Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 More pulse inquiry... This may have been touched upon in the past, but I am still not clear. There seems to be three types of choppy pulse: 1) Rough feeling (actual texture of the pulse) 2) irregular speed (changing with breath, or otherwise) 3) ireegular strength. (Hitting fingers at different intensities, at different times) These all are very different, so what are the diagnostic correspndances to each. (i.e. choppy is choppy, but depedending on which choppy there should be different diagnostic meaning, no?) -JAson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 Jim, Thank you for the great post on Choppy pulses. I had a strong experience with a Choppy pulse this week. My grandmother was in the hospital and had an intensely Choppy pulse on her Left Proximal position. It turned out that she had a blood clot in her urinary catheter - it might of been there most of the morning before they found it. Within a couple of hours of the catheter being cleared, the choppy quality was completely gone. How do you compare a Sandy quality and Vibration in the pulse? Is the Shen/Hammer Vibration analogous to the Sandy quality you describe? It seems that I often feel a static-y quality on the pulses which I have equated to Hammer's description of Light Vibration. -Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 , " " wrote: > These all are very different, so what are the diagnostic > correspndances to each. (i.e. choppy is choppy, but depedending on > which choppy there should be different diagnostic meaning, no?) Jason: You would not find a pure choppy pulse in clinc; it should be compounded with other qualities. Classically it was described like cutting bamboo with a light or dull knife--uneven and rough. It can also be compared to touching sandpaper or wet sand. This is a very general term, and almost anything that is neither Soft nor Slippery may be considered as a Choppy pulse as long as it does not have the smooth type of a texture of the Slippery pulse. It can even feel like very fine sandpaper. A Choppy (also Sandy, Rough, or Fine) pulse is a yin pulse indicating a cold syndrome; the rougher it gets, the colder it is. It is usually found as a cold syndrome in the deeper area of the body, indicating a circulatory imbalance or poor blood circulation. If found in the Right Middle position, you can think of it as middle warmer becoming colder, causing stomach and digestive disorders such as diarrhea, cramps, indigestion, etc. Or it may indicate a depletion of the spleen and the stomach, causing the qi to stagnate on both sides of the rib cage causing fullness and swelling. So there is an obvious stomach problem related to the digestive function. It usually indicates stomach cramps. If you detect Choppy pulse deeper in the stomach location, then it is definitely stomach cramps because cold energy is penetrating deeper into the blood or organ depth. If the Right Distal pulse is Choppy, it indicates their respiratory system is cold and you can suspect that they are retaining fluids in the lungs. It could also be blood retained in the lungs without causing any type of inflammation. If the Left distal position becomes Sandy it means that damaged heart blood is causing chest pain. If the Proximal position is Choppy, it indicates that the lower jiao is cold and depleted of yang. If the Proximal position becomes Sandy it indicates that damage to jing and blood in the lower warmer resulting in knotting of the intestines, constipation, dribbling of urine, intestinal wind, or causing bleeding in the lower jiao. Because the bladder is Taiyang and already associated to cold energy, it is especially susceptible. If a Choppy pulse is especially pronounced in the kidney area, it can indicate kidney pain or lower back pain. If it is found deeper down, it can be a cold type of ache around the knee joints. In men's cases, they may have lower back problems and erection problems. In women's case, it will cause bladder difficulties so they may not be able to hold their bladder. If this pulse is found in both the Left Proximal (Kidney) and Right Proximal (Sanjiao) positions, it indicates yang qi depletion related to the reproductive organs. Any kind of Choppy pulse indicates blood circulation problems, so if you see it as chronic and located in the blood or organ depths, you have to suspect anemia. If Choppy pulse is Floating, it indicates cold is on the surface; if it is Sunken or Sinking it indicates internal cold. If Choppy pulse is excessive it indicates a strong circulatory blockage; if it is deficient then it indicates vital heat is depleted. This cold Choppy pulse is much more difficult to pick out than the pulse associated with heat. It can have a very delicate or sandy quality. Sometime when you palpate you cannot be really sure if that Sandy quality is really there; at first it will feel really Sandy but if you try to verify again and again you cannot be really certain since it is Sandy but at the same time very soft. If you see a pulse showing a Sandy texture like rough sandpaper, it usually indicates heat when it is that rough. It may also have a very thin, vibrant, or Sandy sensation all through the pulse wave. If the tips of the pulse waves are not sharp like teeth of the saw but rather more flat or rectangular, this pulse is also very dry and is lacking any sensation of slipperiness or moisture. So when you find the Sandy pulse the first thing that you will decide is whether the pulse indicates that the patient is lacking jing, xue, or body fluids. When it does not contain enough yang energy, it indicates heat depletion, so it is a cold condition; but the most important part when it is also thin or vibrating is that it is dry. So a Sandy pulse indicates lacks jing. And because jing is lacking, blood will be lacking as well. If there is blood depletion, their body will feel cold. If for example you have found a Sandy pulse in the spleen it would indicate that the spleen is not supplying moisture, so the body is drying up and that might express itself in the skin, organs, body parts, or sensory organs. If the Sandy pulse shows in the liver, there could be some fire symptoms, since the wood phase of liver, by loosing the moisture, and then dries up and accelerates the creative (sheng) cycle; turning into fire and becoming heat. If you find a Sandy pulse in the kidney it is a common indicator that the filtration function is weakening; kidney failure may be occurring. The odd thing is that the when the kidney pulse is Sandy and dry at the same time, the body becomes more watery. The patient will have edema from kidney failure. You will see some cancer patients who are undergoing chemotherapy, and many times you will see a very dry, Sandy pulse moving from the Proximal to the Distal positions. It will feel like a vibratory quality, not slippery but sandy. When it is really light it is just in the kidney, but when it is strong enough it will travel all the way to the Distal position so it can affect the other organs or body as a whole. Water filtration is a kidney yang function. Sandy pulse is a depletion of yang. So it is cold and it looks like it is lacking jing and at the same time it is going dry, so it is a little more subtle, five elemental type of analysis. The most important part is that it is dry, but it started due to lack of yang then it dried up and now it lacks the jing. If this kind of pulse is felt at the Endocrine level of the pulse (the line between the organ or adapted depth and the blood depth), it is the endocrine system drying up. By the time they manifest this pulse they are already show swelling from edema and the kidney is failing. If you have any patients in dialysis, there should be this kind of Sandy shakiness. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 Jason - Do you not consider #2 & #3 choppy? 1) Rough feeling (actual texture of the pulse) 2) irregular speed (changing with breath, or otherwise) 3) ireegular strength. (Hitting fingers at different intensities, at different times) You have identified a serious nomenclature problem that has been historically confused. The elite of this profession provide no consistent response to the question ‘what is a choppy pulse?’ I entered this question on the list previously with no clear response from any quarter. The evidence for confusion about the description of a choppy pulse abounds, just read this list: Jin Wei: this is a pulse that is felt fine, slow, short, scattered, hesitant, and unsmooth, like scraping bamboo with a knife. Maccioccia: This pulse feels rough under the finger:instead of a smooth pulse wave, it feels as though it had a jagged edge to it. Choppy also indicates a pulse that changes rapidly both in rate and quality Li Shizhen: “A pulse which feels thin, minute and short and has an uneven flow, beating three and five times with irregular rhythm, is called choppy.....It feels like a knife scraping bamboo, rough and jagged. It is easily scattered like rain falling onto the sand. It also moves very slowly and at irregular depths, like an ill silkworm eating a leaf.†Wang Shuhe: “a fine and slow pulse, coming and going with difficulty and scattered or with an interruption†Kaptchuk: irregular in rhythm. In this case it is called the three and five not adjusted sometimes three beats per breath and sometimes five beats per breath. Wu Shuiwan: The movement of this pulse is felt as rough and choppy. It is not fluent. It is slow and thin. The wave of this pulse is short. Deng Tietao: it should feel slow and uneven, fine,small,short. CAM: A hesitant pulse feels rough and uneven; stagnations; produce a hesitant and forceful pulse ........insufficiency;creates a hesitant and weak pulse; Pulse descriptions are often used to define the choppy pulse that may or may not have bearing on designating a choppy pulse. These include fine, slow, short, scattered, hesitant, changes of rate, thin. Wu Shuiwan and Jin Wei both describe the pulse as short. The famous Yi Tian Ni used this description, it is a wave that halts abruptly as if it has hit a mass. This is very different from a wave that gives way suddenly due to a deficiency of Qi. The idiosyncratic qualities of Drs Shen and Hammer are derived from many qualities which have traditionally been attributed to the choppy pulse. Macicocia who studied with Dr. Shen describes the choppy pulse similarly to Shen and Hammer –-- a jagged (fixed)edge. However, then he then uses the standard commentary or what Hammer calls ‘changing rate at rest’ to describe a choppy pulse. This important because the pathophysiology ‘of changing rate at rest’ is vastly different from that of a choppy pulse according to Hammer. Interpretation: most of the qualities used to describe the choppy pulse may happen in the presence of blood stasis or essence deficiency. These qualities may be a product of these two processes or they may represent processes that may lead to blood stasis or essence deficiency. If the blood is deficient as demonstrated by the thin, fine, and thready qualities, then the blood is predisposed to stasis due to the lowered circulating blood volume. This does not necessarily indicate blood stasis. Certainly there is an increased possibility of essence deficiency under these circumstances. Review and comparison of the authoritative passages listed above can create tremendous confusion. My recommended solution is that writers specify exactly what it is they are talking about when referring to the rough quality. In addition, when working with other practitioners in the clinic, it is necessary to inquire about the exact sensation that is being discussed. Will Morris Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 Jim, Do you not consider #2 & #3 choppy? 1) Rough feeling (actual texture of the pulse) 2) irregular speed (changing with breath, or otherwise) 3) ireegular strength. (Hitting fingers at different intensities, at different times) -Jason , " James Ramholz " <jramholz> wrote: > , " " wrote: > > These all are very different, so what are the diagnostic > > correspndances to each. (i.e. choppy is choppy, but depedending on > > which choppy there should be different diagnostic meaning, no?) > > > Jason: > > You would not find a pure choppy pulse in clinc; it should be > compounded with other qualities. Classically it was described like > cutting bamboo with a light or dull knife--uneven and rough. It can > also be compared to touching sandpaper or wet sand. > > This is a very general term, and almost anything that is neither > Soft nor Slippery may be considered as a Choppy pulse as long as it > does not have the smooth type of a texture of the Slippery pulse. It > can even feel like very fine sandpaper. A Choppy (also Sandy, Rough, > or Fine) pulse is a yin pulse indicating a cold syndrome; the > rougher it gets, the colder it is. It is usually found as a cold > syndrome in the deeper area of the body, indicating a circulatory > imbalance or poor blood circulation. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 15, 2003 Report Share Posted March 15, 2003 , " " wrote: > Do you not consider #2 & #3 choppy? > 2) irregular speed (changing with breath, or otherwise) > 3) ireegular strength. (Hitting fingers at different intensities, at different times) Jason: Choppy refers to texture; irrgegular speed and strength may be due to emotional or other factors and is not part of the standard choppy definition. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2003 Report Share Posted March 16, 2003 , ajeffres@a... wrote: > How do you compare a Sandy quality and Vibration in the pulse? Is the Shen/Hammer Vibration analogous to the Sandy quality you describe? It seems that I often feel a static-y quality on the pulses which I have equated to Hammer's description of Light Vibration. Anne: Good observation on your family member. Our Sandy quality is similar to choppy---just on the smaller side of the scale. Our vibration quality would be similar to Hammer's findings, and its interpretation also depend on at what depth or in what sector of a position it is found. Often it will mean some sort of emotional or nervous system involvement. For example, if you find a vibratory quality at the endocrine level (the dividing line between the middle and botton third of a position) in the left proximal, it can indicate unexpressed or unconsciously held insecurity. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2003 Report Share Posted March 16, 2003 Leon adapted a very eloquent method of recording the phenomena. Use use the delta for any feature that is changing ie. [5intensity] and changing rate at rest --[5R@R] While these are listed in the literature as features of the choppy pulse...they have entirely different etiology and pathological expressions. Will By themselves, the qualities of irregular speed and irregular strength are descriptions that can be associated with many types of compounded pulses other than choppy. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2003 Report Share Posted March 16, 2003 , " James Ramholz " <jramholz> wrote: > , " " wrote: > > Do you not consider #2 & #3 choppy? > > 2) irregular speed (changing with breath, or otherwise) > > 3) ireegular strength. (Hitting fingers at different intensities, > at different times) > > > Jason: > > Choppy refers to texture; irrgegular speed and strength may be due > to emotional or other factors and is not part of the standard choppy > definition. > > > Jim Ramholz Jim, If #2 & #3 are not included in your idea of choppy, what do you call those pulses? -JAson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 16, 2003 Report Share Posted March 16, 2003 , " " wrote: > , " James Ramholz " > <jramholz> wrote: > > > 2) irregular speed (changing with breath, or otherwise) > > > 3) ireegular strength. (Hitting fingers at different intensities, at different times) If #2 & #3 are not included in your idea of choppy, what do you > call those pulses? >>> Jason: By themselves, the qualities of irregular speed and irregular strength are descriptions that can be associated with many types of compounded pulses other than choppy. If you look at Will Morris' post [15905] listing choppy definitions by a number of authorities, you see they all revolve around the metaphor of a dull knife cutting bamboo; if not explicitly, by implication since it is the standard metaphor and each author must be judged in respect to the tradition. My own teacher's basic definition---'anything that is not smooth can be considered choppy'-- -is the most general. In light of that central image, the descriptions of shortness, roughness, unevenness, shortness, jaggedness, etc., are not out of context or that much of a reach. So, I have perhaps less trouble accepting an author's perspective than does Will. But also keep in mind that each authority has a different skill and sensitivity in recognizing pulse qualities---and ability at description. The subject's difficulty is also indicated by the fact that before Leon Hammer's recent book, the last major work was by Zhang Jie-bin in 1624. Western logic tends to obliterate the contradictions between all these definitions. But we are not describing fixed and discrete objects (the Western method of description), we are discussing a context of substances in relationships. Asian thinking is dialectical and tends to find the similarities in these definitions. Pulse diagnosis makes the cultural differences in the cognition, and perception, and thinking between Asians and Westerners very obvious. Perhaps that is an underlying reason why pulse diagnosis was discouraged in Maoist China and has only developed in limited areas of the USA. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2003 Report Share Posted March 17, 2003 > > > > 2) irregular speed (changing with breath, or otherwise) > > > > 3) ireegular strength. (Hitting fingers at different > intensities, at different times) > If #2 & #3 are not included in your idea of choppy, what do you > > call those pulses? >>> > > > Jason: > > By themselves, the qualities of irregular speed and irregular > strength are descriptions that can be associated with many types of > compounded pulses other than choppy. Jim, Thanx for the detailed explanation of choppy so far... But maybe I am asking the wrong question... I.e. I am still unclear of the clincal significance of #2 and #3 - If these are not choppy, Does TCM make a mention of them? If so, what are they called... then maybe this will help me understand how to apply this to the clinic...If not what do other systems call these or how do they intrepet them... IS this clearer? OR did I just miss the answer somewhere previous... -JAson Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 17, 2003 Report Share Posted March 17, 2003 , " " wrote: I am still unclear of the clincal > significance of #2 and #3 - If these are not choppy, Does TCM make a mention of them? If so, what are they called... then maybe this will help me understand how to apply this to the clinic...If not what do other systems call these or how do they intrepet them... IS this clearer? OR did I just miss the answer somewhere previous... Jason: It is too general a question to say what they mean only by themselves---it depends on what other qualities, positions, and connections they share. For example, in an older patient, if found in all positions, it could indicate physical heart problems. But, you would also want to know what other qualities are in the left distal---choppy, smooth, etc.---to see if blood stasis or choleterol is causing irregular circulation in the chest and heart arteries. Or an irregular pulse, just in the left distal, can indicate value problems. In another example, if the heart pulse is irregular at the blood depth going between the liver and the heart positons, it can mean that the heart is receiving too much stress from the liver, and it is trying to pump a little harder in response---but it is not necessarily doing a good job. In order to find out why the heart is not doing a good job you may have to check the other 11 pulse positions. An irregular movement such as a lack of synchronization between the heart and kidney indicates that the patient's mind and body are not in synch---they day dream or think too much and neglect their body. Jim Ramholz Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 4, 2004 Report Share Posted October 4, 2004 Will, As you correctly point out, the term " choppy " , on first glance, would seem to be fraught with a wide range of conflicting or varying definitions and opinions. Unfortunately, I found that to be true of TCM literature on pulse taking generally, which certainly does nothing to encourage students attempting to learn it. There are several major problems, and it might help to list them here so as to separate them: 1. There are only 28 or so classical pulse types defined, yet these 28 do not even begin to cover the many pulse types that are possible. One problem is that many of the classical pulses are defined in terms of multiple basic parameters (rate, rhythm and irregularities, strength, depth, etc.) - for example a slippery pulse defined as follows: strength = moderate to strong width = wide edge quality = fuzzy time profile = smooth (high frequencies attenuated) But what happens if a pulse is strong, wide, distinct-edged, and with a smooth but variable time profile that changes somewhat each beat? (This is what many would call a slippery-choppy pulse, but it is more accurate to simply describe each parameter rather than use classical terminology that only partially matches.) This example illustrates why I believe we should emphasize describing pulses based on basic parameters, as the 28 classical pulse types do not even begin to describe the myriad possibilities. 