Pulse Chart

Pulses
Preparation:
1. While taking the pulse in the early morning is best, as the qi and blood are not disturbed, it is rarely practical to do this. Have the
patient sit still a bit before taking the pulse to allow the qi and blood settle in.
2. Place the patient sitting comfortably. The arm should be about level with the heart, not stretched too much but parallel to the ground.
Have them sit comfortably, preferably leaning back in the seat. Place patient’s arm on a pillow.
Alternately, you can take the patient’s pulse while he/she is lying down.
Many practitioners ask the patient who are lying down to rest their hands on their stomach since stretching out the arms in this
position will often put too much pressure on the arteries to get a good reading.

How to find the proper position for your fingers on the pulse:
1. Find the styloid process on the radial side of the wrist with your middle finger.
2. Slide your middle finger inward toward the medial side of the arm. It will “fall” into a small pocket just on the other side of the styloid
process. Your middle finger is now at the Guan or 2nd position.
3. Place your index finger down next to the middle finger in the 1st or Cun position. This position is the closest to the wrist.
4. Drop your ringer finger down naturally and this is the Chi or 3rd position, furthest from the wrist

Will Morris suggests you bend the patient’s wrist slightly inward (in the direction of the palm) and then find the divot this makes right
around Lung 9 on the radial side of the wrist, right on the transverse crease of the wrist. Place your index finger here, let your middle
finger drop into place, then your ring finger. If you slide your ring finger proximally a little bit you will feel the edge of a big muscle,
the brachioradialis muscle. You should be just distal to the end of that muscle.

If you want all the goodies from Will Morris’ pulse seminar, read all of the stuff here first, then check out the notes from the seminar
he gave on classic pulses by clicking here.

Region Left side Right side

Cun (1st position) Heart (xin) Lung (fei)
Guan (2nd position) Liver and Gallbladder (gan) Spleen and Stomach (pi)
Chi (3rd position) Kidney/ lower abdomen - Shen/ Kidney Yin Kidney/ lower abdomen – Mingmen/ Kidney Yang

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How to take the pulse:
1. Feel with all 3 fingers at the same time to determine the pulse quality and character overall before you find the character/quality of the
individual positions.
a. Feel all 3 depths: lifting depth, searching/middle depth, and pressing depth.
i. Lifting
Just touching the surface a little. Superficial pulse will be felt this way.
ii. Searching or Middle – medium pressure to tell the nature of the pulse.
Maciocia says keep the fingers still to count the pulse. He goes further saying you can also:
1. Push – move fingers laterally side to side in each position to feel around the pulse and determine its shape and
qualities.
2. Roll – move fingers proximal to distal in each position to determine short, long, moving (and to read pulse in
child aged 1 year of less).
iii. Pressing
Press deeply into both middle and deep levels to determine if the pulse is deep, deficient, normal, hollow, hidden or
empty.

b. Feel for speed.

Normal is considered 4 beats per respiration cycle (one breath in, one breath out). Watch the patient breathe and count the
beats.

c. Feel for rhythm.

Feel for 50 beats in order to determine rhythm or arrhythmia.

2. Feel the individual positions on each side of the body. Be sure to feel at all 3 depths for each individual position also.

What is a normal pulse?

♦ Frequency/Speed
4 beats/respiratory cycle (one breath in/one breath out)

♦ Stomach Qi
Feel for 50 beats to determine this. This is the overall feel—not the feel of the Stomach/Spleen position!
o Not superficial, not deep
o Not fast, not slow
o Calm with regular rhythm.

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♦ Spirit (or Shen)
o Soft, gentle, with strength.
No irregularity.

♦ Root
2 meanings:
o Overall pulse—strength at all depths/all positions even when pressing heavily.
o Pulse in the 3rd positions is strong and with power.

Funky Pulse Positions

♦ Fan guan mai or “opposite gate pulse” – patient’s radial artery runs on the dorsal side of the arm!
♦ Xie fei mai or “oblique flying pulse” – patient’s radial artery goes at an oblique angle from 3rd position to 1st position, going
diagonally towards the dorsal side.
(Maciocia says when you encounter these you should really take pulses at alternate points on the body to get the reading these positions
would normally indicate. He unfortunately failed to elaborate and tell us where these were!)

