答曰。散而浮大者心也。心主无为。相火用事。是为相应。以五服言之。王畿中也。以
王畿
言之。九重中也君主无为。当静以养血。若浮大而出于外。非其所宜也。以王道言之书云。
外作禽荒。未或不忘。经云。主不明。则十二官危矣。此散而浮大者。君主兼臣下之权而不
知反。故曰大则病进。
南政甲巳所临之岁。司天在泉。但见君火在上者。上不应。在下者。下不应。
北政但见君火在上。则下不应。在下则上不应。在左则右不应。在右则左不应。当沉而
浮。当浮而沉也
北政以前为右。以后为左。 臣也
启玄子云天地阴阳视之可见。何必思诸冥昧演法推求。智极心劳。而无所得耶。
仲景先太阳。坎阳明后少阳。自无形传有形。从外而之内者也。仲景之所言。天令而暴
至者
也难经先少阳。次阳明。后太阳。自有形传无形从内而之外者也。故难经之言。言杂病而久
疾者也。
张仲景
王叔和
\r论弦涩图\ps11a5.bmp\r
仲景言弦涩为阴。叔和言弦涩为阳。何意。大抵弦涩东西也。以南北分之。故有阴阳之
别。
涩本燥火弦本水少。虽有南北之分。总而言之。则不离诸数为热。诸迟为寒。仲景叔和言本
两途。非相违背。合而论之皆是也。仲景所言。言伤寒自外而入者。叔和所言。言五脏自内
而出者。
伤寒从气而入。故仲景以弦脉为阴。自艮而之内从外入。先太阳也。位在东北。
杂病从血
而出。故叔和以弦脉为阳。自巽而之外。从内出。先少阳也。位在东南。
北弦 胸中痛 寒在胃 停水满丹田 南目赤 叫呼烦躁 大肠。 胃。 三焦
右 寸肺 关脾 尺命门 左 寸心 关肝 尺肾 寒
引饮脉八九至 小肠 胆弦 膀胱 南弦（理中汤） 子能令母实 北固卫之阳（桂
凡在右者。皆受左克。
里 自右之左 主从客变 右 （大肠庚肺辛） 涩（胃戊脾巳） 缓 命门相火 洪
左 （心丁小肠丙） 洪（肝乙胆甲） 弦（肾 癸 膀胱 壬）沉
表 自左之右 客从主变
凡在左者。皆克诸右
浮克浮 沉克沉
回答说：脉象散乱而浮大，对应的是心脏。心主宰无为（静守），相火行使职能，这是相应的关系。用五服制度来比喻，心位于王畿之中。从王畿的角度来说，处于九重宫阙的中心。君主应当无为，保持安静以滋养血液。如果脉象浮大且向外发散，就不符合心的生理特性了。从王道政治的角度来看，《尚书》说：“在外沉迷于禽兽之乐，没有不导致不忘本分的。”《黄帝内经》说：“君主如果不明智，那么十二个脏腑就会陷入危险。”这就是为什么脉象散乱而浮大时，君主（心）兼领臣下（其他脏腑）的权力却不知反省，所以说“大则病进”（脉象盛大意味着病情加重）。
在南政年份，甲年和己年所主管的岁运中，司天之气在泉之气，只要见到君火在上位，上部就无应；在下位，下部就无应。
在北政年份，只要见到君火在上位，下部就无应；在下位，上部就无应；在左侧，右侧就无应；在右侧，左侧就无应。本该沉的脉象反而浮，本该浮的脉象反而沉。
北政以前方为右，以后方为左，这是臣位的定位。
启玄子（王冰）说：天地阴阳的道理观察即可看见，何必在晦涩不明之处深思苦想、推演法则呢？智力耗尽、心神劳损，却一无所得。
张仲景论述伤寒，先论太阳病，次论阳明病，后论少阳病，这是从无形之气传变为有形之邪，从体表向体内传变的过程。张仲景所说的，是指天气暴寒突然侵袭人体。
《难经》论述杂病，先论少阳，次论阳明，后论太阳，这是从有形之邪传变为无形之气，从体内向体表传变的过程。所以《难经》所说的，是指杂病日久形成的久病。
张仲景
王叔和
[关于弦涩脉的图示]
张仲景说弦脉和涩脉属于阴，王叔和说弦脉和涩脉属于阳，这是什么意思？大体上，弦脉和涩脉涉及东西方位。以南北来划分，所以有阴阳的区别。
涩脉本质属燥火，弦脉本质属水少。虽然有南北之分，但总而言之，数脉多主热，迟脉多主寒。张仲景和王叔和的说法本出于两个不同的角度，并非相互违背，合起来看都是正确的。张仲景所说的，是指伤寒从外部侵入人体；王叔和所说的，是指五脏病变从内部发出。
伤寒从气分侵入，所以张仲景以弦脉为阴，从艮卦方向向内，由外入内，首先影响太阳经。位置在东北方。
杂病从血分发出，所以王叔和以弦脉为阳，从巽卦方向向外，由内出外，首先影响少阳经。位置在东南方。
北方弦脉：胸中痛，胃中有寒，丹田停满水饮。
南方弦脉：目赤，叫喊呼叫，烦躁不安，涉及大肠、胃、三焦。
右手脉：寸部候肺，关部候脾，尺部候命门。
左手脉：寸部候心，关部候肝，尺部候肾，呈寒象。
引饮脉（因饮水引起的脉象变化）：脉率八九至，涉及小肠、胆。
弦脉：膀胱。
南方弦脉（可用理中汤治疗）：子能令母实。
北方固卫阳气（可用桂枝汤等温补固表）。
凡是位于右边的脉象，都受到左边的克制。
里证：自右向左，主从客变。右脉对应大肠（庚金）、肺（辛金）；涩脉对应胃（戊土）、脾（己土）；缓脉对应命门相火；洪脉……
左脉对应心（丁火）、小肠（丙火）；洪脉对应肝（乙木）、胆（甲木）；弦脉对应肾（癸水）、膀胱（壬水）；沉脉……
表证：自左向右，客从主变。
凡是位于左边的脉象，都克制右边的诸脉。
浮脉克浮脉，沉脉克沉脉。
Answer: A pulse that is scattered and floating and large corresponds to the Heart. The Heart governs non-action (stillness), while the Ministerial Fire performs its functions; this is a state of correspondence. Using the system of the Five Services as an analogy, the Heart is located in the Royal Domain (Wangji). From the perspective of the Royal Domain, it is at the center of the ninefold palace. The Sovereign should practice non-action, maintaining stillness to nourish Blood. If the pulse is floating and large and disperses outward, it is not appropriate for the Heart. From the perspective of Kingly Way, the *Book of Documents* states: "Indulging in hunting abroad leads to forgetting one's roots." The *Classic of Difficulties* (*Nanjing*) states: "If the Ruler is not enlightened, the Twelve Officials will be in peril." This explains why when the pulse is scattered, floating, and large, the Ruler (Heart) usurps the authority of the ministers (other organs) without self-reflection; thus it is said that "Large indicates disease progression" (a large pulse signifies worsening condition).
