Floating pulse acupuncture is advisable
According to yang zhu sheng fu (阳主升浮), the principle that qi moves swiftly and vigorously indicates that a floating pulse in a patient resembles the rising of hot air. Therefore, treatment should generally involve acupuncture, as the floating pulse indicates rapid qi movement.
If the floating pulse is also slippery (脉浮兼滑象), it often indicates an invasion of wind-evil carrying phlegm and qi affecting the yang position. In this case, shallow and quick needling is appropriate to dispel wind-heat.
If the floating pulse is strong or forceful (脉浮兼洪或有力之象), it indicates excessive heat-evil. In this case, heavy twisting and shallow needling to open the major points and draw blood is advisable, allowing the heat-evil to disperse with the qi and blood.
If the floating pulse is tight (脉浮兼紧), it indicates that the floating pulse, which represents exterior syndrome due to yang evil, is being constrained by cold. This reflects a conflict between heat and cold. Shallow and quick needling is recommended; once the evil is expelled, the normal state will return.
If the floating pulse is strong and corresponds to painful areas (脉浮有力见有痛处相应), it undoubtedly indicates excessive heat and blood congestion. Heavy needling to drain and draw blood is best.
If the floating pulse is large and weak (脉浮大无力), although it indicates blood deficiency, it is also due to heat. Light needling to drain its qi is appropriate, but blood should not be drawn.
If a floating pulse persists in a specific area (久病气口某部脉浮), it indicates that there is heat-evil in that area, causing qi and blood to be disproportionately abundant. Acupuncture to drain is effective.
If the floating pulse is soft (久病脉浮濡) or slightly scattered and weak (或微散无力之象), this indicates internal injury to essence and blood, with a significant deficiency of righteous qi, leading to the external manifestation of floating yang. Acupuncture should be performed cautiously; heavy needling to drain the external floating yang is not advisable. Fine needles should be used, needled lightly from shallow to deep to harmonize. This pulse pattern is most suitable for using herbal decoctions to greatly tonify essence and blood, which nourishes yin and replenishes blood. At the same time, a comprehensive pulse examination should be conducted; if there is a sinking pulse, moxibustion can be applied to the corresponding areas, which is known as the method of harmonizing and assisting the yang to rescue the yin.
In general, when a patient presents with a rapid pulse, treatment should be through acupuncture.
If the rapid pulse is also strong, heavy twisting and draining needling should be performed to open the points;
If the rapid pulse is floating, it indicates wind-heat residing in the exterior, and shallow needling to quickly drain and disperse the exterior yang evil is advisable, with blood drawn after needling;
If the rapid pulse is thin and small with heat, it indicates yin deficiency, and direct needling to harmonize and retain the needle is recommended;
However, if the rapid pulse is also deep and weak, with no heat and a fear of cold, it should not be needled; moxibustion should be used to tonify heart yang.
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