Traditional Chinese medicine — Vocabulary for diagnostics — Part 2: Pulse

This document specifies the basic terminology of pulse diagnostic methods, the key elements of pulse and pulse condition. Each term of pulse diagnosis includes the English name, the classical Chinese characters and its definition.

Médecine traditionnelle chinoise — Vocabulaire pour les diagnostics — Partie 2: Pouls

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Status
Published
Publication Date
03-Nov-2021
Current Stage
6060 - International Standard published
Start Date
04-Nov-2021
Completion Date
04-Nov-2021
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INTERNATIONAL ISO
STANDARD 23961-2
First edition
2021-11
Traditional Chinese medicine —
Vocabulary for diagnostics —
Part 2:
Pulse
Médecine traditionnelle chinoise — Vocabulaire pour les
diagnostics —
Partie 2: Pouls
Reference number
ISO 23961-2:2021(E)
© ISO 2021
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ISO 23961-2:2021(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2021

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on

the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below

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Email: copyright@iso.org
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Published in Switzerland
© ISO 2021 – All rights reserved
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ISO 23961-2:2021(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction .................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ..................................................................................................................................................................................... 1

3 Terms and definitions .................................................................................................................................................................................... 1

4 Terms relating to the methods of pulse diagnosis........................................................................................................... 2

5 Terms relating to the key elements of pulse .......................................................................................................................... 3

6 Terms relating to pulse condition .....................................................................................................................................................5

Annex A (informative) Pulse diagnosis terms — Chinese, Japanese and Korean characters ..............14

Bibliography .............................................................................................................................................................................................................................20

iii
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ISO 23961-2:2021(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards

bodies (ISO member bodies). The work of preparing International Standards is normally carried out

through ISO technical committees. Each member body interested in a subject for which a technical

committee has been established has the right to be represented on that committee. International

organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.

ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of

electrotechnical standardization.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of ISO documents should be noted. This document was drafted in accordance with the

editorial rules of the ISO/IEC Directives, Part 2 (see www.iso.org/directives).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of

any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www.iso.org/patents).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to

the World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see

www.iso.org/iso/foreword.html.

This document was prepared by Technical Committee ISO/TC 249, Traditional Chinese medicine.

A list of all parts in the ISO 23961 series can be found on the ISO website.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www.iso.org/members.html.
© ISO 2021 – All rights reserved
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ISO 23961-2:2021(E)
Introduction

Traditional Chinese medicine has become increasingly popular all over the world. Traditional Chinese

medicine education has developed rapidly. Traditional Chinese medicine has obtained legal status in

the United States, Singapore, Australia, Thailand and other countries and regions. Academic activities

of traditional Chinese medicine are increasingly active. International communication of traditional

Chinese medicine and medical activities, scientific research, management rules and regulations are in

urgent need of International Standards.

First, standardized terminology is essential to standardize products and services. Pulse diagnosis

is one of the most distinctive traditional Chinese medicine diagnostic methods. At present, the

international trade of pulse-equipment-related products is in great demand in the international market.

This document aims to encourage improvement of the pulse-equipment-related industrial and research

fields. All traditional Chinese medicine pulse diagnostic instruments can use the same vocabulary,

which is very important for international trade and communication. With standardized terminology,

the versatility of pulse-equipment-related products or services can be improved to benefit international

technical cooperation.

Second, the use of standardized terminology in diagnosis helps to avoid confusion among researchers

in the field of pulse diagnosis. But more importantly, the use of standardized terminology in pulse

diagnosis also helps manufacturers to deliver a standardized meaning of TCM pulse obtained by pulse-

related diagnostic medical devices. Considering the close association between the traditional Chinese

medicine diagnosis and diagnostic medical devices, the importance of standardizing diagnostic

terminology is clear.

Third, the purpose of the project is for the use of traditional Chinese medicine diagnostic instruments

and artificial intellige (AI) medicine. As internet-based medicine is developing very quickly, a

standardized terminology is not only important for computerized information but also necessary for

successful communication between physicians and patients from different countries. With advances in

AI, medical AI doctors also need standardized terminology.

Therefore, it is necessary to standardize pulse diagnostic terminology as quickly as possible, in order to

bring benefits to scholars, governments and enterprises worldwide.
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INTERNATIONAL STANDARD ISO 23961-2:2021(E)
Traditional Chinese medicine — Vocabulary for
diagnostics —
Part 2:
Pulse
1 Scope

This document specifies the basic terminology of pulse diagnostic methods, the key elements of pulse

and pulse condition. Each term of pulse diagnosis includes the English name, the classical Chinese

characters and its definition.
2 Normative references
There are no normative references in this document.
3 Terms and definitions

ISO and IEC maintain terminological databases for use in standardization at the following addresses:

— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
3.1
Cun-kou

medial aspect of the styloid process of the radius where the radial artery pulsates

3.2
pulse diagnosis
examination of the pulse in Cun-kou for making diagnosis
3.3
guan/bar
medial side of the styloid process
Note 1 to entry: See Figure 1.
3.4
cun/inch
carpet end of guan
Note 1 to entry: See Figure 1.
3.5
chi/cubit
cubital end of guan
Note 1 to entry: See Figure 1.
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ISO 23961-2:2021(E)
Key
1 styloid process of radius
2 cun/inch
3 guan/bar
4 chi/cubit
5 scap
6 bifur
7 pisit
8 radial artery
9 ulnar artery
10 radius
11 ulna
Figure 1 — Location of cun/inch, guan/bar and chi/cubit for pulse diagnosis
4 Terms relating to the methods of pulse diagnosis
4.1
arrangement of fingers

three fingers being arched with the same level of finger tips, and the physicians feeling the pulsation

with crossing area of the finger tips and bulbs

Note 1 to entry: The spacing of the three fingers can be proportionate to the patient’s height. The fingers are

spaced apart for a tall patient whereas they should be kept close together for a short patient.

