内经分发脏腑左寸(心膻中) 左关(肝胆) 左尺(肾腹中) 右寸(肺胸中) 右
关(脾
胃)
右尺(肾腹中)王叔和分发脏腑 左寸(心小肠) 左关(肝胆) 左尺(肾膀胱) 右寸
(肺大肠)
右关(脾胃) 右尺(命门三焦)
李濒湖分发脏腑左寸(心膻中) 左关(肝胆) 左尺(肾膀胱小肠) 右寸(肺胸中)
右关
(胃脾) 右尺(肾大肠)
张景岳分发脏腑左寸(心膻中) 左关(肝胆) 左尺(肾膀胱大肠) 右寸(肺胸中)
右关
(脾胃) 右尺(肾小肠)
愚按大小二肠。经无明训。其实尺里以候腹。腹者。大小肠与膀胱俱在其中。王叔和以
大小二肠。配于两寸取心肺与二肠相表里之义也。李濒湖以小肠配于左尺。大肠配于右尺。
上下分属之义也。张景岳以大肠宜配于左尺。取金水相从之义。小肠宜配于右尺。取火归火
位之义也。俱皆有至理当以病症相参。如大便秘结。右尺宜实。今右尺反虚。左尺反实。便
知金水同病也。小便热淋。左尺宜数。今左尺如常。而右尺反数者。便知相火炽盛也。或两
尺如常。而脉应两寸者。便知心移热于小肠。肺移热于大肠也。一家之说。俱不可泥如此。
况右肾属火。即云命门。亦何不可。三焦鼎峙。两肾之间。以应地运之右转。即借诊于右尺
。亦何不可乎。
《内经》将脏腑分配为:左寸(心、膻中),左关(肝、胆),左尺(肾、腹中),右寸(肺、胸中),右关(脾、胃),右尺(肾、腹中)。
王叔和将脏腑分配为:左寸(心、小肠),左关(肝、胆),左尺(肾、膀胱),右寸(肺、大肠),右关(脾、胃),右尺(命门、三焦)。
李濒湖将脏腑分配为:左寸(心、膻中),左关(肝、胆),左尺(肾、膀胱、小肠),右寸(肺、胸中),右关(胃、脾),右尺(肾、大肠)。
张景岳将脏腑分配为:左寸(心、膻中),左关(肝、胆),左尺(肾、膀胱、大肠),右寸(肺、胸中),右关(脾、胃),右尺(肾、小肠)。
我认为,关于大小肠的配属,经典中没有明确的训示。实际上,尺部脉象主要候察腹部,而腹部包含大小肠与膀胱。王叔和将大小二肠配属于两寸,是取心肺与二肠相表里的意义。李濒湖将小肠配属于左尺,大肠配属于右尺,这是上下分属的意义。张景岳认为大肠宜配属于左尺,取金水相从的意义;小肠宜配属于右尺,取火归火位的意义。这些说法都有其中的道理,应当结合病症来参考判断。例如大便秘结,右尺脉应当实,如果现在右尺反而虚,左尺反而实,便知道是金水同病。小便热淋,左尺脉应当数,如果现在左尺如常,而右尺反而数,便知道是相火炽盛。或者两尺脉如常,而脉象应合于两寸,便知道是心移热于小肠,肺移热于大肠。对于各家的说法,都不可拘泥如此。况且右肾属火,即使称之为命门,又有什么不可以呢?三焦鼎立,位于两肾之间,以顺应地运之右转,即便借诊于右尺,又有什么不可以呢?
The *Neijing* (Classic of Internal Medicine) distributes the Zang-Fu organs as follows: Left Cun (Heart, Danzhong), Left Guan (Liver, Gallbladder), Left Chi (Kidney, Abdomen), Right Cun (Lung, Chest), Right Guan (Spleen, Stomach), Right Chi (Kidney, Abdomen).
Wang Shuhe distributed the Zang-Fu organs as follows: Left Cun (Heart, Small Intestine), Left Guan (Liver, Gallbladder), Left Chi (Kidney, Bladder), Right Cun (Lung, Large Intestine), Right Guan (Spleen, Stomach), Right Chi (Mingmen, Sanjiao).
Li Binhu distributed the Zang-Fu organs as follows: Left Cun (Heart, Danzhong), Left Guan (Liver, Gallbladder), Left Chi (Kidney, Bladder, Small Intestine), Right Cun (Lung, Chest), Right Guan (Stomach, Spleen), Right Chi (Kidney, Large Intestine).
Zhang Jingyue distributed the Zang-Fu organs as follows: Left Cun (Heart, Danzhong), Left Guan (Liver, Gallbladder), Left Chi (Kidney, Bladder, Large Intestine), Right Cun (Lung, Chest), Right Guan (Spleen, Stomach), Right Chi (Kidney, Small Intestine).
I observe that regarding the attribution of the Large and Small Intestines, there is no explicit instruction in the classics. In reality, the Chi position primarily palpates the abdomen, which contains the Large Intestine, Small Intestine, and Bladder. Wang Shuhe attributed the Large and Small Intestines to the two Cun positions, taking the meaning of the exterior-interior relationship between the Heart/Lungs and the intestines. Li Binhu attributed the Small Intestine to the Left Chi and the Large Intestine to the Right Chi, reflecting the principle of upper-lower distribution. Zhang Jingyue believed that the Large Intestine should be attributed to the Left Chi, taking the meaning of Metal and Water following each other; and the Small Intestine should be attributed to the Right Chi, taking the meaning of Fire returning to its proper position. All these views have sound reasoning and should be referenced in conjunction with clinical symptoms. For instance, in cases of constipation, the Right Chi pulse should be excess; if it is currently deficient while the Left Chi is excess, one knows it is a disease affecting both Metal and Water. In cases of painful urinary dysfunction with heat, the Left Chi pulse should be rapid; if the Left Chi is normal while the Right Chi is rapid, one knows it is due to flourishing Ministerial Fire. Or if both Chi pulses are normal, but the pulse corresponds to the two Cun positions, one knows it is Heat transferred from the Heart to the Small Intestine, or from the Lung to the Large Intestine. One must not rigidly adhere to any single school's theory. Moreover, since the Right Kidney belongs to Fire, even if it is called Mingmen, what harm is there? The Sanjiao stands independently between the two kidneys, responding to the rightward rotation of Earth's movement; thus, even if diagnosis is borrowed from the Right Chi, what harm is there?