Library

The Sanjiao (Triple Burner) occupies a position of hollow suspension. The *Ling Shu · Ying Wei Hui Hui* chapter states: "The Upper Jiao originates from the upper orifice of the stomach, ascends along the pharynx, pierces through the diaphragm, and spreads in the chest. The Middle Jiao is also located within the stomach, posterior to the Upper Jiao; it separates the clear from the turbid, steams and transforms the essence and fluids, converting them into subtle nutrients to generate blood. The Lower Jiao separates from the ileum, pours into the bladder, and permeates therein. Food and drink reside in the stomach, transform into dregs, descend into the large intestine, thereby forming the function of the Lower Jiao." It further states: "The Upper Jiao is like mist, the Middle Jiao like fermentation, and the Lower Jiao like a ditch." From this, it is clear that the Sanjiao is divided into Upper, Middle, and Lower based on location. To list the Sanjiao at the Right Chi pulse position, as the spurious *Mai Jue* does, is indeed absurd! It also says: "Those with fine skin texture and thick skin have a substantial Sanjiao; those with coarse skin texture and thin skin have a deficient Sanjiao." From this, it is evident that the Sanjiao has a physical form. For the spurious *Mai Jue* to claim it is formless is indeed absurd! Furthermore, consulting the *Ling Shu · Ben Shu* chapter states: "The Sanjiao is the Fu organ of the middle channels; water pathways emerge from it, connecting to the Bladder; it is the solitary Fu organ." It is called the "Middle Channel" because it resembles rivers and ditches, with sources and flows originating within it. Just as food and drink enter via the mouth and exit via urination and defecation, they must pass through the Sanjiao from top to bottom; hence it is called the Fu organ of the middle channels, from which water pathways emerge. The Bladder receives water from the Sanjiao and governs its drainage pathway; their Qi mechanisms inherently support each other, and their principles are consistent. Therefore, the descending outlet of the Sanjiao is at Weiyang (BL39), merging with the main branch of the Foot-Taiyang Bladder Meridian, entering and connecting to the Bladder, thus regulating the Lower Jiao. However, among the twelve Zang-Fu organs, only the Sanjiao is the largest, with no other organ matching it; hence it is called the "Solitary Fu Organ." One must understand that although the Sanjiao serves as the reservoir for water pathways, it actually protects all Yang Qi and is also referred to as Ministerial Fire, making it the Fire Fu organ within Water. Thus, in the *Ben Shu* chapter, it says: "The Sanjiao belongs to the Bladder." In the *Su Wen · Xue Qi Xing Zhi* chapter, it says: "Shaoyang (Gallbladder/SanJiao) and Pericardium are exterior-interior pairs." Generally, the lower part is Yin, belonging to the Bladder and combining with Kidney Water; the upper part is Yang, combining with the Pericardium and connecting to Heart Fire. This is why the Sanjiao extends from the extreme top to the extreme bottom, resembling the Six Directions (Heaven, Earth, and Four Cardinal Points), encompassing everything. Observing the distinction of the Six Fu organs in the *Ben Shu* chapter is very clear: because they all have capacity for storage, they are named Fu organs. The Sanjiao is called the "Fu organ of the middle channels" and the "Solitary Fu Organ," clearly indicating a specific Fu organ; it is essentially a large cavity Fu organ outside the Zang-Fu but within the body, enveloping all internal organs. Hence it bears the names "Middle Channel" and "Solitary," and possesses the form of a great Fu organ. The *Nan Jing* already stated it has a name but no form; how much more so for the arrogant Gao Yangsheng! This is akin to searching a bag for items while forgetting that the bag itself is an item. This led to endless disputes in later generations, lacking any basis: some divided it into anterior and posterior Sanjiao, others claimed it was the fat beside the kidneys. Even the brilliant Li Dongyuan divided the Hand-Sanjiao and Foot-Sanjiao into two. If one Sanjiao is said to be formless, and various