Pulses

[Guest guest]

Todd.

 

I agree about the need for demonstration. It is critical for pulse diagnosis

and we cannot afford to make assumptions that they can get it from a book or

from hearing a description. Reading is generally considered a poor method for

developing procedural skills, whereas demonstration and guided practice are

quite effective.

 

There are a few issues that create inter-rater reliability problems for pulse

diagnosis such as agreement upon the image. In addition, there must be a

common palpation technique. For instance, the depth of pressure and placement

along the radial artery must be uniform. Two seasoned practitioners may identify

differing pulse qualities such as slippery and bowstring. The one who

identifies bowstring is often resting superficially on the top of the vessel and

the

one who finds slippery is often resting at the middle depth in the midst of the

blood stream.

 

When there are disparate findings, especially for the se mai and because of

the confusion present in the literature, one must first establish that the

features of the pulse image are understood in a common language. Second, one

must

insure that the palpation technique is the same. Third, it is possible to have

a meaningful dialogue about other problems such as the pulse quality

changing. When precepting, this process is critical to the development of the

learner

because if left unresolved, they leave in a confused and disempowered state.

 

By the way, Ye Tian Ni described choppy as a sudden cessation of the wave as

if it were chopped off. I have found this nowhere in the literature and have

found it a useful identifier for traumatically induced blood stasis.

 

Will

 

 

> Will

>

> Though you don't state this explicitly, the range of descriptions of the

> choppy

> pulse you give, some of which are quite qualitative, implies to me that

> students must indeed be calibrated by a particular practitioner in order to

> reliably identify this pulse. The 3-5 description is quantitative and thus

> more

> easily calibrated. However I was trained more along the lines exemplified

> by

> the following quotes you provide:

>

> Wang Shuhe: a fine and slow pulse, coming and going with difficulty and

> scattered or with an interruption

>

> 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. "

>

> Using these descriptions, I think demonstrationis essential for recognition.

>

> What do you think?

>

 

 

William R. Morris, L.Ac., O.M.D.

Secretary, AAOM

Dean of Educational Advancement

Emperor's College of Oriental Medicine

310-453-8300 phone

310-829-3838 fax

will