Moderate Pulse (缓脉)

Appearance (体象歌)

缓脉四至，来往和匀；微风轻颭，初春杨柳。

Clinical Indications (主病歌)

Clinical Significance

The Moderate Pulse may be either normal or pathological. In healthy individuals, a moderate pulse at four beats per breath, calm and even, indicates harmonious qi and blood and abundant stomach qi. Pathologically, a moderate pulse mainly indicates dampness, spleen deficiency, and insufficiency of qi and blood. It forms when dampness is sticky and obstructs qi movement, or when the spleen and stomach are weak and fail to produce enough qi and blood, causing the pulse to move slowly and gently. A moderate pulse with force usually indicates dampness excess or food stagnation; a moderate pulse without force usually indicates spleen deficiency or qi deficiency. At the left inch position, moderate pulse indicates heart qi deficiency or dampness obstructing the chest, with palpitations, chest oppression, and shortness of breath. At the right inch, it reflects lung-spleen qi deficiency with phlegm-dampness, presenting as cough with copious phlegm, spontaneous sweating, and frequent colds. At the left guan, it points to liver-spleen disharmony with dampness in the middle burner, with rib-side fullness, poor appetite, and bitter taste. At the right guan, it indicates spleen-stomach weakness with damp-turbidity retention, presenting as abdominal fullness, poor appetite, loose stools, and heavy limbs. At the left chi, it reflects kidney yang deficiency with dampness pouring downward, with weak lower back and knees and difficult urination. At the right chi, it indicates lower burner dampness excess or kidney qi deficiency-cold with diarrhea, seminal emission, or clear leukorrhea.

Treatment and Care

For spleen deficiency with dampness and a Moderate Pulse, treatment strengthens the spleen, transforms dampness, and regulates the middle burner. Spleen-stomach weakness with poor appetite and loose stools is treated with Si Jun Zi Tang, Shen Ling Bai Zhu San, or Xiang Sha Liu Jun Zi Tang. Dampness obstructing the middle burner with abdominal fullness is treated with Ping Wei San or Huo Xiang Zheng Qi San. Spleen deficiency with dampness and diarrhea is treated with Shen Ling Bai Zhu San or Bu Zhong Yi Qi Tang. For qi-blood deficiency with weak moderate pulse, supplement qi and nourish blood with Ba Zhen Tang or Gui Pi Tang. For kidney yang deficiency with lower burner dampness, warm the kidneys and transform dampness with Jin Gui Shen Qi Wan or Zhen Wu Tang. Daily care emphasizes regular meals, avoiding raw, greasy, sweet, and hard-to-digest foods that assist dampness and burden the spleen. Eat spleen-strengthening and dampness-draining foods such as Chinese yam, coix seed, poria, atractylodes, and qian shi. Moderate exercise such as walking and ba duan jin supports spleen transformation. Avoid living in damp environments. Moxibustion at Zu San Li, Zhong Wan, Pi Shu, and Yin Ling Quan strengthens the spleen and drains dampness.