《内经》曰∶“诊法常以平旦，阴气未动，阳气未散，饮食未
进，经脉未盛，络脉调匀，气血未乱，乃可诊有过之脉。”（平旦者，阴阳之交
也。营卫之气，一昼夜五十周于身，昼则行阳，夜则行阴，迨至平旦，复会于寸口。
斯时也，平旦初寤之时，阴气将退而未退，阳气将盛而未散，饮食未进，谷气未行，
故经脉未盛，而络脉调匀，气血未至于扰乱，乃可诊有过之脉。有过，犹言有病也。
若饮食入胃，则谷气流行，直行之经，往往强盛，而横行之络，气先至者强，气未至
者弱，经络之脉不能调匀，则气血之盛衰，未可尽凭矣。）
（增补）
《内经》曰∶“从鱼际至高骨，却行一寸，名曰寸口。从寸至
尺，名曰尺泽。故曰尺寸。寸后尺前，名曰关。”（大指从鱼际穴至高骨，得一寸，故名为
寸也。肘腕内廉尺泽穴至高骨得一尺，故名为尺也。正当高
骨之上，乃尺与寸交界之际，故名为关也。其义岂苟哉！）扁鹊曰∶“尺寸者，脉之大要会也。从关至尺是尺，内阴之所
治也。从关至鱼际
是寸口，内阳之所治也。”（要者，扼要也。会者，朝会也。尺寸皆肺之经脉，
百脉皆来朝会，岂非扼要之所乎！肾肝为阴，处乎尺内。心肺为阳，处乎寸内。治，犹属也。言所属之位也。）
岐伯曰∶“人有三部，部有三候，以决死生，以处百病，以调虚实，而除邪疾。”
（三部，上中下也。三候，天地人也。上古诊脉，不独寸口，于诸经
之动脉皆诊之。此云三部九候也。可见扁鹊之三部九候，大非经旨明矣。）帝曰∶“何谓三部？”岐伯曰∶“
有上部，有中部，有下部。部各有三候，三候者，有天，有地，有人。
上部天，两额之动脉；上部地，两颊之动脉；上部人，耳前之动
脉。中部天，手太阴也；中部地，手阳明也；中部人，手少阴也。
下部天，足厥阴也；下部地，足少阴也；下部人，足太阴也。故
下部之天以候肝，地以候肾，人以候脾胃之气。”帝曰∶“中部三
候奈何？”岐伯曰∶“亦有天，亦有地，亦有人。天以候肺，地以
候胸中之气，人以候心。”帝曰∶“上部以何候之？”岐伯曰∶“亦
有天，亦有地，亦有人。天以候头角之气，地以候口齿之气，人
以候耳目之气。三部者，各有天，各有地，各有人。三而成天，
三而成地，三而成人。三而三之，合则为九。”（以此推之，经衣冠文物指
人身上中下动脉各有
所候，以诊诸脏之气，非独以寸口为言也。如仲景脉法，上取寸口，下取趺阳，正是
此意。《难经》所云∶“三部者寸关尺，九候者浮中沉”，乃只以寸口而分三部九候之
诊，后世言脉者皆宗之，虽为捷法，不无背谬经旨乎！【按】扁鹊曰∶“上部法天，主
胸以上至头之有疾。中部法人，主膈以下至脐之有疾。下部法地，主脐以下至足
之有疾，仍宗经旨“上竟上、下竟下”之义。但九候之说，以寸关尺之三部而分浮
中与沉之三候，得无又谬乎！若以扁鹊之说为是，则轩岐之说为非；轩岐之说为
是，则扁鹊之说为非矣！故不得不置一喙于其间也。浮之与沉，固无庸议矣。中
则止有浮之中耳，奚能有沉之中乎！浮而无中，固曰无根。沉则必无中矣，何仅以
为沉脉主里，而全无必死之症乎！盖人但知有中正之中，而不知有中和之中。经
云∶“真脏脉见者死”，脉无胃气者，谓为真脏脉也。是除诸怪脉之外，皆得谓之有
中脉耳。何弃其彰明较着之经文，而反以浮中与沉，索摸于不可知之陋习乎！此
事之不可解者也。况诊脉之法，或以手测，或以目视，而非仅从事于指按也。史称
扁鹊以诊脉为名，而仓公、仲景以下，有不竞趋于名者哉！沿袭至今，而讹以传讹，
为其所纷更者愈多矣。余尝寻绎经文，得其旨趣。人迎止隶于喉旁，三部须兼乎
手足。脏则候之于左手，腑则候之于右手。寸以候上，尺以候下，脏腑皆然，庶不使
有纤毫之疑，而荧惑于其间也。彼七表、八里、九道之纷纭，智又出扁鹊下矣。世
多识之，故不赘焉。）
【按】《内经》以三部各有天地人，三而三之，为九候。上中下不定
乎寸部之位，与扁鹊之寸上关中尺下不同。上部俱定于头面两额之动
脉，即下文天以候头角之气，动应于指（此脉在额两旁瞳子 骨空处）；
人以候两颊之动脉（即听会穴等分）；地以候口齿之气，动应于指（此脉
在鼻孔下旁，近巨 穴之分）。是则面部不独色诊，且脉诊矣。脉诊则
仍用七诊，可以知头面之详矣（独大、独小、独疾、独迟、独热、独寒、独
陷下也）。中部之三候，俱以寸诊。其地候胸中之气，则气口也。本经《经
脉篇》所谓行气于府，即膻中气海穴也。下部之天，候于关之肝，地候于
