夫三部者,寸、关、尺也。寸,应天为上部;关,应人为中部、尺,应地为下部。九候者,各
浮于天,沉于地,中为人也。
高骨旁动脉为关。
中指正按高骨之端是也。俗不明其正理,但以应于下指而差,高骨于
头、中指之间,如此则三指各差在本位之后半部耳。或以头指正在高骨,或
更在高骨之后者,此不通脉之正理也。便使心精了然,既下指失其本位,则亦无以知为何病也。
关前至鱼际为寸,是名阳位。
一名寸口,正在东关前、堂骨后,赤白肥肉际宛中,骨缝陷中,可容一豆者是,乃名鱼际者也。
关后为尺,是名阴位。
关后至本经于太阴所入为合,在肘内大约纹动处是名尺泽,长一尺,故
名尺也。阴阳两者之间则名关,三部长三寸,以应三才。凡男左、女右,以
中指与大指相接如关,度中指上仄中节两横纹之际为一寸。凡取穴以此为则,而脉位之尺寸亦应
此也。凡寸脉主自心胸上至头也;而关脉主中,心胃至脐也;尺脉主下,脐以至足也。
左寸主心及小肠(君火)。左关主肝胆(风木)。左尺主肾、膀胱(寒水)。右寸主肺、
大肠(燥金)。右关主脾、胃(湿土)。右尺主命门、三焦(相火)。
所以然者,左手为阳,阳为君,面南布政,而阳始于子水;以一岁六气
正位分之,则应于亥正至丑终气衰也。水之位主于左尺之脉,脉从尺入寸,故水生风木于左关,应丑至卯
初之气也。木生君火于左寸,阳道已成,故为君火,犹干始于子而终于巳也,自卯正至巳,二之气也。
君上而臣下,阳进而升,阴退而降,故右手为阴,始于午火,火面北而受气,自巳至未正,三之气也。三
焦为正火,主右尺之脉,相火生湿土于右关,正未以至酉,四之气也。湿土生金于右寸,应酉至亥,五
之气也。又主左尺水,周而复始也。及夫男左、女右为夫妇,故左寸君火克右寸之金;左关木克右关之土,左尺
水克右尺之火。及夫命门者右肾也,属火不属水,乃手厥阴心包络之脏。举世皆言心包络之脏有名而无
形,由不明理也。夫三焦乃水谷传化之道路,自口至胃上口为上焦,下至胃下二肠分处为中焦,下至传
化出处为下焦,通曰三焦。今俗妄言无形状而空有名者误也。且如人从头数至足,皆不谓之人,则亦安可言
人无形状耶。全身而言之,固名人也,且血脉尽皆环贯脏腑,营运周身,如果无命、三焦之形体,则何
得气血营运之道路耶。各浮于腑而沉于脏,中而和缓者胸也。
脉在肌肉以上曰浮,在肌肉之下曰沉。或以肺养皮毛,心养血脉,脾养肌肉,肝养筋膜,肾养骨髓,
以此浮沉而分五脏之脉者,言脉位则可,为用则有失治病之道也。
所谓“三部”,指的是寸、关、尺三个部位。寸部,对应天,属于上部;关部,对应人,属于中部;尺部,对应地,属于下部。所谓的“九候”,是指在这三个部位上,分别进行浮取(轻按)、中取(中等力度按压)和沉取(重按),其中浮取应天,沉取应地,中取应人。
手腕高骨(桡骨茎突)旁边的动脉搏动处就是关部。用中指端正地按在高骨的顶端即可。世俗之人不明白其中的正理,只是以手指接触的位置为准而产生偏差,导致高骨位于食指和中指之间,这样三指就都偏离了本位,落在了本位后半部的地方。有的人让食指正好按在高骨上,或者更靠在高骨后面的,这都是不通晓诊脉正理的表现。即使心里对病情了然于胸,一旦下指时失去了正确的位置,也就无法判断是什么疾病了。
从关部向前到鱼际(手掌大鱼际肌肉隆起处)为寸部,这叫做阳位。
寸口又名寸部,正好位于肘横纹内侧端(曲池穴附近,原文有误,实指腕部桡侧)前方、高骨后方,赤白肉际凹陷之中,骨缝陷处,能容纳一颗豆粒大小的位置,这就是所谓的鱼际。
关部向后为尺部,这叫做阴位。
从关部向后到达本经(手太阴肺经)在肘内大纹动处(尺泽穴)作为合穴的地方,名叫尺泽,长度为一尺,所以叫尺部。阴阳两者之间的部位称为关,三部总长三寸,以对应天、地、人三才。凡是男性看左手,女性看右手,将中指与拇指相接形成“关”的形状,测量中指上节中间两道横纹之间的距离为一寸。凡选取穴位以此为准,而脉位的尺寸也应当符合这个标准。一般来说,寸脉主要主管从心胸向上到头部的区域;关脉主要主管中部,从心胃到肚脐的区域;尺脉主要主管下部,从肚脐到足部的区域。
左寸脉主要主管心脏及小肠(君火)。左关脉主要主管肝和胆(风木)。左尺脉主要主管肾和膀胱(寒水)。右寸脉主要主管肺和大肠(燥金)。右关脉主要主管脾和胃(湿土)。右尺脉主要主管命门和三焦(相火)。
之所以如此,是因为左手属阳,阳为主君,面向南方布行政令,阳气始于子时的水;如果按照一年六气正位来划分,则对应从亥正到丑终,此时气衰。水的位置主管于左尺脉,脉气从尺部进入寸部,所以水生风木于左关,对应从丑初到卯初的节气。木生君火于左寸,阳道已成,所以称为君火,就像天干始于子终于巳一样,对应从卯正到巳正的第二个节气。君主在上而在下臣辅佐,阳气进而上升,阴气退而下降,所以右手属阴,始于午时的火,火面向北接受气机,对应从巳到未正的第三个节气。三焦为正火,主管右尺脉,相火生湿土于右关,对应从未正到酉正的第四个节气。湿土生金于右寸,对应从酉到亥的第五个节气。又主管左尺的水,周而复始。至于男左女右如同夫妇关系,所以左寸的君火克制右寸的金;左关的木克制右关的土,左尺的水克制右尺的火。至于命门,是右肾,属火而不属水,是手厥阴心包络之脏。世人都说心包络之脏有名而无形,这是因为不明白道理。三焦是水谷传化的道路,从口到胃上口为上焦,下到胃下二肠分处为中焦,下到传化出口为下焦,通称为三焦。现在世俗胡乱说它没有形状而空有名号是错误的。况且如人从头数到脚,都不称其为一个人,那么怎么能说人没有形体呢?全身而言,固然是人,而且血脉全都环贯脏腑,营运周身,如果真的没有命门、三焦的形体,那么气血营运的道路又在哪里呢?脉象各浮于腑而沉于脏,中间和缓的是胸部的脉象。
