Tricks & Tips for pulse diagnosis

[z00se]

So i started my pulse diagnosis training the other day with this doctor and felt about 60 peoples pulses in the 8 hrs. Have to say i felt i was doing better at it after 2-3 hours than after the 8 hours. The different pulses just started blending into 'just a pulse' that was indistinguisable. Men's pulses were much easier to feel than females and some people i could barely feel at all.

 

I could start to feel weaker pulses in different finger locations indicating what area might be wrong but not as to the detail of what was exactly wrong there. High blood pressure seemed to be the easiest thing to feel. I do feel relaxing was very important because after i was told to feel certain things at certain finger positions my brain did start trying to 'expect' something rather than just feeling what was there. I've found my own pulse does change after eating a heap of sweet junk foods or after qigong. It changes throughout the day.

 

I wonder if anyone has advise they could give me while trying to learn the diagnosis? I'm also trying to find not too complex information on the internet or in books that can help me learn chinese style diagnosis.

 

Also I found a cool tongue diagnosis information site on the net that you guys can look at if your interested at:

http://beyondwellbeing.com/herbs/tongue-diagnosis.shtml

 

Cheers,

 

Louis.

[al.]

Hey louis,

i'm learning too, it really just takes alot of time and alot of practice! my best advice would be close your eyes, cut out the world, cut out your thoughts, and bring your sole attention to your fingertips. Also, i find it really useful to get into that 'qigong state' when feeling- it definately heightens sensitivity.

best o luck good sir

[David Yeh]

Louis, are you learning this without any theoretical background, are you learning theory stuff simultaneously, or do you already have some background? In other words, do you know what you're looking for? Do you know, for instance, that different positions correspond with different organs (or, whatever the equivalent might be in the system you're learning)? Some of that book-knowledge can be helpful, because one way or another it's best to organize and give a direction to your efforts.

 

When I learned pulse, we started by learning the finger positions, depths, and sensations/qualities. It's easiest and least overwhelming to focus on one thing at a time. I don't know how much overview or background you're getting to be able to do this, though, or if you're just being thrown into the deep end, which can be a great, though different, education in and of itself.

 

One thing that was useful when I was starting out was to separate sensation from interpretation. It was too much at first to try to feel some subtle quality AND try to figure out what it meant. One step at a time.

[z00se]

Glad you replied David i was hoping you would.

 

I've got a basic background knowledge of TCM, i read a medium sized book that gave a good overall of the whole thing a couple of years ago and i've got alot of qigong experience so i know how things connect with each other within my own body. I've been told that the 3 positions on each arm are heart/liver/kidney and lung/spleen/bladder and sexual function. He hasn't said anything about depths and in my internet searching i've read a bit about that so i'll have to ask him about it next weekend. I haven't studied anything pulse specific and i can't find any english books here in china unless i get one off the internet but i don't want to get some massive thing to wade through because i feel i could probably pick it up more from practice faster than i could learn from some massively detailed book. Some lighter reading on the subject could definatley provide useful though.

 

Something in my internet reading i'm finding is that how can i work out what is a slippery soggy pulse etc. Like i need to feel an example of that pulse to know what they are talking about in the text. The differences i can feel are:

 

1. A very sharp 'spike' to the pulse of one finger as in if the pulse is a sine wave the peak is much sharp higher and spiked. This seemed to be present with very serious illnesses and i got told it's because of pressure in that organ. It was very easy to feel this feeling.

 

2. High blood pressure felt a bit like this spiked pulse but not spiked quiet as high as i mentioned above, plus the pulse felt this way across all fingers.

 

3. Different strengths of the pulse at different fingers so then you can feel how it is out of balance. Usually the centre finger is a little stronger, especially the stomach if they are hungry or have eaten a big meal and thats normal i was told.

 

4. Uneven pulse, so the pulse doesn't beat in a steady sine wave, some waves are shorter and some are longer than others.

 

5. Another one i found difficult to feel but could feel a tiny bit was his pulse felt ok when u press light but if you push down with the middle finger you couldn't feel the pulse on the outside fingers, or it was very light. The doc said it's because there wasn't enough blood in his veins or something. If it wasn't fixed it could become serious.

