The Pulse in TCM

Pulse diagnosis in TCM is an important part of palpation, which is one of the four main diagnostic methods (along wtih observation, listening-auscultation/ smelling-olfaction, and questioning-interrogation).

In TCM the radial pulse is felt in three positions, and three depths, bi-laterally. Each depth and position on either side of the body corresponds to a particular aspect or organ system in the patient. Besides speed, the pulse in TCM also indicates other qualities such as force, bredth, length, and rhythm. These qualities are designated by name, and carry special significance in a clinical setting. Accurate pulse diagnosis takes many years to develop. Initially distinctions regarding depth, speed, and force of the pulse are discerned. As the practitoner gains experience, a broader understanding of pulse patterns develops, and more information can be obtained through this form of palpation.

Historically it is said that very experienced practitioners were able to diagnose a patient without much conversation nor observation. Today, the pulse viewed from a TCM standpoint is often considered a method of verifying information obtained through other diagnostic methods. It can however independently reveal important information, such as the severity of pain or fatigue, the emotional state, or pregnancy.

Through a combination of the four diagnostic methods, information about the entire body/mind/environment is synthesised into a TCM Syndrome diagnosis. Along with a medical diagnosis of disease, the TCM syndrome diagnosis guides the treatment principles, and helps in the choice of appropriate acupuncture points, herbal medicines, or other treatment methods of TCM.

	English Pulse Name	Other English Names	Name in Chinese	Clinical Significance
1	Floating	Superficial	浮脉 fu2mai4	External syndrome Floating and Powerful= external, excess Floating and Weak= external, deficiency Chronic Internal deficiency
2	Scattered		散脉 san3mai4	Yuan Qi deficiency Jing Qi deficiency
3	Hollow		芤脉 kou1mai4	Loss of Blood Impairment of Yin
4	Sunken	Deep Sinking	沉脉 chen1mai4	Internal Syndrome
5	Slow		迟脉 chi1mai4	Cold Syndrome Slow and Powerful= excess cold Slow and Weak= deficiency cold Internal accumulation of Pathogenic Heat
6	Moderate	Relaxed	缓脉 huan3mai4	Damp Stomach and Spleen deficiency
7	Fast	Rapid	数脉 shuo4 (shu4) mai4	Heat Syndrome Fast and Powerful= heat excess Fast and Weak= deficiency heat Floating External Yang due to deficiency
8	Swift	Racing Hurried	疾脉 ji2mai4	Hyperactive Yang Uncontrolled Kidney Yin deficiency Yuan Qi depletion
9	Weak	Forceless Empty Deficient	虚脉 xu1mai4	Deficiency Syndrome
10	Powerful	Excess Full Replete Forceful	实脉 shi2mai4	Excess Syndrome
11	Slippery		滑脉 hua2mai4	Retention of Phlegm
12	Astringent	Choppy Hesitant	涩脉 se4mai4	Astringent and Powerful= qi stagnation and blood stasis Astringent and Weak= blood and essence deficiency
13	Full	Surging Flooding	洪脉 hong2mai4	Internal Heat
14	Thin	Thready	细脉 xi4mai4	Qi and Blood deficiency Overwork
15	Soft	Soggy	濡脉 ru2mai4	Qi and Blood deficiency Damp
16	Feeble	Weak	弱脉 ruo4mai4	Qi and Blood deficiency
17	Indistinct	Minute Faint	微脉 wei1mai4	Qi and Blood depletion Yang Qi deficiency
18	Taut	Wiry	弦脉 xian2mai4	Liver and Gallbladder Syndrome Pain Syndrome Retention of phlegm and fluid
19	Tense	Tight	紧脉 jin3mai4	Cold Syndrome Pain Syndrome Retention of Food
20	Rapid and Intermittent	Rapid-Irregular Skipping Abrupt	促脉 cu4mai4	Powerful= Hyperactivity of Yang Qi Stagnation Blood stasis Retention of Phlegm and food Weak= Organ Qi deficiency Blood deficiency
21	Slow and Intermittent	Knotted Bound	结脉 jie2mai4	Powerful= Predominance of Yin Qi Stagnation Blood Stasis Retention of Phlegm Weak= Qi and Blood deficiency
22	Slow – Intermittent – Regular		代脉 dai4mai4	Organ Qi deficiency Yuang Qi deficiency
23	Long		长脉 chang2mai4	Yang Syndrome Heat Syndrome Excess Syndrome
24	Short		短脉 duan3mai4	Short and Powerful= Qi Stagnation Short and Weak= Qi Deficiency