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In historical dramas, it is common for doctors to say, “Congratulations, madam, you are pregnant” after feeling the pulse. The “slippery pulse” that assists in diagnosing pregnancy is actually a pulse type in TCM. However, the slippery pulse is not unique to pregnant women; it can appear in both genders under normal conditions and various diseases. Today, we will explore the significance of the slippery pulse.
Standard of Slippery Pulse SensationAccording to the “Pulse Classic”:“The pulse comes and goes, flowing smoothly and turning, resembling a series of beads.”Throughout history, physicians have regarded the “flowing” description of slippery pulse in the “Pulse Classic” as authoritative.In various historical texts on pulse diagnosis, the discussion of slippery pulse aligns with the “flowing” description in the “Pulse Classic”.Li Shizhen from the Ming Dynasty stated in “Binhuh Pulse Studies”:“The slippery pulse comes and goes, flowing smoothly and turning, resembling beads, and is slippery as if wanting to escape.”Li Shizhen agreed with Wang Shuhe’s understanding of the slippery pulse’s flowing nature, opposing the view that slippery pulse contains a rapid pulse component, suggesting that the description of “resembling beads and slippery as if wanting to escape” is the initial concept of “beads rolling on a plate”.
In fact, the slippery pulse merely indicates smooth blood flow and does not signify a change in pulse frequency; if there is a rapid pulse component, it indicates a combination of slippery and rapid pulses.
TCM Understanding of Slippery Pulse MechanismWhen the pathogenic factors are strong and the righteous qi is not deficient, there is a struggle between the righteous and the pathogenic, leading to a surge of qi and blood, hence the pulse flows smoothly.Diagram of Slippery Pulse Pattern
Source: “Essence of Modern Pulse Studies by Xu Yueyuan (Volume 1)”
Modern Physiology and Pathology of Slippery PulseThe occurrence of slippery pulse is directly related to a sharp decrease in peripheral resistance, an increase in cardiac contractility, and an increase in vascular elastic recoil;when the heart contracts powerfully, blood flow velocity increases, and reduced peripheral resistance leads to unobstructed blood flow, while the elastic recoil of blood vessels (including microcirculation) creates a resonant state of blood flow.The forward movement of blood flow in the vessels is driven by the heart; only when there is low resistance and accelerated blood flow will the phenomena of forward and backward flow occur, which is also a result of vascular elastic recoil.The combined effects of various forces create the sensation of a slippery pulse, akin to beads rolling on a plate, dew on a lotus leaf, or the rhythm of a pendulum.
Physiological Slippery Pulse in Health:Occurs when vascular elasticity is good, cardiac output is normal, and peripheral resistance is low.
Pathological Slippery Pulse:Occurs with peripheral vasodilation, decreased arterial elastic modulus, smooth vascular endothelium, and reduced blood viscosity.
Pregnancy-related Slippery Pulse:Occurs with increased hormone (progesterone) levels, peripheral vasodilation, and normal or slightly increased cardiac output. The characteristics of pregnancy-related slippery pulse include floating and slippery left cun pulse, right chi pulse, right guan pulse, or right guan chi pulse, forming a three-point resonance state. It is difficult to distinguish pregnancy-related slippery pulse from that during menstruation or ovulation; the principle is that cardiac output increases, leading to a floating and slippery left cun pulse. Increased blood supply to the uterus and pelvis results in a floating and slippery right chi pulse. Enhanced liver detoxification or increased portal venous return leads to a floating and slippery right guan chi pulse.
Fu Congyuan observed that the slippery pulse appeared in blood donors or normal individuals after alcohol consumption, characterized by reduced cardiac output, similar to pathological slippery pulse. Experimental slippery pulse created by intravenous infusion of dextran solution or vasodilators—such as extracts from Sangjisheng—exhibited cardiovascular characteristics similar to physiological slippery pulse.
Additionally, Li Haoran’s observations revealed that 95.8% of patients exhibited slippery pulse when sweating during fever, and patients with bronchial bleeding, pulmonary tuberculosis, renal tuberculosis, and ulcer disease showed slippery pulse before bleeding. It was also found that patients with high fever who had slippery pulse within 2-3 days after defervescence would experience a recurrence of fever. In patients with bacillary dysentery, pulmonary tuberculosis, urinary tract infections, and chronic nephritis, even if clinically cured, the presence of slippery pulse indicates they are not truly healed.
Characteristics of Slippery PulseNature of Slippery Pulse:Specifically refers to the single factor of smooth pulse qi.Slippery Pulse Sensation:Should feel smooth, resembling beads rolling on a plate, dew on a lotus leaf, or the rhythm of a pendulum.
Combined Slippery Pulse:As a factor of slippery pulse, it can combine with many pulse types. Common combinations include: floating slippery pulse, deep slippery pulse, scattered slippery pulse, fine slippery pulse, slippery rapid pulse, solid slippery pulse, wiry slippery pulse, slow slippery pulse, weak slippery pulse, empty slippery pulse, long slippery pulse, short slippery pulse, wind slippery pulse, flooding slippery pulse, and moist slippery pulse. Slippery pulse and rough pulse should not combine, as they have different pulse qualities. Slippery pulse and arterial pulse should not combine, as arterial pulse has the quality of slippery pulse.
