Library

Diagram of Diagnosis of Six Qi Divided and Combined in Six Parts According to Time and Days 1 \ps98a19.bmp\
Diagram of Diagnosis of Six Qi Divided and Combined in Six Parts According to Time and Days 2 \ps98a20.bmp\

Seasonal climates (Shiling) correspond to the pulse changes of the four seasons. From Great Cold in the twelfth month to Spring Equinox in the second month is the First Qi, governed by Jueyin Wind-Wood (Jueyin Fengmu). The Classic states: "When Jueyin arrives, its pulse is Xian (String-like)." From Spring Equinox to Grain Full is the Second Qi, governed by Shaoyin Sovereign Fire (Shaoyin Junhuo). The Classic states: "When Shaoyin arrives, its pulse is Jun (Uniform/Harmonious)." From Grain Full to Great Heat in the sixth month is the Third Qi, governed by Shaoyang Ministerial Fire (Shaoyang Xianghuo). The Classic states: "When Shaoyang arrives, its pulse is Da (Large) and Fu (Floating)." From Great Heat to Autumn Equinox in the eighth month is the Fourth Qi, governed by Taiyin Damp-Earth (Taiyin Shitu). The Classic states: "When Taiyin arrives, its pulse is Chen (Deep)." From Autumn Equinox to Minor Snow in the tenth month is the Fifth Qi, governed by Yangming Dry-Metal (Yangming Zaojin). The Classic states: "When Yangming arrives, its pulse is Duan (Short) and Se (Choppy)." From Minor Snow to Great Cold in the twelfth month is the Sixth Qi, governed by Taiyang Cold-Water (Taiyang Han shui). The Classic states: "When Taiyang arrives, its pulse is Da (Large) and Chang (Long)."

Taking a balanced year (Pingzhi Zhi Ji) as an example: In years of Excess (Taiguo), if the Qi has not yet arrived, the pulse change precedes the solar term by twelve days as the limit. In years of Deficiency (Bují), if the Qi has arrived but the pulse does not reflect it, the pulse change lags behind the solar term by thirteen days as the limit. In Excess years, the pulse begins to change from the Floating position of the Left Chi (Left Cun-Guan-Chi) starting at Start of Spring. In Deficiency years, the pulse begins to change from the Middle position of the Left Guan starting at Start of Spring. Deduce accordingly. This is the profound principle of the Six Qi, unexplored in medical formularies. One must examine the pulse at dawn (Pingdan), when Yin Qi has not dispersed, Yang Qi has not stirred, food and drink have not been taken, and speech has not been uttered. With a clear mind and regulated breath, investigate each part carefully, and seasonal diseases can be predicted in advance. If the six parts of the pulse are all peaceful, so be it. If there is one that is exclusively Large, Small, Floating, Deep, Long, or Short, differing from other parts, judgment based on the chart will invariably be accurate. For instance, if the Left Guan (Liver/Gallbladder) pulse is exclusively Xian (String-like) and Da (Large), one knows that after Rain Water and around Jingzhe (Awakening of Insects), there will be Wind-Heat disease. Xian indicates Wind, and Da indicates Heat. Moreover, the Left Guan corresponds to the domain of Wind-Wood. If the Right Chi (Kidney/Mingmen) Chen (Deep) position shows an exclusively Huan (Slow/Lax) and Zhi (Stagnant) pulse that is Shi (Solid) and Da (Large), one knows that after Mangzhong (Grain in Ear) and around Summer Solstice, there will be Damp-Heat disease. Huan-Zhi indicates Dampness, and Shi-Da indicates Heat. If the pulse is Huan-Zhi Xu (Deficient) and Da (Large), it is caused by Damp-Heat and Ministerial Fire. Huan-Zhi represents Dampness, and Xu-Da represents Ministerial Fire. Furthermore, being in the Chen (Deep) position, Deep also indicates Dampness, and it is located in the position of Ministerial Fire. In chronic illness, if all six pulses are turbid and stagnant, but only the Right Cun (Lung) Zhong (Middle) position pulse is Congrong (Leisurely) and Hehuan (Harmonious), pure and unstagnated, one knows that after Frost Descent and around Start of Winter, recovery will occur. Other cases can be deduced similarly, with high accuracy.

