Loading...
Chapter 2 of 10
难经
Question: All twelve channels have arterial pulsations. Why is the Cun-Kou (the radial artery at the wrist) exclusively used to determine life, death, fortune, and misfortune of the five viscera and six bowels?
Answer: Cun-Kou is the great convergence point of pulse qi and the site of the pulsation of the Hand-Taiyin Lung Channel. With each exhalation, the pulse travels three cun; with each inhalation, it travels three cun. One inhalation and one exhalation constitute one breath (xi), during which the pulse travels six cun. In one day and one night, a person has approximately 13,500 breaths, and the pulse qi circulates fifty revolutions, encircling the entire body. With the water clock dripping one hundred marks, the Constructive and Defensive Qi (nutritive qi and protective qi, roughly understood as nutrient qi and exterior-defending qi) travels through the yang aspect twenty-five revolutions during the day and through the yin aspect twenty-five revolutions at night, together forming one complete cycle. Therefore, after fifty revolutions, it reconverges at the Hand-Taiyin Lung Channel. Cun-Kou is the starting and ending point of the qi and blood circulation of the five viscera and six bowels; thus, pulse diagnosis takes Cun-Kou.
Question: The pulse has the distinction of "cun and chi." What does this mean?
Answer: Cun and chi are important boundaries in pulse diagnosis. From the Guan (the prominent bone at the wrist) toward the Chi-Ze point constitutes the Chi region, governed by yin; from the Guan toward the Yu-Ji (fish trail) constitutes the Cun region, governed by yang. Therefore, the Chi is distinguished from the Guan, and the Cun is distinguished from the Chi. Yin obtains one cun within the Chi, and yang obtains nine fen within the Cun, together comprising one cun and nine fen; hence, the term "cun chi."
Question: The pulse may exhibit excess, insufficiency, mutual invasion of yin and yang, fu (overflow), yi (spillover), guan (barrier), and ge (repulsion). What do these mean?
Answer: The region before the Guan is where the yang pulse moves; normally, it should be nine fen in length and floating. Exceeding this is excess; falling short is insufficiency. When the pulse extends upward beyond the Yu-Ji, it is called Yi (overflow), signifying "external Guan with internal Ge," a pulse manifestation of yin qi overpowering yang. The region after the Guan is where the yin pulse moves; normally, it should be one cun in depth and sunken. Exceeding this is excess; falling short is insufficiency. When the pulse extends downward deep into the Chi region, it is called Fu (spillover), signifying "internal Guan with external Ge," a pulse manifestation of yang qi overpowering yin. Therefore, it is said that "Fu and Yi" belong to the True Visceral Pulse (critical pulse manifestations revealing the exhaustion of visceral genuine qi), and even if the person shows no obvious external symptoms, they may already be in a critical condition.
Question: The pulse has a method of yin and yang. What does this mean?
Answer: Exhalation corresponds to the heart and lungs; inhalation corresponds to the liver and kidneys; the space between inhalation and exhalation corresponds to the spleen, whose pulse resides in the middle region. Floating pertains to yang; sunken pertains to yin. Hence, the terms yin and yang.
The heart and lung pulses are both relatively floating—how are they distinguished? The heart pulse is floating, large, and scattered; the lung pulse is floating, short, and rough. The liver and kidney pulses are both relatively sunken—how are they distinguished? The liver pulse is firm and long; the kidney pulse is soft upon heavy pressure and full upon lifting the fingers. The spleen resides at the central region, so its pulse is in the middle.
The so-called one-yin-one-yang, one-yin-two-yang, one-yin-three-yang, one-yang-one-yin, one-yang-two-yin, and one-yang-three-yin do not mean that six pulses beat simultaneously at Cun-Kou; rather, they refer to combinations of the six pulse qualities: floating, sunken, long, short, slippery, and rough. Floating, slippery, and long pertain to yang; sunken, short, and rough pertain to yin. For example, one-yin-one-yang means the pulse arrives sunken and slippery; one-yin-two-yang means sunken, slippery, and long; one-yin-three-yang means floating, slippery, and long, with occasional sunkenness. One-yang-one-yin means floating and rough; one-yang-two-yin means long with sunkenness and roughness; one-yang-three-yin means sunken, rough, and short, with occasional floating. According to the location of each channel, one then determines the favorable or unfavorable progression of the disease.
