L0021022 Physician taking pulse
A Indian doctor takes the patient’s pulse. Image by a Delhi painter, name unknown, circa 1825. Image credit: Wellcome Library, London.

No visit to a Western medical clinic is conducted without one very basic procedure: taking the pulse.

It may be surprising to learn that taking the pulse is one of the earliest diagnostic measurements used in Traditional Chinese Medicine (TCM), and was developed over two thousand years ago.

The practice of measuring a patient’s heartbeats became disseminated in the ancient world via trade routes.

Through the work of Christian missionaries, pulse-taking reached Western Europe in the 17th century.

Origins of Sphygmology

Sphygmology, or the procedure of taking the pulse, entered the practice of Traditional Chinese Medicine at least 2500 years ago. A popular legend about the physician Bian Que (C. 500 B.C.E.) claims that the prince of Guo was thought to be dead until Bian Que examined his pulses. Determining that the prince was in a coma, Bian Que used acupuncture and herbal medicine to resuscitate him.

Another legend about Bian Que is that he predicted the death of a nobleman, based on the deterioration of the man’s health, as determined by measuring his pulses.

Sphygmology: Written Records

The first written record of sphygmology in TCM is in the Huang-Di Nei-Jing (Yellow Emperor’s Cannon of Internal Medicine), which dates back to the 2nd or 3rd century B.C.E. The Huang-Di Nei-Jing describes the taking of the pulses by touching the radial arteries located near both wrists. By measuring the pulses, they believed that it was possible to discover the unique patterns of an individual’s body, and therefore diagnose illness.

Written during the Jin Dynasty (3rd century C.E.), Wang Shuhe’s Maijing (Classic of Pulse Diagnosis) is the first book that deals exclusively with pulse measurement. The Meijing mentions the cunkou -the place at the wrists where the radial artery can be felt pulsating. In his 10-volume work, Wang Shuhe divided the pulses into 24 distinct categories. This detailed differentiation is intended to determine whether a patient is sick, what kind of illness the patient has, the severity of the illness, and the ability of the patient to respond to treatment.

Pulse Classifications

The categories of pulse classification used in TCM have expanded to include 28 different types. Each category reveals the condition of one particular aspect of the internal organs and tissues. A strong, steady pulse, for example, would indicate to the practitioner that the individual is healthy. On the other hand a “scattered pulse” is irregular and barely perceptible. This indicates that the patient is critically ill, and may be near death. Other pulse categories include: rapid, slow, soggy, stringy, slippery, choppy, thready, tense, and so on. Pulses also occur in combination: for example, a pulse that is both slippery and rapid may indicate pregnancy, according to TCM.

Click to Read Page Two: Practice of Taking the Pulse Spreads