Loading...
Chapter 5 of 13
脉经
Overview: This volume takes the Five Viscera as its framework, categorizing them into five sections: Liver-Gallbladder, Heart-Small Intestine, Spleen-Stomach, Lung-Large Intestine, and Kidney-Urinary Bladder. The core logic is "Viscera—Bowel—Meridian—Exterior-Interior—Pulse Pattern—Seasonal Flourishing and Decline—Normal, Pathological, and Fatal Pulses—Emotional Injury—Qi Exhaustion and Death Signs." Among these, "Stomach Qi" refers to the gentle, physiological vitality within the pulse, and is the key to determining normal, pathological, or fatal conditions.
The Liver belongs to Wood in the Five Phases and pairs with the Gallbladder as its bowel; the Liver Meridian is Foot Jueyin, in exterior-interior relationship with the Foot Shaoyang Gallbladder Meridian. The liver's seasonal pulse pattern is the Wiry Pulse (straight and long, like pressing a musical string). Liver qi begins to flourish in winter, reaches its peak in spring, declines in summer, is imprisoned in late summer, and dies in autumn. Regarding days and time-periods, the Jia-Yi days, dawn, and sunrise correspond to Liver Wood; the Wu-Ji days, mealtime, and mid-afternoon are when Liver Wood is constrained; the Geng-Xin days, late afternoon, and sunset are when Liver Wood dies. The Liver stores the Ethereal Soul, governs color, nourishes the sinews, and manifests externally in the eyes. Its sound is the shout, its color is blue-green, its odor is gamey, its fluid is tears, its taste is sour, its favorable taste is bitter, and its aversive taste is pungent. The Liver Shu point is at the ninth thoracic vertebra, and its Mu point is Qimen; the Gallbladder Shu point is at the tenth thoracic vertebra, and its Mu point is Riyue.
After the first Jiazi day following the winter solstice, the Lesser Yang qi begins to arise from midnight, and liver qi gradually flourishes. The liver corresponds to Eastern Wood and governs the beginning growth of all things. Its qi should arrive soft, relaxed, and vacuous, hence the pulse is wiry. When the pulse is soft, diaphoresis should not be used; when the pulse is weak, purging should not be used. Relaxed means open and unobstructed, hence called "relaxed and vacuous." In spring, Stomach Qi is the root; one must not injure Stomach Qi.
The Yellow Emperor asked: The spring pulse is like a string. Qi Bo said: The spring pulse corresponds to the liver, to Eastern Wood, and is the pulse of the beginning growth of all things. Therefore, its arrival is soft and weak, light, vacuous, and slippery, straight and long, and is called wiry. When excessive, the pulse qi is replete and strong, and the disease is in the exterior; when insufficient, the pulse qi is not replete but faint, and the disease is in the interior. Excess causes one to be easily angered, dizzy, and clouded, even leading to head disorders; insufficiency causes chest and rib pain referring to the back, and below, fullness in both hypochondria.
The normal liver pulse is soft, weak, light, and moderate, like lifting the tip of a long pole; the pathological pulse is replete, full, and slippery, like palpating along a long pole; the fatal pulse is rapid and hard and forceful, like a freshly drawn bowstring. When the True Liver Pulse (the liver's fundamental pulse without Stomach Qi) arrives, both the exterior and interior are tense, like palpating along a blade's edge; the complexion is blue-green-white and lustreless, the hair and fur break off—the prognosis is dire. In spring, if Stomach Qi is slightly combined with wiry quality, it is normal; if wiry quality predominates with little Stomach Qi, it indicates liver disease; if there is only wiryness without Stomach Qi, it indicates death. The liver stores blood, and the Ethereal Soul resides in blood; excessive grief and sorrow injure the Ethereal Soul. When the Ethereal Soul is injured, one becomes manic and restless, with yin contraction, sinew spasms, inability to raise both hypochondria, withered hair, and faded complexion. This is most critical in autumn.
