Pulse assessment is one of the pillars of Chinese medicine diagnostics and has been used by many other healing traditions. Much of Chinese medical theory is built on basic concepts related to chi (vital energy), blood, and fluids - including quantity, movement, and stagnation thereof. Feeling the pulse provides insight regarding these qualities as well as the condition of the organs, mind, and body as a whole. Provided here is information from the texts (cited in entry body) we have been using in class.
In The Secret of Pulse Diagnosis Bob Flaws describes the first step to learning pulse diagnosis as learning the definitions of the main pathological pulses. He explains that like other Chinese arts mastery comes through mastery of the basics - one must learn the definitions.
Flaws cites the Lakeside Master's Study of the Pulse in stating that there are four main pulse qualities: Floating, Deep, Slow, and Rapid. He categorizes 20 pulse definitions into these four types.
We can start with Flaws' definitions of these four pulses:
Floating: Located in the exterior. With finger raised, it has surplus; when pressing down, it is insufficient. When pressure is released, it regains full strength.
Deep: Located near the bone. Cannot be detected with light or moderate pressure but can be felt with heavy pressure.
Slow: Below 60 beats per minute (BPM) or less than 4 beats per breath.
Rapid: Above 90 beats per minute (BPM) or more than 5 beats per breath.
Flaw discusses the pulses as subdivisions of the four main qualities listed above. He starts with the Floating pulse and then describes several variations:
Drumskin: Bowstring and large with and empty center; feels like the head of a drum.
Surging: Floating, large, comes on exuberant, departs debilitated.
Vacuous: Floating, large, slow, empty, vacuous, soft, forceless.
Scallion Stalk: Floating, soft, large body, but empty center; feels like a scallion leaf.
Scattered: Floating, large, and without root; with light pressure, it is easily irregular, becoming scattered and chaotic. Heavy pressure leads to its absence.
Soft: Floating, fine, soft, and flexible. Can be felt with light pressure but cannot be obtained by heavy pressure.
These are all forms of floating pulses. In The Secret of Chinese Pulse Diagnosis Flaws explains these descriptions, including some alternate names and differing interpretations (pages 23 - 27). He also, in a separate chapter, describes the indications. For now we will focus mostly on the descriptions.
There was some concern expressed last session about learning all these pulses. It is not necessary for everyone to focus on pulse diagnosis as we are studying many forms of diagnosis. We are introducing this material for those who are studying towards clinical application and desire to use pulse. However, if you are studying primarily for home care and self care you need not worry about the daunting task of understanding 29 pulse qualities, their combinations, and their indications. However, the basics should still be interesting, and it is beneficial to have some exposure to these ideas as we discuss cases and if you consult with a Chinese herbalist or acupuncturist.
The following are the three variations of the deep pulse (see above for the definition of the deep pulse).
Weak: Deep, fine, soft like thread.
Hidden: Difficult to feel, under the sinews, not obvious, requires heavy pressure to the bone to obtain.
Confined: Pressed superficially or moderately, does not respond, but can be obtained by heavy pressure. Hard, firm, not changeable, replete, large, bowstring, and long.
Here is the beginning of a monograph on the deep pulse according to Li Shi-Zhen's Pulse Studies by Li Shen-Qing and William Morris:
Like the moist and descending nature of water, this pulse is sunken
Appearing amid the sinews and bones; it is soft, slippery, and distributed evenly
At a woman's cun position and and a man's chi
If the image remains throughout the year, this can be called normal
- Bin-hu's Verse on Pulse Diagnosis
The deep pulse is felt strongest in the depths. There are only minor sensations with light pressure.
A pulse may be deep due to pathogens located at the interior or when there are diseases involving the viscera and bowels. Deficiency conditions may also predispose the pulse to be deep since when the yang and qi are deficient, the amplitude of the wave cannot fill the depths...
TCM Diagnostic Perspectives
Deep pulses are yin where the blood and yang qi do not flow smoothly to reach the exterior. This can be due to deficiencies of qi and yang. Similarly, pathogens at the interior will present with a deep pulse that has force. The deep pulse suggests chronic conditions.
Clinical Perspectives
One should rule out hypothyroidism when the pulse is deep without force. Chronic recurrent infections and serious degenerative diseases are also consistent with deep pulses." - pages 73 - 74
I included this excerpt partially to offer some food for thought in the absence of tonight's class (again, because of weather - another of our Tuesday night snow storms); and to encourage class participants to purchase the book. The verse from Bin-hu (the Lakeside Master) also brings up another angle on our discussion of differences in the pulses of men and women.
We already defined the slow (below 60 beats per minute) and rapid (above 90 bpm). There are a few other distinct pulses based on rate:
Relaxed: A) As a ping mai, level or normal pulse, it is harmonious, relaxed, and forceful. B) As bing mai, or diseased pulse, it is relaxed, loose, slack, and on the verge of slow. It comes right at about 60 bpm.
Racing: Very rapid, over 120 bpm or 7-8 beats per respiration.
Now we have covered the four main pulse definitions (floating, deep, slow, and rapid) and their major sub divisions. Continuing in the future we will go over the remaining images:
Replete: A) A generalized term for various types of forceful pulses. B) A long, bowstring, large, hard, and replete pulse which has a surplus either floating or deep.
Bowstring: Fine, long, has strength, feels like a zither string.
