The Wonders of Chinese Pulse Diagnosis


As I sat there for the first time to get acupuncture for a chronic knee condition, my acupuncturist told me to lay my hands down on the table, palms up, so he could feel my pulses. I suspected that he was simply trying to get the rate, but after five minutes, it became clear to me that there was a lot more that he was looking for.

After several more minutes, my acupuncturist told me in broken English that I had weak kidneys and that is why I felt spaced out and tired a lot of the time. He also told me that my kidneys were responsible for my knee pain, the occasional soreness I felt in my low back, and the low pitched ear ringing that seemed to come out of nowhere. On top of this, he also said that the vague feeling of fear that I get from time to time is due to weak kidney function as well. I looked at him quizzically and asked, ‘ you got all of that from feeling my pulses??’

He simply nodded his head. What struck me as somewhat mind boggling was how accurate he was about each of these symptoms, even though I had only told him about the pain in my knees. Unfortunately, my knees did not respond to the several sessions of acupuncture, but that interaction about my pulses filled me with a trust in Chinese medicine and curiosity about its application that eventually led me to a career as an acupuncturist with a focus on this ancient art.

There are numerous traditions of pulse diagnosis throughout the many strands of Asian medicine. The most popular form that is utilized by Western acupuncturists incorporates twenty-six distinct pulse qualities, each one reflecting specific organ imbalances that may be contributing to the patient’s substandard health. There are also three basic positions along the radial artery on both wrists that the acupuncturist palpates, each one mirroring the function of a major organ in the body. The following diagram reveals each of these organs and their locations.

Left Hand Right Hand (I would recommend inserting a diagram here of the hand/wrist and each of these positions specifically mapped out for the reader)

1st: Heart 1st: Lung

2nd: Liver 2nd: Spleen

3rd: Left Kidney (yin) 3rd: Right Kidney

The acupuncturist will feel for specific qualities at each of these positions to determine the relative health of each organ and how the organs are functioning in relation with one another. The pulse can yield qualities in each of these positions that can be indicative of spiritual, emotional or physical issues; deciphering this information is largely based on the skill of the acupuncturist. Now that we have covered the basics, let’s look at a few of the most compelling features of this diagnostic method.

Stability and Shock

When I first feel the patient’s pulses, the most important dynamic that I examine is the overall stability of the heart. Stability is determined by the consistency in rate, rhythm, and intensity found on the pulse. If the pulse is changing in rate or if it conveys any irregularity in its rhythm of beats or the qualities felt, then stabilizing the pulse becomes a top treatment priority. When the pulse is unstable, then the heart is unstable. This is almost always due to a state of shock that has overtaken the patient’s capacity to experience optimum health and balance. We normally think of shock as a kind of blunt trauma or overt danger that has jeopardized our basic survival. On a more subtle level, however, shock can be seen as any defining moment in life that throws us off balance and undermines our ability to be present in our lives. Situations such as divorce, job loss, verbal abuse, addictions, and stress can all cause this form of shock. When the heart loses its momentary consistency and rhythm, our faculties of awareness and insight likewise become compromised. The heart shen, the spirit or awareness that emanates from the heart, becomes obscured. As this happens, we lose contact with our intuitive faculties, which makes life feel untrustworthy and full of struggle.

The five element acupuncture model states that we can only resolve chronic health concerns when the underlying state of shock is properly addressed. This is why so many of us get stuck in the frustrating cycle of feeling initial improvement in our symptoms, only to experience a regression a short while later that lands us right back where we started or worse. Without this deep foundation of a balanced heart shen, the patient simply does not have their own spirit to use as an ally in the healing process. Interestingly, when patients heal from shock and their pulses become stable, one of the most common statements that I hear in my practice is, ‘I feel like I have my Self back.’ This response to treatment always leads me to an optimistic view of the patient’s situation because they now have an inner resource of awareness and strength to draw on that was previously lacking.

