医流鲜读王氏脉经。而偏熟于脉诀。诀盖庸下人所撰。其疏谬也奚怪哉。戴同父儒者也。而究心
于医书。刊脉诀之误。又集古医经及诸家说为之解。予谓此儿童之谣。俚俗之语。何足以辱通人点窜之笔。
况解书为其高深玄奥。不得不借易晓之辞。以明难明之义也。今歌诀浅近。夫人能知之。而反援引高深
玄奥者为证。则是以所难明解所易晓。得无类奏九韶三夏之音。以聪折杨皇花之耳乎。同父曰。此歌
诚浅近。然医流仅知习此而已。窃虑因其书之误。而遂以误人也。行而见迷途之人。其能已于一呼哉。
予察同父之言。盖仁人之用心。如是而着书。其可也。临川吴澄序。
愚久见此序。而未见其书。岁乙巳秋。得之于金陵郝安常伯。即借而传抄之。慨予光阴有限。故不
及全而节其要云。
朱升题
六朝高阳生。剽窃晋太医令王叔和。撮其切要。撰为脉诀。蔡西山辨之详矣。世相因。人相授。
咸曰王叔和脉诀。既不能正其名。又不能辨其非。讹承惑固。是以罔觉。今刊其误。题曰脉诀。
不以王叔和加其首者。先正其名也。窃取灵素内经、秦越人、张仲景、华佗、王叔和、及历代名医
之书以证。又述诸家所解。集长辨短。知我者其惟脉诀乎。罪我者其惟脉诀乎。
左心小肠肝胆肾。右肺大肠脾胃〔命〕肾。
十二经动脉循环无端。始于手太阴。终于足厥阴。一昼夜五十周。朝于寸口。会于平旦。内经诊
以平旦。难经独取寸口。寸口者。即手太阴之经渠穴也。上古诊法有三。其一。各于十二经动脉见
处。分为三部。
天地人以候各脏腑。其二。以寸口与人迎参之。以验阴阳四时之大小。以决其病。其三。独取寸口。
以内外分脏腑。以高下定身形。斯王叔和之所取。以为寸口。脏腑之位。脉诀述之有差。脉经两尺
并属肾与膀胱。今脉诀以命门列右尺。通真子注。又以三焦为命门合。并属右尺。是不可以不辩。
十八难曰。手心主。少阳火。生足太阴。阳明土。土主中宫。故在中部也。亦未尝言手心主少阳
火在何部也。二十五难曰。心主与三焦为表里。灵枢铜人并同。又未尝以三焦合命门也。且持脉
有道。因动脉而有别。假使以右肾为命门之脏。外无经络。其动脉何在。且命门之说。始于扁鹊。
亦不分男女左右。考之内经。肾固已分为两脏。未尝有命门也。惟铜人有命门穴。在十四椎下。
灵枢言两目为命门。既无动脉。何以为诊。又非正脏。何以列部。肾有两枚。均为肾。尺内以候肾。
同列左右尺。斯黄岐之正论。习医者。不本内经。而信末世昧理之谬论。安能悟其非而造其妙。
三因方以右肾居右尺中。属手厥阴经。与三焦手少阳经合。则又差之甚矣。心主非右肾也。手厥
阴虽与三焦经合。其起于心中。出属心包络。终于手小指次指。其经不行尺部之下也。何以列在
右尺。黎氏曰。扁鹊以心主与三焦为表里。而脉诀以命门与三焦为表里者。以肾为精之舍。三
焦为精之府也。命门虽系一脏。外别无经。与肾俱属足少阴经。与足太阳膀胱相为表里。以此推之。
三焦之气与命门通。而三焦之经不与命门合也。扁鹊之论为正。然则寸口之部位以何为正也。脉
要精微论曰。尺内两旁则季胁也。尺内以候肾。尺外以候腹。中附上。左外以候肝。内以候膈。
右外以候胃。内以候脾。上附上。右外以候肺。内以候胸中。左外以候心。内以候膻中。前以候前。后
以候后。上竟上者。胸喉中事也。下竟下者。少腹腰股膝胫足中事也。此寸口部之定位也。或曰
必以动脉为诊。则手厥阴少阳二经。当列何部也。曰。经云手少阴独无 乎。其外经病而脏不病也。
故治病者治包络之经。无犯其经。则手厥阴同手少阴经部诊也。手少阳为三焦。则各分于上中下部
以诊也。则十二经动脉。皆可诊于寸口矣。洁古以地道自右逆行。言脉三部自手少阴君火心始。逆
而至厥阴风木肝。逆而至太阳寒水。外应十一月。内应于左尺肾与膀胱。接右手。肺应九月。居右
寸。逆至太阴。土为脾。应右关。又逆至手厥阴与三焦。以愚考之。此乃地六气之步位。故岁首于
春初之气。亦始厥阴风木君火不任令。退居二气。而少阳相火当夏为三之气。四气太阴。五气阳明。
六气太阳。乃取地之六气。根据四时而至。难以言寸口三部之位。且六节气位。乃地理之应也。经曰
显明之右。君火之位。君火之右。退行一步。相火治之。复行一步。土气治之。虽始以君火。亦顺
次而行。未尝逆。杨仁斋以右尺其经手厥阴。其藏心包络。其府三焦。其名命脉。决非右肾之命门。
以愚考之。十二经脉。自上古立名。今不悟脉歌非王叔和之本经。又立命脉以附和之。且观于内经
尺内以候肾。原不曾分左右。是合左右之尺。皆以候肾。亦无所谓命脉矣。仁斋直指于医方发明甚高。
惜乎于此未明。
〔女人反此背看之〕（男女脉形有异同。）尺〔脉〕（位）第三同〔断〕（肾）病。
歌首二句。只言部位未论脉。女人反此背看云者。原其惑于男左肾右命门。女右肾左命门。故言反此。
又断之曰尺脉第三同断病。则反此背看者。只论尺脉耳。男女有异同者脉形尔。如男脉关上盛。女
脉关下盛。男左大右小为顺。女右大左小为顺。男女脉位即无异同也。以十二经脉所行之终始。
五岁之定位成形。则一也。惟茎户及胞门子户。精血之不同尔。安可言脉位。女人与男子反而背看乎。
脉诀之误。因于肾与命门有男女之别。不知肾有两。其左为肾。右为命门。难经虽有左右之别。
