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Chapter 28 of 28
濒湖脉学
Wang Zhengzong of Shaoxing held that pulse diagnosis should follow the great principle: "The heart and lungs are both floating (the heart and lungs belong to the yang position, chiefly examined at the superficial level), the liver and kidneys are both deep (the liver and kidneys belong to the yin position, chiefly examined at the deep level), the spleen resides in the central region (the spleen occupies the middle burner, being half-floating and half-sinking)." He considered Wang Shuhe's method of merely designating the cun, guan, and chi positions to correspond to the zang-fu organs for diagnosing the pulse conditions of the five viscera and six bowels to be incorrect.
Zhao Jizong of Cixi stated: The distribution recorded in the Pulse Formula — "the left cun examines the heart and small intestine, the left guan examines the liver and gallbladder, the left chi examines the kidney; the right cun examines the lung and large intestine, the right guan examines the spleen and stomach, the right chi examines the mingmen (life gate)" — is erroneous. He maintained: "The heart and lungs reside in the upper burner, pertaining to yang, so they should chiefly be examined at the superficial level; the liver and kidneys reside in the lower burner, pertaining to yin, so they should chiefly be examined at the deep level; the spleen resides in the middle burner, being half-yin and half-yang, hence half-floating and half-sinking. One should take the left cun as the heart, the right cun as the lung, the left chi as the liver, the right chi as the kidney, and both guan positions as the spleen." He said that the guan is the boundary between yin and yang: before the guan, take three-tenths of yang; after the guan, take three-tenths of yin. This is what is meant by "the earth resides in the center of metal, wood, water, and fire" (the spleen-earth is situated at the center of the four elements), flourishing in all four seasons — it is not only the right guan that examines the spleen. He further questioned: since the liver belongs to yin, how could it be appropriate to examine it at the left guan, which is half-yin and half-yang, half-floating and half-sinking? As for the idea that the mingmen is simply the kidney, it should be examined at the right chi — for details, see the Essentials of Confucian Physicians.
Wu Caolu said: It is incorrect for physicians to casually designate positions on the cun and chi as "this is the heart pulse, this is the lung pulse, this is the liver pulse, this is the spleen pulse, this is the kidney pulse." The five viscera and six bowels together have twelve channels, yet the cun, guan, and chi of both hands are essentially but one single channel — the hand taiyin lung channel. Differentiating various positions is but a means to observe the qi of the other zang-fu organs through this channel. The movement of the pulse begins in the lung, ends in the liver, and then returns to converge in the lung. The lung is the gateway through which qi enters and exits, hence it is called the "qi opening" (qikou), being the great confluence of the pulse, through which one may observe the condition of the entire body. (For details, see his collected works.)
Li Shizhen stated: The six positions of both hands (cun-guan-chi on both left and right) are all areas traversed by the lung channel, merely taken as sites for observing the qi of the five viscera and six bowels — they are not the actual dwelling places of the five viscera and six bowels. In all examinations, each of the lung, heart, spleen, liver, and kidney is observed for one beat. If during fifty beats no interruption occurs, it indicates that the qi of the five viscera is all sufficient; should there be one pause among them, one may know that the pulse of a particular viscus has not arrived. Inferring from this, using the single lung channel to observe the qi of the five viscera and six bowels can be grasped intuitively. Master Chu, Master Chu (another), and Master Zhao failed to understand that the pulse travels through the channel pathways (jing sui) along with the qi of the five viscera, and wished to invert the positional assignments of the zang-fu organs between male and female — such rigidity shows a failure to penetrate the matter. Dai Tongfu once stated: Master Chu inverted the positions of the five viscera, Zhu Danxi differentiated the cun and chi measurements between male and female, and Wu Caolu elucidated that all three positions belong to the lung channel — all three of these theories contain genuine insight, and students should take them as their teachers. As for Master Zhao's theory, it is roughly derived from Song-dynasty scholar Wang Zhengzong's Illustrated Explanation of the Classic of Difficult Issues. How could he know that the division of the pulse into two hands originates from the Plain Questions·Essential Subtleties of Pulse Discourse, and that Qin Yueren (Bian Que) further set forth in the Classic of Difficult Issues the guan pulse and the "one pulse, ten transformations" — these did not begin with Wang Shuhe? If Master Zhao's theory were followed, from what could the "one pulse, ten transformations" be inferred? This may truly be called forced interpretation and arbitrary speculation. As for the claim that "the mingmen is simply the kidney," this is in fact an error of Qin Yueren; I have authored two essays, Examination of the Mingmen and Difficult Questions on the Mingmen and the Triple Burner, totaling more than two thousand characters, to analyze and clarify this.
