一难曰。十二经皆有动脉。
吕曰。是手足经十二脉也。丁曰。十二经皆有动脉者。是人两手足各有三阴三阳之经也。以应天地各有三阴三阳之
气也。所谓天地三阴三阳。各有所主。其时自春分节后。到夏至之前九十日。为天之三阳所主也。夏至之后。秋分之前
九十日。天之三阴所主也。秋分节后。冬至之前九十日。是地之三阴所主也。冬至之后。春分节前九十日。地之三阳所
主也。凡左右上下。各有此三阴三阳之气。合为十二。故人亦有十二经也。所主左右上下之分也。又人膈以上者。手三
阴三阳所主也。即通于天气。膈以下。足三阴三阳所主也。即通于地气。其通天气者为气为脉。其通地气者主味归形。
故十二经通阴阳行气血也。又经者、径也。递相溉灌。无所不通。所以黄帝云。十二经处百病。次决死生。不可不通也。
其言十二经皆有动脉者。即在两手三部各有会动之脉也。即（按此字衍。）左手寸部。心与小肠动脉所出也。心脉曰手少
阴。（按原本此下有心包络脉曰手心主八字。据下文，心包之脉。隶于右尺。不应自相矛盾。故删之。）小肠脉曰手太阳。
其应东南方君火在巽是也。左手关部。肝胆动脉所出也。肝脉曰足厥阴。胆脉曰足少阳。其应东方木在震是也。左手尺
部。肾与膀胱动脉所出也。肾脉曰足少阴。膀胱脉曰足太阳。其应北方水在坎是也。右手寸部。肺与大肠动脉所出也。
肺脉曰手太阴。大肠脉曰手阳明。其应西方金在兑是也。右手关部。脾胃动脉所出也。脾脉曰足太阴。胃脉曰足阳明。
其应中央土在坤是也。右手尺部。心包络与三焦动脉所出也。心包络曰手厥阴。三焦脉曰手少阳。其应南方相火。在离
是也。此三部动脉所出。故经言皆有动脉也。杨曰。凡人两手足。各有三阴脉三阳脉。合十二经脉。肝脉曰足厥阴。脾
脉曰足太阴。肾脉曰足少阴。胆脉曰足少阳。胃脉曰足阳明。膀胱脉曰足太阳。肺脉曰手太阴。心脉曰手少阴。（按原本
此下误衍心包络脉曰手心主八字。与上注同。今删之。）大肠脉曰手阳明。小肠脉曰手太阳。包络脉曰手厥阴。三焦脉曰
手少阳。凡脉皆双行。故有六阴六阳也。吕曰。足太阳动委中。足少阳动耳前。杨曰。下关穴也。又动悬钟。吕曰。足
阳明动趺上。杨曰。冲阳穴也。在足趺上。故以为名。又动颈人迎。又动大迎。吕曰。手太阳动目外 。杨曰。瞳子
穴也。吕曰。手少阳动客主人。杨曰。又动听会。吕曰。手阳明动口边。杨曰。地仓穴也。吕曰。又动阳溪。足厥阴动
人迎。杨曰。按人迎乃足阳明脉。非足厥阴也。吕曰。厥阴动人迎。误矣。人迎通候五脏之气。非独因厥阴而动也。按
厥阴脉动于回骨焉。吕曰。足少阴动内踝下。杨曰。太溪穴也。按此动脉非少阴脉也。斯乃冲脉动耳。冲脉与少阴并行。
因谓少阴脉动。其实非也。亦吕氏之谬焉。少阴乃动内踝上五寸间也。经曰。弹之以候死生是也。吕曰。足太阴动髀上。
杨曰。箕门穴也。吕曰。手少阴动腋下。
杨曰。极泉穴也。又动灵道少海。吕曰。手心主动劳宫。手太阴脉动大渊。杨曰。又动尺泽侠白天府也。虞曰。吕
杨二注。惟各取其经脉流行之穴。言其动脉。与本经下文独取寸口之义。不相乘也。庶今举之。经曰。脉会大渊。大渊
在两手掌后鱼际间。乃手太阴脉之动也。太阴主气。是知十二经脉会于大渊。故圣人准此脉要会之所。于人两手掌后鱼
际间。分别三部。名寸、尺、关。于三部中诊其动脉。乃知人五脏六腑虚实冷热之证。谓一经之中。有一表一里。来者
为阳。去者为阴。两手合六部。六部合之为十二经。其理明矣。察阳者。知病之所在。察阴者。知死生之期。故曰十二
经皆有动脉也。乃合诊法。
独取寸口。以决五脏六腑死生吉凶之法。何谓也。
丁曰。夫独取寸口诊法者。其一指指下。各有上下左右长短浮沉滑涩迟数。见病吉凶也。此法是黄帝脉要精微论中
之旨也。越人引此一篇。以为众篇之首也。昔黄帝问曰。诊法何如。岐伯对曰。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。切脉动静。视精明。察五色。视五脏有余不足。形之盛衰。参
伍决死生之分也。此者是独取寸口之法也。杨曰。自难曰至此。是越人引经设问。从然字以下。是解释其义。余悉如此。
例可知也。
然寸口者。脉之大会。手太阴之脉动也。
吕曰。太阴者。肺之脉也。肺为诸脏上盖。主通阴阳。故十二经皆会手太阴寸口。所以决吉凶者。十二经有病。皆
见寸口。知其何经之动。浮沉滑涩。春秋逆顺。知其死生也。丁曰。其手太阴者、是右手寸部也。为肺主其气。为五脏
六腑之华盖。凡五脏六腑有病。皆见于气口。故曰大会也。虞曰。五味入胃。化生五气。五味者。甘、辛、咸、苦、酸，
五气者，膻、腥、香、焦、腐。乃五行之气味也。其味化气。上传手太阴。太阴主气。得五气以溉灌五脏，若胃失中和。
则不化气。手太阴无所受。故寸口以浮沉长短滑涩。乃知病发于何脏。故经云。寸口者。脉之大要会也。五脏别论曰。
五味入口。以藏于胃。以养五脏气。本经曰。人受气于谷。玉机真藏论曰。因胃气乃能至手太阴。阴阳应象论曰。味归
形。形归气。气归精。精归化。夫如是。则知人之气。自味而化。上传手太阴。故寸口为要会也。
人一呼、脉行三寸。一吸、脉行三寸。呼吸定息。脉行六寸。
吕曰。十二经。十五络。二十七气。皆候于寸口。随呼吸上下。呼脉上行三寸。吸脉下行三寸。呼吸定息。脉行六
寸。二十七气。皆随上下行。以寤行于身。寐行于脏。昼夜流行。无有休息时。丁曰。言人一呼、脉行三寸。一吸、脉
行三寸。呼吸定息。脉行六寸者。即是天地阴阳升降定息也。即是周于六甲。而又日月晓昏。人呼吸上下以六气周身。
故乃法定息六寸也。
人一日一夜。凡一万三千五百息。脉行五十度。周于身。漏水下百刻。荣卫行阳二十五度。行阴亦二十五度。为一