亦无男女左右之分。其实皆肾脏非命门也。至褚氏遗书。则又以女人心肺自尺始。倒装五脏。则
谬又甚焉。或曰南政北政。三阴司天在泉。而尺寸亦或易位。褚氏之论或原此乎。曰不然也。
司天在泉。以天之六步为客脉也。故随南北政以分尺寸之不应耳。其地之六步为主脉。即随候以
见而不移也。心肺在上。肝肾在下。脾脉在中。自三才分而为人。亘古今何尝异。无求子曰。
所谓反者。男子尺脉常弱。今反盛。女子尺脉常盛。今反弱。故谓之反耳。李 范因之。虽于
反字义明。不同于众论。然反盛反弱。乃男女之病脉。今入式歌。方言部位。而遽以病脉牵解。
似非本旨。特作歌者不善行文。故以反此背看传惑于世耳。今刊而改之如上。
心与小肠居左寸。肝胆同居左关定。肾居尺脉亦如然。用意调和审安静。肺与大肠居右寸。
脾胃脉从关里认。命门还与肾脉同。用心仔细须寻趁。
此脉诀重分左右寸关尺部所出也。其曰命门还与肾脉同。以此句观之。命门即肾也。既知其非动
脉。前何必以命门为脏而列部邪。察病指南以右手尺为命门。却又曰一名手心主包络则又差。以命门
为心主也。心为脏。小肠为腑。以腑配脏者。实以手少阴心经。与手太阳小肠经。二经脉相接。故同
一部。其余脏腑同部皆同。然脏腑之脉。实以浮沉之位别之。腑阳也。故因浮而见。藏阴也。故因沉
而见。然以难经一脉十变推之。如云心急甚者肝邪干心。心微急者胆邪干小肠。是又以本脏之脉微甚。
别脏腑也。察病指南以七难六气循甲子旺脉分六腑者非也。阳明脉浮大而短。安得为胃脉形也。浮大
而短。阳明燥金脉也。
〔若诊他脉覆手看要自看时仰手认〕（诊脉皆须仰手看。覆手反诊用不应。）
古人诊病必仰病患手而诊。医者覆其手。以三部九候菽重之法取之。惟反其诊者不然。盖南北二政
之岁。三阴司天在泉。尺寸或有不应者。反其诊则应矣。不应者。脉沉不应诊也。覆病患手诊之。
则脉见也。沉者为浮。细者为大。舍此之外。无覆手之诊。
升按脉诀之言。谓诊他则覆手。自诊则仰手。取手便而已。刊误盖误认歌意。以医之覆手诊人。
为覆病患之手也。自此以后有似此者。节去之而不辩。
三部须教指下明。
难经曰。脉有尺寸何谓也。然。尺寸者脉之大要会也。从关至尺。是尺内。阴之所治也。从关
至鱼际。是寸口内。阳之所治也。故分寸为尺。分尺为寸。故阴得尺中一寸。阳得寸内九分。尺寸终始。
一寸九分。故曰尺寸也。蔡氏曰。手太阴之脉。自腕中横纹至鱼际。横纹得同身之一尺一寸。自腕中
横纹前尽一尺为阴之位。自鱼际后一寸为阳之位。太阴动脉。前不及鱼际横纹一分。后不及腕中横纹
九寸。故古人
于寸内取九分。尺内取一寸。冥契阳九阴十自然之数。尺寸之间。谓之关。关者。阴阳之限也。
索氏曰。
诸家论脉部位。或曰尺寸。或曰寸关尺。或曰三寸为三部。或尺寸三部通论。其不同者何
也。素问言脉之部位。止言尺寸。未言关也。至扁鹊难经。乃言有关部。在尺寸之交。盖扁鹊
假设关位。而寓于尺寸之交。以为三部也。其实只有尺寸而已。逮仲景本论。及王叔和言脉之部位。
或以尺寸通论某脏某腑受病者。是确言诸脏腑之脉只一之意也。乃合黄帝之说矣。或以三部分
论某脏某腑受病者。是假言诸脏腑之脉各出之意也。乃合扁鹊之说矣。今究仲景叔和。既宗黄帝。
言只有尺寸。又从扁鹊三部之说何哉。盖黄帝言尺寸者。约度之义。扁鹊言三部者。亦约度之义。
仲景叔和所以兼取并用。非疑而两存之也。千金载黄帝问曰。何谓三部脉也。岐伯曰。寸关尺也。
今考黄帝书无此说。盖思邈假托耳。通真子曰。素问三部九候论。所述三部。言身之上中下部。
非谓寸关尺也。
九候了然心里印。
素问曰。人有三部。部有九候。乃各于动脉现处候之。分九候。今脉诀所歌。以寸关尺三部。
每三部内有浮中沉三候。浮以候腑。中以候胃气。沉以候脏。通一手三部为九候也。
大肠〔共〕（供）肺为传送。
素问曰。大肠者传导之官。变化出焉。肺者相传之官。治节出焉。传送者大肠之职。非与肺共也。
大肠以肺为脏。供送应副而已。
〔心与小肠为受盛〕（小肠受盛与心应。）
素问曰。小肠者受盛之官。化物出焉。小肠配心脏。与之相应。非心与小肠同受盛也。
脾胃相通五谷消。
素问曰。脾与胃以膜相连尔。胃受五谷。脾气磨而消之。
膀胱肾合〔为津庆〕（通津径。）
肾之所摄者精。胞之所藏者溺。精溺之泄。同为一径窦而出。若曰津庆。膀胱虽为津液之府。
然五脏六腑皆有津液。非肾膀胱所专主也。
三焦〔无状〕（为府）空有名。〔寄〕（分）在胸〔中〕（腹）。膈相应。
此段皆以脏腑配合为歌。至三焦。却不以命门为配。其以三焦附于尺诊欤。且心主与三焦为表里。
心主脉历络三焦。手少阳脉遍属三焦。其治各有所。上焦如雾。中焦如沤。下焦如渎。各有法象。
不偏在下。安可诊于尺也。且难经曰。上部法天。主胸以上至头之有疾。即上焦之部。中下部即中下焦。
分诊甚明矣。三因方之好异也。云。三焦有形如脂膜。附于两肾夹脊。若果如此。则内经难经言之矣。
其经脉又何遍属历络之云乎。
肝胆同为津液〔府〕（居）。〔能〕（上）通眼目为清净。
素问曰。膀胱者州都之官。津液藏焉。则津液府。施于膀胱为当。以为肝胆则非。又肝脏胆腑。今云同为
府。辞又害意。今改之同为津液居。乃言肝胆之津液耳。五脏各有液。肝之液泣。其候目。五腑皆
