What is the principle of "pulse taking" in traditional Chinese medicine?

Guide: Why does Chinese medicine know what disease the patient has for a while by pressing it on his wrist? Do you want to know? Look down!

Before we begin, we should make clear two questions: the correct posture of taking the pulse and the meaning represented by the position of the finger.

Taking the pulse is not just a matter of putting your finger on your wrist. It is very important to find the right location! When pointing down, first press the middle finger on the inner side of the protruding position of the wrist (called "Guan" in Chinese medicine), which is called the middle designated Guan. Then press the index finger to determine the inch before closing, which is closely side by side with the middle finger. Finally, press the ring finger to determine the length after closing, leaving a small gap between the middle finger and the ring finger, so that you can feel the pulse.

Why does Chinese medicine need two hands to feel the pulse? Chinese medicine believes that the "inch gauge" of left hand and right hand represents different meanings. The "inch gauge" of the left hand represents "heart, liver and kidney" and the "inch gauge" of the right hand represents "lung, spleen and kidney (life gate)", so Chinese medicine should take the pulse with both hands. With this in mind, we can begin to learn to analyze pulse conditions!

Traditional Chinese medicine divides pulse conditions into twenty or thirty types, so it is not necessary for ordinary people to know them all. Here are only a few common pulse conditions: ups and downs, strength, thickness, speed and stop.

First of all, ups and downs

There are two kinds of ups and downs.

One is to put your hand gently on the pulse, and you can feel the obvious pulse with only a little force. This is called floating.

If you can't feel it all the time, you can feel the obvious pulse if you continue to push hard and almost press the bone. This is called sinking.

If you can't touch it with a little force, but you don't press it to the end, it is called neither sinking nor floating, or it can be called partial sinking (more force) and partial floating (less force) according to the size of the force, which are collectively called medium.

The other is that you can only feel the pulse of inches obviously when cutting the pulse, but the gap and ruler are not so obvious, which is also called drifting; By analogy, the inch gap is not obvious but the ruler is obvious, which is also called sinking; Inch is not obvious, but it is obvious, also known as medium.

Why pulse condition is different from fluctuation?

Generally speaking, the protective function of the human body is to fight against external evils. First of all, we want to solve the problem from the outside. Body fluid and qi and blood are gathered here to fight, so there is plenty of qi and blood here and the pulse is floating. When the problem can't be solved here, pathogenic factors move in, healthy qi retreats, qi, blood, body fluid are concentrated in the middle (half exterior and half interior), and pulse appears in the middle; Evil spirits win again, and then retreat after righteousness is defeated, all of which are returned inside. Here, we gather our strength to fight the disease to the death, and our pulse will sink.

In short, where vital qi (body fluid, qi and blood) gathers, it will be reflected in the corresponding parts of pulse condition. It is not difficult to observe the pulse by keeping this rule.

Second, strength.

When you find the pulse, you don't just stand still. Doctors will do some "little tricks". Push down slowly, then reduce the force a little, put your fingers back in their original positions, and do it several times.

Why are you doing this? Because you have to feel the resistance of the pulse to your fingers with your fingers. When you press it, you feel the pulse is hard, solid and powerful, which proves that this pulse is powerful. If you don't encounter too much resistance when you press your finger, "you can press it wherever you like, and I won't resist!" "Even if a little hard, the pulse is gone, then the pulse is weak, and the doctor will measure the pulse strength according to this.

So what does it mean to be strong?

Powerful, representing righteousness, but if there is a dispute between evil and righteousness, Chinese medicine usually says that evil is real, righteousness is ok, and treatment according to evil can also be done. No strength is lack of righteousness. In treatment, first of all, it is necessary to supplement vital qi and strengthen vital energy. Sufficient righteousness can naturally compete with evil spirits!

From the point of view of treatment, Chinese medicine often uses strong pulse to attack diarrhea, such as Mahuang decoction syndrome, which requires heavy pulse, Chengqi decoction and the like, and requires strong pulse, which means strong. If the pulse condition cannot use these prescriptions, it will make the patient collapse and faint!

Traditional Chinese medicine usually adopts tonic method for weak pulse, such as slow pulse of Guizhi decoction syndrome and weak pulse of Sini decoction syndrome, which can not be captured but can only be nourished. As for the dosage to be used, the ingredients to be supplemented during the attack, the ingredients to be supplemented during the attack, and the amount to be added, we should analyze and judge from the degree of pulse weakness.

