Analysis of Floating Pulse and Related Pulse Types
According to the “Pulse Classic”: “A floating and large pulse indicates a heavy head and nasal congestion due to wind. A floating and slow pulse suggests numbness of the skin, with wind and cold entering the muscles. A floating and slippery pulse indicates food retention. A short floating pulse suggests lung injury, with minimal qi, leading to death within a year; it should be treated with coughing. A floating and surging pulse indicates damage from cold. A floating, slippery, and rapid pulse suggests undigested food and spleen dysfunction. A floating and fine slippery pulse indicates injury from drinking. A floating, surging, and long pulse suggests wind dizziness and epilepsy. A floating, slippery, rapid, and tight pulse indicates a long-standing illness that is difficult to cure.”
From the “Thousand Gold Prescriptions”: “A floating and slippery pulse at the cun position indicates headache. A floating and large pulse at the cun position, when pressed, becomes rough; the chi position is also thin and rough, indicating food stagnation. A scattered floating pulse at the guan position indicates accumulated heat in the chest, leading to vomiting and heart forgetfulness. A floating and large pulse at the chi position indicates excess yang in the lower jiao.” The “Cui’s Four-Character Essentials” states: “A floating pulse indicates wind-heat, a floating and slow pulse indicates wind-dampness, a floating and tight pulse indicates wind-cold, a floating and slow pulse indicates wind-dampness, a floating and weak pulse indicates heat injury, a floating and surging pulse indicates blood loss, a floating and fine pulse indicates exhaustion, a floating and slippery pulse indicates phlegm-heat, a floating and scattered pulse indicates severe deficiency.”
From the “Three Causes Prescriptions”: “A floating and large pulse indicates nasal congestion, a floating and slow pulse indicates numbness, a floating and long pulse indicates wind dizziness and urinary issues, a floating and slippery pulse indicates food retention, a floating and large and rough pulse indicates food stagnation, a floating and short pulse indicates lung injury and qi deficiency, a floating and slippery pulse indicates drinking or stabbing pain. A floating and fine and slippery pulse indicates injury from drinking, a floating and slippery and rapid pulse indicates lily disease, a floating and scattered pulse indicates constipation and urinary issues, a floating and tight pulse indicates urinary issues or cancer.”
From the “Surgical Essentials”: “A floating and large pulse indicates heart issues, a floating and short and rough pulse indicates lung issues, a floating and rapid pulse indicates heat. A floating and rapid pulse that does not indicate heat but instead shows aversion to cold indicates sores and pox.”
From the “Binh Lake Pulse Studies”: “A floating and slow pulse indicates exterior wind, a floating and rapid pulse indicates heat, a floating and tight pulse indicates cold. A floating pulse with strength indicates wind-heat, while a weak floating pulse indicates blood deficiency.”
From the “Diagnostic Essentials”: “A strong pulse indicates excess, while a weak pulse indicates deficiency. A floating and tight pulse indicates wind-cold, a floating and slow pulse indicates wind, a floating and rapid pulse indicates wind-heat, a floating and slow pulse indicates wind-dampness, a floating and weak pulse indicates heat injury, a floating and short pulse indicates qi deficiency, a floating and surging pulse indicates heat, a floating and fine pulse indicates blood deficiency, a floating and slippery pulse indicates phlegm-heat.”
From the “Medical Entry”: “A strong floating pulse indicates wind, while a weak floating pulse indicates deficiency. A floating and rapid pulse indicates mild wind-heat, a floating and slow pulse indicates body itchiness with no sweat, a floating and tight and slippery pulse indicates lily disease, a floating and large pulse indicates chronic rashes, and a floating and slippery pulse indicates phlegm and pain like a needle.”
From the “Essential Readings of Medical Schools”: “A strong pulse indicates wind, a weak pulse indicates blood deficiency, a floating and slow pulse indicates cold, a floating and rapid pulse indicates wind-heat, a floating and tight pulse indicates wind-cold, a floating and slow pulse indicates wind-dampness, a floating and weak pulse indicates heat injury, a floating and surging pulse indicates deficiency fire, a floating and fine pulse indicates exhaustion, a floating and slippery pulse indicates phlegm-heat.”
From the “Ancient and Modern Medical Systems”: “A floating pulse indicates evil, a floating and weak pulse indicates deficiency, a floating and strong pulse indicates excess, a floating pulse that is strong when pressed indicates excess, while a floating pulse that is weak indicates deficiency. A floating pulse that is large and hard indicates a serious condition, while a floating pulse that is weak indicates a lack of qi. A floating pulse that is large and weak indicates a serious condition, while a floating pulse that is weak indicates a lack of qi.”