In years governed by South Polarity during Jia and Yi cycles, regarding the Heaven- ruling Qi and Earth-ruling Qi: if Ministerial Fire is seen above, there is no response above; if seen below, there is no response below.
In years governed by North Polarity: if Ministerial Fire is seen above, there is no response below; if seen below, there is no response above; if seen on the left, there is no response on the right; if seen on the right, there is no response on the left. The pulse should be deep but appears floating; it should be floating but appears deep.
For North Polarity, the preceding period designates the right side, and the succeeding period designates the left side; these represent the position of the minister.
Qi Xuanzi (Wang Bing) stated: The Yin and Yang of Heaven and Earth can be observed directly; why delve into obscure mysteries and laboriously deduce laws? Exhausting wisdom and straining the mind yields nothing.
Zhang Zhongjing discusses Taiyang first, then Yangming, and finally Shaoyang. This represents transmission from formless Qi to formed pathogens, moving from the exterior to the interior. What Zhang Zhongjing describes refers to sudden severe cold weather invading the body.
The *Nanjing* discusses Shaoyang first, then Yangming, and finally Taiyang. This represents transmission from formed pathogens to formless Qi, moving from the interior to the exterior. Therefore, what the *Nanjing* describes refers to chronic diseases arising from long-standing miscellaneous disorders.
Zhang Zhongjing
Wang Shuhe
[Diagram of Xian and Se Pulses]
Zhang Zhongjing states that Xian (Wiry) and Se (Choppy) pulses are Yin, whereas Wang Shuhe states they are Yang. What is the meaning? Generally, Xian and Se relate to the East-West axis. Divided by North-South, they exhibit Yin-Yang distinctions.
Se fundamentally belongs to Dryness-Fire, while Xian fundamentally belongs to deficient Water. Despite North-South distinctions, generally speaking, numerous pulses indicate Heat, and slow pulses indicate Cold. The statements of Zhang Zhongjing and Wang Shuhe originate from two different perspectives and do not contradict each other; combined, both are correct. Zhang Zhongjing’s statement refers to Cold Damage entering from the exterior; Wang Shuhe’s statement refers to Zang organ pathology emerging from the interior.
Cold Damage enters via Qi; therefore, Zhang Zhongjing considers the Xian pulse as Yin, entering from the Gen trigram direction inward, from outside to inside, affecting the Taiyang channel first. Its position is Northeast.
Miscellaneous diseases emerge via Blood; therefore, Wang Shuhe considers the Xian pulse as Yang, exiting from the Xun trigram direction outward, from inside to outside, affecting the Shaoyang channel first. Its position is Southeast.
North Xian pulse: Chest pain, Cold in the Stomach, water retention filling the Dantian.
South Xian pulse: Red eyes, shouting/calling, irritability/agitation, involving Large Intestine, Stomach, Sanjiao.
Right Hand Pulse: Cun (Inch) reflects Lung, Guan (Bar) reflects Spleen, Chi (Cubit) reflects Mingmen.
Left Hand Pulse: Cun reflects Heart, Guan reflects Liver, Chi reflects Kidney, presenting with Cold signs.
Pulse associated with excessive drinking: 8-9 beats per breath cycle, involving Small Intestine, Gallbladder.
Xian pulse: Bladder.
South Xian pulse (treatable with Lizhong Decoction): "Child makes Mother full" (excess transmission).
North consolidating Wei Yang (using Guizhi Tang or similar warming methods).
Any pulse on the Right is controlled/overcome by the Left.
Interior Syndrome: From Right to Left, Master changes according to Guest. Right side corresponds to Large Intestine (Geng Metal) and Lung (Xin Metal); Se pulse corresponds to Stomach (Wu Earth) and Spleen (Ji Earth); Huan (Moderate) pulse corresponds to Mingmen Ministerial Fire; Hong (Surging) pulse...
Left side corresponds to Heart (Ding Fire) and Small Intestine (Bing Fire); Hong pulse corresponds to Liver (Yi Wood) and Gallbladder (Jia Wood); Xian pulse corresponds to Kidney (Gui Water) and Bladder (Ren Water); Chen (Deep) pulse...
Exterior Syndrome: From Left to Right, Guest changes according to Master.
Any pulse on the Left controls/overcomes all pulses on the Right.
Floating overcomes Floating, Deep overcomes Deep.