Inheriting the fire of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
“Double String Pulse” and “偏弦 Pulse” are mentioned in the Jin Kui Yao Lue · Phlegm and Cough Disease Pulse Diagnosis and Treatment section, stating: “The double string pulse indicates cold” and “The偏弦 pulse indicates fluid retention.” It is also found in the Pulse Classic · Volume Four: “The double string pulse causes tightness and pain under the ribs.” What kind of “image” do the “double string pulse” and “偏弦 pulse” show at the cun (寸) pulse? Later generations of physicians have various interpretations, which can be summarized into the following two views:
One view holds that the “double string pulse” appears as two parallel string pulses in either the left or right cun pulse. As Danbo Yuanjian cites from Wu Kun’s Pulse Language, “Double string means the pulse comes like two lines.” If it is a single string, it is just one line. Xu Zhongke also states in his commentary on the Jin Kui Yao Lue: “If there are two pulses in one hand, it is also called double string.”Another view defines the double string pulse as both left and right cun pulses showing string pulses. As explained in the Yi Zong Jin Jian · Corrected Commentary on the Jin Kui Yao Lue: “The double string pulse means both hands have string pulses; the偏弦 pulse means either the left or right pulse is a single string.” In particular, Jing in the Jin Kui Yao Lue Heart Classic interprets: “The double string means both hands have string pulses” and “偏弦 means one hand has a single string.”Recently, some have suggested that the “double string pulse” is also called the two-line pulse, where there are two parallel pulse vessels in the cun, guan, and chi positions, and proposed that “string pulses can be single or double” and that pulse vessels are not just one by one, but can branch out, with many pulse vessels having forks, etc.The so-called “two-line pulse” and “string pulses can be single or double” raises another related question: why do string pulses have “two lines”? Why is there a distinction between single and double string pulses? And why are there no “two lines” in floating, sinking, slow, or rapid pulses in the classics? Only by answering this question can the so-called “two lines” of string pulses, the “two parallel pulse vessels in the cun, guan, and chi positions,” and the distinction between single and double be convincingly justified.To understand the “double string pulse,” one must first correctly grasp the meaning of the “偏弦 pulse”.In the original text of Zhang Zhongjing, there is no mention of a “single string” pulse. There are only the string pulse, double string pulse, and偏弦 pulse. So where does this “single string” pulse come from? It may stem from later interpretations and misreadings of the “偏弦 pulse.” Because the classic text mentions “double string,” it was imagined that if there is a double, there must be a single, thus fabricating the concept of “single string.” As stated in the Yi Zong Jin Jian · Corrected Commentary on the Jin Kui Yao Lue: “偏弦 means either the left or right pulse is a single string.”However, in the classics, there is only “偏弦” and no “single string”; corresponding to “double string” is “偏弦.” Interpreting “偏弦” as “single string” is a misreading. In fact, the “偏弦” in Zhang Zhongjing’s text does not imply a “single string” at all. The term “偏” means slightly or somewhat;偏弦 is akin to “slightly string” or “somewhat string” or “偏于弦”. Once the true meaning of偏弦 is understood, the “image” of the “double string pulse” becomes clearer.The “double string pulse” is also found in the Shang Han Lun · Differentiating Treatable Pulse Diagnosis and Treatment: “If the double string pulse is slow, there must be hardness under the heart. If the pulse is large and tight, there is yin within yang, and it can be purged, suitable for Da Cheng Qi Tang.” This line is also found in the Jin Kui Yu Han Jing · Volume Five, differentiating treatable pulse forms and treatments, and in the Pulse Classic · Volume Seven, treatable pulse diagnosis. The wording is slightly different.Importantly, this line is also hidden in the Jin Kui Yao Lue · Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment section, stating: “If the pulse is rapid and tight, it is string-like, resembling a bowstring, and does not move upon pressure. A rapid string pulse indicates that the cold should be purged; a tight, large, and slow pulse indicates hardness under the heart; a large and tight pulse indicates there is yin within yang, and it can be purged.” Comparing the text from the Differentiating Treatable Pulse Diagnosis and Treatment with the text from the Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment, it can be found that the phrase “If the double string pulse is slow…” in the Differentiating Treatable Pulse Diagnosis and Treatment is derived from the latter’s second half.The only difference is that in the Differentiating Treatable Pulse Diagnosis and Treatment, “If the double string pulse is slow” replaces “If the pulse is tight, large, and slow” from the Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment.To understand the relationship between the “double string pulse” and the “tight, large pulse,” one must start with the concept of string pulse.The Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment states: “If the pulse is rapid and tight, it is string-like.” From a medical perspective, the term “rapid” here does not refer to pulse rate, as there is no element of rate in string pulses. Therefore, the “rapid” here should be interpreted as “urgent.”The term “rapid” in Zhang Zhongjing’s works can have different meanings based on medical theory, literary context, and situational context. Here, it does not express the pulse rate but rather the state of the pulse’s rise and fall. The “rapid” here indicates that in addition to the pulse’s strength, there is also an element of urgency. Since a “string” cannot be separated from a “bow,” the term “string” is conditional. The character “弦” consists of “弓” (bow) on the left and “玄” (silk) on the right; silk becomes a “string” when stretched on a bow, and without the