（凡脉必随其部。以察其症。则部位不可不明也。然部位须从内经分发。始无差谬。故录
脉要精微论一条。景岳部位解一则。列于四明脉义之首。以补其所未备云。）
脉要精微论曰。尺内两傍。则季胁也。尺外以候肾。尺里以候腹。中附上。左外以候肝。内
以候鬲。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 中。
前以候前。后以候后。上竟上者。胸喉中事也。下竟下者。少腹腰股膝胫中事也。
（尝考内经及东洋医学丛书素问识注解。寸关尺内外。非指两傍也。乃以寸关尺前为外。后为
内也。未知孰是。姑揭出以俟精于脉理者。）
景岳部位解曰。按本经曰。上竟上者。胸喉中事。下竟下者。少腹腰股膝胫中事。所以脉之
形见上者侯上。下者候下。此自然之理也。自王叔和云。心与小肠。合于左寸。肺与大肠。合于
右寸。以致后人遂有左心小肠。右肺大肠之说。其谬甚矣。夫小肠大肠。皆下部之腑。自当应于
两尺。然脉之两尺。左为水位。乃真阴之
舍也。右为火位。乃元阳之本也。小肠属火。而火居火位。故当配于下之右。大肠属金。而金水
相从。故当配于下之左。此亦其当然也。但二肠连胃。气本一贯。故在内经亦不言其定处。而但
曰大肠小肠。皆属于胃。是又于胃气中。总可察二肠之气也。然凡在下焦脏腑。无不各具阴阳。
若欲察下部之阳者。当总在右尺。察下部之阴者。当总在左尺。则尽其要矣。
（按叔和心与小肠合等论。言其配也。景岳以大小肠皆下部之腑。言其位也。各具至理。各
有见地。以予观之。气口之脉。皆属太阴肺经也。借胃气递传合经。鼓动之应耳。故内经有谷气
入胃。脉道乃行。脉经有胃气则生之文。不如以浮主心与肺。沉主肝与肾。中候脾胃。再断以数属
腑迟属脏。无论何部见之。参以色诊。亦直截了当也。何必拘拘于上下之部位哉。）
（凡是诊脉，必须依据脉的部位来观察病症，因此脉的部位不可不明确。然而，脉的部位划分应当遵循《内经》的规定，才能避免差错。所以摘录《脉要精微论》中的一条内容，以及张景岳的《部位解》一篇，列在《四明脉义》之首，以补充之前内容的不足。）
《脉要精微论》说：尺部内侧两旁，对应的是季胁。尺部外侧用来候察肾脏，尺部内侧用来候察腹部。从尺部向上至关部的位置，左手外侧用来候察肝脏，内侧用来候察膈膜；右手外侧用来候察胃腑，内侧用来候察脾脏。从关部再向上至寸部的位置，右手外侧用来候察肺脏，内侧用来候察胸中；左手外侧用来候察心脏，内侧用来候察中焦。
脉象的前面部分用来候察身体前部的病症，后面部分用来候察身体后部的病症。脉气上达寸口尽处（上竟上），反映的是胸部和喉中的情况；脉气下达尺泽尽处（下竟下），反映的是少腹、腰部、大腿、膝盖和小腿的情况。
（我曾经考证《内经》及日本医学丛书《素问识》的注解，认为寸、关、尺的内外，并非指两傍，而是以寸、关、尺的前面为外，后面为内。不确定哪种说法正确，暂且列出，等待精通脉理的人指正。）
张景岳在《部位解》中说：按照本经（《内经》）所说，“上竟上者，胸喉中事；下竟下者，少腹腰股膝胫中事”。所以脉象显现于上部就候察上部，显现于下部就候察下部，这是自然的道理。自从王叔和说“心与小肠合于左寸，肺与大肠合于右寸”，导致后人便有了“左候心与小肠，右候肺与大肠”的说法，这错误很大了。小肠和大肠，都是下部的腑，自然应当对应于两尺部。然而，脉的两尺部，左侧属水，是真阴的居所；右侧属火，是元阳的根本。小肠属火，而火居于火位，所以应当配属于下方的右侧；大肠属金，而金与水相随，所以应当配属于下方的左侧。这也是理所当然的。但是，二肠连着胃，气机原本是一贯的，所以在《内经》中也没有说它们有固定的位置，只是说“大肠、小肠皆属于胃”，这是在胃气中可以总察二肠之气的原因。然而，凡是位于下焦的脏腑，无不各自具备阴阳。如果想要察看下部的阳气，应当总在右尺；察看下部的阴气，应当总在左尺，这样就掌握了要领。
（按：王叔和关于心与小肠相合等论述，讲的是配属关系；张景岳认为大小肠皆为下部之腑，讲的是位置关系。两者各有真理，各有见解。依我看来，气口的脉象，都属于手太阴肺经，是借助胃气的传递配合经络，产生鼓动的应验罢了。所以《内经》有“谷气入胃，脉道乃行”的说法，《脉经》有“有胃气则生”的文章。不如用浮脉主候心与肺，沉脉主候肝与肾，中候主候脾胃，再结合数脉属腑、迟脉属脏来判断，无论在哪一部见到，参考色诊，也直接明了。何必拘泥于上下部位呢？）
(When taking the pulse, one must observe symptoms according to the pulse position; therefore, the positions of the pulse must be clearly understood. However, the division of pulse positions must follow the *Neijing* (Classic of Internal Medicine) to avoid errors. Thus, an excerpt from the "Lun Yu Yao Jing Wei" chapter and Zhang Jingyue's "Jie Shi Bu Wei" are listed at the beginning of *Siming Maiyi* to supplement what was previously incomplete.)
