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[Characteristics of Pulse Image] The image of the Cu (Hasty) pulse is characterized by rapidity with occasional pauses; it resembles running and then stumbling, where continuing forward leads inevitably to death.

[Manifested Diseases] The Cu pulse arises from hyperactive Fire or from the stagnation of pathogenic factors such as food or phlegm. When seen at the Left Cun position, it indicates blazing Heart Fire. When seen at the Right Cun position, it indicates rattling sounds in the Lungs (phlegm-rattle). When seen at the Left Guan position, it indicates disaster due to blood stasis. When located at the Right Guan position, it indicates food stagnation in the Spleen palace. Encountered at the Left Chi position, it causes worry regarding spermatorrhea and seminal emission. Encountered at the Right Chi position, it definitively indicates burning heat.

[Commentary] The meaning of the Cu pulse lies in the occasional pause amidst a rapid rhythm, which is a sign of Yang excess. Mr. Li stated: "Like stumbling while hurrying, with irregular speed," which deeply captures its essence. Wang Shuhe said: "The Cu pulse comes and goes rapidly, pausing occasionally before resuming," which is also quite clear. The Qi and Blood in the human body circulate through the meridians constantly, flowing continuously without cessation. In one day and night, they should complete fifty circuits; if they do not follow this count, it is called reckless generation. Regarding the pulse rate, it should correspond accurately like a drumstick striking a drum, without any deviation. If the Zang-organ Qi is disordered, stagnation and coagulation occur, obstructing the mechanism of circulation, resulting in pauses; this condition is mild. However, if the True Yuan (Original Qi) is exhausted, leading to the relaxation of Yang and depletion of Yin, losing its normal regulatory measure, resulting in pauses; this condition is severe. Nevertheless, the cause of the Cu pulse stems from disordered Zang-organ Qi in six or seven out of ten cases, and from exhausted True Yuan in two or three out of ten cases. It may be due to Qi stagnation, Blood coagulation, Phlegm retention, Food obstruction, external Six Excesses, or internal Seven Emotions, all of which can obstruct the mechanism of circulation. Thus, even during a rapid and frequent rhythm, an occasional pause appears. If the frequency of pauses gradually decreases, the illness improves; if the frequency of pauses gradually increases, the illness worsens. The spurious prescription merely states "located together at the Cun position," which does not fit the meaning of the Cu pulse; furthermore, failing to mention the "occasional pause" is particularly absurd.

Wang Zhankiu of Yanjing sought treatment for Spleen diarrhea, presenting with mental fatigue and emaciated complexion. The Cu pulse was detected, with a pause occurring after every 14 or 15 beats, or after every 17 or 18 beats. I told his original physician: "According to the method, this is incurable." But the physician argued: "This is not the Dai (Intermittent) pulse, but merely the Cu pulse; why does your Honor disregard life so lightly?" I replied: "This is the ruin of True Yuan and the exhaustion of Yin and Yang, manifesting as the Cu pulse, which is incomparable to the Cu pulse caused by stagnation and coagulation." The physician could only agree. One month later, he indeed died.