（增补）
黄帝曰∶“寸口主中，人迎主外，两者相应，俱往俱来，若引
绳大小齐等。”又曰∶“三阳在头，三阴在手。”《灵枢》曰∶“气口候阴，人迎候阳。（
寸口者，即气口也，手太阴肺脉也，故主在中之病。人迎脉
在结喉两旁一寸五分，阳明胃脉也，故主在外之病。盖太
阴行气于三阴，阳明行气于三阳；诊三阳之气于人迎，诊三阴之气于气口。所谓相
应者，往来大小，若引绳之不爽也。故庞安常谓人迎气口，有喉手引绳之义。以
《脉经》以左为人迎，右为气口，竟置阳明胃脉于乌有，大非经旨。况三阳在头，三
阴在手，其义亦谬。人迎谓足阳明之脉，不可以言于手明矣。然上古诊法有三∶一
取三部九候以诊通身之脉，一取太阴阳明以诊阴阳之脉，一取左右气口以诊脏腑
之气。张介宾曰‘初见《脉经》左为人迎，右为气口，不无摇惑，未敢遽辨。及见
《纲目》之释人迎气口，亦云人迎在结喉两旁，足阳明之脉也。又见庞安常论脉曰，
何谓人迎，喉旁取之。近又见徐东皋曰，《脉经》以左手关前一分为人迎，误也。若
此者，皆觉吾之先觉矣。兹特引而正之，呜呼！一言之舛，遗误千载。以此授受，
何时复正哉。立言者可不知详慎考订乎？不若吴草庐之两手俱名为气口者无弊
也。所以《内经》云，五脏六腑之气味皆出于胃，变见于气口。
气口即寸口也。脏腑阴阳之盛衰，莫不由此而征见也明矣。’）春夏人迎微大，
秋冬气口微大，如是者命曰平人。”（春夏主阳故人迎之阳脉微大；秋冬主阴，故气口之阴脉微大。微
大者，犹言略大也。）雷公曰∶“病之益甚与其方衰，如何？”黄帝曰∶“内外皆
在焉。（言表里俱当审察也。）切其脉口滑小紧以沉者，病益甚在中；人迎脉
大紧以浮者，病益甚在外。（益甚，言病进也。脉口，即太阴气口也，故曰在中主脏。人迎，阳明腑脉也，
故曰在外主腑。脉口滑小紧沉者，阴分之邪也。人迎大紧以浮者，阳分之邪也。故皆益进日甚。）脉口浮滑者病
日进；人迎沉滑者病日损（脉口为阴，浮滑者，以阳加阴，故病日进。
人迎为阳，沉滑者，阳邪渐退，故病日损，渐自减也。）脉口滑以沉者，
病日进在内；人迎滑盛以浮者，其病日进在外。（脉口人迎，经分表里，故其滑沉滑浮
而病日进者，有在内在外之别也。）脉之浮沉及人迎与寸口脉小大等者，病难已。人迎
气口之脉，其浮沉大小相等者，非偏于阳，则偏于阴，故病难已。
【按】《禁服篇》曰∶‘春夏人迎脉微大，秋冬寸口微大，如是者命曰平人。’其义则可知。病
之在脏，沉而大者易已，小为逆。病在腑，浮而大者易已。（病在脏者
为阴，阴本当沉，而大为阳气充也，故易已；若见小脉，则真阴衰而为逆矣。病在腑
者为阳，阳病得阳脉为顺，故浮而大者病易已。故曰∶‘阴症见阳脉者生，阳症见阴脉者死。’）人迎盛坚者伤于寒，气口
盛坚者伤于食。”（人迎主表，
盛坚为外感伤寒。气口主里，盛坚为内伤饮食。此古法也。今则止用寸口诊法，不为不妙，然本无以左
右分内外之理。自叔和始以左为人迎，右为气口，其失表里之义久矣。）
（增补）
黄帝说：“寸口脉主要反映体内脏腑的情况，人迎脉主要反映体表经络的情况，两者应当相互呼应，搏动节奏一致，大小相等，就像拉紧的绳子一样整齐。”又说：“三阳经的脉气在头部（人迎），三阴经的脉气在手腕部（气口/寸口）。”《灵枢》中说：“气口脉候察阴分病变，人迎脉候察阳分病变。（寸口，就是气口，属于手太阴肺经的脉动处，所以主要主理体内的疾病。人迎脉位于结喉两侧一寸五分处，属于足阳明胃经的脉动处，所以主要主理体表的疾病。大概是因为太阴经将气运行于三阴经，阳明经将气运行于三阳经；所以在人迎脉诊察三阳经的气机，在气口脉诊察三阴经的气机。所谓‘相应’，是指脉搏往来时的形态大小，如同拉直的绳索一样没有偏差。所以庞安常说，人迎和气口，有像从喉咙到手腕拉绳一样的对应关系。因为《脉经》将左手脉定为人迎，右手脉定为气口，竟然把足阳明胃脉的存在置之不理，这大大违背了经典的本意。况且‘三阳在头，三阴在手’，这种说法也是错误的。人迎指的是足阳明胃经的脉象，这一点不能用手部的脉象来解释是显而易见的。然而上古时期的诊法有三种：一是取三部九候来诊察全身的脉象，二是取太阴和阳明脉来诊察阴阳脉象，三是取左右手的寸口脉来诊察脏腑之气。张介宾说：‘起初看到《脉经》说左为人迎、右为气口，心中有些疑惑，不敢立刻辩驳。后来看到《本草纲目》对人迎气口的解释，也说人迎在结喉两旁，是足阳明胃经的脉象。又看到庞安常论脉时说，什么是人迎？是在喉旁诊察的。最近又看到徐东皋说，《脉经》以左手关前一分为人迎，这是错误的。像这些观点，都让我觉得我是先觉者。现在特意引用并纠正它，唉！一句话的错误，误导了千年。以此传承下去，什么时候才能纠正呢？立言著书的人怎能不详细审慎地考证订正呢？不如吴草庐将两手都称为气口那样没有弊端。所以《内经》说，五脏六腑的精微气味都来源于胃，变化显现于气口。气口即寸口。脏腑阴阳的盛衰，没有不由此征验出来的，这是很明显的。’）春夏季节人迎脉略微偏大，秋冬季节气口脉略微偏大，像这样的人被称为健康无病之人。（春夏季节阳气主事，所以人迎的阳脉略微偏大；秋冬季节阴气主事，所以气口的阴脉略微偏大。略微偏大，就是说稍微大一点。）雷公问：“病情加重和病情刚开始衰退，是怎么回事？”黄帝说：“表里两方面都要考察。（意思是表里都应该仔细审察。）切按患者的脉口，如果脉象滑小紧且沉，说明病邪在体内且日益加重；人迎脉象大紧且浮，说明病邪在体表且日益加重。（益甚，指病势进展。脉口，就是太阴气口，所以称其在内，主脏病。人迎，是阳明腑脉，所以称其在外，主腑病。脉口滑小紧沉，是阴分的邪气。人迎大紧而浮，是阳分的邪气。所以都是病势日渐加重。）脉口浮滑的，病情每日进展；人迎沉滑的，病情每日减轻（脉口属阴，浮滑是阳邪加于阴位，所以病情每日进展。人迎属阳，沉滑是阳邪逐渐消退，所以病情每日减轻，逐渐自愈。）脉口滑而沉的，病邪每日进展在体内；人迎滑盛而浮的，病邪每日进展在体表。（脉口和人迎，分别对应经络的表和里，所以脉象滑沉或滑浮导致病情每日进展的，有在内在外的区别。）脉搏的浮沉以及人迎和寸口脉的大小如果相等，说明病难治愈。人迎和气口的脉象，如果浮沉大小相等，说明不是偏于阳盛，就是偏于阴盛，所以病难治愈。
