The "Huang Di Nei Jing" (黄帝内经  - Yellow Emperor’s Inner Canon) lists six main types of pulse:

• Large
• Small
• Smooth
• Rough
• Fast
• Long

These pulses correspond to the syndromes of deseases as follows:

• Large pulse - the Yang energy is abundant, but the Yin energy is weak and the amount of blood and body juices is insufficient;
• Small pulse - the Yang energy is in vacuity, Yin is weak, there is deficiency of energy and blood;
• Smooth pulse - Yang is in the condition of excess;
• Rough pulse - qi is blocked, the Yang energy is insufficient;
• Fast pulse - the syndrome of cold;
• Long pulse - the syndrome of heat in the viscera.

In presence of the fast pulse there are signs of cold; the cold is caused by the "immobility of the Yin energy in the body"; the needles should be entered deeply and left in the body for a long time.

In presence of the long pulse heat dominates in viscera; it is often caused by an external factor (Yang-heat); puncture superficially and withdraw the needles quickly.

In presence of the large pulse the Yang energy is powerful (Yin energy and blood are weakened); it is necessary to sedate slightly and never use blood-letting.

In presence of the smooth pulse the Yang energy is in excess, the patient's body is hot; puncture superficially and withdraw the needles quickly.

If the smooth pulse becomes rough, it means that the energy is blocked and acupuncture might be not very effective. It is necessary to find the affected channel and choose the appropriate method of puncture (activation or sedation). The needles are left in the body for a long time, at the same time it is necessary to massage the channel to remove the blocking of qi and blood; after extraction of needles massage the point with fingers, so that blood would not appear from the puncture.

The small pulse means vacuity of Yang and Yin, deficiency of the energy and blood, i.e. both internal and external energies are weak; such patients should not be treated by needles, it is necessary to stimulate protective forces of the body.

In addition:

• The pulse is full and hard - hyperfunction, hypertension (Yang)
• The pulse is small and thin - insufficiency, hypofunction, hypotension (Yin)
• The pulse is soft and powerful - inflammatory process (Yang)
• The pulse is small, hard, "sharp"- spasms, contractions, pain (Yang)
• The pulse is abundant, large - excess, presence of inflammatory process, pain (Yang)
• The pulse is weak, hardly felt - exhaustion of protective forces and vital energy of the body (vacuity of Yin).

Some clinical notes:

Moderate long pulse of heart: stagnation below the chest and heart, this stagnation may "move" up and down to the stomach; hemoptysis.

Medium-large pulse of heart: pain in the heart with irradiation to the back, the patient is prone to tears; the reason is impairment of blood circulation in the heart.

Very smooth pulse of heart: there is a lot of heat in blood; prolonged cough.

Very rough pulse of heart: the patient is very weak, can not talk.

Moderately rough pulse of heart: hands and legs are very cold, noise in the ears; possible beginning of hemorrhage (apoplexy).

Moderately fast pulse in lungs: the heat in lungs is replaced by cold; weakness, sometimes phlegm with blood, pain in the back and chest.

Moderately long pulse in lungs: weakness, the neck and nape are in sweat, cerebral hemorrhage with paralysis is possible.

Very small pulse in lungs: the Yang energy is weak, hypofunction of the fu organs.

Very smooth pulse in lungs: shortness of breath (« the energy of lungs moves up, against the normal flow).

Moderately smooth pulse in lungs: mouth and nose bleeding, intestine and urethra.

Moderately rough pulse in lungs: stagnation of energy, enlarged lymphatic glands on the neck and under armpits, weakness in limbs, general weakness.

Moderately long pulse of liver: accumulation of water under the diaphragm, impaired urination.

Very long pulse of liver: unrestrained vomiting is possible.

Moderately large pulse of liver: affection of liver caused by dampness ("BI of liver"), cough, pain in the abdomen.

Very smooth pulse of liver: an inflammation of testicles or inguinal hernia.

Moderately smooth pulse of liver: paresis of the urinary bladder and involuntary urination.

Very rough pulse of liver: accumulation of water in the whole body.

Long pulse of spleen: paralysis of hands and legs owing to the Wind; the channels are affected only, the internal organs are healthy.

Very large pulse of spleen: deep unconscious condition.

Moderately large pulse of spleen: pain in the lower abdomen (stagnation of the energy of spleen), the stomach is inflated, the gases are not released and as a result, suppuration arises inside the abdomen close to the stomach and intestines.

Moderately smooth pulse of spleen: in most cases is connected with worm invasion.

Rough pulse of spleen: an ulcer in the gastro-intestinal tract.

Moderately rough pulse of spleen: an ulcer in viscera, feces with blood and pus.

Very rapid pulse of kidneys: heavy disease called "madness of bones", blocking of energy, the patient is restless, suffers from profuse sweating and dehydratation.

Moderately rapid pulse of kidneys (blocking, stagnation of the energy of kidneys): attacks of giddiness, depression, the spiritual energy is weakened very much, the patient lies with bent legs and can not straighten the legs, defecation and urination are impaired very much.

Moderately large pulse of kidneys (felt deeply): the energy becomes immovable, the water is accumulated (ascites), the breathing is impaired, when water also becomes immovable, stones form in the urine; when the "infringing" water reaches the stomach, the patient dies.

Very small pulse of kidneys: constant diarrhea.

Smooth pulse of kidneys: the patient is not able to urinate; inflammation of genitals.

Moderately smooth pulse of kidneys: the heat has damaged the energy of kidneys, soon bones will be affected, the patient can not stand, consciousness is dulled.

Moderately rough pulse of kidneys: in women - menses cycle disorder, haemorrhoids with bleeding.

Deep, rough, small pulses with bad filling are the signs of the Yin character of the pathological process.

Superficial, rapid, strong, sliding pulses with good filling are the signs of the Yang character of the pathological process.