诀。而不知脉诀。亦实本于脉经也。至右尺主三焦命门之误。李濒湖辨之详矣。
经论脉不及腑。腑病何以候之耶。曰。腑病辨之于症。而以脏脉。候内外之因。假如头角耳前后痛。往来寒热。此
胆经之病症也。而肝脉浮紧。则胆经之风寒。肝脉弦数。则胆经之痰火也。假如胸中胀闷。上焦之病症也。而肺脉滑数。
则上焦之痰火。肺脉沉迟。则上焦之寒气也。
寸关尺。经有外候内候之说。王太仆曰。外谓外侧。内谓内侧。李士材曰。外谓前半部。内谓后半部。二说皆有可
议者。试即尺论之。外以候肾。内以候腹。假令肾病腹不痛。而其脉外侧见病脉。内侧见平脉乎。前半部见病脉。后半
部见平脉乎。即使如此。而一指举按之间。所谓外侧内侧。前半后半之界。能划然清乎。今据经曰。推而外之。内而不
外。有心腹积也。推而内之。外而不内。身有热也。外指浮。内指沉。沉而不浮。故有心腹积。浮而不沉。故身有热。
由是观之。则所谓外候内候。指沉浮而言也明矣。盖五脏六腑之气。朝于脉口。而各有所辨于寸关尺之间。此天地生人
神化莫测之妙。圣人知其故。而于寸关尺浮沉以候之。浮阳也。沉阴也。以脏腑论。则脏阴而腑阳。以脏腑之气论。则
脏气清而腑气浊。清气上升。浊气下降。脉之见于寸关尺者。五脏六腑之气。脏气清。故浮候之。腑气浊。故沉候之也。
胃亦腑。何为又浮以候之乎。曰。五脏皆禀气于胃者也。五脏之脉。有胃气者则平。是五脏之清气。皆胃气之所散布也。
脾受胃之清气。则胃为脾之主也。故浮候胃。而沉候脾也。
赵继宗曰。心肺居上。为阳为浮。肝肾居下。为阴为沉。脾居中州。半阴半阳。半浮半沉。当以左寸为心。右寸为
肺。左尺为肝。右尺为肾。两关为脾。按赵氏之说。可谓妄矣。夫寸关尺之部位。皆手太阴肺经之动脉也。圣人于此分
候脏腑。此其故。惟圣人知之。而其所以然之故。圣人终不得明言之也。赵氏不自知其量。而创论欲异于圣人。抑何妄
乎。至褚澄谓女人之脉。当以左寸为命门。左关为脾。左尺为肺。右寸为肾。右关为肝。右尺为心。则其妄更甚矣。
脉经。心肺俱浮。然浮而大散者心也。浮而短涩者肺也。肝肾俱沉。然牢而长者肝也。按之 。举指采实者肾也。
脾者中洲。故其脉在中。按此。皆论心肺肝肾与脾之脉体。非论寸关尺。而凡浮者为心肺脉。沉者为肝肾脉也。王宗正
不察。为之说曰。诊脉之法。当从心肺俱浮。肝肾俱沉。脾在中州之说。王叔和独守寸关尺。分部位以测五脏六腑之脉。
非也。按宗正。以叔和独守寸关尺为非。不知执心肺俱浮。肝肾俱沉之说。亦非也。今即守寸关尺论之。假如气虚痰郁。
而两寸俱沉之脉。岂以其沉。而遂谓肝肾之乘心肺乎。失血伤精。而关尺俱浮之脉。岂以其浮。而遂谓心肺之乘肝肾乎。
若使不守寸关尺。将不论何部浮。而皆以为心肺病乎。不论何部沉。而皆以为肝肾病乎。况同一浮也。心病肺不病。不
论部位。其何以辨乎。同一沉也。肝病肾不病。不论部位。其何以辨乎。且使心肺俱以浮候。肝肾俱以沉候。经何为又
分心肺肝肾。与脾胃之部乎。夫脉以候病也。守寸关尺以候之。尚不能洞悉其精微。若不守寸关尺。则茫然而无据矣。
经曰。脉者血气之先。血气者阴阳也。故脉有三部俱浮者。阳盛也。非三部之浮。皆心肺脉也。三部俱沉意。阴盛也。
非三部之沉。皆肝肾脉也。当以部位辨之。又以脉之本体辨之。假如浮。必浮洪来盛去衰者。心也。假如沉。必沉而弦
长者。肝也。
经但言。尺外以候肾。尺内以候腹。而叔和则以两尺兼候膀胱。吴写皋。李士材辈。则以左尺兼候小肠与膀胱。其
意皆欲补经之所不及。不知经之论脉。惟详五脏者。盖以五脏能绕乎六腑也。即如伤寒。头痛腰痛项强。此膀胱经之病
症也。而其脉不候于左尺。而候于左寸。愚故曰。腑病辨之以症。而以脏脉。辨内外之因也。由是观之。则以左尺候肾。
兼小肠与膀胱。以为补经之所不及。可以不必矣。且一部候两脉。犹有浮沉阴阳之可辨。至一部。候肾与小肠阳膀胱至
脉。试问何以确辨其为肾脉。为小肠脉。为膀胱脉乎。
Pulse refers to the manifestation of Yin and Yang Qi. Where there is a Floating pulse, there is a Deep pulse; where there is a Large pulse, there is a Small pulse; where there is a Slow pulse, there is a Rapid pulse. Therefore, Wu Caolu, Bo Ren Hua (Hua Bolu), and Li Shizhen all organized pulses according to their opposing relationships. Now, in order to facilitate distinction, those distinguished by Floating are grouped as one category; those distinguished by Deep are grouped as another; those distinguished by combining Floating and Deep are grouped as a third; those not distinguished by Floating or Deep but by frequency (Zhi Shu) are grouped as a fourth; and those not distinguished by Floating, Deep, or frequency, but by shape, are grouped as a fifth.