周也。故五十度复会于手太阴寸口者。五脏六腑之所终始。故法取于寸口也。
吕曰。人一息脉行六寸。十息脉行六尺。百息脉行六丈。千息六十丈。万息六百丈。一万三千五百息。合为八百一
十丈为一周。阳脉出行二十五度。阴脉入行二十五度。合为五十度。阴阳呼吸。覆溢行周毕度数也。（按史记正义引此文
无溢字。）脉行周身毕。即漏水百刻亦毕也。谓一日一夜漏刻尽。天明日出东方。脉还寸口。当复更始也。故曰。寸口者、
五脏六腑之所终始也。丁曰。按旧经注。其脉息以为八百一十丈。即当水下二刻。得周身一度。如百刻。计周身五十度。
如此。则行阳五十度。行阴亦五十度。此乃甚与经意不同也。经言行阳二十五度。行阴亦二十五度。共得五十度而复会
也。所谓行阳行阴各二十五度者。谓一岁阴阳。始于立春。交相复会于立春。故共行五十度也。日之晓昏。人之寤寐。
皆在于平旦。日行二十四时。复会于是。人气始自中焦。注手太阴。行其经络。计二十四。亦复交会于手太阴。其右寸
内有穴太渊。是脉之大会始终。故各计二十五。所以言寸口者。脉之终始也。虞曰。二百七十息。脉行一十六丈二尺。
及一周身。应漏水下二刻。一万三千五百息。脉行八百一十丈。应漏水下百刻。是知一日一夜。行五十周于身。凡行阴
阳。分昼夜。是故行阳二十五度。行阴二十五度也。
第一难说：十二经脉中都有动脉搏动。
吕广注：这里指的是手经和足经共十二条脉。丁德用注：所谓十二经脉都有动脉，是因为人的双手双脚各有三条阴经和三条阳经。这是为了对应天地之间也各有三阴三阳之气。所谓的天地三阴三阳，各自有所主管的时段。从春分节气之后，到夏至之前这九十天，是由天的三阳所主管；夏至之后，秋分之前这九十天，是由天的三阴所主管；秋分节气之后，冬至之前这九十天，是由地的三阴所主管；冬至之后，春分之前这九十天，是由地的三阳所主管。凡是在左、右、上、下各个方位，都具备这三种阴气和三种阳气，合起来就是十二种，所以人也有十二经脉。这是指左右上下各有所主的气机分布。另外，人体膈肌以上的部位，由手三阴、手三阳所主管，这就与天气相通；膈肌以下的部位，由足三阴、足三阳所主管，这就与地气相通。那些与天气相通的，表现为气和脉；那些与地气相通的，主要主管味道以滋养形体。因此，十二经脉贯通阴阳，运行气血。又，“经”的意思就是“径”，即路径，经脉之间依次相互灌溉，没有不通达的地方。所以黄帝说：“十二经脉能诊治百病，其次决定死生，不可不精通。”所谓“十二经皆有动脉”，是指在两手部的寸、关、尺三部都有会动的脉搏。即左手寸部，是心与小肠动脉发出的部位。心的脉象称为手少阴（按：原本此处有“心包络脉曰手心主”八字，根据下文，心包之脉归属于右尺部，不应自相矛盾，故删除）。小肠的脉象称为手太阳，它对应东南方，属君火，位于巽位。左手关部，是肝胆动脉发出的部位。肝的脉象称为足厥阴，胆的脉象称为足少阳，它对应东方，属木，位于震位。左手尺部，是肾与膀胱动脉发出的部位。肾的脉象称为足少阴，膀胱的脉象称为足太阳，它对应北方，属水，位于坎位。右手寸部，是肺与大肠动脉发出的部位。肺的脉象称为手太阴，大肠的脉象称为手阳明，它对应西方，属金，位于兑位。右手关部，是脾胃动脉发出的部位。脾的脉象称为足太阴，胃的脉象称为足阳明，它对应中央，属土，位于坤位。右手尺部，是心包络与三焦动脉发出的部位。心包络的脉象称为手厥阴，三焦的脉象称为手少阳，它对应南方的相火，位于离位。这三部动脉发出的位置，所以经文说“皆有动脉”。杨玄操注：凡是人的双手双脚，各有三条阴脉和三条阳脉，合为十二经脉。肝脉称为足厥阴，脾脉称为足太阴，肾脉称为足少阴，胆脉称为足少阳，胃脉称为足阳明，膀胱脉称为足太阳，肺脉称为手太阴，心脉称为手少阴（按：原本此处误衍“心包络脉曰手心主”八字，与上面的注释相同，现在删除），大肠脉称为手阳明，小肠脉称为手太阳，心包络脉称为手厥阴，三焦脉称为手少阳。凡是脉都是左右双行的，所以有六条阴脉和六条阳脉。吕广注：足太阳经的动脉在委中穴，足少阳经的动脉在耳前。杨玄操注：在下关穴。又在悬钟穴有搏动。吕广注：足阳明经的动脉在足背上方。杨玄操注：在冲阳穴，位于足背上，所以以此命名。又在颈部的迎香穴（注：原文为人迎，但结合上下文及解剖位置，此处杨注可能指颈部动脉或笔误，依原文翻译）和人迎穴有搏动。吕广注：手太阳经的动脉在外眼角。杨玄操注：在瞳子髎穴。吕广注：手少阳经的动脉在客主人穴。杨玄操注：又动听宫穴。吕广注：手阳明经的动脉在口边。杨玄操注：在地仓穴。吕广注：又在阳溪穴有搏动。足厥阴经的动脉在人迎穴。杨玄操注：按人迎穴乃是足阳明经的脉，不是足厥阴经。吕广注：厥阴经在人迎穴搏动是错误的。人迎穴通候五脏之气，不仅仅因为厥阴经而搏动。按厥阴经的脉动在回骨处。吕广注：足少阴经的动脉在内踝下方。杨玄操注：在太溪穴。按这个动脉并不是少阴经的脉，这是冲脉的搏动。冲脉与少阴经并行，因此说是少阴经脉动，其实并非如此。这也是吕广的谬误。少阴经实际上是在内踝上方五寸处搏动。经文说：“弹击它以诊察死生征兆。”吕广注：足太阴经的动脉在大腿上部。杨玄操注：在箕门穴。吕广注：手少阴经的动脉在腋下。杨玄操注：在极泉穴。又在灵道穴和少海穴有搏动。吕广注：心包经的动脉在劳宫穴。手太阴经的动脉在大渊穴。杨玄操注：又在尺泽穴、侠白穴和天府穴有搏动。虞庶注：吕广和杨玄操两位注家，只是各自选取了经脉流注经过的穴位来说明动脉，这与本经下文“独取寸口”的主旨不相符合。姑且列举如下。经文说：“脉会于大渊。”大渊穴在两手掌后鱼际之间的凹陷处，是手太阴经的动脉所在。太阴经主气，由此可知十二经脉的气血会聚于大渊穴。所以圣人依据这个脉要会聚之处，在人的两手掌后鱼际之间，分别划分出寸、关、尺三部。在这三部中诊察动脉，就能知道人五脏六腑虚实寒热的证候。可以说，在一经之中，有一表一里之分，脉气来者为阳，去者为阴。双手合起来共有六部，六部合起来就是十二经脉，其中的道理就很明白了。诊察阳脉，可以知道疾病所在的部位；诊察阴脉，可以知道预后的死生期限。所以说“十二经皆有动脉”，这是符合诊法原理的。
