The Xuan pulse is classified as a Yin pulse. The “Pulse Classic” explains: “When lifted, it is absent; when pressed, it resembles a bowstring.” It also states: “Xuan is similar to Jin (tight).” Therefore, in practice, it is often difficult to distinguish between Xuan and Jin. The “Pulse Differentiation Method” provides a specific explanation: “When the pulse is floating and tight, it is called Xuan. The Xuan pulse resembles a bowstring and does not move when pressed. The tight pulse is like a twisted rope, unstable.” This indicates that the floating and tight pulse is the true Xuan pulse. Special emphasis is placed on distinguishing between Xuan and Jin: the Xuan pulse “resembles a bowstring and does not move when pressed,” while the tight pulse “is like a twisted rope, unstable.” This reminds readers to differentiate based on the pulse’s degree, momentum, and position. A weaker degree and momentum indicate Xuan, while a stronger degree indicates Jin. A pulse that is relatively fixed and particularly prominent is Xuan, while a tight pulse is like a taut rope, appearing in all three positions. The “Pulse Differentiation Method” states: “A pulse that is layered like a long pole is called Yin Jie (Yin knot).” This pulse is the Xuan pulse. Some commentators suggest this is a summer pulse, which is incorrect.
The “Pulse Classic, Volume 4: Pulse of Mixed Diseases” states: “Xuan indicates pain and obstruction; a single Xuan indicates fluid retention; double Xuan indicates tightness and pain under the ribs, with the person feeling chilly and uncomfortable.” Therefore, the Xuan pulse is a common clinical pulse with relatively complex associations. The differences in the degree of “excess” or “deficiency” of the Xuan pulse have significant implications for diagnosis.1. The Xuan pulse is associated with the liver, representing the pulse of spring, with variations in strength and life and death distinctions.Pulse Method:According to the “Pulse Differentiation Method”: “The lung is floating, and the liver is Xuan.”In the “Pulse Differentiation Method”: A question was asked: “What does the liver pulse look like in the east?” The teacher replied: “The liver is wood, named Jueyin. Its pulse is slightly Xuan, moist, weak, and long; this is the liver pulse. If the liver disease presents as moist and weak, it is recoverable. If it presents as purely Xuan, it indicates death. How do we know? Because the pulse is straight like a string, indicating liver injury, hence it is known as death.”In the “Differentiation of Incurable Pulse Patterns and Treatments”: “Xuan governs Yang movement.”Related Text:In the “Essential Prescriptions from the Golden Chamber: Pulse Patterns and Treatments for Vomiting, Belching, and Diarrhea”: “For diarrhea, if the pulse is Xuan and there is fever with sweating, it will self-resolve.”Interpretation:The Xuan pulse belongs to the Yin pulse, but “Xuan governs Yang movement,” representing the Yang within Yin. Therefore, there are many misunderstandings regarding the Xuan pulse in practice. In spring, all things begin to grow, and the Qi rises, so the pulse should show Xuan. The Xuan pulse represents the liver’s main symbol and is an external manifestation of the liver. The liver stores blood, governs Qi movement, and is responsible for smooth flow. The positioning of the Xuan pulse should first be determined by its degree and momentum, distinguishing between the common pulse of ecological balance and the pathological pulse of excess or deficiency. The “Pulse Differentiation Method” states: “The liver is wood, named Jueyin. Its pulse is slightly Xuan, moist, weak, and long; this is the liver pulse.” This “slightly Xuan, moist, weak, and long” should represent the normal Xuan, indicating vitality. Conversely, excess or deficiency indicates a pathological pulse. For example, Wang Shuhe stated that “a long and Xuan pulse indicates liver disease,” which is based on the differences in the degree of Xuan, the positioning of the three positions, and the differentiation of disease mechanisms, locations, and severity.This statement, “If the liver disease presents as moist and weak, it is recoverable. If it presents as purely Xuan, it indicates death,” contrasts the “moist and weak” Xuan with the “pulse layered like a long pole” of pure Xuan, reminding readers to differentiate the main associations of the Xuan pulse based on its degree and momentum, flexibly grasping its application. Therefore, Wang Shuhe further explained in the “Pulse Classic”: “The liver pulse comes moist and weak, like the tip of a lifted pole, indicating balance. Spring is based on stomach Qi. The liver pulse comes full and slippery, like a long pole, indicating liver disease. The liver pulse comes urgent and strong, like a newly drawn bowstring, indicating liver death. The true liver pulse arrives, urgent inside and outside, like a knife’s edge, sharp and distinct, like pressing the strings of a zither. The color is blue-white and lacks luster; if the hair breaks, it indicates death. In spring, a slightly Xuan stomach pulse indicates balance; if Xuan is more than the stomach, it indicates liver disease; but if Xuan lacks the stomach, it indicates death. If there is a stomach and hair, it indicates autumn disease; if the hair is excessive, it indicates current disease.” This not only distinguishes five conditions of the Xuan pulse’s degree and momentum: “In spring, a slightly Xuan stomach pulse indicates balance; if Xuan is more than the stomach, it indicates