Question: The pulse has degrees of heaviness and lightness. What does this mean?
Answer: Pressing initially with the weight of three beans corresponds to the skin and body hair, examining the Lungs; with the weight of six beans, it corresponds to the blood vessels, examining the Heart; with the weight of nine beans, it corresponds to the flesh and muscles, examining the Spleen; with the weight of twelve beans, it is level with the sinews, examining the Liver; pressing down to the bone, and upon lifting the fingers the pulse arrives rapidly, examining the Kidneys. These are the layers of heaviness and lightness in pulse diagnosis.
Question: The pulse manifests yin-excess-with-yang-deficiency and yang-excess-with-yin-deficiency. What does this mean?
Answer: When light pressure yields a weak and small pulse, while heavy pressure yields a full and large pulse, this is called yin-excess-with-yang-deficiency; when heavy pressure yields a weak and small pulse, while light pressure yields a full and large pulse, this is called yang-excess-with-yin-deficiency. This is the meaning of distinguishing yin-yang deficiency and excess through the two aspects of floating and sunken.
Question: The classics state that when Shaoyang arrives, the pulse is alternately large and small, alternately short and long; when Yangming arrives, it is floating, large, and short; when Taiyang arrives, it is surging, large, and long; when Shaoyin arrives, it is tight, large, and long; when Taiyin arrives, it is tight, thin, and long; when Jueyin arrives, it is sunken, short, and tight. Are these six normal pulses or morbid pulses?
Answer: These are all Dominant Pulses (normal pulse manifestations when a particular qi is exerting its seasonal dominance).
Question: In which months does each of their dominant qi prevail, and for how many days does each hold sway?
Answer: After the winter solstice, from the first Jiazi day, Shaoyang begins its dominance; from the second Jiazi day, Yangming dominates; from the third Jiazi day, Taiyang dominates; from the fourth Jiazi day, Shaoyin dominates; from the fifth Jiazi day, Taiyin dominates; from the sixth Jiazi day, Jueyin dominates. Each dominates for sixty days; six times sixty equals three hundred and sixty days, completing one year. This is the general outline of the seasonal timing for the three yang and three yin.
Question: When the Cun-Kou pulse is even, yet death occurs, what does this mean?
Answer: The twelve channels are all connected to the Source of Vital Qi (Sheng Qi Zhi Yuan). What is called the Source of Vital Qi is the root of the twelve channels, namely the Moving Qi between the Kidneys (the fundamental life force stored between the two kidneys). It is the foundation of the five viscera and six bowels, the root of the twelve channels, the gate of respiration, and the origin of the Triple Burner, also known as the "spirit that guards against pathogens." Therefore, qi is the root of a person; when the root is severed, the stems and leaves wither. The Cun-Kou pulse may be even, yet death occurs because the vital qi has already become uniquely exhausted within.
Question: How does one distinguish diseases of the viscera from those of the bowels?
Answer: A rapid pulse indicates the bowels; a slow pulse indicates the viscera. Rapid indicates heat; slow indicates cold. All yang aspects correspond to heat; all yin aspects correspond to cold. Therefore, one can distinguish diseases of the viscera from those of the bowels.
Question: One pulse can manifest as ten different conditions. What does this mean?
