心之脉络小肠,小肠之脉络心;肺之脉络大肠,大肠之脉络肺。此可以论病机,如心移热于小肠,
肺移热于大肠之类,不可定部位也。小肠当候之于右尺,以火从火也。大肠当候之于左尺,以金从水也。
三焦属火,亦候于右肾;膀胱属水,亦候于左肾。一尺而水火两分,一脏而四腑兼属,乃天然不易之至道。
盖胸中属阳,腹中属阴,大肠、小肠、膀胱、三焦所传渣滓、水液、浊气皆阴,惟腹中可以部置,非若胃
为水谷之海。清气在上,胆为决断之官,静藏于肝,可得位之于中焦也。至于上焦,重重膈膜,遮蔽清虚
之宇,惟心肺得以居之,而诸腑不与焉。所谓膈盲之上,中有父母者是也。心主血为阴,肺主气为阳,其
营卫于周身,非父母而何。然心君无为而治,肺为相傅华盖,而覆于心上,以布胸中之气,而燮理其阴阳。膻
中为臣使,包裹而络于心下,以寄喉舌之司,而宣布其政令。是以心火寂然不动,动而传之心胞,与三焦之
火即为相火。《素问》谓手少阳与心主为表里;《灵枢》谓手厥阴之脉出属心胞络,下膈,历络三焦;手少
阳
之脉散络心胞,合心主,正见心胞相火与于少阳相火为表里,故历络于上下两相输应也。心君宁,相火安,
而膻中喜乐出焉。心君扰,相火翕然从之,而百度改其常焉。心胞所主二火之出入关系之重如此,是
以亦得分手经之一,而可称为腑耳。
王叔和以相络之故,大小二肠候之于上,而不知水谷变化,浊秽之气去,膈上父母清阳之气迥不相通,
岂可因外络连属,反谓右寸之清阳上浮者为大肠?脉沉者谓肺脉,经所谓脏真高于肺者,乃真脏高于大
肠矣。左寸之浮者为小肠脉,沉者为心脉,水中污泥反浮于莲花之上,有是理乎?夫心胞之脉裹撷乎心,代
君主行事,从左寸候之,亦理之当然耳。
心脏的脉络连接小肠,小肠的脉络连接心脏;肺脏的脉络连接大肠,大肠的脉络连接肺脏。这可以用来论述病机,例如心火移热于小肠、肺热移热于大肠等情况,但不能据此确定脉诊的部位。小肠应当在右尺部进行候察,因为火从火(同类相求);大肠应当在左尺部进行候察,因为金从水(五行相生或特定对应关系)。三焦属火,也候察于右肾;膀胱属水,也候察于左肾。在一尺(寸关尺中的尺部)之中水火两分,一个脏腑(指下焦肾区)兼属四个腑(小肠、大肠、膀胱、三焦),这是天然不变的最高道理。
大概胸中属阳,腹中属阴,大肠、小肠、膀胱、三焦所传导的渣滓、水液、浊气都属于阴,只有腹部可以安置这些部位,不像胃是水谷之海。清气在上,胆为决断之官,安静地藏于肝中,可以在中焦定位。至于上焦,有重重膈膜遮蔽着清虚的空间,只有心和肺能够居住其中,其他腑不参与其中。这就是所说的“膈盲之上,中有父母”的意思。心主血属阴,肺主气属阳,它们护卫周身营卫,如果不是父母又是什么呢?然而心君无为而治,肺作为相傅和华盖,覆盖在心之上,以布散胸中之气,并调和阴阳。膻中为臣使,包裹并络属于心下,以寄托喉舌的职能,并宣布政令。因此心火寂然不动,一旦动则传于心包,与三焦之火即为相火。《素问》说手少阳与心主(心包)互为表里;《灵枢》说手厥阴的脉络出而归属于心包络,向下穿过膈肌,依次联络三焦;手少阳的脉络散布络属于心包,合于心主,这正是显示心包相火与少阳相火互为表里,所以依次联络上下相互输应。心君安宁,相火安定,膻中便产生喜乐之情。心君受扰,相火随之翕然兴起,各种生理功能就改变常态了。心包所主管的两火出入关系如此重要,因此也能分得手经之一位,而可以称为腑。
王叔和因为经络相连的缘故,将大小肠候察于上部(寸部),却不知道水谷变化后,浊秽之气已去,膈上父母(心肺)的清阳之气截然不同、互不相通,怎么能因为外部经络连属,反而认为右寸部清阳上浮的是大肠呢?脉沉者说是肺脉,经文所谓“脏真高于肺”,其实是真脏之气高于大肠。左寸部浮者为小肠脉,沉者为心脉,水中的污泥反而浮在莲花之上,有这样的道理吗?心包的脉裹挟着心,代君主行事,从左寸部候察,也是理所当然的。
The meridians of the Heart connect with the Small Intestine, and the meridians of the Small Intestine connect with the Heart; the meridians of the Lung connect with the Large Intestine, and the meridians of the Large Intestine connect with the Lung. This can be used to discuss pathogenesis, such as Heart transferring heat to the Small Intestine or Lung transferring heat to the Large Intestine; however, one cannot definitively assign pulse diagnosis locations based solely on this. The Small Intestine should be palpated at the Right Chi (Right Cun-Chi) position, following the principle of "Fire from Fire" (similar elements seeking each other). The Large Intestine should be palpated at the Left Chi position, following the principle of "Metal from Water." The Sanjiao (Triple Burner) belongs to Fire and is also palpated at the Right Kidney position; the Bladder belongs to Water and is also palpated at the Left Kidney position. Within a single Chi position, Water and Fire are divided; within one Zang organ region, four Fu organs are jointly associated. This is the unchangeable supreme principle of nature.
