Summary of Traditional Chinese Diagnosis 06
Pulse Diagnosis
（一）Characteristics of Normal Pulse
There is a stomach—calm, gentle, and smooth.
There is spirit—pulse rhythm is regular, soft yet strong.
There is root—radial pulse is strong, deep and continuous.
（二）28 Pulse Types
1. Floating Pulse Types: Easily felt with light pressure. (Fu Hong Ru San Kao Ge)
(1) Floating: More pronounced with light touch, less with pressure. Exterior syndrome, also seen in Yang deficiency with floating Yang.
(2) Hong: Pulse is wide, full, and strong, with a strong arrival and weak departure. Heat in the Yangming Qi level.
(3) Ru: Floating, fine, weak, and soft. Deficiency syndrome, dampness obstruction.
(4) San: Floating, scattered, and without root, rapid and uneven pulse strength. Dispersed Yuan Qi, righteous Qi about to collapse.
(5) Kao: Floating, large, hollow, like pressing on a scallion tube. Blood loss, Yin injury.
(6) Ge: Floating, large, pressing hard, hollow inside and firm outside, like pressing on a drum skin. Blood loss, loss of essence, postpartum, menorrhagia, Yang Qi floating outside.
2. Deep Pulse Types: Felt only with heavy pressure. (Chen Fu Lao Ruo)
(1) Chen: Not felt with light touch, only with heavy pressure. Interior syndrome (can be deficiency or excess), also seen in healthy individuals.
(2) Fu: Felt only with heavy pressure to the tendons and bones. Pathogenic obstruction, syncope, extreme pain.
(3) Lao: Deep, full, large, taut, and long. Excessive Yin cold, hernia, and accumulation.
(4) Ruo: Deep, fine, weak, and soft. Yang Qi deficiency, both Qi and blood deficiency.
3. Slow Pulse Types: Less than four beats per breath. (Chi Huan Se Jie)
(1) Chi: Less than four beats per breath. Cold syndrome (can be deficiency or excess), pathogenic heat accumulation (such as Yangming organ excess syndrome).
(2) Huan: Four beats per breath, pulse is slow. Dampness disease, spleen and stomach deficiency, also seen in healthy individuals.
(3) Se: Pulse is difficult and sluggish. Qi stagnation, blood stasis, essence injury, blood deficiency.
(4) Jie: Slow with intermittent stops, stops are irregular. Excessive Yin, Qi stagnation, cold phlegm and blood stasis, accumulation of masses, Qi and blood deficiency.
4. Rapid Pulse Types: More than five beats per breath. (Shu Cu Ji Dong)
(1) Shu: More than five beats per breath, less than seven. Heat syndrome, also indicates interior deficiency syndrome.
(2) Cu: Rapid with intermittent stops, stops are irregular. Excessive Yang heat, Qi stagnation, blood stasis, phlegm retention, food accumulation, swelling and abscess (organ failure).
(3) Ji: Pulse is rapid, with seven to eight beats per breath. Extreme Yang, Yin exhaustion, Yuan Qi about to escape.
(4) Dong: Pulse is short like a bean, trembling and shaking, slippery and rapid with strength. Pain, fright.
5. Deficient Pulse Types: Weak response to pressure. (Xu Wei Xi Dai Duan)
(1) Xu: Three positions of the pulse are weak and empty upon pressure. Deficiency syndrome: both Qi and blood deficiency.
(2) Wei: Extremely fine and soft, almost imperceptible. Severe Qi and blood deficiency, Yang Qi weak.
(3) Xi: Pulse is fine like a thread, response is obvious; Qi and blood deficiency, dampness syndrome. Similar pulses: Ru pulse, Ruo pulse, Wei pulse.
(4) Dai: Slow and stops intermittently, stops are regular. Organ Qi weak, Pain, fright, trauma.
(5) Duan: Both ends are short, not reaching the main position. Strong indicates Qi stagnation, weak indicates Qi deficiency.
6. Excess Pulse Types: Strong response to pressure. (Shi Hua Jin Chang Xian)
(1) Shi: Strong and full upon pressure. Excess syndrome, healthy individuals.
(2) Hua: Smooth and flowing, response is round and smooth. Phlegm dampness, food accumulation, excess heat, young adults, pregnant women.
(3) Jin: Taut and tense, like a twisted rope. Excessive cold syndrome, pain, food accumulation (retained food).
(4) Chang: Ends are straight, exceeding the main position. Yang syndrome, heat syndrome, excess syndrome, healthy individuals.
(5) Xian: Straight and long, like pressing on a string. Liver and gallbladder disease, pain, phlegm retention, weak stomach Qi, elderly health.
