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Pulse Diagnosis in Traditional Chinese Medicine

Alternative Medicine and Natural Health in NYC

The analysis of the pulse by an acupuncturist using Traditional Chinese Medicine is much more involved than what we typically see in conventional medicine. When the pulse is palpated in the conventional setting the two concerns are rate and rhythm, that is: how fast the heart is beating and whether the beats occur at regular intervals. These two factors are just as important in TCM pulse diagnosis as they are in Western medicine but in TCM many other aspects of the pulse are also taken into consideration.

The pulse is usually felt on both wrists with three fingers on three positions, each representing a different section of the body or a different pair of organs. It may sound strange, but the pulse can actually feel completely different between left and right wrists and sometimes even between each position on the same wrist. Pulse analysis in TCM can be divided into five dimensions:

Depth: An acupuncturist will feel how strong the pulse is on the surface of the wrist compared to how strong it feels when one presses deeper. A pulse that is stronger or can only be felt on the surface may indicate an External condition (though it can also indicate a Yin deficiency), while a pulse that is stronger or can only be felt on pressing deeper may indicate an Internal condition.

Width: If the blood vessel (the radial artery) feels thin, it generally indicates a Deficient condition, while if the vessel feels wide, it generally indicates an Excess condition.

Length: A pulse is short if it can not be felt with all three fingers, usually indicating Deficiency, whereas a pulse is long if it extends past the three fingers which can sometimes indicates Excess.

Time: This is our familiar rate and rhythm. A fast pulse indicates Heat whether Excess or Deficient, while a slow pulse indicates Cold, again whether Excess or Deficient. Irregular pulses indicate serious and complicated imbalances.

Character: Chinese medicine recognizes several qualities of the pulse that are difficult to describe with words, but can readily be recognized by someone familiar with pulse diagnosis. A “wiry” pulse for example indicates a Liver disharmony, while a “slippery” pulse generally indicates Dampness or Phlegm.

So that is a brief introduction to pulse analysis, one of the more difficult skills to learn in Chinese medicine. Historically, these characteristics have been organized into formal pulse categories, often with descriptive names such as “the scallion stalk pulse” or “the imprisoned pulse”. By comparing the characteristics of the pulse with the finger location where the pulse is palpated, valuable information regarding a patient’s health is readily accessible.