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中医基础诊断复习

时间表
阴阳
五行
精气血津液
脏腑

1	August 4	中医基础：阴阳，五行
2	August 6	中医基础：精气血津液
3	August 13	中医基础：脏腑
4	August 20	中医诊断：望，闻
5	August 27	中医诊断：问，切
6	September 3	中医诊断：八纲辨证
7	September 10	中医诊断：气血辩证
8	September 17	中医诊断：脏腑辨证-1
9	September 24	中医诊断：脏腑辨证-2
10	October 1	中医诊断：卫气营学和六经辨证

阴阳

阴阳的基本含义：阴阳，是人们对自然界相互关联的事物及现象对立双方相对属性的概括。

Yang 阳	Yin 阴
Fire 火	Water 水
Light 光	Darkness 暗
Sun 太阳	Moon 月亮
Brightness 明亮	Shade 阴影
Activity 动	Rest 静
Heaven 天	Earth 地
Round 圆形的	Flat 扁形的
Time 时间	Space 空间
East 东方	West 西方
South 南方	North 北方
Left 左边	Right 右边

阴阳学说的基本内容

1. 阴阳对立与互根：阴阳对立，是指自然界的一切事物及现象存在着相互对立两个方面的相反属性。阴阳互根，是指阴或阳必须以其对方的存在作为自己存在的前提和依据，任何一方都不能脱离对方而单独存在。
2.阴阳的制约与互用阴阳制约，是指相互对立的阴阳双方常可表现出相互抑制和约束的关系。阴阳互用，是指相互依存的阴阳双方常可表现出相互资生和促进的关系。
3. 阴阳消长与转化事物的阴阳双方不是静止不变的，而是处于不断地运动变化之中。其运动变化包括量变的消长和质变的转化两种形式。
4. 阴阳的平衡与失衡阴阳平衡，是指运动中的阴阳双方，其强弱变化适度，处于和谐匀平的状态。阴阳失衡，是指运动中的阴阳双方，其强弱变化太过或不及，超出了动态平衡所限定的范围，导致各种灾变出现的状态。

(1) 阴阳偏胜：

阳胜则热

阳胜，一般是指阳邪致病，阳偏胜大多为实热性病证。由于阳偏胜常会耗伤体内的阴液，从而引起阴液不足的病理变化，故有“阳胜则阴病” 之说。

阴胜则寒

阴胜，一般是指阴邪致病，阴偏胜大多为实寒性病证。由千阴偏胜常会损伤体内的阳气，从而引起阳气不足的病理变化，故有“阴胜则阳病”之说。

(2) 阴阳偏衰：

阳虚则寒

阳虚，一般是指体内阳气虚损，推动和温煦作用明显降低的病理变化。由于阳虚可导致阳不制阴，阴寒之气相对偏盛，表现出虚寒之象。

阴虚则热

阴虚，一般是指体内阴液亏少，滋润和濡养作用明显不足的病理变化。由于阴虚，失去对脏腑组织器官的滋润和濡养，导致阴不制阳，使属于阳的功能活动相对亢奋，表现出虚性亢奋的热象。

(3) 阴阳互累：是指当体内阴或阳任何一方虚损到一定程度时，必然就会累及对方，从而引起阴阳俱损的病理变化。主要有以下情况：阳损及阴即阳虚达到一定程度时，因阳虚不能化生阴液，可进一步导致阴液亦虚。阴损及阳亦虚。无论是阳损及阴，抑或是阴损及阳，两者最终都表现为阴阳俱损的阴阳两虚证。然而，阳损及阴之阴阳两虚多以阳损为主，阴损及阳之阴阳两虚多以阴虚为主。

(4) 阴阳转化：阴证或阳证在一定的条件下可以各自向其相反的方面转化，即阳证可以转化为阴证，阴证可以转化为阳证。如某些外感热病，表现为高热面赤、喘促气粗、烦躁口渴、脉数有力等，属于阳证。由于热毒极盛，严重耗伤元气，在持续高热的情况下，会突然出现体温骤降、面色苍白、四肢厥冷、脉微欲绝等阳气暴脱的危象，此属阳证转化为阴证。再如寒饮中阻患者，本为阴证，由千蕴积日久，寒饮化热，此属阴证转化为阳证。上述悄况说明，阴阳转化是有条件的，前者热毒极盛，阳气亡脱，后者寒饮郁久而化热，即是促成阴阳转化的内部条件。

