From the day it began, China’s centuries-old traditional Chinese medicine has evolved and grown through controversy, debate, and self-renunciation. To this day, the controversy over the academic and clinical application of TCM theories continues unabated. For example, the challenge of “taking a pulse to test for pregnancy” has aroused much attention and heated debate, which shows that many people still have misconceptions and misunderstandings about traditional Chinese medicine, which has been developing and improving itself for thousands of years. Without saying a word, he or she stretches out his or her arm and must ask the doctor to tell him or her where he or she is not well and what disease he or she is suffering from. This is a big headache for many doctors. Any doctor who has received formal education will not be able to deal with such a problem. Because from ancient times to the present day, Chinese medicine is not the way to see patients. But some charlatan doctors dare to think and say, (of course, there are also doctors who graduated from formal institutions are forced to follow the customs), such as liver depression, stomach fire, kidney deficiency, etc.. In particular, the pulse of kidney deficiency, most often felt. No matter how young the patient, how red, you are kidney deficiency anyway. Such patients, as if they have been brainwashed. Spend a lot of money, make up for the mouth and tongue, full of acne, and even prostate inflammation, and never give up. (some doctors may not easily explain the terminology). It is undeniable that “pulse diagnosis” is a characteristic of Chinese medicine and an indispensable treatment, but what is often selectively ignored is that Chinese medicine diagnosis more than two thousand years ago was “look, smell, ask, cut” these four means, rather than a single pulse cutting. Since some time, pulse diagnosis seems to be the only form that represents the characteristics of Chinese medicine, and it is exaggerated without limits. All media about TCM, whether traditional paper, photographs or TV documentaries, invariably choose the pulse cut as the classic image to represent. I also thought so when I was a child, a hand, you will know the truth, the magic, I still remember the Western Journey in the line of pulse, a little older and exposed to the Peking Opera Shajiabang: the sick do not have to speak, you know the root cause of the disease; and Jin Yong’s Ping a finger, Xue Shen doctor’s pulse recognition skills, etc.. This is not the promotion of Chinese medicine, this is the hype. That is literary fabrication, but these misconceptions are widespread. Nowadays, there is a tendency for it to become more and more serious, even more so in areas with relatively backward culture. This has affected the image of TCM and misled many patients who seek TCM treatment, misleading themselves and others. When a TCM doctor treats a disease, is it a combination of four diagnoses, sometimes combined with modern technology, to diagnose and treat the disease in a comprehensive manner; or is it just a pulse check alone? Which is correct and which is more beneficial to the patient? It seems to be a small matter, but in fact it is a big question of right and wrong for every TCM practitioner. Today I will explain the practical significance of pulse diagnosis, so that more people can understand what Chinese medicine should see, and how to use pulse diagnosis for clinical services. I. Pulse diagnosis can only be used as a means of diagnosis We all know that the clinical diagnosis of Chinese medicine is the need to look, smell, ask, cut four diagnoses together, in the “Yellow Emperor’s Classic of Internal Medicine” more than 2,000 years ago that there are detailed records. For example, in Su Wen? It is clearly stated in the “Treatise on the Four Failures”: “The diagnosis of disease does not ask its beginning, worry about the disorder of diet, excessive living, or injury to poison, without first saying this, and then hold the inch mouth, what disease can be hit? Delusion to do the name, for the coarse poor”. Clearly put forward, pulse diagnosis is only one of the four diagnosis of Chinese medicine, part of the content of the cut diagnosis, clearly opposed to the bad diagnostic style of not asking only cut. What’s more, even the pure cut diagnosis also includes many other methods of touching the patient with the hands to diagnose the disease, such as touching the skin, touching the forehead, touching the chest and abdomen organs, etc. Therefore, Chinese medicine also never advocates a single method to diagnose disease by pulse diagnosis. For example, the Royal Hospital of the Qing dynasty compiled the “Medical Zong Jin Jian? Four diagnostic methods” said; “look to the eyes to check, smell to the ears (nose) accounted for, ask the words to review, cut