〔人迎〕诊在结喉旁一寸五分(经云∶阴阳之定于喉手者也,此即人迎穴动脉,以候外感有余之症,足阳明
胃脉也。越人以左关前一分为诊,正当肝胆之分,肝胆为风木之司,故曰人迎紧盛伤于风。夫寸关尺三部,各占
三分,共成寸口,左阳右阴,阳应乎外,故以候表焉。今两存之)。
〔气口〕(一名寸口,亦名脉口)诊在右关前一分(脉候内伤不足之症,穴在两手鱼际穴后一寸,手太阴
肺脉也。此越人不失经旨,专取鱼后寸口,以决死生,乃不易之典)。
《素问》曰∶人有三部,有下部,有中部,有上部;部各有三候,有天、有地、有人。上部天,两额之
动脉(在额两旁,
动应于手,足少阳胆脉之所行也),以候头角之气(以其位在头角之分也);上部地,两颊之动脉(在鼻孔下
两旁近于巨 之分,动应于手,足阳明胃脉之所行也),以候口齿之气(以其位近口齿也);上部人,耳前之
动脉(在耳前陷者中,动应于手,手少阳三焦脉之所行也),以候耳目之气(以其位当耳前脉,抵于目内
也)。中部天,手太阴也(谓肺脉也,在掌后寸口中,是谓经渠,动应于手),以候肺;中部地,手阳明也(谓
大肠脉也,在手大指次指岐骨间,合谷之分,动应于手),以候胸中之气(肠胃同候也);中部人,手少阴也
(谓心脉也,在掌后锐骨之端,神门之分,动应于手),以候心。下部天,足厥阴也(谓肝脉也,在毛际外,
羊矢下一寸半陷中,五里之分,卧而取之,动应于手。女子取太冲,在足大趾本节后二寸陷中是也),以候肝;
下部地,足少阴也(谓肾脉也,在足内踝后跟骨上陷中,太溪之分,动应于手),以候肾;下部人,足太阴也
(谓脾脉也,在鱼腹上趋筋间,直五里下,箕门之分,宽 足单衣,沉取乃得之,而动应于手),以候脾胃之
气(脾脏与胃,以膜相连,故以候脾,兼候胃也。候胃气者,当取足跗之上冲阳之分穴中,动脉乃应手。次第
《三部九候论篇》文)。
(顾英白曰∶轩岐之所谓三部九候者,亦非如后世之谓三部九候也。人有三部,部有三候,是总人之一身,
而分为上中下三部耳,岂第以气口之一脉,而命为寸关尺之三部乎?一部之间,自有天地与人,三候之动脉耳,
岂复以寸关尺之脉,而分为浮中沉之三候乎?若后人之说为是,则轩岐之说为非;轩岐之说为是,则后人之说
为非矣!故不得不置一喙于其间也。浮之与沉,固无庸义矣,中则止有浮之中耳,奚能有沉之中乎?浮而无中,
固曰无根,沉则必无中矣,何仅
以为沉脉主里,而无必死之证乎?盖人但知有中正之中,而不知有中和之中。经言∶真脏脉见者必死。脉无胃
气者,谓为真脏脉也。是除诸怪脉之外,皆得谓之有胃气,皆得谓之有中脉耳。何弃其彰明较置之经文,而反
以浮沉与中,索摸于不可知之陋习乎?此事之不能解者也。况诊脉之法,或以手测,或以目视,而非徒事于按
也。脉之缓者,其皮肤亦缓;脉之急者,其皮肤亦急;脉之滑者,其皮肤亦滑;脉之涩者,其皮肤亦涩;脉之
大者,其皮肤亦贲而起;脉之小者,其皮肤亦减而少气。圣人恫 乃身,爰谆谆以诏后世,而反置之不讲,何
不智若是耶?夫滑脉者,可以望,可以按,均不失夫脉之真者也。至于涩脉,则望之为甚易,按之则甚难,何
也?但视其色之黑而悴者为涩脉,则孩童可以知矣。如必切其,沾沙刮竹而为涩,则虽有明智,若望洋焉。自
扁鹊、仓公、仲景而下,沿袭至今,讹以传讹。予尝缔绎经文,人迎止隶于喉旁。三部须兼乎首足,脏则候
之于左手,腑则候之于右手,寸以候上,尺以候下,脏腑皆然,庶不使有纤毫之疑而容惑于其间也。彼七表八
里九道之纷然,智又出扁鹊下矣。世多识之,故不赘焉)。
【人迎】诊察部位在结喉旁开一寸五分处(古籍记载:阴阳之气定于喉部,此处即为**人迎穴**的动脉搏动处,用以候察外感有余的病证,属于足阳明**胃脉**。扁鹊以左关前一分进行诊察,正当**肝胆**的分野,**肝胆**主宰风木之气,所以说“人迎紧盛”是伤于风邪。至于寸、关、尺三部,各占三分,共同构成寸口,左手主阳右手主阴,阳对应体表,所以用来候察表证。现将两种说法并存)。
【气口】(又名寸口,又称脉口)诊察部位在右关前一分(脉象候察内伤不足的病证,穴位位于两手鱼际穴后一寸处,属于手太阴**肺脉**。这是扁鹊没有违背经典旨意之处,专门选取鱼际后的寸口脉,来决断生死,这是不可更改的经典准则)。
《素问》说:人有三部,有下部,有中部,有上部;每一部各有三候,有天、地、人。上部天,指两额部的动脉(位于额头两旁,搏动应手,是足少阳**胆脉**所经过的地方),用以候察头角的气机(因为其位置在头角之分野);上部地,指两颊部的动脉(位于鼻孔下两旁靠近巨髎穴处,搏动应手,是足阳明**胃脉**所经过的地方),用以候察口齿的气机(因为其位置靠近口齿);上部人,指耳前的动脉(位于耳前凹陷处,搏动应手,是手少阳**三焦脉**所经过的地方),用以候察耳目的气机(因为其位置当耳前脉,通达目内眦)。中部天,是手太阴经(即**肺脉**,位于掌后寸口处,名为经渠,搏动应手),用以候察**肺**;中部地,是手阳明经(即**大肠脉**,位于手大指与次指歧骨间,合谷穴的分野,搏动应手),用以候察胸中的气机(**肠胃**同候);中部人,是手少阴经(即**心脉**,位于掌后锐骨之端,神门穴的分野,搏动应手),用以候察**心**。下部天,是足厥阴经(即**肝脉**,位于毛际外侧,羊矢下一寸半的凹陷中,五里穴的分野,需卧位取穴,搏动应手。女子取太冲穴,位于足大趾本节后二寸凹陷中),用以候察**肝**;下部地,是足少阴经(即**肾脉**,位于足内踝后跟骨上凹陷中,太溪穴的分野,搏动应手),用以候察**肾**;下部人,是足太阴经(即**脾脉**,位于鱼腹上行筋间,直在五里穴下方,箕门穴的分野,需宽衣放松,沉取才能得脉,且搏动应手),用以候察**脾胃**的气机(**脾脏**与**胃**通过膜相连,所以候察**脾**的同时兼候**胃**。候察**胃气**时,应当取足背上的冲阳穴分野中的穴位,动脉才应手。此段次序依据《三部九候论篇》原文)。
