Flooding Pulse (洪脉)

Appearance (体象歌)

洪脉极大，状如洪水；来盛去表，滔滔满指。

Clinical Indications (主病歌)

洪为盛满，气壅火亢。左寸洪大。心烦舌破；右寸洪大，胸满气逆。左关见洪，肝木太过；右关见洪，脾土胀热。左尺洪兮，水枯便难；右尺洪兮，龙火燔灼。

Clinical Significance

The Flooding Pulse indicates exuberant yang heat and intense heat in the qi level. Its form is extremely large, forceful on arrival and weaker on departure, like a flooding river filling the finger. It forms when heat pathogen is intense and healthy qi is actively resisting, causing qi and blood to surge in the vessels. It is commonly seen in the qi-level stage of external febrile diseases or in organ excess-heat patterns. At the left inch position, flooding pulse indicates heart fire with restlessness, mouth sores, and insomnia. At the right inch, it points to lung heat congestion with chest fullness, cough, asthma, and sore throat. At the left guan, it reflects liver wood excess with headache, dizziness, red eyes, irritability, and rib pain. At the right guan, it indicates spleen-stomach damp-heat or stomach fire with abdominal fullness, dry mouth, foul breath, gum swelling, and rapid hunger. At the left chi, it reflects kidney yin deficiency with water depletion and fire excess, presenting as constipation, weak lower back, and tinnitus. At the right chi, it indicates ministerial fire raging with seminal emission, yellow leukorrhea, and lower leg sores. A prolonged flooding pulse with a prominent falling wave warns of heat injuring fluids and damage to both qi and yin.

Treatment and Care

For a Flooding Pulse due to qi-level heat, treatment clears heat and generates fluids. For intense heat in the qi level with high fever and thirst, clear qi-level heat with Bai Hu Tang. For lung heat congestion, clear the lungs and drain heat with Ma Xing Shi Gan Tang or Xie Bai San. For heart fire, clear heart fire with Dao Chi San or Huang Lian Jie Du Tang. For liver fire, clear liver fire with Long Dan Xie Gan Tang. For stomach fire, clear stomach fire with Qing Wei San. For kidney yin deficiency with water depletion, nourish yin and drain fire with Zhi Bai Di Huang Wan or Liu Wei Di Huang Wan. Daily care emphasizes drinking plenty of warm water or lightly salted water to replenish fluids, eating light foods such as watermelon, pear, lotus root, and mung beans to clear heat and generate fluids, and avoiding spicy, alcohol, roasted, and warming tonic foods. Keep the environment cool and avoid heavy labor in high heat. Acupuncture at Da Zhui, Qu Chi, and He Gu can drain heat, but should be used cautiously in deficient patients. Once fever resolves, transition to yin-nourishing foods and formulas prevents lingering dryness and deficiency heat.