learning how to take the pulse

November 26, 2009

Bob

Practitioners need to be very careful with tongue diagnosis.

Through years of focused practice with Ba Gua Fa I have found similarly to

Arya Nielsen that tongue signs can and do change instantly uncovering the

REAL tongue diagnosis which was covered over.

None of this is taught in schools primarily because the teachers DO NOT

know anything about it and most have never experienced any of the kind.

Richard

In a message dated 11/26/2009 12:32:27 P.M. Eastern Standard Time,

boblindeherbalist writes:

Perhaps a need but maybe not urgent. I have been in practice about 8 years

and find that questioning and tongue to be all I need most of the time (and

I work mostly with internal medicine). I find most folks are on

prescription drugs that alter the pulse to include the rate. Also seem great

stuff

with the Hammer pulse, but requires a 30-45 minute analisis...not practical

in most cases. So nice to learn, great tool, some folks really gravitate to

that and excel at it. Others gravitate to ear, hara, facial and many other

tools. I enjoyed learning to sensitize my fingers by placing a hair under a

page in the phone book, adding page after page. Finally I got to ten pages

after a few months. Never tried harder than that.

Be well,

Bob

Robert Linde, AP, RH

Professional Herbalists Training Program

Acupuncture & Herbal Therapies

901 Central Ave

St. Petersburg, FL 33705

www.acuherbals.www

727-551-0857

--- On Thu, 11/26/09, C. Zinnia <_cmszinnia_

(cmszinnia) > wrote:

C. Zinnia <_cmszinnia_ (cmszinnia) >

learning how to take the pulse

_Traditional_Traditional_<WBRTraditional_Tra_

(Chinese Medicine )

Thursday, November 26, 2009, 12:18 PM

I have devoted considerable time trying to learn how to take the pulse

because I see it as an essential diagnostic tool. I have studied with 2 Leon

Hammer teachers, Niki Bilton and now have found some one who knows the

Jeffrey Yuen system. What I have gathered intellectually is that each system

will give you similar information.

I have been completely frustrated in my efforts to learn. It may be that I

do not have a lot of tactile sensitivity or it may be that I was never

able to feel enough pulses in those classes to get really secure in my

judgements.

I still take patients pulses and now write down my own impressions rather

than getting caught up in the " official " names because I an not sure enough

of any thing but the most basic aspects. I am have trained myself to

remember people's pulses and to be able to know when two people have similar

pulses so I can start building a diagnostic base.

Enough said about me.

What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

Zinnia

[Non-text portions of this message have been removed]

November 26, 2009

I have devoted considerable time trying to learn how to take the pulse because I

see it as an essential diagnostic tool. I have studied with 2 Leon Hammer

teachers, Niki Bilton and now have found some one who knows the Jeffrey Yuen

system. What I have gathered intellectually is that each system will give you

similar information.

I have been completely frustrated in my efforts to learn. It may be that I do

not have a lot of tactile sensitivity or it may be that I was never able to feel

enough pulses in those classes to get really secure in my judgements.

I still take patients pulses and now write down my own impressions rather than

getting caught up in the " official " names because I an not sure enough of any

thing but the most basic aspects. I am have trained myself to remember people's

pulses and to be able to know when two people have similar pulses so I can start

building a diagnostic base.

Enough said about me.

What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

Zinnia

November 26, 2009

Perhaps a need but maybe not urgent. I have been in practice about 8 years and

find that questioning and tongue to be all I need most of the time (and I work

mostly with internal medicine). I find most folks are on prescription drugs that

alter the pulse to include the rate. Also seem great stuff with the Hammer

pulse, but requires a 30-45 minute analisis...not practical in most cases. So

nice to learn, great tool, some folks really gravitate to that and excel at it.

Others gravitate to ear, hara, facial and many other tools. I enjoyed learning

to sensitize my fingers by placing a hair under a page in the phone book, adding

page after page. Finally I got to ten pages after a few months. Never tried

harder than that.

Be well,

Bob

Robert Linde, AP, RH

Professional Herbalists Training Program

Acupuncture & Herbal Therapies

901 Central Ave

St. Petersburg, FL 33705

www.acuherbals.com

727-551-0857

--- On Thu, 11/26/09, C. Zinnia <cmszinnia wrote:

C. Zinnia <cmszinnia

learning how to take the pulse

Chinese Medicine

Thursday, November 26, 2009, 12:18 PM

Â

I have devoted considerable time trying to learn how to take the pulse because I

see it as an essential diagnostic tool. I have studied with 2 Leon Hammer

teachers, Niki Bilton and now have found some one who knows the Jeffrey Yuen

system. What I have gathered intellectually is that each system will give you

similar information.

I have been completely frustrated in my efforts to learn. It may be that I do

not have a lot of tactile sensitivity or it may be that I was never able to feel

enough pulses in those classes to get really secure in my judgements.

I still take patients pulses and now write down my own impressions rather than

getting caught up in the " official " names because I an not sure enough of any

thing but the most basic aspects. I am have trained myself to remember people's

pulses and to be able to know when two people have similar pulses so I can start

building a diagnostic base.

Enough said about me.

What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

Zinnia

November 26, 2009

Seems to work for me. I look at tongues stick with what I was taught and people

get better.

Be well,

Bob

Robert Linde, AP, RH

Professional Herbalists Training Program

Acupuncture & Herbal Therapies

901 Central Ave

St. Petersburg, FL 33705

www.acuherbals.com

727-551-0857

--- On Thu, 11/26/09, acudoc11 <acudoc11 wrote:

acudoc11 <acudoc11

Re: learning how to take the pulse

Chinese Medicine

Thursday, November 26, 2009, 12:42 PM

Â

Bob

Practitioners need to be very careful with tongue diagnosis.