（三）Combined Pulses
1. Floating Pulse Combined:
(1) Floating and tense pulse: Exterior cold syndrome, wind-cold bi pain.
(2) Floating and slow pulse: Wind pathogen injuring the defensive Qi, disharmony of Ying and Wei, Taiyang wind syndrome.
(3) Floating and rapid pulse: Exterior heat syndrome.
(4) Floating and slippery pulse: Exterior syndrome with phlegm, constitutionally phlegm-prone and re-exposed to external pathogens.
2. Slow Pulse Combined:
(1) Deep and slow pulse: Interior cold syndrome.
(2) Deep and taut pulse: Liver Qi stagnation, water retention.
(3) Deep and rough pulse: Cold coagulation and blood stasis.
(4) Deep and slow pulse: Spleen and kidney Yang deficiency, water dampness retention.
(5) Deep, fine, and rapid pulse: Yin deficiency with internal heat, blood deficiency.
3. Taut Pulse Combined:
(1) Taut and tense pulse: Cold syndrome, pain syndrome.
(2) Taut and rapid pulse: Liver Qi stagnation transforming into fire, liver and gallbladder damp-heat, liver Yang hyperactivity.
(3) Taut and slippery rapid pulse: Liver fire with phlegm, liver and gallbladder damp-heat.
(4) Taut and fine pulse: Liver and kidney Yin deficiency, blood deficiency with liver Qi stagnation, liver Qi stagnation with spleen deficiency.
4. Rapid Pulse Combined:
(1) Slippery and rapid pulse: Phlegm heat (fire), damp-heat, food accumulation transforming into heat.
(2) Hong and rapid pulse: Yangming channel syndrome, heat in the Qi level.
(3) Floating and rapid pulse: Exterior heat syndrome.
(4) Taut and rapid pulse: Liver Qi stagnation transforming into fire, liver and gallbladder damp-heat, liver Yang hyperactivity.
（四）True Organ Pulses—“Ten Strange Pulses”
Seven Absolute Pulses: No stomach pulse, turning bean pulse, hemp rapid pulse.
1. No Stomach Pulse: No harmony, should be strong and beating.
① No stomach pulse: Pulse comes rapid and taut, like following a knife edge.
② Turning bean pulse: Pulse is short and strong, like following a coix seed.
③ Stone pulse: Rapid and strong, like pressing on a stone. ①②③ Pathogenic excess, righteous Qi weak, stomach Qi cannot follow, heart, liver, kidney, and other organ Qi manifest alone, critical condition.
2. No Spirit Pulse: Irregular pulse rhythm, pulse shape scattered.
① Bird pecking pulse: Pulse between muscles is rapid and irregular, stopping and starting like a bird pecking food.
② Leaky roof pulse: Like a leaky roof dripping, for a long time a drop.
③ Untying knot pulse: Pulse comes and goes, sometimes sparse and sometimes dense, like a tangled rope, sometimes fast and sometimes slow, scattered and disordered.
①②③ Spleen and kidney Yang Qi defeated, spirit Qi scattered, life about to end.
④ Hemp rapid pulse: Pulse comes like scattered hemp seeds, extremely fine. — Defensive Qi exhausted, Ying blood stagnated, critical condition.
3. No Root Pulse: Weak and large without root or weak and unresponsive.
①【Boiling pot pulse】extremely floating and rapid, to the point of being uncountable, like boiling water in a pot, floating and without root. — Three Yang heat extreme, Yin fluids exhausted.
②【Fish swimming pulse】pulse at the skin, head steady and tail shaking, seeming to exist and not exist, like a fish swimming in water. — Three Yin cold extreme, Yang lost to the outside, floating Yang escaping.
③【Shrimp swimming pulse】pulse at the skin, like a shrimp swimming in water, sometimes leaping away, sometimes returning, accompanied by rapid agitation. — Isolated Yang without support, restlessness.
（五）Pressing the chest, ribs, skin, hands and feet, and acupoints
1. Pressing the chest and ribs:
(1) Weak movement in the interior responds to clothing: Zong Qi leaking out.
(2) Pressing produces a strong and large pulse or stops and does not respond: Heart and lung Qi exhausted, critical condition.
(3) Weak movement in the interior with rapid beats and intermittent stops: Zong Qi not contained.
(4) Weak movement in the interior “wants to stop” but no dead pulse: Phlegm retention.
2. Pressing the skin:
(1) Heat at the surface (Wei level): Body heat initially feels very hot, but after prolonged pressure, heat diminishes.
(2) Heat in the interior: Prolonged pressure increases heat.
(3) Body heat not rising: Skin initially feels not very hot, but after prolonged pressure, it feels burning hot, indicating damp-heat accumulation.
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