Pulse-taking includes three methods: acupuncturing, welcoming guests and Zhang Zhongjing. Now it is often used to jog. The pulse diagnosis site is the inside of the wrist, next to the high bone (styloid process of radius) behind the wrist, where the radial artery beats. The pulse position of radial artery corresponding to high bone is off, before off, inch and after off. The name of "Cungui" was first seen in Neijing, and the "Cunkou Diagnosis Method" was developed in the difficult classics. Inch, Guan and Chi correspond to different viscera respectively. The left hand inch corresponds to the heart, Guan corresponds to the liver, and Qi corresponds to the kidney (kidney water). The inch of the right hand corresponds to the lung, the Guan corresponds to the spleen, and the ruler corresponds to the kidney (life gate).
Holism and syndrome differentiation are two concepts in the basic theory of traditional Chinese medicine. Traditional Chinese medicine is a combination of observation, hearing, questioning and palpation, and it is not appropriate to diagnose and treat diseases as a whole with only one diagnostic method. The information of human body is not only reflected in pulse condition, but also in skin surface, sound, smell and so on. It's just that the pulse condition is single and incomplete, which is easy to produce errors. Each of the four diagnostic methods has its own characteristics and unique functions. Pulse diagnosis can not replace other diagnostic methods, but should combine the four diagnosis methods to improve the accuracy of diagnosis.
Common disease pulse
The pulse condition of a healthy person should be four breaths at a time. There are pulses in three parts of the inch gauge, not floating or sinking, gentle and powerful, and the pulse of the foot gauge should be strong. Common pulse diseases include floating pulse, sinking pulse, late pulse, multiple pulse, deficiency pulse, solid pulse, slippery pulse, extensive pulse, thin pulse and chord pulse.
Floating pulse: press lightly to get it, then press again to decrease it. It is characterized by superficial pulse position. Main symptoms: Exterior syndrome is characterized by exterior pulse position because exogenous pathogenic factors stay in exterior, and defensive qi does not invade pathogenic factors, so that pulse qi is excited externally. Strong floating is the real thing; Floating without strength is superficial. Long-term internal injuries are caused by deficiency of yin and blood, deficiency of yang, yang deficiency floating outward and weak pulse.
Sinking pulse: you can't press it lightly, just press it again. It is characterized by deep pulse position. Main symptoms: interior syndrome. Strength is the inner reality, and weakness is the inner weakness. Pathogenic qi is depressed inside, qi and blood block yang, and the pulse is heavy and powerful. Visceral weakness, yang deficiency and qi stagnation, rapid pulse weak gas, weak pulse.
Late pulse: slow pulse, (less than 60 pulses per minute). Main symptoms: cold syndrome. Strong is cold, weak is cold. Cold is depressed, qi and blood move slowly, and the pulse is slow and strong, which is the syndrome of excess cold. Deficiency of Yang Qi, inability of qi and blood to move, and slow and weak pulse are the syndromes of deficiency and cold. Athletes and heavy manual workers often have a late pulse, which is a physiological state.
Pulse count: rapid pulse, (pulse is more than 90 times per minute). Its characteristic is that the pulse is faster than the normal pulse. Main symptoms: heat syndrome. Strong is excess heat, weak is deficiency heat. Exogenous fever starts at the beginning, viscera is full of heat, pathogenic heat is stimulated, blood circulation is accelerated, and strong pulse is excess heat. Blood deficiency, body fluid deficiency, blood deficiency, endogenous deficiency heat, pulse number and weakness are deficiency heat.
Deficiency pulse: all three pulses are weak. Press empty again. It should mean softness, which is the general term for all weak veins. Main symptoms: deficiency syndrome: mostly due to deficiency of both qi and blood, the pulse condition is difficult to stimulate, so it is deficiency.
True pulse: All three pulses are powerful. Main symptoms: empirical evidence: pathogenic qi is abundant and healthy qi is sufficient, and both positive and evil are contending, and qi and blood are full of pulse.
Slippery pulse: it should mean smooth, smooth pressing, as smooth as pressing a ball. Main symptoms: phlegm, indigestion and excess heat, which are more common in young people with deficiency of both qi and blood. The slippery pulse of pregnant women is a phenomenon of vigorous qi and blood to raise the fetus. They are all physiological phenomena.
Hong pulse: The pulse is large and powerful, like a rough wave, one after another. Come and grow. Main symptoms: excess heat. The internal heat is strong, the pulse channels are dilated and the pulse shape is wide. Due to excessive heat, pathogenic factors are blazing, qi and blood are full, and pulse conditions are fluctuating.
