Fundamental_Pulses_Part_12.pdf

7/27/2019 Fundamental_Pulses_Part_12.pdf

1/25

Advanced

Pulse

DiagnosisAdvanced

Pulse

DiagnosisJamesRamholzJamesRamholz

Inrelationtothehumanbody,yangisabovethemiddle

and

on

the

back;

yin

is

below

the

middle

and

on

the

front.

Theeversionofaspherehelpsillustratesthe

internal/externaldivisionandtransformationofyinand

yang.Theexteriorsurfaceofthesphereisyang,andthe

interiorsurfaceisyin.Theinteriorpurpleandexterior

goldsurfacesofthespherechangeplacesin4dimensional

space/time.Thetransformationstartsatthetopleftcorner

andmovesclockwise.Inthisprocess,yangandyinchange

placeusingthemostnaturalwayand,therefore,theleast

amountofenergy.Theeversionofasphereisa4

dimensionalTaiji diagram.

Whentheprocessgetstothemidpoint[lowerright

corner],the

figure

can

be

divided

in

cross

section

to

reveal

theBagua,anoctagonoreightsidedfigure.ThattheBagua

liesatthemidpointonthemoststablepathwaythrough

thisprocessunderscoresitsimportanceinChinesetheory

andmedicine.

Copyright2002,2003byJamesRamholz


2/25

Tableof

ContentsTable

of

Contents

TheNormalPulseWaveTheNormalPulseWave33 BasicPulseWaveDynamicsBasicPulseWaveDynamics

44 TheNormalPulsein3TheNormalPulsein3DD

55 TheNormalPulseinCrossTheNormalPulseinCrosssectionsection

NormalPulsePositionsNormalPulsePositions66 TheImportanceofLocationTheImportanceofLocation

77 1and2LongitudinalDepths1and2LongitudinalDepths

88 3LongitudinalDepths3LongitudinalDepths

99 InteriorandExteriorPerspectivesInteriorandExteriorPerspectives

1010 MoreonOrgansandChannelsMoreonOrgansandChannels

1111 DongHan

Developments,

I:Dong

Han

Developments,

I:

99sectorsModelsectorsModel

1212 DongHanDevelopments,II:DongHanDevelopments,II:

2727sectorsModelsectorsModel

1313 5LongitudinalDepths5LongitudinalDepths

BasicPulseQualitiesBasicPulseQualities1515 FloatingandSinkingFloatingandSinking

1616 FastandSlowFastandSlow

1717 SlipperyandChoppySlipperyandChoppy

1818 LongandShortLongandShort

1919 WiryandSoftWiryandSoft

2020 KnottingintheClassicalFashionKnottingintheClassicalFashion

2121 DongHan

Developments,

III:Dong

Han

Developments,

III:

CancerMovementCancerMovement

2222 Picture:JiangJingExplainingSomePicture:JiangJingExplainingSome

DetailsoftheBreastCancerPulseatDetailsoftheBreastCancerPulseat

NYCSeminarNYCSeminar


3/25

BasicPulse

Wave

DynamicsBasic

Pulse

Wave

Dynamics

ThegeometryoftheNormalwaveformThegeometryoftheNormalwaveform

TheNormalpulse(Zhengchangmai)isrecognizedby

itsuniquesymmetryanduniformrelationto

breathing2beatsontheinhaleand2ontheexhale.

Inyin/yangtheory(base2),aNormalwaveisdefined

astheselfelementofaposition(wiryforWood,etc.)

plusstomachqi.Intermsof5Phases(base5),the

risingandspreadingmovementisWood;thecresting

movementor

expanding

outward

from

apoint

is

Fire;

thedescendingmovementisMetal;andthetroughor

crystallizingtoasinglepointmovementisWater.

Earthcanbeconsideredeitherthelast18o ofeach,or

thesubstantialness ofthewholewave.