to finger reference, clear thinking about the diagnostic path, knowledge of the root cause of the disease, can be combined with the color pulse, can be all-round”. In other words, the diagnosis and treatment to be all-round, want to be perfect, must be four diagnosis together. Just as in Western medicine, on the basis of detailed consultation (complaints, current medical history, and the general scope of the disease), and then using various physical diagnostic tools and modern equipment such as stethoscopes, blood pressure meters, X-rays, electrocardiograms, ultrasound, CT, MRI, and various laboratory data, and then after a comprehensive analysis, a clear diagnosis and treatment can be made (according to domestic and foreign medical records, even with such a According to domestic and international medical records, even with such a detailed diagnosis, the clinical misdiagnosis rate may still be at least 30). The pulse, as a diagnostic tool, is only one of the tools and methods used to guide the diagnosis of disease in Chinese medicine. Any exaggeration of its role and mystification of pulse diagnosis to the point of inscrutability is abnormal or serves another purpose. Because insiders or real TCM practitioners know that pulse diagnosis is a basic knowledge of TCM diagnostic teaching and is generally less used in clinical precision. In ancient times, the significance of pulse diagnosis was to use pulse diagnosis in combination with observation, smell, questioning and (partially) cut diagnosis to analyze the condition comprehensively, to grasp the physical characteristics of the patient as a whole, to identify the type of disease symptoms, and to guide the doctor in identifying and treating the disease with medicine. In modern times, science and technology have been developed to a very high level, such as sphygmomanometer, X-ray, ECG, ultrasound, CT, MRI and other physical diagnostic methods and modern equipment, as well as the combination of various laboratory data, have greatly enriched our means of diagnosing diseases, which can be applied flexibly according to the condition. (Not to mention that many of the diagnostic methods and tools of Western medicine were not first applied in medicine, but in industry or the military. Therefore, as long as it is beneficial to the treatment of disease, Western medicine can be used, Chinese medicine can also be used). Isn’t it funny that some patients, when they come to the clinic, not only refuse to use these new techniques and equipment, but only let the doctor use the methods that were used more than 2,000 years ago, and only a few percent of them? This is a medical consultation for you, not you and the doctor together to tell fortunes. If you may be occult nephritis, often there are no too obvious clinical symptoms, if you do not cooperate with the doctor’s treatment, if you do not test the urine, it will be misdiagnosed. Also, the patient’s violent cough, the patient just does not talk, any doctor will be quiet point or oral antibiotics, often also a long time to cure. In fact, after careful consultation, the patient has hypertension and often takes enalapril-type antihypertensive drugs, which is a side effect of the drug. After switching to other types of antihypertensive drugs, the persistent cough that has been untreated for a long time is quickly cured. The strength of pulse diagnosis often lies in its ability to help determine the type of disease evidence as a whole, guiding our overall grasp of the disease and condemning the prescription. What can be determined by pulse diagnosis is not necessarily determined by routine blood and urine tests, ultrasound, CT, or MRI in Western medicine. But the conventional physical and chemical examinations of Western medicine are often easier to grasp and more advantageous in terms of figurative and microscopic clinical diagnostic indicators. Any natural science is constantly evolving. Therefore, Chinese medicine in the modernization of the development of progress, is also with the times, is also the use of modern science and technology theory and means for my use, in the continuous improvement of self-improvement at the same time, but also continue to improve the level of clinical diagnosis and efficacy. Second, what is the “pulse” pulse is a diagnostic term in Chinese medicine. Healthy people a breath Chinese medicine called “a breath”, the normal pulse should be a breath jump 4-5 times, inch Guan ruler three parts of the pulse, the pulse is not floating not sinking, and slow and strong, ulnar pulse sinking to take should be strong. Chinese medicine to see the disease, the core of the diagnosis and treatment, look, smell, ask questions and cut four diagnoses, although the pulse diagnosis in the last, but it is an important part of Chinese medicine diagnostics. The formation