The "Lun Yu Yao Jing Wei" states: The inner sides of the Chi (尺) position correspond to the hypochondrium. The outer side of Chi is used to inspect the Kidneys, and the inner side of Chi is used to inspect the abdomen. Moving up from Chi to Guan (关), the left outer side inspects the Liver, and the inner side inspects the diaphragm; the right outer side inspects the Stomach, and the inner side inspects the Spleen. Moving further up from Guan to Cun (寸), the right outer side inspects the Lungs, and the inner side inspects the chest cavity; the left outer side inspects the Heart, and the inner side inspects the middle jiao (middle burner).
The anterior aspect of the pulse reflects conditions in the anterior part of the body, and the posterior aspect reflects conditions in the posterior part of the body. Pulse qi reaching the upper limit (Shang Jing Shang) reflects matters concerning the chest and throat. Pulse qi reaching the lower limit (Xia Jing Xia) reflects matters concerning the lower abdomen, waist, thighs, knees, and calves.
(I have examined the *Neijing* and annotations from the Japanese medical series *Suwen Shi*, believing that the inner and outer aspects of Cun, Guan, and Chi do not refer to the lateral sides, but rather that the anterior aspect of Cun, Guan, and Chi is considered 'outer' and the posterior aspect is considered 'inner'. It is uncertain which is correct, so this is noted for experts in pulse diagnosis to verify.)
Zhang Jingyue states in "Jie Shi Bu Wei": According to the classic text, "Shang Jing Shang refers to the chest and throat; Xia Jing Xia refers to the lower abdomen, waist, thighs, knees, and calves." Therefore, if the pulse manifestation appears in the upper part, it inspects the upper body; if it appears in the lower part, it inspects the lower body. This is the natural principle. Since Wang Shuhe stated that "the Heart and Small Intestine combine at the Left Cun, and the Lungs and Large Intestine combine at the Right Cun," later generations adopted the view of "Left inspects Heart and Small Intestine, Right inspects Lungs and Large Intestine," which is a significant error. The Small Intestine and Large Intestine are both fu organs of the lower jiao and should naturally correspond to the two Chi positions. However, in pulse diagnosis, the left Chi represents the water position, which is the residence of true yin; the right Chi represents the fire position, which is the root of primal yang. The Small Intestine belongs to fire, and since fire resides in the fire position, it should be paired with the lower right. The Large Intestine belongs to metal, and metal follows water, so it should be paired with the lower left. This is also logical. Nevertheless, the two intestines connect to the Stomach, and their qi mechanism is continuous. Therefore, the *Neijing* does not specify fixed positions for them but states that "the Large Intestine and Small Intestine both belong to the Stomach," implying that the qi of the two intestines can be observed generally within the Stomach qi. However, all zang and fu organs in the lower jiao possess their own yin and yang. To inspect the yang of the lower part, one should focus on the Right Chi; to inspect the yin of the lower part, one should focus on the Left Chi. This captures the essence.
(Note: Wang Shuhe's discussion on the combination of the Heart and Small Intestine refers to their pairing relationship. Zhang Jingyue's argument that the Large and Small Intestines are lower jiao fu organs refers to their positional correspondence. Both contain truth and unique perspectives. In my opinion, the pulse at the Qi Kou (radial artery) belongs to the Hand Taiyin Lung Meridian; it is merely the response generated by the transmission of Stomach qi coordinating with the meridians. Hence, the *Neijing* states that "when grain qi enters the Stomach, the pulse channels begin to flow," and the *Maijing* (Pulse Classic) states that "life exists if there is Stomach qi." It is more straightforward to use floating pulses to inspect the Heart and Lungs, deep pulses to inspect the Liver and Kidneys, and moderate pulses to inspect the Spleen and Stomach, further distinguishing by rapid pulses indicating fu organs and slow pulses indicating zang organs. Regardless of where these appear in the pulse positions, when combined with color diagnosis, the method is direct and clear. Why insist on rigid upper and lower positions?)