尺之肾，人候于脾胃之气。三部之候，天位乎上，人位乎中，地位乎下。独
下部人候反在天之上者，天气下降，接乎地之阴气，此地中之天，人高于
地，即高乎地中之天矣。三部以头候头之属，以手候脏腑之属，不及脐以
下至足者，以足之四经，肾主骨，肝主筋，脾主四肢，胃主宗筋，与肾相
连，并筋骨主之矣。是则手候脏腑之属，并及脐以下至足，以诸脉皆系于
手足，诸经足之脉亦连于手（上廉、下廉、前廉、后廉之类是也），不可泥
头候头之属，遂泥当以手候手之属，足候足之属也。乃本篇之后复申言
之云∶“以左手足上去踝五寸按之，庶右手足当踝而弹之，其应过五寸以
上，蠕蠕然者不病；其应疾，中手浑浑然者病，中手徐徐然者病；（蠕蠕，
微动貌。浑浑，不清貌。徐徐，缓而迟也。）其应不能至五寸，弹之不应者
死。”（此经文弹按，乃是刺法，与诊脉互相发明其理。）手踝之上，手太阴
肺经脉也，应于中部。（去踝五寸，手踝骨在下，从内廉至太渊，计有五
寸。）足踝之上，足太阴脾经脉也，应于下部。（去内踝骨之上五寸，乃三
阴交之上，漏谷之下也。盖漏谷去踝六寸乃是。）则中部之三候，举一手
太阴，而可概其余。（手太阴者，百脉之所会，大中之中，故应中部。）下部
之三候，举一足太阴，而可概其余。（足太阴，阴土也。阴之与土，其气俱
下，故应下部。）按而弹手足踝者，所以尽两太阴脉之量，周悉无遗也。故
可取之察吉凶也。（诸脉独于两太阴脉加意者，太阴属坤，坤为胃。手太
阴之中部天而即统乎中部之地与人，贵天之中也。是太阴之下部人而即
统乎下部之天与地，贵人之中也。天人之际得中，而地道自宁，不必揭地
之中，且以知天人之中，即胃之中，即地之中也。）《内经》之旨，精奥渊
微，非神圣不能穷其理，故扁鹊以寸关尺配上中下，犹未尽然也。
滑伯仁曰∶“诊脉之道，先调自己气息。男左女右，先以中
指取定关位，却下前后二指。初轻候消息之，次中候消息之，
次重候消息之。自寸关至尺，逐部寻究。一呼一吸之间，脉行
四至为率，闰以太息，五至为平脉也。其有太过不及，则为病
脉，各以其部断之。”（自己之气息调匀，则他脉之至数明辨，故凡诊必先调息
也。男子属阳，故先诊左手；女子属阴，故先诊右手也。
先以中指取定关部，然后下前后二指，则尺寸方准也。轻候消息，其名曰举；中候
消息，其名曰寻；重候消息，其名曰按。一息四至，为和平之脉；若当太息，必以五
至为和平也。太过者，洪大有力；不及者，迟细无力也。各以
五脏六腑察其微甚，审其从违，断其吉凶生死之法如此也。）
又曰∶“臂长则疏下指，臂短则密下指。三部之内，大小、
浮沉、迟数同等，尺寸、阴阳、高下相符，男女、左右、强弱相应，
四时之脉不相戾，命曰平人。其或一部之内，独大、独小，独
疾、独迟，左右、强弱之相反，四时、男女之相背，皆病脉也。左
手不和，为病在表，为阳，主四肢；右手不和，为病在里，为阴，主腹脏。”
（臂长脉亦长，故下指宜疏；臂短脉亦短，故下指宜密。同等者，不大不
小、不浮不沉、不迟不数也。相符者，寸为阳、为高，宜浮大；尺为阴、
为下，宜沉小也。相应者，左大顺男，右大顺女；男子寸盛而尺弱，女子尺盛而寸弱
也。不相戾者，春弦、夏洪、秋毛、冬石也。此四脉者，平人无病之脉也。其或大小
独见，迟数偏呈，左右相反，时令相戾，男女相违，皆知其为病脉也。左属
阳，阳在表，与四肢相应；右属阴，阴在里，与腹脏相应也。余可类推。）
又曰∶“察脉须识上下、来去、至止六字。不明此，则阴阳
虚实不别也。上者为阳，下者为阴；来者为阳，去者为阴；至者
为阳，止者为阴也。上者，自尺部上于寸口，阳生于阴也；下
者，自寸口下于尺部，阴生于阳也。来者，自骨肉之分，而出于
皮肤之际，气之升也；去者，自皮肤之际，而还于骨肉之分，气
之降也。应曰至，息曰止也。”（上下者，以尺与寸相比度也。阳生于阴者，
左尺水，生左关木；左关木，生左寸心火也。
右尺火，生右关土；右关土，生右寸肺金也。阴生于阳者，右寸肺金，生左尺肾水；
左寸君火，分权于右尺相火也。来者，为气之升，主乎阳也；去者，为气之降，主乎
阴也。《内经》以来盛去衰为钩脉，阳气盛满之象。若去来皆盛，钩之太过也；来不
盛，去反盛，钩之不及也。应者，寻常应手之脉也。止者，歇至不匀之脉也，如促结涩代之类是矣。）
