The floating pulse (fu mai) can be understood as the sensation under the fingers resembling pressing on a piece of wood floating on water, or like a small boat on the water’s surface. This means that the pulse wave is located at a relatively superficial level beneath the skin, allowing it to be felt with slight pressure, and the pulsation strength diminishes upon deeper pressure. Some have noticed that certain pulses feel similar to the floating pulse; how can we distinguish them?
1.散脉 (Scattered Pulse)
When touched, it feels scattered; with slight pressure, it feels as if it cannot be felt, and with more pressure, there is no pulsation at all. Sometimes, the pulse beats irregularly, appearing fast and slow, with varying strength, leading to the belief that it is floating without a root, described as “scattered like willow fluff without a fixed trace.” This pulse type is often seen in critical conditions where the qi of the heart and kidneys is about to fail, commonly associated with prolonged illness leading to deficiency of qi, blood, and body fluids, resulting in the dispersal of vital energy and the decline of the organ’s essence.
2.芤脉 (Hollow Pulse)
This pulse presents as large and hollow when floating, feeling like pressing on the surface of a scallion tube. It feels soft under the fingers, floating on the muscle surface, with the sides or top feeling solid, while the middle is empty. This indicates a reduced blood volume within the pulse vessel, insufficient filling, and low tension. This condition often arises from massive blood loss due to vomiting blood, hemorrhage, or severe vomiting and diarrhea, leading to a significant loss of body fluids, where the yin blood cannot sustain the yang qi, causing the yang qi to float outside the pulse. If bleeding is promptly controlled and replenished, the pulse vessel can refill, and the pulse may gradually recover.
3.革脉 (Leather Pulse)
This pulse often feels like pressing on a balloon. It floats on the muscle surface, easily felt with light pressure, but is firm externally and empty internally, similar to pressing on a drum skin. While it shares similarities with the hollow pulse, the leather pulse is floating and taut like a drum skin, whereas the hollow pulse is floating and soft, like pressing on a scallion tube.
The leather pulse is commonly seen in conditions of depleted essence and blood, where the pulse vessel cannot fill, and the righteous qi cannot remain internally, floating on the surface, often observed in cases of blood loss, loss of essence, postpartum conditions, and other related disorders.
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