第二问：单独取寸口脉，来决断五脏六腑的死生吉凶的方法，是什么道理呢？
丁德用注：所谓独取寸口的诊法，是指医生的一根手指按在脉上，脉象各有上、下、左、右、长、短、浮、沉、滑、涩、迟、数等变化，从而显现疾病的吉凶。这个方法是《黄帝内经·脉要精微论》中的宗旨。越人（扁鹊）引用这一篇的内容，作为众多篇章之首。从前黄帝问道：“诊法是怎样的？”岐伯回答说：“通常要在平旦时分，此时阴气尚未扰动，阳气尚未发散，饮食尚未进入体内，经脉之气尚未充盛，络脉调和均匀，气血尚未紊乱，这时才可以诊察有过失的脉象。切按脉象的动静，观察眼睛的神采，诊察五色，视察五脏有余和不足的情况，观察形体的盛衰，综合参伍来判断死生的界限。”这就是独取寸口的方法。杨玄操注：从“难曰”到这里，是越人引用经典设立问题，从“然”字以下，是解释其含义。其余部分都可以按照这个体例类推。
回答：寸口，是脉象的大会合点，是手太阴肺经的动脉所在。
吕广注：太阴，指的是肺的经脉。肺是诸脏之上的华盖，主管贯通阴阳，所以十二经脉的气血都会聚会于手太阴寸口。因此用来决断吉凶，当十二经脉有病时，都会在寸口表现出来，通过诊察可以知道是哪一经脉异常，通过浮、沉、滑、涩等脉象以及春秋季节的逆顺关系，可以判断死生。丁德用注：所谓手太阴，是指右手寸部。因为肺主气，是五脏六腑的华盖。凡是五脏六腑有病，都会表现在气口（寸口），所以称为大会合。虞庶注：五味进入胃中，化生出五种气。五味是指甘、辛、咸、苦、酸；五气是指膻、腥、香、焦、腐，这是五行对应的气味。味道转化为气，上传至手太阴肺经。太阴经主气，接受五气的灌溉以滋养五脏。如果胃失去中和的状态，就不能化生精气，手太阴肺经就无所承受。因此，通过寸口脉的浮、沉、长短、滑、涩，就可以知道疾病发源于哪个脏腑。所以经文说：“寸口，是脉的大要会。”《五脏别论》说：“五味入口，藏于胃，以滋养五脏之气。”本经说：“人受气于谷。”《玉机真脏论》说：“因胃气才能到达手太阴。”《阴阳应象大论》说：“味归形，形归气，气归精，精归化。”像这样，就知道人的气，是从味道转化而来，上传至手太阴，所以寸口是重要的会合点。
人一呼，脉气运行三寸；一吸，脉气运行三寸；呼吸定息（一次完整的呼吸周期），脉气运行六寸。
吕广注：十二经脉、十五络脉、二十七气，都候见于寸口，随着呼吸上下运行。呼气时脉气上行三寸，吸气时脉气下行三寸。一次完整的呼吸周期，脉气运行六寸。二十七气，都随着上下运行，醒时运行于身体，睡时运行于内脏，昼夜流行，没有休息的时候。丁德用注：说人一呼脉行三寸，一吸脉行三寸，呼吸定息脉行六寸，就是指天地阴阳升降的定息时刻。也就是周流于六甲，并且对应日月的早晚昏晓。人的呼吸上下带动六气周身循环，所以法定息为六寸。
人在一天一夜中，总共呼吸一万三千五百次，脉气运行五十个周次，环绕全身。漏壶滴水一百刻，营气和卫气在阳分运行二十五度，在阴分也运行二十五度，这就完成了一个周天循环。所以脉气运行五十个周次后重新会合于手太阴寸口，这里是五脏六腑气血终结和起始的地方，所以诊法取法于寸口。
吕广注：人每一息脉行六寸，十息脉行六尺，百息脉行六丈，千息六十丈，万息六百丈。一万三千五百息，合计八百一十丈，为一个周次。阳脉出行二十五度，阴脉入行二十五度，合为五十度。这是阴阳呼吸、覆溢运行的周毕度数。（按：《史记正义》引用此文没有“溢”字。）脉气运行周身完毕，漏壶滴水一百刻也刚好结束。也就是说，一天一夜漏刻耗尽，天亮日出东方时，脉气回到寸口，应当重新开始。所以说：“寸口，是五脏六腑气血终结和起始的地方。”丁德用注：按照旧经注，脉气行走八百一十丈，相当于水下二刻，得周身一度。如果是一百刻，计算下来周身五十度。如果是这样，那么行阳五十度，行阴也是五十度。这与经文原意非常不同。经文说行阳二十五度，行阴也是二十五度，共得五十度然后重新会合。所谓行阳行阴各二十五度，是指一年的阴阳变化，始于立春，交互重新会合于立春，所以共行五十度。日子的早晚昏晓，人的醒睡，都在于平旦之时。太阳运行二十四时辰，重新会合于此。人气开始从中焦注入手太阴肺经，运行其经络，计为二十四，又重新交会于手太阴。右寸内有太渊穴，是脉之大会的始终点，所以各计二十五度。因此说寸口是脉的终始之地。虞庶注：二百七十息，脉行十六丈二尺，及一周身，对应漏壶水下二刻。一万三千五百息，脉行八百一十丈，对应漏壶水下百刻。由此可知，一天一夜，脉气在周身运行五十周。凡是运行阴阳，区分昼夜，所以行阳二十五度，行阴二十五度。
Chapter 1 states: There are pulsating arteries in all twelve meridians.