Pulse: the pulse is as thin as a line, with obvious fluctuation. Main symptoms: deficiency syndrome, mostly seen in yin deficiency and blood deficiency syndrome. It also controls wet diseases. Yin deficiency and blood deficiency can't fill the pulse, or wet evil can't fill the pulse, and the pulse is small.
Chord pulse: the end is straight and long, pointing down quite suddenly, such as pressing a chord. Treat hepatobiliary diseases, pain syndrome and phlegm. The qi is unfavorable, the liver loses the function of dispersing qi, and the pulse is tense and shows a string pulse. When the patient is sick, qi disorder or phlegm stops, which will lead to poor conduction of qi and string pulse.
Pulse knot: slow pulse and irregular interval. Main diseases: yin deficiency and qi stagnation, cold phlegm and blood stasis. Analysis: Yin cold is the internal knot, and the qi of the pulse channel is blocked, so the pulse comes slowly and stops for a while. Cold phlegm and blood stasis, qi stagnation, stagnation of pulse qi, therefore, if the pulse stops late due to qi deficiency and weak blood, it is weak.
Pulse generation: the pulse has a rest and a fixed number. Main disease: Decline of dirty qi. Analysis: the dirty qi is weak, the vitality is insufficient, and the pulse is blocked.
Normal pulse condition
Normal pulse, also known as flat pulse and normal pulse. The regular pulse condition has three pulses, one breath and four pulses (70-80 pulses per minute earlier), neither floating nor sinking, neither too big nor too small, with even rhythm, calm and gentle, smooth and powerful, and inexhaustible pulse. It's called having a stomach, spirit and roots. Among them, there is stomach, that is, there is stomach qi, and the pulse is gentle, calm, smooth and energetic; God means that the pulse should be strong and soft, and the rhythm should be neat; Have roots. The main manifestation is endless ulnar pulse.
In addition, the pulse condition is closely related to the internal and external environment. Due to the influence of climate, age, sex, physique, rest and mental state, pulse conditions will also undergo some physiological changes. For example, throughout the year, the pulse condition has the changes of spring string, summer flooding, autumn floating and winter sinking; The younger the age, the faster the pulse; Baby's pulse is fast, young adults' pulse is strong, old people's pulse is slightly string, and women's pulse is weak and slightly faster than men's. The fat contact is slightly heavier and the thin contact is slightly floating; After work, the pulse is fast and strong when drinking, full or emotional, and weak when hungry; The pulse of mental workers is much weaker than that of manual workers These should be distinguished from the pulse of the disease. In addition, the radial artery of a few people is abnormal, and there is no pulse at the mouth of the inch. If it appears behind the cunkou, it is called "anti-Guan pulse"; Some are inclined from the foot to the back of the hand, which is called "oblique flying pulse". This is not a disease. 1. Look at the quality of the tongue (1) Lingual spirit: Lingual spirit is mainly manifested in the glory and agility of the tongue. The key to studying the tongue is to distinguish between prosperity and decline. Noble people are radiant, characterized by flexible tongue movement, ruddy tongue color, bright luster and vitality, which shows that there is a god, even if he is sick, the weather is good. The dry person is dull, which is characterized by poor tongue movement and dry tongue quality, indicating that there is no god, which is dangerous and bad weather. It can be seen that the existence of tongue spirit reflects the ups and downs of viscera, qi, blood and body fluid, which is related to the prognosis of the disease. (2) Tongue color: color, that is, the color of the tongue. Generally, it can be divided into light white, light red, red, crimson, purple and cyan. Except for reddish, which is a normal tongue color, the rest are major diseases. Pale red tongue: the tongue is white and reddish, not deep or shallow, and moderately reddish. This is the expression of qi and blood, indicating that the heart is full and the yang is distributed, so it is a normal tongue color. Pale white tongue: the color of the tongue is lighter than that of reddish tongue, or even completely bloodless, which is called pale white tongue. Because yang deficiency reduces the function of biochemical yin and blood, and the power of promoting blood circulation is also weakened, so that blood can not run in the tongue, so the tongue color is pale and white. Therefore, this tongue governs deficiency-cold or deficiency of both qi and blood. Red tongue: the color of the tongue is bright red, which is deeper than the reddish tongue, so it is called red tongue. Because of intense heat, boiling qi and blood, and full tongue pulse, the tongue is bright red, so it is the main heat syndrome. Visible in the empirical evidence, or deficiency-heat syndrome. Crimson tongue: crimson is crimson, darker and thicker than red tongue. It's called crimson tongue The main diseases can be divided into exogenous diseases and internal injuries. Exogenous disease is heat entering the