Essence

1. Pre-Heaven Essence 先天之精
2. Post-Heaven Essence 后天之精

Functions of Essence: 精的功能

• Growth, reproduction and development 繁衍生命，生长发育
• Producer of Marrow 生髓化血
• Basis for the ‘Three Treasures’ (Essence–Qi–Mind, Jing–Qi–Shen) 生气化神

Qi

宗气是指积于胸中之气，是人体后天的根本之气。宗气是由肺所吸入的自然清气与脾胃所化生的水谷精
气相互结合而成的。

元气是指人体最根本、最重要的气，是人体生命活动的原动力。

卫气是指运行于脉外，具有护卫机体作用的气。卫气与营气相对而言，属于阳，故又有“卫阳”之称。

营气是指运营于脉中，具有营养作用的气。营气在脉中是血的重要组成部分，与血可分而不可离，故常以“营血”相称。

Defensive Qi (Wei Qi)卫气

• It circulates outside the channels in the space between skin and muscles. • It protects the body from invasion of external pathogenic factors 护卫肌表。卫气布达于肌表，起着抵御外邪侵袭的功能，集中体现了气的防御作用。
• It warms the muscles 温煦机体。卫气布散周身，内至脏腑，外达肌肤，对脏腑经络、肌肉皮毛发挥着温煦作用。既有助于脏腑的生理活动，又可使肌肉充实、皮肤润泽。

• It regulates the opening and closing of pores 调节胺理开阖。卫气布散于肌表，根据生理活动的需要调节胺理开阖，控制汗液的排泄，以维持体温的相对恒定。

Nutritive Qi (Ying Qi) 营气

• Nourishes the Internal Organs 滋润内脏
• Is closely linked to Blood 化生血液
• Flows in channels and blood vessels 循脉流行于全身

Functions of Qi 气的功能

• Transforming 气化作用
• Transporting 推动作用
• Holding 固摄作用
• Protecting 防御作用
• Warming 温煦作用

Blood 血液

Functions of Blood 血液的功能

• Nourishes and Moistens the body 营养和滋润身体
• Houses the Mind 藏神
• Determines menstruation 化生月经等

Blood with internal organs 血与脏器的联系

Heart governs Blood and the blood vessels. 心主行血

Spleen is origin of blood and hold blood. 脾主统血

Liver stores Blood.肝主藏血

Body Fluids 津液

Body Fluids originate from our food and drink. 源于饮食

Types of body fluids 津液的种类

Fluids (Jin): clear, light and watery, they circulate with Defensive Qi in the space between skin and muscles. They moisten skin and muscles ，津是指性状较为清稀，流动性较大，主要布散于体表皮肤、肌肉和孔窍，并可渗入血脉，而成为血的组成部分，能起到滋润作用的部分；

Liquids (Ye): turbid, heavy and dense, they circulate with Nutritive Qi in the Interior. They moisten brain, spine, bone marrow, joints and sense organs. 液是指性状较为稠厚，流动性较小，主要灌注于骨骼、关节、脏腑、脑髓等组织，能起到濡养和滑润作用的部分。

Relations with internal organs 和内脏的关系

LU -- diffuse 肺宣发

SP --Transform/transport 脾运化

KD -- Transform/ separate/excrete 分清泌浊，

Bladder -- Excretes 排泄

Triple Burner --Transforms/ transports/excretes水道的通畅

Stomach -- Origin of 津液之源泉

There are 12 organs, six Yin and six Yang:

Yin organs	Yang organs	Element
Heart Small	Intestine	Emperor Fire
Liver	Gall Bladder	Wood
Lungs	Large Intestine	Metal
Spleen	Stomach	Earth
Kidneys	Bladder	Water
Pericardium	Triple Burner	Minister Fire

The functions of the Heart discussed are:

• The Heart governs Blood 心主血
• The Heart manifests in the complexion 其华在面
• The Heart houses the Mind 心藏神
• The Heart is related to joy 其志为喜
• The Heart opens into the tongue 开窍于舌
• The Heart controls sweat 在液为汗

