Pulse Diagnosis: The Art of Chinese Pulse Taking

Source: http://www.acupuncture-points.org/pulse-diagnosis.html
Copyright © 2011-2017 by Jonathan Clogstoun-Willmott, www.acupuncture-points.org
The Edinburgh Natural Health Centre
Spirit Health Club, Holiday Inn, 132 Corstorphine Road, Edinburgh EH12 6UA
Scotland, United Kingdom 

Pulse diagnosis
has been made into an art form by the Chinese, whereas few Western-trained doctors know how to evaluate your pulse, except by counting it.

Learning to recognise the different qualities takes effort and experience, but for acupuncturists it’s worth it!

What does Pulse Diagnosis mean? The doctor or nurse who takes your pulse the usual way just counts your radial pulse rate.

The ‘Normal’ rate is 72 per minute. Often they don’t wait a minute while doing it: they count it for 15 seconds, and multiply by 4 to get the rate for a whole minute.

Someone trained in Chinese Pulse Diagnosis would probably take much longer than 15 seconds.

Why? Surely a pulse-rate is a pulse-rate?

Here you’ve exposed a weakness in Western medicine, which has trapped itself into judging things purely on the results of data measured by scientific instruments.

Although we need those careful instrumental tests, they tend to ignore the wealth of information that is qualitative rather than quantitative. This qualitative information comes via our senses: via our senses of touch, smell, sight, hearing, sensation.

The relevance of that measurable data is decided by comparing it with statistics obtained from many such measurements.

This is a sensible way of working but it’s different to the objective way of Chinese medicine, which is more interactive.

Twelve (12) pulses, not one!

Well: not actually 12 different pulses, but 12 positions to take the same pulse, six at each wrist.

Here’s how.

Start by taking your friend’s left hand in your left hand. Now place the middle finger of your right hand over the normal radial pulse position where a doctor would feel for it.

Then place the index finger of your right hand on the skin just distal (ie further down the wrist towards the wrist) to your middle finger, and your ring finger just proximal (ie just closer to your friend’s elbow) to your middle finger. Both index and ring finger will be almost adjacent to your middle finger.

Now, if you feel very carefully and if your friend has a reasonably noticeable pulse, you’ll be able to feel the pulse under each of the three fingers, though you may need to feel around a bit for it.

That’s not all. There are two different depths at which you can feel the pulse, deep and shallow. (Actually there are three depths at which many acupuncturists take the pulse, and some take it at additional positions by rolling the finger over and back and side to side of the basic position.)

You may or may not be able to detect the pulse at these different depths in all three positions. If you can, see if you can feel a difference in the pulse quality at each position.

Each pulse relates to a different body Organ

For example, you have a different pulse position for each of your body Organs eg Stomach, Heart, Liver, Kidney etc. and two which don’t have an official physical organ.

Pulse Qualities

There are about 30 different qualities that acupuncturists aspire to learn to recognise. They include fast and slow, thin, wiry, deep, hidden, and so on, each name describing a syndrome in Chinese medicine. You can have different pulse qualities in different positions.

As there are twelve positions for the pulse (6 at each wrist) you’d think it possible to have 12 different pulse qualities at the same time.

Fortunately there are seldom more than 3 or 4 pulse qualities present so several pulse positions share the same quality.

Your acupuncturist may, depending on his/her training, also assess the strength of the pulses in relation to one another. So if what are called the Wood pulses were deficiency and the Water pulses were strong, he might consider drawing on the body’s energy represented by the strong Water pulses to supplement the Wood energy.

How necessary is Pulse Diagnosis?

For acupuncturists and other practitioners of Chinese medicine, it’s usually very important.

For practitioners who use acupuncture according to the ideas behind Western acupuncture, where the needles are inserted according to very different criteria, often to supplement some other form of treatment like physiotherapy or osteopathy, the pulse may be much less important. They might say that the pulses were nonsense or that they get good results without needing to take them.

But the pulses do provide wonderful information about the patient’s health and feedback about how the treatment is going.

For example, the pulse quality often changes within a few seconds of inserting the needle in the right place. As the right treatment progresses, the pulse qualities and strength improve, so that the acupuncturist knows, from pulse diagnosis, that the patient will start feeling better soon.

How useful is pulse diagnosis?

Very. I’ll say that again: very! It provides an enormous amount of information to someone who can recognise and use it.

