TCM PulseTaking a patient’s pulse from the model of Traditional Chinese Medicine (TCM) is quite an art indeed. It’s an art because it requires “listening” to the pulse and in nine different ways. Briefly and simply, here is how pulse reading is done in TCM along the radial artery: the pads of the practitioner’s three fingers (index, middle and ring) are placed on the radial side of the patient’s wrist (palm side). The first position at the wrist crease is called “cun” and it’s where the index finger is placed. On the left hand this position assesses the primary “fire element” or the Heart (yin) and Small Intestine (yang) meridians. The middle finger which is at the position next to the index finger is called “guan” and it assesses the “wood element” or the Liver (yin) and Gallbladder (yang) meridians. The ring finger which is proximal to the wrist and beside the middle finger is positioned at “chi” and it assesses the “water element” or the Kidney (yin) and Urinary Bladder (yang). On the right hand the sequence is as follows: the index finger which is at the wrist crease assesses the “metal element” or the Lung (yin) and Large Intestine (yang) meridians. The middle finger assesses the “earth element” or the Spleen (yin) and Stomach (yang) meridians. The ring finger assesses the secondary “fire element” or the Pericardium (yin) and the San Jiao (yang).

Along with these six pulse assessments the practitioner feels the superficial level of the pulse where the state of yang organs and qi are, then the middle level where the Stomach and Spleen dominate and at the deep level to the bone where the state of yin organs dominate.

When listening to the pulse at these three levels and six positions the practitioner determines the quality of the pulse in terms of its speed (rapid, slow), strength (empty, full), depth (floating, deep), length (if long in elderly can indicate a long life), size (thin, big), rhythm (knotted, hurried, irregular, etc.) and shape (e.g., slippery, wiry, choppy). At least twenty-eight different combinations are noted that the practitioner must be sensitive to listening to and deciphering.

As the practitioner takes a breath in and exhales a patient’s normal pulse will have 4 to 5 beats, less than 3 beats indicates a slow pulse and anything greater than 5 beats per breath indicates a fast pulse.

Pulse taking is quite comprehensive in TCM. A lot of information can be obtained from the patient by his/her pulse such as: the health of the qi in general; the relationship between yin and yang organs; states of deficiency and excess and whether an exterior pathogen is present.