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Pulse Diagnosis by Jimmy Wei-Yen Chang, L.Ac.

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Acuworld

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2020-07-15 09:09:11

<H1>INTRODUCTION TO CHANG''S PULSE DIAGNOSIS</H1>
<H2>By Jimmy Wei-Yen Chang, L.Ac., Mark Brinkman, L.Ac.</H2>
As a practitioner of Chinese medicine, I realize that the vast majority of those practicing Chinese medicine normally rely on symptoms reported to them by their patients or inspection of the tongue or reports that include patients’ every imaginable historical fact.
In my own experience, it seems to be standard procedure for the majority of teachers and teaching institutions of Chinese medicine to guide their students to consider the pulse only when it can back up what has already been established via alternative diagnostic techniques. This being the case, why does one bother at all to palpate the radial pulse? It can only be surmised that the greater percentage of Chinese doctors realize that there is great potential in examining the pulses but may be unable to effectively utilize it.
Traditionally, pulse diagnosis has been revered by Chinese medical scholars as Chinese medicines cardinal diagnostic practice. This pulse diagnosis system allays the ambiguity and establishes the missing link that has for so long been indiscernible due to a long historical tangle of written and oral transmissions.
Furthermore, a patient’s manifesting symptoms rarely correspond to the ideal standard patterns set forth in the classical text. As a result, a misdiagnosis can easily occur if one should base diagnostic conclusions on them.
Pulse diagnosis is perhaps the least understood diagnostic constituent of Chinese Medicine partly due to the difficulty in disseminating its intricacies, as well as the fact that access to reliable clinical information regarding pulse diagnosis is almost non-existent. Limited access has rendered Pulse Inspection a dying species within the Chinese medicine domain and is therefore rarely considered to be of primary importance. The circumstances that have led to this situation are numerous.
China is a nation that is generally regarded as a source of ancient wisdom. But, it is also a society that historically has not been a great disseminator of its wisdom. Preceding generations of Chinese doctors have passed away without passing along their knowledge to the following generation.
Lacking a medium of direct transmission, a student may research classical medical literature in order to gain deeper insight into the pulse. However, the classical texts that refer to the subject can be extremely variant in nature and as proportionately vague in their explanation of pulses, not to mention the complexities involved in unwinding the snarls of the classical style. The pulse cannot be seen or smelled, nor does it respond to verbal questioning. Information relevant to its nature cannot be accurately discerned via illustration or verbal description. If a picture is worth a thousand words, then regarding pulse inspection, it may be said, “A touch is worth a thousand pictures.” In addition to the difficulties involved in accurately communicating the empirical wisdom that pertains to pulse diagnosis, there is also the issue of too strict reliance upon the standardized Chinese Medical texts. Standardization provides the figurative conceptual guidelines needed to equip one with fundamental tools. At the same time, rigid adherence to these standards may lead to a deceivingly idealistic clinical approach when one is confronted with aberrant disease factors.
According to Wei-Yen Chang’s clinical experience, the pulse locations, the pulse organ correspondences, and the pulse theories are not entirely similar to the modern standardized versions. This may challenge the readers’ previous impressions if they have been molded according to the standard renditions, or, of another school of thought. I urge you to learn with an open mind. Once the concepts of Chang’s pulse system are comprehended, competency in pulse diagnosis does not require an especially long period of study.
When the correct information is available and accessible, it is possible to immediately apply the correct principles to one’s pulse diagnosis practice and begin to apply them clinically. If one is genuinely intent on making a clinical breakthrough, the utilization of the principles expressed in the book Pulsynergy may bring to light the missing links that have rendered pulse diagnosis a dying art.
Cun, Guan, and Chi Locations
<IMG height=176 alt="cun, guan, and chi locations" src="http://www.elotus.org/monthly_articles/figure_article_3_01.gif" width=128 align=left>Traditional Chinese Medicine considers the radial segment of the Hand taiyin Lung channel as the “great gathering place of qi.” The Lungs are said to communicate with all the meridian pathways and therefore resonate pathological changes occurring in the body. Traditional and modern medical sources specify precise locations upon the radial vessel for palpation. They are the Cun, Guan and Chi positions.
In order to play the piano, one must first learn the proper location of the keys. Just like playing the piano, taking the pulse is the same - it is essential to place your fingers on the right position in order to determine the right diagnosis.
Finding the Cun, Guan, Chi positions requires one to first locate the styloid process of the radius. The highest point of this peak is the exact separation point of the Cun and Guan positions. The peak also separates the placement of the index and middle fingers on the radial artery. Your ring finger should then lie alongside your middle finger in order to locate the Chi position. This is the most accurate method of locating the three pulses positions, Cun, Guan and Chi. An alternate method of locating the pulse is to place the index finger directly over the third wrist crease, and place the middle and ring fingers alongside. 
Palpating the Cun, Guan, and Chi
The pad of the index finger should lie flat upon the radial artery. The middle and ring fingers should lie respectively upon the Guan and Chi positions. The middle finger should pull back slightly in order to create a straight line along the outermost tips of the fingers. The three positions should first be evenly palpated by the center of the finger pads. Most consider the fingertips to be more sensitive; however, its range of sensitivity is less than the pads due to the narrow width and more callused exterior.
Use of the fingertips to palpate the pulse may lessen the ability to understand the finer pathological changes of the pulse. The thumb should be placed on Yangchi (TH 4) for support, thereby allowing one to more freely apply pressure upon the vessel. Use the left hand to palpate the patient’s right wrist and vise-versa. Do not use the same hand to palpate both wrists of the patient.
Organ Correlations
Traditionally taught in school, the left side’s Cun, Guan and Chi reflect the Heart, Liver and Kidney yin. The right side’s Cun, Guan and Chi are the Lung, Spleen and Kidney yang. In Chang’s Pulse Diagnosis, the organs are slightly different. When the fingers are placed on the correct locations, the underlying organs to reflect the corresponding radial pulse are as described below. 
<TABLE cellSpacing=0 cellPadding=0 width=580 align=center border=0>
<TBODY>
<TR align=middle bgColor=#567dac height=20>
<TD width=50> </TD>
<TD class=white width=240>Left</TD>
<TD class=white width=240>Right</TD>
<TD width=50> </TD></TR>
<TR align=middle height=20>
<TD>Cun </TD>
<TD>Heart/Small Intestine</TD>
<TD>Lung/Large Intestine</TD>
<TD>Cun </TD></TR>
<TR>
<TD bgColor=#567dac colSpan=4 height=1></TD></TR>
<TR align=middle height=20>
<TD>Guan</TD>
<TD>Liver/Gallbladder</TD>
<TD>Spleen/Stomach</TD>
<TD>Guan</TD></TR>
<TR>
<TD bgColor=#567dac colSpan=4 height=1></TD></TR>
<TR align=middle height=40>
<TD>Chi</TD>
<TD>Kidney (Reproductive function: Chinese Kidney)</TD>
<TD>Kidney (Urinary function: Western Kidney)</TD>
<TD>Chi</TD></TR>
<TR>
<TD bgColor=#567dac colSpan=4 height=2></TD></TR></TBODY></TABLE>
Knowing this relationship, one can easily detect the cause of disorders. For example, to determine whether infertility is due to Kidney deficiency or pelvic inflammatory disorder, one would check the left Chi position. A weak pulse would indicate deficiency and a forceful pulse would indicate inflammation.
A second example is back pain. Everyone knows there may be numerous reasons for back pain. One cause that is often overlooked is kidney stone. This pulse would manifest itself as a sharp, stone-like feeling on the right Chi position. It almost feels like the tip of a ballpoint pen. This pulse is extremely easy to feel when the stones are not inside the kidney but just beginning to move into the ureter. In patients who don’t respond to traditional qi and blood moving herbs for back pain such as Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha) or Du Huo (Radix Angelicae Pubescentis), this pulse offers great insight as one can then select stone dissolving herbs such as Hai Jin Sha (Herba Lygodii), Ji Nei Jin (Endothelium Corneum Gigeriae Galli), Jin Qian Cao (Herba Lysimachiae) and Wei Ling Xian (Radix Clematidis) to treat the back pain.
Finally, the last example is peptic ulcer. A typical peptic ulcer pulse is forceful and floating/superficial on the right Guan.
 