The functions of the Liver

It stores Blood 主藏血
It ensures the smooth flow of Qi 主疏泄
It controls the sinews 在体合筋
It manifests in the nails 其华在爪
It opens into the eyes 在窍为目
It controls tears 在液为泪
It is affected by anger 在志为怒

Functions of the Lungs

They govern Qi and respiration 肺主全身之气和呼吸

They control the diffusing and descending of Qi 肺主宣发和肃降
They regulate the Water passages 通调水道
They manifest in the body hair 其华在毛
They open into the nose 在窍为鼻
They are affected by worry, sadness and grief 在志为悲（忧）

Functions of the Spleen

Governs transformation and transportation 主运化
Controls the ascending of Qi 主生清
Controls Blood 主统血
Controls the muscles and the four limbs 主四肢
Opens into the mouth 在窍为口
Manifests in the lips 其华在唇
Controls saliva 在液为涎
It is affected by pensiveness 在志为思

Functions of the Kidney

Store the Essence and govern birth, growth, reproduction and development 主藏精
Produce Marrow, fill up the brain and control bones 在体合骨，生髓
Govern Water 主水
Control the reception of Qi 主纳气
Open into the ears and two lower orifices 在窍为耳及二阴
Manifest in the hair 其华在发
Control spittle 在液为唾
It is affected by fear 在志为恐

The Functions of the Stomach

1. Controls ‘receiving’受纳水谷

2. Controls the ‘rotting and ripening’of food腐熟水谷。

3. Controls the descending of Qi胃主通降，以降为和。

The Functions of the Small Intestine

1. Controls receiving and transforming受盛化物
2. Separates fluids泌别清浊

The Functions of the Large Intestine

Transforms stools and reabsorbs fluids 传化糟粕吸收水液

The Functions of the Gall Bladder

1. Stores and excretes bile 贮存和排泄胆汁
2. Controls decisiveness 主决断

The Functions of the Bladder

Removes Water by Qi transformation 贮尿和排尿

The Six Extraordinary Yang Organs 奇恒之腑

• Uterus 女子胞
• Brain 脑
• Marrow 髓
• Bones 骨
• Blood Vessels 脉
• Gall Bladder 胆

中医诊断
望诊
闻诊
问诊
切诊
八纲辨证
气血辩证
脏腑辨证

Observation:

Spirit	Body	movement	Head	face
Eyes	Nose	Ears	Mouth	Teeth
Throat	Limbs	Skin	Tongue	Channels

The observation of ‘spirit’ (shen):

• Complexion with spirit has lustre; without spirit, no lustre, dull

• Eyes with spirit have lustre and brightness; without spirit, dull, clouded

• State of mind with spirit is alert and clear; without spirit, dull and depressed

• Breathing with spirit is even; without spirit is laboured

The normal complexion:

• Lustre

• A subtle, slightly reddish hue

• Moisture

Pathological colors:

• White • Yellow • Red • Green • Blue • Black

White complexion

• Blood deficiency (dull-white)

• Yang deficiency (bright-white)

• Yang deficiency with Cold (bluish-white)

Yellow complexion

• Spleen deficiency (sallow yellow)

• Damp-Heat with prevalence of Heat (bright orange-yellow)

• Damp-Heat with prevalence of Dampness (smoky, dull-yellow)

• Heat in Stomach and Spleen (withered, dried-up yellow)

• Cold-Dampness in Stomach and Spleen (dull-pale yellow)

• Spleen deficiency (pale yellow )

Red complexion

• Full-Heat: whole face red

• Empty-Heat: red cheek bones

Green complexion

• Liver patterns

• Interior Cold

• Pain

• Interior Wind

Blue complexion

• Cold in Liver channel (dark-bluish under the eyes)

• Cold or chronic pain (white-bluish)

• Severe Heart-Yang deficiency with Blood stasis (dull-bluish)

• Liver Wind (bluish complexion, in children)

Black complexion

• Cold: black and moist

• Heat: black and dried-up, burned-looking

• Kidney deficiency: Dark with low back pain

• Blood Stasis: Dark without brightness + scaly skin

Eyes

Eyes are clear and have luster indicate have Shen.