Sometimes what the patient says contradicts the pulse qualities, in which case the acupuncturist will want to ask more questions to get at the truth. Without the pulse diagnosis he wouldn’t have known to ask more questions, to delve deeper, and might have done the wrong treatment.

Does pulse diagnosis sometimes fail?

If the patient is taking medication, or just been taking strenuous exercise, pulse taking may not work. Equally, if the patient is under the influence of social drugs it may not reveal much.

You can’t take the pulse so easily if the patient’s wrist is all bandaged up or in a plaster cast, say after surgery. (You can instead take it at the ankle and some other places, but it’s not so easy.)

Some patients have arteries that travel on the thumb side of the radial bone so you can’t feel the pulse in the normal position.

Some patients have pulses so small (itself a pointer to their health, of course) that they are very hard to take.

Some patients have lost an arm or are disabled in some way so their pulses can’t be taken.

Pulse Diagnosis is only part of the picture

Normally, your acupuncturist would also talk to you to find out how you are, look at your tongue, examine and palpate where you have pain or discomfort, and so on.

Each of these adds information. So does how you smell, the sound of your voice, the colour and texture of your skin and the sort of emotions you have.

All help, but pulse reading can often cut right through much of this to point directly at how to treat you.

What do different Pulse Qualities mean?

For instance –

  • A wiry pulse usually indicates pain or tension
  • A slow pulse can mean low energy or cold
  • A fast pulse can mean fever, excitement, a condition of heat, but also a condition of Empty Heat
  • A floating pulse can mean you have caught some kind of recent acute disease. Depending on other factors it could instead suggest Yin deficiency
  • A slippery pulse means you have Dampness or Phlegm, or may not be digesting food properly (it’s called Retention of Food). It can also mean you are pregnant!
  • An empty pulse often feels quite strong but on deeper pressure it disappears. It means Qi deficiency.

Does the Pulse quality apply only to the pulse being taken?

It may and it may not. Most suggest general conditions of the body, but can point to a particular condition related to the Organ in question.

So if the slippery pulse were felt only over the Earth position, ie that of the Stomach and Spleen, it might suggest Retention of Food or Phlegm: not that you were pregnant, unless backed up by other evidence.

Other kinds of Pulse-taking?

Yes! Several.

Korean Hand acupuncture uses the pulse at your wrist in comparison with a pulse in your neck.

Ear acupuncturists using Dr Paul Nogier’s system feel your radial pulse when treating acupuncture points in your ear.

The Japanese way of taking your pulse doesn’t take so much notice of actual pulse qualities as of the pulse strength in each position in relation to the pulse strength in other positions.

These differences reflect how Chinese pulse diagnosis and Chinese medicine developed as they spread round the world.

Theory behind Chinese medicine

If you would like to know more about the theory behind Chinese medicine, there’s lots about it on this site.

I’ve written several books which are intended to show how, if you can set aside the usual way of thinking taught in the West, Chinese medicine can be applied to real health situations we all face.

For example, my book – listed below – on ‘Qi Stagnation’ explains what happens when you are stressed (you probably have a tight or even wiry pulse) and what, practically, you can do about it before you need to visit a doctor – or even an acupuncturist.

On this site, if you wonder where to start, try this page on theory.

Find an Acupuncturist!

Go to the BAcC website.

Study points to acupuncture to reduce period pain

July 18, 2017

A study conducted by researchers from Western Sydney University and the University of Auckland has shown that acupuncture treatment significantly reduces period pain intensity, duration and symptoms over time, with improvements being sustained up to a year after treatment.

