脉诀之来旧矣。今复有议其非者。何也。以其言浅而意深也。惟其言浅。故厌常喜新之徒。乃以诀为不足法。反出
言以诋毁之。惟其意深。故冒昧鲜识之徒。随众附和。望洋而退避之。是以王氏之说终不明。而为脉诀之一大厄也。余
幼自孩提。即闻先大人尝诵此诀。长而二十有四。惟儒业是亲。先大人见余羸弱而多疾也。因命余改儒而就医。意盖欲
其自利而利人也。及执经之日。戒之曰。医诚不易。惟脉尤难。他如崔紫虚。滑伯仁。李濒湖。及诸家之撰。虽各有可
观。终为及肩之墙耳。岂若叔和脉诀。中边皆甜。诚医门之乳海也。但以诸家注释。各有短长。有失作者之旨。致使后
学永堕疑山。汝当学时。只宜参究本文。勿拘旧释。倘从自己胸中体帖出来。方与古人相晤对也。余因谨遵严命。即自
手录脉诀本文一卷。删其注释。熟读而详玩之。即于虚字剩句。亦必细心理会。不敢轻放。于意所已明者。则中心藏
之于意所未明者。然后检阅诸家注释。其诠之善者则选之。其不善者则姑置之。而复参究本文。其中有以数日而得其旨
者。有以数月而得其旨者。有以数年而后得其旨者。噫。夫脉诀之理。渊微如此。毋怪平冒昧浅识之徒。不得其门而入
也。而说者有曰。王氏但有脉经。而无脉诀。诀乃高阳生谬言也。而余曰非也。经固王氏之经。诀亦王氏之诀耳。夫经
者。叔和集诸家之说。以成一书。有缵绪祖述之功。诀则出叔和素所征验者。而成一书。有得心应手之妙。要之皆王氏
之书也。及乎脉诀出。而天下古今。脍炙人口。言言皆妙。字字入微。虽白叟黄童。咸知有此。几与日月争光矣。如果
出于高阳生者。何不自署其书曰高阳氏之书。而甘逊其美于王氏也。夫所谓高阳生之谬言。实无考据。好事者为之耳。
即借有所谓高阳生者。亦不过取叔和之心法。而复歌咏之。以便世之流通云尔。只如素问灵枢。固轩岐之书也。然不尽
轩岐之文。何以知之试观尚书诸篇。语多简炼。况轩岐又在唐虞之上。则其文之朴略可知。其所以得如是之纯粹华美
者。乃汉儒取其文而润泽之。始可通乎流俗。岂亦将曰内经为汉儒之伪造。而非轩岐之书可乎。或又难曰。子既取法轩
岐。则必以内经为准矣。其内经脉要精微论。有曰。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。
内以候膈。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。内以候膻中。前以候前。后以候后。
上竟上者。胸喉中事也。下竟下者。少腹腰股膝胫足中事也。经言如此。夫经之所谓尺者。即今之所为尺部也。经之所
谓中附上者。即经之所为关部也。经之所谓上附上者。即今之所为寸部也。惟其寸居上。故以之候心与肺。惟其尺居下。
故以之候肾与腹。今子而遵脉诀之法。是心与小肠同候左寸。肺与大肠同候右寸。夫心肺在上。其于寸部候之宜矣。至
于小肠大肠。居于至下。而欲候于至高之上。其与经旨不大相背谬乎。余曰。然。据子所言。脉必本诸内经。其诊法当
以脉要精微论为准。是凡在上者。必候于寸。凡在下者。必候于尺矣。独不观脉要精微论中又曰。诊得心脉而急。此为
何病。病形何如。岐伯曰。病名心疝。少腹当有形也。帝曰。何以言之。岐伯曰。心为牝藏。小肠为之使。由此观之即
一篇之中。尚不拘于上下之区字。况平人气象论有曰。寸口脉中手长者。足胫痛。又曰。寸口脉沉而弱者。疝瘕小腹痛。
其灵枢始终篇。以人迎一盛二盛三盛。候手足六阳。以脉口一盛二盛三盛。候手足六阴。然亦未尝拘于上下左右也。若
必执一而论。则轩岐之书。岂自相背谬乎哉。然子之为是言者。乃惑于戴起宗之邪说。而吠影吠声之徒。相率而倡和之
