Pulse Diagnosis

PULSE DIAGNOSIS

The heart is a highly tuned instrument that reads electromagnetic waves. Different frequencies are read by the heart as emotions, just as visually they are read as colors. That is how Stephen Harrod Buhner describes it in perhaps the best explanation of the heart's functioning to a Western audience.

Qi refers to the electromagnetic waves emanating from all life. Every cell in our body has Qi. Every organ system has Qi. Each person, animal, and plant emanates Qi that is the collective resonance of all their cells together.

The heart in Daoist philosophy and Chinese medicine is symbolized by the archetype of the emperor. The brain, and every other organ in the body are subjects of the heart.

When we feel the pulse, we are tapping in directly to all the electromagnetic waves of the body filtered through the heart. We are hearing the emperor speak.

The 6 Pulse Positions

There are 3 pulse positions on each wrist. Each position gives you information on the health of different organ systems. You will want to observe the pulse as a whole, as well as divided into position and depth to give you a complete picture.

How to Find the Pulse

You will use 3 fingers, 1 finger to feel each pulse position. These are your index, middle, and ring fingers. Line up the top crease of your middle finger with the bony part of your wrist closest to your hand. Then wrap your fingers around the wrist. See video here.

The Cun Position

This is the position closest to the wrist felt by your index finger. In a normal pulse it is the most superficial of the 3 positions. On the left it tells you the condition of the heart . On the right of the lungs.

The Guan Position

This is the central position felt by your middle finger. In a normal pulse it is medium in depth. On the left it tells you the condition of the liver. On the right of the spleen and digestion in general.

The Chi Position

This is the position furthest from the wrist a felt by your ring finger. In a normal pulse it is the deepest, but still strong and distinct. On the left it tells you the condition of kidney yin. On the right of kidney yang.

Qualities of the Pulse, and What They Mean

It takes Chinese medicine doctors a lifetime perhaps to master pulse diagnosis, but everyone can understand enough to help guide their own health. There are 29 official pulse types in Traditional Chinese Medicine, with endless combinations. Below I list the pulse types that are most common and relevant.

Normal

A normal pulse (ping mai) is smooth, even and forceful. The pulse is present at the Cun, Guan, and Chi positions and from superficial to deep. Its quality should not change very often or easily. There is a normal variation from person to person.

Depth

Superficial or Floating 浮脉 fú mài

Pulse is strong when barely touch the skin, but disappears with apply deeper pressure.

A superficial pulse most often indicates an exterior pathogen, i.e. the immune system is actively fighting off an invader attacking from the outside. The Defensive Qi of the body builds up at the borders to ward off the attack.

Less commonly deficiency syndromes where Yang Qi floats to the surface.

DEEP 沉脉 chén mài

The pulse can only be felt with stronger pressure.

A deep pulse indicates an interior pattern.

Speed

RAPID or FAST 数脉 shù mài

RAPID = 90 beats/min (5 beats/breath) or more

A rapid pulse pulse indicates Heat.

SLOW 遲脈迟脉 chí mài

Slow = 60 beats/minute (4 beats per breath) or less

A slow pulse indicates Cold.

Length

LONG 長脉 chǎng mài

Pulse is felt beyond the Cun position.

A long pulse indicates excess liver Yang, excess heat in the interior, or a strong pathogenic invasion.

SHORT 短脉 duān mài

The pulse can be felt at the Guan position but not at the Cun and/or Chi positions.

A short pulse indicates there is not enough Qi to move the blood, either due to Qi stagnation or Qi deficiency.

Strength

FULL or EXCESS 实脉 shí mài

The pulse is strong and forceful at Cun, Guan, and Chi positions.

A full pulse indicates an excess condition where both the Qi and blood of the body and the pathogen are strong, i.e. a big fight.

EMPTY or DEFICIENT 虚脉 xū mài

The pulse feels weak.

A deficient pulse indicates weakness in the body.

Quality

FINE OR THREADY 细脉 xì mài

The pulse feels fine like a thread but is distinct.

A thready pulse indicates Qi and blood deficiency, or yin deficiency. In yin deficiency, the pulse is typically fast and thready indicating heat + fluid deficiency.

WIRY or STRING-TAUT 弦脉 xuàn mài

The pulse feels tight and long like a guitar string.

