Pulse Taking在线视频

Hello everyone

We are talking about the diagnostic methods

We have talked about how to do a tongue observing

and the clinical significance of tongue observing

In this session

we will continue to learn about the other important

diagnostic method

pulse taking

Pulse taking is a diagnostic procedure by which the physician

feeling the patient's radial arteries

with the finger-tips

to judge pulse condition

thus learning and inferring the condition of disease

Pulse-taking means that the doctor uses his or her fingers

to press certain part of the patient’s pulse

to examine the conditions of the pulse and diagnose the diseases

Pulse taking as a tool to determine physical condition

is not common knowledge

It is needed to take a very long time to study the pulse

taking knowledge

and to practice clinically over and over

to master this diagnostic technology

Today let’s take a close look at

why and how to use this ancient medical skill

Generally speaking

the pulse conditions are closely related to the viscera

qi and blood

The substantial basis of pulse is the blood

and the power of pulse is the qi

As we have talked about

TCM always holds the view of holistic concept

Based on this view

the internal organs are closely related to the vessel

qi blood and essence

As the condition of internal organs

can be reflected by the condition of tongue

it can be reflected by the condition of pulse

Separately heart dominates blood and vessels

the heart pumps qi and blood into all parts of the body

through the vessels

The lung governs qi and “connects with all vessels”

The distribution of lung qi helps the heart propel blood

The spleen and the stomach are “the source of qi and blood”

the spleen direct blood to circulate in the vessels

The liver regulates the activity of qi through the body and promotes

blood circulation

The kidney stores essence

the essence can be transformed into blood

Therefore we can know the visceral state

and the disease condition by pulse-taking

The location for feeling the pulse is called "cunkou"

Cunkou refers to pulsation of the radial artery on both sides of the wrist

Cunkou is located on the pulsation of the lung meridian

and is divided into three regions

cun guan and chi

There are 3 positions on the wrist which are used for analysis

the front middle and rear positions

and analyzed at 3 different levels

superficial middle and deep

Early morning is the ideal time for taking pulse

because the conditions of the pulse

are not affected by food and other activities

To ensure the patient rest for a while to stabilize the heart

and breath before taking pulse

The pulse should be taken at least for one or three minutes

each time in order to correctly examine the conditions of the pulse

The correspondences between organs and the pulse are as follows

on the left hand

reflect respectively the conditions of the heart

liver and kidney

while on the right hand

the conditions of the lung spleen as well as the kidney

Each of the six regions for pulse-taking

corresponds to one of the internal organs

and reveals the pathological changes of the relevant organ

The patient sits erect or lies in supination

and the forearms

stretches out naturally to the level of the heart

The wrist is put straight

the palm turns over and the fingers are relaxed to extend

the cunkou region and enable qi and blood to flow freely

For the doctor three fingers are put

at the same level and slightly arched

to press the pulse with the belly of the fingers

Normally the middle finger presses on the guan pulse

the index finger presses on the region

anterior the guan pulse

the ring finger on the chi pulse

posterior to the guan pulse

The doctor should put different strength on fingers

to feel pulse at different levels

And the pressing strength may be little moderate or heavy

The normal pulse is characterized by the pulsation in all three portions

which is 4 to 5 beats in one breath

neither deep

nor floating

soft and forceful and in equal intervals

As a normal pulse it should be full of stomach (gastric) qi

Stomach qi means that the pulse is located at the middle

neither floating nor sunken

regular in beating

moderate in size

gentle in sensation

It should be full of spirit

Spirit means that the pulse is soft

powerful and rhythmic

It should be rooted

Root means that the chi pulse is powerful and constantly beating

under heavy pressure

Being full of stomach qi

spirit and root are three basic features of the normal pulse

which complement each other and cannot be separated

There are some factors may affect the normal pulse

such as age

gender

seasonal changes

and geographical factors

For example

the pulse of children usually is smaller and faster than adult

while the pulse of young is usually much more smooth

and slippery than senior

the pulse of man is usually more powerful than woman

All the factors above mentioned may affect the conditions of the pulse

However

if the pulse still keeps stomach qi spirit and root

it is still the normal pulse

After we talking about the normal pulse

let’s see what is morbid pulse

The morbid pulse refers to the pulse conditions

are either the changes of the position

or the difference in rhythm

or variation in morphology

or changes in strength of the pulse

From the dynamic diagram

it is normal if the pulse waves in the middle position

now it waves in the upper position which means a floating pulse

Floating pulse has the features which is sensible under light pressure

weak and constant beating under heavy pressure

Floating pulse is marked by superficial beating

The floating pulse suggests that the patient may have an

external syndrome

Clinically if the pulse is floating and powerful

the patient may have external excessive syndrome

while if the pulse is floating and weak

the patient may have external deficient syndrome

From the dynamic diagram

the pulse waves in the lower position instead of middle positon

which means a deep pulse

Deep pulse has the features which is sensible only under heavy pressure

Deep pulse

indicates

internal

syndrome

It is internal excessive syndrome if the pulse is deep and powerful

It is internal deficient syndrome if the pulse is deep and weak

On the whole

all related factors should be taken into consideration

in differentiating pulse for making correct clinical diagnosis

The significances of pulse examination include

recognizing the exterior and interior of disease

judging the deficiency and excess

determining the nature of disease

identifying causes of disease

inspecting the disease mechanism

as well as predicting the prognosis

Diagnosing patients through pulse examination is actually

much more complicated

So the application should be flexible

and based on the synthetic

analysis of the data

obtained from the four diagnostic methods

OK that’s all for today

I’ll see you in next class