Swift Pulse (疾脉)

Appearance (体象歌)

疾为急疾，数之至极；七至八至，脉流薄疾。

Clinical Indications (主病歌)

疾为阳极，阴气欲竭；脉号离经，虚魂将绝；渐进渐疾，且多殒灭。左寸居疾，勿戢自焚；右寸居疾，金被火乘。左关疾也，肝阴已绝；右关疾也，脾阴消竭。左尺疾兮，涸辙难濡；右尺疾兮。赫曦过极。

Clinical Significance

The Swift Pulse indicates extreme yang exhaustion of yin and critical illness. It is extremely rapid, with seven to eight beats per breath, representing the extreme of the rapid pulse. It forms when yang heat is extremely exuberant and yin fluids are about to dry up, or when floating yang is escaping and heart qi is failing, causing blood to rush uncontrollably. The Swift Pulse is seen in high fever with altered consciousness, stroke closure pattern, heart failure, shock, severe infection, or poisoning. At the left inch position, swift pulse indicates heart fire blazing and heart yin exhausted, presenting as high fever, delirium, restlessness, and confusion. At the right inch, it reflects lung metal being scorched by fire with rapid breathing, chest pain, hemoptysis, and high fever. At the left guan, it points to liver yin exhaustion with internal stirring of liver wind, presenting as convulsions, tremors, red eyes, and headache. At the right guan, it indicates stomach yin and spleen yin consumed, presenting with dry cracked lips, rapid hunger or loss of appetite, and abdominal distension. At the left chi, it reflects kidney yin dried up with weak lower back and knees, tinnitus, seminal emission, and scanty dark urine. At the right chi, it indicates ministerial fire excessively blazing and yin essence damaged, presenting as seminal emission, yellow leukorrhea, hot lower leg sores, and night sweats.

Treatment and Care

For extreme yang heat with a Swift Pulse, treatment clears heat, cools blood, nourishes yin, generates fluids, extinguishes wind, and opens the orifices. For blazing heat in both qi and ying levels with high fever and delirium, clear qi, cool ying, and open the orifices with Qing Ying Tang, An Gong Niu Huang Wan, or Zi Xue Dan. For internal stirring of liver wind with convulsions and collapse, cool the liver and extinguish wind with Ling Jiao Gou Teng Tang. For yin fluids exhausted, greatly nourish yin and rescue fluids with Sheng Mai San, Zeng Ye Tang, or Jia Jian Fu Mai Tang. For floating yang escaping and yin-yang separation, restore yang, rescue reversal, and supplement qi with Shen Fu Tang, Si Ni Tang, or Sheng Mai San combined with Shen Fu Tang. Daily care requires immediate emergency medical care and close monitoring of vital signs. Keep the environment cool and ventilated, avoiding dry heat stimulation. For high fever, use lukewarm water sponge bath for physical cooling, but avoid ice water. Food should be light liquid such as rice soup, lotus root powder, pear juice, and watermelon juice to nourish stomach yin and generate fluids; avoid spicy, warming, greasy, and hard-to-digest foods. Do not force-feed unconscious patients. The Swift Pulse has a dangerous prognosis and requires integrated Chinese and Western emergency treatment. Acupuncture at Ren Zhong, Shi Xuan, and Yong Quan may assist in opening the orifices and reviving the spirit.