Dr. Xiao Bai:Clinical references for TCM cases and discussions
In the general process of TCM diagnosis and treatment, we emphasize the four diagnostic methods of “observation, listening, inquiry, and palpation” to differentiate syndromes, and then prescribe medicine based on the identified syndrome. Have you heard of correlating pulse patterns with Chinese herbs to directly guide prescription? Today, we will explore the theory of “Using Pulse to Guide Medication” by the renowned Qing Dynasty physician Long Bai.
Floating Pulse
【Original Text】Floating pulse is due to wind; for exterior symptoms, it is advisable to use dispersing methods: Qiang Huo (Notopterygium), Gan Cao (Licorice), Gao Ben (Ligusticum), Fang Feng (Siler), Xi Xin (Asarum), Bai Zhi (Angelica Dahurica), Cang Zhu (Atractylodes), Chuan Xiong (Ligusticum), Huang Qin (Scutellaria), Bo He (Mint), and additionally, fresh ginger and scallions, adjusting according to the cold and heat conditions.【Translation】The appearance of a floating pulse is often due to an external invasion of wind, which is classified as an exterior syndrome. Treatment should employ dispersing methods, commonly used herbs include Qiang Huo, Gan Cao, Gao Ben, Fang Feng, Xi Xin, Bai Zhi, Cang Zhu, Chuan Xiong, Huang Qin, and Bo He, along with fresh ginger and scallions. The rational use of these herbs should be carefully considered based on the nature and location of the disease during clinical practice.【Analysis】The herbs listed correspond to Zhang Yuan’s Qiang Huo Chong He Decoction, which removes Di Huang and adds Gao Ben and Bo He. If the patient presents with headache, fever, floating pulse, and neither rapid nor slow pulse, this indicates an exterior wind syndrome. If there is a large pulse in the Yangming position, nasal congestion, pain in the brow ridge, and a white tongue coating, one may add Sheng Ma (Cimicifuga) and Ge Gen (Pueraria); if there is a large pulse in the Taiyang position with pain in the lower back, one may add Gui Zhi (Cinnamon Twig) and Xing Ren (Apricot Kernel); if there is a large pulse in the Shaoyang position with pain in the sides and temples, one may add Chai Hu (Bupleurum); if there is heaviness at the vertex, one may add Tian Ma (Gastrodia). If there is stiffness in the neck, one may add Qin Jiao (Gentiana); if there is phlegm in the upper body, one may add Qian Hu (Peucedanum), Dan Nan Xing (Arisaema), Zhi Ban Xia (Pinellia), Chen Pi (Tangerine Peel), and other phlegm-transforming herbs; if there is aversion to cold, one may add Su Ye (Perilla Leaf). The dosage of the herbs can be adjusted according to the condition.
Deep Pulse
【Original Text】Deep pulse indicates interior conditions, either Qi stagnation or accumulation; Qi stagnation presents as a soft pulse, while accumulation is firm. For accumulation, one should use purging methods; for Qi stagnation, one should regulate and tonify. The purging herbs include Da Huang (Rhubarb), Zhi Shi (Bitter Orange), Hou Po (Magnolia Bark), and Mang Xiao (Glauber’s Salt), which can clear the internal accumulation; Mu Xiang (Aucklandia), Bing Lang (Areca), San Leng (Sparganium), and E Zhu (Curcuma) can disperse heat and drain dampness.For a soft deep pulse, one should regulate Qi and disperse stagnation using Xiang Fu (Cyperus), Shen Qu (Malt), Zhi Zi (Gardenia) fried black, Chuan Xiong, Shan Zha (Hawthorn), Mai Ya (Barley Sprout), Chen Xiang (Aquilaria), Wu Yao (Lindera), and Ren Shen (Ginseng) for tonifying Qi. After taking these herbs, symptoms of abdominal and lateral distension can be alleviated.【Translation】A deep pulse indicates an interior syndrome, which may be due to Qi stagnation or internal accumulation. A soft pulse indicates Qi stagnation, while a firm pulse indicates accumulation. For treating accumulation, purging methods should be employed, while for Qi stagnation, regulation and tonification are necessary.Herbs for purging accumulation include Da Huang, Zhi Shi, Hou Po, and Mang Xiao, which can eliminate internal stagnation; Mu Xiang, Bing Lang, San Leng, and E Zhu can clear heat and drain dampness.For patients with a soft deep pulse, treatment should focus on regulating Qi and dispersing stagnation, using Xiang Fu, Shen Qu, fried Zhi Zi, Chuan Xiong, Shan Zha, Mai Ya, Chen Xiang, and Wu Yao, along with Ren Shen to tonify Qi. After taking these herbs, symptoms of abdominal and lateral distension can be alleviated.