During the spring, when liver qi flourishes, the normal pulse is wiry, thin, and long. If, instead, it appears floating, rough, and short, this indicates Metal (lung) overcoming Wood (liver)—the "Thief Pathogen," which the ancients considered great rebellion and difficult to treat; if it appears surging, large, and scattered, this indicates Fire (heart) assisting Wood (liver)—the "Excess Pathogen," which, though disease is present, can resolve on its own; if it appears deep, soft, and slippery, this indicates Water (kidney) nourishing Wood (liver)—the "Deficiency Pathogen," which, though disease is present, is easy to treat; if it appears large and moderate, this indicates Earth (spleen) insulting Wood (liver)—the "Slight Pathogen," which, though disease is present, is easy to cure.
Regarding the frequency of the liver pulse, the ancients considered two beats per breath cycle as normal, three beats as "leaving the meridian," indicating disease, four beats as depletion of essence, five beats as a fatal sign, and six beats as the end of life. The various changes of the liver pulse—such as extreme tightness, slight tightness, extreme slowness, slight slowness—are respectively associated with conditions such as abusive speech, hypochondriac accumulations (Fei Qi), vomiting, water accumulations with masses and impediment, internal abscesses, liver impediment, excessive drinking, wasting-thirst, sagging hernia, enuresis, phlegm-rheum, and sinew vessel twitching spasms. When Foot Jueyin liver qi is exhausted, the sinews contract, pulling the scrotum and tongue; blue lips, rolled tongue, and contracted scrotum are signs that the sinews die first. The liver's fatal visceral pulse is weak on floating palpation; on deep pressure, it feels like a rope that does not come, or curves like a snake moving—indicating death.
The liver corresponds to Spring Wood; the wiry pulse is a sign of "generative growth," not merely "hardness." The text repeatedly emphasizes that "spring takes Stomach Qi as its root," meaning the pulse must possess gentle Stomach Qi. Wiry and gentle indicates normality; wiry and hard/forceful indicates disease. The liver stores the Ethereal Soul, governs the sinews, and opens to the eyes, showing that the ancients connected emotion, movement, and vision with the liver system.
In modern pulse studies, the wiry pulse is commonly seen in states of elevated vascular tone, emotional tension, pain, or hypertensive tendency, but it cannot be directly equated with these conditions. The seasonal cycles of "flourishing, assisting, declining, imprisoned, dying" and Five-Phase generation/control are ancient systemic models reflecting periodic observation, and should not be used as absolute criteria for predicting life and death. The True Visceral Pulse "without Stomach Qi" can be understood as the pulse losing its physiological elasticity and rhythm, reflecting an extremely poor overall state.
In spring, one should舒展 emotions, engage in moderate activity, and avoid suppression and rage; daily routine should involve early rising and early sleeping, with moderate eating and drinking to nurture the spleen and stomach while "not violating Stomach Qi." These are general lifestyle recommendations, not specific to any disease.
The Heart belongs to Fire and pairs with the Small Intestine; the Heart Meridian is Hand Shaoyin, in exterior-interior relationship with the Hand Taiyang Small Intestine Meridian. The heart's seasonal pulse pattern is the Surging Pulse (arrives abundantly and recedes sparingly, like great flowing water). Heart qi flourishes in spring, peaks in summer, declines in late summer, is imprisoned in autumn, and dies in winter. The Bing-Ding days, mid-morning, and noon correspond to Heart Fire; the Geng-Xin days, late afternoon, and sunset are when it is constrained; the Ren-Gui days, the time of human settlement (dusk), and midnight are when it dies. The Heart stores the Spirit, governs odor, nourishes the blood, and manifests externally in the tongue. Its sound is speech, its color is red, its odor is scorched, its fluid is sweat, its taste is bitter, its favorable taste is sweet, and its aversive taste is salty. The Heart Shu point is at the fifth thoracic vertebra, and its Mu point is Jueque; the Small Intestine Shu point is at the eighteenth thoracic vertebra, and its Mu point is Guanyuan.
The heart corresponds to Southern Fire and governs the flourishing growth of all things. Its pulse is surging, large, and long: surging indicates replete Defensive Qi, large indicates brilliant and abundant Nutritive blood; when surging and large combine, one may induce diaphoresis and promote fluids. In summer, when one drinks much water, sweat emerges from the head and face to moisten the skin and flesh. If, at this time, the body's fluids are already insufficient and the physician mistakenly uses purging, it creates "double deficiency." If the pulse floats with exterior but no interior, this is yin-yang disharmony, harming the body and potentially indirectly harming the liver.