<H1>ABOUT THE AUTHOR </H1>
<H2>Jimmy Wei-Yen Chang, L.Ac.</H2>
Master Jimmy Wei-Yen Chang has over 25 years of concentrated clinical experience applying his expertise in differential diagnosis and herbal prescription. The author of a pulse diagnosis manual, <A href="http://www.elotus.org/book.html">Pulsynergy</A>, Master Chang currently pursues his specialties in private practice in Hacienda Heights, California, and is widely recognized for his skills in correlating expert pulse taking and herbal prescription. To learn more about pulses and herbs, Jimmy Chang is speaking on the following topics for Lotus Institute. All classes are approved for 8 CEUs/PDAs by the California Acupuncture Board and NCCAOM.  
<H1>CLASSES BY THE AUTHOR</H1>
Treatment of Gastrointestinal & Hepatic Disorders
<UL>
<LI>2/24/08 Anaheim, CA </LI></UL>
Women’s Health & Infertility 
<UL>
<LI>6/1/08 Denver, CO </LI></UL>
Fang Jia Fang – The Art and Science of Herbal Combinations (Part I) 
<UL>
<LI>3/16/08 San Francisco, CA </LI></UL>
Fang Jia Fang – The Art and Science of Herbal Combinations (Part II) 
<UL>
<LI>7/27/08 Oakland, CA </LI></UL>
Revolutionary Pulse Diagnosis (Part I) (30 attendees max.) 
<UL>
<LI>10/5/08 Rowland Heights, CA </LI></UL>
Revolutionary Pulse Diagnosis (Part II) (30 attendees max.) 
<UL>
<LI>
<DIV>11/23/08 Rowland Heights, CA </DIV></LI></UL>
Reference: www.elotus.com