Library

Generally, when examining the pulse, one must first determine the normal pulses of the four seasons (Spring, Summer, Autumn, Winter), thereby assessing excess and deficiency, cold and heat, the frequency of beats, the flourishing and declining states of Yin and Yang, the generation and restriction of the Five Elements, and the organ associations, establishing these as the fundamental principles. Then, observe the patient's physical constitution and spirit, height, fat or thin build, combined with the climatic conditions of excess and decline, temperament, social status (commoner or official), age, and strength. If the physical form and spirit accord with the Four Seasons, Five Elements, and climate without violation, this is the root of life; if the physical qi contradicts the Five Elements, the condition is critical. A pulse that is "suspended and severed" (Zhen Zang Mai, True Organ Pulse indicating absence of Stomach Qi) indicates death and is untreatable. In obese individuals, a pulse fine as silk and on the verge of disappearing indicates death; in emaciated individuals, a rapid and restless pulse indicates death. If the body feels rough and stagnant but the pulse flows smoothly, it indicates death; if the body is smooth but the pulse is rough and stagnant, it indicates death. If the body is small but the pulse is large and vigorous, it indicates death; if the body is large but the pulse is small and weak, it indicates death. If the body is short but the pulse is long and slow, it indicates death; if the body is tall but the pulse is short and rapid, it indicates death.

Qibo stated: Generally, if a person is emaciated yet has a large pulse and excessive Qi in the chest, they will die; if a person is robust yet has a fine pulse and insufficient Qi to breathe, their condition is critical. When Form and Qi are harmonious, life is sustained; when there is disharmony among the Five Elements or between Form and Qi, disease occurs. People vary in strength and decline, which the pulse reflects accurately; pulses differ in Yin/Yang and Excess/Deficiency, which the disease reflects accurately. When the pulse, disease, form, and symptoms correspond and do not contradict each other, success is assured in ten thousand cases; if there is even slight contradiction, even an excellent physician cannot apply their skill. Therefore, regarding pulses and diseases, certain patterns are appropriate while others are not; some suit a Large pulse, some a Small pulse, some a Floating pulse, some a Deep pulse, and some are unsuitable for these. Physicians must distinguish these early. (From *Ren Zhai Zhi Zhi*)

If pain is on the left due to illness on the right, or on the right due to illness on the left; if pain is below due to illness above, or above due to illness below, this is called "Reverse" (Ni). Reverse conditions indicate death and are untreatable. Abdominal distension with a Floating and Large pulse indicates survival; a Deep and Small pulse indicates death. High fever with a Floating and Large pulse indicates survival; a Deep and Micro pulse indicates death. The same applies to Epilepsy. Delirium with a洪大 (Hong Da, Full and Large) pulse indicates survival. Jue Ni (Jue Syndrome, Cold Extremities) with a Micro pulse indicates death. Sudden collapse with a Solid and Large pulse indicates survival; a Weak, Hidden, and Fine pulse indicates death. Poisoning with a Hong Da, urgent pulse indicates survival; a Micro, Fine, and irregular pulse is critical. Headache with a Floating and Large pulse indicates safety; a Short and Rough pulse is dangerous. Dysentery with a Micro and Fine pulse indicates survival; a Hong Da pulse indicates death. Hematemesis with fever and a Hong Da pulse indicates survival; a Fine and Small pulse indicates death; without fever, a Fine and Small pulse indicates survival; a Hong Da pulse is critical. After Tai Yang Shang Han (Cold Damage) fever subsides, a Calm and Deep pulse indicates safety; a Hong Da and Restless pulse is critical. Spontaneous sweating with a Void and Fine pulse indicates safety; a Restless and Vigorous pulse is critical. Jue Ni with a Deep and Rough pulse indicates survival; a Floating and Large pulse is critical. Various blood loss conditions with a Small and Weak pulse indicate survival; a Hong Da pulse is critical. Chronic illness with a Fine and Soft pulse indicates survival; a Hong Da pulse is critical. Diarrhea with a Micro and Fine pulse indicates survival; a Floating and Large pulse is critical. Postpartum with a Micro and Small pulse indicates survival; a Hong Da and Rapid pulse is critical. Stroke with locked jaw and a Floating, Slow, and Quiet pulse indicates survival; a Hong Shu (Rapid) pulse with coarse breathing indicates death. Upper asthma with urgency, floating face and eyes, Floating and Slippery pulse with warm hands and feet indicates survival; a Rough pulse with cold extremities indicates death. Sores and carbuncles with a Hong Da pulse indicate survival; a Deep and Fine pulse is critical; after ulceration, a Quiet pulse indicates safety; a Hong Da pulse after ulceration is critical. Yang diseases presenting with Yin pulses, and Yin diseases presenting with Yang pulses, both indicate death. Xiao Ke (Wasting-Thirst) with a Number (Shuo, Rapid) and Large pulse indicates survival; a Void and Fine pulse indicates death. Huo Luan (Cholera-like syndrome) with a Floating and Hong pulse indicates survival; a Void and Fine pulse indicates death.