(附考一日二十四时，释左升右降)
《难经》脉例，以一动为一至，而《脉经》引扁鹊脉例，以再动为一至。此一人而两例
也。
《玉机真脏》云∶若人一息五六至，其形肉虽不脱，真脏虽不见，犹死也。此再动之例也。
《大奇论》浮合如数，一息十至以上，是又一动为一至矣。此一书而两例也。前人绝无辨之
者，而林亿转疑《玉机真脏》为误文，何也?
营卫皆一日五十度周于身，而《卫气行》篇所论，人气一刻在太阳，二刻在少阳，三刻
在阳
明，四刻在阴分。是四刻一周，不合其数。然其下文云∶一十二度半，是半日之度也。又明
明一日二十五度，一夜二十五度矣。此必当时有以一日一夜二百刻纪数者也。前人绝无辨之
者，而戴同甫转疑《灵枢》为衍文，何也?
经言∶左右者，阴阳之道路也。又曰∶阳从左，阴从右。而人身之气，左右并行，绝无
左右先后低昂之迹，然则何升何降耶?前人绝无辨之者，何也?
气之营运于十二经也，虽各经之脉，左右各有一条，而气之左右并行，卒无分于彼此先
后也
。乃脉度十六丈二尺，以手足之经，各具六阴六阳，分纪其数，然则果如所谓左升右降耶?
果尔，则气之行也，必有左右参差之迹矣。而《三部九候论》曰∶上下左右之脉，相应如参
舂者病甚，相失不可数者死。是明明左右并行矣。此大可疑者也，而前人绝无疑之者，何也
六气之加临也，少阴所在，其脉不应，理殊难通。若谓少阴君火不主令，则五气足矣，
何必
虚设君火之位耶?至谓心君位尊，无为而治，更属荒谬。人身气化之事，岂等于人伦之体制
耶?六气分主六年，一年之中，又分主四时，何以五气皆应，此独不应耶?且其脉不应，是绝
无少阴脉象矣，何以又云少阴之至，其脉钩耶?此大可疑者也，而前人绝无疑之者，何也?
考一日二十四时
近泰西制时辰表，以一日夜分二十四小时。此乃近事，且出外夷，难证中国古书之义。
顷读
张洁古《保命集》，近托名刘河间书，刻入《河间三书》中。中卷煮黄丸条下，言一时服一
丸，每日二十四丸。自注云∶一日二十四时也。夫一日既可析为二十四时，独不可析为二百
刻乎?此亦可以借证者矣。一日，一日夜也。《内经》以日为昼，故半日止得四分之一云。
释左升右降
曾着《左升右降论》，谓人身之气，本是表升里降，因左升气盛，右降气盛，故遂曰左
升右
降耳?其论已列入《证治总论》，文繁不复赘述。至真要论少阴之复条有云∶气动于左，
上行于右。张石顽《医通》劳倦门，曾治一人，遍身淫淫如虫行，从左腿脚起，渐次上头，
复下至右脚，脉浮涩而按之不足，决其气虚，用补中益气加味而愈。由此观之，人身果实有
左升右降之气矣。吾为此事，行思坐想，近取诸身，远揣诸物，乃似微有所获者，夫人身之
荣气，行于血脉之中矣。宗气，行于动脉，而外为呼吸矣。独卫气之行于脉外者，其道有二
∶一在肌肉脉络之外，一在皮肉交际之间。人身皮与肉交际之处，有膜以横络其中，皮肉之
气，虽能相通，而不能相从，不独人身为然，凡万物之体，皮里干外，其际莫不有隙，卫气
之
行于肌肉者，日夜五十度，与荣气相应，所行之道，即卫气行篇之所叙是也。若皮膜之气横
行皮里，以固护于大表，其度数与日月相应，左升右降，日夜一周。若有痰湿以滞之，则气
行缓而淫淫如虫矣。是左升右降者，卫气之在皮膜者也。《内经》虽无明文，而其理似有可
通。谨书所见，待质高明!
