Pulse taking
(This article written by Tom also appears in the Summer edition of the British Acupuncture Council's magazine 'Acu').
The art of pulse-taking encapsulates all the richness and fascination of Chinese Medicine, as well as its challenges and occasional frustrations. My experiences with the pulse thus far, about a decade in, leave me in no doubt that sensitive, focused palpation of the radial arteries (the wrist pulses) can reveal a tremendous amount of information. However, reading and applying that information reliably and consistently is a life-long journey.
I consider myself on the more down-to-earth, pragmatic end of the practitioner scale, but I had an experience early in my initial training which I still find hard to explain rationally. A few months in to my acupuncture degree, I was becoming quite anxious about some of the more esoteric aspects of my new vocation, and pulse-taking was high on the list. Surely, I thought, just by putting my fingers on someone’s wrists, I couldn't glean more than rudimentary information that would be more reliably measured with a blood pressure monitor and a clock?
The pulse system we were introduced to is one widely used in modern-day TCM acupuncture. Three fingers are placed on the radial pulse at each wrist, with each of the six positions representing various internal organs. The strength, size, rate and 'quality' of each position is considered to represent the relative health of each organ system. There are 29 recognised qualities, all with complex diagnostic implications. For example a pulse can be 'wiry', ‘slippery’, or ‘hidden’.
But as a newcomer to this methodology, I had many questions. Why are there various different 'systems' of pulse reading, and not just one? Why do the different positions represent the various organs? Wasn't this all far too subjective to be meaningful?
Then we had a lecture on the pulse from Rosey Grandage. Rosey is a very experienced practitioner, who studied for several years with Classical doctors in China, where she became convinced of the importance of regular Qigong practice to cultivate sensitivity and intuition. Again, this sounded far-fetched to me at the time, but when she asked for a volunteer, I came forward. Her head bowed in deep concentration, she placed her fingers on my wrist. After a few moments - and having not met me before - she began describing most of my medical history, including my intermittent asthma, my back ache, and a shoulder pain I had recently developed, down to an exact description of the pathway of the pain. I was startled, and had to completely re-evaluate my scepticism.
Rosey’s advice was to keep pulse-taking simple – just ask yourself ‘what is this pulse trying to tell me?’, and take it from there. This is how I always try to start now – I clear my mind, tune in and ‘listen’ for the overall message. Is there an internal battle going on? Is this person ‘running on empty’? I find it’s best to take the pulse before gaining too much other information where possible, otherwise the temptation to focus on aspects which confirm prior findings (i.e. ‘confirmation bias’) can be overwhelming.
Few of us will be able to read people like a book as Rosey apparently did with me, and I certainly haven’t reached anywhere near that level of skill. But I’m thankful to be able to dip into the mysterious internal world and come back with usable information. And like many aspects of this wonderful medicine, there are multiple approaches to finding and interpreting that information. I no longer see that as a source of anxiety, but rather a sign that acupuncture is as much an art as it is a science.