theories differ, how can there be so many versions of the Sanjiao? Later, Han Feixia cleverly proposed: "When palpating the Right Chi pulse, both hands must be examined simultaneously. Taking the pulse corresponding to the Sanjiao, floating indicates Upper Jiao, combining with Heart and Lung pulses; mid-level indicates Middle Jiao, combining with Spleen and Stomach pulses; deep indicates Lower Jiao, combining with Liver and Kidney pulses. Thus it is said, the third division of the Chi pulse diagnoses diseases together." This is yet another error passed down by Feixia, deviating further from the Dao. The *Su Wen · Mai Yao Jing Wei Lun* states: "The lateral aspect of the Chi region corresponds to the Kidneys; the medial aspect corresponds to the abdomen." It never says the Chi pulse corresponds to the Sanjiao. The *Mai Jing* states: "A Choppy Chi pulse indicates deficiency in the Lower Jiao. A Slow Chi pulse indicates Cold in the Lower Jiao." It also says: "A Floating Chi pulse indicates Exogenous Yang in the Lower Jiao." From these three statements, it is clear that the Chi pulse primarily corresponds to the Lower Jiao. Why should Han's clever theory be attached? The *Mai Jing · Vol 1 · Chapter 7 · Mai Fa Zan* says: "The Right [Chi] is the Zi Hu (Child's Chamber), named Sanjiao." Zi Hu refers to Mingmen (Gate of Life). The Right Kidney is the Mingmen, storing Essence in men and anchoring the Uterus in women, hence called Zi Hu. Calling it Sanjiao here is similar to how the sides of the forehead are also named Taiyang; it does not mean it is the Taiyang Meridian itself. How can one cling to words and harm the meaning? Although *Vol 2 · Chapter 2* says "Right Kidney combines with Sanjiao," the preceding text includes "one theory says," indicating Wang Shuhe attached this remark for reference, not claiming it as a definitive conclusion. Now, it is determined that the Upper Jiao corresponds to the two Cun pulses, the Middle Jiao to the two Guan pulses, and the Lower Jiao to the two Chi pulses. This aligns with the *Mai Yao Jing Wei Lun*: "Upper reaching up corresponds to matters of the chest and throat. Lower reaching down corresponds to matters of the lower abdomen, waist, thighs, knees, shins, and feet." Why are there still numerous dissenting opinions? A physician once told me, "I have practiced medicine for over forty years and never knew to dissect the Sanjiao, yet I am still respected in my time." Alas, such superficial understanding, if preserved without discussion, how can one manage the Eight Corrective Evils, distinguish the Five Internal regions, and assess pulse dynamics? Heart, Liver, Spleen, and Lung each have one pulse position; only the Kidney is divided into two Chi positions because there are two Kidneys, shaped like kidney beans, located on the left and right of the lumbar spine. The spurious *Mai Jue* claims the Left Chi corresponds to the Kidney and the Right Chi to the Mingmen. Consulting classics like *Ming Tang* and *Tong Ren*, the acupoint Mingmen is located in the depression below the fourteenth thoracic vertebra of the Du Meridian, between the two Kidneys. This represents one Yang residing between two Yins, forming the Kan trigram. Moreover, pulses responding under the fingers exist because of meridians that converge at the Cun Kou. The *Nei Jing* mentions no meridian for the Mingmen; how can it be listed at the Right Chi for diagnosis? Differences between men and women lie only in the penis, essence/blood, and uterus/chamber. As for pulse images, they have fixed locations. For example, Water at Left Chi generates Wood at Left Guan; Wood at Left Guan generates Fire at Left Cun. Ruler Fire delegates authority to Ministerial Fire; thus, Fire at Right Chi generates Earth at Right Guan; Earth at Right Guan generates Metal at Right Cun; Metal generates Water at Left Chi. This is the principle of the cyclical generation of the Five Elements. The spurious *Mai Jue* claims "for women, look at it in reverse"; how can this be reasonable! Some even place the Heart at Left Chi and the Lungs at Right Chi, following Chu Cheng's theory of "Earth moves to the right," causing extreme disorder of the Five Elements.

