Library

Pulse does not move on its own but arrives following the Qi. The movement of Qi and the response of the pulse embody the harmony of Yin and Yang.

Qi is like a bellows (Tuo Yue), blood is like waves. Blood vessels and Qi circulate up and down within the body.

Qi belongs to Yang, blood belongs to Yin. Yang governs movement, Yin governs stillness. The movement of the pulse must be preceded by Qi. When Qi moves, blood moves; when Qi agitates, the pulse beats. Yin and Yang correspond to each other without deviation, much like a bond of friendship. Tuo refers to a ring-shaped bellows; Yue refers to a pipe-like flute, an object with holes. The Yang Qi travels from the crown of the head to the soles of the feet. Although it is protected externally, there are no internal obstructions. Its roaming in and out through the muscle valleys (Xi Gu), Mu Yuan (primary areas of defense), and Cou Li (interstices) occurs via various orifices, thus resembling a bellows and a flute. Bo refers to small waves surging forward layer by layer; Lan refers to swirling eddies returning upon themselves. Blood circulating within the Qi rises and flows, also irrigating in a circular manner, thus resembling waves and eddies, appearing united yet separate, mutually serving as substance and function. Circulating up and down without beginning or end, this is the meaning of circulation.

Among the twelve meridians, all have pulsating arteries. However, only the Cun Kou (Cun point) of the Hand Taiyin Lung Meridian is used to determine the condition.

This meridian belongs to the Lung and connects upward to the pharynx and larynx. The great convergence of pulses relates to the inhalation and exhalation of breath.

One exhalation and one inhalation constitute one Xi (respiration cycle). There are 13,500 such cycles in a day and night.

During one exhalation and one inhalation, the pulse Qi travels six cun. In a day and night, it travels 810 zhang, which serves as the standard.

When initially palpating the pulse, instruct the patient to hold their palm upward. The prominent bone behind the wrist is called the Guan (Bar) position.

The area anterior to the Guan is Yang, and the area posterior to the Guan is Yin. Yang corresponds to the Cun (Inch) position, and Yin corresponds to the Chi (Cubit) position; push and seek sequentially.

The Heart and Liver are located on the left [hand], the Lung and Spleen on the right [hand]. The Kidney and Ming Men (Gate of Life) are located at the Chi positions of both hands.

Hun (Ethereal Soul), Po (Corporeal Soul), and Gu Shen (Grain Spirit) are all reflected at the Cun Kou. The left side primarily governs the Zang organs (Officer), and the right side primarily governs the Fu organs (Palace).

A larger pulse on the left is favorable for males, and a larger pulse on the right is favorable for females. The Ben Ming (Life Root) supports destiny; males prioritize the left, females prioritize the right.

The point one fen anterior to the Guan is the master of human life. On the left, it is the Ren Ying (Guest Welcoming) pulse; on the right, it is the Qi Kou (Qi Gate) pulse.

The Shu Men (Spirit Gate) of decision-making lies on both sides posterior to the Guan. If a person lacks these two pulses, death from illness will not be cured.

Male and female pulses are generally the same, except for the Chi position. If Yang is weak and Yin is excessive, reversing this leads to disease.

