Interpretation of Slippery Pulse in ‘Binhuh Pulse Studies’
Introduction: The slippery pulse (hua mai) is one of the most common pulse types associated with liver, gallbladder, spleen, and stomach diseases. The string-like pulse (xian mai) primarily indicates spleen disorders and is often seen in conditions such as phlegm-dampness, food accumulation, and excess heat. The characteristic of the slippery pulse is that it can be felt during pulse diagnosis as a smooth and flowing pulse, described by ancient practitioners as “like beads rolling on a plate.” The slippery pulse is more commonly known in folk medicine as being related to the joyous pulse (xi mai). The slippery pulse is simply a smooth pulse, while the joyous pulse may exhibit a slippery quality at a certain stage but is stronger than a typical slippery pulse. The pulse of a pregnant woman is referred to as the joyous pulse, but the slippery pulse does not immediately manifest after conception; it generally appears in the later stages of pregnancy, around four to five months, when the pulse becomes slippery and stronger, reflecting the activation of yang energy in the pregnant woman. Some pregnant women may find their slippery pulse gradually disappears after five months, but the pulse remains strong. Today, let us examine how the slippery pulse is defined in ‘Binhuh Pulse Studies.’
“The slippery pulse flows smoothly, rolling like beads in response to the fingers” (from ‘Pulse Classic’), flowing as if wanting to escape.
“The slippery pulse indicates an excess of yin energy, hence the pulse flows smoothly like water. The pulse is the vessel of blood; when blood is abundant, the pulse is slippery, thus the kidney pulse is suitable; when qi is abundant, the pulse is rough, thus the lung pulse is suitable.”
In fact, there is no need to remember too much; just experience this pulse as if a bead is sliding and rolling under your fingers. The slippery pulse is characterized by an excess of yin energy, making it particularly smooth, as blood is considered yin energy.
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[Poem on Physical Characteristics]
“The slippery pulse rolls like beads, flowing smoothly yet returning forward.”
“Do not confuse the slippery pulse with the rapid pulse; the rapid pulse should be observed in terms of its frequency.”
The slippery pulse rolls under your fingers, particularly smooth and not stagnant, giving a sense of rolling. “Flowing smoothly yet returning forward” describes this rolling sensation. At the same time, the rapid pulse is also very smooth, hence the saying, “Do not confuse the slippery pulse with the rapid pulse; the rapid pulse should be observed in terms of its frequency,” but the rapid pulse does not have the rolling sensation of the slippery pulse, which is unique to it.
According to pulse rate, a pulse rate below 60 beats per minute is called a slow pulse, 60-85 beats is a normal pulse, and above 85 beats is a rapid pulse. This is based on a clock, and beginners can use this method. The ancients did not have clocks; they relied on the physician’s breathing, with one breath in and out counted as one pulse, provided the physician was healthy and had a calm, even breath, which could replace a clock. Of course, this is not necessary now; we use a clock. The pulse is merely a sensation under the fingers, which requires personal experience.
2. [Poem on Main Diseases]
“The slippery pulse indicates a decline in yang energy, phlegm causes numerous diseases, and food accumulation leads to disasters.”
“Above indicates vomiting, below accumulates blood; a woman’s pulse is regulated, indicating pregnancy.”
The slippery pulse indicates an excess of yin energy; generally, evil qi is considered yin, while righteous qi is yang. Evil qi obstructs the flow of qi and blood, causing the qi and blood to clash with the evil qi, creating a pathological slippery pulse. It is akin to water flowing over stones in a river, creating ripples as it collides with the stones.
The slippery pulse generally indicates excess conditions, belonging to yang; many diseases with evil qi present as slippery pulses, such as excess heat, water retention, blood stasis, qi stagnation with phlegm, and food accumulation can all lead to a slippery pulse. Therefore, do not think of the slippery pulse as a singular phenomenon; it is discussed in many places in ‘Shanghan Lun’, and one can refer to it when time permits. Thus, it is too simplistic to think that a slippery pulse is solely indicative of phlegm.
“The slippery pulse indicates a decline in yang energy, phlegm causes numerous diseases, and food accumulation leads to disasters,” thus the slippery pulse indicates phlegm and also food accumulation, which means overeating.
“Above indicates vomiting, below accumulates blood,” the upper slippery pulse generally refers to phlegm turbidity, food stagnation, and obstruction of qi, leading to phenomena such as vomiting. The lower slippery pulse indicates blood accumulation in the lower jiao, generally referring to blood stasis. There is also a physiological accumulation of blood, which occurs during pregnancy, as blood accumulates after conception.
“A woman’s pulse is regulated, indicating pregnancy,” thus a healthy woman suddenly has no menstruation, and the pulse is slippery, which may indicate pregnancy. How do we detect this joyous pulse? It is often depicted in dramas, but it is not mysterious. Today, I will teach you: a healthy woman, who is not ill, suddenly has no menstruation, and the pulse is slippery; you may suspect she is pregnant. Why? Because after pregnancy, blood accumulates to nourish the fetus, similar to blood accumulation, hence when blood is abundant, which is yin, the pulse becomes slippery. It is generally believed that when a woman’s menstruation is delayed, when can TCM detect her pregnancy? About forty days after the last menstruation, which is ten days late, is when it can typically be felt; this is general experience.
3. [Poem on Pulse Locations]
“The cun pulse is slippery, indicating phlegm causing vomiting, sour swallowing, or coughing.”
“The guan pulse indicates food stagnation, liver and spleen heat; thirst, dysentery, and turbid urination are observed at the chi pulse.”
The cun pulse, located above, indicates phlegm in the chest, where phlegm turbidity obstructs qi, leading to symptoms such as vomiting, coughing, and chest tightness. The primary manifestation of phlegm is nausea and vomiting, and phlegm can also be present in the upper jiao.
Phlegm obstructs the tongue base, leading to phenomena such as tongue stiffness and difficulty in speech. Nowadays, many people experience sour swallowing, and many are diagnosed with gastroesophageal reflux disease, which is the upward flow of sour fluid, quite uncomfortable. There are many reasons, such as liver heat, disharmony between liver and stomach, and liver yin deficiency; phlegm heat can also cause this. Generally, sour vomiting indicates heat, and it is very likely phlegm heat.
“The guan pulse indicates food stagnation, liver and spleen heat,” when a slippery pulse is felt at the guan position, it may indicate food stagnation, phlegm, or excess heat in the liver and spleen.
“Thirst, dysentery, and turbid urination are observed at the chi pulse,” when a slippery pulse is felt at the chi position, it generally indicates heat in the lower jiao, where excess heat damages fluids, leading to thirst, and may also cause dysentery, which is caused by damp-heat and excess evil qi. This includes conditions like damp-heat dysentery and turbid urination, which are issues related to the lower jiao, thus the chi pulse can provide insights.
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