Library

Jing disease (Spasm Disease) differs from ordinary diseases, and Jing pulse (Spasm Pulse) differs from ordinary pulses. It is stated: "In Taiyang disease (Disease of the Taiyang/Bladder channel), if there is fever but the pulse is deep and fine, it is named Jing disease, which is difficult to treat." Fever is a symptom of Taiyang disease, while deep and fine pulses are characteristic of Shaoyin (Disease of the Shaoyin/Kidney channel). Whenever a Wei pulse (Fine/Micropulse indicating Yang deficiency) is seen, it indicates weak Yang; whenever a Xi pulse (Fine pulse indicating Yin/Blood deficiency) is seen, it indicates thin Yin. Weakness leads easily to collapse of Yang, and fineness leads easily to collapse of Yin; therefore, it is difficult to treat. It is also stated: "In Taiyang disease, if the pulse is unexpectedly slow, this is Jing disease." Although this is also a Yang syndrome presenting with a Yin pulse, "Slow" differs significantly from "Wei and Fine." Slow indicates that Ying blood (Nutritive Blood) fails to adequately nourish the sinews, resulting in spasm; its treatment method does not align with that of Shaoyin disease. The differentiation between these two conditions involving Yin pulses is as described above. *Mai Jing* (Pulse Classic) states: "For those suffering from Jing, the pulse is Fu (Hidden/Deep) and firm, running straight up and down; upon palpation, it feels tight and wiry, also running straight up and down," mutually elucidating their meanings. This clarifies that "Fu" does not mean hidden or concealed, but rather palpable upon pressure, which is what is meant by "deep pulse." "Firm" means tight like a wire, unyielding to finger pressure, indicating solid pathogenic factors. "Running straight up and down" occurs because the Du vessel (Governing Vessel) and the Taiyang channel run together within the spine. When Taiyang pathogenic factors are abundant, the Du vessel also manifests abundance, hence the pulse appears straight up and down. *Mai Jing* says: "Straight up and down indicates the Du vessel. Its appearance causes epilepsy in adults and convulsive disorders in children." Because it is intermingled with the deep pulse, it leads to epilepsy and Jing disease. If the pulse is visible with light touch (lifting the finger reveals it), the disease is Yang mania; the patient climbs high walls and fences, possessing strength double that of usual, how could they end up with such spasms? Thus, Jing pulses contain Yang elements, and their differentiation is as follows. Generally, a strong constitution yields a strong pulse; finding a soft, harmonious, and moderate pulse is absolutely impossible. Moreover, strong pulses often intermingle with Yin pulses, resulting in deep-wiry or deep-tight pulses, indicating deep-seated pathogens and constrained pulses, which are hard to rapidly dispel. Therefore, for Jing syndrome to resolve, the tight and solid pulse must transform into a weak and faint one before gradual relief can occur.

Later descriptions of Sun (Damage) pulses follow Yue Ren (Bian Que) as the source, considering soft pulses as deficiency, slow pulses as deficiency, stagnant pulses as deficiency, Kong pulse (Hollow pulse) as middle-jiao deficiency, and wiry pulses as middle-jiao deficiency. Pulses that are fine and microporous indicate simultaneous deficiency of Qi and Blood; small pulses indicate scarcity of both Qi and Blood; deep, small, and slow pulses indicate loss of Qi. Deficiency damage pulses seem summarizable in one phrase, yet this is insufficient to exhaust their profound principles. Zhang Zhongjing said: "The pulse of Xu Lao (Deficiency Consumption) often combines floating and large characteristics. Hence, in healthy men, a large pulse indicates labor/depletion, and extreme weakness also indicates depletion." He further stated that a floating pulse indicates interior deficiency. He also said that for labor disease, the pulse is floating and large, accompanied by vexatious heat in the hands and feet, worsening in spring and summer, and improving in autumn and winter. In men, a floating, weak, and choppy pulse indicates infertility. A pulse presenting with Kong, Agitated, Microporous, or Tight qualities in men indicates loss of essence; in women, it indicates dream intercourse. An extremely weak, Kong, and slow pulse indicates excessive hunger, loss of blood, and loss of essence. A weak, deficient, fine, and minute pulse predisposes to night sweats. Summarizing the meaning: "A wiry and large pulse: wiry indicates reduction, large indicates Kong; reduction implies cold, Kong implies deficiency. Deficiency and cold clashing together is named Ge pulse (Leather pulse). In women, it causes miscarriage and bleeding; in men, it causes loss of blood and essence." Thus, floating, large, wiry, and tight pulses appear sufficient externally but lack substance internally. One should not rigidly rely solely on slow, delayed, weak, or faint pulses to verify the pulse state; the nuances of the pulse cannot escape the fingertips.