The twelve meridians refer to the three Yin and three Yang meridians of the hand and foot. They begin at the Middle Jiao flowing into the Hand Taiyin Lung Meridian, from the Hand Taiyin Lung flowing into the Hand Yangming Large Intestine Meridian, from the Hand Yangming Large Intestine flowing into the Foot Yangming Stomach Meridian, from the Foot Yangming Stomach flowing into the Foot Taiyin Spleen Meridian, from the Foot Taiyin Spleen flowing into the Hand Shaoyin Heart Meridian, from the Hand Shaoyin Heart flowing into the Hand Taiyang Small Intestine Meridian, from the Hand Taiyang Small Intestine flowing into the Foot Taiyang Bladder Meridian, from the Foot Taiyang Bladder flowing into the Foot Shaoyin Kidney Meridian, from the Foot Shaoyin Kidney flowing into the Hand Jueyin Pericardium Meridian, from the Hand Jueyin Pericardium flowing into the Hand Shaoyang Sanjiao Meridian, from the Hand Shaoyang Sanjiao flowing into the Foot Shaoyang Gallbladder Meridian, from the Foot Shaoyang Gallbladder flowing into the Foot Jueyin Liver Meridian, and from the Foot Jueyin Liver returning to flow into the Hand Taiyin Lung Meridian. This constitutes one cycle. The total length of the twelve meridians is sixteen zhang and two chi. Each has different lengths and possesses its own arterial pulsation points. For example, the Hand Taiyin pulse beats at Zhongfu, Yunmen, Tianfu, and Xiabai; the Hand Yangming pulse beats at Hegu and Yangxi; the Foot Yangming pulse beats at Chongyang, Daying, Renying, and Qichong; the Foot Taiyin pulse beats at Jimen and Chongmen; the Hand Shaoyin pulse beats at Jiquan; the Hand Taiyang pulse beats at Tianchuang; the Foot Taiyang pulse beats at Weizhong; the Foot Shaoyin pulse beats at Taixi and Yinggu; the Hand Jueyin pulse beats at Laogong; the Hand Shaoyang pulse beats at Heliao; the Foot Shaoyang pulse beats at Xiaguan and Tinghui; the Foot Jueyin pulse beats at Taichong, Wuli, and Yinlian, etc. Since all have arterial pulsations, diseases can be diagnosed based on these pulses. Why is it that now we only select the Cun Kou arterial pulse of the Hand Taiyin Lung Meridian to determine the life and death, fortune and misfortune of various diseases? Because the Hand Taiyin meridian internally belongs to the Lung organ. The meridian begins at Zhongfu and ends at Shaoshang; its lung system connects upward to the throat and pharynx to facilitate respiration. The Lung governs the Qi of the whole body. Qi cannot move without respiration, and the pulse cannot distribute without Lung Qi. Thus, Zhang Zhongjing said: Respiration is the head/source of the pulse. Furthermore, the Qi that begins to rise at the start of the Yin hour originates from the Middle Jiao. The Middle Jiao refers to the Stomach. The Stomach is the sea of water and grain, belongs to Earth, and resides in the center. It irrigates the four Zang organs and the entire body. The so-called irrigation is nothing but the Qi of water and grain. The four Zang organs inherently contain Earth, and Earth also contains the characteristics of the four Zang organs. (Meaning that the Wei Qi [Stomach Qi] must contain the Xian, Gou, Mao, and Shi pulse qualities, and within the Xian, Gou, Mao, and Shi qualities, there must be Wei Qi.) The pulse circulates fifty times around the body in a day and night. It starts here and ends here. The cycle is continuous without interruption. However, if discussing the four seasons within a day and night, the Gengshi (start of watch) must begin at the early Yin hour. Therefore, the *Suwen: Pulse Essentials and Subtle Discussions* states: Diagnosis is usually performed at Pingdan (early morning). At this time, Yin Qi has not moved, Yang Qi has not scattered, food has not been consumed, the Jing Mai are not full, the Luo Mai are balanced, and Qi and Blood are not chaotic. Thus, abnormal pulses can be diagnosed. This is because at this time, all pulses restart from the Stomach. Their size, deficiency or excess, agitation or calmness, speed or slowness, and all other characteristics are fully revealed. Emerging from the Stomach, they immediately flow into the Lung, being the closest connection. They must also be propelled by the Lung's respiration, which is what is meant by "the Lung faces all vessels." Exhalation belongs to Yang, inhalation belongs to Yin. Two pulse beats per exhalation, two pulse beats per inhalation, totaling four beats per Xi. In a day and night, approximately 13,500 Xi occur. With each Xi, pulse Qi advances six cun. Calculated over 13,500 Xi, the total distance is 810 zhang. Using the pulse length of sixteen zhang and two chi for