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All lessons   Module 2: Pulse   Lesson 7

Module 2   Lesson 7   Mai Zheng

Pulse pictures by pattern

Which pulse belongs to which pattern, and how do you read combinations?

After this lesson you read a combination of qualities as a sentence, you know the pulse of more than thirty patterns by organ and substance, for each one you know the neighbour with a similar pulse and what decides between them, you recognise mixed pictures, and you know what the pulse cannot separate.

Deficiency 虚 Excess 实 Too little Qi empty, weak Spleen-Qi deficiency Lung-Qi deficiency: right cun Heart-Qi deficiency: left cun Too little Yang deep, weak, slow Spleen-Yang deficiency Kidney-Yang deficiency: chi Heart-Yang deficiency Too little Blood thin, choppy Liver-Blood deficiency Heart-Blood deficiency Spleen not holding Blood Too little Yin thin-rapid, floating-empty Kidney-Yin deficiency Heart and Kidneys, Heart-Yin Lung-Yin deficiency Exterior floating Wind-Cold: tight Wind-Heat: rapid Wind-Water: slippery Liver and stagnation wiry Liver-Qi stagnation Liver-Fire: rapid Liver-Yang: often thin Liver invading the Spleen Dampness, Phlegm, food slippery Damp-Heat: rapid Damp-Phlegm Cold-Phlegm: slow Retention of Food: full Heat full, overflowing, rapid Stomach-Heat: right guan Heart-Fire: cun Lung-Heat Stasis choppy, wiry Blood stasis Heart-Blood stasis: knotted Liver-Blood stasis Internal Cold deep, tight, slow Full-Cold Cold invading the Stomach Cold in Liver channel: wiry
Schematic: for each family the shared pulse and the main patterns, with the feature that is added within the family. Pulses by pattern: the line of this course, checked against Chinese and English-language textbook sources. The book gives the pulse for each syndrome in ch. 32 Heart p. 489, ch. 34 Liver p. 529, ch. 35 Lungs p. 571, ch. 36 Spleen p. 597, ch. 37 Kidneys p. 621; Qi, Blood and fluids in ch. 31 pp. 469 to 482.

Know by heart

  • Read a combination as a sentence. Depth tells you where, rate how warm, strength full or empty, shape which pathogenic factor or which substance; mnemonic: where, how warm, how much, what.
  • Deficiency. Qi: empty (Lungs right cun, Heart left cun, Spleen). Yang: deep, weak, slow (the Kidneys mainly at chi). Blood: thin or choppy. Yin: thin-rapid or floating-empty.
  • Excess. Exterior: floating (tight Cold, rapid Heat). Liver and stagnation: wiry. Dampness, Phlegm, food: slippery. Heat: full or overflowing, and rapid. Stasis: choppy or wiry. Internal Cold: deep, tight, slow.
  • Five combinations. Wiry-thin: Liver-Yang on a deficient base. Slippery-rapid: Damp-Heat or Phlegm-Heat. Deep-weak-slow: Yang deficiency with Cold. Floating-tight: Wind-Cold. Thin-rapid: Yin deficiency with Empty-Heat.
  • What the pulse does not separate. Spleen-Yang from Kidney-Yang, Heart-Blood from Liver-Blood, Damp-Heat in Spleen, Bladder or intestine: the same pulse; the symptoms, the location and the tongue decide; mnemonic: the pulse says what, the complaint says where.
  • Mixed pictures. Liver invading the Spleen: left guan wiry, right guan weak. Root empty, branch full: slippery or soggy, without strength on the right. Excess that consumes: from full and rapid to thin and rapid.
  • Red flags. A pattern can fit while the diagnosis is missing. Irregular: ECG. Hurried, minute, scattered or hollow in a sick client: urgent. One side weaker: blood pressure on both arms.

The rest of this lesson is reference.

Three practice questions from this lesson

Which two questions does a floating and tight pulse answer?
  1. Where (exterior) and what (Cold)
  2. How much (empty) and where (interior)
  3. How warm (Heat) and which organ (the Lungs)

Answer: Where (exterior) and what (Cold). Floating says exterior, tight says Cold or pain. Together: Wind-Cold.

Which combination fits Damp-Heat?
  1. Slippery and rapid
  2. Deep, weak and slow
  3. Floating and tight

Answer: Slippery and rapid. Slippery for the Dampness, rapid for the Heat. Deep, weak and slow is Yang deficiency; floating and tight is Wind-Cold.

What does each part of wiry-thin say?
  1. Wiry: Liver or stagnation; thin: too little Blood or Yin
  2. Wiry: Cold that binds; thin: Heat that narrows the vessels
  3. Wiry: Dampness weighing down the wall; thin: too little Qi

Answer: Wiry: Liver or stagnation; thin: too little Blood or Yin. Wiry: the Liver, or something stuck or rising; thin: Blood or Yin falls short underneath. A taut Liver on a base that falls short: often Liver-Yang rising on Blood or Yin deficiency.

The rest of this lesson

In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 17 case-based practice questions, 24 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 2: Pulse.

Try two lessons freeSee Tongue and Pulse