Library

In the *Suwen: Yuji Zhenzang Lun* (Plain Questions: Discussion on the Jade Machine and True Viscera), Qibo stated: The spring pulse corresponds to the Liver, located in the East, belonging to Wood in the Five Elements. It is the time when all things begin to grow. Therefore, its qi comes forth soft, weak, light, empty, and slippery; it is straight and long, hence called the Xian (String-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth solid and strong, this is called "Excess" (Tai Guo), and the disease is in the Exterior. If the qi comes forth not solid but faint, this is called "Deficiency" (Bu Ji), and the disease is in the Interior. Excess leads to forgetfulness, sudden dizziness and vertigo, and diseases of the vertex (top of the head). Deficiency leads to chest pain radiating to the back, and downward, fullness in both hypochondriac regions.

Spring generates, Summer grows, Autumn harvests, Winter stores; this is the circulation of qi that transforms and produces all things. The Liver corresponds to the Wood of the East; its qi is tender and soft, so the pulse is soft, weak, light, empty, and slippery. "Slippery" means flowing. "Straight and long" resembles a string, symbolizing the free flow of Yang qi. Generally, the pulses of the five viscera each have the shape of their respective organ. The Xian (String-like) image in Spring is the normal pulse corresponding to the season, and the same applies to Summer, Autumn, and Winter. If the pulse qi comes forth not light and empty but solid, not soft but strong, this is "Excess." When the disease is in the Exterior, external pathogens attack, causing Liver qi to stagnate and rebel, leading to irritability. Since Wind nature moves upward and shakes, it causes sudden dizziness and vertigo, resulting in diseases of the vertex, such as blurred vision and pulling pain at the top of the head, because the Liver meridian ascends to the vertex and intersects with the Du Meridian. If the qi comes forth not solid but faint, this is "Deficiency," indicating a deficiency of the Middle Jiao, lacking Yang qi and harmonious vital energy. The water passages of the Sanjiao (Triple Burner) are not unblocked. Upward, there is chest stuffiness and bi-syndrome pain radiating to the back; downward, there is empty fullness in the hypochondrium and flanks. As the classic states: "Cold in the zang organs generates fullness diseases." One must use methods to tonify Yang to harmonize Yin, and one must not treat it as excess pain or excess fullness by using purgative or dispersing methods. "Hypochondrium" refers to the soft areas under the ribs, which are all parts traversed by the Liver meridian.

The summer pulse corresponds to the Heart, located in the South, belonging to Fire in the Five Elements. It is the time when all things flourish and grow. Therefore, its qi comes forth vigorous and departs waning, hence called the Gou (Hook-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth vigorous and departs also vigorous, this is "Excess," and the disease is in the Exterior. If the qi comes forth not vigorous but departs vigorously, this is "Deficiency," and the disease is in the Interior. Excess leads to body heat and skin pain, resembling an oozing eruption (Jin Yin). Deficiency leads to vexation in the heart, upward manifestation of cough and expectoration, and downward manifestation of qi leakage.

The mechanism of yin and yang transforming and producing life is nothing other than ascending, descending, exiting, and entering. In summer, Yang qi rises and floats outward, so all things flourish and grow. Human qi responds to this, so the pulse qi rises and exits much while entering little, manifesting as "coming forth vigorous"; it descends and enters little while exiting little, manifesting as "departing waning," and its shape is like a hook. If both coming and departing are vigorous, it is "Excess." Heart fire attracts external fire; Fire pathogen scorches body fluids causing skin pain, and Heat pathogen permeates Ying (Nutritive) and Wei (Defensive) levels, like water soaking throughout the body. If the pulse qi comes forth not vigorous but departs vigorously, it means less rising/exiting and more descending/entering. Internal Yang is deficient, and Heart qi is insufficient to nourish, causing mental restlessness and vexation. Middle deficiency fails to transform fluids, leading to qi stagnation and phlegm condensation. Upward, there is cough and expectoration; downward, there is occasional discharge of foul gas. This is due to deficient Fire failing to keep Spleen Earth solid.

The autumn pulse corresponds to the Lung, located in the West, belonging to Metal in the Five Elements. It is the time when all things mature and are harvested. Therefore, its qi comes forth light, empty, and floating; it arrives swiftly and scatters upon departure, hence called the Fu (Floating) or Mao (Feather-like) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth feather-like but firm in the center and empty on both sides, this is "Excess," and the disease is in the Exterior. If the qi comes forth feather-like but faint, this is "Deficiency," and the disease is in the Interior. Excess leads to rebellious qi and back pain, with a feeling of oppression. Deficiency leads to panting, shortness of breath, and cough, with blood appearing upward from the lungs, and pathological sounds heard downward.