《黄帝内经》说：“诊脉通常选择在清晨进行，此时阴气尚未扰动，阳气尚未耗散，饮食尚未摄入，经脉之气尚未充盛，络脉之气调和均匀，气血尚未紊乱，这样才能诊断出有异常的脉象。”（所谓平旦，是阴阳交替的时刻。营气和卫气在一昼夜中在全身循环五十周次，白天运行于阳经，夜晚运行于阴经，等到平旦时分，重新汇聚于寸口。在这个时候，刚睡醒时，阴气将要消退但尚未完全消退，阳气将要旺盛但尚未发散，饮食尚未吃下，谷气尚未运行，所以经脉之气不充盛，而络脉之气调和均匀，气血没有达到扰乱的状态，才可以诊断出有病的脉象。“有过”，就是说有病的意思。如果饮食进入胃中，谷气就会流行，直行的经脉往往强盛，而横行的络脉，气先到达的地方强盛，气未到达的地方虚弱，经络的脉象就不能调和均匀，那么气血的盛衰情况，就不能完全凭此判断了。）
（增补内容）
《黄帝内经》说：“从鱼际穴到高骨，向后量一寸，称为寸口。从寸口到尺泽穴，称为尺泽。所以叫尺寸。寸口之后、尺泽之前，称为关。”（大拇指从鱼际穴到高骨，得一寸的距离，所以命名为“寸”。肘腕内侧尺泽穴到高骨得一尺的距离，所以命名为“尺”。正好在高骨之上，是尺部和寸部交界的地方，所以命名为“关”。其中的含义难道是不重要的吗！）扁鹊说：“尺寸脉，是脉象的大要会合之处。从关到尺部是尺部，内应阴脏所主治；从关到鱼际是寸口，内应阳脏所主治。”（“要”是指扼要，“会”是指朝会。尺寸脉都属于肺的经脉，百脉都来朝会，这难道不是扼要之处吗！肾和肝属阴，位于尺部之内。心和肺属阳，位于寸部之内。“治”，就是隶属的意思。说的是所属的部位。）岐伯说：“人有三部，每部有三候，用来决断生死，诊治各种疾病，调节虚实，祛除邪疾。”（三部，指上、中、下三部。三候，指天、地、人三候。上古时期诊脉，不仅诊寸口，对各经的动脉都进行诊察。这里说的就是三部九候法。由此可见，扁鹊的三部九候法，与《内经》的原意大不相同，这是很明显的。）黄帝问：“什么叫三部？”岐伯回答：“有上部，有中部，有下部。每部各有三候，三候分别对应天、地、人。上部天，在两额部的动脉；上部地，在两颊部的动脉；上部人，在耳前的动脉。中部天，是手太阴肺经；中部地，是手阳明大肠经；中部人，是手少阴心经。下部天，是足厥阴肝经；下部地，是足少阴肾经；下部人，是足太阴脾经。所以下部天候候肝脏，地候肾脏，人候脾胃之气。”黄帝问：“中部的三候如何？”岐伯说：“也有天，也有地，也有人。天候候肺，地候候胸中之气，人候候心。”黄帝问：“上部用什么来候诊？”岐伯说：“也有天，也有地，也有人。天候候头角之气，地候候口齿之气，人候候耳目之气。三部，各有天，各有地，各有人。三而成天，三而成地，三而成人。三乘以三，合起来就是九。”（由此推断，《内经》中衣冠文物所指的人身上中下动脉各有对应的候诊部位，用以诊察各脏腑之气，并不只是单讲寸口。如张仲景的脉法，上取寸口，下取趺阳脉，正是这个意思。《难经》所说的“三部是寸关尺，九候是浮中沉”，只是以寸口来分三部九候的诊法，后世论脉的人都尊崇这种方法，虽然这是简便之法，但不无违背《内经》原意吧！【按语】扁鹊说：“上部法天，主胸以上至头部的疾病。中部法人，主膈以下至脐部的疾病。下部法地，主脐以下至足部的疾病”，仍然遵循《内经》“上竟上、下竟下”的意义。但是关于九候的说法，以寸关尺的三部来分浮、中、沉三候，难道又不谬误了吗！如果认为扁鹊的说法是对的，那么轩辕岐伯的说法就是错的；如果轩辕岐伯的说法是对的，那么扁鹊的说法就是错的！所以我不得不在此发表一点意见。浮诊和沉诊，本来就不需要议论了。中诊只有浮之中的概念，怎么会有沉之中的概念呢！浮而无中，固然说是无根。沉则必然没有中，为什么仅仅认为沉脉主里证，而没有必死的症状呢！大概人们只知道中正的中，而不知道中和的中。经文说：“真脏脉出现者死”，脉中没有胃气的，称为真脏脉。因此除了各种怪脉之外，都可以称为有中脉。为什么要抛弃那些明显显著的经文，反而去摸索浮中与沉这种不可知的陋习呢！这是无法理解的事情。况且诊脉的方法，有的用手测，有的用眼视，而不只是从事于手指按压。史书称扁鹊以诊脉闻名，而仓公、张仲景以下，有不竞相追求名声的吗！沿袭至今，讹传讹，被其更改得越多越乱。我曾经寻绎经文，得其旨趣。人迎脉只隶属于喉旁，三部必须兼看手足。脏气候于左手，腑气候于右手。寸部候上部，尺部候下部，脏腑都是这样，才不会使丝毫疑惑产生，而在其中迷惑。那些七表、八里、九道的纷纭杂乱，智慧又在扁鹊之下了。世人大多知晓这些，所以不再赘述。）