脉在肌肉以上称为浮,在肌肉之下称为沉。有的人认为肺养皮毛,心养血脉,脾养肌肉,肝养筋膜,肾养骨髓,以此来通过浮沉区分五脏的脉象,这种说法在描述脉位时可以,但在应用上则有违背治病之道的问题。
The so-called "Three Regions" (San Bu) refer to the Cun (Inch), Guan (Bar), and Chi (Foot) positions. The Cun position corresponds to Heaven and belongs to the Upper Region; the Guan position corresponds to Humanity and belongs to the Middle Region; the Chi position corresponds to Earth and belongs to the Lower Region. The so-called "Nine Palpations" (Jiu Hou) involve palpating at each of these three regions using Floating (Fu, light pressure), Moderate (Zhong, medium pressure), and Sinking (Chen, heavy pressure) techniques, where Floating corresponds to Heaven, Sinking corresponds to Earth, and Moderate corresponds to Humanity.
The arterial pulse located beside the high bone (radial styloid process) is the Guan position. It is achieved by pressing the tip of the middle finger squarely on the end of the high bone. Laypeople do not understand the correct principle, relying instead on the contact point of their fingers, which leads to errors. If the high bone falls between the index and middle fingers, all three fingers deviate from their proper positions, landing in the posterior half of their respective zones. Some place the index finger directly on the high bone or even further posterior to it; this demonstrates a lack of understanding of the correct principles of pulse diagnosis. Even if one has clear insight into the pathology, losing the correct anatomical reference point upon palpation makes it impossible to determine the disease.
From the Guan position forward to the Thenar Eminence (Yu Ji) is the Cun position, known as the Yang Position.
Also called Cun Kou, it is located precisely anterior to the Guan (high bone) and posterior to the wrist crease, within the depression at the junction of red and white flesh (skin color change), in the bony groove, a space capable of holding a single bean. This area is referred to as Yu Ji.
Posterior to the Guan is the Chi position, known as the Yin Position.