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 Pulse Chart

Superficial Pulses
Superficial pulses indicate an exterior problem. (In special cases it may indicate the yang floating up – and creating a false shen, but by and
large, it’s an exterior condition. ) Touch very lightly (lifting technique) in order to feel this pulse.

Remember: Cold conditions are indicated by a slow pulse while hot conditions have a fast pulse.

Chinese English name Description Indications

name
Fu Superficial 1. Pulse has most strength at 1. External pathogen
Floating uppermost level and can be felt Circ of qi and blood is focused in the body’s surface to deal with external agent.
with only slight touch Internal circulation temperature is sacrificed to focus on elimination of the
pathogen, in an attempt to keep it from moving deeper.
2. Can feel w/light touch
Grows faint on hard pressure. 2. Deficiency
Debilitated pts may have feeble, floating pulse: inability to retain Qi and yang in
interior due to deific of vital orgs.

Floating Combination Pulses

Floating + tight = external cold.
You might also see chills and fever, aversion to cold, tongue pale with thin white coat, no sweating, and/or clear watery nasal
discharge.

Floating + fast = external heat.

You might also see headache, nasal discharge yellow/sticky, sweating, chills and fever (but more fever than chills).

Superficial + slowed down = External deficiency.

What is this “external deficient”? Sweating is the key point. There will be sweating. They might also have chills and fever.
External damp.

Superficial + slippery = external syndrome, but also has phlegm retention.

Fix the external condition, but also treat the phlegm retention.

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 Pulse Chart
Chinese English name Description Indications
name
Hong Surging 1. Broad, large, forceful 1. Excess heat.
Overflowing Heat isn’t hard to detect, so this pulse doesn’t add much to your diagnosis.
Flooding 2. Like dashing waves with forceful
rise, gradual decline. 2. Force of pulse = pathological condition
Gradual decline of pulse at end = heat syndrome
(due to qi excess not fluid excess)
Ru Soft 1. Superficial, thready, w/o strength. 1. Deficiency
Soggy
2. Superficial, thin, soft. 2. Dampness
W/light touch, like thread floating
on H2O. Note: because it feels easily movable (like thread floating), tends to indicate SP Qi
W/pressing it is faint. deficiency w/accumulation of dampness.

San Scattered 1. Superficial, scattered, indistinct 1. Depletion of Yuan – crisis

irregular without root
Crisis pulse Note: These are cases where patients are critically ill, are hospitalized or sent home to
2. Irregular, hardly perceptible die; diagnosis is usually well-established. Pulse says only that patient is severely ill.

Diffuses on light touch,

faint with heavy pressure

Kou Hollow 1. Superficial, large, empty 1. Loss of blood

(like stalk of green onion)
2. Yin deficiency
2. Feels floating, large, soft, hollow
(like a drinking straw or grn onion) Note: green onion stalk feel means that there is some flow of Qi at vessel’s surface,
but not much blood in the vessel.
Superficially: can feel it lightly
Mid level: barely there
Deep level: can feel it lightly

Ge Leather 1. Wiry, fast, empty inside Essence, blood deficiency

Tympanic (like leather drum head)

2. Wiry + superficial with aspects of

empty pulse.
(like skin of drum)

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 Pulse Chart

Deep Pulses
Deep pulses are felt by pressing heavily. Deep and sinking pulses indicate an interior or chronic (prolonged) problem.
If the pulse is strong and deep = internal excess
If the pulse is weak and deep = internal deficiency

Remember: Cold conditions are generally indicated by a slow pulse while hot conditions have a fast pulse.

Chinese name English name Description Indications

Chen Deep 1. Most strength @ the lowest level. 1. Internal syndrome
Sinking Requires deep pressure to feel well.
2. Circulation of Qi and blood from internal viscera
2. Can only be felt by pressing hard. to the surface is weak

Note: Circulation in this case is confined to the interior as the body attempts
to deal with a serious disorder threatening the internal organs.

Fu* Hidden 1. Can only be felt by pressing hard to bone 1. Closing syndrome
(in this case, pulse closes too)
2. Located even deeper than sinking pulse.
2. Syncope (loss of consciousness)

Note: Extreme pulse. Can barely detect the pulse
except with deep pressure to or near the level of
the bone. You might get a sense that the pulse is
hidden in the muscles or perhaps resting on the
surface of the bone.
3. Extreme pain
Note 1: Conditions such as LOC (loss of consciousness) and severe pain can
be easily determined w/o taking pulse.
Note 2: There are two kinds of loss consciousness—closing and opening
syndromes. Closing means everything clenches like a seizure (scream like pig
or sheep). Opening means everything opens—mouth, fists, anus, urethra.

