素问九卷。为医经之祖。西晋乱后。失其第七一卷。故梁七录所载全元起诠注。皆只八卷。唐王冰谓于郭子斋堂。
得受先师张公秘本。林亿等讥其以阴阳大论之文纂入。犹周官亡冬官以考工记补之之类。何以言之。夫六淫
之邪。以风寒热为三大纲领。考素问风论热论。病情委曲详尽。何以独阙寒论。而热论首言今夫热病者。皆伤寒
之类也。既云类伤寒。则有正伤寒专论可知。惜乎亡于兵火。仲景伤寒论序云。撰用素问九卷。当时尚未亡失。是
伤寒专论。散见于六经篇中。幸高平王叔和编其残帙。使医统正脉。一线不绝。厥功伟矣。又集先贤诊法。着成脉
经。更以师承心验者。别撰脉诀。经高阳生编为歌括。以便记诵。辞俚旨深。朱子跋郭长阳伤寒补亡论。深许其高
骨取关之义。何戴起宗李濒湖辈。不求其旨。但鄙其文。多见其不自量也。余夙好方术。服膺此书。思欲诠释以畅
其义。庚寅之春。于广陵肆中。得脉诀乳海六册。虫啮尘湮。几难卒读。携归案头。如理乱丝。始能成诵。其作者为王
君邦傅。王君不知何时人。亦医林中之矫矫者。以河洛之精义。发叔和之奥旨。而于营卫循行之道。尤深致意焉。
论理精详。引证博雅。金元后仅见才也。惟画图立说。似近胶刻。脏腑拘例。未免沿习。言其所当然。未言其所以然
也。请试明之。易本乎天地。人与天地参。其阴阳之理一也。乾坤六爻以配十四经脉。婺源江氏河洛精蕴。论之綦
详。脏腑定位。西士解剖诸书。言之甚悉。而气化之理阙马。夫归藏商易。取用乎坤。而以十二辟卦。候一年十二月
消息。礼记孔子曰。吾欲观殷道。是故之宋而不足。征也。吾得坤干焉。所谓坤干者。商易归藏也。故系辞曰。变通配
四时。又曰刚柔相推变。在其中矣。又曰。往来不穷。谓之通。又曰。寒往则暑来。暑往则寒来。皆此义也。汉儒每常
言之。十二辟卦者。即十二月令之卦也。又即乾坤二卦六爻之旁解也。盖干之六阳。自十一月建子。冬至一阳始生。
为地雷复卦。即干初九爻。十二月建丑。二阳生。为地泽临。即干九二。正月寅。三阳生。为地天泰。即干九三。二月
卯。四阳生。为雷天大壮。即干九四。三月辰。五阳生。为泽天 。即干九五。至四月建巳。六阳充足。而为干为天。
即干上九。此一年之乾卦也。至五月建午。夏至一阴生。为天风 卦。即坤初六爻。六月建未。二阴生。为天山遁。即
坤六二。七月建申。三阴生。为天地否。即坤六三。八月酉。四阴生。为风地观。即坤六四。九月戌。五阴生。为山地
剥。即坤六五。至十月建亥。六阴纯静。而为坤为地。即坤上六。此一年之坤卦也。夫坤为万物之母。而能生物。然坤
本纯阴。必待干与之交。而得其阳。然后始能生万物也。十二支次序。世人皆以子为首。因坤临十月亥。坤为纯阴之卦。
阴极则阳生。故十一月冬至一阳升于地上。为地雷复也。不知造化端倪。实不在子而在午。盖天地交而后万物生。是干
坤交 之初。即为万物造端之始。然交必阳体充足。而后能交干之六阳。乃充足于四月之巳次为午。故干至五
月建午。始与坤交是则干足于巳而动于午。巳午皆火。故伏羲干居正南。干之外体。属火。干中含蓄阴精属金。故
五行家言。庚金长生在巳。所谓长生者乃指其生之之源而言也。干之初动于午每年五月夏至之时。干上九一。
阳已升至天顶极高。不得不转而向下向下即感动坤阴之气上升而交。故天地三交五月建午为第一交。六月
未为二交。七月申为三交。所谓坤三索于干也。乾坤交而谓之索者。以坤本纯阴。必索于干而后有阳。始能生化
也。干阳入坤而化为气。气升为云为雨。盖十二辟卦。干位巳火也。坤位亥水也。干与坤交。则火入水中。而化为气。
以水为质火为性试以一碗。人张口气呵之则生水故知气之形属水。而其所以能升腾行动者。则火也爻辞曰。
见群龙无首吉。言气升能为云雨。故喻为龙。而干与坤三交。则干上四五之三爻。尽入于坤。而干上爻巳火之首。
早入亥水之中。为育生胚胎之兆。故龙之无首吉也此天地阴阳化育之义推之与人亦然饮入于胃。由胃小肠
相接处幽门。幽门之上有一窍。水饮从此窍散布下焦脂膜之中。由脂膜而渗入膀胱。膀胱无上口。故曰渗入也。
气血之升降。必由呼吸以循环。吸入天之阳。呼出地之阴。吸入之气。由鼻入肺。历心引心火。从总脉管。循督脉入
肾。又从肾系以达下焦胞室。挟膀胱至下口。其吸入天之阳气。令人身心火。蒸动膀胱之水。化而为气。循冲任而
上。化津化汗。过膈入肺。还至于口。由呼而出。斯即乾坤相交。三索之义也。明乎此。不独察水火之征兆。阴阳之盛
衰。即四时伏气之病机。莫不由此悟入。若夫营卫之理。请再明之。卫者气也。卫护于外者也。营者血也。营运于中
者也。但血中有气。气中有血。不可须臾相离。而其本则一。其道有三。如动一也。静一也。所以能使其动静者。又一
也。太极无形。而寓三才之理。凡物皆然。不独指动静而言也。谷入于胃。其糟粕由广肠而出魄门。其精液有微丝
管。吸至颈会管。过肺入心。化而为赤。此即清者为营也。其血赤由总脉管。循督脉下达。胞室。内而脏腑。外而经脉。
一日夜五十周。尽八百十丈之脉道。以应呼吸漏下者。此其一也。人之饮食五味杂投。奚能无毒。胃中悍毒之气。
合下焦水火蒸腾之气。由上焦气街散入微丝血管。微丝血管者。即经所谓孙络。此浊者为卫也。灵枢营卫生会
篇。谓卫气出于下焦者。言其生气之原。五味篇谓卫者。阳明水谷之悍气。从上焦而出卫于表。阳者。言其出入之
道也。奉心化赤。之血气。由络脉管之尾。递入孙络。与阳明悍毒之气并。布散通体皮腠之间。充肤热肉。澹渗毫毛
者。此其二也。清浊混淆。赤血渐变渐紫。西士见其色紫。知其有毒。名之曰炭气。然不知其毒所从来也。孙络散布
遍体。渐并渐粗。而接入回血管之尾。回血管者。即经所谓络脉也。血入回血管。内而脏腑。外而经脉。并脉管交相
逆顺而行。外行于经脉者。有阴阳之别。一支沉于分肉之间。一支浮于肌腠之上。即阳络行于皮表。阴络行于皮
里。而皆与脉管偕行。亦即营行脉中。卫行脉外之义。此其三也。回血管内外行遍。入总回管至心。递入于肺。呼出
悍气。吸入生气。紫者复化为赤。经云。阴阳相贯。如环无端者。此之谓也。诊脉察病。当考诸运血脉管之营卫。外邪
袭入。当考诸微丝血管。缠布周身之营卫。夫太阳主表。太阴亦主表者。盖肺为天。天包地之外。而处于上。膀胱为
水。水环地之极。而处于下。膀胱主水。水阴也。肺主气。气阳也。故寒伤营。当责诸太阳。热伤卫。当责诸太阴。识
此寒热之治。知所适从矣。若口鼻吸受之伏气。当考诸回血管。阳络浮于脉外者。可刺之以泄其气。阴络沉于脉内者。
宜急攻之以杀其毒。观近世沙毒必刺委中诸穴。其血色微紫病轻。深紫或黑病重。故当急刺以出其血。否则毒
由总回管入心。不可施救。此其证也。虽然。其道有三。而气血则一。斯乃阴阳至理。三才指归。乾坤三索。化生万
类。不外乎此。然卫气篇曰。亭亭淳淳乎孰能穷之。足征阴阳之变。虽圣贤亦莫测其机。即其不变者观之。又岂可缘
木以求鱼。故谓画图拘例者泥矣。如浮为表脉。而里虚者无不兼浮。沉为里脉。而表寒重者。阳气不能外达。每多
沉紧。迟为阴寒。若热邪壅结。隧道不利。脉反呈迟。数为阳热。若脉来浮数。大而无力。按之豁然而空。此阴盛于下。
逼阳于上。虚阳浮露之戴阳证也。脉数盛大。按之涩。而外有热证者。此名中寒。乃寒凝血脉。外证热而脉即数也。
是表可主里。里可主表。寒可察热。热可察寒。阴阳变化之机。活法存乎一心。似可不拘拘于成见矣。然不以规矩。
不能使人巧。若舍绳墨。又从何处化裁运用乎。则脉诀一书。尤当深思而索玩者也。故乐为之序。
光绪辛卯初秋。石林旧隐。叶霖子雨氏。书于研医读易之斋。
