In ancient times, how could it be possible to visit the sick with a pulse?

The concept of pulse diagnosis is composed of the visual position (depth), speed (speed), 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 mansion 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. [Edit this paragraph] The meaning of pulse condition refers to the image of pulse condition. The generation of pulse condition is directly related to the fluctuation of heart, the rise and fall of heart qi, the smoothness of pulse and the profit and loss of qi and blood. Therefore, the heart and pulse are the main organs that form pulse conditions. Qi and blood are the material basis of pulse formation. At the same time, blood circulates throughout the body and runs endlessly. In addition to the leading role of the heart, there must also be the coordination role of various organs: the lung is in the pulse, the lung is compressed, and the blood is scattered; Spleen governs blood, which is the source of qi and blood biochemistry. Only by nourishing and controlling spleen can blood run. Liver stores blood and regulates blood flow; Kidney storing essence can generate blood and transform qi, and kidney qi is the motive force of functional activities of various viscera. Therefore, it cannot reflect the comprehensive information of viscera, qi, blood, yin and yang. When the viscera and qi and blood are diseased, it will inevitably appear on the pulse condition, which will become an important basis for disease diagnosis. [Edit this paragraph] The location of pulse condition is mainly treated by "inch-mouth diagnosis" in clinic, that is, the posterior part of the patient's radial artery is cut. 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. [Edit this paragraph] Pulse-cutting should be performed when the patient is quiet. "Su Wen. The theory of pulse essence and stomach emphasizes that patients should take a sitting position or supine position when their pulse is normal, with their forearms and hearts close to the same level, palms up and forearms flat to make blood flow 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. [Edit this paragraph] Precautions for pulse-cutting: Pay attention to the quiet environment when pulse-cutting. If the patient has just had strenuous activities, he should have a rest first, and then feel 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. [Edit this paragraph] The principle of pulse diagnosis appeared in China in the 5th century BC and has been in use ever since, which fully proves its strong vitality and scientificity. Modern pulse research has confirmed that the formation of pulse condition mainly depends on the function of heart, the function of blood vessels and the quality and quantity of blood. These three aspects determine that the pulse condition has some morphological changes, that is, the image that the pulse condition should refer to, that is, the pulse condition. The pulse condition can first show the pathological changes of these three factors, and then infer other pathological changes from them. Obviously, the pulse condition has its objective factors. 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 vasomotor movement of blood vessels reflects the quality, quantity and speed of blood flow. Vascular diseases, such as arteriosclerosis, can also be reflected in 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. [Edit this paragraph] Influencing factors of pulse conditions There are roughly 28 kinds of pulse conditions in the human body, each of which is a reflection of human functions and has a corresponding range of symptoms. Pulse condition is a phenomenon of biological information transmission, which is a signal about circulatory system measured from the outside. Its disadvantages are inaccuracy and lack of quantification. For example, high blood pressure can be found by pulse, but blood pressure can't be measured. It is unscientific to say that hypertension is 180mmhg. Any organism transmits not only endogenous information, but also exogenous information. The endogenous factors that determine the pulse condition are mainly the three factors mentioned above. The external factors that determine the pulse condition are geography, climate and so on. When it is cold, the blood vessels contract and become thinner, and the blood flow will slow down; When the weather is hot, the blood vessels dilate and widen, the blood flow accelerates, and the pulse condition will change accordingly. Even if the external environment is insignificant, the pulse condition may change obviously. If it is within the physiological adjustment range, it belongs to normal pulse condition; Beyond the physiological range is a pathological pulse condition. In the case of interference, the pulse condition is sometimes inaccurate and reliable. At this time, experience is particularly important. A Chinese doctor with superb medical skills and rich experience in pulse diagnosis can find lesions more accurately, while an ordinary Chinese doctor may make unclear diagnosis or even make mistakes. [Edit this paragraph] Pulse diagnosis method is a little dynamic, welcoming people, and Zhang Zhongjing's trisection. Now the inching 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). Holism and syndrome differentiation are two concepts in the basic theory of traditional Chinese medicine. Traditional Chinese medicine is a combination of observation, hearing, questioning and palpation, and it is not appropriate to diagnose and treat diseases as a whole with only one diagnostic method. The information of human body is not only reflected in pulse condition, but also in skin surface, sound, smell and so on. It's just that the pulse condition is single and incomplete, which is easy to produce errors. Each of the four diagnostic methods has its own characteristics and unique functions. Pulse diagnosis can not replace other diagnostic methods, but should combine the four diagnosis methods to improve the accuracy of diagnosis. [Edit this paragraph] The pulse condition of common diseases in healthy people should be four breaths at a time, with three pulses in inches, gentle and powerful, and the ruler pulse 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: press lightly to get it, then press again to decrease 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, just 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, (less than 60 pulses 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: rapid pulse, (pulse is 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. Deficiency pulse: all three pulses are weak. 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 pressing, as smooth as pressing 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. Hong pulse: The pulse is large and powerful, like a rough wave, 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. Pulse: the pulse is as thin as a line, with obvious fluctuation. 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 down quite suddenly, such as pressing a chord. 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. Pulse knot: slow pulse and irregular interval. 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. Pulse generation: 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. [Edit this paragraph] Normal pulse condition The pulse condition of a normal person is also called 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. [Edit this paragraph] Pulse correlation In addition, pulse condition is closely related to 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.