Pulse Diagnosis: Analysis of Pathological Pulse Patterns

1. Analysis of 28 Pulses (Independent Pulse Patterns)

① Pulse patterns primarily characterized by abnormal pulse positions — Floating, Weak, Hollow, Leather, Deep, Hidden, Firm, Short, Long

Concept of “abnormal pulse position”: Refers to changes in the position of the pulse body, such as vertical or horizontal shifts. For example:

1) Floating Pulse (Fu Mai): Characteristics — easily felt with light pressure, insufficient with heavy pressure. Indicates exterior syndrome or deficiency syndrome.

2) Weak Pulse (Ru Mai): Characteristics — floating and fine, does not withstand heavy pressure, not evident with heavy pressure. Indicates deficiency syndrome or dampness syndrome.

Analysis of Weak Pulse: The pulse is superficial, easily felt with light pressure; the pulse body is thin like a thread; the pulse vessel lacks elasticity.

3) Deep Pulse (Chen Mai): Characteristics — not felt with light pressure, only felt with heavy pressure. Indicates interior syndrome.

Analysis of Deep Pulse: The pulse is located deep, cannot be felt with light or moderate pressure, only with heavy pressure.

4) Short Pulse (Duan Mai): Characteristics — both ends are short, cannot fill the entire area. Indicates qi deficiency.

Analysis of Short Pulse: Only noticeable at the Guan position, unclear or not noticeable at the Cun and Chi positions.

5) Long Pulse (Chang Mai): Characteristics — straight at both ends, exceeds its normal position. Indicates a long and strong pulse is excess evil qi. A long and soft pulse is a normal pulse.

Analysis of Long Pulse: The pulse vessel extends beyond the Cun, Guan, and Chi positions, the pulse body is long and straight.

6) Hollow Pulse (Kao Mai): Characteristics — floating, large, and hollow, like pressing on a scallion tube. Indicates blood loss or yin injury.

Analysis of Hollow Pulse: The pulse is floating, easily felt with light pressure; the pulse shape shows vessels on the upper, lower, and both sides, but is hollow in the middle.

7) Leather Pulse (Ge Mai): Characteristics — floating and broad, hollow inside but firm outside, like pressing on a drum skin. Indicates severe deficiency of essence and blood, with yang qi floating outward.

Analysis of Leather Pulse: The pulse is floating, easily felt with light pressure; the outer layer of the pulse vessel is hard but the middle is empty and does not respond to pressure; the entire pulse vessel feels like pressing on a drum skin.

8) Hidden Pulse (Fu Mai): Characteristics — requires heavy pressure to feel, may be hidden and not felt; deeper than the deep pulse. Indicates evil blockage; syncope; extreme pain.

Analysis of Hidden Pulse: Requires significant pressure to feel the pulse, and may still be difficult to detect.

9) Firm Pulse (Lao Mai): Characteristics — combines features of deep, wiry, full, large, and long pulses, firm and unyielding. Indicates internal cold and fullness; hernia symptoms.

Analysis of Firm Pulse: Analysis of deep, wiry, full, and long pulses. The “large pulse” feature indicates a wide pulse body, but the pulse does not surge.

② Pulse patterns primarily characterized by abnormal pulse rates — Rapid, Fast, Slow, Leisurely

Concept of “abnormal pulse rate”: Refers to the speed of the pulse beats per minute being above or below normal. For example:

10) Rapid Pulse (Shu Mai): Characteristics — rapid pulse rate, 90-139 beats/minute (5 or more beats per breath), regular rhythm. Indicates heat syndrome. (“One breath” refers to the time of one inhalation and exhalation of a normal person.)

11) Slow Pulse (Chi Mai): Characteristics — slow pulse, less than 4 beats per breath, regular rhythm. Indicates cold syndrome.

12) Fast Pulse (Ji Mai): Characteristics — urgent and fast pulse, 7-8 beats per breath (over 140 beats/minute). Indicates yang counteracting yin, vital energy about to escape.

13) Leisurely Pulse (Huan Mai): Characteristics — 4 beats per breath, slow and relaxed pulse shape, lacking sufficient tension; pulse rate slightly slower than normal but faster than slow pulse, indicates dampness syndrome; spleen and stomach deficiency; after prolonged illness and treatment, indicates recovery of vital qi.

③ Pulse patterns primarily characterized by abnormal pulse rhythms — Surging, Knotted, Intermittent.

Concept of “abnormal pulse rhythm”: Refers to irregular pulse beats. For example:

14) Surging Pulse (Cu Mai): Characteristics — urgent and irregular, with intermittent pauses. Indicates excessive yang heat.

Analysis of Surging Pulse: Rapid pulse rate, greater than 90 beats/minute, with irregular pauses.

15) Knotted Pulse (Jie Mai): Characteristics — slow pulse with intermittent stops, stops are irregular. Indicates excess yin, qi stagnation, cold phlegm, blood stasis, accumulation of food, etc.

Analysis of Knotted Pulse: Slow pulse with irregular pauses, pulse rate less than or equal to 90 beats/minute, with irregular rhythm.

16) Intermittent Pulse (Dai Mai): Characteristics — pulse stops intermittently, with a fixed number of stops, takes a long time to return. Indicates weak organ qi, pain, fright, trauma.

Analysis of Intermittent Pulse: Normal pulse rate, 60-90 beats/minute. Regular pauses in rhythm.