Thetop

figure

shows

the

wave

movement

in

time,

movinglefttoright.Thebottomfigureshowsthe

waveexpressedinitsenergeticorstatespace.Instead

ofcontinuingalongthetimeline(Xaxis)asinthetop

picture,thewavecompleteseachcyclebyreturning.

Allenergeticvaluesandpossibilitiescanbeillustrated

init.

a

b

d

c

X-axis

Y-axis

a

b

c

d

yang of Yang

yang of Yinyin of Yin

Yin of Yang

a c

d


4/25

BasicPulse

Wave

DynamicsBasic

Pulse

Wave

DynamicsTheRelationofStateorPhaseSpacetoTimeTheRelationofStateorPhaseSpacetoTime

6.4.2.

1.

0. 5

-0. 5

-1.

6.4.2.

1.

0. 5

-0. 5

-1.

6.4.2.

1.

0. 5

- 0. 5

-1.

6.4.2.

1.

0. 5

- 0. 5

-1.

6.4.2.

1.

0. 5

- 0. 5

-1.

Intheseriesoffiguresontheleftside,therotation

alongthecircleismappedtothetimeline.The

figureaboveshowsthecompletedcycle.Then,the

seriesrepeatsitselfagainwiththesequenceonthe

left.Allenergeticvaluesandpossibilitiescanbe

diagramedinthisstatespacetoillustratethe

qualitiesof

each

pulse

position.


5/25

BasicPulse

DynamicsBasic

Pulse

Dynamics

33dimensionsandrotationalaspectofthebasicpulsewavedimensionsandrotationalaspectofthebasicpulsewave

ThepulsewaveineachpositioncanbeThepulsewaveineachpositioncanbe

describedin3describedin3dimensions.dimensions.

TheXThe

X

axis

is

related

to

the

length

along

the

axis

is

related

to

the

length

along

the

arteryandtime(frequency).TheYarteryandtime(frequency).TheYaxisisaxisis

relatedtodepth(amplitude).TheZrelatedtodepth(amplitude).TheZaxisisaxisis

relatedtothewidthofthepulse,andtherelatedtothewidthofthepulse,andthe

positionpositionsoverallcapacitywhenconsideredsoverallcapacitywhenconsidered

withtheamplitude.Therotationalforceofthewiththeamplitude.Therotationalforceofthe

movementiscalledthetorque.movementiscalledthetorque.

AstheNormalpulsemovesforwardalongtheAstheNormalpulsemovesforwardalongthe

XXaxisfromProximaltoDistal,itcanalsorotateaxisfromProximaltoDistal,itcanalsorotate

clockwise,expressing6clockwise,expressing6QiqualitiesincrossQiqualitiesincross

section.

section.

Consideredtogether,thelongitudinalandConsideredtogether,thelongitudinaland

rotationalmovementsexpresshow5rotationalmovementsexpresshow5PhasesPhases

and6and6QiareinterQiareinterrelatedandmutuallyrelatedandmutually

engendering.engendering.

X

Y

Z


6/25

NormalPulseNormal

Pulse33DCrossDCrosssectioninYin/Yangand5sectioninYin/Yangand5PhasesPhases

Pulsescanexpressbothayin/yang(inner/outer)orPulsescanexpressbothayin/yang(inner/outer)or

a5a5Phase

crossPhasecross

section

relating

to

their

associated

section

relating

to

their

associated

qualities.qualities.

Forexample,theHolloworOnionStalkForexample,theHolloworOnionStalk(Kou)(Kou)pulsepulse

takesitsnameandshapefromthecontrastofthetakesitsnameandshapefromthecontrastofthe

emptyyinorinnerportionemptyyinorinnerportionKidney,LiverandKidney,Liverand

SpleencoreSpleencoreto

the

outer

portions.

It

indicates

to

the

outer

portions.

It

indicates

blooddepletion.blooddepletion.