Note 2 to entry: For further information, see A.1.1.
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ISO 23961-2:2021(E)
4.2
individual-finger palpation

placement of one specific finger at one position to examine the state that the region represents

Note 1 to entry: For further information, see A.1.2.
4.3
simultaneous palpation with three fingers

placement of the three fingertips simultaneously on three points with the same strength to examine

the overall pulse condition of the three points
Note 1 to entry: For further information, see A.1.3.
4.4
lifting
light pulse feeling
superficial pulse feeling
gently touching the skin
Note 1 to entry: For further information, see A.1.4.
4.5
pressing
heavy pulse feeling
deep pulse feeling
exerting strong finger power to reach the bones
Note 1 to entry: For further information, see A.1.5.
4.6
searching

gradually increasing finger power and searching the most palpable pulsation from left to right, back

and forth, aroud the cun/inch, guan/bar and chi/cubit at Cun-kou
Note 1 to entry: For further information, see A.1.6.
5 Terms relating to the key elements of pulse
5.1
pulse location
location of pulse beating

Note 1 to entry: Can be superficial or deep, for example with a floating pulse or a sunken pulse.

Note 2 to entry: For further information, see A.2.1.
5.2
pulse rate
frequency of pulse beating

Note 1 to entry: Can be slow or rapid, for example with a slow pulse or a rapid pulse.

Note 2 to entry: For further information, see A.2.2.
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ISO 23961-2:2021(E)
5.3
pulse length
axial length of the pulse beating

Note 1 to entry: Can be short or long, for example with a short pulse or a long pulse.

Note 2 to entry: For further information, see A.2.3.
5.4
pulse strength
force of pulse beating

Note 1 to entry: Can be forceless or forceful, for example with a vacuous pulse or a replete pulse.

Note 2 to entry: For further information, see A.2.4.
5.5
pulse width
radial breadth of pulse beating relating to the thickness or thinness of beats

Note 1 to entry: Can be small or large, for example with a surging pulse or a fine pulse.

Note 2 to entry: For further information, see A.2.5.
5.6
pulse smoothness
流暢度
smoothness of approaching pulse beating

Note 1 to entry: Can be smooth or rough, for example with a slippery pulse or a rough pulse.

Note 2 to entry: For further information, see A.2.6.
5.7
pulse tension
緊張度
tightness of the vessel of pulse beating

Note 1 to entry: Can be tight or relaxed, for example with a tight pulse or a relaxed pulse.

Note 2 to entry: For further information, see A.2.7.
5.8
pulse evenness
均勻度
regularity of pulse beating

Note 1 to entry: Can be irregular or even of rhythm and strength, such as with a racing pulse, a bound pulse or an

intermittent pulse.
Note 2 to entry: For further information, see A.2.8.
5.9
classification of the key elements of pulse
key elements of pulse being divided into different levels

Note 1 to entry: For the classification structure of the key elements of pulse, see Figure 2.

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ISO 23961-2:2021(E)

Note 2 to entry: Pulse conditions being generally discussed in eight key elements: location, rate, length, width,

strength, smoothness, tension and evenness. The varieties of pulse condition can occur as a result of a combination

of degree changes of the above eight aspects. Some pulses involve single element, such as a superficial or deep

pulse (location). Some involve multiple factors, for example a weak pulse is mixture of deep (location), thread

(width) and deficient (strength) quality.
Figure 2 — The classification structure of the key elements of pulse
6 Terms relating to pulse condition
6.1
bound pulse
pulse with slow and irregular pulse rate
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic (《黃帝內經》).

Note 2 to entry: Classic of Difficult Issues (《難經》) states, “A bound pulse has occasional stops and the stops have

no definite pattern”. Treatise on Cold Damage (《傷寒論》) states, “The pulse that arrives unhurriedly, occasionally

stops and then is restored is called irregularly intermittent pulse” (Chapter Bianmaifadiyi, 辨脈法第一). Pulse

Classic (《脈經》) states, “A bound pulse arrives and departs unhurriedly and there is one stop before the normal

pulse beating is restored,” (Volume 1), which was cited by Binhu’s Sphygmology (《瀕湖脈學》).

Note 3 to entry: For further information, see A.3.1.
6.2
dissipated pulse

pulse which is superficial, irregularly chaotic with light pressure and impalpable with heavy pressure

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “A dissipated pulse is large and scattered” (Volume 2), which was cited by

Binhu’s Sphygmology and states, “A dissipated has an irregular pulse rate”. Essential Principles and Practice of

Pulse Diagnosis (《診家正眼》) states, “A scattered pulse is floating and scattered, present in the exterior, not in

the interior, gradually becoming empty at the moderate level and completely expiring with pressure” (Volume 2).

Note 3 to entry: For further information, see A.3.2.
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ISO 23961-2:2021(E)
6.3
drumskin pulse

pulse which is easily felt with gentle touch and superficial with an empty centre, feeling like the surface

of a drum
Note 1 to entry: The first origin is Treatise on Cold Damage.

Note 2 to entry: Pulse Classic states, “A drumskin pulse is deep, hidden, replete, large, long and slightly string-like”

(Volume 1). Binhu’s Sphygmology states,“A drumskin has a hollow centre and is hard and leathery outside just like

a drum”. Systematic Theory and Practice on Four Diagnostic Methods(《四診訣微》) states, “A drumskin pulse is

string-like and hollow, like a drum. It is floating, large, string-like, tight on the outside and empty within. With

light pressure, the pulsation can be clearly felt; with heavy pressure, there is a feeling of emptiness within, as if

pressing on the skin of a drum” (Volume 7). Revised Verses in Pulse Diagnosis(《脈訣指掌》) by Zhu Zhenheng states,

“A drumskin pulse is string-like, replete and large, just like the feeling of drum” (Chapter Bianmaixingmingzhuang,

辨脈形名狀).
Note 3 to entry: For further information, see A.3.3.
6.4
faint pulse
pulse which is extremely thready, soft and barely palpable
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Book to Safeguard Life Arranged by Categorized Patterns(《類證活人書》) states, “Faint means

extremely thready and soft. The pulse is sometimes present but sometimes not” (Volume 2). Corrections of Verse

Errors in Pulse Diagnosis (《脈訣刊誤》) states, “A faint pulse is sometimes present and sometimes not. It ought to

be felt with light pressure. With heavy pressure, sometimes it can be felt and sometimes not” (Volume A).

