Library

Those whose pulse conforms to the four seasons is called a compliant pulse. In spring, the pulse is slightly wiry (Xian); in summer, slightly flooding (Hong); in autumn, slightly floating like down (Mao); in winter, slightly deep like a stone (Shi). Within these, there exists a "harmonious qi" (Heqi) that is soft, slippery, and long; this characterizes a person without disease. Once illness occurs, the pulse changes, but it becomes easy to treat because it originates from the "harmonious qi." The treatment method is foolproof. If the qi opposes the pulse, and the form (xing) and qi are discordant, it is termed "incurable." This is because the form is excessive while the qi is deficient, or the form is deficient while the qi is excessive, hence incurable. Generally, if a person's form and qi are both deficient, yet they can eat, they will die after exceeding the cycle of the eight solar terms; if they cannot eat, they will not exceed the cycle of the eight solar terms before dying. "An gu" refers to the ability to take food and drink; "qi" refers to the climatic cycles of the eight solar terms. (From *Jifeng Fang*)

To diagnose and treat diseases via pulse taking, one must first estimate the patient's fatness or thinness to adjust for the deficiency or excess of qi. Deficiency requires tonification; excess requires purgation. If the body is emaciated, yet the pulse is large, and there is excessive qi in the chest, death is certain. This is because both form and qi are insufficient, yet the pulse appears excessive, leading to death. Therefore, if a person has a robust form but a fine pulse, with shortness of breath and insufficiency, it is a critical condition, nearing death, yet still potentially treatable because the qi is insufficient while the form is robust. If form and qi are harmonious (xiang de), life is sustained, as the person's physical attributes (fatness, thinness, height, length) align with the climate, thus ensuring survival. If the pulse is disordered and irregular (can wu bu tiao), disease exists because the pulse qi is chaotic and uncoordinated. If the pulses at the Cun, Guan, and Chi positions on both hands are uneven and irregular like interlocking pegs (can chun), the disease is severe. If the pulses in the three positions of both left and right hands beat more than ten times per respiration cycle and are uncountable, it is a death sign, as there is no vital energy when the pulse beats over ten times per breath; hence, death ensues. (From *Jifeng Fang*)

Generally, in pulse diagnosis, one first determines the seasonal pulses, then observes excess (tai guo), deficiency (bu ji), deficiency (xu), excess (shi), cold (leng), heat (re), cold (han), warmth (wen), frequency (zhi shu), gain and loss (sun yi), decline and prosperity of yin and yang, generation and restriction of the Five Elements, and organ associations, establishing these as general principles. Then, observe the individual's spirit and form, stature, fatness or thinness, climatic conditions, deficiency or excess, prosperity or decline, temperament, social status (commoner or noble), age (old or young), and strength. As long as one conforms to the spirit and form, four seasons, five qi, and climate without excess, this is the root of life. If the form and qi contradict the Five Elements, the disease is critical. If the pulse is excessively extreme and the form and qi reverse, showing suspended and severed pulses (xuan jue), it is a death sign and incurable. (From *Jifeng Puji Fang*)

Guo Yu was from Guanghan. During the reign of Emperor Zhang of Later Han, he served as a Gentleman of the Palace (Shilang). He was skilled at distinguishing pulses and knowing the time of death. The Emperor ordered a young boy to wear women's clothing, feigning illness, and asked Guo Yu to diagnose him. Guo Yu said, "Who is this woman? Why do you say she is ill? According to the pulse state, yang is excessive and yin is weak; I believe this is not a woman." The Emperor praised him and promoted him to Director of the Central Palace Attendants (Wuguan Zhonglangjiang).