Third, the thickness

It is not enough to know the strength of the pulse. There is also a little trick, that is, use your fingers from thumb to tail, and then from tail to thumb, and carefully massage or rub back and forth horizontally to feel the width of the pulse. In layman's terms, it is to look at the pulse thickness.

Because there is enough vital qi, body fluid and qi and blood, it will not only be strong, but also need a lot of space for pipes (blood vessels). Otherwise, there is enough righteousness but not enough space to send it out in time. Therefore, Zhongjing said that "the pulse of Yangming is big", and Yangming is full of qi and blood, but to transport it, the vessel has to be big. By analogy, "essence" is of course a deficiency of qi and blood.

However, there are some special circumstances. Clinically, there are often examples of large and weak pulse or small and strong pulse. Why? This involves the problem of excessive qi and blood.

Qi and blood are two things that are mutually yin and yang. Qi mainly transports blood and instills it into the whole body, so it belongs to yang, which is active and mainly expands. Blood belongs to yin, nourishing yin, and has a very solid body (liquid), which can be seen and touched; The strength or thickness of pulse is the common contribution of qi and blood, but blood is more important in the strength of pulse, and qi is more important in the thickness of pulse. They are all strong, with thick and powerful pulses; If all fail, it will be thin and weak; When qi declines and blood is strong, the pulse is thin and strong; When qi is strong and blood is weak, the pulse is thick and weak. So the thickness must have the strength to watch together!

This is how Chinese medicine judges whether to use qi-separating drugs or blood-separating drugs. For example, modern people often say that yin deficiency nourishes yin, eat donkey-hide gelatin and drink Polygonum multiflorum juice, but if your pulse condition is fine, eating this is likely to cause acne; Some people like to take tonics, such as ginseng and astragalus, but if your pulse is thick, you will get angry, lose sleep and be agitated. Of course, this is just a general rule, and there are still many details to consider in TCM medication, so I won't say it here.

Fourth, speed.

How fast is the pulse rate normal? Su Wenping's Anthropology says, "When a person breathes his pulse again, he breathes it again. His breathing is uniform and pulsates five times. His breathing rhythm is fixed, and his pulse jumps four times between breaths."

It seems simple and practical, but it is actually difficult to grasp! Who is the standard for people to breathe fast and slow? Western medicine's research in this field is of great help to Chinese medicine.

According to the research results of western medicine, the pulse rate of a normal adult is about 75 times per minute, and the elderly will be relatively slow, the young will be relatively fast, and the baby will be faster. With this standard, the speed is determined: those who fail to meet the standard number of times are called slow; Those that exceed the standard number of times belong to fast.

What's the point of judging speed? There is a saying in "Difficult Classics": "It is cold to count heat, and it is cold to slow down", that is to say, "fast" means that the body's disease-resistant self-protection system is in a more active state; Slow, indicating that the disease-resistant function has been quite exhausted, and it has entered a passive, passive and even want to give up state.

Chinese medicine chooses treatment strategies according to the speed of pulse. If you are quick, you will actively cooperate with evil spirits and provide enough food and ammunition for your body! Slow is transcendental deficiency, strengthen the body's resistance, and don't rush to attack evil. It didn't want to fight by itself, so it was forced to go to the front with food, grass and ammunition. Then either to defect to the enemy or to be a deserter, do ideological work first to arouse their fighting mood.

Five, stop jumping, it's dangerous!

Stop jumping, we can simply understand it as pulse "desertion", which can be divided into three types.

1. Stop jumping regularly.

For example, stop after five jumps, stop after five jumps, and stop after five jumps, which is very regular. This pulse condition is bound to be accompanied by these symptoms: obvious palpitation; Chest tightness; Numbness of hands and feet; Dizziness; My eyes are swollen. Not all, but chest pain and palpitation are necessary.

This pulse shows: "This patient has cardiovascular and cerebrovascular problems, at least the blood supply to the heart or brain is abnormal at present!" This is a warning. If ignored, there may be bigger problems, from fainting to stroke, cerebral hemorrhage and sudden death!

This kind of pulse is more common in young adults, and it is generally due to excessive fatigue and consumption, such as working late at night, playing computer games and mahjong for a long time, or taking antiperspirants to benefit too much, taking the wrong medicine, sweating profusely, and showing signs of collapse. It is generally easier to recover.

2. Irregular jumping stops

It stopped jumping regularly, this time the rules were chaotic and the rhythm was gone! Stop after one jump this time, and stop after three jumps next time, which is irregular. This pulse is more common in the elderly. There are also the accompanying symptoms mentioned in the above article, and they are more serious, some have vomiting and generally have high blood pressure. This pulse must be treated quickly, and the risk of stroke, cerebral hemorrhage and sudden death is quite high!

