Rapid Pulse (数脉)

Appearance (体象歌)

数脉属阳，象为太过；一息六至，往来越度。

Clinical Indications (主病歌)

数脉主腑，其病为热。寸数喘咳，口疮肺；关数胃热，邪火上攻；尺数相火，遗浊淋癃。

Combined Patterns (兼脉歌)

有力实火，无力虚火。浮数表热，沉数里热。阳数君火，阴数相火。右数火亢，左数阴戕。

Clinical Significance

The Rapid Pulse indicates heat patterns. It forms when heat pathogen causes accelerated circulation of qi and blood, or when yin deficiency leads to internal stirring of empty fire, producing more than five beats per breath. A rapid pulse with force usually indicates excess fire, where yang heat is exuberant and the body is actively fighting the pathogen. A rapid pulse without force usually indicates deficiency fire, where yin fluids are depleted and virtual yang is disturbed. At the inch position, rapid pulse indicates heat in the heart and lungs, presenting as cough, asthma, mouth sores, sore throat, and restlessness. At the guan position, it points to stomach heat or liver fire flaming upward, with thirst, gum swelling, hunger with rapid digestion, or red eyes and rib pain. At the chi position, it reflects ministerial fire stirring in the lower burner, manifesting as seminal emission, turbid leukorrhea, painful urinary dribbling, or urinary retention. Floating and rapid indicates exterior heat; deep and rapid indicates interior heat; wiry and rapid indicates liver fire; thin and rapid indicates yin deficiency with internal heat; slippery and rapid indicates phlegm-fire. Combined pulse diagnosis is essential for locating the affected organ and distinguishing deficiency from excess.

Treatment and Care

For a Rapid Pulse due to heat, the main treatment is to clear heat, differentiating excess from deficiency. For exuberant excess fire, clear heat and drain fire with Bai Hu Tang, Huang Lian Jie Du Tang, or Liang Ge San. For lung heat cough and asthma, clear the lungs and transform phlegm with Ma Xing Shi Gan Tang or Xie Bai San. For stomach fire flaming upward, clear stomach fire with Qing Wei San. For liver fire, clear the liver and drain fire with Long Dan Xie Gan Tang. For deficiency fire due to yin deficiency, nourish yin and clear heat with Liu Wei Di Huang Wan, Zhi Bai Di Huang Wan, or Qing Gu San. For yin deficiency with restless heart spirit, use Tian Wang Bu Xin Dan. Daily care emphasizes a light diet, consuming foods such as mung beans, bitter melon, pears, and lotus root to clear heat and generate fluids; avoiding spicy, fried, alcohol, and warming tonic foods. Maintain emotional balance, avoid anger that injures the liver, and ensure adequate sleep to protect yin. Acupuncture at Da Zhui, Qu Chi, and He Gu can drain heat, while moxibustion should be avoided in excess heat patterns. Cooling therapies must be stopped once heat subsides to avoid injuring spleen yang and digestive function.