【按语】《黄帝内经》以三部各有天地人，三乘以三，为九候。上中下并不固定在寸部的位臵，与扁鹊的寸上关中尺下不同。上部全部定于头面两额的动脉，即下文天候候头角之气，动应于指（此脉在额两旁瞳子髎骨空处）；人候候两颊的动脉（即听会穴等分布）；地候候口齿之气，动应于指（此脉在鼻孔下旁，近巨髎穴的分布）。这样面部不仅有色诊，而且有脉诊了。脉诊则仍用七诊法，可以知道头面的详细情况（独大、独小、独疾、独迟、独热、独寒、独陷下也）。中部的三候，都以寸部诊察。其地候候胸中之气，就是气口。本经《经脉篇》所谓行气于府，即膻中气海穴。下部天，候于关部的肝，地候于尺部的肾，人候候脾胃之气。三部之候，天位在上，人位在中，地位在下。唯独下部人候反在天之上者，是因为天气下降，接乎地之阴气，这是地中之天，人高于地，即高乎地中之天了。三部以头候头之所属，以手候脏腑之所属，不及脐以下至足者，是因为足的四条经脉，肾主骨，肝主筋，脾主四肢，胃主宗筋，与肾相连，并筋骨由它们主管。这样手候脏腑之所属，并及脐以下至足，因为诸脉都系于手足，诸经足之脉也连于手（如上廉、下廉、前廉、后廉之类是也），不可拘泥于头候头之所属，就拘泥应当以手候手之所属，足候足之所属。乃本篇之后又申言说道：“用左手足上去踝五寸处按住，然后右手足当踝而弹之，其反应超过五寸以上，蠕蠕然的是不生病；其反应快，手感浑浑然的是有病，手感徐徐然的是有病；（蠕蠕，微动的样子。浑浑，不清的样子。徐徐，缓而迟的意思。）其反应不能至五寸，弹之不应的是死症。”（这段经文中的弹按，乃是刺法，与诊脉互相发明其理。）手踝之上，是手太阴肺经脉，应于中部。（去踝五寸，手踝骨在下，从内廉至太渊，计有五寸。）足踝之上，是足太阴脾经脉，应于下部。（去内踝骨之上五寸，乃三阴交之上，漏谷之下也。盖漏谷去踝六寸才是。）那么中部的三候，举一手太阴，就可以概括其余。（手太阴，是百脉之所会，大中之中，所以应中部。）下部的三候，举一足太阴，就可以概括其余。（足太阴，是阴土。阴与土，其气俱下，所以应下部。）按而弹手足踝，是为了尽两太阴脉的量，周悉无遗。所以可以取之察吉凶。（诸脉独于两太阴脉加意，是因为太阴属坤，坤为胃。手太阴之中部天而即统乎中部之地与人，贵天之中也。是太阴之下部人而即统乎下部之天与地，贵人之中也。天人之际得中，而地道自宁，不必揭地之中，且以知天人之中，即胃之中，即地之中也。）《黄帝内经》的旨意，精奥渊微，非神圣之人不能穷尽其理，所以扁鹊以寸关尺配上中下，还未尽然。
滑伯仁说：“诊脉之道，先调匀自己的气息。男左女右，先用中指取定关位，然后放下前后二指。初轻候消息之，次中候消息之，次重候消息之。自寸关至尺，逐部寻究。一呼一吸之间，脉行四至为率，闰以太息，五至为平脉也。其有太过不及，则为病脉，各以其部断之。”（自己之气息调匀，则他脉之至数明辨，故凡诊必先调息也。男子属阳，故先诊左手；女子属阴，故先诊右手也。先以中指取定关部，然后下前后二指，则尺寸方准也。轻候消息，其名曰举；中候消息，其名曰寻；重候消息，其名曰按。一息四至，为和平之脉；若当太息，必以五至为和平也。太过者，洪大有力；不及者，迟细无力也。各以五脏六腑察其微甚，审其从违，断其吉凶生死之法如此也。）
又说：“臂长则疏下指，臂短则密下指。三部之内，大小、浮沉、迟数同等，尺寸、阴阳、高下相符，男女、左右、强弱相应，四时之脉不相戾，命曰平人。其或一部之内，独大、独小，独疾、独迟，左右、强弱之相反，四时、男女之相背，皆病脉也。左手不和，为病在表，为阳，主四肢；右手不和，为病在里，为阴，主腹脏。”（臂长脉亦长，故下指宜疏；臂短脉亦短，故下指宜密。同等者，不大不小、不浮不沉、不迟不数也。相符者，寸为阳、为高，宜浮大；尺为阴、为下，宜沉小也。相应者，左大顺男，右大顺女；男子寸盛而尺弱，女子尺盛而寸弱也。不相戾者，春弦、夏洪、秋毛、冬石也。此四脉者，平人无病之脉也。其或大小独见，迟数偏呈，左右相反，时令相戾，男女相违，皆知其为病脉也。左属阳，阳在表，与四肢相应；右属阴，阴在里，与腹脏相应也。余可类推。）