【Analysis】A deep pulse indicates that Qi and blood are not adequately filling and moving through the vessels. The underlying causes may include Qi deficiency, blood deficiency, or the presence of tangible accumulations that obstruct the flow of Qi and blood. Tangible accumulations may include phlegm, dampness, food stagnation, blood stasis, or heat toxins.If the cause is Qi deficiency, treatment should focus on tonifying Qi and regulating it, using Si Jun Zi Tang (Four Gentlemen Decoction) with modifications. If the cause is blood deficiency, treatment should nourish blood and invigorate blood circulation while regulating Qi, using Si Wu Tang (Four Substance Decoction) with Xiang Fu and Mu Xiang. For those with blood heat, one should add Sheng Di (Rehmannia), Chi Shao (Red Peony), Dan Pi (Moutan), Zhi Mu (Anemarrhena), and Huang Bai (Phellodendron).If the accumulation is due to stagnation in the body, leading to Qi obstruction, treatment should focus on regulating Qi and relieving stagnation, but the appropriate treatment method should be selected based on the type of accumulation. If it is due to heat toxins, one should clear heat and detoxify, using Huang Qin, Huang Lian, Zhi Zi, and Xia Ku Cao (Selfheal). If it is due to phlegm, one should transform phlegm, adding Ban Xia, Chen Pi, Tian Nan Xing, and Xian Zhu Li (Fresh Bamboo Juice).If it is due to dampness, one should strengthen the spleen, dry dampness, transform dampness, and promote urination, using Cang Zhu, Bai Zhu, Mu Guo (Papaya), Yi Yi Ren (Job’s Tears), Che Qian Zi (Plantago), Ze Xie (Alisma), and Zhu Ling (Polyporus). If it is due to constipation in the Yangming channel, one should use purgatives or moistening laxatives, using Cheng Qi Tang or Ma Zi Ren Wan, with herbs like Da Huang, Mang Xiao, Zhi Shi, Hou Po, Dang Gui, Huo Ma Ren (Hemp Seed), Guo Zi Ren (Melon Seed), and Tao Ren (Peach Kernel).If it is due to food stagnation, one should use methods to eliminate stagnation, using Bao He Wan, with herbs like Shen Qu, Mai Ya, and Shan Zha. If it is due to blood stasis, one should invigorate blood and resolve stasis, selecting appropriate formulas based on the specific condition, such as Wang Qing Ren’s Zhu Yu Tang.
Slow Pulse
【Original Text】Slow pulse indicates cold, with blood coagulated and Qi deficient; the Ren pulse is floating, indicating cold in the exterior. Use Fu Zi (Aconite) and Gui Xin (Cinnamon Heart), Huang Qi (Astragalus), Bai Zhu, ginger, and jujube, Chuan Xiong, and Fu Ling (Poria), with cooked Rehmannia for better results. Heavily use Fang Feng to sweep away exterior cold. For headache, add Bai Zhi, cooked Ai Ye (Mugwort) to disperse, and add Cang Zhu and Wu Yao, along with Ren Shen and fried Hu Jiao (Pepper).【Translation】A slow pulse indicates a cold syndrome, with insufficient Yang Qi and blood cold stagnation. When palpating the Ren pulse, it is floating, indicating that cold evil is present on the surface. The herbs that can be used include Fu Zi, Gui Xin, Huang Qi, Bai Zhu, ginger, jujube, Chuan Xiong, and Fu Ling, with the addition of cooked Rehmannia for better results, and Fang Feng should be used heavily to eliminate the exterior cold.Combining these herbs can help eliminate the cold evil present on the surface. If there is a headache, one may add Bai Zhi and cooked Ai Ye to disperse the meridians, and also add Cang Zhu, Wu Yao, Ren Shen, and fried Hu Jiao. Adjustments should be made based on the condition, requiring careful consideration by the physician.【Analysis】The conditions described in the text indicate that there is insufficient internal Yang Qi to promote blood circulation, while external cold evil invades, causing stagnation of Yang Qi and leading to blood flow stagnation, resulting in a slow pulse.The Ren pulse indicates the exterior; if there is an exterior evil, the Ren pulse should be floating. Treatment should focus on supporting Yang, tonifying Qi, and dispersing cold. The formula should combine Gui Zhi Tang with Si Jun Zi Tang and Si Wu Tang, adding Fu Zi, Cang Zhu, Wu Yao, and fried Hu Jiao to warm Yang and disperse cold, with heavy use of Fang Feng to eliminate exterior evil. In clinical practice, if one encounters a patient with Yang deficiency and blood weakness who is invaded by cold evil, one must avoid using Ma Huang (Ephedra); if mistakenly used, it can lead to dangerous changes.
