Library

The diagnosis of the Floating Pulse (Fu Mai, 浮脉): The pulse feels floating under the fingers; pressure reveals insufficiency, while light touch reveals excess. Repeated searching shows a state of apparent excess, appearing faintly and flutteringly between the skin and hair. It indicates exterior syndromes (Biao Zheng), which may be due to Wind pathogen or deficiency. A floating, large, and scattered pulse corresponds to the Heart. A floating, short, and choppy pulse corresponds to the Lung. A floating and rapid pulse indicates Heat. If accompanied by aversion to cold, it signifies Carbuncle and Ulcer (Chuang Ju).

The diagnosis of the Surging Pulse (Hong Mai, 洪脉): It resembles floating and is large; upon both pressing and lifting, it feels overflowing and fills all three positions (Cun, Guan, Chi). Its shape is like a torrent of water or rising waves. It indicates Blood Excess and accumulated Heat leading to sores and swellings. As stated in medical discussions: A surging and large pulse indicates the progression of Carbuncle and Ulcer. If pus has not yet formed, purgation should be used. After pus discharges, if the pulse remains surging and large, treatment is difficult. If spontaneous diarrhea occurs, it is incurable.

The diagnosis of the Slippery Pulse (Hua Mai, 滑脉): It combines fullness and largeness with smoothness, flowing freely like rolling pearls; pressing reveals a continuous slippery sensation. It indicates either Heat or Deficiency; this is a Yang pulse. For Carbuncle and Ulcer, if pus has not discharged, internal resolution is appropriate. After discharge, supporting the interior (Tuo Li) is appropriate. This is described as starting with Heat and ending with Deficiency.

The diagnosis of the Rapid Pulse (Shu Mai, 数脉): Upon pressing, the pulse beats more than six times per respiratory cycle. Its appearance is similar to Slippery but faster. Floating and rapid indicates Exterior Heat; sinking and rapid indicates Interior Heat. It is also said that all Rapid pulses indicate Heat. Zhang Zhongjing stated: "If a rapid pulse appears intermittently, malignant sores will arise." He also said: "If both Lung pulses are rapid, sores will arise." Diagnosing various sores with surging and rapid pulses suggests impending pus formation internally.

The diagnosis of the Scattered Pulse (San Mai, 散脉): It resembles floating and is scattered. Pressing reveals dispersion and departure; lifting reveals largeness without strength. It indicates Qi Excess and Blood Deficiency, having an exterior but no interior. After sores and swellings discharge pus, if pain and irritability persist, and the pulse is surging, slippery, coarse, and scattered, it is difficult to treat because Healthy Qi is deficient and Pathogenic Qi is excessive. It is also said: Heavy limbs with a large Lung pulse (floating and scattered) indicate death.

The diagnosis of the Long Pulse (Chang Mai, 长脉): Pressing reveals a surging, large, and long pulse extending beyond its normal position. It indicates excess Yang Qi. In Cold Damage (Shang Han), this pulse suggests sweating will lead to resolution. A long and slow pulse is the Stomach pulse; all diseases will resolve. Being called "Long" implies ease of treatment.

The diagnosis of the Gourd Kernel Pulse (Kou Mai, 芤脉): It resembles floating and is soft; pressing reveals emptiness in the center and solidity on the sides. It indicates Blood Deficiency or blood loss. In sores and swellings, obtaining a Gourd Kernel pulse after pus discharge indicates easy treatment because the pulse matches the disease condition.

The diagnosis of the Firm Pulse (Lao Mai, 牢脉): Pressing reveals solidity and wiriness, appearing deep yet floating with a firm and hard quality. In cases of scrofula and nodular swellings, obtaining a Firm pulse... [Text fragment] ...cannot be treated with internal tonification alone.

The diagnosis of the Solid Pulse (Shi Mai, 实脉): Both lifting and pressing reveal strength, resembling a knotted pulse. It is called Solid. The Classics state: "When Pathogenic Qi prevails, it manifests as Solid." For chronically ill and weak patients, this pulse is most taboo. For patients with carbuncles and ulcers, urgent purgation is indicated because both Pathogenic Qi and the Zang-Fu organs are solid/excessive.

The diagnosis of the Wiry Pulse (Xian Mai, 弦脉): Pressing reveals tightness and wiriness; what resembles tightness is defined as wiry. Like pressing a string that does not move, whereas tightness feels like cutting a rope that rotates. Spring pulses are floating and wiry and considered normal; appearing at other times indicates fluid retention or pain, indicating Cold and Deficiency. Discussions on carbuncles state: Internal Cold and External Heat suggest impending carbuncle development.

The diagnosis of the Tight Pulse (Jin Mai, 紧脉): It resembles wiry but is tight; pressing feels like cutting a rotating rope. It indicates sharp pain and accumulations. For any sore or swelling, this pulse indicates stagnant and choppy Qi and Blood.

The diagnosis of the Choppy Pulse (Se Mai, 涩脉): Pressing reveals dispersion followed by return; lifting reveals fineness and insufficiency. A choppy pulse indicates Qi stagnation. It also indicates Blood Deficiency in sores; after discharge... [Text continues to Short Pulse].

The diagnosis of the Short Pulse (Duan Mai, 短脉): Lifting and pressing do not reach the normal position. The *Neijing* states: "Shortness indicates Qi pathology," due to the absence of Stomach Qi. All diseases with short pulses are difficult to treat. A short pulse in sores indicates deficiency of True Qi.

The diagnosis of the Fine Pulse (Xi Mai, 细脉): Pressing reveals a thread-like pulse, fine as a spider's silk, nearly disappearing; lifting reveals it as almost non-existent yet present, fine and subtle. This indicates the loss of Yang and decline of Healthy Qi. In sores, a fine and sinking pulse occurring at specific times indicates Interior Deficiency and impending transformation of symptoms.