Classicallydescribed,whenpressingdownfromClassicallydescribed,whenpressingdownfrom

skintobone(alongtheYskintobone(alongtheYaxis),tensioncanbefeltataxis),tensioncanbefeltat

thesurface,thensoftnessoremptinessatthebloodthesurface,thensoftnessoremptinessattheblood

depth,andthentensionagaininthedeeperpart.depth,andthentensionagaininthedeeperpart.

WhenyoursensitivityisstrongeryoucanalsofeelWhenyoursensitivityisstrongeryoucanalsofeel

thewalloftheOnionStalkcharacteralongthethewalloftheOnionStalkcharacteralongthe

outeredgesorthirddimension.outeredgesorthirddimension.

Lung

Heart

Spleen

Liver

Kidney


7/25

TheImportance

of

Pulse

Positions

and

The

Importance

of

Pulse

Positions

and

PhysicalLocationstotheQualitiesPhysicalLocationstotheQualities

Space,Time,andQualitiesareinseparableaspectsofthediagnoSpace,Time,andQualitiesareinseparableaspectsofthediagnosticstic

informationfromthepulses.informationfromthepulses.

Asit

says

in

the

As

it

says

in

the

Nan

JingNanJing,

,In

each

case,

one

determines

on

the

basis

of

the

In

each

case,

one

determines

on

the

basis

of

the

locationofthemovementsintheconduitswhethertheinfluenceslocationofthemovementsintheconduitswhethertheinfluencesincaseofanincaseofan

illnessillnessproceedcontrarytoproceedcontraryto11 orinaccordancewithorinaccordancewith22 theirpropercourse.theirpropercourse.

Unschuldtranslation,Difficulty4Unschuldtranslation,Difficulty4

1.1.NiNi,,counterflowcounterflow

2.2.ZhengZheng,correct,correct


8/25

Oneand

Two

DepthsOne

and

Two

Depths

ZangZangandandFuFu

Fromskintobone,Fromskintobone,eachpositioncanbeseenasasinglespaceeachpositioncanbeseenasasinglespace

associatedwith

the

associated

with

the

zangzangorgan

of

that

organ

of

that

position;oritcanbedividedinto2depths,position;oritcanbedividedinto2depths,

relatedtoboththerelatedtoboththezangzangandandfufu..

TheTheZangZangandandFuFurefertothesolidandrefertothesolidand

holloworgans,respectively.Theyreflectholloworgans,respectively.Theyreflect

thestorage

and

transformative

capacity

of

the

storage

and

transformative

capacity

of

thePhaseassociatedwiththatposition.thePhaseassociatedwiththatposition.

Likeallotherpulsemodels,eachdepthcanLikeallotherpulsemodels,eachdepthcan

beviewedincombinationwithanothertobeviewedincombinationwithanotherto

describeasinglemovement,orasdifferentdescribeasinglemovement,orasdifferent

sectorsor

spaces

with

their

own

separate

sectors

or

spaces

with

their

own

separate

movements,qualities,anddiagnosticmovements,qualities,anddiagnostic

information.information.

ZangangSolid organsSolid organs

FuuHollowHollow

organsorgans

DistalDistalMiddleMiddleProximalProximal


9/25

3Depths

3Depths

FromtheFromtheNanJingNanJingandandMaiJingMaiJing

Fromskin

to

bone,From

skin

to

bone,

eachpulsepositioncanbedividedeachpulsepositioncanbedivided

into3depths:qi,blood,andinto3depths:qi,blood,and

adapteddepth(inotherpulseadapteddepth(inotherpulse

systems,thisisreferredtoasthesystems,thisisreferredtoasthe

organdepth).Thismodelreflectsorgandepth).Thismodelreflects

bothchannel

and

organ

influences.both

channel

and

organ

influences.

