Pulse Diagnosis Overview Flashcards
Pusle Diagnosis
A special diagnostic method where practitioners use their fingers to feel arterial pulse
Pulse Image
Quality - patient’s pulse beneath the fingers; a combination of - rate, rhythm, shape, etc
Organs Involved
Lungs - Govern Qi, gathers vessels
Sp/St - T&T, controls blood
Li - Stores blood, controls volume of blood, ensures smooth Qi flow
Ki - stores essence (transformed qi/blood)
Clinical Applications
To determine location, disease pathogenesis
To differentiate the nature of disease, deficiency vs excess
To identify etiology of disease
To make disease prognosis
Depths
Superficial - felt at skin level (Touching level)
Middle - moderate pressure, felt at the muscle level (Seeking level)
Deep - heavy pressure, felt at tendon/bone level (Pressing level)
Cun Kou (Radial Artery) Positions
Fingers are placed at a 90 degree angle
Cun - Distal (distal/adjacent to middle finger, crease of wrist)
Guan - Middle (styloid process)
Chi - Proximal (proxmial/adjacent to middle finger)
Left:
Cun - Heart
Guan - Liver
Chi - Kidney
Right:
Cun - Lung
Guan - Spleen
Chi - Mingmen
Healthy Pulse Features
Full of Stomach Qi (Stomach) - Calm, gentle, even with moderate strength and a regular rhythm
Full of Spirit (Shen/Heart) - Moderate force and a unified rhythm in a soft vessel
Rooted (Gen/Kidney) - Can be felt at the deep level of all 3 positions or at least in Chi position
*The 3 aspects cannot be separated and form a smooth, even pulse wave with moderate strength
Components of a Normal Pulse
- Size (Width) - the diameter of the blood vessel, dependant on qi/blood volume; normal = not too thin, not too wide
- Depth - normal pulse should be felt in the middle level with the seeking method, dependant on Stomach Qi and shows that the qi/blood
- Strength - the pulse beating force beneath the finger, dependant on condition of qi/blood; normal = forcefully with moderate strength
- Length - how long he puls can be felt (Cun, Guan, Chi positions), determined by Qi and blood (moreso Qi since it makes the blood move); normal = felt at all 3 positions
- Rate - how many times the pulse beats in a certain amount of time, Yang is the primary determinant (dominates the function of movement of blood via heart and lungs); normal = 4-5 beats per breath (inhale + exhale)
- Rhythm - regular or irregular, Heart Qi determines how blood moves through vessels; normal = regular, arythmic = irregular
- Tension - the hardness of the blood vessels (vsotonia), determened by the condition of Qi/Blood; normal = between too slack and too taught
- Shape - RIsing and dropping of the vessel as the blood flows through, ascending and descending period; normal = both ascending/descending are the same
Variations of Pulse - Seasons
- Spring: Wiry
- Summer: Flooding
- Autumn: Floating
- Winter: Deep
Variations of Pulse - Mental State
- Anger: Wiry/Rapid
- Melancholy: Moderate
- Fear: Deep (Submerged)
- Joy: Slow
- Grief: Short
- Fright: Moving
Variations of Pulse - Causes
- Seasons
- Geographical/Environmental Factors
- “Gender”
- Constitution
- Mental State
- Diet (food, drink, medication)
- Physical Work/Exercise
- Pregnancy/Menstruation
Pathological Pulse Changes
Associated with disease, refers to abnormal pulse
- Change in Size (Width)
- Change in Depth
- Change in Strength
- Change in Rate
- Change in Length
- Change in Rhythm
- Change in Tension
- Change in Wave Shape
Pathological Pulse Changes - Depth
Superficial = Defensive Yang battling pathogens (exterior pattern) or Hyperactive Yang due to insufficient Blood/Qi
Deep = Qi/Blood fails to move toward exterior due to internal pathogen obstruction or deficieincy of Qi/Blood
Simple Pulses = Floating, Submerged or Hidden Pulse
Pathological Pulse Changes - Strength
- Forceful = Strong Qi/Blood fight off external pathogenic invasion or stagnation of Qi/Blood
- Forceless = Deficiency of Qi/Blood (esp. Qi failing to fill and move blood through vessels)
Simple Pulses = Excessive or Deficienct Pulse
Pathological Pulse Changes - Size (Width)
- Indicates Yang affected
- Wide = Yang hyperactivity (either due to ecessive heat in the body or yin deficiency)
- Thin = Insufficient Yin/blood to fill vessels
Simple Pulses = Large or Thin Pulse
