Pulse-Diagnosis and the Concept of Qi in TCM from a Transcultural Perspective

--Dr. ZHANG Chunyue --Dr. ZHANG Chunyue

Department of Humanities, Beijing University of Chinese MedicineDepartment of Humanities, Beijing University of Chinese Medicine

Supervisor: Prof. Dr. EignerSupervisor: Prof. Dr. Eigner

Department of Medical Anthropology, Medical University of ViennaDepartment of Medical Anthropology, Medical University of Vienna

Contents:

1. Pulse manifestations1. Pulse manifestations

2. Qi exercises 2. Qi exercises

3. Brief introduction of TCM (Traditional Chinese Me3. Brief introduction of TCM (Traditional Chinese Medicine)dicine)

1.Pulse Manifestation

• (1)location and method(1)location and method

• (2) feeling practice (2) feeling practice • (3) brief introduction (3) brief introduction

• (4) Practice in patients(4) Practice in patients

• (5) Case examples(5) Case examples

(1) Location and method

• Location: cun, guan, chiLocation: cun, guan, chi

The guan (Second) position is found opposiThe guan (Second) position is found opposite the styloid process of the radius, the cun ite the styloid process of the radius, the cun is between the guan and the wrist, and the chs between the guan and the wrist, and the chi is at a point equal the distance between gui is at a point equal the distance between guan and cun. an and cun.

• Methods:Methods:

Method:

• The different points of the pulse felt on the The different points of the pulse felt on the wrist represent the functions of different orgwrist represent the functions of different organs. ans.

TCM TCM NamesNames

cun positiocun positionn

guanguan

positionposition

chichi

positionposition

Left handLeft hand Heart Heart meridianmeridian

Liver Liver meridianmeridian

Kidney Kidney (yin) M.(yin) M.

Right handRight hand Lung Lung meridianmeridian

Stomach Stomach and spleen and spleen M.M.

Vital gate Vital gate (kidney (kidney yang) M.yang) M.

The pulse is differentiated in The pulse is differentiated in depth, speed, strength, shape and rhythm. depth, speed, strength, shape and rhythm.

A A normal pulsenormal pulse is smooth, even and forceful is smooth, even and forceful with the frequency of four beats per breath with the frequency of four beats per breath (approximate 60/min). (approximate 60/min).

A pulse may vary due to age, sex, and body cA pulse may vary due to age, sex, and body constitution, emotional state and climatic chaonstitution, emotional state and climatic changes. nges.

(2) Feeling practice

• The first step:The first step:

depth, speed, depth, speed, • The second step:The second step:

strength, and rhythmstrength, and rhythm• The third step:The third step:

shapeshape

• The 4The 4thth step step

find the healthy pulsefind the healthy pulse• The 5The 5thth step step

abnormal pulsesabnormal pulses

(3)Introduction of abnormal pulses• Floating (fu mai): Floating (fu mai): Pulse responds to finger on light pressure but Pulse responds to finger on light pressure but

becomes weak on heavy pressure becomes weak on heavy pressure Exterior syndromeExterior syndrome• Deep (chen mai): Deep (chen mai): Not clear with light pressing; clear with heavy Not clear with light pressing; clear with heavy

pressing pressing Interior syndromeInterior syndrome• Slow (chi mai) Slow (chi mai) Rate: is less than 4 beats per breath (less than 60/Rate: is less than 4 beats per breath (less than 60/

min) min) Cold syndromeCold syndrome• Rapid (shu mai)Rapid (shu mai)Rate: is more than 5 beats per breath (more than Rate: is more than 5 beats per breath (more than

90/min)90/min) Heat syndromeHeat syndrome• Deficiency (xu mai):Deficiency (xu mai): 　　 Lack of force, empty and vacuous with Lack of force, empty and vacuous with

pressurepressure　　　　　　　　 Deficiency in qi (vital energy) and bloodDeficiency in qi (vital energy) and blood• Excess (shi mai)Excess (shi mai) ：： Forceful with touching and pressingForceful with touching and pressing　　　　　　　　 Excess syndrome, heat syndromeExcess syndrome, heat syndrome

• Rolling (hua mai)Rolling (hua mai) ：： Smooth and flowing like pearls rolling oSmooth and flowing like pearls rolling on a dish.n a dish.

　　　　　　 Phlegm and fluid detention, excess heat and food retention.Phlegm and fluid detention, excess heat and food retention. But it is also usual in healthy people with ample qi (vital energ But it is also usual in healthy people with ample qi (vital energy) and blood, and in pregnant women. y) and blood, and in pregnant women.

• Hesitant (se mai) Hesitant (se mai) Rough and uneven, opposite to rolling pulse.Rough and uneven, opposite to rolling pulse.　　　　　　 Stagnation of qi (vital energy) or blood, impairment of essStagnation of qi (vital energy) or blood, impairment of ess

ence, and deficiency of blood.ence, and deficiency of blood.