The diagnostic methods of the *Nei Jing* are clear and manifest, like the sun and moon. Since the prevalence of the spurious *Mai Jue*, the *Ling Shu* and *Su Wen* have been shelved, leaving eternal gloom unswept. Therefore, I append several pulse methods from the *Su Wen* to show reverence for the classics. Those who do not believe my drum-beating attack on errors should seek verification in the classics, and their direction will be settled. Are my words false?

The *Su Wen · Mai Yao Jing Wei Lun* states: "The inner sides of the Chi region correspond to the hypochondrium."
The hypochondrium refers to the lower ribs. Located on both sides below the costal margin, it is near the Kidneys.

"The lateral aspect of the Chi corresponds to the Kidneys; the medial aspect corresponds to the abdomen."
"Lateral Chi" refers to the radial half of the Chi pulse. "Medial Chi" refers to the ulnar half. The anterior half corresponds to Yang, the posterior half to Yin. The back is Yang, and the Kidneys attach to the back, so the lateral aspect corresponds to the Kidneys. The abdomen is Yin, so the medial aspect corresponds to the abdomen. The term "abdomen" here encompasses the Large Intestine, Small Intestine, and Bladder. While subsequent sections specify left and right, this one does not, because both Chi pulses govern the Kidneys.

"Attached to the middle, the lateral aspect of the Left corresponds to the Liver; the medial aspect corresponds to the Diaphragm."
"Attached to the middle" means situated above the Chi and in the center, i.e., the Guan pulse. "Left lateral" refers to the anterior half of the Left Guan; "medial" refers to the posterior half. The rest follows this pattern. The Liver is a Zang organ of Yin containing Yang, and it is also close to the back, so the lateral aspect corresponds to the Liver, and the medial aspect to the Diaphragm. Mentioning the Diaphragm covers the Middle Jiao's diaphragmatic membrane and the Gallbladder Fu.

"The lateral aspect of the Right corresponds to the Stomach; the medial aspect corresponds to the Spleen."
The anterior part of the Right Guan corresponds to the Stomach. The posterior part of the Right Guan corresponds to the Spleen. The Spleen and Stomach are officials of the Central Region. Speaking of exterior-interior relations, the Stomach is Yang and the Spleen is Yin; thus, the lateral aspect corresponds to the Stomach, and the medial aspect to the Spleen.

Note: The Cun Kou pulse belongs to the Hand-Taiyin Lung Meridian. The Taiyin circulates Qi through the Three Yin meridians; hence, "Three Yin are in the hand, governing the Five Zang organs." This chapter mentions only the Five Zang organs, excluding the Six Fu organs. However, the Stomach is a Fu organ, yet it is mentioned here specifically. Why? The classic states that the Five Zang organs all receive Qi from the Stomach; the Stomach is the root of the Five Zang. Visceral Qi cannot reach the Hand-Taiyin on its own; therefore, Stomach Qi must be observed here. Additionally, the *Wu Zang Bie Lun* states: "Flavors enter and store in the Stomach to nourish the Qi of the Five Zang organs; the Qi Kou also belongs to the Taiyin. Thus, the Qi and flavors of the Five Zang and Six Fu organs all originate from the Stomach and manifest at the Qi Kou." Therefore, although this chapter mentions only the Stomach, the Qi of the Six Fu organs is also visible here.

"Attached to the upper, the lateral aspect of the Right corresponds to the Lungs; the medial aspect corresponds to the Chest Center."
"Attached to the upper" means uppermost, i.e., the Cun pulse. Among the Five Zang organs, the Lungs are the highest. Thus, the anterior part of the Right Cun corresponds to the Lungs, and the posterior part to the Chest Center. The Chest Center refers to all areas above the diaphragm.

"The lateral aspect of the Left corresponds to the Heart; the medial aspect corresponds to the Dan Zhong (Pericardium)."
Both the Heart and Lungs reside above the diaphragm. Thus, the anterior part of the Left Cun corresponds to the Heart, and the posterior part to the Dan Zhong. Dan Zhong is another name for the Pericardium.

Note: The positions of the Five Zang organs follow the fixed principles of the Five Elements. Fire flourishes in the South, so the Heart resides in the Left Cun. Wood flourishes in the East, so the Liver resides in the Left Guan. Metal flourishes in the West, so the Lungs reside in the Right Cun. Earth flourishes in the Center but寄位 (resides temporarily) in the Southwest, so the Spleen and Stomach reside in the Right Guan. This is the sequence of the Hetu Five Elements.

