Key Points of the Deep Pulse and Its Associated Conditions – Section Seventeen
·The deep pulse indicates internal conditions, primarily cold and accumulation. If strong, it suggests phlegm or food; if weak, it indicates qi stagnation.
·Deep and slow indicates deficiency and cold; deep and rapid suggests hidden heat; deep and tight indicates cold pain; deep and slow suggests water retention.
·Deep and firm indicates chronic cold; deep and solid indicates extreme heat; deep and weak indicates yin deficiency; deep and fine indicates damp obstruction.
·Deep and wiry indicates pain from fluid retention; deep and slippery indicates food stagnation; deep and hidden indicates vomiting and diarrhea; yin toxins accumulate.
1.The deep pulse indicates internal conditions, primarily cold and accumulation. If strong, it suggests phlegm or food; if weak, it indicates qi stagnation:
(1) The pulse felt deep to the bone is called shen. In contrast to the floating pulse, it indicates internal conditions. Cold is associated with water, and accumulation refers to storage, which is related to yin condensation, hence the presence of a deep pulse.
(2) A strong deep pulse indicates something is present internally, either phlegm or food. For phlegm, use Wang Yinjun’s Guo Phlegm Pill; for food, use Zhongjing’s Da Xiao Chengqi Decoction and similar formulas.
(3) A weak deep pulse indicates that the interior is not solid, but rather that qi is not expanding. Use Heji Siqi Decoction or Hejian Zhengqi Tianxiang Powder and similar formulas.
2.Deep and slow indicates deficiency and cold; deep and rapid suggests hidden heat; deep and tight indicates cold pain; deep and slow suggests water retention:
(1) A deep pulse that is also slow indicates internal cold and deficiency. Use Zhongjing’s Lizhong Pill or Fuzi Lizhong Decoction and similar formulas.
(2) A deep pulse that is rapid indicates hidden heat. Use Baojian Jiji Detoxification Decoction, Daohong San, or Huanglian Jiedu Decoction and similar formulas.
(3) A deep and tight pulse indicates cold obstruction, hence the cold pain. Use Jinkui Wutou Decoction or Heji Laifu Dan and similar formulas.
(4) A deep and slow pulse indicates that yang is not functioning properly, leading to water retention. Use Zhongjing’s Wuling Powder or Linggui Zhushugan Decoction and similar formulas.
3.Deep and firm indicates chronic cold; deep and solid indicates extreme heat; deep and weak indicates yin deficiency; deep and fine indicates damp obstruction:
(1) A deep and firm pulse indicates stagnation of yin cold, leading to chronic cold. Use Heji Laifu Dan or Da Qi Xiang Wan.
(2) A deep and solid pulse indicates accumulation of yang qi. Use Zhongjing’s Da Chengqi Decoction or Zihua Shenqi Wan and similar formulas.
(3) A weak deep pulse indicates yin deficiency. Use Jinkui Shenqi Wan or Liuwu Wan and similar formulas.
(4) A deep and fine pulse indicates damp obstruction. Use Jinkui Guizhi Fuzi Decoction or Heji Shenshi Decoction, or Weiling Decoction and similar formulas.
4.Deep and wiry indicates pain from fluid retention; deep and slippery indicates food stagnation; deep and hidden indicates vomiting and diarrhea; yin toxins accumulate:
(1) A deep and wiry pulse indicates fluid retention causing pain. Use Zhongjing’s Xiao Qinglong Decoction or Wuling Powder and similar formulas.
(2) A deep and slippery pulse indicates food stagnation. Use Zhongjing’s Da Chengqi Decoction, Jiegu Zhi Wan, or Danxi Baohuan Wan and similar formulas.
(3) A deep and hidden pulse indicates severe vomiting and diarrhea. If yin toxins accumulate, use Zhizhuan Zhi Wan and similar formulas.
Attached Formulas
·Wang Yinjun’s Guo Phlegm Pill from the “Yao Sheng Zhu Lun” Phlegm can cause various conditions such as migraine, tension headaches, and dizziness. Symptoms may include facial twitching, itching, or swelling in the jaw, limbs, and skin. The patient may experience a sensation of heat, discomfort in the throat, and difficulty swallowing. The phlegm may appear thick and dark, resembling ink or broken cotton. The patient may also experience a sensation of heaviness in the chest, nightmares, and a feeling of being trapped. Treatment requires careful consideration of the underlying causes and may involve the use of specific herbal formulas.
Thus, the Shenmi Chenxiang Wan has been found to be effective for many patients. However, it should not be shared lightly. The poem states:
In the bottle, the golden armor turns, now wearing a grass hall deep.
Meeting at twenty-eight, seeking the right weight, the nitre and the blue stone are doubled like the deep.
Seventeen taels, with a half tael, the water pill must be measured.
To eliminate strange diseases and calm the mind, the water flows smoothly without hindrance.
Da Huang is steamed briefly, turned over and steamed again, then taken out immediately, do not overdo it. Huang Qin each eight taels. Qing stone nitre smoke like gold color. Chenxiang is used in the decoction of a hundred herbs, obtained from secret transmission. This pill, made from this medicine, can gather all stubborn phlegm in one place, then facilitate its expulsion, showing remarkable efficacy.“Doubling like the deep” refers to the combination of Wubeizi and Chenxiang, not the doubling of the stone compared to the deep. Each of the above is five qian.
Grind into a fine powder, form into pills the size of a walnut, and take on an empty stomach with warm water.
1. For all new and old cases of loss of heart and spirit, whether manic or insane, take one hundred pills each time. If the qi is strong and able to eat, for severe mania, add twenty pills, adjusting as needed.
2. For all cases of stroke paralysis, phlegm and fluid obstruction, whether constipation or diarrhea, take eighty to ninety pills each time, or increase to one hundred pills, ensuring no secret constipation issues.