• Thready (xi mai)Thready (xi mai) Feels like a fine thread but is very distinct an Feels like a fine thread but is very distinct and clear.d clear. 　　

　　　　　　 Deficiency due to overstrain and stress or deficiency of qi Deficiency due to overstrain and stress or deficiency of qi (vital energy) and blood.(vital energy) and blood.

• Surging (hong mai) Surging (hong mai) Feels broad, large and forceful like powerfFeels broad, large and forceful like powerful waves that ebb and flow.ul waves that ebb and flow.

　　　　　　 Excessive heatExcessive heat

• Taut (xuan mai)Taut (xuan mai) ： ： Feels taut, straight and long,Feels taut, straight and long, like the string of a violin like the string of a violin

　　　　 Disorders of the liver and gall-bladder, painfDisorders of the liver and gall-bladder, painful syndromes, and phlegm and static fluid detentul syndromes, and phlegm and static fluid detention.ion.

• Tense (jin mai)Tense (jin mai) ：： Feels tight and forceful like Feels tight and forceful like a stretched rope.a stretched rope.

　　　　　　 Syndromes of cold, pain and retention of fSyndromes of cold, pain and retention of food.ood.

• Knotted (jie mai)Knotted (jie mai) ：： Slow and gradual with irreSlow and gradual with irregular or missed beats.gular or missed beats.

Serious conditions with impairment of qi (vSerious conditions with impairment of qi (vital energy) and blood and declining yang-qi.ital energy) and blood and declining yang-qi.

Practice or examples

Introduction

Four diagnostic methods in TCMFour diagnostic methods in TCM• InspectionInspection• Auscultation and olfactionAuscultation and olfaction• InquiryInquiry• Pulse-taking and palpationPulse-taking and palpation

Introduction of details of inquiry

十问歌十问歌• 一问寒热二问汗一问寒热二问汗 , , 三问头身四问便三问头身四问便• 五问饮食六胸腹五问饮食六胸腹 ,, 七聋八渴具当辨七聋八渴具当辨 ..• 九问旧病十问因九问旧病十问因 ,, 再兼服药参机变再兼服药参机变 ..• 妇女犹需问经期妇女犹需问经期 ,, 天花麻疹全占验天花麻疹全占验 ..

Qigong Exersice

• Daoism exerciseDaoism exercise

Taiji Quan

• Sunshi TaijiSunshi Taiji

(5-10min)(5-10min)

3. Brief introduction of TCM (Traditional Chinese Medicine)

• (1) Background generating TCM theories(1) Background generating TCM theories• (2) Characteristics of TCM theories (2) Characteristics of TCM theories • (2) Basic terms(2) Basic terms

Background generating TCM theories

• 1. 1. ZhouyiZhouyi ( (Chou yi; Chou I; IChou yi; Chou I; I))• 2. Huang and Lao Philosophy2. Huang and Lao Philosophy• DaoismDaoism• 3. Agriculture society3. Agriculture society• nature, nature, • climate, climate, • geographygeography

Characteristics of TCM theories

• repeatabilityrepeatability • Reasoning from factual knowledge or evidence Reasoning from factual knowledge or evidence • It is not a symbolic math, while there is math logic in it.It is not a symbolic math, while there is math logic in it.Natural sciences inquiry into the nature of things based on logNatural sciences inquiry into the nature of things based on log

ical reasoning rather than empirical methods. ical reasoning rather than empirical methods. TCM, character math, TCM, character math, Logical deduction by reasoning comes to the third step. Logical deduction by reasoning comes to the third step.

Introduction of TCM Terms• 1. qi one1. qi one• 2. yin and yang two2. yin and yang two• qi and xue (the blood)qi and xue (the blood)• 3. five elements three 3. five elements three • metal (jin), earth (tu), fire (huo-kidney yang)metal (jin), earth (tu), fire (huo-kidney yang)• fire (huo-heart qi), wood (mu), water (shui-kidnfire (huo-heart qi), wood (mu), water (shui-kidn

ey yin) ey yin) • shown in the pulse manifestationshown in the pulse manifestation• 4. pathogenic factors:4. pathogenic factors:• Wind, fire, summer-heat, dampness, dry, coldWind, fire, summer-heat, dampness, dry, cold

• 5. Eight principles in Diagnoses 5. Eight principles in Diagnoses (pathogenesis)(pathogenesis)

• (1) yin and yang(1) yin and yang• (2) the interior and exterior(2) the interior and exterior• (3) cold and heat(3) cold and heat• (4) excess and deficiency(4) excess and deficiency

• 6. Five zang and six fu6. Five zang and six fu• Five zang: xin, gan, pi, fei, shen.Five zang: xin, gan, pi, fei, shen.• heart, liver, spleen, lung, kidney: the related heart, liver, spleen, lung, kidney: the related

structure and function of the five organs and structure and function of the five organs and brain, pancreas, gall bladder, brain, pancreas, gall bladder,

