寸口(kou)(kou)脈(mo)分屑臟腑,《難(nan)經》提出(chu)獨取(qu)寸口(kou)(kou)。至于為什(shen)么獨取(qu)寸口(kou)(kou)?第二難(nan)中明確回答(da),寸口(kou)(kou)是脈(mo)之大(da)要會,為陰(yin)陽(yang)(yang)十二經脈(mo)會合的(de)要點。人體內營(ying)衛的(de)運行(xing),氣機的(de)升降出(chu)入,氣血(xue)的(de)盛衰等變化,這些陰(yin)陽(yang)(yang)往(wang)復的(de)動向,無(wu)一不是從(cong)寸口(kou)(kou)脈(mo)象(xiang)反映出(chu)來。
寸(cun)(cun)口(kou)(kou)脈,屬(shu)于太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin)肺(fei)(fei)(fei)經,獨(du)取寸(cun)(cun),所(suo)以能診(zhen)斷五(wu)(wu)臟六腑(fu)的疾病,關(guan)(guan)(guan)鍵在(zai)于肺(fei)(fei)(fei)。因心(xin)主血(xue)脈,肺(fei)(fei)(fei)主氣(qi),血(xue)隨氣(qi)行(xing)(xing),氣(qi)動則脈應;更因肺(fei)(fei)(fei)司呼吸(xi)之(zhi)氣(qi),運化清濁,吐故納新,治節百(bai)脈,五(wu)(wu)五(wu)(wu)臟六腑(fu)皆受其(qi)(qi)蔭,所(suo)以說(shuo)“肺(fei)(fei)(fei)朝百(bai)脈”。由于寸(cun)(cun)口(kou)(kou)部位是(shi)十二經脈匯流之(zhi)處,五(wu)(wu)臟六腑(fu)氣(qi)血(xue)循環的起止點,因此,五(wu)(wu)臟六腑(fu)有病,氣(qi)血(xue)運行(xing)(xing)失(shi)常,能夠(gou)通過(guo)肺(fei)(fei)(fei)經反映于寸(cun)(cun)口(kou)(kou)。“獨(du)取寸(cun)(cun)口(kou)(kou)”是(shi)古(gu)代脈診(zhen)發展中(zhong)(zhong)(zhong)一大飛躍,導(dao)源(yuan)于《內經》,執簡馭繁,方便易行(xing)(xing),深(shen)為后世所(suo)習用(yong),關(guan)(guan)(guan)于分屬(shu)問題,“十八(ba)難”中(zhong)(zhong)(zhong)載有:左(zuo)手,寸(cun)(cun)配(pei)(pei)心(xin)與小腸,關(guan)(guan)(guan)配(pei)(pei)肝(gan)與膽,尺(chi)(chi)配(pei)(pei)腎與膀胱(guang)。右(you)(you)(you)(you)手,寸(cun)(cun)配(pei)(pei) 肺(fei)(fei)(fei)與大腸,關(guan)(guan)(guan)配(pei)(pei)脾與胃(wei),尺(chi)(chi)配(pei)(pei)心(xin)包與三焦。其(qi)(qi)觀點,從陰(yin)(yin)(yin)(yin)(yin)陽分臟腑(fu)表里,遵五(wu)(wu)行(xing)(xing)分左(zuo)右(you)(you)(you)(you)手、寸(cun)(cun)關(guan)(guan)(guan)尺(chi)(chi)五(wu)(wu)脈所(suo)屬(shu)。誠如《難經集(ji)注》虞庶說(shuo):“……右(you)(you)(you)(you)手尺(chi)(chi)中(zhong)(zhong)(zhong)少(shao)陽火,生(sheng)(sheng)(sheng)關(guan)(guan)(guan)上(shang)陽明(ming)土(tu);關(guan)(guan)(guan)上(shang)陽明(ming)土(tu),卻生(sheng)(sheng)(sheng)寸(cun)(cun)口(kou)(kou)太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin)金(jin