又说：“察脉须识上下、来去、至止六字。不明此，则阴阳虚实不别也。上者为阳，下者为阴；来者为阳，去者为阴；至者为阳，止者为阴也。上者，自尺部上于寸口，阳生于阴也；下者，自寸口下于尺部，阴生于阳也。来者，自骨肉之分，而出于皮肤之际，气之升也；去者，自皮肤之际，而还于骨肉之分，气之降也。应曰至，息曰止也。”（上下者，以尺与寸相比度也。阳生于阴者，左尺水，生左关木；左关木，生左寸心火也。右尺火，生右关土；右关土，生右寸肺金也。阴生于阳者，右寸肺金，生左尺肾水；左寸君火，分权于右尺相火也。来者，为气之升，主乎阳也；去者，为气之降，主乎阴也。《黄帝内经》以来盛去衰为钩脉，阳气盛满之象。若去来皆盛，钩之太过也；来不盛，去反盛，钩之不及也。应者，寻常应手之脉也。止者，歇至不匀之脉也，如促结涩代之类是矣。）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Pulse diagnosis is usually performed at dawn (Pingdan), when Yin Qi has not yet stirred, Yang Qi has not yet dispersed, food and drink have not been ingested, the Jing Mai (Primary Meridians) are not yet full, the Luo Mai (Collaterals) are harmonious and even, and the Qi and Blood are not yet chaotic. Only then can abnormal pulses be diagnosed." (Dawn is the time of transition between Yin and Yang. Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) circulate fifty times through the body in a day and night. During the day, they travel through the Yang meridians; at night, through the Yin meridians. By dawn, they reconverge at the Cun Kou (Radial Artery). At this moment, upon waking, Yin Qi is about to recede but has not fully done so, Yang Qi is about to flourish but has not yet scattered. Food has not been eaten, and Grain Qi has not yet circulated. Therefore, the Qi of the Jing Mai is not yet vigorous, while the Qi of the Luo Mai is harmonious and even, and Qi and Blood have not reached a state of disturbance. It is only then that pathological pulses can be diagnosed. "You Guo" means having disease. If food enters the stomach, Grain Qi flows; the straight-running meridians often become strong, while among the transversely running collaterals, those where Qi arrives first become strong, and those where Qi has not yet arrived become weak. The pulses of the meridians and collaterals cannot be harmonious and even, so the relative strength and weakness of Qi and Blood cannot be fully relied upon.)