【按语】《禁服篇》说：‘春夏人迎脉略微偏大，秋冬寸口脉略微偏大，像这样的人被称为健康无病之人。’其中的道理就可以知道了。病邪在脏，脉象沉而大的容易治愈，脉象小的是逆证。病邪在腑，脉象浮而大的容易治愈。（病在脏属于阴，阴病本应脉沉，若见大脉则是阳气充盛的表现，所以容易治愈；如果见到小脉，则是真阴衰竭，属于逆证。病在腑属于阳，阳病见到阳脉是顺证，所以浮而大的脉象表示病容易治愈。所以说：‘阴证见到阳脉的生存，阳证见到阴脉的死亡。’）人迎脉盛且坚硬的，是伤于寒邪；气口脉盛且坚硬的，是伤于饮食。（人迎主表，盛坚代表外感伤寒。气口主里，盛坚代表内伤饮食。这是古法。现在只使用寸口诊法，并非不好，但本来就没有通过左右手来区分内外的道理。自从王叔和开始将左手定为人迎，右手定为气口，这种失去表里本义的错误已经很久了。）
(Addition)
Huangdi said: "The Cun Kou (Cun Kou, pulse position at the wrist, reflecting interior conditions) primarily governs internal diseases, while the Ren Ying (Ren Ying, pulse position at the neck, reflecting exterior conditions) primarily governs external diseases. The two should correspond to each other, moving together and arriving together, equal in size, like a drawn rope." It is also said: "The three Yang meridians are located at the head, and the three Yin meridians are located at the hands." The *Ling Shu* states: "The Qi Kou (Qi Kou, synonymous with Cun Kou, reflecting Yin conditions) observes Yin, and the Ren Ying observes Yang. (Cun Kou is Qi Kou; it is the pulse of the Hand Taiyin Lung Meridian, thus governing diseases within. The Ren Ying pulse is located 1.5 cun on both sides of the laryngeal prominence; it is the pulse of the Foot Yangming Stomach Meridian, thus governing diseases outside. Generally, the Taiyin meridian circulates Qi among the three Yin meridians, and the Yangming meridian circulates Qi among the three Yang meridians; therefore, the Qi of the three Yang meridians is diagnosed at the Ren Ying, and the Qi of the three Yin meridians is diagnosed at the Qi Kou. What is meant by 'correspondence' is that the coming and going, large and small, are as precise as a straightened rope. Thus, Pang Anchang stated that Ren Ying and Qi Kou have the meaning of a rope drawn from the throat to the hand. Because the *Mai Jing* (Pulse Classic) designated the left side as Ren Ying and the right side as Qi Kou, it completely disregarded the Foot Yangming Stomach Meridian, which greatly contradicts the intent of the classics. Moreover, the saying 'three Yang at the head, three Yin at the hands' is also erroneous. Ren Ying refers to the pulse of the Foot Yangming Meridian; it is evident that this cannot be referred to as a hand pulse. However, there were three diagnostic methods in ancient times: one was to take the Three Regions and Nine Pulses to diagnose the pulses of the whole body; another was to take the Taiyin and Yangming pulses to diagnose Yin and Yang pulses; and the third was to take the left and right Qi Kou pulses to diagnose the Qi of the Zang-Fu organs. Zhang Jiebin said, 'When I first saw the *Mai Jing* stating that the left is Ren Ying and the right is Qi Kou, I was confused and dared not