脈 診 道

TAOIST MEDICINE Insights into Pulse Diagnosis
DAVID MAINENTI, L.AC., DIPL. O.M.
                   

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Pulsing Inspirations1
In the Daoist arts, truth blossoms forth like the Lotus, resembling the sun in that at certain times during the year, clouds block the way of the light, bringing darkness to the surroundings. Fortunately, it can never stay that way forever. As it pertains to Heavenly Master 天師 needling techniques and the meditational form of the Ba Duan Jin 八段錦 or Eight Silken Forms, truth manifests through the great history of the Chinese people; that is why Daoist medical doctors treat both the twelve (12) main meridians (external) along with the eight (8) spiritual meridians (internal), in accordance with Stem and Branch correspondences to harmonize man with nature. Such sages have performed so much research that they could open the Huang Di Nei Jing 黃帝内經 like it was their own palm. A common link among such divine people is that each of them had a deep understanding of the movement of Qi 氣 inside the body as it proceeds through the musical instrument we call the meridian system. By learning how internal and external factors can affect the rhythm of the Six Healing Sounds, these sages invented Pulse Theory to determine the status of the human condition as it moves through the Cycles of Nature. Thus, a true practitioner of Chinese medicine can easily recognize the presence of a pregnant pulse: strong beats, sometimes slippery, with an underlying, small off-beat in between the three pulse positions on the wrist. To pinpoint the pregnancy diagnosis, one must also learn how to take the Shao Yin 少陰 pulse of the ankle to measure the quality of the uterus through its dominating organ, the Kidney 腎. When taking the pulse, one can simply measure the quality of Qi 氣, or one can take it a step further and turn it into Qi Gong 氣功 therapy by sending energy into the patient through one’s
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Dr. Chang Yi Hsiang. David C. Mainenti, ed. “Integrating Sounds and Forms, Part III.” Tai Hsuan Foundation. Daoist Medicine. Lecture. Spring 2002. 3

extremities (e.g., the fingertips). As one learns how to channel energy in meditation through the fingertips, one will eventually become able to adjust the flow of Qi 氣 as it moves through the meridians, restoring harmony to the body using methods employed by Bian Que 扁 鵲 (right), the ancient Chinese doctor who created the Song of the 28 Pulses prior to the 1st century A.D. As one can see from the details on each of the twenty-eight rhythms, taking the pulse is a Qi Gong 氣功 therapy that was derived from the secret methodology contained within Taoist meditation forms. Thus, whereas an X-ray or MRI does little to promote health, Daoist medical measurement techniques restore life through the method of sending Qi 氣 through the extremities, which are responsible for gathering the Yuan Qi 原氣 from nature, being specifically positioned at the location where internal and external realities merge together and interplay with one another. After the methods of Qi Gong 氣 功 are mastered, one can diagnose simply by reviewing the color of the aura that exists in the palm. A true Daoist healer knows that the palm color can change, much like the movement in the vessels can change in rhythm over time. The question, therefore, is how to make the movement of energy change in such a way so as to lead it into harmony and balance. The secret lies in how one moderates the activity between one’s internal and external environment, which happens to take place at one location throughout the body: at the extremities. To learn the proper art of measuring the pulse, one must begin by
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analyzing the part of the hands that are affected by this integration the most (e.g., the fingertips, which contain the Jing well points), which are, ironically enough, used to measure the pulse on patients. As in meditation, changes that affect the color of the tip of the center finger can change the thought process of an individual, due to its correspondence with the Kidney 腎, which is the residence of the Zhi 志. The Zhi 志 is sometimes called Will or the “Power to Make Things Happen;” being a spiritual component of the body that is closely associated with the Sea of Marrow 髓海, it is so powerful that it is capable of changing the quality of a patient’s energy through the thought alone. Thus, it is often said that it is during Part III that one can allow problems to disappear by pushing them outside the limits established by the body’s extremities. It is interesting to note that when the tip of the middle finger (employed in meditation to focus the Spirit 神) is used to measure the pulse, hard pressure determines the Liver 肝 (left) and Spleen 脾 (right) qualities, while light pressure indicates Gallbladder 膽 (left) and Stomach 胃 (right) levels. As a result, when Qi Gong 氣功 is applied through the use of the center finger when taking the pulse, it can treat conditions relating to stress such as ulcers, weight gain, and high blood pressure. This is because the middle finger is the extremity used to manage disease; it is also useful when one needs to adjust the appetite in order to assist with the breakdown of sugars, treating many conditions including Stomach Yin Deficiency 胃陰虛, Liver Yin Deficiency 肝陰虛, Stomach Fire 胃火, Liver Fire 肝火, and Spleen Dampness 脾濕. The question one must ask at this point is why the center finger is able to perform such amazing tasks, considering that it has so few clinical TCM uses. The first concept that must be determined is how the Liver 肝 and Spleen 脾 both associate with the Kidney 腎 at the center tip of the

