图2.洪脉示意图(一)脉象：洪脉如波涛汹涌，来盛去衰，脉如洪水之洪，大而且数，上涌有力。(二)洪脉体状诗脉来洪盛去还衰，满指滔滔应夏时，若在春秋冬月分，升阳散火莫狐疑。(三)图解：洪脉浮取脉力超过正常，常见之浮脉，浮取脉力一般多在5个脉力单位，而洪脉多在6—7个脉力单位，而脉形宽阔，正常脉宽度，以升波基底部表示为2格，洪脉为3格，表示洪脉宽度超过正常1／3以上。其脉力突出在浮取力猛，中取和沉取一般皆在5个脉力单位，而浮取脉力较猛,有时患者浮取可至6—7脉力单位，形成上泛有力，波涛汹涌之势，即形态较正常为宽，上泛较正常有力，至数亦较正常为快。(四)主病：病现洪脉，多为热邪炽盛，深入阳明之候，其脉多右大于左。证状多为身发高热，汗出而不恶寒，心烦口渴，舌质红绛，而苔黄燥。在热性病，洪脉多现于右关，当脉洪大，身热不退，宜重用清热解毒之剂，以白虎汤清解气分之热毒。临床凡各种急性传染病，在热深陷气分时，右关脉多见洪大滑数，高热持续不退，此时应放胆重用清热解毒，生石膏有时用1—2两或3—4两，务使洪脉脉力减至5个脉力单位。脉形渐细，而数象渐减，身热下降为度，须使热毒由气分透卫外达，防其深陷营分，缠绵不愈。总之药量大小，须视脉象变化，而斟酌增减。洪脉象征毒热炽盛，机体为抗御大敌，而气血涌腾，以抗御之。由其脉象洪大，知其毒热炽盛。若病后久虚，或虚劳失血，而现此脉，为阳盛阴竭之凶象。由于邪盛正虚，机体的阴阳不能维持平衡，而现阴阳行将离决之象。另有洪脉浮取虽猛，而脉力仍在5单位之间，而中取重按，则较正常脉力为弱，脉形略宽，亦形成上涌之势，但身不大热，心不烦，多为阴虚火盛，而非阳明经实热。可以脉浮取脉力未超过正常，中取重取均较正常为弱以资鉴别。(五)洪脉主病诗脉洪阳盛血应虚，相火炎炎热病居；胀满胃翻须早治，阴虚泄痢可踌躇。寸洪心火上焦炎，肺脉洪时金不堪；肝火胃虚关内察，肾虚阴火尺中看．(六)洪脉辨证分析表洪脉为热邪燔灼(1)洪而有力——实热(2)洪而无力——虚热(3)洪而兼浮——表热(4)洪而兼沉——里热(5)洪而虚软——热盛阴虚3．虚脉
(一)脉象：虚大而软，按之不足．凡脉重按无力为虚。寻按脉浮中沉力量的对比，如重按之力弱于浮取或中取即谓之无力。(二)虚脉体状诗举之迟大按之松，脉状无涯类谷空，莫把芤虚为一例，芤来浮大似慈葱。(三)示意图解：虚脉宽度和正常相同，而脉力浮取略弱，一般在4—5个脉力单位，中按脉力弱于浮取，重按更弱，一般多在2—3个脉力单位，差距愈大，则阴虚愈甚。如浮取为5个脉力单位，中取4个脉力单位，重取为2个脉力单位则阴虚较轻。若浮取4个脉力单位，中取2个脉力单位，重取1个脉力单位则阴虚为重。本图浮取脉力为3个脉力单位，中取重取皆为1个脉力单位，表明阴虚为重。(四)主病：虚脉为正气之虚，临床常见的虚脉，有阴虚阳虚两种，诊脉时须审清。阴虚之脉，虚大中空重按无力；阳虚之脉，细弱无力，多表现为浮取无力，脉象偏沉；阴虚无力皆为沉取无力，脉象偏浮。《脉经》云：“浮以候阳，沉以侯阴”。治疗时应根据阴阳之偏胜，制订益阴补阳的法则，决不可反其道而行，以免出现不良反应，这是辨证治疗的关键，应格外注意。辨证的方法，浮而无力为气虚，沉而无力为血虚，数而无力为阴虚(数而无力，临床称为虚数脉)，迟而无力为阳虚。阳虚之脉，舌质多淡，便溏肢冷；阴虚之脉，舌质偏红，阴虚的伴有阴虚之证，而阳虚的亦具有阳虚之证，二者综合辨证，方能得其真象。
