What is the scientific basis for taking pulse signals? Really effective?

The unique diagnostic method of traditional Chinese medicine - pulse diagnosis, which means taking the pulse, commonly known as "pulse counting". Diagnosing diseases by taking the pulse has a long history. Sima Qian recorded in "Historical Records" how doctors diagnosed the pulse and treated diseases. In 1973, the bamboo slips and silk medical books unearthed from the Han (Western Han Dynasty) tomb in Mawangdui, Changsha, Hunan, already contained the content of "pulse method". my country's first pulse study monograph, "Mai Jing", was produced in the Jin Dynasty, and the pulse diagnosis methods and theories in it are quite complete.

Early pulse-taking methods were more complicated, requiring cutting and pressing the pulses in multiple places such as the head and neck, hands, and feet. Later, it was gradually simplified to just cutting and pressing the pulse at the wrist, which was called the "Cunkou" diagnosis method. Ancient doctors have done a lot of work on this short and long pulsation area. They divided the pulse about an inch long from the wrist crease upward into three parts: "Cun, Guan, and Chi".

The Cun, Guan, and Chi parts of the left and right hands belong to different internal organs, and it is believed that they can reflect the lesions of the corresponding internal organs. Among them, the right cun reflects the condition of the lungs, the right guan reflects the spleen and stomach, and the right ruler reflects the kidneys (vital gate); the left cun reflects the heart, the left guan reflects the liver, and the left chi reflects the kidneys and bladder.

If you observe carefully, you can find that: the far-end cun part corresponds to the heart and lungs (upper burner, respiratory and circulatory system) in the uppermost part of the human body; the middle guan part corresponds to the liver, spleen and stomach (middle part). Jiao, digestive system); the proximal ulnar part corresponds to the kidneys and bladder (lower Jiao, genitourinary system). In this way, the small "inch" seems to become a holographic window for the internal organs of the human body.

This alone is not enough. When taking the pulse, three different finger forces must be used to press the pulse. Press lightly on the skin to "float"; press with medium force until the muscles are "Centering"; pressing hard until the muscles and bones are "sinking". There are three parts: Cun, Guan and Chi. Each part has three periods: floating, middle and sinking. Together they are called "Three Parts and Nine Periods". The pulses obtained by different techniques have different clinical significance. Usually, if the pulse floats outside, the disease is shallow, and if it sinks inside, the disease is deep.

There are many things to pay attention to when taking pulse. First of all, quietness is required, including the quietness of the external environment and the quietness of both doctors and patients. The patient should rest for a while before taking the pulse, and wait until he is quiet before taking the pulse. Before taking the pulse, the doctor must meditate, adjust his breathing, completely focus his attention on the fingertips, and carefully cut and press for more than one minute. When diagnosing the pulse, the patient should be in a sitting or supine position, with the arms and heart at the same level, the wrists stretched, and the palms facing up.

Secondly, when cutting, the doctor uses three fingers to position the joint, that is, first uses the middle finger to locate the joint, and then adjusts the spacing of the three fingers according to the patient's height. If the patient is tall, the cloth fingers should be sparse; if the patient is short, the cloth fingers should be dense. In children, one finger (thumb) should be used to diagnose the pulse without dividing it into three parts.

To learn to diagnose pulse, you must first understand the normal pulse condition. Normal pulse is called "Ping pulse" or "Constant pulse". It beats about 70-80 times per minute, with a regular rhythm. The pulse pattern is neither thick nor thin, neither floating nor sinking, neither strong nor weak. However, normal pulse conditions often vary with season, age, gender, physical constitution, etc. For example, in spring, summer and autumn, the pulse is mostly floating and has strong pulse; in winter, the pulse is mostly sinking. The younger the age, the faster the pulse. Young adults have stronger pulses, while older people have weaker pulses. Tall people have longer pulses, short ones have shorter pulses, thin people have more floating pulses, and fat people have more sinking pulses. After a full meal and emotions When one is excited, the pulse is fast and strong; when one is hungry, the pulse is weak. If opposite pulse conditions are found, such as floating pulses in winter, floating pulses in fat people, and sinking pulses in thin people, it indicates abnormal pulse conditions.

The following introduces several common abnormal pulse conditions.

The floating pulse is a superficial pulse at the site where the pulse appears. It can be felt easily by pressing lightly, but it will become weaker if pressed harder. Under normal circumstances, it indicates that the disease is on the surface. If the pulse is floating but strong, the pulse is superficial; if the pulse is floating but weak, the pulse is superficial.

The Shen pulse is a type of pulse that is deeper in the area where the pulse appears. It cannot be picked up lightly and can only be seen after pressing hard. Usually, the main syndrome is internal syndrome. Those who are heavy and powerful are internal syndrome, and those who are heavy but weak are internal deficiency syndrome.

