Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 Sunday, January 28, 2001 1:10 PM cha pulse confusion the more I work closely with students, the more it becomes evident that precise understanding of pulse images is essential. several areas of confusion commonly arise. according to tietao deng 1. a vacuous (xu) pulse is felt mainly superficially. however the term xu is often erroneously tossed around to describe any forceless pulse. when a pulse is forceless and deep, the wiseman term is weak (ruo). weak and vacuous are not synonyms, though they do both indicate vacuity. this is not a serious clinical error, but is confusing to students who are aware of what xu actually means (i.e. floating and forceless) Although Deng and others say this, there are other mainstream Chinese texts & teachers that use xu to just indicate lack of strength at any level. 2. deep (chen) or sinking refers to a pulse that is only felt with deep palpation, but with force. it indicates a repletion pattern. however, deep is often used erroneously to describe the deep, forceless pulse found in vacuity, when the correct name is weak (ruo). Or any deep pulse, even with force, is considered to indicate vacuity. these are serious errors. I am not sure if chen indicates only a repletion pattern...deep (my understanding) seems to reference the level not the force... deep and weak (int xu) or deep and forceful (int excess) or deep, tight and rapid = w-c encircling the body in the ext. (deep and tight ext cold w/ int heat)... etc... ruo is many times defined as fine, small, without force, and deep. So possibly: deep, large, and forceless is not ruo...?? Deng says " ... with light pressure it is not felt, but with heavy pressure the pulsations are extremely clear... the form and strength of a pulse beats can be different according to the patterns, and can manifest as complex pulses. " Extremely clear does not seem to reference force just clarity. I found no specific reference to force in his definition. Interesting dilemma??? 3. the short pulse is often assumed to mean that kidneys are weak, however short and forceless means vacuity, while short and forceful indicates depression, a repletion condition. this also is a serious error. Some thoughts -- 3 definitions of short pulse come to mind 1) only felt in the guan position 2) not felt in either the cun or chi position (or relatively-quite deficient) 3) decreased space between each of the positions. So the assumption that the kidneys are deficient in a short pulse is incorrect (as you say)... but, I get the impression that many times when a short pulse is mentioned that it is in reference to definition number 2, and specifically not being able to feel it in the chi position. This seems to be common (in my limited experience) and depending on which pulse system is being used, this could be interpreted as a kidney deficiency- especially in more acupuncture based pulse systems. Herbally I don't think these distinctions are mentioned a very often. So without clarification, yes, assuming a short pulse is kidney deficiency seems very erroneous... question: how do others feel about mixing systems (i.e. acupuncture pulse systems, or other's 'more sophisticated' pulse systems) with herbal prescriptions/treatments. Is there any problem with this? The inexperienced practitioner might feel a deficiency in a pulse and assume there is a specific organ deficiency and prescribe herbs to tonify this organ -- I could see potential for danger... just some thoughts -- - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 Jason If this discussion is to have any merit, it is vital that sources be cited. What other sources decribe the xu mai as merely forceless? Source : Diagnostics of Traditional , Academy Press. Textbook from China, Beijing University. As for the opinions of teachers, this is not really a matter of opinion, it is matter of being able to cite precedent. Many teachers are products of other teachers who may not have had any access to chinese medical literature. The teacher was Chinese. / read from Chinese text. Thus, the background of the teacher and the source of their opinion is vital to assess the validity of the statement. I cited my source, but will now add that Wiseman also agrees and his definition is based upon the consensus of dozens of chinese medical dictionaries. -Jason Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 Jason wrote: >>Extremely clear does not seem to reference force just clarity. I found no specific reference to force in his definition. I agree, but lack of clarity indicates vacuity to me, so the presence of clarity means that repletion is possible. and in fact, deng indicates depression and water swelling for the deep pulse, when no other qualities are also felt. That is a good point... -Jason Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 the more I work closely with students, the more it becomes evident that precise understanding of pulse images is essential. several areas of confusion commonly arise. according to tietao deng 1. a vacuous (xu) pulse is felt mainly superficially. however the term xu is often erroneously tossed around to describe any forceless pulse. when a pulse is forceless and deep, the wiseman term is weak (ruo). weak and vacuous are not synonyms, though they do both indicate vacuity. this is not a serious clinical error, but is confusing to students who are aware of what xu actually means (i.e. floating and forceless) 2. deep (chen) or sinking refers to a pulse that is only felt with deep palpation, but with force. it indicates a repletion pattern. however, deep is often used erroneously to describe the deep, forceless pulse found in vacuity, when the correct name is weak (ruo). Or any deep pulse, even with force, is considered to indicate vacuity. these are serious errors. 3. the short pulse is often assumed to mean that kidneys are weak, however short and forceless means vacuity, while short and forceful indicates depression, a repletion condition. this also is a serious error. Number 2 and 3 can lead to employing tonics in vacuity and draining herbs in repletion. -- Chinese Herbal Medicine Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 , <@o...