pulse-diagnosis-procedure

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Use when performing pulse examination (脉诊) to determine organ pathology and prognosis. Covers the three positions (寸关尺), three depths of pressure (浮中沉), eight pulse qualities, and seasonal correlation as practiced by Bian Que and Cang Gong.

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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

Patient sits or lies comfortably
Examiner faces patient
Use three fingers (index, middle, ring) on radial artery
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

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

Examination Steps

Calibrate Time
- Count patient's breaths
- Normal: 4-5 pulses per breath cycle
Assess Each Position
- Start with left wrist
- Check all three positions at all three depths
- Note: rate, strength, width, depth, quality
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

Correlate with Symptoms
- Match pulse findings to patient complaints
- Identify affected organs
- Determine excess vs. deficiency
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

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