Note 3 to entry: For further information, see A.3.4.
6.5
fine pulse
pulse with a thread-like feeling but obvious with a light touch
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “A fine pulse is fine and small. It is larger than a faint pulse” (Volume 1).

Binhu’s Sphygmology states, “ A fine pulse is fine, straight and soft, like a silken thread.” Essential Principles and

Practice of Pulse Diagnosis states, “A fine pulse is like a silken thread, it is larger than a faint pulse”. (Charpter

Ximaiyi, 細脈陰). Key Principles in Pulse Diagnosis (《脈訣匯辨》) states, “A fine pulse is small and fine, like a silken

thread. It is clearly felt with light touch” (Volume 4).
Note 3 to entry: For further information, see A.3.5.
6.6
firm pulse

pulse with deep location, long length, high tension, forceful strength and palpable only by heavy

pressing
Note 1 to entry: The first origin is The Classic of Difficult Issues.

Note 2 to entry: Pulse Classic states, “A firm pulse is deep, hidden, replete, large, long and slightly string-like”,

which was cited by Binhu’s Sphygmology. Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A firm pulse is

deep, hidden, solid, string-like, long, replete and long” (Chapter Bianmaixingmingzhuang). Key Principles in Pulse

Diagnosis states, “A firm pulse is deep, large, string-like and replete. It is felt with neither light nor moderate

pressure”.
Note 3 to entry: For further information, see A.3.6.
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ISO 23961-2:2021(E)
6.7
floating pulse
pulse which feels obvious with light touch but forceless with pressure
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “With light touch, the pulsation is clearly felt; with heavy pressure, the

pulsation becomes indistinct” (Volume 1), which was cited by Binhu’s Sphygmology. Essential Principles and

Practice of Pulse Diagnosis states, “A floating pulse feels superficial in the skin and body hair, just like a piece of

wood floating on water. With light touch, the pulsation is clearly felt; with heavy pressure, the pulsation becomes

indistinct”. (Chapter Fumaiyang, 浮脈陽). Key Principles in Pulse Diagnosis states, “The word floating describes the

feeling like a piece of wood floating on water. It is clearly felt by a light touch because it’s located superficially in

the skin and body hair; however, just like the wood floating on water, it goes deep on heavy pressure but goes up

when the pressure is released” (Volume 3).
Note 3 to entry: For further information, see A.3.7.
6.8
hidden pulse
pulse which is deep and palpable only by pressing to the bones or tendons
Note 1 to entry: The first origin is The Classic of Difficult Issues.

Note 2 to entry: Pulse Classic states, “With light touch, the pulsation is indistinct; with heavy pressure, the

pulsation is clearly felt” (Volume 1), which was cited by Binhu’s Sphygmology. Revised Verses in Pulse Diagnosis by

Zhu Zhenheng states, “A hidden pulse requires heavy pressure to the tendon and bones to feel clearly” (Chapter

Bianmaixingmingzhuang). Key Principles in Pulse Diagnosis states, “A hidden pulse requires heavy finger pressing.

It is hardly felt by light to moderate or even heavy pressure. It requires pressing to the bones and tendons to feel

the pulsation” (Volume 4).
Note 3 to entry: For further information, see A.3.8.
6.9
hollow pulse
pulse which is superficial, large and hollow

Note 1 to entry: The first origin is Treatise on Cold Damage and Miscellaneous Diseases(《傷寒雜病論》).

Note 2 to entry: Pulse Classic states, “A hollow pulse is floating, large and soft. The centre is empty and the two

sides are replete”(Volume 1). Binhu’s Sphygmology also states, “its shape is comparable to a scallion.” Revised

Verses in Pulse Diagnosis by Zhu Zhenheng states, “A hollow pulse means the center is empty and the two sides are

replete, just like the feeling of a scallion stalk” (Chapter Bianmaixingmingzhuang). Key Principles in Pulse Diagnosis

states, “The pulse is given the name hollow because its shape is comparable to a scallion. It has both the floating

and deep positions, only the center is empty when pressed” (Volume 4).
Note 3 to entry: For further information, see A.3.9.
6.10
intermittent pulse

pulse which has missing beats and pauses longer rather than at regular intermittent intervals

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “An intermittent pulse arrives fast, stops for a relatively longer period of

time and then a recovery of movement” (Volume 1). Corrections of Verse Errors in Pulse Diagnosis states, “An

intermittent pulse arrives fast, stops for a relatively longer period of time and then a recovery of movement”

(Volume A). Essential Principles and Practice of Pulse Diagnosis states, “An intermittent pulse is constant and

regularly intermittent, the stops are normal and frequent, they cannot be self-controlled, there are long stops

and then a recovery of movement”. Binhu’s Sphygmology states, “An intermittent pulse arrives fast, stops for a

relatively longer period of time and then a recovery of movement”.
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ISO 23961-2:2021(E)
Note 3 to entry: For further information, see A.3.10.
6.11
large pulse
pulse with a large width and forcefulness but without turbulent force
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Guidelines for Disease Detection(《察病指南》) states: “The large pulse arrives and departs large

and full under the fingers”. Pulse Reason(《脈理求真》) states: “The pulse is large and full, as well as long, and it's

felt with little force on pressing.”
Note 3 to entry: For further information, see A.3.11.
6.12
long pulse

pulse which is straight and exceeds the three palpation fingers located in inch and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Binhu’s Sphygmology states, “A long pulse is with long extent, longer than its basic position. It is

straight and long like a pole.” Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A long pulse arrives and

departs smoothly. It can be felt at all three positions.” (Chapter Bianmaixingmingzhuang). Essential Principles and

Practice of Pulse Diagnosis states, “A long pulse exceeds the original length. It is straight from head to tail. It is

straight and long like a pole”.
Note 3 to entry: For further information, see A.3.12.
6.13
normal pulse

pulse which is felt in inch, bar and cubit regions, around 60 to 90 beats per minute

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Physiologically, a normal pulse in healthy people has about four beats in a normal cycle of

respiration; the key elements of pulse (pulse location, pulse rate, pulse width, pulse length, pulse strength, pulse

smoothness) are at medium level and pulse evenness is even. A normal pulse can correspondingly change along

with changes in physiological activities and weather.
Note 3 to entry: For further information, see A.3.13.
6.14
racing pulse
pulse with more than 120 beats per minute

Note 1 to entry: The first origin is The Treatise on Cold Pathogenic and Miscellaneous Diseases.

