Bin Hu Mai Xue (濒湖脉学): Li Shizhen's Pulse Study — The Most Influential Pulse Manual in TCM

What Is Bin Hu Mai Xue?

Bin Hu Mai Xue (濒湖脉学), the “Lakeside Pulse Study,” is arguably the most influential pulse diagnosis manual in the history of Traditional Chinese Medicine. Written by Li Shizhen (李时珍) in 1564 — the same genius who authored the monumental Bencao Gangmu (Compendium of Materia Medica) — this concise text defined 27 pulse types in memorable verse.

Despite being a short work (a fraction of the size of his herbal encyclopedia), Bin Hu Mai Xue became the standard pulse diagnosis textbook for generations of Chinese physicians. Its genius lies in its brevity: each pulse type is described in a few lines of verse that students could memorize and carry into clinical practice.

The Author: Li Shizhen

A Medical Polymath

• Lived 1518–1593, during the Ming Dynasty
• One of the greatest physicians and naturalists in Chinese history
• Best known for the Bencao Gangmu (Compendium of Materia Medica) — the most comprehensive herbal text ever written
• Also produced influential works on pulse diagnosis and acupuncture
• His study was located near Lake Bi (濒湖) in Hubei — hence “Bin Hu” in the title

Why He Wrote Bin Hu Mai Xue

Li Shizhen recognized that:

• Wang Shuhe’s Mai Jing was comprehensive but too long for daily reference
• Earlier pulse texts used inconsistent terminology
• Students needed a concise, memorable, practical guide to pulse diagnosis
• The verse format would make the information stick

The 27 Pulse Types

Li Shizhe took Wang Shuhe’s original 24 pulses and added three: Chang (Long), Duan (Short), and Ru (Soft). Each pulse is described in:

1. A verse (歌诀) — memorable lines defining the pulse’s characteristics
2. A commentary — explaining clinical significance and differentiating similar pulses

The 27 Pulses

Pulse	Chinese	Key Characteristic	Clinical Significance
Floating	浮脉 (Fu)	Felt with light pressure	Exterior pattern
Deep	沉脉 (Chen)	Felt only with heavy pressure	Interior pattern
Slow	迟脉 (Chi)	< 4 beats per breath	Cold pattern
Rapid	数脉 (Shu)	> 5 beats per breath	Heat pattern
Surging	洪脉 (Hong)	Large, forceful, wave-like	Excess heat
Fine	细脉 (Xi)	Thin, thread-like	Deficiency, dampness
Empty	虚脉 (Xu)	Forceless at all levels	General deficiency
Excess	实脉 (Shi)	Forceful at all levels	Excess pattern
Long	长脉 (Chang)	Added by Li Shizhen	Normal or excess
Short	短脉 (Duan)	Added by Li Shizhen	Qi deficiency
Tight	紧脉 (Jin)	Tense, like twisted rope	Cold, pain
Moderate	缓脉 (Huan)	Relaxed, slightly slow	Dampness or normal
Wiry	弦脉 (Xian)	Taut, like guitar string	Liver pattern, pain
Slippery	滑脉 (Hua)	Rolling, like pearls	Phlegm, pregnancy
Rough	涩脉 (Se)	Choppy, uneven	Blood stasis, deficiency
Scallion	芤脉 (Kou)	Hollow, like scallion stalk	Massive blood loss
Drumskin	革脉 (Ge)	Tight and hollow	Blood loss, Jing depletion
Firm	牢脉 (Lao)	Deep, firm, forceful	Deep accumulation
Soft	软脉 (Ruan)	Added by Li Shizhen	Dampness, deficiency
Weak	弱脉 (Ruo)	Soft and deep	Qi/Blood deficiency
Scattered	散脉 (San)	Scattered, rootless	Critical Qi depletion
Hidden	伏脉 (Fu)	Very deep, hard to find	Severe block, extreme cold
Prominent	促脉 (Cu)	Rapid with pauses	Heat with stagnation
Bound	结脉 (Jie)	Slow with irregular pauses	Yin excess, cold, phlegm
Skipping	代脉 (Dai)	Regular pauses	Organ Qi decline, pain
Stirred	动脉 (Dong)	Bouncing, short, rapid	Pain, fright, pregnancy
Rapid with pauses	疾脉 (Ji)	Very rapid (> 7 per breath)	Extreme heat, critical Yang