*Jin Gui Yao Lue* discusses slow and rapid pulses: "Cunkou (Radial artery at wrist) pulse is floating and slow. Floating indicates heat; slow indicates submergence (latent). Heat and submergence clashing is named Chen (Sinking). Zuyang (Dorsalis pedis artery) pulse is floating and rapid. Floating indicates heat; rapid indicates cessation/stagnation. Heat and stagnation clashing is named Fu (Hidden). Sinking and Hidden clashing is named Water (Edema). Sinking implies empty collaterals; Hidden implies difficulty in urination. Emptiness and difficulty clashing cause water to flow into the skin, forming edema." Such explanations make even intelligent and knowledgeable individuals unable to comprehend. Cunkou is where the Lung pulse passes; Zuyang is where the Stomach pulse passes; diagnosing these two together determines exterior and interior. *Nei Jing* states: "Constriction of the Three Yin channels is called Water." Diagnosis should be determined via Cunkou and Zuyang. At Cunkou, floating indicates Wei Qi (Defensive Qi)/Yang, and slow indicates Ying Qi (Nutritive Qi)/Yin. If Wei does not harmonize with Ying, Yang resides alone outside the pulse causing heat, while Ying hides inside the pulse without Wei, causing submergence. Between Ying and Wei, the clashing of heat and submergence pulses prevents Lung Qi from distributing and transforming, leading to natural constriction and sinking. The Spleen and Stomach are connected by membranes and form an interior-exterior pair. At Zuyang, floating and rapid indicate Stomach Yang failing to combine with Spleen Yin. Floating and residing alone at the exterior causes heat; Spleen Yin, lacking Stomach Yang's harmony, is urged by Yang Qi to undergo quantitative changes; rapidity indicates Yin blood becomes more deficient and stagnates. Clashing of rapidity and stagnation is named Fu (Hidden); although Zuyang pulse is not inherently hidden, it becomes hidden due to heat and stagnation. The sinking at Cunkou and hidden nature at Zuyang clash in the middle jiao to form water, which is indeed the definitive diagnosis of Three Yin constriction? Since the Lung governs the skin and hair, and skin is where collaterals pass, Lung sinking and Qi failing to nourish, along with Ying submerging and Blood failing to nourish, result in empty collaterals. The Spleen transports fluids for the Stomach; Spleen hiddenness prevents fluids from entering the Bladder, causing urinary difficulty. Empty collaterals and urinary difficulty allow accumulated water to enter the skin interspace, causing swelling.

Cheng Jiaoqian stated: "Floating, rapid, large, agitated, and slippery pulses are named Yang." Regarding floating and large pulses, Zhang Zhongjing said: "Floating indicates lack of blood; large indicates cold." Regarding rapid pulses: "Rapid indicates deficiency; deficiency indicates cold." Regarding agitated and slippery pulses: "These indicate injury to the Sanjiao (Triple Burner)." He also said: "Slippery indicates hiccups." These critical junctures of excess and deficiency are precisely where Yin and Yang transform. If learners cannot discern the subtleties of pulse pathology, exhaust their variations and latent forms, and prevent their overcoming and recurrence, they will lack sharp insight into doubtful pulses and how can they wield decisive treatment like thunderous axes for difficult diseases?

Zhang Yinan stated: "Identifying pulses is difficult; examining pulses is even harder." For pulses such as floating, sinking, slow, rapid, slippery, and choppy, and the twenty-four pulse types, using comparative methods to identify them is still relatively easy to distinguish under the fingers. What is meant by "examining pulses" is understanding why a pulse appears in a robust constitution, what symptoms the governed disease presents, achieving certainty through intuitive resonance ("heart-to-heart"). Wang Shuhe said: "Floating indicates exterior; sinking indicates interior; rapid indicates Fu organs; slow indicates Zang organs." He also said: "Floating indicates heat, wind, Qi excess, Qi deficiency, lack of blood, and deficiency." Is this external contraction or internal injury? Is it Qi or Blood? Is it Excess or Deficiency? One must examine the exterior-interior, Yin-Yang, cold-heat, and excess-deficiency of the syndrome, the duration (old vs. new) of the disease, and the forcefulness or weakness of the pulse, then make a judgment based on reasoning.