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Chapter 3 of 13
脉经
This chapter describes the feel of twenty-four basic pulse patterns under the fingers and serves as the outline for pulse diagnosis in the Pulse Classic.
The end of the chapter lists distinctions between similar pulses: floating is similar to hollow and surging; string-like is similar to tight; slippery is similar to rapid; leather is similar to excess; deep is similar to hidden; faint is similar to rough; soft is similar to weak; moderate is similar to slow.
The Yellow Emperor asked: Why is pulse diagnosis always performed at dawn? Qi Bo replied: At dawn, the body's yin qi has not yet been stirred, yang qi has not yet dispersed, no food or drink has been consumed, the channels have not been excessively filled, the collateral vessels are in harmony, and qi and blood are not disturbed—therefore it is suitable for pulse diagnosis. After this time, external factors, diet, and emotions will all affect the pulse. One must also combine observation of the eyes' spirit, the five colors, the excess or deficiency of the five organs, the strength or weakness of the six bowels, and the exuberance or decline of the physical body, referencing all these together, before one can determine prognosis.
From the thenar eminence to the prominent bone one inch behind it is called Cun-kou; the segment from Cun to the elbow crease (Chi-ze) is called the Chi region; the position between Cun and Chi is called Guan. Yang emerges and yin enters, with Guan as the boundary. Yang emerges three fen, yin enters three fen, hence it is called the three yin and three yang. Cun governs the upper burner, observing the head, face, skin, and hands; Guan governs the middle burner, observing the abdomen and waist; Chi governs the lower burner, observing from the lower abdomen to the feet.
Why is it that although all twelve channels have moving pulses, only the Cun-kou is used? Because Cun-kou is the great convergence of all pulses—it is the moving pulse of the hand-taiyin lung channel. With one breath, the pulse travels three cun; with one exhalation, the pulse travels three cun; with one full respiration, the pulse travels six cun. In a full day and night, there are approximately 13,500 respirations, and the pulse circulates fifty times through the entire body; the nutritive and defensive qi travel twenty-five cycles through the yang and twenty-five cycles through the yin. After fifty cycles, they converge again at the hand-taiyin Cun-kou, so by examining Cun-kou one can know the condition of the five organs and six bowels.
Before Guan is yang, which should appear floating at nine fen; after Guan is yin, which should appear deep at one cun. Exceeding this is "excess"; falling short is "insufficiency." Yang qi rising to the thenar eminence is called "overflowing," indicating external obstruction with internal blockade—yin overcoming yang. Yin qi entering the Chi region is called "covering," indicating internal obstruction with external blockade—yang overcoming yin. The appearance of "covering" or "overflowing" belongs to the true organ pulses, which the ancients believed portend death even if no illness is currently manifest.
When taking the pulse, one must consider whether the person is tall or short, fat or thin, in temperament hurried or relaxed, as well as age and gender. When the pulse matches the person's physical constitution and nature, it is concordant; when it contradicts, it is discordant. For children of four or five years, a pulse of eight beats per breath that is thin and rapid is considered normal; women's pulses are generally more soft and weak than men's; for men, a larger left pulse is concordant; for women, a larger right pulse is concordant; fat people tend toward deep pulses, thin people toward floating pulses. If a large person has a thin pulse, a small person has a large pulse, or an impatient person has a slow pulse—these are discordant.
The pulse is examined at different depths corresponding to the five organs:
The Pulse Method Eulogy states: The liver and heart are on the left; the spleen and lungs are on the right; the kidneys and life-gate (Mingmen) are both in the Chi region. The left Cun observes the heart, the left Guan observes the liver, and the left Chi observes the kidney; the right Cun observes the lungs, the right Guan observes the spleen, and the right Chi observes the kidney (the left belongs to the kidney, the right is called the "child's door," also known as the Triple Burner). Each organ is paired with its corresponding bowel in exterior-interior relationship.
A rapid pulse indicates bowel disease and heat; a slow pulse indicates organ disease and cold. The normal lung pulse is floating and large; the normal kidney pulse is deep and slippery like a stone; the normal liver pulse is like a bowstring; the normal heart pulse arrives rapidly and recedes slowly. When the normal pulse of an organ or bowel is not seen where it should be, disease is present. Disease has varying degrees of depth, and one must investigate the cause of pathogenic invasion.
Exhalation belongs to the heart and lungs; inhalation belongs to the kidneys and liver; the spleen lies between inhalation and exhalation, and its pulse resides in between. Floating is yang; deep is yin. The heart and lungs are both floating: the heart pulse is floating, large, and scattered; the lung pulse is floating, short, and rough. The kidneys and liver are both deep: the liver pulse is firm and long; the kidney pulse is soft when pressed, and upon lifting the fingers arrives solid. The spleen pulse is moderate, slow, and long.
Pulses may manifest yang exuberance with yin deficiency, or yin exuberance with yang deficiency, distinguished by comparing floating and deep qualities. There are also patterns of one yin with one yang, one yin with two yang, and so forth—these are combinations of the six qualities of floating, deep, long, short, slippery, and rough—not six pulses beating simultaneously.
