In Western medicine, the pulse is only a minor diagnostic tool, it is, however, very important in TCM. Pulse diagnosis gives information on
TCM practitioners feel the pulse and note the rate. They discern width or amplitude, length, how close it is to the surface, how deep and close to the bone, the strength, and other qualities.
Three area of the Pulse:
|Inch or Cun:||Distal or Front (at wrist crease)|
|Bar or Guan:||Middle (just medial to radial styloid process)|
|Cubit or Chi:||Proximal or Rear|
Three Levels of the Pulse:
|Superficial:||State of Qi and Yang Organs in general|
|Middle:||State of Blood|
|Deep:||State of Yin and Yin Organs|
Three Levels Can Also Be Viewed As:
|Superficial:||The condition of the Exterior or of the Upper Burner|
|Middle:||Stomach and Spleen diseases|
|Deep:||Interior diseases, esp. Liver and Kidneys|
Three positions at each wrist, along the radial artery. The pulses are palpated at three positions, superficial, middle and deep.
The pulse essentially reflects the state of Qi in the different burners of the San Jiao (triple burner).
The pulse positions mainly give information regarding the Yin Organs. It is more difficult to assess the Yang Organs at individual positions (we tend to assess the Intestines in the Lower Burner position)
In pulse diagnosis, the most important things to assess:
Each pulse position can reflect different phenomena in different situations. For example: The Lung pulse full can occur as a result of emotional problem (grief) affecting Lungs or from Phlegm in Lungs or from an Excess in Large Intestine channel, such as a tooth abscess.
Feel pulses with the pads of the fingers (most sensitive part)
Hand must be relaxed - neither tense nor flaccid, but flexible and maintained in the pulse-taking position with the minimum of effort.
Exercise: Tense the hand as much as possible. Then relax and let the hand droop. Then gradually, with as much attention as possible, put just enough energy into your hand to lift the fingers. Imagine your fingers are like the leaves of a tree; if you waved your arm your hand and fingers would float gently after your arm. This is the optimum condition of the hand for pulse taking, relaxed, flexible but responsive.
Place the third (middle) finger pad on the radial artery just medial to the styloid process. The index finger is then placed in the distal position at the wrist crease and the ring finger in the proximal position.
NOTE: on a small person, the fingers will have to be squeezed close together but on a large person they may need to be spread out.
Try to feel the radial artery pulse with all three fingers. Use equal pressure on all three fingers and then release the pressure on the middle finger slightly to compensate for the styloid process. (The pressure of the radial artery on the styloid can produce an artificial pulse reading if the same amount of pressure is exerted there. The pulse would then appear to be excessive in the middle position.)
When you can just feel the radial artery, and have adjusted the pressure of your finger tips, release the pressure equally until you can JUST feel the pulse. This is the superficial position.
Then press as deeply as possible (maintaining the relative pressure levels as before) until you cut off the pulse altogether. Release the pressure until the pulse just returns. This is the deep position.
Patient's pulse is traditionally correlated with the Practitioner's Breathing Cycle in order to determine if patient's pulse is slow or rapid. (This was misinterpreted for a long time in the West).
|Normal pulse:||4-5 beats per practitioner's breath.|
|Three beats or less:||Slow Pulse|
|More than five beats:||Rapid Pulse|
Also pulse can be counted using a watch according to following table:
|1-4||90 or above|