ThedistalpositioncanreflecttheThedistalpositioncanreflectthe

bodyfromtheheadtothebodyfromtheheadtothe

diaphragm;themiddlepositiondiaphragm;themiddleposition

fromthediaphragmtothenavelorfromthediaphragmtothenavelor

groin;andtheproximalpositiongroin;andtheproximalposition

fromthenavelorgrointothefeet.fromthenavelorgrointothefeet.

dapteddaptedOrgans andOrgans anddeeper ordeeper orhabituatedhabituatedpatternspatterns

loodloodCurrentCurrentphysiologicalphysiologicalprocessesprocesses

QiiSkin,Skin,meridians,meridians,emotionsemotions



10/25

Interiorand

Exterior

PerspectivesInterior

and

Exterior

Perspectives

NavellineNavelline

LowerAbdomenLowerAbdomen

LowerbackLowerback

Diaphragm

lineDiaphragm

line

AbdomenAbdomen

Middleof

backMiddle

of

back

ChestorFrontChestorFrontUpperbackUpperbackSkin

Bone

Bone

Surface


11/25

Moreon

Channels

and

OrgansMore

on

Channels

and

Organs

NanJingNanJingDifficulty18Difficulty18

The3DepthModel,seenearlier,presentsthebasisThe3DepthModel,seenearlier,presentsthebasis

foracombined

channel

and

organ

pulse

for

acombined

channel

and

organ

pulse

perspective.perspective.NanJing,NanJing,Difficulty18,furtherDifficulty18,further

examinesthepulsepositionsfrombothanorganexaminesthepulsepositionsfrombothanorgan

andchannelperspective.andchannelperspective.

Thisperspectiveshowsthebasic5Thisperspectiveshowsthebasic5PhasePhase

networkingandconnectionbetweenthepositionsnetworkingandconnectionbetweenthepositions

forthe

organs.for

the

organs.

ButbecausemostchannelstransversetheentireButbecausemostchannelstransversetheentire

body,thisperspectivedoesnotrevealthecorrectbody,thisperspectivedoesnotrevealthecorrect

channelsymmetry,flow,andconnectionbetweenchannelsymmetry,flow,andconnectionbetween

positions.positions.

ThisproblemwassolvedintheDongHansystem.ThisproblemwassolvedintheDongHansystem.

LikeaChinesepuzzle,thechannelsymmetryandLikeaChinesepuzzle,thechannelsymmetryand

interactionsareonlyrevealedwhenexaminingtheinteractionsareonlyrevealedwhenexaminingthe

pulsesatadifferentscale.pulsesatadifferentscale.

San JiaoSan Jiao

ShaoyangShaoyang

KidneyKidney

ShaoyinShaoyin

SpleenSpleenTaiyinTaiyin

LiverLiverTzuyinTzuyin

LungLung

TaiyinTaiyin

HeartHeart

ShaoyinShaoyin

Creation (Sheng)Cycle

Control (Ke)Cycle


12/25

Moreabout

3Depths

ModelMore

about

3Depths

Model

DongHanDevelopment,VDongHanDevelopment,V

dapteddaptedOrgans andOrgans and

deeper ordeeper or

habituatedhabituatedpatternspatterns

loodloodCurrentCurrentphysiologicphysiological processesal processes

QiiSkin,Skin,meridians,meridians,emotionsemotions


IntheDongHansystem,weoftenexaminetheIntheDongHansystem,weoftenexaminethe

qualitiesof

several

different

combined

positions,

qualities

of

several

different

combined

positions,

sectors,ordepthsinordertointerpretthingsnotsectors,ordepthsinordertointerpretthingsnot

previouslyaccountedforinclassicalpulsediagnosis.previouslyaccountedforinclassicalpulsediagnosis.

ManyideasfromWesternmedicinecanbefoundinManyideasfromWesternmedicinecanbefoundin

thistypeoforganization.thistypeoforganization.

MovementsonthedividinglinebetweentheqiandMovementsonthedividinglinebetweentheqiand

blooddepthsoftenrelatetothesensorylevel[yellowblooddepthsoftenrelatetothesensorylevel[yellow

dottedline].Problemsrelatedtothesensorysystemdottedline].Problemsrelatedtothesensorysystem

associatedwithaparticularorgancanoftenbefoundassociatedwithaparticularorgancanoftenbefound

here.Forexample,earsinthekidneyposition,etc.here.Forexample,earsinthekidneyposition,etc.

