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Hand/Wrist Pulse Feeling

In traditional Chinese medicine the pulse is considered as having three divisions : cun, guan, and chi. A normal pulse is neither superficial nor deep, neither quick no slow, and it beats in medium frequency, i.e., 4-5 beats per breath, with a regular rhythm.

To feel the pulse correctly, place the patients hand comfortably on a cushion with the palm facing upward. First, the practitioner should put their middle finger on the guan division, then the index and ring fingers should naturally fall on the cun and chi divisions. Finger force should at first be light, then moderate and finally heavy to get a general picture of the depth, rhythm, strength, and form of the pulse. An even force should be applied on the three regions. Through comparisons of the three regions, the practitioner can gain a correct impression of the pulse as a whole. A normal pulse is of moderate frequency, i.e., 4-5 beats per breath, regular rhythm, even and forceful.

The following are abnormal pulses commonly seen in the clinic:

Floating Pulse (fumai)

When the pulse is pressed lightly it appears under the finger, and when pressed heavily it becomes weak. It often occurs in the early stages of diseases caused by exogenous pathogenic wind cold and heat, i.e., exterior syndromes. If it is seen in patients who are suffering from prolonged chronic diseases, it indicates a dangerous site where the yang qi of the body flows outward.

Deep Pulse (chimai)

No clear pulse is felt by superficial pressure, only by heavy pressure. This indicates an interior syndrome.

Rapid Pulse (sumai)

The pulse beats rapidly at a rate higher than the normal 5 beats per breath (i.e., more than 90 times per minute). This indicates a heat syndrome.

Xu Type Pulse (xumai)

If the pulses of the three regions are weak and forceless, this indicates xu type syndromes. These are mostly caused by both qi and blood deficiencies and are seen during the process of chronic diseases.

Shi Type Pulse (shimai)

If the pulses of the three regions are forceful with both light and heavy pressure, shi type syndromes are present.

Slippery pulse (huamai)

If the pulse is smooth and flowing, like a pearl rolling on a plate, this indicates excessive phlegm, retention of food, or shi heat type syndromes.

Rough Pulse (semai)

This pulse is uneven and has a roughness similar to scraping bamboo with a knife. It indicates a deficiency of blood and essence, qi stagnation, and blood stasis.

Fine Pulse (ximai)

This pulse is as fine as a silk thread, and indicates exhaustion of qi and blood.

Full Pulse (hongmai)

This pulse beats like a dashing wave, with one rising wave following another. It indicates excessive heat.

Wiry Pulse (xuanmai)

This pulse is straight and long, like a tremulous music string, seen usually in diseases of liver, gall bladder, pain, or phlegm-humor.

Tense Pulse (jinmai)

The pulse is taut and forceful, like a tightly stretched cord, and occurs in diseases caused by cold, pain, or retention of food.

Hollow Pulse (koumai)

This pulse is floating, large, and empty inside, feeling like a scallion stalk. It indicates a massive loss of blood and essence.

Hesitant Pulse (cumai)

This pulse is rapid with irregular intermittent beats. It indicates excessive yang and shi heat, qi stagnation, pathogenic phlegm mixture with cold, blood stasis, etc.

Knotted Pulse (jiemai)

This pulse is slow and uneven with irregular intervals. It indicates excessive yin, qi stagnation, pathogenic phlegm mixture with cold, blood stasis, etc.

Intermittent Pulse (daimai)

This pulse is slow with regular intervals. It indicates qi exhaustion of the zang organs, or syndromes of wind and pain caused by emotional pathogenic fright and fear.

Read more on Body Pulse.

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