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What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
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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