(顾英白说:轩辕和岐伯所说的三部九候,并不像后世所说的三部九候那样。人有三部,每部有三候,这是总括人的全身,分为上、中、下三部罢了,难道只是以气口的一脉,就命名为寸、关、尺三部吗?在一部之间,自然有天地与人三候的动脉罢了,难道又用寸、关、尺的脉,分为浮、中、沉三候吗?如果后世的说法是正确的,那么轩辕岐伯的说法就是错误的;如果轩辕岐伯的说法是正确的,那么后世的说法就是错误的!所以我不得不在此发表意见。浮取和沉取,本来就不需要多解释,所谓的“中”,只有浮取之中的意思,怎么会有沉取之中呢?浮取而无中取,固然说是无根,沉取则必然没有中取了,为什么仅仅认为沉脉主里证,而没有必死的证候呢?大概人们只知道中正的中,而不知道中和的中。经文说:真脏脉出现的必定死亡。脉象没有胃气的,称为真脏脉。因此除了各种怪脉之外,都可以称为有胃气,都可以称为有中脉。为什么要抛弃那些明显显著的经文,反而去摸索浮沉与中这种不可知的陋习呢?这是无法解释的事情。况且诊脉的方法,有的用手测度,有的用眼观察,而不只是从事按压。**脉象缓的**,其皮肤也缓;**脉象急的**,其皮肤也急;**脉象滑的**,其皮肤也滑;**脉象涩的**,其皮肤也涩;**脉象大的**,其皮肤也贲起;**脉象小的**,其皮肤也减少而气弱。圣人痛切于身,谆谆告诫后世,却反而被搁置不讲,怎么如此不智呢?**滑脉**,可以望诊,可以按诊,都不失脉之真意。至于**涩脉**,望诊很容易,按诊很难,为什么呢?只要看面色黑而憔悴的就是涩脉,那么孩童就可以知道了。如果一定要切脉,感觉像沾沙刮竹一样涩滞,那么即使明智的人,也像面对汪洋大海一样茫然。自从扁鹊、仓公、仲景以下,沿袭至今,以讹传讹。我曾经研究经文,人迎只隶属于喉旁。三部必须兼顾首足,脏候于左手,腑候于右手,寸候上,尺候下,脏腑都是这样,这样才能使没有丝毫疑惑而在其中产生困惑。那些七表八里九道的纷乱说法,智慧又在扁鹊之下了。世人大多知晓这些,所以不再赘述)。
[Renying] The Renying point is located 1.5 cun lateral to the Adam's apple (Classics state: "The Yin and Yang are fixed at the throat." This is the arterial pulse of the **Renying acupoint**, used to observe excess syndromes from external pathogens, belonging to the Foot-Yangming **Stomach meridian**. Bian Que diagnosed at one fen anterior to the left Guan position, corresponding to the region of the **Liver** and **Gallbladder**. Since the Liver and Gallbladder govern Wind-Wood, it is said that a "tight and full Renying" indicates injury by Wind. Regarding the Cun, Guan, and Chi positions, each occupies three fen, collectively forming the Cun Kou. The left corresponds to Yang and the right to Yin; Yang corresponds to the exterior, thus it is used to observe exterior conditions. Both theories are preserved here).