有出入。惟胆无出入。其胆之精气。则因肝之余气溢入于胆。故藏在肝短叶间。相并而居。内藏
精汁三合。其汁清净。经曰。胆者清净之府。肝藏血。开窍于目。目受血而能视。故上通眼。人年
老目昏者。血衰。肝叶薄。胆汁减也。
智者能调五脏和。自然察认诸家病。
素问曰。常以不病调病患。医不病。故为病患平息以调之为法。陈氏曰。凡欲诊脉先调自气息。
压。取病患息。以候其迟数。过与不及。所谓以我医彼。莫之敢违。
掌后高骨号为关。骨下关脉形宛然。以次推排〔名〕（分）尺〔泽〕（寸）。三部还须仔细看。
尺泽者手太阴之合穴。在肘中约纹上。其取一寸九分之法。上始鱼际太渊。下终尺泽一尺一寸。
于尺取一寸。于寸取九分。为三部之位。通真子云。三部。寸口在上。关脉在中。尺泽在下。尺泽者。
尺脉一寸之外。余脉所不出不见。如入深泽而穴。故曰尺泽。安可以穴名而言尺部。今改之。无求
子于三部。每部以浮中沉及四旁。分为七候。先浮按消息之。次中按消息之。次重按消息之。次上竟
消息之。次下竟消息之。次推指外消息之。次推指内消息之。此无求子合经中诸法以为定法也。凡诊
平人之脉常以平旦。凡诊病脉。则不以昼夜。王贶子亨法也。
关前为阳名寸口。关后为阴直下取。阳弦头痛定无疑。阴弦腹痛何方走。阳数〔即吐〕（为热）
兼〔头痛〕（吐血）。
难经曰。数则为热。脉经曰。阳数则吐血。
阴微即泻脐中吼。阳实应知面热风。阴微盗汗劳兼有。阳实大滑应舌强。阴数〔脾热并口臭〕
（脐下热痛久。）
Medical practitioners rarely study Wang Shuhe's *Mai Jing* (Pulse Classic), but instead become overly familiar with the *Mai Jue* (Pulse Rhymes). The *Mai Jue* was likely compiled by mediocre and inferior individuals; thus, its omissions and errors are hardly surprising. Dai Tongfu was a Confucian scholar who devoted himself to medical texts. He corrected the errors in the *Mai Jue* and collected ancient medical classics and various schools' theories to annotate it. I consider this merely children's nursery rhymes and vulgar slang; how could they merit the editing pen of a learned person? Moreover, annotating a book is necessary because its content is profound and abstruse, requiring plain language to elucidate difficult meanings. Now, this rhyme is shallow and straightforward, known by everyone, yet it cites profound and abstruse content as proof. This is using what is hard to understand to explain what is easy to understand. Is this not like playing the elegant music of *Jiu Shao* and *Xian Chi* for ears accustomed only to the popular tunes of *Zhe Yang* and *Huang Hua*? Dai Tongfu said: "This rhyme is indeed shallow, but medical practitioners only know to study it. I fear that due to the errors in this book, people will be misled. If one sees a lost person on the road, how can one refrain from calling out to them?" Observing Dai Tongfu's words, I perceive the intention of a benevolent person. Writing such a book is commendable. Preface by Wu Cheng of Linchuan.
