AbstractThis article analyzes efforts by Soviet and present-day scientists in Russia to “rationalize” and ultimately automate the diagnostic techniques of Tibetan medicine. It tracks the institutional and conceptual histories of designing a pulse diagnostic system, a project that began in the Soviet Union in the early 1980s. It has recently been re-enlivened in Buryatia, an ethnic minority region in Southeastern Siberia, in efforts to mobilize indigenous medical practices in response to local and national public health concerns. I focus on the translational ideologies that informed efforts to develop the pulsometer as a medical imaging technology, and analyze obstacles to these efforts found at the core of the device. Scientists working on the pulsometer have systematically tried to discern whether their measurements indicate sustained bodily pathologies, or instead reflect only technological white noise, and they still recruit and rely on the embodied expertise of practitioners of Tibetan medicine to validate their findings. In so doing they reaffirm claims that Tibetan medicine in Buryatia is inextricable from the forms of knowledge and practice that their projects work to standardize. I show how the apparent failures at perfect mechanization have made the pulsometer a surprisingly productive site for creating new kinds of expert communities and forms of knowledge making.