The *Classic of Internal Medicine* (*Huangdi Neijing*) states: The inner sides of the Chi position correspond to the hypochondrium (the lower lateral part of the thorax). The outer side of Chi is used to inspect the Kidney, and the inner side of Chi is used to inspect the Abdomen. "Zhong Fu Shang" (reaching inward from the Guan position, referred to as Guan in the *Nan Jing*). On the left hand, the outer side of Chi inspects the Liver, and the inner side inspects the Diaphragm. On the right hand, the outer side of Chi inspects the Stomach, and the inner side inspects the Spleen. "Shang Fu Shang" (reaching upward from the Guan position, referred to as Cun Kou in the *Nan Jing*). On the right hand, the outer side of Cun inspects the Lung, and the inner side inspects the Chest Center. On the left hand, the outer side of Cun inspects the Heart, and the inner side inspects the Dan Zhong (located between the nipples). Pushing the pulse outward (superficially) reveals conditions of the anterior body; pushing it inward (deeply) reveals conditions of the posterior body. Pulse qi extending upward to its limit (above the Guan position) reflects matters of the chest and throat. Pulse qi extending downward to its limit (below the Guan position) reflects matters of the lower abdomen, waist, thighs, knees, calves, and feet. Pushing the pulse outward (light pressure): if the pulse appears inward (deep/unobtainable on superficial touch), it indicates diseases of the Heart and Abdomen. Pushing the pulse inward (heavy pressure): if the pulse appears outward (superficial/obtainable on light touch), it indicates fever in the body. Pushing the pulse upward: if pulse qi manifests only above and not below, it indicates coldness in the waist and feet. Pushing the pulse downward: if pulse qi manifests only below and not above, it indicates pain in the neck and nape. Pressing the pulse down to the bone: if the pulse Qi is weak, it indicates pain in the waist and spine accompanied by Bi syndrome.
