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Criticism against
traditional pulse taking
Looking at the evolution of pulse taking in oriental medicine, we
see that in ancient times pulse taking was limited to judging only about yin,
yang, and sufficient and excessive syndromes, but in later times the pulse was
subdivided and attributed to the organs of the human body, and used to
determine abnormal organ syndromes.
With the passing of time, pulse taking
theory became more detailed and complicated, which brought on various opinions
among scientists about the location for taking the pulse, the organ linked to
the pulse and the type of pulse.
The traditional place to take a person's pulse is the radial artery above the
wrist. It is divided into three regions: cun, guan, chi. The region of
the styloid process of the radius is guan, the one before guan,
that is, between guan and the wrist joint, is cun, and the one
behind guan is chi.
Traditionally there are 28 pulses determined by depth, speed, strength, form,
etc. Here is the list: floating, deep, slow, rapid, rolling, hesitant,
insufficient, excess, long, short, surging, faint, tense, relaxed, taut,
hollow, hard, firm, soft, weak, scattered, thready, hidden, throbbing, abrupt,
knotted, regularly intermittent, and large pulses. However, there are classics
that assert 19, 27, 33, or 36 pulses.
Here I do not aim to explain in detail each of these pulses, but I present
several of them for your orientation.
A floating pulse shows up on the surface of the skin and is easily felt with
light pressure.
A rolling pulse flows smoothly and gives the impression of pearls rolling on a
plate.
A hollow pulse is empty inside like a green onion and can be felt with a light
pressure or heavy pressure, but not with middle pressure.
A taut pulse is tense, straight and long and gives the impression of a
stretched chord of a musical instrument.
A soft pulse is floating and thready and can be felt with light pressure, but
not with heavy pressure.
A scattered pulse is floating and sporadically wide and can be felt with the
whole finger with light pressure.
As explained above, there are pulses that are relatively easy to understand,
but there are many that are extremely subjective and abstract and in practice
difficult to determine. Especially since those pulses can appear together at
the same time to form the pulse of a specific illness.
Here are some examples:
* Floating and soft pulses:
insufficient yin.
* Taut and rapid pulses: insufficient and cold body.
* Slow and rolling pulses: diarrhea.
* Deep and large pulses: kidney disease and fever in
the internal body.
* Long and taut pulses: liver disease and tense nerves.
* Thready and weak pulses: cold sweat at night.
* Short and rapid pulses: kidney pain and heart fever.
Not only two, but three pulses can together form the pulse of a specific
illness.
* Floating, rolling and rapid pulses: hepatic abscess.
* Taut, tense and excess pulses: hepatic sclerosis.
* Taut, rolling and rapid pulses: cholecystitis.
* Floating, hesitant and rapid pulses: pyelitis.
* Deep, slow and rolling pulses: chronic bronchitis.
Similarly, many pulses not only form the pulse of a certain disease, but also
that of other diseases according to the pulse region.
* Floating pulse in the left cun: fever, headache, dizziness from
wind.
* Floating pulse in the left guan: liver wounded by wind, fever or
great anger.
* Floating pulse in the left chi: bloody urine from a bladder
wound by wind and fever.
Twenty-eight pulses by themselves, in pairs or triplets form unique pulses and
also different pulses according to the regions cun, guan and
chi of each hand. Thus, many hundreds of very complicatedly varying pulses
can be distinguished.
When I studied pulse science in the university, memorizing so many different
pulses for the exams was a real pain. Even if you succeed in memorizing all the
pulses and keeping them straight in your head, it's another matter to
distinguish them one from another in clinical practice.
It is difficult enough
to distinguish the 28 pulses, let alone trying to distinguish all the possible
combinations. We can't deny the concepts about the pulse described by the
ancients in the classics, but their pulse theories turn out to be too abstract
and complicated and have an unreal and impractical side.
Of course, the ancients classified the pulses
according to their real experience. Likewise, any followers must be able to
come to the reality of pulses through experience, learning and practice;
otherwise the pulse theory remains only a vain theory.
It seems that pulse theory still remained difficult even in the time of Lee
Jema more than a hundred years ago. He opined about pulses in his book:
"Taking pulses is one of the methods to diagnose syndromes. So there
are four main pulses, floating, deep, slow and rapid, which help to diagnose
yin, yang, cold, warm, insufficient and excess syndromes."
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