Pulse Taking

Pulse Taking Overview

  • Pulse positions are categorized as:

    • Front (Sun)

    • Middle (Guan)

    • Rear (Chi)

  • Each position correlates with Yin and Yang organs located on the left and right sides of the body:

    • Front (Sun):

      • Left: Heart and Small Intestine

      • Right: Lungs and Large Intestine

    • Middle (Guan):

      • Left: Liver and Gallbladder

      • Right: Spleen and Stomach

    • Rear (Chi):

      • Left: Kidney and Bladder

      • Right: Gate of Vitality (Mingmen)

        • Mingmen: Physiological fire related to Kidney Yang and lower burner

Energy Types and Positions

  • Energy Types: Each position relates to a specific energy type as follows:

    • Front (Sun): Related to Chi (energetic layer), connected to the upper burner (heart and lungs)

    • Middle (Guan): Associated with Blood and the middle burner (stomach and spleen)

    • Rear (Chi): Involves more Yin, indicating organ functions in the lower burner (kidneys)

Taking the Pulse

  • Positioning:

    • Use three fingers on the radial pulse, each corresponding to layers:

      • Middle finger: Under the styloid process

      • Index finger: Between the middle finger and the wrist crease

      • Ring finger: Equidistant below the middle finger

  • Pressure Methodology: Start superficially, then progress deeper, checking for differences in pulse strength and quality.

Moving Techniques to Assess Pulse Quality

  • Types of Movements:

    • Lifting: Assess strength of the pulse at the superficial level by gently lifting fingers.

    • Pressing: Press down to evaluate pulse at both the middle and deep levels.

    • Searching: Remain still to assess the rate of the pulse (slow, normal, rapid).

    • Pushing: Move fingers from medial to lateral to analyze shape and quality of the pulse.

    • Rolling: Move fingers proximal to distal to ascertain if the pulse is short or long.

Factors Influencing Pulse Assessment

  • Seasons: Influences quality of pulse, e.g., deeper pulses in winter (associated with kidneys) versus wiry pulses in spring (indicating liver activity).

  • Gender Differences: Men's pulses may show stronger qualities on the left (heart-related), whereas women's may be stronger on the right, though this may be influenced by individual variations.

  • Athletes: Generally have slower pulses, which must be considered in context of normal for each individual.

Pulse Qualities and Definitions

  • Normal Pulse:

    • Normal Range: 60-100 beats per minute. Normal: Gentle, calm, with moderate quality indicating good stomach chi.

  • Floating and Deep Pulses: Explain the surface vs. deep characteristics o Floating pulses indicate exterior pathogenic invasions.

  • Categories of Pulses:

    • Slow Pulses: Less than 60 beats per minute, associated with cold patterns (deficiency or full cold).

    • Rapid Pulses: Greater than 90 beats per minute, indicating heat patterns (empty or full heat).

  • Empty & Full Determination:

    • Empty: Soft, can be pushed through indicating deficiency.

    • Full: Hard, indicates excess or stagnation.

Detailed Pulse Qualities

  • Full Pulses:

    • Definitions:

      • Full: Feeling large, possibly harder, indicative of excess.

      • Overflowing: Superficially large and extends beyond normal channels, indicating extreme heat.

      • Wiry: Indicating disharmony (often liver-related), feels well-defined and taut.

      • Tight: Indicates interior or exterior cold, related to pain.

Conclusion on Influencing Factors

  • Evaluating the pulse requires an understanding of individual physiology, environmental conditions, and clinically relevant histories. Adjustments must be made based on context specific to the patient.