In autumn, Yang qi descends into the earth, and all things become solid. The floating and洪 (surging) quality of the summer pulse turns to light floating. "Arriving swiftly" is the image of gathering tension; "scattering upon departure" is the image of Yang qi descending. Because the superficial layer is light and empty, it is named the Mao (Feather) pulse. If the qi comes forth feather-like but firm in the center and empty on both sides, it indicates internal heat constrained by external coolness, making the center firm. This is an Excess pulse, causing Lung qi to rebel and back pain. "Yun Yun Ran" describes a state of depression and discomfort. If the qi comes forth feather-like but faint, pressing reveals emptiness and weakness; this is a Deficiency pulse. Disease lies in deficient Middle qi, causing panting, shortness of breath, and cough. Qi deficiency fails to control blood, so blood appears with cough, and obstructive sounds are heard in the throat.

The winter pulse corresponds to the Kidney, located in the North, belonging to Water in the Five Elements. It is the time when all things are stored. Therefore, its qi comes forth deep and pounding, hence called the Ying (Camp/Nourishing) or Shi (Stone) pulse. If it is contrary to this, it indicates disease. The Yellow Emperor asked: How does it become contrary? Qibo replied: If the qi comes forth like bouncing stones, this is "Excess," and the disease is in the Exterior. If the qi departs rapid and frequent, this is "Deficiency," and the disease is in the Interior. Excess leads to laxity of sinews and bones (Xie Ji), spinal pain, shortness of breath, and reluctance to speak. Deficiency leads to a sensation of hunger as if ill, coldness in the epigastrium, spinal pain, lower abdominal fullness, and changes in urination.

In winter, Yang qi fully enters the earth, and all things return to storage. Thus, the pulse qi comes forth deep and pounding, meaning insufficient upon light pressure but forceful upon heavy pressure. Yang is stored and circulates internally, hence called Ying (Nourishing); because it is forceful in the deep position, it is also called Shi (Stone) pulse. If the qi comes forth like bouncing stones, it lacks softness; this is an Excess pulse. When disease is in the Exterior, Jing (Essence) is injured, and Yang qi leaks out without consolidation. Thus, meridians become lax, a condition named Xie Ji (laxity), with spinal pain. Yuan Qi is scattered, causing shortness of breath and reluctance to speak. If the qi departs rapid and frequent, the descending qi is fast, but the driving force is weak; this is a Deficiency pulse. Disease lies in the Interior. A heart hanging like hunger occurs because Middle qi is empty, and the Heart lacks mastery, feeling suspended and hungry yet unable to eat. Coldness in the epigastrium and spinal pain occur. "Yao" refers to the soft waist. The spine belongs to the Du Meridian. These indicate Kidney deficiency and Liver stagnation, leading to lower abdominal fullness and abnormal urination, either scanty or difficult, due to powerless Qi transformation in the Lower Jiao. Both conditions are internal injuries.

The Yellow Emperor asked: The sequence of the four seasons has variations of compliance and rebellion. But what governs the Spleen pulse alone? Qibo replied: The Spleen pulse belongs to Earth. It is the solitary Zang organ that irrigates the four directions. The Yellow Emperor asked: Then can the good and bad of the Spleen pulse be seen? Qibo replied: The good cannot be seen; the bad can be seen. If it comes forth like flowing water, this is "Excess," and the disease is in the Exterior. If it comes forth like the beak of a bird, this is "Deficiency," and the disease is in the Interior. Excess leads to inability to lift the limbs. Deficiency leads to obstruction of the nine orifices, named Zhong Qiang (Heavy Stiffness).

The Xian, Gou, Mao, and Shi pulses correspond to the qi of Spring, Summer, Autumn, and Winter. Their rebellious or compliant variations allow one to verify the auspiciousness or inauspiciousness of the disease. Only Spleen Earth resides in the center of the Five Elements, hence called the solitary Zang. It drives and distributes the essence of grain and water from the Stomach to irrigate above, below, and around. Therefore, the pulses of Xian, Gou, Mao, and Shi all take harmony and slowness as their root, representing the Qi of the Spleen and Stomach. Thus, it is said that when the Spleen is in a healthy state, it is not visible. "Bad" refers to the pulse coming forth like flowing water, which is excessive softness, i.e., the pathological pulse mentioned earlier where weakness exceeds Stomach qi. Weakness fails to distribute Stomach qi to the limbs, causing limb weakness and inability to lift. Such qi has ascending and descending but lacks exiting and entering dynamics, so like flowing water, it lacks driving force. If the pulse comes forth like a bird's beak, it is firm, sharp, rapid, and numerous, indicating insufficient softness and slowness. Consequently, ascending and descending are disregulated, clear and turbid mix, causing the nine orifices to be obstructed and internal/external stagnation, hence named Zhong Qiang, meaning excess pathogenic factor. This insufficiency of softness/slowness, and the aforementioned excessive softness, both result from failing to obtain the harmonious middle qi of the Spleen and Stomach, leading to disease.