1. Pulse Secrets
Floating Pulse: Lightly felt, heavy pressing yields nothing; it floats like wood on water. A strong floating pulse indicates wind-heat, while a weak floating pulse suggests blood deficiency.
Deep Pulse: Requires heavy pressure to be felt; like a stone sinking in water. A strong deep pulse indicates cold pain, while a weak deep pulse suggests deficiency-cold.
Slow Pulse: A pulse that comes slowly, three beats per breath; a very slow pulse should be noted. A slow pulse indicates organ disease or excess cold, requiring careful analysis of deficiency and excess.
Rapid Pulse: A pulse that comes quickly, six beats per breath; a rapid pulse must be noted. Floating and deep, deficiency and excess must be distinguished, as the treatment for the fire of the monarch and minister differs.
Weak Pulse: A weak pulse is characterized by lack of strength, floating large and soft without root; a weak pulse with body heat indicates heat from the middle, while qi deficiency leads to weakness.
Full Pulse: A full pulse is large and long, with three positions filled with strength; a full pulse in a new illness indicates strong evil qi, while in a chronic illness, it indicates misfortune.
Slippery Pulse: A slippery pulse is difficult to interpret, like beads rolling on a plate; it indicates fullness from food stagnation or phlegm-heat in the chest, and in women, it should be regulated during pregnancy.
Rough Pulse: A rough pulse is like scraping bamboo, thin, slow, and stagnant, as if wanting to stop; it indicates blood deficiency, dryness of fluids, and qi stagnation. In women, it indicates absence of menstruation unless pregnant.
Surging Pulse: A surging pulse is full and wave-like; it is strong when it comes but fades away gently. A surging pulse indicates the progression of disease and strong evil qi, making treatment difficult.
Minute Pulse: A minute pulse is as fine as a thread, felt only with great difficulty; it indicates exhaustion from overwork and qi-blood deficiency, and dampness stagnation is also common.
Tight Pulse: A tight pulse feels like a rope, tense and urgent; it indicates pain from cold injury, and floating and deep must be clearly distinguished.
Slow Pulse: A slow pulse is four beats per breath; it is calm and gentle, indicating balance. It may be due to spleen deficiency or wind-damp disease, requiring careful evaluation.
Soft Pulse: A soft pulse is floating, gentle, and fine, like cotton floating on water; it can be seen in postpartum conditions, but in healthy individuals, it indicates worry.
Weak Pulse: A weak pulse is soft and fine, like cotton in water, indicating weak yang and blood deficiency; it is acceptable in the elderly but should be avoided in the young.
Long Pulse: A long pulse is extended and exceeds the normal position; it is soft when pressed, indicating strong heart and kidney roots, but excessive length indicates heat.
Short Pulse: A short pulse is contracted, like a turtle; it indicates difficulty in treating various diseases due to deficiency of true yuan qi.
Empty Pulse: An empty pulse is characterized by a hollow center; it feels soft like scallions; it indicates heat invading the yang channels and blood overflowing, causing heat injury to the yin channels.
String-like Pulse: A string-like pulse is straight and taut, resembling a guitar string; it indicates liver-gallbladder issues, phlegm, and pain, with varying degrees of severity.
Scattered Pulse: A scattered pulse is floating and chaotic, gradually disappearing upon pressing; it indicates a sign of birth or miscarriage, and in chronic illness, it suggests a desire to break free.
Fine Pulse: A fine pulse is as thin as a line, felt only with great difficulty; it indicates excessive worry and qi-blood deficiency, and dampness stagnation is also common.
Hidden Pulse: A hidden pulse requires careful searching; it is felt deep in the bones, indicating qi stagnation, cold accumulation, and food stagnation, leading to nausea.
Moving Pulse: A moving pulse is rapid and irregular, with no clear beginning or end; it indicates pain and shock, and in the case of the lesser yin, it indicates pregnancy.
Leather-like Pulse: A leather-like pulse is tense and urgent, resembling a drum skin; it indicates postpartum issues and men’s energy deficiency or nocturnal emissions.
Firm Pulse: A firm pulse is strong and solid, indicating internal accumulation of cold and pain, and can lead to misfortune.
Rapid Pulse: A rapid pulse is quick and urgent, with a frequency of seven to eight beats per breath; it indicates excessive yang without control, leading to exhaustion of true yin, and indicates a critical condition.
2. Pulse Theory
What is a normal pulse? A normal person has a pulse of four beats per breath, calm and even, indicating vitality; this is the normal pulse, while others are pathological pulses. Special populations must also be considered, such as the elderly having slightly string-like pulses, children having rapid pulses, and variations due to body type and seasonal changes, as documented in literature.
Knowing the normal pulse, the next step is to understand the four types of pulses: floating, deep, slow, and rapid.Floating pulses are lightly felt, while deep pulses require heavy pressure; a pulse with fewer than four beats is slow, while one with more than four beats is rapid.