Through years of focused practice with Ba Gua Fa I have found similarly to

Arya Nielsen that tongue signs can and do change instantly uncovering the

REAL tongue diagnosis which was covered over.

None of this is taught in schools primarily because the teachers DO NOT

know anything about it and most have never experienced any of the kind.

Richard

In a message dated 11/26/2009 12:32:27 P.M. Eastern Standard Time,

boblindeherbalist@ writes:

Perhaps a need but maybe not urgent. I have been in practice about 8 years

and find that questioning and tongue to be all I need most of the time (and

I work mostly with internal medicine). I find most folks are on

prescription drugs that alter the pulse to include the rate. Also seem great

stuff

with the Hammer pulse, but requires a 30-45 minute analisis...not practical

in most cases. So nice to learn, great tool, some folks really gravitate to

that and excel at it. Others gravitate to ear, hara, facial and many other

tools. I enjoyed learning to sensitize my fingers by placing a hair under a

page in the phone book, adding page after page. Finally I got to ten pages

after a few months. Never tried harder than that.

Be well,

Bob

Robert Linde, AP, RH

Professional Herbalists Training Program

Acupuncture & Herbal Therapies

901 Central Ave

St. Petersburg, FL 33705

www.acuherbals. www

727-551-0857

--- On Thu, 11/26/09, C. Zinnia <_cmszinnia (AT) gmail (DOT) cms_

(cmszinnia (AT) gmail (DOT) com) > wrote:

C. Zinnia <_cmszinnia (AT) gmail (DOT) cms_ (cmszinnia (AT) gmail (DOT) com) >

learning how to take the pulse

_Traditional_ Traditional_ <WBRTraditional_ Tra_

(Traditional_ Chinese_Medicine )

Thursday, November 26, 2009, 12:18 PM

I have devoted considerable time trying to learn how to take the pulse

because I see it as an essential diagnostic tool. I have studied with 2 Leon

Hammer teachers, Niki Bilton and now have found some one who knows the

Jeffrey Yuen system. What I have gathered intellectually is that each system

will give you similar information.

I have been completely frustrated in my efforts to learn. It may be that I

do not have a lot of tactile sensitivity or it may be that I was never

able to feel enough pulses in those classes to get really secure in my

judgements.

I still take patients pulses and now write down my own impressions rather

than getting caught up in the " official " names because I an not sure enough

of any thing but the most basic aspects. I am have trained myself to

remember people's pulses and to be able to know when two people have similar

pulses so I can start building a diagnostic base.

Enough said about me.

What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

Zinnia

November 26, 2009

Chinese Medicine , " Bob Linde, AP, Herbalist "

<boblindeherbalist wrote:

>

" Perhaps a need but maybe not urgent. I have been in practice about 8 years and

find that questioning and tongue to be all I need most of the time (and I work

mostly with internal medicine). I find most folks are on prescription drugs that

alter the pulse to include the rate. "

ditto

me too

To which I would add " the gentle observation of non-verbals " and reasonable

palpatory skills

I consider reliance upon poorly taught pulse-taking skills, using any number of

hybridized pulse theories - often the case in my experience - to be at best an

educated guess, and potentially a highly subjective experience.

The pulse is not the be-all and end-all of our information gathering skills.

I consider reliance upon the pulses as a final arbiter in a TCM diagnostic

process to be as foolish as an MD determining treatment based on a single set of

blood test results, or a single blood pressure reading. I'd be saying this if

I'd been taught by every pulse Master in the history of our medicine.

It is possible to be a very effective practitioner without having sophisticated

pulse-taking skills.

Afterall, which pulse 'theory' is one to embrace?

And will the theory or model I/we study and understand today, be the one which

works for me/us and our patients in 50 years time?

And will the teachers and masters of these skills have left their hubris at

home?

I've observed that effective practitioners do the following:

- treat patients as individuals

- gather a great deal of information and seek to understand its relelvance to

the individual, within that person's unique 'context'

- treat what is, not what is most likely

- never assume

- always continue to learn

- look for, acknowledge, and address their mistakes, oversights and omissions

Go well everyone...

Margi Macdonald

http://margihealing.wordpress.com/

November 27, 2009

I beg to differ, in the strongest possible terms.

Pulse diagnosis is the core diagnostic skill, and we ignore it at our peril.

In my own practice, and that of my teachers, we first take the pulse to uncover

information about the patient that isn't biased by their own presumptions or

medical reports. Then, we can confirm with questioning, palpating the abdomen,

color, sound, etc. To dismiss the pulse because of pharmaceutical influences is

a cop-out, because that information is important, and doesn't usually obscure

other information available in the pulse.

It is possible to learn more than one pulse system, that is correct, but if one

is taught correctly one doesn't need to be confused.

As you point out, it is largely a problem of education. So let's do something

about making accurate pulse diagnostic systems available to our Chinese medicine

community, instead of minimizing its importance because it is being taught and

practiced in a sloppy manner at large. Pulse diagnosis is one of the tools that

distinguishes our profession from many other healing systems.

---- " margi.macdonald " <margi.macdonald wrote:

>

> Chinese Medicine , " Bob Linde, AP,

Herbalist " <boblindeherbalist wrote:

> >

> " Perhaps a need but maybe not urgent. I have been in practice about 8 years

and find that questioning and tongue to be all I need most of the time (and I

work mostly with internal medicine). I find most folks are on prescription drugs

that alter the pulse to include the rate. "

>

> ditto

> me too

> To which I would add " the gentle observation of non-verbals " and reasonable

palpatory skills

>

> I consider reliance upon poorly taught pulse-taking skills, using any number

of hybridized pulse theories - often the case in my experience - to be at best

an educated guess, and potentially a highly subjective experience.

>

> The pulse is not the be-all and end-all of our information gathering skills.