blood. Miscellaneous diseases caused by internal injuries are all due to yin deficiency and excessive fire. Purple tongue: purple tongue is always caused by poor blood circulation and blood stasis. Therefore, the purple tongue governs the disease, which is nothing more than cold and heat. Excess heat impairs body fluid, and qi and blood stagnate, which is mostly manifested as crimson dryness and insufficient body fluid. Cold coagulation and blood stasis or yang deficiency lead to a cold, and the tongue is pale purple or blue and moist. Bluetongue disease: the tongue is like the "blue veins" of exposed skin, and there is no red at all, which is called bluetongue disease. Ancient books describe it as the tongue of a buffalo. Because yin cold is strong, yang is depressed, and blood coagulation is stagnant, the tongue is blue. Main cold congeals yang depression, or yang deficiency congeals cold, or there is blood stasis inside. (3) Tongue shape: refers to the shape of the tongue body, including old and tender, fat and thin, expansion and contraction, cracks, burrs, tooth marks and other abnormal changes. Old tongue: the tongue is rough and solid, which is called old tongue. No matter what the color of the tongue is, the old tongue belongs to an empirical study. Delicate tongue: the tongue is delicate in quality, delicate in color and plump in shape, which is called delicate tongue and lacking in many subjects. Swelling tongue: divided into fat and swollen. The tongue body is larger than the normal tongue, and even the tongue is covered with oral cavity or tooth marks, which is called fat tongue. The tongue is swollen, full of mouth and can't be closed, which is called swollen tongue and fat tongue. Most of them are caused by phlegm-dampness block caused by drinking water. Tongue swelling is mostly caused by stagnation of qi and blood due to heat toxicity and alcoholism, which leads to swelling of the tongue, and is mainly used for heat syndrome or toxic syndrome. Thin and thin: a thin and thin tongue is called a thin and thin tongue. It is always caused by deficiency of qi, blood and yin that cannot fill the tongue. Dominate deficiency of both qi and blood or fire flourishing due to yin deficiency. Thorn: It is normal to have soft thorn on the tongue surface (that is, the nipple of the tongue). If the soft thorns on the tongue surface increase and rise to the same height as the thorns, it is called a barbed tongue. Most of them are caused by excessive pathogenic heat. The more thorns, the more pathogenic heat. According to the place where the tingling occurs, it can be distinguished that the heat in the five internal organs, such as the tingling on the tip of the tongue, is mostly caused by excessive heart fire; There are thorns on the tongue side, mostly liver and gallbladder fire; There are thorns in the tongue, which dominate gastrointestinal heat. Crack: there is a crack on the tongue surface, but there is no tongue coating in the crack, which is called cracked tongue. Most of them are caused by blood loss, body fluid injury and tongue dystrophy. So many experts have lost blood. In addition, it is about 0 in healthy people. 5% people have deep longitudinal and transverse grooves on the tongue surface, which is called congenital cleft lip and palate. Most cracks are covered with tongue coating and there is no other discomfort in the body, which is different from cracked tongue. Tooth marks: there are traces of tooth marks on the edge of the tongue body, so it is called tooth-marked tongue. Its etiology is mostly due to spleen deficiency, which can not be too wet, so that the temperature is blocked by the tongue, and the fat of the tongue is squeezed by the dentition to form tooth marks. Therefore, tooth marks are more common in the fat and tender tongue, which is mainly caused by spleen deficiency or dampness. (4) Tongue state: refers to the state when the tongue body moves. The normal tongue picture state is flexible tongue body activity, and the pathological tongue picture state is tough, weak, vertical, short, paralyzed, trembling, crooked, vomiting and so on. Toughness: the tongue is hard and hard, and its movements are ineffective, resulting in unclear language, which is called tough tongue. Most of them are caused by heat disturbing the mind, uncontrollable tongue, or yin injury caused by high fever, nutrient loss of tendons and veins, or phlegm blocking tongue collaterals. It is more common in pericardium invasion by heat, body fluid injury by high fever, phlegm and blood stasis, stroke or stroke omen. Weakness: the tongue is weak and cannot bend and stretch, which is called flaccid soft tongue. Most of them are caused by deficiency of qi and blood, and yin fluid does not nourish tendons and veins. Visible in the deficiency of both qi and blood, heat burning and body fluid injury, extreme yin deficiency and other syndromes. Tongue lengthways: The tongue sticks out of the mouth, and it is difficult or impossible to retract, which is called tongue lengthways. It is always caused by the relaxation of tongue muscles. It can be seen in excess heat, phlegm-fire disturbing the heart and qi deficiency syndrome. Shortening: the tongue body contracts and cannot be extended, which