*Suwen* (Basic Questions) consists of nine volumes and is the ancestor of medical classics. After the chaos of the Western Jin Dynasty, the seventh to eleventh volumes were lost. Therefore, the commentary by Quan Yuanqi recorded in *Liang Qilu* only contains eight volumes. Wang Bing of the Tang Dynasty claimed to have received a secret copy from his predecessor Master Zhang in Guozi's study. Lin Yi and others mocked him, stating that he compiled texts from *Yinyang Dalun* (Great Treatise on Yin and Yang), similar to how *Kaogongji* (Records of Examining the Art) was used to supplement the missing *Dongguan* (Winter Office) in *Zhouli* (Rites of Zhou). Why is this said? The pathogenic factors of the Six Excesses are categorized into three main guidelines: Wind, Cold, and Heat. Examining *Fenglun* (Discourse on Wind) and *Relun* (Discourse on Heat) in *Suwen*, the descriptions of diseases are detailed and comprehensive. Why is there a lack of *Hanlun* (Discourse on Cold)? However, *Relun* begins with "All current heat diseases belong to the category of Shanghan" (Cold Damage). Since it says "category of Shanghan," it implies the existence of a specific treatise on Zheng Shanghan (True Cold Damage). Unfortunately, it was destroyed in war. In the preface to *Shanghan Lun* (Treatise on Cold Damage), Zhang Zhongjing stated, "I utilized the nine volumes of *Suwen*." At that time, *Suwen* had not yet been completely lost. Thus, the specific discussions on Shanghan were scattered among the chapters of the Six Meridians. Fortunately, Wang Shuhe from Gaoping compiled these fragmented manuscripts, ensuring that the lineage of medicine remained unbroken. His merit was great. He also collected the diagnostic methods of sages past to compose *Maijing* (Pulse Classic), and separately wrote *Maijue* (Pulse Aphorisms) based on inherited experiences and insights. Gao Yangsheng arranged them into rhymed verses for easier memorization. The language is colloquial but the meaning is profound. Zhu Xi, in his postscript to Guo Changyang's *Shanghan Buwang Lun* (Supplemental Lost Arguments on Cold Damage), highly praised the principle of "locating Guan at the high bone." Why did Dai Qizong and Li Shizhen fail to seek its deeper meaning and merely despised its literary style? This only reveals their overestimation of themselves. I have long cherished medical arts and deeply revered this book, desiring to annotate it to clarify its principles. In the spring of the Gengyin year, I obtained six volumes of *Maijue Ruhai* (Sea of Pulse Aphorisms) at a bookstore in Guangling. Infested by insects and covered in dust, it was barely readable. Bringing it home to my desk, I unraveled it like tangled silk until I could recite it. The author was Wang Bangfu. Little is known about Wang's era, but he was a prominent figure in the medical field. Using the profound principles of Hetu and Luoshu (River Map and Luo Script), he elucidated the obscure meanings of Wang Shuhe, paying particular attention to the circulation of Ying (Nutrient) and Wei (Defensive) Qi. His theoretical discussions were precise and detailed, and his citations were extensive and elegant; he was a talent rarely seen since the Jin and Yuan dynasties. However, his use of diagrams seemed somewhat rigid, and his definitions of Zang-Fu organs followed conventions too closely, explaining what should be so without explaining why. Let me attempt to clarify this. *Yijing* (Book of Changes) is rooted in Heaven and Earth. Man participates in Heaven and Earth, sharing the same principles of Yin and Yang. The six lines of Qian and Kun correspond to the fourteen