2. There needs to be an attempt to create a terminology that is based on classical descriptions, but that clearly separates the descriptions of the palpated sensation from the TCM indications for such. The range of opinion on what " choppy " means is perhaps biased by everyone's assumption that choppy indicates Blood Stagnation, and there is an attempt to include within the definition of choppy all of those phenomena that might be associated with Blood Stagnation. (Sort of reminds me of the attempt by the TCM materia medica compilers to fudge the flavor of herbs to match what the theory predicts their flavors should be.) For example, most texts I've seen agree that choppiness is a phenomena that results in a non-smooth pressure pulse waveform, but various authors attach other baggage, such as irregularities of rhythm. If an irregular rhythm is also present, that can certainly indicate Heart Blood Stagnation or severe obstruction of Qi, Blood, or Phlegm, but irregular rhythm is not a necessary quality of choppiness, and I feel it should not be included in its definition. A pulse can, of course, be both choppy and have an irregular rhythm. From a purely descriptive perspective, to allow practitioners an accurate way to represent palpated sensations, confounding the qualities of changeable pulse pressure profile with irregular rhythm is not helpful. Keep them separate. To attempt making some sense of pulse taking and to develop teaching tools that resolve much of the confusion, I took pulse descriptions from several classical sources (including Li Shizhen, Macciocia, Kaptchuk, Porkert) and from all of the pulse descriptions compiled a list of all of the independent basic parameters that are mentioned in these descriptions: Rate Rhythm Strength Depth Depth Spread Length Width Boundary profile-Choppiness profile-Smoothness profile-Onset Elasticity When one considers all of the possible combinations, with 4-7 possible values for each parameter, there are over 900,000,000 possibilities that a skilled pulse master should be able to distinguish. So far, this merely gives us an accurate descriptive system that avoids the frustrating confusions generated by imprecise terminology. For example, what in creation is a " slippery-bowstring " pulse? I know many people use this term, but I dare anyone to define it, for it is fraught with contradictions. Compare the two: Slippery: Bowstring: mod. to strong strong wide narrow fuzzy edge distinct edge profile=smooth elasticity=taut How can a pulse be both wide and narrow? And how can it be simultaneously fuzzy-edged and distinct? This is nonsense. I insist that my own students describe pulses only using basic parameters, and only then noting which classical pulse types *might* have some similarities. The TCM classical literature only yields so much insight. The next step I took was to re-examine my old graduate-school textbooks and notes on circulatory biophysics to see if I could use this information to better understand classical pulse definitions. The following is relevant to the debate over choppy pulses: Blood Stagnation correlates with a number of physiological phenomena including buildup of arterial plaque and turbulence in blood flow resulting from plaque deposits. Likewise, blood clots create obstructions that also may result in turbulence of blood flow. In any fluid, when the flow changes from regular laminar flow to turbulent flow, the pulse pressure profile becomes characterized by a high-frequency noise component added to the underlying pressure pulse. This is what creates the classically described " knife-scraping-bamboo " choppy pulse. This type of pulse is most likely to be felt at branching points in the arterial tree, as in the wrist, because the reflected pulse energy that results at any point where the complex mechanical impedance changes is more likely to reveal irregularities and noise in the waveform. However, there are a number of common ways that this knife-scraping-bamboo choppy pulse can be modified. If in addition to turbulent flow from clots or plaque deposits, the blood cells tend to agglutinate, which happens in infections, auto-immune disorders, and even in food sensitivities or allergies, the blood will become more viscous. (These phenomena might be asscociated with a range of TCM phenomena including Interior Heat, DampHeat, Dampness, Yin Deficiency.) Increased viscosity will result in mechanical damping (attenuation) of the high frequency components; the pulse pressure profile will become smoother, but will the underlying turbulence will result in variations of the shape of consecutive pressure pulses. This is no longer a knife-scraping-bamboo choppy pulse, but is a pulse with a profile that is simultaneously smooth and irregular (profile=choppy), or what some people call slippery-choppy. I dislike this latter term, as it is not as concise. See for illustration (snapshot showing the Pulse Simulator that we use in our teaching materials): http://www.rmhiherbal.org/tchs-cd/pu-04.html If a knife-scraping-bamboo choppy pulse or a pulse with a choppy-smooth profile is associated with a condition of Stagnation of Blood together with heart arrythmias, an irregular rhythm may be superimposed on the previous qualities. But there are several TCM factors that may result in arrythmias, not just Heart Blood Stagnation. Interior Liver Wind, with its nervous tics and spasms, if it affects the innervation of the heart, can result in arrhythmias. Metabolic toxemia from a wide variety of sources (and organs) can result in disturbances of the innervation of the heart, manifesting as Interior Wind or other patterns. Blood Stagnation of the heart, especially if it affects the SA node or its innervation, can result in arrythmias. Variations in strength, but not necessarily associated with arrhythmias might be associated with Heart Blood Stagnation or other factors (Interior Wind, toxemia), that affect the AV node or ventricular spread of the depolarization wave. Alternatively, if the heart and its rhythms are relatively unaffected, severe Blood Stagnation and its associated turbulence of blood flow may result in apparent differences in the peak pressure reached at consecutive pressure pulses, even though the contractility of the heart during each beat may be identical. I've used these types of explanations in my courses for many years now. I've run them by several cardiologists who've taken my courses, making a few refinements along the way. These folks have been able to pick up TCM-style pulse taking very quickly. In general, a lot of the seeming inconsistencies and handwaving in the traditional literature can be resolved by studying the conventional medical theory on circulatory biophysics, cardiology, and hemodynamics. ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org > Sat, 2 Oct 2004 10:32:23 EDT > WMorris116 >Gu (now choppy pulse) > >Roger - > >This issue of the choppy pulse has come up many times over the years. I >performed a brief experiment about two years ago on this list. I asked listers to >describe the image of a choppy pulse. No one gave the same description. This >confusion around this issue is not just a contemporary one as you will see from >the list below. > > >The choppy pulse is a complex image. However, there are modern practitioners >such as Dr. John Shen who have suggested that the choppy pulse be considered >as a simple image. LuYubin also describes choppy as a simple image [1] >paraphrased: ’Äòthe rough nature is juxtaposed to the smoothness of the slippery >quality.’