右手第二指连脾。四十五动无诸疑。
此言医者以第二中指探病患右关。乃脾脉也。亦须准前五九四十五
动之数而不歇。则不必疑其有疾厄也。
急动名为脾热极。食不能消定若斯。
脾脉宜和而缓。今则动而急。乃脾土为风热所乘。失其运化之机。故不
能磨谷而消食矣。
欲知疾患多为冷。指下寻之慢极迟。
脾喜温而恶寒。今诊得其脉慢而且迟。迟则为寒。是知所生之病为冷
也。
吐逆不定经旬日。胃气中心得几时。
脾属土。在变动为哕。今吐逆不定。而经旬日之久。旬日十日也。土之生
数五。成数十。吐逆自五日以至十日。则生成之数俱过。而吐犹不定。脾
败可知矣。脾败则恶气冲胃。胃之上心也。心为君主之官。而为恶气所
犯。纵生能得几时也。
右手命门三指下。四十五动不须怕。一十九动默沉沉。百死无生命绝也。
凡人有五脏六腑。或又曰六藏五腑。难经固已言之。而犹未见其畅达
也。天有五行。水火木金土。人有五脏。心肝脾肺肾。然五行之中。各有阴
阳。合为十干。甲丙戊庚壬。阳也。乙丁己辛癸。阴也。在人亦有阳阴。阴者
为脏。心肝脾肺肾是也。阳者为腑。胆胃大肠小肠膀胱是也。若然。则为
五脏六腑矣。何以有十二经脉为哉。不知天有十干。地有十二支。人亦
有十二脏腑。以配天之三阴三阳。风热暑湿燥寒是也。故经曰。厥阴之
上。风气主之。中见少阳。少阳之上火气主之。中见厥阴。所以在人则肝
络胆。胆络肝。心包络三焦。三焦络心胞也。又曰。太阴之上湿气主之。中
见阳明。阳明之上。燥气主之。中见太阴。所以在人则脾络胃。胃络脾。肺
络大肠。大肠络肺也。又曰。少阴之上热气主之。中见太阳。太阳之上。寒
气主之中见少阴。所以在人则心络小肠。小肠络心。肾络膀胱。膀胱络
肾也。故人之十二经。分候于左右手寸关尺之六部。浮以候表。沉以候
里。浮以候腑。沉以候脏。不易之论也。然左寸则以候心与小肠矣。左关
则以候肝与胆矣。左尺则以候肾与膀胱矣。右寸则以候肺与大肠矣。
右关则以候脾与胃矣。然则心包之与三焦。舍右尺奚候焉。夫两尺皆
肾也。左曰肾。右曰命门。而手厥阴。手少阳。寄旺于此。夫厥阴风木也。少
阳相火也。手厥阴既为风木。故其生克之理。亦当与足厥阴肝木同其
好恶。故诀曰。右手命门三指下。言医人以第三指探病患之右尺。乃命
脉也。其脉亦须准前九畴之数。四十五动而不歇。则手厥阴心包之气
全矣。故曰。不须怕也。若数得一十九动上默然而沉。以三五除之。尚余
其四。四乃金之生数。以二五除之。尚余其九。九乃金之成数。合生成之
数皆金。则风木之生气被克。故曰百死无生命绝也。
按刘守真曰。经云。七节之傍。中有小心。杨上善注太素曰。人之脊骨。有
二十一节。从下第七节之傍。左者为肾。右者为命门。命门者。小心也。又
曰。右肾命门小心。为手厥阴包络之藏。故与手少阳三焦。合为表里。故
脉同出。见手右尺也。
指下急急动如弦。肾脏有风尤莫治。
言诊得右手命脉急。而又急动之如弦。夫右尺又主少阳相火。少阳乃
春生之木。相火乃龙雷之火。今诊得其脉弦而且急。是为风火相煽。要
知火与风皆耗水之物。而肾水伤矣。故曰肾脏有风尤莫治也。
七动沉沉更不来。努力今朝应是死。
此言右尺又为命门真火。其脉当流利而滑沉。今于七动之上。沉而又
沉。不能复来。夫七。火之成数也。于七动上沉而不至。则命门之真火绝
矣。然此一点真火。乃人身之根本。今既已绝。又安得其久待耶。
右手第二指对应脾脉。脉搏跳动四十五次且无间歇，便无需怀疑。
这里说的是医生用右手中指探查患者右关部的脉象，这是脾脉。也必须符合前面所说的九的倍数即四十五次的次数且不歇止，那么就不必怀疑其有疾病了。
脉搏急促跳动称为脾热极盛。饮食不能消化正是如此。
脾脉应当和缓。现在脉搏急促跳动，是脾土受到风热邪气侵袭，失去了运化功能，所以不能磨碎谷物并消化食物了。
想要知道疾病多由寒冷引起，手指下感觉极其缓慢迟滞。