meridians. Jiang Shi of Wuyuan discussed this in detail in *Heluo Jingyun*. The positioning of Zang-Fu organs is described extensively in Western anatomical texts, yet the principles of Qi transformation are lacking. *Guicang*, the *Yijing* of the Shang Dynasty, utilized Kun and employed the Twelve辟 Gua (Month Hexagrams) to monitor the waxing and waning of the twelve months of the year. Confucius said in *Liji*: "I wished to observe the Way of Yin, so I went to Song, but it was insufficient for verification. I obtained Kun and Qian." What is meant by Kun and Qian here is the Shang *Yijing*, *Guicang*. Thus, *Xici* (Appended Statements) says, "Variations and penetrations correspond to the Four Seasons," and again, "Hardness and softness push each other, and changes occur within." It also says, "Coming and going without end is called penetration," and "When cold goes, heat comes; when heat goes, cold comes." All these express this meaning. Han scholars often spoke of this. The Twelve Month Hexagrams are the hexagrams of the twelve monthly commands, which are also the lateral interpretations of the six lines of Qian and Kun. Generally, the six Yang lines of Qian begin in the eleventh month, Zi (Rat). At Winter Solstice, one Yang begins to generate, forming the hexagram Di Lei Fu (Earth over Thunder Reversal), corresponding to the first Nine of Qian. In the twelfth month, Chou (Ox), two Yangs generate, forming Di Ze Lin (Earth over Lake Approach), corresponding to the second Nine of Qian. In the first month, Yin (Tiger), three Yangs generate, forming Di Tian Tai (Earth over Heaven Peace), corresponding to the third Nine of Qian. In the second month, Mao (Rabbit), four Yangs generate, forming Lei Tian Da Zhuang (Thunder over Heaven Great Strength), corresponding to the fourth Nine of Qian. In the third month, Chen (Dragon), five Yangs generate, forming Ze Tian Guai (Lake over Heaven Decision), corresponding to the fifth Nine of Qian. By the fourth month, Si (Snake), six Yangs are full, forming Qian Wei Tian (Qian as Heaven), corresponding to the top Nine of Qian. This is the process of the Qian hexagram throughout the year. By the fifth month, Wu (Horse), at Summer Solstice, one Yin begins to generate, forming Tian Feng Gou (Heaven over Wind Coming Together), corresponding to the first Six of Kun. In the sixth month, Wei (Goat), two Yins generate, forming Tian Shan Dun (Heaven over Mountain Retreat), corresponding to the second Six of Kun. In the seventh month, Shen (Monkey), three Yins generate, forming Tian Di Pi (Heaven over Earth Standstill), corresponding to the third Six of Kun. In the eighth month, You (Rooster), four Yins generate, forming Feng Di Guan (Wind over Earth Contemplation), corresponding to the fourth Six of Kun. In the ninth month, Xu (Dog), five Yins generate, forming Shan Di Bo (Mountain over Earth Splitting Apart), corresponding to the fifth Six of Kun. By the tenth month, Hai (Pig), six Yins are pure and quiet, forming Kun Wei Di (Kun as Earth), corresponding to the top Six of Kun. This is the process of the Kun hexagram throughout the year. Kun is the mother of all things and can give birth. However, being purely Yin, it must wait to interact with Qian to obtain Yang before it can generate all things. The sequence of the Twelve Earthly Branches starts with Zi in common belief