How does Chinese medicine say the fate of hitting the left hand, heart, liver, kidney, right hand, lung and spleen in the pulse?

Now the inching diagnosis method is commonly used. The pulse diagnosis site is the inside of the wrist, next to the high bone (styloid process of radius) behind the wrist, where the radial artery beats. The pulse position of radial artery corresponding to high bone is off, before off, inch and after off. The name of "Cungui" was first seen in Neijing, and the "Cunkou Diagnosis Method" was developed in the difficult classics. Inch, Guan and Chi correspond to different viscera respectively. Left hand inch corresponds to the heart, Guan corresponds to the liver, and red corresponds to the kidney (kidney water). The inch of the right hand corresponds to the lung, the Guan corresponds to the spleen, and the ruler corresponds to the kidney (life gate).

Common disease pulse

The pulse condition of a healthy person should be four breaths at a time. There are pulses in three parts of the inch gauge, not floating or sinking, gentle and powerful, and the pulse of the foot gauge should be strong. Common pulse diseases include floating pulse, sinking pulse, late pulse, multiple pulse, deficiency pulse, solid pulse, slippery pulse, extensive pulse, thin pulse and chord pulse.

Floating pulse:

Tap to get it, and press it again to get it. It is characterized by superficial pulse position. Main symptoms: Exterior syndrome is characterized by exterior pulse position because exogenous pathogenic factors stay in exterior, and defensive qi does not invade pathogenic factors, so that pulse qi is excited externally. Strong floating is the real thing; Floating without strength is superficial. Long-term internal injuries are caused by deficiency of yin and blood, deficiency of yang, yang deficiency floating outward and weak pulse.

Sinking pulse:

You can't press it lightly, you can press it again. It is characterized by deep pulse position. Main symptoms: interior syndrome. Strength is the inner reality, and weakness is the inner weakness. Pathogenic qi is depressed inside, qi and blood block yang, and the pulse is heavy and powerful. Visceral weakness, yang deficiency and qi stagnation, rapid pulse weak gas, weak pulse.

Late pulse:

Slow pulse (pulse less than 60 times per minute). Main symptoms: cold syndrome. Strong is cold, weak is cold. Cold is depressed, qi and blood move slowly, and the pulse is slow and strong, which is the syndrome of excess cold. Deficiency of Yang Qi, inability of qi and blood to move, and slow and weak pulse are the syndromes of deficiency and cold. Athletes and heavy manual workers often have a late pulse, which is a physiological state.

Pulse count:

Fast pulse (more than 90 times per minute). Its characteristic is that the pulse is faster than the normal pulse. Main symptoms: heat syndrome. Strong is excess heat, weak is deficiency heat. Exogenous fever starts at the beginning, viscera is full of heat, pathogenic heat is stimulated, blood circulation is accelerated, and strong pulse is excess heat. Blood deficiency, body fluid deficiency, blood deficiency, endogenous deficiency heat, pulse number and weakness are deficiency heat.

Virtual pulse:

All three blood vessels are fragile. Press empty again. It should mean softness, which is the general term for all weak veins. Main symptoms: deficiency syndrome: mostly due to deficiency of both qi and blood, the pulse condition is difficult to stimulate, so it is deficiency. True pulse: All three pulses are powerful. Main symptoms: empirical evidence: pathogenic qi is abundant and healthy qi is sufficient, and both positive and evil are contending, and qi and blood are full of pulse.

Slippery pulse:

It should mean smooth, smooth, as smooth as a ball. Main symptoms: phlegm, indigestion and excess heat, which are more common in young people with deficiency of both qi and blood. The slippery pulse of pregnant women is a phenomenon of vigorous qi and blood to raise the fetus. They are all physiological phenomena.

Flood pulse:

The pulse is big and powerful, such as rough waves, one after another. Come and grow. Main symptoms: excess heat. The internal heat is strong, the pulse channels are dilated and the pulse shape is wide. Due to excessive heat, pathogenic factors are blazing, qi and blood are full, and pulse conditions are fluctuating.

Veins:

The pulse is as thin as a line, with obvious ups and downs. Main symptoms: deficiency syndrome, mostly seen in yin deficiency and blood deficiency syndrome. It also controls wet diseases. Yin deficiency and blood deficiency can't fill the pulse, or wet evil can't fill the pulse, and the pulse is small.

Chord pulse:

The end is straight and long, pointing downwards quite naturally, such as pressing a string. Treat hepatobiliary diseases, pain syndrome and phlegm. The qi is unfavorable, the liver loses the function of dispersing qi, and the pulse is tense and shows a string pulse. When the patient is sick, qi disorder or phlegm stops, which will lead to poor conduction of qi and string pulse.

