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The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
B Vitamins Improve Memory, Prevent Brain Atrophy
The 2010 OPTIMA study showed that the accelerated rate of brain atrophy in elderly with mild cognitive impairment could be slowed via supplementation with homocysteine-lowering B vitamins, which included folic acid, vitamin B12 and vitamin B6.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
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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