褚氏遗书其论男女之脉与叔和大异不知有所据否如本气篇中有一转语云心以役气肺以通
气脾
以养气肾以泄气惟肝不用愚谓肝非无用也素问云肝者将军之官谋虑出焉四脏皆与气相关不以
肝而节度谋用焉则必至于太过不及之患矣黄庭内经云肝脏胆腑最为紧切如变化设施断谋远虑
其功有过于四脏者但以心主血肝藏血者收藏之义大抵血随气行不以气而制驭之则血妄行若言
肝与气不相关则不可也
近时医者多执前人肝常有余肾常不足之说往往举手便用平肝之剂按圣济经云原四时之所
化始
于木究十二之所养始于肝女子受娠一月是厥阴肝经养之肝者乃春阳发动之始万物生长之源故
戒怒养阳使先天之气相生于无穷所以肝主色气和则体泽气伤则枯槁故养肝戒忿是摄生之切要
也不可专泥前说
症治要诀伤食门有云人之饮食下咽而入肝由肝而入脾由脾而入胃因食所伤肝食不理故痰
涎壅
塞如中风状有半身不遂者肝主筋故也治以风药则误矣余谓此论甚正但云食下咽而先入肝次入
脾再次入胃之语未免有疑按存中笔谈云凡人之有咽有喉二者而已咽则纳饮食喉则通气咽则下
入胃脘次入胃又次入肠又次入大小肠喉则下通五脏出入息五脏之气呼吸正如冶家之鼓 人之
饮食药饵但自咽入肠胃何尝能至五脏凡人之肌骨五脏肠胃虽各别其入肠之物英精之气味皆能
洞达但滓秽即入大小肠矣凡所谓某物入肝某物入肾之类以气味到彼尔物质岂能至彼哉余因未
谙前说而书此以证之或原礼别有一说也
褚氏遗书中关于男女脉象的论述与叔和（王叔和）大相径庭，不知是否有依据。例如在《本气篇》中有一段转语说：“心用来役使气，肺用来通调气，脾用来滋养气，肾用来排泄气，只有肝不使用。”我认为肝并非无用。《素问》说：“肝是将军之官，谋虑由此产生。”四脏都与气相关，如果不以肝来节制和谋划，就必然会导致太过或不及的祸患。《黄庭内经》说：“肝脏和胆腑最为紧要，如变化设施、深谋远虑，其功效超过其他四脏。”只是由于心主血、肝藏血，有收藏的意义，大体上血随气运行，如果不以气来制约驾驭它，血液就会妄行。如果说肝与气不相关，那是不可以的。
近来的医生多拘泥于前人“肝常有余，肾常不足”的说法，往往一动手就用平肝的方剂。按《圣济经》所说，推究四季的变化始于木，探究十二经脉的养护始于肝。女子受孕一个月时，是厥阴肝经在养护胎儿。肝乃是春阳发动的开始，万物生长的源头，所以要戒除愤怒以保养阳气，使先天之气生生不息。所以肝主管面色，气和顺则身体润泽，气受伤则干枯憔悴。因此养肝戒怒是摄生的关键要点，不能专门拘泥于前人的说法。
《症治要诀·伤食门》中有这样的话：“人的饮食咽下后进入肝，由肝进入脾，由脾进入胃。因为食物损伤了肝，肝不能调理，所以痰涎壅塞，像中风的样子，有的半身不遂，这是因为肝主筋的缘故。如果用治风药治疗就错了。”我认为这个论述很正确，但说食物咽下后先入肝，再入脾，最后入胃的说法未免令人怀疑。按沈括《笔谈》所说：“大凡人有咽和喉两个部分而已。咽用来容纳饮食，喉用来通气。咽将食物送入胃脘，其次进入胃，再次进入肠，又再次进入大小肠；喉则向下连通五脏，出入气息，五脏之气的呼吸正像冶铸工匠鼓风一样。人的饮食药饵只是从咽进入肠胃，何尝能到达五脏？大凡人的肌骨、五脏、肠胃虽然各自不同，但进入肠中的东西，其精华的气味都能通达全身，只有渣滓秽物才进入大小肠罢了。凡是说什么某物入肝、某物入肾之类的说法，是指气味到达那里罢了，物质怎么可能到达那里呢？”我因为不熟悉前人的说法而写下这些来验证它。或许原礼另有别的说法吧。
The *Chu Shi Yi Shu* (Extant Book of Master Chu) discusses the pulses of men and women, differing significantly from those of Shuhe (Wang Shuhe). It is unknown whether there is any basis for this. For instance, in the "Ben Qi Pian" (Chapter on Original Qi), there is a remark stating: "The Heart employs Qi; the Lungs regulate Qi; the Spleen nourishes Qi; the Kidneys excrete Qi; only the Liver does not utilize [Qi]." I contend that the Liver is not without function. The *Su Wen* (Basic Questions) states: "The Liver is the General's office, where strategy and deliberation originate." All four Zang organs are related to Qi. If the Liver is not used to moderate and plan, it will inevitably lead to disorders of excess or deficiency. The *Huang Ting Nei Jing* (Inner Classic of the Yellow Court) states: "The Liver and Gallbladder are most critical; in terms of transformation, implementation, deep planning, and long-term consideration, their efficacy surpasses that of the other four Zang organs." This is because the Heart governs Blood and the Liver stores Blood, implying a function of storage and conservation. Generally, Blood follows Qi in its movement; if Qi is not used to control and guide it, Blood will flow recklessly. Therefore, to say that the Liver is unrelated to Qi is incorrect.