A wiry pulse indicates that the liver Qi is not flowing smoothly due to imbalances in the liver and gallbladder organ systems, pain, or phlegm retention.

SLIPPERY or ROLLING 滑脉 huá mài

The pulse feels smooth, flowing, and uninhibited; like pearls rolling in a dish.

A slippery pulse indicates an accumulation of internal pathogenic factors such as phlegm-damp, food stagnation (indigestion), or excess heat. It is considered normal (ping mai) for women during pregnancy.

CHOPPY or ROUGH 涩脉 sè mài

The pulse feels rough and uneven, "like a knife scraping bamboo." The opposite of a rolling pulse.

A choppy pulse indicates blood not flowing smoothly. This could be due to blood deficiency, blood stagnation, or Jing deficiency.

Beat Regularity

REGULAR IRREGULAR 代脉 dài mài

The pulse is relaxed and weak, stopping at regular intermittent intervals. These intervals may be strikingly long.

A regular irregular pulse indicates trauma or advanced heart disease. This pulse indicates a serious health condition.

KNOTTED (IRREGULAR IRREGULAR) 结脉 jié mài

The pulse is relaxed and slow, stopping at irregular intervals.

A knotted pulse indicates an excess Yin condition: Qi stagnation due to Yin excess, blood stagnation due to phlegm-damp, or blood stagnation. In Western terms , it indicates an irregular beat or palpitation stemming from the ventricle of the heart, but is less serious than a regular irregular pulse.

By andrews|2019-03-26T14:29:27+00:00August 2nd, 2018|Diagnosis|Comments Off

Civility; the Beauty of the Metal Element
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Civility; the Beauty of the Metal Element

5 Element Personality Typing, Diagnosis, Feng Shui, Five Elements

Civility; the Beauty of the Metal Element

Confucianism, at its heart, is the ideal of taking the individual and the society to their highest potential. It parallels western notions of chivalry and civility. All have fallen into disfavor in modern culture.

During the social revolutions of the past, notions of decorum felt too restrictive. We questioned, rightly, everything society told us we must do. Now we have the opportunity to follow ideals of civility consciously rather than reflexively.

The Metal Element

We need the best of all our elements, but perhaps none so much as Metal at this moment in history. There is great beauty in cultivating our own Metal element. It is the part of us that chisels the raw, blunt rock into an exquisite statue.

When we look at the boorishness, anti-intellectualism, and plain meanness that we are devolving into, we have the choice, each of us, to act daily to create a better world. There are two ways we can start doing this now:

Cultivating Awe & Reverence

Perhaps the simplest way to shift our behavior is to create the habit of awe and reverence for the beauty around us. If we take a moment to hold reverence for a stately old tree, we will naturally begin to treat the environment around us with more respect. If we allow ourselves the vulnerability to sit in awe of the man or woman or child before us it will transform our relationships into greater harmony and mutual happiness.

To feel reverence = to really see someone or something

We hold reverence when we see the magnificence of the one who stands before us. It is what everything in existence craves; to be seen in truth.

The Golden Rule

This simple age-old rule has stood the test of time because it is so perfect. It guides us to practice empathy in our daily lives. If I were an elderly person standing on a crowded subway, how would I want someone to treat me?

If you already have a highly developed sense of empathy and perhaps need to be kinder to yourself, the corollary also holds: “Do unto yourself as you do unto others.”

A Balance

Civility does not mean having people run all over us. There are people who need boundaries and we can set them with finesse. Civility guides us to ask the questions “How can we structure society to increase the odds our children grow into good adults?” “How can we contain dangerous people so the rest of society is safe?” “How do we stop rewarding bad behavior in public places?”

Civility has an integral place in our daily and spiritual lives. It is time we honor the gift of the Metal Element within us.

By andrews|2019-03-26T14:29:28+00:00June 26th, 2018|5 Element Personality Typing, Diagnosis, Feng Shui, Five Elements|Comments Off

Tongue Diagnosis
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Tongue Diagnosis

Detox, Detoxification, Diagnosis, Nurturing Life Project, Period Care, Postpartum Care, Second Spring, Traditional Chinese Medicine

Tongue Diagnosis

The tongue is a part of the interior of our bodies that we can see. The tongue is slower to change as compared to the pulse. By using both tongue and pulse diagnosis, acupuncturists are able to get a clear picture of a patient’s current state of health, and what what may have gotten him/her there.

