The Yellow Emperor asked: “What is the pulse like in a healthy person?”

Qi Bo answered: “In a healthy person, one breath in and one breath out constitute one respiration. Additionally, the exchange time from the end of an inhalation to the start of an exhalation is considered a leap in respiration, with a total of five pulses. This is the pulse pattern in healthy individuals: two pulse beats for each inhalation and two pulse beats for each exhalation. Doctors use this normal breathing pattern to regulate the patient’s pulse rate. Since doctors are healthy, they can synchronize their own breathing to measure the patient’s pulse rate accurately. This is the principle of pulse diagnosis.”

When a person breathes in, if their pulse beats only once, it indicates Qi deficiency. If a healthy person breathes in and their pulse beats three times, breathes out and the pulse beats three times and is agitated, and the skin at the wrist is hot, it indicates a warm disease. If the wrist skin is not hot and the pulse is smooth, it indicates a wind disease. If the pulse beats more than four times in one breath, it indicates imminent death. A pulse that stops and does not return also indicates imminent death. An irregular pulse that alternates between slow and fast also indicates imminent death.”

A normal pulse originates from the stomach, which is the source of the balanced pulse in healthy individuals. If the pulse lacks stomach Qi, it is called a reverse sign, which can be fatal.

The spring pulse should have a string-like quality with harmonious stomach Qi, indicating a normal pulse. If the string quality predominates and stomach Qi is deficient, it indicates liver disease. If only a string pulse without stomach Qi is felt, it indicates impending death. If a feather pulse is also present, the person will get sick by autumn; an excessively strong pulse indicates immediate illness. Spring’s true organ Qi manifests in the liver, which governs the tendons.

The summer pulse should have a hook-like quality with harmonious stomach Qi, indicating a normal pulse. If the hook quality predominates and stomach Qi is deficient, it indicates heart disease. If only a hook pulse without stomach Qi is felt, it indicates impending death. If a stone pulse is also present, the person will get sick by winter; an excessively strong pulse indicates immediate illness. Summer’s true organ Qi manifests in the heart, which governs the vessels.

The long summer pulse should be soft and weak with stomach Qi, indicating a normal pulse. If the weak quality predominates and stomach Qi is deficient, it indicates spleen disease. If only a weak pulse without stomach Qi is felt, it indicates impending death. If a stone pulse is also present, the person will get sick by winter; an excessively strong pulse indicates immediate illness. Long summer’s true organ Qi manifests in the spleen, which governs the muscles.

The autumn pulse should have a hair-like quality with harmonious stomach Qi, indicating a normal pulse. If the hair quality predominates and stomach Qi is deficient, it indicates lung disease. If only a hair pulse without stomach Qi is felt, it indicates impending death. If a string pulse is also present, the person will get sick by spring; an excessively strong pulse indicates immediate illness. Autumn’s true organ Qi manifests in the lungs, which govern the skin and hair.

The winter pulse should have a stone-like quality with harmonious stomach Qi, indicating a normal pulse. If the stone quality predominates and stomach Qi is deficient, it indicates kidney disease. If only a stone pulse without stomach Qi is felt, it indicates impending death. If a hook pulse is also present, the person will get sick by summer; an excessively strong pulse indicates immediate illness. Winter’s true organ Qi manifests in the kidneys, which govern the bones and marrow.

The great Luo of the stomach, known as Xu Li, emerges below the left breast, passing through the diaphragm to the lungs, and its pulse should be palpable on the clothes. If the pulse is extremely strong and fast, it indicates a disorder in the chest. If the pulse stops and shifts horizontally, it indicates a mass. If the pulse ceases, it indicates impending death. A strong pulse at Xu Li, felt through the clothes, indicates an outward leakage of Zong Qi.

