Introduction of the Palpation method of TCM Diagnostics.
Introduction
✵The Palpation is one of the four examinations of TCM Diagnostic methods, examination of the surface of the body by feeling with the hand or fingers, including taking the pulse.
Introduction of Palpation.
Introduction about Palpation: The main content of Palpation is introduced as:
✵Palpation: an examination of the surface of the body by feeling with the hand or fingers, including taking the pulse.
✵Pulse image:the condition of the pulse felt on examination.
✵Pulse lore:study of the pulse.
✵Pulse examination:examination of the pulse for making diagnosis.
✵Pulse-taking:feeling the pulse.
✵Cun, Guan, Chi: also known as inch, bar, and cubit, the three sections over the radial artery considered when feeling the pulse.The bar(guan) is just over the eminent head of the radius at the wrist, where the tip of the physician's middle finger is placed, the inch(cun) is next to it on the distal side where the tip of the physician's index finger rests, and the cubit(chi) is on the proximal side where the tip of the physician's ring finger is placed.
✵Lifting, pressing, and searching:the three manipulations in pulse-taking. By touching is meant resting the fingers on the patient's wrist very lightly; by pressing is meant feeling the pulse with proper force, and by searching is meant varying the force or moving the fingers to get a more distinct pulse reading.
✵Pushing:pushing and moving the finger to examine the pulse.
✵Tracing:moving the examining finger along the radial artery to find out the pulse conditions in detail.
✵Total palpation:taking the pulse of the three sections with three fingers simultaneously.
✵Individual palpation:taking the pulse at each of the three sections individually.
✵Normal breathing: the normal respiratory cycle of the physician, used as a unit for measuring the patient's pulse rate.
✵Nine readings of three sections:(1).taking the pulse on three portions of the body, the head, and the upper and lower limbs. At each portion the pulses of the following arteries are examined:the temporal artery at point taiyang(EX-HN5) for the state of the head, the auricular artery at point ermen(TE21) for the ears, the buccal artery at points dicang(ST4) and daying(ST5) for the mouth and teeth, the radial artery at inch(cun) for the lung, the ulnar artery at point shenmen(HT7) for the heart.Also, the pulse at point hegu(LI4) is examined for the chest, the pulse at points wuli(LR10) and taichong(LR3) for the liver, the pulse at points qimen(LR14) and chongyang(ST42) for the spleen and stomach, and the pulse at point taixi(KI3) for the kidney-a method of general examination adopted in ancient times,(2).three sections of the radial artery at the wrist for pulse feeling are designated as inch, bar and cubit, each section felt with light, moderate and heavy force to study the superficial, medium and deep pulse, respectively.
✵Cunkou: wrist pulse, the pulsation of the radial artery felt at the wrist, also known as Qi opening, wrist pulse.
✵Radial artery at the wrist: the portion of the radial artery the pulsation of which can be easily felt at the wrist.
✵Anterior tibial artery: the artery the pulsation of which can be easily felt at the instep close to the ankle joint.
✵Common carotid artery: the artery the pulsation of which can be easily felt beside Adam's apple.
✵Floating pulse: also known as superficial pulse, a pulse which can be felt by a light touch and grows faint on hard pressure, usually indicating an exterior syndrome.
✵Sunken pulse: also known as deep pulse, a pulse which can only be felt when pressing hard, showing that disease is located in the interior of the body.
✵Hidden pulse: a pulse which can only be felt upon pressing to the bone, located even deeper than sunken pulse, seen in cases of syncope, shock, or severe pain.
✵Rapid pulse: a pulse with five or six beats to one cycle of the physician's respiration(more than 90 beats per minute), indicating the presence of heat.
✵Slow pulse: a pulse with less than four beats to one cycle of the physician's respiration(less than 60 beats per minute), usually indicating a cold syndrome, but occasionally seen in cases of interior accumulation of heat.
✵Moderate pulse:a pulse with a moderate rate, even rhythm and moderate tension, indicating a normal condition.
✵Relaxed pulse:a pulse with diminished tension and moderate frequency, seen in cases of dampness or spleen insufficiency.
✵Empty pulse:a feeble and void pulse, indicating deficiency of Qi and blood or consumption of body fluids.
✵Pulse of deficiency type:a collective term for various pulse conditions showing deficiency.
✵Full pulse: a pulse feeling vigorous and forceful upon both light and heavy pressure, indicating an excessive syndrome.
✵Pulse of excess type:collective term for various pulse conditions showing excessiveness.
✵Surging pulse: a pulse beating like dashing waves with forceful rising and gradual decline, usually indicating the presence of excessive heat.
✵Thready pulse:also known as thin pulse, fine pulse, a pulse as thin as a silk thread, straight and soft, feeble yet always perceptible upon hard pressure, indicating deficiency of Qi and blood, and seen in other kinds of deficiency conditions, but also in cases of a sudden attack of cold or severe pain.