I have seen this preface for a long time but had not seen the book. In the autumn of the Yisi year, I obtained it from Hao Anchang (courtesy name Bo) in Jinling. I borrowed it and made a copy. Lamenting my limited time, I did not transcribe the whole text but selected the essentials. Inscribed by Zhu Sheng.
Gao Yangsheng of the Six Dynasties plagiarized Wang Shuhe, the Imperial Physician of the Jin Dynasty, extracting key points to compile the *Mai Jue*. Cai Xishan analyzed this in detail. People followed suit and taught each other, all claiming it was Wang Shuhe's *Mai Jue*. Since its name could not be corrected nor its errors identified, the misinformation persisted firmly, causing unawareness. Now, correcting its errors, the title remains *Mai Jue*, without adding "Wang Shuhe" at the beginning, to first correct its name. I have cited the *Ling Shu*, *Su Wen*, *Nei Jing*, Qin Yue-ren (Bian Que), Zhang Zhongjing, Hua Tuo, Wang Shuhe, and books by famous doctors of successive generations to verify it. I have also presented explanations from various schools, collecting strengths and distinguishing weaknesses. Those who understand me will do so through this *Mai Jue*; those who blame me will do so through this *Mai Jue*.
Left Cun, Guan, Chi correspond to Heart, Small Intestine, Liver, Gallbladder, Kidney. Right Cun, Guan, Chi correspond to Lung, Large Intestine, Spleen, Stomach [Mingmen], Kidney.
The twelve meridian arteries circulate endlessly, starting from the Hand-Taiyin Lung Meridian and ending at the Foot-Jueyin Liver Meridian. They complete fifty cycles in a day and night, gathering at the Cun Kou (Radial Artery) at dawn. The *Nei Jing* advocates pulse diagnosis at dawn, while the *Nan Jing* advocates exclusively taking the Cun Kou. The Cun Kou is the Jing-Well point (Jingqu) of the Hand-Taiyin Lung Meridian. There were three diagnostic methods in ancient times: First, observing the twelve meridian arteries at their respective sites, divided into three parts, using Heaven, Earth, and Man to inspect each Zang-Fu organ. Second, comparing the Cun Kou with the Ying-Cou (Carotid) pulse to verify the magnitude of Yin-Yang and the four seasons, thereby determining the disease. Third, exclusively taking the Cun Kou, dividing internal and external to distinguish Zang-Fu organs, and high and low to determine body positions. This is the method adopted by Wang Shuhe to establish the Zang-Fu positions at the Cun Kou. The *Mai Jue* describes these with discrepancies. The *Mai Jing* attributes both Chi positions to the Kidney and Bladder. However, the *Mai Jue* places the Mingmen (Gate of Life) at the Right Chi. Tongzhenzi's annotation further combines the Sanjiao (Triple Burner) with the Mingmen, attributing both to the Right Chi. These must be clarified.
