Library

[Chapter 10: Differentiating Deficiency and Excess]
Humans have three types of deficiency (Xu) and excess (Shi). What are they? The answer is: there is the deficiency and excess of pulse, the deficiency and excess of disease, and the deficiency and excess of diagnosis. Regarding the deficiency and excess of pulse: a pulse that feels soft and weak indicates deficiency, while a firm and solid pulse indicates excess. Regarding the deficiency and excess of disease: symptoms moving outward indicate deficiency, while those moving inward indicate excess; the ability to speak indicates deficiency, while inability to speak indicates excess; a slow and relaxed pulse indicates deficiency, while a rapid and tense pulse indicates excess. Regarding the deficiency and excess in diagnosis: itching indicates deficiency, while pain indicates excess; external pain with internal comfort signifies external excess and internal deficiency; internal pain with external comfort signifies internal excess and external deficiency. Thus, these are referred to as deficiency and excess.

Question: What is meant by deficiency and excess? Answer: When pathogenic factors are vigorous, it is excess; when essential qi is depleted, it is deficiency. What is heavy excess (Chong Shi)? Heavy excess refers to cases where a patient with a severe heat disease exhibits intense heat in the qi and a full pulse, which is termed heavy excess.

Question: How should one treat a condition where both meridians and collaterals present excess? Answer: When both meridians and collaterals are in excess, the pulse at the Cun position is urgent/tense while the Chi position is relaxed/slow; both must be treated simultaneously. Therefore, a slippery pulse indicates favorable progression, while a choppy pulse indicates unfavorable progression. The variations of deficiency and excess follow analogical principles. If the five zang organs and bones/flesh are smooth and lubricated, longevity can be achieved.

[Chapter 11: Pulse Patterns of Following, Horizontal, Reverse, Smooth, and Hidden]
Question: Pulses exhibit mutual overacting (Cheng), following/vertical (Cong/Zong), horizontal (Heng), reverse (Ni), and smooth/compliant (Shun). What do these mean? The Master said: Water acting upon Fire, and Metal acting upon Wood, are called "Zong" (Note: In Zhang Zhongjing's text, this character is written as Zong); Fire acting upon Water, and Wood acting upon Metal, are called "Heng"; Water acting upon Metal, and Fire acting upon Wood, are called "Ni"; Metal acting upon Water, and Wood acting upon Fire, are called "Shun".

The Classic states: There are hidden pulses. Hidden in which zang organ, and why are they called hidden? The answer is: This refers to yin and yang mutually overacting and mutually hiding. When a pulse located in the yin positions (Chi) unexpectedly shows yang characteristics (such as floating, rapid, or large), it is yang overacting on yin. Although the pulse may occasionally appear deep, choppy, and short, this indicates yin hidden within yang. When a pulse located in the yang positions (Cun) unexpectedly shows yin characteristics (such as deep, slow, or thin), it is yin overacting on yang. Although the pulse may occasionally appear floating, slippery, and long, this indicates yang hidden within yin. Excessive yin leads to manic-depressive psychosis (Dian); excessive yang leads to mania (Kuang). Loss of yang results in hallucinations (seeing ghosts); loss of yin results in blindness.

Question: What are the destructive/harmful pulses (Can Zei)? The Master said: Among pulses, there are wiry (Xian), tight (Jin), choppy (Se), slippery (Hua), floating (Fu), and deep (Chen). These six pulse qualities are considered destructive because they can cause pathology in various meridians.

Question: I was once challenged regarding the origin of the tight pulse. Where does it come from? The Master said: Suppose a patient suffers from profuse sweating or vomiting, and cold resides in the lungs; this causes a tight pulse. Suppose a patient coughs due to drinking cold water; this causes a tight pulse. Suppose a patient suffers from diarrhea due to deficiency-cold in the stomach; this causes a tight pulse.

Question: A pulse that suddenly floats and then sinks is called slippery. What does this mean? The Master said: Deepness belongs purely to yin, while sudden floating belongs positively to yang. When yin and yang harmonize, the pulse becomes slippery.

[Chapter 12: Differentiating Disaster, Strange, Terrifying, and Miscellaneous Pulses]
Question: What is a "disaster" pulse (Zai Guai)? The Master said: Suppose a person is ill, and the pulse corresponds to Taiyang disease, matching the clinical presentation. Consequently, a decoction is prescribed. However, upon returning to administer the medicine, the patient suddenly experiences severe vomiting or dysentery/diarrhea, accompanied by abdominal pain. Upon inquiry, the patient says, "I did not exhibit these symptoms during the initial pulse diagnosis; now there is an unexpected change." This is called a disaster. Why does this vomiting and diarrhea occur? The answer is: Perhaps the patient had taken other medications previously, which are now taking effect, causing this disastrous phenomenon.

Question: What kind of pulse appears when a person is terrified? The Master said: The pulse feels like tracing silk threads continuously, and the face is pale and devoid of color.

Question: What kind of pulse appears when a person feels ashamed? The Master said: The pulse is naturally floating and weak, and the complexion alternates between white and red.

Question: What kind of pulse appears when a person does not drink water? The Master said: The pulse is naturally choppy, and the lips and mouth are dry. Speaking slowly indicates wind pathogen; shaking the head while speaking indicates interior pain; walking slowly indicates exterior stiffness; sitting while leaning forward indicates shortness of breath; sitting with only one knee hanging down indicates lower back pain; guarding the abdomen with hands as if holding an egg indicates heart pain. If the patient yawns while the practitioner takes the pulse, there is no disease; if the patient stretches and groans during pulse taking, there is no disease (another version states groaning indicates disease). If a patient lies facing the wall, does not rise upon hearing the practitioner's arrival, but instead glances sideways (another version states turning the face upward), speaks intermittently stopping frequently, and swallows saliva while being palpated, this is feigned illness. If the pulse is harmonious, yet the patient claims the disease is severe and requires emetic/purgative drugs and dozens or hundreds of acupuncture points for cure, it is likely feigned.