Lu Guang comments: This refers to the twelve meridians of the hands and feet. Ding Deyong comments: The statement that "all twelve meridians have pulsating arteries" means that each hand and foot has three Yin and three Yang meridians. This corresponds to the Heaven and Earth, which also possess three Yin and three Yang Qi. The so-called Heaven and Earth's three Yin and three Yang each govern specific periods. From after the Spring Equinox to before the Summer Solstice, a period of ninety days, is governed by the Heaven's three Yang. From after the Summer Solstice to before the Autumn Equinox, a period of ninety days, is governed by the Heaven's three Yin. From after the Autumn Equinox to before the Winter Solstice, a period of ninety days, is governed by the Earth's three Yin. From after the Winter Solstice to before the Spring Equinox, a period of ninety days, is governed by the Earth's three Yang. In all directions—left, right, upper, and lower—these three Yin and three Yang Qi exist, combining to form twelve; thus, humans also have twelve meridians. This refers to the distribution of Qi governing left, right, upper, and lower. Furthermore, the area above the diaphragm is governed by the Hand Three Yin and Hand Three Yang, connecting with Heavenly Qi; the area below the diaphragm is governed by the Foot Three Yin and Foot Three Yang, connecting with Earthly Qi. Those connecting with Heavenly Qi manifest as Qi and pulse; those connecting with Earthly Qi primarily govern flavors to nourish the form. Therefore, the twelve meridians connect Yin and Yang and circulate Blood and Qi. Moreover, "Jing" (Meridian) means "path"; they irrigate each other sequentially without obstruction. Thus, the Yellow Emperor said, "The twelve meridians diagnose hundred diseases and determine life and death; one must not fail to understand them." The phrase "all twelve meridians have pulsating arteries" refers to the pulsating arteries found in the Cun, Guan, and Chi positions on both wrists. Specifically, the Cun position on the left wrist is where the Heart and Small Intestine arteries originate. The Heart pulse is called Shou-Shao-Yin (Hand Shaoyin) [Note: The original text contained "Xin-Bao-Luo Mai Yue Xin-Shou-Zhu" (Pericardium Meridian is called Hand Jueyin), but since the Pericardium meridian is assigned to the Right Chi position later, this was deleted to avoid contradiction]. The Small Intestine pulse is called Shou-Tai-Yang (Hand Taiyang), corresponding to the Southeast direction, ruling Jun-Huo (Ministerial Fire) at the Xun position. The Guan position on the left wrist is where the Liver and Gallbladder arteries originate. The Liver pulse is called Zu-Jue-Yin (Foot Jueyin), and the Gallbladder pulse is called Zu-Shao-Yang (Foot Shaoyang), corresponding to the East direction, ruling Wood at the Zhen position. The Chi position on the left wrist is where the Kidney and Bladder arteries originate. The Kidney pulse is called Zu-Shao-Yin (Foot Shaoyin), and the Bladder pulse is called Zu-Tai-Yang (Foot Taiyang), corresponding to the North direction, ruling Water at the Kan position. The Cun position on the right wrist is where the Lung and Large Intestine arteries originate. The Lung pulse is called Shou-Tai-Yin (Hand Taiyin), and the Large Intestine pulse is called Shou-Yang-Ming (Hand Yangming), corresponding to the West direction, ruling Metal at the Dui position. The Guan position on the right wrist is where the Spleen and Stomach arteries originate. The Spleen pulse is called Zu-Tai-Yin (Foot Taiyin), and the Stomach pulse is called Zu-Yang-Ming (Foot Yangming), corresponding to the Center, ruling Earth at the Kun position. The Chi position on the right wrist is where the Pericardium and Sanjiao (Triple Burner) arteries originate. The Pericardium pulse is called Shou-Jue-Yin (Hand Jueyin), and the Sanjiao pulse is called Shou-Shao-Yang (Hand Shaoyang), corresponding to the South direction, ruling Xiang-Huo (Ministerial Fire) at the Li position. These three positions are where the arterial pulses originate, hence the scripture says "all have pulsating arteries."
Yang Xucao comments: Every human has three Yin and three Yang meridians in each hand and foot, totaling twelve meridians. The Liver pulse is Zu-Jue-Yin, the Spleen pulse is Zu-Tai-Yin, the Kidney pulse is Zu-Shao-Yin, the Gallbladder pulse is Zu-Shao-Yang, the Stomach pulse is Zu-Yang-Ming, the Bladder pulse is Zu-Tai-Yang, the Lung pulse is Shou-Tai-Yin, the Heart pulse is Shou-Shao-Yin [Note: Original error "Xin-Bao-Luo Mai Yue Xin-Shou-Zhu" deleted], the Large Intestine pulse is Shou-Yang-Ming, the Small Intestine pulse is Shou-Tai-Yang, the Pericardium pulse is Shou-Jue-Yin, and the Sanjiao pulse is Shou-Shao-Yang. All meridians run bilaterally, hence there are six Yin and six Yang meridians.
