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Chapter 12 of 28
濒湖脉学
Overall Paraphrase
The Hong pulse belongs to the yang category of pulses. Ancient physicians held that the Hong pulse feels extremely broad and large beneath the fingers (Maijing), with vigorous force on arrival and diminished strength on departure (Suwen). Tong Zhenzi summarized it as "large on arrival, long on departure." In analogical correspondences, the Hong pulse is associated with the Li trigram (Fire) 🔥 in the Eight Trigrams, summer among the four seasons, and the Heart in the human body. The Suwen refers to the Hong pulse as the "Large pulse" and also the "Hook pulse." Physician Hua said: The Hong pulse arrives abundantly and declines when departing, resembling the curved shape of a hook descending from its peak—mirroring the dynamic of blood and vessels in motion, much like summer's lush vegetation spreading outward with drooping branches. Zhan Yanju held that describing it as "like a ring of pearls" is inaccurate. The Maijue once stated that "the Hong pulse suits the long-summer season and is unsuitable in autumn, winter, during sweating, or with purging," but Li Shizhen considered this view erroneous.
The Form Poem means: The pulse arrives full and large, declines on departure, and feels beneath the fingers like surging waves filling the entire palpation area—corresponding to the summer season. If the Hong pulse appears in spring, autumn, or winter, ancient physicians considered it appropriate to explore the therapeutic principle of "elevating yang and dispersing fire" without hesitation.
The Comparison Poem means: The Hong pulse arrives with wave-crashing sensation 🌊—declining on departure, surging on arrival, like rolling billows. Its distinction from the Solid pulse (a firm and forceful pulse type) lies in the difference: the Solid pulse feels wiry, long, firm, and replete whether palpated lightly or heavily. A Hong pulse that is large and forceful leans toward the Solid pulse; a Solid pulse with insufficient force approaches the Hong pulse.
The Indications Poem means: The Hong pulse predominantly indicates exuberant yang qi with relatively insufficient yin blood, with ministerial fire (the yang qi that Chinese medicine holds as residing in the liver and kidneys) tending toward hyperactivity—commonly seen in febrile disorders. If accompanied by abdominal distension and stomach qi rebelling upward with vomiting, ancient physicians held that early intervention is needed; if yin deficiency is present with diarrhea or dysentery, careful judgment is required. Among the cun, guan, and chi positions (the three palpation sites at the wrist), a Hong pulse at the cun position mainly indicates heart fire and heat in the upper jiao (region above the diaphragm); a Hong pulse at the lung position indicates the lung metal (the lungs, which correspond to metal in the Five Phases) being scorched by fire and unable to bear it; a Hong pulse at the guan position calls for examination of liver fire or stomach deficiency; a Hong pulse at the chi position warrants attention to kidney deficiency with internal stirring of yin fire (deficiency fire). The Hong pulse generally indicates the pathological pattern of exuberant yang with yin deficiency. Those suffering from chronic diarrhea, chronic dysentery, blood loss, or prolonged cough who present a Hong pulse were regarded by ancient physicians as showing a pulse contradicting the condition—a poor prognostic sign.
The classics further state: "When the body is emaciated yet the pulse is large, it suggests qi floating externally—ancient physicians regarded this as an unfavorable prognosis." "When the pulse becomes large, it often indicates that the disease is progressing."
Here, "elevating yang and dispersing fire" and "inducing sweating and purging" pertain to discussions of ancient therapeutic methods—offered solely for theoretical comprehension, not as medication guidance.
The defining characteristics of the Hong pulse are "abundant arrival with decline on departure and a broad, large pulse body," reflecting a state of qi surging and blood flooding with yang-heat hyperactivity. Ancient physicians correlated pulse morphology with nature, seasons, and organs, establishing an analogical model of "summer—heart—Hong pulse" to assist in diagnosing febrile conditions and states of yang exuberance with yin deficiency. The key distinction between the Hong pulse and the Solid pulse lies in the degree of forcefulness and whether the pulse force is sustained: the Solid pulse is firm and forcefully replete, while the Hong pulse arrives abundantly but declines on departure, with less sustained force under heavy pressure than the Solid pulse. The Hong pulse's indications emphasize "yang exuberance with yin deficiency"—though heat is vigorous, yin blood has already been consumed. Therefore, when patients with yin fluid damage from chronic diarrhea, chronic dysentery, blood loss, or prolonged cough paradoxically present a Hong pulse, ancient physicians viewed this as a pulse contradicting the condition—an unfavorable prognostic sign.
From a modern standpoint, the Hong pulse bears resemblance to hyperdynamic circulatory states: when heart rate increases, stroke volume rises, and peripheral vessels dilate, the pulse may feel notably full and forceful. This can be observed in fever, post-exercise states, emotional agitation, hot environments, hyperthyroidism, anemia, and other conditions, as well as in certain cardiovascular issues causing widened pulse pressure. The Hong pulse is therefore not evidence of a single disease and certainly should not be used for self-diagnosis based on pulse alone.
That said, mapping the Hong pulse to the Li trigram, summer, and the heart belongs to the analogical thinking model—useful for memory and reasoning but not a diagnostic standard in the modern medical sense. The disagreements among ancient physicians regarding the Hong pulse's description also reveal the subjectivity inherent in pulse diagnosis, which must be integrated with inspection, auscultation/olfaction, and inquiry for comprehensive assessment.
These are general lifestyle wellness suggestions, not targeted at any specific disease.
Bu Gua Note: This content is based on classical Chinese medicine texts and is provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, medication recommendation, or treatment advice. If you feel unwell, please seek medical attention promptly.