Eyes are rather dull or clouded, it shows disturbed Shen.

A red colour in the corners of the eye indicates Heart- Fire;

a red colour in the sclera indicates Lung-Heat.
A yellow colour of the sclera indicates Damp-Heat.
If the whole eye is red, painful and swollen, it indicates either an exterior invasion of Wind-Heat or rising of Liver-Fire.
A dull-white color of the corners indicates Heat and a pale-white color indicates Blood deficiency.

Infant Finger Venules

Venule observation is a diagnostic method that can replace pulse diagnosis for children under 3 years old.

vein near LI meridian on radial side.

if it is not present = not diseased or in poor health

first wind gate/feng guan: exterior /mild pathology
second gate/qi guan: more interior and more severe
third gate is life/ming gate: severe internal condition,life threatening
Slightly red =Cold, Dark red/purple = Heat

fine & light – blood def

dark & heavy – food retention, stasis of qi or blood

Depth of venules

shallow – EPI
deep – internal

Tongue

Tongue-body color

Pale tongue
• Yang deficiency (slightly wet)
• Blood deficiency (slightly dry)
• Pale sides: Liver-Blood deficiency

Purple tongue
• Always indicates Blood stasis
• Reddish-Purple: Blood stasis from Heat
• Bluish-Purple: Blood stasis from Cold
• Reddish-Purple sides: Liver-Blood stasis
• Bluish-Purple sides in a woman: Blood stasis in the Uterus

tongue map

Red tongue

• Red: Heat
• Red with coating: Full-Heat
• Red without coating: Empty-Heat
• Red tip: Heart-Fire or Heart Empty-Heat (coating: latter without)
• Red sides with coating: Liver-Fire or Gall-Bladder Heat
• Red sides without coating: Liver-Yin deficiency with Empty-Heat
• Red Centre: Heat or Empty-Heat of the Stomach (depending on whether there is a coating or not)
• Red points on the tip: Heart-Fire
• Red points on the sides: Liver-Fire
• Red spots on the root: Heat in the Lower Burner
• Red points in or around the center: Stomach-Heat

Tongue-body shape

• Thin: Blood or Yin deficiency (Pale or Red without coating, respectively)
• Swollen: Dampness or Phlegm
• Partially swollen: Heat
• Stiff: interior Wind or Blood stasis
• Flaccid: deficiency of Body Fluids
• Short: severe Yang or Yin deficiency (Pale or Red without coating, respectively)
• Cracked: Heat or Yin deficiency
• Deviated: interior Wind
• Tooth-marked: Spleen-Qi deficiency

Tongue coating:

• Normal coating is thin white

• Thick coating: pathogenic factor (the thicker the coating, the stronger the pathogenic factor)
• Absence of coating: Stomach-Yin deficiency
• Total absence of coating, Red tongue body: Stomach- and Kidney-Yin deficiency with Empty-Heat
• White coating: Cold pattern
• Yellow coating: Full-Heat pattern
• Grey and black coating: extreme Cold or extreme Heat (tongue wet or dry, respectively)

Moisture of tongue
• Indicates state of Body Fluids
• Normal tongue is slightly moist
• Too wet: Yang deficiency
• Too dry: Heat or Yin deficiency
• Sticky/slippery: Dampness and/or Phlegm

The 16 questions

1. Pain
2. Food and taste
3. Stools and urine
4. Thirst and drink
5. Energy levels
6. Head, face and body
7. Chest and abdomen
8. Limbs
9. Sleep
10. Sweating
11. Ears and eyes
12. Feeling of cold, feeling of heat and fever
13. Emotional symptoms
14. Sexual symptoms
15. Women’s symptoms
16. Children’s symptoms

Causes of pain

• Qi stagnation: distension more than pain, or a distending pain, no fixed location, coming and going

• Blood stasis: severe, stabbing pain, with a fixed location

• Cold (Full or Empty): cramping, spastic pain aggravated by cold weather and cold foods/liquids and alleviated by the application of heat

• Retention of food: intense pain with feeling of fullness (more in children)