通过临床的体验，凡气血虚弱的，其脉必虚，如虚而浮细，每为卫气之虚，必有恶风自汗，心悸气短等证，虚而细数，为肾阴不足，必有心烦失眠，腰酸痛等证。(五)虚脉主病诗：脉虚身热为伤暑，自汗怔忡惊悸多，发热阴虚须早治，养营益气莫蹉跎，血不荣心寸口虚，关中腹胀食难舒；骨蒸痿痹伤精血，却在神门两部居。(六)虚脉辨证分析表虚脉多见于气血虚弱(1)虚而兼浮——表虚自汗(2)虚而兼沉——里虚多泄(3)虚而兼迟——多为虚寒(4)虚而兼数——阴虚劳热(5)虚而兼大——阴虚不敛虚而兼细——气弱血虚(7)虚而兼涩——心血之虚虚而兼小——脾阳不振4.散脉(一)脉象；散脉浮大而散，举之散漫，按之全无，形如羹上肥，即浮取散漫无纪，中取重取皆无，这就是说浮取散漫节律不齐，而中取重取，则脉象渺然无踪。(二)散脉体状诗散似杨花散漫飞，去来无定至难齐，产为生兆胎为堕，久病逢之仔细医。(三)示意图解：散脉浮取脉力很弱，多在3个脉力单位或更少，而脉搏节律不整，时有间歇，中取重取脉搏渺无踪迹，仅浮取，脉浮泛无力，而脉律不齐，形如汤中上浮之油，泛泛于表面之上，而中按重取，则指下感空空无物。(四)主病：散脉多见于心肾阴虚，不能维阳，形成阴阳离决之候，为一种病势危笃不易治疗之险证，在心脏病垂危时往往见之。(五)散脉主病诗左寸怔忡右寸汗，溢饮左关应软散，右关软散跗肿，散居两尺魂应断。
5．芤脉图5芤脉示意图(一)脉象：指下浮大无力为芤，凡脉浮取有力，而中取重按皆无力为芤。(二)芤脉体状诗芤形浮大软如葱，边实须知内已空；火犯阳经血上溢，热侵阴络下流红。(三)示意图解：芤脉浮取脉力正常，一般为5个脉力单位，中取脉力则显著减弱，临床常见者多在1—2脉力单位。重按较好，每在2—3单位，以中取脉力最弱，为与虚脉不同之点。虚脉浮取有力，而中按重按皆无力，芤脉浮取有力，中取重按虽皆无力，而中按无力更为突出。(四)主病：芤脉多为失血亡阴，阴气损伤，阳气浮散之象，如因突然失血过多，为阴气损伤，阳气偏胜，阴虚则无以维阳，致阳现浮散之象。凡失血过多，及产后多见此脉。如小量出血或慢性出血，临床一时见不到芤脉，若时间较长，虽小量出血亦往往呈现芤脉。宜养阴止血，补血法治之。芤脉除失血伤阴外，在热性病，灼津铄液，热邪不解，临床亦可见到芤脉。(五)芤脉主病诗寸芤失血在于胸，关里逢芤肠胃痈，尺部见之多下血，赤淋红痢漏崩中。(六)芤脉辨证分析表芤脉(1)芤而寸盛：多为吐衄上焦的出血。(2)芤而尺盛：常见漏崩尿血便血等证。(3)芤而上泛有力：多属热邪内犯。(4)芤而虚数：阴血两虚。
6．革脉(一)脉象：革脉之形状，内空虚而外绷急。凡脉浮取坚硬搏指，重按豁然而空的即谓革脉。(二)革脉体状诗革大弦急，浮取即得；按之中空，浑如鼓革。(三)示意图解：革脉浮取脉力超过正常，多在6—7个脉力单位，而坚硬搏指，无缓和柔软之象。中取重按脉力细弱，每在1—2脉力单位，是阴气大伤，无以维阳，形成孤阳外越，即将离决之象。(四)主病：革脉出现，在男子为失精亡血，妇人为半产漏下。按革脉自古即有两种不同的见解，一谓病见革脉，为危证死证；一谓革脉为阴气虚竭。这两种说法，从表面看，似有矛盾，其实是革脉在轻重程度上的不同。如革脉浮取虽坚硬搏指，而定息寻按，尚较和缓，为阴气骤伤，无以维阳，致孤阳外越坚硬搏指，毫无雍容和缓之意，久按较缓是一时性的孤阳外越，如及时以育阴扶正，养阴以维阳，尚能挽救。总之革脉的出现，不外两种情况；一为外邪袭表，病势较重，机体为捍卫外邪，竭尽全力，促使气血趋表以抗病，故脉现坚硬绷急，一为阴气虚竭，无以敛阳，孤阳外越。二者均属危候。
(五)革脉主病诗
革主表寒，亦属中虚。左寸之革，心血虚痛；右寸之革，金衰气壅。左关迂之，疝瘕为祟；右关迂之，土虚为疼。
左尺诊革，精空可必，右尺诊革，殒命为忧。妇女得之，半产漏下。
7．滑脉(一)脉象；滑脉往来流利，如珠走盘，即指下感到流利如珠。(二)滑脉体状诗滑脉如珠替替然，往来流利却还前，莫将滑数为同类，数脉惟看至数间。(三)示意图解：滑脉浮取有力，根据病情而略有不同，体健热盛者，脉力可在5—6脉力单位，中取重取，大致相同，指下有圆滑流利之感，热轻体弱者，一般在4—5脉力单位。脉的宽度一般和正常接近，或有时宽些。(四)主病：滑脉为气实血壅之候，为痰热上逆，或食积、呕吐、满闷。脉象滑大，滑数，为内热，上为心肺头目咽喉之热，下为小肠膀胱之热，总视滑脉表现之部位而定。如妇人脉滑数，而经断者，为有孕。若平人脉滑而和缓，为荣卫充实，健康之象。若滑大滑数，则为热邪内犯。凡发热由外邪诱发者，其右脉多现滑数。而各种传染病，当热毒在气分时，则右脉多现洪大滑数。