Modern Clinical Significance of Slippery PulseSlippery pulse is commonly seen in various causes of anemia, liver diseases (such as cirrhosis, liver cancer, severe hepatitis), rheumatic diseases, active systemic lupus erythematosus, leukemia, malignant tumors, pregnancy-induced hypertension, acute infectious diseases, food poisoning, acute gastroenteritis, and the edema phase of acute and chronic nephritis, as well as in various febrile patients or before sweating in febrile patients, in shock patients during microvascular dilation, during ovulation or pregnancy, after women’s midday rest, and before and after ejaculation in men.Clinical practice has proven that slippery pulse has site-specific characteristics.
Modern Clinical Significance of Slippery Pulse by LocationSlippery Cun Pulse:Seen in infectious diseases of the heart, brain, lungs, trachea, and bronchi, during the febrile phase of allergic diseases and recovery phase, also seen before and after cerebral hemorrhage, hyperthyroidism, thyroid enlargement, and cervical lymphadenopathy.Slippery Guan Pulse:Seen in early and recovery phases of inflammation in the liver, gallbladder, pancreas, stomach, kidneys, and duodenum, also seen in vomiting, tumors, spleen hyperfunction, cervical lymphadenopathy, pregnancy, ovulation, and after midday rest.Slippery Chi Pulse:Seen in inflammation, bleeding, and lymphadenopathy in the intestines, urinary system, reproductive system, and lower limbs.Left Cun Slippery Pulse:Seen in left cerebral hemorrhage, left tinnitus, left sinusitis, myocarditis, endocarditis, pericarditis, left bronchitis, left pleuritis, during menstruation, pregnancy, ovulation, and after midday rest.Right Cun Slippery Pulse:Seen in right cerebral hemorrhage, right tinnitus, right sinusitis, right bronchitis, right pleuritis, pharyngitis, etc.Left Guan Slippery Pulse:Seen in inflammation of the spleen, stomach, gallbladder, pancreas, left kidney, left adrenal gland, tumors, and systemic metastasis, as well as prolonged low fever.Right Guan Slippery Pulse:Seen in inflammation of the liver, gallbladder, bile ducts, pancreas, duodenum, right kidney, right adrenal gland, tumors, and stones.Left Chi Slippery Pulse:Seen in sigmoid colon inflammation, left ureteral stones, left adnexal masses, and inflammation, stones, bleeding, and pain in the urinary, reproductive systems, and left lower limb.Right Chi Slippery Pulse:Seen in right ureteral stones, right adnexal inflammation, masses, and urinary reproductive system, left lower limb diseases, and pregnancy.Left Chi and Right Guan Chi Slippery Pulse:Seen in women during menstruation, ovulation, and after midday rest, also seen in early to mid-pregnancy. Pregnancy in women cannot be concluded solely from left cun and right guan chi pulses; left cun and right guan chi pulses must exclude pregnancy and other conditions.Modern Clinical Significance of Combined Slippery PulseFine Slippery Pulse:Seen in neurasthenia, epilepsy, brain infections, brain trauma, and poisoning, as well as poor gastrointestinal function.Scattered Slippery Pulse:Seen in the pulse of the affected side in stroke patients.Slippery and Slow Pulse:If the defensive qi is full, it is a healthy pulse; if pathological, it is often seen with internal heat.Weak Slippery Pulse:Often seen in infectious diseases of the urinary and reproductive systems.Wind Slippery Pulse:Seen in hemorrhagic strokes.
Moist Slippery Pulse:Seen in ear-related deafness, labyrinthitis, and motion sickness.
Important Books on Pulse Diagnosis
The author of this article, Professor Xu Yueyuan, is a renowned clinical expert who integrates Chinese and Western medicine, trained in Western medicine and from a family of TCM practitioners. He has spent 40 years researching meridians and proposed the diagnostic thought of “feeling the pulse of the person.” He believes that “pulse qi” reflects the constitution of the body, while “pulse shape” embodies the connotations of diseases.
“Essence of Modern Pulse Studies by Xu Yueyuan (Volume 1) – The Practice and Exploration of Traditional Pulse Diagnosis in Modern Medical Diagnosis”
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This book explores the main ideas of “pulse shape” and “pulse qi,” revealing the secrets of pulse diagnosis in understanding diseases; it identifies pulse types such as edge pulse, wind pulse, turbid pulse, and tide pulse, standardizing the naming of combined pulses and creating precise pulse diagrams. By studying this book, one can master the author’s pulse diagnosis thinking and clinical practical techniques, achieving a comprehensive understanding of diseases and symptoms.Previous HighlightsRECOMMEND
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This article’s content is partially selected from “Essence of Modern Pulse Studies by Xu Yueyuan (Volume 1) – The Practice and Exploration of Traditional Pulse Diagnosis in Modern Medical Diagnosis” (published by China Traditional Chinese Medicine Press, authored by Xu Yueyuan), with all rights reserved by the original author, recommended for publication byReading Traditional Chinese Medicine(WeChat ID: ydzhongyi). The cover and images in the text are sourced from Shetu Network, with copyright belonging to the original authors. If there is any infringement, please contact for deletion. Unauthorized reproduction is prohibited!
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