Library

[Image of the Pulse] The image of the Se (Choppy) pulse is obstructed and stagnant, like a knife scraping bamboo; it is slow, thin, and short, with all three characteristics fully present.

[Main Diseases] The Se pulse indicates blood deficiency, and also governs essence injury. A Se pulse at the Cun (inch) position indicates heart pain, or palpitations (Zhenchong). A Se pulse at the Guan (bar) position indicates Yin deficiency, leading to heat in the middle jiao. At the Right Guan position, it indicates Spleen Earth deficiency; at the Left Guan position, it indicates hypochondriac distension. A Se pulse at the Chi (cubit) position indicates spermatorrhea or stranguria, and can also be determined as bloody dysentery; in pregnancy, it indicates fetal pathology; without pregnancy, it indicates blood exhaustion.

[Combined Pulses] If the Se pulse is combined with firmness and largeness, it indicates excess heat. If the Se pulse is combined with emptiness and softness, it indicates deficient fire flaming upward.

[Commentary] "Se" means not smooth or unrefreshing. The *Neijing* states: "irregular and uneven," referring to stagnation where the pulse rate is not uniform. The *Maijue* uses the metaphor of a light knife scraping bamboo, meaning that scraping bamboo causes obstruction and lacks smoothness. Tongzhenzi uses the metaphor of rain soaking into sand, meaning that rain on metal or stone is smooth and fluid, whereas rain on sand is choppy and does not flow. Li Shizhen uses the metaphor of a silkworm eating leaves while ill, meaning the movement is slow and difficult. The spurious *Maijue* states: "seeking under the finger seems to exist, lifting reveals nothing," which describes the Wei (Minute) pulse rather than the Se pulse. Wang Shuhe claimed it has a pause before returning, which is also a flaw. This is because the Se pulse comes and goes slowly and with difficulty, resembling a pause, but is actually not a pause. It is also said: "thin and slow, coming and going with difficulty." Furthermore, the Se pulse is more prominent in the floating layer and less so in the sinking layer, resembling the San (Scattered) pulse but is not actually the San pulse. One must know that extremely soft, seeming to exist yet not existing, is the Wei pulse; floating, thin, and soft is the Ru (Soggy) pulse; sinking, thin, and soft is the Ruo (Weak) pulse. These three pulses are all vague and unclear under the fingers, appearing somewhat similar to the Se pulse but having definite distinctions. The Lung is an organ with much Qi and little Blood, so seeing this pulse at the Right Cun position is within normal limits. The Kidney is an organ specifically responsible for Essence and Blood, so seeing this pulse at the Left Chi position is a sign of severe deficiency and depletion. Regardless of gender, whenever the Chi position presents a sinking and Se pulse, conception will certainly be difficult; this is precisely the syndrome of blood deficiency and essence injury. If one is pregnant and obtains a Se pulse, it means there is insufficient blood to nourish the fetus. If one is not pregnant and obtains a Se pulse, there is the worry of Yin decline and marrow exhaustion.

Generally speaking, all things in the world, if moist and lubricated, will necessarily be Hua (Slippery); if dry and withered, they will necessarily be Se. Therefore, the Hua pulse governs phlegm-fluid retention, and the Se pulse governs Yin decline; this principle is inherent and beyond doubt.