I didn't learn to feel the pulse alone.
Only by systematically studying the theory of traditional Chinese medicine can we know what the pulse condition refers to and what its significance is. After you have the basic knowledge of Chinese medicine, buy a copy of Hu Ling Pulse Sutra, which recites dozens of pulse conditions, and then play your own and others' every day, trying to figure out more than a dozen people every day, and you will be able to get started in three months.
If you want to improve, you have to study the origin of the four saints. I also have a brother who refused to read the book on pulse science, only wrote down the name of the pulse condition and ignored the meaning of the pulse condition in the book. After more than ten years of clinical practice, he went back to read the book and found that his experience was basically consistent with that in the book.
He is famous for being able to tell the patient's suicidal thoughts. There is also a big brother who can tell you about the seafood you ate last night.
Pulse science is a bit mysterious, the level depends entirely on personal experience, and if patients cooperate, the proportion in the four diagnoses is not large, so there is no need to be too reluctant. Of course, I will meet a new patient who doesn't trust you, and I will answer "OK" when I ask anything. At this time, I won't bother to ask in detail. Through inquiry and pulse diagnosis, the effect is also good.
2. What is the pulse condition doing?
Traditional Chinese medicine (TCM) always needs to feel the pulse, because through the change of pulse condition, we can not only collect the information of the disease, understand the strength of healthy qi, but also help to predict whether the disease is getting better or worse.
When you have a cold, you can often feel the obvious pulse beating by gently pressing the radial artery with your hand, which is called floating pulse. Chinese medicine describes it as wood floating on the water. The so-called floating veins are like "floating wood in water". Floating veins are also common in the early stage of other exogenous diseases, indicating that the lesions are shallow.
If you have to press hard, you can feel the pulse. This is called sinking pulse, which is common in many chronic diseases, indicating that the lesion is deep and has involved the viscera. Faster pulse, called pulse counting, is mostly a reflection of fever.
Slow pulse, called delayed pulse, means late arrival, which is a manifestation of cold disease. Weak pulse, called deficiency pulse, indicates insufficient vitality.
If the patient is deficient in both qi and yin, the pulse is often weak, which is described as "as thin as silk thread" by Chinese medicine. Strong pulse, called solid pulse, indicates that healthy qi is still strong.
If the patient has excess vital energy and insufficient pathogenic heat, there will often be a heavy pulse, which seems to be choppy. Some pulse conditions have important reference value for some diseases.
For example, the pulse condition is neither soft nor tight, as if it is pressed on a bowstring, which is called a string pulse, and often indicates that the patient may have arteriosclerosis or high blood pressure. Irregular pulse, frequent pause, or strong and weak, is called knot pulse, which is more common in patients with heart disease.
Smooth pulse condition is called slippery pulse. Traditional Chinese medicine describes it as "walking beads", which is common in patients with excessive phlegm, but it cannot be generalized. Chord pulse is also common in general pain or exogenous diseases. Occasionally, there is no heart disease, but slippery pulse is more common in normal pregnant women. Pulse condition is also helpful to judge the prognosis. Although the condition is serious, the pulse condition and toughness are still improving. If the pulse is too subtle to understand, it is a symbol of poor prognosis.
In a word, pulse-taking is an important diagnostic method, a unique diagnostic method of traditional Chinese medicine and an important link in the four diagnoses. After long-term practice, TCM has accumulated rich experience in pulse diagnosis, and there are many monographs on pulse science, such as Pulse Classic written by Wang Shuhe in Jin Dynasty and Pulse Science on Lake written by Li Shizhen in Ming Dynasty.
Modern times have done a lot of research on pulse condition. Someone has planned various pulse conditions with a pulse meter. Some people use electrocardiogram to study the principle of pulse condition.
3. How does Chinese medicine feel the pulse?
Pulse cutting should be performed when the patient is quiet.
"Su Wen. The theory of pulse essence and stomach emphasizes that patients should take a sitting position or supine position when their pulse is normal, with their forearms and hearts close to the same level, palms up and forearms flat to make blood flow smooth.