Primary Dysmenorrhea (period pain) is the most common gynaecological complaint in menstruating women with up to four in five women suffering at some stage during their reproductive years.
The pilot study involved 74 women aged 18-45 years with suspected or confirmed primary dysmenorrhea and no known cause of secondary dysmenorrhea from Auckland and Wellington in New Zealand.
Over half the women receiving manual acupuncture had a least a 50 per cent reduction in their severity of period pain over the three months of treatment.
The paper published in the international journal PLOS ONE, also shows a connection between both the treatment timing and frequency, with high frequency of treatment providing greater improvements in health-related quality of life, such as overall physical component, vitality, social function, and bodily pain.
A reduction in pain relief medication when using manual acupuncture compared to electro-acupuncture was also found.
The randomised controlled trial was led by Dr Mike Armour, postdoctoral research fellow from NICM with fellow researchers from NICM, Western Sydney University and the Department of Obstetrics and Gynaecology, University of Auckland.
Dr Armour says the results are promising and with further larger trials may lead to the development of evidence-based guidelines for acupuncture in the treatment of period pain and its associated symptoms.
“Pragmatic trials of acupuncture have shown a reduction in pain intensity and an improvement in quality of life in women with period pain, however evidence has been limited for how changing the ‘dosage’ of acupuncture might affect the outcome,” says Dr Armour.
“Our pilot study found that using manual stimulation of the needles, rather than an electrical pulse, commonly used in many Chinese studies for period pain, resulted in reduced need for pain relieving medication and improvement in secondary symptoms such as headaches and nausea. The latter was unexpected and will be explored further in future, larger trials.”
Women in the trial kept a menstrual diary and were given individualised acupuncture treatments after being randomly assigned to one of four treatment groups: high frequency manual acupuncture, low frequency manual acupuncture, high frequency electro acupuncture and low frequency electro acupuncture.
Twelve treatments were performed over three menstrual cycles, either once per week (low frequency groups) or three times in the week prior to their period (high frequency groups). All groups received a treatment in the first 48 hours of their period.

All treatments were determined based on Chinese Medicine diagnosis. A manualised protocol was used which allowed selection from a number of suitable acupuncture points based on the Chinese Medicine diagnosis.
Explore further: Acupuncture may not be effective in treating infertility

More information:
Mike Armour et al. The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial, PLOS ONE (2017). DOI: 10.1371/journal.pone.0180177
Journal reference: PLoS ONE
Provided by: University of Western Sydney

Could acupuncture be the cure for period pain?

Could acupuncture be the cure for period pain?

New study claims the ancient Chinese practice can reduce pain at that time of the month by HALF

  • A recent study has revealed that acupuncture could help relieve period pain 
  • The study looked at 74 women aged 18 to 45 over a three month period
  • It found that more than half had at least a 50 percent reduction in pain severity
  • The effects lasted up to a year with women reporting less need to use painkillers

Researchers in Australia and New Zealand have found that acupuncture can significantly reduce the severity and duration of period pain.

The study conducted by Australian and New Zealand researchers also found it relieved associated headaches and nausea.

‘Our pilot study found that using manual stimulation of the needles, rather than an electrical pulse, commonly used in many Chinese studies for period pain, resulted in reduced need for pain-relieving medication and improvement in secondary symptoms such as headaches and nausea,’

said Dr Mike Armour.

The latter was unexpected and will be explored further in future, larger trials.

Researchers in Australia and New Zealand have found that acupuncture can significantly reduce the severity and duration of period pain

Researchers in Australia and New Zealand have found that acupuncture can significantly reduce the severity and duration of period pain

Dr Armour is a postdoctoral research fellow at Western Sydney University’s National Institute of Complementary Medicine.

It was a small pilot study of 74 women aged between 18 and 45 which found that more than half had at least a 50 percent reduction in the severity of their period pain after undergoing acupuncture treatment.

Many of the women also reported less of a need to use painkillers to treat their period pain and an improvement in secondary symptoms.

This included headaches and nausea, according to the study published in the international journal PLOS One.

The women underwent the treatment for three months, with the effects lasting for up to a year

Known in medical circles as primary dysmenorrhea, period pain is most common in women aged under 25.

It is also the most common gynaecological problem among women generally, with four in five encountering it during their reproductive years.

The researchers from Western Sydney University and the University of Auckland also found that manual acupuncture, where thin needles are inserted at certain points on the body, provided more relief than electro-acupuncture, which involves a small electrical current passing through the needles.

Known in medical circles as primary dysmenorrhea, period pain is most common in women aged under 25

During the study, the women kept a diary and underwent one of four types of manual or electro acupuncture treatments.

Twelve treatments were carried out either once or three times a week over three menstrual cycles.

The women reported significant reductions in ‘peak pain’ during the first three days of their period and in “average pain” experienced over their entire period, with the effects sustained for 12 months.

Twelve treatments were carried out either once or three times a week over three menstrual cycles

Twelve treatments were carried out either once or three times a week over three menstrual cycles.

Many also experienced improvements in PMS-related symptoms such as mood swings.

Treatment timing appears to play a small role, with high frequency of treatment providing greater improvements in health-related quality of life.