Tight: Tight, has strength, feels like a taut rope.
Long: Long, can be felt beyond its own location or range.
Short: Does not reach (i.e., fill longitudinally) its location or range.
And that is 20 of the 29 pulse images. One can take note that some of the pulse image names are used in the definitions of other images.
New material shortly.
Flaws cites the Lakeside Master's Study of the Pulse in stating that there are four main pulse qualities: Floating, Deep, Slow, and Rapid. He categorizes 20 pulse definitions into these four types.
We can start with Flaws' definitions of these four pulses:
Floating: Located in the exterior. With finger raised, it has surplus; when pressing down, it is insufficient. When pressure is released, it regains full strength.
Deep: Located near the bone. Cannot be detected with light or moderate pressure but can be felt with heavy pressure.
Slow: Below 60 beats per minute (BPM) or less than 4 beats per breath.
Rapid: Above 90 beats per minute (BPM) or more than 5 beats per breath.
Flaw discusses the pulses as subdivisions of the four main qualities listed above. He starts with the Floating pulse and then describes several variations:
Drumskin: Bowstring and large with and empty center; feels like the head of a drum.
Surging: Floating, large, comes on exuberant, departs debilitated.
Vacuous: Floating, large, slow, empty, vacuous, soft, forceless.
Scallion Stalk: Floating, soft, large body, but empty center; feels like a scallion leaf.
Scattered: Floating, large, and without root; with light pressure, it is easily irregular, becoming scattered and chaotic. Heavy pressure leads to its absence.
Soft: Floating, fine, soft, and flexible. Can be felt with light pressure but cannot be obtained by heavy pressure.
These are all forms of floating pulses. In The Secret of Chinese Pulse Diagnosis Flaws explains these descriptions, including some alternate names and differing interpretations (pages 23 - 27). He also, in a separate chapter, describes the indications. For now we will focus mostly on the descriptions.
There was some concern expressed last session about learning all these pulses. It is not necessary for everyone to focus on pulse diagnosis as we are studying many forms of diagnosis. We are introducing this material for those who are studying towards clinical application and desire to use pulse. However, if you are studying primarily for home care and self care you need not worry about the daunting task of understanding 29 pulse qualities, their combinations, and their indications. However, the basics should still be interesting, and it is beneficial to have some exposure to these ideas as we discuss cases and if you consult with a Chinese herbalist or acupuncturist.
The following are the three variations of the deep pulse (see above for the definition of the deep pulse).
Weak: Deep, fine, soft like thread.
Hidden: Difficult to feel, under the sinews, not obvious, requires heavy pressure to the bone to obtain.
Confined: Pressed superficially or moderately, does not respond, but can be obtained by heavy pressure. Hard, firm, not changeable, replete, large, bowstring, and long.
Here is the beginning of a monograph on the deep pulse according to Li Shi-Zhen's Pulse Studies by Li Shen-Qing and William Morris:
Like the moist and descending nature of water, this pulse is sunken
Appearing amid the sinews and bones; it is soft, slippery, and distributed evenly
At a woman's cun position and and a man's chi
If the image remains throughout the year, this can be called normal
- Bin-hu's Verse on Pulse Diagnosis
The deep pulse is felt strongest in the depths. There are only minor sensations with light pressure.
A pulse may be deep due to pathogens located at the interior or when there are diseases involving the viscera and bowels. Deficiency conditions may also predispose the pulse to be deep since when the yang and qi are deficient, the amplitude of the wave cannot fill the depths...
TCM Diagnostic Perspectives
Deep pulses are yin where the blood and yang qi do not flow smoothly to reach the exterior. This can be due to deficiencies of qi and yang. Similarly, pathogens at the interior will present with a deep pulse that has force. The deep pulse suggests chronic conditions.
Clinical Perspectives
One should rule out hypothyroidism when the pulse is deep without force. Chronic recurrent infections and serious degenerative diseases are also consistent with deep pulses." - pages 73 - 74
I included this excerpt partially to offer some food for thought in the absence of tonight's class (again, because of weather - another of our Tuesday night snow storms); and to encourage class participants to purchase the book. The verse from Bin-hu (the Lakeside Master) also brings up another angle on our discussion of differences in the pulses of men and women.
We already defined the slow (below 60 beats per minute) and rapid (above 90 bpm). There are a few other distinct pulses based on rate:
Relaxed: A) As a ping mai, level or normal pulse, it is harmonious, relaxed, and forceful. B) As bing mai, or diseased pulse, it is relaxed, loose, slack, and on the verge of slow. It comes right at about 60 bpm.
Racing: Very rapid, over 120 bpm or 7-8 beats per respiration.
Now we have covered the four main pulse definitions (floating, deep, slow, and rapid) and their major sub divisions. Continuing in the future we will go over the remaining images:
Replete: A) A generalized term for various types of forceful pulses. B) A long, bowstring, large, hard, and replete pulse which has a surplus either floating or deep.
Bowstring: Fine, long, has strength, feels like a zither string.
Tight: Tight, has strength, feels like a taut rope.
Long: Long, can be felt beyond its own location or range.
Short: Does not reach (i.e., fill longitudinally) its location or range.
And that is 20 of the 29 pulse images. One can take note that some of the pulse image names are used in the definitions of other images.
New material shortly.
