Slippery Pulse
1 Pulse Characteristics
The slippery pulse is smooth and flowing, like pearls rolling over each other.
2 Pulse Diagnosis
Left cun (寸) slippery pulse indicates excessive heat in the heart, with a strong pulse causing palpitations and a stiff tongue.
Left guan (关) slippery pulse indicates liver heat with eye pain, while left chi (尺) slippery pulse indicates painful urination with red discharge.
Right cun slippery pulse indicates phlegm and saliva causing nausea, with a dry throat and dizziness.
Sometimes there is sticky phlegm and cough, indicating lung heat needing treatment.
Right guan slippery pulse indicates spleen heat with bad breath, and vomiting when food is not digested.
Right chi slippery pulse indicates excessive fire from the mingmen (命门) causing sperm leakage, with dizziness and lower back pain; or damp-heat affecting the large intestine causing diarrhea, with yellowish-white discharge in women.
3 Brief Explanation
1. The slippery pulse indicates phlegm and heat. When the left cun pulse is slippery, it indicates phlegm-heat disturbing the heart, leading to insomnia and palpitations. If the pulse is slippery and strong, it indicates intense heat in the heart, with phlegm-heat obstructing the clear orifices, resulting in palpitations and a stiff tongue, and in severe cases, confusion and loss of awareness.
2. The left guan slippery pulse indicates heat in the liver and gallbladder, with symptoms such as headache, red eyes, tinnitus, bitter mouth, and yellow urine.
3. The left chi slippery pulse indicates heat in the bladder, commonly seen with short, painful, and yellow urination, with heat and pain in the urethra, and in severe cases, difficult urination.
4. The right cun slippery pulse often indicates phlegm-heat obstructing the lungs, leading to cough and chest tightness, with thick yellow phlegm, dry mouth, and dizziness.
5. The right guan slippery pulse indicates heat accumulation in the spleen and stomach, often due to undigested food, leading to sour regurgitation, nausea, vomiting, and bad breath.
6. The right chi slippery pulse indicates two conditions: one is excessive fire from the mingmen causing sperm leakage, with dizziness and lower back pain; the other is damp-heat affecting the large intestine causing diarrhea, with yellowish-white discharge in women.
4 Case Study
Wang, male, 35 years old, first diagnosed on August 14, 1963.
Current Symptoms: For the past year, he has frequently experienced sudden dizziness, light-headedness, and a feeling of heaviness in the head and lightness in the feet, sometimes accompanied by nausea and vomiting, with reluctance to open his eyes. Each episode can last from several hours to two or three days, and after the episode, there is still mild dizziness, accompanied by chest tightness and phlegm, and a bitter mouth.
Tongue and Pulse: The tongue is red with a yellow-white greasy coating. The left guan pulse is slippery and large, while the right guan pulse is floating and slippery.
Diagnosis Based on Pulse: The slippery pulse indicates phlegm, observed in both guan positions, indicating the disease is in the liver and spleen meridians. When the spleen’s function is weak, dampness accumulates and phlegm forms, with liver fire disturbing the clear orifices, leading to dizziness.
Treatment Method: Resolve phlegm and clear heat, drain liver fire.
Herbal Formula: Modified Wen Dan Tang (温胆汤).
Ingredients: 6g tangerine peel (橘皮), 5g banxia (半夏), 9g poria (茯苓), 2g licorice (甘草), 5g zhi shi (枳实), 12g job’s tears (生薏仁), 9g xia ku cao (夏枯草), 5g gardenia (栀子), 5g mulberry leaf (桑叶), 3g fried tribulus (炒白蒺藜), 5g vitex (蔓荆子), 2g tong cao (通草), and 3 slices of ginger (生姜), decocted in water.
This formula was taken for 10 doses, and the dizziness has resolved, with follow-up showing no recurrence for over a year.
5 Commentary
This is a medical case by Mr. Xiao Tongwu.
The causes and mechanisms of dizziness have been understood differently by various medical practitioners throughout history.
The Nei Jing states: “All dizziness belongs to the liver.” Zhu Danxi believes: “Dizziness is caused by phlegm combined with qi deficiency and fire; without phlegm, there is no dizziness, and phlegm is caused by fire.” Liu Hejian believes: “Dizziness is caused by wind and fire.” Zhang Jingyue believes: “Dizziness cannot occur without deficiency; most cases are due to deficiency, while fire and phlegm account for only a small portion; treatment should focus on deficiency.”
It is evident that dizziness has multiple causes, and in clinical diagnosis, as long as the pulse and symptoms are carefully analyzed, it is not difficult to identify the cause and provide appropriate treatment.
Generally speaking, if dizziness is due to deficiency, the pulse must be weak and thin or wiry and weak; if liver fire is combined with wind and yang rising, the pulse is often wiry and rapid; if phlegm-damp obstructs, the pulse will show slippery characteristics.In this case, the dizziness is due to phlegm stagnation transforming into fire, hence the pulse is seen as slippery and large, thus the treatment of resolving phlegm and clearing liver fire was effective.
This article is excerpted from: Pulse Diagnosis and Clinical Experience of Xiao Tongwu, edited by Xiao Hanxi and Xiang Qi.Compiled by Lan Zi for educational exchange purposes; please indicate the source when reprinting.
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