How do we diagnose excess and deficiency at the Cun Kou pulse? A short pulse indicates headache; a long pulse indicates leg pain. A short, urgent, upper pulse without a lower counterpart indicates shoulder pain. A deep, firm pulse indicates a central issue. A superficial, strong pulse indicates an external issue. A deep, weak pulse indicates cold, heat, and abdominal masses. A deep, tight, diagonal pulse indicates pain in the flanks and abdomen. A deep, rapid pulse indicates cold and heat. A strong, slippery, tight pulse indicates severe illness, especially in the six Fu organs. A small, firm pulse indicates severe illness in the five Zang organs. A small, weak, rough pulse indicates chronic illness; a floating, slippery, rapid pulse indicates a new illness. A tight pulse indicates hernias and abdominal pain. A slippery pulse indicates wind disease. A rough pulse indicates obstruction. A slow, slippery pulse indicates heat in the middle. A strong, tight pulse indicates abdominal distension. A pulse in harmony with Yin and Yang indicates easy recovery; otherwise, recovery is difficult. A pulse that aligns with the seasons indicates mild illness; one that opposes the seasons indicates severe illness.”

String pulses in the arm indicate blood loss. A slow, rough pulse in the wrist indicates fatigue and a desire to lie down. A hot, strong pulse in the wrist indicates severe blood loss. A rough, slippery pulse in the wrist indicates excessive sweating. A cold, thin pulse in the wrist indicates diarrhea. A coarse, warm pulse in the wrist indicates internal heat.”

The true organ pulse of the liver indicates death on the Geng and Xin days; the heart on the Ren and Gui days; the spleen on the Jia and Yi days; the lungs on the Bing and Ding days; and the kidneys on the Wu and Ji days.

Abnormal neck pulse with asthma and cough indicates water disease. Swollen eyelids resembling sleeping silkworms indicate water disease. Yellow-red urine and a desire to lie down indicate jaundice; hunger after eating indicates stomach jaundice. Facial swelling indicates wind, and leg swelling indicates water. Yellow eyes indicate jaundice. Strong Shaoyin pulses in both hands indicate pregnancy in women.

A pulse that opposes the seasons means a true organ pulse should appear but instead shows another organ’s pulse. For instance, thin, small pulses in spring and summer or large, floating pulses in autumn and winter indicate seasonal opposition. Wind-heat pulses should be agitated but are calm; diarrhea and blood loss pulses should be weak but are strong; internal illness pulses should be strong but are weak; external illness pulses should be floating and slippery but are rough and firm. Such opposition to the seasons makes treatment challenging.”

Human life depends on water and grains; without them, life ceases. The pulse without stomach Qi also indicates death. The absence of stomach Qi means a true organ pulse without harmonious stomach Qi.

Shaoyang governs the first and second months, with pulses that are alternately dense and sparse, short and long. Yangming governs the third and fourth months, with pulses that are large, floating, and short. Taiyang governs the fifth and sixth months, with pulses that are large and long.

A normal heart pulse flows continuously like pearls, indicating health. If the heart is diseased, the pulse is rapid and slightly bent, indicating illness. A bent pulse like a hooked belt with no smoothness indicates death.

A normal lung pulse is light, floating, and soft like blowing on elm leaves, indicating health, with autumn’s basis in stomach Qi. A pulse like rubbing feathers with firmness indicates illness. A pulse like floating grass on water, swaying in the wind, indicates death.

A normal liver pulse is like holding a long, soft rod, indicating health, with spring’s basis in stomach Qi. A full, smooth pulse like rubbing a long rod indicates illness. A rapid, strong pulse like a newly bent bow indicates death.

A normal spleen pulse is soft and spirit-filled like a chicken’s foot touching the ground, indicating health, with long summer’s basis in stomach Qi. A full, rapid pulse like a chicken running urgently indicates illness. A rapid, jumping pulse like a bird pecking or water dripping from a roof indicates death.

A normal kidney pulse is small, firm, round, and smooth, like feeling a stone, indicating health, with winter’s basis in stomach Qi. A pulse like pulling tough vines, firm on pressure, indicates illness. A pulse like untangling a rope, rapid and scattered, like flicking a stone, firm and tight, indicates death.