is called short tongue. Contraction can be caused by cold coagulation of tendons and veins and contraction of tongue; Internal resistance of phlegm-dampness induces liver wind, wind evil carries phlegm and blocks the root of tongue; Excessive heat injures body fluids and narrows the tendons; Deficiency of both qi and blood, loss of nourishing temperature of tongue. Whether due to deficiency or excess, it is a critical symptom. Paralysis: Paralysis of the tongue is caused by numbness and ineffective exercise. Most of them are caused by blood not getting to the tongue. If the tongue is numb for no reason, it is heart-blood deficiency; If the tongue is numb and vibrates from time to time, or has symptoms of stroke, it is a syndrome of liver wind moving internally. Trembling: the tongue vibrates and cannot move autonomously, which is called tongue vibration. Most of them are caused by deficiency of both qi and blood, dystrophy of tendons and veins, or extreme heat injury to body fluids. It can be seen in the syndrome of blood deficiency leading to wind and extreme heat leading to wind. Skew: the tongue extends to one side and the tongue body is not straight, which is called skew tongue. Most of them are caused by wind evil in collaterals, or wind phlegm blocking collaterals, and some of them are caused by wind evil in zang-fu organs. However, due to the obstruction of meridians and veins on one side and the relaxation of tongue muscles on the diseased side, they always tend to lean towards the healthy side. More common in stroke syndrome or stroke aura. Spit out the tongue: those who often stick out of the mouth are "spit out the tongue"; If the tongue does not stop licking the upper, lower, left and right lips, or if the tongue sticks out of the mouth slightly, it will be withdrawn immediately. This is called "getting the tongue". Both of these diseases are called tongue spitting, which are caused by internal heat of the heart and spleen, burning body fluids, tightening the tendons and veins, and frequent shaking. Tongue distortion is common in children with mental retardation. 2. The tongue coating of Wang's tongue coating is steamed by stomach qi, so the rise and fall of stomach qi can be reflected from the change of tongue bitterness. The formation of pathological tongue coating is caused by the rising of turbid qi in the stomach and food stagnation; One is the rise of evil spirits. When looking at tongue coating, we should pay attention to the changes of coating quality and coating color. Quality of tongue coating: Quality of tongue coating refers to the shape and quality of tongue coating. Including the thickness of bitter tongue, moist, rough and sticky, greasy, peeling, rooted and rootless. Thickness: The thickness is based on "bottoming out" and "bottomless". The place where the quality of the tongue is faintly visible through the coating of the tongue is the bottom, that is, the thin coating. Born of stomach qi, it belongs to normal tongue coating, which is common in this disease, mostly due to pathogenic factors at the early stage of onset or on the surface, and the condition is mild. If you can't see the tongue through the tongue coating, it is bottomless and thick coating. Most of them are pathogenic factors, or gastrointestinal stagnation, and the condition is serious. The tongue coating is thin and thick, mostly positive and invincible, and the pathogenic factors from the outside to the inside, and the condition changes from light to heavy, which is the performance of the disease development; The tongue coating turned from thick to thin, mostly due to the return of healthy qi, the evil of internal depression was dissipated, and the condition turned from heavy to light, and the condition subsided. Moistening: The tongue surface is moist, with moderate dryness and wetness, which is moistening the fur. Indicates that the body fluid is not injured; If there is too much water, it will be slippery, and even the tongue will drip. This is slippery moss. It is a reflection of dampness and cold, which is more common in the syndrome of yang deficiency and phlegm. If hope dries up. There is no body fluid in ammonia, which is caused by dry moss and body fluid can't be carried out. It is more common in syndromes such as heat hurting body fluid, yin deficiency, yang deficiency and water insoluble body fluid, and dryness hurting lung. Tongue coating turns from moistening to dryness, mostly because dryness hurts body fluid, or heat consumes a lot of body fluid, indicating that the condition is aggravated; Bitter tongue turns from dryness to moistening, mostly due to dryness and heat, and body fluid gradually recovers, indicating that the condition has improved. Rotten and greasy: thick coating with coarse and loose particles, like bean curd residue accumulated on the tongue surface, can be wiped off, called "rotten coating". Due to excessive yang heat in the body, turbid qi in the transpiration stomach overflows, which is common in phlegm and food retention, and has the syndrome of gastrointestinal stagnation. Moss particles are so fine that they can't be wiped off or scraped off. The upper mask is covered with a different layer of greasy mucus, which is called "greasy fur", which