Thin Pulse (细脉)

Appearance (体象歌)

细直而软，累累萦萦；状如丝线，较显于微。

Clinical Indications (主病歌)

细主气衰，诸虚劳损。细居左寸，怔忡不寐；细在右寸，呕吐气怯。细入左关，肝阴枯竭；细入右关，胃虚胀满。左尺若细，泄痢遗精；右尺若细，下元冷惫。

Clinical Significance

The Thin Pulse indicates qi-blood deficiency and various patterns of deficiency and consumption. Its form is as thin as a silk thread, soft but clearly perceptible, more visible than the faint pulse. It forms when qi is insufficient to move blood and blood is insufficient to fill the vessels, or when dampness obstructs qi movement. It is primarily a deficiency pulse. At the left inch position, thin pulse indicates heart blood deficiency with palpitations, insomnia, and forgetfulness. At the right inch, it reflects lung qi deficiency with cough, shortness of breath, spontaneous sweating, low voice, and frequent colds. At the left guan, it points to liver yin deficiency with dry eyes, blurred vision, muscular tension, and emotional depression. At the right guan, it indicates stomach deficiency and spleen weakness with abdominal fullness, poor appetite, loose stools, and sallow complexion. At the left chi, it reflects kidney yin deficiency with seminal emission, diarrhea, and weak lower back and knees. At the right chi, it indicates kidney yang deficiency with cold lower burner, cold limbs, clear urine, impotence, and weakness of the lower back and knees. Thin pulse may also appear in chronic blood loss or after prolonged illness when recovery is incomplete, and careful palpation distinguishes it from the faint pulse by its slightly greater definition and persistence.

Treatment and Care

For qi-blood deficiency with a Thin Pulse, treatment supplements qi and nourishes blood. Heart blood deficiency is treated with Gui Pi Tang or Tian Wang Bu Xin Dan. Lung qi deficiency is treated with Bu Fei Tang or Sheng Mai San combined with Yu Ping Feng San. Liver yin deficiency is treated with Yi Guan Jian or Qi Ju Di Huang Wan. Spleen-stomach weakness is treated with Xiang Sha Liu Jun Zi Tang or Shen Ling Bai Zhu San. Kidney yin deficiency is treated with Liu Wei Di Huang Wan or Zuo Gui Wan. Kidney yang deficiency is treated with Jin Gui Shen Qi Wan or You Gui Wan. If thin pulse is due to internal dampness obstruction, transform dampness and regulate qi with Ping Wei San or Huo Xiang Zheng Qi San. Daily care emphasizes nutritious yet easily digestible food such as Chinese yam, red dates, lotus seeds, qian shi, lean meat, and fish; avoiding raw, cold, greasy, spicy, and excessively cold foods. Maintain regular routines, avoid overwork and late nights, and practice gentle walking or tai chi. Moxibustion at Zu San Li, San Yin Jiao, and Guan Yuan helps cultivate qi and blood. Soups containing Chinese yam, goji berry, and lean meat provide gentle nourishment without overburdening digestion, and a gradual return to activity is preferred over sudden exertion, which can further deplete qi and blood.