The *Pulse Classic* (*Mai Jing*) states: From the radial styloid process (Yu Ji) to the high bone (radial styloid), moving backward one cun, this area is named Cun Kou. From Cun Kou to Chi Ze, it is named Chi Ze. Hence it is called Cun-Chi. Behind Cun and in front of Chi is named Guan. Yang emerges and Yin enters, with Guan as the boundary. Yang emerges three fen upward from Guan; Yin enters three fen downward from Guan. Hence it is called Three Yang and Three Yin. Yang originates at Chi and moves at Cun; Yin originates at Cun and moves at Chi. Cun governs the Upper Jiao, including the head, skin, hair, and extending to the hands. Guan governs the Middle Jiao, including the abdomen and waist. Chi governs the Lower Jiao, including the lower abdomen and feet.
The *Classic of Internal Medicine* uses the Cun, Guan, and Chi positions to inspect the Five Zang organs, mentioning only the Kidney among the Six Fu organs. This is because the innate Qi of the Five Zang organs relies on the postnatal Qi of water and grain for nourishment. The reason other Fu organs are not listed separately is that they are subsumed under the Zang organs. Since the Kidney opens into the two yin openings, the Small Intestine and Bladder belong to the anterior yin opening, and the Large Intestine belongs to the posterior yin opening; thus, the Kidney governs the Large Intestine, Small Intestine, and Bladder. The Gallbladder attaches to the Liver, so the Liver governs the Gallbladder. The San Jiao (Triple Burner) is not governed by a single Zang organ; therefore, the inner side of Cun inspects the Chest Center, the inner side of Guan inspects the Diaphragm, and the inner side of Chi inspects the Abdomen. The Chest Center is the Upper Jiao; the Diaphragm is the Middle Jiao; the Abdomen is the Lower Jiao. Moreover, the Five Zang organs are the masters of the body. Externally, they govern the eyes, ears, nose, mouth, four limbs, skin, hair, muscles; internally, they govern the sinews, bones, vessels, blood, Qi, spirit, essence, and soul. Thus, disease can occur anywhere in the body, but if pathogenic factors enter the Zang organs, death ensues; if True Zang pulses appear, death ensues. This is why the *Classic of Internal Medicine* discusses pulse diagnosis, detailing only the Five Zang organs. Pulses in the four seasons that possess Stomach Qi indicate life; those lacking Stomach Qi indicate death. This is why the *Classic of Internal Medicine* discusses pulse diagnosis regarding the Six Fu organs, mentioning only the Stomach.
The *Classic of Internal Medicine* does not pair the Six Fu organs with the Five Zang organs in pulse diagnosis. However, Wang Shuhe's *Pulse Classic* (*Mai Jing*) posits that the Heart and Small Intestine are inspected at the Left Cun; the Lung and Large Intestine at the Right Cun; the Liver and Gallbladder at the Left Guan; the Spleen and Stomach at the Right Guan; and the Kidney and Bladder at the Left Chi. It further states that the Left Chi belongs to the Kidney, while the Right Chi is the "House of the Child," named San Jiao. It also claims that both the Kidney and Ming Men (Gate of Life) originate from the Chi position. The book contains many internal contradictions, leading to suspicion that it was not entirely authored by Wang Shuhe. People criticize Gao Yangsheng's *Pulse Rhyme* (*Mai Jue*), unaware that the *Pulse Rhyme* is actually based on the *Pulse Classic*. Li Shizhen has detailedly refuted the error regarding the Right Chi governing San Jiao and Ming Men.
If the *Classic of Internal Medicine* does not discuss pulse diagnosis for the Fu organs, how are Fu organ diseases inspected? The answer is: Fu organ diseases are differentiated by symptoms, while Zang pulses are used to inspect internal and external causes. For example, pain in the temples and around the ears, alternating chills and fever, are symptoms of the Gallbladder Meridian. If the Liver pulse is Floating and Tight, it indicates Wind-Cold in the Gallbladder Meridian; if the Liver pulse is Wiry and Rapid, it indicates Phlegm-Fire in the Gallbladder Meridian. For example, chest distension and oppression are symptoms of the Upper Jiao. If the Lung pulse is Slippery and Rapid, it indicates Phlegm-Fire in the Upper Jiao; if the Lung pulse is Deep and Slow, it indicates Cold-Qi in the Upper Jiao.