Acupuncture Lessens Migraine Attacks in Chinese Study

Action Points

  • Acupuncture may be helpful for migraine prevention, according to a randomized controlled, but non-blinded, clinical trial from China.
  • Note that migraine prevention currently consists of pharmacologic options which are often associated with adverse events, and clinical study results of acupuncture for prevention have been inconsistent.

Acupuncture may be helpful for migraine prevention, according to a randomized controlled trial from China.

The trial included both real and sham acupuncture, as well as a wait-list control group. Over 16 weeks, real acupuncture treatment was associated with a greater reduction in migraine attacks without aura than sham acupuncture and the wait-list control (3.2 attacks versus 2.1 attacks and 1.4 attacks), according to Fanrong Liang, MD, of Chengdu University of Traditional Chinese Medicine in Sichuan in China, and colleagues.

“Acupuncture should be considered as one option for migraine prophylaxis in light of our findings,” they wrote online in JAMA Internal Medicine.

But in an accompanying editorial, Amy Gelfand, MD, of the University of California San Francisco, warned that the study was seriously limited by its lack of blinding, both among participants — who may have been able to tell whether they were in the real or sham acupuncture group based on pain intensity — and acupuncture practitioners.

“By training and interest, the acupuncturists likely believe that true acupuncture is effective and sham acupuncture is not,” Gelfand wrote. “They may have unconsciously transmitted to the participants their impression of how likely, or unlikely (ie., a potential ‘nocebo’ effect for the sham group), they thought the participant was to benefit from the treatment being given.”

Migraine prevention currently consists of pharmacologic options like divalproex sodium, topiramate, metoprolol, and propranolol, but these are often associated with adverse events such as weight gain, fatigue, sleep disturbance, and gastrointestinal intolerance. They also carry a risk of medication overuse headache and a possible uptick in headache frequency.

Some migraine patients have turned to acupuncture, but clinical study results of its efficacy for prevention have been inconsistent, so Liang’s group conducted their three-arm study at three clinical sites in China.

They enrolled 249 adult patients who had migraine, without aura, who had an attack frequency of two to eight per month. Most of these patients (77%) were female. They were randomized to one of the three groups after an initial 4-week baseline period.

Those in the real acupuncture arm received treatment for 30 minutes a day, 5 days a week, for 4 consecutive weeks. Needles were inserted at four specific points, and therapists elicited the “Deqi” sensation each time; this is a feeling of soreness, numbness, distention, or radiating that indicates effective needling.

Those in the sham acupuncture group had needles inserted at points considered to be inactive, with no attempts at drawing out Deqi.

The primary outcome was the change in frequency of migraine attacks at 16 weeks; a total of 245 of the patients were included in the final intention-to-treat analysis.

Overall, Liang’s group found that attack frequency fell significantly more in the true acupuncture group than in the sham group (3.2 attacks versus 2.1 attacks, P<0.002), and true acupuncture also beat out the wait-list group (3.2 versus 1.4, P<0.001). The sham group wasn’t statistically different from the wait-list group.

They also found that mean migraine days were significantly lower in the true acupuncture group than in the sham group (2 versus 3.1 days, P=0.005), and the same went for the headache intensity score as measured by the Visual Analog Scale (VAS) (3.4 versus 4.2, P=0.008).

The authors noted that there were no serious adverse events, which could be a major advantage for acupuncture over pharmacotherapeutic migraine prevention.

Study limitations included using fewer acupoints than are typical, and not being able to blind the wait-list group.

Gelfand pointed out the additional limitations of not blinding the real and sham acupuncture participants, or the practitioners.

She said the study “doesn’t convincingly demonstrate acupuncture’s efficacy for migraine prevention” because participants experiencing Deqi could have led to a higher degree of placebo response.

But Gelfand acknowledged that the treatment effect size seen in the study was “on par with what is seen” in other migraine prevention studies, and that it does suggest some benefit for acupuncture over medications, including a lack of serious adverse events and a persisting benefit.

“It is probably safe to try — it is not clear it is effective,” she wrote. “The main risks are likely to [a patient’s] pocketbook and their time.”

The study was supported by the State Key Program for Basic Research of China, the National Natural Science Foundation of China, and the Project of Youth Fund of Sichuan Province.

Liang and co-authors disclosed no relevant relationships with industry.

Gelfand disclosed relevant relationships with Eli Lilly, Zosano, Teva, Allergan, eNeura, MedImmune, and Quest.

