Calibration

[Guest guest]

 

As usual, you make a fine and trenchant point. How do we calibrate

pulse-taking? It seems to me that a consensus of calibration can come through a

reading

of pulse depths. The two major systems of Li Shi Zhen and its offshoots, and

the Nan Jing and its offshoots, differ not only on what is read at what

position but on how to read depths. The Li Shi Zhen school divides the pulse

into

three major depths--qi, blood, yin, something like that. The Nan Jing school

divides the pulse into yin and yang depths. It seems to me that a minimum level

of

mastery at pulse reading would be to take these depth subdivisions one step

further in each case. In other words, be able to read each of the three depths

of qi, blood and yin, and then further subdivide and distinguish qi, blood and

yin depths within each of the three major subdivisions. Or read the pulse

depths as yang above and yin below, then further divide each depth into yin and

yang. Say the L.Ac. practitioner must be able to demonstrate consistent reading

of the major subdivisions of depth, and the DAOM must be able to go one

division better. This of course does not cover all the bases of pulse reading,

but

it seems to me to at least be a good point ofordiscussion. By the way, has

anyone ever tried to read the pulse of an herb?

Joseph Garner

 

>>>Group

 

The discussion of modeling and how to best achieve a desired goal harks

back to our earlier discussions of interrater reliability visa ve chinese

diagnostics.  As Will pointed out at that time, reliability requires

calibration.  Calibration requires somewhat narrowly focused practice as

in the Hammer method Will described.  Bob Felt has also pointed out that

japanese acupuncturists in certain schools can become quite calibrated in

the same fashion.  I am pretty sure Jim has made the same point with

regard to his dong han style of pulsetaking.  If TCM style herbology has

fully developed over the past three hundred years, it makes sense to

calibrate to this style when teaching it.  I am hardly suggesting not to

calibrate to other styles when teaching those.  Nor would I want to insist

we calibrate students in one style only at any given school.  But without

the calibration, one can't really accomplish any teaching in any style.  I

would also argue that calibration includes calibrating one's method of

assessing and planning.  So while on one hand, we must respect the

inherent plurality of CM as one of its strengths, we must also recognize

that within that plurality one must still focus on whatever one is

personally doing.  The concept of plurality as Scheid described it does

not mean that everyone needs to know or practice many styles, just that CM

as a whole embraced such plurality.

 

<<<

 

 

 

[Guest guest]

Jim,

Thank you for your article. I look forward to reading it with great interest.

But what I meant by my somewhat whimsical though serious question was: Has

anyone ever tried to read the " pulse " of a plant? A living plant, growing in

dirt. I don't know if it's possible, though I do know that Sri Lanka has a

tradition of acupuncturing plants. Seems to me it would potentially be easier to

read a plant's pulse than to check its tongue. And how do you manage to read

pulses shortly after patients drink herb decoctions? Do you brew the herbs

yourself?

Joseph Garner

 

>>> , acugrpaz@a... wrote:

By the way, has anyone ever tried to read the pulse of an herb?

 

Joseph:

I always check the pulses to see the effects of herbal formulas. You

should see significant changes from the herb or formula in a few

minutes.

 

I've uploaded a PDF file, " Herb Qualities and The Pulse, " with a

diagram showing how basic herb tastes effect the Normal pulse. You

should easily extrapolate to all positions and the 5-Elements.

Jim Ramholz<<<

 

 

 

[Guest guest]

, acugrpaz@a... wrote:

By the way, has anyone ever tried to read the pulse of an herb?

 

 

 

 

Joseph:

 

I always check the pulses to see the effects of herbal formulas. You

should see significant changes from the herb or formula in a few

minutes.

 

I've uploaded a PDF file, " Herb Qualities and The Pulse, " with a

diagram showing how basic herb tastes effect the Normal pulse. You

should easily extrapolate to all positions and the 5-Elements.

 

 

Jim Ramholz

[Guest guest]

, acugrpaz@a... wrote:

> Thank you for your article. >>>

 

It's only a diagram of how herb tastes effect a particular aspect of

the pulse. The general info about herbs and their relation to organs

will fill in the rest.

 

 

>>> But what I meant by my somewhat whimsical though serious

question was: Has anyone ever tried to read the " pulse " of a plant?

A living plant, growing in dirt. >>>

 

Sorry, didn't get that. And have never tried it . . . even in the

60s ;-) But I would guess that someone on this forum has in the past.

 

 

>>> I don't know if it's possible, though I do know that Sri Lanka

has a tradition of acupuncturing plants. Seems to me it would

potentially be easier to read a plant's pulse than to check its

tongue. >>>

 

Sounds too whimsical. But there are shamanistic practices where you

connect to the consciousness of a plant. You might want to talk to

your local Shaman. They must have some left in AZ.

