Slow Pulse – DGR – Draft

 In Misc. CM articles, Uncategorized

There has been some recent discussion and debate on some online forums about the meaning of a slow pulse in Chinese medicine. Many believe this relates solely to rate of the heartbeat and thus corresponds to something like three beats per breath or less than 60 BPM. Although this is substantiated in modern and historical literature, it is only half the story. The slow pulse can correspond to a sluggishness or slowness in the arrival and departure of the wave. Consequently we see case studies and pulse treatises talking about a slow pulse in individual positions. This proves that a slow pulse can occur irrespective of that actual rate. Below is Ding Ganren’s treatise on slow pulse.

Slow Pulse (迟脉)

Ding Ganren (丁甘仁) (1865-1926)

(Rough translation by Jason Blalack)

The slow pulse is a yin pulse, it arrives three (or two) times with one breath, [or it]  departs and arrives extremely slow (man æ…¢). {Mai Jing} It is yang that does not prevail over yin. Therefore the pulse arrives insufficiently.{bin hu mai xue}

Slow pulse arrives only three times with one breath. Yang does not prevail over yin cold [pathogenic qi], [or there is] qi and blood cold. Nevertheless, distinguishing if floating and deep [will determine if that pathology] is in the exterior or interior. To disperse yin one must augment the source of fire.

Similarities of a slow pulse [with other pulses]

One breath three arrivals is slow. If it is a little quicker than slow it is regarded as moderate [pulse]. Slow, thin, and difficult is choppy. A slow pulse that [periodically] stops is a bound [pulse]. If it stops with a fixed number [of beats in-between] then this is an intermittent [pulse]. {Li Shizhen}

Moderate arrives four [times in each breath] and is slightly faster than a slow [pulse]…

Mr. Li (黎) said, “Slow [pulse] is overabundance of yin and debilitation of yang. Moderate [pulse] is overabundance of protective and weakness in the nutritive.”

Diseases of the slow pulse.

Slow pulse is yin and corresponds to a state of desolation of yang qi, which is cold and deficienct. You should warm and tonify. The slow pulse is in charge of yin organ disease or profuse phlegm, serious and protracted illness, immobile and mobile abdominal masses. One must pay careful attention [to such conditions].

If has strength and slow this is cold pain. If slow and lacks strength then definitely deficiency cold. A distal slow pulse certainly corresponds to upper burner cold. The middle position masters cold in the middle causing unbearable pain. The proximal position is kidney deficiency with heaviness in the lower back and legs, fecal and urinary incontinence, and hernia stretching to the testicles.

Slow pulse governs the yin organs. If has strength then there is cold pain. If lacks strength then deficient cold. If floating and slow then this is exterior cold. If deep and slow then this is interior cold.

Left distal position: Heart fire and qi debilitation and essence spirit exhaustion. (The Heart masters fire season (火令??)), fulminant pain in the heart [region] and abdomen (cold pathogen),  or vomiting of clear oral mucus (In general the slow pulse is suitable for the Heart-sovereign).

Left middle position: Liver and Gallbladder qi is cold, ???, cold hands and feet, pain under the ribs, tense and cold sinews, aversion to eating and not eating. For this type of disease, it is also suitable to tonify and nourish the Heart blood.

Left proximal position: Kidney deficiency lower back pain, unable to bend forward and backward (qi that is cold).  Reversal cold of the extremities. Black facial complexion, abdominal pain, tinniutus, bowed head (头倾) (within water (坎) there is true yang, if slow [pulse] then yang qi is debilitated, solitary yin is unable to survive) (This yin maybe be a typo, and be yang). Kidney deficiency with turbid urine and no menses.

Right distal position: aversion to cold, shivering (yang qi not ascending). Lack of strength when speaking, wheezing and cough that wears them out, and clear nasal mucus.

Right middle position: Non-transformation of food and drink (fire is unable to generate earth), vomiting at the sight of food, or vomiting and diarrhea that contains food, or inability to lift the limbs (This pattern is suitable to warm and tonify)

Right proximal position: Ministerial fire debilitation, slow and lacks strength (maybe a typo: should be “has strength”), lower abdomen pain reaching to the genitals (cold qi pathogen). If slow and lacks strength this is counterflow cold from lower [burner] deficiency (yang fire debilitation)

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Showing 4 comments
  • Z'ev Rosenberg

    Nice job translating this little gem. It is very helpful in clarifying this germane discussion on the slow pulse. .

  • Teru

    I’m an acupuncturist myself and I have a client/patient who’s pulse is always slow but his body type is yang and I have been looking into it. Thank you for the useful information.

  • David Thiederman

    I had a Medtronic Pacemaker inserted Nov 2016 after being diagnosed with Bradycardia. I am in otherwise very good health, no medications, and active. My heart rate is set at 60bpm and I download the Medtronic data every 3 months to my doctor in Sandpoint, Idaho; the pacemaker does increase my heart rate when exercising but responds much slower than prior to the pacemaker. I recently visited Dr Yang in Richland, WA for acupuncture for improved immune system (most interested in avoiding the flue in the Winter since I don’t take flue shots); I also told him of my pacemaker and asked if he could use acupuncture for Bradycardia. After 4 treatments (2 per week), my heart rate now is consistently above 60bpm and responds to movement much more rapidly than the pacemaker; total indication that my heart signal has returned after 8 months of 60bpm.

  • Diana Hubbard

    Hello , I suffer from severe bradycardia and require a pacer to keep me at 50bpm. I’m searching for someone that might have experience with this . I live in southern Colorado . Thanks Di

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