From the “Jing Yue Complete Book”: “A floating and large pulse indicates wind injury, a floating and tight pulse indicates cold injury, a floating and slippery pulse indicates food retention, a floating and slow pulse indicates damp stagnation, a floating and weak pulse indicates blood loss, a floating and rapid pulse indicates wind-heat, and a floating and surging pulse indicates mania. A strong and spirited floating pulse indicates excess yang, which leads to fire, or phlegm in the middle, or qi stagnation above, which can be inferred. If the floating pulse is weak and empty, it indicates a lack of yin, leading to water deficiency, or blood not nourishing the heart, or essence not transforming into qi, indicating a deficiency in the middle. If this is considered an exterior condition, it is a great harm! If the floating pulse is large and hard, even four times larger, it is called a “closed pulse” in the Inner Canon. This is not a sign of spirit but a true sign of extreme yin deficiency and rootless yang, a very ominous sign.”
From the “Pulse Verification”: “A floating and surging pulse indicates wind-fire, a floating and rapid pulse indicates wind-fire, a floating and string-like pulse indicates wind-phlegm, a floating and slippery pulse indicates wind-phlegm and wind-heat, and a floating and long pulse indicates wind-heat and wind-rash.”
From the “Pulse Differentiation”: “A weak pulse indicates deficiency, a strong pulse indicates excess, a floating and tight pulse indicates wind-cold, a floating and slow pulse indicates wind-dampness, a floating and rapid pulse indicates wind-heat, a floating and slow pulse indicates wind deficiency, a floating and weak pulse indicates heat injury, a floating and surging pulse indicates deficiency fire, a floating and fine pulse indicates blood deficiency, a floating and slippery pulse indicates phlegm-heat, a floating and rapid pulse indicates no heat, indicating sores and ulcers.”
From the “Pulse Enlightenment”: “A floating and tight pulse indicates wind-cold, a floating and slow pulse indicates wind-dampness, a floating and rapid pulse indicates wind-heat, a floating and surging pulse indicates wind-fire, a floating and rough pulse indicates blood injury, a floating and weak pulse indicates blood loss, a floating and short pulse indicates qi deficiency, a floating and slippery pulse indicates phlegm-heat.”
From the “Three-Finger Zen”: “A floating and tight pulse indicates cold injury, a floating and weak pulse indicates heat injury, a floating and rapid pulse indicates wind injury, a floating and slow pulse indicates damp injury.”
From the “Pulse Studies Explained”: “A floating and slow pulse indicates exterior cold, a floating and surging pulse indicates exterior heat, a floating and slow pulse indicates wind-dampness, a floating and weak pulse indicates heat injury, a floating and slippery pulse indicates phlegm-heat, a floating and fine pulse indicates qi deficiency, a floating and rough pulse indicates blood deficiency, and a floating and scattered pulse indicates extreme deficiency.”
The floating and slippery pulse indicates a deficiency of yin, a deficiency of qi, or an injury from heat. The floating and slippery pulse is a type of floating pulse, easily felt with light pressure. However, the floating pulse is abundant when lifted but insufficient when pressed, like wood floating on water. The slippery pulse is extremely soft and fine, like silk floating on water. The combination of floating and slippery indicates a shallow pulse position, easily felt with light pressure, but weak in strength, indicating a lack of qi. Therefore, the “Binh Lake Pulse Studies” states that a floating and soft pulse indicates deficiency. The slippery pulse indicates blood loss and yin deficiency, with the marrow and essence already depleted. Depending on the different parts of the floating and slippery pulse, the main diseases vary. If seen at the cun pulse, it indicates yang deficiency; if seen at the guan pulse, it is often attacked by dampness; if seen at the chi pulse, it indicates yin deficiency and blood injury. Therefore, Li Shizhen said: “A floating and soft pulse at the cun indicates weak yang and excessive sweating… A floating and soft pulse at the chi indicates blood deficiency and severe cold.” Li Zhongzi also said: “A floating and soft pulse at the right guan indicates spleen deficiency and dampness, while a floating and soft pulse at the left chi indicates blood loss and damage, and at the right chi indicates fire deficiency and life-threatening conditions.” The “Pulse Studies Explained” states: “A floating and slippery pulse indicates heat injury.” This is due to the external invasion of summer heat and dampness, causing the body to resist the summer heat, leading to a floating pulse. The slippery pulse indicates a deficiency of qi and yin, and summer heat easily injures body fluids and depletes qi, so the floating and slippery pulse is a common pulse pattern seen in summer heat injuries.