Note 2 to entry: Essential Principles and Practice of Pulse Diagnosis states, “A racing pulse is extremely fast and

rapid, with seven, eight or more beats in one breath (approximately 120 to 140 beats per minute, and the flow is

thin and racing” (Chapter Jimaiyang, 疾脈陽). Key Principles in Pulse Diagnosis states, “A pulse that has at least six

beats in one breath (>90 times per minute) is called racing or extremely racing pulse” (Volume 4).

Note 3 to entry: For further information, see A.3.14.
6.15
rapid pulse
pulse with more than 90 beats per minute
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.
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ISO 23961-2:2021(E)

Note 2 to entry: Pulse Classic states, “A rapid pulse refers to fast pulsations” (Volume 1). Binhu’s Sphygmology

states, “A rapid pulse is six beats in one breath (90 beats per minute). The pulsations are rapid”. Essential

Principles and Practice of Pulse Diagnosis states, “A rapid pulse is attributed to yang. The pulsations are extremely

fast – six beats in one breath (90 beats per minute)”. The word rapid describes the feeling of fast-moving. Since

qi moves 3 inches with exhalation (breathing out) and moves another 3 inches with inhalation (breathing in), qi

moves 6 inches in one breath”.

Note 3 to entry: Traditionally, a rapid pulse is considered to be more than 5 or 6 beats within a cycle of respiration.

Note 4 to entry: For further information, see A.3.15.
6.16
relaxed pulse

pulse which is slower than a normal pulse but more rapid than a slow pulse, with about 60 beats per

minute
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “A relaxed pulse departs and arrives slowly; it is faster than a slow pulse”

(Volume A), which was cited by Binhu’s Sphygmology. Essential Principles and Practice of Pulse Diagnosis states, “A

relaxed pulse is four beats in one breath (60 times per minute). It arrives and departs evenly like gentle breeze

in spring” (Chapter Huanmaiying,緩脈陰). Corrections of Verse Errors in Pulse Diagnosis states, “A relaxed pulse

arrives and departs slowly. It is faster than a slow pulse. With moderate to heavy pressure, it is soft and slow. It is

smaller than a deep pulse. In addition, it is leisurely and soft” (Volume A).
Note 3 to entry: For further information, see A.3.16.
6.17
replete pulse

pulse which feels forceful by both light touch or heavy pressure in inch, bar and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A replete pulse is forceful with both

light or heavy pressure. It is neither fast nor slow.” (Chapter Bianmaixingmingzhuang).

Note 3 to entry: For further information, see A.3.17.
6.18
rough pulse
pulse which feels stagnant, thready, slow and irregular
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Binhu’s Sphygmology states, “A rough pulse is thready and slow. It arrives and departs roughly.

It is short and scattered, feeling like using a knife to scrape bamboo or a sick silkworm biting leaves” (Chapter

Qiyanjuese 七言決澀). Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A rough pulse is stagnant like rain

touching the sand” (Chapter Bianmaixingmingzhuang). Essential Principles and Practice of Pulse Diagnosis states,

“A Rough pulse is stagnant, like a blade scraping bamboo. It is slow, thready and short, all indicating obstruction”

(Chapter Semaiyin, 澀脈陰).
Note 3 to entry: For further information, see A.3.18.
6.19
short pulse

pulse which is shorter than the three palpation fingers located in inch, bar and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.
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ISO 23961-2:2021(E)

Note 2 to entry: Note2 to entry: Pulse Classic states, “The shape of a short pulse that beats felt under the fingers

do not fill the three positions” (Volume A), which was cited by Binhu’s Sphygmology. Revised Verses in Pulse

Diagnosis by Zhu Zhenheng states, “A short pulse feels rapid with light touch and pressure; however, the beats

under the fingers do not fill the positions” (Chapter Bianmaixingmingzhuang). Essential Principles and Practice

of Pulse Diagnosis states, “A short pulse is rough and small, its head and tail are both hidden; it protrudes at the

centre, but cannot fill the positions”.
Note 3 to entry: For further information, see A.3.19.
6.20
skipping pulse
pulse with more than 90 beats per minute and irregular beating

Note 1 to entry: The first origin is Treatise on Cold Pathogenic and Miscellaneous Diseases.

Note 2 to entry: Treatise on Cold Pathogenic states, “A skipping pulse arrives as urgent and skipping, sometimes

there is a pause, skipping a beat” (Chapter Bianmaifadiyi). Revised Verses in Pulse Diagnosis by Zhu Zhenheng

states, “A skipping pulse arrives and departs rapidly, sometimes there is a pause in its arrival”. (Chapter

Bianmaixingmingzhuang). Pulse Classic states, “A skipping pulse arrives and departs rapidly and sometimes there

is a pause in its arrival,” which was cited by Binhu’s Sphygmology.

Note 3 to entry: Traditionally, a skipping pulse is considered to be more than 5 or 6 beats within a normal cycle of

respiration and irregular
...