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middle finger (Zhong Chong 中衝 (PC-9)). By looking deeper, an obvious connection between the three Yin 陰 meridians of the leg emerges, comprised of the Liver 肝 (Jue Yin 厥陰), Spleen 脾 (Tai Yin 太陰陰), and Kidney 腎 (Shao Yin 少陰). It is through these three meridians that Yin 陰 is distributed throughout the body as it penetrates upwards from the Earth into the construct of the human body. By rooting downward, a pumping action is created whereby primal energy can move up these three meridians to meet at Guan Yuan 關元, which coincidently happens to be the Mu 募/Alarm point of the Small Intestine 小腸, which belongs to the element of Fire and, in the cycle of Qi 氣 , represents the connection between the Water and Fire elements of the Shao Yin 少陰. Combine this idea with the fact that Fire exists between the Wood (Liver 肝) and Earth (Spleen 脾) elements in the generation cycle of transformation and the idea of a sixth Zang 賍 meridian, acting as Minister of the Interior, emerges to explain how the Pericardium 心包 acts, via the Yin Wei Mai 陰維脈, to connect the entire Yin 陰 of the body. By providing the root of Yin 陰 energy, it naturally pairs with the Triple Burner 三焦, reaching everything, including the Yuan Qi 原氣, through the Yang Wei Mai 陽維脈, which explains how something as Yin 陰 as the Heart (albeit residing in the upper burner) could house something as subtle as the Shen 神. The secret lies in the fact that two Fire pairs exist for a single element; this is why the confluent point of the Yin Wei Mai 陰維脈 is Nei Guan 内 關 (PC-6), the Luo 絡 /Connecting point of the Pericardium 心包 (which connects with the Liver 肝 via the Jue Yin 厥陰 as a means of storing and circulating blood, connecting with the Hun 魂), and why it must lie directly opposite to Wai Guan 外關 (TB-5), the Luo 絡 connecting point of the Triple Burner; it also explains why that point would be used clinically to treat disorders of the spirit. Thus, it is the tip of the center finger, the Jing 井/Well
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point of the Minister of the Interior, is where the Spirit 神 dwells as it pertains to its external nature; the upper body cannot extend itself further. What is interesting to note is that Lao Gong 勞宮 is the exit point of the channel; thus Zhong Chong 中衝 represents a rushing (沖) well, corresponding to the Wood element, which lies between the Water and Fire elements in the cycle of the Five Elements. This is a place where internal and external worlds merge together at the extremity of the physical aura (e.g., the energy that only extends out with the physical body), representing a primordial thoroughfare (Chong 衝) that runs through a centrally located, strategic point. By studying classical texts as a Daoist scholar and learning about the history of the Chinese people, one can learn why all the correspondences exist, what the different pulse positions mean, and other interesting phenomena. However, through the proper cultivation of the body (Tiao Shen 調身) as a musical instrument to be used for spiritual cultivation and healing, one can learn how to read energetic patterns by merging the Qi 氣 field around the tip of one’s center finger with the aura that surrounds the Guan 關 position on the wrist pulse. By harmonizing these two Qi 氣 fields, one can heal by talking the pulse; this method can also be applied to other pulse positions located throughout the body, such as the register surrounding Bai Hui 百會, the neck (Ren Ying 人 迎), the chest (Shan Zhong 膻中), the lower abdomen (Dan Tian 丹 田), and the ankles (Tai Xi 太谿). It is wise to take the pulse at a number of specific positions before confirming the diagnosis with the wrist pulse and the tongue. When meditating, one must learn how the Wei Qi 衛氣 and Ying Qi 營氣 circulates through the entire body before reuniting at the wrist, enveloping the body in a protective aura of circulating energy.