);寸(cun)(cun)口(kou)(kou)太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin)金(jin),卻生(sheng)(sheng)(sheng)左(zuo)手尺(chi)(chi)中(zhong)(zhong)(zhong)水;左(zuo)手尺(chi)(chi)中(zhong)(zhong)(zhong)少(shao)陰(yin)(yin)(yin)(yin)(yin)水,卻生(sheng)(sheng)(sheng)左(zuo)手關(guan)(guan)(guan)上(shang)厥(jue)陰(yin)(yin)(yin)(yin)(yin)木;關(guan)(guan)(guan)上(shang)厥(jue)陰(yin)(yin)(yin)(yin)(yin)術,卻生(sheng)(sheng)(sheng)左(zuo)手寸(cun)(cun)口(kou)(kou)少(shao)陰(yin)(yin)(yin)(yin)(yin)火;卻又(you)別心(xin)主火。故心(xin)主生(sheng)(sheng)(sheng)足(zu)太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin)陽明(ming)土(tu)也,此乃(nai)五(wu)(wu)行(xing)(xing)相生(sheng)(sheng)(sheng)之(zhi)意耳(er)!又(you)足(zu)厥(jue)陰(yin)(yin)(yin)(yin)(yin)與足(zu)太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin),何以居于左(zuo)右(you)(you)(you)(you)兩手關(guan)(guan)(guan)部中(zhong)(zhong)(zhong)?胃(wei)脾太(tai)(tai)陰(yin)(yin)(yin)(yin)(yin),脾脈居于中(zhong)(zhong)(zhong)州,乃(nai)在(zai)右(you)(you)(you)(you)手關(guan)(guan)(guan)上(shang)也。又(you)足(zu)厥(jue)陰(yin)(yin)(yin)(yin)(yin)木,本者根(gen)生(sheng)(sheng)(sheng)于地,枝葉長于天,亦陰(yin)(yin)(yin)(yin)(yin)陽共(gong)焉!故亦在(zai)左(zuo)手中(zhong)(zhong)(zhong)部也。”
《脈(mo)經(jing)》對寸兩手(shou)六脈(mo)分臟(zang)腑所(suo)屬(shu)(shu),心肝(gan)為(wei)(wei)(wei)陽(yang)(yang)(yang)臟(zang),出于(yu)左(zuo)手(shou);肺脾為(wei)(wei)(wei)陰(yin)臟(zang),出于(yu)右(you)(you)(you)(you)手(shou)。遵《內經(jing)》:“左(zuo)右(you)(you)(you)(you)者,陰(yin)陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)道路也。”六腑與五臟(zang)表里相(xiang)配,宗《難經(jing)》。其不同者,引(yin)《脈(mo)法贊》:“腎(shen)與命(ming)(ming)(ming)門(men)俱出尺部。”又說:“左(zuo)屬(shu)(shu)腎(shen),右(you)(you)(you)(you)為(wei)(wei)(wei)于(yu)戶(hu),名曰l三(san)(san)焦(jiao)(jiao)。”是子(zi)戶(hu)即命(ming)(ming)(ming)門(men)。命(ming)(ming)(ming)門(men)為(wei)(wei)(wei)什么配右(you)(you)(you)(you)尺? 