(五)滑脉主病诗
滑脉为阳元气衰，痰生百病食生灾；
上为吐逆下蓄血，女脉调时定有胎。
寸滑膈痰生呕吐，吞酸舌强或咳嗽；
当关宿食肝脾热，渴痢颓淋看尺部。
(六)滑脉辨证分析表
(1)病脉
①滑而兼浮——风痰
②滑而兼沉—一食满
③滑而兼数——风火痰热、热毒壅盛
④滑而兼实——积滞
(2)平脉
①滑而和缓——健康之象
②滑而经断——妇女受孕之征
Figure 2. Schematic Diagram of Hong Pulse (Surging Pulse)
(I) Pulse Image: The Hong pulse is like surging waves, coming strongly and receding weakly. Its pulse image is grand and rapid like floodwater, with powerful upward surge.
(II) Poem on the Form of Hong Pulse: The pulse comes surging and recedes weakly, filling the fingers like a torrent corresponding to summer time; if it appears in spring, autumn, or winter months, one should not hesitate to raise yang and scatter fire.
(III) Diagram Explanation: When palpated at the superficial level (Fu), the force of the Hong pulse exceeds normal levels. For the common Fu pulse, the superficial force is generally around 5 units, whereas for the Hong pulse, it is mostly between 6–7 units, and the pulse shape is broad. The width of a normal pulse, represented by the base of the ascending wave, is 2 grids, while the Hong pulse is 3 grids, indicating that the width of the Hong pulse exceeds normal by more than 1/3. Its force is prominent in the superficial palpation being fierce, while moderate (Zhong) and deep (Chen) palpations are generally around 5 units. However, the superficial force is stronger; sometimes patients may reach 6–7 units upon superficial palpation, forming a powerful upward surge and surging wave effect. That is, the shape is wider than normal, the upward surge is more powerful, and the rate (Zhi Shu) is faster than normal.