 

6. Another one difficult to feel but i felt a tiny bit was one of the fingers the pulse didn't go all the way through the finger (like from left to right) - it was the right most finger. Said there was some blockage or organ or heart wasn't strong enough for the blood to go through.

 

Maybe i should continue with my trying to catorgorise the feelings within my own head without trying to attach it to the theory yet so then my thoughts won't effect my feelings and create a desire to catorgorise it with the literature. I do have a nagging urge to start to learn some theory too though because i'm only going to have this opportunity for a month or two before i leave China. Hopefully after a couple of weeks i can go to the practice three times a week that will speed up my learning lots.

[Taotao]

Hi Louis,

 

Maybe this will help you a little. I found this articles very interesting and it did help me with my learning & practicing with pulse. They were written by the late Jim Ramholz who was the student of master Sung Baek\Jiang Jing who has a specail tradition and is an expert in pulse diagnosis. Some of them are quite complex and some are less, but you can find new ideas that will help you with the pulse.

 

So, you can find the articles in:

 

1. http://pulsediagnosi...anTradition.htm

 

2. In yahoo groups, check the FILES section in these 3 groups (all the articles by the nick "jramholz") :

a. http://health.groups...PulseDiagnosis/

b. http://health.groups...PulseDiagnosis/

c. http://health.groups...eseherbacademy/

 

On the other hand, after all the intelectual lerning in the head (which is very important), you realy need to "forget all of it" when you come to feel the pulse. You should concentrate just on the feeling of the pulse, what you realy feel, without any judging... you may have only phisical sensations, and you may have also emotional and spiritual sensations.. You need to be very receptive when you check the pulse, listen very carefuly. Only after that you can again start to analyze what you felt with what you know and lernt in your head.

I hope this will help you

[David Yeh]

Hi Louis,

 

Okay, so you are not going in totally blind, that's helpful.

 

The way I like to look at it is that learning the pulse is like learning a language. You learn the qualities and sensations (words and vocabulary). You learn the positions and depths (grammar/syntax). And you learn the interpretation (meaning). In the beginning you start out not being able to do much but just pick up on bits here and there, but with enough practice, you can go in and have a whole conversation with a pulse in a matter of seconds.

 

You don't have the luxury of learning it in an "organized" way, i.e. first the words, then the grammar, then the meaning. You're in a situation that's more akin to the way most of us learn how to talk: by being exposed repeatedly, and learning the rules of the language through osmosis. That's great, but I think you would benefit by just trying to apply your intention according to the simple framework I described.

 

On the qualities in particular, I categorize them roughly in this way:

1. Thinness. Wide, thin, or normal?

2. Depth. Is it felt on the surface, or felt when pressing in hard? Is the sensation the same at all pressures/depths?

3. Volume. Is there a lot of force or substance to the pulse, or not very much?

4. Shape/Texture. Is it soft? Slippery? Is it hard -- taut, tense, tight, wiry? Are there hard or narrow "spots" or "spikes"? Does it feel rough?

5. Rate. Fast, slow, normal?

6. Rhythm. Does the rate change as you take the pulse? Any skipped beats?

7. Stability. Is the pulse stable or does it change in amplitude? Does it change from quality to quality or does it stay the same?

 

There might be other aspects to your pulse system that aren't covered by mine, or vice versa. Your teacher is the final authority of course!!!

 

Now, just some notes on the specific qualities you mention feeling. This is just to help you but obviously the system you're learning may be different from mine. Impossible to compare across the Internet!

 

1. A very sharp 'spike' to the pulse of one finger as in if the pulse is a sine wave the peak is much sharp higher and spiked. This seemed to be present with very serious illnesses and i got told it's because of pressure in that organ. It was very easy to feel this feeling.

 

I think there's a lot of consensus that this is commonly interpreted as blood or phlegm stagnation; the sharper the spike, the more intense the stagnation. If it's softer, more rounded, bigger, that indicates less stagnation, and may be more on the qi stagnation end of the spectrum.

 

3. Different strengths of the pulse at different fingers so then you can feel how it is out of balance. Usually the centre finger is a little stronger, especially the stomach if they are hungry or have eaten a big meal and thats normal i was told.

 

Commonly the middle pulses are a bit higher and the proximal pulses are a bit deeper. Last week I had a patient in my office who was extremely hungry, and she was eating as I felt her pulse. Initially I was concerned as her right middle position was nearly absent. After a few minutes, I checked again and it was present -- it had filled in as she ate!