Lu Guang comments: The Foot-Tai-Yang meridian has a pulse at Weizhong (BL-40); the Foot-Shao-Yang meridian has a pulse anterior to the ear. Yang Xucao comments: At Xiaguan (ST-7). Also pulsates at Xuanzhong (GB-39). Lu Guang comments: The Foot-Yang-Ming meridian has a pulse on the dorsum of the foot. Yang Xucao comments: At Chongyang (ST-42), located on the dorsum of the foot, hence its name. It also pulsates at Renying (ST-9) and Daying (ST-5). Lu Guang comments: The Hand-Tai-Yang meridian has a pulse at the outer canthus. Yang Xucao comments: At Tongziliao (GB-1). Lu Guang comments: The Hand-Shao-Yang meridian has a pulse at Keyuren (ST-7/GB-2 context varies, here likely referring to temporal region). Yang Xucao comments: Also at Tinghui (GB-2). Lu Guang comments: The Hand-Yang-Ming meridian has a pulse at the side of the mouth. Yang Xucao comments: At Dicang (ST-4). Lu Guang comments: Also at Yangxi (LI-5). The Foot-Jue-Yin meridian has a pulse at Renying (ST-9). Yang Xucao comments: Renying belongs to the Foot-Yang-Ming meridian, not Foot-Jue-Yin. Lu Guang comments: It is an error to say Jueyin pulsates at Renying. Renying reflects the Qi of all five Zang organs, not just Jueyin. The Jueyin meridian actually pulsates at Huigu. Lu Guang comments: The Foot-Shao-Yin meridian has a pulse below the medial malleolus. Yang Xucao comments: At Taixi (KI-3). Note: This pulsation is not the Shaoyin meridian itself, but the Chong Mai (Penetrating Vessel). The Chong Mai runs parallel to Shaoyin, leading to the misconception that it is the Shaoyin pulse; this is actually an error by Lu Guang. The Shaoyin meridian actually pulsates five cun above the medial malleolus. The scripture says: "Pluck it to assess life and death." Lu Guang comments: The Foot-Tai-Yin meridian has a pulse on the thigh. Yang Xucao comments: At Jimen (SP-11). Lu Guang comments: The Hand-Shao-Yin meridian has a pulse in the axilla. Yang Xucao comments: At Jiquan (HT-1). Also at Lingdao (HT-4) and Shaohai (HT-3). Lu Guang comments: The Pericardium meridian has a pulse at Laogong (PC-8). The Hand-Tai-Yin meridian has a pulse at Da Yuan (LU-9). Yang Xucao comments: Also at Chize (LU-5), Xiabai (LU-8), and Tianfu (LU-3).