[Qikou] (Also known as Cun Kou, or Maikou) The Qikou pulse is located one fen anterior to the right Guan position (The pulse observes insufficiency syndromes from internal injury. The acupoint is located one cun posterior to the Yuji acupoint on both hands, belonging to the Hand-Taiyin **Lung meridian**. This reflects Bian Que's adherence to the classic principles, specifically selecting the Cun Kou behind the thenar eminence to determine life and death, which is an unchangeable classic standard).
The *Suwen* states: Humans have three sections (Bu), namely the Lower Section, Middle Section, and Upper Section; each section has three observations (Hou), namely Heaven, Earth, and Human.
Upper Section Heaven refers to the arterial pulse at both temples (located on both sides of the forehead, palpable with the fingers, where the Foot-Shaoyang **Gallbladder meridian** passes), used to observe the Qi of the head and angles (due to its location in the head/angle region);
Upper Section Earth refers to the arterial pulse at both cheeks (located on both sides below the nostrils near the Juliao acupoint, palpable with the fingers, where the Foot-Yangming **Stomach meridian** passes), used to observe the Qi of the mouth and teeth (due to its proximity to the mouth and teeth);
Upper Section Human refers to the arterial pulse anterior to the ears (located in the depression anterior to the ear, palpable with the fingers, where the Hand-Shaoyang **Sanjiao meridian** passes), used to observe the Qi of the eyes and ears (due to its location at the anterior ear pulse, reaching the inner canthus of the eye).
Middle Section Heaven is the Hand-Taiyin meridian (i.e., the **Lung meridian**, located at the Cun Kou distal to the wrist crease, named Jingquan, palpable with the fingers), used to observe the **Lung**;
Middle Section Earth is the Hand-Yangming meridian (i.e., the **Large Intestine meridian**, located between the metacarpals of the thumb and index finger, at the Hegu acupoint, palpable with the fingers), used to observe the Qi of the chest (observing both **Intestines** and **Stomach** together);
Middle Section Human is the Hand-Shaoyin meridian (i.e., the **Heart meridian**, located at the end of the styloid process of the ulna, at the Shenmen acupoint, palpable with the fingers), used to observe the **Heart**.