The summer pulse is like a hook: arriving abundantly and receding sparingly is called the hook. When excessive, it arrives abundantly and recedes abundantly, manifesting as fever, skin pain, and spreading sores; when insufficient, it arrives not abundantly but recedes excessively, manifesting as vexation of the heart, vomiting, and upper coughing with sputum.
The normal heart pulse is like a string of pearls, like palpating along a beautiful gem; the pathological pulse is rapid and continuous, with slight curvature; the fatal pulse is hooked in front and settled behind, like holding a hooked belt. When the True Heart Pulse arrives, it is hard and pounding, like palpating Job's-tears seeds, with a complexion of red-black and lustreless, withered hair as a critical sign. In summer, Stomach Qi with slight hook quality is normal; much hook with little Stomach Qi indicates heart disease; only hook without Stomach Qi indicates death. The heart stores the vessels, and the Spirit resides in the vessels; excessive fright, fear, and anxious rumination injure the Spirit. When the Spirit is injured, one becomes fearful, loses self-control, muscles emaciate and fall away, hair withers, and complexion fades—most critical in winter.
During summer, when heart fire flourishes, the normal pulse is surging, large, and scattered. If, instead, it appears deep, soft, and slippery, this indicates Water (kidney) overcoming Fire (heart)—the Thief Pathogen; if large and moderate, this indicates Earth (spleen) assisting Fire (heart)—the Excess Pathogen; if wiry, thin, and long, this indicates Wood (liver) generating Fire (heart)—the Deficiency Pathogen; if floating, rough, and short, this indicates Metal (lung) insulting Fire (heart)—the Slight Pathogen. Heart pulse frequency: two beats per breath is normal, three indicates disease, four indicates essence depletion, five is fatal, six ends life. Extreme tightness of the heart pulse: sinew vessel spasms; slight tightness: heart pain referring to the back, inability to eat; extreme slowness: manic laughter; slight slowness: abdominal mass (Fu Liang), occasional vomiting of blood; extreme largeness: throat obstruction; slight largeness: heart impediment referring to the back, easily tearing; extreme smallness: hiccough; slight smallness: wasting-thirst; extreme slipperiness: thirst; slight slipperiness: heart hernia referring to the navel, with borborygmus in the lower abdomen; extreme roughness: loss of voice; slight roughness: hemorrhage, cold extremities, tinnitus, head disorders. When Hand Shaoyin qi is exhausted, the blood vessels become blocked; when blood does not flow, the complexion becomes black like lacquered firewood—this is a sign that blood dies first. The heart's fatal visceral pulse is replete on floating palpation, like a bean or hemp seed striking the hand; on deeper pressure it is even more restless and rapid—indicating death.
The heart corresponds to Summer Fire; the surging pulse is a sign of "flourishing growth," but surging and large must still carry Stomach Qi, otherwise it is "only hook without Stomach Qi." The heart governs the blood vessels and stores the Spirit; emotional states of fright, fear, and rumination injure the Heart-Spirit, reflecting the concept of "unity of form and spirit." Sweat is the fluid of the heart; the relationship between fluids, Defensive Qi, and Nutritive Blood is critically discussed.
The surging pulse may correspond to increased cardiac output, peripheral vasodilation, fever, or hypermetabolic states, but cannot be diagnosed by pulse alone. Emotional stress is indeed linked to cardiovascular function. The ancients' discussions of sweat, fluids, diaphoresis, and purging are ancient therapeutic contraindications and serve only as theoretical study.
In summer, one should calm the mind and nurture the spirit, avoiding rage, fright, and excessive rumination; when sweating profusely, fluids should be adequately replenished, but one should not excessively seek coolness and injure Yang. These are general health principles.