because Kun corresponds to the tenth month, Hai. Kun is a purely Yin hexagram; when Yin reaches its extreme, Yang generates. Thus, at the Winter Solstice in the eleventh month, one Yang rises above ground, becoming Di Lei Fu. However, the beginning of creation actually lies not in Zi but in Wu. Because Heaven and Earth must interact for all things to be born, the initial interaction of Qian and Kun marks the start of creation. Interaction requires sufficient Yang body to interact with the six Yangs of Qian. Yang becomes sufficient in the Si position of the fourth month and moves in Wu. Thus, Qian interacts with Kun starting in the fifth month, Wu. This means Qian is full in Si and moves in Wu. Si and Wu both belong to Fire. Therefore, in Fuxi's arrangement, Qian resides in the due South; the outer body of Qian belongs to Fire, while the hidden Yin essence within Qian belongs to Metal. Hence, Five Elements theorists say Geng Metal is born in Si. "Born" refers to the source of its generation. When Qian first moves in Wu, during the Summer Solstice of May each year, the top Nine of Qian has risen to the highest point in the sky and must turn downward. Downward movement stirs the Yin Qi of Kun to rise and interact. Thus, among the three interactions of Heaven and Earth, the fifth month, Wu, is the first interaction; the sixth month, Wei, is the second; the seventh month, Shen, is the third. This is called "Kun seeks three times from Qian." The term "seek" in the interaction of Qian and Kun exists because Kun is purely Yin and must seek from Qian to obtain Yang for generation and transformation. Yang Qi of Qian enters Kun and transforms into Qi, rising as clouds and rain. In the Twelve Month Hexagrams, Qian is located in Si Fire, and Kun is located in Hai Water. When Qian and Kun interact, Fire enters Water and transforms into Qi. Taking water as substance and fire as nature, if one blows air onto a bowl of water, moisture forms. Thus, we know the form of Qi belongs to Water, but its ability to rise and move is due to Fire. The line statement says, "Seeing a group of dragons without a head brings good fortune." This means Qi rising can become clouds and rain, hence metaphorically called dragons. After Qian and Kun interact three times, the upper five, four, and three lines of Qian all enter Kun, and the head of the top line of Qian (Si Fire) has already entered the water of Hai, signaling the embryo's gestation. Hence, the dragon without a head is auspicious. This is the meaning of Heaven and Earth's Yin-Yang nurturing. Applied to humans, it is the same. Drinking enters the Stomach. From the pylorus, where the Stomach connects to the Small Intestine, there is an orifice above the pylorus. Fluids spread from this orifice into the fat membranes of the Lower Jiao, seeping from the membranes into the Bladder. The Bladder has no upper opening, hence it is called "seeping." The ascent and descent of Qi and Blood must circulate through respiration. Inhaling Heaven's Yang, exhaling Earth's Yin. Inhaled Qi enters the nose and Lungs, passes through the Heart guiding Heart Fire, travels via the main vessel, follows the Du Mai (Governor Vessel) to the Kidneys, then reaches the Lower Jiao Baozhong (Uterus/Bladder area) via the Kidney channel, accompanying the Bladder to its lower outlet. The inhaled Heavenly