Library

When a child reaches one year of age, pulse diagnosis should be performed. Due to the small size of the wrist area, the practitioner uses one finger to assess all three positions: Cun (Inch), Guan (Bar), and Chi (Cubit). The <i>Floating Pulse</i> (Fu Mai, Floating Pulse) is perceived by light palpation on the skin surface; the <i>Sinking Pulse</i> (Chen Mai, Sinking Pulse) is perceived by heavy pressure down to the bone and muscle level. A normal pulse beats six times per respiratory cycle (<i>Yi Xi</i>, one inhalation and exhalation); if it exceeds this rate, it is a <i>Rapid Pulse</i> (Shu Mai, Rapid Pulse); if it falls short, it is a <i>Slow Pulse</i> (Chi Mai, Slow Pulse). The <i>Slippery Pulse</i> (Hua Mai, Slippery Pulse) feels like rolling beads and flows smoothly; the <i>Choppy Pulse</i> (Se Mai, Choppy Pulse) feels rough and difficult to flow. If the pulse is weak at all three depths (superficial, middle, deep), it is a <i>Deficient Pulse</i> (Xu Mai, Deficient Pulse); if strong at all three depths, it is an <i>Excess Pulse</i> (Shi Mai, Excess Pulse). If weak at the middle depth, it is a <i>Hollow Pulse</i> (Kou Mai, Hollow Pulse); the <i>Micropulse</i> (Wei Mai, Micropulse) is extremely faint, seeming present yet absent. The <i>Surging Pulse</i> (Hong Mai, Surging Pulse) arrives with force but departs weakly; the <i>Crowded Pulse</i> (Cu Mai, Crowded Pulse) is rapid with intermittent pauses; the <i>Knotted Pulse</i> (Jie Mai, Knotted Pulse) is slow with intermittent pauses. The <i>Taut Pulse</i> (Jin Mai, Taut Pulse) feels like a twisting rope on both sides; the <i>Wiry Pulse</i> (Xian Mai, Wiry Pulse) is straight and long, like a drawn bowstring. A floating pulse indicates disease in the exterior, typically due to external contraction; a sinking pulse indicates disease in the interior, typically due to internal injury. A rapid pulse indicates disease in the Fu organs, belonging to Yang-Heat; a slow pulse indicates disease in the Zang organs, belonging to Yin-Cold. A slippery pulse indicates Phlegm; a surging pulse indicates Fire-Heat; a micropulse indicates weakness and deficiency; a wiry pulse indicates retained fluids; a knotted pulse indicates accumulation; a crowded pulse indicates fright and convulsions. A hollow pulse indicates blood loss; a choppy pulse indicates blood deficiency; a sinking-taut pulse indicates abdominal pain; a floating pulse indicates exposure to cold. A deficient pulse indicates various conditions of insufficiency; an excess pulse indicates various conditions of surplus. When <i>Smallpox</i> or <i>Chickenpox</i> are about to erupt, the pulse tends to be surging and taut; an irregular pulse of varying sizes suggests <i>Zhong-E</i> (sudden severe illness/evil qi). Three beats per respiratory cycle indicate extreme deficiency-cold; nine to ten beats indicate extreme heat. One or two beats, or eleven to twelve beats per cycle, are signs of death. A floating-scattered pulse without root or a deeply hidden pulse that does not respond to pressure are difficult-to-treat pulses. Although pulse diagnosis can determine the exterior-interior, yin-yang, and deficiency-excess nature of diseases, in pediatric practice, these findings must be carefully correlated with clinical manifestations.

[Note] "One year old" refers to the age of one. When ill, pulse diagnosis is necessary, but the position is very small and cannot be assessed with three fingers; one must use one finger to define the three positions. The three positions refer to Cun, Guan, and Chi. The floating pulse is felt lightly on the skin, hence called floating. The sinking pulse is seen when pressing heavily between muscles and bones, hence called sinking. "Yi Xi" refers to one breath of a person. "Zhi" refers to the number of pulse beats. Six beats per breath is a harmonious pulse, indicating no disease. If the frequency is excessive, seven or eight beats, it is called a rapid pulse; if reduced, four or five beats, it is called a slow pulse. A slippery pulse resembles a bead, flowing smoothly; a choppy pulse is stagnant and difficult to flow. The three positions refer to the superficial, middle, and deep levels of the pulse. Weakness at all three levels indicates deficiency; strength at all three levels indicates excess. A hollow pulse is weak at the middle level; a micropulse is fine upon pressure, seeming present yet absent; a surging pulse is strong upon arrival but weak upon departure; a crowded pulse is rapid with occasional stops; a knotted pulse is slow with occasional stops; a taut pulse feels like a turning rope; a wiry pulse is straight like a drawn bowstring. These describe the image and rhythm of the pulse. A floating pulse indicates exterior disease, such as external wind-cold; a sinking pulse indicates interior disease, such as internal dietary injury. A rapid pulse indicates disease in the Six Fu organs, belonging to Yang; a slow pulse indicates disease in the Five Zang organs, belonging to Yin. Slippery indicates abundant phlegm; surging indicates fire-heat; micropulse indicates timidity and weakness. Wiry indicates retained fluids; knotted indicates accumulation; crowded indicates fright and convulsions; hollow indicates blood loss; choppy indicates blood deficiency. Sinking-taut indicates abdominal pain; floating-taut indicates exposure to cold. Deficiency indicates insufficiency, governing various deficiency syndromes; Excess indicates surplus, governing various excess syndromes. Surging-taut indicates impending eruption of smallpox/chickenpox. Irregular size indicates Zhong-E syndrome. Three beats per breath is extreme deficiency-cold; nine to ten beats is excessive fire-heat. These are the diseases governed by these pulses. If only one or two beats, or eleven to twelve beats occur per breath, they are death pulses. Floating-scattered without root or pulses that do not respond to pressure at any depth are difficult-to-treat pulses. Although the yin-yang, exterior-interior, and deficiency-excess of diseases can be diagnosed via pulse, one must combine observation, listening/smelling, and inquiry during clinical practice for careful reference.