（附考：一日二十四时辰，解释左升右降）
《难经》的脉象法则，以脉搏跳动一次算作一“至”；而《脉经》引用扁鹊的脉象法则，以脉搏跳动两次算作一“至”。这是同一种书却有两种不同的计数方法。
《素问·玉机真脏论》说：“如果人呼吸一次，脉搏跳动五六次，虽然形体肌肉没有脱失，真脏脉也没有出现，但也是死证。”这是采用“两动为一至”的例子。
《素问·大奇论》说：“脉象浮合如数，一息十次以上”，这又是采用“一动为一至”的例子。这是一本书中两种例子并存。前人完全没有辨析这个问题，而林亿反而怀疑《玉机真脏论》是误文，为什么呢？
营气（运行于脉中的精气）和卫气（行于脉外的阳气）都一天一夜在周身循环五十周次。然而《灵枢·卫气行》篇所论述的，人气一刻钟在太阳经，二刻钟在少阳经，三刻钟在阳明经，四刻钟在阴分。这样看来是四刻钟完成一周，这与五十周的总数不合。但是该篇下文又说：“十二度半，这是半日的度数。”又明确说明一日二十五度，一夜二十五度。这必定是当时有以一日一夜二百刻来纪数的制度。前人完全没有辨析这个问题，而戴同甫反而怀疑《灵枢》中有衍文（多余的文字），为什么呢？
经文说：“左右，是阴阳运行的道路。”又说：“阳从左升，阴从右降。”然而人身之气，左右并行，完全没有左右先后高低起伏的痕迹。既然如此，那么什么是升，什么是降呢？前人完全没有辨析这个问题，为什么呢？
气在十二经脉中营运，虽然各经的脉，左右各有一条，但气的左右并行，最终并没有区分彼此先后的界限。然而《灵枢·脉度》记载脉长十六丈二尺，根据手足之经，各自具备六条阴经、六条阳经，分别记录其数量。那么，果真像所说的“左升右降”吗？如果真是这样，那么气的运行，必然会有左右参差错落的痕迹。而《灵枢·三部九候论》说：“上下左右的脉，相应如同捣米一样同步的是病重，相互失调无法计数的为死证。”这明明显示左右是并行的。这是非常可疑的地方，而前人完全没有质疑这一点，为什么呢？
六气（风、寒、暑、湿、燥、火）加临于人体时，少阴君火所在之处，其脉不应（摸不到脉象），道理特别难以通融。如果说少阴君火不主时令，那么五气就足够了，何必虚设君火的位置呢？至于说心君地位尊贵，无为而治，更是荒谬。人身气化运行的事情，难道等同于人伦社会的体制吗？六气分主六年，一年之中又分主四季，为什么五气都有应验，唯独少阴不应呢？而且既然脉不应，就是完全没有少阴脉象了，为什么又说“少阴之至，其脉钩”呢？这是非常可疑的地方，而前人完全没有质疑这一点，为什么呢？
考证一日二十四时辰
近代西洋制定时辰表，将一日一夜分为二十四小时。这是近事，且出自外国，难以用来证明中国古书的义理。最近读到张洁古的《保命集》，这部书近托名刘河间，刻入《河间三书》中。中卷煮黄丸条目下，说一时辰服一丸，每日二十四丸。自注说：“一日二十四时也。”既然一日可以析分为二十四时，难道不可以析分为二百刻吗？这也算是可以借用的证据了。“一日”，指的是一昼夜。《内经》以日指代昼，所以半天只得四分之一云云。
解释左升右降
曾经撰写《左升右降论》，认为人身之气，本是表升里降，因为左升之气盛，右降之气盛，所以才称为左升右降。这个论述已经列入《证治总论》，文字繁杂不再赘述。《素问·至真要大论》少阴之复条有云：“气动于左，上行于右。”张石顽《医宗必读》劳倦门，曾治疗一人，遍身感觉如虫爬行，从左腿脚起，逐渐上头，再下到右脚，脉浮涩而按之不足，判断其为气虚，用补中益气汤加味而痊愈。由此看来，人身确实有左升右降的气机了。我为了这件事，行思坐想，近取诸身，远揣诸物，似乎略微有所收获。夫人身之营气，行于血脉之中；宗气（积于胸中之大气），行于动脉，外表现为呼吸。唯独卫气行于脉外，其道有两条：一条在肌肉脉络之外，一条在皮肉交际之间。人身皮与肉交际之处，有膜横络其中，皮肉之气，虽然能相通，但不能相从。不独人身如此，凡万物之体，皮里干外，其际莫不有隙。卫气之行于肌肉者，日夜五十周次，与营气相应，所行之道，即《卫气行》篇所叙述的那样。若皮膜之气横行于皮里，以固护于大表，其度数与日月相应，左升右降，日夜一周。如果有痰湿阻滞它，则气行缓慢而感觉如虫爬行。这就是所谓的左升右降，是卫气在皮膜中的表现。《内经》虽然没有明文记载，但其理似可通融。谨书所见，等待高明之士指正！
(Attached Examination: Twenty-four Hours of a Day, Explaining Left Ascending and Right Descending)
The pulse example in the *Nan Jing* (Classic of Difficult Issues) considers one pulse beat as one "Zhi" (unit of respiration-pulse ratio), whereas the *Mai Jing* (Pulse Classic) cites Bian Que's pulse example, considering two beats as one "Zhi". This represents two different examples within the same context.
The *Su Wen · Yu Ji Zhen Zang Lun* (Chapter on the Jade Machine and True Viscera) states: "If a person has five or six beats per respiration, although their flesh is not wasted and the True Viscera pulse is not yet visible, they will still die." This is an example of the "two beats equal one Zhi" method.
