Slippery pulse indicates phlegm disease, governs food stagnation, inch position indicates vomiting, and cubit position indicates blood and pus in stool.【Note】Slippery pulse is a yang pulse, with excess yang indicating phlegm, hence it governs phlegm diseases.The right guan position corresponds to the stomach, thus it governs phlegm from food.The left guan position corresponds to the liver, thus it governs wind phlegm.The inch position corresponds to the upper jiao, thus it governs vomiting.The cubit position corresponds to the lower jiao, thus it governs blood and pus in stool.【Zhang’s Note】Zhongjing states: “The pulse is slippery and sinking, known as slippery,” describing an extremely smooth condition. All large, full, and solid pulses belong to the slippery category. This indicates a condition of qi stagnation and blood obstruction, manifesting as phlegm, food stagnation, vomiting, qi counterflow, fullness, swelling, distension, diarrhea, yin injury, and yangming dryness and blockage.Ancient practitioners considered slippery to indicate a pulse with more blood and less qi, which is not the case. More water leads to slipperiness, and evil qi forcing qi and blood to flow rapidly can also result in a slippery pulse.If a normal person’s pulse is slippery and gentle, it is a good sign of nourishing the defensive and nutritive qi. However, if it is excessively slippery, large, and rapid, it indicates a disease of evil heat, affecting the heart, lungs, head, throat above, and small intestine, bladder, and urination below.Moreover, patients with deficiency often exhibit a string and slippery pulse, indicating yin deficiency; those with diarrhea also often show a string and slippery pulse, indicating injury to the spleen and kidneys, which should not be treated with fire. Symptoms such as phlegm, vomiting, and food injury are all diseases of the upper and middle jiao, with slippery indicating the presence of water and phlegm.If the expelled material is neither phlegm nor food, it is considered vomiting, and the pulse must show a rough quality. Blood in urine, amenorrhea, or conditions like dysentery may indicate internal accumulation, blood accumulation resembling liquid, or phlegm coagulation, which must be discerned through intention.However, slipperiness can also be distinguished by strength; if it is slippery, large, and rapid, the pulse should be considered excessive; if it is merely light, floating, and gentle without much strength, it should not be treated as excessive.It may be due to qi deficiency unable to control yin fire, resulting in a slippery pulse; or due to internal accumulation of phlegm and dampness, resulting in a slippery pulse.If a woman has a slippery and rapid pulse during menstruation, it indicates pregnancy; if it is slippery and rapid during labor, it indicates abnormality. If diarrhea presents with a string and slippery pulse, it indicates injury to the spleen and kidneys; if it is string and slippery after a long illness, it indicates yin deficiency.Can it be treated as a general excess? If the pulse is slippery and urgent, like a bouncing stone, it is called kidney exhaustion, as it lacks the gentle and harmonious stomach qi, hence the prognosis is short-term.Rough pulse indicates deficiency, damp obstruction, cubit position indicates injury to essence and blood, inch position indicates depletion of sweat and fluids, guan position indicates loss of liquid in the stomach.【Note】Roughness indicates a pulse with less blood and stagnation; seen in all six pulses, it indicates a deficiency of the main qi and damp obstruction.If seen in both cubit positions, it indicates injury to essence and blood.If seen in both inch positions, it indicates excessive sweating and injury to fluids.If seen in both guan positions, it indicates obstruction and reflux of the stomach, leading to loss of liquid in the intestines.【Zhang’s Note】A rough pulse feels like a knife scraping bamboo, difficult and unyielding, all belonging to the category of deficiency, fine, and slow. All pulses that show roughness and stagnation are often due to unfulfilled emotions, depletion of defensive and nutritive qi, leading to insufficient blood and unimpeded qi.In the upper jiao, there is discomfort, in the lower jiao, there is lack of movement, on the surface, there is fatigue of muscles and bones, and internally, there is a lack of spirit. All these belong to the category of deficiency, stagnation, and closure, indicating a disease of both blood and qi deficiency, blood loss, and essence injury.It may manifest as shortness of breath, worry, pain, stiffness, numbness, lack of sweating, coldness of limbs, male essence injury, female blood loss, infertility, and irregular menstruation.However, it is also necessary to distinguish between cold, dryness, heat, and deficiency:External evils may invade, causing qi to be unbeneficial, leading to cold roughness; loss of defensive qi may cause yang to weaken and lead to deficiency roughness; dryness of the intestines and stomach may lead to loss of fluids, resulting in dry roughness; excessive sweating, vomiting, or blood loss may lead to dryness, thus even heat may result in roughness, which is called dry roughness.All are rough pulses, but they differ in floating, rapid, sinking, and fine qualities, which depend on the practitioner’s sensitivity. However, there are also cases of heat and excess, where the pulse is strong and rapid, indicating a real heat condition, which can be treated as such.Ultimately, it is based on symptom examination; can one generalize blood deficiency without careful consideration?String pulse governs fluid, wood harms the spleen meridian, inch string indicates headache, cubit string indicates abdominal pain.【Note】String pulse is a yin pulse, with excess yin indicating fluid; string pulse is a wood pulse, with excess wood harming earth, leading to fluid diseases.In the inch position, yin overcomes yang, thus it governs headache. In the cubit position, yin overcomes yin, thus it governs abdominal pain.