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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 18 · Pulse Images of the Healthy Person
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “What is a normal healthy person like?”
Qi Bo replied: “Two pulse movements during one exhalation and two during one inhalation, with five through the settled full breath and allowance for the longer breath, are called normal. Normal means without illness. Use the unill to regulate examination of the ill. The physician is not ill, so settling the breath to assess the patient is the method.
One pulse movement in an exhalation and one in an inhalation mean scant qi. Three in each, with agitation, mean warm illness if the chi region is hot; if chi is not hot and the pulse slippery, Wind illness; if rough, obstruction. Four or more in one exhalation means death. A pulse that ceases and does not arrive means death. Alternating sparse and rapid arrival means death.
A healthy person’s normal qi is received from Stomach. Stomach is the healthy person’s normal qi. Without Stomach qi the course is contrary, and a contrary course means death.
In spring, Stomach qi with slight stringlikeness is normal. Much stringlikeness with little Stomach qi means Liver illness; only stringlikeness without Stomach qi means death. Stomach qi with a hairlike quality predicts autumn illness; a marked hairlike quality means illness now. True organ qi spreads in Liver, which stores the qi of sinews and membranes.
In summer, Stomach qi with a slight hook is normal. Much hook with little Stomach qi means Heart illness; only hook without Stomach qi means death. Stomach qi with a stonelike quality predicts winter illness; marked stone means illness now. True organ qi communicates in Heart, which stores the qi of blood and vessels.
In late summer, Stomach qi with slight softness and weakness is normal. Much weakness with little Stomach qi means Spleen illness; only an intermittent pulse without Stomach qi means death. Softness and weakness with stone predicts winter illness; marked weakness means illness now. True organ qi moistens in Spleen, which stores the qi of flesh.
In autumn, Stomach qi with slight hairlikeness is normal. Much hairlikeness with little Stomach qi means Lung illness; only hairlikeness without Stomach qi means death. Hairlikeness with stringlikeness predicts spring illness; marked stringlikeness means illness now. True organ qi rises in Lung to move nutritive and defensive qi, yin and yang.
In winter, Stomach qi with slight stone is normal. Much stone with little Stomach qi means Kidney illness; only stone without Stomach qi means death. Stone with hook predicts summer illness; marked hook means illness now. True organ qi descends in Kidney, which stores the qi of bones and marrow.
Stomach’s great network vessel is called Xuli. It penetrates the diaphragm, connects with Lung and emerges below the left breast. Its movement answers through clothing: it is the pulse of gathering qi. Strong panting with repeated interruptions means illness within. Binding and transverse movement means accumulation. Cessation without arrival means death. Movement below the breast visibly answering through clothing means gathering qi leaking out.
To know excess and insufficiency at Cunkou: a short pulse under the hand means headache; long means shin and foot pain; urgent upward striking means shoulder and back pain; sinking and firm means illness within; floating and abundant means illness outside. Sinking and weak means cold and heat, hernia, masses and lower-abdominal pain. Sinking and transverse means accumulation beneath the flanks and painful transverse accumulation in the abdomen. Sinking and panting means cold and heat.
An abundant, slippery and firm pulse means illness outside. Small, replete and firm means illness within. Small, weak and rough means old illness. Slippery, floating and rapid means new illness. Urgent means hernia, masses and lower-abdominal pain. Slippery means Wind. Rough means obstruction. Relaxed and slippery means internal heat. Abundant and tight means distention.
A pulse following yin and yang makes illness easy to end; opposing them makes it difficult. Following the seasons means no other complication. Opposing the seasons, with no interval between organ transmissions, makes recovery difficult.
Many blue-green vessels on the arm mean blood depletion. A relaxed, rough chi pulse means lassitude. Lying at ease with an abundant pulse means blood depletion. Rough chi skin with a slippery pulse means much sweat. Cold chi with a fine pulse means diarrhea. Coarse pulse and chi that remain hot mean internal heat.
Reading note: The supplied 解聡 is read as the traditional lassitude term xie yi; its graphic irregularity is not made into a new diagnosis.
Liver appearing predicts death on Geng or Xin; Heart on Ren or Gui; Spleen on Jia or Yi; Lung on Bing or Ding; Kidney on Wu or Ji. These are appearances of the true organ pulse, all fatal.
A neck pulse moving with panting and rapid cough indicates Water. Slight swelling around the eyes like a raised silkworm indicates Water. Yellow-red urine with a wish to lie down indicates jaundice. Hunger as though unfed after eating indicates Stomach jaundice. Facial swelling indicates Wind; swelling of shins and feet Water; yellow eyes jaundice.
In a woman, pronounced movement of the Hand Shaoyin pulse indicates pregnancy.
Pulses may follow or oppose the seasons before a true organ form appears. A lean pulse in spring and summer, or a floating large pulse in autumn and winter, is contrary to the seasons. A still pulse with Wind heat, a replete pulse with diarrhea and blood loss, a deficient pulse with illness inside, or a rough firm pulse with illness outside are all difficult to treat and called contrary to the seasons.
Water and grain are the human foundation: deprivation brings death. A pulse without Stomach qi also means death. Without Stomach qi means finding only the true organ pulse and no Stomach qi. A pulse failing to obtain Stomach qi is also described as Liver not stringlike and Kidney not stonelike.
Reading note: The supplied last clause is retained alongside the preceding true-organ explanation rather than rewritten to remove its apparent tension.
Taiyang arrives surging, large and long. Shaoyang arrives now rapid, now sparse, now short, now long. Yangming arrives floating, large and short.
The normal Heart pulse arrives as successive linked pearls or as tracing polished jade: Heart is balanced. In summer, Stomach qi is its root. The ill Heart pulse arrives panting and linked, with a slight curve within: Heart is ill. The dying Heart pulse bends in front and remains behind, like grasping a belt hook: Heart is dying.
The normal Lung pulse arrives gently and lightly, like falling elm seeds: Lung is balanced. In autumn, Stomach qi is its root. The ill Lung pulse neither rises nor descends, like tracing chicken feathers: Lung is ill. The dying Lung pulse is like a floating object or hair blown by wind: Lung is dying.
The normal Liver pulse arrives soft, weak and swaying, like lifting the tip of a long pole: Liver is balanced. In spring, Stomach qi is its root. The ill Liver pulse arrives full, replete and slippery, like tracing a long pole: Liver is ill. The dying Liver pulse grows urgent and strong, like a newly drawn bowstring: Liver is dying.
The normal Spleen pulse arrives harmonious and soft, with separated steps like a chicken treading the ground: Spleen is balanced. In late summer, Stomach qi is its root. The ill Spleen pulse arrives replete, full and rapid, like a chicken lifting its foot: Spleen is ill. The dying Spleen pulse is sharp and firm like a crow’s beak, like a bird’s spur, like a leaking roof or flowing water: Spleen is dying.
The normal Kidney pulse arrives in successive panting movements like hooks and is firm under pressure: Kidney is balanced. In winter, Stomach qi is its root. The ill Kidney pulse resembles pulling a vine and grows firmer under pressure: Kidney is ill. The dying Kidney pulse bursts forth like a rope snatched away or repeated flicks against stone: Kidney is dying.”
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