因腎(shen)為(wei)(wei)(wei)陰(yin)陽(yang)(yang)(yang)之(zhi)(zhi)(zhi)臟(zang),水火之(zhi)(zhi)(zhi)宅;腎(shen)精(jing)為(wei)(wei)(wei)元陰(yin),命(ming)(ming)(ming)門(men)為(wei)(wei)(wei)元陽(yang)(yang)(yang),水火同居,渾一(yi)太極。火之(zhi)(zhi)(zhi)體陰(yin),動(dong)于(yu)右(you)(you)(you)(you);水之(zhi)(zhi)(zhi)體陽(yang)(yang)(yang),動(dong)于(yu)左(zuo);故左(zuo)尺為(wei)(wei)(wei)腎(shen),右(you)(you)(you)(you)尺為(wei)(wei)(wei)命(ming)(ming)(ming)門(men)。又命(ming)(ming)(ming)門(men)與三(san)(san)焦(jiao)(jiao)同配右(you)(you)(you)(you)尺,以(yi)命(ming)(ming)(ming)門(men)與腎(shen)脈(mo)通,內寓(yu)腎(shen)陽(yang)(yang)(yang);且三(san)(san)焦(jiao)(jiao)內寄相(xiang)火,其經(jing)氣稟受于(yu)命(ming)(ming)(ming)門(men),故三(san)(san)焦(jiao)(jiao)配右(you)(you)(you)(you)尺。膀胱(guang)(guang)也同配右(you)(you)(you)(you)尺,因膀胱(guang)(guang)與腎(shen)相(xiang)表里,《靈樞·本臟(zang)篇》說:“腎(shen)合(he)三(san)(san)焦(jiao)(jiao)膀胱(guang)(guang)。”所(suo)以(yi)右(you)(you)(you)(you)尺分屬(shu)(shu)腎(shen)(即命(ming)(ming)(ming)門(men)),及三(san)(san)焦(jiao)(jiao)與膀胱(guang)(guang)。
后世醫(yi)家(jia)對寸(cun)口(kou)脈(mo)(mo)臟(zang)腑(fu)分(fen)屬,《千金(jin)方》與《四言舉要(yao)(yao)》宗《內(nei)經(jing)(jing)(jing)》之(zhi)(zhi)(zhi)說;《診(zhen)家(jia)樞要(yao)(yao)》以(yi)(yi)右(you)尺(chi)主心(xin)包(bao)絡之(zhi)(zhi)(zhi)臟(zang),配(pei)三焦之(zhi)(zhi)(zhi)腑(fu),并在(zai)注中(zhong)(zhong)有“命(ming)門與腎脈(mo)(mo)通”,是臺《難經(jing)(jing)(jing)》與《脈(mo)(mo)經(jing)(jing)(jing)》的觀點李東(dong)垣亦同此說。《瀕(bin)湖脈(mo)(mo)學》與《脈(mo)(mo)經(jing)(jing)(jing)》同。明(ming)·張(zhang)三錫對《脈(mo)(mo)經(jing)(jing)(jing)》有異}義(yi)。認為:“診(zhen)脈(mo)(mo)之(zhi)(zhi)(zhi)法(fa),當(dang)以(yi)(yi)心(xin)肺(fei)俱浮(fu)、腎肝俱沉(chen),脾主中(zhong)(zhong)州之(zhi)(zhi)(zhi)說,王叔和守寸(cun)關尺(chi)分(fen)部位(wei),以(yi)(yi)別五臟(zang)六(liu)腑(fu)者非也。五臟(zang)六(liu)腑(fu)之(zhi)(zhi)(zhi)氣(qi),晝夜循環,始(shi)于(yu)肺(fei)而終于(yu)肺(fei),是肺(fei)為一身之(zhi)(zhi)(zhi)主氣(qi),而寸(cun)口(kou)乃(nai)肺(fei)之(zhi)(zhi)(zhi)動脈(mo)(mo)所行之(zhi)(zhi)(zhi)處也;特藉以(yi)(yi)候(hou)五臟(zang)之(zhi)(zhi)(zhi)氣(qi),前(qian)賢辨之(zhi)(zhi)(zhi)詳矣!至于(yu)諸經(jing)(jing)(jing)動脈(mo)(mo),各從所行之(zhi)(zhi)(zhi)處。”張(zhang)氏(shi)以(yi)(yi)浮(fu)中(zhong)(zhong)沉(chen)三候(hou)分(fen)臟(zang)腑(fu)。《古今醫(yi)統》認為:“兩尺(chi)外以(yi)(yi)候(hou)腎,內(nei)候(hou)腹(fu)中(zhong)(zhong),大腸(chang)、小腸(chang)、膀(bang)胱(guang)三腑(fu)盡屬腹(fu)中(zhong)(zhong)下部之(zhi)(zhi)(zhi)位(wei)。
