pulse diagnosis

3 positions of pulse

cun (1) guan (2) chi (3)

cun vital substance

qi

- upper burner

guan vital substance

blood

- middle burner

chi vital substance

yin

- lower burner

levels of pulse vital substance

superficial: qi (yang organs)

middle: blood

deep: yin (yin organs

cun position

L: HT, SI

R: LU, LI

guan position

L: LV, GB

R: SP, ST

chi position

L: KD (yin), UB

R: KD (yang), mingmen

characteristics of pulse

1. depth

2. speed

3. strength

4. shape

5. rhythm

normal pulse qualities

1. healthy stomach qi pulse: good stomach qi is the msot important quality for a good prognosis

2. spirit: soft but strong with regular rhythm and quality

3. root: clearly felt, even and moderate, at the deep level in chi position.

pulse based on sex

males: pulse is stronger.

- LEFT (yang) pulse should be stronger than the right, cun is stronger than chi

females: pulse is weaker than males

- RIGHT (yin) pulse should be stronger than the left, chi pulse is stronger than cun

superficial pulse

invasion by exterior pathogen

deep pulse

interior pattern

superficial and tight

wind-cold

superficial and rapid

wind-heat

superficial and thready

deficiency of blood

deep and weak

qi and yang deficiency

deep and forceful

stasis of qi and blood due to internal phlegm

rapid pulse

heat pattern

rapid and thready

yin deficiency w/ deficiency heat

slow pulse

cold pattern

excess pulse

fills all three levels

deficient pulse

felt at any of the three levels, big and soft (forceless)

- qi and blood deficiency

surging pulse

superficial and middle levels

- extreme heat of either excess or deficiency

thready pulse

middle or sinking, thin

- yin and blood deficiency

thready and rapid

deficient heat due to yin deficiency

thready and deep

internal dampness

thready and wiry

liver yin deficiency

rolling pulse

- phlegm or dampness syndromes

- retention of food

- pregnancy

choppy pulse

moves at irregular depths, uneven rate

choppy and deficient

blood deficiency, yin and essence deficiency, exhaustion of body fluids

choppy and excess

blood and qi stagnation due to pathogenic excess

tight pulse

forceful like a twisted rope that vibrates form side to side

- 5 beats per breath, impatient

- pain syndromes

- food stagnation

tight and deep

excess cold in the interior

wiry

straight and long, 5 beats per breath, impatient

- liver and gallbladder syndromes

- phlegm and retained fluids

- pain syndromes

soft pulse

superficial, 4-5 beats per breath, weak completely vanishing under pressure, thready like a strand of cotton on water

- yin, blood, qi deficiency

- dampness syndromes

weak pulse

deep, 4-5 beats per breath, soft and thin

- yang deficiency

- qi and blood deficient

moderate

4 beats per breath, relaxed and soft/thin

- "normal pulse" indicating an abundance of shen, stomach qi, and kidney qi

moderate and superficial

exterior deficiency syndrome (taiyang wind syndrome)

moderate and deep

interior cold dampness

moderate and deficient

qi deficiency

abrupt

rapid and missed beats

- heart fire or heart qi deficiency

abrupt and excess

excess heat accompanied by qi, blood, phlegm or food stagnation

abrupt and deficient

deficient of zang fu

knotted

slow and missed beats

- qi and blood stagnation due to cold

- cold with deficiency of heart yang

knotted, superficial, excess

cold accumulation stagnating in the meridians

knotted, deep, excess

internal cold accumulation obstructing qi

knotted and deficient

deficiency of antipathogenic qi (zheng qi)

regularly intermittent

4 beats per breath, missed beats at regular intervals

- if pulse skips every 4 beats or less, condition is serious

- sudden onset: pain syndrome, disorders caused by fear or shock, contusions or sprains, internal wind

- gradual onset: decline and failure of qi in the zang organs

long

longer than normal, felt beyond the first and third positions

long and wiry

excess heat in the blood or the yangming fu organs

long, relaxed, calm

good health

short

felt in only one position, or fails to fill either the cun or chi position

short and excess

qi stagnation

qi and deficient

qi deficiency

scattered

superficial, uncountable/hard to feel, very weak and uneven

- severe deficiency of yuan qi and blood

- exhaustion of kidney qi and kidney yang in chronic disease

minute

4 beats per breath, weak, thin and short

- severe qi and blood deficiency (primarily yang deficiency

hollow

superficial, 4-5 beats per breath, full at superficial level, weak at the deeper level

- blood loss leading to blood deficiency

leather

superficial, hollow under pressure, big and wiry at superficial level

- severe deficiency of blood, yin, and kidney essence

firm

deep, strong, big wiry and long

- internal cold accumulation with subsidence and stagnation of yang qi (hernia, pain, abdominal mass)

hidden

very deep, difficult to feel, hidden beneath the bone

- extreme yang deficiency with internal cold

- extreme cold obstructing the meridians

moving

rapid, strong, short and tight just rising in the center

- shock and fright

- extreme pain

swift

7-8 beats per breath, agitated

- excess yang with fire exhausting yin

- impending exhaustion of vital qi