Three Articles on Pulse Diagnosis: Pulse Techniques, Pulse Theory, and Pulse Methods!
1.
Fú Mài (Floating Pulse): Lightly pressing reveals the pulse; heavy pressing does not. It floats like wood on water. A strong floating pulse indicates wind-heat, while a weak floating pulse suggests blood deficiency.
Chén Mài (Deep Pulse): Requires heavy pressure to feel; it is like a stone sinking in water. A strong deep pulse indicates cold pain, while a weak deep pulse suggests deficiency-cold.
Chí Mài (Slow Pulse): A pulse that comes once every three breaths, extremely slow. A slow pulse indicates organ disease or excess cold; careful analysis is needed between deficiency and excess.
Shuò Mài (Rapid Pulse): A pulse that comes six times per breath, fast and requires attention. Distinguish between floating and deep, deficiency and excess; the fire of the monarch and minister differs in treatment.
Xū Mài (Weak Pulse): A weak pulse is formless, large, and soft without root. A weak pulse with body heat indicates heat stroke; qi deficiency leads to weakness.
Shí Mài (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.
Huá Mài (Slippery Pulse): A slippery pulse is difficult to interpret, like beads rolling on a plate. It indicates food stagnation, phlegm-heat fullness in the chest, and in women, it should be regulated during pregnancy.
Sè Mài (Choppy Pulse): A choppy pulse is like scraping bamboo, thin, slow, and short, resembling a desire to stop. It indicates blood deficiency, dryness of fluids, and qi stagnation; in women, it suggests non-pregnancy or amenorrhea.
Hóng Mài (Surging Pulse): A surging pulse is full and wave-like, though it calms down upon leaving. It indicates the progression of disease and strong evil qi, making treatment difficult.
Wēi Mài (Weak Pulse): A weak pulse is like a thread, barely felt. It indicates severe deficiency and chronic illness, with difficulty in recovery.
Jǐn Mài (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.
Huǎn Mài (Slow Pulse): A slow pulse is four beats per breath, gentle and relaxed, indicating a normal state. It may suggest spleen deficiency or wind-damp disease; careful evaluation is needed.
Rú Mài (Soft Pulse): A soft pulse is floating, gentle, and weak, like cotton floating on water. It can be seen in postpartum conditions, but in healthy individuals, it indicates concern.
Ruò Mài (Weak Pulse): A weak pulse is soft and fine, like cotton in water, indicating declining yang qi and blood deficiency; it is acceptable in the elderly but should be avoided in the young.
Cháng Mài (Long Pulse): A long pulse extends beyond its normal position, soft upon pressing. A long pulse indicates strong heart and kidney foundations, while a long, hard pulse indicates fire-related issues.
Duǎn Mài (Short Pulse): A short pulse is contracted, like a turtle, indicating a hidden condition. A short pulse suggests various difficult-to-treat diseases due to deficiency of true yuan qi.
Kāo Mài (Hollow Pulse): A hollow pulse feels soft in the middle, like pressing on a drum skin. It indicates heat invading the yang channels, leading to blood overflow and heat damaging the yin channels.
Xián Mài (Wiry Pulse): A wiry pulse is straight and taut, resembling a guitar string. It indicates liver and gallbladder issues, phlegm, and pain, with varying degrees of severity.
Sàn Mài (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 disconnect.
Xì Mài (Fine Pulse): A fine pulse is as thin as a thread, felt only with deep pressure. It indicates excessive worry and qi-blood deficiency, often seen with dampness.
Fú Mài (Hidden Pulse): A hidden pulse requires careful searching, felt only by pressing deeply. It indicates qi stagnation, cold accumulation, and food blockage, leading to nausea.
Dòng Mài (Moving Pulse): A moving pulse is rapid and irregular, indicating pain and shock. It is often seen in severe conditions.
Gé Mài (Leather Pulse): A leather pulse is tense and urgent, resembling a drum skin. It indicates postpartum conditions in women and deficiency in men.
Láo Mài (Firm Pulse): A firm pulse is strong and solid, indicating internal accumulation, cold, and pain.
Cù Mài (Rapid Pulse): A rapid pulse is quick and stops intermittently, indicating heat and dryness.
Jié Mài (Knotted Pulse): A knotted pulse is slow and stops intermittently, indicating stagnation and emotional distress.
Dài Mài (Intermittent Pulse): An intermittent pulse is absent for a long time, indicating chronic illness and difficulty in treatment.
Jí Mài (Rapid Pulse): A rapid pulse is fast and urgent, indicating excess heat and danger.
This table should be memorized vertically and applied horizontally.
2.
What is a normal pulse? A normal person has a pulse of four beats per breath, calm and even, indicating vitality. Any deviation indicates a pathological pulse, considering special populations such as the elderly, children, and seasonal variations.
Knowing the normal pulse, the next step is to understand the four pulse types: floating, deep, slow, and rapid.
A floating pulse is lightly felt, while a deep pulse requires heavy pressure. A pulse with fewer than four beats is slow, while one with more than four beats is rapid.
What 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.
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 pulse, 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 with slow and rapid, we can generally distinguish between yin and yang, exterior and interior, cold and heat. Additionally, we assess strength; strong indicates excess, while weak indicates deficiency. This allows us to clarify the distinctions of yin and yang, exterior and interior, cold and heat. Finally, by considering the pulse location, we can determine which organ the pulse reflects.