【Zhang’s Note】According to the five elements, the string pulse corresponds to wood, in the four seasons, it corresponds to spring, and in the five organs, it corresponds to the liver.In the Suwen – Discussion on the True Storage of the Jade Machine, it states: “The spring pulse corresponds to the liver, the east corresponds to wood, the source of all life. Therefore, its qi is soft, weak, light, and slippery, straight and long, hence it is called string. The opposite indicates disease. If its qi is strong and excessive, it indicates an external disease; if its qi is weak and insufficient, it indicates an internal disease. Excess leads to irritability, dizziness, and headaches; insufficiency leads to chest and flank pain radiating to the back, fullness in the flanks.”In the Su Wen – Discussion on the Normal Qi of the Liver, it states: “The normal liver pulse is soft and weak, like lifting the tip of a long pole, called liver normal. The diseased liver pulse is full and slippery, like following a long pole, called liver disease. The dead liver pulse is urgent and strong, like a newly drawn bowstring, called liver dead.”Thus, the meaning of string is like the tautness of a stringed instrument, slightly elongated.In the Su Wen – Discussion on the Separation of Yin and Yang, it states: “The lesser yang is the pivot,”in cases of cold damage, if both inch and cubit pulses are string, it indicates lesser yang disease. Lesser yang is the boundary between yin and yang, thus the string pulse is both floating and fine, indicating the root pulse of lesser yang; if it is string and rapid, it indicates the two pathways of entering the house and transmitting yin; if it is string and accompanied by sinking, rough, and weak, can it not be called yin?It is said that if the inch pulse is string, it indicates tightness and pain in the flanks, causing one to feel cold.Moreover, if the cold damage pulse is string and fine, with headache and fever, it belongs to lesser yang, indicating yang headache; pain must be seen in the taiyang, as the head is where the six yangs converge, and if yang is deficient and cannot expand, it may lead to pain.Yang pulse is rough, yin pulse is string, and the law should indicate urgent pain in the abdomen, thus the string pulse indicates abdominal pain, which must be seen in the lower abdomen, all belonging to the lesser yang region.In lesser yin disease, if one wants to vomit but cannot, and it begins, with cold hands and feet, and the pulse is string and slow, this indicates fullness in the chest, which should be vomited; if there is cold fluid in the diaphragm causing dry retching, it should not be vomited, but urgently warmed.In detail, one should not generalize string and roughness as yin; careful examination of symptoms and pulse is essential, as the method lies in the practitioner’s skill and sensitivity.In examining various diseases, if the pulse is string due to excess evil, it is often seen; if the pulse is string due to deficiency, it is often seen as well. In other pulses, if string characteristics are also present, they are not uncommon.In cases of cold damage and severe illness, string pulses are common; in cases of deficiency and internal injury, string pulses are often more than half, hence Nanyang is often regarded as the leader of the six remnants.Other conditions such as malaria, cold fluid, and various diseases also exhibit string pulses.However, the string pulse generally arises from excess wood, deficiency of earth, and depletion of water, but the presence of string indicates the strength of stomach qi; the fullness or emptiness of string indicates the strength of evil qi; the floating or sinking of string indicates the yin and yang of the surface and interior; the inch and cubit string indicates the rise and fall of disease qi.In deficiency conditions, improper use of cold and coolness will lead to a string pulse in both cubit positions; if the stomach is deficient and cold, food stagnation will often show a string pulse.Conditions such as abdominal pain, distension, stomach reflux, chest obstruction, phlegm accumulation, blood retention, cold damage, wind injury, cholera, stagnation, internal qi stagnation, and cold-heat fullness all exhibit string pulses, all due to the weakness of middle qi, with earth failing and wood invading.No matter what condition is present, if string is seen with harmony and spirit, and stomach qi is not lacking, the string pulse can be treated.If the string is strong and fine, like following a knife edge, or strong and straight, like a newly drawn bowstring, or following a long pole, or pressing horizontally, all indicate string without stomach qi.In cases of deficiency and internal injury, the inch pulse is often large, while the cubit string is fine and beats against the fingers, indicating string without stomach qi, which cannot be treated.If the string is strong and fine, it indicates lack of stomach qi; how can it be treated?The article is excerpted from: Commentary on the Essentials of the Four Diagnostic Methods by Zhang Litiao. We thank Teacher Zhang Litiao for the authorization; we hope to assist everyone on their journey in Traditional Chinese Medicine.Related Articles, click to read the original text:Zhang Litiao: Commentary on the Essentials of the Four Diagnostic Methods (Vernacular Explanation) 30 – Floating, Sinking, Slow, Rapid, the Principles of Pulse.Zhang Litiao: Commentary on the Essentials of the Four Diagnostic Methods (Vernacular Explanation) 7 – Diagnostic Methods of the Five Organs on the Face.Zhang Litiao: Commentary on the Essentials of the Four Diagnostic Methods (Vernacular Explanation) 1 – General Principles of the Four Diagnostics.//////////【 Read Previous Highlights 】#Introduction to TCM Collection #Vernacular Explanation of the Twelve Meridians #Donghai Medical Collection #Experience of Old TCM Practitioners #Wonderful TCM Formulas #Proven Formulas and Secret Recipes #Masters of Traditional Chinese Medicine#Famous Cases of Cold Damage #Selected Famous Cases from the Golden Cabinet#Four Gentlemen Decoction #Causes of Disease #Properties of Medicinal Substances #Song of Medicinal Properties of 400 Herbs #Three-Character Classic of Medicine #Daily Insights from Mentorship#Daily Insights from Mentorship on Principles, Methods, Formulas, and Medicines#TCM Serialization Collection-END-