✵Weak pulse:a deep, soft and thin pulse, seen in debilitated patients with deficiency of Qi and blood.
✵Soggy pulse: a pulse which can felt on light pressure like a thread floating on water, but growing faint upon hard pressure, seen in deficiency conditions or retention of dampness, also known as soft pulse.
✵Slippery pulse: a pulse coming and going smoothly like beads rolling on a plate, seen in patients with phlegm and dampness or stagnation of food, and also in pregnant women and normal persons.
✵Choopy pulse: a pulse coming and going unsmoothly with small, fine, slow joggling tempo like scraping bamboo with a knife, indicating sluggishness of blood circulation caused by the deficiency of blood and essence or stagnancy of Qi and blood.
✵Tympanic pulse: a pulse felt hard and hollow as if touching the surface of a drum, seen after loss of blood or spermatorrhea.
✵Firm pulse: a forceful and taut pulse, felt only by hard pressure, seen in cases of accumulation of yin cold and mass formation.
✵Long pulse: a pulse with large extend exceeding cun, guan and chi sections, seen in cases of excessive heat syndrome, but also in normal persons.
✵Short pulse:a pulse with shorter extent, only felt at cun or guan section, but not perceptible at chi section, indicating Qi disorders.
✵Swift pulse:a hasty and swift pulse, 7~8 beats to one cycle of respiration(120-140 beats per minute), seen in severe cases of acute febrile diseases or consumptive conditions.
✵Hurried pulse: a rapid pulse with irregular intermittence, seen in cases of excessive heat, stagnation of Qi and blood, retention of phlegm, or indigestion.
✵Intermittent pulse:a pulse pausing at regular intervals, indicating a decline of the visceral functions.
✵Knotted pulse:a pulse of moderate rate, pausing at irregular intervals, seen usually in cases of Qi stagnation.
✵Tense pulse: as tight pulse, a pulse feeling like a tightly stretched cord, usually indicating the presence of pathogenic cold or pain.
✵Scattered pulse: a pulse that feels diffusing and feeble upon a light touch and faint upon hard pressure, indicating exhaustion of Qi in critical illnesses.
✵Wiry pulse: a straight and long pulse, like a musical string, seen usually in liver and gallbladder disorders or cases of severe pain.
✵Hollow pulse: a floating, large, soft, and hollow pulse, like a scallion stalk, formed by a sudden decrease of circulating blood volume, as seen in cases of massive loss of blood or severe vomiting and diarrhea.
✵Large pulse: a pulse with a high wave which lifts the examiner's finger to a greater height than normal, either forceful(seen in cases of excessive heat with undamaged body resistance) or weak(seen in cases of general debility).
✵Throbbing pulse:a quick, jerky pulse, like a bouncing pea, seen in cases of fright or pregnancy.
✵Seven moribund pulse:seven kinds of pulses indicating impending death, also known as seven paradoxical pulses.
✵Bird-pecking pulse: an abrupt, quick, arrhythmic pulse resembling the pecking of a bird, one of the seven pulses indicating impending death.
✵Fish-swimming pulse: an extremely short pulse resembling a swimming fish with only its tail wagging, one of the seven pulses indicating impending death.
✵Shrimp-darting pulse: a nearly imperceptible pulse with occasional darting beats, one of the seven pulses indicating impending death.
✵Bubble-rising pulse: an extremely floating and rapid pulse like bubbles rising to the surface in boiling water, one of the seven pulses indicating impending death.
✵Dripping pulse: an extremely retarded pulse resembling water dripping from a roof crack, one of the seven pulses indicating impending death.
✵Flicking pulse: a deep and solid pulse resembling flicking a stone with the finger tips, one of the seven pulses indicating impending death.
✵Snapping pulse: a rhythmless pulse resembling the snapping of a cord, one of the seven pulses indicating impending death.
✵Pregnancy pulse:pulse indicating pregnancy.
✵Single-featured pulse:pulse with only one distinct feature, such as slow pulse or slippery pulse.
✵Multi-featured pulse: pulse with two or more distinct features, such as floating and tense pulse, deep, fine and rapid pulse.
✵Dorsally located pulse: an antomic anomaly of the radial artery which makes the pulse beat felt on the dorsal aspect of the wrist.
✵Slantingly located pulse: an anatomic anomaly of the radial artery which makes the pulse beat felt running from the chi(cubit) section outward and slantwise to the back of the hand.
✵Pulse corresponding to the season: change of the pulse in response to the change of season,e.g., the normal pulse being slightly taut in spring and somewhat full in summer.
✵Pulse contrary to the season:failure of pulse in varying with the change of the season,e.g.,floating instead of taut in spring, and deep instead of full in summer, indicating inability of the body to adapt itself to the change of season.