>

> I consider reliance upon the pulses as a final arbiter in a TCM diagnostic

process to be as foolish as an MD determining treatment based on a single set of

blood test results, or a single blood pressure reading. I'd be saying this if

I'd been taught by every pulse Master in the history of our medicine.

>

> It is possible to be a very effective practitioner without having

sophisticated pulse-taking skills.

> Afterall, which pulse 'theory' is one to embrace?

> And will the theory or model I/we study and understand today, be the one which

works for me/us and our patients in 50 years time?

> And will the teachers and masters of these skills have left their hubris at

home?

>

> I've observed that effective practitioners do the following:

> - treat patients as individuals

> - gather a great deal of information and seek to understand its relelvance to

the individual, within that person's unique 'context'

> - treat what is, not what is most likely

> - never assume

> - always continue to learn

> - look for, acknowledge, and address their mistakes, oversights and omissions

>

> Go well everyone...

>

> Margi Macdonald

> http://margihealing.wordpress.com/

>

November 27, 2009

Lonny

I am in agreement with the great value of pulse diagnosis.

But please do not reduce tongue to a much lesser value.

When one knows what you know in pulse dx - in tongue dx....a great deal

more is revealed.

The so-called better that might be reported in tongue can be gotten

instantly with Ba Gua Fa (Gua Sha and cupping) and THEN the hidden tongue signs

show up.

Richard

In a message dated 11/27/09 9:04:47 A.M. Eastern Standard Time,

Revolution writes:

Lonny: This, of course, depends on what one considers " better " . The pulse

has tremendous and nuanced predictive value far into the future in a way

the tongue and other parameters simply do not. I've studied pulse 30 years

and 24 of that in full time clinical practice. I'm daily thankful for the

time Ive put in and humbled by the infinite depth that pulse diagnosis

provides. The pulse is a fundamental and irreplaceable part of the glue that

makes

Chinese medicine the most sophisticated holistic and integral medicine on

earth. Without it, true predictive validity is gone and one is incapable of

responding to the largest possible picture. Without pulse one can respond

to a degree in accordance with what is there now but one's capacity to

account for the past and the future is greatly limited.

November 27, 2009

Bob Linde: " Perhaps a need but maybe not urgent. I have been in practice about 8

years

and find that questioning and tongue to be all I need most of the time (and

I work mostly with internal medicine).

Lonny: Well, you never know what you don't know. I'd think humility would be

appropriate in the face of one of the greatest diagnostic and predictive

paradigms in the 4000 year evolution of medicine.

Bob: I find most folks are on

prescription drugs that alter the pulse to include the rate.

Lonny: The argument that " many people are on drugs and this renders pulse

diagnosis irrelevant " is wrong. In fact, it argues FOR pulse diagnosis. If I

know a patient is on a drug pulse diagnosis can reveal how it's effecting the

system and what to do as a response. If someone is taking steroids and I see

increased dampness on the pulse I can respond in an organ specific way both for

short term and long term medications. Responding to the effects of drugs are no

different than to that of diet or lifestyle choices. Their immediate and long

term effects are a fact of physiology that can be read on the pulse. if a

patient's pulse evidences yinxu, a suppressed wave form, and heat, one treats

for that, even if the findings are contributed to by a drug.

Bob: I look at tongues stick with what I was taught and people get better.

Lonny: This, of course, depends on what one considers " better " . The pulse has

tremendous and nuanced predictive value far into the future in a way the tongue

and other parameters simply do not. I've studied pulse 30 years and 24 of that

in full time clinical practice. I'm daily thankful for the time Ive put in and

humbled by the infinite depth that pulse diagnosis provides. The pulse is a

fundamental and irreplaceable part of the glue that makes Chinese medicine the

most sophisticated holistic and integral medicine on earth. Without it, true

predictive validity is gone and one is incapable of responding to the largest

possible picture. Without pulse one can respond to a degree in accordance with

what is there now but one's capacity to account for the past and the future is

greatly limited.

November 27, 2009

Hi Zinnia,

I can understand your frustration. Pulse is a very difficult art/science to

learn and especially master. But I would very much encourage you to continue

with your studies. I am not sure when you took your classes in CCPD, but

generally it is ideal for there to be some ongoing instruction, at least in the

form of communication with your teacher, and ideally with repeated classes.

Sometimes this is difficult as classes are hard to fill due to what many

perceive as an intimidating subject to learn.

As a certified teacher of CCPD who has been teaching it for a number of years,

(and who remembers the process of learning it), I can relate. And I do think

it's great to learn other pulse systems, too. I have taken classes and practice

other systems concurrently with CCPD, especially Jeffrey's system. What I have

found is that each system actually provides a very different approach to

diagnosis but that they can very readily be integrated into a complete

diagnostic and treatment strategy. I recently wrote a blog post on this exact

topic blending CCPD and Jeffrey's pulse system into a case study. You can find

it here:

http://rossrosen.blogspot.com/2009/11/pulling-it-all-together-ccpd-com-ccm.html

So, I encourage you to keep the pulse training up, keep using it with your

patients, and trust what you feel. This is paramount. I would also like to

invite you to my next pulse class. It is for those who have taken the beginning

weekends already. I will be advertising it soon, but the dates are Jan 9-10 at

my office in New Jersey. Personally, I feel that pulse provides the most

rounded and sophisticated and detailed information about a patient. Yes, it is

one of the four major pillars, but a crucial one at that. It is what I use to

tie all the others together and explain the interrelationships, past, present

and future.

I hope you'll join us in Jan, or at least continue your studies of the pulse.

Good luck.

