The subject of pulse diagnosis was first tackled in an organized manner by Wang Shuhe, who lived during the 3rd century A.D. His text on pulse diagnosis became known as the Mai Jing (Pulse Classic). In the Mai Jing, a broad spectrum of applications for pulse diagnosis is delineated, including etiology of disease, nature of the disease, and prognosis.
Pulse diagnosis is one of the original four diagnostic methods that are described as an essential part of traditional Oriental medical practice. However, Today, doctors often deviate from the treatment methods of ancient times. They may not even follow the changes in the four seasons that influence the pulse and other body conditions. Additionally, they often do not know the importance and principles of the pulses.
The aim of pulse diagnosis, like the other methods of diagnosis, has always been to obtain useful information about what goes on inside the body, what has caused disease, what might be done to rectify the problem, and what are the chances of success. According to Eastern theory, the pulse can reveal whether a syndrome is of a hot or cold nature, whether it is of excess or deficiency type, which of the humors (qi, moisture, blood) are affected, and which organ systems are suffering from the dysfunction. In order to make these determinations, the physician must feel the pulse under proper conditions, while following established procedures, and must then translate the unique pulse that is felt into one or more of the categories of pulse form.
The most standard iconography involves 24 different pulse forms, include 15 Primary pulses and 9 Extraordinary pulses. The 15 Primary pulses are matched with the five elements and three components by their characteristics. The 9 Extraordinary pulses are matched with the eight trigrams and nine palaces by their characteristics.
15 Primary pulses
Wood pulses: Wiry (heaven), Tight (human), Hidden (earth)
Fire pulses: Hollow (heaven), Overflowing (human), Full (earth)
Earth pulses: Minute (heaven), Slowed-down (human), Slow (earth)
Metal pulses: Floating (heaven), Weak (human), Choppy (earth)
Water pulses: Soft (heaven), Slippery (human), Deep (earth)
9 Extraordinary pulses
Heaven (Long) - Earth (short)
Lake (Knotted) - Mountain (Moving)
Fire (Empty) - Water (Abrupt)
Thunder (Leather) - Wind (Fine)
Feeling the pulse at each of the individual positions on the wrists is necessary to assess the condition of each of the internal organs. However, the association of individual pulse positions with internal organs has changed over time and varies from one traditional system to another. The current understanding is that the left wrist presents information for the heart, liver, and kidney yin, while the right wrist presents information for the lung, spleen, and kidney yang. This classification is consistent with the five element system that depicts five basic viscera; the kidney is subdivided to make the sixth. However, one can alternatively incorporate the pericardium/triple burner system in place of the kidney yang pulse.
Pulse diagnosis is one method of determining the internal conditions of patients with the aim of deciding upon a therapeutic regimen. In order to make use of this diagnostic, the practitioner must learn the proper method of taking the pulse, the factors that influence the pulse, and the categories into which each patient's unique pulse form can be fit. Practitioners must remain especially alert to new factors that influence the pulse readings so as to assure that the results of pulse taking are meaningful.
Most authorities agree that in the modern era one must be able to detect a relatively limited basic group of pulse forms in order to utilize the information for devising a therapy (i.e., acupuncture, herbs). These requisite forms determine whether the focus of the pathological process is at the body's surface or interior, is of a hot or cold nature, or is of an excess or deficiency type. There have been recent attempts to broaden the scope of pulse diagnosis; for example, feeling the pulses immediately after insertion of acupuncture needles has been suggested recently as a means of determining whether the "qi has arrived" as a result of correct point selection and needle manipulation. Pulse diagnosis remains an important part of the practice of traditional Oriental medicine that is still being explored and developed. In conclusion, Pulse diagnosis adds critical information that can greatly alter the treatment strategy, and therefore, practitioners should master Pulse diagnosis because it is an essential part of traditional Oriental medicine.