三部九候论帝曰∶愿闻天地之至数,合于人形血气,通决死生,为之奈何?岐伯曰∶天地之至
数,始于一,终于九焉。一者天,二者地,三者人,因而三之,三三为九,以应九野。故人有三部,
部有三候,以决死生,以处百病,以调虚实,而除邪疾。帝曰∶何谓二部?曰∶有下部,有中部,有
上部。部各有三候,三候者,有天,有地,有人也。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。故下部之候,天以候肝,地以候肾,人以候脾胃之
气。中部之候,天以候肺,地以候胸中之气,人以候心。上部之候,天以候头角之气,地以候口齿之
气,人以候耳目之气。帝曰∶以候奈何?岐伯曰∶必先度其形之肥瘦,以调其气之虚实,实则泻之,
虚则补之。
按∶寸口脉亦有三部九候。三部者,寸关尺也;九候者,三部中各有浮中沉也。察三部可知病
之高下,如寸为阳,为上部,主头项以至心胸之分也;关为阴阳之中,为中部,主脐腹 胁之分也;
尺为阴,为下部,主腰足胫股之分也。三部中各有三候,三而三之,是为九候。如浮主皮肤,候表
及府;中主肌肉,以候胃气;沉主筋骨,候里及脏。此皆诊家之枢要,当与本篇互相求察也。
黄帝问道:我想了解天地至高的数理,如何与人的形体气血相合,从而通晓判断生死的方法,该怎么做呢?岐伯回答说:天地的至高数理,起始于一,终结于九。一代表天,二代表地,三代表人,由此将三者再乘以三,三三得九,以对应九州(或九野)。所以人体分为三部,每部又有三种脉候,用以决断生死,诊治各种疾病,调理虚实,祛除邪气疾病。
黄帝问道:什么叫三部?岐伯说:有下部、中部、上部。每一部各有三种脉候,这三种脉候分别对应天、地、人。上部的天候,位于两额角的动脉;上部的地候,位于两颊的动脉;上部的人候,位于耳前的动脉。中部的天候,是手太阴肺经;中部地候,是手阳明大肠经;中部的人候,是手少阴心经。下部的天候,是足厥阴肝经;下部地候,是足少阴肾经;下部的人候,是足太阴脾经。所以下部的脉候,天候用来诊察肝脏,地候用来诊察肾脏,人候用来诊察脾胃之气。中部的脉候,天候用来诊察肺脏,地候用来诊察胸中之气,人候用来诊察心脏。上部的脉候,天候用来诊察头角之气,地候用来诊察口齿之气,人候用来诊察耳目之气。
黄帝问道:如何通过脉象来诊察呢?岐伯说:必须先度量患者形体的肥瘦,以调节其气的虚实,实证用泻法,虚证用补法。
按语:寸口脉也有三部九候。三部指的是寸、关、尺;九候指的是在寸、关、尺三部中,每部又各分浮、中、沉三种指力。通过诊察三部可以知道病位的高下,例如寸脉属阳,对应上部,主要主管头项直到心胸的部位;关脉处于阴阳之间,对应中部,主要主管脐腹胁肋的部位;尺脉属阴,对应下部,主要主管腰足胫股的部位。三部中每部各有三种脉候,三乘以三,共为九候。例如浮脉主皮肤,诊察表证及六腑病变;中脉主肌肉,用以诊察胃气;沉脉主筋骨,诊察里证及五脏病变。这些都是诊脉的关键要点,应当与本篇内容互相参照考察。
Yellow Emperor asked: I wish to hear about the supreme numbers of Heaven and Earth, how they correspond to human form and blood qi, and how to use them to determine life and death. What should be done?
Qibo replied: The supreme numbers of Heaven and Earth begin with one and end with nine. One represents Heaven, two represents Earth, and three represents Humanity. Multiplying these by three, three times three equals nine, corresponding to the Nine Regions (Jiuye). Therefore, the human body is divided into three sections (Bu), each section having three pulses (Hou), which are used to determine life and death, treat various diseases, regulate deficiency and excess, and eliminate pathogenic disorders.
The Yellow Emperor asked: What do you mean by three sections?
Qibo said: There are the Lower Section, Middle Section, and Upper Section. Each section has three pulses. These three pulses correspond to Heaven, Earth, and Humanity.
In the Upper Section:
- The pulse of Heaven is located at the arteries on both sides of the forehead.
- The pulse of Earth is located at the arteries on both cheeks.
- The pulse of Humanity is located at the artery in front of the ear.
In the Middle Section:
- The pulse of Heaven corresponds to the Hand Taiyin Lung Meridian (Shoutaiyin).
- The pulse of Earth corresponds to the Hand Yangming Large Intestine Meridian (Shouyangming).
- The pulse of Humanity corresponds to the Hand Shaoyin Heart Meridian (Shoushaoyin).
In the Lower Section:
- The pulse of Heaven corresponds to the Foot Jueyin Liver Meridian (Zujueyin).
- The pulse of Earth corresponds to the Foot Shaoyin Kidney Meridian (Zushaoyin).
- The pulse of Humanity corresponds to the Foot Taiyin Spleen Meridian (Zutaiyin).
Thus, in the Lower Section, the Heaven pulse inspects the Liver, the Earth pulse inspects the Kidneys, and the Humanity pulse inspects the Qi of the Spleen and Stomach. In the Middle Section, the Heaven pulse inspects the Lungs, the Earth pulse inspects the Qi of the Chest, and the Humanity pulse inspects the Heart. In the Upper Section, the Heaven pulse inspects the Qi of the head and horns, the Earth pulse inspects the Qi of the mouth and teeth, and the Humanity pulse inspects the Qi of the ears and eyes.
The Yellow Emperor asked: How are these inspected?
Qibo said: One must first measure the fatness or thinness of the patient's body to regulate the deficiency or excess of their Qi. For excess conditions, apply draining methods; for deficiency conditions, apply tonifying methods.
Note: The Cun Kou pulse also possesses the Three Sections and Nine Pulses. The Three Sections refer to Cun, Guan, and Chi. The Nine Pulses refer to the Floating (Fu), Moderate (Zhong), and Deep (Chen) pulses found within each of the three sections. By inspecting the three sections, one can know the location of the disease. For example, the Cun pulse is Yang, corresponding to the Upper Section, primarily governing the area from the head and neck to the chest and heart. The Guan pulse is between Yin and Yang, corresponding to the Middle Section, primarily governing the area of the umbilicus, abdomen, and hypochondrium. The Chi pulse is Yin, corresponding to the Lower Section, primarily governing the area of the waist, feet, shins, and thighs. Within each of the three sections, there are three pulses; three multiplied by three makes nine pulses. For instance, the Floating pulse governs the skin, inspecting exterior conditions and the Fu organs; the Moderate pulse governs the muscles, inspecting Stomach Qi; the Deep pulse governs the sinews and bones, inspecting interior conditions and the Zang organs. These are all pivotal points in pulse diagnosis and should be cross-referenced with this chapter.