One of the four diagnostic methods in Traditional Chinese Medicine (TCM), pulse diagnosis is a great way for your practitioner to glean vital information about your overall health. Before imaging technologies, doctors needed a way to determine the status of their patients’ internal organs and learned that the pulse could offer a wealth of information. While the pulse is an instrumental tool used in both Western and Chinese medicine, in TCM, it is used to assess the overall health and functionality of the major organs, blood flow and the state of the qi/energy (in the body).
If you have ever had an acupuncture treatment, your acupuncturist may have started the session by examining your pulse via your radial artery (in the wrist). But what exactly can this tell a practitioner about our health?
How Does Pulse Diagnosis Work?
Traditional pulse diagnosis has almost 30 specific qualities; however, there are “16 basic single-feature pulse conditions.” These 16 conditions are the basis of all pulse diagnosis categories, and can be broken up into several categories.
- Fast (Shuo Mai)—indicates “heat” in the body, which can mean fever, increased stress or inflammation.
- Slow (Chi Mai)—categorized as a “cold” condition. Specifically, this indicates poor circulation or that a certain bodily system is functioning inefficiently.
- Overflowing (Hong Mai)—a common pulse, this implies phlegm build up or intestinal issues. A typical diagnosis is allergies or digestive issues.
- Thin or thready (Xi Mai)—deficiency is the main issue with a thin pulse. Whether it’s blood or other fluid that’s deficient, it’s often associated with fatigue, insomnia, nutritional or absorption problems.
- Strong, full (Shi Mai)—suggests an excess, such as anger, stress, high blood pressure and even headaches
- Weak, empty (Ruo Mai)—similar to a thin pulse, a weak or empty pulse also deals with a deficiency. Conditions include general weakness, fatigue, low blood pressure and depression.
- Minute, faint (Wei Mai)—both thready and soft, this type of pulse illustrates extreme exhaustion.
- Hasty (Ji Mai)—very rapid, this pulse is between 120-140 BPM (twice normal levels) and signals extreme distress.
- Knotted (Jie Mai)—slow and irregular, a knotted pulse represents a stagnation in qi and blood; however, there is no direct correlation with a modern diagnosis. A blockage or obstruction is oftentimes the cause.
- Intermittent (Dai Mai)—categorized as slow with regular pauses and is often presented in patients who have an advanced disease and/or are hospitalized.
- Rolling, slippery, smooth (Hua Mai)—once used to help determine pregnancy (when presented alongside a rapid pulse), a rolling pulse is described as “like pearls rolling on a dish.” It also indicates phlegm-dampness and/or food stagnation.
- Choppy, uneven (Se Mai)—like “scratching a bamboo with a knife,” this pulse is slow and relaxed and has an inconsistent tempo. It is associated with blood deficiency.
- Wiry (Xian Mai)—signifies liver or gallbladder issues, this pulse is long and straight, much like a string instrument.
- Scattered (San Mai)—perhaps the most severe of the pulses, a scattered pulse infers that the patient is critically ill. It will present as irregular, barely detectable and floating, and signifies an exhaustion of qi.
With these qualities established, here is how acupuncturists perform pulse diagnosis.
Reading a Pulse
In TCM, pulse diagnosis is traditionally taken from the wrist. As Figure 1 demonstrates, three fingers should be placed along the three positions: cun, guan and chi. To accurately assess a patient’s health, the acupuncturist will place varying levels of pressure (superficial, middle and deep).
With the proper technique in place, a practitioner can determine which organs are affected (shown in Figure 2). For example, if the pulse is choppy (Se Mai) in position 1 (cun), this signifies deficient heart qi and chest pain. If only felt on the left wrist, heart pain and palpitations, and on the right wrist, deficient lung qi and a cough with an excess of phlegm.
While modern medicine has given us advanced imaging technologies that can help medical professionals assess a patient’s health, pulse diagnosis is still widely used in TCM. The next time you’re getting an acupuncture treatment and your practitioner takes your pulse, you will know just how much information they’re discovering because of it!