脾喜温而恶寒。现在诊察到脉搏缓慢而且迟滞，迟脉主寒，由此可知所患疾病为寒证。
呕吐逆乱不定持续十天半月，胃气中心还能维持多久呢？
脾属土，在变动方面表现为呃逆（哕）。现在呕吐逆乱不定，且持续十天之久。“旬”意为十日。土的生成数中，生数为五，成数为十。呕吐从五日持续到十日，则生成之数都已超过，而呕吐仍不停止，可知脾气已败坏。脾败则浊气冲犯胃，胃位于心之下。心为君主之官，若被浊气侵犯，纵然能存活又能有多久呢？
右手第三指下方对应命门脉。脉搏跳动四十五次且无间歇，便不必害怕。若脉搏仅跳动十九次，且深沉无声，则是百死无生的绝脉。
凡人有五脏六腑，有的说法是六脏五腑，《难经》中已经论述过，但尚未完全通达透彻。天有五行：水、火、木、金、土；人有五脏：心、肝、脾、肺、肾。然而五行之中，各分阴阳，合为天干。甲、丙、戊、庚、壬为阳；乙、丁、己、辛、癸为阴。在人身上也有阴阳之分。阴者为脏，即心、肝、脾、肺、肾；阳者为腑，即胆、胃、大肠、小肠、膀胱。如果是这样，那就是五脏六腑了。为什么还有十二经脉呢？不知道天有十个天干，地有十二个地支，人也有十二脏腑，以配合天的三阴三阳（风、热、暑、湿、燥、寒）。所以经文说：厥阴之上，风气主之，中见少阳；少阳之上，火气主之，中见厥阴。所以在人体中，肝络胆，胆络肝；心包络三焦，三焦络心包。又说：太阴之上，湿气主之，中见阳明；阳明之上，燥气主之，中见太阴。所以在人体中，脾络胃，胃络脾；肺络大肠，大肠络肺。又说：少阴之上，热气主之，中见太阳；太阳之上，寒气主之，中见少阴。所以在人体中，心络小肠，小肠络心；肾络膀胱，膀胱络肾。因此人的十二经脉，分别候诊于左右手的寸、关、尺六部。浮取候表，沉取候里；浮取候腑，沉取候脏，这是不可改变的论断。然而左寸候心与小肠，左关候肝与胆，左尺候肾与膀胱，右寸候肺与大肠，右关候脾与胃。那么心包与三焦，除了右尺部还能候哪里呢？两尺部都对应肾。左尺曰肾，右尺曰命门，而手厥阴心包经与手少阳三焦经寄旺于此。厥阴属风木，少阳属相火。手厥阴既为风木，所以其生克之理，也应当与足厥阴肝木相同好恶。所以歌诀说：“右手命门三指下”，意思是医生用第三指（无名指）探查患者右尺部，这是命门脉。其脉也应符合前述“九畴”之数，即四十五次跳动且不歇止，则手厥阴心包之气充足，所以说“不须怕”。如果脉搏仅跳动十九次，且深沉无声，用三五相除，尚余四；四乃金的生数；用二五相除，尚余九；九乃金的成数。合起来生成之数皆属金，则风木的生气被克制，所以说“百死无生命绝”。
按刘完素（守真）所说：经文云：“七节之傍，中有小心。”杨上善注释《太素》说：人的脊骨有二十一节，从下往上第七节的旁边，左边是肾，右边是命门。命门就是小心。又说：右肾命门小心，是手厥阴心包之藏，所以与手少阳三焦互为表里，故脉象同出于右手尺部。
手指下感觉急促跳动如弦脉，肾脏有风邪尤其难以治疗。
这里说的是诊得右手命门脉急，且急促跳动如弦脉。右尺又主少阳相火，少阳乃春生之木，相火乃龙雷之火。现在诊得其脉弦而且急，这是风火相煽。要知道火与风都是耗伤肾水的因素，导致肾水受损，所以说“肾脏有风尤莫治”。
脉搏仅跳动七次，深沉且不再来复，努力撑过今天应该就是死了。
这里说的是右尺部又是命门真火所在，其脉应当流利而滑沉。现在在七次跳动之上，脉象沉而又沉，不能再回升。七是火的成数。在七次跳动时沉而不现，则命门的真火已绝。然而这一点真火，是人体生命的根本，现在已经断绝，怎么能长久等待呢？
The second finger on the right hand corresponds to the Spleen pulse. If the pulse beats forty-five times without any pause, there is no need for doubt.
