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[Body and Image] The slow pulse (Huan Mai) has a rate of four beats per breath, coming and going with evenness and moderation; its sensation is like a gentle breeze brushing lightly, or like willow branches in early spring.

The slow pulse signifies width, comfort, and moderation, being exactly opposite to the tight pulse (Jin Mai). Therefore, it is said that when the pulse is moderate and even, neither floating nor sinking, neither large nor small, neither rapid nor slow, full of spirit and vitality, leisurely and graceful, difficult to describe in words, this is the pulse possessing true Stomach Qi (Wei Qi).

[Combined Pulses and Disease Manifestations] The slow pulse represents Stomach Qi and does not primarily indicate disease on its own. Only by observing combined pulses can one diagnose the condition. A floating-slow pulse indicates Wind-Strike (Shang Feng); a deep-slow pulse indicates Cold-Dampness. A large-slow pulse indicates deficiency due to severe Wind; a thin-slow pulse indicates Damp-Bi syndrome. A choppy-slow pulse indicates Spleen Qi deficiency; a weak-slow pulse indicates Qi deficiency. A choppy-slow pulse at the left Cun position indicates Shaoyin Blood deficiency; a floating-slow pulse at the left Guan position indicates internal stirring of Liver Wind; a slow-choppy pulse at the left Chi position indicates insufficiency of Essence Palace (Kidney Jing). A floating-slow pulse at the right Cun position indicates residence of Wind pathogen; a deep-slow pulse at the right Guan position indicates weakness of Earth (Spleen) invaded by Dampness; a thin-slow pulse at the right Chi position indicates extreme decline of True Yang.

Su Wen: Yu Ji Zhen Zang Lun states: "Qibo said: The Spleen belongs to Earth, an isolated organ that irrigates the four directions. Its healthy state is invisible, while its pathological state becomes visible." Thus, the slow pulse itself does not indicate disease. One must examine the combined pulses to determine the pathology. Floating and slow indicates Wind ascending; deep and slow indicates Dampness invading from below. Slow and large indicates internal abundance of Wind-deficiency; slow and thin indicates external invasion of Damp-Bi. Slow and choppy indicates the Spleen's inability to control blood; slow and weak indicates the Lung's inability to govern Qi.

Note: In the Eight Trigrams, the slow pulse corresponds to Kun; in the Five Elements, it belongs to Earth; in seasons, it corresponds to the end of each season; in the human body, it corresponds to the Foot-Taiyin Spleen Meridian. If the Cun (Yang) and Chi (Yin) positions are equal above and below, floating and large yet soft without excess or deficiency, it is a harmonious pulse. Therefore, Zhang Taisu compared it to "like silk threads in a scroll, not rolled up; responding to the finger with moderation, coming and going very evenly." Since Earth is the mother of all things, if the Middle Qi is harmonized, hundred diseases do not arise. The significance of the slow pulse in pulse diagnosis is indeed great!

Su Wen: Yu Ji Zhen Zang Lun says: "When the pulse comes flowing like water, this is called Excess (Tai Guo), indicating disease in the exterior; when it comes sharp like a bird's beak, this is called Deficiency (Bu Ji), indicating disease in the interior. Excess causes heavy limbs unable to move; Deficiency causes obstruction and blockage of the nine orifices." Mai Jing states: "During the time when the Spleen prospers, its pulse is grand and slow, named Ping Mai (Normal Pulse). If instead a string-taut, thin, and long pulse is obtained, this is Liver Wood overacting on Spleen Earth, known as Thief Evil (Ze Xie), which is fatal and untreatable. If instead a floating, choppy, and short pulse is obtained, this is Lung Metal overacting on Spleen Earth, where the child supports the mother, known as Solid Evil (Shi Xie); although ill, it will heal spontaneously. If instead a surging, large, and scattered pulse is obtained, this is Heart Fire overacting on Spleen Earth, where the mother returns to the child, known as Empty Evil (Xu Xie); although ill, it is easy to treat. If instead a deep, soft, and slippery pulse is obtained, this is Kidney Water overacting on Spleen Earth, where Water floods Earth, known as Minor Evil (Wei Xie); although ill, it will recover quickly." The spurious Jue (Pulse Rhymes) claims that the slow pulse governs Spleen Heat, bad breath, regurgitation, toothache, and dreaming of ghosts, seemingly suggesting the slow pulse governs excess heat syndromes; this is entirely fabricated.