MovementsonthedividinglinebetweenthebloodandMovementsonthedividinglinebetweenthebloodand

adapteddepthsoftenrelatetotheendocrinelevel[redadapteddepthsoftenrelatetotheendocrinelevel[red

dottedline].Problemsrelatedtotheendocrinesystemdottedline].Problemsrelatedtotheendocrinesystem

associatedwithaparticularorgancanoftenbefoundassociatedwithaparticularorgancanoftenbefound

here.For

example,

adrenals

in

the

kidney

position,

etc.here.

For

example,

adrenals

in

the

kidney

position,

etc.


13/25

DongHan

DevelopmentDong

Han

Development,I,I

BasedonBasedonNanJingNanJingDifficulty18Difficulty18

IntheDongHansystem,eachpulsepositionIntheDongHansystem,eachpulseposition

issubdivided

into

asmaller

scale

fractal

is

subdivided

into

asmaller

scale

fractal

imageofall3imageofall3jiaos.jiaos.Inthisway,thewholeInthisway,thewhole

bodycanbeexaminedfromtheperspectivebodycanbeexaminedfromtheperspective

ofeachrespectiveorganorphase.Forofeachrespectiveorganorphase.For

example,ifthisistherightwrist,thenweareexample,ifthisistherightwrist,thenweare

examiningtheuppermiddleandlowerexaminingtheuppermiddleandlowerjiaojiao

fromtheperspectiveoftheEarthphase.fromtheperspectiveoftheEarthphase.

WhendividedapositionfromskintoboneWhendividedapositionfromskintobone

into3depths,wecreate9into3depths,wecreate9sectorsineach.sectorsineach.

WecanevenfirstdividethepositionintoWecanevenfirstdividethepositioninto

zangzangandandfufubeforedividingitinto3beforedividingitinto3depths;depths;

inwhich

case

each

depth

has

its

own

9in

which

case

each

depth

has

its

own

9

sectors.Doingso,wecanexaminethesectors.Doingso,wecanexaminethe

relationofeitherorboththespleenorrelationofeitherorboththespleenor

stomachchannelstothewholebodyinallstomachchannelstothewholebodyinall

threethreejiaosjiaos..

Proximal Middle Distal


14/25

DongHan

DevelopmentDong

Han

Development,II,II

MoreonMoreonNanJingNanJingDifficulty18Difficulty18

Proximal Middle Distal

Wecangostillanotherstepfurtherthanour

previousdevelopmentontheNanJing.When

includingthe3rddimension,thewidthofthe

artery,the

9sectors

model

develops

into

a27

sectorsmodel.Inthiswaywecanseebothleft

andrightsidesofthebodyononewrist.

Wecanalsofirstdivideeachpositionupinto

zang andfubeforeexaminingbothdepthsin

termsof27sectors.Thisisabasicunit inthe

DongHan

system,

and

it

can

be

interpreted

in

severaldifferentways.

Later,wewillcontinuetodivideeachposition

inavarietyofotherways,too.Aslongasweare

consistentwiththeoryandcandemonstrate

clinicaleffectiveness,allofthesepulsemodels

willbeanimportantandusefuldevelopmentof

classicaltheory.


15/25

FiveDepthsFiveDepths

NanJingNanJingDifficulty5Difficulty5

Fromskintobone,eachpulsepositioncanbedividedFromskintobone,eachpulsepositioncanbedivided

into

5

depths.into

5

depths.

ThispulsemodelisnotalwaysstrictlyrelatedtoThispulsemodelisnotalwaysstrictlyrelatedto

channelandorganinfluences.Instead,eachchannelandorganinfluences.Instead,each

depthisrelatedtothetypesoftissueassociateddepthisrelatedtothetypesoftissueassociated

withtheLung,Heart,Spleen,Liver,andKidney:withtheLung,Heart,Spleen,Liver,andKidney:

skin,capillaries,connectivetissue,muscles,andskin,capillaries,connectivetissue,muscles,and

bonerespectively.bonerespectively.