The Yellow Emperor asked: “What is the pulse like in a healthy person?”

Qi Bo answered: “In a healthy person, one breath in and one breath out constitute one respiration. Additionally, the exchange time from the end of an inhalation to the start of an exhalation is considered a leap in respiration, with a total of five pulses. This is the pulse pattern in healthy individuals: two pulse beats for each inhalation and two pulse beats for each exhalation. Doctors use this normal breathing pattern to regulate the patient’s pulse rate. Since doctors are healthy, they can synchronize their own breathing to measure the patient’s pulse rate accurately. This is the principle of pulse diagnosis.”

When a person breathes in, if their pulse beats only once, it indicates Qi deficiency. If a healthy person breathes in and their pulse beats three times, breathes out and the pulse beats three times and is agitated, and the skin at the wrist is hot, it indicates a warm disease. If the wrist skin is not hot and the pulse is smooth, it indicates a wind disease. If the pulse beats more than four times in one breath, it indicates imminent death. A pulse that stops and does not return also indicates imminent death. An irregular pulse that alternates between slow and fast also indicates imminent death.”

A normal pulse originates from the stomach, which is the source of the balanced pulse in healthy individuals. If the pulse lacks stomach Qi, it is called a reverse sign, which can be fatal.

The spring pulse should have a string-like quality with harmonious stomach Qi, indicating a normal pulse. If the string quality predominates and stomach Qi is deficient, it indicates liver disease. If only a string pulse without stomach Qi is felt, it indicates impending death. If a feather pulse is also present, the person will get sick by autumn; an excessively strong pulse indicates immediate illness. Spring’s true organ Qi manifests in the liver, which governs the tendons.

The summer pulse should have a hook-like quality with harmonious stomach Qi, indicating a normal pulse. If the hook quality predominates and stomach Qi is deficient, it indicates heart disease. If only a hook pulse without stomach Qi is felt, it indicates impending death. If a stone pulse is also present, the person will get sick by winter; an excessively strong pulse indicates immediate illness. Summer’s true organ Qi manifests in the heart, which governs the vessels.

The long summer pulse should be soft and weak with stomach Qi, indicating a normal pulse. If the weak quality predominates and stomach Qi is deficient, it indicates spleen disease. If only a weak pulse without stomach Qi is felt, it indicates impending death. If a stone pulse is also present, the person will get sick by winter; an excessively strong pulse indicates immediate illness. Long summer’s true organ Qi manifests in the spleen, which governs the muscles.

The autumn pulse should have a hair-like quality with harmonious stomach Qi, indicating a normal pulse. If the hair quality predominates and stomach Qi is deficient, it indicates lung disease. If only a hair pulse without stomach Qi is felt, it indicates impending death. If a string pulse is also present, the person will get sick by spring; an excessively strong pulse indicates immediate illness. Autumn’s true organ Qi manifests in the lungs, which govern the skin and hair.

The winter pulse should have a stone-like quality with harmonious stomach Qi, indicating a normal pulse. If the stone quality predominates and stomach Qi is deficient, it indicates kidney disease. If only a stone pulse without stomach Qi is felt, it indicates impending death. If a hook pulse is also present, the person will get sick by summer; an excessively strong pulse indicates immediate illness. Winter’s true organ Qi manifests in the kidneys, which govern the bones and marrow.

The great Luo of the stomach, known as Xu Li, emerges below the left breast, passing through the diaphragm to the lungs, and its pulse should be palpable on the clothes. If the pulse is extremely strong and fast, it indicates a disorder in the chest. If the pulse stops and shifts horizontally, it indicates a mass. If the pulse ceases, it indicates impending death. A strong pulse at Xu Li, felt through the clothes, indicates an outward leakage of Zong Qi.