is caused by the stagnation of spleen and the suppression of yang by yin evil. More common in phlegm and dampness. Exfoliation: The patient's tongue was originally covered with moss, and suddenly all or part of it fell off, and the falling place bottomed out, which is called exfoliative moss. If it is completely peeled off, it will not grow new moss, and it is as smooth as a mirror, which is called mirror tongue and sliding tongue. It is caused by stomach yin failure, severe stomach qi injury and no hair-generating qi. No matter what color it is, it belongs to the danger that stomach qi will run out. If the tongue coating is not completely peeled off, the peeling place is smooth and the residual spots are mottled, which is called flower peeling, which is caused by both stomach qi and yin injuries. Tongue coating from existence to absence is a manifestation of deficiency of both stomach qi and yin and gradual decline of healthy qi; However, after the tongue coating is peeled off, the thin and white coating will revive, which is a good sign that the evil can be overcome and the stomach qi will gradually recover. It is worth noting that no matter whether the tongue coating is long or light, it is better to change gradually. If the tongue coating suddenly grows back, it is mostly a sign of mutation. Rooted moss and rootless moss: regardless of the thickness of the moss, if it is close to the surface of the tongue, it seems that people born from the tongue have roots, which is also called true moss; If the moss is untrue, it seems to float on the tongue and scrape off. If it is not born on the tongue, it is called rootless moss, also called false moss. Root coating shows that although pathogenic factors are abundant, stomach qi is not declining; No root coating means that the stomach qi has failed. In short, by observing the thickness of tongue coating, we can see the depth of the disease; The moistening of tongue coating can distinguish the profit and loss of body fluid; The tongue coating is greasy and can be seen as wet and turbid; Tongue coating shedding, rooting and rootlessness can show the rise and fall of qi and yin and the development trend of diseases. (2) coating color: coating color, that is, the color of tongue coating. Generally, it can be divided into four categories: white hair, yellow bitter, gray black and color change, because the color of fur is related to the nature of disease and evil. Therefore, observing the color of fur can understand the nature of the disease. (1) White fur: generally common in exterior syndrome and cold syndrome. Because exogenous pathogens have not spread, the tongue coating often has no obvious change, and it is still a normal thin white coating. If the tongue is pale and the coating is white and wet, it is often cold syndrome or cold-dampness syndrome. But under special circumstances, white fur also treats heat syndrome. If the tongue coating is white, if there is white powder accumulation, it will not dry, because "accumulated powder coating" is caused by dirty gas outside and toxic heat inside. Common in febrile diseases or carbuncle. Another example is that the fur is white, dry, cracked like gravel and rough, which is called "rough hair". All of them are caused by rapid transformation of heat due to dampness, sudden fire and sudden injury of body fluid. The fur is not yellow, and the internal heat is blazing, which is common in fever or taking warm tonics by mistake. (2) Yellow coating: general interior syndrome and heat syndrome. The yellow fur is due to evil heat. Light yellow heat, heavy dark yellow heat, scorching heat junction. Exogenous disease, the fur turns from white to yellow, is a sign that the exterior evil enters the interior and turns into heat. If the moss is thin and yellow, it is exogenous wind-heat exterior syndrome or wind-cold heat. Or the tongue is light, fat and tender, and the fur is yellow and slippery, which is mostly caused by yang deficiency and water dampness. (3) Gray moss: The gray moss is light black. Often transformed from the dullness of white fur, it can also be seen with yellow fur. Interior syndrome is common in internal heat syndrome and cold-heat syndrome. The fur is gray and dry, mostly caused by excessive heat, which can be seen as exogenous fever or fire due to yin deficiency. Common in internal injuries and diseases. The fur is gray and moist, which can be seen in phlegm and turbidity, or cold and dampness. (4) Black coating: Black coating is mostly developed from burnt yellow coating or gray coating. Generally speaking, regardless of cold and heat, the main symptoms are critical. The darker the moss, the more serious the disease. If the moss is black and dry, it will even produce thorns, which is extremely hot and dry; Black and dry fur, seen in the tongue, is a sign of intestinal dryness, otherwise the stomach will be destroyed; Seen at the base of the tongue, the lower jiao is very hot; What was found on the tip of the tongue was a heart fire burn; The fur is black and slippery, and the tongue is pale and white, which is yin cold and the water is not wet; The black and sticky fur is caused by phlegm-dampness blocking collaterals. 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