Discussion on Disease and Examination of the Cunkou Pulse

The Yellow Emperor asked Qi Bo, saying: “I wish to diagnose disease by examining the forearm and cubit alone, without observing the complexion or feeling the pulse, and to speak of the illness from external signs to understand internal conditions. How should this be done?” Qi Bo replied: “By examining the slowness or rapidity, largeness or smallness, slipperiness or roughness of the forearm skin, as well as the firmness or fragility of the muscles, the signs of disease can be determined.”

Observe if there is slight swelling above the eye sockets, as if one has just awakened, with pulsation in the neck vessels and frequent coughing. Press the hands and feet; if depressions remain and do not rebound immediately, it is wind-water skin swelling disease. If the forearm skin is smooth and glossy, it is wind disease. If the muscles of the forearm are soft, the body is sluggish and weak, the person lies quietly, and the muscles are wasted, it is cold-heat disease, difficult to treat. If the forearm skin is smooth and glossy like applied oil, it is wind disease. If the forearm skin is rough, it is wind-bi disease. If the forearm skin is rough like dried fish scales, it is water-retention disease. If the forearm skin is intensely hot, and the pulse is large and agitated, it is warm disease; if the pulse is large and smooth, the pathogenic factor is about to exit. If the forearm skin is cold, and the pulse is fine and small, it is diarrhea and qi deficiency. If the forearm skin is scorching hot, with heat first and cold later, it is cold-heat disease; if the forearm skin is cold first, and after pressing for a long time becomes hot, it is also cold-heat disease. If the elbow alone is hot, there is heat above the waist; if the hand alone is hot, there is heat below the waist. If the front of the elbow alone is hot, there is heat in the chest; if the back of the elbow alone is hot, there is heat in the shoulders and back. If the middle of the arm alone is hot, there is heat in the waist and abdomen. If the area three or four inches below the thick part of the back of the elbow is hot, there are worms in the intestines. If the palm of the hand is hot, there is heat in the abdomen; if the palm of the hand is cold, there is cold in the abdomen. If there are blue blood vessels on the white flesh of the thenar eminence, there is cold in the stomach. If the forearm skin is scorching hot and the renying pulse is large, there should be loss of blood; if the forearm skin is firm and large, but the pulse is fine and small, it is qi deficiency; if the disease worsens, death will occur immediately.

If the eyes are red, the disease is in the heart; if white, the disease is in the lungs; if green, the disease is in the liver; if yellow, the disease is in the spleen; if black, the disease is in the kidneys. If yellow but cannot be clearly described, the disease is in the chest.

When examining eye pain, if red vessels run from above downward, it is disease of the taiyang channel; if from below upward, it is disease of the yangming channel; if from the outer canthus inward, it is disease of the shaoyang channel.

When examining cold-heat disease, if red vessels run from above downward to the pupil, and one vessel is seen, death occurs after one year; if one and a half vessels are seen, death occurs after one and a half years; if two vessels are seen, death occurs after two years; if two and a half vessels are seen, death occurs after two and a half years; if three vessels are seen, death occurs after three years.

When examining dental caries pain, press the yangming channel pulse to diagnose; if there is abnormal localized heat, on the left side there is heat on the left, on the right side there is heat on the right, above there is heat above, below there is heat below. When examining blood vessels, if red is abundant, there is much heat; if green is abundant, there is much pain; if black is abundant, it is chronic bi; if red, black, and green all appear, it is cold-heat disease.

If the body is painful, the complexion slightly yellow, the teeth are stained and yellow, and the fingernails are yellow, it is jaundice disease. If the person lies quietly, urine is yellow and red, and the pulse is fine, small, and rough, there is no desire to eat. If a person is ill and the cunkou pulse and renying pulse are equal in size, and also equal in floating and sinking, the disease is difficult to cure.

If the hand shaoyin pulse in a woman is distinctly moving, she is pregnant.

If an infant is ill and all the hair stands upward and is rebellious, death is certain. If there are prominent green vessels in the ear region, it is convulsive pain. If stool contains red clumps, undigested food is passed in diarrhea, the pulse is fine and small, and the hands and feet are cold, it is difficult to cure; if undigested food is passed in diarrhea, the pulse is fine and small, and the hands and feet are warm, the diarrhea is easy to cure.

The changes of the four seasons, the alternation of cold and heat: when yin reaches its extreme, it must turn to yang; when yang reaches its extreme, it must turn to yin. Therefore, yin governs cold, and yang governs heat. Thus, when cold reaches its extreme, heat is generated; when heat reaches its extreme, cold is generated. Hence it is said that cold can generate heat, and heat can generate cold. This is the law of yin-yang transformation. Therefore it is said: When injured by cold in winter, warm-heat disease will arise in spring; when injured by wind in spring, diarrhea with undigested food and dysentery will arise in summer; when injured by summerheat in summer, malaria will arise in autumn; when injured by dampness in autumn, coughing will arise in winter. This is the sequence of disease onset in the four seasons.