④ Pulse patterns primarily characterized by abnormal pulse shapes — Flooding, Thin, Slippery, Rough, Wiry, Tight

Concept of “abnormal pulse shape”: Refers to the pulse feeling abnormal in shape during beats, including amplitude and speed of rise and fall, smoothness of surface, elasticity, volume, and area under the fingers. For example:

17) Flooding Pulse (Hong Mai): Characteristics — wide pulse body, resembling a flood, strong on arrival and weak on departure. Indicates excessive yang heat, residual yang escaping.

Analysis of Flooding Pulse: Wide pulse body; large amplitude; very fast rise and fall like “a strong surge on arrival and a slow retreat”; pulse beats strongly and not weakly.

18) Thin Pulse (Xi Mai): Characteristics — thin pulse body, resembling a thread, responds clearly to pressure. Indicates deficiency syndrome or dampness syndrome.

Analysis of Thin Pulse: When the pulse beats, the fingers feel the pulse body is thin like a thread, with a fine line sensation.

19) Slippery Pulse (Hua Mai): Characteristics — pulse comes and goes smoothly and roundly, like beads rolling, responds smoothly. Indicates phlegm syndrome, food accumulation, excess heat syndrome (can also be seen in normal individuals and pregnant women).

Analysis of Slippery Pulse: When the pulse beats, the fingers feel the pulse comes smoothly, flowing freely; like beads rolling quickly, with a smooth surface.

20) Rough Pulse (Se Mai): Characteristics — difficult to come and go, feels rough and stagnant (opposite of slippery pulse), like “a light knife scraping bamboo”. Indicates rough and strong for excess syndrome, blood stasis, food accumulation, phlegm obstruction; rough and weak for essence injury, blood deficiency.

Analysis of Rough Pulse: When the pulse beats, there is no smooth feeling, the pulse flows as if it is difficult to pass, with a fine serrated feeling on the surface.

21) Wiry Pulse (Xian Mai): Characteristics — straight and long, like pressing a guitar string. Indicates liver and gallbladder disease, pain, phlegm fluid, malaria.

Analysis of Wiry Pulse: The pulse vessel is long and straight; under the fingers, it feels like a guitar string, with slightly higher tension.

22) Tight Pulse (Jin Mai): Characteristics — pulse comes tight and urgent, resembling a twisted rope. Indicates cold syndrome, pain syndrome, food stagnation in the gastrointestinal tract.

Analysis of Tight Pulse: The pulse body has high tension, when beating, the fingers feel the pulse flowing in a rotating manner, with strong response under the fingers.

23) Moving Pulse (Dong Mai): Characteristics — pulse shape like a bean, slippery and short, trembling and shaking, especially noticeable at the Guan position. Indicates pain syndrome, fright.

Analysis of Moving Pulse: The noticeable feeling of the pulse is mainly at one position, often seen at the Guan position (i.e., short); smooth surface, fast speed (i.e., slippery and rapid); when beating, it feels like a bean jumping.

⑤ Pulse patterns primarily characterized by abnormal pulse strength — Full, Empty, Weak, Minute, Scattered

Concept of “abnormal pulse strength”: Refers to changes in the momentum and strength of the pulse.

24) Full Pulse (Shi Mai): Characteristics — strong at the Cun, Guan, and Chi positions, with a feeling of fullness. Indicates excess syndrome.

Analysis of Full Pulse: The pulse body is long and large, with a feeling of fullness, strong pulse strength at the Cun, Guan, and Chi positions.

25) Empty Pulse (Xu Mai): Characteristics — when the pulse beats, there is a feeling of emptiness and weakness. Indicates deficiency syndrome.

Analysis of Empty Pulse: The pulse strength is weak, with a feeling of emptiness; lifting, pressing, and searching all feel weak.

26) Weak Pulse (Ruo Mai): Characteristics — extremely soft and weak. Indicates deficiency of qi and blood; yang deficiency.

Analysis of Weak Pulse: The pulse beats deeply (i.e., deep pulse), when beating, the fingers feel the pulse body is thin like a thread (i.e., thin pulse); the pulse elasticity is soft; the pulse strength is extremely weak.

27) Minute Pulse (Wei Mai): Characteristics — pulse shape is tiny, pulse strength is weak, almost imperceptible. Indicates severe deficiency of qi and blood; yang qi is weak.

Analysis of Minute Pulse: The pulse beats like a fine line, lacking strength and energy, almost imperceptible.

28) Scattered Pulse (San Mai): Characteristics — floating and scattered without root, slightly pressed and it disappears, with irregular beats.

Analysis of Scattered Pulse: The pulse beats are floating (i.e., easily felt with light pressure), with slight pressure causing the pulse to be undetectable; the pulse beats are irregular, varying within different “breaths”.

2. Strange Pulses:Including critical pulses, often seen in heart disease, heart failure, arrhythmia, such as Boiling Pot Pulse, Leaky Roof Pulse, Bird Pecking Pulse, Knotted Rope Pulse, Fish Swimming Pulse, Shrimp Swimming Pulse, Stone Bouncing Pulse.

3. Combined Pulses

① Concept of “combined pulses”: Combined pulses refer to independently named pulse patterns that are seen together, such as: floating tight, floating leisurely, floating rapid, floating slippery, deep slow, wiry rapid, slippery rapid, flooding rapid, deep wiry, deep rough, wiry thin, deep leisurely, deep thin, wiry slippery, etc.

② Main diseases of combined pulses: A combination of the main diseases of each pulse. For example: floating rapid = floating pulse + rapid pulse, indicating exterior heat.

Pulse Diagnosis: Analysis of Pathological Pulse Patterns

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