Deep Pulse
(1) Pulse Characteristics
The deep pulse, like the superficial pulse, has two layers of meaning: one is the concept of location. Any pulse that can only be felt by pressing down to the bones, regardless of its size, speed, strength, or weakness, is termed deep; the other refers to the deep pulse, which has strict characteristics. To distinguish between the two, the former can be called “pulse deep“, while the latter can be referred to as “deep pulse”.
A normal deep pulse is insufficient when lifted and excessive when pressed, resembling sand wrapped in cotton, firm inside and soft outside. In addition to being located deep, it must also possess the characteristic of being “soft and smooth”. Soft and smooth indicates a gentle appearance within the deep pulse, flowing evenly, which is a manifestation of stomach qi. A deep and smooth pulse indicates that the deep aspect is yin, while the smooth aspect is yang, symbolizing yang submerged in water; this represents the pulse of winter and the kidneys.
(2) Pulse Theory and Main Diseases
The deep pulse is a very important pulse, as the pulse is fundamentally deep and rooted in depth. The pulse is governed by the balance of deficiency and excess, and the distinction between deficiency and excess lies in the strength or weakness of the deep pulse. Therefore, the deep pulse is extremely important.
Why is the pulse deep? Because the qi and blood cannot express outwardly to invigorate and fill the blood vessels, hence the pulse is deep. Why can qi and blood not express outwardly? There are two main reasons: one is deficiency of righteous qi, leading to weakness in the ability of qi and blood to express outwardly, resulting in a deep pulse; the other is obstruction by pathogenic qi, which blocks the pathway for qi and blood to express outwardly, also leading to a deep pulse.
1. Deficiency Leading to Deep Pulse
A deep pulse due to deficiency can be seen in conditions of yang deficiency, qi deficiency, blood deficiency, and yin deficiency. Yang is active and can stimulate and invigorate the functions of the entire body.
Yang deficiency cannot effectively stimulate the circulation of qi and blood, thus the pulse is deep.
Qi acts like a bellows, invigorating the blood vessels. Qi deficiency means there is insufficient strength to invigorate, hence the pulse is deep.
Blood deficiency means there is insufficient filling of the blood vessels, leading to a deep pulse. Moreover, blood deficiency often accompanies qi deficiency, resulting in both qi and blood being insufficient, causing the pulse to lose its fullness and vigor, thus it is deep.
Yin deficiency leads to insufficient filling of the blood vessels, and the pulse can also be deep.
In cases of deficiency, the pulse is deep but weak.
When encountering a deep and weak pulse in clinical practice, the nature of the disease is undoubtedly deficiency. However, to determine whether it is yang deficiency, qi deficiency, blood deficiency, or yin deficiency, one must analyze and judge comprehensively based on the accompanying pulses and the three diagnostic methods of observation, listening, and inquiry.
In cases of yang deficiency, the pulse is deep, slow, and weak, accompanied by cold limbs, pale tongue, and slippery coating indicating cold symptoms.
In cases of qi deficiency, the pulse is deep and weak, accompanied by shortness of breath and weakness.
In cases of blood deficiency, the pulse is deep, thin, and weak, accompanied by a pale complexion, palpitations, and a pale, tender tongue.
In cases of yin deficiency, the pulse is deep, thin, and rapid, accompanied by symptoms of deficiency heat, a red tongue, and little coating.
In the introduction discussing the superficial pulse, it was mentioned that deficiency can lead to a superficial pulse; here it is stated that deficiency can also lead to a deep pulse. Is this not contradictory? Not at all. Deficiency can lead to either a deep or superficial pulse, depending on the degree and nature of the deficiency.
In cases of yang deficiency, although there is deficiency, if it is not severe, the pulse can be deep but weak; if yang deficiency leads to a rejection of yin and yang, causing yang qi to escape outward, the pulse can change from deep and weak to large, rapid, superficial, and scattered. If yang deficiency further worsens, losing even the ability to float, the pulse can change from large and superficial to deep, thin, and almost imperceptible, or even absent.
In cases of mild qi deficiency, the pulse may not respond to heavy pressure, or it may feel weak upon pressing. If qi deficiency is accompanied by internal heat, the qi and blood may float outward due to the pressure of the internal heat, resulting in a large, rapid, and superficial pulse. In cases of extreme qi deficiency, the pulse may float and scatter, or it may change to deep, thin, and almost imperceptible.
Since blood is the mother of qi, blood deficiency often accompanies varying degrees of qi deficiency. When qi and blood are insufficient, they cannot invigorate the blood vessels, leading to a deep, thin, and weak pulse. If blood deficiency cannot retain internally, qi loses its support, causing qi to float outward and the pulse to become large and weak. Especially when blood is violently lost, qi escapes outward, resulting in a large, hollow pulse.
In cases of yin deficiency, if yang qi has not yet floated outward, the pulse often presents as deep, thin, and rapid. If yin deficiency is more severe, and yin does not restrain yang, leading to yang floating outward, the pulse may become large, rapid, and superficial, or yin may be exhausted below while yang rises above, presenting a pulse of strong yang and weak yin. Therefore, even with deficiency, the pulse can be deep or superficial, depending on the degree and nature of the deficiency.
Note: This article is excerpted from “Insights into Pulse Diagnosis” compiled by Master Li Shimao, published by the Ancient Chinese Medicine Publishing House. This public account is for learning and communication purposes only; if there is any infringement, please contact us for removal.
Click the blue text ยท Follow us
Please click “Share” to give me some support~