Note 3: This is a form of protection to keep the Shen inside.

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Lao Firm 1. Full, large, wiry and long 1. Cold
Confined 2. Internal excess
2. Is a form of hidden pulse. Opposite of 3. Shan Disorder (hernia)
leathery. Very deep, wiry, usually long and 4. Mass
strong.
Note: unusual to find this pulse.
3. Deep, taut, wiry, long, large, forceful.
Combined together.

Wiry = like guitar string: tight and hard.

Resistant

Ruo Weak 1. Deep, thready, w/o strength Qi deficiency and Blood deficiency
Frail Usually from a long term condition. Occurs when the Qi cannot
2. Feels deep and soft. support the pulse and there isn’t enough blood to make the pulse
strong.

Cannot feel this pulse superficially! Note 1: Usually indicates weakness of SP Qi leading to deficiency of both qi
and blood.

Note 2: Similar to fine pulse, but softer in quality

Note 3: Is basically the opposite of the replete (shi) pulse.

*This Fu is different than that of the superficial pulse called Fu and is a different character when written in Chinese.

Deep Pulse Combinations

Deep + slow = internal cold.
Can be excess/deficient, depending on how strong it hits your finger, depending on how long it’s been going on—long time =
deficient. (Might also have ingested something cold.) Treat by warming. Tongue may be swollen/teeth marks/watery/cold signs.
Deep + thin = internal and deficiency (generally yin or blood).
Thin is distinct, no matter where located. Shape should be very clear. Thin is under the finger like a thread. This pulse would probably
be fast—generally a yin deficiency or blood deficiency.
Deep + slowed down = internal and damp/deficient
Spleen qi def will have this type of pulse. Damp is sticky, slows everything down.
Deep + slippery = internal and dampness.

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Slow Pulses
Slow is usually less than 60bpm. Exceptions include athletes in great shape who may have much lower pulse than non-athletes.
Slow is usually gauged as 4 beats or less per respiratory cycle (one breath in/out).

Slow pulses usually indicate Cold conditions…however, Choppy is in this category and it does not indicate Cold.

Chinese name English name Description Indications

Chi Slow 1. Pulse = < 60bpm or 4 beats/breath Cold syndrome
Can be:
2. Pulse with reduced frequency, less than 60 Yang deficient or empty cold (slow+weak+deep)
bpm. Yin excess or full cold (slow+strong)

Note: must be interpreted in light of other diagnostic info since slow pulse
could be due to other reasons (like very fit athletes).

Huan Slowed –down 1. 60 bpm or more, but the pulse feels sluggish 1. Dampness
Relaxed to you.
Loose 2. Phlegm
Moderate 2. Diminished tension in pulse. Normal in
depth, speed, strength, width. 3. Spleen qi deficiency
Look for greasy tongue coating, perhaps MJ discomfort to support your
guess.

Note: Pulse has a softness/looseness due to weakness of Qi + obstructing

effect of damp.

Differs from phlegm-damp in that it has no solidity.

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Se Choppy 1. Pulse is uneven and rough (like scraping 1. Qi stagnation
Uneven down bamboo with a knife)
Hesitant 2. Blood deficiency
2. Coming and going choppily w/small, fine, You’ll see this when the severity of blood disorder is great
slow, joggling tempo
3. Blood stasis/stagnation
Usually found in the deep areas, but might be in You could see this in patients with arteriosclerosis and in severe blood
middle/searching area. deficiency, but also in trauma victims who also have qi/blood stagnation

Feel for brief hesitations or interruptions in 4. Essence deficiency

movement.
5. Phlegm

6. Food retention

Note: NEVER indicates Cold!!

Jie Knotted 1. Irregularly irregular and slow. 1. Yin excess

Pulse seems to miss a beat w/o an apparent
pattern 2. Cold phlegm

2. Slow pulse with irregular missed beats. 3. Blood stasis

This is a key point to know for the test!
4. Qi stagnation

5. Blockage

6. Obstruction

Note: Can indicate coronary artery disease when accompanied by chest pain.

