Pulse Diagnosis: The 28 Pulses (脈診二十八脈)
Pulse diagnosis (脈診, Mai Zhen) is arguably the most sophisticated diagnostic tool in Chinese Medicine — and the most demanding to master. The 28 classical pulse types (二十八脈) provide nuanced information about the nature, location, and pattern of disease that no other diagnostic method can match.
The Three Positions
Diagnosis occurs at the radial artery on both wrists using three positions: Cun (寸) — the position closest to the wrist crease (Left: Heart/Small Intestine; Right: Lung/Large Intestine). Guan (關) — the middle position (Left: Liver/Gallbladder; Right: Spleen/Stomach). Chi (尺) — furthest from wrist (Left: Kidney Yin, Bladder; Right: Kidney Yang/Ming Men).
The Eight Principal Pulse Pairs
(1) Floating (浮) vs. Deep (沉): Exterior/surface conditions vs. Interior/organ-level conditions. (2) Rapid (數) vs. Slow (遲): Heat/Yang excess vs. Cold/Yin excess or deficiency. (3) Full/Strong (實) vs. Weak (虛): Excess pattern vs. Deficiency pattern. (4) Wide (洪) vs. Thin (細): Heat/Blood excess vs. Blood/Yin deficiency. (5) Wiry (弦) vs. Moderate (緩): Liver disharmony/pain vs. Spleen Qi harmony. (6) Slippery (滑) vs. Choppy (澀): Phlegm/Food stagnation or pregnancy vs. Blood deficiency/stasis. (7) Tight (緊) vs. Soft (濡): Cold-Pain pattern vs. Dampness/deficiency. (8) Short (短) vs. Long (長): Qi deficiency vs. Excess/Liver excess.
The Art and Science of Pulse Reading
The ideal pulse reading time is early morning — before eating, movement, or emotional stimulation. The practitioner's own inner stillness is prerequisite: as the Nei Jing states, 'the Spirit (Shen) must be concentrated' for accurate pulse reading. Advanced pulse diagnosis reveals not just current conditions but constitutional tendencies and future vulnerability patterns.