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When a practitioner meditates and focuses on the breath, pondering the circulation of Qi 氣, one cannot help but notice the pulsating sensation that exists in the tip of the center finger. One must allow this Qi 氣 field at Zhong Chong 中衝 to sink back and down into Lao Gong 勞宮 before rushing through Nei Guan 内關 to both Qu Ze 曲澤 (PC-3) and Qu Chi 曲池 (LI-11), the He 合/Sea points of the Pericardium 心包 and Large Intestine 大暢 meridians, before merging upwards to Bi Nao 臂臑 (LI-14), the root point of the Large Intestine 大暢 channel and a meeting point of the Yang Wei Mai 陽維脈. From Bi Nao 臂臑, energy flows up and across to Shu Fu 俞府 before going deep into the interior layers of the body, connecting down to the Dan Tian 丹田 before moving up the spine and into the brain, completing the ‘reversion method.’ This is the secret practice of Taoist meditation. Once one has mastered this flow, the body is nourished and is ready to move from the inside outward, beginning in the brain at the Ni Wan Gong 泥丸宮, where the reversal of Water (Kan 坎) and Fire (Li 離) completes its journey. From here, energy moves down to the head of the Dragon 龍 at Ren Zhong 人中 (DU-26) before descending to the tip of the tongue, moving up and down upon inhalation and exhalation, merging Dragon 龍 (Du Mai 督脈) with Tiger 虎 (Ren Mai 任脈). Then send the self down to the center of the chest inside Shan Zhong 膻中, the Huang Ting Gong 黃亭宮; this palace then looks down to the Ming Men 明門 and the Shen Que Gong 神闕宮, representing the altar of the body. At this point, the energy descends into the core root, the Dan Tian 丹田, located inside from Guan Yuan 關元 at the Jiu Chiu Gong, the Secret Palace of the Ancestors. In Ling Gui Ba Fa 靈龜八法 spiritual acupuncture, this palace just so happens to correspond to Nei Guan 内關 (PC-6), which is the return of the circulation back to its source at Zhong Chong 中衝.
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Through cosmic integration with nature, the ancient sages learned that the body, when cultivated in the image of the Ling Zhi 靈芝, grows like a gigantic Pine 松 tree, extending out into the universe through its extremities, reaching upwards by virtue of its nature of rooting downward. Behind it all is the pulsating energy that flows through the physical body, connecting various components of Yin 陰 with Yang 陽.

Diagnostic Precision2
When attempting to regulate something as ethereal as Qi 氣, one must remember that Daoist Medicine is based on classical texts written over 3,000 years ago. Therefore, begin as a scholar to develop the knowledge necessary to be a good practitioner of Traditional Chinese Medicine; one must especially learn how to decipher the classical medical terminology as written by the Chinese sages of long ago. By learning the poetic style of mathematic precision used at the time the medicine was formally conceived, one can truly see into the depths of wisdom necessary to formally lay out the foundation of this system of infinite correspondence. This is why entire texts were reserved for single topics such as the law of correspondences (Nan Jing 難經) and the measurement of Qi 氣 (Mai Jing 脈經), commonly referred to as the ‘taking of the pulse.’ Previously, we have discussed the importance of the healing well; when this energetic potential is combined with diagnostic ability, one can learn to go truly beyond in medicine, even to the point of healing incurable diseases. This is because the methodology behind Taoist meditation is also the foundation for the Huang Di Nei Jing 黃帝内 經 in that they are both rooted in the principles of the Yi Jing 易經.
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Dr. Chang Yi Hsiang. David C. Mainenti, ed. “The Great Pulse Classic.” Tai Hsuan Foundation. Daoist Medicine. Lecture. Spring 2002. 9