What diseases do floating pulses indicate? They often indicate exterior conditions, while deep pulses indicate interior conditions. Slow pulses indicate cold, and rapid pulses indicate heat, with exceptions; for instance, a floating pulse may appear if the yin is severely deficient and yang is excessive, indicating a serious condition.
The next step is to return to our hands, using the high bone at the back of the wrist as the guan pulse, the front as the cun, and the back as the chi pulse. The left hand’s cun pulse corresponds to the heart and small intestine, the guan pulse corresponds to the liver and gallbladder, and the chi pulse corresponds to the bladder and kidney. The right hand’s cun pulse corresponds to the lung and large intestine, the guan pulse corresponds to the spleen and stomach, and the chi pulse corresponds to the kidney and mingmen.
In the cun, guan, and chi positions, the cun represents yang, the chi represents yin, the floating pulse represents yang, and the deep pulse represents yin. By combining floating and deep, slow and rapid, we can generally distinguish between yin and yang, exterior and interior, cold and heat. Additionally, we consider strength and weakness, with strength indicating fullness and weakness indicating deficiency. By observing the pulse shape and length, we can further clarify the distinctions between yin and yang, exterior and interior, cold and heat, deficiency and excess. Finally, by considering the pulse location, we can determine which organ the pulse reflects and diagnose the disease.
With this knowledge, we can recombine these pulse types, as clinical practice often presents many combinations, such as floating-slow, floating-rapid, floating-long, and floating-fine. Similarly, deep pulses can also be combined, such as deep-short, deep-strong, and deep-rapid, all requiring careful analysis.
For example, if the left cun pulse is deep, short, and weak, while the cun and guan pulses are normal.
First, the left cun corresponds to the heart, indicating the disease is located in the heart. A short pulse indicates deficiency, and weakness also indicates deficiency. What diseases can arise from insufficient heart pulse? The heart governs blood, and its insufficient function can lead to inadequate blood supply to the brain, resulting in dizziness, memory loss, and fatigue.
If the left chi pulse is deep and rapid, the deep pulse indicates an interior condition, while the rapid pulse indicates heat. If the disease is located in the kidney and bladder, it suggests heat in the kidney and bladder, leading to symptoms such as yellow and hot urination, heat in the hands and feet, lower back pain, and night sweats.
For instance, if the cun pulse is floating and rapid, while the chi pulse is deep and fine, the cun pulse indicates yang, the rapid pulse indicates heat, the floating pulse also indicates yang, while the chi pulse indicates yin and deficiency. This combination suggests that yin is insufficient to control yang, leading to yang floating above. Such patients are likely to experience dizziness, and treatment may involve nourishing yin and subduing yang.
Moreover, practice is essential. We have many people around us, including friends and family, who can serve as practice subjects. Everyone has this condition, and more practice will yield results. When I started, I sometimes saw dozens of people in a day. Afterward, I would compare and analyze which were correct and which were wrong, gradually becoming proficient. When diagnosing pulses, it is crucial to conduct a comprehensive analysis, considering the location and organ functions. Each organ’s function can indicate what issues may arise from cold, heat, exterior, interior, yin, yang, deficiency, and excess. Additionally, one should not rely solely on one diagnosis; the ancient practice of integrating the four examinations is very reasonable.
Lastly, regarding the issue of gender prediction, it is said that a rapid pulse in the left hand indicates a boy, while the opposite indicates a girl. My experience shows that this is quite accurate around 40 days, but after four to five months, the accuracy decreases to about 60-70%. Perhaps further improvement is needed.
Pulse diagnosis has a long history in our country, being a summary of the long-term medical practice of ancient Chinese physicians. The famous physician Bian Que, recorded in the “Records of the Grand Historian” during the Spring and Autumn period, was particularly renowned for his expertise in observation, inquiry, auscultation, and palpation, especially pulse diagnosis. To effectively treat diseases, a correct diagnosis is essential. Modern medicine utilizes increasingly advanced scientific techniques for disease diagnosis. However, in ancient times, physicians primarily relied on observation, inquiry, auscultation, and palpation. This was similar in many ancient countries, each with its rich experience. The pulse diagnosis used in ancient Chinese medicine is a unique diagnostic method. Pulse diagnosis, also known as palpation, is one of the four examinations (observation, inquiry, auscultation, and palpation) in TCM and is an indispensable objective basis for syndrome differentiation and treatment.
3. Pulse Methods
Pulse diagnosis is simple; it only requires differentiation.
1. Strength or weakness—distinguishing the adequacy of yang qi.
2. Pulse size—distinguishing the adequacy of yin and blood.
3. Pulse position—distinguishing whether yang qi is in the exterior or interior.
That is sufficient for differentiation.
Floating pulse: indicates yang qi in the exterior attacking evil (strong), or insufficient yang qi (weak), or yang qi circulating in the exterior during summer.
