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110 Cards in this Set

  • Front
  • Back
Six pulse categories
superficial or deep
slow or rapid
forceful or forceless
Characteristics of a normal pulse
Has an even and gentle pulsation in all three positions, beats 4-5 times in one breath (of the practitioner), approximately 60-90 beats/min. Full of stomach Qi, full of Spirit, puse is rooted.
*Floating pulse image
Fu Mai
forceful on superficial depth, decreasing in strength with depth (but without feeling empty)

Like wood floating on the surface of water
Floating pulse indications
exterior syndrome or deficiency syndrome
floating + forceful
exterior excess
exogenous factors invade the exterior of the body, defense yang qi rises against it. The yang pushes the qi and blood to the surface to defend the body from attack.
floating + moderate
exterior deficiency
exogenous factors invade the exterior of the body, defense yang qi rises against it. The yang pushes the qi and blood to the surface to defend the body from attack.
floating + forceless + thin
yin, blood exhaustion
yin is deficient and can't anchor the yang, or
floating + forceless
yang exhaustion
yang is nearing exhaustion, too weak to match yin, yang will float to the surface as separation yin and yang begins
*Submerged pulse image
(deep, sunken)
Chen Mai
absent on superficial depth, increasing in stregth with depth; distinct only when pressing down on bones and tendons

Like a stone thrown into a well, it must sink to the bottom.
Submerged pulse indications
interior syndrome
submerged + forceful
interior excess
pathogenic factors accumulate in the body, obstructing the outward movement of the qi, blood and yang
submerged + forceless
interior deficiency
Qi and blood deficiency cannot fill the channels or viscera
Autumn pulse
Winter pulse
submerged pulse
When is a floating pulse normal?
pulse in Autumn, or in thin people; also in patients on vasodilating pharmaceuticals
When is a submerged pulse normal?
pulse in Winter, or in a heavy person
*Slow pulse image
Chi Mai
Pulse frequency is less than 3 beats per breath (40-60 bpm), but with regular rhythm
Slow pulse indications
cold syndrome or
qi deficiency
slow + forceful
cold accumulation
Cold causes contraction. Cold invades the body, the qi and blood become stagnant.
slow + forceless
deficiency cold
Cold causes contraction. Deficiency of yang produces cold, the qi and blood becomes stagnant.
When is slow pulse normal?
Pulse in some healthy persons, like athletes or those engaged in heavy physical labor.
*Rapid pulse image
Shuo Mai
Pulse frequency is more than 5 beats per breath (90-140 bpm), with regular rhythm
Rapid pulse indications
heat syndrome
rapid + forceful
excess heat
Excessive pathogenic heat increases the circulation of the qi and blood which causes the pulse to quicken
rapid + thin
yin deficiency
yin deficiency causes a relative hyperactivity of yang which causes the pulse to quicken
rapid + hollow
blood deficiency
blood deficiency causes a relative hyperactivity of yang which causes the pulse to quicken
*Excessive pulse image
(full, replete)
Shi Mai
Long, wide, and forceful (sense of fullness). Pulse can be felt in all three positions and at all three depths.
Excessive pulse indications
excess syndrome
hyperactivity of pathogenic factors vs. strong antipathogenic qi
ex: pathogenic cold accumulation, food stagnation, phlegm retention, qi or blood stagnation
Excessive pulse as normal pulse
When pulse is strong and calm it indicates that the person has sufficient atipathogenic qi and zang fu organ functions.
*Deficient pulse image
(empty, vacous)
Xu Mai
Wide, forceless at all three positions with either light or heavy pressure, slack (sense of emptiness in this pulse).
Deficiency pulse indications
deficiency syndrome
floating + deficient
qi deficiency
-pulse will be forceless
submerged + deficient
internal deficiency
choppy + deficient
blood deficiency
rapid + deficient
yin deficiency
slow + deficient
yang deficiency
Large pulse image
Da Mai
Wide, the vessel is wide and thick
wide + forceful
excess heat
excess pathogenic heat in the interior dilates the blood vessels and accelerates the qi and blood circulation
wide + forceless
extreme deficiency of essence or yin cannot anchor the yang, so yang floats to the lateral margins of the vessels
*Thin pulse image
(fine, thready, "small")
Xi Mai
Width is very thin, feels like fine thread, but very distinct and clear without interruption of rhythm when pushing on the pulse.
