TCM Pulse Types Explained: The 28 Pulses in Plain English

Daoyi AI Health · Guides · 10 min read

Pulse reading (mai zhen) is the part of Chinese medicine that sounds the most mystical and is actually the most systematic. Classical texts describe 28 pulse types; almost all of them are combinations of a handful of physical qualities.

How the pulse is read

The practitioner places three fingers on each wrist, over the radial artery, at three positions traditionally mapped to different organ systems. At each position they assess qualities: depth, rate, width, length, tension, smoothness and force. A “pulse type” is a named combination of those qualities.

The core families

By depth

• Floating (fu) — felt at the surface, fades with pressure. Traditionally read as an exterior pattern, such as the early stage of a cold.
• Sinking (chen) — only felt with firm pressure. Read as an interior pattern.

By rate

• Slow (chi) — fewer than four beats per breath cycle. Associated with cold.
• Rapid (shuo) — more than five beats per cycle. Associated with heat.

By texture

• Slippery (hua) — smooth, “like beads on a plate”. Associated with phlegm, dampness, or pregnancy.
• Choppy (se) — the opposite: hesitant, uneven. Associated with blood stasis or deficiency.
• Wiry (xian) — taut, like a guitar string. Associated with liver patterns and tension.
• Tight (jin) — wiry and stronger; associated with cold or pain.

By width and length

• Thin (xi) — fine and soft; deficiency of blood or yin.
• Large / broad (hong) — wide and forceful; heat or excess.
• Long (chang) — extends beyond the three positions; often read as a healthy, strong pulse.
• Short (duan) — does not reach the far position; qi stagnation or deficiency.

By force

• Empty (xu) — soft and weak on firm pressure; deficiency.
• Full / excess (shi) — strong at all levels; excess.

The rest of the 28

The remaining names are largely compounds or refinements: soggy (floating, thin, soft — damp-heat), hollow (like a scallion stalk — blood loss), hidden (deep and faint), stirred (rapid and irregular), knotted (slow and irregular), intermittent (pauses at regular intervals — traditionally a serious sign), and several position-specific variants.

Why this matters practically

Two things follow from the structure. First, you do not need to memorise 28 names: learn six qualities and the names become descriptions rather than vocabulary. Second, the pulse is always read together with the tongue and the interview — a wiry pulse in a calm person means something different from a wiry pulse in someone who has not slept for a week.

Honest limits

Pulse reading is a skilled tactile art; a chart cannot teach your fingers. Studies of inter-practitioner agreement show modest consistency, which is exactly why it should be treated as one observation among several rather than a verdict. And a genuinely irregular pulse — skipped beats, racing, or a pulse that feels different on one side — is a reason to see a doctor, not to consult a chart.

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