Yang Qi heats the body, steaming the Bladder's water to transform it into Qi. This Qi ascends via the Chong and Ren Mai, transforming into fluids and sweat, crossing the diaphragm into the Lungs, returning to the mouth, and exiting via exhalation. This is the meaning of Qian-Kun interaction and the three searches. Understanding this allows one to perceive not only signs of Water and Fire and the waxing/waning of Yin and Yang, but also the pathology of latent pathogens in the four seasons. Regarding Ying and Wei, let us clarify further. Wei is Qi, protecting externally. Ying is Blood, circulating internally. Yet Blood contains Qi, and Qi contains Blood; they cannot be separated for a moment, sharing one origin. Their path has three aspects. Movement is one, stillness is one, and that which causes movement and stillness is another. Taiji is formless but contains the principles of the Three Powers; all things are thus, not just regarding movement and stillness. Grain enters the Stomach. Waste exits via the Large Intestine and anus. Nutrients are absorbed by capillaries, reaching the neck junction, passing through the Lungs to the Heart, turning red. This is the clear part becoming Ying. The red blood flows from the main vessel, down the Du Mai to the Baozhong, internally to Zang-Fu, externally to meridians. In one day and night, it completes fifty cycles, traversing 810 zhang of vessels, corresponding to the leakage of water clocks. This is the first aspect. Human diet involves mixed flavors, inevitably containing toxins. The fierce toxic Qi in the Stomach combines with the steaming Qi of Water and Fire in the Lower Jiao, dispersing from the Upper Jiao Qi Street into capillaries. Capillaries are what the classics call Sunluo (Sun Collaterals). This is the turbid part becoming Wei. The *Lingshu: Yingwei Shenghui* chapter states Wei Qi originates from the Lower Jiao, referring to its source of generation. The *Wuwei* chapter states Wei is the fierce Qi of Yangming grain and fluids, emerging from the Upper Jiao to protect the exterior. "Yang" refers to its path of entry and exit. The Qi and Blood nourishing the Heart and turning red pass from the tail of collateral vessels into Sunluo, merging with the fierce Qi of Yangming, spreading throughout the skin and muscles, filling the flesh, warming the meat, and permeating hair follicles. This is the second aspect. Clear and turbid mix, red blood gradually turns purple. Westerners see the purple color, recognize toxicity, and name it carbon dioxide. However, they do not know the source of this toxicity. Sunluo spreads throughout the body, gradually merging and thickening, connecting to the tail of venous vessels. Venous vessels are what the classics call Luomai (Collateral Vessels). Blood entering venous vessels flows internally to Zang-Fu and externally to meridians, moving counter and顺 (smoothly) with arterial vessels. Those running externally in meridians have Yin and Yang distinctions. One branch sinks between muscle layers, one floats above muscle and skin. That is, Yang Luos run on the skin surface, Yin Luos run beneath the skin, both traveling with the main vessels. This is also the meaning that Ying runs inside vessels and Wei runs outside. This is the third aspect. After circulating internally and externally, venous blood enters the main vein