Today, we will learn about Xian Mai (Xian Pulse) and Jin Mai (Jin Pulse).
Characteristics of Pulse Patterns
Xian Mai: Straight and long, like pressing a guitar string
Jin Mai: The pulse feels tense and strong, resembling a taut rope
This may sound abstract, but in concrete terms, the Xian Mai has a longer shape and a harder pulse channel, giving a strong pulse sensation when palpated. When taking the pulse, it feels as if the three positions (cun, guan, chi) have a straight rise and fall, with a stable beat.
Thus, the ancients described it as “straight through the middle, firmly pointing down, like pressing a guitar string.” The Xian Mai is characterized by its length, strength, and hardness.
The characteristic of Jin Mai is a tense and powerful pulse, with a firm beat that resists pressure, and a sensation of rotation and lateral movement. This means that when palpating, the pulse channel feels hard, with a bouncing sensation, and is very tight, indicating an unstable pulse position.
As stated in the “Zhen Jia Zheng Yan”: “The pulse is strong, bouncing left and right, like twisting a rope, like pressing a tight string.” Imagine if two people pull a rope very tightly; that is the sensation of Jin Mai.
Comparing Xian Mai and Jin Mai: Both exhibit strong and tense pulse characteristics.
However, Xian Mai feels like pressing on a guitar string, thus it does not have the tense, unstable quality.
In contrast, Jin Mai feels tense, like pressing on a taut rope.
Therefore, comparatively, Jin Mai is stronger and more urgent than Xian Mai.
Clinical Significance
Xian Mai: Generally, it is believed to be closely related to liver and gallbladder diseases, pain syndromes, and phlegm retention. It can also be seen in severe cases, such as in individuals with stomach qi deficiency. Additionally, it may appear in healthy individuals and can occur in spring.
Jin Mai: Often seen in cases of excess cold syndrome, pain syndromes, and food stagnation.
As we know, the liver governs the smooth flow of qi and is valued for its gentleness.
If various reasons lead to the liver’s failure to regulate, causing qi stagnation, it can result in tightness in the meridians and a tense pulse. At this time, pressing down feels like pressing on a guitar string, which is a basic mechanism of Xian Mai related to liver and gallbladder diseases.
When pain occurs or phlegm retention is present, it can also obstruct the flow of qi, leading to a tense pulse, which can manifest as Xian Mai.
We previously mentioned that Hua Mai (Slippery Pulse) also indicates phlegm dampness; here we mention that Xian Mai can be seen in cases of phlegm retention. Is there a specific difference?
Generally, when the body is prone to phlegm dampness, Hua Mai is more common. In contrast, when phlegm obstruction occurs, Xian Mai is more frequently observed. Xian Mai and Hua Mai can also coexist, forming Xian Hua Mai.
If the pulse is thin and strong, like the feeling of running a knife’s edge, we say this pulse indicates a severe condition, often seen in cases of stomach qi deficiency.
Why do normal individuals exhibit a slightly Xian Mai pulse in spring?
Because in early spring, yang qi begins to rise, but the weather is still relatively cold, so the pulse qi is slightly tense, and the pulse pattern appears as Xian, yet remains gentle. Thus, we say Xian Mai is suitable for spring.
Why do elderly individuals also tend to exhibit Xian Mai?
Elderly individuals often have insufficient yin and blood, and after the pulse channel loses its nourishment, its elasticity decreases, losing its gentle quality, thus Xian Mai can be observed. In Western medicine, this corresponds to the decreased elasticity of blood vessels in the elderly. Young people can also exhibit Xian Mai, but their Xian Mai is gentle and does not present the pathological sensation of Xian Mai.
Additionally, liver and gallbladder diseases can have both deficiency and excess patterns, and can also coexist with other organ diseases. Therefore, when there are changes in the liver and gallbladder, Xian Mai can appear alongside various pulse patterns, such as Xian Wei Mai (Thin Xian Pulse), Xian Shuo Mai (Rapid Xian Pulse), etc.
In clinical practice, many patients with hypertension often exhibit a hyperactive liver fire or excess liver yang type, and their pulse often presents as Xian and strong, or Xian and rapid, etc. The pulse feels very strong and powerful. Thus, by palpating the patient’s pulse, especially in cases of strong and powerful Xian Mai, we can understand that their blood pressure is likely elevated.
Next, we discuss Jin Mai, which can indicate excess cold syndrome, pain syndromes, and food stagnation.
First, why can Jin Mai appear in cases of excess cold syndrome?
Because when cold pathogens invade the body, the righteous qi is not weakened, and the struggle between righteous and evil qi is intense, causing the pulse vessels to constrict and tighten, resulting in a tense and strong pulse sensation, like pressing on a taut rope.
In cases of excess cold syndrome: the pulse appears as floating and tight. Floating indicates the exterior, while tight indicates cold.
In cases of interior excess cold syndrome: the pulse appears as deep and tight.
Why do pain syndromes and food stagnation also exhibit Jin Mai?
This is also due to the evil qi (mainly cold evil) or accumulation and stagnation within, which conflicts with the righteous qi, causing the pulse to lose its gentle quality and present as tense and strong.
Modern Mechanisms
The formation of Xian Mai mainly involves total peripheral resistance, cardiac output, and arterial compliance.
Pathological Xian Mai is primarily due to increased total peripheral resistance, decreased arterial compliance, often accompanied by reduced cardiac output.
Physiological Xian Mai, especially in adolescents, has sufficient cardiac output, while total peripheral resistance and arterial compliance remain normal, indicating vigorous function.
Elderly individuals experience a decline in cardiovascular system function; thus, their Xian Mai may appear under normal physiological conditions, but its formation mechanism resembles that of pathological Xian Mai.
Additionally, the neuroendocrine system’s regulation of the cardiovascular system can also affect the formation of Xian Mai. Hypertension, chronic hepatitis, and other diseases are also commonly associated with Xian Mai; stimuli such as pain, cold, anger, and tension can excite the sympathetic nervous system, increasing the secretion of vasoconstrictive neuropeptides or endocrine hormones, which can also lead to a Xian Mai pulse.
In summary
Both Xian Mai and Jin Mai exhibit tense pulse qi, but Xian Mai feels like pressing on a guitar string, without the tense urgency. In terms of disease indication, both primarily indicate pain syndromes, but Xian Mai is also seen in liver and gallbladder diseases and phlegm retention; Jin Mai is seen in cold syndromes and food stagnation.
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