Junction pulse:

The pulse is slow and irregular. Main diseases: yin deficiency and qi stagnation, cold phlegm and blood stasis. Analysis: Yin cold is the internal knot, and the qi of the pulse channel is blocked, so the pulse comes slowly and stops for a while. Cold phlegm and blood stasis, qi stagnation, stagnation of pulse qi, therefore, if the pulse stops late due to qi deficiency and weak blood, it is weak.

Generate pulse:

The pulse has a rest and a fixed number. Main disease: Decline of dirty qi. Analysis: the dirty qi is weak, the vitality is insufficient, and the pulse is blocked.

Pulse diagnosis

Pulse cutting should be performed when the patient is quiet. "Su Wen. The theory of pulse essence and stomach emphasizes that the pulse condition is often flat. When pulse cutting, let the patient take a sitting position or supine position, the forearm of the hand is almost at the same level as the heart, the palm is facing up, and the forearm is lying flat, so that the blood flow is smooth. Cunkou pulse measurement, clearance and ruler. For adult pulse diagnosis, use three designated positions. First, press the middle finger in an arc and press the pulp of the finger to touch the pulse to press the pulse. The density of three fingers should be adjusted according to the patient's height. Children's cunkou pulse is too small to hold three fingers, so the "one finger (thumb) method does not need to subdivide three parts. "Children under the age of three can look at fingerprints instead of pulse. There are three kinds of finger force commonly used in pulse-cutting, first light force, touching the skin as floating, called "lifting"; Then apply moderate strength and touch to the middle of the muscle, which is called "seeking"; Touch and press again until the bones and muscles sink, which is called "pressing". According to clinical needs, you can repeatedly touch and press in the order of lifting, searching, pressing or reversing, and you can also adopt finger pressing experience at different parts. There are three parts: inch, pass and pool, and each part has three stages: floating, middle and sinking, which are called three phases and nine phases. Attention should be paid to a quiet environment when pulse-cutting. If the patient has just experienced strenuous activity, he should rest for a while before taking his pulse. The pulse-cutter must breathe evenly, take a serious attitude, focus on his fingers and carefully identify the pulse condition. The pulse-cutting time should not be less than one minute at a time. The heart is the dynamic organ that forms the pulse condition, so the pulse condition can first reflect the pathological changes of the heart. Such as coronary heart disease, insufficient blood supply to the heart, low cardiac function, etc., can be reflected by pulse conditions. For example, when coronary heart disease is formed, the heart can stop beating, and then the pulse can be found through the pulse condition. The pulse characteristics of knot pulse are slow pulse, intermittent pulse and irregular pulse. And coronary heart disease, rheumatic heart disease, hyperthyroidism heart disease and other diseases can appear pulse arrest. The pulse condition of string pulse is characterized by increased vascular tension and straight and long pulse body end. String pulse reflects hypertension, increased blood flow resistance and hardening of blood vessel wall. The pulse characteristics of pulse condition are thin, shallow and weak, that is, floating and weak. When the human body has a gastrointestinal cold (loss of appetite, nausea, vomiting, diarrhea, etc. And insufficient intake), acute gastroenteritis, vomiting, decreased body fluid and deficiency of qi and blood, all of which can be reflected in the pulse condition.

Normal pulse condition

Normal pulse, also known as flat pulse and normal pulse. The regular pulse condition has three pulses, one breath and four pulses (70-80 pulses per minute earlier), neither floating nor sinking, neither too big nor too small, with even rhythm, calm and gentle, smooth and powerful, and inexhaustible pulse. It's called having a stomach, spirit and roots. Among them, there is stomach, that is, there is stomach qi, and the pulse is gentle, calm, smooth and energetic; God means that the pulse should be strong and soft, and the rhythm should be neat; Have roots. The main manifestation is endless ulnar pulse. In addition, the pulse condition is closely related to the internal and external environment. Due to the influence of climate, age, sex, physique, rest and mental state, pulse conditions will also undergo some physiological changes. For example, throughout the year, the pulse condition has the changes of spring string, summer flooding, autumn floating and winter sinking; The younger the age, the faster the pulse; Baby's pulse is fast, young adults' pulse is strong, old people's pulse is slightly string, and women's pulse is weak and slightly faster than men's. The fat contact is slightly heavier and the thin contact is slightly floating; After work, the pulse is fast and strong when drinking, full or emotional, and weak when hungry; The pulse of mental workers is much weaker than that of manual workers These should be distinguished from the pulse of the disease. In addition, the radial artery of a few people is abnormal, and there is no pulse at the mouth of the inch. If it appears behind the cunkou, it is called "anti-Guan pulse"; Some are inclined from the foot to the back of the hand, which is called "oblique flying pulse". This is not a disease. There are about 20 kinds of common pulse conditions recorded in ancient literature, such as floating, sinking, late, counting, slippery, astringent, virtual, real, Confucian, slow, weak, knot, generation, acceleration, tight, string, broad, thin and slight. Let's take a few of them as examples and briefly introduce them.

