The twenty-eight pulses refer to the twenty-four meridians of the left and right hands and feet, plus the Ren (任) and Du (督) meridians, as well as the Yin Qiao (阴蹻) and Yang Qiao (阳蹻) meridians, totaling twenty-eight meridians.
Twenty-Eight Pulse Types and Their Associated Conditions:
1. Floating Pulse (Fu Mai)
Pulse Characteristics: Easily felt with light pressure, slightly diminished with heavy pressure, but not empty. The “Pulse Classic” states: “Easily felt with a light touch, floating on top like wood floating on water.” The “Three Flavors of Diagnosis” also mentions: “Diminishes slightly upon pressure but is not empty, floating and smooth when lifted.”
Main Conditions: (1) Exterior syndrome: A strong floating pulse indicates an exterior excess, while a weak floating pulse indicates an exterior deficiency.
(2) Interior deficiency: Tuberculosis with Yin deficiency, Yang Qi deficiency.
2. Surging Pulse (Hong Mai)
Pulse Characteristics: Broad and large pulse, easily felt with light pressure, strong on the rise and weak on the fall, resembling surging waves. The “Binhai Pulse Studies” states: “Extremely large under the fingers, strong on the rise and weak on the fall, large on the rise and long on the fall.”
Main Conditions: Indicates excess Yang heat syndrome. Commonly seen in the peak stage of externally contracted febrile diseases, with symptoms such as high fever, thirst, sores, and a red tongue with yellow coating, and the pulse is often strong.
3. Hollow Pulse (Kao Mai)
Pulse Characteristics: Floating, large, and soft, with a hollow feeling in the center, like pressing on a scallion tube. The “Pulse Studies Misinterpretation” states: “Hollow grass, its leaves resemble scallions, with a hollow center.” The “Pulse Classic” states: “Hollow pulse is floating, large, and soft, with a hollow center and solid sides.”
Main Conditions: Indicates blood loss and Yin injury. Commonly seen after severe bleeding or violent vomiting and diarrhea leading to loss of body fluids.
4. Leather Pulse (Ge Mai)
Pulse Characteristics: Floating, large, and beats against the fingers, firm on the outside and hollow on the inside, like pressing on a drum skin. It is a floating pulse that feels tense and urgent, firm on the surface but hollow inside, similar to the sensation of pressing on a drum skin.
Main Conditions: Indicates blood loss, loss of essence, postpartum issues, and metrorrhagia.
5. Soft Pulse (Ru Mai, also known as Weak Pulse)
Pulse Characteristics: Floating, fine, and soft, easily felt with light pressure, but not prominent with heavy pressure, like fluff floating on water.
Main Conditions: Indicates deficiency syndrome; often associated with dampness as a pathogenic factor.
6. Scattered Pulse (San Mai)
Pulse Characteristics: Scattered and ungraspable, floating without a root, with an unclear rhythm. Zhang Lu’s “Zhang’s Medical Communication” states: “Floating and scattered when lifted, absent when pressed, unclear in rise and fall, aimless without roots.” The “Binhai Pulse Studies” likens it to “flowers scattering and flying in the wind.”
Main Conditions: Indicates scattered Yuan Qi. Represents Yang deficiency that fails to consolidate, with Qi and blood depletion, and exhaustion of the organs’ essence, especially in critical conditions where kidney Qi is about to fail. In pregnant women, a scattered pulse indicates a risk of miscarriage.
7. Deep Pulse (Chen Mai)
Pulse Characteristics: Not felt with light pressure, but can be felt with heavy pressure. The “Pulse Classic” states: “Deep pulse is insufficient when lifted, but strong when pressed.” The “Pulse Studies Misinterpretation” points out: “Not felt with a light touch on the skin, but responds when pressed to the middle of the muscle, and is strong when pressed to the bone.” This indicates that the deep pulse is felt in the middle of the muscle and is strong at the bone level.
Main Conditions: Indicates interior syndrome.
(1) A strong deep pulse indicates an interior excess syndrome, often due to water, cold, or stagnation. Commonly seen in diarrhea, edema, vomiting, food stagnation with heat, Qi stagnation, etc.
(2) A weak deep pulse indicates an interior deficiency syndrome, often due to weak Yang Qi that fails to regulate Qi externally, or due to blood loss and Yin deficiency.
Today, we introduced seven pulse types; tomorrow we will introduce the remaining seven pulse types: Fu (伏), Lao (牢), Chi (迟), Huan (缓), Se (涩), Jie (结), and Dai (代). Remember to tune in!
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