What do your pulses tell?

By Dr. Bolz

You have no doubt often heard the phrase, ‘the pulse of the nation,” the pulse of the planet,” “the daily pulse,” etc. This must mean that the pulse is and has been considered very important, from ancient times until now. Indeed, if we humans do not have a pulse, we are not alive. So, yes, the pulse is vital. It is a proof of our existence, a sign that our heart is functioning and we are alive!

In Traditional Chinese Medicine (TCM), for the doctor, we talk about the pulses of one human, not just one pulse. The TCM doctor will say, for example, “Let me check your pulses.” We do not usually say, “let me check your pulse.” This is because there are six different positions on the wrist for pulse taking all at the same time, and in reality there are 18 positions, because we check the superficial, middle, and deep layer of the pulses in each of the six places on the wrists.

In TCM, the pulses tell us much more than the fact that we are alive, that the rate is normal or abnormal and reflects more internal organs than just the heart. Of course, it reflects the blood circulation throughout the body, but there is much more that can be learned about the person’s health if the doctor is trained to “read” the pulses. Indeed, the doctor of TCM learns to read the body’s signs, so much so that it often reveals what can be found through radiology and hematology, but it can reveal also that which does not show up in these modern tests. It can reveal the very finite and subtle imbalances which would not be revealed in the modern technological tests until the disease is at a later stage.

On the other hand, radiology and imaging can also define specifics that can only be generalized in pulse reading. So using both methods is the best for diagnosing a patient’s health condition, especially if it is serious. Another case where TCM can really help is the case where the patient feels lousy, has a myriad of symptoms, and allopathic medicine (conventional Western medicine) has done every test under the sun and still cannot find anything wrong with the patient. This is really where TCM can find the imbalance and help the person improve greatly, in most cases.

Since pulse diagnosis is one of the major diagnostic tools in Traditional Chinese Medicine (TCM), I will try to explain briefly a little bit about how it is done. Keep in mind that it is said by the great masters of this medicine from ancient times until now, that it takes a good ten years of clinical practice after graduating Oriental medical school to truly be proficient at it. It is not easy and should not be attempted by the nonprofessionals to prescribe their own herbs or acupuncture, or other modalities. This is merely an overview which is useful for people so that they may have some idea about some of the diagnostic evaluation methods of this medicine. In the last issue, I wrote about tongue diagnosis, which you might have read if you are a regular reader of this magazine and my articles.

It is difficult to summarize a very complicated technique, and really will probably end up in only showing you how difficult it must be. However, once learned by the professional, it is truly astounding how accurate the system can be and how much your body does “speak” if one is trained to read the language of the pulses and other physiological signs which the body manifests.

In diagnosing the pulses, the patient extends and relaxes his arms with his/her palms facing upward. There are three positions on each wrist. The positions closest to the prominent bone of the wrist (the styloid process of the radius, thumb side) is termed the “cun” position. Thinking in terms of going towards the elbow, the next position is the “guan” position, belonging to yang, and behind the guan position is the “chi” position, which belongs to yin. These positions are the same in both wrists.

Pathologies of the internal organs are reflected at the wrist pulse, and each organ has an individual position. The cun position on the left wrist belong to the heart. The guan position on the left wrist belongs to the liver and gallbladder. The chi position on the left wrist belongs to the kidneys, small intestines and bladder. The cun position on the right wrist belongs to the lungs. The guan position on the right wrist belongs to the spleen and stomach. The chi position on the right wrist belongs to the “Gate of Life” (Ming Men) and large intestine. However, this is only one idea of how the six positions on the left and right hands relate to the internal organs. These other ideas will not be mentioned here.

Seven diagnostic techniques include the superficial, middle, deep, upper, lower, left and right techniques.

The medical practitioner will spend a good amount of time just feeling the pulses and listening to them while pressing on the different pulse positions with different pressures. I have had some patients comment that it is as if I am playing a piano when I palpate their pulses.