以为脉诀不足法。实叔和之罪人也。如果不足以为法。则从上诸大名医。每着书立说。多引其诀以为证。故王海藏着此
事难知。其首即曰。医之可法者有十。而脉诀居其一焉。夫海藏岂无所见而云然哉。大抵学医而不熟玩王氏脉诀。纵博
采诸书。终非正统。故先大人谆谆告戒。命之曰乳海。夫乳者。言其开食必先。海者。言其含蕴无尽也。余故不惜管窥。
逐节疏释。俾古圣先贤之学。昭着详明。而后之君子。勿蔽邪说。仍命其书曰乳海云。
《脉诀》流传已久。如今又有人议论它的非议，为什么呢？因为它的言辞浅显而意蕴深远。正因为言辞浅显，所以那些厌恶常规、喜好新奇的人，便认为这部诀要不足以效法，反而出言诋毁它。正因为意蕴深远，所以那些鲁莽无知的人，便随声附和，望而生畏地退避。因此，王叔和的理论最终未能彰显，这成了《脉诀》的一大劫难。
我自幼从孩童时期起，就听说先父曾经诵读这部诀要。等到我二十四岁时，只亲近儒家学业。先父见我身体瘦弱且多病，于是命令我放弃儒业转而学习医学。他的意图大概是希望我能自利并惠及他人。当我开始研读医书时，他告诫我说：“医学确实不容易，其中诊脉尤其困难。其他如崔紫虚、滑伯仁、李濒湖以及各家著作，虽然各有可取之处，但终究只是及肩之墙（比喻学问浅薄），哪里比得上王叔和的《脉诀》，内外皆甜美，确实是医学门派的‘乳海’（指源头活水或根本经典）。只是因为各家注释各有长短，偏离了作者的初衷，致使后学者永远陷入疑惑的山谷。你在学习时，只应当参悟研究本文，不要拘泥于旧的注释。如果从自己心中体察领悟出来，才能与古人面对面交流。”
我于是谨遵严命，亲手抄录《脉诀》正文一卷，删去其中的注释，熟读并仔细玩味。即使是虚词剩句，也必定细心领会，不敢轻易放过。对于意思已经明白的地方，则藏在心中；对于意思尚未明白的地方，然后再检阅各家的注释。其中诠释好的就选取，不好的就暂时搁置，然后再参究本文。其中有几天就领悟其旨意的，有几个月才领悟其旨意的，也有几年后才领悟其旨意的。唉！《脉诀》的道理如此深奥微妙，难怪那些鲁莽浅识的人无法找到入门的途径。
有人说：王叔和只有《脉经》，而没有《脉诀》，《脉诀》是高阳生的谬误之作。我说：不对。《脉经》固然是王叔和的著作，《脉诀》也是王叔和的著作。所谓《脉经》，是王叔和汇集各家之说而成的一本书，有继承祖述的功劳；《脉诀》则是出于王叔和平时征验心得而写成的一本书，有得心应手的妙处。总之都是王叔和的书。等到《脉诀》问世后，天下古今之人，都对其赞不绝口，言言精妙，字字入微，即使是白发老人和黄发儿童，都知道有此书，几乎可以与日月争光。如果真是出自高阳生之手，为什么不自己署名说这是高阳氏的书，却甘愿把美名让给王叔和呢？所谓高阳生的谬论，实际上没有考证依据，不过是好事者编造罢了。即使真有所谓的高阳生这个人，也不过是取用王叔和的心法，再次歌咏它，以便在世间流通而已。
就像《素问》《灵枢》，虽然是黄帝岐伯的著作，但并非全是黄帝岐伯的文字。怎么知道的呢？试看《尚书》各篇，语言大多简练。况且黄帝岐伯又在唐尧虞舜之上，那么他们的文字质朴粗略是可以知道的。之所以能得到如此纯粹华美的文章，是因为汉代儒生取其文字加以润色，这才能够通晓于流俗。难道也要说《内经》是汉代儒生的伪造，而不是黄帝岐伯的书吗？
