左心小肠肝胆肾,右肺大肠脾胃命。心与小肠居左寸,肝胆同归左关定。肾脉元在左尺中,膀胱是腑常相
应。肺与大肠居右寸,脾胃脉从右关认。心胞右尺配三焦,此为初学入门诀。
左心主血,肝胆肾膀胱皆精血之隧道,故次附之;右肺主气,脾胃命门三焦各以气为运化,故次附之。分
之曰气、曰血,曰脉,总之惟脉营运气血而已。是以气血盛脉盛,气血衰脉衰,气血和脉平,气血乱脉病。由
此知脉乃气血之体,气血乃脉之用也。心与小肠为表里,旺于夏,而位左寸,沉取候心,浮候小肠。肝与胆为
表里,旺于春,而位左关,沉取候肝,浮候胆。肾与膀胱为表里,旺于冬,而位左尺,沉取候肾,浮候膀胱。
肺与大肠为表里,旺于秋,而位右寸,沉取候肺,浮候大肠。脾与胃为表里,旺于四季,而位右关,沉取候脾,
浮候胃。命门与三焦为表里,寄旺于夏,而位右尺,沉取候命门,浮候三焦。然以循环之序言之;则左尺
水生左关木,左关木生左寸火,左寸火接右尺火,右尺火生右关土,右关土生右寸金,右寸金生左尺水,生生
之意不绝,有子母之亲也。若以对待之位言之∶则左寸火克右寸金,左关木克右关土,左尺水克右尺火,左刚
右柔,有夫妇之别也,然左手属阳,右手属阴,左寸君火以尊而在上,右尺相火以卑而在下,有君臣之道也。
三部之中有此自然之理,是以善诊者,诊父而知其子也。
左手寸、关、尺三部分别对应心、小肠、肝、胆、肾;右手寸、关、尺三部分别对应肺、大肠、脾、胃、命门。心和其相表里的小肠位于左手的寸部,肝和胆同属于左手的关部。肾脉原本位于左手的尺部,膀胱作为其腑与肾相应。肺和大肠位于右手的寸部,脾和胃的脉象从右手的关部来辨识。心包络在右手的尺部配合三焦,这是初学者入门的口诀。
左手脉主要反映血的状况,肝、胆、肾、膀胱都是精血运行的通道,所以附在后面论述;右手脉主要反映气的状况,脾、胃、命门、三焦各自以气作为运化的动力,所以也附在后面论述。分开来说有气、有血、有脉,总而言之只有脉能够营运气和血。因此,气血旺盛则脉象盛大,气血衰弱则脉象微弱,气血调和则脉象平和,气血紊乱则脉象有病态。由此可知,脉是气血的本体,气血是脉的功能作用。
心和其相表里的小肠,在夏季旺盛,位置在左寸,沉取候察心的状况,浮取候察小肠的状况。肝和其相表里的胆,在春季旺盛,位置在左关,沉取候察肝的状况,浮取候察胆的状况。肾和其相表里的膀胱,在冬季旺盛,位置在左尺,沉取候察肾的状况,浮取候察膀胱的状况。肺和其相表里的大肠,在秋季旺盛,位置在右寸,沉取候察肺的状况,浮取候察大肠的状况。脾和其相表里的胃,在四季(每季最后十八天)旺盛,位置在右关,沉取候察脾的状况,浮取候察胃的状况。命门和其相表里的三焦,寄旺于夏季,位置在右尺,沉取候察命门的状况,浮取候察三焦的状况。
然而,如果按照循环生成的顺序来说:左尺的水生左关的木,左关的木生左寸的火,左寸的火连接右尺的火,右尺的火生右关的土,右关的土生右寸的金,右寸的金生左尺的水,生生不息,具有母子之间的亲情。如果按照对待的位置来说:左寸的火克右寸的金,左关的木克右关的土,左尺的水克右尺的火,左边刚强右边柔和,具有夫妇之间的区别。然而左手属阳,右手属阴,左寸的君火以尊贵而在上,右尺的相火以卑微而在下,具有君臣之间的道理。三部脉中蕴含这些自然的道理,所以善于诊脉的人,通过诊察父亲就能知道儿子的情况。
The left cun, guan, and chi positions correspond to the Heart (Xin), Small Intestine (Xiaochang), Liver (Gan), Gallbladder (Dan), and Kidney (Shen); the right cun, guan, and chi positions correspond to the Lung (Fei), Large Intestine (Dachang), Spleen (Pi), Stomach (Wei), and Mingmen (Gate of Life). The Heart and its interiorly-exteriorly related organ, the Small Intestine, are located at the left cun position; the Liver and Gallbladder both belong to the left guan position. The Kidney pulse originally resides in the left chi position, with the Bladder (Pangguang) as its fu-organ corresponding to it. The Lung and Large Intestine are located at the right cun position, while the pulses of the Spleen and Stomach are identified from the right guan position. The Pericardium (Xinbao) is paired with the Sanjiao (Triple Burner) at the right chi position; this is a mnemonic for beginners.
