尺内两旁，则季胁也，尺外以候肾，尺里以候腹。中附上，左外以候肝，内以候膈；右外以候胃，内以候
脾。上附上，右外以候肺，内以候胸中；左外以候心，内以候膻中。前以候前，后以候后。上竟上者，胸喉中
事也；下竟下者，少腹腰股膝胫足中事也。
此专指两手之脉也。李仕材曰∶季胁，小肋也，在胁下两旁。尺外者，尺脉前半部也。前以候阳，后以候
阴。背为阳，肾附背，故外以候肾，腹为阴，故里以候腹。所谓腹者，凡大小
肠、膀胱、命门皆在其中矣。以上诸部，俱言左右，而此独不分者，以两尺皆主乎肾也。中附上者，言尺之上，
即关脉也。左外者，左关之前半部也；内者，后半部也。肝亦附近于背，故外以候肝，内以候膈，膈者，中焦
之膈膜，胆腑俱在其中矣。右关之前，所以候胃，关后所以候脾，脾胃皆在中州，胃为阳，脾为阴，故外以候
胃，内以候脾也。本篇止言五脏，而不及他腑，独言胃者，以五脏皆禀气于胃，而为脏腑之海，则脏腑之气亦
可见乎此也。上附上者，关上寸脉也。五脏惟肺最高，故右寸之前以候肺，后以候胸中，胸中，膈膜以上皆是
也。心肺皆居膈上，故左寸之前以候心，后以候膻中，膻中者，心包络之别名也。前以候前，后以候后者，重
申上下内外之义也。统而言之，寸为前，尺为后；分而言之，上半部为前，下半部为后。上竟上者，言脉则尽
于鱼际，在体则应乎胸喉也；下竟下者，在脉则尽于尺部，在体则应乎少腹腰膝足也。此章首言尺，以次及于
寸，自内而至外者，以尺为根本，寸为枝叶也。按内外二字，诸注皆云内侧外侧，若以侧言，必脉形匾阔，或
有两条乃可耳，不然于义不通矣。如前以候前，后以候后，上竟上，下竟下者，皆内外之义也。观《易》卦六
爻，自下而上，上三爻为外卦，下三爻为内卦，则上下内外之义昭然矣。余观李仕材举卦象以明上下内外之
义，甚为确当，然其错处颇多。盖经之论阴阳也，随地变化，各有义理，不可混淆。若举周身而言，则背为阳，
腹为阴；若以表里而言，则表为阳，里为阴；若以营卫而言，则营为阴，卫为阳；若以腑脏而言，则腑为阳，
脏为阴也。脉者，根于脏腑之气血，流行出入，升降于表里者也，故当以脏腑之阴阳为主，不当以腹背阴阳淆
混也。夫阳之升，自然行上行表，自内出外；阴主降，自然行下行里，自外入内。故经文止言五脏一胃之部位，
而他腑之气，即可就阴阳之理而推之，以诊其脉也。经言左关之前以候肝，后以候膈，膈者，膈膜空洞之地，
候其气血，有无窒滞
而已。如右寸之前以候肺，后以候胸中，一律也。若胆，实连缀于肝，且与肝合为表里，而腑为阳，理当浮部
候胆，沉部候肝也。《难经》言左为肾，右为命门，男子以藏精，女子以系胞，则尺脉浮部当候膀胱，沉部
候肾，而命门独候于右尺者，因后天卦干在西北，正人身之右尺脉，以有先天之元阳所在，是人之命根，要如
门户之固密，故称命门也。今仕材言背为阳，肾附于背，故外以候肾；腹为阴，故里以候腹，腹者，凡大小肠、
膀胱、命门皆在其中矣。又言膈者，胆在其中也。此皆凭臆之说，不独脏腑部位错乱，而阴阳至理全失矣。仕
材医学精诣，独其论脉，每有似是而非者。余三集《活人新书》首卷，有诊脉纲要一篇，凡自古疑惑而聚讼
不休者，余皆本《易》理、《灵》、《素》、《难经》，详辨明晰，可为定论矣。其聚讼者，皆未究圣经至理
故也。
尺部内侧两旁，对应的是季胁部位；尺部外侧用来诊察肾脏，尺部内侧用来诊察腹部。从尺部向上连接关部的区域，左手脉象的外侧用来诊察肝脏，内侧用来诊察膈膜；右手脉象的外侧用来诊察胃，内侧用来诊察脾脏。再向上连接寸部的区域，右手脉象的外侧用来诊察肺脏，内侧用来诊察胸中；左手脉象的外侧用来诊察心脏，内侧用来诊察膻中。脉象的前面部分用来诊察身体前部的病症，后面部分用来诊察身体后部的病症。脉象向上延伸至尽头（鱼际处），反映的是胸部和喉部的情况；向下延伸至尽头（尺泽以下），反映的是小腹、腰部、大腿、膝盖、小腿和足部的情况。
这段文字专门论述双手的脉象。李仕材说：季胁，就是小肋骨，位于胁肋下方的两旁。尺外，指的是尺脉的前半部。前面候阳，后面候阴。背部属阳，肾脏依附于背部，所以外侧候肾；腹部属阴，所以内侧候腹。所说的“腹”，凡是大小肠、膀胱、命门都在其中了。以上各个部位，都提到了左右手，唯独这里没有区分左右，是因为两手的尺脉都主司肾脏。所谓“中附上”，是指尺脉之上，也就是关脉的位置。左外，是左关脉的前半部；内，是后半部。肝脏也靠近背部，所以外侧候肝，内侧候膈膜，膈膜是中焦的膈膜，胆腑都在其中了。右关之前，用来候胃，关后用来候脾，脾胃都居中州，胃属阳，脾属阴，所以外侧候胃，内侧候脾。本篇只说了五脏，而没有提及其他腑，唯独提到胃，是因为五脏的气血都禀受于胃，胃是脏腑之海，那么脏腑的气血状况也可以从这里看出来了。所谓“上附上”，是指关上之寸脉。五脏之中只有肺位置最高，所以右寸的前面候肺，后面候胸中，胸中，就是膈膜以上的部位。心和肺都居住在膈上，所以左寸的前面候心，后面候膻中，膻中，是心包络的别名。前面候前，后面候后，是重申上下内外含义的意思。统而言之，寸为前，尺为后；分而言之，上半部为前，下半部为后。“上竟上”，是说脉象尽于鱼际，在人体则对应胸喉；“下竟下”，在脉象上尽于尺部，在人体则对应小腹、腰膝和足部。这一章开头说尺，接着说到寸，由内而外，是以尺为根本，寸为枝叶。按照“内外”二字，许多注解都说是内侧和外侧，如果按侧面来说，必须脉形扁阔，或者有两条脉才可以，否则在义理上讲不通。如前面候前，后面候后，上竟上，下竟下，都是内外的含义。观察《易经》卦象的六爻，自下而上，上三爻为外卦，下三爻为内卦，那么上下内外的含义就显而易见了。我看李仕材用卦象来阐明上下内外的含义，非常恰当，然而他的错误之处很多。大概经典论述阴阳时，随地变化，各有义理，不可混淆。若以全身而言，则背为阳，腹为阴；若以表里而言，则表为阳，里为阴；若以营卫而言，则营为阴，卫为阳；若以腑脏而言，则腑为阳，脏为阴。脉象，根源于脏腑的气血，流行出入，升降于表里之间，所以应当以脏腑的阴阳为主，不应当以腹背的阴阳来混淆。阳气上升，自然行于上行和体表，从内出到外；阴气主降，自然行于下行和体内，从外入到内。所以经文只讲了五脏和一胃的部位，而其他腑的气血，就可以根据阴阳的道理来推断，从而诊察脉象。经文说左关的前面候肝，后面候膈，膈，是膈膜空洞的地方，诊察那里的气血，看是否有阻滞罢了。如右寸的前面候肺，后面候胸中，是一样的道理。至于胆，实际上连缀于肝，且与肝互为表里，而腑属阳，按理应当在浮部候胆，沉部候肝。《难经》说左为肾，右为命门，男子用以藏精，女子用以系胞，那么尺脉的浮部应当候膀胱，沉部候肾，而命门独自在右尺候察，是因为后天八卦中乾卦在西北方，正对应人身体的右尺脉，因为这里有先天的元阳所在，这是人的命根，要紧如门户之固密，所以称为命门。现在李仕材说背为阳，肾附于背，所以外侧候肾；腹为阴，所以内侧候腹，腹者，凡大小肠、膀胱、命门都在其中了。又说膈者，胆在其中。这些都是凭主观臆断的说法，不仅脏腑部位错乱，而且阴阳至理完全丧失。李仕材医学造诣精深，唯独他论脉，每每有似是而非的地方。我第三集《活人新书》首卷，有一篇诊脉纲要，凡是自古以来疑惑而争论不休的问题，我都依据《易》理、《灵枢》、《素问》、《难经》，详细辨析明晰，可以成为定论了。那些聚讼不休的人，都是因为未探究圣经中的至理缘故。
