This chapter is mainly based on 《Ling Shu Chapter 9》.

《素問陰陽別論篇第七》

脈有陰陽﹐知陽者知陰﹐知陰者知陽。三陽在頭﹐三陰在手﹐所謂一也。

《Su Wen Chapter 7》

There are the Yin pulse and Yang pulse, one who knows the Yang pulse will also know the Yin pulse and vice versa. The pulse that represents three Yang meridians is located at the head (Renying, carotid artery) while the pulse that represents three Yin meridians is at the hand (Cunkou, radial artery). The Renying and Cunkou pulses on the same side are actually one as Yin/Yang is one.

《靈樞四時氣第十九》

氣口候陰﹐人迎候陽也。

《Ling Shu Chapter 19》

The Cunkou pulse represents Yin; the Renying pulse represents Yang.

《靈樞禁服第四十八》

寸口主中﹐人迎主外﹐兩者相應﹐俱往俱來﹐若引繩大小齊等﹐春夏人迎微大﹐秋冬寸口微大﹐如是者名曰平。

《Ling Shu Chapter 48》

         The Cunkou pulse represents the Yin meridians; the Renying pulse represents the Yang meridians. The strength of both pulses should be the same. The Renying pulse should be slightly stronger than the Cunkou pulse in the spring and summer while the Cunkou pulse is slightly stronger than the Renying pulse in the fall and winter.

《靈樞終始第九》

凡刺之道﹐畢于終始﹐明知終始﹐五藏為記﹐陰陽定矣。

終始者﹐經脈為紀。持其脈口人迎﹐以知陰陽有余不足﹐平與不平﹐天道畢矣。所謂平人者不病﹐不病者﹐脈口人迎應四時也﹐上下相應而俱往來也﹐六經之脈不結動也﹐本末之寒溫相司守也﹐形肉血氣必相稱也﹐是為平人。

《Ling Shu Chapter 9》

In acupuncture practice, it is very important to know the individual’s Yin/Yang balance; excess or deficiency of the meridians by checking the Renying and Cunkou pulse.

Healthy people should have (1) an even strength of the Renying and Cunkou pulse; (2) relative changes of Renying and Cunkou pulse according to the changes of the four seasons;(3) no irregular Renying and Cunkou pulses; (4) the functions of the internal organs and the surface of the body should follow the weather change and (5) the flesh of the body matches the condition of the Qi/Blood.

【Comment】

《Ling Shu Chapter 1》states that “An acupuncturist must check the patient’s pulse before needling in order to know the condition of the patient and make the right differentiation.” (《靈樞九針十二原第一》﹕“凡將用針﹐必先診脈﹐視氣之劇易﹐乃可以治也。”)  The chapters above discuss several key points relating to the Cunkou and Renying pulse.

(1)   “The Cunkou pulse represents Yin; the Renying pulse represents Yang.”

The Cunkou pulse represents three yin meridians (Taiyin, Shaoyin, and Jueyin) and Renying pulse represents three yang meridians (Taiyang, Shaoyang, and Yangming), Cunkou and Renying pulses can be called Yin/Yang pulse.

All kinds of diseases can be considered as an imbalance of yin/yang according to the theory of yin/yang; therefore, through the checking of both pulses, one would be able to detect a balance or imbalance of Yin/Yang in the meridian.

Yin/Yang theory is the foundation of Traditional Chinese Medicine. Renying and Cunkou pulses and their applications in acupuncture embody this.

In the following discussions, we will study all the applications of this pulse diagnosis in every aspect of acupuncture practice. One will see that it is impossible to practice acupuncture correctly without the pulse diagnosis of Renying and Cunkou.

However, there is no record of such crucial pulse diagnosis in present acupuncture textbooks, not even in China.

(2) What is the condition of the Cunkou and Renying pulse in a healthy man?

Healthy people should have (1) an even strength of the Renying and Cunkou pulse; (2) relative changes of Renying and Cunkou pulse according to the changes of the four seasons; (3) no irregular Renying and Cunkou pulses.

