Library

A question was asked: "Regarding the limbs and bones of the human body, and the various diseases of the Zang-Fu organs and meridians, all are determined by the three positions (Cun, Guan, Chi) of the radial pulse. To which category does the pulse belong? What Qi moves within it? And is the method of pulse diagnosis exactly as stated by the ancient sages?"

The answer was: "The pulse is governed by Ying-Qi (Nutritive Qi), serving as the source of Blood and Qi. Therefore, it can enter and exit the Zang-Fu organs, connect with the meridians, travel through the interstices of muscles and sinews, and pulsate up and down following the movement of Qi. The manifestations felt under the fingers may be clear or turbid, small or large, slightly small or slightly large. Although this is attributed to different congenital endowments, it is actually revealed by one's spiritual consciousness and cannot be judged by a single rigid standard. Even if the ancient sages meticulously described its forms to deduce the mechanisms of Yin-Yang and cold-heat, they merely established the general principles. Wise practitioners value flexible thinking and analogical reasoning; thus, achieving profound insight is not difficult.

Although the manifestations of the pulse are subtle, their significance is immense. It receives its vital energy before chaos was divided, and circulates when the embryo is just forming. This applies to all things in heaven and earth. For instance, the rotation of celestial bodies like the armillary sphere and the tides of rivers and seas represent the normal operation of heavenly pulses; white halos piercing the sun and floods covering the sky represent pathological changes in heavenly vessels; lightning in deep winter and hail in midsummer represent chaotic interactions of heavenly Qi; blood raining from the sky and hair growing during earthquakes represent extraordinary anomalies of heaven and earth. Summer heat and winter cold, southern warmth and northern chill, are deviations of Yin and Yang in heaven and earth. Since humans exist within this interaction of Qi, how can their pulse presentations remain unchanged? When heaven and earth undergo changes, how can pulse diagnosis remain the same?

Observe that although plants have no mind, their bark, stems, and leaves possess veins to transport fluids; even inert stones contain internal structures to communicate with mountain and marsh energies. During extreme droughts, heavy rains, severe cold, or intense heat, trees and stones change color, let alone humans.

Speaking of the normal degree of the pulse, it originates from the Middle Jiao, follows the Lung Meridian, and reaches the three positions (Cun, Guan, Chi). Extending from the interior to the exterior, it is the primary arterial point in the body, distinct from others. Although ancients discussed methods to distinguish floating, sinking, slippery, and choppy pulses, tracing their origin reveals that the有形 (form) of the pulse is distributed from the essence of food and water, endowed by Earth; while its pulsating motion is stimulated by无形 (formless) Qi, endowed by Heaven. The mechanism of communicating between Heaven and Earth, harmonizing Yin and Yang for continuous generation, is endowed by the interaction of Qi. Moreover, these attributes of Blood and Qi cannot be defined by geometric shapes. Just as human faces share similar features, careful examination shows that among millions, none are identical. *Jing Mai Bie Lun* states: 'In diagnosing the pulse, observe courage or timidity, bone structure, muscle, and skin to understand the condition.' Thus, in ancient times, Qiu Dai Ji was tasked with regulating complexion and pulse to achieve divine clarity. Complexion is the manifestation of Shen (Spirit), and pulse is the reliance of Blood and Qi. Therefore, combining complexion and pulse ensures success in every attempt. Grasping this principle makes one's mind and eyes bright as the sun and moon, truly beyond the speculation of inferior scholars. *Yin Yang Ying Xiang Da Lun* says: 'Those skilled in diagnosis observe complexion and palpate the pulse, first distinguishing Yin and Yang; examining clarity and turbidity to know the location; observing breathing and listening to voice to know the suffering; observing balance and rules to know the affected organ; pressing Cun-Chi for floating/sinking, slippery/choppy to know the origin of disease. Thus, treatment will not fail.' This is another expression of 'combining complexion and pulse for universal success.' However, what is emphasized most is adapting to the patient's temperament. If one does not understand the 'Five Faults and Four Errors' in diagnosis, one remains a crude practitioner.

Recently, patients exhibit three faults: First, concealing symptoms to test the doctor's skill through guessing; second, having hidden ailments and using clever words to deceive the physician; third, revealing past illnesses before pulse-taking, causing the doctor to rely on preconceived notions without detailed examination. Even renowned old doctors may waste effort deliberating, often admitting errors themselves, yet failing to heed advice. Without silent introspection, few avoid compounding mistakes due to misdiagnosis.