Ross

Chinese Medicine , " C. Zinnia " <cmszinnia

wrote:

>

> I have devoted considerable time trying to learn how to take the pulse because

I see it as an essential diagnostic tool. I have studied with 2 Leon Hammer

teachers, Niki Bilton and now have found some one who knows the Jeffrey Yuen

system. What I have gathered intellectually is that each system will give you

similar information.

>

> I have been completely frustrated in my efforts to learn. It may be that I do

not have a lot of tactile sensitivity or it may be that I was never able to feel

enough pulses in those classes to get really secure in my judgements.

>

> I still take patients pulses and now write down my own impressions rather than

getting caught up in the " official " names because I an not sure enough of any

thing but the most basic aspects. I am have trained myself to remember people's

pulses and to be able to know when two people have similar pulses so I can start

building a diagnostic base.

>

> Enough said about me.

>

> What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

>

> Zinnia

>

November 27, 2009

Good points –

Why pursue an activity that doesn't make a difference in how we see the world?

Bob – I find placing a hair under the page of a book a rather peculiar practice.

And, the ability to palpate 10 pages deep and still feel the hair suggests to me

that your nervous system would be overloaded with data. From my perspective,

what you don't observe is equally if not more important than what you do

observe. Apparently, you agree. ;-)

If we gain clinical success using methods we find easy, then why pursue methods

that can be more difficult? In the end, we are dealing with medical

epistemology. Biological systems communicate in complex ways. Inquiry and

observation are a part of what has been used as the foundation of Chinese

medicine. Master T'ung did not use pulse. Each of us learns to practice in ways

that fill our clinical needs and meets our individual capacities.

If one is familiar with what I write and teach, it is apparent that I am biased

towards pulse diagnosis as a basis of practice. In my experience, it has led to

better results over my 28 years of pulse diagnosis study. Thus, I must ask, how

do we come to a resolution of the importance placed upon pulse by the authors of

the Long Shu, Nan Jing, Mai Jing, Qi Jing Ba Mai Kao and Bin Hu Mai Xue? For me,

the question is – what were these people talking about? Why such an emphasis?

How did this emphasis get lost in contemporary practice? Throughout the history

of Chinese medicine, there have been personalities who bemoan the loss of pulse

diagnostic skills. Z'ev, I thought for sure you would use this opportunity to

quote one of those people, Hsu Ta-ch'un.

Most students receive insufficient exposure to pulse diagnosis in TCM programs.

This leads to a lack of confidence, which leads to the use of other tools where

confidence is more easily gained.

The problem is not that any practitioner has determined through their

professional judgment to avoid a standard of practice. Rather, the problem is

that social systems that set forth standards in education about Chinese medicine

(in this case, pulse diagnosis) do not see value and the competencies are not

necessary for graduation, certification and licensure.

Warmly,

Will

William R. Morris, PhD, DAOM, LAc

http://pulsediagnosis.com/

http://www.aoma.edu/

http://taaom.org/

November 27, 2009

Zinnia -

I posted this on the pulse diagnosis list serve with no response. There are

reasons that pulse can be difficult to learn. Part of that relates to teaching

methods.

Dear All -

We just had a very successful weekend of Shen-Hammer pulse diagnosis here in

Austin at AOMA. The follow-up will be January 9th and 10th for those who have

already had the introductory weekend.

I regularly tweak the teaching methods which are mostly lecture, demonstration

and guided practice. The places where differences can be made in teaching this

work -- which arguably, is not easy -- are primarily in the sequencing and

pacing of information. Two years ago, I started teaching from the lower burner

up rather than beginning with the left distal position. This strategy allowed

for learners to gain more confidence early on. This weekend, we started with

unique qualities of the S-H system.

After the introductions, we went straight into the assessment of the blood depth

- blood unclear, blood heat and blood think. I left out full overflowing since

it is often an artifact of other patterns. We then went on to the cotton pulse

and the ropy pulse. After, that a general organization of the pulse

descriptions. This provided a nomenclature for describing the sensations that

would present as we progressively explored the S-H anatomical map from the lower

burner to the upper burner.

As an add, this weekend went the best of any class since I began teaching the

method in 1993. The students seems to agree, giving a perfect 100 score for the

class and the teaching across the board. This experience is based on my

foundation as an authorized teacher under Hammer between 1993 and 2000, and a

master degree in medical education from USC.

I discontinued in the role of a Dragon Rises authorized teacher due to

differences of opinion regarding nomenclature with Hammer. Another advantage of

teaching 'outside the fold' as it were, are greater flexibility in course

design, and of course, the use of more conventional nomenclature where

appropriate. But also, it allowed me to develop the Neoclassical system which

allows for a more comprehensive analysis of the channel systems, and answers

questions that S-H does not address. Examples of this latter include

interpretations for radial distortions of the artery in the right distal

position, and possible alternative interpretations for a positive mitral valve

prolapse, or a special lung pulse which fails to confirm clinically.

We have an obligation to make this material as clear as possible.

Warmly,

Will

--

William R. Morris, PhD, DAOM, LAc

http://pulsediagnosis.com/

http://www.aoma.edu/

http://taaom.org/

Chinese Medicine , " C. Zinnia " <cmszinnia

wrote:

>

> I have devoted considerable time trying to learn how to take the pulse because

I see it as an essential diagnostic tool. I have studied with 2 Leon Hammer

teachers, Niki Bilton and now have found some one who knows the Jeffrey Yuen

system. What I have gathered intellectually is that each system will give you

similar information.

>

> I have been completely frustrated in my efforts to learn. It may be that I do

not have a lot of tactile sensitivity or it may be that I was never able to feel

enough pulses in those classes to get really secure in my judgements.

>

> I still take patients pulses and now write down my own impressions rather than

getting caught up in the " official " names because I an not sure enough of any

thing but the most basic aspects. I am have trained myself to remember people's

pulses and to be able to know when two people have similar pulses so I can start

building a diagnostic base.

