Pulse

Table of contents

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

Pulse

NameClinical SignificanceFeelingKindAspectBody Psych
Floating (Fu)
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
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
depth rate strength size length shape rhythm
Slow (Chi)
Cold patternEmpty-Cold (Slow and Weak) Full-Cold (Slow and Full)
This pulse has three beats per respiration cycle
Slow
rate
Rapid (Shu)
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
Empty (Xu)
Qi deficiency
The Empty pulse feels rather big but soft.
Empty
strength
Full (Shi)
Full pattern Full-Heat (Full-Rapid) Full-Cold (Full-Slow)
This pulse feels full, rather hard and rather long.
Full
strength
Slippery (Hua)
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
Choppy (Se)
Blood deficiency Exhaustion of Body Fluids
This pulse feels rough under the finger
Other
shape
Long (Chang)
Heat pattern
This pulse is basically longer than normal
Full
length
Short (Duan)
Severe Qi deficiency Stomach-Qi deficiency
Occupies a shorter space than the normal position
Empty
length
Overflowing (Hong)
Full-Heat Empty-Heat (Overflowing-Empty)
This pulse feels big, extending beyond normal pulse position.
Full
size
Fine (Xi)
Blood deficiency Dampness with severe Qi deficiency
This pulse is thinner than normal
Empty
size
Minute (Wei)
Severe deficiency of Qi and Blood
It is extremely thin, small and difficult to feel
Empty
size
Tight (Jin)
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
Wiry (Xian)
Liver disharmony Pain Phlegm
This pulse feels taut like a guitar string. The Wiry pulse really hits the fingers.
Other
shape
Slowed-down (Huan)
G
This pulse has four beats for each respiration cycle
Slow
rate
Hollow (Kou)
Haemorrhage Forthcoming haemorrhage (Hollow and Rapid)
Empty in the middle, felt superficial and deep.
Floating
shape
Leather (Ge)
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
Firm (Lao)
Blood stasis Interior Cold (Firm and Slow) Pain
Wiry pulse at the deep level
Deep
shape
Soggy (or Weak-Floating) (Ru)
Dampness with Qi deficiency Deficiency of Yin Deficiency of Essence
The Soggy pulse feels very soft and is only slightly floating.
Empty
other
Weak (Ruo)
Yang deficiency Blood deficiency
Felt only at the deep level
Empty
strength
Scattered (San)
Severe deficiency of Qi and Blood Severe deficiency of Kidney-Qi Serious condition
This pulse feels very small and is relatively superficial
Empty
strength
Hidden (Fu)
Severe Yang deficiency
This pulse feels as if it were hidden beneath the bone
Deep
depth
Moving (Dong)
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
Hasty (Cu)
Severe Heat Deficiency of Heart-Qi Heart-Fire
This pulse is Rapid and it stops at irregular intervals
Rapid
rhythm
Knotted (Jie)
Cold with deficiency of Heart-Yang
This pulse is Slow and it stops at irregular intervals
Slow
rhythm
Intermittent (Dai)
Serious problem in Internal Organ Heart 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

Pulse Positions

Pulse positions

NameSidePositionOrganOverviewBody Psych
Distal—Heart
left
distal
Skin—Ht Blood/Yin Def, Ht Fire/Stagnation Superficial—Home Middle—Ht Qi/Yang def, Damp affecting Ht Absent—Blocked/stag
Middle—Liver
left
middle
Superficial—Lr Blood/Yin def, Lr Fire Middle—Home Deep—GB Qi def, GB damp Absent—Blocked/stag
Proximal—Kidney TCM
left
proximal
Middle—Ki blood/yin def Deep—Home Absent—Ki Qi/ yang def Blocked/stag
Distal—Lung
right
distal
Skin—Lu Blood/Yin Def, Lu heat (infection) Superficial—Home Middle—Lu Qi/Yang def, Lu Damp Absent—Blocked/stag
Middle—Spleen
right
middle
Superficial—St Yin def, St Fire Middle—Home Deep—Sp Qi/Yang def, Sp damp Absent—Blocked/stag
Proximal—Kidney WM
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
  • – Moving – Hollow – Firm

  • According to rhythm: Knotted – Hasty – Intermittent
  • Invasion of external Wind
  • Yin deficiency (interior conditions)
  • Invasion of external Wind
  • Yin deficiency (interior conditions)