Reference Guide
How to Use This Reference
The 28 pulse qualities are grouped below into six categories: Depth, Rate, Force, Width, Rhythm, and Texture. In clinical practice, multiple qualities are usually present simultaneously — a pulse is commonly described as a compound: "thin and rapid," "wiry and slippery," "deep and slow." The compound reveals more than any single quality alone.
The Most Clinically Important Pulses
The following pulses are considered the eight most clinically significant for pattern diagnosis: Floating (浮), Sinking (沉), Slow (遲), Rapid (數), Empty (虛), Full/Excess (實), Slippery (滑), and Choppy (澀). Mastery of these eight covers the majority of clinical presentations.
Category 01
Depth Qualities
Floating vs. Sinking
浮沉 · fú chén
Floating 浮脈fú mài
"Like wood floating on water — present at the surface, diminishes on pressing."
Pattern: Exterior invasion (Wind-Cold or Wind-Heat). In deficiency conditions: Yin or Blood deficiency causing Yang to float upward. Floating + rapid + tight = Wind-Cold exterior excess.
Sinking 沉脈chén mài
"Like a stone sinking — only found on firm, deep pressure near the bone."
Pattern: Interior pattern. Deep + forceful = interior excess (Cold, Qi stagnation, Blood stasis). Deep + weak and soft = interior deficiency (Kidney, Spleen). Deepest level always reflects Kidney Qi.
Hidden 伏脈fú mài
"Deeper than Sinking — only found when pressing to the very bone."
Pattern: Severe interior pathology — extreme Cold obstruction, fainting, severe pain syndromes, or Yang collapse. Also seen in extreme Phlegm obstruction. Clinically rare but significant.
Hollow 芤脈kōu mài
"Like pressing a hollow scallion stalk — present on surface and deep, empty in the middle."
Pattern: Sudden massive Blood loss. The walls remain but the interior is empty — Blood has been lost but the vessel walls haven't yet collapsed. Post-hemorrhage, heavy menstrual loss, severe trauma.
Category 02
Rate Qualities
Fast vs. Slow
遲數 · chí shù
Slow 遲脈chí mài
"Fewer than 4 beats per practitioner's breath (<60 bpm). Unhurried, held back."
Pattern: Cold. Slow + forceful = excess Cold obstructing circulation. Slow + weak = Yang deficiency — not enough energetic fire to drive the pulse faster. Also seen in athletes (physiological bradycardia) — requires context.
Rapid 數脈shù mài
"More than 5 beats per breath (>90 bpm). Hurrying forward."
Pattern: Always indicates Heat. Rapid + forceful = excess Heat. Rapid + thin + weak = Empty Heat (Yin deficiency). Rapid + floating = exterior Heat (febrile illness). Rapid + deep = interior Heat.
Moderate 緩脈huǎn mài
"Relaxed, slightly slower than normal — 4 beats per breath. Unhurried and even."
Pattern: When relaxed and even = normal Stomach Qi (a healthy quality). When slightly loose and lacking tension = Spleen deficiency with Damp. Context determines whether this is a sign of health or pathology.
Racing 疾脈jí mài
"7 or more beats per breath (>120 bpm). Extremely rapid and urgent."
Pattern: Extreme Heat or extreme Yang deficiency (as the Yang collapses, the pulse races before it fails). Very serious sign in any chronic illness context. Also seen in high fever, hyperthyroid states, severe anxiety attacks.
Category 03
Force Qualities
Excess vs. Deficiency
虛實 · xū shí
Full / Excess 實脈shí mài
"Large, forceful, and present at all three levels — pushing back against the finger."
Pattern: Excess condition — the pathogenic factor is strong and the body's resistance is also strong. Interior excess: Heat, Phlegm, Blood stasis, or food stagnation in significant quantity. Strong constitution fighting a strong pathogen.
Empty / Deficient 虛脈xū mài
"Present at light pressure but soft and without force — collapses on deeper pressing."
Pattern: Deficiency of Qi and/or Blood. The pulse lacks the substance to push back. The most direct indication of overall deficiency. Often accompanied by fatigue, shortness of breath, pallor, and weak voice.
Weak 弱脈ruò mài
"Deep, soft, and thin — only felt on pressing, without force."
Pattern: Qi and Blood deficiency in the interior — specifically organ deficiency. The combination of being deep (interior) + soft (no force) + thin (insufficient substance) confirms significant depletion. Common in chronic illness and elderly patients.
Scattered 散脈sàn mài
"Large but diffuse and formless at the surface — like blowing leaves, cannot be grasped."
Pattern: Exhaustion of Kidney Qi — the root of the body's vitality. Considered a serious prognostic sign in acute illness. The pulse has lost its cohesion because the fundamental organizing force (Kidney Qi) is severely depleted.
Category 04
Width & Length Qualities
Thin vs. Large
寬窄 · kuān zhǎi
Thin / Thready 細脈xì mài
"Like a fine thread — distinct and clear but extremely narrow in width."