>

> Enough said about me.

>

> What are we going to do as a profession? How are we going to teach all

acupuncturists to read the pulse accurately? This is an urgent need.

>

> Zinnia

>

November 27, 2009

William,

Welcome back from China! I am in NY right now, so I don't have my medical

library with me, at least the non-digital portion. Xu Da-chun not only decried

the loss of pulse-taking skill, but also the loss of acupuncture skills as well.

Good source for an argument for more emphasis on pulse practice.

The last few semesters I've led the 'tongue and pulse club' for PCOM students,

sponsored by the Student Council. The students are very enthusiastic and happy

to see that one can trust one's own senses in developing their skills. I have

them keep journals and draw pictures of what they feel under their fingers, and

describe it visually rather than trying to conform to a pre-conceived idea of a

pulse image. I tell them that the 28 pulse qualities are the alphabet of

pulses, but the language, sentences, concepts of pulse diagnosis comes with

practice and experience.

You mention Master Tong's system that doesn't rely on pulse diagnosis. We

should remember that palpation of the channels comes from the same source as

pulse differentiation, since it involves the same channels. Paul Unschuld

translates mai zhen as 'movement in the vessels' rather than pulse

differentiation, because we are looking for the movement under our fingers, we

are touching the flow of qi, blood and information.

One final comment from an earlier posting, on the argument of 'treating what

you see'. Do we really want to limit ourselves to just a here-now picture of

illness? In Chinese medicine, all disorders are in flux, constant change, and

we need to see the entire picture, i.e. the pathomechanisms that led to the

disorder (bing yin/etiology or disease origin), and predict the further

development of the disorder (zhen hou, prognosis). Otherwise we can only treat

symptomatically. This is one of the arguments for studying such texts as the

Nan Jing and Shang Han Lun, they provide models (five phase, internal evils in

NJ, six channel progressions in SHL) that allow the physician to see the broader

picture of illness and treat accordingly.

---- William <wmorris33 wrote:

> Good points Â–

>

> Why pursue an activity that doesn't make a difference in how we see the world?

>

> Bob Â– I find placing a hair under the page of a book a rather peculiar

practice. And, the ability to palpate 10 pages deep and still feel the hair

suggests to me that your nervous system would be overloaded with data. From my

perspective, what you don't observe is equally if not more important than what

you do observe. Apparently, you agree. ;-)

>

> If we gain clinical success using methods we find easy, then why pursue

methods that can be more difficult? In the end, we are dealing with medical

epistemology. Biological systems communicate in complex ways. Inquiry and

observation are a part of what has been used as the foundation of Chinese

medicine. Master T'ung did not use pulse. Each of us learns to practice in ways

that fill our clinical needs and meets our individual capacities.

>

> If one is familiar with what I write and teach, it is apparent that I am

biased towards pulse diagnosis as a basis of practice. In my experience, it has

led to better results over my 28 years of pulse diagnosis study. Thus, I must

ask, how do we come to a resolution of the importance placed upon pulse by the

authors of the Long Shu, Nan Jing, Mai Jing, Qi Jing Ba Mai Kao and Bin Hu Mai

Xue? For me, the question is Â– what were these people talking about? Why such

an emphasis? How did this emphasis get lost in contemporary practice? Throughout

the history of Chinese medicine, there have been personalities who bemoan the

loss of pulse diagnostic skills. Z'ev, I thought for sure you would use this

opportunity to quote one of those people, Hsu Ta-ch'un.

>

> Most students receive insufficient exposure to pulse diagnosis in TCM

programs. This leads to a lack of confidence, which leads to the use of other

tools where confidence is more easily gained.

>

> The problem is not that any practitioner has determined through their

professional judgment to avoid a standard of practice. Rather, the problem is

that social systems that set forth standards in education about Chinese medicine

(in this case, pulse diagnosis) do not see value and the competencies are not

necessary for graduation, certification and licensure.

>

> Warmly,

>

> Will

>

> William R. Morris, PhD, DAOM, LAc

> http://pulsediagnosis.com/

> http://www.aoma.edu/

> http://taaom.org/

>

November 27, 2009

Almost all of the diagnostics written in the Nei jing are based on pulse

listening.... not on tongue reads. There are a few lines in the Shang han

lun describing tongues, but mainly pulses and abdominal reads. There is a

pulse classic, but no tongue classic.

Tongue reading is helpful, but if a pulse is changed by pharmaceuticals,

wouldn't the tongue reflect that as well?

K

On Fri, Nov 27, 2009 at 8:15 AM, <zrosenbe wrote:

>

> William,

> Welcome back from China! I am in NY right now, so I don't have my medical

> library with me, at least the non-digital portion. Xu Da-chun not only

> decried the loss of pulse-taking skill, but also the loss of acupuncture

> skills as well. Good source for an argument for more emphasis on pulse

> practice.

>

> The last few semesters I've led the 'tongue and pulse club' for PCOM

> students, sponsored by the Student Council. The students are very

> enthusiastic and happy to see that one can trust one's own senses in

> developing their skills. I have them keep journals and draw pictures of what

> they feel under their fingers, and describe it visually rather than trying

> to conform to a pre-conceived idea of a pulse image. I tell them that the 28

> pulse qualities are the alphabet of pulses, but the language, sentences,

> concepts of pulse diagnosis comes with practice and experience.

>

> You mention Master Tong's system that doesn't rely on pulse diagnosis. We

> should remember that palpation of the channels comes from the same source as

> pulse differentiation, since it involves the same channels. Paul Unschuld

> translates mai zhen as 'movement in the vessels' rather than pulse

> differentiation, because we are looking for the movement under our fingers,

> we are touching the flow of qi, blood and information.