Rapid Pulse
【Original Text】Rapid pulse indicates heat, with three parts detailed: the inch indicates heat in the upper jiao, the guan indicates heat in the abdominal organs, and the chi indicates urinary issues such as hematuria or prolapse. A rapid pulse on the left indicates eye diseases, while on the right indicates throat sores, possibly accompanied by restlessness, vomiting, or manic behavior, with dry, itchy skin, and boils or abscesses.The treatment principle is to clear heat; the method is good: use Xuan Shen (Scrophularia), Huang Lian, Chen Pi, Bo He, Niu Bang Zi (Burdock), Qiao Mu (Forsythia), Chai Hu, Sheng Ma, Jie Geng (Platycodon), Ma Bo (Morus), and Jang (Silkworm) to promote urination and relieve thirst, along with Mu Tong (Akebia) and Sheng Di Huang (Rehmannia) to clear heat toxins, which can treat all skin sores.If the pulse is neither floating nor deep, and the tongue coating is thick and greasy like frost, this indicates the initial stage of an epidemic; one can use Da Yuan Yin to treat it, with herbs like Cao Guo (Tsaoko), Gan Cao, Hou Po, Bing Lang, Zhi Mu, Huang Qin, and Bai Shao, which can disperse the evil and clear heat. Additionally, one may add Qiang Huo, Chai Hu, and Ge Gen to disperse the three Yang channels; if the evil has transmitted inward, one can use Da Huang, which is a key formula for epidemics, also known as Tian Fang.【Translation】A rapid pulse indicates a heat syndrome, with the inch, guan, and chi pulses indicating heat in the upper jiao, abdominal organs, and urinary issues respectively, such as hematuria or prolapse. A rapid pulse on the left indicates potential eye diseases, while on the right indicates throat sores, possibly accompanied by restlessness, vomiting, or manic behavior, with dry, itchy skin, and boils or abscesses.The treatment principle is to clear heat; the method is effective: use Xuan Shen, Huang Lian, Chen Pi, Bo He, Niu Bang Zi, Qiao Mu, Chai Hu, Sheng Ma, Jie Geng, Ma Bo, and Jang to promote urination and relieve thirst, along with Mu Tong and Sheng Di Huang to clear heat toxins, which can treat all skin sores.If the pulse is neither floating nor deep, and the tongue coating is thick and greasy like frost, this indicates the initial stage of an epidemic; one can use Da Yuan Yin to treat it, with herbs like Cao Guo, Gan Cao, Hou Po, Bing Lang, Zhi Mu, Huang Qin, and Bai Shao, which can disperse the evil and clear heat. Additionally, one may add Qiang Huo, Chai Hu, and Ge Gen to disperse the three Yang channels; if the evil has transmitted inward, one can use Da Huang, which is a key formula for epidemics, also known as Tian Fang.【Analysis】A rapid pulse indicates heat, which may be either deficient or excess. Treatment should focus on dispersing wind, detoxifying, clearing heat, and nourishing Yin. Based on the location of the rapid pulse in the inch, guan, and chi positions, one should clear heat from the corresponding organs.The left hand pulse corresponds to the liver; a rapid pulse indicates heat in the liver, which opens to the eyes, hence the occurrence of eye diseases; the right hand pulse corresponds to the spleen; a rapid pulse indicates heat in the spleen, which connects to the throat, hence the occurrence of throat sores.If an epidemic is in its initial stage, symptoms may include headache, fever, and a white tongue coating that is thick and greasy, indicating that the evil heat is lurking in the membrane source, with dampness and turbidity blocking the Qi mechanism. Using Da Yuan Yin can directly address the disease, clear the lurking evil, clear heat, nourish Yin, and promote the smooth flow of Qi, allowing the evil to retreat and the pulse to stabilize.When the evil manifests in the Taiyang channel, Qiang Huo is the chief herb; if it manifests in the Shaoyang channel, Chai Hu is the chief herb; if it manifests in the Yangming channel, Ge Gen is the chief herb. If it involves all three Yang channels, one should use Qiang Huo, Chai Hu, and Ge Gen together; if the evil heat has already transmitted inward, Da Huang should be used as the chief herb. Formulas may include Dong Yuan Pu Ji Xiao Du Yin, Ben Shi Huo Fu Dan, Wu Shi Da Yuan Yin, and San Xiao Yin.