In the pulse, large is yang, floating is yang, rapid is yang, skipping is yang, long is yang, and slippery is yang; deep, rough, weak, string-like, short, and faint are yin. Yang disease with yin pulse portends death; yin disease with yang pulse portends life. Before Guan is yang; after Guan is yin. The chapter also lists various discomforts corresponding to different Cun-kou and Chi pulses, such as "Cun-kou pulse floating, large, and rapid" being called yang-within-yang, causing distress of fullness in the chest, body heat, headache, and abdominal heat; "Chi pulse deep and thin" being called yin-within-yin, causing aching soreness in both lower legs, inability to stand for long, and so forth. Wind injures yang; cold injures yin. Yang disease is easy to treat; yin disease is difficult to treat.
Deficiency and excess are divided into three categories: deficiency and excess of the pulse, of the disease, and of examination. In the pulse, softness indicates deficiency and firmness indicates excess. In disease, exit indicates deficiency and entry indicates excess; ability to speak indicates deficiency, inability to speak indicates excess; slowness indicates deficiency, urgency indicates excess. In examination, itching indicates deficiency and pain indicates excess; outer pain with inner comfort indicates external excess with internal deficiency; internal pain with outer comfort indicates internal excess with external deficiency. The core principle is: When pathogenic qi is exuberant, there is excess; when essential qi is depleted, there is deficiency. Great heat conditions with qi heat and full pulse are called "double excess." When both channels and collaterals are in excess, the Cun pulse is urgent and the Chi pulse is moderate, and both should be treated simultaneously; slippery indicates a favorable course, rough indicates an unfavorable one.
The pulse may manifest mutual invasion among the five elements, divided into following, crossing, contrariety, and conformity. For example, water invading fire, or metal invading wood, is called "following"; fire invading water, or wood invading metal, is called "crossing"; water invading metal, or fire invading wood, is called "contrariety"; metal invading water, or wood invading fire, is called "conformity." These are applications of the five-element generating and controlling relationships in pulse diagnosis.
Hidden-concealed pulses refer to yin and yang mutually invading and concealing: yin pulses appearing in yang regions indicate yang invaded by yin, and yang pulses appearing in yin regions indicate yin invaded by yang. The chapter concludes with "Double yin produces mania; double yang produces madness. Depletion of yang causes seeing ghosts; depletion of yin causes blindness"—the ancients' summary of the relationship between mental-spiritual changes and visual disturbances with yin and yang, colored by the historical period.
The six pulses of string-like, tight, rough, slippery, floating, and deep are called "lingering bandits" (canzei), capable of causing disorders in all channels. A tight pulse may be caused by excessive sweating, vomiting, lung cold, cold drinks, or deficiency-cold in the stomach. A slippery pulse is the manifestation of "harmonious union of yin and yang."
"Calamitous and strange" occurs when the symptoms match the pulse, but after prescribing medication the patient instead experiences severe vomiting, diarrhea, or abdominal pain—upon questioning, it is discovered this was a delayed reaction to previously taken medication. In fear or fright, the pulse is like following a silk thread, and the complexion is white; in shame, the pulse is floating and weak, and the complexion alternates between white and red; without drinking water, the pulse becomes rough and the lips and mouth become dry. The chapter also mentions judging illness by observing speech, actions, and posture, as well as the method of recognizing feigned illness—if the pulse is harmonious but the patient displays exaggerated symptoms, it may be malingering.
The Cun-kou pulse can distinguish internal-external, deficiency-excess, and the route of pathogenic invasion. When the pulse comes from the front, it is excess pathogen; from behind, deficiency pathogen; from the non-controlling element, thief pathogen; from the controlled element, minute pathogen; when the organ itself is diseased, it is proper pathogen. A rapid pulse indicates wind; a slippery pulse indicates food stagnation; slippery and agitated indicate heat; rough indicates cold-dampness.
When the pulse arrives rapidly and recedes slowly, it indicates internal deficiency with external excess; when it arrives slowly and recedes rapidly, internal excess with external deficiency. A long, string-like pulse indicates disease in the liver; a small pulse with blood deficiency indicates disease in the heart; firm below with deficiency above indicates disease in the spleen and stomach; slippery and slightly floating indicates disease in the lungs; large and firm indicates disease in the kidneys. A floating-slippery pulse with wind-induced wandering pain and fluid retention is difficult to treat. When the pulse is deep and heavy, then rushes straight onward and ceases, it indicates blood disease in the intestinal region—these are all ancient correspondences between pulse and symptoms.
The concluding line, "The pulse is the treasury of blood. When long, qi is well governed; when short, qi is diseased; when rapid, the heart is troubled; when large, disease is advancing..." is the summary statement of this chapter.
This chapter infers the causes of disease based on the five organ pulses in relation to the four seasons, directions, foods, and calendrical days. For example, falling ill in spring without a liver pulse means liver disease; if a liver patient travels westward or eats chicken, the disease may manifest in autumn or on geng-xin days. There are also "king pulse," "minister pulse," "fetal pulse," "imprisoned pulse," "resting pulse," and "dead pulse," each corresponding to different circumstances/locations. This section clearly carries elements of ancient numerology, five-element matching, and folk beliefs, and should be viewed rationally as cultural-historical material rather than as a basis for clinical diagnosis.
If the sizes, slowness, rapidity, depth, and floating of the Cun, Guan, and Chi are equal, even if cold and heat have not yet fully resolved, yin and yang are already tending toward balance, and spontaneous recovery may occur. If the Cun-kou pulse and the Renying pulse are equal in size, depth, and floating, then the disease will be difficult to resolve. This is one of the ancients' methods for judging the outcome of disease.
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, or treatment advice. If you experience discomfort, please seek medical attention promptly.