Pulse Diagnosis       

The location for feeling the pulse is above the wrist where the radial artery throbs. It is divided into three regions: CUN, GUAN and CHI. The region opposite to the styloid process of the radius is konw as GUAN, that distal to GUAN (ie., between guan and the wrist joint) is cun and that proximal to guarn is chi. Thre three regions of CUN, GUAN and CHI of the left hand reflect repectively the conditions of the heart, liver and kidney, and those of the right hand reflect conditions of the lung, spleen and kidney.

The Significance of the Wrist Pulse.
During inhalation Da Qi enters the circulatory system via the Lung channel and connects with the Ying and Wei Qi. It provides nourishment for the Kidneys and hence replenishes the pre-natal Qi which in turn vitalises the other Zang-Fu. Therefore the vitality of the Lungs reflects the vitality of the entire body and the best place from which to judge this vitality is near the Yuan point of the Lung Channel- at the wrist pulse.

 

Method of taking pulse
In feeling the pulse, let the patient place his/her hand easily on a cushion palm up. First locate the guan region with the middle finger, then put the index and ring finers naturally on the cun and chi regions. Finger force is exerted first lightly, then moderately and finally heavily to get a general idea of the depth, frequency, rhythm, strength and frm of the pulse. Any abnormal changes in any region of the puse should be determined by exerting an even force on teh three regions, then by feeling three regions separtely and making comparisons in order to have a correct impression of the pulse as a whole.

A normal pulse is of medium frequency, i.e., 4-5 beats per breath, and regular rhythm. It is even and forceful.

 

The Three Levels of the Pulse
At the superficial level the pulse reflects activity at the level of the Wei Qi- usually external diseases caused by external attacks. At the middle level the pulse reflects the activities of the Spleen and Stomach. At the deep level the pulse reflects activity at the internal level

 

 

 

Abnormal pulse readings and thir clinical significance are as follows:


Floating - strong enough to rise. It feels powerful under slight pressure- but not strong enough to maintain its power under stronger pressure. It feels like wood floating on water.
Significance- external attacks and superficial diseases.

Sinking- needs heavy pressure to be felt as it is only in the deep level.
Significance- internal diseases

Slow- 3 beats or less per respiration
Significance- Cold diseases or Yang Deficient.

Rapid- 6 beats or more per respiration. 5-6 beats/ respiration is impatient.
Significance- hot diseases, deficient diseases


Empty- very weak with wide form
Significance- deficient diseases, mainly Qi Deficiency. Used as a collective term for pulses without strength.


Full- very strong wide form.
Significance- excess diseases. Used as a collective term for pulses with strength


Slippery- feels very round and smooth. Comes and goes smoothly like beads on a plate.
Significance- phlegm or food accumulation but can also indicate pregnancy.

Choppy- relatively weak and unsmooth beats, like a knife lightly scraping bamboo. The opposite of slippery.
Significance- Qi & Blood Deficiency or extravasated Blood

Wiry- long and straight like pressing a wire.
Significance- Liver and Gallbladder diseases, Phlegm or pain.


Tight- strong and wiry.
Significance- Cold and pain.

Soft- relatively weak floating and thin mainly indicates
Significance- Qi & Blood Deficiency or trapped Dampness

Flooding strong wide form, comes with strength, but goes weakly.
Significance- mainly indicates Hot diseases with abundant perverse Qi.

Thin- feels thin fine like a thread.
Significance- Qi & Blood Deficiency (mainly Blood Deficiency), or Yin Deficiency

Weak- without strength sinking Qi & Blood Deficiency Big wide form refers only to pulse form, not to strength

Scattered very weak floating, bit and without root Qi & Blood exhausted and scattered, Jing Qi about to be exhausted. Tight strong wiry mainly indicates Cold and pain

Hollow- weak floating and hollow in the center, like a shallot stalk
Significance- death of Blood, loss of Jing, usually seen in excessive loss of Blood

Firm- deep and strong
Significance- Cold pain and means Yin Cold abundant internally usually called sinking and wiry

Lesurely- 3 to 4 beats per respiration normal

Knotted-/Intermittent/Hasty all irregular pulses
Significance- Failing of Zang Qi- particularly Heart Qi. Blood or Phlegm obstructions can block the chest.

Essentials of Chinese Acupuncture - Beijing Foreign Language Press