Pulse Diagnosis Procedure (脉诊)

Overview

Detailed pulse examination method as practiced by Bian Que and Cang Gong (Chunyu Yi). Used to determine organ pathology, disease progression, and prognosis.

Prerequisites

• Quiet environment
• Patient calm and rested
• Examiner focused and attentive

Positioning

1. Patient sits or lies comfortably
2. Examiner faces patient
3. Use three fingers (index, middle, ring) on radial artery
4. Left wrist examines right-side organs; right wrist examines left-side organs

The Three Positions (寸关尺)

寸

• Position: Closest to thumb
• Corresponds: Heart, Lungs, Chest

关

• Position: Middle position at styloid process
• Corresponds: Liver, Gallbladder, Spleen, Stomach

尺

• Position: Closest to elbow
• Corresponds: Kidney, Bladder, Lower abdomen

Three Depths of Pressure

1. Superficial (浮取): Light touch, detects external conditions
2. Middle (中取): Moderate pressure, detects organ function
3. Deep (沉取): Heavy pressure, detects internal conditions

Examination Steps

1. Calibrate Time

   • Count patient's breaths
   • Normal: 4-5 pulses per breath cycle

2. Assess Each Position

   • Start with left wrist
   • Check all three positions at all three depths
   • Note: rate, strength, width, depth, quality

3. Identify Pulse Qualities

Quality	Chinese	Indication
Floating	浮	External pathogen
Deep	沉	Internal condition
Rapid	数	Heat condition
Slow	迟	Cold condition
Weak	虚	Deficiency
Strong	实	Excess
Slippery	滑	Phlegm, food stagnation
Choppy	涩	Blood stasis, deficiency

4. Correlate with Symptoms

   • Match pulse findings to patient complaints
   • Identify affected organs
   • Determine excess vs. deficiency

5. Determine Prognosis

   • Pulse matching season = favorable

• Pulse opposite to season = unfavorable
• Sudden changes = acute condition
• Gradual changes = chronic condition

Documentation

Record:

• Date and time
• Pulse qualities at each position
• Corresponding organ assessment
• Prognosis
• Recommended treatment

Expected Outcome

• Identification of disease location
• Understanding of disease nature (hot/cold, excess/deficiency)
• Prognostic assessment
• Treatment direction

Verification

1. Confirm that all three positions (寸, 关, 尺) on both wrists have been examined at all three depths of pressure before forming conclusions.
2. Validate that pulse findings have been correlated with patient symptoms and seasonal factors to identify affected organs.
3. Ensure documentation includes date, pulse qualities at each position, organ assessment, prognosis, and recommended treatment.