Why Bin Hu Mai Xue Became the Standard

1. Verse Format — Easy to Memorize

Each pulse is described in seven-character verse lines. Example for the Floating pulse:

浮脉惟从肉上行 (The floating pulse is felt only at the flesh level) 如循榆荚似毛轻 (Like tracing elm pods, as light as hair) 三秋得令知无恙 (In autumn this is normal and healthy) 久病逢之却可惊 (In chronic illness, however, it is alarming)

This format allowed students to memorize all 27 pulses and recall them at the bedside.

2. Differential Diagnosis Focus

Each pulse description includes how to distinguish it from similar pulses:

• Is it truly Floating, or could it be Surging? (Both are felt easily)
• Is it Rapid, or could it be Surging? (Both are faster than normal)
• Is it Wiry, or could it be Tight? (Both are tense)

3. Clinical Correlations

Each pulse is directly linked to:

• The disease pattern it indicates
• The organ system involved
• The prognosis it suggests

4. Practical Length

Unlike the 10-volume Mai Jing, Bin Hu Mai Xue could be read in a single sitting and carried in a pocket. This practicality ensured its widespread adoption.

Li Shizhen’s Three New Pulses

Chang (Long) Pulse — 长脉

• Extends beyond the normal pulse positions (cun, guan, chi)
• Can be normal in tall, healthy individuals
• In disease: indicates excess heat or strong pathogenic factor
• Often seen with wiry or surging pulses

Duan (Short) Pulse — 短脉

• Does not fill the normal pulse positions
• Falls short of the expected length
• Indicates Qi deficiency or Qi stagnation
• Often seen with fine or choppy pulses

Ruan (Soft) Pulse — 软脉

• Also called “Ruan” (软) or “Ru” (濡)
• Floating, fine, and soft — felt with light pressure but without force
• Indicates dampness or dual Qi-Blood deficiency
• Often seen in chronic digestive weakness

Legacy and Modern Relevance

In TCM Education

• Still required reading in every TCM university program
• The verse portions are memorized by students
• Forms the basis of modern pulse diagnosis chapters in TCM textbooks
• The 27-pulse system is the standard taught in China today

Influence on Pulse Diagnosis Worldwide

• Translated into Japanese, Korean, Vietnamese, and eventually European languages
• Influenced pulse diagnosis traditions across all of East Asia
• Western acupuncturists study the 27 pulses as their primary framework
• Modern pulse research often references Li Shizhen’s descriptions as a starting point

Comparison with Earlier Pulse Texts

Feature	Mai Jing (280 AD)	Bin Hu Mai Xue (1564)
Author	Wang Shuhe	Li Shizhen
Pulse types	24	27
Format	Prose, 10 volumes	Verse, pocket-sized
Length	Comprehensive, long	Concise, memorizable
Best for	Reference	Daily clinical use

Key Takeaways

• Bin Hu Mai Xue (1564) by Li Shizhen is the most influential pulse diagnosis manual in TCM history
• Defined 27 pulse types in memorable verse — expanding Wang Shuhe’s original 24
• Still required reading in every TCM university program today
• Its genius is brevity — every pulse described in a few memorable lines
• The three pulses Li Shizhen added (Long, Short, Soft) remain in the standard pulse curriculum

Disclaimer: This article is for educational purposes only. Pulse diagnosis requires extensive clinical training.

Related Articles

• Mai Jing: The Pulse Classic
• Pulse Diagnosis in TCM
• Bencao Gangmu: Compendium of Materia Medica
• Four Diagnostic Methods in TCM