Pattern: Blood deficiency or Yin deficiency. Not enough substance to fill the vessels. Thin + rapid = Yin deficiency with Empty Heat. Thin + slow = Blood deficiency with Cold. One of the most common pulses in chronic illness.
Large 洪脈hóng mài
"Like a cresting wave — surging up powerfully and diminishing gradually."
Pattern: Extreme exterior Heat flooding the channels. Classic in high fever, sunstroke, intense febrile disease. Surging force on arrival, diminishing on return — the pattern of Heat driving Blood outward with force.
Long 長脈cháng mài
"Extends beyond its position — felt past the Cun toward the fingers, or past the Chi toward the elbow."
Pattern: If forceful = excess Heat or Liver Yang excess. If relaxed and even = normal in constitutionally strong individuals (healthy Qi). Excess Qi driving the pulse beyond its expected boundaries.
Short 短脈duǎn mài
"Felt only under one finger — doesn't fill all three positions."
Pattern: Qi deficiency (if short and forceless) — Qi cannot move Blood to fill the vessels fully. Or severe Qi stagnation with obstruction (if short and forceful) — Qi is blocked from extending. Most commonly indicates deficiency.
Category 05
Tension & Texture Qualities
The Most Clinically Distinctive Pulses
形質 · xíng zhì
Wiry 弦脈xián mài
"Like pressing a taut bowstring — straight, tense, resistant."
Pattern: Liver and Gallbladder patterns, Qi stagnation, pain, Phlegm retention. The most common abnormal pulse in modern clinical practice. Wiry + rapid = Liver Fire. Wiry + thin = Liver Blood deficiency with Qi stagnation.
Slippery 滑脈huá mài
"Like rolling pearls — smooth, round, gliding under the finger."
Pattern: Phlegm, Damp, food stagnation, excess patterns. Also: normal pregnancy (the Blood fills to nourish the fetus). Slippery + rapid = Phlegm-Heat. Slippery + wiry = Phlegm with Liver stagnation.
Choppy / Rough 澀脈sè mài
"Like a knife scraping bamboo — hesitant, uneven, difficult to feel."
Pattern: Blood deficiency or Blood stasis. The opposite of Slippery — indicates insufficient or obstructed Blood flow. Choppy + thin = Blood deficiency. Choppy + forceful = Blood stasis. Classic in post-blood-loss states and chronic pain.
Tight 緊脈jǐn mài
"Like a twisted rope — taut and twisting under the finger with a certain urgency."
Pattern: Cold and pain. The Cold causes the vessels to contract and tighten. Tight + floating = exterior Wind-Cold. Tight + deep = interior Cold accumulation. Tight + wiry = Cold with Liver involvement (severe cramping or pain with Cold).
Soft / Soggy 濡脈rú mài
"Floating, thin, and soft — like a thread floating in water, disappears on pressing."
Pattern: Dampness with Qi and Blood deficiency. The Damp is present (floating quality) but the substance is insufficient (thin). Classic in chronic Spleen-Damp patterns where the person is both damp and depleted. Common in chronic fatigue with heaviness.
Firm 牢脈láo mài
"Deep, wiry, and forceful — like pressing on a taut cord fixed near the bone."
Pattern: Interior excess Cold or Yin accumulation in fixed locations (masses, accumulations). The combination of deep + wiry + forceful indicates a substantial, solidified obstruction in the interior. Associated with masses, Blood stasis accumulations.
Category 06
Rhythm Qualities
Regularity and Interruptions
節律 · jié lǜ
Intermittent 代脈dài mài
"Regular beats with stops at regular intervals — the pause is predictable and extended."
Pattern: Organ Qi decline — specifically declining Zang organ Qi with inability to maintain regular rhythm. Also: pain, fright, or pregnancy-related. Traditionally considered a serious sign of internal organ weakness. Modern correlation: heart block or severe deficiency.
Knotted 結脈jié mài
"Slow with irregular pauses — like a stream with obstacles, stopping unpredictably."
Pattern: Cold, Qi stagnation, Blood stasis, or Phlegm accumulation obstructing the Heart channel. The slowness + irregular pauses indicate Cold obstruction. Also: emotional constrain causing Heart Qi blockage.
Hurried 促脈cù mài
"Rapid with irregular pauses — like rapid footsteps that occasionally stumble."
Pattern: Excess Heat with Qi stagnation, Blood stasis, or Phlegm obstruction — the Heat drives the pulse to race, but accumulated pathology interrupts the flow. The rapid base + irregular pauses = excess disrupting regularity.
Moving 動脈dòng mài
"Like a bean jumping under the finger — slippery, rapid, felt only at the Guan position."
Pattern: Pain or fright causing sudden Qi disruption. The pulse feels almost localized — jumping at one position only. Also associated with pregnancy. The "jumping bean" quality distinguishes it from all other pulses.