of the pulse is closely related to the qi and blood of the viscera, including the frequency, rhythm, degree of filling, the smoothness of the situation, the slow movement, the magnitude of fluctuations, such as the heart is the main blood vessels, the lungs towards the hundred veins, the spleen to regulate blood, the liver to collect blood, the kidney essence to transform blood and other functional changes, can lead to changes in the pulse, so different pulse can reflect the physiological and pathological changes in the qi and blood of the viscera. Pulse diagnosis is the basic skill necessary for every Chinese medicine practitioner. However, nowadays there are many doctors who have poor basic skills in pulse diagnosis, so it will be more of a problem if such doctors are allowed to diagnose the pulse. Jin? Tai Medical Order Wang Shuhe said in the Pulse Classic: “The pulse is delicate, its body is difficult to identify, in the heart is easy to understand, under the finger is difficult to understand”. Not to mention that many young doctors now do not understand the theoretical pulse in the heart (i.e., how to describe what kind of pulse verbally, are not able to say), how do you let him feel in the clinic? Then again, even if the pulse can be understood, it is not perfect to feel the pulse alone to see the complex disease. I served in the Chinese hospital for seventeen years as the dean of business work, the weekly business check-ups, combined with specific cases to test the level of pulse diagnosis of doctors at all levels. I have also lectured on pulse science in the city’s continuing medical education courses many times. However, I can’t recall a time in all my years of practice when I have diagnosed and treated a disease in any patient by feeling the pulse alone. Another example is that there are no more than thirty simple pulse signs in normal Chinese medicine, (excluding rare pulse signs such as scattered, hollow, slight, rapid, knotted, and substitution, there are even fewer), while there are about several hundred commonly associated and combined pulse signs. But there are tens of thousands of human diseases, and each disease can produce dozens of types in constant change. For example, gastritis (or stomach pain) can have stomach cold, stomach fire, stomach deficiency, stomach solid, and can have a mixture of cold and heat, deficiency and reality, liver and stomach disharmony, spleen and stomach cold, diet stagnation, and so on, a total of dozens of types; and the same type in the winter and summer seasons, different ages, male and female gender and different physiological periods, there are different changes. In other words, different pulse signs can be produced. Anyone who knows a little probability science will not make this common sense mistake. How to attribute tens of hundreds of pulse signs to feel tens of thousands of diseases and hundreds of thousands of disease types? How to judge? What’s more, when there are clinical conditions that do not match the pulse, the doctor will often decide whether to give up the pulse from the symptoms, or give up the symptoms from the pulse, based on a comprehensive judgment. All of these require a doctor’s rich clinical experience and a strong theoretical foundation to do well, and the comprehensive and integrated judgment of looking, smelling, asking, and cutting is necessary. TCM believes that if one can understand, analyze, and control the condition in a certain range (what is the disease? What is the disease in general, etc.?) Then combined with pulse diagnosis, and even with some physical and chemical testing methods of Western medicine, it will greatly improve the degree of diagnostic accuracy, but also significantly improve the clinical efficacy. Third, can Chinese medicine diagnose and find problems with the pulse, there may be devout believers in Chinese medicine to this question to be serious, Chinese medicine can diagnose and find problems with the pulse? The answer is: within certain limits, certain diseases can be determined by pulse diagnosis! For example, if the patient’s pulse is weak (irregular heart rhythm, weak pulse), combined with a yellowish, dark complexion and an overall weak appearance. Doctors will first think of myocarditis, anemic heart disease, coronary heart disease and other heart disease. However, even if such a simple diagnosis is made, it is not as comprehensive as looking, smelling, asking and cutting; moreover, this kind of disease requires blood tests, electrocardiogram and other physical and chemical examinations to cooperate with the diagnosis and treatment. If, one day, the patient has a whim, think about it, sue you for cutting corners in treatment, many of the tests should be done not done, delaying the disease, you the unqualified doctor how to do? (I have encountered too