✵Stomach Qi,vitality, and root:three qualities for a normal pulse.
✵Pulse with stomach Qi: a pulse beating smoothly with a regular rhythm, normal frequency, moderate force, appropriate volume, and situated in median depth(neither floating nor sunken), indicating the adequacy of stomach Qi.
✵Pulse without stomach Qi: a pulse that has lost its usual rhythm, frequency, and evenness, indicating a critical lack of stomach Qi.
✵Pulse with vitality:pulse beating with moderate but sufficient strength.
✵Pulse with root:pulse that can be felt upon deep palpation.
✵Calm pulse: a pulse that becomes gentle and even in the course of an illness, usually indicating improvement of the condition.
✵Agitated pulse:pulse that becomes rapid and rushing, usually indicating deterioration of the condition.
✵Disease indicated by pulse condition: type of pulse indicative of a particular syndrome,e.g., the floating pulse of an exterior syndrome, deep pulse of the interior syndrome, wiry pulse of liver disorder, etc.
✵Floating pulse at both yin and yang:floating pulse felt at both the inch(cun) and cubit(chi) sections, indicating an exterior syndrome.
✵Tense pulse at both yin and yang:tense pulse felt at both the inch(cun) and cubit(chi) sections, indicating an exterior syndrome caused by cold.
✵Visceral exhaustion pulse:a pulse condition indicating exhaustion of Zang viscera, often found in a critically ill patient.
✵Extremely abnormal pulse:pulse very different from the normal, usually seen in severe cases.
✵Consideration of both pulse and complexion:making a diagnosis by reviewing the patient's pulse condition together with the complexion.
✵Comprehensive consideration of the four examination: making a diagnosis by analyzing the results of all the four examinations.
✵Consideration of both pulse and symptoms: making a diagnosis by reviewing the patient's pulse condition together with the symptoms.
✵Preference for symptoms over pulse: making a diagnosis on the basis of symptoms rather than the pulse condition.
✵Preference for pulse over symptoms:making a diagnosis on the basis of pulse condition rather than symptoms.
✵Touching:examination of the body surface by touch with the hand or fingers.
✵Palpation of the forearm: an examination of the forearm with the hand for determining the texture of the skin, development of the muscles and temperature of the extremities.
✵Palpation of the skin: an examination of a certain area of skin with the hand for determining local temperature, moisture, pain, swelling, and other local change.
✵Palpation of the chest and abdomen: an examination of the chest and abdomen with the hand to determine the location and extend of the affected region and the pathological change of the viscera.
✵Palpation of the epigastrium and abdomen: an examination of the abdomen, including the epigastric region with the hand for local temperature, consistency, distention, mass formation, and tenderness.
✵Palpation of the hands and feet: an examination of the hands and feet chiefly for determining the cold or heat nature of a syndrome.
✵Pressing on acupoints: an examination of acupoints with the finger to search for tender points which can reflect diseases in corresponding internal viscera.
✵Refusal of pressure:a condition in which pressing can aggravate discomfort or pain.
✵Preference for pressing:a condition in which pressing can relieve discomfort or pain.
References:
1.Introduction of the Palpation method of TCM Diagnostics.
✵The Palpation is one of the four examinations of TCM Diagnostic methods, examination of the surface of the body by feeling with the hand or fingers, including taking the pulse.
Introduction about Palpation: The main content of Palpation is introduced as:
✵Nine readings of three sections:(1).taking the pulse on three portions of the body, the head, and the upper and lower limbs. At each portion the pulses of the following arteries are examined:the temporal artery at point taiyang(EX-HN5) for the state of the head, the auricular artery at point ermen(TE21) for the ears, the buccal artery at points dicang(ST4) and daying(ST5) for the mouth and teeth, the radial artery at inch(cun) for the lung, the ulnar artery at point shenmen(HT7) for the heart.Also, the pulse at point hegu(LI4) is examined for the chest, the pulse at points wuli(LR10) and taichong(LR3) for the liver, the pulse at points qimen(LR14) and chongyang(ST42) for the spleen and stomach, and the pulse at point taixi(KI3) for the kidney-a method of general examination adopted in ancient times,(2).three sections of the radial artery at the wrist for pulse feeling are designated as inch, bar and cubit, each section felt with light, moderate and heavy force to study the superficial, medium and deep pulse, respectively.
Moderate pulse:a pulse with a moderate rate, even rhythm and moderate tension, indicating a normal condition.
✵Pulse corresponding to the season: change of the pulse in response to the change of season,e.g., the normal pulse being slightly taut in spring and somewhat full in summer.
✵Palpation of the forearm: an examination of the forearm with the hand for determining the texture of the skin, development of the muscles and temperature of the extremities.