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Rapid Pulses
Rapid pulses are 5 beats per breath or more. Rapid pulses indicate Heat conditions.

Chinese name English name Description Indications

Shuo Rapid 1. Is at least > 90bpm or 5 beats per Heat Syndrome.
Fast respiratory cycle (one breath in and out) Bit more rapid than normal, usually occurs only when serious illness,
when there is fever.
2. A pulse with increased frequency (more
than 90 bpm) If pulse is strong and rapid = excess (yang excess)
If this pulse is weak and rapid = deficiency (yin deficiency)
This will be thin, fast, and weak

NOTE: Pulse can become rapid from activity prior to pulse taking. Don’t
jump to the conclusion of heat without other supporting evidence!

Cu Abrupt 1. Hurried, rapid, irregular missed beats. 1. Excessive Yang heat

Hasty Very fast, irregular irregular like jie mai 2. Qi and blood stagnation
Running pulse. 3. Phlegm retention
Hurried 4. Food retention
2. Hasty and rapid with irregular
intermittence. Note: this is like an excess version of knotted pulse. Rapidity indicates heat
Irregular, missed, fast. Similar to knotted. and irregular indicates blockage caused by stagnation and/or accumulation.

Ji Swift 1. More than 120bpm or 7 beats per breath 1. Depletion of Yuan Qi

Crisis pulse cycle.
2. Feels hasty and swift, 120-140bpm Pulse is so rapid (twice as fast as normal) that it is easily detected. The acute
febrile disease involves an easily measured high temperature, usually
Palpitations pathology can be found in testing.

Consumptive conditions w/such high pulse are generally under emergency

medical care.

Dong Moving 1. Short, slippery, fast, forceful 1. Pain

Spinning Bean 2. Combination of short, tight, slippery, rapid
pulses. 2. Frightened

Felt in only ONE position, not all. Also

described as “incomplete, without a head or tail,
like a bean.” You cannot feel this easily

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Deficient Pulses
Also called Empty pulses. Indicate deficient conditions. (Yeah, that’s kind of a duh.)

Chinese name English name Description Indications

Xu Empty 1. Forceless on the three regions at all 3 levels Deficiency syndrome
Deficiency of pressure (key point for this pulse)
Similar to weak, fine, faint pulses.
2. A pulse feeling feeble and void Occurs when deficiency of blood is more severe than in weak/fine pulses, but
not so deficient as the faint pulse.
Easy pulse to mistake. Pay attention to the key
point highlighted above. So on a scale of severity, least to most severe: 1) weak, 2) fine, 3)
empty/deficient, 4) faint.

Wei Minute 1. Extreme thin and soft 1. Yin deficiency

Feeble 2. Yang deficiency
Crisis pulse Faint 2. Feels thready and soft; scarcely perceptible 3. Qi deficiency
4. Xue deficiency
Weaker than the thready pulse.
Feels this way on all levels, all pressures. Extreme exhaustion is obvious to both patient and doc. Pulse lacks substance,
volume, strength; exhaustion of body essences. Prognosis is very bad.

Xi Thready 1. Fine thread 1. Deficiency due to overstrain and stress

Thin No kidding: it feels like a literal thread and 2. Yin deficiency
Fine you can feel it on all levels/depths. It can 3. Blood deficiency
even be strong, but slender. 4. Qi deficiency
Very distinct and clear. Key point 5. Dampness
6. Essence deficiency due to chronic illness
2. Always feels like a fine thread, distinctly
perceptible.

Dai Intermittent or 1. Regularly irregular – pulse seems to miss a 1. Exhaustion of the organs
Regularly beat but with definite pattern. 2. Trauma (accident)
intermittent
2. A slow pulse pausing at irregular, Usually only see in cases where patient is hospitalized or in advanced disease
predictable intervals. stage.

This is the only regular irregular pulse! Example: serious heart disease due to deficiency/blockage, blood
stasis/phlegm.

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Duan Short 1. Not felt in all 3 positions (depths) 1. Qi deficiency

2. Pulse with short extent. 2. Qi stagnation or block

Short pulse seems to deteriorate from central The fact that this pulse strikes hard on the mid finger and leaves quickly can
pulse position towards the 2 adjacent pulse represent: 1) contraction of Qi – aka liver qi stagnation, or 2) deficiency of
positions. Strikes the middle finger sharply, Qi.
leaves quickly.