Thin pulse indications
Qi, blood, or yin deficiency
Excess - dampness
When thin pulse is normal
Thin pulse more commonly encountered in females than males; if person has smaller constitution, not pathological
Long pulse image
Chang Mai
long and straight, extend beyond usuall three pulse positions
Long pulse indications
excess syndromes:
Liver yang rising
Excess interior heat
When is long pulse normal
When long pulse is moderate in strenth can also be a sign of health in normal person.
Short pulse image
Duan Mai
Pulse cannot be felt in all three positions.
Short pulse indications
qi disease
short + forceful
qi stagnation
qi stagnation fails to move the blood, so vessel is not stretched, the pulse is short
short + forceless
qi deficiency
qi too weak to move blood, blood circulation is slow and blood in vessels will stagnate
*Slippery pulse image
Hua Mai
The pulse is quick (though not rapid), slippery, smooth. It is rounded inside the vessel. Like a pearl rolling on a plate
Slippery pulse indications
excess heat
phlegm or dampness
food stagnation
When is slippery pulse normal?
Pregnant women in whom it indicates sufficient and harmonious qi and blood. In absence of any pathogenic changes the slippery pulse can be found in the normal person.
*Choppy pulse image
(rough, hesitant, sluggish)
Se Mai
Pulse seems to be slow and not smooth. Vessel is thin. Rhythm is irregular in force and fullness. Like knife scraping bamboo.
Choppy pulse indications
excess syndrome
deficiency syndrome
choppy and forceful
excess syndrome: qi & blood stagnation; food stagnation; phlegm stagnation
choppy and forceless
deficiency syndrome: blood deficiency; essence deficiency; threatened abortion; seminal emission
*Flooding pulse image
(overflowing, surging)
Hóng Mái
Easily felt at superficial depth, wide and forceful although fades gently. Vessel is wide and thick. Like ocean wave that comes strongly, but leaves calmly.
Flooding pulse indication
excess heat on the qi level
When flooding pulse is normal
in the Summer
*Rapid Irregular Pulse Image
(hasty, abrupt, skipping)
Cù Mài
Rapid, irregular pauses
feels agitated and urgent, like a man running and suddenly falling down
Rapid irregular pulse indications
excess syndrome
deficiency of zang fu organs
rapid irregular + forceful
excess heat
stagnation (pathogen causes blockages)
Excess heat can give rise to stagnation and stagnation can cause heat.
rapid irregular + forceless
yin and yang disharmony
Yin deficiency gives rise to a rapid pulse. In time, leads to deficiency of yang which limits Heart's ability to push the blood, resulting in irregular pauses.
When rapid irregular pulse is normal.
In cases of congenital variation
*Slow irregular pulse image
(knotted, bound)
Jié Mái
Slow, irregular pauses; after missed beat, the pulse immediately resumes
slow irregular pulse indication
excess syndrome: stagnation, cold, tumor or mass
deficiency syndrome: Heart qi deficiency
When slow irregular pulse is normal.
In cases of congenital variation
*Consistently irregular pulse
(intermittent, regularly intermittent)
Dài Mài
regularly missed beats, long pauses
Consistently irregular pulse indications
excess syndromes
deficiency syndromes
consistently irregular + rapid
wind syndrome
emotional shock
consistently irregular + forceless
qi and/or blood deficiency
zang fu organ qi deficiency
When consistently irregular pulse is normal
in congenital variation; also found during 2nd and 3rd month of pregnancy.
*Soggy pulse image
(weak-soft, soft)
Rú Mài
Superficial, thin, forceless. If pressed becomes weaker and weaker.
Like a strand of cotton floating on water, feels very thin and indistinct.
Soggy pulse indications
deficiency syndrome (if pulse disappears when pressed, the yang is expiring)
abnormal soggy pulse indications
If this pulse present in a young or otherwise strong patient, the prognosis is not good. Excessive diseases with deficient pulses do not suggest a good prognosis.