Deep pulse: indicates yang qi in the interior attacking evil (strong), or insufficient yang qi (weak), or yang qi circulating in the interior during winter.
A floating pulse with insufficient yang qi (weak) indicates that qi does not converge and disperses outward.
A deep pulse with insufficient yang qi (weak) indicates that qi does not disperse outward and can return to its original position.
The key points for differentiation are:
1. The amount of energy (adequate or inadequate);
2. The direction of energy (ascending or descending).
This is consistent with the essence of the six meridians discussed in the “Treatise on the Simplest Diseases”.
The above is a general discussion, followed by specific discussions—
Distinguishing the left hand for yin and blood, and the right hand for yang qi, or saying: the left hand indicates energy storage, while the right hand indicates energy production.
Left hand: cun (寸) corresponds to the heart, guan (关) corresponds to the liver, chi (尺) corresponds to the kidney. The heart governs blood, the liver stores blood, and the essence of blood enters the kidney.
Right hand: cun (寸) corresponds to the lung, guan (关) corresponds to the spleen, chi (尺) corresponds to the kidney. The kidney governs yang, the lung governs qi, the spleen generates qi, and the kidney’s yang transforms essence into qi.
Men are yang and have abundant energy, hence the right hand’s pulse is stronger than the left hand’s pulse.
Women are yin and have abundant blood, hence the left hand’s pulse is stronger than the right hand’s pulse.
This is the normal pulse for men and women.
What if a woman has a stronger right pulse than the left pulse?
Before taking medicine, one should differentiate whether there is excessive yang that cannot converge, leading to floating pulses in both cun and chi.
After taking medicine, one should differentiate whether yang qi has been supported, accelerating transformation, leading to sinking pulses in both cun and chi.
At the same time, one can observe that both guan pulses are the strongest.
The right guan corresponds to the spleen and stomach, which strengthens energy absorption (the spleen governs transformation).
The left guan corresponds to the liver pulse, which strengthens energy storage (the liver governs blood storage).
The premise is crucial: whether medicine has been taken. The same syndrome has completely different significance in differentiation.
The essence of yang lies in its ability to descend; the cun pulse is located above (exterior), and yang should converge and sink. The middle pulse can be obtained with light pressure.
The essence of yang lies in its ability to converge; the chi pulse is located below (interior), and yin should converge and solidify. The heavy pulse can be obtained with firm pressure.
The essence of yang lies in its ability to circulate; the guan pulse is located in the middle (central), and it should be smooth and flowing. The light pulse can be obtained with gentle pressure.
In simple terms, the ends are small, and the middle is large—this is the best energy structure in modern society, referred to as the olive shape.
Application of differentiation—
First, determine whether energy is adequate or inadequate, then determine whether energy is stored (whether the fire is in place, whether yangming descends, and whether ascending and descending are balanced).
Whether energy is adequate or not can be determined by the size of the pulse and whether it is strong or weak; there is no need for detailed discussion.
The relative fire originates in the kidney and first activates in the liver; therefore, if the relative fire is not in place, the liver pulse will be string-like, often tense and strong (indicating qi attacking).
If the relative fire is in place and energy is sufficient, the liver pulse may be string-like but exhibits a gentle and rhythmic quality (like a general who does not get angry but commands respect).
However, the more forcefully one presses down, the stronger the rebound force becomes (like a master of Tai Chi, appearing soft on the surface but strong within; the stronger the opponent, the stronger one becomes).
When using yang, the cun pulse must be floating; if the relative fire is not in place, the cun pulse will also be floating (due to yang qi not converging and dispersing outward). How to distinguish?
Short-term use of yang (speaking, exercising, using spirit, etc.) will lead to the cun pulse returning to convergence after a short period of rest.
If the relative fire is not in place (long-term yang dispersion, similar to using yang), the cun pulse will not converge even after a short period of rest.
If the relative fire originates in the kidney, then if the relative fire is not in place, the chi pulse will often be floating (the kidney water is the mother, and the liver wood is the child; if the child squanders the mother’s savings, it must draw from the mother’s reserves).
If after sitting quietly, the cun pulse remains floating, it indicates that yangming is not descending and the relative fire is not in place; one can infer: insomnia, excessive dreaming, emotional agitation, dry eyes, itchy throat, tinnitus—this can be known through the pulse.
If the cun pulse is floating and the chi pulse is also floating, the relative fire is not in place, which can confirm that the chi pulse floating is conclusive evidence of long-term yang qi dispersing outward.
If the left hand’s chi pulse (kidney yin) is absent, it indicates amenorrhea, cessation of menstruation, or light menstruation.
If the right hand’s chi pulse (kidney yang) is absent, it indicates impotence, sexual coldness, infertility, miscarriage, dysmenorrhea, cold hands and feet, depression, memory loss, muscle weakness, and frequent urination.
The rest can be inferred based on the functions of the respective organs. In the simplest terms, regardless of the organs, one can deduce based on yang deficiency symptoms.