>

> One final comment from an earlier posting, on the argument of 'treating

> what you see'. Do we really want to limit ourselves to just a here-now

> picture of illness? In Chinese medicine, all disorders are in flux, constant

> change, and we need to see the entire picture, i.e. the pathomechanisms that

> led to the disorder (bing yin/etiology or disease origin), and predict the

> further development of the disorder (zhen hou, prognosis). Otherwise we can

> only treat symptomatically. This is one of the arguments for studying such

> texts as the Nan Jing and Shang Han Lun, they provide models (five phase,

> internal evils in NJ, six channel progressions in SHL) that allow the

> physician to see the broader picture of illness and treat accordingly.

>

> ---- William <wmorris33 <wmorris33%40gmail.com>> wrote:

> > Good points –

> >

> > Why pursue an activity that doesn't make a difference in how we see the

> world?

> >

> > Bob – I find placing a hair under the page of a book a rather peculiar

> practice. And, the ability to palpate 10 pages deep and still feel the hair

> suggests to me that your nervous system would be overloaded with data. From

> my perspective, what you don't observe is equally if not more important than

> what you do observe. Apparently, you agree. ;-)

> >

> > If we gain clinical success using methods we find easy, then why pursue

> methods that can be more difficult? In the end, we are dealing with medical

> epistemology. Biological systems communicate in complex ways. Inquiry and

> observation are a part of what has been used as the foundation of Chinese

> medicine. Master T'ung did not use pulse. Each of us learns to practice in

> ways that fill our clinical needs and meets our individual capacities.

> >

> > If one is familiar with what I write and teach, it is apparent that I am

> biased towards pulse diagnosis as a basis of practice. In my experience, it

> has led to better results over my 28 years of pulse diagnosis study. Thus, I

> must ask, how do we come to a resolution of the importance placed upon pulse

> by the authors of the Long Shu, Nan Jing, Mai Jing, Qi Jing Ba Mai Kao and

> Bin Hu Mai Xue? For me, the question is – what were these people talking

> about? Why such an emphasis? How did this emphasis get lost in contemporary

> practice? Throughout the history of Chinese medicine, there have been

> personalities who bemoan the loss of pulse diagnostic skills. Z'ev, I

> thought for sure you would use this opportunity to quote one of those

> people, Hsu Ta-ch'un.

> >

> > Most students receive insufficient exposure to pulse diagnosis in TCM

> programs. This leads to a lack of confidence, which leads to the use of

> other tools where confidence is more easily gained.

> >

> > The problem is not that any practitioner has determined through their

> professional judgment to avoid a standard of practice. Rather, the problem

> is that social systems that set forth standards in education about Chinese

> medicine (in this case, pulse diagnosis) do not see value and the

> competencies are not necessary for graduation, certification and licensure.

> >

> > Warmly,

> >

> > Will

> >

> > William R. Morris, PhD, DAOM, LAc

> > http://pulsediagnosis.com/

> > http://www.aoma.edu/

> > http://taaom.org/

> >

>

--

www.tcmreview.com

November 27, 2009

Hey Kokko

Kokko said:

Almost all of the diagnostics written in the Nei jing are based on pulse

listening.... not on tongue reads. There are a few lines in the Shang

han lun describing tongues, but mainly pulses and abdominal reads.

There is a pulse classic, but no tongue classic.

Tongue reading is helpful, but if a pulse is changed by pharmaceuticals,

wouldn't the tongue reflect that as well?

Stephen:

Great points!!

And...yes, the tongue and coat change plenty due to pharmaceuticals as

well as food, herbs, mouth breathing, chewing habits etc.

Stephen Woodley LAc

www.shanghanlunseminars.com

--

http://www.fastmail.fm - The professional email service

November 27, 2009

John,

I wouldn't discount the importance of tongue diagnosis in clinical practice,

even as a later development of Chinese medicine. As you know, the Warm Disease

current relies a lot on the tongue, and it provides a different diagnostic

dimension from the pulse that is very valuable in internal medicine.

You might be interested in a Qing dynasty text that's available to view on

the Database site, cm-db.com, translated by Herman Oving,that

gives all of the tongue pictures for Shang Han Lun patterns ( " Tongue Pictures in

Cold Damage " ). It is very useful indeed. .

---- <johnkokko wrote:

> Almost all of the diagnostics written in the Nei jing are based on pulse

> listening.... not on tongue reads. There are a few lines in the Shang han

> lun describing tongues, but mainly pulses and abdominal reads. There is a

> pulse classic, but no tongue classic.

>

> Tongue reading is helpful, but if a pulse is changed by pharmaceuticals,

> wouldn't the tongue reflect that as well?

>

> K

>

> On Fri, Nov 27, 2009 at 8:15 AM, <zrosenbe wrote:

>

> >

> > William,

> > Welcome back from China! I am in NY right now, so I don't have my medical

> > library with me, at least the non-digital portion. Xu Da-chun not only

> > decried the loss of pulse-taking skill, but also the loss of acupuncture

> > skills as well. Good source for an argument for more emphasis on pulse

> > practice.

> >

> > The last few semesters I've led the 'tongue and pulse club' for PCOM

> > students, sponsored by the Student Council. The students are very

> > enthusiastic and happy to see that one can trust one's own senses in

> > developing their skills. I have them keep journals and draw pictures of what

> > they feel under their fingers, and describe it visually rather than trying

> > to conform to a pre-conceived idea of a pulse image. I tell them that the 28

> > pulse qualities are the alphabet of pulses, but the language, sentences,

> > concepts of pulse diagnosis comes with practice and experience.