• Phlegm: does not usually cause pain, but it may do so especially in the joints (as in rheumatoid arthritis)

Taste

• Lack of taste sensation: Spleen and Stomach deficiency

• Bitter taste: Heat in Liver or Heart
• Sweet taste: Spleen deficiency or Damp-Heat
• Sour taste: retention of food or Liver invading Stomach
• Salty taste: Kidney-Yin deficiency
• Pungent taste: Lung-Heat

Food
• Condition relieved by eating: Empty
• Condition aggravated by eating: Full

• Lack of appetite: Spleen-Qi deficiency
• Excessive hunger: Stomach-Heat
• Feeling of fullness: Dampness or retention of food
• Feeling of distension: Qi stagnation

• Preference for hot foods/drinks: Cold pattern
• Preference for cold foods/liquids: Heat pattern

Vomiting

• Sour vomiting: invasion of Stomach by Liver
• Bitter vomiting: Liver and Gall Bladder-Heat
• Clear watery vomiting: Cold in the Stomach with retention of fluids
• Vomiting soon after eating: Heat pattern

Constipation
• Aggravation of a condition after a bowel movement: Empty pattern
• Amelioration of a condition after a bowel movement: Full condition

• Acute constipation with thirst and dry yellow coating: Heat in the Stomach and Intestines

• Constipation in old people or women after childbirth: deficiency of Blood

• Constipation with small, dry, bitty stools like goat’s stools indicates stagnation of Liver-Qi and Heat in the Intestines

• Constipation with abdominal pain: internal Cold, which may be Full or Empty
• Constipation with dry stools, dry mouth, desire to drink in small sips: Yin deficiency, usually of Kidneys and/or Stomach

• Alternation of constipation and diarrhea: stagnant Liver-Qi invading the Spleen

Loose stools/diarrhea
• Chronic loose stools/diarrhea: Spleen- and/or Kidney-Yang deficiency
• Chronic diarrhea every day in the very early morning: Kidney-Yang deficiency

• Diarrhea with abdominal pain: interior Cold in the Intestines
• Diarrhea with mucus in the stools: Dampness in the Intestines

• Diarrhea with mucus and blood in the stools: Damp-Heat in the Intestines

• Loose stools with undigested food: Spleen-Qi deficiency
• Stools not loose or only slightly loose but very frequent, deficiency of Spleen with sinking of Spleen-Qi

• Foul-smelling stools: Heat
• Absence of smell: Cold

• Burning sensation in the anus while passing stools: Heat

Thirst and drink

• Thirst with desire to drink large amounts of cold water: Full-Heat pattern
• Thirst with desire to drink in small sips: Yin deficiency (usually of Stomach or Kidneys)

• Absence of thirst: Cold pattern, usually of the Stomach or Spleen

• Thirst but with no desire to drink: Damp-Heat

• Desire to drink cold liquids: Heat pattern
• Desire to drink warm liquids: Cold pattern

Headache
Onset
• Recent onset, short duration: headache from exterior attack of Wind-Cold
• Gradual onset, in attacks: interior type

Time of day
• Daytime: Qi or Yang deficiency
• Evening: Blood or Yin deficiency, Blood stasis

Location
• Nape of neck: Greater Yang channels (can be from exterior invasion of Wind-Cold, or from interior Kidney deficiency)
• Forehead: Bright Yang channels (can be from Stomach-Heat or Blood deficiency)
• Temples and sides of head: Lesser Yang channels (can be from exterior Wind in the Lesser Yang, or from interior Liver and Gall Bladder Fire rising)
• Vertex: Terminal Yin channels (usually from deficiency of Liver-Blood)
• Whole head: exterior invasion of Wind-Cold

Character of pain
• Heavy feeling: Dampness or Phlegm
• Pain which is ‘inside’ the head, ‘hurting the brain’: Kidney deficiency
• Distending, throbbing: rising of Liver-Yang
• Boring, like a nail in a small point: stasis of Blood

Condition
• With aversion to wind or cold: exterior invasion

• Aggravated by cold: Cold pattern
• Aggravated by heat: Heat pattern

• Aggravated by fatigue, improved by rest: Qi deficiency

• Aggravated by emotional tension: Liver-Yang rising
• Aggravated by sexual activity: Kidney deficiency