Late pulse, the pulse comes slowly, less than 60 times per minute. Most of them are caused by cold syndrome, because cold can slow down the blood flow. Those who are late and powerful are cold accumulation syndrome, and those who are late and weak are Yang deficiency syndrome.

Count the pulse. The pulse comes quickly, more than 90 times per minute, and comes and goes quickly. Most of them are heat syndrome, because heat can accelerate the blood flow speed. Those who are strong when counting are called excess heat syndrome, and those who are weak when counting are called deficiency heat syndrome.

Thin veins are also called small pulses. The pulse is like a thin line, weak and weak, but it should be obvious. This is a sign of dampness syndrome and deficiency syndrome. It is caused by dampness blocking the arteries or Qi and blood deficiency that cannot fill the arteries.

Hong Vein, the vein is broad, substantial and powerful, rising and falling, like a flood. Most of them are evidence of excessive evil heat.

Xian pulse, the pulse shape is straight, like pressing a string. Commonly seen in patients with hepatobiliary disease, phlegm syndrome, and pain syndrome.

Slippery pulse, the pulse is slippery and smooth, like a running bead. It is syndrome of excessive heat, syndrome of phlegm and fluid retention, syndrome of food injury, or pulse condition of pregnancy.

Astringent pulse, the pulse is difficult and not smooth, like scraping bamboo with a light knife. It is a sign of qi stagnation, blood stasis, and lack of essence and blood.

Asthenic pulse means that all three pulses are weak when pressed and move faintly under the fingers. It is a general term for all weak pulses. It is a sign of deficiency syndrome, mainly qi deficiency or qi and blood deficiency syndrome.

The real pulse is a general term for all powerful pulses. This is a sign of reality, indicating that the evil energy is real but the healthy energy is not deficient.

Promoting the Jie Dai pulse, that is, promoting the pulse, knotting the pulse, and Dai pulse, are pulses with abnormal rhythm and intermittent pulses. A pulse-promoting pulse is rapid and rapid with irregular intervals. A pulse that is rapid and strong is a sign of excessive yang heat. A pulse that is rapid and weak is mostly a sign of qi deficiency. A knotted pulse is a pulse that is slow and has irregular intervals. There are many main diseases such as yin excess, qi stagnation, cold phlegm, blood stasis, etc. Daimai is characterized by slow and regular pulses with long intervals. It is a syndrome of weak internal organs or qi stagnation and blood stasis.

There are many pulse conditions, the above are the most important ones. In the clinical treatment of TCM, in addition to looking, smelling and asking, pulse checking is also very important. Sun Simiao, a famous doctor in the Tang Dynasty, said: "The great cause of medicine is the pulse. If you don't study its way deeply, how can you be a doctor?!" In syndrome differentiation, the pulse condition often plays a decisive role.

For example, I recently treated an elderly patient who had frequent and recurring diarrhea for many years. When he was diagnosed, he had 5 or 6 bowel movements a day with watery diarrhea. The stool was not very smelly, and there was no pus or blood. He could not eat any food containing crude fiber. , you can only eat a small amount of porridge or rotten noodles every day, otherwise you will have more diarrhea. Observe that the tongue is light red and the fur is thin and white. Judging from the above symptoms, there seems to be no fever. However, the patient's pulse was very rapid (124 times per minute, he had a history of coronary heart disease, and he often had palpitations, chest tightness and other symptoms). According to the syndrome differentiation, the patient has a long course of disease and has a weak spleen, but there is a fire evil. The fire evil presses down on the large intestine and causes diarrhea, and disturbs the mind and causes palpitations. Therefore, I used qi-tonifying Codonopsis pilosula and other drugs combined with Coptis chinensis to clear away heat and purge fire (it can both purge the large intestine fire and clear the heart fire, killing two birds with one stone). After seven doses, I returned to the hospital and my bowel movements were reduced to 1 or 2 times a day. The symptoms of heart palpitations improved and my heart rate also improved. slow down.

Of course, the etiology and pathological changes of the disease are very complex, so the clinical pulses are often also very complex, and two or more pulse conditions are often seen together, such as floating pulse, Shen Chi, sliding number, string astringency, etc. There is also the issue of whether the pulse syndrome is consistent or not. When they are inconsistent, it is necessary to decide whether to ignore the syndrome and follow the pulse, or to abandon the pulse and follow the syndrome. In addition, it is not difficult to diagnose pulse in theory, but in actual operation, it is not easy to determine the pulse and explain and analyze the relationship between pulse and disease. The ancients said: "The pulse is so subtle that it cannot be explained in words. It is difficult to understand when you know it in your heart." Without years of repeated practice, careful understanding, and without careful understanding and comparison, it is impossible to truly grasp the pulse diagnosis.