Pulse miracles

Having said in another post that I don't emphasise pulse diagnosis especially in my current way of working, I wanted to share a pivotal experience I had during my acupuncture training.  We were a few weeks into the course, and I was struggling quite seriously to buy into some of the concepts of Chinese medicine.  Pulse diagnosis was one of them.  How could feeling the pulse give more than basic information about the way the patient's heart was pumping blood around the body?

We had a class on pulse taking, led by an experienced tuina practitioner, and advocate of qigong.  She asked for a volunteer.  Being entirely sceptical, and feeling as though some others may be inclined to agree with whatever was being said in a similar way to victims of cold reading, I put my hand up.  Perhaps it was fate, but I was chosen to come to the front.  I had not spoken to the teacher before that day.

She had me sit down, placed her fingers on my wrist, and closed her eyes.  I was expecting to hear something like 'You have some kind of medical condition, don't you?' - something vague that everyone would answer 'yes' to if they wanted to believe.  But I was astonished when she said 'You've had a pain in your left shoulder, haven't you - not at the moment, but a few months ago?'.  She put her hand on my upper back in the exact area I had struggled with a nagging pain for some time - as she correctly said, it had cleared up quite recently. She went on to reveal most of my significant medical history, including my asthma, and several other past and present ailments.  Nothing she said was wrong.

From that day on, I had a new perspective on pulse taking, and what was possible in Chinese medicine.  I don't think it is possible for most people to reach that level of skill, but I now believe it can be done by some, and that anyone can get to a level where meaningful and clinically useful information is obtainable from the pulse.

So for me, rather than dismissing the power of pulse-taking, it's a case of acknowledging my current limitations and building an overall picture of the patient from all available sources.


Please note: this blog is intended for educational and general interest purposes only. If you have any health concerns, please discuss them with your doctor.

www.tomtheacupuncturist.co.uk

How important are tongue and pulse diagnosis?

As I've mentioned in other posts, my treatment style (at least currently) emphasises palpation of the patients body for tight and tender areas, as I believe this often gives the most relevant clinical information.  But the whole process of diagnosis and treatment is a balancing act, and because there is limited time, I try to concentrate on what I think will give me the most relevant information.

For example, if a young and apparently fit and healthy patient presents with an acute back pain, it is quite possible I won't take their pulse or look at their tongue, unless there is reason to believe there is an underlying organ imbalance contributing to the picture.  I find TCM-style Zang Fu theory can easily confuse the picture in these cases - there is always an internal pattern of disharmony if you're determined to find one, but quite often what really needs to be examined and treated are the superficial sinew channels (i.e. tight and tender muscles).

If someone presents with gynaecological problems for example, the pulse and tongue will no doubt give vital clues.  But even with what is seemingly a purely internal pattern, I think palpation of relevant channels is often just as important as tongue and pulse, if not more so.  There are practitioners who will take the pulse very carefully, base their entire treatment on the information they glean, refer again to the pulse through the course of the treatment, and judge their success or failure on any perceived changes.  This is fine if it leads to improvements in the patient's condition, but sometimes this priority seems to be lost - as long as the pulse is 'improving', the practitioner is happy.  This seems odd to me - if the pulse changes radically for the better, but next week the patient comes back with the same back ache, has the patient really been served well?

Everyone develops their own style, and certainly I've come across a few experienced practitioners who can uncover remarkable information from the pulse, but I think this is rare.  As a mere mortal, I generally use the pulse to get an 'overview' of the patient's internal condition, but only use this information as one piece of the puzzle.  The tongue gives another, more objective level of information.  Questioning fills in other gaps, and palpation often makes sense of the whole picture.  Then, changes in the presenting condition over time let me know whether I'm on track or not.

Please note: this blog is intended for educational and general interest purposes only. If you have any health concerns, please discuss them with your doctor.

www.tomtheacupuncturist.co.uk