Collated and proofread by Zhu Minghua of Shangyuan (courtesy name Zaochen).
The central concern of this chapter is to clarify a fundamental question in pulse diagnosis: Is the relationship between the cun-guan-chi positions and the five viscera and six bowels one of "physical location correspondence" or "qi-transformation information mapping"?
This constitutes an important epistemological clarification in the theory of Chinese pulse diagnosis:
Early naive understanding: Directly equating the cun-guan-chi positions of both hands with the anatomical positions of the zang-fu organs — the left cun is the heart, the right cun is the lung, the left guan is the liver… This understanding is intuitive but cannot withstand clinical and theoretical scrutiny.
Zhao Jizong's corrective attempt: Seeking to reassign the positions using the principle of "upper is yang and floating, lower is yin and deep, center is half-yin and half-yang," moving the liver and kidney to the chi positions and assigning the spleen to both guan positions. This theory reflects the mindset of yin-yang ascent and descent, yet it still does not escape the framework of "position = zang-fu entity" — it represents "a different assignment," not a change in the mode of understanding.
Wu Caolu's and Li Shizhen's breakthrough: Clearly advancing a key proposition — the six positions of both hands are all one channel, the hand taiyin lung channel. The cun-guan-chi are not the "residences" of the five viscera and six bowels, but rather information-gathering points demarcated along a single channel. The lung is the "qi opening," where the qi of the twelve channels converges, thus through this one pulse, one can read the state of qi of the entire five viscera and six bowels.
The value of this understanding lies in elevating pulse diagnosis from the level of "anatomical localization" to the level of "holographic mapping." The pulse is not the zang-fu organs themselves, but the "signal" left by the qi of the zang-fu organs at the qi opening through the channel system. This laid the foundation for the later diagnostic principle that "the pulse observes qi, not physical form."
Li Shizhen also pointed out a methodological principle: using fifty beats as the baseline to determine the abundance or deficiency of the qi of the five viscera. Within fifty beats, if there is one pause, one infers that the pulse of one viscus has not arrived — this reflects the ancients' observation of the rhythmic correspondence between "pulse rate and visceral qi," constituting a diagnostic approach of "measuring abnormality against normality."
From the standpoint of modern science, the discussions in this chapter can be understood on several levels:
The rational core of the "qikou holographic" view: Modern medicine has confirmed that the pulse wave at the radial artery indeed carries rich information about the cardiovascular system, including cardiac pump function, vascular elasticity, peripheral resistance, blood volume, and more. Traditional Chinese medicine regards the cun-guan-chi as a "sampling window" for whole-body information — this approach resonates with the systems-theory notion that "the part reflects the whole." Of course, the "qi of the five viscera" as understood in Chinese medicine encompasses far more than cardiovascular indices, including empirical generalizations of digestive, urinary, and endocrine system functional states.
Historical limitations should be acknowledged honestly: Neither the traditional assignment of "left cun for heart, right cun for lung" nor Zhao Jizong's "reassignment between left and right" possesses direct evidence in the modern anatomical and physiological sense. The one-to-one correspondence of five viscera to specific positions on the left and right hands is more of an empirical model than a verifiable physical fact. Li Shizhen's negation of "position = zang-fu entity" is correct, but his assertion of the lung channel as the sole pathway is also not substantiated by modern anatomy — the structures at the radial pulse region are not limited to the hand taiyin lung channel alone.
The clinical wisdom of "fifty beats": The ancients' requirement that pulse examination count at least fifty beats (approximately one minute) retains practical significance to this day. Modern medicine also emphasizes that heart rate measurement should be sustained over a certain period to detect intermittent abnormalities (such as premature beats). The ancient claim that "if fifty beats pass without interruption, the five viscera are all sufficient" may be regarded as a simple early observation of pulse rhythm stability.
Although this chapter primarily concerns scholarly analysis, several non-therapeutic lifestyle insights may nonetheless be derived:
This content is based on classical Chinese medical texts and is provided solely for the study of traditional culture. It does not constitute any form of medical diagnosis, medication, or treatment advice; please consult a qualified physician promptly if you are unwell.