These statements indicate three characteristics of normal Cunkou and Renying pulses: A) The strength of both pulses is the same on palpation; B) The Renying pulse is slightly stronger than the Cunkou pulse in the spring and summer while the Cunkou pulse is slightly stronger than the Renying pulse in the fall and winter; C) no irregular Renying and Cunkou pulses.

Although there is no further information regarding how to check these pulses in 《Ling Shu》, in the past several years we have been practicing it on thousands of patients in the clinic and obtained some experience.  Refer to appendix 1 of this section.

(3) The location of the Cunkou and Renying pulse.

The Cunkou pulse is located at the wrist where the radial artery is; and the Renying pulse is located at the neck where the carotid artery is.

This Chapter is mainly based on 《Su Wen Chapter 9》and《Ling Shu Chapter 9》.

《素問六節藏象論篇第九》

故人迎一盛病在少陽﹐二盛病在太陽﹐三盛病在陽明﹐四盛已上為格陽。寸口一盛病在厥陰﹐而二盛病在少陰﹐三盛病在太陰﹐四盛已上為關陰。人迎與寸口俱盛四倍以上為關格﹐關格之脈贏﹐不能極于天地之精氣﹐則死矣。

《Su Wen Chapter 9》

The disordered meridian is Shaoyang if the Renying pulse is two times stronger than Cunkou; the disordered meridian is Taiyang if the Renying pulse is three times stronger than Cunkou; the disordered meridian is Yangming if the Renying pulse is four times stronger than the Cunkou.

Yang is extremely strong that it can not communicate with Yin if the Renying pulse is five times stronger than Cunkou;

The disordered meridian is Jueyin if the Cunkou pulse is two times stronger than Renying; the disordered meridian is Shaoyin if the Cunkou pulse is three times stronger than Renying; the disordered meridian is Taiyin if the Cunkou pulse is four times stronger than Renying.

Yin is extremely strong that it can not communicate with Yang if the Cunkou pulse is five times stronger than Renying.

If both Cunkou and Renying pulse are five times stronger than normal, it means that death is imminent.

《靈樞終始第九》

人迎一盛﹐病在足少陽﹐一盛而躁﹐病在手少陽﹔人迎二盛，病在足太陽﹐二盛而躁﹐病在手太陽﹔人迎三盛﹐病在足陽明﹐三盛而躁﹐病在手陽明﹔人迎四盛﹐且大且數﹐名曰溢陽﹐溢陽為外格。

脈口一盛﹐病在足厥陰﹐一盛而躁﹐在手心主。脈口二盛﹐病 在足少陰﹐二盛而躁﹐在手少陰。脈口三盛﹐病在足太陰﹐三盛而躁﹐在手太陰。脈口四盛﹐且大且數者﹐名曰溢陰﹐溢陰為內關﹐內關不通死不治。人迎與太陰脈口俱盛四倍以上﹐命曰關格﹐關格者與之短期。

《Ling Shu Chapter 9》

The disordered meridian is Foot-Shaoyang, if the Renying pulse is two times stronger than Cunkou; if the Renying pulse is two times stronger than Cunkou and the pulse shows restlessness, the disordered meridian is Hand-Shaoyang.

The disordered meridian is Foot-Taiyang if the Renying pulse is three times stronger than the Cunkou; if the Renying pulse is three times stronger than Cunkou and the pulse shows restlessness, the disordered meridian is the Hand-Taiyang.

The disordered meridian is Foot-Yangming if the Renying pulse is four times stronger than Cunkou; if the Renying pulse is four times stronger than Cunkou and the pulse shows restlessness, the disordered meridian island-Yangming.

Yang is extremely strong that it can not mingle with Yin, if the Renying pulse is five times stronger than Cunkou, then the pulse will be full-sized and rapid.

The disordered meridian is Foot-Jueyin if the Cunkou pulse is two times stronger than Renying; if the Cunkou pulse is two times stronger than Renying and the pulse shows restlessness, the disordered meridian is Hand-Jueyin.

The disordered meridian is Foot-Shaoyin if the Cunkou pulse is three times stronger than Renying; if the Cunkou pulse is three times stronger than Renying and the pulse shows restlessness, the disordered meridian is Hand-Shaoyin.

