The dual string pulse indicates cold, as it is often found in cases of significant deficiency after purging. The single string pulse indicates fluid retention. — Jin Kui Yao Lue
This string pulse is primarily associated with cold and fluid retention, as well as pain, and is linked to the Shaoyang pulse, which is characterized by its string-like quality. Generally, this fluid pulse is more pronounced in one hand, typically the right hand, which relates to the concept that water belongs to the Qi aspect.
In cases of blood stasis, you may notice that any abnormal pulse phenomena are limited to the left side. Not only is the pulse confined to the left hand, but the affected area is also on the left side.
For instance, in the case of Tao He Cheng Qi Tang (Peach Pit Decoction to Order the Qi), the acute distension in the lower abdomen is also predominantly on the left side. If you encounter this condition, you can palpate the area, and you will find that the acute distension is indeed more pronounced on the left side, which is an ancient observation.
From my observations, it may be related to the heart being on the left side, as the blood aspect tends to be more concentrated on the left, while the Qi aspect is more on the right. This water aspect belongs to the Qi aspect, not the blood aspect, which is why in Zhang Zhongjing’s texts, he refers to it as Yang Qi; Qi is associated with Yang, while blood is associated with Yin. Therefore, regarding body fluids, he refers to it as Yang Qi, which differs from later interpretations, leading to frequent misunderstandings in the annotations of Shang Han Jin Kui.
If both hands exhibit a string pulse, it likely indicates cold. Why is it cold? Because after significant purging, the middle becomes deficient, leading to coldness. Thus, it is suggested that the condition is likely related to water.
Although there are symptoms of water retention, one should not hastily use purgatives. For example, Shi Zao Tang (Ten Jujube Decoction) also purges water, but as discussed later, it should not be used indiscriminately. If purgatives are used and both hands exhibit a string pulse, it results in a state of deficiency and cold.
Thus, the sentence structure is inverted; it should be stated as, “The single string pulse indicates fluid retention,” placed first; and “The dual string pulse indicates cold,” placed afterward for better understanding.
In summary, the transformation of the pulse from a single string to a dual string occurs due to significant purging, which easily leads to deficiency, and extreme deficiency results in cold.
【Source: Xiao Dao Jing Fang】