Answer: This refers to the rigid and yielding encounters of the five pathogenic influences. Taking the heart pulse as an example: if the heart pulse is extremely tight, it is the liver pathogen encroaching upon the heart; if the heart pulse is slightly tight, it is the gallbladder pathogen encroaching upon the small intestine; if the heart pulse is extremely large, it is the heart pathogen itself encroaching upon the heart; if the heart pulse is slightly large, it is the small intestine pathogen itself encroaching upon the small intestine; if the heart pulse is extremely moderate/slack, it is the spleen pathogen encroaching upon the heart; if the heart pulse is slightly moderate/slack, it is the stomach pathogen encroaching upon the small intestine; if the heart pulse is extremely rough, it is the lung pathogen encroaching upon the heart; if the heart pulse is slightly rough, it is the large intestine pathogen encroaching upon the small intestine; if the heart pulse is extremely sunken, it is the kidney pathogen encroaching upon the heart; if the heart pulse is slightly sunken, it is the bladder pathogen encroaching upon the small intestine. Each of the five viscera has rigid and yielding pathogenic qi, so one pulse can manifest in ten different conditions.
Question: The classics state that when the pulse has not yet completed fifty beats and has one interruption, it indicates that one viscus has lost its qi. Which viscus is this?
Answer: When a person inhales, qi follows yin and enters; when exhaling, qi follows yang and exits. Now, if inhalation cannot reach the kidneys but returns at the liver, one knows that one viscus has lost its qi—the kidney qi is the first to be exhausted.
Question: The classics state that when the pulses of the five viscera are already exhausted internally, the acupuncturist instead tonifies the exterior; when the pulses of the five viscera are already exhausted externally, the acupuncturist instead tonifies the interior. How does one distinguish internal from external exhaustion?
Answer: When the pulses of the five viscera are already exhausted internally, it means the qi of the kidneys and liver is already exhausted internally, yet the physician instead tonifies the heart and lungs; when the pulses of the five viscera are already exhausted externally, it means the qi of the heart and lungs is already exhausted externally, yet the physician instead tonifies the kidneys and liver. When yang is exhausted but one rather tonifies yin, or yin is exhausted but one rather tonifies yang, this is called "reinforcing excess and reducing deficiency," that is, diminishing what is insufficient and augmenting what is already in surplus. Death resulting from such treatment is due to the physician's erroneous management.
Question: The classics state that when one observes the facial color yet obtains a non-corresponding pulse, if a mutually overpowering (xiang sheng) pulse is instead obtained, death ensues; if a mutually generating (xiang sheng) pulse is obtained, the disease will resolve of itself. Color and pulse should be mutually corroborated. What are the specifics?
Answer: The five viscera have five colors, all manifested on the face, and they should correspond to the Cun-Kou and the Chi-area skin. For example, if the facial color is green, the pulse should be wiry and tense; if the facial color is red, the pulse should be floating, large, and scattered; if the facial color is yellow, the pulse should be moderate, slack, and large; if the facial color is white, the pulse should be floating, rough, and short; if the facial color is black, the pulse should be sunken, soft, and slippery. This is the correspondence between the five colors and the pulse.
If the pulse is rapid, the skin of the Chi area is also rapid; if the pulse is tense, the Chi-area skin is also tense; if the pulse is moderate, the Chi-area skin is also moderate; if the pulse is rough, the Chi-area skin is also rough; if the pulse is slippery, the Chi-area skin is also slippery. Each of the five viscera has its own sound, color, odor, and taste, which should correspond to the Cun-Kou and the Chi-area skin. Non-correspondence indicates disease. For example, if the facial color is green and the pulse is floating, rough, and short, or large and moderate, this is mutual overpowering; if the pulse is floating, large, and scattered, or small and slippery, this is mutual generation.
The classics state: Knowing one aspect makes one a lower-level practitioner; knowing two makes one a middle-level practitioner; knowing three makes one an upper-level practitioner. The upper-level practitioner cures nine out of ten; the middle-level cures seven out of ten; the lower-level cures six out of ten. This is precisely what is being discussed.
The core of Issues 1–13 is the establishment of a diagnostic framework centered on Cun-Kou pulse diagnosis:
Together, these contents reflect one idea: pulse diagnosis is not merely palpating the pulse in isolation, but rather observing the body's qi-blood—viscera-yin-yang holistic state through the pulse manifestation.
This content is based on classic 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 unwell, please seek proper medical attention promptly.