Different from a pulsus paradoxus, a pulsus philosophicus is any pulse that causes the examiner to question the nature of things. Pulsus philosphicus is the one and only maneuver that can be considered as part of both the physical exam and the metaphysical exam.
Example of a Pulsus Philosophicus
"Your pulse is really weak and thready... but what is real anyway? What is reality?"
"Your pulse begs the question: what is the meaning of life?"