Sweating
Full
• Heat
• Damp-Heat

Empty
• Deficiency of Yang
• Deficiency of Yin

Tinnitus
Onset
• Sudden onset: Full condition, Liver-Fire, Liver-Yang rising, Liver-Wind
• Gradual onset: Empty condition, Kidney deficiency

Pressure
• Noise aggravated by pressing with one’s hands on the ears: Full condition
• Noise alleviated by pressing with one’s hands on the ears: Empty condition

Character
• Loud, high-pitched noise, like whistle: Liver-Yang, Liver-Fire, Liver-Wind
• Low-pitched noise like rushing water: Kidney deficiency

Deafness
• Sudden onset: Full condition, Liver-Fire, Liver-Yang rising, Liver-Wind
• Gradual onset: Empty condition, deficiency of Kidneys, Blood or Qi deficiency

Menstruation
Cycle
• Periods always early: Blood-Heat or Qi deficiency
• Periods always late: Blood deficiency or stagnation of Blood or Cold
• Periods irregular, sometimes early and sometimes late: stagnation of Liver-Qi or Liver-Blood, or Spleen deficiency

Amount
• Heavy loss of blood: Blood-Heat or Qi deficiency
• Scanty periods: Blood deficiency or stagnation of Blood or Cold

Colour
• Dark-red or bright-red: Blood-Heat
• Pale: Blood deficiency
• Purple or blackish blood: stasis of Blood or Cold
• Fresh-red: Empty-Heat from Yin deficiency

Quality
• Congealed blood with clots: stasis of Blood or Cold
• Watery blood: Blood or Yin deficiency

Pain
• Before the periods: stagnation of Qi or Blood
• During the periods: Blood-Heat or stagnation of Cold
• After the periods: Blood deficiency

• Pulse
• Skin
• Limbs
• Chest
• Abdomen
• Points

Pulse

Right		Left
LU	Cun	HT
SP	Guan	LV
MM	Chi	KD

The normal pulse
The pulse should have three qualities, which are described as having Stomach-Qi, having spirit and
having a root.

1. Floating (Fu)
Feeling
This pulse can be felt with a light pressure of the fingers, just resting the fingers on the artery.

• Invasion of external Wind
• Yin deficiency (interior conditions)

2. Deep (Chen)
Feeling
it can only be felt with a heavy pressure of the fingers and is felt near the bone.

• Pathogenic factor in the Interior (Deep-Full)
• Yang deficiency (Deep-Weak)

3. Slow (Chi)
Feeling
This pulse has three beats per respiration cycle (of the practitioner).

• Cold pattern
• Empty-Cold (Slow and Weak)
• Full-Cold (Slow and Full)

4. Rapid (Shu)
Feeling
This pulse has higher rate than normal, five beats per each respiration cycle or more.

Rapid pulse
• Heat pattern
• Full-Heat (Rapid and Full)
• Empty-Heat (Rapid and Floating-Empty)

5. Empty (Xu)
Feeling
The Empty pulse feels rather big but soft. this pulse is actually rather big but it feels empty on a slightly stronger pressure and is soft.

Empty pulse
• Qi deficiency

6. Full (Shi)
Feeling
This pulse feels full, rather hard and rather long.

‘Full’ is often used in two slightly different ways.

On the one hand, this term is often used to indicate any pulse of the Full type.

• Full pattern
• Full-Heat (Full-Rapid)
• Full-Cold (Full-Slow)

7. Slippery (Hua)

Feeling
A Slippery pulse feels smooth, rounded, slippery to the touch, as if it were oily. It slides under the fingers.

• Phlegm
• Dampness
• Retention of food
• Pregnancy

8. Choppy (Se)
Feeling
This pulse feels rough under the finger: instead of a smooth pulse wave, it feels as if it has a jagged edge to it.

Choppy also indicates a pulse that changes rapidly both in rate and quality.

• Blood deficiency
• Exhaustion of Body Fluids

9. Long (Chang)
Feeling
This pulse is basically longer than normal: it extends slightly beyond the normal pulse position.