(IV) Indications: The appearance of a Hong pulse usually indicates excessive heat pathogen penetrating deeply into the Yangming channel. The right pulse is often larger than the left. Symptoms include high fever, sweating without aversion to cold, irritability, thirst, red and crimson tongue body, and yellow dry coating. In febrile diseases, the Hong pulse often appears at the Right Guan position. When the pulse is large and surging with persistent fever, heavy doses of heat-clearing and detoxifying agents should be used, such as Baihu Tang (White Tiger Decoction) to clear heat toxins from the Qi level. Clinically, in various acute infectious diseases where heat has deeply penetrated the Qi level, the Right Guan pulse often presents as Hong, Da, Hua, and Shu, with persistent high fever. At this time, bold use of heat-clearing and detoxifying herbs is warranted; Shigao (Gypsum Fibrosum) may sometimes be used in doses of 1–2 taels or 3–4 taels. The goal is to reduce the force of the Hong pulse to 5 units. As the pulse shape becomes thinner and the rapidity decreases, until body temperature drops, it is necessary to ensure that heat toxins are transmitted from the Qi level to the Wei level and outward, preventing them from sinking deeply into the Ying level and causing lingering illness. In summary, dosage must be adjusted based on changes in the pulse image. The Hong pulse symbolizes intense toxic heat; the body's Qi and blood surge to resist this major enemy. From the surging and large pulse image, we know the toxic heat is intense. If this pulse appears after prolonged deficiency following illness, or in consumptive disease with blood loss, it is an ominous sign of Yang excess and Yin exhaustion. Due to excess pathogen and deficient healthy Qi, the body's Yin and Yang cannot maintain balance, leading to a sign of impending separation of Yin and Yang. Additionally, there is a case where the Hong pulse feels fierce upon superficial palpation, but its force remains within 5 units, and upon moderate or deep palpation, it is weaker than normal. The pulse shape is slightly wide, also forming an upward surge, but without significant fever or irritability. This is mostly due to Yin deficiency with Fire hyperactivity, rather than excess heat in the Yangming channel. Differentiation can be made by noting that the superficial force does not exceed normal, and both moderate and deep forces are weaker than normal.
(V) Poem on Diseases Indicated by Hong Pulse: A surging pulse indicates Yang excess and corresponding Blood deficiency; blazing Xiang Huo (Ministerial Fire) is found in febrile diseases; distension and stomach turning require early treatment; Yin deficiency with diarrhea and dysentery warrants hesitation. Surging pulse at Cun indicates Heart Fire flaming upward; when Lung pulse is surging, Metal is unbearable; Liver Fire and Stomach deficiency are observed at Guan; Kidney deficiency with Yin Fire is seen at Chi.
(VI) Analysis Table for Differentiating Hong Pulse: Hong pulse is caused by blazing heat pathogens. (1) Hong and forceful – Excess Heat; (2) Hong and forceless – Deficiency Heat; (3) Hong combined with Floating – Exterior Heat; (4) Hong combined with Deep – Interior Heat; (5) Hong and empty/soft – Heat excess with Yin deficiency.
3. Xu Pulse (Deficient Pulse)
(I) Pulse Image: Large and soft, lacking strength upon pressing. Any pulse that lacks strength upon deep pressure is considered Xu. Comparing the strength at superficial, moderate, and deep levels: if the deep pressure strength is weaker than superficial or moderate pressure, it is called "forceless."
(II) Poem on the Form of Xu Pulse: Lifting reveals slow and large, pressing reveals loose; the pulse form is boundless like an empty valley. Do not confuse Kou pulse with Xu pulse; the Kou pulse comes floating and large like green onion stalks.
