Pulse diagnosis is the most technically demanding part of the classical examination. Traditional texts describe dozens of pulse qualities, each with a name, a felt character and an associated pattern, and the skill is transmitted by feeling many pulses alongside a teacher.
That is also why it is hard to study. The measuring instrument is a practitioner's fingers, and studies repeatedly find only modest agreement between practitioners examining the same person - better than chance in some settings, less impressive in others. Reproducibility, not the existence of a pulse, is the open question.
Instrumented approaches exist: pressure sensors, Doppler ultrasound and smartphone-based systems have all been used to try to capture a pulse objectively. These produce numbers, but the classical categories were not defined numerically, so mapping one to the other is not straightforward.
What can be said fairly: the pulse carries real information. Rate, rhythm and the character of the arterial wall are clinically meaningful and are used in conventional medicine too. What has not been shown is that the specific classical categories can be assigned reliably and repeatably by different practitioners, or that they map onto particular conditions in the way the tradition claims. A practitioner who treats pulse findings as one input among several is being straightforward; one who treats the pulse alone as decisive is not.
脉诊是古典诊法中对技术要求最高的一环。传统文献列出数十种脉象，每种有名称、有指下的手感、有对应的证候，这门技术靠跟着老师摸大量脉象来传授。
这也正是它难以研究的原因：测量工具是操作者的手指。多项研究反复发现，不同操作者诊察同一个人时，一致性只是中等——有些场景下高于随机，另一些场景下并不突出。真正悬而未决的是「可重复性」，而不是「脉象是否存在」。
仪器化的路径确实存在：压力传感器、多普勒超声、基于智能手机的系统都被用来尝试客观记录脉象。这些方法能产生数字，但古典脉象并非按数字定义的，两者之间的对应并不直接。
可以公允地说：脉象确实承载信息——脉率、节律、动脉壁的性状在临床上有意义，现代医学同样在使用。尚未被证实的是：那些具体的古典脉象类别，能否由不同操作者稳定、可重复地判定；以及它们是否如传统所言，对应到特定的证候。把脉象当作多项依据之一的实践者是诚实的；把脉象单独当成决定性依据的，则不是。
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