故三(san)(san)部(bu)(bu)寸(cun)關尺(chi)(chi)(chi)(chi)之(zhi)(zhi)(zhi)(zhi)(zhi)配(pei)(pei)(pei)診(zhen),則(ze)各因某(mou)臟(zang)腑之(zhi)(zhi)(zhi)(zhi)(zhi)位焉,何常泥(ni)于(yu)(yu)(yu)經(jing)絡而候(hou)之(zhi)(zhi)(zhi)(zhi)(zhi)也?況且命(ming)門(men)并無經(jing)臟(zang),三(san)(san)焦(jiao)亦非一腑,而何可以(yi)(yi)候(hou)之(zhi)(zhi)(zhi)(zhi)(zhi)右(you)(you)(you)(you)(you)尺(chi)(chi)(chi)(chi)耶?”《醫(yi)宗(zong)(zong)必讀(du)》、《圖書(shu)編(bian)》均(jun)同此(ci)說(shuo)。是又以(yi)(yi)上(shang)、中、下(xia)(xia)(xia)三(san)(san)焦(jiao)分候(hou)臟(zang)腑之(zhi)(zhi)(zhi)(zhi)(zhi)位。《景岳全(quan)書(shu)》以(yi)(yi)左寸(cun)配(pei)(pei)(pei)心與(yu)(yu)心包(bao)絡,右(you)(you)(you)(you)(you)寸(cun)配(pei)(pei)(pei)肺(fei)(fei)與(yu)(yu)膻(shan)中,以(yi)(yi)左尺(chi)(chi)(chi)(chi)腎配(pei)(pei)(pei)膀胱與(yu)(yu)大腸(chang)(chang)(chang)(chang),右(you)(you)(you)(you)(you)尺(chi)(chi)(chi)(chi)腎配(pei)(pei)(pei)命(ming)門(men)、三(san)(san)焦(jiao)與(yu)(yu)小(xiao)(xiao)腸(chang)(chang)(chang)(chang)。其注(zhu)云:“兩寸(cun)部(bu)(bu)所謂上(shang)以(yi)(yi)候(hou)上(shang)也,故凡(fan)頭(tou)而咽喉(hou)口齒頸項(xiang)肩(jian)背之(zhi)(zhi)(zhi)(zhi)(zhi)疾(ji)皆(jie)候(hou)于(yu)(yu)(yu)此(ci)。兩尺(chi)(chi)(chi)(chi)部(bu)(bu)所謂下(xia)(xia)(xia)以(yi)(yi)候(hou)下(xia)(xia)(xia)也,故凡(fan)腰腹陰道及腳膝之(zhi)(zhi)(zhi)(zhi)(zhi)病,皆(jie)候(hou)于(yu)(yu)(yu)此(ci)。……自王叔(shu)和云心與(yu)(yu)小(xiao)(xiao)腸(chang)(chang)(chang)(chang)合于(yu)(yu)(yu)左寸(cun),肺(fei)(fei)與(yu)(yu)大腸(chang)(chang)(chang)(chang)合于(yu)(yu)(yu)右(you)(you)(you)(you)(you)寸(cun),以(yi)(yi)致后人遂有(you)(you)左心小(xiao)(xiao)腸(chang)(chang)(chang)(chang),右(you)(you)(you)(you)(you)肺(fei)(fei)大腸(chang)(chang)(chang)(chang)之(zhi)(zhi)(zhi)(zhi)(zhi)說(shuo),其謬甚(shen)矣!