How do we diagnose excess and deficiency at the Cun Kou pulse? A short pulse indicates headache; a long pulse indicates leg pain. A short, urgent, upper pulse without a lower counterpart indicates shoulder pain. A deep, firm pulse indicates a central issue. A superficial, strong pulse indicates an external issue. A deep, weak pulse indicates cold, heat, and abdominal masses. A deep, tight, diagonal pulse indicates pain in the flanks and abdomen. A deep, rapid pulse indicates cold and heat. A strong, slippery, tight pulse indicates severe illness, especially in the six Fu organs. A small, firm pulse indicates severe illness in the five Zang organs. A small, weak, rough pulse indicates chronic illness; a floating, slippery, rapid pulse indicates a new illness. A tight pulse indicates hernias and abdominal pain. A slippery pulse indicates wind disease. A rough pulse indicates obstruction. A slow, slippery pulse indicates heat in the middle. A strong, tight pulse indicates abdominal distension. A pulse in harmony with Yin and Yang indicates easy recovery; otherwise, recovery is difficult. A pulse that aligns with the seasons indicates mild illness; one that opposes the seasons indicates severe illness.”

String pulses in the arm indicate blood loss. A slow, rough pulse in the wrist indicates fatigue and a desire to lie down. A hot, strong pulse in the wrist indicates severe blood loss. A rough, slippery pulse in the wrist indicates excessive sweating. A cold, thin pulse in the wrist indicates diarrhea. A coarse, warm pulse in the wrist indicates internal heat.”

The true organ pulse of the liver indicates death on the Geng and Xin days; the heart on the Ren and Gui days; the spleen on the Jia and Yi days; the lungs on the Bing and Ding days; and the kidneys on the Wu and Ji days.

Abnormal neck pulse with asthma and cough indicates water disease. Swollen eyelids resembling sleeping silkworms indicate water disease. Yellow-red urine and a desire to lie down indicate jaundice; hunger after eating indicates stomach jaundice. Facial swelling indicates wind, and leg swelling indicates water. Yellow eyes indicate jaundice. Strong Shaoyin pulses in both hands indicate pregnancy in women.

A pulse that opposes the seasons means a true organ pulse should appear but instead shows another organ’s pulse. For instance, thin, small pulses in spring and summer or large, floating pulses in autumn and winter indicate seasonal opposition. Wind-heat pulses should be agitated but are calm; diarrhea and blood loss pulses should be weak but are strong; internal illness pulses should be strong but are weak; external illness pulses should be floating and slippery but are rough and firm. Such opposition to the seasons makes treatment challenging.”

Human life depends on water and grains; without them, life ceases. The pulse without stomach Qi also indicates death. The absence of stomach Qi means a true organ pulse without harmonious stomach Qi.

Shaoyang governs the first and second months, with pulses that are alternately dense and sparse, short and long. Yangming governs the third and fourth months, with pulses that are large, floating, and short. Taiyang governs the fifth and sixth months, with pulses that are large and long.

A normal heart pulse flows continuously like pearls, indicating health. If the heart is diseased, the pulse is rapid and slightly bent, indicating illness. A bent pulse like a hooked belt with no smoothness indicates death.

A normal lung pulse is light, floating, and soft like blowing on elm leaves, indicating health, with autumn’s basis in stomach Qi. A pulse like rubbing feathers with firmness indicates illness. A pulse like floating grass on water, swaying in the wind, indicates death.

A normal liver pulse is like holding a long, soft rod, indicating health, with spring’s basis in stomach Qi. A full, smooth pulse like rubbing a long rod indicates illness. A rapid, strong pulse like a newly bent bow indicates death.

A normal spleen pulse is soft and spirit-filled like a chicken’s foot touching the ground, indicating health, with long summer’s basis in stomach Qi. A full, rapid pulse like a chicken running urgently indicates illness. A rapid, jumping pulse like a bird pecking or water dripping from a roof indicates death.

A normal kidney pulse is small, firm, round, and smooth, like feeling a stone, indicating health, with winter’s basis in stomach Qi. A pulse like pulling tough vines, firm on pressure, indicates illness. A pulse like untangling a rope, rapid and scattered, like flicking a stone, firm and tight, indicates death.