Many patients have a combination of patterns occurring at the same time, making real world diagnosis more complicated than the straightforward explanations below. First we will look at the tongue body then the tongue coating.

Normal Tongue
A normal tongue is pink, not too big and not too small, with a very thin white coating.

Tongue Body

Jutting Tongue
This tongue to “v” shaped and juts out forcefully. The tension in the tongue is indicative of the tension held in the body. It is a sign of Liver excess (Liver Qi Stagnation or Fire). Possible symptoms include muscle tension, stress, irritability, depression, and PMS. If the tongue veers to one side this indicates Liver Wind and potentially stroke or convulsions.

Puffy Tongue
Also known as a enlarged or fat tongue. This indicates Phlegm and is a sign of congestion of body fluids. Phlegm is implicated in many modern diseases including sinus or lung congestion, excess weight, irrational thinking, obsessive thoughts, fatigue, foggy thinking, chronic joint pain, high cholesterol, polycystic ovarian syndrome, and channel blockages.

Small Tongue
A tongue that is smaller than normal indicates a deficiency of substance in the body, namely Blood Deficiency or Yin Deficiency. Common symptoms include anxiety, restlessness, tinnitis, insomnia, night sweats, and female hormone deficiency.

Scalloped Tongue
Teeth marks on the sides of the tongue indicates Spleen Qi Deficiency. This can present as weak digestion, food allergies, fatigue, poor muscle tone, a tendency to bruise, low immunity, and organ prolapse.

Assessing Tongue Color

Red indicates Heat (inflammation and/or toxicity). Symptoms can include thirst, constipation, irritability, acne, excess hunger, bad breath, strong body odor, and excessive bleeding.

Pallor indicates Cold or Deficiency (Qi, Blood, and/or Yang). Symptoms may include feeling cold, fatigue, emotional sensitivity, insomnia, lack of physical strength, and knee and low back weakness.

Purple or bluish indicates Blood Stagnation. Physical trauma, longstanding emotional stress, uterine fibroids, heart issues, or other conditions impeding healthy blood circulation. There may be difficulty sleeping, stubborn depression, pain, stiffness, and stuck emotional patterns.

Red Tip The very tip of the tongue corresponds to the Heart. A red tip indicates Heart Heat, or emotional unrest. This can manifest as stress, anxiety, or insomnia. If the tip has a cleft it indicates longstanding or constitutional tendency towards emotional issues. Petechiae (little red dots) indicate Wind Heat; a cold with fever and yellow phlegm, typically bacterial in origin.

Tongue Coating

Thick White Coat
A thick tongue coating indicates Dampness. This is a pathological accumulation of fluids associated with digestive impairment. Common signs include weight gain, abdominal bloating, cloudy urination, mucous in the stools, edema, excessive vaginal discharge, poor digestion, and loose stools.

Thin Yellow Coat
The coating is thin, but distinctly yellow. This indicates Heat, either internal (inflammation) or Wind Heat (cold with fever, typically bacterial in origin).

Thick Yellow Coat
The tongue appears heavily coated and yellow. This indicates Damp Heat, the combination of Dampness and Heat (fluid accumulation mixed with inflammation). Commons symptoms include excess weight, feeling hot, anger, Liver/Gallbladder issues, and red weepy skin conditions.

Scanty or Mirrored Coat
The tongue looks shiny, like liver. This indicates Yin Deficiency and the patient may present with insomnia, anxiety, fatigue, thirst, low back pain, tinnitis, hot flashes, and night sweats.

Common Combination Patterns

By andrews|2019-03-26T14:29:30+00:00December 29th, 2017|Detox, Detoxification, Diagnosis, Nurturing Life Project, Period Care, Postpartum Care, Second Spring, Traditional Chinese Medicine|Comments Off

Heal Blood Deficiency with Chinese Medicine Diet and Lifestyle
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Heal Blood Deficiency with Chinese Medicine Diet and Lifestyle

Acupuncture, Diagnosis, Nurturing Life Project, Traditional Chinese Medicine

Heal Blood Deficiency with Chinese Medicine Diet and Lifestyle

BLOOD IN CHINESE MEDICINE?
Blood (血 xuè) encompass the Western concept of the word and much more. Blood and Qi are as inseparable and interconnected as Yin and Yang. Qi moves and directs the flow of Blood, while Blood provides substance through which Qi can move and nourishes the organs that produce Qi.