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The *Huangdi Neijing* states: "From the Yu Ji point to the high bone, measuring backwards one cun, is named Cun Kou. From Cun Kou to Chi Ze, it is named Chi Ze. Hence it is called Cun-Chi. Behind Cun Kou and before Chi Ze is named Guan." (From the Yu Ji point to the high bone on the thumb measures one cun, hence named "Cun". From the Chi Ze point on the inner elbow/wrist to the high bone measures one chi, hence named "Chi". Exactly above the high bone is the junction of the Chi and Cun sections, hence named "Guan". Is its meaning insignificant!) Bian Que said: "Cun and Chi are the great convergence of pulse essentials. From Guan to Chi is the Chi section, governing the interior Yin organs. From Guan to Yu Ji is the Cun Kou, governing the interior Yang organs." ("Yao" means essential; "Hui" means assembly. Both Cun and Chi belong to the Lung meridian, and all pulses come to assemble here; is this not an essential location! The Kidney and Liver are Yin, located within the Chi section. The Heart and Lungs are Yang, located within the Cun section. "Zhi" means belonging/subordination, referring to the associated positions.) Qi Bo said: "Humans have three sections, each with three positions, used to determine life and death, treat various diseases, regulate deficiency and excess, and eliminate pathogenic disorders." (Three sections refer to Upper, Middle, and Lower. Three positions refer to Heaven, Earth, and Human. In ancient times, pulse diagnosis was not limited to the Cun Kou but included palpation of arterial pulses in various meridians. This refers to the San Bu Jiu Hou method. Thus, Bian Que's San Bu Jiu Hou differs significantly from the original intent of the *Neijing*, which is clear.) The Yellow Emperor asked: "What are the three sections?" Qi Bo replied: "There is an Upper section, a Middle section, and a Lower section. Each section has three positions, corresponding to Heaven, Earth, and Human. Upper Heaven is the arterial pulse at both temples; Upper Earth is the arterial pulse at both cheeks; Upper Human is the arterial pulse in front of the ears. Middle Heaven is the Hand Taiyin (Lung) meridian; Middle Earth is the Hand Yangming (Large Intestine) meridian; Middle Human is the Hand Shaoyin (Heart) meridian. Lower Heaven is the Foot Jueyin (Liver) meridian; Lower Earth is the Foot Shaoyin (Kidney) meridian; Lower Human is the Foot Taiyin (Spleen) meridian. Thus, Lower Heaven inspects the Liver, Lower Earth inspects the Kidney, and Lower Human inspects the Qi of the Spleen and Stomach." The Yellow Emperor asked: "How are the three positions of the Middle section?" Qi Bo said: "There is also Heaven, Earth, and Human. Heaven inspects the Lungs, Earth inspects the Qi of the Chest Center, and Human inspects the Heart." The Yellow Emperor asked: "How is the Upper section inspected?" Qi Bo said: "There is also Heaven, Earth, and Human. Heaven inspects the Qi of the head and angles, Earth inspects the Qi of the mouth and teeth, and Human inspects the Qi of the eyes and ears. The three sections each have Heaven, Earth, and Human. Three make Heaven, three make Earth, three make Human. Three multiplied by three equals nine." (From this, we deduce that the *Neijing* indicates specific arterial locations on the upper, middle, and lower parts of the body correspond to specific areas for diagnosis, not just the Cun Kou. For example, Zhang Zhongjing's pulse method takes the Cun Kou above and the Duzhong pulse below, following this principle. The *Nanjing* states that "the three sections are Cun, Guan, Chi, and the nine positions are Floating, Moderate, and Deep," dividing the three sections and nine positions solely by the Cun Kou. Later generations of pulse experts revere this method. Although it is a convenient method, does it not deviate from the *Neijing*'s original intent? [Commentary] Bian Que said: "Upper section follows Heaven, governing diseases from the chest up to the head. Middle section follows Human, governing diseases from below the diaphragm to the umbilicus. Lower section follows Earth, governing diseases from below the umbilicus to the feet," still adhering to the *Neijing*'s principle of "upper corresponds to upper, lower corresponds to lower." However, regarding the nine positions, dividing them into Floating, Moderate, and Deep based on the Cun, Guan, Chi sections—could this not be erroneous again! If Bian Que's view is correct, then Xuanyuan Qibo's view is wrong; if Xuanyuan Qibo's view is correct, then Bian Que's view is wrong! Therefore, I must interject. Floating and Deep palpation need no debate. There is only "Moderate within Floating"; how can there be "Moderate within Deep"? Floating without Moderate implies rootlessness. Deep necessarily lacks Moderate. Why is it