Regarding the Cun, Guan, and Chi positions, the *Classic of Internal Medicine* mentions "Outer Inspection" (Wai Hou) and "Inner Inspection" (Nei Hou). Wang Bing (Wang Taipu) stated: Outer refers to the lateral side, Inner refers to the medial side. Li Shicai stated: Outer refers to the anterior half, Inner refers to the posterior half. Both interpretations have flaws. Let us examine the Chi position. The outer side inspects the Kidney, and the inner side inspects the Abdomen. Suppose there is Kidney disease but no abdominal pain. Would the pathological pulse appear on the outer side while the normal pulse appears on the inner side? Or would it appear on the anterior half while the posterior half shows a normal pulse? Even if so, within the span of one finger's lifting and pressing, can the boundaries of "outer/inner" or "anterior/posterior" be clearly delineated? Now, referring to the classic text: "Pushing outward, if it appears inward (Deep without Floating), there is accumulation in the Heart and Abdomen." "Pushing inward, if it appears outward (Floating without Deep), there is fever in the body." Here, "Outer" refers to Floating, and "Inner" refers to Deep. Deep without Floating indicates accumulation in the Heart and Abdomen; Floating without Deep indicates fever. Thus, it is clear that "Outer Inspection" and "Inner Inspection" refer to Floating and Deep pulses. The Qi of the Five Zang and Six Fu organs converges at the pulse site and is distinguished among Cun, Guan, and Chi. This is the mysterious efficacy of Heaven and Earth in human generation. The Sages understood this and used the Floating and Deep qualities at Cun, Guan, and Chi for inspection. Floating is Yang; Deep is Yin. In terms of Zang-Fu theory, Zang is Yin and Fu is Yang. In terms of Zang-Fu Qi, Zang Qi is Clear and Fu Qi is Turbid. Clear Qi ascends; Turbid Qi descends. Regarding the pulses manifesting at Cun, Guan, and Chi, which represent the Qi of the Five Zang and Six Fu: because Zang Qi is Clear, it is inspected via Floating pulses; because Fu Qi is Turbid, it is inspected via Deep pulses.
The Stomach is also a Fu organ; why is it inspected via Floating pulses? The answer is: The Five Zang organs derive their Qi from the Stomach. A Zang pulse possessing Stomach Qi is balanced. This indicates that the Clear Qi of the Five Zang organs is dispersed by Stomach Qi. The Spleen receives the Clear Qi of the Stomach; thus, the Stomach is the master of the Spleen. Therefore, the Stomach is inspected via Floating pulses, and the Spleen via Deep pulses.
Zhao Jizong stated: The Heart and Lung reside superiorly, are Yang, and are Floating; the Liver and Kidney reside inferiorly, are Yin, and are Deep; the Spleen resides in the Central Region, being half-Yin half-Yang, half-Deep half-Floating. One should assign the Left Cun to the Heart, Right Cun to the Lung, Left Chi to the Liver, Right Chi to the Kidney, and both Guans to the Spleen. Zhao's theory is absurd. The positions of Cun, Guan, and Chi are all arterial movements of the Hand-Taiyin Lung Meridian. The Sages divided these positions to inspect Zang-Fu organs; only the Sages know the reason, and the Sages could never explicitly state the underlying mechanism. Zhao, lacking self-awareness, created theories to differ from the Sages, which is highly presumptuous. Chu Cheng claimed that for women, the Left Cun should be Ming Men, Left Guan the Spleen, Left Chi the Lung, Right Cun the Kidney, Right Guan the Liver, and Right Chi the Heart. His error is even more severe.