FINAL
INTERNATIONAL ISO/FDIS
DRAFT
STANDARD 23961-2
ISO/TC 249
Traditional Chinese medicine —
Secretariat: SAC
Vocabulary for diagnostics —
Voting begins on:
2021-08-09
Part 2:
Voting terminates on:
Pulse
2021-10-04
RECIPIENTS OF THIS DRAFT ARE INVITED TO
SUBMIT, WITH THEIR COMMENTS, NOTIFICATION
OF ANY RELEVANT PATENT RIGHTS OF WHICH
THEY ARE AWARE AND TO PROVIDE SUPPOR TING
DOCUMENTATION.
IN ADDITION TO THEIR EVALUATION AS
Reference number
BEING ACCEPTABLE FOR INDUSTRIAL, TECHNO-
ISO/FDIS 23961-2:2021(E)
LOGICAL, COMMERCIAL AND USER PURPOSES,
DRAFT INTERNATIONAL STANDARDS MAY ON
OCCASION HAVE TO BE CONSIDERED IN THE
LIGHT OF THEIR POTENTIAL TO BECOME STAN-
DARDS TO WHICH REFERENCE MAY BE MADE IN
NATIONAL REGULATIONS. ISO 2021
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ISO/FDIS 23961-2:2021(E)
COPYRIGHT PROTECTED DOCUMENT
© ISO 2021

All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may

be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting

on the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address

below or ISO’s member body in the country of the requester.
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Published in Switzerland
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ISO/FDIS 23961-2:2021(E)
Contents Page

Foreword ........................................................................................................................................................................................................................................iv

Introduction ..................................................................................................................................................................................................................................v

1 Scope ................................................................................................................................................................................................................................. 1

2 Normative references ...................................................................................................................................................................................... 1

3 Terms and definitions ..................................................................................................................................................................................... 1

4 Terms relating to the methods of pulse diagnosis ............................................................................................................. 2

5 Terms relating to the key elements of pulse ............................................................................................................................ 3

6 Terms relating to pulse condition ...................................................................................................................................................... 5

Annex A (informative) Pulse diagnosis terms — Chinese, Japanese and Korean characters .................14

Bibliography .............................................................................................................................................................................................................................20

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ISO/FDIS 23961-2:2021(E)
Foreword

ISO (the International Organization for Standardization) is a worldwide federation of national standards

bodies (ISO member bodies). The work of preparing International Standards is normally carried out

through ISO technical committees. Each member body interested in a subject for which a technical

committee has been established has the right to be represented on that committee. International

organizations, governmental and non-governmental, in liaison with ISO, also take part in the work.

ISO collaborates closely with the International Electrotechnical Commission (IEC) on all matters of

electrotechnical standardization.

The procedures used to develop this document and those intended for its further maintenance are

described in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the

different types of ISO documents should be noted. This document was drafted in accordance with the

editorial rules of the ISO/IEC Directives, Part 2 (see www .iso .org/ directives).

Attention is drawn to the possibility that some of the elements of this document may be the subject of

patent rights. ISO shall not be held responsible for identifying any or all such patent rights. Details of

any patent rights identified during the development of the document will be in the Introduction and/or

on the ISO list of patent declarations received (see www .iso .org/ patents).

Any trade name used in this document is information given for the convenience of users and does not

constitute an endorsement.

For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and

expressions related to conformity assessment, as well as information about ISO's adherence to the

World Trade Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www .iso .org/

iso/ foreword .html.

This document was prepared by Technical Committee ISO/TC 249, Traditional Chinese medicine.

A list of all parts in the ISO 23961 series can be found on the ISO website.

Any feedback or questions on this document should be directed to the user’s national standards body. A

complete listing of these bodies can be found at www .iso .org/ members .html.
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ISO/FDIS 23961-2:2021(E)
Introduction

Traditional Chinese medicine has become increasingly popular all over the world. Traditional Chinese

medicine education has developed rapidly. Traditional Chinese medicine has obtained legal status in

the United States, Singapore, Australia, Thailand and other countries and regions. Academic activities

of traditional Chinese medicine are increasingly active. International communication of traditional

Chinese medicine and medical activities, scientific research, management rules and regulations are in

urgent need of International Standards.

First, standardized terminology is essential to standardize products and services. Pulse diagnosis

is one of the most distinctive traditional Chinese medicine diagnostic methods. At present, the

international trade of pulse-equipment-related products is in great demand in the international market.

This document aims to encourage improvement of the pulse-equipment-related industrial and research

fields. All traditional Chinese medicine pulse diagnostic instruments can use the same vocabulary,

which is very important for international trade and communication. With standardized terminology,

the versatility of pulse-equipment-related products or services can be improved to benefit international

technical cooperation.

Second, the use of standardized terminology in diagnosis helps to avoid confusion among researchers

in the field of pulse diagnosis. But more importantly, the use of standardized terminology in pulse

diagnosis also helps manufacturers to deliver a standardized meaning of TCM pulse obtained by pulse-

related diagnostic medical devices. Considering the close association between the traditional Chinese

medicine diagnosis and diagnostic medical devices, the importance of standardizing diagnostic

terminology is clear.

Third, the purpose of the project is for the use of traditional Chinese medicine diagnostic instruments

and artificial intellige (AI) medicine. As internet-based medicine is developing very quickly, a

standardized terminology is not only important for computerized information but also necessary for

successful communication between physicians and patients from different countries. With advances in

AI, medical AI doctors also need standardized terminology.