The diagnosis of the Micro Pulse (Wei Mai, 微脉): Pressing reveals a soft, small, and extremely minute pulse. It indicates Deficiency. Recovery of True Qi leads to life; dominance of Pathogenic Qi leads to danger. After sores discharge, a micro and even pulse indicates natural recovery.

The diagnosis of the Slow Pulse (Chi Mai, 迟脉): Lifting and pressing reveal a slow arrival; within one respiratory cycle, only three beats are counted. Its shape resembles Slow but is slightly slower. In chronic diseases, it is favorable; in acute diseases, it indicates exhaustion of Healthy Qi. In sores, it indicates self-healing after discharge.

The diagnosis of the Moderate Pulse (Huan Mai, 缓脉): Pressing feels similar to Slow, but slightly... [Text fragment] ...faster than Slow. Zhang Zhongjing stated: "Yang pulse floating, large, and moist; Yin pulse floating, large, and choppy; when Yin and Yang are equal, it is called Long and Moderate." Seeing a Long and Moderate pulse means all diseases will heal naturally. For sores after discharge, a choppy, slow, and moderate pulse indicates easy recovery because the pulse matches the disease, showing the presence of Stomach Qi.

The diagnosis of the Deep Pulse (Chen Mai, 沉脉): Lifting reveals insufficiency; pressing reveals it like rotten cotton. It indicates Pathogenic Qi in the Zang organs. Water-Dampness obtaining this pulse causes rebellion; this is a Yin pulse.

The diagnosis of the Hidden Pulse (Fu Mai, 伏脉): Different from Deep, it lies beneath the tendons and is visible only after pushing the tendons aside. Similar to Deep, but the Pathogenic Qi is deeper.

The diagnosis of the Deficient Pulse (Xu Mai, 虚脉): Pressing reveals insufficiency; it is very large and soft. Light lifting feels hollow. The Classics state: "Pulse deficiency indicates Blood deficiency; Blood deficiency generates Cold; Yang Qi is insufficient." For sores with a deficient pulse, supporting the interior, harmonizing Qi, and nourishing Blood is indicated.

The diagnosis of the Soft Pulse (Ruan Mai, 软脉): Pressing feels like silk in water, extremely soft, deep, and fine. Also called Ruan, it indicates weak Stomach Qi. For sores, supplementation is indicated.

The diagnosis of the Weak Pulse (Ruo Mai, 弱脉): Resembles Soft but is extremely minute, arriving faintly and seemingly present. Zhang Zhongjing stated: "A micro and weak pulse, continuous like the end of pouring lacquer, indicates dual deficiency of Qi and Blood, and insufficiency of form and spirit." Generally, for patients with sores, deep, slow, soft, and weak pulses all require supporting the interior.

The diagnosis of the Hasty Pulse (Cu Mai, 促脉): Pressing reveals speed with occasional stops before returning. Zhang Zhongjing stated: "Yang excess causes Hasty pulse; it indicates Heat accumulation in the interior; purgation brings harmony." For sores with a hasty pulse, purgation is also indicated.

The diagnosis of the Knotted Pulse (Jie Mai, 结脉): Pressing reveals slow and intermittent flow, stopping occasionally before returning. Zhang Zhongjing stated: "Yin excess causes Knotted pulse." The Classics state: "Hasty and Knotted pulses indicate survival..." [Text fragment] ...whereas Dai Pulse...

The diagnosis of the Intermittent Pulse (Dai Mai, 代脉): Its stops have a constant number and do not err. For example, if it stops every ten beats, even after dozens of cycles, it always stops after ten beats; if every twenty beats, it always stops after twenty. Dai pulse indicates Qi decline; seeing it in various diseases is inauspicious. For sores, hasty and knotted pulses are difficult to treat, let alone the Dai pulse.

The diagnosis of the Moving Pulse (Dong Mai, 动脉): Seen at the Guan position, without head or tail, about the size of a bean, quivering and shaking. The *Mai Jing* states: "Yin and Yang struggle, hence it is called Moving." Movement in Yang indicates Yang Qi deficiency and syncope; movement in Yin indicates Yin Qi deficiency and fever. Yang originates at the Chi position and moves to Cun; Yin originates at Cun and moves to Chi. This must be distinguished carefully.

Carefully noted: Pulses are the creation of the human body, the external manifestation of disease mechanisms, and the standard for physicians. They must be studied meticulously. Taixi (KI3) and Chongyang (ST42) are crucial for diagnosis, determining life and death. Thus, the twelve meridians are connected to Sheng Qi (Vital Qi). This Qi is the root of humans. If the Cun Kou pulse is level but the patient dies, it is because Sheng Qi is exclusively severed internally. The *Nan Jing* states: "If there is pulse above but none below, the person should vomit; if they do not vomit, they die. If there is no pulse above but pulse below, although distressed, it poses no fatal threat." This shows pulses have roots, and humans have Yuan Qi (Original Qi). Humans receive Qi from grain, transmitted to Zang-Fu. The clear part becomes Ying (Nutritive) Qi, the turbid part becomes Wei (Defensive) Qi. Ying circulates within the vessels, Wei outside. Yin and Yang interconnect like a circle without end, circulating through the body, following regular daily rhythms. Disconnection indicates disease. When disease becomes severe, the pulse pathways become abnormal. I have treated strange pulses like Sparrow Pecking or House Leaking; if caused by harsh drug treatments, urgently using formulas with Ginseng, Astragalus, Angelica, Atractylodes, Ginger, and Aconite often results in recovery. One must not abandon treatment.