Generally, the chest belongs to Yang, and the abdomen belongs to Yin. The residues, fluids, and turbid qi transmitted by the Large Intestine, Small Intestine, Bladder, and Sanjiao all belong to Yin. These can only be situated in the abdomen, unlike the Stomach, which is the Sea of Water and Grain. Clear Qi resides above; the Gallbladder is the Official of Decision, quietly stored within the Liver, and can be located in the Middle Jiao. As for the Upper Jiao, it is shielded by multiple layers of diaphragmatic membranes, covering the clear and empty space where only the Heart and Lung reside, while the other Fu organs do not participate. This refers to what is said: "Above the diaphragm and blind area, there are the Parents." The Heart governs Blood and belongs to Yin; the Lung governs Qi and belongs to Yang. They protect the Ying and Wei (Nutritive and Defensive Qi) throughout the body; if not Parents, then who? However, the Heart Monarch governs through non-action (Wu-Wei), while the Lung acts as the Prime Minister and Imperial Canopy, covering the Heart to distribute Qi in the chest and harmonize Yin and Yang. The Danzhong (Chest Center) serves as the Envoy, enveloping and connecting below the Heart, entrusting the functions of the throat and tongue, and proclaiming decrees. Therefore, Heart Fire remains still and unmoving; when it moves, it transmits to the Pericardium, which together with the Sanjiao Fire constitutes the Ministerial Fire (Xiang Huo). The *Suwen* states that the Hand Shaoyang and the Heart Master (Pericardium) are interior-exterior partners; the *Lingshu* states that the meridian of the Hand Jueyin emerges and connects to the Pericardium Collateral, passes downward through the diaphragm, and successively connects with the Sanjiao; the meridian of the Hand Shaoyang scatters and connects to the Pericardium, merging with the Heart Master. This precisely shows that the Pericardium's Ministerial Fire and the Shaoyang's Ministerial Fire are interior-exterior partners, hence connecting successively between the upper and lower for mutual transmission. When the Heart Monarch is tranquil, the Ministerial Fire is secure, and joy emanates from the Danzhong. If the Heart Monarch is disturbed, the Ministerial Fire rises vigorously along with it, and all physiological processes deviate from their normal state. The relationship of entry and exit regarding the two Fires governed by the Pericardium is so significant that it merits a position among the Hand Meridians and can be termed a Fu organ.
Wang Shuhe, due to the connection of collaterals, placed the pulses of the Large and Small Intestines in the upper positions (Cun), failing to realize that after the transformation of water and grain, turbid and foul qi has departed, and the clear Yang Qi of the Parents (Heart and Lung) above the diaphragm is entirely distinct and does not mix. How can one, merely because of external collateral connections, claim that the clear Yang floating upward at the Right Cun position belongs to the Large Intestine? A deep pulse is described as the Lung pulse; the classic text states that the "True Zang Qi is higher than the Lung," meaning the True Zang Qi is actually higher than the Large Intestine. A floating pulse at the Left Cun is the Small Intestine pulse, while a deep pulse is the Heart pulse. Would mud in water float above a lotus flower? Is there any logic in that? The Pericardium meridian wraps around the Heart, acting on behalf of the Monarch; palpating it at the Left Cun is therefore logically consistent.