Pulse diagnosis is composed of the visual position (depth), speed (speed), intensity (strength), rhythm (regularity, endless) and shape of arterial pulse. Pulse condition is an important basis of TCM syndrome differentiation, which has important clinical significance in distinguishing the cause, inferring the change of the disease, distinguishing the true from the false and judging the prognosis of the disease. Because the pulse condition is the house of blood and runs through the whole body, the pathological changes of the body and viscera are often reflected in the pulse condition, and sometimes the pulse condition has changed before the symptoms are fully manifested. Therefore, pulse condition, as a traditional culture in China, has been passed down to this day.
Part of the pulse
1. "Inch-mouth diagnosis" is mainly used in clinic, that is, the wrist of the patient after cutting the radial artery. There are records of "full-time diagnosis" and "three-part diagnosis" in Neijing, which are rarely used in modern clinic, so they are not introduced. Pulse diagnosis has two theoretical bases: first, the lungs are faced with hundreds of pulses, and the pulses will be too deep. That is to say, all the meridians of the human body will converge in the lung, and the cunkou is the circulation part of the Taiyin hand lung meridian, and the Taiyuan point above is the place where the veins will meet, so there is a saying that the veins will be too deep. Secondly, the spleen and stomach are the sources of qi and blood of all zang-fu organs, and the rise and fall of qi and blood of all zang-fu organs are closely related to the strength of spleen and stomach functions, and the lung meridian of Taiyin hand is also based on the function of middle energizer. Therefore, the ups and downs of qi and blood in the viscera and meridians of the whole body can be reflected from the cunkou pulse.
Distribution law of viscera in Cunkou and Cunkou
1, which is also called air port or pulse port. Cunkou pulse can be divided into three parts: Cunkou pulse, Guankou pulse and ulnar pulse. Usually, the styloid process of the posterior wrist radius is marked, and the inside is Guan, the front inch is Guan, and the back foot is Guan. The three parts of English gauge can also be used for floating, middle and sinking. This is the three stages and nine stages of inching diagnosis.
2. There are different opinions about the distribution of zang-fu organs in inch scale. Now, according to the principles of "from top to bottom" and "from top to bottom" in Neijing, the zang-fu organs are divided into three parts: the left inch treats the heart, the right inch treats the lungs, and covers diseases above the chest and head; The left is related to the liver and gallbladder, and the right is related to the spleen and stomach, covering diseases from the diaphragm to the navel; Both feet wait for the kidney, including diseases from the navel to the feet.
Pulse diagnosis time
1. It is recorded in Huangdi Neijing that Pingdan is the best time for pulse diagnosis, which means that the ideal time for pulse diagnosis is early morning. However, it is generally difficult to do so. Generally speaking, the consultation room is required to be quiet during pulse-taking, so that patients should wait for diagnosis all the time, rest in a quiet environment, minimize interference factors, and achieve the same effect of calming the gallbladder and pulse-taking. Especially for some critically ill patients, there is no need to insist on waiting for treatment and delay the treatment time.
Pulse position
1. The correct posture of the patient during pulse diagnosis is sitting or supine. The forearm is naturally flat forward and at the same level as the heart. Wrist straight, palm up, fingers slightly bent. A soft pulse pillow is placed under the wrist joint, so that the mouth of the inch is fully exposed and stretched, and the qi and blood are unobstructed, thus diagnosing the pulse condition.
2. If you lie on your side and twist your upper arm, it may cause blood vessels to be compressed and pulse gas cannot be unblocked; Too high or too low arm will affect blood circulation and distort pulse condition.
Pulse diagnosis technique
Fingering methods commonly used in pulse diagnosis can be summarized as finger selection, finger matching and finger movement.
1. Finger selection
The doctor should touch the patient's right hand with his left hand and touch the patient's left hand with his right hand. The ends of the three fingers are flush, the fingers are slightly arched, and they are inclined at about 45 degrees with the patient's body surface. This angle can make the finger close to the pulse, which is convenient for taking the pulse.
Step 2 cloth fingers
When the doctor points down, he first presses the middle finger on the artery inside the styloid process of the radius, which is called the middle designated point, then presses it with the index finger to determine the number of inches before closing, and presses it with the ring finger to determine the length after closing. Finger spacing is appropriate.
3. Yun Zhi
Doctors have seven kinds of fingers.
(1) Lifting method: refers to the method that the doctor presses the skin with light force to check the pulse. Also known as "floating" and "taking it lightly".
(2) Pressing method: refers to the method that doctors use gravity to press bones and muscles to observe the pulse. Also known as "sinking" and "retrieving".
(3) Seeking method: there are two meanings: one is seeking, that is, finding, which means that the doctor can nudge or re-push his finger, carefully observe the pulse condition and find the most obvious part of the pulse. Secondly, it refers to the method of taking the pulse according to the tendon, that is, "take the middle and find it"
(4) Diagnostic method: refers to a method of taking the pulse by moving the finger up and down along the axis of the pulse channel, mainly to observe the length of the pulse.
(5) Inference: refers to a method of observing the speed, strength and trend of pulse condition through left, right, inner and extrapolation after aiming at the pulse ridge.
(6) Total pressing: that is, the method that three fingers feel the pulse with equal finger force at the same time.
(7) Single press: the method of feeling the pulse with one finger. It is mainly used to understand the position, quantity, shape, potential and other changing characteristics of pulse condition in inch, off and ruler.
Pulse is calm
1, a calm "breath" refers to a breath. Calm means that the doctor should keep breathing evenly and have a calm mind when taking the pulse. Calm has two meanings: on the one hand, doctors use their normal breathing as the time unit to detect the patient's pulse. Normal people breathe 16~ 18 times per minute, and their pulse is 72~80 times per minute. Based on this calculation, each breathing pulse is about 4-5 times. On the other hand, calming down is helpful for doctors to concentrate their thoughts and point down, so as to carefully identify the pulse condition.
Fifty moves
"Fifty pulses" means that the time for doctors to feel the patient's pulse should generally not be less than 50 pulses. That is, each hand should be no less than 1 min, and the appropriate time for both hands is about 3 minutes.