Appendix:
Four Character Pulse Diagnosis SummaryThe principles of pulse diagnosis are subtle and difficult to measure; distinguishing between the seven exterior and eight interior conditions is challenging.I am neither Qi Huang nor He Yi, but I hold the four-character summary.The four characters are the outline of pulse diagnosis; floating, deep, slow, and rapid are the joints.Floating indicates exterior, while rapid indicates heat; deep indicates interior, while slow indicates cold.Also observe strength and weakness; between deficiency and excess, one must determine the distinction.Exterior and interior, cold and heat, deficiency and excess, the four characters encompass the six family principles.Floating and strong indicate wind; weak and Qi deficient indicate the root condition.Deep and strong indicate accumulation; weak indicates Qi stagnation or obstruction.Slow and strong indicate pain that is hard to endure; weak indicates cold phlegm in the chest.Rapid and strong indicate heat; weak indicates blood deficiency, sores, and pain.1. Seven Exterior Pulses:Floating, hollow, slippery, solid, wiry, tight.Eight Interior Pulses: weak, deep, slow, rough, slow, hidden, soft, weak.2. Essentials of Pulse TheoryThe principles of pulse diagnosis are as fine as hair; few can grasp the subtleties. Understanding the main ideas is sufficient; floating, deep, slow, and rapid are the four characters, while deficiency and excess, cold and heat correspond to each other. The seven exterior and eight interior pulses are not to be confused; these four must be clearly analyzed to ensure accurate prescriptions.3. Floating PulseListen to my teachings on floating pulse; gently feel it. Within the floating character, distinguish between slow and rapid; floating and slow indicate exterior cold, while floating and rapid often indicate excess heat. Floating without strength indicates great deficiency heat; floating with strength indicates wind-cold. Remember the floating character well.4. Deep PulseLet me explain the deep character to you; press heavily to the bottom. The deep character also contains the principles of slow and rapid; deep and slow indicate cold like ice, while deep and rapid indicate internal heat that does not need to be mentioned. A deep pulse without strength indicates Qi deficiency; a deep pulse with strength indicates accumulation. Remember the deep character well.5. Pulse LocationTo learn pulse diagnosis, one must clearly distinguish the locations: the inch, guan, and chi are the same on both sides. The five organs and six bowels correspond accordingly: the left corresponds to the heart, liver, gallbladder, and kidney; the right corresponds to the lung, spleen, stomach, and life gate. The kidney and bladder correspond to each other, while the life gate pulse corresponds to the three jiaos. The large and small intestines are divided into two inches. In clinical practice, the pulse should be calm; do not look askance or listen carelessly. With a clear mind, observe the pulse symptoms; determine which organ is affected, whether it is deficient or excess, cold or heat; if it is deficient, tonify; if it is excess, purge; if it is cold, warm; if it is hot, clear. By clearly distinguishing deficiency and excess, cold and heat, one will not be ashamed of the title of physician.6. Observing Pulse BreathingWhen diagnosing the pulse, breathe steadily; use your breath to observe theirs, noting the interruptions and continuities. One breath with four beats indicates a harmonious pulse; adding one beat is also auspicious; six beats or seven indicate a rapid pulse; ten beats indicate impending death. Physicians must distinguish between Yin and Yang; floating and rapid indicate Yang, while deep and slow indicate Yin. The guan and chi positions should be analyzed for Yin and Yang; within Yin is Yang, and within Yang is Yin; when Yin is extreme, it resembles Yang, and when Yang is extreme, it resembles Yin. The balance between the two is crucial; if a physician cannot distinguish between Yin and Yang, it is no wonder that they may cause life or death.7. Left Inch Floating Pulse (Heart)Left inch floating indicates heart fire deficiency, unable to generate earth; if earth is constrained, metal will surely fail, leading to cough with phlegm, palpitations, night sweats, and returning to the spleen as the main focus. Remove Mu Xiang and replace with Bai Shao; use Wu Wei Zi for astringency; formulas include Yang Xin Tang and Bu Xin Dan, adjusted as needed.Gui Pi Tang poem states:Ren Shen, Bai Zhu, Huang Qi, and Shen, with far-reaching return of fragrance and jujube seeds,Gan Cao must be used roasted, decocted with ginger and jujube to guide.Yang Xin Tang poem states:Ren Shen, Huang Qi, and Fu Ling, with jujube and Bai Pi,Ban Xia, Zhi Gui, and the flavor of blood will calm the heart.Bu Xin Dan poem states:Ren Yuan, Shen Ling, Gui Pi, and Tian Mai Dong,with far-reaching flavor of jujube and Bai Pi, and inside there is Jie Geng.8. Left Inch Deep Pulse (Heart)Left inch deep indicates heart fire excess, which can harm and transfer heat to the small intestine, causing constipation, red and painful urination, or turbid urination, or oral ulcers, with unbearable pain. Use Dao Chi San combined with Xiao Yao San; one dose of Qing Tai can also be effective.Dao Chi San poem states:Sheng Di, Mu Tong, and Gan Cao slightly, with bamboo leaves to clear the upper jiao,several cooling flavors can reduce the excess heat, and naturally, the southern fire will dissipate.Xiao Yao San poem states:Xiao Yao, the ancients were not self-satisfied, with Ling, Bai Shao, and Gui Zhi,Sheng Di and Bo He are decocted together, with Shan Zhi and Dan Pi added.Qing Tai Tang poem states:Qing Tai Tang contains Huang Lian and Huang Qin, three flavors can drain the excess heat strongly,Da Huang must be used with wine, and for Huang Lian, it is also acceptable.9. Left Inch Slow Pulse (Heart)Left inch slow indicates cold in the heart, causing cold shivers, a blue complexion, and white urination, with a preference for hot drinks and aversion to cold water. The intense fire does not warm; use Zhen Wu Tang and Li Zhong Tang, with Fu and Gui as necessary, and if it is not too cold, use Yang Rong Tang for safety.Li Zhong Tang and Zhen Wu Tang poem states:Bai Zhu, Ren Shen, ginger, and jujube are known as Li Zhong,Fu Ling, Bai Shao, and Zhen Wu are known as Zhen Wu, returning to the root and reviving Yang.Yang Rong Tang poem states:Ren Shen, Bai Zhu, Huang Qi, and Chen Pi, with Gui and Bai Shao,this formula cannot be used without breathing, warming the meridians and eliminating cold is greatly beneficial.10. Left Inch Rapid Pulse (Heart)Left inch rapid indicates heat in the heart, which is fire; the heart belongs to fire, and rapid indicates fire; fire within fire, or redness and swelling, or itchy sores, all indicate fire burning. Use Gui Pi Tang to effectively drain the fire within the fire, and add Liu Wei Tang with Bai Shao to gradually reduce it.Liu Wei Tang poem states:Di Huang, Shan Yao, and Fu Ling, with Dan Zhi and Bai Shao added,Yin generates Yang and descends naturally; what fear is there if the pulse is rapid and fire is seen?11. Left Guan Floating Pulse (Liver)Left guan floating indicates liver Qi deficiency, with no fire in wood; without fire, wood cannot generate heart, leading to blood deficiency and weakness in the tendons, possibly resulting in lumps or scrofula. Liver Qi is not harmonious; use Qi Wei Yin for treatment.Qi Wei Yin poem states:Six flavors plus Gui, known as Qi Wei, with the spicy flavor to moisten it,water can generate wood, and wood can grow strong; why worry about the liver’s floating pulse?12. Left Guan Deep Pulse (Liver)Left guan deep indicates liver Qi excess, which is stagnant and cannot extend; causing chest and lateral pain, stomach pain, red and dim eyes, anger injures the liver, leading to weak tendons, and prolonged cases may lead to bleeding or turbid urination; after eating, sourness may be felt, like vinegar soaking the heart. Use Xiao Yao San with Zuo Jin added.Zuo Jin Xiao Yao San poem states:Wu Yao fried with Lian, known as Zuo Jin, Xiao Yao is not extended,dispersing the fire of the liver and gallbladder, this formula is truly effective,add a