liver disease; but if Xuan lacks the stomach, it indicates death; if there is a stomach and hair, it indicates autumn disease; if the hair is excessive, it indicates current disease,” but also defines the ecological pulse of balance: “Spring is based on stomach Qi,” warning that “a slightly Xuan stomach pulse indicates balance.” Thus, it is understood that the Xuan pulse does not solely govern one organ or disease, but is based on stomach Qi, and the pulse should show “the pulse comes moist and weak, like the tip of a lifted pole,” indicating “slightly Xuan, moist, weak, and long.” Therefore, in the “Essential Prescriptions from the Golden Chamber: Pulse Patterns and Treatments for Vomiting, Belching, and Diarrhea”: “For diarrhea, if the pulse is Xuan and there is fever with sweating, it will self-resolve.” Here, the “Xuan pulse” should belong to the recovery of stomach Qi; diarrhea harms Yin and consumes Qi, so the pulse should be weak. Now, if it is Xuan and there is fever with sweating, it indicates that the Ying and Wei are harmonized, hence it self-resolves.In the process of pulse differentiation, only by correctly recognizing the Xuan pulse as the main symbol of the liver, corresponding to spring and aligning with disease patterns, can one finely discern the disease mechanism from the degree and momentum of the Xuan pulse. The “Pulse Classic” categorizes the Xuan pulse into five types: “In spring, a slightly Xuan stomach pulse indicates balance; if Xuan is more than the stomach, it indicates liver disease; but if Xuan lacks the stomach, it indicates death; if there is a stomach and hair, it indicates autumn disease; if the hair is excessive, it indicates current disease.” In summary, these are slightly Xuan, more Xuan, Xuan, slightly floating Xuan, and floating Xuan. Such classification indicates that the differences in the degree and momentum of the Xuan pulse determine the different disease mechanisms and main associations, and also dictate that the description of the Xuan pulse in clinical practice must be diverse to fit reality. The Xuan pulse can be classified based on the degrees of excess and deficiency, with the pulse state being constant and the pulse momentum being variable, containing different disease mechanisms within the constant and variable. Later scholars have further refined the classification of the Xuan pulse based on their experiences, possibly due to clinical needs, but this inevitably includes some irregular factors.The Xuan pulse is the most common pulse in clinical practice, with broad associations and many accompanying pulses. The Xuan and Jin pulses are similar and often seen together, making differentiation difficult. There is also the accumulation pulse, which should be distinguished from Xuan and Jin. The Xuan, Jin, and hard pulses all feel Xuan under the fingers, but Xuan is relatively weak, Jin is relatively strong, and hard is slightly short, with different main associations. The “Essential Prescriptions from the Golden Chamber: Pulse Patterns and Treatments for Wind-Cold Accumulation Diseases” states: “For all accumulations, if the pulse is fine and attached to the bone, it indicates accumulation.” This “fine pulse attached to the bone” feels like a sinking Xuan and solid hard knot, hence it can be described as a “hard pulse.” Yang transforms Qi, Yin forms shape; the necrosis or degeneration of organ tissues or the tangible growths like tumors often manifest as a sinking Xuan pulse corresponding to the pulse positions of Cun, Guan, and Chi, but the hard knot appears like a bean and does not disperse.2. The Xuan pulse indicates Shaoyang disease.Pulse Method:According to the “Treatise on Febrile Diseases”: “When both Cun and Guan pulses are Xuan, it indicates Shaoyang disease, which will manifest in three to four days. Its pulse circulates under the ribs and is associated with deafness. All three meridians are affected, but if it has not entered the organ, it can be treated with sweating.”Related Text:In section 142: “When Taiyang and Shaoyang are both affected, with strong pain in the head and neck, or dizziness, sometimes resembling chest tightness, and a feeling of fullness under the heart, one should needle Dazhui (the first interspace) and the back Shu points of the lung and liver, and be cautious not to induce sweating. If sweating is induced, it will lead to delirium; if the pulse is Xuan, and delirium persists for five days, one should needle Qimen (the gate of Qi).”Interpretation:The Xuan pulse is the main symbol of the liver. The “Pulse Differentiation Method” states: “The liver is wood, named Jueyin,” and the liver and gallbladder are paired organs, hence their meridians are Yin and Yang. The “Pulse Classic” explains: “After the winter solstice, on the first Jiazi (the first day of the Chinese calendar), Shaoyang rises at midnight, and the liver is the king. The liver is the eastern wood, where all things begin to grow, and its Qi is weak and expansive, hence the pulse is Xuan. Weakness cannot be treated with sweating, and expansion must not be violated. Spring is based on stomach Qi, which must not be disturbed.” The “Treatise on Febrile Diseases” states: “When both Cun and Guan pulses are Xuan, it indicates Shaoyang disease, which will manifest in three to four days. Its pulse circulates under the ribs and is associated with deafness. All three meridians are affected, but if it has not entered the organ, it can be treated with sweating.” Therefore, it is known that the