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 |
|---|---|---|---|---|---|
Invasion of external Wind Yin deficiency (interior conditions) | This pulse can be felt with a light pressure of the fingers, just resting the fingers on the artery. | Floating Deep Slow Rapid Empty Full | depth rate strength size length shape rhythm | ||
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 | depth rate strength size length shape rhythm | ||
Cold patternEmpty-Cold (Slow and Weak) Full-Cold (Slow and Full) | This pulse has three beats per respiration cycle | Slow | rate | ||
Heat pattern Full-Heat (Rapid and Full) Empty-Heat (Rapid and Floating-Empty) | This pulse has more than five beats per each respiration cycle | Rapid | rate | ||
Qi deficiency | The Empty pulse feels rather big but soft. | Empty | strength | ||
Full pattern Full-Heat (Full-Rapid) Full-Cold (Full-Slow) | This pulse feels full, rather hard and rather long. | Full | strength | ||
Phlegm Dampness Retention of food Pregnancy | A Slippery pulse feels smooth, rounded, slippery to the touch, as if it were oily. It slides under the fingers. | Other | shape | ||
Blood deficiency Exhaustion of Body Fluids | This pulse feels rough under the finger | Other | shape | ||
Heat pattern | This pulse is basically longer than normal | Full | length | ||
Severe Qi deficiency Stomach-Qi deficiency | Occupies a shorter space than the normal position | Empty | length | ||
Full-Heat Empty-Heat (Overflowing-Empty) | This pulse feels big, extending beyond normal pulse position. | Full | size | ||
Blood deficiency Dampness with severe Qi deficiency | This pulse is thinner than normal | Empty | size | ||
Severe deficiency of Qi and Blood | It is extremely thin, small and difficult to feel | Empty | size | ||
Cold Exterior 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 | ||
Liver disharmony Pain Phlegm | This pulse feels taut like a guitar string. The Wiry pulse really hits the fingers. | Other | shape | ||
G | This pulse has four beats for each respiration cycle | Slow | rate | ||
Haemorrhage Forthcoming haemorrhage (Hollow and Rapid) | Empty in the middle, felt superficial and deep. | Floating | shape | ||
Severe deficiency of Kidney-Essence Severe 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 | ||
Blood stasis Interior Cold (Firm and Slow) Pain | Wiry pulse at the deep level | Deep | shape | ||
Dampness with Qi deficiency Deficiency of Yin Deficiency of Essence | The Soggy pulse feels very soft and is only slightly floating. | Empty | other | ||
Yang deficiency Blood deficiency | Felt only at the deep level | Empty | strength | ||
Severe deficiency of Qi and Blood Severe deficiency of Kidney-Qi Serious condition | This pulse feels very small and is relatively superficial | Empty | strength | ||
Severe Yang deficiency | This pulse feels as if it were hidden beneath the bone | Deep | depth | ||
Shock anxiety fright pain | The Moving pulse has a round shape like a bean; it is short and it ‘trembles’ under the finger | Rapid | length | ||
Severe Heat Deficiency of Heart-Qi Heart-Fire | This pulse is Rapid and it stops at irregular intervals | Rapid | rhythm | ||
Cold with deficiency of Heart-Yang | This pulse is Slow and it stops at irregular intervals | Slow | rhythm | ||
Serious problem in Internal Organ Heart problem (in Western medical sense) | This pulse stops at regular intervals | Other | rhythm | ||
Fire exhausting Yin | This pulse is very rapid, but it also feels very agitated and urgent | Rapid | rate |
Pulse Positions
| Name | Side | Position | Organ | Overview | Body Psych |
|---|---|---|---|---|---|
left | distal | Skin—Ht Blood/Yin Def, Ht
Fire/Stagnation
Superficial—Home
Middle—Ht Qi/Yang def, Damp affecting Ht
Absent—Blocked/stag | |||
left | middle | Superficial—Lr Blood/Yin def, Lr Fire
Middle—Home
Deep—GB Qi def, GB damp
Absent—Blocked/stag | |||
left | proximal | Middle—Ki blood/yin def
Deep—Home
Absent—Ki Qi/ yang def Blocked/stag | |||
right | distal | Skin—Lu Blood/Yin Def, Lu heat (infection)
Superficial—Home
Middle—Lu Qi/Yang def, Lu Damp
Absent—Blocked/stag | |||
right | middle | Superficial—St Yin def, St Fire
Middle—Home
Deep—Sp Qi/Yang def, Sp damp
Absent—Blocked/stag | |||
right | proximal | Middle—Ki or Bl infection or inflammation, neck shoulder pain
Deep—Home
Absent—Blocked/stag |
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