(III) Diagram Explanation: The width of the Xu pulse is the same as normal, but the superficial force is slightly weak, generally 4–5 units. The moderate force is weaker than superficial, and deep pressure is even weaker, generally 2–3 units. The greater the gap, the more severe the Yin deficiency. For example, if superficial is 5 units, moderate is 4 units, and deep is 2 units, Yin deficiency is mild. If superficial is 4 units, moderate is 2 units, and deep is 1 unit, Yin deficiency is severe. In this diagram, superficial force is 3 units, and both moderate and deep are 1 unit, indicating severe Yin deficiency.
(IV) Indications: The Xu pulse indicates deficiency of Healthy Qi. Clinically common Xu pulses include Yin deficiency and Yang deficiency types, which must be clearly distinguished during diagnosis. The pulse of Yin deficiency is large, hollow in the middle, and forceless upon deep pressing. The pulse of Yang deficiency is thin, weak, and forceless, often manifesting as forceless superficial palpation with a tendency toward deepness. Forcelessness in Yin deficiency is characterized by forceless deep palpation and a tendency toward floating. The *Mai Jing* states: "Superficial palpation examines Yang, deep palpation examines Yin." Treatment should formulate principles of nourishing Yin and tonifying Yang based on Yin-Yang imbalance; one must never act contrary to this to avoid adverse reactions. This is key to syndrome differentiation and treatment, requiring extra attention. Methods of differentiation: Floating and forceless indicates Qi deficiency; Deep and forceless indicates Blood deficiency; Rapid and forceless indicates Yin deficiency (clinically called Xu-Shu pulse); Slow and forceless indicates Yang deficiency. Pulses of Yang deficiency often present with pale tongue body, loose stools, and cold limbs. Pulses of Yin deficiency often present with reddish tongue body. Yin deficiency accompanies Yin deficiency syndromes, and Yang deficiency accompanies Yang deficiency syndromes; comprehensive differentiation is required to grasp the true picture.
Through clinical experience, those with weak Qi and Blood will inevitably have a Xu pulse. For instance, Xu and floating-thin often indicates Wei Qi deficiency, accompanied by aversion to wind, spontaneous sweating, palpitations, and shortness of breath. Xu and thin-rapid indicates Kidney Yin insufficiency, accompanied by irritability, insomnia, and soreness/weakness of the lower back.
(V) Poem on Diseases Indicated by Xu Pulse: Pulse Xu with body heat indicates Summerheat injury; spontaneous sweating, palpitations, and fright are frequent; fever due to Yin deficiency requires early treatment; nourish Ying and tonify Qi without delay. Blood failing to nourish the Heart manifests as Xu at Cun; distension and difficulty digesting food occur at Guan; bone-steaming, wasting-thirst, numbness, and damage to Essence and Blood are located at Shenmen positions.
(VI) Analysis Table for Differentiating Xu Pulse: Xu pulse is mostly seen in Qi and Blood weakness. (1) Xu combined with Floating – Exterior Xu with spontaneous sweating; (2) Xu combined with Deep – Interior Xu with frequent diarrhea; (3) Xu combined with Slow – mostly Deficiency Cold; (4) Xu combined with Rapid – Yin deficiency with劳热 (consumptive fever); (5) Xu combined with Large – Yin deficiency failing to contain; Xu combined with Thin – Qi weak and Blood deficient; (7) Xu combined with Choppy – Heart Blood deficiency; Xu combined with Small – Spleen Yang not uplifting.
4. San Pulse (Scattered Pulse)
(I) Pulse Image: The San pulse is floating, large, and scattered. Upon lifting, it feels diffuse; upon pressing, it is completely absent. Its shape is like fat floating on soup, meaning superficial palpation is diffuse and irregular, while moderate and deep palpations reveal no trace. This means superficial palpation is diffuse and rhythmically irregular, while moderate and deep palpations show the pulse image vanishing without a trace.
(II) Poem on the Form of San Pulse: Scattered like willow catkins flying diffusely, coming and going不定ly, difficult to align; in childbirth, it signifies life, in pregnancy, miscarriage; encountering it in chronic illness requires careful medical attention.
