Clinically, it is essential to recognize the seven basic pulse types.
Floating indicates exterior; sinking indicates interior;
Slow indicates cold; regardless of external or internal cold, the pulse is slow. Slow is defined as less than 60 beats per minute.
Rapid indicates heat (regardless of excess heat, deficiency heat, low fever, or high fever); rapid is defined as more than 90 beats per minute;
Slippery indicates food stagnation, pregnancy, phlegm-dampness, or damp-heat;
Wiry indicates pain, liver and gallbladder Qi stagnation;
Thin pulse indicates deficiency of Qi and blood in the five organs and six bowels.
Floating pulse: Lightly felt, indicates an exterior pathogen, or if the exterior pathogen has not resolved, the pulse is floating and tight or floating and slippery. A floating pulse at the cun position indicates a quick recovery from a cold; generally, during a fever, all six positions are rapid, and the pulse is floating and rapid.
Sinking pulse: Lightly felt, not responsive; only felt with heavy pressure; insufficient when lifted, excessive when pressed. Especially if both chi positions are heavy, if heavy pressure does not yield a response, it indicates deficiency of Qi and blood in the five organs, corresponding to various positions. Generally, a sinking pulse with increased pressure is normal. If both cun positions cannot be felt with increased pressure, it indicates Qi deficiency; if not felt with heavy pressure, it indicates a critical condition.
Slow pulse: Less than 60 beats per minute, indicates deficiency of Yang Qi, and sluggish movement. For bradycardia, Western medicine has almost no effective treatment; after treatment with atropine, the patient may flush and have an increased heart rate. Traditional Chinese medicine (TCM) with Qiang Huo (Notopterygium) has good effects on slow arrhythmias, and Gui Zhi (Cinnamon Twig) can improve heart rhythm. Rapid pulse: More than 90 beats per minute. In Western medicine, a heart rate of 60-90 beats per minute is considered normal. However, clinically, when a patient’s pulse rate reaches 90 beats per minute, they often feel uncomfortable, experiencing palpitations.
Slippery pulse: Flows smoothly, like beads rolling on a plate, should feel round and smooth. The right cun position being slippery indicates phlegm-dampness, with the patient possibly having pharyngitis, tonsillitis, or upper respiratory infections, indicating issues above the right diaphragm. The left cun position being slippery indicates cardiovascular diseases, palpitations, and shortness of breath.
Wiry pulse: The pulse feels strong, like pressing a guitar string. In men, the pulse is wiry and strong, relatively soft; in elderly individuals, the pulse is wiry and hard, generally indicating arteriosclerosis and hypertension. In women, a wiry pulse may indicate dysmenorrhea or liver Qi stagnation, with generalized pain. Rough pulse: Thin and slow, with difficulty in flow, the pulse strength and rate are uneven, should feel like a light knife scraping bamboo, thus can be understood as an unflowing pulse. Generally indicates blood stasis, infertility. For example, girls with dysmenorrhea, especially with endometriosis or adenomyosis, often exhibit such changes.
Weak pulse: Lifts without strength, feels empty and soft when pressed, is a general term for all weak pulses. Weak pulse (thin pulse, sinking thin pulse): Like a thread or silk, indicating deficiency in the organs’ Qi and blood, Yin and Yang. Common symptoms for such individuals include fatigue and tiredness.
