pulse diagnosis

[Guest guest]

This is some material on the choppy pulse I have been working on

recently....please feel free to comment as I am particularly interested in

collegial discussion regarding pulse diagnosis in light of the recent

conversations regarding signs.

 

Sincerely,

Will Morris

 

Choppy

 

The pulse feels rough under the finger as if the wave had a jagged edge to it .

This is the sensation described as choppy by Hammer and Maccioccia both of whom

studied under John Shen.

 

The choppy quality as described in the standard literature includes features

such

as changing rate at rest, changing amplitude/intensity, slow, fine, and changing

qualities.

 

Wang shu-he describes the choppy pulse as follows : it is fine and slow, coming

and going with difficulty and scattered or with an interruption, but has the

ability to recover. (Other versions of the Mai Jing describe it as short and

floating or another version describes it as short with interruption or

scattered).

 

This results in a confused state for some practitioners that may find some

resolution as we pick through the remains.

 

The features listed below are categorized separately by Hammer. The description

of choppy tends to vary widely in the literature, here are a few of the

characterizations of the choppy pulse, some are paraphrased for organizational

purposes.

 

1) Changing rate at rest is categorized under rhythm and rate by Hammer, it is a

clear indication of a choppy pulse in the literature. Hammer gives this quality

a

psychological interpretation as does Shen in the form of emotional instability

and nervousness of the Heart. This may be classified as a mild Heart Qi Xu

causing the Blood Stasis due to insufficient or uneven pumping power due to

weakness or agitation of the Qi.

2) Slow is categorized under rate by Hammer, the literature refers to Cold, and

will be dealt with in greater detail under the discussion of rate. Suffice to

say

that clinical experience and what I have learned from both Hammer and Shen

suggest that there are other distinct possibilities.

3) Fine is primarily referring to width, Hammer refers to it as thin. The

reduced

blood volume represented by the thin pulse may result in Blood stasis.

4) Changing amplitude (frequently mistaken for a missed beat if held to

superficially) is classified under stability.

5) Changing qualities are also classified under stability.

6) Scattered

 

These features may lead to the conclusion that since there are differing

qualities for blood stasis, there may also be different etiologies for the

condition of Blood Stasis.

1) Blood stasis due to Blood Deficiency may have a thin quality in combination

with the slight changing rate at rest, or any other features reflecting

roughness, instability and/or lack of continuity.

2) Blood stasis due to Qi deficiency may have changing rate at rest, changing

amplitude, changing qualities.

3) Damage to the Luo Mai may have the rough, jagged quality in the wave that

Hammer and Maccioccia describe.

4) Blood stasis due to profound deficiencies of multiple essential substances

may

be found with the scattered pulse. Other features such as changing rate at rest

should be found concomitantly. This is a very serious condition that is of poor

prognosis.

5) Qi stagnation leading to Blood Stagnation should have a taut to tense pulse

in

combination with some of the above aspects.

6) Damp Heat causing Blood Stasis may have a more slippery quality. The slippery

quality in the Blood depth may also indicate Blood Stasis.

 

 

Maccioccia G. The Foundations of . Pp 168. Churchill

Livingstone 1994.

Wang Shu-he. Translated by Yang Shou-zhang. The Pulse Classic. Pp. 4. Blue

Poppy Press 1997.

[Guest guest]

Z'ev: at Yo San, we have had lots of requests from students for more pulse

diagnosis (we actually devote a large part of our 56-hour diagnosis class to

the pulse, and part of our 168-hour Principles and Theories course, but it is

not enough), but we have not found a way for them to feel enough pulses. It

is not helpful for them to continually feel the pulses of their classmates;

it would be more helpful to feel pulses of actual patients (which they do, of

course in the observation and practice internship phases). Without divulging

PCOM's secrets, do you have any good ideas on how to accomplish this, either

at the Masters level or the doctorate? We thought about asking each student

to bring in a patient each week but not sure if that is practical.

 

Julie Chambers, L.Ac.

[Guest guest]

Julie,

This is something that is a work-in-progress, lots of research, adding

and subtracting material to cirriculi. I'll be glad to share more with you

as this process becomes more clarified. In the meantime, I think an entire

semester should be devoted to pulse diagnosis alone, at the masters level.

 

 

 

 

>Z'ev: at Yo San, we have had lots of requests from students for more pulse

>diagnosis (we actually devote a large part of our 56-hour diagnosis class to

>the pulse, and part of our 168-hour Principles and Theories course, but it is

>not enough), but we have not found a way for them to feel enough pulses. It

>is not helpful for them to continually feel the pulses of their classmates;

>it would be more helpful to feel pulses of actual patients (which they do, of

>course in the observation and practice internship phases). Without divulging

>PCOM's secrets, do you have any good ideas on how to accomplish this, either

>at the Masters level or the doctorate? We thought about asking each student

>to bring in a patient each week but not sure if that is practical.

>

>Julie Chambers, L.Ac.

>

[Guest guest]

Anecdotes -

I once met a Tibetan traditional physician (he was physician to His

Holiness the Karmapa) - he practiced an ancient style of medicine

coming from the Bon (a tradition in Tibet before Buddhism arrived).

 

His ability to diagnose disease from the signs and symptoms was

extraordinary and at times seemed like magic. He could diagnose any

case after examining a sample of the patients urine. He did not need

to see the patient or hear the symptoms - a beaker of urine was enough.

He could tell anyone everything about their past and future from the

pulse. He described my mother and father perfectly from my pulse - he

even pointed out the thyroid disease running in my mother's family -

that I inherited - he could even tell that I was supplementing with

thyroid hormone. People are often unbelieving when they hear such

stories - but I assure you that human physiology has been understood

by some individuals beyond ordinary experience - in fact there are

ancient sciences that have systematized every aspect of the human

experience. We will be centuries learning the meaning and validity of

all of this vast knowledge.

 

I think I told here before about a famous Swami in Gujarat state India

who can diagnose without even looking or speaking directly to the

patients. He is a celibate monk and is not allowed to speak to women

yet he gives free medical consultation every morning to dozens of

women. He does this by asking the ladies to set along a wall on a

bench - he walks by with an assistant doctor who writes down the

Swami's diagnosis and prescription for the case - he never looks

directly at the patients he only sees them out of the corner of his

eye - noone would ever know he was paying very close attention to

these ladies - but he was and could give a full explanation for what

he 'saw' yet it was impossible to observe he was doing that.

 

Another example was an old style Chinese doctor in LA who diagnosed by

smell - he would smell the patients breath, hair, ears - and give a

perfect TCM diagnosis of the organ patterns (he also was able to

diagnose by the urine - emphasizing the smell).

 

There are so many things we have to learn in this life - sometimes we

are so backward in these matters that it is not even possible to know

the levels of ignorance and poor observation that we suffer under.