(III) Diagram Explanation: The superficial force of the San pulse is very weak, mostly 3 units or less, with irregular rhythm and occasional interruptions. Moderate and deep palpations find no pulse trace. Only upon superficial palpation is there a floating, weak, and irregular pulse, resembling oil floating on soup surface, spreading on top. Upon moderate or deep pressing, the fingers feel empty.
(IV) Indications: The San pulse is mostly seen in Heart and Kidney Yin deficiency unable to sustain Yang, forming a state of separation of Yin and Yang. It is a critical and difficult-to-treat dangerous condition, often seen in terminal heart disease.
(V) Poem on Diseases Indicated by San Pulse: Left Cun indicates palpitations; Right Cun indicates sweating; Overflowing Fluid at Left Guan corresponds to soft and scattered; Soft and scattered at Right Guan indicates ankle swelling; San at both Chis suggests the soul should depart.
5. Kou Pulse (Bamboo-Knot Pulse)
Figure 5. Schematic Diagram of Kou Pulse
(I) Pulse Image: Floating, large, and forceless under the fingers is Kou. Any pulse that is forceful upon superficial palpation but forceless upon moderate and deep palpation is Kou.
(II) Poem on the Form of Kou Pulse: Kou shape is floating, large, and soft like a green onion; knowing the edges are solid, one must realize the inside is already empty; Fire invading Yang channels causes upper bleeding; Heat invading Yin collaterals causes lower red flow.
(III) Diagram Explanation: The superficial force of the Kou pulse is normal, generally 5 units, while the moderate force significantly weakens, commonly seen clinically at 1–2 units. Deep palpation is better, often 2–3 units. The moderate force is the weakest, which distinguishes it from the Xu pulse. In Xu pulse, superficial is forceful, but moderate and deep are forceless. In Kou pulse, superficial is forceful, and although moderate and deep are forceless, the forcelessness at moderate depth is more prominent.
(IV) Indications: The Kou pulse mostly indicates blood loss and Yin collapse, with damaged Yin Qi and floating/scattered Yang Qi. For example, sudden massive blood loss damages Yin Qi, causing Yang to prevail. Since Yin is deficient and cannot sustain Yang, Yang appears floating and scattered. This pulse is common in cases of massive blood loss and postpartum. In small or chronic bleeding, the Kou pulse may not be immediately visible clinically; however, if the duration is long, even small amounts of bleeding often present a Kou pulse. Treatment should employ methods to nourish Yin, stop bleeding, and tonify Blood. Besides blood loss and Yin injury, the Kou pulse can also be seen in febrile diseases where heat scorches fluids and body liquids, and the heat pathogen persists.
(V) Poem on Diseases Indicated by Kou Pulse: Kou at Cun indicates chest bleeding; Kou at Guan indicates gastrointestinal abscesses; Kou at Chi indicates lower bleeding, red dysentery, leukorrhea, and metrorrhagia.
(VI) Analysis Table for Differentiating Kou Pulse: Kou pulse. (1) Kou and strong at Cun: mostly hematemesis or epistaxis (upper Jiao bleeding). (2) Kou and strong at Chi: common in leukorrhea, metrorrhagia, hematuria, and hematochezia. (3) Kou and forcefully surging upward: mostly internal invasion by heat pathogen. (4) Kou and deficient-rapid: dual deficiency of Yin and Blood.
6. Ge Pulse (Drum-Taut Pulse)
(I) Pulse Image: The shape of the Ge pulse is empty inside and tense outside. Any pulse that feels hard and pounding upon superficial palpation but hollow upon deep pressing is called Ge pulse.
(II) Poem on the Form of Ge Pulse: Ge is large, wiry, and urgent, obtained upon superficial palpation; pressing reveals emptiness in the middle, resembling a drum skin.
(III) Diagram Explanation: The superficial force of the Ge pulse exceeds normal, mostly 6–7 units, feeling hard and pounding against the finger, without any gentle or soft quality. Moderate and deep palpations reveal thin and weak force, often 1–2 units, indicating severe Yin damage unable to sustain Yang, forming isolated Yang floating outward, approaching separation.
