Pulse Diagnosis in Chinese Medicine

In Chinese medicine, the pulse is more than just a heartbeat. It is a diagnostic tool that has been used for hundreds of years in various Oriental countries.

It’s like a flowing river beneath the skin, carrying subtle messages about the body’s inner landscape. By feeling the pulse, a practitioner can gather information about your overall vitality, the state of your organs, and the balance of Yin and Yang.

There are many different systems and approaches to pulse diagnosis in Chinese Medicine, but the intention is always the same, it is a diagnostic technique used to assess the body’s internal condition and overall health.

When your acupuncturist is taking your pulse, they are not counting the pulse and checking your heart rate, they are exploring the internal organ systems and the body’s current state of well being. They are assessing qualities such as the depth, strength, speed and shape of the pulse.

Pulse diagnosis forms a very important part of the intake process

Why We Check the Pulse

Pulse diagnosis is not considered a stand alone clinical tool. It is one of the Four Pillars of Chinese diagnosis, along with looking, listening/smelling, and asking.

It’s a tool to:

  • Identify patterns of imbalance – Whether your body shows signs of excess heat, cold, dampness, stagnation, or deficiency.
  • Assess organ systems – The Liver, Heart, Spleen, Lung, and Kidney each have distinct pulse positions and qualities.
  • Track progress – Comparing pulses over time can reveal improvements, even before you feel them physically. Some practitioners will check the pulse throughout the treatment to further assess the efficacy of the point selection and treatment plan.
  • Understand root causes – A headache, for example, could stem from tension, digestive weakness, or even hormonal shifts. The pulse helps narrow the source.

What a practitioner feels for when taking the pulse

The Chinese pulse is not just “fast” or “slow.” There are as many as 28 traditional pulse qualities – each like a unique texture or rhythm.

Some common examples:

  • Wiry – Taut, like a tight guitar string; often linked to stress or Liver Qi stagnation.
  • Slippery – Smooth and rolling, like pearls in a dish; can indicate dampness, phlegm, or pregnancy.
  • Thin – Fine but distinct; often a sign of blood or Yin deficiency.

The pulse is checked on both wrists at three positions (cun, guan, chi) and at three depths (superficial, middle, deep).

  • Superficial level – Shows the state of the body’s exterior and defensive Qi. Whether the body is fighting off an external pathogen.
  • Middle level – Reflects the the balance of Qi and blood.
  • Deep level – Tells us about the condition of the internal organs and Yin energy. This could also add information about a chronic of long standing imbalance in the body.

Why It Matters for You

A pulse reading isn’t about predicting the future – it’s about understanding the present. It gives your practitioner a fuller picture of your health so treatment can be tailored to your body’s needs. That might mean acupuncture, moxibustion, herbal medicine, dietary adjustments, or lifestyle guidance.

When you come for a session, that quiet moment where your practitioner holds your wrist is not just tradition – it’s a conversation with your body in its own language.

Pulse diagnosis is a skill developed with time, for practitioners it can be one of the hardest tools to master. It relies on the subjective sensations felt by the practitioner, which makes it a difficult method to prove in evidence based research. However, combined with looking, listening, smelling and asking, it is a powerful tool to support the diagnosis and treatment protocol.

Tongue diagnosis is another unique method used in Traditional Chinese medicine.

Pulse is taken on both the right and left hand.