The Power of Prevention

Susan, a 33 year old female, came to my practice looking for ways to manage a severe anxiety and depressive disorder that had been persisting for several years. At the time I saw her, she was taking two anti-depressants. She complained of fatigue, feeling excessively warm, thirst, and restless sleep. Susan had a classic pattern of yin deficiency, which means that the cooling, calming, and moistening aspects of her physiology had been compromised. Yin deficiency is typically seen in people between the ages of 45-65. It is a sign that one’s constitutional strength is weakening due to over thinking, worry, or anxiety.. To see this pattern in Susan, a 33 year old, suggests that her mental condition was causing her to age prematurely. Given that the pattern would likely continue to worsen over years if it was not treated, my prediction was that Susan would enter menopause in her late thirties or early forties and that her body may give out on her long before she had lived a full life. As I used acupuncture and herbs to nourish her yin, we were concurrently working to heal not only her current symptoms but also her tendency toward premature aging. As her pulse began to relax and soften, Susan began to feel more emotionally balanced than she had in years and she actually began to look noticeably younger. She felt cooler, more energized, and was sleeping more soundly. It was apparent from her pulses and overall presentation that Susan’s general health had improved dramatically and that her potential for longevity had greatly increased due to her course of yin nourishing treatment.

This case study reveals how the pulse serves as an accurate gauge for clarifying our tendencies toward health and longevity or illness and degeneration. Simply put, the pulse clearly shows the acupuncturist which way the wind is blowing. Is the patient cultivating energy through balance and moderation or depleting energy through excessive worry or activity, dietary imbalances, or other lifestyle factors? Each individual organ position conveys that organ’s tendency toward health or disease. Therefore, a skilled acupuncturist is able to not only address the patient’s current health concerns, but also educate them on health trends that will likely manifest in the future as based on the patient’s pulse qualities. Western medicine is only interested in treating disease when it is fully manifest, whereas Chinese medicine, by virtue of pulse diagnosis, is more capable of cutting through the momentum that is leading up to the disease. As stated by many of the leading doctors and medical pioneers throughout history, this latter ability is more truly indicative of the real purpose of medicine: To educate patients so that their lifestyle choices create a state of heightened wellness that makes them impervious to disease..

The Truth Revealed

An astute pulse diagnostician is able to experience the patient’s pulse as a direct line of communication that reveals poignantly honest and emotionally charged material. This is often in contrast to what the patient actually says about their situation, given that language is so often filtered through our subjective sense of what we want others to know about us. For example, a patient may convey a facade of everything being ‘fine’, but their pulse pattern contrastingly conveys a clear state of instability or disharmony. Another common scenario that I encounter is the patient who exudes an image of tranquility, but whose pulses show a deeply confined feeling of suppressed anger. When the acupuncturist can detect the true state of the patient’s inner life, then the potential for a powerful healing experience becomes much more accessible. In fact, one of the ultimate goals of highly developed pulse practitioners is to be able to prescribe very precise herbal formulas purely based on the patient’s pulse pattern. This ability is indicative of a truly holistic form of medicine, in that it sees beyond the patient’s myriad symptoms into the underlying pattern of disharmony that is causing their substandard health. As the pulse begins to balance, the acupuncturist becomes more confident that the patient’s overall health is improving, even if this occurs before the patient actually notices overt improvement. I have had several cases in which the patient’s pulses evidenced drastic improvement before their symptoms actually felt better. After my encouragement to stick with the process a while longer, these patients almost always begin to notice dramatic progress shortly after their pulses reflect a more harmonious state.

There are pulse practitioners who are so gifted at absorbing the meaning of the qualities they feel that their abilities appear to cross into a psychic terrain. The acupuncturist of this caliber, however, will often say that their abilities are completely ordinary and what is felt on the patient’s pulse is merely common sense knowledge that is accessible to anyone. The idea here is that the patient’s entire life story is just sitting there waiting to be acknowledged; it is simply a matter of keeping the senses open to all of the information being presented, whether it is of a physical or emotional nature. As with many alternative forms of healing, the ordinary nature of the method or plant being utilized is what makes it so magical. The incredibly rich tradition of Chinese pulse diagnosis is, unfortunately, dying because more practitioners are relying upon technological devices for their diagnostic information. The simple act of feeling another person’s pulse may not seem ‘objective’ or ‘mechanistic’ enough for many of us in the modern world. In my experience, however, it is this very ordinary level of contact with another person that so often marks the difference between genuine healing and palliative care.