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Chinese/Japanese Pulse Image chart: Tough Pulse (laomai). Wellcome Collection. Attribution 4.0 International (CC BY 4.0). Source: Wellcome Collection.
Illustration of Tough Pulse (laomai) from Renyuan maiying guizhi tushuo (Pictorial Handbook of Pulse Images Based on the Person). This is a specialist text on pulse diagnosis attributed to the third-century master Shuhe, edited and revised by Shen Jifen in the Ming period (1368-1644). It discusses various pulse images and the medical conditions to which they relate, and contains 48 pulse image diagrams. This undated edition was engraved and published in Japan.
The text states: With regard to the pulse image of Tough Pulse, when sought with the fingers it cannot be felt, but it becomes perceptible under firm pressure. Tough Pulse (laomai) relates to bone disorders and stagnant Qi (qijie). Disorders relating to this pulse cannot readily be cured.