*Frail pulse image (weak)
Ruò Mài
deep, thin, forceless
if more pressure applied, the pulse is lost
Frail pulse indications
yin, yang, qi or blood deficiency syndrome
sign of decline
Hollow pulse image
(scallion stalk)
Kōu Mài
floating, wide, and slack, with obscure center; pulse is wide and soft when touched lightly, hollow when seeking, with pressure edges of vessel clearly felt but center is obscure
Hollow pulse indications
severe condition, loss of blood or yin condition
hollow and forceless
loss of blood
hollow + rapid
yin depletion
Leather pulse image
(tympanic, drum-skin)
Gé Mài
large (thick and wide), rapid and forceful when lightly touched, but hollow when pressed deeply
Leather pulse indications
blood loss; essence exhaustion; abortion; metrorrhagia and metrostaxis
Scattered pulse image
Sàn Mài
superficial, scattered without root, uneven rhythm (when seeking or pressing, pulse disappears, rate hard to count)
Scattered pulse indications
exhaustion of qi, functional failure of zang fu organs; critical condition; when pulse appears in pregnancy in 3rd trimester, labor is imminent; if pulse present in 2nd trimester, means potential miscarriage
Hidden pulse image
Fú Mài
Pulse cannot be felt when touching, seeking, or pressing. Only by pressing very heavily to the bone can it be felt. Pulsation comes from beneath tendons and bone.
Hidden pulse indications
pathogens obstructing the interior
syncope (yang deficiency)
Hidden pulse normal
During pregnancy, woman may have a hidden pulse. In absence of other signs and symptoms this pulse would not indicate pathological change.
Confined pulse image (firm)
Láo Mài
deep, forceful, wide, taut, long, stable
Deeply located, it cannot be felt by light or moderate pressure
Confined pulse indications
Interior excess cold syndrome (Hernia, lumps, and masses)
Faint pulse (minute pulse) image
Wēi Mài
Vessel is extremely thin and forceless. It seems to be felt, and then not felt. When pressing deeply, the vessel and pulse become vague.
Faint pulse indications
yin, yang, qi or blood deficiency syndrome
sign of decline
*Wiry pulse image
(string-taut, taut, string-like)
Xián Mài
Long, taut, stable (not vibrating), forceful whether under pressure of the fingers or not. Like a string stretched on a musical instrument.
Wiry pulse indications
Lv/GB disease
Wiry pulse pathogenesis in Lv/GB disease
Wirly pulse is manifestation of tense vascular qi. Lv fails to disperse and govern the flow of qi, qi accumulates and strongly pushes the blood which increases the vasotonia and gives rise to the wiry pulse.
Wiry pulse pathogenesis in phlegm, pain and malaria
Wiry pulse is yin hidden within yang. Pulse caused by qi and blood stagnation. Phlegm, pain and malaria result in imbalance between yin and yang, increasing the tension of vascular qi.
When is wiry pulse normal?
*Tight pulse image (tense)
Jŭn Mài
Pulse rises and falls with strength and vibrates to the left and right.
Tense and taut, forceful, vibrating (unstable, movable)
Like fingers on a tightly stretched and twisted chord, snapping back and forth.
Tight pulse indications
Cold pattern
food stagnation
Moderate pulse image
(slowed-down, lax, retarded, leisurely)
Huăn Mài
Pulse beats four times per practitioner's breath, faster than slow pulse.
Feels slow, though normal in rate when timed
Normal Moderate pulse
Pulse is vigorous with equal intervals, moves smoothly, and is the same in all three positions.
Morbid Moderate pulse
Pulse is sluggish; it's movement feels slow. Usually accompanied by other pulse qualities.
Moderate pulse indications
Dampness syndrome
Spleen and Stomach deficiency
Moving pulse image
(stirred, spinning bean, bouncing)
Dòng Mài
Shape is short and round, slippery and rapid, forceful in the middle position.
Like a bean bouncing in the vessel, with well defined peaks, but without head or tail.
Moving pulse indications
Sign of struggle between yin and yang.
When is a moving pulse normal?
Can be seen in pregnant women in their first trimester, at which time this is considered a normal pulse.
Racing pulse image
(hurried, urgent, swift)
Jí Mài
Extremely rapid. More than 7 times per breath (140-180 bpm). Rhythm is regular.
racing + forceful
hyperactivity of yang and excessive heat
critical pulse
racing + forceless
yin exhaustion and antipathogenic qi collapse
critical pulse
What are the seasonal changes in pulse quality?
Spring - Wiry
Summer - Flooding
Autumn - Floating
Winter - Deep