The concept of "Bu Ying" (Non-responsive) pulse explains pulses that do not match the season. "Bu Ying" refers to a Chen (Deep) and Xi (Fine) pulse. Its presence indicates non-responsiveness. When encountering such non-responsiveness, it signifies that the annual运气 (Yunqi) is appropriate; no treatment is needed. Mis-treatment would harm Tianhe (Heavenly Harmony/Natural Vitality).

Earth Yun (Movement) is Nan Zheng (Southern Governance). Earth resides in the center and governs facing South. The other four Yun (Wood, Fire, Metal, Water) assist it, governing facing North, hence Bei Zheng (Northern Governance). In Jia and Ji years, it is Earth Yun Nan Zheng. If Shaoyin Si Tian (Governs Heaven/First Half of Year), both Cun (Inch) pulses are Bu Ying. If Jueyin Si Tian, the Right Cun is Bu Ying. If Taiyin Si Tian, the Left Cun is Bu Ying. If Shaoyin Zai Quan (Governs泉水/Second Half of Year), both Chi (Cubit) pulses are Bu Ying. If Jueyin Zai Quan, the Right Chi is Bu Ying. If Taiyin Zai Quan, the Left Chi is Bu Ying.

In Yi, Bing, Ding, Wu, Geng, Xin, Ren, Gui years (eight years total), it is Bei Zheng. If Shaoyin Si Tian, both Chi pulses are Bu Ying. If Jueyin Si Tian, the Right Chi is Bu Ying. If Taiyin Si Tian, the Left Chi is Bu Ying. If Shaoyin Zai Quan, both Cun pulses are Bu Ying. If Jueyin Zai Quan, the Right Cun is Bu Ying. If Taiyin Zai Quan, the Left Cun is Bu Ying.

If the Chi should be Bu Ying (Deep/Fine) but is instead Fu (Floating) and Da (Large), and the Cun should be Fu and Da but is instead Chen and Xi; if the Cun should be Bu Ying but is Fu and Da, and the Chi should be Fu and Da but is Chen and Xi, this is called Chicun Fan (Reversal of Inch and Cubit). The Classic states: "Chicun Fan leads to death." If the Right should be Bu Ying but is Fu and Da, and the Left should be Fu and Da but is Chen and Xi; if the Left should be Bu Ying but is Fu and Da, and the Right should be Fu and Da but is Chen and Xi, this is called Zuoyou Fan (Reversal of Left and Right). The Classic states: "Zuoyou Fan leads to death."

Zhen Zang Mai (True Organ Pulse) indicates incurable conditions. Humans rely on Wei Qi (Stomach Qi) as the root. The Wei Qi pulse feels harmonious and moderate, pleasant and relaxed, difficult to describe. Excess or Deficiency constitutes disease. Obtaining the Zhen Zang Mai without Wei Qi indicates death.

The Classic states: "Pulse Qi is in excess, Form Qi is deficient; survival depends on prioritizing the pulse." It also states: "Form and flesh are depleted; even if the Nine Probes are harmonious, death occurs; this prioritizes form and flesh." Why does the Classic seem contradictory? Both aspects must not be neglected. Pulse Qi in excess implies no severe internal disease. Form Qi deficiency implies flesh has not yet wasted away; why fear death? If both form and flesh are depleted, it must be a chronic illness. Although the patient may feel no discomfort from the external pathogen, Qi and Blood are exhausted, leaving only a faint thread of Qi lingering. Thus, the Nine Probes appear like silk threads, seemingly harmonious. However, the body stands like firewood, major muscles have failed. Spleen governs muscles; Earth collapses, Spleen perishes. Without shelter from wind and rain, it is like oil running out of a lamp; the light extinguishes itself.

One considers the Chi (Cubit) position as the root. Human Chi is like tree roots. Water is the origin of Tianyi (Heavenly One), the congenital root of life. Wang Shuhe said: "Even if Cun and Guan are absent, if Chi is not cut off, why worry about demise?" This means there is still a root. If only the Kidney pulse fails, there is no root. Another view considers the Chen (Deep) probing as the root. The Classic states: "All Floating pulses without a root lead to death." This is having exterior without interior, called Gu Yang (Lone Yang) which cannot generate life. Creation sustains itself through Yin and Yang,互为根 (mutually rooting). If Yin is extinct, how can Lone Yang survive alone? These two views seem different but are essentially consistent. Both Chi positions belong to the Kidneys; all six pulses probed deeply relate to the Kidneys. Therefore, lack of root in both Chi positions and lack of root upon deep probing both indicate exhaustion of Kidney Water. Hence, "Pulse values Shen (Spirit)." Shen means having a root upon heavy pressure. Like a tree, if the root is destroyed, no amount of cultivation will bring forth new growth.