> >

> > You mention Master Tong's system that doesn't rely on pulse diagnosis. We

> > should remember that palpation of the channels comes from the same source as

> > pulse differentiation, since it involves the same channels. Paul Unschuld

> > translates mai zhen as 'movement in the vessels' rather than pulse

> > differentiation, because we are looking for the movement under our fingers,

> > we are touching the flow of qi, blood and information.

> >

> > One final comment from an earlier posting, on the argument of 'treating

> > what you see'. Do we really want to limit ourselves to just a here-now

> > picture of illness? In Chinese medicine, all disorders are in flux, constant

> > change, and we need to see the entire picture, i.e. the pathomechanisms that

> > led to the disorder (bing yin/etiology or disease origin), and predict the

> > further development of the disorder (zhen hou, prognosis). Otherwise we can

> > only treat symptomatically. This is one of the arguments for studying such

> > texts as the Nan Jing and Shang Han Lun, they provide models (five phase,

> > internal evils in NJ, six channel progressions in SHL) that allow the

> > physician to see the broader picture of illness and treat accordingly.

> >

> > ---- William <wmorris33 <wmorris33%40gmail.com>> wrote:

> > > Good points Â–

> > >

> > > Why pursue an activity that doesn't make a difference in how we see the

> > world?

> > >

> > > Bob Â– I find placing a hair under the page of a book a rather peculiar

> > practice. And, the ability to palpate 10 pages deep and still feel the hair

> > suggests to me that your nervous system would be overloaded with data. From

> > my perspective, what you don't observe is equally if not more important than

> > what you do observe. Apparently, you agree. ;-)

> > >

> > > If we gain clinical success using methods we find easy, then why pursue

> > methods that can be more difficult? In the end, we are dealing with medical

> > epistemology. Biological systems communicate in complex ways. Inquiry and

> > observation are a part of what has been used as the foundation of Chinese

> > medicine. Master T'ung did not use pulse. Each of us learns to practice in

> > ways that fill our clinical needs and meets our individual capacities.

> > >

> > > If one is familiar with what I write and teach, it is apparent that I am

> > biased towards pulse diagnosis as a basis of practice. In my experience, it

> > has led to better results over my 28 years of pulse diagnosis study. Thus, I

> > must ask, how do we come to a resolution of the importance placed upon pulse

> > by the authors of the Long Shu, Nan Jing, Mai Jing, Qi Jing Ba Mai Kao and

> > Bin Hu Mai Xue? For me, the question is Â– what were these people talking

> > about? Why such an emphasis? How did this emphasis get lost in contemporary

> > practice? Throughout the history of Chinese medicine, there have been

> > personalities who bemoan the loss of pulse diagnostic skills. Z'ev, I

> > thought for sure you would use this opportunity to quote one of those

> > people, Hsu Ta-ch'un.

> > >

> > > Most students receive insufficient exposure to pulse diagnosis in TCM

> > programs. This leads to a lack of confidence, which leads to the use of

> > other tools where confidence is more easily gained.

> > >

> > > The problem is not that any practitioner has determined through their

> > professional judgment to avoid a standard of practice. Rather, the problem

> > is that social systems that set forth standards in education about Chinese

> > medicine (in this case, pulse diagnosis) do not see value and the

> > competencies are not necessary for graduation, certification and licensure.

> > >

> > > Warmly,

> > >

> > > Will

> > >

> > > William R. Morris, PhD, DAOM, LAc

> > > http://pulsediagnosis.com/

> > > http://www.aoma.edu/

> > > http://taaom.org/

> > >

> >

>

> --

>

> www.tcmreview.com

>

November 27, 2009

David,

I think an in-depth study of Ling Shu acupuncture is one of the next steps

for interested folks in our profession, as it is the source for all of the

acupuncture systems that developed afterwards, from Nan Jing to Yang Ji-zhou to

the multiplicity of modern approaches. It will help clear up the confusion that

we are experiencing in our field. There are a number of websites that can be

accessed, google ling shu acupuncture, nei jing acupuncture, or Steven Alpern's

website. ... I don't have the links with me. .

Z'ev

---- singlewhip2001 <singlewhip2001 wrote:

> Hi Zev:

>

> Interesting note on Tong acupuncture, i have a few thoughts on it besides no

emphasis on tongue. They often quote chapter 63 of the su wen as the basis for

contra-later needling, but this chapter is using that method for Luo Channels,

when a pathogen is transferred to the opposite side, its very clear about this,

not to be used for primary channels. They say they do channel acupuncture based

on the classics, but the classic of Ne Jing have specific signs and symptoms of

each channel (not the organ) and that with the pulse, identifies the channel to

be treated, its not just where the pain is located.

>

> The Su Wen does not have any info on the tongue, its not part of the

diagnostic method there.

>

> regards,

> david

>

> Chinese Medicine , <zrosenbe wrote:

> >

> > William,

> > Welcome back from China! I am in NY right now, so I don't have my medical

library with me, at least the non-digital portion. Xu Da-chun not only decried

the loss of pulse-taking skill, but also the loss of acupuncture skills as well.

Good source for an argument for more emphasis on pulse practice.

> >

> > The last few semesters I've led the 'tongue and pulse club' for PCOM

students, sponsored by the Student Council. The students are very enthusiastic

and happy to see that one can trust one's own senses in developing their skills.

I have them keep journals and draw pictures of what they feel under their

fingers, and describe it visually rather than trying to conform to a

pre-conceived idea of a pulse image. I tell them that the 28 pulse qualities

are the alphabet of pulses, but the language, sentences, concepts of pulse

diagnosis comes with practice and experience.

> >

> > You mention Master Tong's system that doesn't rely on pulse diagnosis.

We should remember that palpation of the channels comes from the same source as

pulse differentiation, since it involves the same channels. Paul Unschuld

translates mai zhen as 'movement in the vessels' rather than pulse

differentiation, because we are looking for the movement under our fingers, we

are touching the flow of qi, blood and information.