Cunkou pulse measurement, clearance and ruler. For adult pulse diagnosis, use three designated positions. First, press the middle finger in an arc and press the pulp of the finger to touch the pulse to press the pulse.
The density of three fingers should be adjusted according to the patient's height. Children's cunkou pulse is too small to hold three fingers, so "one finger (thumb) method can be used without subdividing three parts."
Children under three can look at fingerprints instead of pulse. There are three kinds of finger force commonly used in pulse-cutting, first light force, touching the skin as floating, called "lifting"; Then apply moderate strength and touch to the middle of the muscle, which is called "seeking"; Touch and press again until the bones and muscles sink, which is called "pressing".
According to clinical needs, you can repeatedly touch and press in the order of lifting, searching, pressing or reversing, and you can also adopt finger pressing experience at different parts. There are three parts: inch, pass and pool, and each part has three stages: floating, middle and sinking, which are called three phases and nine phases.
Attention should be paid to a quiet environment when pulse-cutting. If the patient has just experienced strenuous activity, he should rest for a while before taking his pulse. The pulse-cutter must breathe evenly, take a serious attitude, focus on his fingers and carefully identify the pulse condition.
The pulse-cutting time should not be less than one minute at a time. The pulse condition of a healthy person should be four breaths at a time. There are pulses in three parts of the inch gauge, not floating or sinking, gentle and powerful, and the pulse of the foot gauge should be strong.
Common pulse diseases include floating pulse, sinking pulse, late pulse, multiple pulse, deficiency pulse, solid pulse, slippery pulse, extensive pulse, thin pulse and chord pulse. Floating pulse: press lightly to get it, then press again to decrease it.
It is characterized by superficial pulse position. Main symptoms: Exterior syndrome is characterized by exterior pulse position because exogenous pathogenic factors stay in exterior, and defensive qi does not invade pathogenic factors, so that pulse qi is excited externally.
Strong floating is the real thing; Floating without strength is superficial. Long-term internal injuries are caused by deficiency of yin and blood, deficiency of yang, yang deficiency floating outward and weak pulse.
Sinking pulse: you can't press it lightly, just press it again. It is characterized by deep pulse position.
Main symptoms: interior syndrome. Strength is the inner reality, and weakness is the inner weakness.
Pathogenic qi is depressed inside, qi and blood block yang, and the pulse is heavy and powerful. Visceral weakness, yang deficiency and qi stagnation, rapid pulse weak gas, weak pulse. Late pulse: slow pulse, (less than 60 pulses per minute).
Main symptoms: cold syndrome. Strong is cold, weak is cold.
Cold is depressed, qi and blood move slowly, and the pulse is slow and strong, which is the syndrome of excess cold. Deficiency of Yang Qi, inability of qi and blood to move, and slow and weak pulse are the syndromes of deficiency and cold.
Athletes and heavy manual workers often have a late pulse, which is a physiological state. Pulse count: rapid pulse, (pulse is more than 90 times per minute).
Its characteristic is that the pulse is faster than the normal pulse. Main symptoms: heat syndrome.
Strong is excess heat, weak is deficiency heat. Exogenous fever starts at the beginning, viscera is full of heat, pathogenic heat is stimulated, blood circulation is accelerated, and strong pulse is excess heat.
Blood deficiency, body fluid deficiency, blood deficiency, endogenous deficiency heat, pulse number and weakness are deficiency heat. Deficiency pulse: all three pulses are weak.
Press empty again. It should mean softness, which is the general term for all weak veins.
Main symptoms: deficiency syndrome: mostly due to deficiency of both qi and blood, the pulse condition is difficult to stimulate, so it is deficiency. True pulse: All three pulses are powerful. Main symptoms: empirical evidence: pathogenic qi is abundant and healthy qi is sufficient, and both positive and evil are contending, and qi and blood are full of pulse.