Ge Gen Tang Syndrome
In the past, while teaching at a TCM school in Ximen, I had little time to treat patients, so I rarely made house calls. A young man from Guanghua Optical Company, named Yuan, had been bedridden for four to five days, unconscious. His brother wanted to take him home but asked me to diagnose him first. I went to see him as dusk approached. The patient lay silently on the bed upstairs, without any signs of cold or heat, but with pain in the neck and back, unable to turn or shift. I checked his pulse; the right three positions were tight and floating, while the left three positions showed no floating signs, becoming tight when pressed. Although I suspected a solar cold injury, the left pulse did not match. At that time, his brother went downstairs to fetch firewood and returned shortly. I asked: “Has your brother been indulging in wine and lust?” His brother replied: “No, he just spent a month in Shantou during spring, where he was quite extravagant, staying at a brothel and spending excessively.” I said: “This is indeed the case. Now, the left pulse not being floating indicates insufficient yin, unable to respond to the solar condition. However, his tongue coating must be dry and heartless.” Upon inspection, it was indeed so. I prescribed:
Ge Gen (2 qian) – Pueraria lobata, Gui Zhi (1 qian) – Cinnamon twig, Ma Huang (8 fen) – Ephedra, Bai Shao (2 qian) – White peony root, Zhi Gan Cao (1 qian) – Honey-fried licorice root, Hong Zao (5 pieces) – Red dates, Sheng Jiang (3 slices) – Fresh ginger.
I gently told his brother: “After taking the medicine, if there is a slight sweat, he will recover. If not, I cannot guarantee anything.”
Before leaving, I worried that his yin fluids were insufficient to reach the surface to induce sweating, so I instructed him to add a cup of glutinous rice to the medicine and then returned to my residence. The next morning, his brother came for a follow-up. I went to check, and all six pulses were harmonious. I asked the patient, who said: “I have not slept well for five days, but after taking the medicine, I had a slight sweat and fell asleep without realizing it. When I woke up, I felt very relaxed and did not know when the illness had left me.” I then advised him to rest for two to three days, and he later went to Hankou for business after seven days.
Note: The “Inquiry and True Words of the Golden Coffer” states: “Essence is the foundation of the body. Therefore, if it is stored in essence, one does not fall ill in spring.” The “Theory of Vital Energy” states: “In winter, if one is harmed by cold, they will surely fall ill in spring.” These phrases are known to practitioners of TCM. However, there are many discussions that contradict the essence of the classics. I, Zhuang, am not sensitive, and I would like to use this case of the young man named Yuan as an explanation of the “Inner Canon”. In short, the young man indulged in brothels and did not store his essence, leading to a warm disease. I treated him with Ge Gen Tang, which is the main formula for warm diseases. Essence is the fluid gathered in one place, while fluids are the essence dispersed throughout the body. Therefore, essence and fluids are originally one and the same. Since this person usually does not store essence, it means that the fluids are already damaged, and when he is invaded by external wind, he does not present as a solar wind or solar cold but rather as a solar warm disease, which is not suitable for Gui Zhi Tang or Ma Huang Tang, but rather for Ge Gen Tang. This is how the “Inner Canon” and “Cold Damage” can be interpreted together.
However, it is important to note that the storage of essence is not limited to winter, but it is especially important in winter. Therefore, the “Cold Damage Examples” states: “In winter, when it is severely cold, all things are deeply hidden. A gentleman remains cautious, so he is not harmed by cold. Those who are exposed are called cold damage.” The formation of warm diseases is not limited to spring; the case of the young man named Yuan moaning in mid-autumn shows this, but it is especially severe in spring. This is because spring follows winter closely, and if winter does not close and store, it disturbs the yang, then spring cannot flourish, and it cannot grow and thrive with all things in nature. The leakage of essence is not limited to sexual relations; anyone who is diligent and has many desires, who is anxious and fearful, who is overworked and fatigued, and who indulges in desires that harm the eyes and confuse the heart, all fall into the category of not storing essence, but especially those who directly deplete kidney essence. Therefore, we can conclude: “If essence is not stored in winter, one will surely fall ill in spring.” This is a significant principle that should be understood.
Nevertheless, as I write this, I cannot help but feel a sense of dread. What do I fear? I fear that people will use this case as a basis to extend the theory of warm diseases lurking in the Shaoyin, as the so-called Shaoyin refers to the kidney meridian. I say: Those who deplete kidney essence will have insufficient body fluids, and once they are invaded by external wind, they will be unable to expel the evil and may easily transform into heat. This is still an abstract statement, and it is somewhat close, but it is still saying: Those with weak intestines and stomachs are prone to Gui Zhi Tang syndrome, which is still a valid argument. If one insists on saying that warm diseases are evil qi lurking in the kidney, it is like saying that the evil qi of wind stroke must lurk in the intestines and stomach, which is not acceptable. Not only this, but children, who are innocent and pure, do not deplete kidney essence; why do they suffer from many warm diseases like rashes? This is because their pure yang body, during their growth, requires fluids urgently, and transforming heat is easy, which is not related to kidney issues. Why then is the warm disease said to lurk in the Shaoyin and manifest in other meridians? This is indeed an unsolvable issue.
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