Äô However, Lu does not specify what aspect is rough. The choppy quality >described throughout the literature may include features such as changing rate at >rest, changing amplitude/intensity, slow, fine, and changing qualities. Wang >Shu-he describes the choppy pulse as [2] fine and slow, coming and going with >difficulty and scattered or with an interruption, but has the ability to >recover. Other versions of the Mai Jing describe it as short and floating or another >version describes it as short with interruption or scattered. > >Jin Wei: " this is a pulse that is felt fine, slow, short, scattered, >hesitant, and unsmooth, like scraping bamboo with a knife. " > >Maccioccia: " This pulse feels rough under the finger: instead of a smooth >pulse wave, it feels as though it had a jagged edge to it. Choppy also indicates >a pulse that changes rapidly both in rate and quality " > > > >Li Shizhen: ’ÄúA pulse which feels thin, minute and short and has an uneven >flow, beating three and five times with irregular rhythm, is called choppy.....It >feels like a knife scraping bamboo, rough and jagged. It is easily scattered >like rain falling onto the sand. It also moves very slowly and at irregular >depths, like an ill silkworm eating a leaf.’Äù > > > >Wang Shuhe: ’Äúa fine and slow pulse, coming and going with difficulty and >scattered or with an interruption’Äù > > > >Kaptchuk: irregular in rhythm. In this case it iscalled the three and five >not adjusted sometimes three beats per breath and sometimes five beats per >breath. > >Wu Shuiwan: " The movement of this pulse is feltas rough and choppy. It is not >fluent. It is slow and thin. The wave of thispulse is short. " > >Deng Tietao: it should feel slow and uneven, fine, small, short. > >CAM: " A hesitant pulse feels rough and uneven......stagnations, produce a >hesitant and forceful pulse ........insufficiency creates a hesitant and weak >pulse " > >Wu Shuiwan and Jin Wei both describe the pulse as short, also, Yi Tian Ni >used this description; it is a wave that halts abruptly as if it has hit a mass. >This is very different from a wave that gives way suddenly due to a >deficiency of Qi. Macicocia who studied with Dr. Shen describes a jagged edge, however, >then he retreats into the notion of rate as a defining feature of the choppy >pulse. > >[1] Lu Yubin. Pulse Diagnosis. Shandong Science and Technology Press. >[2] Wang Shu-he. Translated by Yang Shou-zhang. The Pulse Classic. Pp. 4. >Blue Poppy Press 1997. > >Best - Will > >> To detect a choppy pulse, one must essentially store an image of the way >> each pulse beat feels and then compare it with the next pulse beat. >> (Mathematically this is called auto-correlation.) It means that each pulse beat will >> have a slightly different pulse pressure profile in time. The trickiest aspect >> of this is to detect choppiness in a pulse that is otherwise smooth in profile >> - a slippery-choppy pulse is one example. >> >> We use video simulation software to demonstrate this to our students, and it >> helps greatly. A picture is worth a thousand words. See the sequence of 5 >> slides starting at: >> >> http://www.rmhiherbal.org/tchs-cd/pu-01.html >> >> The sequence of slides shown above illustrates several different complex >> pulse types. >> (Keep in mind that these are snapshots of moving images.) >> >> In a slippery-choppy pulse, the pulse pressure profile will not have the >> classical quality of " knife scraping bamboo " , but the shape does change, and >> this can include variations in strength, which is one manifestation of >> choppiness. > > >William R. Morris, LAc, OMD, MSEd ---Roger Wicke, PhD, TCM Clinical Herbalist contact: www.rmhiherbal.org/contact/ Rocky Mountain Herbal Institute, Hot Springs, Montana USA Clinical herbology training programs - www.rmhiherbal.org Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 5, 2004 Report Share Posted October 5, 2004 > > rw2 [rw2] > Monday, October 04, 2004 9:38 PM > > Re: choppy pulse > > > Will, > > As you correctly point out, the term " choppy " , on first glance, would seem > to be fraught with a wide range of conflicting or varying definitions and > opinions. Unfortunately, I found that to be true of TCM literature on > pulse taking generally, which certainly does nothing to encourage students > attempting to learn it. > > There are several major problems, and it might help to list them here so > as to separate them: > > 1. There are only 28 or so classical pulse types defined, yet > these 28 do not even begin to cover the many pulse types that are possible. > One problem is that many of the classical pulses are defined in terms of > multiple basic parameters (rate, rhythm and irregularities, strength, > depth, etc.) - for example a slippery pulse defined as follows: > strength = moderate to strong > width = wide > edge quality = fuzzy > time profile = smooth (high frequencies attenuated) > But what happens if a pulse is strong, wide, distinct-edged, and with a > smooth but variable time profile that changes somewhat each beat? (This is > what many would call a slippery-choppy pulse, but it is more accurate to > simply describe each parameter rather than use classical terminology that > only partially matches.) > This example illustrates why I believe we should emphasize describing > pulses based on basic parameters, as the 28 classical pulse types do not > even begin to describe the myriad possibilities. > > 2. There needs to be an attempt to create a terminology that is > based on classical descriptions, but that clearly separates the > descriptions of the palpated sensation from the TCM indications for such. > The range of opinion on what " choppy " means is perhaps biased by > everyone's assumption that choppy indicates Blood Stagnation, and there is > an attempt to include within the definition of choppy all of those > phenomena that might be associated with Blood Stagnation. (Sort of reminds > me of the attempt by the TCM materia medica compilers to fudge the flavor > of herbs to match what the theory predicts their flavors should be.) For > example, most texts I've seen agree that choppiness is a phenomena that > results in a non-smooth pressure pulse waveform, but various authors > attach other baggage, such as irregularities of rhythm. If an irregular > rhythm is also present, that can certainly indicate Heart Blood Stagnation > or severe obstruction of Qi, Blood, or Phlegm, but irregular rhythm is not > a necessary quality of choppiness, and I feel it should not be included in > its definition. A pulse can, of course, be both choppy and have an > irregular rhythm. From a purely descriptive perspective, to allow > practitioners an accurate way to represent palpated sensations, > confounding the qualities of changeable pulse pressure profile with > irregular rhythm is not helpful. Keep them separate. > > > To attempt making some sense of pulse taking and to develop teaching tools > that resolve much of the confusion, I took pulse descriptions from several > classical sources (including Li Shizhen, Macciocia, Kaptchuk, Porkert) and > from all of the pulse descriptions compiled a list of all of the > independent basic parameters that are mentioned in these descriptions: > Rate > Rhythm > Strength > Depth > Depth Spread > Length > Width > Boundary > profile-Choppiness > profile-Smoothness > profile-Onset > Elasticity > When one considers all of the possible combinations, with 4-7 possible > values for each parameter, there are over 900,000,000 possibilities that a > skilled pulse master should be able to distinguish. > > So far, this merely gives us an accurate descriptive system that avoids > the frustrating confusions generated by imprecise terminology. For example, > what in creation is a " slippery-bowstring " pulse? I know many people use > this term, but I dare anyone to define it, for it is fraught with > contradictions. Compare the two: > Slippery: Bowstring: > mod. to strong strong > wide narrow > fuzzy