Acupuncture is safe: Cycling Weekly

Source: Cycling Weekly
Date/Issue: 01 Sept 2016

Expert opinion: Mark Bovey is research manager at the Acupuncture Research Resource Centre/The British Acupuncture Council, and he’s written in response to an article by Edzard Ernst

In my view, Professor Edzard Ernst’s claim about 100 fatalities having resulted from acupuncture was unduly alarmist.

He failed to address key questions. Where does his figure come from, over what period and in which countries? How many acupuncture treatments in total were given during this time; how frequently do fatalities occur? Were the acupuncturists involved properly trained, and how many of the deaths could definitely be tied to acupuncture as the cause?

Without this background information or references, Ernst’s article risks falling into the category of misleading sensationalism.

Investigations of reported fatalities have shown that some cannot be substantiated as being caused by the acupuncture; one, included in a study by Ernst, was self-inflicted with a sewing needle!

Fatalities, of which there have been few, have diminished steadily since the Nineties, with better hygiene practices and practitioner training.

Many unsafe practices recorded worldwide over the last 50 years would never have happened if current UK professional safe practice guidelines had been followed.

Acupuncture treatment is not absolutely risk-free, but its degree of risk is comparatively low.

Acupuncture: why it works

Acupuncture: Why It Works

June 23, 2016 | 89,590 views – reproduced from mercola.com

By Dr. Mercola

More than 3 million Americans receive acupuncture each year, and its use is increasing.1 While there are a variety of acupuncture techniques, those typically used in the U.S. incorporate traditions from China, Japan and Korea and involve penetrating your skin with a thin needle at certain points on your body.

The needle is then stimulated by hand or electrically.2 Acupuncture has been in use for thousands of years around the globe, and it has withstood the test of time because it works to safely relieve many common health complaints.

How it works has remained largely a mystery, but last year researchers revealed a biochemical reaction that may be responsible for some of acupuncture’s beneficial effects.

Scientists Reveal How Acupuncture Reduces Inflammation and Pain

An animal study looking into the effects of acupuncture on muscle inflammation revealed that manual acupuncture downregulates (or turns off) pro-inflammatory cells known as M1 macrophages. At the same time, it upregulates (or activates) anti-inflammatory M2 macrophages, thereby reducing pain and swelling.3

This is an effective strategy because M2 macrophages are a source of anti-inflammatory interleukin-10 (IL-10), a cytokine involved in immune response. It’s thought that upregulating M2 macrophages leads to an increase in IL-10, which subsequently helps relieve pain and inflammation. The Epoch Times reported:4

Acupuncture literally flips a switch wherein initial inflammatory responses are reduced and the secondary healing responses are promoted.

M1 macrophage downregulation and M2 macrophage upregulation triggered by acupuncture was positively associated with reductions in muscle pain and inflammation.”

It’s likely that acupuncture works via a variety of mechanisms. In 2010, for instance, it was found that acupuncture activates pain-suppressing receptors and increased the concentration of the neurotransmitter adenosine in local tissues.5

Adenosine slows down your brain’s activity and induces sleepiness. According to a Nature Neuroscience press release:6

“ … [T]he authors propose a model whereby the minor tissue injury caused by rotated needles triggers adenosine release, which, if close enough to pain-transmitting nerves, can lead to the suppression of local pain.”

Acupuncture Influences Your Body on Multiple Levels

With documented use dating back more than 2,500 years, acupuncture is based on the premise that there are more than 2,000 acupuncture points in the human body, which are connected by bioenergetic pathways known as meridians.

According to traditional medicine, it is through these pathways that Qi, or energy, flows, and when the pathway is blocked the disruptions can lead to imbalances and chronic disease.

Acupuncture is proven to impact a number of chronic health conditions, and it may work, in part, by stimulating your central nervous system to release natural chemicals that alter bodily systems, pain and other biological processes. Evidence suggests that acupuncture may also work by:7

  • Stimulating the conduction of electromagnetic signals, which may release immune system cells or pain-killing chemicals
  • Activation of your body’s natural opioid system, which may help reduce pain or induce sleep
  • Stimulation of your hypothalamus and pituitary gland, which impact numerous body systems
  • Change in the secretion of neurotransmitters and neurohormones, which may positively influence brain chemistry

1, 2 National Health Statistics Report February 10, 2015
3 Molecular Neurobiology February 2015
4 Epoch Times May 27, 2016
5 Nature Neuroscience 13, 883–888 (2010)
6 Nature Neuroscience July 2010
7World Health Organization, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials, 2003