The area on both sides of the inner edge of the Chi (尺) pulse corresponds to the hypochondriac region. The outer part of the Chi pulse is used to inspect the Kidney, while the inner part is used to inspect the Abdomen. Moving upwards from the Chi to connect with the Guan (关) pulse: on the left hand, the outer part inspects the Liver, and the inner part inspects the Diaphragm; on the right hand, the outer part inspects the Stomach, and the inner part inspects the Spleen. Moving further upwards to connect with the Cun (寸) pulse: on the right hand, the outer part inspects the Lung, and the inner part inspects the Chest Center; on the left hand, the outer part inspects the Heart, and the inner part inspects the Shanzhong (膻中). The anterior aspect of the pulse inspects the anterior part of the body, and the posterior aspect inspects the posterior part of the body. When the pulse extends fully upwards to its limit (at the Thenar eminence), it reflects conditions in the chest and throat; when it extends fully downwards to its limit (below the Chi position), it reflects conditions in the lower abdomen, waist, thighs, knees, shins, and feet.
This passage specifically refers to the pulses of both hands. Li Shicai stated: The hypochondriac region refers to the lower ribs, located on both sides below the costal margin. "Chi outer" refers to the anterior half of the Chi pulse. The anterior aspect corresponds to Yang, and the posterior aspect corresponds to Yin. The back belongs to Yang, and the Kidneys are attached to the back, hence the outer aspect inspects the Kidney; the abdomen belongs to Yin, hence the inner aspect inspects the Abdomen. By "Abdomen," it encompasses the Large Intestine, Small Intestine, Bladder, and Mingmen (Gate of Vitality). Although the aforementioned regions mention both left and right hands, this specific section does not distinguish between them because both Chi pulses govern the Kidneys. "Zhong fu shang" (connected above the middle) refers to the area above the Chi pulse, which is the Guan pulse. "Left outer" refers to the anterior half of the left Guan pulse; "inner" refers to the posterior half. The Liver is also close to the back, so the outer aspect inspects the Liver, and the inner aspect inspects the Diaphragm. The Diaphragm is the membrane of the Middle Jiao, within which the Gallbladder resides. The anterior part of the right Guan is used to inspect the Stomach, and the posterior part is used to inspect the Spleen. Both the Stomach and Spleen reside in the Central Region (Zhongzhou); the Stomach is Yang and the Spleen is Yin, hence the outer aspect inspects the Stomach and the inner aspect inspects