The *Nan Jing·Chapter 18* states: "The Hand-Shaoyin (Pericardium) and Shaoyang (Sanjiao) are interior-exterior pairs; Fire generates Earth. The Foot-Taiyin (Spleen) and Yangming (Stomach) belong to Earth, which governs the Central Palace, hence located in the middle part." Yet, it never specifies where the Hand-Shaoyin and Shaoyang Fire are located. The *Nan Jing·Chapter 25* states: "The Xin-Zhu (Pericardium) and Sanjiao are interior-exterior pairs." Both the *Ling Shu* and *Tong Ren Jing* agree, and neither combines the Sanjiao with the Mingmen. Furthermore, pulse diagnosis follows specific principles based on arterial differences. If the Right Kidney is considered the organ of the Mingmen, and it has no exterior meridians, where is its artery? Moreover, the concept of Mingmen originated with Bian Que and does not differentiate between male and female sides. Examining the *Nei Jing*, although the Kidneys are described as two organs, there is no mention of the Mingmen as an organ. Only the *Tong Ren Jing* mentions the Mingmen acupoint, located below the 14th thoracic vertebra. The *Ling Shu* refers to the eyes as the Mingmen. Since there is no artery there, how can it be used for diagnosis? Also, it is not a principal organ, so why is it listed in pulse positions? There are two kidneys, both called Kidney. The inner Chi position inspects the Kidney, listed on both left and right. This is the orthodox theory of Huangdi and Qibo. Medical students who do not base themselves on the *Nei Jing* but believe in the erroneous theories of later ignorant people cannot comprehend their mistakes or achieve mastery. The *San Yin Fang* claims the Right Kidney resides in the Right Chi, belonging to the Hand-Jueyin Pericardium Meridian, combined with the Hand-Shaoyang Sanjiao Meridian. This is even more erroneous. The Xin-Zhu is not the Right Kidney. Although the Hand-Jueyin Pericardium Meridian combines with the Sanjiao Meridian, it originates from the heart, emerges to connect with the Pericardium, and ends at the tip of the ring finger. Its meridian does not run under the Chi position. Why list it at the Right Chi? Li Shi stated: "Bian Que considered the Xin-Zhu and Sanjiao as interior-exterior pairs, whereas the *Mai Jue* considers the Mingmen and Sanjiao as interior-exterior pairs because the Kidney is the residence of Essence, and the Sanjiao is the mansion of Essence. Although the Mingmen is a single organ with no other exterior meridians, it belongs to the Foot-Shaoyin Kidney Meridian along with the Kidney, and is interior-exterior with the Foot-Taiyang Bladder Meridian. Inferring from this, the Qi of the Sanjiao connects with the Mingmen, but the Sanjiao meridian does not combine with the Mingmen." Bian Que's argument is correct. So, what is the correct position for the Cun Kou? The *Su Wen·Mai Yao Jing Wei Lun* states: "The inner sides of the Chi region correspond to the hypochondrium. The inner Chi inspects the Kidney; the outer Chi inspects the abdomen. Attached to the middle, the left outer inspects the Liver, and the inner inspects the Diaphragm; the right outer inspects the Stomach, and the inner inspects the Spleen. Attached higher up, the right outer inspects the Lung, and the inner inspects the Chest Center; the left outer inspects the Heart, and the inner inspects the Danzhong. The anterior inspects the anterior body, and the posterior inspects the posterior body. The upper extreme concerns the chest and throat; the lower extreme concerns the lower abdomen, waist, thighs, knees, shins, and feet." This defines the positioning of the Cun Kou. One might ask: "If diagnosis must rely on arteries, where should the Hand-Jueyin and Hand-Shaoyang meridians be listed?" The answer is: "The classic says the Hand-Shaoyin has no distinct pulse elsewhere; it indicates disease in the exterior meridian but not the interior organ. Therefore, when treating diseases, one treats the Pericardium meridian without violating the main meridian. Thus, the Hand-Jueyin is diagnosed together with the Hand-Shaoyin position. The Hand-Shaoyang is the Sanjiao, diagnosed separately in the upper, middle, and lower sections." In this way, the arteries of the twelve meridians can all be diagnosed at the Cun Kou. Jiegu (Zhang Yuansu) argued that the earth's energy moves counter-clockwise from the right, stating that the three pulse positions start from the Hand-Shaoyin Sovereign Fire (Heart), move counter-clockwise to the Jueyin Wind-Wood (Liver), then to the Taiyang Cold-Water, corresponding externally to November and internally to the Left Chi Kidney and Bladder. Continuing to the right hand, the Lung corresponds to September, located at the Right Cun, moving counter-clockwise to the Taiyin Earth (Spleen), corresponding to the Right Guan, and further to the Hand-Jueyin and Sanjiao. Upon investigation, this describes the steps of the Earth's Six Qi. Thus, at the beginning of the year during the spring Qi, it starts with Jueyin Wind-Wood; the Sovereign Fire does not govern and retreats to the second Qi, while the Shaoyang Ministerial Fire governs the summer as the third Qi. The fourth is Taiyin, fifth is Yangming, sixth is Taiyang. This takes the Earth's Six Qi according to the four seasons, making it difficult to explain using the Cun Kou three-position model. Moreover, the six solar term positions are geographical correspondences. The classic states: "To the right of Xianming is the position of Sovereign Fire; to the right of Sovereign Fire, retreating one step, Ministerial Fire governs; retreating another step, Earth Qi governs." Although starting with Sovereign Fire, it proceeds sequentially without reversal. Yang Renzhai believed the Right Chi meridian is the Hand-Jueyin, the organ is the Pericardium, the fu is the Sanjiao, and its name is Mingmai (Life Pulse), definitely not the Mingmen of the Right Kidney. Upon investigation, the twelve meridians were named since antiquity. Today, failing to realize that the Pulse Rhyme is not Wang Shuhe's original work, one creates "Mingmai" to support it. Looking at the *Nei Jing*, which states "the inner Chi inspects the Kidney," originally without left-right distinction, combining both Chi positions to inspect the Kidney means there is no so-called "Mingmai." Yang Renzhai's *Zhi Zhi Fang* made great contributions to medical formulas, but unfortunately failed to clarify this point.