Cun pulse Floating indicates Taiyang. If combined with Ji (Rapid) pulse, this is Yang within Yang, named Chong Yang (Double Yang). Chi inside is Chen (Deep) and Xi (Fine), Yin. If combined with Chi (Slow) pulse, this is Yin within Yin, named Chong Yin (Double Yin). Upper body Chong Yang, lower body Chong Yin, Yang hyperactivity and Yin blockage lead to Dian Kuang (Mania/Psychosis). Six pulses having exterior without interior, such as Ru (Soggy) pulse, is named Tuo Yin (Collapse of Yin). Six pulses having interior without exterior, called Xian Xia (Sinking/Collapse), such as Ruo (Weak) pulse, is named Tuo Yang (Collapse of Yang). Sudden collapse of six pulses indicates simultaneous collapse of Yin and Yang. The Classic states: "Tuo Yin results in blindness; Tuo Yang results in hallucinations; simultaneous collapse of Yin and Yang is critical."

The Classic states: "There is a method for holding the pulse; emptiness and tranquility are preserved. Spring pulses float, like fish swimming in waves. Summer pulses are in the skin, abundant like all things in summer. Autumn pulses descend below the skin, like insects preparing to hibernate. Winter pulses are in the bone, like insects tightly sealed, and gentlemen stay indoors." Thus: "Those who know the interior press and record them; those who know the exterior conclude and begin anew." These six points are the great methods of pulse diagnosis.

Chongyang (ST42) is the Stomach pulse, located five cun above the foot dorsum (instep), between the bones where the artery throbs, three cun above Xangu. Earth is the mother of all things. If Chongyang pulse does not decline, Stomach Qi remains. Even if the disease is critical, life is possible. Taixi (KI3) is the Kidney pulse. Located behind the medial malleolus, above the heel bone (the round bones on the back two sides of the foot dorsum, commonly known as 'lone turn bone'), in the depression where the artery throbs. Water is the origin of Tianyi. If Taixi does not decline, Kidney Qi is not exhausted. Even if critical, life is possible. Taichong (LR3) is the Liver pulse. Located two cun posterior to the base of the big toe, in the depression. Liver is Wood of the East, the beginning of biological generation. If this pulse does not decline, the mechanism of life is hopeful, hence named the Gate of Life and Death. This is especially important for women, as women govern Blood, Liver is the Sea of Blood, and it is the beginning of Eastern generation. Qihai (CV6) is located one and a half cun below the umbilicus. Qihai is the sea of generating Qi for men. Dantian is three cun below the umbilicus, which is Guanyuan (CV4), the meeting point of Foot Shaoyin and Ren Mai, and the gate of Yin and Yang. It is the root of the human body, the storage place of Spirit. The moving Qi in these two places is the root of the pulse.

The Classic states: "Ying (Nutritive) flows within the vessels, Wei (Defensive) flows outside the vessels." This describes the paths of Ying and Wei, but is it enough to exhaust the changes of the pulse? Thus, the Classic states: "Rooted in the middle, it is called Shen Ji (Spirit Mechanism)." The reason the pulse manifests its spiritual function is because Yuan Shen (Primordial Spirit) concentrates above, commanding the mechanism, and the essence of the Zang-Fu transforms its form. If we consider only Qi and Blood functioning within the pulse, then the skin of Cun and Chi is nothing but Qi and Blood. All could be verified by palpating the pulse.

"Shang Yu" (Ascending to the Fish) means the pulse extends to the Yuji (LU10) area. People often have this pulse, but diseases differ; it cannot be generalized. Some have it on both hands, some on one hand. If a healthy person with full spirit and color has this pulse, it indicates strong congenital endowment, full Yuan Shen overflowing to the Yu area; such a person will live long. If a person usually lacks this pulse and suddenly develops it, it is a pathological pulse. The Nan Jing states: "Anterior to the Guan is the movement of Yang. The pulse should be nine fen and floating. If reduced, it is legally termed Deficiency; if excessive, it is legally termed Excess. Thus ascending to Yu is called Yi (Overflow), representing Wai Guan Nei Ge (External Blockade, Internal Obstruction), which is a pulse of Yin invading Yang."