• Heat pattern

10. Short (Duan)
Feeling
It occupies a shorter space than the normal position.

• Severe Qi deficiency
• Stomach-Qi deficiency

11. Overflowing (Hong)
Feeling
This pulse feels big. It extends beyond the pulse position. It is superficial and generally feels as if it overflows the normal pulse channel, like a river overflow during a flood.

• Full-Heat
• Empty-Heat (Overflowing-Empty)

12. Fine (Xi)
Feeling
This pulse is thinner than normal.

• Blood deficiency
• Dampness with severe Qi deficiency

13. Minute (Wei)
Feeling
It is extremely thin, small and difficult to feel.

• Severe deficiency of Qi and Blood

14. Tight (Jin)
Feeling
This pulse feels twisted like a thick rope.

• Cold
• Exterior Cold (Tight-Floating)
• Interior Full-Cold (Tight-Full-Deep)
• Interior Empty-Cold (Tight-Weak-Deep)
• Pain

15. Wiry (Xian)
Feeling
This pulse feels taut like a guitar string. It is thinner, more taut and harder than the Tight pulse. The Wiry pulse really hits the fingers.

• Liver disharmony
• Pain
• Phlegm

16. Slowed down (Huan)
Feeling
This pulse has four beats for each respiration cycle.

• Generally, a healthy pulse

17. Hollow (Kou)
Feeling
This pulse can be felt at the superficial level, but if one presses slightly harder to find the middle level it is not there; it is then felt again at the deep level with a stronger pressure. In other words, it is Empty in the middle.

• Haemorrhage
• Forthcoming haemorrhage (Hollow and Rapid)

18. Leather (Ge)
Feeling
This pulse feels hard and tight at the superficial level and stretched like a drum, but it feels completely Empty at the deep level. It is a large pulse, not thin.

• Severe deficiency of Kidney-Essence
• Severe deficiency of Kidney-Yin

19. Firm (Lao)
Feeling
The Firm pulse is felt only at the deep level and it feels hard and rather wiry. It could be described as a Wiry pulse at the deep level.

• Blood stasis
• Interior Cold (Firm and Slow)
• Pain

20. Soggy (or Weak-Floating) (Ru)
Feeling
The Soggy pulse can be felt only on the superficial level. It feels very soft and is only slightly floating: It disappears when a
stronger pressure is applied to feel the deep level. It is similar to the Floating-Empty pulse, but it is softer and not so Floating.

• Dampness with Qi deficiency
• Deficiency of Yin
• Deficiency of Essence

21. Weak (Ruo)
Feeling
A Weak pulse cannot be felt on the superficial level, but only at the deep level. It is also soft.

• Yang deficiency
• Blood deficiency

22. Scattered (San)
Feeling
This pulse feels very small and is relatively superficial.nstead of feeling like a wave, the pulse feels as if it were ‘broken’ in small dots.

• Severe deficiency of Qi and Blood
• Severe deficiency of Kidney-Qi
• Serious condition

23. Hidden (Fu)
Feeling
This pulse feels as if it were hidden beneath the bone.
It is very deep and difficult to feel. It is basically an extreme case of a Deep pulse.

• Severe Yang deficiency

24. Moving (Dong)
Feeling
The Moving pulse has a round shape like a bean; it is short and it ‘trembles’ under the finger. It has no definite shape, having no head or tail, just rising up in the centre. It feels as if it is shaking and is also somewhat slippery.

• Shock, anxiety, fright
• Pain

25. Hasty (Cu)
Feeling
This pulse is Rapid and it stops at irregular intervals.

• Severe Heat
• Deficiency of Heart-Qi
• Heart-Fire

26. Knotted (Jie)
Feeling
This pulse is Slow and it stops at irregular intervals.

• Cold with deficiency of Heart-Yang

27. Intermittent (Dai)
Feeling
This pulse stops at regular intervals.

• Serious problem in Internal Organ
• Heart problem (in Western medical sense)

28. Hurried (Ji)
Feeling
This pulse is very rapid, but it also feels very agitated and urgent.

• Fire exhausting Yin

• Pulse
• Skin
• Limbs
• Chest
• Abdomen
• Points

Pulse

Right		Left
LU	Cun	HT
SP	Guan	LV
MM	Chi	KD