 

 

>>> And how do you manage to read pulses shortly after patients

drink herb decoctions? Do you brew the herbs yourself? >>>

 

No, I just take concentrated powders in capsules. If you've done qi

gong for a while, you should be sensitive enough to do it. I do it

on myself, sometimes patients, and on another practitioner who rents

in my office. The only problem is in adjusting the formula more than

a few times. Taking repeated doses changes the pulse too much from

the original baseline.

 

 

 

Jim Ramholz

[Guest guest]

Joseph,

I think you were at my talk at the CHA conference. If you'll

remember, I spoke about how different pulse maps were designed for

primarily internal medicine (Li Shih-zhen), or primarily channel-based

treatment (acumoxatherapy). The Nan Jing, difficulty 18, lists both

channel relationships via five phase, and three depths (heaven human

earth), and the upper middle and lower burner pulses (inch, bar, cubit).

 

There isn't really a conflict. We discussed this yesterday at my

seminar in Seattle. Many students and practitioners think that pulse

reading is 'inaccurate, subjective, and/or unnecessary " because of

variances in different pulse maps. When you go deeper, you see that

rumors of conflict are largely unjustified.

 

 

On Monday, August 25, 2003, at 11:01 AM, acugrpaz wrote:

 

>

>

> As usual, you make a fine and trenchant point. How do we calibrate

> pulse-taking? It seems to me that a consensus of calibration can come

> through a reading

> of pulse depths. The two major systems of Li Shi Zhen and its

> offshoots, and

> the Nan Jing and its offshoots, differ not only on what is read at what

> position but on how to read depths. The Li Shi Zhen school divides the

> pulse into

> three major depths--qi, blood, yin, something like that. The Nan Jing

> school

> divides the pulse into yin and yang depths. It seems to me that a

> minimum level of

> mastery at pulse reading would be to take these depth subdivisions one

> step

> further in each case. In other words, be able to read each of the

> three depths

> of qi, blood and yin, and then further subdivide and distinguish qi,

> blood and

> yin depths within each of the three major subdivisions. Or read the

> pulse

> depths as yang above and yin below, then further divide each depth

> into yin and

> yang. Say the L.Ac. practitioner must be able to demonstrate

> consistent reading

> of the major subdivisions of depth, and the DAOM must be able to go one

> division better. This of course does not cover all the bases of pulse

> reading, but

> it seems to me to at least be a good point ofordiscussion. By the way,

> has

> anyone ever tried to read the pulse of an herb?

[Guest guest]

Z'ev,

I agree with you wholeheartedly. As teachers and as a field, I think it

behooves us to spread the word about pulse reading that it actually does make

sense, and that different maps can be reconciled, at least for the most part. I

look forward to reading your article with glee. I believe this particular

project

of clarifying pulse diagnosis needs to be supported enthusiastically, and

that doing so will help our field to no end. As a field (though not necessarily

as individuals), we have presented pulse reading as though it is the Rosetta

stone of diagnosis, but we have stumbled badly in translating and teaching the

" hieroglyphs. "

Joseph Garner

 

>>>Joseph,

   I think you were at my talk at the CHA conference.  If you'll

remember, I spoke about how different pulse maps were designed for

primarily internal medicine (Li Shih-zhen), or primarily channel-based

treatment (acumoxatherapy).  The Nan Jing, difficulty 18, lists both

channel relationships via five phase, and three depths (heaven human

earth), and the upper middle and lower burner pulses (inch, bar, cubit).

 

There isn't really a conflict.  We discussed this yesterday at my

seminar in Seattle.  Many students and practitioners think that pulse

reading is 'inaccurate, subjective, and/or unnecessary " because of

variances in different pulse maps.  When you go deeper, you see that

rumors of conflict are largely unjustified.

 

<<<

 

 

 

[Guest guest]

Z'ev and Joseph and list

 

fascinating...

 

I got your conference tape (traditional chinese herbs - well recommended and it

is nice to put a sound to the letters, but more importantly for me the

conference is very useful.

 

These days I often think about what you mention with regard to feeling the

pulse and the life of the patient...

 

Looking forward to your book when?

 

and to Jims books as well, When?

 

Will are you coming out with a pulse book?

 

Marco

[Guest guest]

, " Marco " wrote:

> and to Jim's books as well, When? >>>

 

 

Marco:

 

The book is slow going, but I hope to have it out by Fall of 2004.

It includes the articles I've already written and things that I

teach in seminar that are only in draft right now.

 

In the Dong Han system, we always look at pulses from the

perspective of organs, channels, and many other methods. It's all

about how the patient presents.