[For women, view it reversed/backwards] (Male and female pulse forms have similarities and differences.) Chi [pulse] (position) third [judge] (Kidney) disease.
The first two lines of the rhyme only discuss positions, not pulse qualities. "View it reversed/backwards for women" originally stemmed from confusion regarding men having the Left Kidney and Right Mingmen, and women having the Right Kidney and Left Mingmen, hence saying "reversed." It then concludes "Chi pulse third judge disease equally," meaning "viewing reversed" applies only to the Chi pulse. The similarities and differences between males and females refer to pulse form. For example, in men, the Guan pulse is vigorous; in women, the Guan-xia (lower Guan) pulse is vigorous. Men follow the pattern of larger left and smaller right as favorable; women follow larger right and smaller left as favorable. The pulse positions for men and women are identical. Based on the termination and commencement of the twelve meridians and the formation of the body at five years old, they are the same. Only the urethral opening and the uterus differ in essence and blood. How can one say that pulse positions are reversed for women compared to men? The error in the *Mai Jue* lies in believing the Kidney and Mingmen differ by gender, not knowing there are two kidneys, the left being the Kidney and the right being the Mingmen. Although the *Nan Jing* distinguishes left and right, it does not distinguish by gender. In reality, they are all Kidneys, not the Mingmen. Later, Chu Shi's *Yi Shu* claimed that for women, the Heart and Lung start from the Chi, inverting the Five Zang organs, which is even more erroneous. Some argue: "In Nan Zheng and Bei Zheng years, with Three Yin governing the Sky and Spring, the Cun and Chi positions might change. Could Chu Shi's theory originate from this?" The response is: "No. Governing the Sky and Spring refers to the Heavenly Six Steps as guest pulses, so the non-responsive Cun and Chi vary with Nan/Bei Zheng. The Earth's Six Steps are master pulses, appearing with observation without shifting. Heart and Lung are above, Kidney and Liver are below, Spleen pulse is in the middle. Since the separation of Heaven, Earth, and Man into humans, this has never changed throughout history. Wu Qiuzi said: 'What is meant by reversed is that men's Chi pulse is usually weak but now becomes strong; women's Chi pulse is usually strong but now becomes weak.' Hence it is called reversed." Li Dongyuan and others followed this. Although clear on the meaning of "reversed," differing from other views, strong and weak pulses are pathological signs for men and women. The current entry-style rhyme discusses positions, yet hastily interprets them with pathological pulses, seemingly missing the original intent. It is merely poor composition by the author that caused confusion with "viewed reversed." Now corrected as above.
Heart and Small Intestine reside in the Left Cun; Liver and Gallbladder are fixed at the Left Guan. Kidney resides in the Chi pulse similarly; use intention to harmonize and examine calmly. Lung and Large Intestine reside in the Right Cun; Spleen and Stomach pulses are recognized from the Guan. Mingmen shares the same pulse as the Kidney; examine carefully and seek diligently.
This comes from the *Mai Jue*'s emphasis on distinguishing the left and right Cun, Guan, and Chi positions. It says "Mingmen shares the same pulse as the Kidney." From this sentence, Mingmen is the Kidney. Since it is known not to be an artery, why was it previously listed as an organ in the pulse positions? The *Cha Bing Zhi Nan* identifies the Right Chi as the Mingmen, yet also says it is another name for the Hand-Jueyin Pericardium, which is again incorrect, equating Mingmen with Xin-Zhu. The Heart is a Zang, and the Small Intestine is a Fu. Pairing Fu with Zang is because the Hand-Shaoyin Heart Meridian and Hand-Taiyang Small Intestine Meridian connect, hence sharing the same position. Other Zang-Fu pairs share positions similarly. However, Zang and Fu pulses are actually distinguished by floating and sinking positions. Fu organs are Yang, so they appear with floating pulses; Zang organs are Yin, so they appear with sinking pulses. However, deducing from the *Nan Jing*'s "one pulse, ten transformations," if severe heart urgency is caused by Liver pathogen invading the Heart, and slight heart urgency is caused by Gallbladder pathogen invading the Small Intestine, this distinguishes Zang and Fu based on the severity of the primary organ's pulse. The *Cha Bing Zhi Nan*'s classification of the Six Fu organs based on the Seven Difficulties and Six Qi following the Jiazi cycle is incorrect. The Yangming pulse is floating, large, and short; how can this be the stomach pulse form? Floating, large, and short is the pulse form of Yangming Dry-Metal.
