What Does Pulse Diagnosis Show?

In an article on electronic fetal heart rate monitoring (EFM)  Traditional Healers, External Fetal Monitoring, and the NICHD, Academic OB/GYN wrote:

Continuous fetal heart rate monitoring is at its core an almost laughable idea. We are checking a single vital sign and using that vital sign to extrapolate a host of ideas and meanings. OBs that have read strips for years can make some sense of them, but would we give so much meaning to any other single vital sign? Would we do it with an adult? Of course not, but there are people who do. In fact, there are entire countries where this is a major methodology for determining the etiology of illnesses.

But the people doing this are not physicians – they are the healers of various cultures. Throughout the world there are practitioners who claim to divinate illness through feeling a person’s pulse for several minutes. This is particularly prominent in Asia. They describe using the rate, strength, and character of the pulse to make all manner of determinations. This practice is fairly laughable to physicians, as it seems crazy to get so much meaning from feeling someone’s pulse.

But is this so much different than EFM? In fact its quite similar….

Here is an elaborated form of my reply:

Image care of http://www.tcm-jaygolding.co.uk/documents/63.html

I agree with you about electronic fetal monitoring, and found the continuous monitoring to interfere with my own ability to move to relieve pain and progress labor, but you are all wet when it comes to pulse diagnosis in Asian medicine. First off, the “healers” are phpysicians in most countries, but doctors whose specialties are in traditional medicine. Traditionally pulses were used diagnostically by the great doctors of history like Zhong Zhang Jing, Li Shi Zhen or Huato and by great doctors of Ayurveda, Unani and Galenic medicine.  Galen and Avincenna wrote extensively on the pulse. More importantly, the pulse alone is never the sole or most important method of diagnosis.

When I see a client after the first  intake, I spend some 20 minutes doing discussion and physical examination (a lost art in western medicine.)   Questioning about symptom differentiation is perhaps the most important aspect and one found seriously lacking from doctors who fob it off on assistants who do not continue the treatment, providing a second-hand recitation that inevitably leaves out important information.

From ITM http://www.itmonline.org/arts/pulse.htm

In the course of the physical examination I take pulses. What does it show? Far more than simple rate, rhythm and pattern as cardiologists well know. I look at that, then at quality of the pulse, which differs for pregnant women than the same women unpregnant. (Pregnancy pulses have a type of shadow pulse.) Murmurs and valvular conditions affect the pulse rhythm and pattern. Hypertensive pulses feel like the blood is pushing out on the walls of the blood vessel.

Lipids in the blood feel slippery, like the blood has balls of higher density. (Patients are referred out to a MD if pulses combined with other symptoms so indicate.) I feel the width of the blood vessel, whether it is replete with blood or flaccid, whether the skin around it is edematous (“damp” ) or tightly strained (“tight” or “wiry”).  If someone’s pulse responds to my touch, it indicates certain psychological propensities and then I need to allow the pulse to settle down to find other information. The six basic positions I look at on two arms access different depths of the blood vessel over the bone, which millennia of medical treatment has assigned to different functional systems. The positions on the radial artery are generally relative, as Tibetan doctors frequently go slightly lower on the wrist than Chinese doctors, but have similar observations.  (One Korean system goes down at least 24 levels in one position instead, but most of us can’t differentiate that well and the traditional six position, three depth pulse diagnosis works better for me.)  However some systems also look at accessory blood vessels which are more specific.

More importantly there is also a heart/ mind electromagnetic or radio wave entrainment between patient and doctor that communicates possibilities to be explored diagnostically. The Dalai Lama’s physician diagnosed the pulse of my friend David Winston and was able to access whole other levels, telling him about childhood accidents from his pulse.  While few of us have the cultivation to do that, there is information communicated by touch alone.

It is an axiom in medicine, traditional or otherwise that no single diagnostic parameter is sufficient for diagnosis. While a human can measure things a machine cannot, neither EFM nor traditional pulse diagnosis is sufficient to make a diagnostic decision.

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