Traditional Chinese Medicine: Pulse and Tongue Diagnosis

Traditional Chinese medicine pulse diagnosis and tongue diagnosis (中医脉诊舌诊) represents the most distinctive diagnostic methods in Chinese medicine — through feeling the pulse at the wrist and observing the tongue, experienced TCM practitioners can identify patterns of disharmony, determine the condition of internal organs, and guide treatment strategies. These diagnostic arts require years of training and practice to master, and they remain central to TCM clinical practice despite the availability of modern diagnostic tools.

Pulse Diagnosis

Pulse diagnosis (脉诊) is performed at three positions on each wrist: the "cun" (寸), "guan" (关), and "chi" (尺) positions at the superficial, middle, and deep levels, yielding twenty-eight pulse qualities. Major pulse types include: the "floating pulse" (浮脉) — felt at the superficial level, indicating exterior conditions; the "deep pulse" (沉脉) — felt only with heavy pressure, indicating interior conditions; the "slow pulse" (迟脉) — less than four beats per breath, indicating cold; the "rapid pulse" (数脉) — more than five beats per breath, indicating heat; the "thready pulse" (细脉) — thin and fine, indicating deficiency; the "wiry pulse" (弦脉) — taut and straight like a violin string, indicating liver qi stagnation or pain; the "slippery pulse" (滑脉) — smooth and flowing, indicating phlegm-dampness or pregnancy; and the "choppy pulse" (涩脉) — rough and irregular, indicating blood stasis. The "three positions" correspond to different organs on each side.

Tongue Diagnosis

Tongue diagnosis (舌诊) examines the tongue's body, coating, and moisture: the "tongue body" (舌体) — its color (pale, red, crimson, purple), shape (swollen, thin, cracked, teeth-marked), and movement; the "tongue coating" (舌苔) — its color (white, yellow, gray, black), thickness (thin, thick), and distribution; the "moisture" (润燥) — wet or dry indicating fluid conditions; and the "sublingual veins" (舌下络脉) — indicating blood stasis. Correspondence: the "tip" (舌尖) reflects the heart and lung; the "sides" (舌边) reflect the liver and gallbladder; the "center" (舌中) reflects the spleen and stomach; and the "root" (舌根) reflects the kidney. A normal tongue is "pink body, thin white coating, moderately moist."

Clinical Integration

Pulse and tongue diagnosis are integrated with the "four examinations" (四诊): the "observation" (望诊) — including tongue, face, and general appearance; the "listening and smelling" (闻诊) — including voice, breath, and body odors; the "inquiry" (问诊) — questioning about symptoms, lifestyle, and medical history; and the "palpation" (切诊) — including pulse diagnosis and abdominal palpation. The "eight principles" (八纲) — cold/heat, interior/exterior, deficiency/excess, yin/yang — guide pattern identification. Master diagnosticians combine all findings into a coherent pattern, determining the appropriate treatment strategy of herbal formula, acupuncture, or other therapeutic methods.