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Pulse diagnosis, also known as "qiemai" (切脈) or "anmai" (按脈), is one of the most important diagnostic methods in Traditional Chinese Medicine (TCM). In the general impression, pulse diagnosis only involves pressing the artery near the wrist joint on the back of the thumb, which is referred to as the "cunkou" (寸口) in TCM texts, also known as the "qikou" (氣口), specifically the radial artery on the inner side of the radial styloid process (Figure 1). According to the TCM classic Neijing, important arteries throughout the body can be used for pulse diagnosis. Another TCM classic, Nan Jing, prefers the "cunkou" pulse. Modern TCM physicians also primarily use the "cunkou" for pulse diagnosis, which is further divided into three parts: cun (寸), guan (關), and chi (尺).

From the perspective of modern medicine, the pulse reflects more than just the heart rate. Factors such as the autonomic nervous system, endocrine system, etc., directly affect the tension and thickness of the vessels. The normal function of internal organs also determines the concentration of substances within the vessels, which in turn reflects the fullness of the vessels. The resistance of peripheral circulation also feeds back to the smoothness of blood flow in the vessels, resulting in different vessel pulsation patterns. Therefore, theoretically, with sufficient skill, a wealth of information about the human body can be extracted solely from arterial pulsations. However, pulse diagnosis remains largely unexplored in modern medicine.

During pulse diagnosis, the state of the vessel and its surrounding tissues are key points of observation. This includes the skin surface of the vessel, the tension, temperature, roughness or smoothness of nearby tissues, the shape, depth, thickness, softness or hardness, and tension of the vessel, the fullness of blood within the vessel, the strength of the vessel's pulsation, and the pulse frequency. Due to the asymmetry of internal organs in the human body, the information revealed by the "cunkou" pulse on both hands differs. The "cunkou" pulse is considered the "holographic element" of the human body, inevitably revealing all information about the entire body. However, the "cunkou" pulse is only felt within the narrow space between fingers, and the amount of information that can be extracted depends on the physician's skill, much like learning Braille, requiring long-term "exploration" to enhance the sensitivity of the fingertips. Physicians must also eliminate distractions and observe carefully during pulse diagnosis. It is unlikely to gather detailed information while chatting and taking the pulse simultaneously.

The reason the "cunkou" pulse is preferred by TCM physicians is that it happens to be the "holographic element" of the human body—a small part that reflects the state of the entire body. Through long-term practice and induction, ancient practitioners discovered that the "cun" section reflects the state of organs above the diaphragm; the "guan" section reflects the state of the abdominal organs; and the "chi" section reflects the state of the pelvic organs. The six sections on both hands correspond to one organ each, instantly reflecting the state of the internal zang-fu organs (Figure 2). For example, a normal pulse is relaxed; if the right cun pulse is floating and tight, it often indicates that the patient has caught a cold. A normal pulse has uniform thickness in the cun, guan, and chi sections; if the left chi pulse is thin and weak, it often indicates insufficient kidney qi and a weak pelvic condition.

Compared to the other three diagnostic methods of observation, listening/smelling, and inquiry, pulse diagnosis is undoubtedly the most unique. The "cunkou" is like a window opened by the human body, allowing the physician to clearly "see" the current state of the five zang and six fu organs and the rise and fall of pathogenic qi. Observation, listening/smelling, and inquiry lack the immediacy and clarity of pulse diagnosis, making pulse diagnosis often the key final decision in the four diagnostic methods.

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1. Neijing states: "Meridians are usually invisible, and their deficiency and excess can be known through the Qikou." "Qikou" refers to the radial artery on the inner side of the styloid process of the radius. From this, it can be understood that, based on the empirical observations of the ancients, the pulse at "Qikou" reflects the prosperity and decline of the 12 meridians, and the prosperity and decline of meridians are closely coupled with the prosperity and decline of the qi and blood of the zang-fu organs. Therefore, the condition of the zang-fu organs can be indirectly understood through "Qikou." Proof: This can be demonstrated by the fact that acupuncture on a specific meridian can immediately alter the pulse at the corresponding cunkou location.