3. Irregular+variable speed to stop jumping

Before and after the first two stops, the pulse speed was the same, but this time it changed. If the speed is fast, it may slow down after stopping, and may even change the intensity, sometimes strong and sometimes weak. This pulse generally appears in critically ill patients who need to be rescued! Seeing this pulse, stroke, cerebral hemorrhage and sudden death have basically happened. If the rescue fails, you have to go down and play mahjong with the terrorists!

"ups and downs, strength, thickness, speed and stop" are the most basic elements of pulse diagnosis and the most basic kung fu of pulse diagnosis. What is said here is superficial and not difficult to understand, but it takes long-term practice and practice to master it skillfully, so don't take the nonsense like "learning to feel the pulse in three minutes" seriously. For those who want to study pulse science in Chinese medicine, here are some reference books for you to learn by yourself. Any other questions? Tell me about the comments.

Chinese medicine quickly grasps the key points of pulse condition in Song Dynasty.

First, the floating pulse

Body image floats on fur like water on wood; More than enough, less than enough.

The main disease of floating pulse in Song Dynasty is Yang, and its disease is exterior. Inch floating cold, headache and stuffy nose; If you are floating, the wind is in the middle focus; Floating to the right, wind phlegm is in the diaphragm; Foot pulse, lower energizer, dysuria, constipation and astringency.

Concurrent pulse songs are unable to express emptiness, but powerful to express reality. Floating tight and cold, floating late; Wind-heat and rheumatism. The floating fly loses blood and is short of breath; Floating and heat deficiency, floating and heat exhaustion; Floating blood hurts, floating gas defeats.

Second, sink the pulse.

The body is like a song sinking bones and muscles, like water throwing stones; It is more than enough to press, but it is not enough to raise.

The main disease is that the deep pulse is yin, and its disease is in the stomach. Tilting and shortness of breath, chest pain and intimidation; Or treat phlegm. Or water and blood. It hurts because it is cold in Guanluo; Or full of boredom, swallowing acid. Ruler governs low back pain and waist and knees; It's wet and itchy in the shade. Turbid stranguria and diarrhea

The pulse song is weak, powerful and solid. Sinking is cold at night, and sinking is hot inside; Sinking phlegm and astringent blood; Weak, sinking and accumulating; Severe cold and pain, severe cold and dampness.

Third, late pulse

The body image of Song Dynasty is Yin, but the image is not as good as that of Song Dynasty. Slow communication, three to one interest.

The main disease is that the pulse is delayed and the viscera is dominant, and the disease is cold. Inch late cold, heartache stop coagulation; Close the crux of late and moderate colds and contractures; Feet burn late, there is no way, or waist and feet are sick, hernia pain leads to yin.

The function of storing cold is strong, but the function of deficiency cold is weak. Floating late is cold, sinking late is cold; Slow astringent blood, slow dampness and cold; Too late to slip, too late to swell, too late to decide.

Fourth, count the pulse.

The body image of Song is Yang, with too many images; Six times in one breath, the more communication.

The main disease is the pulse number and the fu-organs are dominant, and the disease is heat. Inch asthma and cough, aphtha and lung; Turn off the stomach heat and the evil fire will break out; In a few feet of fire, turbid water was soaked through.

Pulse songs are strong and real, weak and empty. It is hot on the floating platform and hot on the sinking platform. Yang is Wang Huo and Yin is fire. On the right is fire, and on the left is cloudy.

Five, slippery pulse

The body image is changed into a slippery pulse, and the communication is smooth; The shape of the vegetable beads means lotus dew.

The main symptom is that slippery pulse is yang, and phlegm and saliva are the main symptoms. Tend to cough. Chest full of vomiting; Closing stomach heat, suffocating gas and hurting food; Foot slip, or dysentery, men drown in blood and women suffer from menstrual depression.

The pulse is floating in the wind, and the phlegm is slippery. Slip a few phlegm fires and slip a short air plug. It's slippery and floating, and it hurts to pee. Slipping and drifting, stroke paralysis. Slippery, pregnancy can be decided.

Six, astringent pulse

Body image is like a song, pulse stagnation is like a knife scraping bamboo; Late and short, three elephants are afraid of feet.

The main disease is deficiency of qi and blood, but it also damages essence. Tendency and heartache, or palpitations. Yin deficiency is due to astringency, so the heat is moderate; The right side is short of soil and the left side is swollen. The foot is astringent, and the blood benefits can be determined; Pregnancy is a fetal disease, and there is no dragon blood.