Therefore, it is necessary to standardize pulse diagnostic terminology as quickly as possible, in order to

bring benefits to scholars, governments and enterprises worldwide.
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FINAL DRAFT INTERNATIONAL STANDARD ISO/FDIS 23961-2:2021(E)
Traditional Chinese medicine — Vocabulary for
diagnostics —
Part 2:
Pulse
1 Scope

This document specifies the basic terminology of pulse diagnostic methods, the key elements of pulse

and pulse condition. Each term of pulse diagnosis includes the English name, the classical Chinese

characters and its definition.
2 Normative references
There are no normative references in this document.
3 Terms and definitions

ISO and IEC maintain terminological databases for use in standardization at the following addresses:

— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at http:// www .electropedia .org/
3.1
Cun-kou

medial aspect of the styloid process of the radius where the radial artery pulsates

3.2
pulse diagnosis
examination of the pulse in Cun-kou for making diagnosis
3.3
guan/bar
medial side of the styloid process
Note 1 to entry: See Figure 1.
3.4
cun/inch
carpet end of guan
Note 1 to entry: See Figure 1.
3.5
chi/cubit
cubital end of guan
Note 1 to entry: See Figure 1.
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Key
1 styloid process of radius
2 cun/inch
3 guan/bar
4 chi/cubit
5 scap
6 bifur
7 pisit
8 radial artery
9 ulnar artery
10 radius
11 ulna
Figure 1 — Location of cun/inch, guan/bar and chi/cubit for pulse diagnosis
4 Terms relating to the methods of pulse diagnosis
4.1
arrangement of fingers

three fingers being arched with the same level of finger tips, and the physicians feeling the pulsation

with crossing area of the finger tips and bulbs

Note 1 to entry: The spacing of the three fingers can be proportionate to the patient’s height. The fingers are

spaced apart for a tall patient whereas they should be kept close together for a short patient.

Note 2 to entry: For further information, see A.1.1.
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4.2
individual-finger palpation

placement of one specific finger at one position to examine the state that the region represents

Note 1 to entry: For further information, see A.1.2.
4.3
simultaneous palpation with three fingers

placement of the three fingertips simultaneously on three points with the same strength to examine

the overall pulse condition of the three points
Note 1 to entry: For further information, see A.1.3.
4.4
lifting
light pulse feeling
superficial pulse feeling
gently touching the skin
Note 1 to entry: For further information, see A.1.4.
4.5
pressing
heavy pulse feeling
deep pulse feeling
exerting strong finger power to reach the bones
Note 1 to entry: For further information, see A.1.5.
4.6
searching

gradually increasing finger power and searching the most palpable pulsation from left to right, back

and forth, aroud the cun/inch, guan/bar and chi/cubit at Cun-kou
Note 1 to entry: For further information, see A.1.6.
5 Terms relating to the key elements of pulse
5.1
pulse location
location of pulse beating

Note 1 to entry: Can be superficial or deep, for example with a floating pulse or a sunken pulse.

Note 2 to entry: For further information, see A.2.1.
5.2
pulse rate
frequency of pulse beating

Note 1 to entry: Can be slow or rapid, for example with a slow pulse or a rapid pulse.

Note 2 to entry: For further information, see A.2.2.
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5.3
pulse length
axial length of the pulse beating

Note 1 to entry: Can be short or long, for example with a short pulse or a long pulse.

Note 2 to entry: For further information, see A.2.3.
5.4
pulse strength
force of pulse beating

Note 1 to entry: Can be forceless or forceful, for example with a vacuous pulse or a replete pulse.

Note 2 to entry: For further information, see A.2.4.
5.5
pulse width
radial breadth of pulse beating relating to the thickness or thinness of beats

Note 1 to entry: Can be small or large, for example with a surging pulse or a fine pulse.

Note 2 to entry: For further information, see A.2.5.
5.6
pulse smoothness
流暢度
smoothness of approaching pulse beating

Note 1 to entry: Can be smooth or rough, for example with a slippery pulse or a rough pulse.

Note 2 to entry: For further information, see A.2.6.
5.7
pulse tension
緊張度
tightness of the vessel of pulse beating

Note 1 to entry: Can be tight or relaxed, for example with a tight pulse or a relaxed pulse.

Note 2 to entry: For further information, see A.2.7.
5.8
pulse evenness
均勻度
regularity of pulse beating

Note 1 to entry: Can be irregular or even of rhythm and strength, such as with a racing pulse, a bound pulse or an

intermittent pulse.
Note 2 to entry: For further information, see A.2.8.
5.9
classification of the key elements of pulse
key elements of pulse being divided into different levels

Note 1 to entry: For the classification structure of the key elements of pulse, see Figure 2.

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Note 2 to entry: Pulse conditions being generally discussed in eight key elements: location, rate, length, width,

strength, smoothness, tension and evenness. The varieties of pulse condition can occur as a result of a combination

of degree changes of the above eight aspects. Some pulses involve single element, such as a superficial or deep

pulse (location). Some involve multiple factors, for example a weak pulse is mixture of deep (location), thread

(width) and deficient (strength) quality.
Figure 2 — The classification structure of the key elements of pulse
6 Terms relating to pulse condition
6.1
bound pulse
pulse with slow and irregular pulse rate
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic (《黃帝內經》).

Note 2 to entry: Classic of Difficult Issues (《難經》) states, “A bound pulse has occasional stops and the stops have

no definite pattern”. Treatise on Cold Damage (《傷寒論》) states, “The pulse that arrives unhurriedly, occasionally

stops and then is restored is called irregularly intermittent pulse” (Chapter Bianmaifadiyi, 辨脈法第一). Pulse

Classic (《脈經》) states, “A bound pulse arrives and departs unhurriedly and there is one stop before the normal

pulse beating is restored,” (Volume 1), which was cited by Binhu’s Sphygmology (《瀕湖脈學》).

Note 3 to entry: For further information, see A.3.1.
6.2
dissipated pulse

pulse which is superficial, irregularly chaotic with light pressure and impalpable with heavy pressure

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “A dissipated pulse is large and scattered” (Volume 2), which was cited by

Binhu’s Sphygmology and states, “A dissipated has an irregular pulse rate”. Essential Principles and Practice of

Pulse Diagnosis (《診家正眼》) states, “A scattered pulse is floating and scattered, present in the exterior, not in

the interior, gradually becoming empty at the moderate level and completely expiring with pressure” (Volume 2).

Note 3 to entry: For further information, see A.3.2.
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6.3
drumskin pulse

pulse which is easily felt with gentle touch and superficial with an empty centre, feeling like the surface

of a drum
Note 1 to entry: The first origin is Treatise on Cold Damage.

