In Donguibogam, the human heart is compared to the monarch organ, the sovereign ruler governing the nation of the body. It explains that only when the heart is peaceful and fulfills its role properly can all the five viscera and six bowels maintain their places and function in harmony. But what happens if this sovereign's pulse becomes irregular?
Just as the drumbeats of a military band might suddenly fall out of step or cut off abruptly, a pulse that feels inconsistent and irregular was diagnosed in Korean medicine as a bound pulse or intermittent pulse. In particular, a bound pulse refers to a pulse that beats, suddenly pauses, and resumes, with the duration of the pause being characteristically irregular. Donguibogam noted that if the pulse slows and pauses before resuming, recovery remains possible, but if it pauses rapidly, the situation was considered critical.
This did not signify an issue confined solely to the heart. It was interpreted as a sign that the circulation of qi and blood, the pathways carrying vital life energy, was obstructed or had lost balance. The heart was regarded not only as a pump sending blood throughout the body, but also as the residence of the spirit, which governs mental activity. Therefore, an irregular pulse also meant that the monarch's heart was shaken. Stress, exhaustion, and excessive emotional fluctuations known as the seven emotions (joy, anger, sadness, thought, grief, fear, and fright) were believed to injure the heart, impede the circulation of qi and blood, and destabilize the pulse.
When the cardiac rhythm becomes unstable, blood cannot circulate properly and may pool. It is like a gently flowing river suddenly stagnating because an obstruction blocks the channel. The blood stasis generated from such stagnation was seen as far more than simple clotted blood; it was understood to cause pain, inflammation, and eventual masses, becoming the source of various illnesses. For this reason, Korean medicine placed great importance on calming the heart, replenishing qi and blood, and clearing blood stasis to correct an irregular pulse. All of these steps were efforts to restore peace to the heart, the monarch of the body, and regain the harmony of the five zang and six fu organs.
