resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
October, 2003, Vol. 03, Issue 10
The "Secret" of Chinese Pulse Assessment
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.
Author's note: In the first two articles in this series, I described the way pulses are taken (www.massagetoday.com/archives/2003/06/07.html) and how to perform a quantitative pulse analysis (www.massagetoday.com/archives/2003/08/06.html).The following article, which will discuss performing a simple qualitative pulse analysis, will be best understood after reading the previous articles in the series.
In my last article, I referred to Dr. Hammer's book as being 800 pages. He corrected me: It is only 756 pages (811, with a comprehensive index). My mistake, however, demonstrates how deeply one can be drawn into the study of pulse diagnosis. I am grateful Dr. Hammer took 20 years to study and record an oral pulse tradition. Reliable information can be obtained from the pulses in a relatively short amount of time; however, incredibly in-depth and accurate diagnoses can be obtained with additional study. If you find you have a good feel for the pulses - as many bodyworkers do - I recommend taking more extensive courses.
Check out www.dragonrises.org for more information.
It is generally agreed there are 28 main pulse qualities that can be identified in the 12 different pulse positions (there are many more positions and qualities in the book mentioned above). For the purpose of Asian Bodywork Therapy (ABT), I start students with qualities related to the Eight Principles and the Five Elements.
The Eight Principles is a method of pattern identification, with some elements dating back thousands of years to the Huang Ti Nei Jing and the Shang Han Lun. However, it was formulated into Interior/ Exterior; Hot/Cold; Full/Empty; and Yin/Yang in the early Qing dynasty (late 1600s). It is a useful system for unraveling the genesis and nature of just about any disharmony.
Exterior/Interior identifies the location of the problem, not the etiology. An Exterior condition affects the skin, muscles and/or meridians. It is categorized as Interior when it primarily affects the organs and bones. An Exterior condition can arise from an external pathogenic factor, or it can come from an internal problem and vice versa. Interior/Exterior only describes the location at the moment the pulse is taken. Simply, an Exterior condition manifests as a Floating pulse. It is a pulse felt at the superficial level, using light pressure. An Interior condition is felt with more pressure and is called a Deep pulse.
Hot/Cold describes an aspect of the nature of a pattern. Clinically, Hot manifests as a Rapid pulse. Traditionally, the pulse rate was measured in relation to the practitioners' breath, but for consistency's sake, it might be better to use a watch. Rapid is roughly over 80 beats per minute. Children run a little hotter, temperature wise, than adults; their pulses are more naturally rapid, which doesn't necessarily indicate pathology.
Cold is usually considered less than 65 beats per minute and is described as a Slow pulse; however, someone who is athletic typically has a Slow pulse. In that case, it is not necessarily a cold condition. Interestingly, regular exercise tends to "chill us out," so these people may be treating their hot natures, bringing themselves and their pulses into a more relative balance.
Full/Empty may be the easiest conditions to relate to a pulse type. These conditions are sometimes referred to as Excess/Deficiency, and manifest as Full and Empty pulses. A Full pulse can be a specific pulse often described as hard and rather long, extending beyond the normal pulse position. It also can be used to describe any pulse type that has a bigger, more substantial feel under the fingertips. An Empty pulse indicates a lack of something, such as Qi, Blood, Yin or Yang, and is referred to as a Deficiency. It occupies a shorter space and has a less substantial feel to it. It is used also in the general sense to describe a whole range of different deficiency type/weak pulses.
Yin/Yang can describe a generalization of the other six principles; therefore, a condition that is entirely Yin would be Interior, Cold and Empty. The pulse quality is a combination of Deep-Slow-Weak. A Yang condition is Exterior, Hot and Full; thus, the pulse for a strictly Yang condition is Floating-Rapid-Full. Yin/Yang are more frequently used to describe conditions of emptiness, commonly called Yin or Yang Deficiency. If there is not enough cooling Yin, it is referred to as a Yin Deficiency. This condition is Hot and Empty, manifesting as a Rapid-Empty pulse. If there is not enough warming Yang, it is called a Yang Deficiency. The condition is Cold and Empty, and the pulse appears Slow-Empty. So, in a way, there are only six main pulse types - all of the other qualities being variations of these six.
The pulse quality left out of the table is called a Leisurely or Slowed-Down pulse. It is about the same strength in every position: not too strong or weak, and with a moderate rhythm and rate. This pulse indicates a fairly balanced and healthy individual, and so far, I have never felt it with anyone coming into my clinic! Maybe it was more common in ancient times?
A good way to learn five common pulse qualities is by relating them to the Five Elements and the Yin organs that relate to each one:
The pulse qualities outlined in this article are the simplest to begin with. The more that pulse assessment is consistently practiced, the more the information received will make sense. Get started!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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