(IV) Indications: Appearance of Ge pulse indicates seminal emission and blood loss in men, and incomplete abortion or uterine bleeding in women. Historically, there are two different views on Ge pulse: one considers it a critical/deadly sign; the other considers it Yin Qi exhaustion. These seem contradictory but reflect differences in severity. If Ge pulse is hard upon superficial palpation but becomes relatively gentle upon steady counting, it indicates sudden Yin damage unable to sustain Yang, causing temporary isolated Yang floating outward. If treated promptly with nourishing Yin and supporting Healthy Qi, it can be saved. In summary, Ge pulse arises from two situations: one is external pathogen attacking the exterior with severe condition, where the body exerts all effort to defend against the pathogen, driving Qi and Blood to the exterior, resulting in hard and tense pulse; the other is Yin Qi exhaustion unable to constrain Yang, causing isolated Yang floating outward. Both are critical conditions.
(V) Poem on Diseases Indicated by Ge Pulse
Ge indicates exterior cold and also Middle Jiao deficiency. Ge at Left Cun indicates Heart Blood deficiency and pain; Ge at Right Cun indicates Metal decline and Qi stagnation. Ge at Left Guan indicates hernia and masses; Ge at Right Guan indicates Earth deficiency and pain.
Diagnosing Ge at Left Chi confirms empty Essence; diagnosing Ge at Right Chi worries about death. Women obtaining this suffer incomplete abortion and uterine bleeding.
7. Hua Pulse (Slippery Pulse)
(I) Pulse Image: The Hua pulse flows smoothly back and forth, like pearls rolling on a plate, feeling smooth like pearls under the fingers.
(II) Poem on the Form of Hua Pulse: Hua pulse is like pearls, continuous and smooth, flowing back and forth yet returning forward. Do not classify Slippery and Rapid together; look only at the rate for Rapid pulse.
(III) Diagram Explanation: The superficial force of the Hua pulse is forceful, varying slightly by condition. In robust individuals with excess heat, force may be 5–6 units; moderate and deep palpations are similar, feeling round, smooth, and slippery. In those with mild heat and weak constitution, it is generally 4–5 units. The width is generally close to normal or sometimes wider.
(IV) Indications: The Hua pulse indicates excess Qi and congested Blood, phlegm-heat counterflow, food retention, vomiting, or fullness. Pulse images of Hua-Da (Large) and Hua-Shu (Rapid) indicate internal heat: upper heat in Heart, Lung, head, eyes, throat; lower heat in Small Intestine and Bladder. This depends on the location of the Hua pulse manifestation. For women, if the pulse is Hua-Shu and menstruation has stopped, it indicates pregnancy. If a healthy person has a smooth and harmonious Hua pulse, it indicates sufficient Ying and Wei Qi, a sign of health. If Hua is large and rapid, it indicates internal invasion by heat pathogen. Fever induced by external pathogens often presents with Hua-Shu on the Right pulse. In various infectious diseases, when heat toxin is at the Qi level, the Right pulse often presents as Hong, Da, Hua, and Shu.
(V) Poem on Diseases Indicated by Hua Pulse
Hua pulse is Yang, Yuan Qi declines; Phlegm generates hundred diseases, Food generates disasters; Upper leads to vomiting and retching, Lower accumulates Blood; When women's pulses adjust, pregnancy is certain.
Cun slipperiness indicates Phlegm in Diaphragm causing vomiting, acid regurgitation, stiff tongue, or cough; Guan indicates retained food, Liver and Spleen heat; Chi section shows thirst, dysentery, strangury, and priapism.
(VI) Analysis Table for Differentiating Hua Pulse
(1) Disease Pulses
① Hua combined with Floating – Wind-Phlegm
② Hua combined with Deep – Food Fullness
③ Hua combined with Rapid – Wind-Fire, Phlegm-Heat, Heat-Toxin congestion
④ Hua combined with Excess – Accumulation/Stagnation
(2) Normal Pulses
① Hua combined with Harmonious – Sign of Health
② Hua combined with Cessation of Menses – Sign of Pregnancy in Women