only stated that Deep pulse governs Interior syndromes, without mentioning inevitable fatal symptoms? People generally know the "Middle" of centrality but not the "Middle" of harmony. The classic states: "When True Zang pulses appear, death occurs." Pulses lacking Stomach Qi are called True Zang pulses. Thus, except for various strange pulses, all can be considered as having "Moderate." Why abandon obvious scriptural texts to grope in the ignorance of Floating-Moderate and Deep-Moderate distinctions? This is inexplicable. Moreover, pulse diagnosis involves hand measurement and visual inspection, not just finger palpation. History records Bian Que famous for pulse diagnosis, and subsequent figures like Cang Gong and Zhang Zhongjing competed in fame. Errors have propagated, becoming more complex over time. I have studied the classics and grasped their essence. Renying pulse is only beside the throat; the three sections must include hand and foot arteries. Zang Qi is inspected on the left hand, Fu Qi on the right hand. Cun inspects the upper, Chi inspects the lower, for both Zang and Fu, avoiding any doubt or confusion. The complexities of Seven Tables, Eight Li, and Nine Channels are inferior even to Bian Que's wisdom. Since most people know these, I will not elaborate further.)
[Commentary] The *Huangdi Neijing* posits that each of the three sections has Heaven, Earth, and Human, totaling nine positions. Upper, Middle, and Lower are not fixed to the Cun position, differing from Bian Que's Cun-Upper, Guan-Middle, Chi-Lower. The Upper section is entirely defined by arterial pulses at the temples (Heaven inspects head/angles, pulse felt at the empty space beside the pupil bone); Human inspects cheek arteries (Tinghui points etc.); Earth inspects mouth/teeth Qi (pulse near Juliao point). Thus, the face has not only color diagnosis but also pulse diagnosis. Pulse diagnosis uses the Seven Diagnoses to detail head and face conditions (excessively large, small, rapid, slow, hot, cold, sunken). The three positions of the Middle section are all diagnosed at Cun. Earth inspects Chest Center Qi, which is the Qi Kou. As stated in the *Meridians Chapter*, Qi moves to the Fu organs, specifically the Danzhong/Qihai point. Lower Heaven inspects Liver at Guan, Lower Earth inspects Kidney at Chi, Lower Human inspects Spleen/Stomach Qi. In the three sections' positions, Heaven is upper, Human is middle, Earth is lower. Lower Human appears above Heaven because Heavenly Qi descends to connect with Earth's Yin Qi; this is Heaven within Earth. Humans are higher than Earth, thus higher than Heaven within Earth. The three sections use Head to inspect Head-related matters, Hand to inspect Zang-Fu related matters, excluding below the umbilicus to feet because the four foot meridians involve Kidney governing bones, Liver governing sinews, Spleen governing limbs, Stomach governing tendons, connected to Kidney and governed by bones/sinews. Thus, Hand inspects Zang-Fu and extends to below umbilicus/feet because all pulses connect hands and feet, and foot meridians connect to hands (e.g., Shanglian, Xialian, etc.). One should not rigidly adhere to Head-inspects-Head to mean Hand-inspects-Hand or Foot-inspects-Foot. Later in the chapter, it reiterates: "Press five cun above the ankle with the left hand, then flick the right foot at the ankle. If the response exceeds five cun and feels slightly moving (Ruru), the person is healthy. If the response is rapid and feels chaotic (Hunhun), there is disease. If slow and delayed (Xuxu), there is disease. If the response does not reach five cun or does not respond to flicking, death ensues." (This flicking technique relates to acupuncture principles, elucidating pulse theory together.) Above the wrist is the Hand Taiyin Lung meridian, corresponding to the Middle section (five cun from ankle to Taiyuan). Above the ankle is the Foot Taiyin Spleen meridian, corresponding to the Lower section (five cun above medial malleolus, above Sanyinjiao, below Lougu). Thus, the Middle section's three positions can be summarized by the Hand Taiyin (assembly of all pulses, central center). The Lower section's three positions can be summarized by the Foot Taiyin (Yin Earth, Qi descends). Pressing and flicking ankles exhausts the measure of the two Taiyin meridians completely, allowing assessment of auspiciousness/misfortune. Special attention to Taiyin meridians is due to Taiyin belonging to Kun (Earth/Stomach). Hand Taiyin Middle Heaven governs Middle Earth and Human, valuing Heaven's center. Lower Human governs Lower Heaven and Earth, valuing Human's center. Harmony between Heaven and Human stabilizes Earth. The *Neijing*'s profound meaning requires sage-like understanding; thus, Bian Que's mapping of Cun/Guan/Chi to Upper/Middle/Lower is incomplete.
