Pulse-taking and palpation in TCM Diagnosis

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The methods for taking pulse in TCM diagnosis
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Time: Early morning is the ideal time for taking pulse because the conditions of the pulse are not affected by food and other activities. However, this requirement is difficult to fill in clinical practice. To ensure accurate pulse taking, the patient should rest for a while to tranquilize the heart and breath before the taking of pulse. The pulse should be taken at least for one minute each time in order to correctly examine the conditions of the pulse.

Normal and calm breath:
Normal and calm breath means that the doctor keeps his or her own breath quiet to examine the pulse of the patient and calculate the beat of the pulse according to his or her own cycle of exhalation and inhalation. Healthy people breathe 16 - 18 times one minute under normal conditions. And the pulse beats 4 - 5 times in a cycle of exhalation and inhalation, about 60 - 90 beats per minute.

Posture:
The patient sits erect or lies in supination and the forearms stretches out naturally to the level of the heart. The wrist is put straight, the palm turns over and the fingers are relaxed to extend the cunkou region and enable qi and blood to flow freely.

Arrangement of fingers:
The three fingers of the doctor are put at the same level and slightly arched to press the pulse with the belly of the fingers. The middle finger presses on the guan pulse, the index finger presses on the region anterior the guan pulse (distal to the heart region), and the ring finger on the chi pulse posterior to the guan pulse (proximal to the heart region). The arrangement of the fingers is made according to the conditions of the patient’s arm. In diagnosing diseases in children, "one finger is used to press just the guan pulse". It is unnecessary to divide the pulse into three parts in this case.
 
General pressure and single pressure:
General pressure means to press the pulse with three fingers to distinguish the conditions of cun, guan and chi pulses on both hands. Single pressure means to examine the pulse on one hand with just one finger to differentiate the states of cun, guan and chi pulses. Clinically these two methods are used according to the pathological conditions in question.

Lifting, pressing and searching: Lifting, pressing and searching refer to flexible pressure of pulse in order to distinguish the conditions of pulse. Light pressure means "lifting"; heavy pressure means "pressing"; and mobile?moderate pressure means "searching" which is used to look for the most obvious region of the pulse. In the procedure of diagnosis, doctors should pay attention to the use of these three methods to distinguish the variations of pulse.

Examining the conditions of pulse:
The conditions of the pulse refers to the sensation of pulse felt by the fingers. The examination of pulse conditions means to distinguish the features of pulse according to the position of pulse, the rhythm of pulse, the shape of pulse and the strength of pulse.



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