夫(fu)小(xiao)(xiao)腸(chang)(chang)(chang)(chang)大腸(chang)(chang)(chang)(chang)皆(jie)下(xia)(xia)(xia)部(bu)(bu)之(zhi)(zhi)(zhi)(zhi)(zhi)腑,自當應于(yu)(yu)(yu)兩尺(chi)(chi)(chi)(chi),然(ran)脈之(zhi)(zhi)(zhi)(zhi)(zhi)兩尺(chi)(chi)(chi)(chi),左為水位,乃真陰之(zhi)(zhi)(zhi)(zhi)(zhi)舍也,右(you)(you)(you)(you)(you)為火位,乃元陽之(zhi)(zhi)(zhi)(zhi)(zhi)本(ben)也。小(xiao)(xiao)腸(chang)(chang)(chang)(chang)屬(shu)火,而火居火位,故當配(pei)(pei)(pei)于(yu)(yu)(yu)下(xia)(xia)(xia)之(zhi)(zhi)(zhi)(zhi)(zhi)右(you)(you)(you)(you)(you);大腸(chang)(chang)(chang)(chang)屬(shu)金,而金水相從,故當配(pei)(pei)(pei)于(yu)(yu)(yu)下(xia)(xia)(xia)之(zhi)(zhi)(zhi)(zhi)(zhi)左,此(ci)亦其當然(ran)也。”關于(yu)(yu)(yu)大小(xiao)(xiao)腸(chang)(chang)(chang)(chang)之(zhi)(zhi)(zhi)(zhi)(zhi)分屬(shu),《醫(yi)宗(zong)(zong)金鑒》、《脈訣啟悟》、《脈確》等均(jun)同此(ci)說(shuo)。《脈義簡摩》在引《脈經(jing)》文后說(shuo):“此(ci)臟(zang)腑分配(pei)(pei)(pei)不易之(zhi)(zhi)(zhi)(zhi)(zhi)定法也。三(san)(san)焦(jiao)既(ji)分配(pei)(pei)(pei)于(yu)(yu)(yu)兩手之(zhi)(zhi)(zhi)(zhi)(zhi)三(san)(san)部(bu)(bu)矣,復于(yu)(yu)(yu)右(you)(you)(you)(you)(you)尺(chi)(chi)(chi)(chi)名(ming)日三(san)(san)焦(jiao)者,蓋三(san)(san)焦(jiao)有(you)(you)腑、有(you)(you)經(jing)、候(hou)腑于(yu)(yu)(yu)三(san)(san)部(bu)(bu),候(hou)經(jing)于(yu)(yu)(yu)右(you)(you)(you)(you)(you)尺(chi)(chi)(chi)(chi)也。經(jing)候(hou)右(you)(you)(you)(you)(you)尺(chi)(chi)(chi)(chi)者,以(yi)(yi)某(mou)稟氣(qi)于(yu)(yu)(yu)命(ming)門(men),候(hou)于(yu)(yu)(yu)步(bu)陽之(zhi)(zhi)(zhi)(zhi)(zhi)經(jing)氣(qi),實候(hou)命(ming)門(men)之(zhi)(zhi)(zhi)(zhi)(zhi)原氣(qi)也。”
關(guan)于(yu)(yu)(yu)(yu)寸(cun)口(kou)脈(mo)(mo)臟(zang)(zang)(zang)腑(fu)(fu)(fu)(fu)分屬(shu),應以(yi)《脈(mo)(mo)經(jing)》為本(ben)。根(gen)據(ju)脈(mo)(mo)診的發展,通(tong)過歷(li)代(dai)醫(yi)家(jia)之(zhi)實踐(jian)檢驗,取其與義為長者補充。各家(jia)見解,對(dui)于(yu)(yu)(yu)(yu)五臟(zang)(zang)(zang)所(suo)主,基本(ben)一一致。對(dui)于(yu)(yu)(yu)(yu)六腑(fu)(fu)(fu)(fu)所(suo)屬(shu),分歧于(yu)(yu)(yu)(yu)大小腸及焦(jiao)。