In recent times, many physicians have adhered rigidly to the previous saying that "the Liver is often in a state of excess, while the Kidney is often in a state of deficiency," frequently prescribing agents to soothe the Liver at the slightest sign of illness. According to the *Sheng Ji Jing* (Classic of Holy Relief), the transformations of the four seasons begin with Wood, and the nurturing of the twelve meridians begins with the Liver. When a woman conceives, during the first month, it is the Jueyin Liver Meridian that nurtures the fetus. The Liver is the beginning of the stirring of Spring Yang and the source of growth for all things. Therefore, one must guard against anger to preserve Yang Qi, allowing the Pre-heaven Qi to be generated endlessly. Thus, the Liver governs complexion; when Qi is harmonious, the body is lustrous, but when Qi is injured, it becomes withered. Hence, nourishing the Liver and guarding against resentment is a crucial aspect of health preservation, and one should not rigidly adhere to the previous theory.
The *Zheng Zhi Yao Jue* (Essentials of Symptom Treatment), in the section on Food Injury, states: "When food is swallowed, it enters the Liver, then passes to the Spleen, and from there to the Stomach. If food injures the Liver, causing the Liver to fail in its regulating function, phlegm and saliva become obstructed, resembling stroke symptoms, such as hemiplegia, because the Liver governs the sinews. Treating this with wind-dispelling herbs would be a mistake." I consider this argument quite correct, but the statement that food enters the Liver first upon swallowing, then the Spleen, and finally the Stomach is somewhat questionable. According to Shen Kuo's *Bi Tan* (Dream Pool Essays): "Humans essentially have two passages: the Pharynx and the Larynx. The Pharynx receives food and drink, while the Larynx conducts air. The Pharynx directs food into the stomach region, then into the stomach, next into the intestines, and subsequently into the large and small intestines. The Larynx connects downward to the five Zang organs, facilitating the inhalation and exhalation of Qi. The respiration of the five Zang organs is like bellows used by metalworkers. Food and medicine enter through the Pharynx into the gastrointestinal tract; how could they possibly reach the five Zang organs? Although human muscles, bones, five Zang organs, and gastrointestinal tract are distinct, the essence and aroma of ingested substances can permeate throughout the body, while only the dregs and impurities enter the large and small intestines. Statements such as 'this substance enters the Liver' or 'that substance enters the Kidney' refer only to the arrival of their aromas/energies there; the physical matter certainly cannot reach them." I record these thoughts here to verify the previous theories, as I was unfamiliar with them. Perhaps Yuan Li had another explanation.