Having a Finger on the Pulse

Last week’s article mentioned that the second pillar for diagnosing patterns of disharmony according to Traditional Chinese Medicine (the first pillar being the tongue) is the pulse. While observation of the tongue is relatively straightforward, interpreting the pulse is a subtle and complex art that takes extensive training, experience, and sensitivity.

When the nurse at your doctor’s office takes your pulse, she’s counting the beats per minute. When a practitioner of Chinese medicine takes your pulse, she’s looking at a system of “wrist/organ” correspondences that reveal the health of the body organs – heart, lungs, stomach, liver, etc.

Pulse diagnosis is important because it not only gives detailed information on the state of specific organs, but also reflects the composite of the whole system. However, it is an extremely subjective form of diagnosis – if the tongue is red, we can all see and agree upon its color, but pulse types must be described, and description is always open to interpretation. One can imagine a “wiry” pulse as feeling like a “taut guitar string” under the fingertip, but that’s just the beginning. Skillful pulse diagnosis requires a tremendous amount of attentiveness, discernment, and practice.

Another reason that pulse-taking can be tricky is that the pulse is subject to external, short-term influences. For example, running up the stairs to get to the appointment would make the pulse rapid, but only because of the unusual burst of speed. Likewise, if someone has been working hard and not sleeping much for several days before the appointment but is otherwise reasonably healthy, their pulse may show as weak and deep but it will be restored with a good rest and thus is not an indication of something more serious.

The pulses change with the seasons, reflecting the larger environment. In winter, when our energy is more in hibernation mode and we’re focused on keeping warm at the core, the pulses naturally are deeper. In summer, when there’s so much outward energy – plants in full growing mode, and hot sun raising the temperatures and bringing sweat from the pores, the pulses naturally are more superficial, even overflowing.

Gender, age, and activity level also factor into pulse differences. Women’s pulses are usually softer and quicker than men’s; in women, the right pulse is usually stronger than the left, and opposite for men. Athletes often have a slow pulse; young children have quick pulses; older folks may have deeper pulses – but that, too, depends more on overall health and strength than age.

Along with the quality of speed that the nurse is checking, other categories are depth, width, strength, overall shape and quality, rhythm, and length. There are about 28 basic pulses, which present in combinations, never just one by itself (which further complicates matters!). One also looks for “spirit”, or essential vitality, and “root”, strength at the baseline; these are indicators of how well someone will recover from illness.

Yin and yang pairs of organs are felt in three positions and depths on the wrists. The correspondences are because of connections from the meridians, or energy lines, and their specific organs to the wrist positions. Over the centuries, there have been varying attributions of organs to wrist positions, but one of the most common is: on the left are the Heart/Small Intestine, Liver/Gall Bladder, and Kidney Yin/Bladder; on the right are Lung/Large Intestine, Spleen/Stomach, and Kidney Yang/Triple Burner (a system of temperature regulation throughout the body).

This explanation of pulse-taking is a very basic introduction to the subject. Since it is such a complex skill to master, it’s good that there are other ways of gathering information from the body.

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