Huangdi NeijingHuangdi’s Classic on Medicine• 从阴阳则生，逆之则死；从阴阳则生，逆之则死；

从之则治，逆之则乱。从之则治，逆之则乱。反顺为逆，是谓内格。反顺为逆，是谓内格。是故圣人不治已病治未病，不治已乱治是故圣人不治已病治未病，不治已乱治未乱，此之谓也。未乱，此之谓也。夫病已成而后药之，乱已成而后治之，夫病已成而后药之，乱已成而后治之，譬犹渴而穿井斗而铸锥，不亦晚乎！譬犹渴而穿井斗而铸锥，不亦晚乎！

• Following the principle of yinyang ensures life, while breaking them Following the principle of yinyang ensures life, while breaking them may lead to death; conforming to the principles of yinyang guarantees may lead to death; conforming to the principles of yinyang guarantees health, while violating them may result in disease. health, while violating them may result in disease.

• The movement from conformity to violation is known as interior rejectThe movement from conformity to violation is known as interior rejection. ion.

• Therefore, wise doctors give prevention the priority over treatment, anTherefore, wise doctors give prevention the priority over treatment, and pay less attention to the treatment of disease but more to the preventid pay less attention to the treatment of disease but more to the prevention of disease. on of disease.

• This is the reason.This is the reason.• Applying medicine only when disease has emerged, and resorting to trApplying medicine only when disease has emerged, and resorting to tr

eatment when disorder has appeared, are just like drilling a well when eatment when disorder has appeared, are just like drilling a well when one feels thirsty, and manufacturing weapons when war has already brone feels thirsty, and manufacturing weapons when war has already broken out. It is certainly too late!oken out. It is certainly too late!

• ////• Man will survive when following the law of yin and yang, and dies whMan will survive when following the law of yin and yang, and dies wh

en acts against it.en acts against it.• If the yang energy fails to enter into the body and yin energy can not cIf the yang energy fails to enter into the body and yin energy can not c

ome out from the body, the favorable condition of health will turn to tome out from the body, the favorable condition of health will turn to the adversity, the contradiction between exterior and interior will cause he adversity, the contradiction between exterior and interior will cause the disease of mutual excluding of yin and yang.the disease of mutual excluding of yin and yang.

《灵枢 经脉》：• 肺手太阴之脉：起于中焦，下络大肠，肺手太阴之脉：起于中焦，下络大肠，

还循胃口，上膈属肺。从肺系，横出腋还循胃口，上膈属肺。从肺系，横出腋下，下循臑内，行少阴、心主之前，下下，下循臑内，行少阴、心主之前，下肘中，循臂内上骨下廉，入寸口，上鱼，肘中，循臂内上骨下廉，入寸口，上鱼，循鱼际，出大指端。循鱼际，出大指端。 其支者：从腕后，直出次指内廉，出其 其支者：从腕后，直出次指内廉，出其端。端。

Lingshu · Meridians• Lung Meridian of Hand Taiyin Lung Meridian of Hand Taiyin • The Lung Meridian of the Hand Taiyin originates from the Zong Jiao (stomacThe Lung Meridian of the Hand Taiyin originates from the Zong Jiao (stomac

h), and descends to connect with the large intestines. It then turns back and goh), and descends to connect with the large intestines. It then turns back and goes along the upper orifice of the stomach, passing through the diaphragm and ees along the upper orifice of the stomach, passing through the diaphragm and enters the lung (the pertaining organ) and exits transversely from the arm pit. It nters the lung (the pertaining organ) and exits transversely from the arm pit. It then descends along the anterior-medial side of the upper arm, going in front othen descends along the anterior-medial side of the upper arm, going in front of the Hand Jueyin, and reaches the elbow. It then goes downward along the radf the Hand Jueyin, and reaches the elbow. It then goes downward along the radial side on the medial aspect of the forearm and enters the cunkou (anterior maial side on the medial aspect of the forearm and enters the cunkou (anterior margin of the styloid process at the wrist) where the radial artery at the wrist palprgin of the styloid process at the wrist) where the radial artery at the wrist palpates. It then passes through the major thenar eminence and goes along its radiaates. It then passes through the major thenar eminence and goes along its radial border and goes out to end at the medial side of the tip of the thumb.l border and goes out to end at the medial side of the tip of the thumb.

• A branch of this meridian splits from the styloid process of the wrist A branch of this meridian splits from the styloid process of the wrist (Lieque point, LU7), and runs to the radial side of the tip of the index finger, (Lieque point, LU7), and runs to the radial side of the tip of the index finger, where it connects to the Large Intestine Meridian of the HanD Yangming.where it connects to the Large Intestine Meridian of the HanD Yangming.

quotation

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