In Yang Excess, people know the pulse is Hong (Surging) and Da (Large). At its extreme, the pulse hides and vanishes. This is like the Top Nine of Qian (Heaven): "Arrogant dragon will have cause to repent." In Yin Deficiency, people know the pulse is Wei (Micro) and Xi (Fine). At its extreme, the pulse becomes Zao (Restless) and Ji (Rapid). This is like the Top Six of Kun (Earth): "Dragon fights in the field." These are principles of Yin-Yang hyper-restriction, known only to the wise.

Pulses have Cheng (Overacting) and Wu (Counter-acting). Suppose Lung disease presents Heart pulse. Although "what overcomes me is Thief Evil," the organ itself is solid, causing this. The Classic states: "Where evil gathers, Qi must be deficient," like a state without virtuous men allows villains to take advantage. Again, Lung disease presenting Liver pulse: "What I overcome is Minor Evil," but this indicates the decline of the primary organ. Thus, the Classic states: "When Qi is insufficient, what I normally overcome lightly counter-acts me." Only when the Way of the Gentleman declines does the Way of the Petty Man grow. The same applies to other organs.

Men prioritize Yang; the two Cun pulses are usually stronger than the Chi. If Cun is weak and Chi is strong, Kidney is deficient. Women prioritize Yin; the two Chi pulses are usually stronger than the Cun. If Chi is weak and Cun is strong, the Upper Jiao is in excess. Deficiency is definitely disease; excess is also disease. Excess is no different from Deficiency.

For the elderly and weak, the pulse should be Huan (Slow) and Ruo (Weak). If the pulse is overly vigorous, it is disease. For the young and strong, the pulse should be Chongshi (Full and Solid). If the pulse is overly weak, it is disease. However, there is more to say. An elderly person with a vigorous but not restless pulse indicates strong congenital endowment and longevity; this is called Shou Mai (Longevity Pulse). If the pulse is restless and rapid, having exterior without interior, it is Gu Yang (Lone Yang). Death will be swift. A strong person with a fine, harmonious, and slow pulse, equal in all three positions, indicates quiet, pure, and elegant congenital endowment; this is called Yin Mai. If the pulse comes fine and stiff/straight, unequal front and back, one can determine the time of death.

Pathological Yin pulses include Chen (Deep), Jin (Tight), and Shu (Rapid). Zhang Zhongjing generally describes them as Wei (Micro) and Xi (Fine). Chen requires heavy pressure to detect; Jin and Shu are also seen within Chen-Xi, unlike Yang syndromes which are Fu (Floating), Da (Large), Jin (Tight), and Shu (Rapid).

Xue Shi said: "People know Shu (Rapid) indicates Heat, but do not know that Shu seen within Chen-Xi indicates severe Cold. True Yin-Cold syndromes sometimes have pulses of seven or eight beats per breath, but they are powerless upon pressure despite being rapid. One must examine deeply."

Pulse methodology originated from Qi Bo and Huang Di, merely to assess disease condition and decide life or death. How could there be such a thing as Taisu? Since Yang Shangshan promoted "Taisu Pulse Method," predicting fortune and misfortune, comparing it to spirits, these are all physiognomists claiming the name "Taisu" to mystify their theory. However, there are valuable sentences, such as: "Pulse shape is round and clean, beat count distinct, called Qing (Clear). Pulse shape is scattered and choppy, beat count vague, called Zhuo (Turbid). Clear constitution, clear pulse: wealth and honor, much joy. Turbid constitution, turbid pulse: poverty and low status, much worry. Clear constitution, turbid pulse: outwardly wealthy/inwardly poor, many disappointments, few satisfactions. Turbid constitution, clear pulse: outwardly poor/inwardly wealthy, many satisfactions, few disappointments. Wealthy and long-lived: pulse is Qing and Chang (Long). Poor and short-lived: pulse is Zhuo and Cu (Hasty). Qing and Chang: wealthy but short-lived. Zhuo and Cu: poor but long-lived." These are all valuable insights, truly signs of fortune and misfortune, yet they cannot escape physiognomy.