[If diagnosing other pulses, look with the hand turned over; when self-diagnosing, recognize with the palm up] (Pulse diagnosis requires looking with the palm up. Turning the hand over is for non-responsive cases.)
Ancients always diagnosed patients with the patient's hand supinated (palm up), while the physician covered the hand, using the method of three positions and nine inspections with pressure like bean weights. Only reverse diagnosis differs. Generally, in Nan Zheng and Bei Zheng years, with Three Yin governing the Sky and Spring, the Cun and Chi pulses might be non-responsive. Reverse diagnosis makes them responsive. Non-responsive means the pulse is deep and not palpable. Turning the patient's hand allows the pulse to be felt. Deep becomes floating, thin becomes large. Apart from this, there is no reverse-hand diagnosis.
Zhu Sheng notes: The *Mai Jue* says diagnosing others requires turning the hand, while self-diagnosis uses the palm up, merely for convenience. The editor mistakenly interpreted the rhyme, thinking the physician covering the hand meant turning the patient's hand. Similar cases thereafter were deleted without debate.
One must make the three positions clear under the fingers.
The *Nan Jing* asks: "What are Cun and Chi?" The answer is: "Cun and Chi are the major convergence of pulses. From Guan to Chi is the Chi region, governed by Yin. From Guan to Yuji is the Cun Kou region, governed by Yang. Thus, Cun is divided from Chi, and Chi from Cun. Yin obtains one cun in the Chi region, Yang obtains nine fen in the Cun region. Cun and Chi total one cun and nine fen, hence called Cun and Chi." Cai Shi said: "The Hand-Taiyin meridian extends from the wrist crease to Yuji, measuring one chi and one cun in equal body measurement. One chi before the wrist crease is the Yin position; one cun behind Yuji is the Yang position. The Taiyin artery falls short of the Yuji crease by one fen and short of the wrist crease by nine cuns. Thus, ancients took nine fen in the Cun region and one cun in the Chi region, coinciding with the natural numbers of Yang Nine and Yin Ten. Between Cun and Chi is called Guan. Guan is the limit of Yin and Yang." Suo Shi said: "Various schools discuss pulse positions: some say Cun-Chi, some say Cun-Guan-Chi, some say three cuns constitute three parts, some discuss Cun-Chi and three parts together. What is the difference? The *Su Wen* mentions only Cun and Chi, not Guan. It was Bian Que in the *Nan Jing* who mentioned the Guan position, at the junction of Cun and Chi. Bian Que likely hypothesized the Guan position within the Cun-Chi junction to create three parts. In reality, there are only Cun and Chi. When Zhang Zhongjing's *Ben Lun* and Wang Shuhe discussed pulse positions, sometimes they used Cun-Chi generally to discuss which Zang-Fu was diseased, truly implying that all Zang-Fu pulses are one, aligning with Huangdi. Sometimes they used three parts to discuss specific Zang-Fu diseases, hypothetically implying pulses emerge separately, aligning with Bian Que. Investigating Zhongjing and Shuhe, since they revered Huangdi and said there are only Cun and Chi, why adopt Bian Que's three-part theory? Perhaps Huangdi's Cun-Chi and Bian Que's three parts are both approximate measurements. Zhongjing and Shuhe used both, not out of doubt but coexistence. The *Qian Jin Fang* records Huangdi asking: 'What are the three pulse parts?' Qibo answers: 'Cun, Guan, Chi.' However, checking Huangdi's texts reveals no such statement; Sun Simiao likely fabricated it. Tongzhenzi said: The 'three parts' in *Su Wen·San Bu Jiu Hou Lun* refer to the upper, middle, and lower parts of the body, not Cun, Guan, and Chi."
Nine inspections clearly imprinted in the mind.
The *Su Wen* states: "Man has three parts, each with nine inspections." This means inspecting at the visible arterial sites, divided into nine inspections. The *Mai Jue* sings of the three parts (Cun, Guan, Chi), each containing three inspections: Floating, Middle, and Sinking. Floating inspects Fu organs, Middle inspects Stomach Qi, and Sinking inspects Zang organs. Combining all three parts of one hand constitutes nine inspections.
Large Intestine [together] (supplies) Lung for transmission.
The *Su Wen* states: "The Large Intestine is the official of transmission, where changes occur. The Lung is the official of transmission, where governance arises." Transmission is the duty of the Large Intestine, not shared with the Lung. The Large Intestine relies on the Lung as its Zang partner for supply and coordination.
[Heart and Small Intestine for reception and storage] (Small Intestine receives and stores, responding to Heart.)
The *Su Wen* states: "The Small Intestine is the official of reception and storage, where transformation occurs." The Small Intestine pairs with the Heart, responding to it, not jointly receiving and storing.
Spleen and Stomach connect to digest grains.
The *Su Wen* states: "The Spleen and Stomach are connected by membranes. The Stomach receives grains, and the Spleen grinds and digests them."