This refers to the physician using the middle finger of the right hand to palpate the Guan position (middle position) of the patient's right wrist, which represents the Spleen pulse. It must also conform to the number mentioned previously, a multiple of nine totaling forty-five beats, without cessation; thus, one need not suspect the presence of disease.
A rapid and urgent beating indicates extreme Spleen Heat. The inability to digest food is precisely due to this condition.
The Spleen pulse should be harmonious and slow. Now that it beats rapidly and urgently, it signifies that Spleen Earth has been invaded by Wind-Heat pathogenic factors, losing its mechanism of transformation and transportation. Consequently, it cannot grind grain and digest food.
To know if the illness is mostly caused by Cold, feel under the fingers for a pulse that is extremely slow and delayed.
The Spleen prefers warmth and dislikes cold. Now, upon palpation, the pulse is found to be slow and delayed. A delayed pulse indicates Cold; therefore, it can be known that the disease generated is due to Cold.
Vomiting and regurgitation are irregular and persist for ten days or more; how long can the Stomach Qi sustain itself?
The Spleen belongs to Earth, and in terms of pathological changes, it manifests as hiccups (Yue). Now, vomiting and regurgitation are irregular and have persisted for a full "Xun" (ten days). In the generative numbers of Earth, the generative number is five, and the completion number is ten. If vomiting persists from five days to ten days, both the generative and completion numbers are exceeded, yet the vomiting remains unresolved; this indicates the failure of the Spleen Qi. When the Spleen fails, turbid Qi rushes to attack the Stomach. The Stomach is located below the Heart. The Heart is the official of the sovereign; if it is invaded by turbid Qi, even if life continues, for how long will it last?
Below the third finger on the right hand lies the Mingmen (Gate of Life) pulse. If the pulse beats forty-five times without pause, there is no need to fear. If the pulse beats only nineteen times and is silent and deep, it signifies death with no hope of life.
Humans possess Five Zang organs and Six Fu organs, though some theories speak of six Zang and five Fu. The *Nan Jing* (Classic of Difficult Issues) has already discussed this, yet the explanation is not fully thorough. Heaven has Five Elements: Water, Fire, Wood, Metal, and Earth. Humans have Five Zang organs: Heart, Liver, Spleen, Lung, and Kidney. However, within each of the Five Elements, there is Yin and Yang, combining to form the Ten Heavenly Stems. Jia, Bing, Wu, Geng, Ren are Yang; Yi, Ding, Ji, Xin, Gui are Yin. In humans, there is also Yin and Yang. Yin constitutes the Zang organs: Heart, Liver, Spleen, Lung, Kidney. Yang constitutes the Fu organs: Gallbladder, Stomach, Large Intestine, Small Intestine, Bladder. If so, these are merely Five Zang and Six Fu. Why then are there Twelve Meridians? It is unknown that Heaven has Ten Heavenly Stems and Earth has Twelve Earthly Branches; similarly, humans have twelve Zang-Fu pairs to correspond to the Three Yin and Three Yang of Heaven (Wind, Heat, Summer-heat, Dampness, Dryness, Cold). Thus, the classics state: Above Jueyin, Wind Qi dominates, revealing Shaoyang internally; above Shaoyang, Fire Qi dominates, revealing Jueyin internally. Therefore, in the human body, the Liver connects with the Gallbladder, and the Gallbladder connects with the Liver; the Pericardium connects with the Sanjiao (Triple Burner), and the Sanjiao connects with the Pericardium. It is also stated: Above Taiyin, Dampness Qi dominates, revealing Yangming internally; above Yangming, Dryness Qi dominates, revealing Taiyin internally. Therefore, in the human body, the Spleen connects with the Stomach, and the Stomach connects with the Spleen; the Lung connects with the Large Intestine, and the Large Intestine connects with the Lung. Furthermore: Above Shaoyin, Heat Qi dominates, revealing Taiyang internally; above Taiyang, Cold