Moving posteriorly from the Guan to the He-Sea point of the relevant meridian (Hand Taiyin Lung Meridian) located in the large crease of the inner elbow (Chi Ze point), which is named Chi Ze, and is one Chi (foot) long, hence the name Chi. The region between Yin and Yang is named Guan. The total length of the three regions is three Cun (inches), corresponding to Heaven, Earth, and Humanity (San Cai). Generally, for men, the left hand is examined; for women, the right hand. To measure, join the middle finger and thumb to form a Guan shape; the distance between the two transverse creases at the middle joint of the middle finger constitutes one Cun. This standard applies to acupoint selection, and the dimensions of the pulse positions should correspond to this measurement. Generally, the Cun pulse primarily governs the area from the heart and chest up to the head; the Guan pulse primarily governs the middle area, from the heart and stomach to the umbilicus; the Chi pulse primarily governs the lower area, from the umbilicus down to the feet.
The Left Cun pulse primarily governs the Heart and Small Intestine (Ministerial Fire / Jun Huo). The Left Guan pulse primarily governs the Liver and Gallbladder (Wind-Wood). The Left Chi pulse primarily governs the Kidney and Bladder (Cold-Water). The Right Cun pulse primarily governs the Lungs and Large Intestine (Dry-Metal). The Right Guan pulse primarily governs the Spleen and Stomach (Damp-Earth). The Right Chi pulse primarily governs the Mingmen (Gate of Life) and San Jiao (Triple Burner) (Ministerial Fire / Xiang Huo).
The reason for this arrangement is that the left hand represents Yang, with Yang acting as the Sovereign, facing South to administer governance, starting with Water at Zi hour. Dividing the year's Six Qi according to their correct positions, this corresponds to the period from Zheng Hai to the end of Chou, where Qi declines. The position of Water is governed by the Left Chi pulse. As Qi moves from Chi to Cun, Water generates Wind-Wood at the Left Guan, corresponding to the Qi from early Chou to early Mao. Wood generates Ministerial Fire (Jun Huo) at the Left Cun, completing the Yang path, thus named Ministerial Fire, similar to how Heavenly Stems start at Zi and end at Si, corresponding to the second Qi from Zheng Mao to Zheng Si. The Sovereign is above and the minister below; Yang advances and ascends, while Yin retreats and descends. Therefore, the right hand represents Yin, starting with Fire at Wu hour. Fire faces North to receive Qi, corresponding to the third Qi from Si to Zheng Wei. San Jiao is the Proper Fire, governing the Right Chi pulse. Ministerial Fire generates Damp-Earth at the Right Guan, corresponding to the fourth Qi from Zheng Wei to You. Damp-Earth generates Metal at the Right Cun, corresponding to the fifth Qi from You to Hai. This again governs the Water of the Left Chi, cycling continuously. Regarding men (Left) and women (Right) as husband and wife, the Ministerial Fire of the Left Cun controls the Metal of the Right Cun; the Wood of the Left Guan controls the Earth of the Right Guan; the Water of the Left Chi controls the Fire of the Right Chi. As for Mingmen, it is the Right Kidney, belonging to Fire rather than Water, and is the Zang organ of the Hand Jueyin Pericardium Meridian. The world generally states that the Pericardium Zang has a name but no form, due to a lack of understanding of the principles. San Jiao is the pathway for the transmission and transformation of water and grain: from the mouth to the upper opening of the stomach is the Upper Jiao; down to the separation of the lower stomach and intestines is the Middle Jiao; down to the exit of transformation is the Lower Jiao, collectively termed San Jiao. It is erroneous for modern laypeople to claim it has no shape and only an empty name. For instance, counting from head to foot, one does not call any part "a person," so how can one say humans have no form? Speaking of the whole body, it is indeed called a person, and blood vessels circulate through the Zang-Fu organs and operate throughout the body. If there were truly no physical form for Mingmen and San Jiao, where would be the pathways for the operation of Qi and Blood? Pulses float at the Fu organs and sink at the Zang organs; those that are moderate and relaxed are in the Chest.
A pulse located above the muscle layer is called Floating (Fu); one located below the muscle layer is called Sinking (Chen). Some argue that the Lungs nourish skin and hair, the Heart nourishes blood vessels, the Spleen nourishes muscles, the Liver nourishes sinews, and the Kidneys nourish bones, using this floating and sinking distinction to differentiate the pulses of the Five Zang organs. While this description of pulse location may be acceptable, its application involves a deviation from the true way of treating diseases.