3. For all cases of yang syndrome, wind toxin, and leg edema, take eighty to ninety pills each time. If ineffective, increase to one hundred pills.
4. For all healthy individuals experiencing generalized pain without a clear diagnosis, whether headache or toothache, or sensations of itching or discomfort, take eighty to ninety pills. If phlegm is abundant and qi is strong, add more.
5. For all cases of acid reflux, chest tightness, abdominal pressure, vomiting, and excessive salivation, take as needed, adjusting for symptoms.
6. For all new and old cases of phlegm and cough, or vomiting, dizziness, adjust dosage as needed.
7. For all cases of swelling and hardness in the jaw and neck, or mouth sores, take sixty to seventy pills each time. Add a little honey, chew and dissolve in one place, and swallow slowly at night. For those with mouth sores, take twenty to thirty pills, following the same method, and recovery will occur in two to three nights.
8. For all men and women, young and old, experiencing heart pain radiating to the abdomen, weakness, and vomiting of green water or black bile, take as needed. If the condition is critical, take up to one hundred pills for immediate recovery. If not in a critical state, take thirty to fifty pills, and improvement will be seen. Continue as needed, along with medications to nourish fluids and transform phlegm, and warm the middle to regulate qi.
9. For all lingering diseases, whether men or women, not related to cold damage, or excessive indulgence, or vomiting blood, or menstrual irregularities, or anxiety and restlessness, or abdominal distension and pain, fatigue, dizziness, or sudden illness, take as needed, adjusting for symptoms. Generally, when taking medicine, one should lie down, take a mouthful of warm water, and swallow before lying down. This allows the medicine to settle in the throat and gradually descend. If the illness arises unexpectedly during the day, and the pain is unbearable, one must take the medicine while lying down. For most of the day, avoid taking soup or water, and do not get up to walk or talk. Wait until the pills have expelled the phlegm and harmful substances, then can one move. Each night, take twice. The next day, if the phlegm has been expelled three to five times, continue with the previous dosage. If it has been expelled five to seven times, or only two to three times and the condition has improved, reduce by twenty pills the next night. If the previous night’s dosage did not expel harmful substances, increase by ten pills the next night. For strong individuals with severe conditions, increase to one hundred pills, adjusting as needed based on the condition. If one has taken too much and feels congested in the throat, it is due to the phlegm and qi clashing. After a while, the medicine will take effect, and one will feel at ease. Often, if the illness has lingered and solidified in the lungs and stomach, or if there is no phlegm, taking the medicine and swallowing while lying down will lead to immediate calmness and clarity in the five organs. The next morning, one should have a bowel movement. The remaining times will be phlegm and harmful substances. Observe the stool, and if it is watery, it is all phlegm and mucus. If there is slight abdominal pain or kidney discomfort, it indicates the presence of stubborn phlegm and harmful substances, causing gas obstruction and heaviness in the abdomen, resembling dysentery, which will resolve shortly. If there is phlegm and mucus that can be easily expelled, the relief is immeasurable, and one will feel refreshed. If there is occasional fatigue, it is due to prolonged illness and discomfort, temporarily overwhelmed by the medicine’s effect, feeling as if one has just awakened from a bath or sleep. This medicine does not cause excessive diarrhea but rather removes phlegm and harmful substances from the intestines in order. The remaining waste will not be harmed. The expulsion of feces is due to the medicine’s effect, hence the initial removal of feces. The rest cannot be fully described; those who take it will know.
·Zhongjing’s Da Chengqi Decoction This formula is used to expel evil heat from the interior, causing fullness and dryness. Later generations have used it to treat all excess accumulations in the lower abdomen. However, it is not suitable for cold drinks and cold accumulations.[Commentary] The path is blocked, unable to follow the heavens. The reason for expelling is to allow for proper flow. There are degrees of heaviness, hence the decoction varies in strength.
Da Huang four taels, washed with wine; Hou Po half a jin, roasted and peeled; Zhi Shi five pieces, roasted; Mang Xiao three heaping parts.
Combine with one dou of water, first boil the two ingredients to obtain five sheng. Remove the Da Huang, boil to obtain two sheng. Remove the dregs, add Mang Xiao, and simmer gently until boiling, then take warm.
·Zhongjing’s Xiao Chengqi Decoction is slightly less potent than Da Chengqi Decoction and is suitable for those with less severe dryness and hardness.
Da Huang four taels; Hou Po two taels; Zhi Shi three pieces.
Combine the three ingredients with four sheng of water, boil to obtain one sheng and two ge, remove the dregs, and take in two doses warm. When taking the decoction, one should change clothes. If not, drink it all. If changing clothes, do not take again.
·Da Qi Xiang Decoction is the same as Heji Siqi Decoction and is used to treat emotional disturbances, excessive worry, and the resulting imbalance of qi, leading to abdominal distension.
Bansha and Fuling each four taels; Hou Po three qian; Zisu two qian.
Crush and decoct with ginger for consumption.
·Hejian Zhengqi Tianxiang Powder is used to treat the nine qi.
Wuyao two taels; Xiangfu powder eight taels; Chen Pi Su Ye Gan Jiang each one tael.
Grind into a fine powder, take one qian with salt water.
·Zhongjing’s Lizhong Pill with added Fuzi two qian, roasted, is now called Fuzi Lizhong Pill. It is used for treating cold and deficiency in the spleen and stomach, as well as for conditions like cholera, diarrhea, and all cases of spleen and stomach deficiency.
Gan Jiang roasted; Bai Zhu roasted; Gan Cao roasted; Ren Shen each two and a half taels.
Use two bowls of water, decoct to eight parts, and take warm before meals.
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