Yu Shu comments: The annotations by Lu Guang and Yang Xucao merely select acupoints along the meridian flow to describe pulsations, which does not align with the principle of "isolating the Cun Kou" stated later in this chapter. For reference: The scripture says, "The Pulse meets at Da Yuan." Da Yuan is located in the depression posterior to the thenar eminence of the palm, representing the pulsation of the Hand-Tai-Yin meridian. Since Tai-Yin governs Qi, it is known that the Qi of the twelve meridians converges at Da Yuan. Therefore, the Sages, based on this convergence point, divided the area posterior to the thenar eminence of both hands into three sections named Cun, Guan, and Chi. By palpating the pulsations in these three sections, one can discern the excess, deficiency, cold, and heat patterns of the five Zang and six Fu organs. Within one meridian, there is a exterior-interior relationship; the incoming pulse is Yang, and the outgoing pulse is Yin. Both hands combined make six positions, and the six positions combined represent the twelve meridians; the logic is clear. Examining Yang pulses reveals the location of disease; examining Yin pulses reveals the timing of death or survival. Hence, "all twelve meridians have pulsating arteries," which conforms to diagnostic methods.
Question 2: What is the rationale for isolating the Cun Kou (Radial Artery at the wrist) to determine the life, death, good fortune, and misfortune of the five Zang and six Fu organs?
Ding Deyong comments: The method of isolating the Cun Kou involves feeling various qualities under one finger: up/down, left/right, long/short, floating/sinking, slippery/choppy, slow/rapid, thereby revealing the auspiciousness or inauspiciousness of the disease. This principle originates from the *Mai Yao Jing Wei Lun* (Essential Secrets of Pulse Diagnosis) in the *Huangdi Neijing*. Bian Que (Yue Ren) cited this chapter as the opening of his work. Formerly, the Yellow Emperor asked, "How should diagnosis be performed?" Qibo replied, "Usually, at dawn, when Yin Qi has not yet stirred, Yang Qi has not dispersed, food has not been ingested, meridian Qi is not yet full, collateral Qi is harmonious, and Blood and Qi are not chaotic, one may diagnose abnormal pulses. By palpating pulse dynamics, observing eye clarity, inspecting the five colors, assessing Zang organ excess/deficiency, and evaluating physical prosperity/decline, one can use complex analysis to determine life and death." This is the method of isolating the Cun Kou. Yang Xucao comments: From "Nan Yue" to here, Bian Que cites classics to pose questions; from the character "Ran" onwards, he explains the meaning. This structure applies throughout.
Answer: The Cun Kou is the great convergence of pulses, specifically the pulsation of the Hand-Tai-Yin (Lung) meridian.
Lu Guang comments: Tai-Yin refers to the Lung meridian. The Lung is the canopy over all Zang organs and governs the communication of Yin and Yang. Therefore, the Qi of all twelve meridians converges at the Hand-Tai-Yin Cun Kou. Thus, to determine fortune or misfortune, when any of the twelve meridians is diseased, it manifests at the Cun Kou, allowing identification of the affected meridian through floating, sinking, slippery, or choppy pulses and seasonal reversals/harmonies to judge life and death. Ding Deyong comments: The Hand-Tai-Yin corresponds to the Cun position on the right wrist. Since the Lung governs Qi and is the canopy of the five Zang and six Fu organs, diseases of all Zang and Fu organs manifest at the Qi Kou (Cun Kou), hence it is called the Great Convergence. Yu Shu comments: Five flavors enter the stomach and transform into five Qi. The five flavors are Sweet, Pungent, Salty, Bitter, Sour; the five Qi are Musky, Fishy, Fragrant, Scorched, Rotten, corresponding to the Five Elements' aromas. Flavors transform into Qi, which ascends to the Hand-Tai-Yin. Tai-Yin governs Qi, receiving the five Qi to irrigate the five Zang organs. If the Stomach loses harmony, it fails to transform Qi, and the Hand-Tai-Yin receives nothing. Therefore, through the floating, sinking, length, slipperiness, and choppy nature of the Cun Kou pulse, one knows which Zang organ is diseased. Hence the scripture says, "The Cun Kou is the major convergence of pulses." The *Wu Zang Bie Lun* states, "Five flavors enter the mouth, store in the Stomach, and nourish the Qi of the five Zang organs." This classic states, "Humans receive Qi from grain." The *Yu Ji Zhen Zang Lun* states, "It is due to Stomach Qi that it reaches the Hand-Tai-Yin." The *Yin Yang Ying Xiang Da Lun* states, "Flavors nourish the form, form nourishes Qi, Qi nourishes Essence, Essence nourishes Transformation." Thus, human Qi transforms from flavors and ascends to the Hand-Tai-Yin; therefore, the Cun Kou is the critical convergence.