edge distinct edge > profile=smooth elasticity=taut > How can a pulse be both wide and narrow? And how can it be simultaneously > fuzzy-edged and distinct? This is nonsense. I insist that my own students > describe pulses only using basic parameters, and only then noting which > classical pulse types *might* have some similarities. > > > The TCM classical literature only yields so much insight. The next step I > took was to re-examine my old graduate-school textbooks and notes on > circulatory biophysics to see if I could use this information to better > understand classical pulse definitions. The following is relevant to the > debate over choppy pulses: > > Blood Stagnation correlates with a number of physiological phenomena > including buildup of arterial plaque and turbulence in blood flow > resulting from plaque deposits. Likewise, blood clots create obstructions > that also may result in turbulence of blood flow. In any fluid, when the > flow changes from regular laminar flow to turbulent flow, the pulse > pressure profile becomes characterized by a high-frequency noise component > added to the underlying pressure pulse. This is what creates the > classically described " knife-scraping-bamboo " choppy pulse. This type of > pulse is most likely to be felt at branching points in the arterial tree, > as in the wrist, because the reflected pulse energy that results at any > point where the complex mechanical impedance changes is more likely to > reveal irregularities and noise in the waveform. > > However, there are a number of common ways that this knife-scraping-bamboo > choppy pulse can be modified. If in addition to turbulent flow from clots > or plaque deposits, the blood cells tend to agglutinate, which happens in > infections, auto-immune disorders, and even in food sensitivities or > allergies, the blood will become more viscous. (These phenomena might be > asscociated with a range of TCM phenomena including Interior Heat, > DampHeat, Dampness, Yin Deficiency.) Increased viscosity will result in > mechanical damping (attenuation) of the high frequency components; the > pulse pressure profile will become smoother, but will the underlying > turbulence will result in variations of the shape of consecutive pressure > pulses. This is no longer a knife-scraping-bamboo choppy pulse, but is a > pulse with a profile that is simultaneously smooth and irregular > (profile=choppy), or what some people call slippery-choppy. I dislike this > latter term, as it is not as concise. See for illustration (snapshot > showing the Pulse Simulator that we use in our teaching materials): > http://www.rmhiherbal.org/tchs-cd/pu-04.html > > If a knife-scraping-bamboo choppy pulse or a pulse with a choppy-smooth > profile is associated with a condition of Stagnation of Blood together > with heart arrythmias, an irregular rhythm may be superimposed on the > previous qualities. But there are several TCM factors that may result in > arrythmias, not just Heart Blood Stagnation. Interior Liver Wind, with its > nervous tics and spasms, if it affects the innervation of the heart, can > result in arrhythmias. Metabolic toxemia from a wide variety of sources > (and organs) can result in disturbances of the innervation of the heart, > manifesting as Interior Wind or other patterns. Blood Stagnation of the > heart, especially if it affects the SA node or its innervation, can result > in arrythmias. > > Variations in strength, but not necessarily associated with arrhythmias > might be associated with Heart Blood Stagnation or other factors (Interior > Wind, toxemia), that affect the AV node or ventricular spread of the > depolarization wave. Alternatively, if the heart and its rhythms are > relatively unaffected, severe Blood Stagnation and its associated > turbulence of blood flow may result in apparent differences in the peak > pressure reached at consecutive pressure pulses, even though the > contractility of the heart during each beat may be identical. > > I've used these types of explanations in my courses for many years now. > I've run them by several cardiologists who've taken my courses, making a > few refinements along the way. [Jason] Very interesting... But have you run this by some heavy hitter Chinese TCMers? Because, from my perspective it sounds ungrounded, and I am quite skeptical... but that is just me... - Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2005 Report Share Posted March 11, 2005 Will et al... As many, I am always looking at pulse info... (esp choppy)... and I just want to verify that what kaptchuk says below is straight from a mainstream source. (choppy (can equal) irregular rhythm)... the Chinese actually says san1 wu3 bu4 tiao2 - threes and five pulse. So assume that it just means the rhythm will vary (as stated below)... correct? -Jason > > WMorris116 [WMorris116] > Saturday, October 02, 2004 8:32 AM > > Gu (now choppy pulse) > > > Roger - > > > > This issue of the choppy pulse has come up many times over the years. I > performed a brief experiment about two years ago on this list. I asked > listers to > describe the image of a choppy pulse. No one gave the same description. > This > confusion around this issue is not just a contemporary one as you will see > from > the list below. > > > > The choppy pulse is a complex image. However, there are modern > practitioners > such as Dr. John Shen who have suggested that the choppy pulse be > considered > as a simple image. LuYubin also describes choppy as a simple image [1] > paraphrased: 'the rough nature is juxtaposed to the smoothness of the > slippery > quality.' However, Lu does not specify what aspect is rough. The choppy > quality > described throughout the literature may include features such as changing > rate at > rest, changing amplitude/intensity, slow, fine, and changing qualities. > Wang > Shu-he describes the choppy pulse as [2] fine and slow, coming and going > with > difficulty and scattered or with an interruption, but has the ability to > recover. Other versions of the Mai Jing describe it as short and floating > or another > version describes it as short with interruption or scattered. > > Jin Wei: " this is a pulse that is felt fine, slow, short, scattered, > hesitant, and unsmooth, like scraping bamboo with a knife. " > > Maccioccia: " This pulse feels rough under the finger: instead of a smooth > pulse wave, it feels as though it had a jagged edge to it. Choppy also > indicates > a pulse that changes rapidly both in rate and quality " > > > > Li Shizhen: " A pulse which feels thin, minute and short and has an uneven > flow, beating three and five times with irregular rhythm, is called > choppy.....It > feels like a knife scraping bamboo, rough and jagged. It is easily > scattered > like rain falling onto the sand. It also moves very slowly and at > irregular > depths, like an ill silkworm eating a leaf. " > > > > Wang Shuhe: " a fine and slow pulse, coming and going with difficulty and > scattered or with an interruption " > > > > Kaptchuk: irregular in rhythm. In this case it iscalled the three and five > not adjusted sometimes three beats per breath and sometimes five beats per > breath. > > Wu Shuiwan: " The movement of this pulse is feltas rough and choppy. It is > not > fluent. It is slow and thin. The wave of thispulse is short. " > > Deng Tietao: it should feel slow and uneven, fine, small, short. > > CAM: " A hesitant pulse feels rough and uneven......stagnations, produce a > hesitant