There are approximately 27 pulse states that are ascribed to each of the six positions at the three levels. This is important; the quality or state, of the pulse. These are as follows: A floating pulse: It is a pulse which feels strong under slight pressure, but when the pressure is increased, it loses its strength. A sinking pulse: This is a pulse which cannot be felt unless strong pressure is exerted to the level of the tendons and bones. Slow pulse: A pulse which beats only three times per respiration is called a slow pulse. Rapid pulse: This is a pulse which beats six times per respiration. Slippery pulse: This type of pulse feels round and smooth and flows evenly. It is like a greasy round ball, which slides under the fingers. Choppy pulse: This type feels thin, minute and short and has an uneven flow, beating three and fives times with irregular rhythm. Empty pulse: This pulse feels floating and big with slow beats, but becomes obviously soft and deficient when slightly more pressure is applied. Full pulse: When a pulse is felt both superficially and deeply, and has big, long, wiry, strong beats, it is called a full pulse. Long pulse: This type is neither big nor small, but feels long, soft and calm, like the end of a bamboo shoot, and it is long. This indicates good health. Short pulse: The beats are strong, but it rises and falls abruptly. At the beginning of the cun position and at the end of the chi position, it is not easily felt. Flooding pulse: It is rough and big with beats that rise strongly but fade out as they fall. Minute pulse: This type is very thin and very soft. Tight pulse: A tight pulse rises and falls with strength and vibrates to the left and the right. Leisurely pulse: This type is slightly faster than a slow pulse, with exactly four beats per respiration. Hollow pulse: A hollow pulse feels floating, big and soft under slight pressure but without substance at the center under heavier pressure. It is lik a spring onion, which feels strong at the edge but without strength inside. Wiry pulse: This is a pulse which feels taut, long and strong, whether under pressure or not, and passes straight under the fingers without vibrating to the left or right or without give any wavelike sensations. Leather pulse: This feels wiry, almost rapid and without substance in its center. Firm pulse: This kind is very deep, almost hidden, and not only strong and long but also wiry and impatient. Soft pulse: This type feels floating, very thin and without strength. Weak pulse: A pulse which is felt to be very soft and thin under deep pressure, but cannot be felt at the superficial level is called a weak pulse. Scattered pulse: A scattered pulse feels indistinct, big and without strength when slight pressure is applied. Thin pulse: This type feels like a fine thread and is also soft, weak and without strength. Hidden pulse: This cannot be felt until deep pressure is applied to the level of the bone, and even then, the beats seems to come from beneath the tendons. Moving pulse: This pulse type feels rapid, tight, slippery and short with strong beats. Hasty pulse: It feels rapid but loses a beat at irregular intervals. Knotted pulse: This type feels leisurely, but loses a beat at irregular intervals. Intermittent pulse: this pulse loses a beat and then pauses a little longer before starting again, at regular intervals.

Each of these type of pulses has clinical significance. If that is not difficult enough, there are many combinations of these types of pulses and each position on the wrist will be very different from the other position; remember the cun, guan, and chi. It takes extreme concentration, diligence, and practice to use this method; but after the practitioner gets good at it, it is very reliable. It is like an endoscope into each of the internal organs. It is amazing how well the body will give the signs of what is in balance or what is out of balance, once the practitioner is skillful at it. This can be very reliable, amazingly so. It is as though the patient’s pulses “speak” to the skillful practitioner.

As the patient’s condition changes, it is quickly reflected in the pulses. That is why the TCM practitioner will usually take the pulses each time when treating the patient, even if they are coming weekly of daily. Whether the condition is getting better or worse in different organs or meridians, or in general; it will be shown in the pulses. The pulses show any imbalances and are a true measure of the life force in each of the individual.

There is much more to pulse diagnosis than mentioned here. This is writing is to give you an idea, a glance only, of this diagnostic method.

Other diagnostic tools the clinician uses are looking into the eyes, looking at the condition of the nails, the skin, the feces, the urine, the sputum, the sweat, and the thirst levels and cravings of the patient, etc. The color and texture of excretions are important to observe. The doctors of ancient times did not have the modern technology as we have today, yet they were extremely proficient at diagnosing and prescribing the right treatment for each person.

There is another very good diagnostic tool that the TCM practitioner can use: “fukushin” in Japanese, meaning “abdominal diagnosis” in English. This is also a complicated and elaborate system of diagnosing by palpating the different areas of the abdomen, although easier to learn than pulse diagnosis.

You cannot take your own pulses in this manner and learn how to do it without the proper education in TCM, but you can be on the lookout for changes in your nails, skin, feces, urine, sputum, eyes, ears, etc. If there are certain colors and textures of these body parts or excretions that are not normal, this can give you good clues about your own health.

A Traditional Chinese Medicine doctor can often times find the imbalances in your health and help you improve and even recover completely to obtain good health. Pulse diagnosis and tongue diagnosis are two of the complicated diagnostic methods on which great importance is given in this medicine. It can be astounding how revealing and how reliable these diagnostic tools can be. Along with the other body signs, and the patient’s symptoms, an understanding of the individual’s own disease or imbalances can be met that mere technology alone can never reveal. The body does not lie, and it can reveal all to those that are trained to read it. Moreover, the patient avoids excessive invasive tests. The TCM practitioner will also utilize the bells and whistles of modern medicine, but this just isn’t enough. For the whole story of the individual’s condition of disease or imbalance, ALL of the available tools should be used. Is it any wonder why we use the term pulse in so many expressions in our speech? Our pulses, indeed, show our life force.

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