In one exhalation, the pulse moves three cun; in one inhalation, the pulse moves three cun. In one complete breath cycle (rest between breaths), the pulse moves six cun.
Lu Guang comments: The twelve meridians, fifteen collaterals, and twenty-seven Qi all reflect at the Cun Kou, moving up and down with respiration. During exhalation, the pulse moves up three cun; during inhalation, it moves down three cun. In one complete breath cycle, the pulse moves six cun. The twenty-seven Qi move up and down, circulating in the body while awake and in the viscera while asleep, flowing day and night without rest. Ding Deyong comments: The statement that the pulse moves three cun per breath and six cun per cycle refers to the equilibrium of Heaven and Earth Yin and Yang ascent/descent. It circulates through the Six Jia and corresponds to the sun's rising and setting. Human respiration drives the Six Qi around the body, hence the fixed distance of six cun per cycle.
In one day and night, a person breathes 13,500 times. The pulse completes 50 circuits around the body. The water clock drops 100 marks. Ying (Nutrient) and Wei (Defensive) Qi circulate in the Yang aspect 25 times and in the Yin aspect 25 times, completing one great cycle. Thus, after 50 circuits, the pulse returns to converge at the Hand-Tai-Yin Cun Kou, which is the beginning and end of the five Zang and six Fu organs. Therefore, the diagnostic method takes its standard from the Cun Kou.
Lu Guang comments: One breath moves the pulse six cun; ten breaths move it six chi; one hundred breaths move it six zhang; one thousand breaths move it sixty zhang; ten thousand breaths move it six hundred zhang. Thirteen thousand five hundred breaths total eight hundred ten zhang for one circuit. Yang meridians travel outward 25 degrees; Yin meridians travel inward 25 degrees, totaling 50 degrees. This represents the degrees of Yin-Yang respiration and overflow/completion. [Note: *Shiji Zhengyi* omits the character 'Yi']. When the pulse completes circulation around the body, the water clock also finishes 100 marks. That is, when the day-night cycle ends and the sun rises in the east, the pulse returns to the Cun Kou to restart. Hence, "The Cun Kou is the beginning and end of the five Zang and six Fu organs." Ding Deyong comments: According to old commentaries, the pulse traveling 810 zhang corresponds to two water-clock marks, completing one circuit. If calculated over 100 marks, it would be 50 circuits. This would mean 50 cycles in Yang and 50 in Yin, which contradicts the scripture. The scripture states 25 cycles in Yang and 25 in Yin, totaling 50 before re-convergence. The "25 cycles in Yang/Yin" refers to the annual Yin-Yang cycle starting at Lichun (Start of Spring), where they interchange and meet again at Lichun, totaling 50 cycles. Sun rise/set and human wake/sleep occur at dawn. The sun travels 24 hours and meets here. Human Qi begins at the Middle Jiao, enters the Hand-Tai-Yin, and travels its meridians, counting 24, then meets again at the Hand-Tai-Yin. Inside the Right Cun lies the Taiyuan acupoint, the start and end of the pulse's great convergence, hence counted as 25 each. Thus, the Cun Kou is the beginning and end of the pulse. Yu Shu comments: 270 breaths move the pulse 16 zhang 2 chi, completing one circuit, corresponding to two water-clock marks. 13,500 breaths move the pulse 810 zhang, corresponding to 100 water-clock marks. Thus, in one day and night, the pulse circulates the body 50 times. Dividing Yin and Yang by day and night, it travels 25 degrees in Yang and 25 degrees in Yin.