Functions of Blood in TCM:

Houses the Shen. Shen is often translated as “spirit” but it also encompasses the concept of “mind” and “consciousness”. If Blood is deficient the Shen “has no home” and becomes scattered and disordered. This explains why patients with Blood deficiency often feel mentally scattered, have difficulty focusing or remembering, feel emotionally vulnerable, anxious, timid, are easily frightened, suffer from palpitations, and have trouble sleeping. (If Blood is stagnant, as often happens after trauma, it also has mental/emotional ramifications: depression, severe insomnia).
Moistens Organs, Tissue, and Meridians. Healthy Blood gives our skin a rosy glow, provides luster and life to our hair, and gives us strong nails. Blood deficiency is implicated in many skin issues that have symptoms of dryness, itching, and pallor. Healthy Blood lubricates our tendons and muscles. Chronic tension and stiffness is a sign of Blood deficiency. Blood nourishes the eyes. Deficient Blood causes blurred vision and other vision issues.
Allows For Sensation and Movement. Localized blood deficiency can lead to a lack of sensation and function such as numbness or atrophy.
Anchors Qi. The moist substance of Blood keeps Qi from moving upward recklessly as in some cases of headaches and tinnitis.
Menstruation. Healthy shows itself in normal menstrual blood that is red and of medium volume. Symptoms of Blood deficiency include delayed period (body takes a long time to build up the uterine lining), pale blood, and scanty volume.

WHAT WEAKENS BLOOD?

Excessive mental work and stress.
Excessive or pathological bleeding such as internal bleeding or heavy periods.
Qi deficiency.
Caretaking.

DIET TO STRENGTHEN QI
There is an old Chinese saying that it takes “40 parts of Qi to make 1 part of Blood”. Building Blood takes more time and requires high protein foods. The best foods to build blood are animal products: liver (or desiccated liver pills), chicken, and bone marrow broth. Chlorophyll-rich greens are very important. Vegetarians will take a little longer and are more dependent on Chinese herbs. Try to eat organic as much as possible. MacClean and Littleton recommend a diet of 30-40% carbohydrates, 40-50% vegetables, and 20-30% protein.

Specific foods to strengthen Blood: liver, eggs, chicken, beef, bone marrow, bone broth, pork trotters, oyster, mussel, tempeh, miso, quinoa, rice, beans and legumes (especially black beans), carrots, beets, go ji berries, longan berries, mulberries, jujube dates, black sesame seed, wheatgrass, blue-green algae, spinach, kale, collards, swiss chard, dill, cilantro, parsley, dark beer (small quantities).

Avoid or limit: excessive raw food, chemicals, refined food.

LIFESTYLE TO STRENGTHEN BLOOD

Rest during menstruation and postpartum.
Balance self-care with nurturing others.
Balance activity with rest. Sleep an extra hour after a tough workout or a hard day.
Practice meditation, qigong/taichi, or other stress-relieving activity.

TIMES WHEN BLOOD IS WEAKENED

Women during menses, postpartum, and menopause.
After a period of blood loss.
Periods of stress and extreme mental exertion.

For more information on Blood and how you can improve your health check out my books 7 Times a Woman and The Postpartum Recovery Program.

By andrews|2019-03-26T14:29:31+00:00June 20th, 2016|Acupuncture, Diagnosis, Nurturing Life Project, Traditional Chinese Medicine|Comments Off

Heal Qi Deficiency with Chinese Medicine Diet and Lifestyle
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Heal Qi Deficiency with Chinese Medicine Diet and Lifestyle

Acupuncture, Diagnosis, Nurturing Life Project, Traditional Chinese Medicine

Heal Qi Deficiency with Chinese Medicine Diet and Lifestyle

From 7 Times a Woman and Clinical Handbook of Internal Medicine; Volume 2:

WHAT IS QI?
Qì 气(氣) is the energy that animates our bodies and all of life. Qi is a difficult concept for Westerners to grasp and has been further confused by changes in language. You may see Qi spelled “chi” which is from an older romanization of Chinese characters created by Western missionaries called Wade-Giles. In the 1950’s Zhou Youguang created the official romanization of Chinese used today. In Japanese it is pronounced “ki”.