And the pulse is astringent and strong, which is caused by excess heat; It's astringent and soft, and the virtual fire is burning.

Seven, virtual pulse

The body image is empty and four-shaped, floating big and soft; Even if you press it, you can hardly see it.

Deficiency in Song Dynasty governs blood deficiency. It also hurts the summer heat. Left inch palpitation, palpitation; Right inch lung deficiency, sweating and fear. Left liver injury, blood does not nourish muscles; The spleen in the right hand is cold and the food cannot be digested. Left foot water failure, waist and knee paralysis; Fire in the right foot is failing, and cold syndrome causes bees to rise.

Eight, true pulse

Body image Song is strong, growing and strong; It should be said that it is the same three times.

The main symptoms are excess blood, excess pulse and fire. Left inch exhausted, strong tongue; Right inch lung disease, vomiting, sore throat. Seeing the truth on the left, anger and hypochondriac pain; Seeing the truth right off, I am full of anger and pain. Seeing it with your left foot will cause abdominal pain; See it with your right foot, and the fire will be strong.

Strong and tight pulse, cold accumulation. Solid and smooth, phlegm coagulation is precious.

Nine, long pulse

Body image songs have long veins, beginning and ending; Go straight up and down, as with a long pole.

The main disease is more than the main disease, and the qi is against the fire. Left inch is good, fire is disease; Right inch is good, all by inversion. Zuo Guan is good at it, and the wood is solid; You Guan is good at it, but the soil is boring. When you saw it with your left foot, you rushed to the dolphin and trembled all over; The right foot is good at it and the fire is special.

Short pulse

The body image of Song Dynasty is short, with head and tail bent down; Protruding in the middle, not the whole body.

The main disease is short and insufficient, which is a syndrome of qi deficiency. Short life in the main inch, uneasy; Myopia right inch, lung deficiency headache. Left passage is short, and liver qi is injured; Shorter than the right pass, the diaphragm is a disaster. When the left foot is short, the lower abdomen will hurt less; The right foot is short, and the fire does not last.

XI。 Flood pulse

The body image is like a flood, and it is like a flood. Come and fill the table, full of fingers.

The main diseases are full of water and stagnation of qi. The left inch is big. Upset and broken tongue; The right inch is big, and the anger in the chest is furious. Seeing the flood on the left, there are too many trees in the liver; See the right pass flood, spleen and soil swelling. When the left foot is flooded, the water is hard to dry up; His right foot is latosolic red, and the dragon fire is blazing.

XII. Micropulse

The micro-pulse of the body image song is extremely thin and soft; It seems that there is nothing, and the heart is not unique.

The main symptoms are song dynasty, fuzzy micro-pulse, and great decline of qi and blood. Left inch afraid, right inch short of breath. Cold contracture of left hand and cold stomach of right. The left foot is too small and the bone marrow is exhausted; The right foot is too small, and the yang will die.

Thirteen, veinlets

Body image is thin, straight and soft, full of lingering; Like silk thread, it is more obvious than micro.

The main disease is fine, the main qi is weak, and all kinds of fatigue. Living in the left inch, can't sleep; Fine in the right inch, vomiting fear. Essence enters the left pass, and liver yin is exhausted; Essence enters the right pass, and the stomach cavity is full. If the left foot is thin, diarrhea and nocturnal emission will occur; If the right foot is thin, the next yuan will be cold.

Fourteen, wet pulse.

Body image is both rigid and flexible, which is seen in floating point; If you lift it, you can see it. If you press it, it will be empty.

The main disease is yin deficiency and pulp injury. Seeing the left inch, forgetfulness and fright; See right inch full, sweating. Left clearance meets everything, and blood does not nourish muscles; Right-handed, spleen deficiency and wet immersion. Wet left foot, blood failure; If you get it with your right foot, you will lose your life.

Fifteen, weak pulse

Body image Song weak pulse is small, which can be seen in Shenfen; If you hold it up, you will get nothing, but if you press it, you will get it.

The main disease is weak in Song Dynasty and depressed in Yang, and the true qi is weak. Left inch guilty, fear and forgetfulness; Right inch lung deficiency, spontaneous sweating and shortness of breath. Left wood is bitter and urgent; You Guan Tu Han, Shui Gu's disease. The left foot is weak, and the main stream can be levied; Weak right foot, yang depression can be observed.

