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The normal pulse, known in ancient times as Ping Mai (平脉), is the pulse of a healthy person without disease. The characteristics of a normal pulse include three parts having pulse, with a breath rate of four beats per breath (or five beats during a leap year, equivalent to 72-80 beats per minute), neither floating nor sinking, neither large nor small, calm and gentle, soft yet strong, with a consistent rhythm. The pulse at the wrist (Chi Mai, 尺脉) should be taken with a certain strength and will vary normally according to the activities of the individual and environmental conditions. The normal pulse has three characteristics: Wei (胃, Stomach), Shen (神, Spirit), and Gen (根, Root).
Wei: A pulse with Wei Qi (胃气, Stomach Qi) is described in many ways by ancient scholars. Generally, a normal pulse is neither floating nor sinking, neither fast nor slow, calm and gentle, with a consistent rhythm, indicating the presence of Wei Qi. Even in pathological pulses, if they exhibit a slow and gentle quality, they still possess Wei Qi.
If the pulse has Wei Qi, it is considered a Ping Mai (平脉, Normal Pulse); if the pulse has little Wei Qi, it indicates pathological changes, and if there is no Wei Qi, it is classified as a true organ pulse (真脏脉), which may indicate a difficult or untreatable condition. Therefore, the presence or absence of Wei Qi is significant for assessing the prognosis of diseases.
Shen: The pulse with Shen is characterized by a gentle quality. For example, a string-like pulse (Xian Shi Mai, 弦实之脉) still carries a gentle quality; a weak pulse that is not completely powerless is also considered to have pulse Shen. The strength or weakness of Shen is significant for assessing the prognosis of diseases.
However, it is essential to combine the observations of sound, color, and form to draw accurate conclusions. The presence of Wei and Shen in the pulse indicates a harmonious quality; thus, in clinical practice, the diagnostic methods for Wei and Shen are similar.
Gen: A pulse that is strong when taken at the three positions indicates a Gen pulse. If the Chi pulse is strong, it suggests that the kidney Qi is still present, and the innate essence has not been exhausted, indicating vitality. Conversely, if the pulse is floating, large, and chaotic, and cannot be felt upon pressure, it indicates a lack of root, signifying a dispersion of the original Qi, which marks a critical condition.
The normal pulse varies physiologically in response to internal and external factors affecting the body.
Seasonal Climate: Due to climatic influences, the Ping Mai (平脉, Normal Pulse) changes with the seasons: spring shows a string-like quality, summer a surging quality, autumn a floating quality, and winter a sinking quality. This reflects the correspondence between humans and nature, as the physiological functions of the body also change with the seasonal climate.
Geographical Environment: The geographical environment can also affect the pulse. For instance, in the south, where the climate is warmer and more humid, the pulse tends to be fine and soft or slightly rapid; in the north, where the terrain is higher and the air is dry and cold, the pulse tends to be deep and solid.
Gender: Women’s pulses are generally softer and slightly faster than men’s. After marriage and during pregnancy, women’s pulses often appear slippery and rapid yet harmonious.
Age: The younger the individual, the faster the pulse. Infants have a pulse rate of 120-140 beats per minute; children aged five to six have a pulse rate of 90-110 beats per minute; as age increases, the pulse becomes more moderate. Young adults have strong pulses, while the elderly may have weak pulses due to deficiency of Qi and blood.
Body Type: Individuals with larger physiques tend to have longer pulse manifestations; shorter individuals have shorter pulse manifestations. Thin individuals with less muscle may have floating pulses, while obese individuals with thick subcutaneous fat may have sinking pulses. Commonly observed six pulses that are fine and deep without pathological signs are called Liu Yin Mai (六阴脉); those that are large and surging without pathological signs are called Liu Yang Mai (六阳脉).
Emotions: Temporary emotional stimuli can also cause changes in the pulse. For example, joy may lead to a slow pulse, anger may lead to a rapid pulse, and shock may cause chaotic pulse movements. This indicates that emotional changes can affect the pulse, but once emotions stabilize, the pulse returns to normal.
Labor and Rest: Intense exercise or long journeys often result in a rapid pulse; after falling asleep, the pulse tends to slow down; individuals engaged in mental labor may have weaker pulses compared to those engaged in physical labor.
Diet: After meals or alcohol consumption, the pulse is often more vigorous; during hunger, it may be slightly slower and weaker.
Additionally, some individuals may have pulses that are not felt at the Cun Kou (寸口, Inch Position) but are felt diagonally from the Chi position towards the back of the hand, known as Xie Fei Mai (斜飞脉); if the pulse appears on the dorsal side of the Cun Kou, it is called Fan Guan Mai (反关脉). Other variations at different wrist positions are physiological peculiarities of the radial artery’s anatomical position and are not considered pathological pulses.
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