Xian Pulse
Introduction: The Xian pulse (弦脉) is one of the most common pulse types associated with liver, gallbladder, spleen, and stomach diseases. The Xian pulse primarily indicates liver disorders, often related to liver and gallbladder diseases, pain syndromes, fluid retention, and conditions mixed with cold and heat pathogens. Regarding the main diseases associated with the Xian pulse, the great physician Zhang Zhongjing once stated: “The pulse is Xian and rapid, indicating cold fluid, difficult to treat in winter and summer.” Why is this so? This is because the Xian pulse is originally associated with heat fluid, but has now become cold fluid, which is a mismatch in pulse diagnosis. Furthermore, seasonally, the Xian pulse should be predominant in spring, yet it manifests in winter and summer, indicating a reverse pattern in pulse diagnosis, thus making treatment more challenging. However, the ancient notion of difficulty in treatment does not imply that it is untreatable today. Let us now examine how the Xian pulse is defined in the Binhuh Pulse Studies (《濒湖脉学》).
Xian Pulse
The Xian pulse is straight and long (《素问》), resembling a taut bowstring (《脉经》). When pressed, it does not move, and feels like the strings of a zither (巢氏), straight through the center, firm and pointing downwards (《刊误》).
The Xian pulse is straight and long, like a taut bowstring. If you have stringed instruments at home, such as a guitar or guqin, you can press on them to feel the sensation. The Xian pulse feels like a bowstring pulled tight; when pressed, it has a firm, unyielding sensation, hence it is described as resembling the strings of a zither. It feels straight through the center, firm and pointing downwards. If you press a bowstring, you will feel it has a certain elasticity while being taut, which is the sensation of the Xian pulse.
Xian Pulse
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[Body Condition Poem]
The Xian pulse is long and straight, indicating a strong liver (木) and potential injury to the spleen (土).
Anger fills the chest, often leading to shouting, and tears flow like rain from the eyes.
“The Xian pulse is long and straight,” indicates that the Xian pulse is characterized by its straightness and length, like the end of a long rod, having a certain elasticity when touched, with an up-and-down bouncing sensation.
“The strong liver (木) injures the spleen (土),” generally indicates that the Xian pulse is often associated with liver stagnation, hence the term strong liver injuring spleen. If the liver wood is too strong, it can injure the earth, leading to many patients with liver stagnation presenting with a Xian pulse.
“Anger fills the chest, often leading to shouting,” describes the stagnation of liver qi, obstruction of the meridians, fullness in the chest, and the feeling of anger rising in the chest. Modern people often have excessive heat and tend to shout.
“Tears flow like rain from the eyes,” as the liver opens to the eyes, those who often injure the liver with anger are prone to eye problems. Nowadays, many people have eye issues, especially when liver stagnation transforms into fire, causing inflammation in the eyes, leading to conditions like cataracts. Why do tears flow in the wind? This is due to wind and fire attacking. “Tears flow from the eyes” refers to cataracts obscuring the pupil, causing blindness.
Xian Pulse
Xian Pulse
2. [Similar Condition Poem]
The Xian pulse is straight like a silk string, tight like a rope, bouncing left and right.
Tightness indicates strength, while the Xian pulse indicates a long and floating sensation.
“The Xian pulse is straight like a silk string,” in the past, guqin strings were made of silk, while now they are steel strings, which were changed after liberation for louder sound and performance. However, the feeling is still somewhat lacking. If one could find a silk-string guqin, it would be rare. The ancient guqin was a tool for self-cultivation, not for performance. The ancient saying that the Xian pulse resembles a taut bowstring refers to silk strings, as there were no steel strings in ancient times. If the silk string is particularly fine and taut, it becomes overly straight and lacks harmony, thus a pathological Xian pulse resembles a silk string, having elasticity and being taut.
“Tight like a rope,” indicates that a tight pulse lacks elasticity, resembling a rope. Thus, it is described as a tightly stretched rope, which has no elasticity. You can imagine a rope pulled very tight; when you press it, it bounces left and right, rolling in that manner.
“Tightness indicates strength,” hence the sensation of twisting the rope. This is the description of the tight pulse. The Xian pulse is characterized by its straightness and length, with a bouncing sensation when pressed.
