Discussion on the Signs of Qi in Healthy Individuals

The Yellow Emperor asked: What is the pulse condition of a healthy person? Qi Bo replied: When a person exhales once, the pulse beats twice; when they inhales once, the pulse also beats twice. Between breaths, during the pause, the pulse beats five times, and with one longer breath (adding a sighing breath), this is called a healthy person. What is called a healthy person is someone who is not ill. Usually, the breath of a healthy person is used to regulate the breath of a sick person. The physician himself is not ill, so he uses his calm breathing to regulate the patient's breathing, taking this as the rule for pulse diagnosis. If a person exhales once and the pulse beats once, and inhales once and the pulse beats once, this is called diminished qi. If a person exhales once and the pulse beats three times, and inhales once and the pulse beats three times with the pulse being agitated, and the skin on the cubit region is hot, this is warm disease; if the cubit skin is not hot but the pulse is smooth and slippery, this is wind disease; if the pulse is rough and sluggish, this is bi disease. If a person exhales once and the pulse beats four times or more, death will occur; if the pulse is interrupted and does not come, death will occur; if the pulse is sometimes rapid and sometimes slow, death will occur.

The healthy person’s upright qi originates from the stomach. Stomach qi is the upright qi of a healthy person. If a person lacks stomach qi, it is called reversal, and reversal leads to death. In spring, stomach qi with a slightly wiry pulse is a normal pulse; if the wiry pulse predominates and stomach qi is diminished, it is liver disease; if there is only the wiry pulse without stomach qi, death will occur. If stomach qi carries a fuzzy pulse, disease will arise in autumn; if the fuzzy pulse is excessive, disease will arise immediately. The true qi of the five zang organs disperses to the liver; the liver stores the qi of the sinews and membranes. In summer, stomach qi with a slightly hooked pulse is a normal pulse; if the hooked pulse predominates and stomach qi is diminished, it is heart disease; if there is only the hooked pulse without stomach qi, death will occur. If stomach qi carries a stony pulse, disease will arise in winter; if the stony pulse is excessive, disease will arise immediately. The true qi of the five zang organs penetrates to the heart; the heart stores the qi of the blood and vessels. In long summer, stomach qi with a slightly soft and weak pulse is a normal pulse; if the weak pulse predominates and stomach qi is diminished, it is spleen disease; if there is only the intermittent pulse without stomach qi, death will occur. If the soft and weak pulse carries a stony pulse, disease will arise in winter; if the weak pulse is excessive, disease will arise immediately. The true qi of the five zang organs nourishes the spleen; the spleen stores the qi of the muscles. In autumn, stomach qi with a slightly fuzzy pulse is a normal pulse; if the fuzzy pulse predominates and stomach qi is diminished, it is lung disease; if there is only the fuzzy pulse without stomach qi, death will occur. If the fuzzy pulse carries a wiry pulse, disease will arise in spring; if the wiry pulse is excessive, disease will arise immediately. The true qi of the five zang organs resides in the lungs, used to circulate the nutritive and defensive yin and yang qi. In winter, stomach qi with a slightly stony pulse is a normal pulse; if the stony pulse predominates and stomach qi is diminished, it is kidney disease; if there is only the stony pulse without stomach qi, death will occur. If the stony pulse carries a hooked pulse, disease will arise in summer; if the hooked pulse is excessive, disease will arise immediately. The true qi of the five zang organs descends and returns to the kidneys; the kidneys store the qi of the marrow and bones. The great collateral of the stomach, called Xu Li, penetrates the diaphragm and connects with the lungs, appearing below the left breast. Its beating can move the clothing; this is the ancestral qi of the pulse. If the beating is rapid, panting, and frequently interrupted, disease is in the chest; if the pulse qi is knotted and transversely rebellious, there are accumulations; if the pulse qi is cut off and does not come, death will occur. If the beating below the breast can move the clothing, this is leakage of ancestral qi.

To understand the excess and deficiency of the cunkou pulse: If the cunkou pulse feels short, it is headache. If the cunkou pulse feels long, it is pain in the lower leg and shin. If the cunkou pulse feels rapid and strikes upward, it is shoulder and back pain. If the cunkou pulse is deep and firm, disease is in the interior. If the cunkou pulse is floating and vigorous, disease is in the exterior. If the cunkou pulse is deep and weak, it is cold-heat, hernia aggregations, and lower abdominal pain. If the cunkou pulse is deep and transversely rebellious, there are accumulations below the ribs and transverse accumulations in the abdomen causing pain. If the cunkou pulse is deep and rapid, it is cold-heat. If the pulse is vigorous, smooth, and firm, disease is in the exterior. If the pulse is small, substantial, and firm, disease is in the interior. If the pulse is small, weak, and rough, it is chronic disease. If the pulse is smooth, floating, and rapid, it is new disease. If the pulse is tight, it is hernia aggregations and lower abdominal pain. If the pulse is smooth, it is wind disease. If the pulse is rough, it is bi disease. If the pulse is relaxed and smooth, it is heat in the middle. If the pulse is vigorous and tight, it is distention disease.

