TCM Pulse Diagnosis Chart: All 28 Classical Pulses
Every classical pulse quality, grouped by the mechanism it shares with its neighbours rather than listed alphabetically.
Wang Shu-He's Mài Jīng (3rd century CE) systematised twenty-four qualities; Li Shi-Zhen's Bīn Hú Mài Xué (1564) settled on twenty-eight. Grouping them into six families — depth, rate, width and force, tension and shape, rhythm, and special qualities — makes them learnable in an afternoon, even though feeling them reliably takes years. Pair this chart with the three pulse positions to locate each finding.
Depth
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Floating浮 · fú | Clear under light touch, fades as you press toward the bone. | Exterior pattern; early wind-cold or wind-heat invasion. | Exterior / Wei level |
| Deep沉 · chén | Absent at the surface, only found with heavy pressure. | Interior pattern; Qi cannot reach the surface. | Interior |
Rate
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Rapid數 · shuò | Over 90 bpm — more than five beats per breath cycle. | Heat, whether excess heat or empty heat from Yin deficiency. | Heat |
| Slow遲 · chí | Under 60 bpm — fewer than four beats per breath cycle. | Cold; Yang deficiency when weak, excess cold when forceful. | Cold |
| Moderate緩 · huǎn | Around 72 bpm, relaxed and even. | Normal when it has root; Spleen dampness when also soggy. | Normal / Dampness |
Width & Force
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Thin (Thready)細 · xì | Narrow as a silk thread, but clearly defined. | Blood or Yin deficiency. | Blood / Yin deficiency |
| Big (Large)大 · dà | Wide and spreading under all three fingers. | Excess heat, or deficiency presenting with false expansion. | Excess heat |
| Surging (Flooding)洪 · hóng | Arrives wide and forceful like a wave, recedes weakly. | Excess heat at the Qi level (Yángmíng). | Qi-level heat |
| Minute (Faint)微 · wēi | Extremely thin and soft — almost not there. | Severe Qi and Blood deficiency; Yang collapse. | Collapse |
| Weak弱 · ruò | Deep, thin and soft, with no strength on pressure. | Qi and Yang deficiency, often with Blood deficiency. | Qi / Yang deficiency |
| Empty (Deficient)虛 · xū | Big but soft and powerless at every depth. | Qi and Blood deficiency; commonly seen after illness. | Deficiency |
| Full (Excess)實 · shí | Forceful, long and strong at all three depths. | Excess pattern with intact upright Qi. | Excess |
Tension & Shape
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Wiry (String-like)弦 · xián | Taut and straight, like pressing a guitar string. | Liver Qi stagnation, pain, chronic stress. | Liver Qi stagnation |
| Tight緊 · jǐn | Taut and forceful, rolling like a twisted rope. | Cold, acute pain, food stagnation. | Cold / Pain |
| Slippery滑 · huá | Smooth and rounded, like pearls rolling on a plate. | Phlegm, dampness, food stagnation — and normal pregnancy. | Phlegm-Damp |
| Choppy (Rough)澀 · sè | Uneven and hesitant, like scraping bamboo with a knife. | Blood stasis; also Blood/Yin deficiency or Essence depletion. | Blood stasis |
| Long長 · cháng | Extends beyond the three finger positions. | Excess pattern; Liver Yang rising when also wiry. | Excess / Liver Yang |
| Short短 · duǎn | Palpable only at the middle (guān) position. | Qi deficiency when weak; Qi stagnation when forceful. | Qi deficiency |
Rhythm
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Knotted結 · jié | Slow, with irregular missed beats. | Cold accumulation, Qi stagnation, phlegm obstructing the Heart. | Cold stagnation |
| Hurried促 · cù | Rapid, with irregular missed beats. | Excess heat with Qi or Blood stagnation. | Heat with stagnation |
| Intermittent代 · dài | Regular rhythm broken by regular, predictable pauses. | Organ decline, exhaustion, serious Heart pathology. | Organ decline |
Special Quality
| Pulse | How it feels | Clinical significance | Pattern |
|---|---|---|---|
| Leather (Drum-skin)革 · gé | Floating, taut and hollow — like pressing a drum head. | Blood loss, Essence depletion, miscarriage. | Essence / Blood loss |
| Soggy (Soft)濡 · rú | Floating, thin and soft — vanishes under moderate pressure. | Dampness with Qi deficiency. | Damp / Qi deficiency |
| Confined (Firm)牢 · láo | Deep, wiry, forceful and long. | Interior cold accumulation; abdominal masses. | Interior cold accumulation |
| Scattered散 · sàn | Floating and irregular, dissolving entirely under pressure. | Kidney Qi exhaustion; critical decline. | Critical / rootless |
| Hollow芤 · kōu | Floating and big but empty in the middle, like a spring-onion stalk. | Acute blood loss or severe fluid depletion. | Acute blood loss |
| Spinning Bean (Moving)動 · dòng | Short, slippery, rapid and trembling — a bean bouncing under the finger. | Severe pain, fright, mixed heat-cold patterns. | Pain / Fright |
The eight parameters behind all 28
Depth
Floating ↔ deep
Rate
Rapid ↔ slow
Width
Thin ↔ wide
Strength
Forceful ↔ weak
Length
Long ↔ short
Shape
Smooth, wiry, choppy
Rhythm
Regular ↔ irregular
Tension
Taut ↔ soft
Common questions
What are the 28 pulses in Chinese medicine?
The twenty-eight classical pulses are floating, deep, hidden, rapid, slow, moderate, thin, big, surging, minute, weak, empty, full, wiry, tight, slippery, choppy, long, short, knotted, hurried, intermittent, leather, soggy, confined, scattered, hollow and spinning bean. Li Shi-Zhen fixed this set in the Bīn Hú Mài Xué in 1564.
Do I have to memorise all 28 pulse types?
No. Every one of the twenty-eight is a combination of eight parameters — depth, rate, width, strength, length, shape, rhythm and tension. Learn to describe a pulse in those terms and the classical name follows from the description rather than from rote memory.
What is the difference between a wiry and a tight pulse?
Both are taut. A wiry pulse (xián 弦) is straight and unyielding like a guitar string and points to Liver Qi stagnation. A tight pulse (jǐn 緊) also rolls or twists under the finger like a stretched rope and points to cold or acute pain.
Educational content — not a substitute for professional clinical assessment.