A person sitting nearby asked: 'Master often says, "Combining complexion and pulse ensures universal success." But what if a lady in the inner chambers is strictly veiled behind screens, preventing observation of her face? How should one proceed?' The Master replied: 'How ignorant such words are! Confucius said, "If I explain one corner and you cannot deduce the other three, I will not repeat myself." One need only examine the pallor or ruddiness, fatness or leanness of the wrist's skin to see a part of the whole. Furthermore, the smoothness or roughness of the flesh, the density of pores, the firmness or softness of muscles, the thickness of sinews, the size of bones, the hardness or flexibility of nails, the plumpness of fingers, the thickness of palms, the coldness or warmth of the Chi position, along with movements indicating safety or danger, and the strength or weakness of breath, combined with pulse and symptoms, allow one to clearly understand the deficiency or excess of Qi and Blood, the rigidity or gentleness of temperament, the labor or rest of the body, the quality of diet, and the favorable or unfavorable nature of the illness.

Another question arose: 'I know the correspondence of the five colors to the five Zang organs, but I am unfamiliar with the rest. Please enlighten me.' The reply was: 'What I refer to as complexion-pulse diagnosis is the Five-Color Diagnosis of Cang Gong, a secret from *Yu Ji Zhen Zang Lun* known to very few. Its subtlety lies in assessing constitution and complexion to correlate with pulse and symptoms, like a shadow following the form. Adhere to this without loss. As stated in *Ling Shu*, "Crude practitioners guard the form; superior practitioners guard the Spirit." This is the meaning.

Spirit manifests as complexion; form manifests as substance. Assume Yellow belongs to Spleen and Stomach: If yellow and obese, there is Phlegm-Dampness in the Stomach; if yellow and withered, there is Fire in the Stomach; if yellow and pale, Spleen-Stomach Qi is originally deficient; if yellow and dark, Body Fluids have been exhausted for a long time. Yellow is the color of the Center; its deficiency/excess and cold/heat mechanisms should be inferred from diet and urination/defecation.

White belongs to the Lung. White and moist indicates充盈 (fullness) of Lung and Stomach; fat and white, soft upon pressure, indicates Qi deficiency with Phlegm; white and emaciated, with bright red fingernails, indicates Qi deficiency with Fire; white and dull/lusterless, with pale fingernails, indicates Lung-Stomach Deficient-Cold; white with slight bluish tint, or many blue veins on arms, indicates Qi deficiency failing to control Blood. If accompanied by blue fingernails, it is a Cold-Yin syndrome. White is a sign of Qi deficiency; even with hemorrhage or fever, it is Deficient Fire, never Excess Heat.

Bluish-black belongs to Liver and Kidney. Bluish and coarse texture indicates strain on sinews and bones; bluish and withered indicates exhaustion of Ying-Blood; black and plump/moist indicates fullness of Marrow; black and thin/emaciated indicates internal damage by Yin-Fire. Bluish-black indicates vigorous Qi in the Lower Jiao; even if attacked by external Cold, it inevitably transforms into Pathogenic Heat, showing absolutely no signs of Deficient-Cold.

Red belongs to the Heart and governs the San Jiao. Deep red and hard indicates a constitution prone to Fire; red and hard indicates full Ying-Blood; slightly red and bright indicates Qi deficiency with Fire; red and dry/lusterless indicates Blood deficiency with hyperactive Fire. Red is the color of blazing Fire; one only worries about dried fluids and exhausted Blood, with no concern for Deficient-Cold. Generally, Fire-type individuals are never obese with much Dampness; even if they have phlegm-cough, it is due to Dryness.

Smoothness or roughness of skin reflects the abundance or scarcity of Body Fluids; density of pores reflects the strength or weakness of Ying and Wei Qi; firmness or softness of muscles reflects the deficiency or excess of Stomach Qi; thickness of sinews reflects the fullness or emptiness of Liver Blood; size of bones reflects the courage or timidity of Kidney Qi; hardness or flexibility of nails reflects the purity or turbidity of Gallbladder Juice; plumpness of fingers reflects the flourishing or withering of Jing-Qi; thickness of palms reflects the abundance or scarcity of Zang-Qi; coldness or warmth of the Chi area reflects the Yin-Yang of Exterior and Interior. *Lun Ji Zhen Chi* states: 'If Chi skin is very hot and pulse is盛大 (vigorous) and restless, it is a Warm Disease; if pulse is vigorous and slippery, the disease is about to exit; if Chi skin is cold and pulse is small, it is diarrhea with little Qi.' These are secrets of millennia, suddenly clarified, truly the primary principle for clinical application, grasped effortlessly. One must pay close attention to this."