Thus, conceptual analysis of health and disease evolved through the development of history as it naturally unfolded in ancient China. In every ancient text, it is stated that one’s diagnostic capability (or the ability to measure the flow of the Qi 氣) is what determines the level of a practitioner. It is very important to understand that the better the diagnosis, the better the results will be. According to Bian Que 扁鵲, the first great Taoist medical practitioner, the proper measurement of the pulse is of great importance. This art is expounded upon in the Da Mai Lun 大脈論, which translates as ‘The Great Pulse Classic.’ It states that one must learn how to not only identify disharmonies in the pulse, but also how to directly regulate it through the application of Qi Gong 氣功. The Da Mai Lun 大 脈 論 states that there are twenty eight (28) ancient pulse rhythms, each corresponding to one of the twenty-eight constellations, which extend outward into the Four Directions to connect with the ebb and flow of energies in the universe. It is interesting to note how the rhythms of the pulse in ancient times were discovered to be in tune with the movement of the planets and stars. Thus, just how life events could be predicted through the art of Chinese astrology, one could also predict the course of health and disease in the microuniverse of the human body through an analysis of Qi 氣 as it moves through the various rhythms in nature. In later times, studies of the pulses increased and changes were made to the numerological system to take into account all the various theories that sprang up from commentaries on the classical texts, such as
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pulse discussions in the Nan Jing 難經, Mai Jing 脈經, and during the Ming Dynasty 明. Along with the twenty-eight qualities, there are four main pulses of the body, each corresponding to one of the Four Seas 四 海 , representing the ‘whole land.’ One of these four points is Ren Ying 人 迎 (ST-9), residing on the Yang Ming 陽 明 channel and corresponding to the Sea of Qi 氣海; up through modern times, this point has been considered to provide the most accurate reading. In ancient times, due to cold and custom, it was often difficult to take the pulse at this position; thus, a second area was discovered at the wrist between Tai Yuan 太 淵 and Lie Que 列 缺 , corresponding to the Tai Yin 太陰 and the Sea of Blood 血海. Amazingly it is the Lung that holds Tai Yuan 太淵, the influential point of the blood vessels, corresponding to the location where Qi 氣 (Wei 衛) and Blood 血 (Ying 營) merge together. A third pulse was also discovered at the ankle in Tai Xi 太谿, corresponding to the Shao Yin 少陰 and the Sea of Marrow 髓海. A fourth pulse also exists that connects the ‘whole land,’ representing the Sea of Water and Grains 水谷海: it resides in the lower Dan Tian 丹田. When taking the pulse at any of these locations, the proper method is for the practitioner to use their right hand on the patient’s left and vice versa. In this manner, Yin 陰 and Yang 陽 are crossed to provide for maximum energetic potency in polarity. If one uses the same-sided hand, it will be difficult to measure and transmit energy; therefore, if you take your own pulse, one must use the other hand and go around from underneath to invoke the same style as previously noted (right). The best way to learn how to properly measure the quality of Qi 氣 that flows through the pulse is to start by taking one’s own pulse, beginning at the wrist. Once comfortable at this location, one can branch out and learn to measure energy at other positions;
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ultimately, one will learn that there is a pulse at every point on the body. Just remember to begin measuring at the wrist, learning how to differentiate various qualities and rhythms before locating the neck and ankle pulses, which require more skill and mastery of the energy. However, the more you work with the Ren Ying 人迎 and Tai Xi 太谿 pulses, the easier it will be to master the pulse at Tai Yuan 太淵. By developing diagnostic accuracy through the pulse, one can go beyond Western diagnostics, even though each reading is so subjective in nature. If modern Taoist practitioners combine Eastern and Western diagnostic techniques together, blood work could be analyzed in terms of the twenty-eight qualities of the pulse and paired with a reading of the tongue to connect spirit 神 with form, providing a more ‘complete’ medicine to the community. From a clinical perspective, multiple pulse points are a necessary component to a complete Daoist Healer’s repertoire, especially with modern practices. For instance, the Heavenly Master 天師 had a female patient who had been trying to get pregnant, but to no avail. When her neck pulse was measured at Ren Ying 人迎, it was discovered that emptiness (Xu 虛) was everywhere. From the measurement of this pulse alone, the Heavenly Master 天 師 determined that there were two problems occurring simultaneously: the health of her eggs was an issue, as well as the levels of three female hormones, affecting the uterus and ovaries. To confirm her suspicions, the Heavenly Master 天師 referred the patient to a Western doctor for blood work to be performed, and the results confirmed her findings; therefore, it is important for TCM practitioners to gain the ability to order patient diagnostic testing. Although politics currently block this endeavor, the future of medicine will eventually become a combination of modern diagnostic procedures with natural medicines discovered by the sages of long ago. By combining technology with ancient