The *Su Wen · Da Qi Lun* (Chapter on Great Anomalies) states: "The pulse floats and gathers like numbers, with ten or more beats per respiration," which is another example of "one beat equals one Zhi". Thus, there are two examples within one book. Previous scholars never辨析 (analyzed/distinguished) this, yet Lin Yi suspected the text of the *Yu Ji Zhen Zang Lun* to be erroneous. Why?
Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) both circulate fifty times around the body in one day and night. However, the chapter *Wei Qi Xing* (Movement of Defensive Qi) in the *Ling Shu* discusses that at one *Ke* (quarter-hour), Qi is in the Taiyang channel; at two *Ke*, it is in Shaoyang; at three *Ke*, in Yangming; and at four *Ke*, in the Yin divisions. This implies one cycle takes four *Ke*, which does not match the total count of fifty cycles. Yet, the subsequent text says: "Twelve and a half cycles constitute half a day." It clearly states twenty-five cycles for the day and twenty-five for the night. This must imply a system where a day and night were counted as two hundred *Ke*. Previous scholars never analyzed this, yet Dai Tongfu suspected the *Ling Shu* contained superfluous characters. Why?
The Classics state: "Left and right are the pathways of Yin and Yang." It also says: "Yang ascends from the left, Yin descends from the right." However, Qi in the human body runs parallel on both sides, showing no trace of priority, sequence, or elevation difference between left and right. Then, what ascends and what descends? Previous scholars never analyzed this. Why?
Qi circulates in the Twelve Channels. Although each channel has a left and right vessel, Qi runs parallel on both sides without distinguishing between left and right or prior and posterior. Yet, the *Mai Du* (Length of Vessels) chapter records the vessels as sixteen zhang and two chi long, counting six Yin and six Yang channels for hands and feet respectively. So, is it truly as stated, "Left Ascending and Right Descending"? If so, the movement of Qi must show traces of left-right disparity. However, the *San Bu Jiu Hou Lun* (Discussion on Three Regions and Nine Palpation Sites) states: "When the pulses above, below, left, and right respond synchronously like pounding grain, the disease is severe; when they are discordant and uncountable, death occurs." This clearly shows parallel running on left and right. This is highly suspicious, yet previous scholars never questioned it. Why?