Slip Boyren (Hua Boluo) said: "In pulse diagnosis, first regulate one's own breath. For men, left hand first; for women, right hand first. Use the middle finger to locate the Guan position, then place index and ring fingers. Initially, lightly feel (Ju); moderately feel (Xun); heavily feel (An). From Cun to Chi, investigate each section. Four beats per respiration is the standard; with a deep sigh, five beats is the normal pulse. Excess or deficiency indicates pathological pulses, judged by their respective sections." (Regulating breath clarifies pulse rate. Men are Yang, so left hand first; women are Yin, so right hand first. Locating Guan with the middle finger ensures accuracy of Cun and Chi. Light pressure is Ju; moderate is Xun; heavy is An. Four beats/respiration is harmonious; five with a sigh is harmonious. Excess is surging/large/forceful; deficiency is slow/fine/weak. Judge severity based on Zang-Fu, assess compliance/deviation, and determine fate/life/death.)
He also said: "If arms are long, space fingers widely; if short, place fingers closely. Within the three sections, if size, floating/deep, slow/rapid are equal, and Cun/Chi, Yin/Yang, high/low match, and male/female, left/right, strong/weak correspond, and seasonal pulses do not conflict, the person is healthy. If any section shows exclusively large/small, rapid/slow, or left/right, strong/weak contradict, or seasons/gender oppose, these are pathological pulses. Left hand disharmony indicates Exterior/Yang disease, governing limbs; Right hand disharmony indicates Interior/Yin disease, governing abdominal organs." (Long arms imply long pulses, requiring wider spacing; short arms imply short pulses, requiring closer spacing. Equal means not large/small, floating/deep, slow/fast. Matching means Cun (Yang/high) should be floating/large; Chi (Yin/low) should be deep/small. Correspondence means larger left suits men, larger right suits women; men have strong Cun/weak Chi, women have strong Chi/weak Cun. Non-conflict means Spring wiry, Summer surging, Autumn fine, Winter stone. These four are healthy pulses. Exclusivity in size/rate, contradiction in left/right/season/gender indicates pathology. Left is Yang/Exterior/limbs; Right is Yin/Interior/abdominal organs. Others follow this logic.)
He further said: "Understanding pulse requires knowing six characters: Up, Down, Come, Go, Arrival, Stop. Without this, Yin/Yang and Deficiency/Excess cannot be distinguished. Up is Yang, Down is Yin; Come is Yang, Go is Yin; Arrival is Yang, Stop is Yin. Up moves from Chi to Cun, Yang born from Yin. Down moves from Cun to Chi, Yin born from Yang. Come emerges from muscle/bone to skin, Qi ascending. Go returns from skin to muscle/bone, Qi descending. Response is Arrival, Rest is Stop." (Up/Down compares Chi and Cun. Yang born from Yin: Left Chi Water generates Left Guan Wood; Left Guan Wood generates Left Cun Fire. Right Chi Fire generates Right Guan Earth; Right Guan Earth generates Right Cun Metal. Yin born from Yang: Right Cun Metal generates Left Chi Water; Left Cun Sovereign Fire shares power with Right Chi Minister Fire. Come is Qi ascending, governing Yang. Go is Qi descending, governing Yin. *Neijing* describes "strong coming, weak going" as Hook pulse, image of abundant Yang Qi. If both strong, Hook is excessive; if coming weak and going strong, Hook is deficient. Response is normal pulse feeling. Stop is irregular pause, such as Cu, Jie, Se, Dai pulses.)