The Spleen belongs to Earth and pairs with the Stomach; the Spleen Meridian is Foot Taiyin, in exterior-interior relationship with the Foot Yangming Stomach Meridian. The spleen's seasonal pulse pattern is the Moderate Pulse (harmonious, soft, relaxed, and slow). Spleen qi flourishes in summer, peaks in late summer, declines in autumn, is imprisoned in winter, and dies in spring. The Wu-Ji days, mealtime, and mid-afternoon correspond to Spleen Earth; the Ren-Gui days, the time of human settlement (dusk), and midnight are when it is constrained; the Jia-Yi days, dawn, and sunrise are when it dies. The Spleen stores Intent, governs taste, nourishes the flesh, and manifests externally in the mouth. Its sound is singing, its color is yellow, its odor is fragrant, its fluid is drool, its taste is sweet, its favorable taste is pungent, and its aversive taste is sour. The Spleen Shu point is at the eleventh thoracic vertebra, and its Mu point is Zhangmen; the Stomach Shu point is at the twelfth thoracic vertebra, and its Mu point is Taicang.
Spleen Earth is thick and substantial, capable of nourishing and growing all things, hence it is said, "those who receive blessings are many." The spleen pulse should be moderate and slow, with slight differences between the cun and chi positions. When Earth is cold, one warms it; when Earth is hot, one cools it; Earth generates Metal, Metal fears Fire, and in winter Metal is hidden within Water—this is the Five-Phase generation and control model. If Spleen Earth becomes weak and water-dampness overflows, facial and limb edema and heavy extremities may appear. The text criticizes "ignorant physicians seeing water and directly purging," which further weakens the spleen and stomach, allowing water qi to rise and attack, causing lung qi to float and create wheezing. If correctly treated, by regulating the pivot points, opening the water passages, allowing fluids to flow downward and yin-yang to harmonize, the wheezing and gasping will naturally resolve.
The spleen pulse does not govern a single season alone, but is the "solitary viscus that irrigates the four sides." Its pathological pulse: when it arrives like flowing water, this is excess, manifesting as heavy extremities unable to lift; when like a bird's beak, this is insufficiency, manifesting as blockage of the nine orifices. The normal spleen pulse is harmonious, soft, and distinct, like a chicken's foot stepping on the ground; the pathological pulse is replete, rapid, and counting, like a chicken lifting its foot; the fatal pulse is hard and sharp like a bird's beak, spur, roof-dripping, or water drippings. When the True Spleen Pulse arrives, it is weak and alternately sparse and scattered, with a blue-green-yellow complexion without luster and withered hair as a critical sign. In late summer, Stomach Qi with slight soft-weak quality is normal; more weakness with little Stomach Qi indicates spleen disease; only intermittent (dai) pulse without Stomach Qi indicates death. The spleen stores Nutritive Qi, and Intent resides in it; unresolved anxiety and worry injure Intent. When Intent is injured, one becomes oppressed, confused, limbs cannot lift, hair withers, and complexion fades—most critical in spring.
During late summer, when spleen earth flourishes, the normal pulse is large and harmoniously moderate. If, instead, it appears wiry, thin, and long, this indicates Wood (liver) overcoming Earth (spleen)—the Thief Pathogen; if floating, rough, and short, this indicates Metal (lung) generating Earth (spleen)—the Excess Pathogen; if surging, large, and scattered, this indicates Fire (heart) generating Earth (spleen)—the Deficiency Pathogen; if deep, soft, and slippery, this indicates Water (kidney) insulting Earth (spleen)—the Slight Pathogen. Spleen pulse frequency: two beats per breath is normal, three indicates disease, four indicates essence depletion, five is fatal, six ends life. Extreme tightness of the spleen pulse: sinew vessel spasms; slight tightness: spleen fullness, vomiting immediately after eating, foamy stool; extreme slowness: atrophy reversal; slight slowness: wind atrophy, limbs nonfunctional but spirit clear; extreme largeness: falling down; slight largeness: abdominal masses (Pi Qi), pus and blood in the intestines and stomach; extreme smallness: alternating fever and chills; slight smallness: wasting-thirst; extreme slipperiness: sagging urinary obstruction; slight slipperiness: worm accumulation, borborygmus, and fever; extreme roughness: intestinal prolapse; slight roughness: internal ulceration with copious pus-blood discharge. When Foot Taiyin qi is exhausted, the mouth lips lose nourishment, the philtrum becomes full and upturned—a sign that flesh dies first. The spleen's fatal visceral pulse is large and moderate on floating palpation; on deeper pressure, like turning over a cup—restless and unstable—indicating death.