Note 2 to entry: Pulse Classic states, “A drumskin pulse is deep, hidden, replete, large, long and slightly string-

like” (Volume 1). The Li Bin-hu’s Teachings on Pulse Diagnosis states,“A drumskin has a hollow centre and is hard

and leathery outside just like a drum”. Systematic Theory and Practice on Four Diagnostic Methods(《四診訣微》)

states, “A drumskin pulse is string-like and hollow, like a drum. It is floating, large, string-like, tight on the outside

and empty within. With light pressure, the pulsation can be clearly felt; with heavy pressure, there is a feeling of

emptiness within, as if pressing on the skin of a drum” (Volume 7). Revised Verses in Pulse Diagnosis(《脈訣指掌》)

by Zhu Zhenheng states, “A drumskin pulse is string-like, replete and large, just like the feeling of drum” (Chapter

Bianmaixingmingzhuang, 辨脈形名狀).
Note 3 to entry: For further information, see A.3.3.
6.4
faint pulse
pulse which is extremely thready, soft and barely palpable
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Book to Safeguard Life Arranged by Categorized Patterns(《類證活人書》) states, “Faint means

extremely thready and soft. The pulse is sometimes present but sometimes not” (Volume 2). Corrections of Verse

Errors in Pulse Diagnosis (《脈訣刊誤》) states, “A faint pulse is sometimes present and sometimes not. It ought to

be felt with light pressure. With heavy pressure, sometimes it can be felt and sometimes not” (Volume A).

Note 3 to entry: For further information, see A.3.4.
6.5
fine pulse
pulse with a thread-like feeling but obvious with a light touch
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “A fine pulse is fine and small. It is larger than a faint pulse” (Volume 1).

Binhu’s Sphygmology states, “ A fine pulse is fine, straight and soft, like a silken thread.” Essential Principles and

Practice of Pulse Diagnosis states, “A fine pulse is like a silken thread, it is larger than a faint pulse”. (Charpter

Ximaiyi, 細脈陰). Key Principles in Pulse Diagnosis (《脈訣匯辨》) states, “A fine pulse is small and fine, like a silken

thread. It is clearly felt with light touch” (Volume 4).
Note 3 to entry: For further information, see A.3.5.
6.6
firm pulse

pulse with deep location, long length, high tension, forceful strength and palpable only by heavy

pressing
Note 1 to entry: The first origin is The Classic of Difficult Issues.

Note 2 to entry: Pulse Classic states, “A firm pulse is deep, hidden, replete, large, long and slightly string-like”,

which was cited by Binhu’s Sphygmology. Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A firm pulse is

deep, hidden, solid, string-like, long, replete and long” (Chapter Bianmaixingmingzhuang). Key Principles in Pulse

Diagnosis states, “A firm pulse is deep, large, string-like and replete. It is felt with neither light nor moderate

pressure”.
Note 3 to entry: For further information, see A.3.6.
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6.7
floating pulse
pulse which feels obvious with light touch but forceless with pressure
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Pulse Classic states, “With light touch, the pulsation is clearly felt; with heavy pressure, the

pulsation becomes indistinct” (Volume 1), which was cited by Binhu’s Sphygmology. Essential Principles and

Practice of Pulse Diagnosis states, “A floating pulse feels superficial in the skin and body hair, just like a piece of

wood floating on water. With light touch, the pulsation is clearly felt; with heavy pressure, the pulsation becomes

indistinct”. (Chapter Fumaiyang, 浮脈陽). Key Principles in Pulse Diagnosis states, “The word floating describes the

feeling like a piece of wood floating on water. It is clearly felt by a light touch because it’s located superficially in

the skin and body hair; however, just like the wood floating on water, it goes deep on heavy pressure but goes up

when the pressure is released” (Volume 3).
Note 3 to entry: For further information, see A.3.7.
6.8
hidden pulse
pulse which is deep and palpable only by pressing to the bones or tendons
Note 1 to entry: The first origin is The Classic of Difficult Issues.

Note 2 to entry: Pulse Classic states, “With light touch, the pulsation is indistinct; with heavy pressure, the

pulsation is clearly felt” (Volume 1), which was cited by Binhu’s Sphygmology. Revised Verses in Pulse Diagnosis by

Zhu Zhenheng states, “A hidden pulse requires heavy pressure to the tendon and bones to feel clearly” (Chapter

Bianmaixingmingzhuang). Key Principles in Pulse Diagnosis states, “A hidden pulse requires heavy finger pressing.

It is hardly felt by light to moderate or even heavy pressure. It requires pressing to the bones and tendons to feel

the pulsation” (Volume 4).
Note 3 to entry: For further information, see A.3.8.
6.9
hollow pulse
pulse which is superficial, large and hollow

Note 1 to entry: The first origin is Treatise on Cold Damage and Miscellaneous Diseases(《傷寒雜病論》).

Note 2 to entry: Pulse Classic states, “A hollow pulse is floating, large and soft. The centre is empty and the two

sides are replete”(Volume 1), which was cited by The Li Bin-hu’s Teachings on Pulse Diagnosis. Binhu’s Sphygmology

also states, “its shape is comparable to a scallion.” Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A

hollow pulse means the center is empty and the two sides are replete, just like the feeling of a scallion stalk”

(Chapter Bianmaixingmingzhuang). Key Principles in Pulse Diagnosis states, “The pulse is given the name hollow

because its shape is comparable to a scallion. It has both the floating and deep positions, only the center is empty

when pressed” (Volume 4).
Note 3 to entry: For further information, see A.3.9.
6.10
intermittent pulse

pulse which has missing beats and pauses longer rather than at regular intermittent intervals

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.
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Note 2 to entry: Pulse Classic states, “An intermittent pulse arrives fast, stops for a relatively longer period of

time and then a recovery of movement” (Volume 1). Corrections of Verse Errors in Pulse Diagnosis states, “An

intermittent pulse arrives fast, stops for a relatively longer period of time and then a recovery of movement”

