Library

Artery (Dong Mai) manifests as a pulsation that trembles and moves restlessly, smooth and rapid like rolling pearls, appearing at the Guan position. Any pulse that is floating and large or floating and rapid belongs to the category of Artery. It differs from Slippery Pulse (Hua Mai), which presents as smooth, rapid, and fluent in all positions (Cun, Guan, Chi). (This passage is from Zhang Lu. Additionally, Li Shizhen's poem states: "The Artery trembles, the rapidity is at the Guan; without head or tail, it forms a bean-like cluster; its origin lies in the struggle between Yin and Yang; the deficient side trembles, while the victorious side remains stable.") The Artery is a sign of the mutual struggle between Yin and Yang. (Wang Yutai said: "Yang ascends and Yin descends; when these two communicate smoothly, how can an Artery appear? Only when Yang desires to descend but Yin opposes it, and Yin desires to ascend but Yang opposes it, do they struggle with each other, unable to move up or down. This drumming force causes a high prominence, thereby revealing the form of the Artery." This statement vividly captures the essence of the Artery.) If the Artery appears in the Yang position (Cun), symptoms such as sweating, pain, and palpitations/fright may occur; if it appears in the Yin position (Chi), symptoms such as fever and hemorrhage may occur; if the Artery is accompanied by smoothness, rapidity, floating, and largeness, it indicates a struggle between pathogenic factors and heat, which should be cleared. However, spontaneous sweating due to Yang deficiency with an Artery at the Cun position, fever due to Yin deficiency with an Artery at the Chi position, and pregnancy indicated by an Artery at the Chi position in women, should not be treated as Heat syndromes. (Zhang Zhongjing stated: "The Artery indicates pain and fright." *Su Wen* states: "Yin deficiency with vigorous Yang pulsation is called Bang [uterine bleeding]." It also states: "When the Heart-Shaoyin pulse is markedly active in women, it indicates pregnancy.")

Deep Pulse (Fu Mai) hides beneath the tendons; it cannot be felt with light pressure, feels rough and difficult under heavy pressure, and requires careful, curved searching. Sometimes all three positions are Deep, sometimes only one position is Deep; it must be pressed against the bone to be detected. Any pulse that is sinking, minute, thin, or short belongs to the category of Deep Pulse. It differs from Short Pulse (Duan Mai), which is shortened at the Cun and Chi positions but distinct in the middle, and from Sinking Pulse (Chen Mai), where all three positions are sinking but readily felt upon pressing. (This passage is from Zhang Lu. Additionally, Li Shizhen's descriptive poem states: "Search for the Deep Pulse by pushing the tendons to the bone; faint movement is felt deep within the fingers. In cold damage, when sweat is desired and Yang is about to resolve, or in cold-induced reversal with umbilical pain, the syndrome belongs to Yin.") The Deep Pulse is a sign of obstruction and blockage. It may result from blockage by Fire, blockage by Cold, or blockage by Qi stagnation. Symptoms may include extreme pain, hernia, and masses; constipation and rebellious Qi; food retention and anger; cold reversal and fluid retention. One must carefully investigate the cause, distinguishing between Cold and Fire, Qi and Phlegm, and new versus old conditions, to differentiate them accurately. If there is Fire, clearing and descending Fire is the priority; if there is Cold, dispersing Cold is urgent; if there is Qi stagnation, regulating Qi is appropriate; if there is Phlegm, resolving Phlegm is suitable. New conditions usually involve acute blockage and can be treated with unblocking methods; chronic conditions may linger, so one must guard against gradual depletion of Zheng Qi. How can one blindly use unblocking methods merely upon observing a Deep Pulse? (Li Shizhen stated: "In cold damage, a Deep pulse in one hand is called Single Deep; in both hands, Double Deep. One should not diagnose based on the presence of Yin pulses in Yang syndromes. This occurs when Fire pathogen is internally constrained and cannot vent out; extreme Yang resembles Yin, hence the pulse is Deep. Resolution comes through profuse sweating, similar to the sky darkening before rain after a long drought, followed by the revival of all things. There is also 'Cold Damage with Clamped Yin,' where latent Yin exists internally, compounded by external Cold contraction. With excess Yin and deficient Yang, four limbs experience cold reversal, and six pulses are sinking and Deep. Ginger and Aconite decoctions along with moxibustion at Guanyuan (CV4) are required for the pulse to reappear. If pulses at Taixi (KI3) and Chongyang (ST42) are absent, death ensues.")