Sixteen, tight pulse

The body image song is tight and powerful, and the fingers are flicked around; For example, twist a rope, such as cut a tight rope.

The main disease in Song Dynasty is both cold and painful. The left inch is tight, and the heart is full of severe pain; Right inch tight, typhoid cough. Throw away people's welcome, float tight typhoid fever; Close the vent to the right to avoid food injury. From the left foot, it hurts terribly under the navel; You can see it on your right foot. It's a dolphin hernia.

Seventeen, slow pulse

The body image song has a slow pulse and harmony; Xu Lai is a cool breeze, and the flowers are bright.

The main disease and pulse slow to stomach qi, not the main disease; Only taking both can break the syndrome. Floating slows down wind injury, sinking slows down cold and dampness. Relieve wind deficiency and dampness arthralgia. Slow astringency and thin spleen, slow weakness and qi deficiency. The right inch floats slowly, and the wind is evil; The left inch is astringent and slow, and the yin and blood are insufficient. The left is slow, and the liver is bulging; The gap on the right is very slow. Weak wet invasion. The left foot is slow and astringent, and the uterus is not as good; The right foot is slow and thin, and the anode is really declining.

Eighteen, string pulse

Body is like a song string, smooth; The end is straight and long, and the fingers are quite natural.

The main symptoms are liver wind, malaria and phlegm. If the string is in the left inch, the pain is in my heart; String in the right inch, chest headache. Leaving strings, phlegm and malaria; Closing the string to the right, stomach cold and diaphragmatic pain. The left foot touches the chord. Drink in the lower jiao; The right foot touches the chord, and leg cramps is colic.

And the pulse song floats the string to hold the drink, and sinks the string to hang the drink. How hot the strings are, how cold they are. The string is big and weak, and the string is thin and urgent. Headache in the yang string, abdominal pain in the yin string. Danxian is a heavy drinker.

Nineteen. artery

The body image of Song has no head and no tail, moving like a bean; Shake when syncope, and it will slide at the same time.

The main disease is pain, but there is also shock. The left inch can be moved, and the fright can be broken; If you can move your right inch, you will undoubtedly sweat. If the left moves, it will cause shock and contracture; Move right, heart and spleen ache. With the left foot, sperm death is a disease; See it with your right foot, and the dragon is full of fire.

Twenty, promoting pulse

The body image song is in a hurry and the number of times stops; Follow the trend, and you will die if you advance.

The main disease is promoted by fire, but stopped by things. Left inch promotion, the heart is burning; My lungs giggle when I see the right inch. Promoting left circulation, blood stagnation is a disaster; Promote living in the right pass, spleen palace food stagnation. When the left foot meets it, it is worrying to slip; I hit my right foot, and it was extremely hot.

Twenty-one, knot pulse

The body image of the song condenses, and if it is slow, it will stop; Slow and lazy, quite interesting.

The kink of the main symptom belongs to yin cold and is also caused by condensation. The left inch is chilling, and the pain can be determined; Right inch lung deficiency, qi and cold condensation; When you see the left knot, hernia will appear; Right hand knot, phlegm and blood stasis and food stagnation. Left foot knot, soft furuncle; Knot your right foot, and yin cold is Chu.

Twenty-two, generation pulse

The body image song is changed into Zen, only unchanged; I can't go back. It's been a long time.

Main disease Song Dynasty main disease, dangerous evil. Spleen and soil are corrupted, and spitting profit is the blame; Abdominal pain is hard to save if you don't eat in the middle cold. Two strokes and one stop, three or four days of death; Four moves and one stop, dead for six or seven days. Inference, without losing the purpose.

Twenty-three, skin pulse

The body image is big and the string is urgent, which can be obtained by floating; Press it. It's empty, as muddy as a drum skin.

The main disease of Song Ge is mainly cold, and it also belongs to deficiency in the middle. Left inch leather, heart and blood deficiency pain; Right inch leather, gold does not change. When Zuo Guan met, hernia was precious; When you meet the right pass, the soil deficiency hurts. It is necessary to diagnose leather with a left ruler; Diagnosis of leather with the right foot, death is a worry. Women got what they wanted, and half the production leaked.

24. Prison Pulse

Song's body image is steady, big and solid; If you wait in the middle, you won't get it.

The main disease is the song of prison. Sick in it. Left-inch prison, floating beam disease; The power is limited, and the rest can be decided. See the prison on the left and accumulate blood in the liver; Seeing the prison in the right customs, yin and cold are addictive. The left foot is fixed, and the dolphin is bitter; The right ulna is strong and the hernia is very painful.