Pulse & Tongue Assessment

What general characteristic indicates Heat, and what is its typical rate?

Rapid, more than 5 beats per breath of practitioner (usually 70+ bpm)

What general characteristic indicates Cold, and what is its typical rate?

Slow, less than 3 beats per breath (usually less than 60 bpm)

What does a Full (Excess) pulse (large and strong) indicate?

Any Excess pattern

What does a Weak (Deficient/Empty) pulse (soft and weak) indicate?

Deficiency of Yang or Blood, or deficiency of Qi

What pulse characteristic indicates significant Qi deficiency, especially of the Stomach?

Short (feels as though it occupies less length than normal pulse)

What pulse characteristic indicates Heat patterns and feels extended?

Long (feels as though it occupies more length than normal pulse)

Describe a Wiry pulse and list its primary indications.

Tense and firm, like a wire (like a guitar string). Indicates stagnation, pain, phlegm; especially relates to the Liver.

• It represents an Excess pattern.

How is a Thready or Thin pulse characterized, and what does it indicate?

Carries tension similar to a wiry pulse, but is smaller and thinner.

• Indicates: wiry pulse of a deficient state, deficiency with stagnation, or pain

What term is used for a pulse that is Twisted like rope, and what does it indicate?

Tight. Indicates Cold or pain. (It can be either full or weak, and the term should be reserved for tension caused by Cold

A Floating pulse is felt with light pressure. What are its two main indications?

1. Wind invasion (Wei Qi is active)

2. Yin deficiency (unrooted yang rises to superficial level)

Describe a Slippery pulse and list its indications.

Smooth, squishy, as if oily, difficult to pin down. Indicates: Dampness, Phlegm, food retention, or pregnancy

What do all pulses with tension (Wiry, Tight, Thready, Taut, etc.) suggest?

Stagnation, Stasis, Obstruction, or pain

Which organs are represented by the two front positions (cun) of the pulse?

The Lungs and Heart (Upper Burner)

Which organs are represented by the two middle positions (guan) of the pulse?

• Spleen

• Stomach

• Liver (Middle Burner)

Which organs are represented by the two rear positions (chi) of the pulse?

Kidneys (lower burner)

The Right hand pulses represent the state of ____ and ____.

Qi and Yang

The Left hand pulses represent the state of ____ and ____.

Blood and Yin

What state is reflected by the Superficial pulse level?

The state of Qi

What state is reflected by the Middle pulse level?

The state of Blood

What state is reflected by the Deep pulse level?

The state of Yin and the Yin organs.

How do pulses change during and after menses (D1-8)?

They are weak (especially on the Left) because Blood is deficient and empty

How do pulses change as ovulation approaches?

They are strong (especially on the Right) and smooth, as Yang dominates and Blood successfully returns

What naturally causes the pulse to become Slippery during pregnancy?

A fetus is Phlegm

Which Kidney pulse presentation during pregnancy suggests it is more likely a girl?

• Kidney Yin pulse is Full and Kidney Yang is normal

OR

• Kidney Yang is stronger, but both are weak and Kidney Yin is Deep (Yin being consumed)

Which Kidney pulse presentation during pregnancy suggests it is more likely a boy?

Kidney Yang pulse is Full and Kidney Yin is normal, OR Kidney Yin pulse is stronger, but both are weak and Kidney Yang is Deep (Yang being consumed)

What are the three deficiency patterns indicated by a Thin & small tongue body shape?

• Qi Deficiency

• Blood Deficiency

• Yin Deficiency

What two conditions are indicated by a Swollen tongue body?

Damp/phlegm accumulation or Yang deficiency

What two conditions are indicated by Teeth prints/Scalloped edges?

Damp/phlegm accumulation or Qi deficiency

What does the presence of Papules on the tongue body texture indicate?

Heat Syndrome

What 3 conditions are indicated by a Fissured tongue?

• Yin deficiency

• Heat syndrome

• Blood deficiency

List the 4 conditions indicated by a Trembling tongue.

• Qi

• Blood

• Yang deficiency

• Extreme heat producing wind

List 4 conditions indicated by a Rigid tongue.

1. Heat invading Pericardium

2. Excess Heat impairing body fluids

3. Phlegm accumulation

4. Wind stroke

A Deviated tongue indicates what major condition?

Wind stroke or a threatening sign of wind stroke

What does a Blue or Purple tongue color indicate?

Excess Cold or Blood Stasis

What does a Pale tongue color indicate?

Deficiency or Cold

What does the Coating Color manifest, and which two organs are involved?

• Manifestation of Stomach Qi

• Kidneys are also involved with coat

What does the Thickness of the coating indicate?

Intensity of pathogenic factor and/or Weakness of body’s Qi

A coating color of White is associated with ____, while a color of Yellow is associated with ____.

Cold (White)

Heat (Yellow)

A Moist coat (if white, gray, or black) is associated with ____, while a Dry coat (if gray, black, yellow, etc.) is associated with ____.

Cold (Moist)

Heat (Dry)

List the guidelines for inspecting the tongue body color regarding Heat.

Red indicates Heat (Excess or Deficient). Dark Red indicates Heat (Excess or Deficient) or Stasis

What is the rule for how long a patient should stick out their tongue for inspection?

Do not have tongue out > 20 sec each time, and it should be natural (relaxed and not forceful)

What does the Distribution of the coating indicate?

Location of the pathogenic influence and Organs affected