The concept of Qi may be foreign to modern life, but is similar to the understanding of energy in many cultures. For example, we find the concept of prana in Hinduism, mana in native Hawaiian culture, axé in Candomblé, and lüng in Tibetan Buddhism.

The Chinese character is made of two radicals:

米 (mǐ) = rice
气 (qi) = air/steam

The visual of steam emanating from cooked rise gives us a clear picture of Qi; it is insubstantial, it transforms, it is hot, and like rice in ancient China, it is vital to life. Qi is present everywhere in our bodies and the world around us. In our bodies, there are concentrated pathways of Qi (rivers of energy) known as meridians. It is easier to access and affect the way Qi flows in the body by stimulating these meridians. This is the basis for acupuncture, qigong/taichi, and Chinese masssage.

In the body Qi performs 6 major functions:

Transforms Substances. For example, Qi transforms food and air into usable fuel in the body, unusable substances into urine, and Qi into Blood. Weak Qi means weak digestion and an inability to draw nurturing from the environment. It causes Blood deficiency and other weaknesses.
Transports Substances. For example, Qi transports vital nutrients extracted from food and blood from the heart to the uterus for menstruation. When Qi is weak it can cause stagnation and blockage because there is not enough Qi to move substances.
Protects the Body. Qi circulates on the surface of the skin, protecting the body from external invasion of pathogens. Weak Qi means weak immunity.
Holds in Substance. Qi holds in body fluids like keeping blood in the blood vessels, urine in the bladder, and sweat from seeping out indiscriminately. Weak Qi can allow substances to come out excessively or at inappropriate times such as spotting or early menses, urinary incontinence, spider veins, and spontaneous sweating.
Raises the Organs and Tissue. Qi keeps the skin and organs raised up in their proper place. Weak Qi can cause conditions such as uterine prolapse or sagging skin.
Warms the Body. Qi is a function of Yang, and provides the heat necessary for the bodies functions. Weak Qi can manifest as coldness.

WHAT WEAKENS QI?

Too much physical work or working out. Long stretches of cardio particularly weaken Qi. If you feel exhausted rather than exhilarated after a workout you have depleted your Qi.
Overthinking, worrying, ruminating, researching, and studying exhaust Qi.
Poor or inappropriate diet. The decreasing quality of our food supply (GMOs, pollution, etc.) has a negative effect of everyone’s Qi, but certain people will be more susceptible.
Stress.

DIET TO STRENGTHEN QI
To strengthen Qi eat simple, uncomplicated meals and favor long cooking times. Congee, porridge, stew, broth, and soup all break down food and make it easier to digest, requiring less effort by the body to extract nutrients. This is why traditional cultures recommend soup for people when they are sick. Limit raw foods as they require more Qi to break down. Eat smaller meals and eat at regular times. Do not allow yourself to go hungry. Avoid drinks other than tea with meals. MacClean and Littleton recommend a diet of 40-60% carbohydrates, 30-40% vegetables, and 10-20% protein.

Specific foods to strengthen Qi: rice, oats, yams, sweet potatoes, carrots, winter squash, pumpkin, peas, green beans, cooked fruit, eggs, most meat and fish (chicken, beef, lamb, tuna). Use cooking spices such as onions, ginger, garlic, clove, etc. Incorporate small amounts of complex natural sweeteners such as honey (though most Americans already eat too many sweet foods).

Avoid or limit: raw fruits and vegetables, soy products, seaweed, salt, brown rice, excessive sweets, dairy, nuts.

LIFESTYLE TO STRENGTHEN QI

Eat regular meals.
Go to bed by 10pm.
Be more active and eat bigger meals in the morning and early afternoon. Practice relaxation and rest in late afternoon and evening. Don’t eat past 7pm.
Balance activity with rest. Sleep an extra hour after a tough workout or a hard day.
Practice qigong or taichi.
Spend time in nature.

TIMES WHEN QI IS WEAKENED

Before the age of 6 and after menopause/andropause.
During illness.
Periods of stress and extreme mental or physical exertion.
Women after childbirth and during menses.
Men after orgasm.

For more information on Qi and how you can improve your health check out my books 7 Times a Woman and The Postpartum Recovery Program.

