Library

Zhang Zhongjing considered the floating and moderate pulse (Fuhuan Mai) as the pulse of Wind-Stroke (Zhongfeng). The floating, choppy, and tight pulse (Fusai Er Jin) is the pulse of Cold Damage (Shanghan). Wind-Stroke is characterized by sweating, whereas Cold Damage is characterized by an absence of sweating. Why is this? The *Neijing* states: A slippery pulse indicates an excess of Yin Qi; a choppy pulse indicates an excess of Yang Qi. An excess of Yang Qi leads to body heat and absence of sweating; an excess of Yin Qi leads to profuse sweating and coldness of the body. Generally speaking, Yin and Yang should be in a state of balanced harmony. If Yang Qi is insufficient, Yin Qi invades it, resulting in an apparent excess of Yin. If Yin Qi is insufficient, Yang Qi follows it, resulting in an apparent excess of Yang. When Wind pathogen damages the Wei Qi (Defensive Qi), Ying Qi (Nutritive Qi) remains unaffected, leading to insufficient Yang and relative excess of Yin. Therefore, the pulse in Wind-Stroke is floating and moderate, accompanied by profuse sweating. When Cold pathogen damages Ying Qi, Wei Qi remains unaffected, leading to insufficient Yin and relative excess of Yang. Therefore, the pulse in Cold Damage is floating, choppy, and tight, also characterized by absence of sweating. Zhang Zhongjing’s differentiation of the pulses and symptoms of these two conditions was based on such principles.

Zhang Zhongjing stated: "Generally, diseases of Cold Damage often arise from exposure to Wind-Cold. Initially, Wind-Cold resides in the exterior; if it penetrates inward, it will not resolve spontaneously. If one intends to attack the interior excess, one must first release the exterior before applying purgation. If the exterior is resolved but internal stagnation persists, presenting with severe fullness, solidity, hardness, and dry feces, purgation may naturally be applied. Even if four or five days have passed, this will not cause harm. However, if purgation is applied inappropriately when contraindicated, it causes deficiency in the interior and allows heat to penetrate, leading to Heat-Collateral Diarrhea (Xiere Li) and numerous other complications such as restlessness, which are too numerous to count. In mild cases, the condition becomes critical; in severe cases, death is inevitable." (The original text contained repetitions that were difficult for those with superficial understanding to comprehend; therefore, I deleted and corrected this section to make the principle clearer.) Generally, when Wind-Cold penetrates inward and fails to resolve, there must be dry feces or constipation with hard stools. Purgation should only be employed after the pulse is no longer floating, aversion to wind and cold has ceased, and all exterior signs have disappeared. Constipation, even if lasting four or five days, will not necessarily cause harm. However, ignoring the exterior condition and directly applying purgation will lead to Heat-Collateral Diarrhea.

Zhang Zhongjing stated: "A deficient pulse accompanied by fever is caused by Summerheat Injury (Shangshu)." He also said: "Why is the pulse wiry-thin-khollow-slow (Xian Xi Kou Chi)?" The *Suwen* states: "Cold damages the form (body structure); Heat damages the Qi." Since Heat damages Qi without damaging the form, Qi is consumed, resulting in a weak and deficient pulse. The wiry, thin, khollow, and slow pulses are all types of Deficient Pulses. Zhang Zhongjing regarded the wiry pulse as Yin, and Zhu Gong also stated that the pulse in Summerheat Stroke is fine and weak. Thus, it can be known that these are all Deficient Pulses.