and forceful pulse ........insufficiency creates a hesitant and > weak > pulse " > > Wu Shuiwan and Jin Wei both describe the pulse as short, also, Yi Tian Ni > used this description; it is a wave that halts abruptly as if it has hit > a mass. > This is very different from a wave that gives way suddenly due to a > deficiency of Qi. Macicocia who studied with Dr. Shen describes a jagged > edge, however, > then he retreats into the notion of rate as a defining feature of the > choppy > pulse. > > [1] Lu Yubin. Pulse Diagnosis. Shandong Science and Technology Press. > [2] Wang Shu-he. Translated by Yang Shou-zhang. The Pulse Classic. Pp. 4. > Blue Poppy Press 1997. > > Best - Will > > > To detect a choppy pulse, one must essentially store an image of the way > > each pulse beat feels and then compare it with the next pulse beat. > > (Mathematically this is called auto-correlation.) It means that each > pulse beat will > > have a slightly different pulse pressure profile in time. The trickiest > aspect > > of this is to detect choppiness in a pulse that is otherwise smooth in > profile > > - a slippery-choppy pulse is one example. > > > > We use video simulation software to demonstrate this to our students, > and it > > helps greatly. A picture is worth a thousand words. See the sequence of > 5 > > slides starting at: > > > > http://www.rmhiherbal.org/tchs-cd/pu-01.html > > > > The sequence of slides shown above illustrates several different complex > > pulse types. > > (Keep in mind that these are snapshots of moving images.) > > > > In a slippery-choppy pulse, the pulse pressure profile will not have the > > classical quality of " knife scraping bamboo " , but the shape does change, > and > > this can include variations in strength, which is one manifestation of > > choppiness. > > > William R. Morris, LAc, OMD, MSEd > Dean of Educational Advancement > Emperor's College of Oriental Medicine > 310-453-8300 phone > 310-829-3838 fax > will > http://emperors.edu/doctoral/doc_mission.html > > This message is a PRIVATE communication. This e-mail and any attachments > may > be confidential and/or legally privileged. If you are not the intended > recipient, please do not read, copy, or use it, and do not disclose it to > others. > Please notify the sender of the delivery error by replying to this message > with > the word delete in the subject column, and then delete it and any > attachments > from your system. Thank you. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2005 Report Share Posted March 11, 2005 > > [] > Friday, March 11, 2005 7:40 AM > > RE: choppy pulse > > > Will et al... > > As many, I am always looking at pulse info... (esp choppy)... and I just > want to verify that what kaptchuk says below is straight from a mainstream > source. (choppy (can equal) irregular rhythm)... the Chinese actually > says > san1 wu3 bu4 tiao2 - threes and five pulse. [Jason] Sorry that is " AT threes and fives (pulse) " -Jason So assume that it just means > the > rhythm will vary (as stated below)... correct? > > > -Jason > > > > > > WMorris116 [WMorris116] > > Saturday, October 02, 2004 8:32 AM > > > > Gu (now choppy pulse) > > > > > > Roger - > > > > > > > > This issue of the choppy pulse has come up many times over the years. I > > performed a brief experiment about two years ago on this list. I asked > > listers to > > describe the image of a choppy pulse. No one gave the same description. > > This > > confusion around this issue is not just a contemporary one as you will > see > > from > > the list below. > > > > > > > > The choppy pulse is a complex image. However, there are modern > > practitioners > > such as Dr. John Shen who have suggested that the choppy pulse be > > considered > > as a simple image. LuYubin also describes choppy as a simple image [1] > > paraphrased: 'the rough nature is juxtaposed to the smoothness of the > > slippery > > quality.' However, Lu does not specify what aspect is rough. The choppy > > quality > > described throughout the literature may include features such as > changing > > rate at > > rest, changing amplitude/intensity, slow, fine, and changing qualities. > > Wang > > Shu-he describes the choppy pulse as [2] fine and slow, coming and going > > with > > difficulty and scattered or with an interruption, but has the ability to > > recover. Other versions of the Mai Jing describe it as short and > floating > > or another > > version describes it as short with interruption or scattered. > > > > Jin Wei: " this is a pulse that is felt fine, slow, short, scattered, > > hesitant, and unsmooth, like scraping bamboo with a knife. " > > > > Maccioccia: " This pulse feels rough under the finger: instead of a > smooth > > pulse wave, it feels as though it had a jagged edge to it. Choppy also > > indicates > > a pulse that changes rapidly both in rate and quality " > > > > > > > > Li Shizhen: " A pulse which feels thin, minute and short and has an > uneven > > flow, beating three and five times with irregular rhythm, is called > > choppy.....It > > feels like a knife scraping bamboo, rough and jagged. It is easily > > scattered > > like rain falling onto the sand. It also moves very slowly and at > > irregular > > depths, like an ill silkworm eating a leaf. " > > > > > > > > Wang Shuhe: " a fine and slow pulse, coming and going with difficulty and > > scattered or with an interruption " > > > > > > > > Kaptchuk: irregular in rhythm. In this case it iscalled the three and > five > > not adjusted sometimes three beats per breath and sometimes five beats > per > > breath. > > > > Wu Shuiwan: " The movement of this pulse is feltas rough and choppy. It > is > > not > > fluent. It is slow and thin. The wave of thispulse is short. " > > > > Deng Tietao: it should feel slow and uneven, fine, small, short. > > > > CAM: " A hesitant pulse feels rough and uneven......stagnations, produce > a > > hesitant and forceful pulse ........insufficiency creates a hesitant and > > weak > > pulse " > > > > Wu Shuiwan and Jin Wei both describe the pulse as short, also, Yi Tian > Ni > > used this description; it is a wave that halts abruptly as if it has > hit > > a mass. > > This is very different from a wave that gives way suddenly due to a > > deficiency of Qi. Macicocia who studied with Dr. Shen describes a jagged > > edge, however, > > then he retreats into the notion of rate as a defining feature of the > > choppy > > pulse. > > > > [1] Lu Yubin. Pulse Diagnosis. Shandong Science and Technology Press. > > [2] Wang Shu-he. Translated by Yang Shou-zhang. The Pulse Classic. Pp. 4. > > Blue Poppy Press 1997. > > > > Best - Will > > > > > To detect a choppy pulse, one must essentially store an image of the > way > > > each pulse beat feels and then compare it with the next pulse beat. > > > (Mathematically this is called auto-correlation.) It means that each > > pulse beat will > > > have a slightly different pulse pressure profile in time. The > trickiest > > aspect > > > of this is to detect choppiness in a pulse that is otherwise smooth in > > profile > > > - a slippery-choppy pulse is one example. > > > > > > We use video simulation software to demonstrate this to our students, > > and it > > > helps greatly. A picture is worth a thousand words. See the sequence > of > > 5 > > > slides starting at: > > > > > > http://www.rmhiherbal.org/tchs-cd/pu-01.html > > > > > > The sequence of slides shown above illustrates several different > complex > > > pulse types. > > > (Keep in mind that these are snapshots of moving images.) > > > > > > In a slippery-choppy pulse, the pulse pressure profile will not have > the > > > classical quality of " knife scraping bamboo " , but the shape does > change, > > and > > > this can include variations in strength, which is one manifestation of > > > choppiness. > > > > > > William R. Morris, LAc, OMD, MSEd > > Dean of Educational Advancement > > Emperor's College of Oriental Medicine > > 310-453-8300 phone > > 310-829-3838 fax > > will > > http://emperors.edu/doctoral/doc_mission.html > > > > This message is a PRIVATE communication. This e-mail and any attachments > > may > > be confidential and/or legally privileged. If you are not the intended > > recipient, please do not read, copy, or use it, and do not disclose it > to > > others. > > Please notify the sender of the delivery error by replying to this > message > > with > > the word delete in the subject column, and then delete it and any > > attachments > > from your system. Thank you. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 11, 2005 Report Share Posted March 11, 2005 Yes, according to the definition you give, the choppy pulse speeds up and slows down without losing an actual beat. It is NOT one of the three skipped beat pulses. In its textbook standard form, it is fine and slightly slow (huan, relaxed). It then goes from slightly slow ot normal speed and back to slightly slow. This happens in tandem with the breath. So it is a type of sinus arrhythmia according to Western medicine. Bob , " " <@c...> wrote: > Will et al... > > As many, I am always looking at pulse info... (esp choppy)... and I just > want to verify that what kaptchuk says below is straight from a mainstream > source. (choppy (can equal) irregular rhythm)... the Chinese actually says > san1 wu3 bu4 tiao2 - threes and five pulse. So assume that it just means the > rhythm will vary (as stated below)... correct? > > > -Jason > > > > > > WMorris116@A... [WMorris116@A...] > > Saturday, October 02, 2004 8:32 AM > > > > Gu (now choppy pulse) > > > > > > Roger - > > > > > > > > This issue of the choppy pulse has come up many times over the years. I > > performed a brief experiment about two years ago on this list. I asked > > listers to > > describe the image of a choppy pulse. No one gave the same description. > > This > > confusion around this issue is not just a contemporary one as you will see > > from > > the list below. > > > > > > > > The choppy pulse is a complex image. However, there are modern > > practitioners > > such as Dr. John Shen who have suggested that the choppy pulse be > > considered > > as a simple image. LuYubin also describes choppy as a simple image [1] > > paraphrased: 'the rough nature is juxtaposed to the smoothness of the > > slippery > > quality.' However, Lu does not specify what aspect is rough. The choppy > > quality > > described throughout the literature may include features such as changing > > rate at > > rest, changing amplitude/intensity, slow, fine, and changing qualities. > > Wang > > Shu-he describes the choppy pulse as [2] fine and slow, coming and going > > with > > difficulty and scattered or with an interruption, but has the ability to > > recover. Other versions of the Mai Jing describe it as short and floating > > or another > > version describes it as short with interruption or scattered. > > > > Jin Wei: " this is a pulse that is felt fine, slow, short, scattered, > > hesitant, and unsmooth, like scraping bamboo with a knife. " > > > > Maccioccia: " This pulse feels rough under the finger: instead of a smooth > > pulse wave, it feels as though it had a jagged edge to it. Choppy also > > indicates > > a pulse that changes rapidly both in rate and quality " > > > > > > > > Li Shizhen: " A pulse which feels thin, minute and short and has an uneven > > flow, beating three and five times with irregular rhythm, is called > > choppy.....It > > feels like a knife scraping bamboo, rough and jagged. It is easily > > scattered > > like rain falling onto the sand. It also moves very slowly and at > > irregular > > depths, like an ill silkworm eating a leaf. " > > > > > > > > Wang Shuhe: " a fine and slow pulse, coming and going with difficulty and > > scattered or with an interruption " > > > > > > > > Kaptchuk: irregular in rhythm. In this case it iscalled the three and five > > not adjusted sometimes three beats per breath and sometimes five beats per > > breath. > > > > Wu Shuiwan: " The movement of this pulse is feltas rough and choppy. It is > > not > > fluent. It is slow and thin. The wave of thispulse is short. " > > > > Deng Tietao: it should feel slow and uneven, fine, small, short. > > > > CAM: " A hesitant pulse feels rough and uneven......stagnations, produce a > > hesitant and forceful pulse ........insufficiency creates a hesitant and > > weak > > pulse " > > > > Wu Shuiwan and Jin Wei both describe the pulse as short, also, Yi Tian Ni > > used this description; it is a wave that halts abruptly as if it has hit > > a mass. > > This is very different from a wave that gives way suddenly due to a > > deficiency of Qi. Macicocia who studied with Dr. Shen describes a jagged > > edge, however, > > then he retreats into the notion of rate as a defining feature of the > > choppy > > pulse. > > > > [1] Lu Yubin. Pulse Diagnosis. Shandong Science and Technology Press. > > [2] Wang Shu-he. Translated by Yang Shou-zhang. The Pulse Classic. Pp. 4. > > Blue Poppy Press 1997. > > > > Best - Will > > > > > To detect a choppy pulse, one must essentially store an image of the way > > > each pulse beat feels and then compare it with the next pulse beat. > > > (Mathematically this is called auto-correlation.) It means that each > > pulse beat will > > > have a slightly different pulse pressure profile in time. The trickiest > > aspect > > > of this is to detect choppiness in a pulse that is otherwise smooth in > > profile > > > - a slippery-choppy pulse is one example. > > > > > > We use video simulation software to demonstrate this to our students, > > and it > > > helps greatly. A picture is worth a thousand words. See the sequence of > > 5 > > > slides starting at: > > > > > > http://www.rmhiherbal.org/tchs-cd/pu-01.html > > > > > > The sequence of slides shown above illustrates several different complex > > > pulse types. > > > (Keep in mind that these are snapshots of moving images.) > > > > > > In a slippery-choppy pulse, the pulse pressure profile will not have the > > > classical quality of " knife scraping bamboo " , but the shape does change, > > and > > > this can include variations in strength, which is one manifestation of > > > choppiness. > > > > > > William R. Morris, LAc, OMD, MSEd > > Dean of Educational Advancement > > Emperor's College of Oriental Medicine > > 310-453-8300 phone > > 310-829-3838 fax > > will@e... > > http://emperors.edu/doctoral/doc_mission.html > > > > This message is a PRIVATE communication. This e-mail and any attachments > > may > > be confidential and/or legally privileged. If you are not the intended > > recipient, please do not read, copy, or use it, and do not disclose it to > > others. > > Please notify the sender of the delivery error by replying to this message > > with > > the word delete in the subject column, and then delete it and any > > attachments > > from your system. Thank you. > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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