By andrews|2019-03-26T14:29:31+00:00June 18th, 2016|Acupuncture, Diagnosis, Nurturing Life Project, Traditional Chinese Medicine|Comments Off

The Year of the Green Wooden Sheep
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The Year of the Green Wooden Sheep

Acupuncture, Diagnosis, Dr. Judith, Spirituality, Traditional Chinese Medicine

The Year of the Green Wooden Sheep

by Dr. Judith Andrews, DAOM, L.Ac.

2015 is the Year of the Green Wooden Sheep (or Goat or Ram if someone wants to sound more macho). It is the year 4713 in the Chinese calendar system.

Chinese Stem-Branch Calendar is a cyclic numeral system of 60 combinations of the two basic cycles, the ten Heavenly Stems and the twelve Earthly Branches. This calendar system has been used in China since the second millennium BC, and adopted throughout Asian cultures. Animal names are given to years and days, just like we name our months and days of the week.

To determine the Chinese horoscope sign we look at the start of spring in the Chinese Stem-Branch Calendar. Start of spring is when the sun enters the 315^th degree of the tropical zodiac. In California, for example, a baby born after 8 pm on February 3, 2015 is born on the year of the sheep. If the baby is born at 7:59 pm on February 3, 2015, he or she is still in the year of the horse.

To make things a bit confusing, Chinese New Year Day is February 19, 2015. Chinese New Year Day is determined by the new moon day of the first lunar moon. That is the day Chinese New Year is celebrated.

A practitioner of Chinese acupuncture may include the person’s astrological sign during a health assessment. For the acupuncturist it is just another tool to examine the forces of nature at play within the dynamic of an individual’s personality and life path.

Some of us like to have more fun with this knowledge. What the year of the sheep will bring into our lives. Which signs are compatible, the signs that are not.

Sheep is a yin sign associated with peace, tranquility, and incredible good luck. The wood element in the year of the sheep lends fortitude and steadiness to 2015. If you have been working hard these past 2 years look forward to reaping the rewards. If the last 2 years have been difficult, things will turn around this year.

By andrews|2019-03-26T14:29:39+00:00February 4th, 2015|Acupuncture, Diagnosis, Dr. Judith, Spirituality, Traditional Chinese Medicine|Comments Off

Miley Cyrus: Tongue Diagnosis

Though is difficult to do face reading or tongue diagnosis from pictures due to lighting and limited angles, as an acupuncturist I found it interesting to track Miley Cyrus’ tongue. These are photos compiled on Digital Spy.

Miley earlier 2008

Miley in 2008 presents with a pale enlarged tongue with a white coating.

Palor indicates Qi and/or Blood deficiency. The puffiness and white coating are a sign of Phlegm Damp accumulation.

Miley later 2008

Miley later 2008, presents a redder tongue with a distinctly red tip and a yellowish/dirty coating.

The red tip shows Heat in the Heart, typical of emotional stress, insomnia, and agitation. The tongue body is also a bit red indicating generalized Heat. The coating would indicated Dampness had progressed to Damp Heat.

Miley earlier 2013

Jumping to Miley 2013, we see a pale tongue body, slightly red tip, and yellowish coating.

The pale tongue body indicates Qi and Blood deficiency. The redder tip indicates continued Heart Shen disruption as in emotional stress. The slightly yellow coating indicates Dampness with a little Heat.

Miley 2013

Recent Miley shots sport this side tongue. It gives the tongue a “v” shape characteristic of Liver Qi stagnation. Also a tongue veering off to the side like that would typically indicate Liver Wind and potential serious conditions such as stroke or seizures. However, since this appears to be a practiced positioning, I would not worry.

Miley 2013 VMA Awards

This side angle from the 2013 VMA Awards again shows a pale tongue body with slightly yellowed coating.

If the pictures are an accurate indicator, Miley tends towards Qi and Blood deficiency with Dampness and occasional Heat flare ups, particularly in the Heart. Though her persona is that of a Liver excess personality (even going so far as to imitate the Liver excess tongue), she appears to be more of a Spleen deficient/Heart excess type. I would recommend perhaps a modified Gui Pi Tang.

By andrews|2019-03-26T14:29:42+00:00October 21st, 2013|Diagnosis|Comments Off