The spleen belongs to Earth and is the "solitary viscus" that irrigates the four sides. The spleen pulse values "harmonic softness," being moderate yet orderly. The text emphasizes most strongly "Stomach Qi" and "not recklessly purging": once Spleen Earth becomes deficient, a cascade of reactions—dampness, Wood overcoming, Metal floating—ensues. Emotionally, "anxiety and worry injure Intent" reflects excessive rumination injuring the spleen.
The moderate pulse may reflect digestive function, metabolic rhythm, and autonomic nervous system state. The text's descriptions of "water-dampness overflow" and "facial and limb edema" have some phenomenological correspondence with edema and malabsorption, but are not specific disease diagnoses. The ancients' emphasis on protecting spleen-stomach qi parallels the modern focus on nutritional status and intestinal function.
Eat and drink with moderation; avoid excessive rumination; during late summer when dampness is heavy, pay attention to strengthening the spleen and resolving dampness, but do not self-medicate or purge. Regular meals, thorough chewing, and maintaining emotional ease are general principles of health cultivation.
The Lung belongs to Metal and pairs with the Large Intestine; the Lung Meridian is Hand Taiyin, in exterior-interior relationship with the Hand Yangming Large Intestine Meridian. The lung's seasonal pulse pattern is the Floating Pulse (light and vacuous above, like a feather floating on water). Lung qi flourishes in late summer, peaks in autumn, declines in winter, is imprisoned in spring, and dies in summer. The Geng-Xin days, late afternoon, and sunset correspond to Lung Metal; the Jia-Yi days, dawn, and sunrise are when it is constrained; the Bing-Ding days, mid-morning, and noon are when it dies. The Lung stores the Corporeal Soul, governs sound, nourishes the skin and body hair, and manifests externally in the nose. Its sound is weeping, its color is white, its odor is fishy-raw, its fluid is nasal mucus, its taste is pungent, its favorable taste is salty, and its aversive taste is bitter. The Lung Shu point is at the third thoracic vertebra, and its Mu point is Zhongfu; the Large Intestine Shu point is at the sixteenth thoracic vertebra, and its Mu point is Tianshu.
The lung corresponds to Western Metal and governs the harvesting and completion of all things, when leaves fall and branches remain. The lung pulse is slightly floating like fine hair: Defensive Qi is sluggish and Nutritive Qi tends to be rapid, hence it is called the "Hair Pulse." If yin-yang ascent and descent lose their normal order, one is susceptible to invasion by external pathogens. If Yang is invaded by pathogens, there is contraction and aversion to cold; if Yin is invaded by pathogens, the pulse becomes tight and there is shivering; cold and shivering mutually contending can form malaria; the timing of malarial onset corresponds to the time of pathogen invasion. The pulse may be slow or rapid; viscera may be distant or near; the circulation of Defensive and Nutritive Qi follows its own measure. In autumn, Yang qi descends, yin qi ascends, and the lung pulse floats, light, and vacuous—hence it is normal.
The autumn pulse is like floating: when excessive, the pulse is hair-like but with the center hard and both sides vacuous, manifesting as qi counterflow, back pain, and dull discomfort; when insufficient, the pulse is hair-like and faint, manifesting as panting, shortness of breath, coughing, upper hematemesis, and lower abdominal audible sounds of disease. The normal lung pulse is rustling and soft, like falling elm seeds; the pathological pulse is neither ascending nor descending, like palpating along a chicken feather; the fatal pulse is like something floating on water, like wind blowing on hair. When the True Lung Pulse arrives, it is large and vacuous, like feathers touching human skin, with a red-white complexion without luster and withered hair as a critical sign. In autumn, Stomach Qi with slight hair-like quality is normal; much hair with little Stomach Qi indicates lung disease; only hair without Stomach Qi indicates death. The lung stores qi, and the Corporeal Soul resides in it; excessive joy and pleasure injure the Corporeal Soul. When the Corporeal Soul is injured, one becomes manic, fails to recognize people, and the skin becomes scorched and withered—most critical in summer.
