复问神门为心经之动脉。而王氏又云。神门决断。两在关后者。是指尺中肾脉而言。其故何也
。答曰。神门之脉有二。如前所言神门即是命门。命门即是三焦。属于七节之上。故于尺中求之。以尺为六脉之
根也。越人云。人之有尺。譬如树之有根。水为天一之元。先天之命根也。若肾脉独败。是无根矣。此与诸脉
之重按有力为有根。脉象迥异。而为肾气之所司则一也。如虚浮无根。是有表无里。孤阳岂能独存乎。若尺内
重按无根。不独先天肾水之竭。亦为后天不足之征。仲景所谓营气不足。血少故也。脉微所云。是指心经动脉而
言。按气交变论中。岁水太过一节。内有神门绝者死不治。言水胜而火绝也。其穴在掌后兑骨之端。即如人迎
与气口并称。皆主关前一分而言。其穴在喉之两旁。乃足阳明之动脉。能于是处求诸经之盛衰乎。可知神门二
说。各有主见。各有至理。不可附会牵合而致疑殆也。
问冲阳太溪。皆足之动脉。每见时师求之于垂毙之时。验乎不验乎。答曰。是即仲景趺
阳少阴也。尝闻气口成寸。以决死生。未尝决之于二处也。或谓以此本属胃与肾脉。虽变其名。仍当气口尺中
诊之。脉法以寸口趺阳少阴三者并列而论。是即寸关尺三部之别号。但未明言其故耳。喻嘉言释仲景平脉首条
云。条中明说三部。即后面趺阳少阴。俱指关尺而言。然何以止言趺阳少阴。盖两寸主乎上焦。营卫之所司。
不能偏于轻重。故言寸口。两关主乎中焦。脾胃之所司。宜重在右。故言趺阳。两尺主乎下焦。宜重在左。故言
少阴。此先得我心之所同然。但二处动脉。犹可求其绝与不绝。非推原某脉主某病也。设闺中处子。而欲按其足
上之脉。殊为未便。
Again, it is asked: Shenmen (Spirit Gate) is the arterial pulse of the Heart Meridian. However, Wang Bing stated that Shenmen governs decision-making, and both are located behind the Guan position. Does this refer to the Kidney pulse in the Chi position? What is the reason for this?
Answer: There are two interpretations of the Shenmen pulse. As mentioned previously, Shenmen is identical to Mingmen (Gate of Life), and Mingmen is identical to the Sanjiao (Triple Burner). It is located above the seventh vertebral segment; therefore, it is sought in the Chi position because the Chi position is the root of the six pulses. Yue Ren (Bian Que) said, "A person having a Chi pulse is like a tree having roots." Water is the origin of Tianyi (Heaven One) and is the root of congenital life. If the Kidney pulse alone fails, there is no root. This is distinctly different from other pulse conditions where heavy pressing reveals strength, indicating the presence of a root, yet both are governed by Kidney Qi. If the pulse is deficient, floating, and rootless, it indicates exterior without interior; how can isolated Yang exist independently? If the inner Chi position lacks a root upon heavy pressing, it signifies not only the exhaustion of congenital Kidney Water but also a sign of acquired insufficiency. Zhang Zhongjing referred to this as "deficiency of Ying Qi and insufficient blood." The term "pulse micro" (Wei) refers to the arterial pulse of the Heart Meridian. In the chapter on "Qi Jiao Bian Da Lun" (Treatise on Changes in Qi Interactions) within the *Suwen*, under the section regarding "Excessive Water in a Year," it states, "If Shenmen is severed, death is incurable and untreatable," meaning that excessive Water leads to the severance of Fire. The acupoint is located at the end of the pisiform bone (Duigu) at the posterior aspect of the wrist. This is analogous to the Renying (Human Welcome) and Qikou (Qi Mouth) points being mentioned together, both referring to the portion anterior to the Guan position. The Renying point is located on both sides of the throat and is the arterial pulse of the Foot-Yangming Stomach Meridian; can one determine the prosperity or decline of various meridians at this location? Thus, it can be known that the two theories regarding Shenmen each have their own viewpoints and profound principles; they should not be forced into conformity, which would lead to doubt and peril.
It is asked: Chongyang (Chongyang) and Taixi (Taixi) are both arterial pulses of the foot. It is often observed that contemporary physicians examine them only when patients are on the verge of death. Is this accurate?
Answer: These are precisely the Duyang (Foot-Yang) and Shaoyin (Lesser Yin) pulses of Zhang Zhongjing. I have heard that the Cun Kou (Inch Port) pulse is used to determine life and death, but never that these two locations are used for such determination. Some argue that since these belong originally to the Stomach and Kidney pulses, despite the change in name, they should still be examined at the Cun Kou and Chi positions. Pulse methodologies discuss Cun Kou, Duyang, and Shaoyin together, implying that these are merely alternative names for the Cun, Guan, and Chi positions, though the rationale is not explicitly stated. Yu Jiayan explained the first article of Zhang Zhongjing's *Ping Mai* (Calm Pulse) chapter: "The text clearly mentions three positions; the subsequent mentions of Duyang and Shaoyin both refer to the Guan and Chi positions." However, why mention only Duyang and Shaoyin? Presumably, because the two Cun positions primarily govern the Upper Jiao (Upper Burner), which is the domain of Ying and Wei (Nutritive and Defensive Qi), and cannot be biased towards light or heavy pressure; thus, it is called Cun Kou. The two Guan positions primarily govern the Middle Jiao (Middle Burner), which is the domain of the Spleen and Stomach, and right-side pressure is emphasized; thus, it is called Duyang. The two Chi positions primarily govern the Lower Jiao (Lower Burner), and left-side pressure is emphasized; thus, it is called Shaoyin. This aligns with my own understanding. However, examining these two arterial pulses allows one to determine whether they are present or absent, rather than deducing specific diseases from specific pulses. Furthermore, it would be highly inappropriate to palpate the foot pulses of a maiden living in seclusion.