“The firm pulse is both Xian and long, deeply hidden within, while the Xian pulse can be felt at floating, middle, and deep levels.”
Xian Pulse
3. [Main Disease Poem]
The Xian pulse corresponds to the liver and gallbladder meridians in the east, with phlegm and cold-heat afflicting the body.
Floating, sinking, slow, and rapid must be distinguished; large and small pulses have different weights.
“The Xian pulse corresponds to the liver and gallbladder meridians in the east,” Traditional Chinese Medicine (TCM) is inseparable from the five elements, which correspond to directions and seasons. Therefore, TCM is a study of the relationship between humans and nature. When studying a person, one must consider nature, the five directions, the five qi, and the seasons, as all are interconnected. Humans are not isolated; they are connected to the external world, seasons, and directions. The Xian pulse corresponds to the liver and gallbladder meridians, so when there are issues with the liver and gallbladder, the Xian pulse often appears.
“Phlegm and cold-heat afflict the body,” there are many diseases of the liver meridian, hence various liver diseases. The pulse of malaria is often Xian, as it is often related to Shaoyang disharmony, which is connected to the liver and gallbladder. Cold and heat alternating often indicates Shaoyang disharmony. Why is phlegm and fluid often seen with the Xian pulse? Because phlegm and fluid generally arise from spleen deficiency, which cannot transform water and dampness, leading to phlegm and fluid. However, an important factor is qi stagnation, which is governed by the liver, hence phlegm and fluid can often be seen with the Xian pulse.
“Floating, sinking, slow, and rapid must be distinguished,” the Xian pulse must differentiate between floating, sinking, slow, and rapid, which is a combination pulse. Floating, sinking, slow, rapid, and Xian pulse combined are different.
“Large and small pulses have different weights,” the Xian pulse must be distinguished as to whether it is large or small. A large Xian pulse, when pressed, is strong, indicating a full condition. A small Xian pulse, which is actually fine, when pressed, is strong, generally indicates qi stagnation. A weak Xian pulse indicates deficiency. The so-called single Xian and double Xian actually refer to two pulse types; are both Xian, or is one Xian? The ancients said single Xian indicates cold, while double Xian indicates fluid.
Xian Pulse
4. [Divisional Poem]
At the cun position, the Xian pulse indicates headache and phlegm accumulation; cold and heat symptoms should be assessed at the left guan.
At the right guan, stomach cold leads to abdominal pain; at the chi position, yin hernia and leg cramps.
“At the cun position, the Xian pulse indicates headache and phlegm accumulation,” when the cun pulse shows a Xian pulse, it indicates liver qi rising, which can easily lead to headaches. Both deficiency and excess can be present, and phlegm and fluid may also be possible, as phlegm and fluid can obstruct qi movement, leading to a Xian pulse at the cun position.
“Cold and heat symptoms should be assessed at the left guan,” the left guan corresponds to the liver and gallbladder, so Shaoyang disharmony and obstruction can lead to cold and heat symptoms, which are related to the Xian pulse at the left guan. Symptoms of masses in the body are due to qi and blood stagnation, which can also be seen with the Xian pulse.
“At the right guan, stomach cold leads to abdominal pain,” the right guan corresponds to the spleen and stomach. When the Xian pulse is felt at the right guan, it indicates that the liver pulse is present in the spleen and stomach area. This means that wood is overcoming earth, indicating that the spleen and stomach are being affected. If the Xian pulse at the right guan is strong, it indicates that liver qi is obstructing the spleen. A weak Xian pulse indicates spleen deficiency with wood overpowering it, leading to stomach cold and abdominal pain. Many people suffer from stomach issues, and TCM believes that many stomach problems are related to the liver. Thus, some TCM doctors treat liver issues when they see stomach pain, which can resolve the stomach problem. In contrast, Western medicine views stomach inflammation as a stomach issue and prescribes many stomach medications, reflecting the differing perspectives of TCM and Western medicine.
“At the chi position, yin hernia and leg cramps,” if the Xian pulse is felt at the chi position, it indicates yang deficiency in the lower jiao, or obstruction of yin pathogens, leading to conditions like cold hernia, cramps, or muscle spasms.
Image and text: wdx
Compilation: zzj
Review: gyj
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