Lower Section Heaven is the Foot-Jueyin meridian (i.e., the **Liver meridian**, located laterally to the pubic hairline, in the depression 1.5 cun below the 'sheep testicle' landmark, at the Wuli acupoint; taken in supine position, palpable with the fingers. For women, the Taichong acupoint is taken, located in the depression 2 cun proximal to the base of the big toe), used to observe the **Liver**;
Lower Section Earth is the Foot-Shaoyin meridian (i.e., the **Kidney meridian**, located in the depression posterior to the medial malleolus and superior to the calcaneus, at the Taixi acupoint, palpable with the fingers), used to observe the **Kidney**;
Lower Section Human is the Foot-Taiyin meridian (i.e., the **Spleen meridian**, located between the tendons on the upper calf, directly below Wuli, at the Jimen acupoint; clothing should be loosened, deep pressure required to obtain the pulse, and it is palpable with the fingers), used to observe the Qi of the **Spleen** and **Stomach** (The **Spleen** and **Stomach** are connected by membranes, so observing the **Spleen** simultaneously observes the **Stomach**. To observe **Stomach Qi**, one should take the Chongyang acupoint on the dorsum of the foot, where the arterial pulse responds to touch. This sequence follows the text of the *Chapter on Three Sections and Nine Observations*).
(Gu Yingbai stated: The "Three Sections and Nine Observations" mentioned by Xuanyuan and Qibo are not like the "Three Sections and Nine Observations" of later generations. Humans have three sections, each with three observations; this totals the whole body, dividing it into Upper, Middle, and Lower sections. Is it merely naming the single pulse of the Qikou as the three sections of Cun, Guan, and Chi? Within one section, there are naturally the arterial pulses of Heaven, Earth, and Human observations. Is it again dividing the Cun, Guan, and Chi pulses into Floating, Middle, and Sinking observations? If the later theory is correct, then the theory of Xuanyuan and Qibo is wrong; if the theory of Xuanyuan and Qibo is correct, then the later theory is wrong! Thus, I must interject my voice. Floating and Sinking do not need further explanation. The "Middle" only refers to the middle of the Floating technique; how can there be a "middle" of Sinking? Floating without Middle implies rootlessness; Sinking necessarily lacks Middle. Why is it solely believed that Sinking pulse governs interior syndromes, without implying fatal conditions? People generally know the "Middle" of centrality but not the "Middle" of harmony. The classics state: "Appearance of Zang-Fu true pulses indicates death." Pulses lacking Stomach Qi are called Zang-Fu true pulses. Therefore, except for various strange pulses, all can be said to possess Stomach Qi, and all can be said to possess the "Middle" pulse. Why abandon the obvious classic texts and instead grope in the ignorance of Floating, Sinking, and Middle? This is inexplicable. Moreover, pulse diagnosis involves hand palpation and visual observation, not just pressing. A slow pulse corresponds to loose skin; a rapid pulse corresponds to tight skin; a slippery pulse corresponds to smooth skin; a choppy pulse corresponds to rough skin; a large pulse corresponds to bulging skin; a small pulse corresponds to diminished skin and Qi. The Sages, feeling pain as their own, earnestly instructed future generations, yet this was ignored. How unwise! Slippery pulses can be observed visually and palpated, retaining the truth of the pulse. Choppy pulses are easy to observe visually but difficult to palpate. Why? If one sees black and haggard complexion, even a child knows it is a choppy pulse. If one must feel the pulse as if scraping sand or bamboo, even a wise person feels lost like facing an ocean. From Bian Que, Cang Gong, and Zhang Zhongjing onwards, errors have been passed down. I have studied the classics: Renying is only located by the throat. The three sections must cover the head and feet. Zang organs are observed on the left hand, Fu organs on the right hand. Cun observes the upper, Chi observes the lower; this applies to both Zang and Fu. This prevents any doubt or confusion. The chaotic theories of Seven Surfaces, Eight Interiors, and Nine Channels show wisdom inferior to Bian Que. Since the world knows these well, I will not elaborate further.)