Understanding these, we can recombine the pulse types, as clinical practice often presents many combinations, such as floating-slow, floating-rapid, floating-long, and floating-fine. Similarly, deep pulses can be 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 insufficiency can lead to insufficient 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. The disease is located in the kidney and bladder, suggesting heat in these organs, leading to symptoms like yellow and hot urination, heat in the hands and feet, lower back soreness, 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, and the chi pulse indicates yin and deficiency. This combination suggests that yin is insufficient to control yang, leading to an excess of yang. 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; more practice leads to better results. When I started, I sometimes saw dozens of patients a day. Afterward, I would compare my findings, noting what was correct and what was wrong, gradually becoming proficient. During pulse diagnosis, it is crucial to analyze comprehensively, considering the location and organ functions. Each organ’s function can indicate what issues arise from cold, heat, exterior, interior, yin, yang, deficiency, and excess. Additionally, do not rely solely on one diagnosis; the ancient method of combining the four examinations is very reasonable.
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 or 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 practices of ancient physicians. The famous physician Bian Que from the Spring and Autumn period is particularly known for his expertise in observation, listening, questioning, and pulse diagnosis. To effectively treat diseases, accurate diagnosis is essential. Modern medicine utilizes increasingly advanced scientific techniques for diagnosis. However, in ancient times, physicians primarily relied on observation, questioning, listening, smelling, and touching. This was common in many ancient countries, each with its rich experience. The pulse diagnosis used in ancient Chinese medicine is a unique diagnostic method, also known as pulse-taking, and is one of the four examinations (observation, listening, questioning, and pulse-taking) in TCM, serving as an indispensable objective basis for syndrome differentiation and treatment.
3.
Pulse diagnosis is simple; it only requires distinguishing:
1. Strength vs. Weakness – to discern the adequacy of yang qi.
2. Size of the pulse – to discern the adequacy of yin and blood.
3. Floating vs. Deep – to discern whether yang qi is in the exterior or interior.
This is sufficient for syndrome differentiation.
A floating pulse indicates yang qi in the exterior attacking evil (strong), or insufficient yang qi (weak), or summer yang qi circulating in the exterior.
A deep pulse indicates yang qi in the interior attacking evil (strong), or insufficient yang qi (weak), or winter yang qi circulating in the interior.
A floating pulse with insufficient yang qi (weak) indicates that qi is not gathering and is dispersing outward.
A deep pulse with insufficient yang qi (weak) indicates that qi is not dispersing outward and can return to its original position.
The key points for syndrome differentiation are:
1. The amount of energy (sufficient or insufficient);
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 of All 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: Cùn (Cun Pulse) – Heart; Guān (Guan Pulse) – Liver; Chǐ (Chi Pulse) – Kidney Yin. The heart governs blood, the liver stores blood, and the essence of blood enters the kidney yin.
Right hand: Cùn (Cun Pulse) – Lung; Guān (Guan Pulse) – Spleen; Chǐ (Chi Pulse) – Kidney Yang. The lung governs qi, the spleen generates qi, and the kidney’s yang transforms essence into qi.
Men are yang and have abundant qi, 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 gender.
If a woman has a stronger right pulse than the left, how should it be interpreted?
Before taking medication, it should be differentiated as excessive yang that cannot be contained, with both cun and chi pulses being floating.
After taking medication, it should be differentiated as yang qi being supported, accelerating transformation, with both cun and chi pulses being deep.
At the same time, the strongest pulses are observed in both hands’ guan positions.
The right guan corresponds to the spleen and stomach, indicating enhanced energy absorption (the spleen governs transformation).
The left guan corresponds to the liver pulse, indicating enhanced energy storage (the liver governs blood storage).
The premise is crucial: whether medication has been taken. The same syndrome can have completely different meanings in diagnosis.
The essence of yang lies in its ability to descend; the cun pulse is located above (exterior), and yang should be gathered and descended. The middle pulse can be obtained lightly.
The essence of yang lies in its ability to contain; the chi pulse is located below (interior), and yin should be gathered and secured. The deep pulse can be obtained heavily.
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 easily.
In simple terms, the ends are small, and the middle is large — the best energy structure in modern society is called: olive-shaped.
Application of syndrome differentiation —
First, determine whether energy is sufficient or insufficient, 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 sufficient 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 taut and often strong (indicating qi attacking).
If the relative fire is in place and energy is sufficient, the liver pulse may be taut but exhibits a gentle rhythmic quality (like a general who does not get angry but commands respect).
However, the more forcefully one presses down, the more rebound strength increases (like a Tai Chi master who appears soft on the surface but is strong inside; the stronger the opponent, the stronger I become).
When using yang, the cun pulse must be floating. If the relative fire is not in place, the cun pulse will also be floating (yang qi is not contained and disperses outward). How to distinguish?
Short-term use of yang (talking, exercising, using spirit, etc.) will allow the cun pulse to return to a contained state 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 return to a contained state even after a short period of rest.
If the relative fire originates in the kidney, then the chi pulse will often be floating (kidney water is the mother, liver wood is the child; if the child squanders the mother’s savings, it must draw from the mother’s deposits).
If after sitting quietly, the cun pulse remains floating, it indicates that yangming is not descending and the relative fire is not in place. This can be inferred as insomnia, excessive dreaming, irritability, dry eyes, itchy throat, and tinnitus — all indicated by the pulse.
If both the cun pulse and chi pulse are floating, and the relative fire is not in place, it can be diagnosed without doubt. A floating chi pulse is conclusive evidence of long-term yang qi dispersing outward.
If the left hand’s chi pulse (kidney yin) is absent, it indicates amenorrhea, irregular menstruation, or light menstrual flow.
If the right hand’s chi pulse (kidney yang) is absent, it indicates impotence, frigidity, infertility, miscarriage, dysmenorrhea, cold hands and feet, depression, memory loss, muscle weakness, and frequent urination.
Other conditions can be inferred based on the functions of the respective organs. In the simplest terms, regardless of the organs, one can infer based on yang deficiency symptoms.
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