"The anterior corresponds to the anterior; the posterior corresponds to the posterior."
This reiterates the meanings of upper/lower and interior/exterior. Generally speaking, Cun is anterior, and Chi is posterior. Specifically, the upper half is anterior, and the lower half is posterior. It means the upper part corresponds to the upper body, and the lower part to the lower body.

"Upper reaching up corresponds to matters of the chest and throat. Lower reaching down corresponds to matters of the lower abdomen, waist, thighs, knees, shins, and feet."
"Jing" means end. "Reaching up to the end" means in the pulse, it ends at the Yu Ji area; in the body, it corresponds to the chest and throat. "Reaching down to the end" means in the pulse, it ends at the Chi region; in the body, it corresponds to the lower abdomen, waist, and feet.

Note: This chapter first discusses the Chi, then the middle attachment becoming the Guan, and finally the upper attachment becoming the Cun, all moving from interior to exterior. This is because the Taiyin meridian travels from the chest to the hand, taking the Chi as the root and the Cun as the branches. Hence, it is said that human pulses may have roots without branches, but cannot have branches without roots.

Furthermore, regarding the terms "interior" and "exterior," commentators generally interpret them as medial. If referring to sides, the pulse shape would need to be flat and broad, or there would need to be two distinct lines; otherwise, the meaning would not hold. Terms like "anterior corresponds to anterior," "posterior corresponds to posterior," "upper reaches up," and "lower reaches down" all express the meaning of interior/exterior. Observing the six lines of the I Ching hexagrams, from bottom to top, the upper three lines form the Outer Trigram, and the lower three lines form the Inner Trigram; thus, the meanings of upper/lower and interior/exterior become clear.

"Pushing outward, if it is interior but not exterior, there is accumulation in the heart and abdomen."
"Push" means to investigate or seek. When diagnosing, one first investigates the exterior. If there is only a Deep pulse without a Floating pulse, it indicates interior presence without exterior expression; thus, disease involves accumulation in the heart and abdomen.

"Pushing inward, if it is exterior but not inward, there is heat in the body."
Investigating the interior reveals a Floating pulse without Deepness, indicating disease is external rather than internal. Only when pathogens are on the surface does the body feel hot.

"Pushing upward, if it is upper but not downward, the waist and feet are cold."
"Qing" means cold. Investigating the waist, if the upper pulse is strong and the lower pulse is weak, this indicates excess above and deficiency below, resulting in cold feet. "Upper and lower" has two meanings: referring to Cun/Guan/Chi, Cun is upper and Chi is lower; referring to Floating/Middle/Deep, Floating is upper and Deep is lower.

"Pushing downward, if it is lower but not upward, there is pain in the head and neck."
Investigating the lower region shows strength in the lower pulse and weakness in the upper pulse. This indicates that Clear Yang cannot ascend, causing head and neck pain. Alternatively, Yang deficiency allowing Yin to gather can also cause head and neck pain.

"Pressing to the bone, if the pulse Qi is scanty, there is pain in the waist and spine and numbness in the body."
Pressing to the bone corresponds to the Kidney and Liver regions. Scanty pulse Qi means weakness. Deficiency of Kidney Water causes waist and spine pain; deficiency of Liver Blood causes bodily numbness (Bi syndrome).

Note: This chapter states that "upper reaching up" corresponds to chest/throat issues and "lower reaching down" corresponds to lower abdomen/knee/foot issues, clearly indicating upper corresponds to upper and lower to lower. Yet Wang Shuhe claimed, "The Heart region is at the Cun Kou before the Left Guan, exterior-interior with the Hand-Taiyang, forming a Fu with the Small Intestine, combining with the Upper Jiao," etc. The spurious *Mai Jue* then adopted the concept of Left Heart and Small Intestine. It is unknown since the Qin and Han dynasties that anyone used the Small/Large Intestines to correspond to the two Cun pulses. The oral transmissions of Bian Que and Zhang Zhongjing are verifiable; how could the spurious *Mai Jue* cover the sky with one hand?

