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Capítulo 8 de 28
濒湖脉学
Overall Paraphrase
This section discusses the Xu pulse (deficient pulse), which refers to a pulse that is weak on palpation and feels hollow and soft when pressed, belonging to the yin category of pulse types. Its typical tactile sensation is: the pulse arrives slowly, the pulse shape is relatively large but soft, and when pressed, the force is insufficient, giving a feeling of emptiness under the fingers. Cui Zixu summarized it as "large in shape but weak in force"—although the pulse shape is large, its driving force is feeble, and this is precisely the manifestation of "xu" (deficiency).
The Pulse Formula states that the xu pulse is "insufficient when pressed deeply, and sufficient when lifted lightly." Li Shizhen believed that this merely describes the floating pulse (clearly felt on light touch, but insufficient on deep pressure), without reflecting the xu pulse's characteristic of being "hollow, soft, and weak." Yang Renzhai described it as "like willow catkins, scattered and slow," and Mr. Hua said it is "scattered, large, and soft." These descriptions more closely resemble the scattered pulse (a pulse where qi is dissipated and has no root) and are not characteristics of the xu pulse.
The poem comparing the xu pulse with similar patterns further elaborates: on light palpation, the pulse is slow and large, but on deep pressure, it is soft and hollow, with unclear boundaries, resembling an empty valley. It should not be confused with the hollow pulse (which feels like pressing on a scallion stalk, empty in the center)—the hollow pulse is floating and large yet empty in the middle, indicating major blood loss; the xu pulse is floating and large yet slow, and weak on pressure, indicating blood deficiency (insufficient blood failing to fill the vessels). The floating pulse and scattered pulse belong to another category of pulse types and must be distinguished separately.
The poem on associated illnesses states: a xu pulse combined with body heat often indicates summer heat injury (summer heat consuming qi and damaging body fluids); spontaneous sweating, palpitations, anxiety, easy startling, and excessive dreaming are also common. If fever is due to yin deficiency (insufficient yin fluid with internal false heat), it should be regulated early, and the classical approach is to nourish the nutritive and boost qi (tonify nutritive blood and reinforce righteous qi; this is a theoretical framework, not medicinal guidance), which should not be delayed.
At the cun position of the wrist, a xu pulse indicates that blood fails to nourish the heart; at the guan position, abdominal distension and post-meal discomfort may appear; at the chi position (including both mendian areas), a xu pulse is often related to bone steaming, wilting bi, and injury to essence and blood.
The classics state: when blood is deficient, the pulse is deficient; when the pulse qi comes weak and barely perceptible, it is categorized as "insufficiency," indicating that the disease lies internally; the appearance of a xu pulse in protracted illness suggests a relatively poor prognosis.
The core pathological mechanism of the xu pulse is deficiency of qi and blood, with insufficient filling of the pulse channels and lack of qi to drive the pulse. Although the pulse shape may be relatively large, "weakness" is the key to diagnosing a xu pulse. In Chinese pulse diagnosis, there is a dictum: "Force versus lack of force differentiates deficiency from excess"—this is the critical distinguishing point for identifying the xu pulse.
Li Shizhen particularly emphasized differential diagnosis among pulse types: the floating pulse represents "sufficiency when lifted lightly, insufficiency when pressed deeply"; the hollow pulse is empty in the center like a scallion stalk and indicates great blood loss; the scattered pulse is dissipated without root; and the xu pulse is "slow, large, and soft, with weak pressure response." Although these four pulses all fall within the floating and large category, their pathological mechanisms and associated conditions differ, and they must not be confused.
Regarding associated illnesses, the xu pulse can correspond to summer heat injury, yin deficiency fever, blood failing to nourish the heart, spleen deficiency with abdominal distension, essence and blood depletion, and other symptoms of "vacuity." The core in all cases is insufficiency of righteous qi, yin blood, and essential nutrients in the human body.
Pulse diagnosis carries a relatively strong subjective component, and different practitioners may differ in their tactile assessment of the xu pulse. However, descriptions such as "weak on pressure" and "hollow" bear some correspondence to states in modern medicine including lowered vascular filling, reduced cardiac output, and decreased peripheral circulatory resistance.
The Chinese medicine concepts of blood deficiency (xue xu) and yin deficiency (yin xu) cannot be simplistically equated with modern medical anemia, dehydration, or malnutrition; they are comprehensive syndrome concepts. The appearance of a xu pulse in protracted illness often indicates a generally poor state of circulation and metabolism and carries certain prognostic significance, but it cannot be regarded as an absolute judgment.
— Buguam Reminder: These contents are based on classical works of traditional Chinese medicine and are provided solely for studying traditional culture and academics. They do not constitute any form of medical diagnosis, medication guidance, or medical advice. Please consult a qualified physician promptly if you experience any discomfort.