The disordered meridian is Foot-Taiyin if the Cunkou pulse is four times stronger than Renying; if the Cunkou pulse is four times stronger than Renying and the pulse shows restlessness, the disordered meridian is Hand-Taiyin.

Yin is extremely strong that it can not mingle with Yang if the Cunkou pulse is five times stronger than Renying, then the pulse will be full-sized and rapid.

If both Cunkou and Renying pulse show five times stronger than normal, it means that death is imminent.  

【Comment】

         (1) These two chapters of 《Huangdi Neijing》reveal one very important principle regarding meridian differentiation, an excess condition of a meridian can be determined by checking the Cunkou and Renying pulse.

        For example, “The disordered meridian is Foot-Shaoyang if the Renying pulse is two times stronger than Cunkou; if the Renying pulse is two times stronger than Cunkou and the pulse shows restlessness, the disordered meridian is Hand-Shaoyang.”

What is the meaning of “two times stronger?” It means the strength of the pulse that is felt, not the size of the pulse.

What is the meaning of “the pulse shows restlessness?” It means that the palpitation of the pulse is not steady.

A strong or weak pulse between the Renying and Cunkou may be easy to exhibit, but whether it is two times; three times or four times stronger is not easy to master or identify.  The restless pulse is also more difficult to differentiate. This may be the one of the many reasons why one does not see the practice of this type of pulse diagnosis in clinic after Ling Shu.

Are we able to learn this pulse diagnosis in the clinic step by step? Are we able to master this pulse diagnosis one day? How do we do this? The answer is in 《Ling Shu Chapter 10》.《Ling Shu Chapter 10》records the symptoms due to the disorder of each meridian, and each meridian has their special group of symptoms.  For example; the pathological manifestations of the lung meridian are “a sensation of fullness in the chest, asthmatic cough, pain in the supraclavicular fossa. The patient comes with the hand crossed on the chest and blurry vision when the case is severe.”  With this unique group of symptoms, one could determine the disordered meridian first, and then refer to this chapter to learn how to differentiate the pulse strength.  For example, if the patient is diagnosed as having a disordered Foot-Taiyin meridian by the pathological manifestations and his Cunkou pulse is stronger than his Renying pulse, according to this chapter this patient’s Cunkou must be four times stronger than Renying, and thus one can experience a Cunkou pulse that is four times stronger than its Renying pulse.  An accumulation of such experiences will enable one to master pulse diagnosis by determining the disordered meridian using the Cunkou and Renying pulse without the clinical pathological manifestations.

Presently, this is the only way to learn and master pulse diagnosis and it requires a lot of clinical practice and observation.  Of course, we may have a pulse diagnosis device one day through modern technology, but this device must pass through clinical studies conducted under the theory of Ling Shu.

Table 1-2-1:  The Pulse Diagnosis of Renying and Cunkou in《Ling Shu Chapter 9》. (R=Renying; C=Cunkou; Disordered meridian=D/M; Condition of meridian=C/M)

 (2) The statement in 《Ling Shu Chapter 48》regarding how to determine the excess condition of a meridian by checking the Cunkou and Renying pulse is the same as《Su Wen Chapter 9》and 《Ling Shu Chapter 9》. (《靈樞禁服第四十八》﹕人迎大一倍於寸口，﹐病在足少陽﹐一倍而躁﹐在手少陽﹔人迎二倍，病在足太陽﹐二倍而躁﹐病在手太陽﹔人迎三倍﹐病在足陽明﹐三倍而躁﹐病在手陽明﹔人迎四倍者﹐且大且數﹐名曰溢陽﹐溢陽為外格，死不治。寸口大一倍於人迎﹐病在足厥陰﹐一倍而躁﹐在手心主。寸口二盛﹐病 在足少陰﹐二倍而躁﹐在手少陰。寸口三盛﹐病在足太陰﹐三倍而躁﹐在手太陰。寸口四倍者﹐名曰內關﹐內關者，且大且數，死不治。)