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Pulse Diagnosis


#1

I'm new to this forum so forgive me if this topic has been covered. I have a very basic question about pulse. When I read pulse indications for disharmonies in TCM Tech books how does one know which position the pulse was taken from?


#2

If you mean when you read an indication such as slippery, would you know which organ is indicated - then the answer would be no. While it is true that some meridians are prone to certain imbalances - there would be no way to safely decipher specific meridian imbalances.

That said, the patterns are often generalized so if you have a slippery pulse that is quite meaningful without narrowing it down to a specific meridian system. The basics are covered in my article on pulse diagnosis.


#3

Thank-you for your reply. I have read some of your works and they are very clear..excellent work. The only thing I still do not get is when you say "slippery" for example, are you on all three pulse points and getting a 'general' reading from all three positions? IF so, do you take it on both wrists and compare?


#4

Within pulse diagnosis an individual "diagnosis" can be either overall (from all three and/or both sides) or particular organs. For example, you could have a wiry liver pulse and a slippery spleen pulse - in which case you would have Liver Qi Stagnation and Spleen Qi Deficiency, for example, as overall diagnoses. Alternatively, you could have an overall wiry pulse which could still lead to a Liver Qi Stagnation diagnosis.

An important point to keep in mind is that the pulse is only one of many diagnostic tests which are used to form a Chinese Medicine diagnosis. The pulse, in general, is not used exclusively but more to fine tune a diagnosis formed from the patients symptoms and other findings within the tongue, by palpation, etc.

Furthermore, there are many different ways of using the pulse. For example, within the Japanese Acupuncture section the pulses are often used relationally rather than by the feel of individual or group pulses. So in a spleen deficiency pattern all you are looking for in the pulse to verify is that both the heart and spleen pulses are the weakest compared to the rest of the pulses.

Pulse diagnosis takes a while to feel comfortable with and it is, ultimately, somewhat subjective. The main thing is to understand how you interpret the imbalances within the pulse first and foremost and then be certain that you know how to correct those imbalances with your treatment. Whether you think a pulse is spongy and someone else choppy matters less so long as you can correct what you feel with an appropriate diagnosis and treatment plan to alleviate the patients symptoms.


#5

Thank-you! Great information! I am studying for the NCCAOM exam and pulse has been the hardest thing for me to grasp. When I study pathology, I see there is a specific pulse that relates to the given diagnosis. In Flaws Compendium of TCM Patterns and Treatments under 'Large Intestine Qi Stagnation'for example, it gives a pulse image of a slippery pulse. Was I correct to assume it was taken in the LI position ( perhaps after the disharmony was already detected through the other examinations)? On another note, would this pulse image of 'slippery' confirm that the LI is weak and the weakness is contributing to the stagnation? If so, if it were wiry would that mean the stagnation is from a different cause?

There are other disharmonies that list multiple pulse qualities so I did not know which positions these were comming from. For example "Lung /Spleen Qi Vacuity" ...it states the pulse image is soggy and weak. I think I am too literal at times...but I was trying to figure out where it would be soggy and where it would be weak.

Does one always check each individual position independently or are there times when all three fingers are placed on the various positions for the overall pulse quality?
Thank-you for your patience!


#6

In general you check the pulse with all three fingers down on the arm and first look for general imbalances in the overall pulse and then try to look at the individual organs by focusing on each of the three positions. When people list "wiry", for example, it can be overall or in a specific meridian - it really depends on the practitioner and their specific training and methods. Most often in texts they are talking about an overall sensation in the pulse sometimes verified by checking into individual organs.

With regards to the exam, I wouldn't worry too much about the specifics - they won't ask questions with such detail as they are too subjective. In your own practice, however, you will need to come to some understanding of what you are feeling and how to remedy the deciphered imbalance. The only way to really do this is to work very closely with someone who has mastered pulse diagnosis. There are many practitioners, however, who use the pulse marginally if at all and base their diagnosis and treatment plan on a variety of other signs and information.


#7

It is all very clear to me now. My sincere graditude Master Dupuis. I appreciate your time and wisdom very much.
Healthsangel


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