During autumn, when lung metal flourishes, the normal pulse is floating, rough, and short. If, instead, it appears surging, large, and scattered, this indicates Fire (heart) overcoming Metal (lung)—the Thief Pathogen; if deep, soft, and slippery, this indicates Water (kidney) assisting Metal (lung)—the Excess Pathogen; if large and moderate, this indicates Earth (spleen) generating Metal (lung)—the Deficiency Pathogen; if wiry, thin, and long, this indicates Wood (liver) insulting Metal (lung)—the Slight Pathogen. Lung pulse frequency: two beats per breath is normal, three indicates disease, four indicates essence depletion, five is fatal, six ends life. Extreme tightness of the lung pulse: manic-depressive disorders; slight tightness: lung cold-heat, lethargy, coughing with blood, pulling pain in the back and chest, nasal polyps with obstruction; extreme slowness: profuse sweating; slight slowness: atrophy impediment and hemiparesis due to wind, with incessant sweating from the head downward; extreme largeness: lower leg swelling; slight largeness: lung impediment; extreme smallness: undigested food diarrhea (sun-xie); slight smallness: wasting-thirst; extreme slipperiness: panting with qi rushing upward (xi-ben); slight slipperiness: upper and lower hemorrhage; extreme roughness: vomiting blood; slight roughness: scrofula (rat fistulas), conditions between neck and axillae, unable to bear lifting things and craving sour tastes. When Hand Taiyin qi is exhausted, the skin and body hair become withered and dry, fluids depart, skin and joints are injured, nails wither, and hair breaks—a sign that qi dies first. The lung's fatal visceral pulse is vacuous on floating palpation; on deeper pressure, weak like the hollow stem of a scallion, without root below—indicating death.
The floating pulse is mostly associated with exterior patterns, the early stages of external contraction, or superficial dilation of blood vessels. The lungs govern the skin and body hair and open into the nose, which corresponds to some extent with the modern view of the respiratory tract and skin as the body's external barriers. However, statements such as "death when the body hair breaks down and falls" belong to ancient prognostic judgments and should not be directly applied to modern practice.
In autumn, one should restrain the spirit and qi, avoid excessive grief that may harm the lungs, keep warm to reduce cold wind stimulation, and maintain emotional balance by avoiding excessive joy or sorrow. These are general recommendations for health maintenance.
The kidney corresponds to water (the original text says "wood," but according to the context it should be "water") and is paired with the urinary bladder; the kidney meridian is Foot Shaoyin, externally-internally related to the Foot Taiyang bladder meridian. The seasonal pulse of the kidney is the deep pulse (hidden within, requiring heavy pressure to feel). Kidney qi is flourishing in autumn, most vigorous in winter, declining in spring, imprisoned in summer, and fatal in late summer. On ren-gui days, and at the time of Bedtime and Midnight, it corresponds to kidney water; on bing-ding days, and at the times of Breakfast and Noon, it is constrained; on wu-ji days, and at the times of Meal and Midafternoon, it is the time of death. The kidney stores will (zhi), governs fluids, nourishes the bones, manifests externally in the ears, its voice is groaning, its color is black, its smell is rotten, its fluid is spittle, its taste is salty, what it favors is sour, and what it dislikes is sweet. The kidney shu point is at the fourteenth vertebra, and its front-mu point is Jingmen; the bladder shu point is at the nineteenth vertebra, and its front-mu point is Zhongji.
The kidney corresponds to northern water and governs the closure and storage of all things. In winter, all creatures hibernate, yang qi descends, and yin qi rises, so the pulse is deep. The deep pulse indicates the interior; in winter, sweating should not be induced, for inducing sweat is like hibernating insects emerging to meet frost and ice. Nor should purging be done recklessly, for purging injures the spleen, and when the spleen is weakened, water-dampness moves chaotically. If sweating is forcefully induced by methods such as burning needles or fumigation, it will cause guest heat to enter internally, resulting in wheezing, mouth and tongue sores, chaotic interplay of yin and yang, and even chest binding (jiexiong) or diarrhea with undigested food and clear urine. This emphasizes that the deep and hidden winter pulse must not be treated recklessly against the season.
The winter pulse is like a tent (ying) (deep and gathered): if excessive, the pulse comes like flicking a stone, indicating disease externally; if insufficient, it goes as if rapid, indicating disease internally. When excessive, the body feels lazy and weary, there is pain in the spinal ridge, shortness of breath, and reluctance to speak; when insufficient, there is a hollow sensation in the heart like hunger, coldness in the calves, spinal pain, abdominal distension in the lower abdomen, and yellow-red urine.
