Library

The rapid pulse (Shu Mai, 数脉) primarily corresponds to Fu-organ diseases, and is indicative of vomiting and mania. A forceful rapid pulse indicates heat, while a feeble one suggests sores or ulcers.

The rapid pulse belongs to Yang, and the six Fu organs also belong to Yang; therefore, the rapid pulse governs Fu-organ conditions. *Nan Jing* (Classic of Difficult Issues), Chapter 9, states: "Rapid [pulse] corresponds to the Fu organs." It further states: "Rapid [pulse] indicates heat." The *Shanghan Lun* (Treatise on Cold Damage) also says: "Rapid [pulse] signifies disease in the Fu organs." This classification uses slow and rapid pulses to distinguish Yin and Yang, thereby associating them with Zang and Fu organs; however, this cannot be regarded as an absolute generalization. In cases where pulse patterns are complex and intermingled, a slow pulse may appear in Fu-organ diseases, a rapid pulse in Zang-organ diseases, a slow pulse in exterior syndromes, and a rapid pulse in interior syndromes. How can one rigidly confine these phenomena merely to the concepts of "Fu" or "Zang"?

The rapid pulse indicating vomiting arises because the pulse qi originates in the Middle Jiao (Middle Burner). Vomiting causes Stomach Qi to rebel upward, disrupting the Middle Jiao. The rebellious Qi moves vigorously, resulting in a rapid pulse. (Treatment should include Liu Junzi Tang [Six Gentlemen Decoction], Shengjiang [Fresh Ginger Rhizome], Zhuru [Bamboo Shavings], and combinations such as Huanglian [Coptis Rhizome] with Zhuyu [Evodia Fruit].)

The rapid pulse indicating mania occurs because during mania, the spirit and mind become confused, and Qi loses its control. When Qi is uncontrolled, it rushes to the four limbs, causing them to become full and solid. Because the four limbs are full and solid, the patient is able to climb high, walk far, and jump abnormally. The four limbs are the root of all Yang meridians; when Yang pathogenic factors fill them, strength is doubled. *Nan Jing*, Chapter 20, states: "Excess Yang leads to mania." The *Suwen* (Basic Questions), chapter "Bing Neng Lun," states: "Mania arises from Yang." It further states: "The Yangming meridian is constantly pulsating, whereas the Juyang [Taiyang] and Shaoyang meridians do not normally pulsate. If the non-pulsating meridians begin to pulsate rapidly and forcefully, this is the sign of mania." This implies that the Yangming meridian normally pulsates, while the Taiyang and Shaoyang meridians do not. Now, regardless of whether they normally pulsate, even those that do not are pulsating, and the pulsation is large and rapid; this constitutes the manifestation of mania. Observing this, it is clear why the rapid pulse appears in mania. (Treatment should include Zhu Sha Anshen Wan [Cinnabar Calming the Spirit Pill] by Li Dongyuan, or Jiyan Long Nao Anshen Wan [Collected Efficacy Dragon Brain Calming the Spirit Pill].)

A rapid pulse that is forceful indicates heat accumulating and driving the pulse. (If exterior syndrome signs are present, sweating and dispersing methods should be used: Zhang Zhongjing recommends Guizhi Tang [Cinnamon Twig Decoction] for patients with sweating, and Mahuang Tang [Ephedra Decoction] for those without sweating. For patients without exterior syndromes, Liangge San [Cooling the Chest Powder] from the *Heji Ju Fang* [Formulas of the Bureau of Medical Relief], or herbs such as Huangqin [Scutellaria Root], Huanglian [Coptis Rhizome], Zhizi [Gardenia Fruit], and Huangbai [Phellodendron Bark] should be used.)

A rapid pulse that is feeble indicates heat accompanied by deficiency and dispersion. Heat dissipating to the exterior is a sign of developing sores or ulcers. (Treatment should include Huanglian Jiedu Tang [Coptis Decoction for Resolving Toxicity], Xiaozhong Tang [Reduce Swelling Decoction], or Danggui Yinzi [Angelica Drink].)