Qi dominates, revealing Shaoyin internally. Therefore, in the human body, the Heart connects with the Small Intestine, and the Small Intestine connects with the Heart; the Kidney connects with the Bladder, and the Bladder connects with the Kidney. Thus, the twelve meridians of the human body are examined at the Cun, Guan, and Chi positions of both left and right hands. Superficial palpation examines the exterior; deep palpation examines the interior. Superficial palpation examines Fu organs; deep palpation examines Zang organs. This is an unchangeable principle. However, the left Cun examines the Heart and Small Intestine; the left Guan examines the Liver and Gallbladder; the left Chi examines the Kidney and Bladder; the right Cun examines the Lung and Large Intestine; the right Guan examines the Spleen and Stomach. Then, where else can the Pericardium and Sanjiao be examined except at the right Chi? Both Chi positions correspond to the Kidney. The left is called Kidney, and the right is called Mingmen (Gate of Life). The Hand Jueyin Pericardium Meridian and Hand Shaoyang Sanjiao Meridian thrive here. Jueyin belongs to Wind-Wood, and Shaoyang belongs to Ministerial Fire. Since the Hand Jueyin is Wind-Wood, its principles of generation and restriction should share the same preferences as the Foot Jueyin Liver-Wood. Hence, the verse states: "Below the third finger on the right hand is the Mingmen." This means the physician uses the third finger (ring finger) to palpate the right Chi position of the patient, which is the Mingmen pulse. Its pulse should also conform to the aforementioned "Nine Categories" number, beating forty-five times without pause, indicating sufficient Qi of the Hand Jueyin Pericardium; thus, it says, "No need to fear." If the pulse beats only nineteen times and is silent and deep, dividing by three and five leaves a remainder of four; four is the generative number of Metal. Dividing by two and five leaves a remainder of nine; nine is the completion number of Metal. Combining these, the generative and completion numbers all belong to Metal, meaning the generating Qi of Wind-Wood is restricted. Thus, it says, "Death is certain, life is severed."
According to Liu Shouzhen (Liu Wansu): The classic states, "Beside the seventh vertebra from the bottom, there is the 'Small Heart'." Yang Shangshan, annotating the *Tai Su*, said: The human spine has twenty-one segments. Beside the seventh segment from the bottom, the left side is the Kidney, and the right side is the Mingmen. The Mingmen is the "Small Heart." It is further stated: The right Kidney, Mingmen, and "Small Heart" constitute the storage of the Hand Jueyin Pericardium, hence they are interior-exterior partners with the Hand Shaoyang Sanjiao, and their pulses emerge together at the right Chi position.
If the pulse feels urgent and beats like a string under the fingers, Wind in the Kidneys is particularly difficult to treat.
This describes palpating the right Mingmen pulse as urgent, beating rapidly and tightly like a string. The right Chi also governs the Shaoyang Ministerial Fire. Shaoyang represents the Wood of spring growth, and Ministerial Fire is the fire of dragons and thunder. Now, finding the pulse tight and urgent indicates that Wind and Fire are fanning each other. One must know that both Fire and Wind consume Water, damaging Kidney Water. Therefore, it says, "Wind in the Kidneys is particularly difficult to treat."
If the pulse beats only seven times, sinks deeply, and does not return, striving through today implies death.
This explains that the right Chi is also the seat of the True Fire of the Mingmen. Its pulse should be slippery, flowing, and deep. Now, above the seventh beat, the pulse sinks deeply and does not rebound. Seven is the completion number of Fire. If the pulse sinks and fails to appear at the seventh beat, the True Fire of the Mingmen is extinguished. However, this single point of True Fire is the root of human life. Now that it is extinguished, how can one expect to survive much longer?