Diagnosis · ངོས་འཛིན་ ngos ’dzin

Reading the body བརྟག་ཐབས་

Before any treatment, the menpa reads the disorder — chiefly by touching the pulse and looking at the urine, with a corroborating glance at the tongue. Each discloses which humor is disturbed, where, and how far. Explore them below.
Pending menpa verification
Scaffolded for study from the Root of Diagnosis — pending menpa verification. Not diagnostic.
Scaffolded for study from the Root of Diagnosis — pending menpa verification. Not diagnostic.

The physician lays three fingers on the radial artery of each wrist, reading the patient's left wrist with the right hand and the right wrist with the left. Each fingertip reads two organs by rolling to its two halves — a solid (vital) organ on the thumb-side, a hollow one on the outer edge — so the two wrists together disclose twelve organs.

  • Read at dawn, before food, drink, stimulants or exertion have stirred the humors; the patient first rests until the pulse is calm.
  • The physician reads with the opposite hand — right hand on the patient's left wrist, left hand on the right — the three fingers a rice-grain apart, the thumb resting by the patient's thumb.
  • The index sits about a finger-width below the wrist crease; index, middle and ring then press ever more firmly (skin → flesh → bone), reading the upper, middle and lower body.
  • Each fingertip reads two organs by rolling: the thumb-side half a solid (vital) organ, the outer half a hollow one.
  • A healthy pulse beats five times to one of the physician's breath-cycles — faster is hot, slower is cold (a child's beats six, an infant's eight).
TsönIndex finger · Lightest — at the skinReads the upper body — head, chest & shoulders
Solid · thumb-sideHeartsnying
Hollow · outer halfSmall intestinergyu ma

On the left wrist of a man — surface pressure, resting on the skin.

The twelve organ positions
Only the index (tsön) reading swaps by sex — Heart/Small-intestine and Lung/Large-intestine trade wrists between men and women (traditionally because the heart's apex tilts left in a man, right in a woman). Kang and Chak are the same for both. Click a cell to place the finger.
Left wrist
Right wrist
What the pulses look like
The three humor pulses
Wind pulserlung gi rtsa
Floating · empty · halting
surfacedeep

Felt at the surface and hollow beneath the finger, it rises then vanishes under pressure and skips at intervals — like a bubble that empties and floats up again.

Bile pulsemkhris pa'i rtsa
Rapid · taut · overflowing
surfacedeep

Quick, forceful and tight like a taut, twisting cord — it strikes the finger hard and fast, overflowing its channel.

Phlegm pulsebad kan gyi rtsa
Sunken · slow · weak
surfacedeep

Submerged and declining — one must press deep to find it. It beats slowly and faintly, sinking away from the finger.

Constitutional pulses
Male pulsepho rtsa
Bold · thick · strong
surfacedeep

A robust, full and prominent constitutional pulse — Wind-like in character. A person of any sex may have it; it is established first, then read against (not confused with) the disease pulses.

Female pulsemo rtsa
Fine · rapid · subtle
surfacedeep

A fine, thin and quicker constitutional pulse — Bile-like; slender under the finger but regular.

Neuter pulsema ning rtsa
Smooth · long · even
surfacedeep

The ‘bodhisattva’ (neuter) pulse — smooth, supple, long and even, Phlegm-like. The most balanced constitutional pulse, and the most auspicious.

Abnormal & prognostic pulses
Twisted pulse'khyil ba
Twisting · coiling
surfacedeep

Not a fixed type but a quality — a thin, taut beat that twists and coils side to side, like a plucked lute-string (most marked in the Bile and spring pulses). When a beat also wanders in strength and place, it is read as the changing ‘spirit’ (gdon) pulse.

Mortal pulse'chi rtsa
Interrupted · failing
surfacedeep

One of the death signs read at the pulse — long silences broken by sudden darting beats, like a fish flicking then still. A grave prognostic sign.