Learning how to feel the pulse and perform diagnosis could help you to pin-point any imbalance in the Zang-Fu organs of your body.
The concept of the pulse is quite different in Chinese Medicine. It is a way of coming directly into contact with the patient’s Qi, as it is the Lungs that govern Qi through respiration. Great differences can be felt between the pulse in each wrist, which, interestingly, would be confirmed by a cardiologist.
The eighteen Pulses
An experienced practitioner of Chinese Medicine is able to locate nine different pulses on each wrist, giving a total of eighteen. The physician will use three fingers, carefully putting each on top of a different pulse. There are three levels to the pulse at each position, giving a total of nine pulses.
Each of the eighteen pulses is related to a specific internal organ, and gives detailed information about the state of that organ. Additionally, there are 28 pulse qualities that describe the state of the Qi. These translate into terms such as the Slippery Pulse, which indicates the presence of Dampness, or the Tight Pulse, which appears when there is obstruction. Any of the pulse qualities can be found at any of the pulse positions, and each signifies a different condition.
Let’s look at the picture above. In each of three positions on the wrist, there are three different levels of pulse, making a total of nine pulses.
Adding both wrists together makes a total of eighteen pulses. Each area is linked to an organ. The Heart refers to organs and functions above the diaphragm (especially left side); the Liver to those between diaphragm and navel (especially lateral areas); the KidneyYin to those below the navel (especially lower left).
The Lung correlates with organs and functions above the diaphragm (especially right side); the Spleen with those between diaphragm and navel (especially central); KidneyYang with those below the navel (especially lower right).
How to feel the pulse?
Let’s look at how a Chinese physician feels the pulse:
(1) First, make sure the person is sitting opposite you, with hands held comfortably at around the level of the solar plexus or chest.
(2) Use the fingers of your right hand to feel the person’s left wrist, and vice versa.
(3) Use the middle three fingers of your left hand to feel the right pulse. Place your second finger just below the person’s wrist crease (on the thumb side) over the radial artery. Then allow the other two fingers to rest gently next to this. You should not use your thumb, as you may confuse your own pulse with that of the patient.
Press with all three fingers, evenly and gently, until you can just feel a pulse. Stay here for a minute and become aware of the quality of the pulse.
Press a little harder until the pulse disappears, then ease off very slightly until you can feel it again. Stay here for a minute, and see if you think the nature of the pulse at this deeper level is different in any way from the first pulse. You have now felt the quality of the person’s Qi.
What to look for in your pulse?
Depth, Speed, and Strength are the aspects to look for.
The healthy pulse is felt easily, and has a smooth and steady rhythm. It varies according to age, constitution and fitness. Generally, the pulse slows down with age and its strength will depend on build – a muscular man has a more forceful pulse than a thin woman. The pulse is not considered to be fully developed in children under seven, and a novice is unlikely to gain much useful information from a child’s pulse.
Depth – a pulse can be Normal, Superficial, or Deep
The Normal pulse should be easy to find, at all depths.
The Superficial pulse is felt very easily with light pressure, but disappears on deep pressure. This pulse signifies that there is more Qi in the upper part of the body than the lower part. (This happens in Yin Deficiency of the Kidneys, causing headaches, tinnitus and hot flushes. It can also appear when there is too much energy in the Lungs, such as a cough or symptoms of asthma.)
The Deep pulse is absent upon light palpation and is only felt on deep pressure. It indicates a Deficiency of Yang energy, as there is not enough Yang Qi to lift the pulse up to the surface. (Amongst other problems, this can lead to symptoms such as tiredness, prolapse, diarrhoea, incontinence and vaginal discharge.)
Speed – a pulse can be Normal, Rapid, or Slow
The Normal pulse has a smooth, steady rhythm, neither fast nor slow.
The Rapid pulse is faster than is normal for the patient’s age. (This must be measured as the resting pulse. The pulse will be elevated if the person has just been active or is very anxious.) The Rapid pulse indicates Heat, and the faster the pulse, the more Heat is present. The Heat can be of a Full or Empty nature, and this is differentiated by other signs and symptoms.
The Slow pulse is slower than is normal for the patient’s age.A Slow pulse indicates Cold, and the slower the pulse, the more Cold is present. This Cold can be of a Full or Empty nature, and this is ascertained from other signs and symptoms.
Strength – a pulse can be Normal, Full or Empty
The pulse in the right wrist gives information mostly about the Qi, whereas the pulse in the left wrist is predominately Blood-oriented. If the Fullness or Emptiness is mostly on one side, then the organs which are affected are as follows:
Left: Liver, Heart, Kidney Yin.
Right: Spleen, Stomach, Lungs, Kidney Yang.
The Full pulse is very forceful, with an aggressive wave quality. It will usually be felt easily on both levels, and with all three fingers. The more pronounced the force, the greater the degree of Fullness. A Full pulse reveals an Excess of something in the body, so the appropriate treatment is to determine and then clear it.
The Empty pulse is weak, with a loose wave quality. The more pronounced the weakness, the more Empty the condition is. An Empty pulse marks a Deficiency of something in the body, so the appropriate treatment is to determine the area of weakness and then strengthen it.