The *Pulse Classic* states: Both Heart and Lung pulses are Floating. However, a Floating, Large, and Scattered pulse is the Heart pulse; a Floating, Short, and Choppy pulse is the Lung pulse. Both Liver and Kidney pulses are Deep. However, a Firm and Long pulse is the Liver pulse; a pulse that feels solid upon pressing and substantial upon lifting is the Kidney pulse. The Spleen is in the Central Region, so its pulse is in the middle. These descriptions refer to the pulse characteristics of the Heart, Lung, Liver, Kidney, and Spleen, not to the Cun-Guan-Chi positions. Generally, Floating pulses belong to Heart/Lung, and Deep pulses belong to Liver/Kidney. Wang Zongzheng failed to investigate this and argued: The method of pulse diagnosis should follow the saying that Heart and Lung are Floating, Liver and Kidney are Deep, and the Spleen is in the Central Region. Wang Shuhe's adherence to Cun-Guan-Chi positions to measure Zang-Fu pulses is incorrect. Wang Zongzheng considers Wang Shuhe's exclusive reliance on Cun-Guan-Chi as wrong, yet he fails to realize that adhering to "Heart/Lung Floating, Liver/Kidney Deep" is also wrong. Let us analyze based on Cun-Guan-Chi. Suppose Qi deficiency and Phlegm stagnation cause both Cun pulses to be Deep. Can we say, simply because it is Deep, that Liver/Kidney is invading Heart/Lung? Suppose blood loss and Essence injury cause both Guan and Chi pulses to be Floating. Can we say, simply because it is Floating, that Heart/Lung is invading Liver/Kidney? If we do not adhere to Cun-Guan-Chi, then any Floating pulse anywhere would be attributed to Heart/Lung disease, and any Deep pulse anywhere to Liver/Kidney disease? Moreover, even if both are Floating, how to distinguish Heart disease from Lung disease without positional differentiation? Even if both are Deep, how to distinguish Liver disease from Kidney disease? Furthermore, if Heart and Lung were always inspected via Floating pulses, and Liver and Kidney via Deep pulses, why did the Classic differentiate positions for Heart, Lung, Liver, Kidney, Spleen, and Stomach? Pulse diagnosis is for detecting disease. Even adhering to Cun-Guan-Chi makes it difficult to fully grasp the subtleties; abandoning them leads to confusion and lack of basis.
The Classic states: Pulse is the precursor of Blood and Qi; Blood and Qi are Yin and Yang. Thus, there are cases where all three positions are Floating, indicating Yang Excess; this does not mean all Floating pulses are Heart/Lung pulses. Similarly, all three positions being Deep indicates Yin Excess; this does not mean all Deep pulses are Liver/Kidney pulses. Differentiation must be made by position and by the intrinsic nature of the pulse. For instance, a Floating pulse must be Floating, Surging, strong on arrival and weak on departure to be identified as a Heart pulse. A Deep pulse must be Deep, Wiry, and Long to be identified as a Liver pulse.
The *Classic of Internal Medicine* only states: "Chi outer inspects Kidney, Chi inner inspects Abdomen." Wang Shuhe, however, used both Chi positions to inspect the Bladder. Wu Xigao, Li Shicai, and others used the Left Chi to inspect the Small Intestine and Bladder. Their intent was to supplement what the Classic omitted. They did not realize that the Classic details only the Five Zang organs because the Zang organs encompass the Six Fu organs. Take Shaoyang (Cold Damage) as an example: headache, lower back pain, and stiff neck are symptoms of the Bladder Meridian. Yet, the pulse is not inspected at the Left Chi, but at the Left Cun. I therefore assert: Fu organ diseases are differentiated by symptoms, and Zang pulses are used to determine internal and external causes. Thus, using the Left Chi to inspect the Kidney, Small Intestine, and Bladder simultaneously, under the guise of supplementing the Classic, is unnecessary. Moreover, if one position inspects two pulses, Floating and Deep/Yin-Yang distinctions can still be made. But if one position inspects the pulses of Kidney, Small Intestine, and Bladder simultaneously, how can one accurately distinguish which is the Kidney pulse, which is the Small Intestine pulse, and which is the Bladder pulse?