 

4. Uneven pulse, so the pulse doesn't beat in a steady sine wave, some waves are shorter and some are longer than others.

 

Do you mean height, as in amplitude, or length? Or rhythm?

 

5. Another one i found difficult to feel but could feel a tiny bit was his pulse felt ok when u press light but if you push down with the middle finger you couldn't feel the pulse on the outside fingers, or it was very light. The doc said it's because there wasn't enough blood in his veins or something. If it wasn't fixed it could become serious.

 

This is a new one to me, at least the way you're describing it. I've seen where the pulse is felt upon light touch, but when pressing deeper (with all fingers), it diminishes or disappears. That's considered a version of the Empty quality, and similarly indicates serious qi and blood deficiency.

 

6. Another one difficult to feel but i felt a tiny bit was one of the fingers the pulse didn't go all the way through the finger (like from left to right) - it was the right most finger. Said there was some blockage or organ or heart wasn't strong enough for the blood to go through.

 

As with #1, any time there's a narrowing or restriction, it would be diagnosed as stagnation of some sort. I believe it would be on the same spectrum as indicated in #1.

 

 

By the way, I would not necessarily recommend that you buy a pulse book. Each pulse system is different, some extremely different. You have a great opportunity studying directly from a master, just go with what he tells you and immerse yourself in that one system, especially since you don't have much time.

 

I do have some notes that I put together to help me organize my thinking around the pulse system I've studied. I could send it to you (it's a Word document), it might help you organize your thinking. But the same caveat would apply.

 

My teacher, Leon Hammer, was in a situation like yours, except for years. He had no book or anything to go on and didn't speak Chinese. It was a great creative effort to put together and organize all of the material and experience that he has. So it may not always be to your benefit to rely on someone else's framework ... At the same time, if you're only there for 1-2 months ...

 

Hope this helps. Asking questions in one of the Pulse Diagnosis groups that Taotao mentioned might be fruitful too.

[z00se]

Thanks alot guys. Those articles you posted taotao are just what i wanted. Started reading up and got a better idea of what i should be looking for.

 

David: Number 4 uneven pulse i meant the amplitude of the sine wave changes. I found it hard to distinguish length of the sign wave changing unless it was quiet a large difference. I guess i will get better in time. I will start trying to feel for the details you described in the pulse.

 

Going there again tomorrow and i'll ask him if i can practice some other days too so hopefully speed my learning up a bit. I'm sure i'll be back again with a few more questions after tomorrow.

 

Thanks again!

 

Louis.

[z00se]

Something i didn't mention that really surprised me is when it came to lunchtime the boss shouts everyone in the clinic to lunch. There was about 5-6 people who went including myself and finished off a whole bottle of spirit including the doctors and herb people. Then go back to the practicing diagnosing cancer etc haha. I got told that it's normal and happens every time. You'd never be allowed to do that in the west. If i knew that before i wouldn't have taken the doctor so seriously but he still is right on with his diagnosises. Maybe alcohol improves your diagnosis, that the thing i'm choosing to learn from it. Can't wait till i've got my own clinic and can get drunk at lunch time haha.

[David Yeh]

Drunken Master!!!

[Aetherous]

Different paradigm (Ayurveda instead of TCM), but I recently got this book. It's excellent and clear...not discouraging at all to learn. I think it's possible to learn without a personal teacher, and it's encouraged to practice on yourself in addition to other people. There's quite a bit of what seems like rare information in here.

 

(one thing that's different is how the author switches the wood and earth element positions on the pulse, from the TCM way...it's based on his personal observation and might confuse some people if they aren't reading closely).

 

Same author has a textbook which contains more methods of diagnosis, such as tongue and face...I don't know if the pulse information is as complete as the other book.

Using multiple methods of diagnosis is great, because then you can double check your pulse findings and be really sure about how to move forward. Tongue diagnosis is even easier.

I'm also extremely interested in this Ayurvedic pulse DVD, but it's costly.

Edited October 10, 2013 by turtle shell

[Aetherous]

http://www.gancao.net/diagnosis/palpation-pulse/intro-1138

 

This free online resource really helps to make sense of TCM pulse diagnosis.