Empty Pulse (虚脉)

Appearance (体象歌)

虚合四形，浮大迟软；及乎寻按，几不可见。

Clinical Indications (主病歌)

虚主血虚。又主伤暑。经络技巧公众号提示左寸心亏，惊悸怔忡；右寸肺亏，自汗气怯。左关肝伤，血不营筋；右关脾寒，食不消化。左尺水衰，腰膝痿痹；右尺火衰，寒证蜂起。

Clinical Significance

The Empty Pulse indicates dual deficiency of qi and blood. It forms when constitutional weakness, inadequate postnatal nourishment, chronic illness, or overwork exhausts qi and blood, causing the vessels to lose filling and the blood flow to lose propulsion. The pulse therefore feels floating, large, slow, and soft, and nearly disappears under pressure. It is commonly seen in chronic consumptive diseases, especially those with combined qi-blood deficiency. At the left inch position, empty pulse indicates heart blood deficiency with palpitations, insomnia, and forgetfulness. At the right inch, it indicates lung qi deficiency with spontaneous sweating, shortness of breath, and susceptibility to external pathogens. At the left guan, it points to liver blood insufficiency with muscle cramps, numbness, and blurred vision. At the right guan, it reflects spleen-stomach weakness with poor appetite, abdominal distension, loose stools, and sallow complexion. At the left chi, it indicates kidney yin deficiency with weak lower back and knees, muscular atrophy, and tinnitus. At the right chi, it reflects kidney yang deficiency with aversion to cold, cold limbs, impotence, and early morning diarrhea. The pulse often improves gradually as qi and blood are restored through consistent supplementation and rest, and chronic deficiency may involve multiple organs, requiring combined formulas that address spleen, kidney, and heart simultaneously.

Treatment and Care

Treatment for an Empty Pulse focuses on supplementation according to the type of deficiency. For combined qi-blood deficiency, use Ba Zhen Tang or Gui Pi Tang. For heart-spleen deficiency, use Gui Pi Tang. For lung-spleen qi deficiency, use Bu Zhong Yi Qi Tang or Si Jun Zi Tang. For liver blood deficiency, use Si Wu Tang with modifications. For kidney yin deficiency, use Liu Wei Di Huang Wan or Zuo Gui Wan. For kidney yang deficiency, use Jin Gui Shen Qi Wan or You Gui Wan. For summerheat injury with empty pulse, clear summerheat and augment qi with Qing Shu Yi Qi Tang. Daily care emphasizes balancing work and rest, avoiding overexertion, eating warm and nutritious foods such as astragalus, codonopsis, Chinese yam, red dates, and longan, and avoiding cold, greasy, and spicy foods that damage healthy qi. Gentle exercises such as tai chi and ba duan jin help cultivate primordial qi, and moxibustion at Zu San Li, Guan Yuan, and Qi Hai supports upright qi. Meals should be warm, regular, and nutrient-dense, emphasizing easily digested grains, soups, and steamed vegetables, and avoiding mental overwork and sexual excess helps preserve essence and supports the recovery of healthy qi.