to the Heart, then to the Lungs, exhaling fierce Qi and inhaling vital Qi. Purple blood turns red again. The classic says, "Yin and Yang interconnect like a ring without end," referring to this. In pulse diagnosis and disease examination, one should examine the Ying and Wei operating in the blood vessels. For external pathogens invading, one should examine the Ying and Wei entangling the capillaries throughout the body. Taiyang governs the exterior, and Taiyin also governs the exterior. This is because the Lung is Heaven, enveloping Earth externally and positioned superiorly. The Bladder is Water, surrounding the extremities of Earth and positioned inferiorly. The Bladder governs Water, which is Yin. The Lung governs Qi, which is Yang. Therefore, Cold injuring Ying should be attributed to Taiyang. Heat injuring Wei should be attributed to Taiyin. Recognizing this treatment for Cold and Heat guides proper action. If latent pathogens are inhaled via mouth and nose, examine the venous vessels. Yang Luos floating outside vessels can be needled to drain Qi. Yin Luos sinking inside vessels require urgent attack to kill toxicity. Observing modern treatments for Sha toxin, one must needle穴位 like Weizhong. Slightly purple blood indicates mild disease; deep purple or black indicates severe disease. Thus, urgent needling to release blood is necessary. Otherwise, toxin enters the Heart via the main vein, making rescue impossible. This is the manifestation. Although the path has three aspects, Qi and Blood are one. This is the ultimate principle of Yin and Yang, the return of the Three Powers. Qian and Kun's three searches generate all species, nothing outside this. However, the *Wei Qi* chapter asks, "Who can exhaust the profound mystery?" proving that even sages cannot fathom the mechanisms of Yin-Yang changes. Even observing the unchanging, can one seek fish by climbing a tree? Thus, those who stick rigidly to diagrams are inflexible. For example, Floating pulse indicates Exterior, but Interior deficiency always accompanies Floating. Sinking pulse indicates Interior, but severe Exterior Cold often presents with Sinking-Tight pulse as Yang Qi fails to reach the exterior. Slow pulse indicates Yin-Cold, but if Heat pathogen obstructs and tunnels are blocked, the pulse may appear Slow. Rapid pulse indicates Yang-Heat, but if the pulse is Floating-Rapid, large and forceless, feeling empty upon pressure, this is Yin excess below forcing Yang upward, a Daiyang syndrome (Floating Yang) of deficient Yang floating outward. A pulse that is Rapid and Surging but feels Choppy upon pressure, accompanied by external Heat symptoms, is named Zhonghan (Internal Cold), caused by Cold congealing blood vessels, presenting external Heat but Rapid pulse. Thus, Exterior can indicate Interior, Interior can indicate Exterior, Cold can reveal Heat, and Heat can reveal Cold. The mechanism of Yin-Yang change lives in the mind, suggesting one should not be bound by preconceptions. Yet, without rules and compass, skill cannot be achieved. Without ink lines, where would one apply adaptation? Therefore, the *Maijue* deserves deep contemplation and study. Hence, I gladly write this preface. Early Autumn of Xinmao Year, Guangxu Era. Ye Lin, courtesy name Ziyu, pseudonym Shilin Jiuyin, wrote in the Studio for Studying Medicine and Yijing.