ThisisthefirstpulsemodelthatdramaticallyThisisthefirstpulsemodelthatdramatically

changesourdiagnosticperspective.Usingit,wechangesourdiagnosticperspective.Usingit,we

canexaminehighlylocalizedandevenisolatedcanexaminehighlylocalizedandevenisolated

problems;notsimplyrelategeneralinformationproblems;notsimplyrelategeneralinformation

abouttheposition.abouttheposition.

Eachofthese5depthscanbelookedatinEachofthese5depthscanbelookedatin

combinationwithotherstodescribeasinglecombinationwithotherstodescribeasingle

movement,sometimesacrossseveralpositions.movement,sometimesacrossseveralpositions.

TheycanalsobeseenasindividualsectorsorTheycanalsobeseenasindividualsectorsor

separatespaceswiththeirownwavesqualitiesseparatespaceswiththeirownwavesqualities

andinformation.andinformation.

Hearteart

Spleenpleen

Kidneyidney

Liveriver

LungungDistalDistalMiddleMiddleProximalProximal


16/25

ChoosingaParticular

Pulse

ModelChoosing

aParticular

Pulse

Model

Withthewidevarietyofpulsemodelspossible,thequestionariWiththewidevarietyofpulsemodelspossible,thequestionarisesastosesastowhich

does

apractitioner

choose

to

applywhich

does

apractitioner

choose

to

applyone

or

another?one

or

another?

Itisnotamatterofchoiceforthepractitioner.ThepatientwItisnotamatterofchoiceforthepractitioner.Thepatientwillalreadyhaveillalreadyhavechosenchosenorpresentedtheirproblemintheirownway.Thatiswhytheorpresentedtheirproblemintheirownway.Thatiswhythevarietyofpulsemodelsexistsinthefirstplace.varietyofpulsemodelsexistsinthefirstplace.


17/25

Basic

Pulse

QualitiesBasic

Pulse

QualitiesSymmetryBreakingoftheNormalPulseSymmetryBreakingoftheNormalPulse

TheNormalpulse(Zhengchangmai)is

recognizedby

its

unique

symmetry

and

uniformrelationtobreathingtwobeatsonthe

inhaleandtwoontheexhale.Thisreflectsthe

respiratoryandcardiovascularcirculationsqi

andbloodmovingandworkinginharmony.

Allother

pulse

qualities,

their

combinations,

andtheirdiagnosticmeaningsarederivedfrom

thebreakdowninsymmetryoftheNormal

pulse.

IntheDaoDeJing,LaoTzusaysthattheDao

createdtheOne,OnecreatedTwo,andTwo

createdmyriadthings.a

b

d

c

X-axis

Y-axis

a

b

c

d

yang of Yang

yang of Yin yin of Yin

Yin of Yang


18/25

FloatingandSinkingQualities

Floatingand

Sinking

refer

to

the

most

superficialandgreatestdepthatwhichyou

findthepulsemovement.AFloatingpulseis

feltassoonasthefingerstouchtheskin,but

disappearswhenfurtherpressureisapplied.

ASinkingpulsefeelsdistinctonlyatthedeep

level.ASunkenpulseisessentiallyassociated

withinteriorpatterns,althoughtheexterior

patternsofexternaldiseasesmaytemporarily

presentwithatightSunkenpulsewhenthe

bodysyang

qi

is

obstructed.


19/25

SlowandFastQualities

ASlowpulsehas3orfewerbeatsperrespiration.

TheSlow

pulse

is

principally

associated

with

cold

andyangvacuity.Itmayoccurinanydisease

involvinginsufficiencyofyangqiorobstructionof

qimovement,suchascold,phlegmturbidity,and

staticblood.

ARapidpulsehasmorethan4beatsperrespiration.

