Which pulse is characterized by being slow with irregular missed beats?

The knotted pulse, or jie mai, is characterized by a slow rhythm with irregular missed beats. This pulse typically indicates the presence of stagnation or obstruction in the flow of qi and blood, often associated with conditions such as cold accumulation or, in some cases, heart-related disorders where there is a disruption in the heart's rhythm. The irregularity of the beats suggests an intermittent flow, reflecting deeper imbalances that may affect overall health.

In contrast, the choppy pulse, or se mai, conveys a sense of thinning or breaks in the pulse indicating blood deficiency or excessive heat causing obstruction. The long pulse, or chang mai, signifies an abundance of qi and could reflect relaxation or a general excess state. The intermittent pulse, or dai mai, is marked by irregular gaps but does not specifically imply slowness, making it distinct from the knotted pulse. Each of these pulses corresponds to different pathological states, but the knotted pulse is unique in its slow and irregular nature.