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The Ge pulse (Reed Pulse) is the most perilous among pathological pulses, yet people often overlook it because they are unaware of its true manifestation; even those who know it often do not understand its treatment. Its shape resembles pressing on a drum skin: hard on the outside but hollow in the middle, which is essentially a Xian pulse (Wiry Pulse) that is large and forceful. Because this pulse is similar to the Xian pulse, although it is large, it is not Hong (Surging) due to the lack of up-and-down fluctuation; although it is forceful, it is not Hua (Slippery) due to its hollowness. By contemplating this pulse, its true nature can be discerned. It indicates a disease where Yin and Yang are severed, with no connection between the upper and lower parts. When the pulse reaches such a state, the illness is about to undergo transformation (hence the name "Ge" or Reed), presenting a critical situation where death could occur at any moment. In the Ding-Mao year in Tianjin, I cured several cases of Ge pulse syndrome. Only one case, an eighty-six-year-old woman, did not recover, which was due to her advanced age. Here, I specifically record the most dangerous case in detail below as a guide for treating such syndromes.

My grandson, Wang XX, aged fifty, had always been physically frail. In midsummer, he contracted a Warm Disease (Wen Bing). He experienced heat and irritability in the heart region, alternating between rising and lying down without any rest. His pulse was large and hard, slightly accompanied by a Hong (Surging) image. His tongue coating was thin and slightly black, with black spots resembling speckles. This indicated that both internal injury and external contraction were severe. His bowels had not moved for four days, and his abdomen was distended and hard upon palpation. His family stated that the abdominal fullness and hardness were chronic conditions lasting over half a year, which contributed to his increasing emaciation. Considering that the chronic condition should be treated slowly, clearing the warm-heat became the urgent priority. I prescribed Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng), using 1.5 liang of raw Shigypsum Fibrosum (Gypsum), 5 qian of Yetaishen (Wild Panax ginseng from Taihang Mountains), and replacing the Jingmi (Oryza sativa var. japonica) in the formula with 8 qian of raw Shanyao (Dioscorea opposita). The decoction was prepared into two bowls and taken warm in three doses. After one dose, the external heat subsided significantly, and irritability decreased slightly, though he remained restless, able to sleep only briefly. The Hong (Surging) quality of the pulse disappeared, but it remained large and hard. His bowels still had not moved, and abdominal distension worsened. Consequently, I used 1 liang each of finely powdered Sheng Zheishi (Hematitum) and raw Huai Shanyao (Dioscorea polystachya), 6 qian of Yetaishen (Wild Panax ginseng), 5 qian each of Zhimu (Anemarrhenae Rhizoma) and Xuanshen (Scrophulariae Radix), and half a qian of raw Jineijin (Galli Gigerii Endothelium Corneum). After taking the decoction, his bowels moved. Two hours later, his abdomen made sounds, indicating that the stagnation had begun to clear. He passed stool three times consecutively, all consisting of old accumulation. Suddenly, his condition changed drastically: the largeness and hardness of the pulse increased nearly twofold compared to before, with all peripheral vessels pulsating strongly, almost threatening rupture. His cardiac irritability, mental disturbance, and frequent restlessness were indescribable. His family looked around in extreme fear, but I firmly promised to cure him. I immediately prescribed 1.5 liang each of purified Yurou (Corni Fructus) and raw Longgu (Fossilia Ossis Mastodi), 1 liang each of Shudi Huang (Rehmanniae Radix Praeparata) and raw Shanyao (Dioscorea opposita), 6 qian each of Yetaishen (Wild Panax ginseng) and Baizhu (Atractylodis Macrocephalae Rhizoma), and 3 qian of Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma). Prepared as a large bowl of decoction and taken warm in two doses, his condition stabilized somewhat, and the pulse began to gather. On the same day, another dose according to the prescription allowed him to lie down peacefully. Shortly after, his pulse returned to the state it was in before the evacuation of stagnation, and his abdomen softened, although he occasionally felt heat in the heart region. Subsequently, I removed Baizhu (Atractylodis Macrocephalae Rhizoma) from the original formula and added 8 qian of Sheng Di Huang (Rehmanniae Radix). One dose was taken daily. After three doses, the pulse became nearly peaceful, but his bowels had not moved for several days, and he felt that the old accumulation was not fully cleared. Therefore, I reduced the dosage of Yurou (Corni Fructus) and Longgu (Fossilia Ossis Mastodi) by 5 qian each and added 6 qian of Sheng Zheishi (Hematitum) and 3 qian of Danggui (Angelicae Sinensis Radix). He passed more old accumulation subsequently. His pulse became large again, so I removed Zheishi (Hematitum) and Danggui (Angelicae Sinensis Radix). After continuing the remaining prescription for more than ten doses, he completely recovered.