據(ju)李時(shi)珍、張三錫所(suo)說(shuo),寸(cun)口(kou)脈(mo)(mo)是肺經(jing)脈(mo)(mo)動處,特藉以(yi)候五臟(zang)(zang)(zang)之(zhi)氣,非候五臟(zang)(zang)(zang)六腑(fu)(fu)(fu)(fu)之(zhi)位,故(gu)以(yi)臟(zang)(zang)(zang)腑(fu)(fu)(fu)(fu)表里關(guan)系分候為妥。心(xin)包絡(luo)當屬(shu)左(zuo)(zuo)寸(cun),因心(xin)包絡(luo)代(dai)君(jun)行令,包絡(luo)之(zhi)氣通(tong)于(yu)(yu)(yu)(yu)心(xin),其氣之(zhi)動靜,聽命于(yu)(yu)(yu)(yu)心(xin),故(gu)候于(yu)(yu)(yu)(yu)左(zuo)(zuo)寸(cun),與義為長。三焦(jiao)分屬(shu)左(zuo)(zuo)尺(chi)(chi),因手步陽三焦(jiao)之(zhi)經(jing)受氣于(yu)(yu)(yu)(yu)命門(men),其經(jing)氣通(tong)于(yu)(yu)(yu)(yu)腎。心(xin)包絡(luo)分屬(shu)左(zuo)(zuo)寸(cun),三焦(jiao)分屬(shu)右足(zu),二經(jing)相(xiang)表里,內寄相(xiang)火;厥陰(yin)之(zhi)火宜降,三焦(jiao)之(zhi)火宜升,以(yi)溫煦胃土。至于(yu)(yu)(yu)(yu)二腸究屬(shu)兩寸(cun)或為兩尺(chi)(chi)?大小腸兩腑(fu)(fu)(fu)(fu)皆為至陰(yin)之(zhi)類,腑(fu)(fu)(fu)(fu)氣宜通(tong)不宜實,經(jing)氣宜情不宦熱(re),故(gu)有候經(jing)于(yu)(yu)(yu)(yu)寸(cun),候腑(fu)(fu)(fu)(fu)于(yu)(yu)(yu)(yu)兩尺(chi)(chi)之(zhi)說(shuo)。誠如(ru)陳修園說(shuo):“俱為近理,當以(yi)病證相(xiang)參。”
脈(mo)分(fen)臟(zang)腑(fu),亦(yi)有(you)不分(fen)寸(cun)關尺,而(er)以(yi)浮中(zhong)沉(chen)三(san)候分(fen)臟(zang)腑(fu)。《難(nan)經(jing);四難(nan)》說(shuo):“……心(xin)肺俱浮,……腎(shen)肝俱沉(chen),……脾(pi)主中(zhong)州,其(qi)脈(mo)在中(zhong)……”《五難(nan)》載:“初持脈(mo)如三(san)菽(shu)(shu)(shu)之(zhi)重(zhong),與(yu)皮(pi)毛相得者(zhe)(zhe)(zhe)肺部也(ye)。如六菽(shu)(shu)(shu)之(zhi)重(zhong),與(yu)血脈(mo)相得者(zhe)(zhe)(zhe)心(xin)部也(ye)。如九菽(shu)(shu)(shu)之(zhi)重(zhong),與(yu)肌(ji)肉相得者(zhe)(zhe)(zhe)脾(pi)部也(ye)。如十二菽(shu)(shu)(shu)之(zhi)重(zhong),與(yu)筋平者(zhe)(zhe)(zhe)肝部也(ye)。按之(zhi)至骨舉指來疾者(zhe)(zhe)(zhe)腎(shen)部也(ye)。”后世醫(yi)家亦(yi)有(you)與(yu)《難(nan)經(jing)》相同的見解。如《脈(mo)經(jing)》、《千金(jin)方(fang)》、《四言舉要》、《瀕湖脈(mo)學》等均同此說(shuo)。
《醫學入門(men)》以(yi)浮(fu)(fu)沉(chen)(chen)(chen)(chen)(chen)候(hou)臟(zang)腑,與寸(cun)(cun)關(guan)尺(chi)三部(bu)(bu)分(fen)屬臟(zang)腑結合,每(mei)一部(bu)(bu)中(zhong)沉(chen)(chen)(chen)(chen)(chen)以(yi)候(hou)臟(zang),浮(fu)(fu)以(yi)候(hou)腑。