pinch of rice to treat dysentery.13. Left Guan Slow Pulse (Liver)Left guan slow indicates cold in the liver, with ice hiding charcoal; it is not heat, and cool herbs should not be used; the whole body trembles, eyes close, hands clench; the waist bends, and the legs are weak, with tightness and spasms; use Gui Wei Yin and Ba Wei Yin, with both formulas available.Poem:Six flavors and eight flavors are similar, just missing Gui and Fu herbs.Eight flavors do not have sweet goji berries, while Zuo Gui does not have Fu Ling and Dan Zhi.14. Left Guan Rapid Pulse (Liver)Left guan rapid indicates heat in the liver, which increases fire; the upper burns metal, while the middle injures the spleen, leading to phlegm and fluid depletion; the ruler is unclear, and the rebels assist in chaos; seeking help from the north, eliminate the rebels; use large doses of Liu Wei Tang, adding Bai Shao.15. Left Chi Floating Pulse (Kidney)Left chi floating indicates kidney Qi deficiency, leading to water overflow; water overflows, and earth cannot be consolidated, leading to floating phlegm; use Li Zhong Tang, adding Bai Dou Kou, and Mu Xiang to control half; also, if the life gate is weak, it cannot be paired. Use Ba Wei Yin to tonify and eliminate phlegm.16. Left Chi Deep Pulse (Kidney)Left chi deep indicates kidney Qi excess, leading to water accumulation; water does not flow, and the other organs cannot be nourished; red eyes, dry lips, and nasal congestion; skin dryness, throat dryness, and urinary retention; use Si Wu Tang, Ba Wei Yin, and add Liu Wei.17. Left Chi Slow Pulse (Kidney)Left chi slow indicates cold in the kidney, leading to water coagulation; when water coagulates, it freezes in winter; wear thick clothes and approach the fire, difficult to stop the cold; with cold limbs, blue lips, and abdominal cramps; use ginger and Fu, adding cinnamon to the soup.Poem states:Cold leads to stagnation, while heat flows; all physicians understand this.When the sun shines, ice and frost dissolve; it is just two eights and Li Zhong.18. Left Chi Rapid Pulse (Kidney)Left chi rapid indicates heat, leading to boiling water; when water boils, it must overflow; who can stop it? Upward phlegm and downward essence, what danger lies ahead? Use Yi Qi Tang and Zhi Bai Wan to clear water and tonify the earth; taking both formulas can nourish and support.19. Right Inch Floating Pulse (Lung)Right inch floating indicates lung Qi deficiency, unable to secure the exterior; unable to control wood, unable to generate water, leading to fire burning; causing dry cough and night sweats; Huang Qi Tang is effective; with wood being strong and water being weak, only the lung can be preserved; quickly use Sheng Jin Yin, both formulas are harmonious.Poem states:Huang Qi Tang contains Gui, Bai Zhu, and Huang Qi, with Yuan Zhi and Jujube seeds to tonify; Sheng Jin Yin contains Dang Shen, Bai Zhu, and Bai Shao, with Sheng Di, Mai Dong, and Dan Pi, and Gan Cao.20. Right Inch Deep Pulse (Lung)Right inch deep indicates lung Qi excess, with internal heat and exterior cold; the cough is deep, the throat is slightly dry, and there is a reluctance to eat; Qi does not disperse, causing fullness in the chest and abdomen, leading to discomfort; use Si Jun Zi Tang lightly, and Yi Qi Tang heavily; both formulas can be selected; Ping Fei San, Sheng Mai San, and Xie Bai San.Poem states:Ren Shen, Ling, Qing, and Zhi Wei Tian, this is Ren Shen Ping Fei San;Sheng Mai San contains Ren Shen and Mai Wei, while Xie Bai San contains Bai Shao and two skins of Gan.21. Right Inch Slow Pulse (Lung)Right inch slow indicates cold in the lung, which is difficult to overcome; if wood is too strong, it will burn gold, further injuring the spleen; if the spleen is weak, it cannot generate gold, and gold will suffer; the exterior is not protected, and the surface is loose, making it easy for evil wind to enter; one should also use Sheng Jin Yin, and take several doses.Poem states:Gold generates water, and water generates wood; fire balances the wood.When gold is strong, wood is restrained; do not dare to let the spleen be harmed.22. Right Inch Rapid