Slippery pulse: it should mean smooth, smooth pressing, as smooth as pressing a ball. Main symptoms: phlegm, indigestion and excess heat, which are more common in young people with deficiency of both qi and blood.
The slippery pulse of pregnant women is a phenomenon of vigorous qi and blood to raise the fetus. They are all physiological phenomena.
Hong pulse: The pulse is large and powerful, like a rough wave, one after another. Come and grow.
Main symptoms: excess heat. The internal heat is strong, the pulse channels are dilated and the pulse shape is wide. Due to excessive heat, pathogenic factors are blazing, qi and blood are full, and pulse conditions are fluctuating.
Pulse: the pulse is as thin as a line, with obvious fluctuation. Main symptoms: deficiency syndrome, mostly seen in yin deficiency and blood deficiency syndrome.
It also controls wet diseases. Yin deficiency and blood deficiency can't fill the pulse, or wet evil can't fill the pulse, and the pulse is small.
Chord pulse: the end is straight and long, pointing down quite suddenly, such as pressing a chord. Treat hepatobiliary diseases, pain syndrome and phlegm.
The qi is unfavorable, the liver loses the function of dispersing qi, and the pulse is tense and shows a string pulse. When the patient is sick, qi disorder or phlegm stops, which will lead to poor conduction of qi and string pulse.
Pulse knot: slow pulse and irregular interval. Main diseases: yin deficiency and qi stagnation, cold phlegm and blood stasis.
Analysis: Yin cold is the internal knot, and the qi of the pulse channel is blocked, so the pulse comes slowly and stops for a while. Cold phlegm and blood stasis, qi stagnation, stagnation of pulse qi, therefore, if the pulse stops late due to qi deficiency and weak blood, it is weak.
Pulse generation: the pulse has a rest and a fixed number. Main disease: Decline of dirty qi.
Analysis: the dirty qi is weak, the vitality is insufficient, and the pulse is blocked.
4. How to feel the pulse
Pulse diagnosis, also known as pulse-taking, is a diagnostic method that Chinese medicine presses the patient's artery by hand according to the pulse condition to understand the internal changes of the disease. Pulse diagnosis has a long history, which reflects the characteristics and experience of TCM in diagnosing diseases. Pulse condition can be understood as pulse condition. It consists of the location (depth), speed (speed), intensity (strength), rhythm (regularity, endless) and shape of arterial pulsation. Pulse condition is an important basis of TCM syndrome differentiation, which has important clinical significance in distinguishing the cause, inferring the change of the disease, distinguishing the true from the false and judging the prognosis of the disease. Because the pulse condition is the mansion of blood and runs through the whole body, the pathological changes of the body and viscera are often reflected in the pulse condition, and sometimes the pulse condition has changed before the symptoms are fully manifested.
Pulse cutting should be performed when the patient is quiet. "Su Wen. The theory of pulse essence and stomach emphasizes that the pulse condition is often flat.
When pulse cutting, let the patient take a sitting position or supine position, the forearm of the hand is almost at the same level as the heart, the palm is facing up, and the forearm is lying flat, so that the blood flow is smooth.
Cunkou pulse measurement, clearance and ruler. For adult pulse diagnosis, use three designated positions. First, press the middle finger in an arc and press the pulp of the finger to touch the pulse to press the pulse. The density of three fingers should be adjusted according to the patient's height. Children's cunkou pulse is too small to hold three fingers, so "one finger (thumb) method can be used without subdividing three parts." Children under three can look at fingerprints instead of pulse. There are three kinds of finger force commonly used in pulse-cutting, first light force, touching the skin as floating, called "lifting"; Then apply moderate strength and touch to the middle of the muscle, which is called "seeking"; Touch and press again until the bones and muscles sink, which is called "pressing". According to clinical needs, you can repeatedly touch and press in the order of lifting, searching, pressing or reversing, and you can also adopt finger pressing experience at different parts. There are three parts: inch, pass and pool, and each part has three stages: floating, middle and sinking, which are called three phases and nine phases.