bow, silk cannot become a string. Once the “string” is separated from the “bow,” it is no longer a “string” but merely a soft “silk.” Thus, it can be said that “without a bow, there is no string.” Here, the role of the “bow” is to stretch outward, maintaining a certain degree of tension in the silk. From this common sense, it can also be concluded that “without tension, there is no string.” From this, it can be understood that in the pulse image of “string,” there is no element of speed or rate, but there is an element of tension and relaxation. Understanding this principle clarifies the meaning of “If the pulse is rapid and tight, it is string-like.”The Differentiating Pulse Method states: “If the pulse is floating and tight, it is called string. The string is shaped like a bowstring and does not move upon pressure.” Here, “floating” refers to the superficial position of the string pulse, while “tight” indicates that the string pulse should have a strong pulse force, with a certain tension felt beneath the pulse. Through comparing the phrase “If the pulse is rapid and tight, it is string-like” from the Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment with “If the pulse is floating and tight, it is called string” from the Differentiating Pulse Method, it can be concluded that there must be an element of tightness within the string pulse. The degree of tightness determines the degree of string; within a certain range, the higher the degree of string, the more pronounced the element of tightness.Understanding the relationship between tightness and string in the pulse, it can be said that the phrase “If the pulse is rapid and tight, it is string-like” is a general expression of the string pulse image, which is a conventional expression. In the specific context of the Jin Kui Yao Lue phlegm and cough disease section, it is referred to as “平” (normal), as in “If there is phlegm and the patient cannot lie down, with shortness of breath, the pulse is平.” In this context, “平” does not express that the pulse of such a patient is “normal”; if interpreted this way, it would be clearly inconsistent with medical theory. The correct understanding should be that the patient’s “string” is a common, ordinary, standard string pulse.In contrast to the above, the “偏弦 pulse” indicates fluid retention. This “偏弦” is a “slightly string” pulse, indicating that the pulse has a slight string image. The “tight, large pulse” indicates a more intense state than the ordinary string pulse, a special expression of a higher degree of string compared to the usual standard string pulse.The Differentiating Treatable Pulse Diagnosis and Treatment takes the latter half of the phrase from the Abdominal Fullness, Cold Hernia, and Food Retention Disease Pulse Diagnosis and Treatment: “If the pulse is rapid and tight, it is string-like, resembling a bowstring, and does not move upon pressure. A rapid string pulse indicates that the cold should be purged; a tight, large, and slow pulse indicates hardness under the heart; a large and tight pulse indicates there is yin within yang, and it can be purged” and extracts it as an independent line, inferring the image of “double string pulse” within the “tight, large pulse.” It can be said that the “double string pulse” is equivalent to the “tight, large pulse.” The “double string pulse” particularly emphasizes the degree of string. Double means two, akin to double or more. The double string is akin to double string, more string, or extreme string. Furthermore, the Pulse Classic · Volume Six · Spleen Foot Taiyin Disease section states: “The cun pulse is double tight,” where double also has the same meaning.Only “string” and “tight” can have a comparative measure of strength. Understanding this point is essential to truly grasp the original meaning of “double string” and “double tight,” and to understand why there are no “double floating,” “double sinking,” “double slow,” “double rapid,” “double slightly,” “double weak,” or “double surging” in the classics.The Phlegm and Cough Disease Pulse Diagnosis and Treatment states: “If there is lung fluid, it is not string-like, but only causes shortness of breath.” This emphasizes that the pulse is “not string-like.” “String” is the pulse image; “not string” is not the pulse image. Since “not string” is not the pulse image, what is the purpose of emphasizing “not string” here? It is to express that in this case of lung fluid, the pulse is “expected to be string but is not.” Because for phlegm and cough diseases, “string” is the common “平” pulse. Rearranging the relevant lines from the Phlegm and Cough Disease Pulse Diagnosis and Treatment: Lung fluid is not string-like, but only causes shortness of breath. (Expected to be string but is not) 偏弦 pulse indicates fluid retention. (Slightly string) Phlegm also causes shortness of breath and cannot lie down, with shortness of breath, the pulse is平. (String) The double string pulse indicates cold. (Extreme string) This precisely describes the different degrees of tension in the string pulse of phlegm and cough diseases in different states: from not string—偏弦 (slightly string)—平 (string)—double string (extreme string).Textual research is very important; one must respect the original texts. If one departs from the original meaning and starts from a concept of “single string” that does not exist in the original text, proposing that “the double string pulse is also called the two-line pulse” and that “there are two parallel pulse vessels in the cun, guan, and chi positions,” as well as “if there are two pulses in one hand, it is also called double string” and “if it is a single string, it is just one line,” this is like constructing a loft in mid-air, which can only be considered a misreading that misleads future learners. This trend should not be followed.This is for clinical reference only; non-professional doctors should not attempt acupuncture or medication.
Copyright Statement:Edited by Lao Jun Zhi Lu, Proofread by Feng Tu, Source from publicly available online materials. Copyright belongs to the original author.
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