> >

> > One final comment from an earlier posting, on the argument of 'treating

what you see'. Do we really want to limit ourselves to just a here-now picture

of illness? In Chinese medicine, all disorders are in flux, constant change,

and we need to see the entire picture, i.e. the pathomechanisms that led to the

disorder (bing yin/etiology or disease origin), and predict the further

development of the disorder (zhen hou, prognosis). Otherwise we can only treat

symptomatically. This is one of the arguments for studying such texts as the

Nan Jing and Shang Han Lun, they provide models (five phase, internal evils in

NJ, six channel progressions in SHL) that allow the physician to see the broader

picture of illness and treat accordingly.

> >

> > ---- William <wmorris33 wrote:

> > > Good points Ã‚Â–

> > >

> > > Why pursue an activity that doesn't make a difference in how we see the

world?

> > >

> > > Bob Ã‚Â– I find placing a hair under the page of a book a rather peculiar

practice. And, the ability to palpate 10 pages deep and still feel the hair

suggests to me that your nervous system would be overloaded with data. From my

perspective, what you don't observe is equally if not more important than what

you do observe. Apparently, you agree. ;-)

> > >

> > > If we gain clinical success using methods we find easy, then why pursue

methods that can be more difficult? In the end, we are dealing with medical

epistemology. Biological systems communicate in complex ways. Inquiry and

observation are a part of what has been used as the foundation of Chinese

medicine. Master T'ung did not use pulse. Each of us learns to practice in ways

that fill our clinical needs and meets our individual capacities.

> > >

> > > If one is familiar with what I write and teach, it is apparent that I am

biased towards pulse diagnosis as a basis of practice. In my experience, it has

led to better results over my 28 years of pulse diagnosis study. Thus, I must

ask, how do we come to a resolution of the importance placed upon pulse by the

authors of the Long Shu, Nan Jing, Mai Jing, Qi Jing Ba Mai Kao and Bin Hu Mai

Xue? For me, the question is Ã‚Â– what were these people talking about? Why such

an emphasis? How did this emphasis get lost in contemporary practice? Throughout

the history of Chinese medicine, there have been personalities who bemoan the

loss of pulse diagnostic skills. Z'ev, I thought for sure you would use this

opportunity to quote one of those people, Hsu Ta-ch'un.

> > >

> > > Most students receive insufficient exposure to pulse diagnosis in TCM

programs. This leads to a lack of confidence, which leads to the use of other

tools where confidence is more easily gained.

> > >

> > > The problem is not that any practitioner has determined through their

professional judgment to avoid a standard of practice. Rather, the problem is

that social systems that set forth standards in education about Chinese medicine

(in this case, pulse diagnosis) do not see value and the competencies are not

necessary for graduation, certification and licensure.

> > >

> > > Warmly,

> > >

> > > Will

> > >

> > > William R. Morris, PhD, DAOM, LAc

> > > http://pulsediagnosis.com/

> > > http://www.aoma.edu/

> > > http://taaom.org/

> > >

> >

>

November 27, 2009

I hope it will, I will play my role in it. One challenge is the master's and

DAOM do not address these aspects of Chinese medicine, so one has to want to

learn other ways to practice.

David

Chinese Medicine , <zrosenbe wrote:

>

> David,

> I think an in-depth study of Ling Shu acupuncture is one of the next steps

for interested folks in our profession, as it is the source for all of the

acupuncture systems that developed afterwards, from Nan Jing to Yang Ji-zhou to

the multiplicity of modern approaches. It will help clear up the confusion that

we are experiencing in our field. There are a number of websites that can be

accessed, google ling shu acupuncture, nei jing acupuncture, or Steven Alpern's

website. ... I don't have the links with me. .

>

> Z'ev

>

> ---- singlewhip2001 <singlewhip2001 wrote:

> > Hi Zev:

> >

> > Interesting note on Tong acupuncture, i have a few thoughts on it besides no

emphasis on tongue. They often quote chapter 63 of the su wen as the basis for

contra-later needling, but this chapter is using that method for Luo Channels,

when a pathogen is transferred to the opposite side, its very clear about this,

not to be used for primary channels. They say they do channel acupuncture based

on the classics, but the classic of Ne Jing have specific signs and symptoms of

each channel (not the organ) and that with the pulse, identifies the channel to

be treated, its not just where the pain is located.

> >

> > The Su Wen does not have any info on the tongue, its not part of the

diagnostic method there.

> >

> > regards,

> > david

> >

> > Chinese Medicine , <zrosenbe@> wrote:

> > >

> > > William,

> > > Welcome back from China! I am in NY right now, so I don't have my

medical library with me, at least the non-digital portion. Xu Da-chun not only

decried the loss of pulse-taking skill, but also the loss of acupuncture skills

as well. Good source for an argument for more emphasis on pulse practice.

> > >

> > > The last few semesters I've led the 'tongue and pulse club' for PCOM

students, sponsored by the Student Council. The students are very enthusiastic

and happy to see that one can trust one's own senses in developing their skills.

I have them keep journals and draw pictures of what they feel under their

fingers, and describe it visually rather than trying to conform to a

pre-conceived idea of a pulse image. I tell them that the 28 pulse qualities

are the alphabet of pulses, but the language, sentences, concepts of pulse

diagnosis comes with practice and experience.

> > >

> > > You mention Master Tong's system that doesn't rely on pulse diagnosis.

We should remember that palpation of the channels comes from the same source as

pulse differentiation, since it involves the same channels. Paul Unschuld

translates mai zhen as 'movement in the vessels' rather than pulse

differentiation, because we are looking for the movement under our fingers, we

are touching the flow of qi, blood and information.

> > >

> > > One final comment from an earlier posting, on the argument of 'treating