PULSE DIAGNOSIS

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I. General Information



A. Positions



1. “ INCH” -CUN- Most distal

R- Lu/L.I.

L- He/S.I.

2. “ BAR” -GUAN- middle

R- St/Sp

L- Liv/G.B

3. “CUBIT”-CHI-Most proximal

R- Kidney Yang

L- Kidney Yin



B. Levels

1. SUPERFICIAL- External Attack

2. MIDDLE- ST/Sp pathology ( Middle Jiao)

3. DEEP- Internal Injury or disease


C. Main Characteristics

1. Rate- Indicates Heat or Cold; normal is 4-5 beats per breath

2. Force- relative force of the pulse flow indicates strength of the Qi

3. Constraint- indicates lack of free-flow, String taut pulse indicates Qi or Blood stagnation

4. Shape- (Fat or thin) indicates excess or deficiency of either Qi or Blood

5. Length- Short indicates deficiency of Blood; deficiency or damage

in general. Long means abundance of Qi.

6. Depth- refers to the level at which the pulse qualities are most pronounced.


D. Normal Pulses

1. Heart- Superficial level pulse feels big and scattered; gets rougher as you press down, but remains broad, big.

2. Lung- Superficial, feels choppy and short

3. Liver- deep, the pulse feels wiry, taut

4. Kidney- Deep, feels, full, strong, slippery

5. Spleen- regular in middle position; gentle, relatively slow, with

"Spirit" and "Root"

E. General Rules For Pulse taking

1. Best to take the pulse in the morning, before the Yang emerges

2. Patient should be calm, lying down.

3. Drugs, alcohol, food, exercise, traffic, can all effect pulse; to be accurate, the patient must rest for some time.

4. At least five beats at each level to establish a pattern.

5. Pulse will change throughout the day

6. Arm should be level, not held higher than the heart

7. The normal pulse of pregnancy is full and Rolling

8. Pulse is more superficial in summer, deeper in winter

9. Men's dominant pulse:Left; Women's dominant pulse: Right

II. Pulse Qualities

1. SUPERFICIAL ( FLOATING)- (FU MAI)

- external Excess; pure and slightly rising, like
wood floating on water. “ Felt moving above the muscle”
a. HONG MAI-( Overflowing/Surging); Excess pulse; indicates heat, a big, rough body, rises and falls like a large wave

b. XIAN MAI- WIRY (STRING TAUT); Liver Qi stagnation; also indicates pain. Excess. Feels taut like a guitar string

c. HUA MAI- SLIPPERY (ROLLING) Phlegm or dampness accumulation. Feels smooth, rounded and slippery to the touch. Oily, slides under fingers.

d. RUO MAI- SOGGY/SOFT/ WEAK-FLOATING; soft, palpable near the surface, but disappears when more pressure is applied.

Qi Xu with Dampness

2. DEEP- (CHEN MAI)-

Can only be felt with heavy pressure, near the bone;
In general, indicates an Internal Injury; implies Zang viscera are affected..

a. XU MAI- EMPTY/DEFICIENT Typically Deep; usually deficiency of QI and Yang. Feels big, but soft; lacks resistance, elasticity of vessel wall.

1. XI MAI- THREADY; Blood deficiency

2. RU MAI- SHORT; Qi Deficiency; espec. Stomach

3. RUO MAI- WEAK; short, deep, weak- Yang Xu or Xue Xu

b. EXCESS (SHI MAI) and Deep, accumulation, usually of cold,
or stagnation of Qi or Blood.

1. JIN MAI- TIGHT; Interior cold, or stagnation

2. SLOW (CHI MAI) -

usually indicates Cold; can be excess or deficient

Three beats/per respiration



a. HUAN MAI- LEISURELY; even in all respects, usually about four beats per breath. When this pulse has Spirit and Root, it is considered good health. When it is lacking, it usually indicates Dampness.



b. SE MAI- CHOPPY, can be slow or rapid, with rough, thin, uneven beats at surface; if lacking Spirit indicates Blood Deficiency; if spirited Blood stagnation.

c. JIE MAI- KNOTTED; leisurely with irregularly missed beats;

usually indicates Heart Yang Deficiency; usually Deficient

d. DAI MAI- REGULARLY INTERMITTENT; leisurely and weak with regular pauses, indicates serious problem , decline, or failure of one or more Zang.

4. RAPID (SHU MAI)-

usually indicates Heat, can be excess or deficient;

five or more beats per breath.

a. HONG MAI- SURGING



b. CU MAI- ABRUPT. Excess Yang has damaged Yin. Irregular.

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5. WEAK/DEFICIENT

a. RU-SOGGY



b. KOU-HOLLOW- Felt at superficial level, and again at deep level, but empty in the middle. Also called Scallion Stalk. Indicates Desertion or sudden loss of blood.



c. GE- LEATHER- hard and tight at surface, like a stretched drum skin, but empty below. It is large, not thin, and indicates severe depletion of Kidney Yin or Essence. This seen more and more commonly in chronic immune compromised situations, especially caused by toxicity like environmental toxin or heavy metal.



d. XI MAI- FINE/THREADY



e. RU MAI- SHORT



f.. RUO MAI- WEAK



g. WEI MAI- Minute- fine thready, but extremely weak



h FU MAI- HIDDEN; very, very deep; very, very weak



6. STRONG/EXCESS



A XIAN-WIRY



B. HONG- OVERFLOWING



C. HUA- SLIPPERY



D. CHANG-LONG



E. JIN- TIGHT





III. EXCESS AND DEFICIENCY



A. EXCESS



1. Superficial



2. Excess



3. Surging



4. Slippery



5. Wiry



6. Tense



7. Choppy



B. DEFICIENT

1. Deep


2. Deficient


3. Thready


4. Choppy


5. Soft


6. Weak

7. Abrupt

8. Knotted

9. Regularly Intermittent

This information comes from David Cohen's Traditonal Chinese Theory Notes.