immediately refute it. Upon seeing the explanation of Ren Ying and Qi Kou in the *Ben Cao Gang Mu*, it also stated that Ren Ying is located on both sides of the laryngeal prominence and is the pulse of the Foot Yangming Stomach Meridian. I also saw Pang Anchang discuss pulses, asking, "What is Ren Ying?" and answering, "It is taken beside the throat." Recently, I saw Xu Donggao state that the *Mai Jing*'s designation of the front one-fen of the left Guan position as Ren Ying is incorrect. Seeing these views made me feel that I was a forerunner. I hereby cite them to correct this. Alas! A single error in words can mislead for a thousand years. If passed down in this manner, when will it ever be corrected? Those who establish doctrines must not fail to examine and verify details carefully. It would be better, without drawbacks, to follow Wu Caolu's practice of naming both hands as Qi Kou. Therefore, the *Nei Jing* says, "The essence and qi of the five Zang and six Fu organs all originate from the Stomach and manifest in the Qi Kou." Qi Kou is Cun Kou. It is clear that the prosperity and decline of the Zang-Fu organs and Yin-Yang cannot but be evidenced through this.') In spring and summer, the Ren Ying pulse is slightly larger; in autumn and winter, the Qi Kou pulse is slightly larger. Such a person is called a healthy individual. (Spring and summer are governed by Yang, hence the Yang pulse of Ren Ying is slightly larger; autumn and winter are governed by Yin, hence the Yin pulse of Qi Kou is slightly larger. "Slightly larger" means somewhat larger.) Leigong asked: "How do we distinguish between the worsening of a disease and its initial remission?" Huangdi replied: "Both interior and exterior must be considered. (This means both exterior and interior should be carefully examined.) If the Mai Kou (Mai Kou, synonymous with Qi Kou/Cun Kou) pulse is slippery, small, tight, and deep, the disease is worsening internally; if the Ren Ying pulse is large, tight, and floating, the disease is worsening externally. ('Yi shen' means the disease is progressing. Mai Kou is the Taiyin Qi Kou, thus called 'internal' and governing Zang diseases. Ren Ying is the Yangming Fu pulse, thus called 'external' and governing Fu diseases. A slippery, small, tight, and deep Mai Kou indicates pathogenic factors in the Yin aspect. A large, tight, and floating Ren Ying indicates pathogenic factors in the Yang aspect. Thus, both indicate daily progression of the disease.) If the Mai Kou pulse is floating and slippery, the disease progresses daily; if the Ren Ying pulse is deep and slippery, the disease diminishes daily (The Mai Kou is Yin; floating and slippery indicates Yang pathogen superimposed on Yin, hence the disease progresses daily. The Ren Ying is Yang; deep and slippery indicates the gradual retreat of Yang pathogen, hence the disease diminishes daily and gradually subsides.) If the Mai Kou pulse is slippery and deep, the disease progresses internally; if the Ren Ying pulse is slippery, vigorous, and floating, the disease progresses externally. (Mai Kou and Ren Ying correspond to the exterior and interior of the meridians; thus, whether the disease progresses due to slippery/deep or slippery/floating pulses distinguishes between internal and external locations.) If the floating and deep qualities of the pulse, as well as the sizes of the Ren Ying and Cun Kou pulses, are equal, the disease is difficult to cure. When the Ren Ying and Qi Kou pulses are equal in floating, deep, large, and small qualities, it indicates either Yang excess or Yin excess, hence the disease is difficult to cure.
[Commentary] The *Jin Fu Pian* chapter states: 'In spring and summer, the Ren Ying pulse is slightly larger; in autumn and winter, the Cun Kou pulse is slightly larger. Such a person is called a healthy individual.' The principle here can be understood. For diseases in the Zang organs, a deep and large pulse indicates easy recovery, while a small pulse indicates an adverse prognosis. For diseases in the Fu organs, a floating and large pulse indicates easy recovery. (Diseases in the Zang are Yin; Yin diseases should naturally present with a deep pulse, and a large pulse indicates sufficient Yang Qi, hence easy recovery. If a small pulse appears, it indicates depletion of True Yin, which is adverse. Diseases in the Fu are Yang; Yang diseases presenting with Yang pulses are favorable, hence a floating and large pulse indicates easy recovery. Thus, it is said: 'Yin syndromes presenting with Yang pulses survive; Yang syndromes presenting with Yin pulses die.') A Ren Ying pulse that is vigorous and firm indicates injury from Cold; a Qi Kou pulse that is vigorous and firm indicates injury from food. (Ren Ying governs the exterior; vigor and firmness indicate exogenous Cold damage. Qi Kou governs the interior; vigor and firmness indicates endogenous dietary injury. This is the ancient method. Currently, only the Cun Kou diagnostic method is used, which is not bad, but originally there was no rationale for distinguishing interior and exterior by left and right. Since Wang Shuhe began designating the left as Ren Ying and the right as Qi Kou, the loss of the meaning of exterior and interior has persisted for a long time.)