wk3 - pulses - 3 deep & 4 fast

Question 1

3 pulses defined by deep depth

Answer 1

1. deep
2. hidden
3. confined

Question 2

deep pulse – description

Answer 2

• found at or near bone
• not found with light pressure; ONLY found with heavy pressure
• may be either forceful or forceless (depending upon whether excess or deficient condition)

Question 3

deep pulse – pathology

Answer 3

if forceless due to underlying vacuity:

• Qi + Blood vacuity
• vacuity cold (aka Yang deficiency)

if forceful due to underlying repletion:
- excess cold (aka Yin repletion)

• could also be water swelling / edema (accumulation of fluids pushes pulse down to deep level) (water swelling sometimes defined as excess over vacuity)

Question 4

hidden pulse – description

Answer 4

• found IN the bone
• not found with light pressure; ONLY found with heavy pressure
• may be either forceful or forceless (depending upon whether excess or deficient condition)

Question 5

hidden pulse – pathology

Answer 5

pathology is deep in body; generally more chronic in nature:

• if forceful: intense cold + pain (e.g. woman doubled over with severe menstrual cramps)
• if forceless: sudden turmoil + other pathologies that deplete patient (SX incl. diarrhea + vomiting) (e.g. cholera outbreak)
• heat evil / toxin that’s really deep – in which case, pulse may be forceful or forceless (but more likely forceful at least early on)
• rapid if heat pathology; slow if cold pathology

Question 6

confined pulse – description

Answer 6

• EXCESS ONLY; always forceful (rageful, angry)
• not found with light pressure; ONLY found with heavy pressure
• always large
• long
• string-like, lacks contour
• hard
• (when drawing, color in the pulse bc it’s always forceful)

Question 7

confined pulse – pathology

Answer 7

• cold pain

- masses / growths

Question 8

4 pulses defined by fast rate

Answer 8

1. rapid
2. uber rapid
3. spinning bean / stirred
4. slippery

Question 9

rapid pulse – description

Answer 9

• 90 to 110 beats per minute (normal is 70 to 90)

- 6 or more beats per breath (4 is normal, 5 is fast, 6 is pathological)

Question 10

rapid pulse – pathology

Answer 10

generally heat condition:

1. excess heat (forceful)
2. vacuity heat (forceless)

Question 11

uber rapid pulse – description

Answer 11

• 120 to 140 beats per minute

- 7 or 8 beats per breath

Question 12

uber rapid pulse – pathology

Answer 12

• lots of heat (could be forceful or forceless bc could be excess or deficient)
• yang vacuity / deficiency cold (forceless) (e.g. Heart Yang vacuity leading to atrial fibrilliations)

Question 13

spinning bean / stirred pulse – description

Answer 13

• found primarily in the guan position
• sense of urgency
• rapid (90 to 110 beats per minute)
• forceful (excess)
• (it’s a very distinct pulse; has a regular rhythm; LV/SP pulsations are very distinct)

Question 14

spinning bean / stirred pulse – pathology

Answer 14

generally counterflow conditions:

• labor + delivery room
• fear + fright / trauma (e.g. war zone)
• serious pain
• disregulation of Chong + Ren (blood accumulation, counterflow)

Question 15

slippery pulse – description

Answer 15

• in fast category bc due to its slippery nature, it feels fast (but probably less than 90 bpm)
• smooth + even in texture
• arrives and departs smoothly
• has an oily quality (slides underneath your fingers)
• classical description is “pearls on a porcelain plate”
• (when drawing, fill it in with color bc this pulse is full + abundant)

Question 16

slippery pulse – pathology

Answer 16

non-pathological:
- abundance + health (e.g. later stages of pregnancy)

pathological:
- accumulation of phlegm + damp (with underlying SP Qi vacuity, which presents as an abundance of phlegm + damp)
- food accumulation / stagnation