Full Pulse (实脉)

Appearance (体象歌)

实脉有力，长大而坚；应指愊愊，三候皆然。

Clinical Indications (主病歌)

血实脉实，火热壅结。左寸心劳，舌强气涌；右寸肺病，呕逆咽疼。左关见实，肝火胁痛；右关见实，中满气疼。左尺见之，便闭腹疼；右尺见之，相火亢逆。

Combined Patterns (兼脉歌)

实而且紧，寒积稽留。实而且滑，痰凝为祟。

Clinical Significance

The Full Pulse indicates excess patterns. It forms when pathogenic factors are exuberant while healthy qi remains relatively intact, so that qi and blood surge forcefully in the vessels. The pulse feels full, large, long, and firm under all three levels of pressure. It is seen in conditions such as heat toxin accumulation, phlegm-fire binding, blood stasis, cold accumulation, and food stagnation. At the left inch position, full pulse indicates heart fire flaming upward or phlegm-fire disturbing the heart, with restlessness, mouth sores, stiff tongue, and qi rushing upward. At the right inch, it points to lung heat accumulation with cough, asthma, chest pain, sore throat, and vomiting. At the left guan, it reflects liver fire with headache, red eyes, rib pain, and irritability. At the right guan, it indicates stomach heat or food stagnation with abdominal fullness, pain, belching, and constipation. At the left chi, it reflects large intestine dryness-heat or bladder damp-heat with constipation, abdominal pain, and difficult urination. At the right chi, it indicates ministerial fire rebelling upward with seminal emission, yellow leukorrhea, and lower leg sores. Persistent excess heat can injure body fluids and transform into deficiency heat if not properly drained, and observation of tongue coating, body fluid, and stool pattern assists in locating the organ of excess.

Treatment and Care

Treatment for a Full Pulse focuses on expelling pathogenic factors according to their nature. For exuberant excess heat, clear heat and drain fire with Bai Hu Tang, Huang Lian Jie Du Tang, or Liang Ge San. For phlegm-fire binding, clear heat and transform phlegm with Qing Qi Hua Tan Wan or Gun Tan Wan. For liver fire, clear the liver and drain fire with Long Dan Xie Gan Tang. For lung heat cough and asthma, clear the lungs and transform phlegm with Ma Xing Shi Gan Tang. For food stagnation, promote digestion and remove stagnation with Bao He Wan or Zhi Shi Dao Zhi Wan. For cold accumulation with abdominal pain, warm and purge cold accumulation with Da Huang Fu Zi Tang. For blood stasis, activate blood and resolve stasis with Xue Fu Zhu Yu Tang or Tao Ren Cheng Qi Tang. Daily care emphasizes a light diet, avoiding fatty, spicy, fried, and warming foods that assist heat and phlegm; maintaining regular bowel movements; and moderate exercise. Acupuncture at Qu Chi, He Gu, and Nei Ting can drain excess heat, but should be applied under professional guidance. After purging excess, the diet should be gradually restored to protect stomach qi and spleen function, and hydration with warm water supports elimination of heat toxins and prevents fluid depletion.