Library

The *Suwen: Pulse Essentials and Subtleties* states: The pulse is the mansion of blood. A long pulse indicates regulated Qi; a short pulse indicates diseased Qi; a rapid pulse (Shu) indicates mental restlessness; a large pulse indicates advancing disease; excess in the upper part indicates Qi rebellion upwards; excess in the lower part indicates Qi stagnation leading to distension; an intermittent pulse (Dai) indicates Qi deficiency; a fine pulse indicates scanty Qi; a choppy pulse indicates heart pain; a pulse that comes turbid and rapid like a gushing spring, with worsening condition and deteriorated complexion, indicates advancing disease; a pulse that goes continuously like a breaking bowstring indicates death. A coarse and large pulse indicates Yin insufficiency and Yang excess, constituting Heat Zhong syndrome. A pulse that comes rapidly but departs slowly indicates excess above and deficiency below, leading to Jue and head diseases; a pulse that comes slowly but departs rapidly indicates deficiency above and excess below, leading to aversion to wind. Therefore, those afflicted by wind evil receive Qi [invasion]. If pulses are all deep, fine, and rapid, it is Shaoyin Jue. A deep, fine, rapid, and scattered pulse indicates alternating cold and heat. A floating and scattered pulse leads to collapse/fainting. All floating pulses without agitation indicate pathology in the Yang aspect, manifesting as heat; if accompanied by agitation, the pathology is in the hand meridians. All fine and deep pulses indicate pathology in the Yin aspect, manifesting as bone pain; if accompanied by stillness, the pathology is in the foot meridians. A pulse that is rapid, moving, and has one intermittent beat indicates pathology in the Yang pulse, presenting with diarrhea and pus-blood in stool. A choppy pulse indicates Yang Qi excess; a slippery pulse indicates Yin Qi excess. Yang Qi excess manifests as body heat and absence of sweat; Yin Qi excess manifests as profuse sweating and cold body; excess in both Yin and Yang manifests as absence of sweat and aversion to cold. Pressing down to the bone, if the pulse Qi is weak, it indicates lumbar and spinal pain with Bi syndrome in the body.

The *Suwen: Distinctions of Yin and Yang* states: When both Yin and Yang are deficient, death occurs from Chang Pi (dysentery). When Yang acts upon Yin, it is called sweat. Yin deficiency with vigorous Yang pulsation is called Beng (metrorrhagia/metrostaxis).

The *Suwen: Phenomena of Normal People* states: Wind-heat with a calm pulse, diarrhea with blood loss and a full pulse, internal disease with a deficient pulse, and external disease with a choppy and firm pulse are all difficult to treat; this is termed contrary to the Four Seasons.

The *Suwen: Jade Machine and True Zang Pulses* states: In treating any disease, one must observe the patient's form, Qi, color, and luster, assess the flourishing or declining state of the pulse, and determine whether the disease is new or old, then treat accordingly without delaying the timing. When form and Qi are harmonious, it is called treatable; when color and luster are bright and floating, it is called easily curable; when the pulse conforms to the Four Seasons, it is called treatable; when the pulse is weak and slippery, indicating Stomach Qi, it is called easy to treat; when form and Qi are discordant, it is called difficult to treat. When the complexion is dull and lacks luster, it is called difficult to cure; when the pulse is full and hard, it indicates worsening condition; when the pulse contradicts the Four Seasons, it is untreatable. One must carefully examine these four difficulties and clearly inform the patient. Heat disease with a quiet pulse, diarrhea with a large pulse, blood loss with a full pulse, internal disease with a full and firm pulse, and external disease with a not-full and not-firm pulse are all difficult to treat.

Commentary: The meaning of these two chapters seems contradictory as stated previously: the former chapter says internal disease with a deficient pulse is difficult to treat, while the latter says internal disease with a full and firm pulse is difficult to treat; the former says external disease with a choppy and firm pulse is difficult to treat, while the latter says external disease with a not-full and not-firm pulse is difficult to treat. Why do they seem opposite? Essentially, when Excess Evil is internal, the pulse should not be deficient; when Deficient Evil is internal, the pulse should not be full. When Yang Evil is external, the pulse should be slippery and soft, not choppy and firm; when External Evil is just flourishing, the pulse should be full and large, not deficient and small. There is profound meaning in each case; those who consider them errors simply fail to understand the principles.