the Spleen. This chapter mentions only the Five Zang organs and omits other Fu organs, except for mentioning the Stomach, because the Qi of the Five Zang organs is derived from the Stomach, which is the Sea of the Zang-Fu organs; thus, the Qi status of the Zang-Fu can be observed here. "Shang fu shang" (connected above the upper) refers to the Cun pulse above the Guan. Among the Five Zang organs, the Lung is the highest; therefore, the anterior part of the right Cun inspects the Lung, and the posterior part inspects the Chest Center, which includes all areas above the diaphragm. Both the Heart and Lung reside above the diaphragm; thus, the anterior part of the left Cun inspects the Heart, and the posterior part inspects the Shanzhong, which is another name for the Pericardium. "Anterior inspects anterior, posterior inspects posterior" reiterates the meaning of superior-inferior and interior-exterior. Generally speaking, Cun is anterior and Chi is posterior; specifically, the upper half is anterior and the lower half is posterior. "Shang jing shang" (upper reaches its end) means the pulse ends at the Thenar eminence, corresponding anatomically to the chest and throat; "Xia jing xia" (lower reaches its end) means the pulse ends at the Chi position, corresponding anatomically to the lower abdomen, waist, knees, and feet. This chapter begins with Chi, then moves to Cun, from interior to exterior, treating Chi as the root and Cun as the branches. Regarding the terms "interior" and "exterior," many commentators interpret them as medial and lateral sides. If interpreted as sides, the pulse form would need to be broad or bifurcated, otherwise the interpretation is logically flawed. Terms like "anterior inspects anterior," "posterior inspects posterior," "upper reaches its end," and "lower reaches its end" all refer to the concepts of interior and exterior. Observing the six lines of a hexagram in the *I Ching* (Book of Changes), from bottom to top, the upper three lines constitute the Outer Trigram, and the lower three lines constitute the Inner Trigram; thus, the meanings of superior-inferior and interior-exterior become clear. I observe that Li Shicai’s use of hexagrams to elucidate the meanings of superior-inferior and interior-exterior is quite appropriate; however, he has many errors. The classics discuss Yin and Yang as changing according to context, each having its own rationale, which must not be confused. If considering the whole body, the back is Yang and the abdomen is Yin; if considering superficial-deep, the exterior is Yang and the interior is Yin; if considering Ying and Wei (Nutritive and Defensive Qi), Ying is Yin and Wei is Yang; if considering Fu and Zang, Fu organs are Yang and Zang organs are Yin. Pulses are rooted in the Qi and Blood of the Zang-Fu organs, circulating and