Pulse Diagnosis Part Two: Relaxed, Spirited, and Strong

Here I share some material I've been reading about pulses that comes from Péng Zhòngshàn's Collection of Medical Lectures of Zhèng Qīnān and Lú Zhùzīi.

I love that this lecture begins with an appreciation of the good karma that brings us together to transmit and receive medical knowledge.

善缘：大家都是通过推荐人而坐在一起的，因为有了推 荐人，让我们结成传与受的关系。传，是把老一辈的东西传 给大家；受，是学习。 
Good karma: We all sit together because someone recommended you to be here. Because of this recommendation, we form a relationship of transmitting and receiving. Transmitting means passing on the things of the older generation to everyone; receiving means learning.

Zheng-Lu’s Medicine Pulse Criteria
健康人脉的标准概括起来就是 三个字：缓、神、力。这三个字一定要记到，首先，一个人 的脉要有缓象，就如人走路，从从容容，不急不忙，每步步 伐稳定实在，很有神，这是比喻，要自己去体会。从脉象说 就是：不快不慢，不浮不沉，缓和从容。你们学过数学的， 回忆一下三角里的SIN曲线，运动得很舒畅，圆圆的一直下 去，不是三角形，三角形就是紧脉了。
We can summarize the healthy person's pulse criteria with three words: relaxed, spirit, and strength. We must remember these three words. First, a person's pulse must be relaxed, just like a person walking, calm and leisurely, not in a hurry; each step is steady and solid, and each step has spirit. This is a metaphor. You want to learn from your own experience. In terms of pulse image, it is neither fast nor slow, neither floating nor sinking, slow and calm. For those of you who have studied mathematics, recall what happens with the SIN wave in trigonometry. The wave movements are very smooth, going down in a rounded way. It is not like a triangle. If it were like a triangle, it would be a tight pulse.

脉除了缓，还要有 神，如果脉疲疲沓沓的，一会儿快，一会儿慢，力度也不 够，就是神也不够。所以，缓、力、神三个字，是左右整体 脉象的健康标准。 
In addition to being relaxed, the pulse also needs to have spirit. If the pulse is lax, whether slow or fast, there is not enough strength, which means there is not enough spirit. Therefore, the three characters, relaxed, strong, and spirit, are the criteria for health and are the healthy standards that influence the overall pulse image.

My Commentary:
These simple words are so helpful when approaching the pulse. Without knowing more, when we touch and listen to the pulse, we can ask ourselves, "Is it relaxed? Does it have spirit? Does it have strength?" If a pulse position has these three qualities, we can know about the resources our patient brings to treatment. If a pulse position is missing one of these qualities, we can listen to what is there instead. Since reading this passage, I have asked myself these questions upon first contact with the pulse.

Furthermore, we can extend these three questions to our observation of the patient as a whole. Are they relaxed? Do they have spirit? Do they have strength? Our impressions of this can give us information that is foundational to diagnosis. We can also reflect our observations back to the patient where we see resources. It is often very helpful for patients who come in sick and suffering to hear our observations of the strengths they bring to treatment. 

¹ 郑钦安卢铸之医学讲授/彭重善, Chinese Medical Publishing House, Beijing, July 2016.  
²Though it’s a bit of a stretch, the character for pulse is 脈 Mài, which also means vessels and could be expanded to mean the river where spirit and form meet and pulse with life.  Hence the human being as a whole is a Mài.