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Chapter 21 of 28
濒湖脉学
Overall Paraphrase
The "Binhu Pulse Studies: Hasty Pulse" section discusses the hasty pulse (a pulse that is rapid and urgent, with an occasional pause before resuming), classified under yang pulses. Its definition originates from the Mai Jing (Pulse Classic): the pulse comes and goes rapidly and urgently, suddenly pauses mid-beat, then resumes. Master Li (Li Shizhen) describes it as resembling a person on the verge of falling, with hurried and disordered footsteps, irregular in speed.
Li Shizhen specifically corrects a prior error: the Mai Jing only states "rapid with occasional pause is hasty"; the Mai Jue (Pulse Formulas) claims the hasty pulse is only seen at the cun position (the radial artery at the wrist, one of the three pulse positions in Chinese medicine), without mentioning the "occasional pause," which is incorrect. He holds that rapid with occasional pause is hasty, slow with occasional pause is knotted — it should not be limited solely to the cun position.
The Form Poem states: the hasty pulse beats rapidly with occasional pauses, which the ancients regarded as extreme yang heat about to damage yin fluids (the fluid substances in the body that moisten and nourish). When San Jiao (the body's three upper, middle, and lower qi-transformation regions) is afflicted by blazing stagnant fire, continued intensification of heat portends a poor prognosis, whereas abatement of heat leaves hope for recovery.
The Comparison Poem notes that the hasty pulse should be cross-referenced with the intermittent pulse (Dai), as detailed in the section on that pulse.
The Disease Indications Poem states: the hasty pulse is generally analyzed through heat-fire-type conditions, and its causes must be carefully differentiated into five categories—qi stagnation, blood stasis, phlegm obstruction, fluid retention, and food stagnation. Frequent wheezing and coughing are often related to phlegm accumulation, and may also manifest as mania, rashes, or toxic abscesses.
The hasty pulse indicates yang exuberance disorders. The causes of pauses in both the hasty and knotted pulses can be distinguished among the five types of stagnation: qi, blood, phlegm, fluid, and food. Whenever any one of these stagnations obstructs, the pulse may exhibit pauses.
The core of this passage is to clarify the definition of the hasty pulse: rapid with an occasional single pause, belonging to the yang pulse category; its opposite is the knotted pulse (slow with an occasional pause), belonging to yin. Li Shizhen criticizes the Mai Jue's claim of "taking only the cun position," emphasizing that pulse assessment must synthesize all three positions, and that no single pulse pattern should be confined to the cun position alone.
In terms of pathogenesis, the hasty pulse is attributed to hyperactive yang heat, blazing stagnant fire in the San Jiao, and damage to yin fluids; however, it is also pointed out that the direct cause of "pauses" in both hasty and knotted pulses is the retention and stagnation of five types of pathogens—qi, blood, phlegm, fluid, and food—whether tangible or intangible, disrupting the continuity of pulse qi. This embodies the dialectical insight of Chinese medicine that "not all pulse pauses indicate deficiency": excess-type stagnation can also cause the pulse to pause.
From a modern viewpoint, "rapid with an occasional pause" bears superficial descriptive similarity to tachyarrhythmia with intermittent beats, but the two cannot be directly equated. Chinese pulse diagnosis is an empirical model formed on the basis of holistic observation in antiquity; terms such as "extreme yang about to exhaust yin" and "stagnant fire in the San Jiao" are traditional pathogenetic terminology, not modern pathological diagnoses. The saying "progression means no survival, regression means survival" should be understood as the ancients' rough prognostic assessment of disease trends, not as an absolute conclusion.
No modern disease can be diagnosed based on pulse findings alone, nor should one self-diagnose life-and-death outcomes or treatment efficacy from one's own pulse. This content is better suited for study as traditional culture and medical history.
In terms of emotional wellbeing, maintain a calm and even state of mind, reducing prolonged irritability and pent-up anger. In diet, favor light and moderate fare, avoiding excessive spicy, greasy, or rich foods to prevent food stagnation and damp-heat from engendering internally. Maintain a regular sleep schedule and avoid chronic overexertion. If you notice significantly irregular pulse rhythms, excessively rapid heartbeats, or chest discomfort in daily life, do not self-manage according to the "hasty pulse" concept—seek prompt medical evaluation.
Associated Concepts:
Further Reading: Mai Jing (by Wang Shuhe), Mai Jue (Pulse Formulas), Binhu Pulse Studies: Knotted Pulse, Binhu Pulse Studies: Intermittent Pulse, Huangdi Neijing: Suwen: Mai Yao Jing Wei Lun ("Essential Subtleties of Pulse Examination").
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, prescription, or treatment advice; if you feel unwell, please seek prompt medical attention.
— Annotated by Bugu