The Five Zang organs differ, each having its own fundamental pulse. The Heart at Left Cun is Floating, Large, and Scattered. The Lungs at Right Cun are Floating, Choppy, and Short. The Liver at Left Guan is Deep, Wiry, and Long. The Kidney at Left Chi is Deep, Stone-like, and Soft. The Spleen at Right Guan has a Harmonious and Moderate pulse. The Ministerial Fire at Right Chi is diagnosed similarly to the Left Cun.

The Heart and Lungs reside superiorly, so their pulses should be Floating. The Kidneys and Liver reside inferiorly, so their pulses should be Deep. The Spleen and Stomach reside between the Heart/Lungs and Kidneys/Liver, termed the Central Region, so their pulses should be between Floating and Deep. Both Heart and Lung pulses are Floating, but Floating-Large-Scattered resembles Summer Fire, so it belongs to the Heart; Floating-Choppy-Short resembles Autumn Metal, so it belongs to the Lungs. Both Kidney and Liver pulses are Deep, but Deep-Wiry-Long resembles Spring Wood, so it belongs to the Liver; Deep-Stone-Soft resembles Winter Water, so it belongs to the Kidney. The pulse is Harmonious and Moderate, with a mild and blended atmosphere, reflecting the nature of Earth, so it belongs to the Spleen. Although the Right Kidney is in the Water position, Ministerial Fire resides within it, so it is diagnosed together with the Left Cun.

Furthermore, exhalation relates to the Heart and Lung as Yang, so their pulses are Floating. The Heart is Yang within Yang, so the pulse is Floating, Large, and Scattered; the Lung is Yin within Yang, so the pulse is Floating with Shortness and Choppy quality. Inhalation relates to the Kidney and Liver as Yin, so their pulses are Deep. The Kidney is Yin within Yin, so the pulse is Deep and Solid; the Liver is Yang within Yin, so the pulse is Deep with Long quality. The Spleen is the Central Region, so it is neither Floating nor Deep, but Middle. If Zhao Zhengzong's version of the *Nan Jing Tu Shuo* argues that Earth resides among Metal, Wood, Water, and Fire, so both Guan pulses should belong to the Spleen; and since Liver is Yin, it should not be at the semi-floating/semi-deep Left Guan... unaware that Yue Ren (Bian Que) clarified the meaning of the *Su Wen*, keeping it concise and maintainable, avoiding unnecessary debate.

Spring is Wiry, Summer is Hooked (Large), Autumn is Feather-like (Floating), Winter is Stone-like (Deep); at the end of the four seasons, the pulse is Harmonious and Moderate without error. Excess and strength indicate disease arising externally; deficiency and minuteness indicate disease arising internally.