(Volume A). Essential Principles and Practice of Pulse Diagnosis states, “An intermittent pulse is constant and

regularly intermittent, the stops are normal and frequent, they cannot be self-controlled, there are long stops

and then a recovery of movement”. Binhu’s Sphygmology states, “An intermittent pulse arrives fast, stops for a

relatively longer period of time and then a recovery of movement”.
Note 3 to entry: For further information, see A.3.10.
6.11
large pulse
pulse with a large width and forcefulness but without turbulent force
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Guidelines for Disease Detection(《察病指南》) states: “The large pulse arrives and departs large

and full under the fingers”. Pulse Reason(《脈理求真》) states: “The pulse is large and full, as well as long, and it's

felt with little force on pressing.”
Note 3 to entry: For further information, see A.3.11.
6.12
long pulse

pulse which is straight and exceeds the three palpation fingers located in inch and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Binhu’s Sphygmology states, “A long pulse is with long extent, longer than its basic position. It is

straight and long like a pole.” Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A long pulse arrives and

departs smoothly. It can be felt at all three positions.” (Chapter Bianmaixingmingzhuang). Essential Principles and

Practice of Pulse Diagnosis states, “A long pulse exceeds the original length. It is straight from head to tail. It is

straight and long like a pole”.
Note 3 to entry: For further information, see A.3.12.
6.13
normal pulse

pulse which is felt in inch, bar and cubit regions, around 60 to 90 beats per minute

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic.

Note 2 to entry: Physiologically, a normal pulse in healthy people has about four beats in a normal cycle of

respiration; the key elements of pulse (pulse location, pulse rate, pulse width, pulse length, pulse strength, pulse

smoothness) are at medium level and pulse evenness is even. A normal pulse can correspondingly change along

with changes in physiological activities and weather.
Note 3 to entry: For further information, see A.3.13.
6.14
racing pulse
pulse with more than 120 beats per minute

Note 1 to entry: The first origin is The Treatise on Cold Pathogenic and Miscellaneous Diseases.

Note 2 to entry: Essential Principles and Practice of Pulse Diagnosis states, “A racing pulse is extremely fast and

rapid, with seven, eight or more beats in one breath (approximately 120 to 140 beats per minute, and the flow is

thin and racing” (Chapter Jimaiyang, 疾脈陽). Key Principles in Pulse Diagnosis states, “A pulse that has at least six

beats in one breath (>90 times per minute) is called racing or extremely racing pulse” (Volume 4).

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Note 3 to entry: For further information, see A.3.14.
6.15
rapid pulse
pulse with more than 90 beats per minute
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Pulse Classic states, “A rapid pulse refers to fast pulsations” (Volume 1). Binhu’s Sphygmology

states, “A rapid pulse is six beats in one breath (90 beats per minute). The pulsations are rapid”. Essential

Principles and Practice of Pulse Diagnosis states, “A rapid pulse is attributed to yang. The pulsations are extremely

fast – six beats in one breath (90 beats per minute)”. The word rapid describes the feeling of fast-moving. Since

qi moves 3 inches with exhalation (breathing out) and moves another 3 inches with inhalation (breathing in), qi

moves 6 inches in one breath”.

Note 3 to entry: Traditionally, a rapid pulse is considered to be more than 5 or 6 beats within a cycle of respiration.

Note 4 to entry: For further information, see A.3.15.
6.16
relaxed pulse

pulse which is slower than a normal pulse but more rapid than a slow pulse, with about 60 beats per

minute
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Pulse Classic states, “A relaxed pulse departs and arrives slowly; it is faster than a slow pulse”

(Volume A), which was cited by Binhu’s Sphygmology. Essential Principles and Practice of Pulse Diagnosis states, “A

relaxed pulse is four beats in one breath (60 times per minute). It arrives and departs evenly like gentle breeze

in spring” (Chapter Huanmaiying,緩脈陰). Corrections of Verse Errors in Pulse Diagnosis states, “A relaxed pulse

arrives and departs slowly. It is faster than a slow pulse. With moderate to heavy pressure, it is soft and slow. It is

smaller than a deep pulse. In addition, it is leisurely and soft” (Volume A).
Note 3 to entry: For further information, see A.3.16.
6.17
replete pulse

pulse which feels forceful by both light touch or heavy pressure in inch, bar and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A replete pulse is forceful with both

light or heavy pressure. It is neither fast nor slow.” (Chapter Bianmaixingmingzhuang).

Note 3 to entry: For further information, see A.3.17.
6.18
rough pulse
pulse which feels stagnant, thready, slow and irregular
Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Binhu’s Sphygmology states, “A rough pulse is thready and slow. It arrives and departs roughly.

It is short and scattered, feeling like using a knife to scrape bamboo or a sick silkworm biting leaves” (Chapter

Qiyanjuese 七言決澀). Revised Verses in Pulse Diagnosis by Zhu Zhenheng states, “A rough pulse is stagnant like rain

touching the sand” (Chapter Bianmaixingmingzhuang). Essential Principles and Practice of Pulse Diagnosis states,

“A Rough pulse is stagnant, like a blade scraping bamboo. It is slow, thready and short, all indicating obstruction”

(Chapter Semaiyin, 澀脈陰).
Note 3 to entry: For further information, see A.3.18.
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6.19
short pulse

pulse which is shorter than the three palpation fingers located in inch, bar and cubit regions

Note 1 to entry: The first origin is (Huangdi’s) Internal Classic .

Note 2 to entry: Note2 to entry: Pulse Classic states, “The shape of a short pulse that beats felt under the fingers

do not fill the three positions” (Volume A), which was cited by Binhu’s Sphygmology. Revised Verses in Pulse

Diagnosis by Zhu Zhenheng states, “A short pulse feels rapid with light touch and pressure; however, the beats

under the fingers do not fill the positions” (Chapter Bianmaixingmingzhuang). Essential Principles and Practice

of Pulse Diagnosis states, “A short pulse is rough and small, its head and tail are both hidden; it protrudes at the

centre, but cannot fill the positions”.
Note 3 to entry: For further information, see A.3.19.
6.20
skipping pulse
pulse with more than 90 beats per minute and irregular beating
Note 1 to entry: The first origin is Tre
...

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