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Massage Today
August, 2003, Vol. 03, Issue 08

The "Secret" of Chinese Pulse Assessment, Part II

By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc

Editor's note: This series of articles is based on information from Barbra Esher's forthcoming textbook, Shiatsu and Chinese Medicine.

Last time, I gave an introduction to taking the pulses using the information gathered within the context of Chinese assessment principles.

In this article, you will find the method for taking the pulse and the correlations to the whole body.

Method for Taking the Pulse

If you want accurate readings, it is essential to decrease your variables as much as possible. I can't emphasize this enough! There are so many things that will affect your readings. Being consistent each time you take a pulse will enable you to better evaluate the information.

Chart on Chinese pulse assessment. - Copyright – Stock Photo / Register Mark The best time to take the pulse is at the crack of dawn, which is considered a neutral time between yin and yang when you can get the most accurate reading. I don't know about you, but I am not ready to restructure my practice so that my clients line up at 6 a.m. to have their pulses taken! Instead, I give my clients a few minutes to settle down from the yang of rushing to get to their appointment (between the yang of the outside world and the relative yin of my office) and take their pulses at that time. Most of my questions are guided by what I feel in their pulses.

Chart on meridian correlation of the pulse positions. - Copyright – Stock Photo / Register Mark To start, make sure you are grounded: both feet on the floor if you are sitting, shoulders relaxed and your breath regular and natural. Traditionally, the pulse is compared to that of the healthy practitioner. You could always use a clock if you aren't in optimal shape! Likewise, the client needs to be relaxed: shoulders dropped, with nothing even slightly occluding the arteries. The hands need to be below their hearts, resting naturally on a pillow or their bodies. The client can be sitting or lying down, but be consistent with whatever way you do it.

Use your first three fingers to rest on the radial artery at the styloid process, with your right hand on the left wrist and your left hand on the right wrist. The first position is sometimes referred to as cun, or inch, and is on the wrist crease, just distal to the styloid process. The second position is called guan, or bar, and is right over the process; the third position, chi, or cubit, is just proximal to it. The pressure is fairly light at the superficial level, slightly deeper at the middle level, and just before the bone for the deepest level.

Pulse Position Correlations

It is common for the superficial and deep positions to be each associated with a meridian; there are three superficial and deep pulse positions on each hand, making a total of twelve pulse positions. Interestingly, the positions were described in the Nan Jing (Classic of Difficulties, written around the 2nd century CE) using six meridian terminology, such as Hand Taiyang and Hand Shaoyin for Small Intestine and Heart. This specifically relates to the meridians more than the organs - a distinction not normally made in English. That's why ABTs often use this pulse map, compared to later ones commonly used by herbalists.

Diagram of pulse positions. - Copyright – Stock Photo / Register Mark The Nan Jing used and developed the Five Element theory more than other Chinese medicine texts, and you may notice those correlations within the positions. The elements associated with the positions on the left hand control or act on the positions on the right. Fire (SI/H) controls Metal (LI/Lu); Wood (GB/Li) controls Earth (St/Sp); and Water (Bl/Ki) controls Fire (TH/Pc). Thus, it is thought that the pulses on the left hand are stronger than the right, though often with people that are Blood-deficient, this is not the case.

Start taking the pulses using this map and write down how strong or weak the pulses are in each position. Group the pulses into the upper part of the body for the first position; the middle part of the body for the second position; and the lower part of the body for the third position. You will notice that the part of the body in which your client feels the most discomfort is the pulse that stands out as the most weak or strong, in relationship to the other pulses. You will refine this technique the more you practice!

Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.


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