Onehavingbetween5and6beatsistermeda

slightlyRapid;morethan6beatsisveryRapid.The

Rapidpulseisassociatedwithheatbutmay,

sometimes,beanindicationofdepletion.Aforceless

fineRapid

pulse

indicates

yin

vacuity

fire

effulgence

andisgenerallyseenindepletionpatterns.A

forcefulRapidpulseindicatesrepletionheatandis

mostcommonlyseeninfebrilediseases.


20/25

SlipperyandChoppyQualities

ASlipperypulsefoundsystemwideisusually

indicativeofexcessqiinthebody.Itdoesnot

necessarilyindicatethatthemucusisstagnating

andformingblockagesbutratherthatthebody

isintheprocessofsecretingit.Itisalso

sometimesseeninhealthypeople,indicatingan

abundanceof

qi

and

blood.

AChoppypulsedoesnotflowsmoothlyandis

classicallydescribedasaknifescraping

bamboo. Theroughpulseisoftenseeninblood

stasispatternsanddualvacuityofbloodandqi.


21/25

LongandShortQualities

AShortpulsedoesnotlongitudinallyfillits

position.Itwillnotlastlongsinceitdoesnothave

enoughsupport

to

create

that

energy

much

longer;

oritcanindicatealocalizedproblem.The

movementisbecomingmoreyin.

ALongpulseisamovementthatextendsbeyondits

ownposition.Themovementisbecomingmore

yang.It

is

often

seen

when

one

position

is

sending

itsinfluencetoanotherpositionalongtheSheng

cycle.

LongandLarge(alongtheverticaldimension)are

yangincomparisontoShortandSmall.Largeand

Small

generally

indicate

qi

or

yang

qualities,

while

LongandShortindicatebloodoryinqualities.Soa

Largepulseisyangofyang,aSmallpulseisyinof

yang,aLongpulseisyangofyin,andShortpulseis

yinofyin.


22/25

WiryandSoftQualities

AWirypulsefeelslikeastringofamusical

instrument.Thestringlike pulseiscommonly

associatedwithdiseasesoftheliverand

gallbladder,andinparticularwithascendant

hyperactivityofliveryang.Itisalsoassociated

withneuromusculartension,pain,andphlegm

rheumpatterns.

The

Wiry

pulse

is

generally

strong.Butifforceless,itistermedavacuous

stringlike pulse,indicatingthevacuityofyin

andhyperactivityofyang.

ASoftpulseiswithoutstrengthandindicates

depletionof

the

yin

and

blood

and

depletion

of

jing.


23/25

KnottingintheClassicalTradition

This

movement

is

described

by

Li

Shi

zhen as

one

that

missesabeatatirregularintervals.Itisanirregular

pulsationindicativeofenergyblockagesandaggregation

ofyinsuchasseeninphlegmblockages,tumors,cancer,

orbloodclots.


24/25

Cancer

MovementDongHanDevelopment,III

ThestandarddefinitionofKnotting(jie)

inTCMisonethatmissesabeatat

irregularintervals.

IntheDongHansystem,thistermismodernizedto

includeamovementthatseemstobecresting,flattening,

andstopping.Butevenwhileitisstoppingorflattening

atthecrestthereisstillsomemovementgoingoninside

it.Sometimeswhenthepulserisestothetopofitsarch

youcan

feel

avibratory

quality

without

any

descending

motion.Itmayalsofeellikeasmalltornadoonitsside;

whatwenicknamedspinners. Thisvibratingor

spinningqualityindicatesthattheenergyis

concentratingandcreatinganaggregation,andcanbe

interpretedinseveralways.IfthemovementKnots

irregularly,youcansuspectacystorhematoma.Butifit

Knotswitheachbeat,youshouldsuspectcancer.


25/25

JiangJing

BreastCancerSeminarinNYC

In

the

discussion

of

acasestudyduring

theBreastCancer

seminarinNYC,

notethe

Dong

Han

styledrawingsof

theKnottingpulse

movementsonthe

whiteboard.

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