The normal pulse
The pulse should have three qualities, which are described as having Stomach-Qi, having spirit and having a root.
Stomach-Qi
A pulse is said to have Stomach-Qi when it feels ‘gentle’, ‘calm’ and is relatively slow (four beats per respiratory cycle).
A pulse with Stomach-Qi is not rough. The Stomach is the Sea of Food, the Root of the Post-Heaven Qi and the origin of Qi and Blood. For this reason, it gives ‘body’ to the pulse. If the pulse feels too rough or hard, it indicates that the Stomach function is impaired. The ‘Simple Questions’ in chapter 19 says: ‘The Stomach is the Root of the 5 Yin organs; the Qi of the Yin organs cannot reach the Lung channel [i.e. the radial artery on the Lung channel] by itself but it needs Stomach-Qi ... if the pulse is soft it indicates that it has Stomach-Qi and the prognosis is good.’
This particular quality of being ‘soft’ (but not too soft), ‘gentle’, ‘calm’ and ‘not rough’ is important: beginners often take a rough and hard quality of the pulse as being ‘healthy’.
Spirit
The pulse is said to have spirit when it is soft but with strength, neither big nor small, and regular. It should also be regular in its quality: that is, it should not change quality very easily and frequently. A pulse that has these qualities reflects a good state of Heart-Qi and Blood.
Root
A pulse is said to have root in two different senses. It has a root when the deep level can be felt clearly, and also when the Rear position can be felt clearly. Having a root indicates that the Kidneys are healthy and strong.
Thus a pulse that has spirit, Stomach-Qi and root indicates a good state of the Mind, Qi and Essence, respectively.
When interpreting the pulse one should therefore pay attention to the following elements and in this order:
1. Feel the pulse as a whole 2. Feel whether the pulse has spirit, Stomach Qi and root 3. Feel the three levels and the three positions 4. Feel the strength of the pulse 5. Feel the overall quality of the pulse (if there is one) 6. Feel the quality of individual pulse positions
Pulse
Name | Clinical Significance | Feeling | Kind | Aspect | Body Psych |
|---|---|---|---|---|---|
Floating (Fu) | Invasion of external WindYin deficiency (interior conditions) | This pulse can be felt with a light pressure of the fingers, just resting the fingers on the artery. | FloatingDeepSlowRapidEmptyFull | depthratestrengthsizelengthshaperhythm | Yin (deficiency)Exterior |
Deep (Chen) | Pathogenic factor in the Interior (Deep-Full)Yang deficiency (Deep-Weak) | This pulse is the opposite to floating: it can only be felt with a heavy pressure of the fingers and is felt near the bone. | Deep | depthratestrengthsizelengthshaperhythm | Yang (deficiency)Interior |
Slow (Chi) | Cold patternEmpty-Cold (Slow and Weak)Full-Cold (Slow and Full) | This pulse has three beats per respiration cycle | Slow | rate | ColdExcess ColdDeficient Cold |
Rapid (Shu) | Heat patternFull-Heat (Rapid and Full)Empty-Heat (Rapid and Floating-Empty) | This pulse has more than five beats per each respiration cycle | Rapid | rate | Excess HeatDeficient HeatHeart-FireLiver-Fire |
Empty (Xu) | Qi deficiency | The Empty pulse feels rather big but soft. | Empty | strength | Qi deficiency |
Full (Shi) | Full patternFull-Heat (Full-Rapid)Full-Cold (Full-Slow) | This pulse feels full, rather hard and rather long. | Full | strength | Full (excess)Excess HeatExcess ColdHeart-FireLiver-Fire |
Slippery (Hua) | PhlegmDampnessRetention of foodPregnancy | A Slippery pulse feels smooth, rounded, slippery to the touch, as if it were oily. It slides under the fingers. | Other | shape | Damp |
Choppy (Se) | Blood deficiencyExhaustion of Body Fluids | This pulse feels rough under the finger | Other | shape | Blood deficiency |
Long (Chang) | Heat pattern | This pulse is basically longer than normal | Full | length | Excess HeatDeficient Heat |
Short (Duan) | Severe Qi deficiencyStomach-Qi deficiency | Occupies a shorter space than the normal position | Empty | length | Qi deficiency |
Overflowing (Hong) | Full-HeatEmpty-Heat (Overflowing-Empty) | This pulse feels big, extending beyond normal pulse position. | Full | size | Excess HeatDeficient HeatHeart-FireStomach-Fire |
Fine (Xi) | Blood deficiencyDampness with severe Qi deficiency | This pulse is thinner than normal | Empty | size | Blood deficiencyDampQi deficiency |
Minute (Wei) | Severe deficiency of Qi and Blood | It is extremely thin, small and difficult to feel | Empty | size | Qi deficiencyBlood deficiency |
Tight (Jin) | ColdExterior Cold (Tight-Floating)Interior Full-Cold (Tight-Full-Deep)Interior Empty-Cold (Tight-Weak-Deep)Pain | This pulse feels twisted like a thick rope | Full | shape | ColdDeficient ColdExcess ColdInteriorExcess PainDeficient Pain |
Wiry (Xian) | Liver disharmonyPainPhlegm | This pulse feels taut like a guitar string. The Wiry pulse really hits the fingers. | Other | shape | Excess PainDeficient PainLiver-Fire |
