The Leather, Tympanic, Drum-Skin Pulse (Ge Mai)

Leather Pulse (?? Ge Mai, tympanic, drum-skin)

Key points: superficial, forceful, taut, wide, and hollow

Indications: blood loss, abortion, jing exhaustion: sudden loss of blood or jing causes qi to float with the hollow insides due to sudden lack of blood or jing.

Explanation: this is a situation where a sudden and profound loss of blood or jing (these two are commonly related as they can transform into one another) causes the pulse to share aspects of deficiency and excess.

The way that this works is thus: you have a normal pulse, but then there is a sudden loss of blood. This is likely going to be due to trauma, though I wouldn’t be surprised to see this pulse arise after childbirth either. Now you’ve got a sudden loss of substance within the vessels. With blood loss, there will be qi loss, but not yet. There’s still plenty of qi pushing a lower volume of blood. Now you have a dysregulation between opposing components. There’s too much qi and not enough blood. This gives rise to a relative excess of qi in much the same way that a deficiency of yin can cause symptoms of heat. Now, applied to the qualities of this pulse, that relative excess of qi will show up as a forceful and wide, even hard (taut) pulse. However it is also hollow meaning that it is strong superficially, and palpable deeply, but it has no force at the middle depth. That’s what hollow means. This lack of “middle” is consistent with the loss of blood or jing that the patient has recently experienced. Got it?