If the pulse conforms to yin and yang, the disease is easy to heal; if the pulse is contrary to yin and yang, the disease is difficult to heal. If the pulse conforms to the four seasons, it is called disease without other changes; if the pulse is contrary to the four seasons and cannot transmit to the controlling organ, it is called difficult to heal.

If there are many bluish vessels on the arm, it is loss of blood. If the cubit pulse is relaxed and rough, it is called jieyi (fatigue and weakness); if the person rests peacefully and the pulse is vigorous, it is called loss of blood. If the cubit pulse is rough and the pulse is smooth, it is called excessive sweating. If the cubit pulse is cold and the pulse is fine, it is called post-diarrhea (diarrhea). If the cubit pulse is coarse and often hot, it is called heat in the middle.

Liver disease encountering the gengxin day (metal day) will result in death; heart disease encountering the rengui day (water day) will result in death; spleen disease encountering the jiayi day (wood day) will result in death; lung disease encountering the bingding day (fire day) will result in death; kidney disease encountering the wuji day (earth day) will result in death. This is called the appearance of the true visceral pulse, and all will die.

If the neck pulse beats rapidly with coughing and panting, it is water disease. If the eyelids are slightly swollen like the appearance of a lying silkworm, it is water disease. If the urine is yellow-red and the person rests peacefully, it is jaundice. If the person feels hungry even after eating, it is stomach jaundice. If the face is swollen, it is wind disease. If the lower leg and shin are swollen, it is water disease. If the eyes are yellow, it is jaundice. If the pulse at the hand shaoyin channel is vigorous, the woman is pregnant.

There are pulses that conform to the four seasons and those that are contrary. If the corresponding visceral pulse form does not appear, and the pulse is thin and small in spring and summer, or floating and large in autumn and winter, this is called being contrary to the four seasons. In wind-heat disease, if the pulse is calm; in diarrhea and loss of blood, if the pulse is substantial; in disease in the interior, if the pulse is weak; in disease in the exterior, if the pulse is rough and firm—all these are difficult to treat and are called violating the four seasons.

People rely on water and grain to sustain life. Thus, if a person is deprived of water and grain, they will die; if the pulse lacks stomach qi, they will also die. What is called lacking stomach qi is that only the true visceral pulse is seen and no stomach qi is visible. What is called the pulse not obtaining stomach qi is that the liver pulse is not wiry and the kidney pulse is not stony. The pulse of the taiyang channel is large and long; the pulse of the shaoyang channel is sometimes rapid, sometimes slow, sometimes short, sometimes long; the pulse of the yangming channel is floating, large, and short. The normal heart pulse, when it comes, is like a string of beads, as if touching langgan fine jade; this is called the heart pulse being level, with summer taking stomach qi as its root. The diseased heart pulse, when it comes, is rapidly connected with slight bending; this is called heart disease. The fatal heart pulse, when it comes, is bent in front and straight behind, like holding a hooked belt; this is called heart death. The normal lung pulse, when it comes, is light, floating, and soft, like falling elm seeds; this is called the lung pulse being level, with autumn taking stomach qi as its root. The diseased lung pulse, when it comes, neither rises nor falls, like touching chicken feathers; this is called lung disease. The fatal lung pulse, when it comes, is like something floating, like wind blowing feathers; this is called lung death. The normal liver pulse, when it comes, is soft and relaxed, like lifting the tip of a long pole; this is called the liver pulse being level, with spring taking stomach qi as its root. The diseased liver pulse, when it comes, is substantial and smooth, like touching a long pole; this is called liver disease. The fatal liver pulse, when it comes, is tight and forceful, like a newly drawn bowstring; this is called liver death. The normal spleen pulse, when it comes, is relaxed and even, like a chicken stepping on the ground; this is called the spleen pulse being level, with long summer taking stomach qi as its root. The diseased spleen pulse, when it comes, is substantial and rapid, like a chicken lifting its foot; this is called spleen disease. The fatal spleen pulse, when it comes, is sharp and firm like a bird’s beak, like a bird’s claw, like water leaking from a roof, like water flowing away; this is called spleen death. The normal kidney pulse, when it comes, is rapidly connected like a hooked pulse, and when pressed, it is firm; this is called the kidney pulse being level, with winter taking stomach qi as its root. The diseased kidney pulse, when it comes, is like pulling a kudzu vine, and when pressed, it is even firmer; this is called kidney disease. The fatal kidney pulse, when it comes, is like seizing a rope, making a pi-pi sound like a stone being flicked; this is called kidney death.