Pulse (Lung)Right inch rapid indicates lung Qi heat, leading to dryness; harming liver wood, making it difficult for the liver to store, leading to phlegm and blood; dry nostrils, dry skin, and large intestine constipation; drive away the child, come to persuade the mother, and anger can be resolved; use Gan Lu Yin and Qing Jin Yin, both formulas should be taken.Gan Lu Yin and Qing Jin Yin poem states:Heaven descends sweet dew to nourish all things; earth Qi does not generate, and heaven is without.Two earths and two winters, with Ling shells and grass, with loquat, Yin Chen, and Shi Hu,add to Mai Wei Tang to increase Bai Shao, and clear gold to nourish water, curing all diseases.Gan Lu Yin: Sheng Di, Shu Di, Tian Dong, Mai Dong, Fu Ling, Zhi Ke, Gan Cao, Ye Zhi, Yin Chen, Shi Hu.Qing Jin Yin: Gan Lu Yin plus Huang Qin.23. Right Guan Floating Pulse (Spleen)Right guan floating indicates spleen Qi deficiency, making it difficult to digest food; the stomach is difficult to accept, and the spleen cannot grind, leading to stagnation; the best treatment is Zhi Shu Wan, which combines tonification and digestion; if necessary, use Bei Ji Dan, stopping the disease immediately; overall, it is not as good as Shen Ling San, which has endless benefits.Poem states:Zhi Shu contains only two ingredients, with Bei Ji and ginger beans; Shen Ling Bai Zhu San, the medicinal flavors must be detailed,with Bian Lian, Yi Ren, and Chen, and also add ginger and jujube.Zhi Shu Wan: Zhi Shi, Bai Zhu.Bei Ji Dan: Ginger, Ba Dou, Da Huang.Shen Ling Bai Zhu San24. Right Guan Deep Pulse (Spleen)Right guan deep indicates spleen Qi excess, leading to stagnation; the earth is stagnant and cannot digest food, leading to dampness; if dampness is excessive, it transforms into phlegm, causing continuous vomiting; use Er Chen Tang and Si Jun Zi Tang, which are excellent formulas; Shan Zha and Suan Zhi Ren are effective with Shen Qu.Er Chen Tang and Si Jun Zi Tang poem states:Chen Pi, Bai Ling, and the name Er Chen, add Ren Shen and Bai Zhu to make Si Jun;Shan Zha and Shen Qu are good for digestion, warming the meridians and harmonizing the stomach with Suan Zhi Ren.(Any formula can add Shan Zha, Shen Qu, and Suan Zhi Ren)25. Right Guan Slow Pulse (Spleen)Right guan slow indicates cold in the spleen, with cold in the stomach; unable to eat, food cannot be digested, leading to abdominal pain, cold limbs, and unblinking eyes; observe the shape and listen to the sound; the condition is dangerous; simply use Li Zhong Tang, one dose can ensure recovery. Poem states: The spleen and stomach are located in the center; the name of the soup is Li Zhong; cold in the center leads to this condition, hence it is treated in the center.26. Right Guan Rapid Pulse (Spleen)Right guan rapid indicates heat in the spleen, which is fire; fire generates earth, and earth is pleased, but it must not be too fierce; if it is too fierce, the spleen cannot control it, leading to blood loss; blood flows erratically, running through the throat, who can stop it? Use Gui Pi Tang, adding Zhi Dan for frequent use.Poem states:Gui Pi leads blood back to the spleen; if blood does not return to the spleen, it must be used;other symptoms can be treated with Mu Xiang and Bai Shao, but only blood deficiency requires Mu Xiang.27. Right Chi Floating Pulse (Life Gate)Right chi floating indicates deficiency in the life gate, with declining fire; there is a name for fire, but no actual fire, indicating that the fire is not intense; yet it can still burn the upper jiao, causing harm; symptoms of inflammation are not limited to one channel; one must nourish kidney water and match it with related herbs; husband and wife must support each other;Poem states:Deficient fire leads to illness; return the fire to the original channel.If asked what herbs to use, the eight flavors can be adjusted flexibly.28. Right Chi Deep Pulse (Life Gate)Right chi deep indicates excess in the life gate, which cannot be released; like wet grass covering it, it seems to be extinguished; yet internally it steams, causing toxic urine and hematuria; select a formula that nourishes