Xuan pulse indicates Shaoyang disease. By analogy, the Xuan pulse in the liver is Yin, while in the gallbladder it is Yang, hence the Xuan pulse indicates the Shaoyang pivot is not functioning properly, representing the Yang within Yin. The pulse should be seen in all three positions, with the double positions being prominent.In section 142: “When Taiyang and Shaoyang are both affected, with strong pain in the head and neck,” the disease belongs to Taiyang, “or dizziness, sometimes resembling chest tightness, and a feeling of fullness under the heart” indicates the Jueyin liver pulse is either excessive or deficient, belonging to Shaoyang, suggesting that the pathogenic factor has penetrated from the exterior to the interior, having entered the organ, indicating a combined Taiyang and Shaoyang disease. Therefore, “one should needle Dazhui (the first interspace) and the back Shu points of the lung and liver, and be cautious not to induce sweating.” The basis is that “Shaoyang is affected, and it will manifest in three to four days… All three meridians are affected, but if it has not entered the organ, it can be treated with sweating.” If treated incorrectly, “inducing sweating will lead to delirium; if the pulse is Xuan, and delirium persists for five days, one should needle Qimen,” indicating that the pathogenic factor has moved from Yang to Yin, heat has entered the blood chamber, belonging to the liver invading the spleen, hence treatment should involve needling Qimen to drain the liver. Section 108 can assist: “In febrile disease, if there is abdominal fullness and delirium, and the pulse is floating and tight, this indicates the liver invading the spleen, known as Zong, and one should needle Qimen.” This “floating and tight pulse” is indeed the Xuan pulse. In pulse differentiation, the Xuan pulse is used to discern the transition from Taiyang disease to Shaoyang disease.Dazhui (the first interspace) can be needled to drain Taiyang heat. This is also seen in section 171: “When Taiyang and Shaoyang are combined, with fullness under the heart and a stiff neck, one should needle Dazhui, the back Shu points of the lung and liver, and be cautious not to induce purging.” The back Shu point of the lung is at the third vertebra, and the Mu point is at the middle of the chest. Needling it can drain Yangming heat. The back Shu point of the liver is at the ninth vertebra, and the Mu point is at Qimen. Needling it can drain Shaoyang heat. Needling Qimen is a method of interceptive treatment. As stated in section 8: “In Taiyang disease, if the headache resolves after seven days, it is due to the completion of the meridian. If one wishes to create a second meridian, needle the foot Yangming to prevent the meridian from transmitting, thus achieving recovery.” Section 216 clearly states: “In Yangming disease, if there is blood in the stool and delirium, this indicates heat entering the blood chamber, but if there is sweating, one should needle Qimen to drain it according to its nature. If sweating occurs, recovery will follow.” The “Essential Prescriptions from the Golden Chamber: Treatments for Women’s Miscellaneous Diseases” states: “If a woman with febrile disease has a fever, and menstruation arrives during the day, but at night there is delirium, as if seeing ghosts, this indicates heat entering the blood chamber. Treatment must not disturb stomach Qi and the upper two Jiao, and it will self-resolve.” This emphasizes needling Qimen to drain the liver, aiming to harmonize Qi movement, balance Yin and Yang, intercept transmission, and ensure that the pathogenic heat can be expelled from the pivot, allowing for a slight amount of blood to exit and the heat to dissipate.3. The Xuan pulse indicates rib pain.Pulse Method:According to the “Essential Prescriptions from the Golden Chamber: Pulse Patterns and Treatments for Abdominal Fullness, Cold Hernia, and Food Stagnation”: “If the pulse at the Cun position is Xuan, it indicates tightness and pain under the ribs, with the person feeling chilly and uncomfortable.” Related Text:In section 140: “In Taiyang disease, if purging is applied, and the pulse is rapid but does not indicate chest tightness, this indicates a desire for resolution. If the pulse is floating, it must indicate chest tightness. If the pulse is tight, it must indicate throat pain. If the pulse is Xuan, it must indicate tightness under both ribs. If the pulse is fine and rapid, it indicates that the headache has not yet resolved. If the pulse is sinking and tight, it indicates a desire to vomit. If the pulse is sinking and slippery, it indicates heat and benefit. If the pulse is floating and slippery, it indicates blood loss.”Interpretation:The essence of section 140 is to inform readers how to differentiate the various changes that may occur after mistakenly applying purging methods instead of sweating in Taiyang disease. Here, the Xuan pulse indicates “tightness under both ribs,” which is consistent with the meaning of “if the pulse at the Cun position is Xuan” in the “Essential Prescriptions from the Golden Chamber: Pulse Patterns and Treatments for Abdominal Fullness, Cold Hernia, and Food Stagnation,” indicating “tightness and pain under the ribs.” The reason for this is that the Xuan pulse is the main symbol of Shaoyang, and since the Shaoyang meridian circulates under the ribs, the Xuan pulse indicates rib pain, which should be differentiated at the Guan position.
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