Pulse chart

"Floating" and "sinking" have been recorded in Neijing, and also discussed in Difficult Classics and Treatise on Febrile Diseases. They reflect the position of the pulse. The so-called pulse position is the most obvious part of the pulse detected by fingertip pulse cutting. "Floating" means that the pulse can be felt by pressing lightly with fingers, but it will be weakened after reconnection, which mainly means that the disease is in the "exterior", which is common at the beginning of exogenous diseases, and the body competes with exogenous pathogens (exogenous pathogens) for the muscle surface. Physiologically and pathologically, this is mostly caused by the increase of cardiac output, the acceleration of blood circulation, the decrease of vascular elastic resistance and the increase of flexor artery filling degree. On the contrary, "sinking" means that the pulse of hypochondriac can only be detected by pressing it again, which mainly means that the disease is "inside" and the yang drops, which is common in heart patients. Physiologically and pathologically, this is mostly caused by decreased cardiac output, decreased blood pressure, decreased peripheral arterial blood and increased vascular elastic resistance. "Qi" and "Shu" are pulse conditions recorded in classic documents such as Neijing. These two pulse conditions reflect the pulse rate. "Late" pulse means that the pulse beats less than four times (less than 60 times per minute), indicating that the disease is "cold" and the qi and blood of the body are not functioning normally. In modern medical research, it is mostly caused by changes in the heart, such as increased vagal excitability and atrioventricular block. On the contrary, the "counting" pulse is faster than the normal pulse, breathing more than five times (taking pills more than ten times per minute), which is common in "heat" syndrome and mainly reflects the hyperactivity of the body. Dai pulse reflects the rhythm of pulse condition. It has been recorded in Neijing. The pulse meridian says that it is a pulse condition that jumps a few times and then stops a few times. This is a slow and regular intermittent pulse, which is equivalent to double pulse, three pulse and four pulse in modern medicine. It is more common in patients with heart disease with metabolic dysfunction, patients with severe heart failure or patients with critical health. Neijing points out that this pulse indicates weakness of dirty qi, which is consistent with modern medicine. "Slippery" and "astringent" are mainly manifested as pulse waveform, that is, abnormal change of pulse vertical speed. The "slippery" pulse has been described in Neijing, and it is described as "flowing clouds" in Pulse Classic, which was called "moving like a pearl" by Sun Simiao, a famous doctor in Tang Dynasty. This pulse is common in phlegm, asthma, cough, hematocele, excess heat and other symptoms. Physiologically and pathologically, it is mostly caused by vigorous metabolism, rapid vasodilation and poor blood flow, which is common in hyperthyroidism and arteriosclerosis. After three months of pregnancy, women often have a "slippery" pulse due to factors such as increased blood volume and output and accelerated blood flow. This is not a sick pulse. It is reasonable for ancient Chinese medicine to know that pregnancy can be judged by pulse diagnosis. The "astringent" pulse is just the opposite, and it is a difficult pulse. This kind of pulse is "stagnant but not smooth", and it is said in "A Brief Introduction to Pulse in Neijing" that "astringency leads to heartache". This pulse can be divided into deficiency and excess. Deficiency means loss of qi and blood, but in fact it means qi, food, phlegm and so on. Blocking meridians, qi and blood flow is not smooth. Physiologically and pathologically, this is mainly due to the decrease of cardiac output and slow blood flow, which is common in anemia, blood loss and cardiac insufficiency. The ancients also summed up that "all diseases should be avoided", such as "poisoning should be large and avoid subtlety; Those with blood in the abdomen should be smooth and avoid weakness: the stroke should be slow and avoid urgency. " Wait a minute. It also summarizes that there are "common pulse conditions", such as "the pulse is deep inside, strong inside and weak inside; Severe cold and pain: severe cold and dampness: severe late illness and cold: severe internal heat: heavy slippery phlegm; Heavy and depressing; " Wait a minute. These are valuable for the diagnosis of etiology, types of diseases, pathogenesis and prognosis of diseases. Of course, pulse diagnosis cannot replace all diagnostic methods. Neijing and Treatise on Febrile Diseases have long pointed out that pulse-taking must be combined with comprehensive observation, advocating the combination of "four diagnoses" (looking, smelling, asking and pulse-taking), treating diseases based on syndrome differentiation, and opposing judging diseases only by pulse-taking.

