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

The slow pulse with irregular missed beats is indicative of a knotted pulse, also known as jie mai. This pulse pattern is typically associated with conditions of excess or deficiency, often revealing an imbalance in the body's energy or blood flow. A knotted pulse can signify both stagnation and a potential deficiency in yang energy, leading to a disordered rhythm of the heartbeat where beats may be missed or spaced irregularly. This can suggest a deeper pathology, such as heart conditions or other systemic imbalances.

The other pulse types mentioned differ in their characteristics and implications. For instance, the long pulse is associated with an excess of qi or blood, often leading to a strong, continuous beat rather than the irregularity found in a knotted pulse. The intermittent pulse, while it may sound similar to the knotted pulse, typically reflects a more consistent rhythm, albeit with gaps, often seen in cases of serious disease or depletion. The choppy pulse suggests a deficiency of blood or qi, revealing a thin and fragile nature rather than the distinct slow irregularity seen in the knotted pulse.

Understanding these distinctions helps practitioners assess and diagnose conditions effectively in Traditional Chinese Medicine.