Regarding the influence of the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), at the location of Shaoyin Jun Huo (Ministerial Fire), the pulse should not be palpable. This reasoning is difficult to reconcile. If one argues that Shaoyin Jun Huo does not govern the season, then Five Qi would suffice; why create a vacant position for Ministerial Fire? To claim that the Heart Monarch is noble and rules through non-action is even more absurd. Is the physiological transformation of Qi equivalent to human social hierarchy? The Six Qi govern six years, and within one year, they govern the four seasons. Why do all Five Qi correspond, but this one does not? Moreover, if the pulse is absent, there is absolutely no Shaoyin pulse image; how can it then be said that "When Shaoyin arrives, its pulse is Hook-shaped"? This is highly suspicious, yet previous scholars never questioned it. Why?
**Examination of Twenty-four Hours of a Day**
The modern Western timekeeping system divides a day and night into twenty-four hours. This is a recent development originating from foreign lands, making it difficult to use to prove the meaning of ancient Chinese texts. Recently, I read Zhang Jiegou's *Bao Ming Ji* (Collection for Preserving Life), which is recently attributed to Liu Hejian and included in the *Hejian San Shu* (Three Books of Hejian). Under the entry for Zhu Huang Wan (Boiled Yellow Pill) in the middle volume, it states: "Take one pill per Shi (two-hour period), twenty-four pills daily." The self-note says: "One day consists of twenty-four Shi." Since one day can be divided into twenty-four Shi, why could it not be divided into two hundred Ke? This serves as corroborative evidence. "One day" refers to a full day and night. The *Nei Jing* uses "day" to refer to daytime, hence half a day gets only one-quarter, etc.
**Explanation of Left Ascending and Right Descending**
I previously wrote the *Treatise on Left Ascending and Right Descending*, arguing that Qi in the human body is naturally ascending on the exterior and descending on the interior. Because Qi ascending on the left is vigorous and Qi descending on the right is vigorous, it is termed "Left Ascending and Right Descending." This argument is already included in the *General Treatise on Diagnosis and Treatment*, so it is not repeated here due to length. The *Zhi Yao Da Lun* (Great Discussion on Essential Truths) in the section on Shaoyin Repetition states: "Qi moves from the left and ascends to the right." In the section on Fatigue in Zhang Shiweng's *Yi Tong* (Medical Generalities), he treated a patient who felt a sensation like insects crawling all over his body, starting from the left leg and foot, gradually moving up to the head, and then down to the right foot. The pulse was floating and choppy, insufficient upon pressure. He diagnosed Qi deficiency and cured him using modified Buzhong Yiqi Tang (Midway-Supplementing Qi-Boosting Decoction). From this, we see that the human body indeed possesses Qi of Left Ascending and Right Descending.
I pondered this matter deeply, observing my own body and inferring from external objects, and seemed to gain slight insight. Ying Qi (Nutritive Qi) travels within the blood vessels. Zong Qi (Gathering Qi) travels in the arteries and manifests externally as respiration. Only Wei Qi (Defensive Qi), which travels outside the vessels, has two paths: one outside the muscle meridians, and one in the junction between skin and flesh. At the junction of skin and flesh in the human body, there are membranes crisscrossing within. Although Qi in the skin and flesh can communicate, they cannot follow each other freely. This is not unique to humans; in all living bodies, between the skin and the interior, there are gaps. Wei Qi traveling in the muscles completes fifty cycles day and night, corresponding with Ying Qi. The path it travels is exactly as described in the *Wei Qi Xing* chapter. However, Qi in the skin membranes travels horizontally beneath the skin to protect the exterior. Its cycles correspond with the sun and moon, ascending on the left and descending on the right, completing one cycle day and night. If Phlegm-Dampness stagnates it, Qi movement slows, causing a sensation like insects crawling. Therefore, "Left Ascending and Right Descending" refers to Wei Qi residing in the skin membranes. Although the *Nei Jing* lacks explicit text on this, the principle seems plausible. I record my observations here, awaiting correction from experts.