Tympanic Pulse (革脉)

Appearance (体象歌)

革大弦急，浮取即得；按之乃空，浑如鼓革。

Clinical Indications (主病歌)

革主表寒，亦属中虚。左寸之革，心血虚痛；右寸之革，金衰气壅。左关遇之，疝瘕为祟；右关遇之，土虚为疼。左尺诊革，精空可必；右尺诊革，殒命为忧。女人得之，半产漏下。

Clinical Significance

The Tympanic Pulse indicates deficiency-cold with blood loss and severe internal deficiency of essence and blood. It is large, wiry, and urgent, felt superficially but empty on deeper pressure, like a drumhead. It forms when yin blood is suddenly depleted and yang qi has nothing to anchor to, so it floats outward, or when external cold constrains the surface while the interior is empty. The Tympanic Pulse is commonly seen after massive bleeding, chronic leakage, or long-standing deficiency and consumption. At the left inch position, it indicates heart blood deficiency with chest pain and palpitations. At the right inch, it reflects lung qi decline with qi congestion, presenting as chest oppression, shortness of breath, and weak cough. At the left guan, it points to liver blood insufficiency with cold congelation and qi stagnation, causing hernia, abdominal masses, and rib-side pain. At the right guan, it indicates spleen-stomach weakness with middle burner deficiency-cold, presenting as abdominal pain, poor appetite, and loose stools. At the left chi, it reflects kidney essence emptiness with weak lower back and knees, seminal emission, and tinnitus. At the right chi, it indicates life-gate fire decline and yang on the verge of collapse with cold limbs, edema, impotence, and a poor prognosis. In women, a tympanic pulse is commonly associated with miscarriage or uterine bleeding.

Treatment and Care

For essence-blood deficiency with a Tympanic Pulse, treatment supplements blood, enriches essence, boosts qi, and secures leakage. After massive bleeding with qi-blood collapse, greatly supplement qi and blood with Dang Gui Bu Xue Tang, Shi Quan Da Bu Tang, or Ren Yang Ying Rong Tang. For spleen failure to govern blood with persistent uterine bleeding, strengthen the spleen, boost qi, and stop bleeding with Gui Pi Tang or Jiao Ai Tang. For kidney yin deficiency and essence-blood depletion, nourish the kidneys and fill essence with Zuo Gui Wan or Da Bu Yin Wan. For kidney yang decline, warm and supplement kidney yang and secure essence with You Gui Wan or Jin Gui Shen Qi Wan. For middle burner deficiency-cold with abdominal pain, warm the middle and supplement deficiency with Xiao Jian Zhong Tang or Huang Qi Jian Zhong Tang. Daily care requires quiet rest, avoidance of overexertion, and keeping warm. Eat warming and nutritious foods such as red dates, longan, e-jiao, Chinese yam, black chicken, and pork liver; avoid raw, cold, spicy, and blood-moving foods. During active bleeding, remain in bed and avoid strenuous activity and emotional excitement. Moxibustion at Guan Yuan, Qi Hai, Zu San Li, and San Yin Jiao can supplement qi and blood, but acute bleeding requires medical management.