water, clears fire, and drains toxins; it must be used, with Du Qi Yin, adding Ze Xie heavily to drain the toxins.29. Right Chi Slow Pulse (Life Gate)Right chi slow indicates cold in the life gate, with Yang Qi about to disperse; if Yang is exhausted, it can be revived, it must be a divine method; be cautious with the slow pulse, as it indicates a slight Yang; think of a wonderful method to save its critical state; use Fan Ben Tang, adding Ren Shen and Fu to restore Yang Qi.Fan Ben Tang poem states:Fan Ben and Hui Yang, Ren Shen and ginger, Mai Wei, Chen, and cinnamon are strong;decoct with wax gourd and ginger jujube, adding two spoons of honey to moisten the five organs;if there is no pulse, add pig bile; for vomiting, ginger and half summer are effective.Fan Ben Tang: Dang Shen, Fu Zi, Pao Jiang, Mai Dong, Wu Wei Zi, Chen Pi, Gan Cao, Rou Gui, wax gourd, ginger, and honey.30. Right Chi Rapid Pulse (Life Gate)Right chi rapid indicates heat in the life gate, with Yang Qi too strong; the right life gate and the womb are both related; the ruler is weak, while the minister is strong, leading to chaos; assist the ruler’s fire and extinguish the minister’s fire, and the country will be safe and sound; either use Ba Wei or Yang Rong, to restore the evil and eliminate the righteous. The principles of the valley cannot be parallel; evil and righteousness cannot coexist; all are gentlemen, and there is no place for villains.The right side has been completed, and the lung, spleen, and life gate pulses are all included;although the prescriptions are written in detail, learners must look at each other; listing several formulas establishes the foundation; it is not the familiarity that is valuable, but the flexibility; if one can apply the principles of pulse diagnosis, the divine changes will be endless.– End –Recommended Reading, click to read the original text:TCM Pulse Diagnosis Hand-in-Hand Teaching, the Most Comprehensive Animated Demonstration and Key Formulas!Renowned Gynecologist from Lingnan, Cai Yang Gao’s Experience in Pulse DiagnosisLearning from Mao Jin Jun’s 76 Cases to Analyze the Pathogenesis and Treatment of Six MeridiansYue Su Ling: An Intermediate TCM Reading List for Self-Learners (Part 1 and 2)Don’t Miss This Spring Fruit, It is the King of Nourishing Liver and Kidney and Supplementing Liver Blood in TCM! It Can Also Promote Black Hair and Bright Eyes!Master He Ren: What is the Essence of Using Wen Jing Tang?Zhou Zhong Ying: Insights and Techniques from 60 Years of TCM Diagnosis (All Essentials)Ding Guang Di: Qiang Huo Sheng Shi Tang for Treating “Five Morning Diarrhea”Unexpectedly, “Qing Gu San” is indeed the formula for clearing fever after fractures!Dan Zha San for Treating Hyperlipidemia (Including Four Hyperlipidemia Recipes)Shanghai Shen’s Gynecology 600-Year Family Secret FormulaMagical! A Wonderful Experience of Using Ancient Formulas to Treat Tooth Decay! The Ancient Formula “San Liang Ban” Quickly Heals Lumbar Muscle Strain! 【Collect】 Eight Recipes from Nan Master for Treating Insomnia, Hypertension, and Gastrointestinal Diseases!
Recommended Reading98-Year-Old National Medical Master: This is My Last Contribution (Experience Sharing)Collection of Secret Recipes from 31 National Treasure-Level Renowned TCM PhysiciansMaster of Classical Formulas Huang Huang – Experience Formulas for Treating Allergic RhinitisThree Medicinal Pairs from Zhongjing, Insight into the Core Ideas of Medicinal CompatibilityDiscussion on the “Transmission” of the “Inner Classic” and the Theory of Qi Mechanism in TCM – Revealing the Millennial Mysteries of TCM Human Qi Mechanism TheoryYang Zhi Yi: Thirteen Methods for Treating Dampness (Worth Learning)Gao Jian Zhong: Distinguishing Between External and Internal Injuries, Expanding the Application of Classical Formulas (Complete)Zhang Li Shan: Discussing Coughing in the Six Meridians (Three Yang and Three Yin Meridians) – Including Cases“Dai Li San Medical Experience Selection” Discussing the Clinical Application of San Dou Tang and Its ModificationsRecommended Reading:
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