Methods and precautions of pulse diagnosis

1. Time: The best time to feel the pulse is early in the morning. Su Wen's Meridian Theory points out: "The diagnosis method is often Ping Dan, Yin Qi has not moved, Yang Qi has not dispersed, the diet has not entered, the meridians are not full, the meridians are well adjusted, and the qi and blood are not chaotic, so the pulse that has passed can be diagnosed." Because the patient is not affected by various factors such as diet and morning activities, the internal and external environment is relatively quiet, and the qi and blood meridians are in a state of less interference, so it is easy to identify the pulse. But that doesn't mean you can't feel the pulse at other times. Wang Ji believes: "You can see a doctor at any time if you are sick, and you don't have to take Pingdan as a detention." Generally speaking, pulse diagnosis needs a quiet internal and external environment. Let the patient rest for a while before taking the pulse, so as to make the qi and blood calm, keep the clinic quiet, avoid the influence of the external environment and the fluctuation of the patient's mood, and help the doctor understand the pulse condition. Under special circumstances, patients should be examined anytime and anywhere, and there is no need to stick to these conditions.

2. Posture: Let the patient take a sitting or lying position, with his arms flat, his heart nearly at the same level, his wrist straight and his palm up, and put a cloth pillow on the back of his wrist joint to facilitate pulse-cutting. Incorrect posture will affect local blood circulation and pulse condition.

3. Fingering: The doctor and the patient sit sideways, with the left hand pressing the patient's right hand and the right hand pressing the patient's left hand. When feeling the pulse downward, first press the middle finger on the inner side of the high metacarpal bone to close the pulse, then press the inch pulse with the index finger to close it again, and then press the ruler pulse with the ring finger to close the pulse. Three fingers should be arched and fingers should be flush. Touch the pulse with fingertips, which is more sensitive. The density of finger cloth should be adapted to the patient's body shape. Old people with long arms should have sparse fingers and short arms should be dense. After the positioning is accurate, the three-finger flat cloth presses the pulse forcefully at the same time, which is called total pressing. In order to focus on a pulse condition, you can also press a pulse condition with one finger, for example, when diagnosing an inch pulse, the middle finger and the ring finger are slightly raised; When feeling the pulse, the index finger and ring finger are slightly lifted; When diagnosing ulnar pulse, the index finger and middle finger are slightly raised, and the combination of total press and single press is often used in clinic. The method of "one finger (thumb) determining pulse" can be used to diagnose pulse in children without subdividing three parts. Because children have short mouths, they are not allowed to specify three inches, and it is easy to cry and not cooperate.

4. Lift, press and find: This is a technique to detect the pulse condition by using the weight and displacement of finger force during pulse diagnosis. Hua Boren's "Physician's Summary" said: "There are three kinds of pulse: lifting, pressing and searching. Handle with care, press with your hands, neither light nor heavy, and ask for many blessings. At the beginning, take the pulse and wait gently, and you will see the pulse between your skin. This is also the yang qi and fu qi, and it is also the response of your heart and lungs. If the hand is heavy and the pulse is under the flesh, it is also the yin and the liver and kidney. It is neither light nor heavy, and it is taken from the middle vein, and its pulse should be between the flesh and blood, yin and yang are suitable, and the spleen and stomach are in harmony. If you can't see it in the floating, you will be blessed. If you can't see it, then Yin and Yang are hidden, and all three are the same. " Pressing lightly on the skin with your fingers is called lifting, also called floating or gently taking; Pressing the fingers between the bones and muscles with excessive force is called pressing, which is also called sinking or retracting; Finger force can be light or heavy, so it is called compromise. So be sure to pay attention to the pulse changes between lifting, pressing and searching. In addition, when the three veins are unique, it is necessary to gradually move the finger position and look inside and outside. The meaning of seeking is not the meaning of taking.

5. Calm down: Breathe in one breath. When taking the pulse, the doctor should breathe naturally and evenly, and use the time of one breath to calculate the patient's pulse number, such as the late pulse number. In addition, doctors are also reminded to be calm and open-minded, concentrate their thoughts and concentrate on understanding the pulse condition. "Su Wen Pulse Diagnosis Essentials" says: "Take the pulse properly and feel at ease."

6. Fifty strokes: Take your pulse every time. In other words, every time you press the pulse, the pulse on each side should not be less than 50 times. Its significance lies in: on the one hand, it is to know whether there are knots, generations and pulses in 50 pulses. However, if necessary, it can be postponed to the second, thirty or fifty times, and the purpose is always to identify the pulse condition, so it is appropriate to wait for the pulse for 3 to 5 minutes each time; On the other hand, remind doctors not to take three actions in a hurry and press two acupoints when pulse-taking.