Slippery Pulse
Authors: Li Shimao, Tian Shuxiao
(1) Pulse Characteristics
The slippery pulse is characterized by a smooth and flowing sensation, akin to pearls rolling, moving forward and then retreating. The “Pulse Classic” states: “Moving forward and retreating, flowing smoothly and turning, resembling the number of beats.”
(2) Similar Pulses
Both slippery and rapid pulses exhibit a smooth and flowing quality. However, the primary feature of the slippery pulse is its forward and retreating motion. Forward indicates progression, while retreating indicates regression. It moves forward and then retreats, like pearls rolling. The rapid pulse, on the other hand, is characterized by urgency in movement, without the rolling sensation.
(3) Pulse Theory and Associated Conditions
1. Normal Pulse
In healthy individuals, a slippery pulse indicates abundant qi and blood.
The kidney’s normal pulse is deep, soft, and slippery. The kidneys store essence, and the essence of the five organs and six bowels is gathered and stored in the kidneys. Qi and blood share the same source; thus, when the kidney’s essence and blood are abundant, the pulse is slippery. Additionally, the kidney pulse is deep, indicating storage; slippery represents yang, akin to fire submerged in water, hence a deep and soft slippery pulse is normal.
Pregnant women accumulate blood to nourish the fetus, resulting in a rich and slippery pulse.
2. Pathological Pulse
(1) Pathogenic Obstruction:
A slippery pulse indicates an excess of pathogenic factors. When pathogenic qi obstructs, qi and blood desire to flow but clash with the pathogens, resulting in a vigorous and slippery pulse. It is like water flowing over stones in a river, creating waves as it collides with the stones. Thus, the “Golden Cabinet” states: “Slippery indicates fullness.”
Pathogenic factors that can lead to a slippery pulse are broad, including excess heat, water retention, blood stasis, qi stagnation, phlegm retention, and food accumulation.
For instance, the “Treatise on Cold Damage” states: “If the pulse is slippery and there is a reversal, there is heat in the interior; Bai Hu Decoction is indicated.” In another instance, it states: “If the pulse is slippery and rapid, there is food stagnation.” This indicates food stagnation causes a slippery pulse. The “Golden Cabinet” states: “When the deep and slippery pulse clashes, there is blood stasis at the uterine orifice.” This indicates blood stasis causes a slippery pulse. The “Golden Cabinet” also states: “Slippery indicates qi.” This indicates qi stagnation leads to a slippery pulse. The “Treatise on Cold Damage” states: “If there is a small chest knot, located below the heart, pressing it causes pain, and the pulse is floating and slippery, Xiao Xian Xiong Decoction is indicated.” This indicates phlegm-heat causes a slippery pulse. All of the above are examples of pathogenic fullness leading to a slippery pulse.
One may ask, since it is a pathogenic obstruction, why is the pulse not deep, slow, thin, rough, or knotty but rather slippery? The reason is that when the obstruction is severe, the stagnation of qi is also significant, making it difficult for qi and blood to flow, hence the pulse may appear deep, slow, thin, rough, or knotty, or even closed and faint. However, if the obstruction is not severe, and qi and blood clash with the pathogens, causing waves to rise, the pulse can be slippery. This slippery pulse must be strong upon palpation.
(2) Deficiency with Slippery Pulse
In cases of deficiency, the pulse should not be slippery. Due to a deficiency of qi and blood, there is a lack of strength to create a slippery pulse.
Therefore, Zhang Luyu stated: “A slippery pulse does not exhibit weakness, nor does it indicate deficiency or cold.” However, when the righteous qi is significantly deficient, unable to consolidate internally and leaks externally; or when righteous qi is deficient and fire is internally blazing, the pulse can also be slippery. As stated in the “Essentials of Pulse Diagnosis”: “However, in cases of deficiency, there are instances of a slippery pulse, indicating the leakage of original qi.” The “True Pulse Theory” also states: “Sometimes due to qi deficiency, unable to control yin fire, the pulse may appear slippery and smooth.” This slippery pulse must be weak upon palpation.
Clinically, a slippery pulse due to deficiency is often seen in cases of spleen deficiency leading to phlegm, which is also slippery and weak, or slow and slippery without the ability to withstand firm pressure.
If the slippery pulse is firm and rebounds upon palpation, lacking a gentle quality, it indicates a decline of stomach qi, representing a significant deficiency. For example, the true heart pulse is “firm and rebounds, like rolling Job’s tears, in clusters.” This is the true organ pulse, indicating significant deficiency and should not be mistaken for a full pulse.
Conclusion
When discussing the slippery pulse, our first reaction is “smooth and flowing, like pearls rolling,” knowing that slippery primarily indicates phlegm retention, or recognizing that the pulse of pregnant women is slippery.
We must also learn to distinguish between the slippery pulse and the rapid pulse; the slippery pulse moves forward and backward, like a pearl rolling on a plate, while the rapid pulse is primarily characterized by urgency.
A normal slippery pulse is a manifestation of abundant qi and blood, or the soft and slippery kidney pulse, or the rich blood of pregnant women nourishing the fetus.
Pathologically, a slippery pulse may arise from mild pathogenic obstruction, where qi and blood clash with pathogens, presenting a vigorous and slippery pulse, such as from excess heat, water retention, blood stasis, qi stagnation, phlegm retention, and food accumulation; another situation is deficiency unable to consolidate, leading to the leakage of qi and blood, with a slippery and weak pulse, commonly seen in cases of spleen deficiency leading to phlegm.
If the pulse is slippery yet firm and rebounds upon palpation, lacking gentleness, this indicates a decline of stomach qi, representing significant deficiency.
Note: This article is excerpted from “Insights into Pulse Diagnosis,” compiled by Master Li Shimao, published by the Ancient Chinese Medicine Publishing House in 1994. This public account is solely for the dissemination of TCM culture and learning exchange. If there is any infringement, please contact us for removal.
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