many cases where the doctor asked to do physical and chemical examinations on the patient, the patient firmly refused and only asked to feel the pulse, and then later claimed for misdiagnosis by the doctor, resulting in the doctor and the hospital accompanied the money). Then there is the determination of pregnancy by pulse, which has been done by Chinese medicine since ancient times. If a woman of childbearing age; a couple living together and not using contraception; normal menstruation on a regular basis, but recently menstruation has suddenly stopped without obvious cause; and a slippery pulse, the initial diagnosis of early pregnancy can be made. The pulse of a pregnant woman is mostly the “slippery pulse”, which is often referred to as the “happy pulse”. Many people may feel that Chinese medicine to feel the pulse to test for pregnancy is very magical, but in fact this requires prerequisites. ① first of all, a woman of childbearing age; ② there are conditions for conception; ③ usually normal menstruation, but recently without obvious cause menstruation suddenly stopped; ④ normal physiological cycle of married women of the right age suddenly stopped menstruation, and mild bloating, nausea and vomiting, tiredness and other symptoms, but the pulse is full and fluent, no signs of disease. At this point, the combination of pulse diagnosis can determine whether the pregnancy is early or not. However, this also requires the patient to answer some of the questions asked first. This will allow the doctor to determine the signs of pregnancy by combining the pulse with the four diagnoses of the examination. From the pulse, the “slippery pulse” is a kind of pulse that is fluent, like a pearl on a plate, and round and smooth, but it is also often seen in people suffering from actual heat, phlegm, food and blood accumulation diseases; it is also seen in healthy people who are full of qi and blood. Therefore, the so-called “happy pulse” can be found in both healthy and sick men. So the slippery pulse is not unique to the diagnosis of pregnant women, but can be found in many cases. Therefore, it is not correct to simply feel the pulse to test for pregnancy. In my past practice of medicine, I have also come across such an example, a doctor diagnosed a 28-year-old young woman pregnant by feeling the pulse, which can cause a furore, a lot of fun. It was a particularly sensitive time for such things, and the woman was unmarried. The doctor is also very aggrieved, the patient asked three not to say, feel the pulse is slippery pulse, and then look at the woman’s age and so old, had to feel such a diagnosis. Blame who? Both the doctor and the patient have responsibility. Nowadays has developed to the modern high-tech era, the development of any natural science is to keep pace with the times. In Chinese medicine, we need to test urine for nephritis; in Chinese medicine, we need to measure blood pressure for hypertension; in Chinese medicine, we need to measure body temperature for fever. Chinese medicine diagnosis of external fever does not test the blood test, do not test the white blood cells, how to identify the bacterial or viral infection, etc.. Of course, experienced TCM doctors, in a long career, through the accumulation of experience, through long-term clinical training, it is possible to maximize the senses, and the mastery of the four diagnostic skills of looking, smelling, asking, and cutting can become increasingly sophisticated. Here of course includes a deep understanding and clinical use of pulse science. In the past, Western medicine also requires young doctors to practice the basic clinical skills of looking, touching, tapping and listening. Any means of diagnosis and treatment, the results of any physical and chemical examination, the information obtained are different, but also the solution to the problem of choice is different, even if the examination of a problem, mutual corroboration is the best way to diagnose clearly. Two hands to hold the precious things, do not use one hand to show off, our health is so valuable, doctors look, smell, see, touch, hear, all applications are still afraid of insufficient, but also with the help of a variety of modern high-tech physical and chemical testing methods to diagnose and analyze the condition. And even so, there are still many diseases that can not be understood. Therefore, do not play with your own health because of your ignorance and misunderstanding of Chinese medicine. When seeing a doctor, the doctor and the patient are comrades in a trench, and our common enemy is the disease. If you can provide first-hand information in detail and answer the doctor’s questions truthfully, all this, you can better cooperate with the doctor to make an accurate diagnosis, choose the right treatment method and improve the efficacy.