'The Slippery Pulse comes smoothly flowing and uninhibited; it feels smooth like pearls rolling in a dish.'  One of twenty eight classical pulse descriptions used in diagnosis in Traditional Chinese Medicine.

The examination of the pulse is one of the main methods of arriving at a diagnosis in Chinese medicine.  It is a part of the si zhen, or four examinations, which include visual examination, inquiry, listening and smelling, and palpation.  Today the pulse is almost exclusively felt on both of the radial arteries, close to the wrists, or what is termed the cun kou in Chinese.  In the past the pulse was also palpated at other locations on the body, including the ankle and neck.  Practitioners of Chinese medicine believe that feeling the pulse at the wrist provides an image or representation of the flow of chi, blood, and body fluids within the entire body.  This is an idea that extends back to the earliest days of Chinese medicine, being mentioned in the ancient Nan Ching, or The Classic of Difficulties:

'All the twelve [acupuncture] channels have sections where the movement in these vessels can be felt.  Still, one selects only the cun kou in order to determine whether the five viscera and six bowels harbour a pattern of death or life, of good or evil auspices.'

One of the great texts regarding the art and science of pulse diagnosis (as used in acupuncture) is Li Shi-zhen's 'The Lakeside Master's Study of the Pulse'.  It is an expansion and explanation of a late Ming dynasty book from Cui Jia-yan called 'Gathered Essentials in Four Characters', written around 479 A.D.  This earlier text set to rhyme four word or syllable lines which spell out the essential character of some 27 discrete pulse types.  Li's expansion on this work involves the composition of seven word or syllable lines which sometimes repeat the previous material, and sometimes add new information to clarify it.  The essential point of composing the work in verse was that it was meant as an aide memoire to students of Chinese medicine.  The nature of its composition and succinct presentation, has therefore ensured that it is a perennial favourite in China, right up to the modern age.

Below are a few extracts describing some of the more common pulse qualities found in day-to-day examination.  Although these descriptions may seem outlandish to a novice, clinical experience confirms that they are in fact accurate descriptions of the illusive and changing nature of the pulsative flow of blood through the vessels.  As these are translations, the do not hold with the original syllable, word or rhyming scheme:

Slow Pulse

Slow Pulse, one respiration, three arrivals.
Departs and comes extremely slowly.

Slippery Pulse

A slippery pulse goes and comes, advances and retreats
Flowingly, uninhibited, unfurled, revolving.
It responds to the fingers like a pearl.
Seeping, seeping as if on the verge of escaping.

Bowstring Pulse

The bowstring pulse is level and straight like the long.
It is like a drawn bowstring.
Press and it does not vary.
Pluck, pluck, like pressing the strings of a dulcimer.
Its shape is like the strings of a zither.
Passing through, straight and continuous,
It is stiff under the fingers.

Fine Pulse