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Excess Pulses
Also called Full pulses. Indicate excess conditions.

Chinese name English name Description Indications

Shi Full 1. Pulse can be felt strongly on all 3 levels. 1. Excess heat
Replete Key point.
Forceful Gives little info other than condition = excess. Use all other diagnostic skills
Excess 2. Felt vigorously and forcefully on both light to determine the nature of the excess.
and heavy pressure
Generally, indicates you should not use tonification because this also
Very strong indicates the body’s resistance is undamaged.

Hua Slippery 1. Smooth, like a row of pearls on a dish 1. Dampness

Smooth rolling past under your fingers 2. Phlegm
Rolling 3. Food retention
2. Beads rolling on a plate 4. Pregnancy (often called “happy pulse” in China)

Very regular and orderly, hitting the fingers one While this pulse can be a normal condition it is often good confirmation of
at a time diagnosis of phlegm-damp accumulation

NOTE: Never indicates deficiency!

Slippery Combinations
Slippery is always an excess pulse. Not deficiency!

Slippery + fast = Damp heat. Phlegm heat/fire. Food retention w/heat.

☯ Indicates damp is middle jiao, spleen can’t metabolize the water properly.

☯ Indicates Phlegm. Phlegm is primarily stored in the lungs but can also be present in the meridians. Phlegm is more condensed and
sticky than just dampness. This is like dampness, but congealed by either heat cooking the excess liquid off or congealed by cold.
Phlegm in the Lung is literal phlegm that can (eventually) be coughed out. Phlegm in the meridians is “invisible” phlegm. or it
could be invisible phlegm. Invisible phlegm can cause Shen disturbance by blocking the easy flow of Qi and blood to and from the
heart and brain and it can get blown around by an inner wind and cause a condition such as a stroke. Phlegm, literal or invisible
can cause stagnation and blockage which can lead to an interior condition of fire.

☯ Food retention. Babies get this a lot—food retention leads to fever and internal heat.

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Jin Tight 1. Tight, forceful like a stretched rope (thicker 1. Cold.
Tense feel than the Xian or Wiry pulse) Cold stretches and contracts, hence the tight tense pulse.
♦ External cold
2. Like a tightly stretched cord. ♦ Internal cold = tight, slow pulse
2. Pain
3. Food retention
Tight is the hardest – no flex
Wiry – hard, but will still flex Similar to wiry pulse, but not as long.
Slippery – soft and flexible
While pain can easily be reported, cold is sometimes disguised by localized
heat symptoms. This pulse can indicate either exterior or interior cold.

Chang Long 1. Straight/ beyond position 1. Excess Yang Qi

2. Heat
2. Pulse w/long extent, prolonged stroke
Shows that the vessels are strong and Stringy quality indicates a level of tension, corresponding to a liver
flexible. syndrome.

In young people especially: can feel this pulse If acute disease, long pulse will occur when there is a strong confrontation
across all 3 finger positions at once. between body resistance and pathogen.

Xian Wiry 1. Taut, straight, long, like violin string 1. Liver

Stringy 2. Gallbladder (inflammation—alcohol and fried foods make it worse)
Taut 2. Feels straight and long, like musical string 3. Pain
String-taut instrument. 4. Phlegm
Bowstring 5. Malaria
Hits all 3 fingers at the same time.
Similar to tense pulse, but longer, more tremulous. Severe pain can be easily
Note: leathery pulse is superficial, feels similar, reported, but wiry pulse confirms liver and/or gallbladder as the point of
but wiry pulse is not a superficial pulse. disharmony.

Wiry Pulse Combinations

In order of hardness: 1) tight, 2) wiry, 3) slippery

Wiry + fast = liver heat.

May have a bitter taste in the mouth and/or anger. Hepatitis patients have this pulse in the acute stage. Look at the tongue: the sides
will be red or you might see a red tongue, possibly with a yellow coat.

Wiry + thin = liver and kidney yin deficiency.

Hypertension patients and arteriosclerosis patients can have this pulse. Hits the fingers hard and strong.
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Strange Pulses
In addition to the 28 disease pulses, there are 10 strange pulses (very severe conditions) and 7 death pulses. Both indicate dangerous
conditions with poor prognosis—yang is almost gone, stomach qi almost gone. This dude is dead, man.

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