 

For example, chapter 18 of the Nan Jing sets the foundation for both

channel and organ perspectives in the pulse; but if you look at the

diagram in the Unschuld translation [p.256], something is inherently

missing. We know that the channels traverse the entire body but

appear to be found in the diagram only in their respective 5-Element

position. This can make for some confusion since channel problems

can be found in all three jiaos.

 

What's left out or not discussed in the Nan Jing is that we can

reiterate the upper, middle, and lower jiao in each position---

distal, middle, and proximal. If we diagram this out, when we look

at it along with the heaven, earth, and man divisions, we have a 9-

sector tic-tac-toe pattern in each position. This 9-sector model

looks at the entire body from the perspective or its respective

channel. Those who have read Jiang Jing's article, " A Brief Survey

of the Korean Dong Han System of Pulse Diagnosis " (Oriental Medicine

Journal, Spring 1993), may remember some of those diagrams since

this concept is an innovation that he has used and developed for

many years. I'll try to an original find a copy and post it to the

forum files.

 

But we can go one better than the Nan Jing---not everything is

written down in the classics---by adding left and right to the 9-

sector diagram to make a cube of 27 sectors. The 27-sector cube

reiterates the whole body in each position of the three jiaos. This

is actually a " basic unit " of the Dong Han system. Whereas left and

right are usually taken to mean left and right wrists in TCM, we can

now look at left and right from the perspective of each channel by

dividing each position into center, left, and right---along with

heaven, earth, man and upper, middle, and lower jiao. In past CHA

postings, I've sometimes refered to these models without decribing

them in detail. Then, the zang and fu depths of each position can be

divided into 9- or 27-sectors; yeilding 18 and 54 sectors per

position. In this way, you can look at the whole body from the

perspective of any organ or any channel. Later, after you learn

these, things get more complicated.

 

While smaller sectors are more difficult to read at the beginning,

each division multiplies the clinical information available from

each position. These 9-sector and 27-sector models are fractal

dimensions of the whole position and of the whole body. Each sector

provides the first data for diagnosis---as realtors say, " location,

location, location " ---and can be looked at independently of the

others. This is how I developed my thyroid shortcut that I've

written about elsewhere. Even though there is no thyroid pulsein

classical Chinese literature, per se, by using this method, we can

tell whether a thyroid is hypo or hyper. We can correctly monitor

their medication dosage.

 

While it takes time for someone to learn and develop the sensitivity

to use these models effectively, with perseverence, it can be done,

and it will change the way you practice CM. In my seminars, I go

into much more detail about clinical applications for these models.

 

 

Jim Ramholz

[Guest guest]

Z'ev wrote:

 

> I think you were at my talk at the CHA conference.  If you'll

> remember, I spoke about how different pulse maps were designed for

> primarily internal medicine (Li Shih-zhen), or primarily channel-based

> treatment (acumoxatherapy). 

 

I wouldn't mind seeing something like this in graphic form. I'll be

teaching an Oriental Diagnosis class next quarter and would like to be

able to address this technique as well. It isn't something that I use

very often, though I'd like to learn it. My style is pretty much the

zang-fu style that is most commonly taught.

 

Z'ev you can probably upload a graphic file to the site

without having to send it through to the list. Once it has been

uploaded, a notice will go out to the list such as what Jim Ramholz did

yesterday.

 

--

 

Pain is inevitable, suffering is optional.

-Adlai Stevenson

 

 

 

[Guest guest]

>

 

HI Marco -

 

Yes, I am releasing a book entitled 'Neoclassical Pulse Diagnosis' -

unpredicted release date - it deals with analysis of the ying, wei and yuan qi

plus

other discourse. Acupuncture Today has the bare bones material on this. It is

original research that has clinical confirmation while retaining authentic

segments of Chinese Traditional Medicine.

 

This is distinctly different from the trademark TCM that is the attempt by

the Chinese government to reduce the complex mansion of Chinese medicine with

it's many floors and rooms down into the play pen of 'TCM'....at least this is

the metaphor Paul Unschuld uses in his German release " Was Is Medezine? " BTW I

practice and enjoy 'TCM.' And - I agree with Unschuld's characterization of

the impact of western scientific logic (internally consistent thinking) applied

to the profoundly heterogeneous body of Chinese Traditional Medicine (CTM).

 

Best regards,

 

Will Morris...

 

 

 

 

 

 

 

[Guest guest]

Hi

 

can anyone help me out with improving my calibration.

 

I use the skills as laid out in Tranceformations, but there's not a lot

there to play with.

 

Does anyone have any advice ?

 

 

 

 

Warm Regards

 

 

Simon