Bladder and Kidney combine [for fluid passage] (passage of fluids).
What the Kidney摄 (controls) is Essence; what the Bao (uterus/bladder) stores is Urine. The excretion of Essence and Urine exits through the same orifice. If called "fluid celebration," although the Bladder is the mansion of fluids, all Zang-Fu organs possess fluids, not exclusively controlled by the Kidney and Bladder.
Sanjiao [formless] (is a Fu) empty name. [Resides] (divided) in Chest [Center] (Abdomen). Corresponds to Diaphragm.
This section uses Zang-Fu pairing for the rhyme. Regarding the Sanjiao, it does not pair with the Mingmen. Does it attach the Sanjiao to the Chi inspection? The Xin-Zhu and Sanjiao are interior-exterior pairs; the Xin-Zhu meridian traverses the Sanjiao, and the Hand-Shaoyang meridian遍布 (covers) the Sanjiao. Their treatments have specific focuses. Upper Jiao is like mist, Middle Jiao like foam, Lower Jiao like ditch. Each has its characteristics, not biased downward. How can it be diagnosed at the Chi? The *Nan Jing* states: "The upper part models Heaven, governing diseases from the chest to the head, i.e., the Upper Jiao region. The middle and lower parts correspond to Middle and Lower Jiao." The division is very clear. The *San Yin Fang*'s eccentric claim that "the Sanjiao has shape like fat membrane, attached between the two kidneys and spine" is flawed. If true, the *Nei Jing* and *Nan Jing* would have mentioned it, and the meridians would not speak of traversing and covering.
Liver and Gallbladder together are [residence] (dwelling) of fluids. [Can] (ascend) to connect eyes as pure and clear.
The *Su Wen* states: "The Bladder is the official of the provincial capital, where fluids are stored." Thus, the mansion of fluids applies to the Bladder, not the Liver and Gallbladder. Also, Liver is Zang, Gallbladder is Fu; saying they are both "Fu" harms the meaning. Changed to "together residence of fluids," referring to the fluids of Liver and Gallbladder. Each Zang has its fluid; the Liver's fluid is tears, inspected in the eyes. All Fu organs have entrances and exits, except the Gallbladder. Its essence and qi overflow from the Liver's surplus into the Gallbladder, residing between the short lobes of the Liver, side-by-side, storing three he of pure juice. The classic states: "The Gallbladder is the pure and clear Fu." The Liver stores blood and opens into the eyes; the eyes see when nourished by blood, hence connecting upward to the eyes. Elderly people with dim vision suffer from blood deficiency, thin liver lobes, and reduced bile.
The wise can harmonize the five Zang organs. Naturally inspecting and recognizing diseases of various schools.
The *Su Wen* states: "Always use the healthy state to adjust the patient. The doctor, being healthy, calms his own breath to adjust the patient as a method." Chen Shi said: "Before diagnosing, first regulate one's own breath. Press, take the patient's breath, to inspect its slowness or speed, excess or deficiency. This is 'using myself to treat him,' which none dare violate."
The high bone behind the palm is called Guan. Under the bone, the Guan pulse form is distinct. Sequentially push to [name] (divide) Chi [Ze] (Cun). The three parts require careful examination.
Chize is the He-Sea point of the Hand-Taiyin Lung Meridian, in the elbow crease. The method of taking one cun and nine fen starts from Yuji and Taoyuan above, ending at Chize below, totaling one chi and one cun. Take one cun in Chi, nine fen in Cun, forming the three positions. Tongzhenzi said: "Three parts: Cun Kou is upper, Guan pulse is middle, Chize is lower. Chize means outside the one cun of Chi pulse, where other pulses do not emerge or appear, like entering a deep marsh, hence called Chize." How can one use an acupoint name to describe the Chi position? Now changed to "Cun." Wu Qiuzi divided each of the three parts into seven inspections using Floating, Middle, Sinking, and four directions. First inspect floating, then middle, then heavy pressing, then upper extreme, then lower extreme, then push finger outward, then push finger inward. This is Wu Qiuzi's definitive method combining classic techniques. Diagnosing healthy people is usually done at dawn. Diagnosing sick people is not restricted by day or night. This is the method of Wang Kuang Ziheng.
Anterior to Guan is Yang, named Cun Kou. Posterior to Guan is Yin, take directly downward. Yang stringy pulse indicates headache without doubt. Yin stringy pulse indicates abdominal pain, where does it go? Yang rapid [implies vomiting] (indicates heat)
plus [headache] (hematemesis).
The *Nan Jing* states: "Rapid indicates heat." The *Mai Jing* states: "Yang rapid leads to hematemesis."
Yin weak implies diarrhea and roaring in the umbilicus. Yang solid indicates facial wind and heat. Yin weak includes night sweats and consumption. Yang solid, large, and slippery indicates stiff tongue. Yin rapid [Spleen heat and bad breath]
(Umbilical lower heat and pain for a long time.)