The normal kidney pulse is rapid and continuous like a hook yet firm upon pressure; the diseased pulse is like pulling kudzu vine, increasingly firm upon pressure; the fatal pulse arises like seizing a rope, snapping harshly like flicking a stone. When the true kidney pulse arrives, it is gathered and severed, like flicking a stone with the finger, with a yellow-black, lusterless complexion; breaking of body hair indicates a critical condition. In winter, stomach qi with a slight stone-like quality is normal; excessive stone quality with less stomach qi indicates kidney disease; and stone quality alone without stomach qi indicates death. The kidney stores essence, and the essence houses the will; if great anger is not restrained, it injures the will. When the will is injured, one forgets previous words, suffers lumbosacral pain, and has difficulty bending and stretching, which becomes critical mostly in late summer.
When kidney water is vigorous in winter, the normal pulse is deep, soft, and slippery. If instead it is large and slow, this is spleen earth overcoming kidney water, a thief pathogen; stringlike, thin, and long is liver wood assisting kidney water, an excess pathogen; floating, rough, and short is lung metal generating kidney water, a deficiency pathogen; surging, large, and scattered is heart fire insulting kidney water, a minor pathogen. The kidney pulse beats: twice per breath cycle is normal, three times indicates disease, four times indicates essence depletion, five times indicates death, and six times indicates the end of life. When the kidney pulse is extremely tense, it indicates bone wilting and epilepsy; slightly tense indicates running piglet (bentun), inability to withdraw the feet, and urinary and fecal difficulty; extremely slow indicates a broken spine; slightly slow indicates cave-down diarrhea with vomiting immediately after eating; extremely large indicates yin wilting; slightly large indicates stone water with lower abdominal swelling extending to the stomach cavity; extremely small indicates cave diarrhea; slightly small indicates wasting-thirst (xiaodan); extremely slippery indicates urinary retention; slightly slippery indicates bone wilting, inability to sit up, and blurred vision; extremely rough indicates a large abscess; slightly rough indicates amenorrhea and internal hemorrhoids. When Foot Shaoyin qi is exhausted, the bones wither, the flesh cannot adhere, the teeth grow long with filth, and the hair loses its luster, indicating that the bones die first. The fatal kidney pulse is firm on floating palpation, chaotic on deep palpation like rolling pills, and penetrating deep into the chi section, indicating death.
The kidney corresponds to winter water, and the deep pulse is the "image of closure and storage." In winter, yang qi is stored internally, so the pulse is deep and firm; if it is deep but stiff like flicking stone without softness, it becomes a true organ pulse. The kidney stores essence, governs bones, and produces marrow, opens into the ears, and its fluid is spittle. In terms of emotions, "great anger injures the will" indicates that excessive fear and anger can both stir the essence and harm the kidney. The text particularly emphasizes that the winter pulse must not be treated with reckless sweating, purging, or fumigation, reflecting the therapeutic taboo of "adapting to the four seasons."
The deep pulse is often associated with deeper blood vessel positioning, peripheral resistance, or circulatory status, and may also appear normally in winter or in those of sturdy constitution. Theories such as the kidney governing bones and storing essence carry comparative significance on multiple levels of systemic regulation, endocrinology, reproduction, and skeletal health, but cannot be equated with the modern anatomical kidney. The true organ pulse "like flicking a stone" suggests stiff blood vessel walls with extremely poor elasticity, representing an ancient observation of the pulse in critical illness.
In winter, one should store essence and qi in hiding, avoid overexertion, profuse sweating, staying up late, and fright or panic; keep warm, moderate sexual activity, and avoid excessively salty food. These are general principles of winter health regulation.
Bogua's Note: Although Volume Three of the Maijing extensively discusses pulse manifestations and prognoses, its core is not "determining life and death by pulse" but rather "the pulse takes stomach qi as its foundation, with mutual reference among the four seasons and five organs." The various organ disease manifestations and fatal signs above all belong to the observations and theoretical deductions of ancient physicians and should be understood within their historical context. 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; please seek medical attention promptly if you feel unwell.