有人又责难道：您既然效法黄帝岐伯，那就必须以《内经》为准了。《内经·脉要精微论》中说：“尺部内侧两旁，对应季胁。尺部外侧候肾，尺部内侧候腹中。关部之上（上附上），左侧外侧候肝，内侧候膈；右侧外侧候胃，内侧候脾。再往上（上上附），右侧外侧候肺，内侧候胸中；左侧外侧候心，内侧候膻中。前侧候身前，后侧候身后。寸部尽头以上，是胸喉中的事；尺部尽头以下，是少腹、腰、股、膝、胫、足中的事。”经文是这样说的。经文中所说的“尺”，就是现在的“尺部”；经文中所说的“中附上”，就是经文所说的“关部”；经文中所说的“上附上”，就是现在的“寸部”。正因为寸部居上，所以用它来候心与肺；正因为尺部居下，所以用它来候肾与腹。现在您如果遵循《脉诀》的方法，就是心与小肠同候左寸，肺与大肠同候右寸。心肺在上，它们在寸部被候察是适宜的。至于小肠大肠，居于最下，却想要在至高之上的部位被候察，这与经文的旨意不是大大相违背吗？
我说：是的。根据您所说的，脉诊必然基于《内经》，其诊法应当以《脉要精微论》为准。这样看来，凡是位于上方的，必须在寸部候察；凡是位于下方的，必须在尺部候察。难道没看到《脉要精微论》中又说：“诊得心脉而急，这是什么病？病症表现如何？岐伯说：病名叫心疝，少腹部应当有形状显现。”黄帝说：为什么这么说？岐伯说：心为阴脏，小肠是它的使道。由此看来，即使在同一篇文章中，尚且不拘泥于上下区域的区别，何况《平人气象论》中说：“寸口脉按之感觉长，主足胫痛。”又说：“寸口脉沉而弱，主疝瘕、小腹痛。”还有《灵枢·始终篇》，用人迎脉一盛、二盛、三盛来候手足六阳经，用脉口一盛、二盛、三盛来候手足六阴经。然而也没有拘泥于上下左右。如果一定要固执一端来论述，那么黄帝岐伯的书籍，难道是自相矛盾的吗？
然而您说这样的话，是被戴起宗的邪说所迷惑，那些吠影吠声的人，相继倡和，认为《脉诀》不足以效法，这实际上是王叔和的罪人。如果《脉诀》真的不足以效法，那么从上以来的各位大名医，每著书立说，大多引用它的诀要作为证明。所以王海藏记载这件事难以知晓，他在开头就说：“医生可以效法的有十项，而《脉诀》位列其中。”王海藏难道是毫无见解而这样说吗？大体上学医如果不熟读玩味王叔和的《脉诀》，纵然广泛采集诸书，终究不是正统。所以先父谆谆告诫，称它为“乳海”。所谓“乳”，是说开启饮食必先喝奶；所谓“海”，是说包含蕴藏无尽。所以我也不惜管窥之见，逐节疏释，使古圣先贤的学问，昭着详明，而后来的君子，不要被邪说蒙蔽，仍然将这本书命名为《乳海》。
The *Mai Jue* (Pulse Aphorisms) has been in circulation for a long time. Yet now, there are those who criticize it. Why? Because its language is superficial while its meaning is profound. Precisely because the language is superficial, those who despise convention and favor novelty consider the aphorisms unworthy of emulation, instead speaking out to slander them. Precisely because the meaning is profound, those who are rash and ignorant simply echo the crowd, retreating in awe and fear. Thus, Wang Shuhe’s theories remain obscure, which constitutes a major calamity for the *Mai Jue*.