calculation, it corresponds to fifty circuits around the body. This is the standard for the degree of pulse movement during day and night. (According to *Nanjing: Twenty-third Difficulty*: The total length of the pulse is sixteen zhang and two chi, including the Ren, Du, and Qiao vessels. Calculating six cun per Xi, over 13,500 Xi in a day and night, the total distance is 810 zhang. Circling the body, it achieves fifty degrees. It further states: It begins at the Middle Jiao flowing into the Hand Taiyin, ending at the Foot Jueyin. The Jueyin returns to flow into the Hand Taiyin, described as a circle without end. It is unknown where the two Qiao and Ren/Du vessels connect? Do they attach to the Foot Shaoyin and Foot Taiyang? If attached, they cannot be within the cyclic flow. This awaits clarification by those who know.) When initially palpating a person's pulse, first instruct them to hold their hand upward. Align the high bone of the wrist with the level place, called the Guan position. Anterior to the Guan is Yang, posterior is Yin. Yang is called Cun, Yin is called Chi. From Chi to Cun, the length is one cun and nine fen. This one cun and nine fen are divided into three parts: Cun, Guan, and Chi. Guan is in the center, acting as the boundary between Yin and Yang, while Yin and Yang actually intersect here. By carefully investigating before and after, one will inevitably ascertain the disease condition. Within the three positions, there are specific locations. Wood and Fire are on the left, Metal and Earth on the right, Water below. Discussing according to the generating cycle: Left Guan Liver Wood generates Left Cun Heart Fire; Left Cun Heart Fire generates Right Guan Spleen Earth; Right Guan Spleen Earth generates Right Cun Lung Metal; Right Cun Lung Metal generates both Chi Kidney Water. Hun is the spirit of the Liver, Po is the spirit of the Lung. Gu Shen cannot be called the spirit of the Spleen, yet its transformative generation sustains life and death, being even more miraculous. Gu Shen is Hun and Po; Hun and Po are Gu Shen, and they are collectively governed by the Heart Monarch. Roaming in and out, reaching everywhere; yet their prosperity, decline, reversal, or smoothness are all verified from the Cun Kou. The left Liver and Heart are Wood and Fire, belonging to Yang, governing ascent, growth, and functions of dissemination and exertion, hence called Si Guan (Governing Officer). The right Lung and Spleen are Metal and Earth, belonging to Yin, governing descent, reception, and functions of gathering and storing, hence called Si Fu (Governing Palace). Males are born in the Yin hour, taking Yang as their substance. The left is Yang. A large left pulse means Qi gathers in Yang, which is favorable for males. Females are born in the Shen hour, taking Yin as their substance. The right is Yin. A large right pulse means Qi gathers in Yin, which is favorable for females. Thus, the Ben Ming of males and females is linked to the left and right respectively. If favorable, even if ill, the Ben Ming can still support. The point one fen anterior to the Guan, the master of human life, refers to Hun, Po, and Gu Shen. The left being Ren Ying and the right being Qi Kou refers to Si Guan and Si Fu, deciding at Shu Men. The two points posterior to the Guan refer to the two Kidneys. This corresponds to the Dong Qi (moving Qi) between the kidneys, which is the Yuan Qi of the Sanjiao mentioned in the Eighth Difficulty of *Nanjing*, the God guarding against evil, hence called Shu Men. The Gu Shen anterior to the Guan and Shu Men posterior to the Guan represent the Pre-Heaven and Post-Heaven of human life. Lacking these two means lacking these pulses. Without them, the root is severed, leading to death. (Lacking even one leads to death.) Zhang Zhongjing said: If the Cun pulse does not reach down to the Guan, it is Yang Absence; if the Chi pulse does not reach up to the Guan, it is Yin Absence. This likely refers to the areas anterior and posterior to the Guan. Male and female pulses are the same regarding positioning. Only the Chi differs, differing in excess and deficiency. Males gather in Yang, hence Yin is weak. Females gather in Yin, hence Yin is excessive. Verification is unique to the Chi because at the beginning of Tian Yi's generative power, Yin and Yang are distinguished here. (The Chi is the root of human life, just as the color, fragrance, flowers, and fruits of plants are determined by the root.) Reversing this results in males having female-like excess and females having male-like weakness, causing both to lose their normal state, thus disease arises.