The floating pulse category includes six pulse types: floating pulse (fu mai), surging pulse (hong mai), soft pulse (ru mai), scattered pulse (san mai), hollow pulse (kao mai), and leather pulse (ge mai). Their common characteristic is that they can be felt with light pressure. The classification is based on the frequency and strength of the pulse, but in actual pulse diagnosis, various pulse types often mix, and it is rare to find a single pulse type. Therefore, mastering pulse diagnosis requires long-term experience accumulation.
1. Floating Pulse (Fu Mai)
Pulse Characteristics: Felt with light pressure, slightly diminished with heavy pressure but not empty, rising and floating like wood on water.
Main Conditions: Exterior syndrome, deficiency syndrome.
Pulse Theory: The floating pulse indicates an exterior condition, reflecting the pathogenic factors in the meridians and superficial layers. The pathogen invades the muscles, and the defensive yang rises to resist, causing the pulse to be strong and floating. In cases of chronic internal injury and deficiency, the yang cannot sink and thus floats outward, resulting in a floating pulse that is large but weak.
2. Surging Pulse (Hong Mai)
Pulse Characteristics: Extremely large, resembling surging waves, strong on arrival and weak on departure.
Main Conditions: Internal heat syndrome.
Pulse Theory: The surging pulse forms due to excess yang, qi stagnation, and internal heat, leading to the expansion of the pulse vessels and a surge of qi and blood. If the surging pulse appears in cases of chronic illness with qi deficiency or blood loss, it indicates a dangerous condition of deficiency with excess pathogenic factors or depletion of yin fluids, leading to solitary yang rising or loss of yang. At this time, the floating pulse is surging, while the sinking pulse is weak and spiritless.
3. Soft Pulse (Ru Mai)
Pulse Characteristics: Floating and fine, like silk in water.
Main Conditions: Deficiency syndrome, dampness syndrome.
Pulse Theory: The soft pulse indicates various deficiencies. If both essence and blood are injured, and yin cannot support yang, the pulse is floating and soft. If there is qi deficiency and yang decline, the pulse is also floating and soft, thus forming a soft pulse. If dampness obstructs the pulse vessels, a soft pulse may also be observed.
4. Scattered Pulse (San Mai)
Pulse Characteristics: Floating and scattered without roots, irregular in frequency, resembling scattered willow fluff.
Main Conditions: Dispersed vital energy.
Pulse Theory: The scattered pulse indicates a critical condition where the vital energy is dispersed, and the qi of the organs is about to collapse. Due to heart failure, yin and yang cannot consolidate, leading to a floating and scattered pulse that is not tight. With slight pressure, it cannot be felt, appearing rootless; if yin declines and yang dissipates, the heart qi cannot maintain blood circulation, resulting in an irregular pulse.
5. Hollow Pulse (Kao Mai)
Pulse Characteristics: Floating, large, and hollow, like pressing on a scallion tube.
Main Conditions: Blood loss, yin injury.
Pulse Theory: The hollow pulse is often seen in cases of blood loss and yin injury, indicating a loss of yin blood and insufficient filling of the pulse vessels. Sudden excessive blood loss leads to a rapid decrease in blood volume, insufficient nourishing blood, or severe fluid loss, causing the blood to be unable to fill the vessels, resulting in a large and hollow floating pulse.
6. Leather Pulse (Ge Mai)
Pulse Characteristics: Floating and strong to the touch, hollow inside but firm outside, like pressing on a drum skin.
Main Conditions: Blood loss, loss of essence, postpartum issues, or leakage.
Pulse Theory: The leather pulse is a combination of the string and hollow pulses, resulting from internal deficiency of essence and blood, with qi unable to anchor and floating outward, resembling the constriction of cold yin energy, thus appearing strong outside and hollow inside.
Sinking Pulse Classification and Main Conditions:
The sinking pulse category includes sinking, hidden, weak, and firm pulses. The pulse position is deeper, felt only with heavy pressure, thus categorized together.
1. Sinking Pulse (Chen Mai)
Pulse Characteristics: Not felt with light pressure, but felt with heavy pressure, like a stone sinking to the bottom of water.
Main Conditions: Internal syndrome. It can also be seen in normal individuals without disease.
Pulse Theory: The pathogenic factors are internal, and the righteous qi is battling within, causing qi and blood to be trapped internally, resulting in a sinking and strong pulse, indicating an internal excess condition. If the organs are weak and yang is deficient, with insufficient qi and blood, the pulse is sinking and weak, indicating an internal deficiency condition.
2. Hidden Pulse (Fu Mai)
Pulse Characteristics: Felt only with heavy pressure on the muscles and bones, and may be hidden and not felt at all.
Main Conditions: Pathogenic closure, syncope, extreme pain.
Pulse Theory: Due to the internal lurking of pathogenic qi, the pulse qi cannot circulate, leading to a hidden pulse. If yang qi is weak and about to collapse, it cannot stimulate the blood vessels, resulting in a hidden pulse. The former is often seen in acute pathogenic conditions, while the latter is more common in chronic illness with declining righteousness.
3. Weak Pulse (Ruo Mai)
Pulse Characteristics: Extremely soft and sinking.
Main Conditions: Deficiency of qi, blood, yin, and yang.
Pulse Theory: Insufficient yin blood cannot fill the pulse vessels, and with declining yang and insufficient qi, the pulse is sinking and soft, forming a weak pulse.
4. Firm Pulse (Lao Mai)
Pulse Characteristics: Sinking, firm, large, and long, solid and immovable.
Main Conditions: Yin cold accumulation, internal excess.
Pulse Theory: The firm pulse forms due to the solidification of pathogenic qi and internal accumulation of cold yin, with yang qi sinking below, resulting in a sinking, solid, large, and long pulse that is firm and immovable. The firm pulse indicates a distinction between excess qi and blood, with palpable masses indicating solid blood conditions; while non-palpable distensions indicate solid qi conditions. If the firm pulse is seen in cases of blood loss or yin deficiency, it indicates a critical condition of sudden loss of yin blood.
The sinking pulse is one of the pulse types in Traditional Chinese Medicine. It is often characterized by being imperceptible with light touch but only felt with heavy pressure. In other words, the pulse is low and cannot be felt without forceful pressing. Generally, most normal individuals may exhibit a sinking pulse, but no special treatment is required. However, some patients with a sinking pulse may often be related to conditions such as blood stasis, qi stagnation, or phlegm-dampness. Therefore, it is essential to seek a detailed diagnosis from an experienced TCM practitioner.
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