《脈(mo)(mo)(mo)(mo)如》又(you)將寸(cun)(cun)口(kou)脈(mo)(mo)(mo)(mo)之(zhi)三部(bu)(bu),與浮(fu)(fu)中(zhong)沉(chen)(chen)(chen)(chen)(chen),上(shang)下(xia),內(nei)外(wai)四者(zhe)結合而(er)(er)分(fen)臟(zang)腑。并提(ti)出(chu)“脈(mo)(mo)(mo)(mo)無(wu)根有兩說(shuo),浮(fu)(fu)無(wu)根,尺(chi)無(wu)根”。“中(zhong)候(hou)胃(wei)氣,設六脈(mo)(mo)(mo)(mo)俱沉(chen)(chen)(chen)(chen)(chen),亦可斷其(qi)無(wu)中(zhong)氣耶(ye)?!不(bu)知中(zhong)固中(zhong)也(ye),而(er)(er)浮(fu)(fu)之(zhi)亦有中(zhong)(胃(wei)氣),況之(zhi)中(zhong)亦有中(zhong)(胃(wei)氣),不(bu)當(dang)泥其(qi)形而(er)(er)求(qiu)其(qi)神也(ye)”。《脈(mo)(mo)(mo)(mo)義簡(jian)摩》引王漢皋《醫存》說(shuo):“有不(bu)分(fen)寸(cun)(cun)關(guan)尺(chi),但分(fen)浮(fu)(fu)中(zhong)沉(chen)(chen)(chen)(chen)(chen),左診心肝腎,右診肺脾腎,“定各臟(zang)病(bing)者(zhe),此(ci)因病(bing)劇證危,而(er)(er)求(qiu)其(qi)本也(ye)。診老人(ren)虛人(ren),久(jiu)病(bing)產后,皆(jie)不(bu)可無(wu)此(ci)法(fa)。”這(zhe)是(shi)說(shuo)以(yi)寸(cun)(cun)關(guan)尺(chi)分(fen)候(hou)五(wu)臟(zang)為(wei)衡,而(er)(er)以(yi)浮(fu)(fu)中(zhong)沉(chen)(chen)(chen)(chen)(chen)分(fen)候(hou)五(wu)臟(zang)為(wei)權。然(ran)而(er)(er),周學海于《脈(mo)(mo)(mo)(mo)筒補義》又(you)說(shuo):“寸(cun)(cun)關(guan)尺(chi),候(hou)身之(zhi)上(shang)中(zhong)下(xia)者(zhe)也(ye),浮(fu)(fu)中(zhong)沉(chen)(chen)(chen)(chen)(chen)候(hou)經絡臟(zang)腑之(zhi)表里者(zhe)也(ye),此(ci)以(yi)脈(mo)(mo)(mo)(mo)之(zhi)縱(zong)橫(heng)之(zhi)部(bu)(bu)位,主身之(zhi)縱(zong)橫(heng)之(zhi)部(bu)(bu)位,理之(zhi)至(zhi)顯而(er)(er)不(bu)易者(zhe)。雖病(bing)之(zhi)由(you)上(shang)及下(xia)者(zhe),脈(mo)(mo)(mo)(mo)未(wei)嘗不(bu)由(you)浮(fu)(fu)而(er)(er)沉(chen)(chen)(chen)(chen)(chen)。病(bing)之(zhi)由(you)表而(er)(er)里者(zhe),脈(mo)(mo)(mo)(mo)未(wei)嘗不(bu)由(you)寸(cun)(cun)而(er)(er)尺(chi)。究其(qi)各有所主,則其(qi)中(zhong)有必然(ran),有或然(ran),不(bu)可過泥。”
根據上(shang)述,我們認為浮中沉分(fen)候臟腑(fu)(fu)(fu),應與兩手三部寸(cun)關尺分(fen)候臟腑(fu)(fu)(fu)相結合;寸(cun)關尺以候五臟六(liu)腑(fu)(fu)(fu)之(zhi)氣(qi)而定其病(bing)(bing)變之(zhi)臟腑(fu)(fu)(fu)。浮中沉以候病(bing)(bing)證之(zhi)在(zai)表在(zai)里(li)與病(bing)(bing)之(zhi)性質(zhi),及(ji)其人體正氣(qi)之(zhi)盛衰,二(er)者不可偏(pian)廢。
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