> wrote: > > > [@i...] > Sunday, January 28, 2001 1:10 PM > cha > pulse confusion > > the more I work closely with students, the more it becomes evident that > precise understanding of pulse images is essential. several areas of > confusion commonly arise. according to tietao deng > > 1. a vacuous (xu) pulse is felt mainly superficially. however the term > xu is often erroneously tossed around to describe any forceless pulse. > Although Deng and others say this, there are other mainstream Chinese texts > & teachers that use xu to just indicate lack of strength at any level. > Jason If this discussion is to have any merit, it is vital that sources be cited. What other sources decribe the xu mai as merely forceless? As for the opinions of teachers, this is not really a matter of opinion, it is matter of being able to cite precedent. Many teachers are products of other teachers who may not have had any access to chinese medical literature. Thus, the background of the teacher and the source of their opinion is vital to assess the validity of the statement. I cited my source, but will now add that Wiseman also agrees and his definition is based upon the consensus of dozens of chinese medical dictionaries. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 , <@o...> wrote: > 2. deep (chen) or sinking refers to a pulse that is only felt with deep > palpation, but with force. it indicates a repletion pattern. Jason wrote: > I am not sure if chen indicates only a repletion pattern. You are right. I meant to say it " often " indicates a repletion pattern. Jason wrote: ...deep (my > understanding) seems to reference the level not the force... deep and weak Force was also a poor choice of terms, but it is felt clearly, as opposed to the weak pulse, which is deep and not felt clearly. So deep does refer to depth, but felt alone, as it often is, it does not indicate vacuity, as so often is assumed. Jason wrote: >>Extremely clear does not seem to reference force just clarity. I found no specific reference to force in his definition. I agree, but lack of clarity indicates vacuity to me, so the presence of clarity means that repletion is possible. and in fact, deng indicates depression and water swelling for the deep pulse, when no other qualities are also felt. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 , <@o...> wrote: I get the impression that many times > when a short pulse is mentioned that it is in reference to not being able to feel it in the chi position. This > seems to be common (in my limited experience) and depending on which pulse > system is being used, this could be interpreted as a kidney deficiency- which would be correct if it is short and forceless > especially in more acupuncture based pulse systems. Herbally I don't think > these distinctions are mentioned a very often. Actually, this is one of the more common positional correlations in herbal texts. It can be found in Bensky's introduction to jin gui shen qi wan, for example. However you are correct, as I have argued before on this list, that most herbal and internal med sources seem to rarely mention pulse position. > question: how do others feel about mixing systems (i.e. acupuncture pulse > systems, or other's 'more sophisticated' pulse systems) with herbal > prescriptions/treatments. Is there any problem with this? The > inexperienced practitioner might feel a deficiency in a pulse and assume > there is a specific organ deficiency and prescribe herbs to tonify this > organ -- I could see potential for danger... just some thoughts -- I have frequently seen even experienced acupuncturists who are unfamiliar with the actual indications and contraindications for a given formula prescribe herbs based upon the type of pulse analysis you describe. this has often resulted in prescribing heavy tonics in cases of phlegm, damp, dampheat. Luckily, these px are typically using low dose patents, so neither harm nor good is done. but it sets a bad example for students who plan to practice high dose internal medicine. We should follow precedent until precedent fails us. And it is premature to dismiss precedent unless one has deeply studied the precedents. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 28, 2001 Report Share Posted January 28, 2001 on 1/28/01 9:03 AM, at wrote: > > > Jason > > If this discussion is to have any merit, it is vital that sources be > cited. What other sources decribe the xu mai as merely forceless? > Source : Diagnostics of Traditional , Academy Press. > Textbook from China, Beijing University. > As > for the opinions of teachers, this is not really a matter of opinion, > it is matter of being able to cite precedent. Many teachers are > products of other teachers who may not have had any access to chinese > medical literature. > The teacher was Chinese. / read from Chinese text. A native Chinese speaker freely translating from a Chinese text without using a Chinese/English dictionary of glossary, or a reliable Chinese/English translation of a text, can only base his choice of English term on his own understanding and/or opinion. Just arbitrarily choosing a term as a translation choice only creates more confusion among students who do not have access to the original characters, since they cannot check the material with their own resources, but must take verbatim the information being received. For example, students have a difficult enough time gaining a working vocabulary for pulse diagnosis when there are several terms being used in different student texts. Anyone doing translation, whether a native Chinese speaker or native English speaker who is accessing Chinese medical literature, should be required to back up term choices. Otherwise, valuable information may be lost in transmission, or interpretation may obscure the meaning of the original source. I would suggest whenever learning pulse terms and information, you should inquire as to the pinyin and (if possible) the Chinese character, and look up the definition in a Chinese/English medical dictionary. This is the only means available to 'rectify the names'. Quote Link to comment Share on other sites More sharing options...
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