Slowed-down (Huan) | This pulse has four beats for each respiration cycle | Slow | rate | ||
Hollow (Kou) | HaemorrhageForthcoming haemorrhage (Hollow and Rapid) | Empty in the middle, felt superficial and deep. | Floating | shape | |
Leather (Ge) | Severe deficiency of Kidney-EssenceSevere deficiency of Kidney-Yin | This pulse feels hard and tight at the superficial level and stretched like a drum, but it feels completely Empty at the deep level. It is a large pulse, not thin. | Floating | depth | Yin (deficiency) |
Firm (Lao) | Blood stasisInterior Cold (Firm and Slow)Pain | Wiry pulse at the deep level | Deep | shape | InteriorColdExcess PainDeficient Pain |
Soggy (or Weak-Floating) (Ru) | Dampness with Qi deficiencyDeficiency of YinDeficiency of Essence | The Soggy pulse feels very soft and is only slightly floating. | Empty | other | DampQi deficiencyYin (deficiency) |
Weak (Ruo) | Yang deficiencyBlood deficiency | Felt only at the deep level | Empty | strength | Yang (deficiency)Blood deficiency |
Scattered (San) | Severe deficiency of Qi and BloodSevere deficiency of Kidney-QiSerious condition | This pulse feels very small and is relatively superficial | Empty | strength | Qi deficiencyBlood deficiency |
Hidden (Fu) | Severe Yang deficiency | This pulse feels as if it were hidden beneath the bone | Deep | depth | Yang (deficiency) |
Moving (Dong) | Shockanxietyfright | The Moving pulse has a round shape like a bean; it is short and it ‘trembles’ under the finger | Rapid | length | Excess PainDeficient Pain |
Hasty (Cu) | Severe HeatDeficiency of Heart-QiHeart-Fire | This pulse is Rapid and it stops at irregular intervals | Rapid | rhythm | Excess Heat |
Knotted (Jie) | Cold with deficiency of Heart-Yang | This pulse is Slow and it stops at irregular intervals | Slow | rhythm | ColdYang (deficiency) |
Intermittent (Dai) | Serious problem in Internal OrganHeart problem (in Western medical sense) | This pulse stops at regular intervals | Other | rhythm | |
Hurried (Ji) | Fire exhausting Yin | This pulse is very rapid, but it also feels very agitated and urgent | Rapid | rate | Yin (deficiency) |
Pulse Positions
Name | Side | Position | Organ | Overview | Body Psych |
|---|---|---|---|---|---|
Distal—Heart | left | distal |  Heart Ht | Skin—Ht Blood/Yin Def, Ht Fire/Stagnation Superficial—Home Middle—Ht Qi/Yang def, Damp affecting Ht Absent—Blocked/stag | Yin (deficiency)Blood deficiencyStagnationQi deficiencyYang (deficiency)DampHeart-FireExcess HeatHeat |
Middle—Liver | left | middle |  Liver Lv Gall Bladder GB | Superficial—Lr Blood/Yin def, Lr Fire Middle—Home Deep—GB Qi def, GB damp Absent—Blocked/stag | Yin (deficiency)Blood deficiencyLiver-FireQi deficiencyDampStagnationExcess HeatHeat |
Proximal—Kidney TCM | left | proximal |  Kidney Ki | Middle—Ki blood/yin def Deep—Home Absent—Ki Qi/ yang def Blocked/stag | Blood deficiencyYin (deficiency)Qi deficiencyYang (deficiency)Stagnation |
Distal—Lung | right | distal |  Lung Lu | Skin—Lu Blood/Yin Def, Lu heat (infection) Superficial—Home Middle—Lu Qi/Yang def, Lu Damp Absent—Blocked/stag | Blood deficiencyYin (deficiency)Qi deficiencyYang (deficiency)Empty (deficiency)HeatExcess HeatDampStagnation |
Middle—Spleen | right | middle |  Spleen Sp | Superficial—St Yin def, St Fire Middle—Home Deep—Sp Qi/Yang def, Sp damp Absent—Blocked/stag | Yin (deficiency)Stomach-FireQi deficiencyYang (deficiency)DampStagnation |
Proximal—Kidney WM | right | proximal | Kidney Ki | Middle—Ki or Bl infection or inflammation, neck shoulder pain Deep—Home Absent—Blocked/stag | Stagnation |
Summary
Pulse Kinds
The 28 pulse qualities can be grouped into six groups of pulses with similar qualities :
- The Floating kind: Floating – Hollow – Leather
- The Deep kind: Deep – Firm – Hidden
- The Slow kind: Slow – Knotted
- The Rapid kind: Rapid – Hasty – Hurried – Moving
- The Empty kind: Empty – Weak – Fine – Minute – Soggy – Short – Scattered
- The Full kind: Full – Overflowing – Wiry – Tight – Long
It may help us to understand the nature of pulse qualities if we realize that they reflect different aspects of the pulse: for example, Slow and Rapid clearly refer to an irregularity of the rate of the pulse, while Knotted, Hasty and Intermittent refer to an irregularity of the rhythm.
Pulse aspects
These different aspects are:
- According to depth: Floating – Deep – Hidden – Firm – Leather
- According to rate: Slow – Rapid – Slowed-down – Hurried – Moving
- According to strength: Empty – Full – Weak – Scattered
- According to size: Overflowing – Fine – Minute
- According to length: Long – Short – Moving
- According to shape: Slippery – Choppy – Wiry – Tight
- According to rhythm: Knotted – Hasty – Intermittent
- Invasion of external Wind
- Yin deficiency (interior conditions)
- Invasion of external Wind
- Yin deficiency (interior conditions)
– Moving – Hollow – Firm