Since childhood, I heard my father recite these aphorisms. By the time I was twenty-four, I was devoted solely to Confucian studies. Seeing that I was frail and prone to illness, my father ordered me to abandon Confucianism and turn to medicine. His intention was likely to enable me to benefit myself and thereby benefit others. When I began studying medical texts, he admonished me: "Medicine is indeed difficult, and pulse diagnosis is particularly so. Others, such as Cui Zixu, Hua Bo Ren, Li Binhu, and various other authors, though each having merits, represent only walls reaching one's shoulder [a metaphor for shallow learning]. How can they compare to Wang Shuhe's *Mai Jue*, which is sweet inside and out, truly the 'Milky Sea' [metaphor for the source or fundamental classic] of the medical school? However, because commentaries by various schools have their respective strengths and weaknesses, they deviate from the author's original intent, causing later students to fall forever into mountains of doubt. When you study, you should only investigate the original text, without being constrained by old commentaries. Only if you derive understanding from your own mind and body can you converse with the ancients."
I therefore strictly obeyed this solemn command, personally copying one volume of the original text of the *Mai Jue*, deleting the commentaries, reading it repeatedly, and carefully pondering it. Even filler words and redundant sentences were carefully considered, never lightly dismissed. For meanings already clear, I kept them in mind; for meanings not yet clear, I then consulted various commentaries. Those interpreted well were selected; those poorly interpreted were temporarily set aside, after which I returned to investigate the original text. Some grasped its essence within days, some within months, and some only after years. Alas! The principles of the *Mai Jue* are so profound and subtle. No wonder rash and shallow-minded individuals cannot find the door to enter.
Some say: Wang Shuhe had only the *Mai Jing* (Pulse Classic), but no *Mai Jue*; the *Mai Jue* is a false work by Gao Yangsheng. I say: This is incorrect. The *Mai Jing* is undoubtedly Wang Shuhe's work, and the *Mai Jue* is also Wang Shuhe's work. The *Mai Jing* is a book compiled by Wang Shuhe gathering theories from various schools, possessing the merit of inheritance and elaboration. The *Mai Jue* is a book written based on Wang Shuhe's personal clinical experiences and insights, possessing the subtlety of ease and mastery. In short, both are works of Wang Shuhe. After the *Mai Jue* was published, people throughout history have praised it endlessly; every word is exquisite, every character meticulous. Even white-haired elders and yellow-haired children know of this book, rivaling the sun and moon in brilliance. If it were truly authored by Gao Yangsheng, why would he not sign it as the work of the Gao Yang clan, yet willingly yield this glory to Wang Shuhe? The so-called falsehood of Gao Yangsheng lacks evidentiary basis and is merely fabricated by busybodies. Even if Gao Yangsheng existed, he merely took Wang Shuhe's core methods and versified them for easier dissemination among the world.
Just as the *Su Wen* (Basic Questions) and *Ling Shu* (Spiritual Pivot) are works of Huang Di and Qi Bo, they do not consist entirely of their original words. How do we know this? Observe the chapters of the *Shang Shu* (Book of Documents); the language is concise. Moreover, Huang Di and Qi Bo lived before Yao and Shun, so their writing style must have been simple and rough. The reason the texts appear so pure and magnificent is that Han dynasty scholars polished and refined the language, making it accessible to common people. Would one also claim that the *Nei Jing* (Inner Canon) is a forgery by Han scholars and not the work of Huang Di and Qi Bo?