ascending-descending between the superficial and deep layers. Therefore, one should prioritize the Yin-Yang of the Zang-Fu organs rather than confusing them with the Yin-Yang of the back and abdomen. Yang Qi ascends naturally, moving upward and outward, from interior to exterior; Yin Qi descends naturally, moving downward and inward, from exterior to interior. Thus, the classic text only specifies the positions of the Five Zang organs and one Fu organ (Stomach); the Qi of other Fu organs can be deduced based on the principles of Yin and Yang to diagnose the pulse. The classic states that the anterior part of the left Guan inspects the Liver, and the posterior part inspects the Diaphragm. The Diaphragm is a hollow space; inspecting it involves checking for any stagnation in Qi and Blood. Similarly, the anterior part of the right Cun inspects the Lung, and the posterior part inspects the Chest Center. As for the Gallbladder, it is physically connected to the Liver and forms an interior-exterior relationship with it. Since Fu organs are Yang, theoretically, the Gallbladder should be inspected at the floating (superficial) level, and the Liver at the deep level. The *Nanjing* (Classic of Difficult Issues) states that the left side represents the Kidney and the right side represents the Mingmen. In men, it stores Essence; in women, it connects to the Uterus. Therefore, the floating part of the Chi pulse should inspect the Bladder, and the deep part should inspect the Kidney. The Mingmen is uniquely inspected at the right Chi because, in the Later Heaven Bagua, the Qian trigram is in the northwest, corresponding to the right Chi pulse of the human body. This is where the Pre-Heaven Primordial Yang resides, which is the root of life, requiring firmness like a secure gate, hence called Mingmen. Now, Li Shicai says the back is Yang, the Kidney attaches to the back, so the outer aspect inspects the Kidney; the abdomen is Yin, so the inner aspect inspects the Abdomen, encompassing the Large Intestine, Small Intestine, Bladder, and Mingmen. He also claims the Gallbladder is within the Diaphragm. These are subjective speculations that not only confuse the positions of Zang-Fu organs but also completely lose the profound truth of Yin and Yang. Although Li Shicai had profound medical expertise, his discussions on pulse diagnosis were often plausible yet incorrect. In the first volume of my third collection, *Huoren Xinshu* (New Book for Reviving People), there is a section on the essentials of pulse diagnosis. For all issues that have been debated and unresolved since ancient times, I have clarified them based on the principles of the *I Ching*, *Ling Shu*, *Su Wen*, and *Nanjing*, providing definitive conclusions. Those who continue to debate have failed to investigate the ultimate truths of the sacred classics.