Symptoms 4, pulse

Below is a brief description of the pulse signs, with links to entries that provide more detail.

Depth

Floating pulse (浮脉 fú mài): Superabundant under a light touch but insufficient under heavy pressure. It occurs in exterior patterns. Also seen in vacuity yáng floating upward (upcast yáng).

Scattered pulse (散脉 sǎn mài): Also called dispersed pulse large floating pulse without root. It is large at the superficial level and lacking in force, ceasing to be felt when the slightest pressure is applied. It signifies dispersion of original qì and impending expiration of essential qì.

Scallion-stalk pulse (芤脉 kōu mài): A pulse in which the vessel feels empty in the middle like a scallion stalk. It means blood loss or damage to yīn.

Sunken pulse (沉脉 chén mài): Not felt under light pressure; only felt under heavy pressure. It occurs in interior patterns.

Hidden pulse (伏脉 fú mài): Only felt when heavy pressure against the sinew and bone is applied. It is observed in evil block, reversal disease, and extreme pain.

Confined pulse (牢脉 láo mài): Also called firm pulse. A pulse that is replete, large, stringlike, and long when pressed to the deep level. It indicates cold pain. The term is no longer used much and is replaced with sunken and replete.

Speed

Rapid pulse (数脉 shuò mài): More than 5 beats per respiration, but less than 7. It indicates heat. Also seen in qì vacuity.

Racing pulse (疾脉 jí mài): 7–8 beats per minute. It has the same significance as the rapid pulse, but greater consideration should be given to the possibility of vacuity.

Slow pulse (迟脉 chí mài): Less than four beats. It indicates cold. It is also seen in evil heat binding and gathering. May also be seen in yáng brightness (yáng míng) (yáng míng) bowel patterns.

Moderate pulse (缓脉 huǎn mài): Four beats per respiration (not as slow as the slow pulse). It means dampness or spleen-stomach vacuity. It is also seen in healthy individuals.

Force

Replete pulse (实脉 shí mài): Forceful and solid when light or heavy pressure is applied. It indicates that although the body is afflicted by an exuberant evil, right qì is still holding firm.

Vacuous pulse (虚脉 xū mài): Forceless when light or heavy pressure is applied; loose and soft to the touch. It means dual vacuity of qì and blood.

Weak pulse (弱脉 ruò mài): Sunken, fine, forceless, and soft. It signifies debilitation of yáng qì or dual vacuity of qì and blood.

Fluency

Slippery pulse (滑脉 huá mài): Comes and goes smoothly; slick and slippery to the touch, like pearls rolling in a dish. Repletion; healthy individuals.

Stirred pulse (动脉 dòng mài): Short like a bean, slippery, rapid, and forceful. It is seen in pain conditions and in fear and fright.

Rough pulse (涩脉 sè mài): Comes and goes slowly and with difficulty: It means damage to essence; scant blood; qì stagnation; blood stasis; or phlegm-food collecting internally.

Tension

Stringlike pulse (弦脉 xián mài): Straight and long; like the string of a musical instrument. It occurs in liver-gallbladder disease; pain; phlegm-rheum; healthy elderly individuals.

Tight pulse (紧脉 jǐn mài): Taut and flicking against the fingers, like a tightly pulled and twisted rope. It occurs in repletion cold and in abiding food.

Drumskin pulse (革脉 gé mài): This is a stringlike pulse that is empty in the middle. It has the same significance as the scallion-stalk pulse and is commonly referred to as such.

Soggy pulse (濡脉 rú mài): Fine, forceless, and soft. It occurs in vacuity patterns and in damp encumbrance.

Faint pulse (微脉 wēi mài): Extremely fine and soft; barely perceptible. In severe cases, it is described as being on the verge of expiration (that is, of disappearing altogether). It occurs in great vacuity of qì and blood and in fulminant desertion of yáng qì.

Breadth

Surging pulse (洪脉 hóng mài): The blood vessel feels broad and full; the pulse is exuberant on arrival and debilitated on departure. It reflects exuberant heat.

Large pulse (大脉 dà mài): Vessel feels broad. No connotation of force. It occurs in healthy individuals or means that illness is advancing.

Fine pulse (细脉 xì mài): The vessel feels fine like a thread; well defined. It indicates blood vacuity or yīn vacuity; dual vacuity of qì and blood; dual vacuity of yīn and yáng. Also observed in dampness.

Regularity

Skipping pulse (促脉 cù mài): Rapid and interrupted at irregular intervals. It reflects exuberant yáng heat; stasis and stagnation; phlegm-food accumulation; or debilitation of visceral qì.

Bound pulse (结脉 jié mài): Slow and stopping at irregular intervals. It reflects exuberant yīn and binding qì; cold-phlegm and static blood; or dual vacuity of qì and blood.

Intermittent pulse (代脉 dài mài): Slow and stopping at regular intervals. It reflects debilitation of visceral qì; pain; fright and fear; or injury from knocks and falls.

Length

Long pulse (长脉 cháng mài): Felt beyond the inch and cubit, long and straight. Superabundance of yáng qì; yáng patterns; heat; repletion; healthy individuals.

Short pulse (短脉 duǎn mài): A pulse felt over a shorter area than normal. If forceful, it means qì depression; if forceless; it means damage to qì.

Pulse Combinations

• Floating and tight: Exterior cold patterns resulting from external contraction of cold evil; or wind-cold impediment (bì) disease.
• Floating and moderate: Greater yáng (tài yáng) wind strike with damage to defense by wind evil and provisioning-defense disharmony.
• Floating and rapid: Exterior heat patterns attributable to wind-heat assailing the exterior.
• Floating and slippery: Exterior patterns complicated by phlegm. Often seen in contraction of external evils in patients with pre-existing phlegm-damp.
• Sunken and tight: Interior cold.
• Sunken and fine: Yīn vacuity or blood vacuity.
• Sunken and slow: Interior cold patterns.
• Sunken and moderate: Spleen vacuity with water-damp collecting in the interior.
• Sunken and stringlike: Depressed liver qì or water-rheum collecting in the interior.
• Sunken and rough: Blood stasis, especially in patients with yáng vacuity with congealing cold causing blood stasis.
• Sunken, fine, and rapid: Yīn vacuity with internal heat; blood vacuity.
• Stringlike and tight: Cold patterns; pain. Often seen in cold stagnating in the liver vessel or when liver qì depression gives rise to pain.
• Stringlike, slippery, and rapid: Liver fire complicated by phlegm; liver-gallbladder damp-heat; or liver yáng harassing the upper body with phlegm-fire brewing internally.
• Stringlike and fine: Liver-kidney yīn vacuity; blood vacuity with depressed liver qì; liver depression with spleen vacuity.
• Slippery and rapid: Phlegm-heat, phlegm-fire, damp-heat, or food accumulation with internal heat.
• Surging and rapid: yáng brightness (yáng míng) channel patterns; exuberant qì-aspect heat.