This describes the normal pulses of the four seasons. Heaven and Earth Qi rise from the East, belonging to Wood, positioned at Yin and Mao, corresponding to Spring when all things begin to grow. Its Qi emerges from dormancy, like a wisp of smoke or a thread of spring water; in humans, the Liver responds, showing a Wiry pulse. This is what the *Su Wen · Yu Ji Zhen Zang Lun* calls "its Qi comes soft and weak, light, void, slippery, straight, and long," and what the *Ping Ren Qi Xiang Lun* describes as "soft and swaying, like holding the tip of a long bamboo pole." Qi turns south, belonging to Fire, positioned at Si and Wu; corresponding to Summer when all things flourish. Its Qi expands outward after rising, like surging waves or prairie fires; in humans, the Heart responds, showing a Hooked pulse. This is what the *Yu Ji Zhen Zang Lun* calls "its Qi comes abundant and departs declining," and the *Ping Ren Qi Xiang Lun* describes as "pulse coming continuously like linked pearls, like tracing agate." Qi turns west, belonging to Metal, positioned at Shen and You; corresponding to Autumn when all things are harvested. Its Qi begins to retract from maximum expansion outward; like calm waves and extinguished flames; in humans, the Lungs respond, showing a Feather-like pulse. This is what the *Ping Ren Qi Xiang Lun* describes as "pulse coming gently and softly, like falling elm seeds." Qi turns north, belonging to Water, positioned at Hai and Zi; corresponding to Winter when all things hide. Its Qi descends and condenses, like buried furnace fire or pooled spring water; in humans, the Kidneys respond, showing a Stone-like pulse. This is what the *Yu Ji Zhen Zang Lun* calls "its Qi comes deep and firm," and the *Ping Ren Qi Xiang Lun* describes as "pulse coming rapidly and heavily like a hook, firm upon pressure." Regarding the four seasonal pulses mentioned above, although their shapes change with the seasons, they must always contain a soft, gentle, and moderate appearance. Moderation and gentleness belong to Earth, representing Stomach Qi. Having Stomach Qi combined with the season constitutes a Normal Pulse. The *Yu Ji Zhen Zang Lun* says: "The Spleen pulse is Earth, the solitary Zang that irrigates the four directions." Today, within the Wiry, Hooked, Feather, and Stone pulses, this moderation and gentleness represents irrigation of the four directions, is Earth, and is also the Spleen pulse. Because it resides within the four pulses, it is also said: "The good ones cannot be seen." The *Ping Ren Qi Xiang Lun* also says: "Late Summer belongs to the Spleen; its pulse is soft and separated, like a chicken stepping on the ground." Observing this pulse image merely describes its moderation. In the months of Chen, Xu, Chou, and Wei, Earth prospers for eighteen days each, representing the meaning of irrigating the four directions. Thus, divided into four, there is Earth but Earth is not seen separately. If discussing the Five Elements, it is analyzed into five, with Earth in the middle, belonging to Late Summer. Moreover, Late Summer resides between Metal and Fire, representing an excessive phase of generation, different from other seasons/months, so it uniquely shows the ruling seasonal pulse. Although the two explanations differ, their meanings do not contradict; they should be consulted together. The terms "excess" and "deficiency" refer to the Wiry, Hooked, Feather, and Stone pulses corresponding to the times; they should all be moderate and适中 (appropriate), wanting them slightly present, not too obvious; wanting them slightly visible, not invisible. Taking the Wiry pulse as an example: if it goes beyond slightly Wiry to too Wiry, this is Excess. Excess means Qi is solid and strong; Qi strong means it bulges outward, and disease arises externally. Pulses that are Large, Tight, Rapid, Long-Wiry, Slippery, and Solid indicate Excess, caused by external pathogens of Wind, Cold, Summerheat, Dampness, Dryness, or Fire. If it is less than slightly Wiry and not Wiry at all, this is Deficiency. Deficiency means Qi is empty and minute; Qi minute means it collapses inward, and disease arises internally. Pulses that are Empty, Minute, Fine, Weak, Short, Choppy, and Soft indicate Deficiency, caused by internal harm from the Seven Emotions: Joy, Anger, Worry, Thought, Sorrow, Fear, and Fright. The excess and deficiency of Hooked, Feather, and Stone pulses follow the same logic.

Progress step by step, harmonizing with nature; arriving on time is correct, agitation and haste are errors.

The ancient *Mai Yao* states: "In Spring, no Deep; in Summer, no Wiry; in Autumn, no Rapid; in Winter, no Choppy; this is called the Four Obstructions." This means that if pulses do not follow the four seasons progressively, they become obstructed and blocked. Therefore, in the first months of Spring, Summer, Autumn, and Winter, the pulses should still follow the norms of Winter, Spring, Summer, and Autumn respectively, without changing their degree, waiting until after the Equinoxes and Solstices to transition to the ruling Qi of the current season; this is the smooth pulse of a healthy person. Thus, Heavenly Dao: Spring is not warm until the Equinox, Summer is not hot until the Solstice; this is natural operation, enduring forever. If human pulses were Wiry immediately in Spring and Rapid immediately in Summer, added to by agitation and haste, the yearly cycle would end in less than three quarters. How could one live long! Therefore, it is said that within a year, abnormal pulses should not reappear. For example, Spring should be Wiry, but if the pulse is Large, it is a pathological pulse, indicating the True Zang Qi has leaked prematurely. Nowadays, people encounter a Wiry pulse before the Start of Spring and claim the time is near Spring, not considering it pathological; saying "the Qi of the four seasons: those that succeed retreat, those that come next advance." The words seem辩 (dialectical), but actually violate reason.

For all diseases of the four seasons, Stomach Qi is the root; the pulse values Spirit/Shen, which must be carefully examined.