Others might object: Since you emulate Huang Di and Qi Bo, you must take the *Nei Jing* as the standard. The *Nei Jing · Mai Yao Jing Wei Lun* states: "The inner sides of the chi position correspond to the hypochondrium. The outer side of chi corresponds to the kidneys; the inner side of chi corresponds to the abdomen. Above the guan position (shang fu shang), the left outer side corresponds to the liver, and the inner side to the diaphragm; the right outer side corresponds to the stomach, and the inner side to the spleen. Further above (shang shang fu), the right outer side corresponds to the lungs, and the inner side to the chest center; the left outer side corresponds to the heart, and the inner side to the Dan Zhong. The anterior corresponds to the anterior body, and the posterior to the posterior body. The end of the cun position upwards relates to the chest and throat; the end of the chi position downwards relates to the lower abdomen, waist, thighs, knees, calves, and feet." Such is the wording of the classic. What the classic calls "chi" is what we now call the chi position; what the classic calls "zhong fu shang" is the guan position; what the classic calls "shang fu shang" is the cun position. Because the cun is superior, it corresponds to the heart and lungs. Because the chi is inferior, it corresponds to the kidneys and abdomen. Now, if you follow the method of the *Mai Jue*, you place the heart and small intestine together at the left cun, and the lungs and large intestine together at the right cun. The heart and lungs are superior, so corresponding them to the cun position is appropriate. But the small and large intestines are located at the lowest part of the body, yet you wish to correspond them to the highest position. Does this not greatly contradict the intent of the classic?
I reply: True. According to your argument, pulse diagnosis must be based on the *Nei Jing*, and the diagnostic method should follow the *Mai Yao Jing Wei Lun*. In that case, anything superior must be diagnosed at the cun, and anything inferior at the chi. Have you not seen elsewhere in the *Mai Yao Jing Wei Lun*: "If the heart pulse is rapid and tense, what disease is this? What are the symptoms?" Qi Bo answered: "The disease is named Xin Shan (Heart Hernia), and there should be visible signs in the lower abdomen." The Emperor asked: "Why do you say so?" Qi Bo replied: "The heart is a Yin organ, and the small intestine is its envoy." From this, we see that even within the same chapter, the distinction between upper and lower regions is not rigidly adhered to. Furthermore, the *Ping Ren Qi Xiang Lun* states: "A cunkou pulse that feels long upon palpation indicates pain in the lower legs." It also states: "A cunkou pulse that is deep and weak indicates Shan Jia (hernia and masses) and lower abdominal pain." Additionally, the *Ling Shu · Shi Zhong Pian* uses the Ren Ying pulse (one-fold, two-fold, three-fold excess) to diagnose the six Yang meridians of the hands and feet, and the Mai Kou pulse to diagnose the six Yin meridians. Yet it does not rigidly adhere to upper/lower or left/right distinctions. If one insists on holding to a single view, would the books of Huang Di and Qi Bo be self-contradictory?
However, your statement stems from being confused by Dai Qizong's erroneous theories, and those who bark at shadows and echoes barks have joined in advocating that the *Mai Jue* is unworthy of emulation. This makes them sinners against Wang Shuhe. If the *Mai Jue* were truly unworthy of emulation, why did great physicians throughout history frequently cite its aphorisms as proof when writing their works? Therefore, Wang Haizang noted the difficulty of this matter, stating at the beginning: "There are ten things worthy of emulation in medicine, and the *Mai Jue* is one of them." Did Wang Haizang speak without insight? Generally, if one studies medicine without thoroughly mastering Wang Shuhe's *Mai Jue*, even if one extensively collects other books, one will ultimately not follow the orthodox path. Thus, my father earnestly advised calling it the "Milky Sea." "Ru" (Milk) implies that nursing comes first; "Hai" (Sea) implies boundless containment and depth. Therefore, I do not hesitate to offer my limited perspective, explaining section by section, so that the learning of ancient sages and worthies may be clearly illuminated, preventing later gentlemen from being blinded by erroneous theories. I have retained the title *Ru Hai* for this book.