Pulse-taking and palpation in TCM Diagnosis

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Morbid pulse in TCM diagnosis
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The pulse in a morbid condition is called morbid pulse, in which the manifestations of pulse conditions are either the changes of the position of the pulse, or the difference in rhythm, or variation in morphology, or changes in strength. Sometimes morbid pulse may show difference in various aspects, such as the position, rhythm, and strength of the pulse. The following is a specific discussion:

Floating pulse
Features: Sensible under light pressure, weak and constant beating under heavy pressure. Floating pulse is marked by superficial beating.

Clinical significance: Floating pulse Indicates external syndrome, floating and powerful pulse signifying?external sthenia syndrome while floating and weak pulse manifesting external asthenia syndrome. Floating pulse can also be seen in internal asthenia syndrome due to consumption of essence and blood in chronic disease and external floating of asthenic yang.

Scattered pulse
Features: Rootless, arrhythmic and disappearing under pressure.

Hollow pulse
Features: Floating, large and hollow like the leaf of scallion.
Clinical significance: Indicating loss of blood and impairment of yin.

Sunken pulse
Features: Sensible only under heavy pressure.
Clinical significance: Indicating internal syndrome. Sunken and powerful pulse signifies sthenia internal syndrome, while sunken and weak pulse shows asthenic internal syndrome

Slow pulse
Features: No more than 4 beats in a cycle of breath (<60/min).
Clinical significance: Indicating cold syndrome. Slow and powerful pulse signifies sthenia cold syndrome, while slow and weak pulse shows asthenic cold syndrome. Such a pulse condition is also seen in internal sthenia heat syndrome due to internal accumulation of pathogenic heat. Athletes with slow pulse are in a normal condition.

Rate pulse      
Features: The pulse is moderate and powerful, beating 4 times in a cycle of breath; or moderate and sluggish, beating 4 times in a cycle of breath (60 - 70/rain).
Clinical significance: Indicating damp disease and weakness of the stomach and spleen.

Fast pulse
Features: The pulse beats over 5 - 6 times in a cycle of breath (90- 110/min)
Clinical significance: Indicating heat syndrome. Fast and powerful pulse signifies sthenia heat syndrome, while fast and weak pulse shows asthenic heat syndrome. Such a?pulse condition is also seen in the syndrome due to external floating of asthenic yang.

Swift pulse
Features: The pulse beats over 7 times in a cycle of breath (≥140/min).
Clinical significance: Indicating loss of control of hyperactive yang, declination of kidney yin and near depletion of primordial qi.

Weak pulse
Features: Weak pulse is marked by weak beating of the pulse at all the cun, guan and chi regions.
Clinical significance: Indicating asthenia syndrome, usually seen in asthenia of both qi and blood, especially in qi asthenia.

Powerful pulse      
Features: Powerful pulse is marked by powerful sensation of pulse beating at cun, guan and chi regions under, superficial, moderate and heavy pressure.

Slippery pulse  
Features: The pulse is beating freely and smoothly like the movement of beads of an abacus.
Clinical significance: Indicating retention of phlegm and fluid, dyspepsia and sthenia heat. Such a pulse condition is also seen among young and strong people and gravida.

Full pulse
Features, Full pulse is marked by wide size and full content, beating like roaring waves and sensibility under light pressure and surges as well as sudden flowing and ebbing.
Clinical significance: Indicating exuberant internal heat.

Thin pulse
Features: The pulse is as thin as a thread, weak and quite sensible under pressure.
Clinical significance: Indicating asthenia of both qi and blood, various overstrain and diseases due to pathogenic dampness.


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