The left-hand pulse primarily reflects blood; the Liver, Gallbladder, Kidney, and Bladder are all channels for the circulation of essence and blood, hence they are discussed subsequently. The right-hand pulse primarily reflects qi; the Spleen, Stomach, Mingmen, and Sanjiao each utilize qi for transformation and transportation, hence they are also discussed subsequently. Separately, there is qi, there is blood, and there is the pulse; in summary, only the pulse can circulate and nourish qi and blood. Therefore, when qi and blood are abundant, the pulse is vigorous; when qi and blood are deficient, the pulse is weak; when qi and blood are harmonious, the pulse is calm; when qi and blood are chaotic, the pulse indicates disease. From this, we know that the pulse is the substance of qi and blood, and qi and blood are the function of the pulse.
The Heart and its interiorly-exteriorly related Small Intestine flourish in summer and are located at the left cun; deep palpation assesses the Heart, while superficial palpation assesses the Small Intestine. The Liver and its interiorly-exteriorly related Gallbladder flourish in spring and are located at the left guan; deep palpation assesses the Liver, while superficial palpation assesses the Gallbladder. The Kidney and its interiorly-exteriorly related Bladder flourish in winter and are located at the left chi; deep palpation assesses the Kidney, while superficial palpation assesses the Bladder. The Lung and its interiorly-exteriorly related Large Intestine flourish in autumn and are located at the right cun; deep palpation assesses the Lung, while superficial palpation assesses the Large Intestine. The Spleen and its interiorly-exteriorly related Stomach flourish during the four seasons (the last eighteen days of each season) and are located at the right guan; deep palpation assesses the Spleen, while superficial palpation assesses the Stomach. The Mingmen and its interiorly-exteriorly related Sanjiao parasitically flourish in summer and are located at the right chi; deep palpation assesses the Mingmen, while superficial palpation assesses the Sanjiao.
However, speaking in terms of the cycle of generation: Water at the left chi generates Wood at the left guan; Wood at the left guan generates Fire at the left cun; Fire at the left cun connects to Fire at the right chi; Fire at the right chi generates Earth at the right guan; Earth at the right guan generates Metal at the right cun; Metal at the right cun generates Water at the left chi. This generative process is unceasing, reflecting the intimacy of mother and child. Speaking in terms of positional opposition: Fire at the left cun overcomes Metal at the right cun; Wood at the left guan overcomes Earth at the right guan; Water at the left chi overcomes Fire at the right chi. The left is firm and the right is yielding, reflecting the distinction between husband and wife. However, the left hand belongs to Yang, and the right hand belongs to Yin. The Ministerial Fire (Junhuo) at the left cun is superior and positioned above; the Assistantal Fire (Xianghuo) at the right chi is humble and positioned below, reflecting the way of ruler and minister. These natural principles exist within the three positions; therefore, a skilled diagnostician, by examining the father, can know about the son.