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methods, one will be able to lead the way in reinventing the medical profession to allow it to become a more complete system of health care. At Tai Xuan 太 玄 , the ancient heritage and Daoist teachings remain alive in the modern world; therefore, one can learn to take different pulses of the body, instead of simply at the wrist. There are also the pulses of the Nine Palaces 九宮, located at Bai Hui 百會, Er Men 耳門 (TB-21), Fu Tu 扶突 (LI-18), Xuan Ji 琁璣, Shan Zhong 膻中, Zhong Wan 中脘 (REN-12), Ming Men 明門, Guan Yuan 關元, and Zhong Ji 中極 (REN-3), from top to bottom. One must take pulses regularly at these locations in order to truly identify where disease and disharmony is located in each patient. Then, one can confirm the results with an analysis of the tongue and a measurement of the pulse at the wrist. Finally, as points are selected for needling, one can measure these energies and harmonize any imbalance prior to insertion of the needle.

Measuring the Land
Dan Tian 丹田/Sea of Water and Grains The Dan Tian 丹田 is a pulse that can be easily felt, residing in the center of the lower Jiao 下三焦. It is interesting to analyze the characters for Dan Tian 丹田; when interpreted together, they are a symbol of the pulsating nature of Qi 氣. The character Tian 田 is a square made up of four sub-squares, which comprise the four corners and thus the ‘whole land.’ Tian 田 represents the idea of having four areas of measurement; in the ancient times, these four squares represented the Four Seas 四 海 and their four corresponding pulses. The character Tian 田 also represents the manner in which a rice field is aligned, with the four corner directions symbolizing Earth.
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On the other hand, the character for Dan 丹 is more rounded; thus, it corresponds to Heaven. The original name of Tai Xuan 太玄 is Shan Dan Tian Liu Yi 山丹田六兿 or Lily Siou’s School of the Six Chinese Arts. Upon further review, the characters contain much more meaning than that. Shan represents the fact that the teaching of the Heavenly Masters 天師 extends back to Long Hu Shan 龍 虎 山 , ‘Dragon and Tiger Mountain,’ in Jiang Xi 江 西 province. Dan Tian 丹田 thus can be interpreted as an immortal elixir field, a gathering place for the primal energies of the universe. Liu 六 corresponds to the number six (6), which is one of the two primal numbers used in the Yi Jing 易經 to correspond with change, representing Earth to some extent but also representing the idea of moving from Yin 陰 (physical) to Yang 陽 (ethereal), which is the path to immortality. The character for arts represents the idea of creativity in that at Tai Xuan 太玄, one learns about many different subjects, each alive in nature. From a poetic perspective, one could read that in the tradition of the Heavenly Masters 天師, we learn how to make immortality pills, drifting like a Dragon 龍 in the clouds, a powerful, spiritual creature existing between Heaven and Earth. When studying the art of Chinese calligraphy (Shu 書), one is taught that characters can be written left to right, top to bottom, or in a square, like the school seal (image, left), which contains the four main characters noted above. When you practice writing a character, do not press down hard with the brush or it will be ruined; instead, one must flow in accordance with the Qi 氣 using the energy at Tai Yuan 太淵. In fact, one should stand when writing calligraphy in a manner similar to standing meditation, connecting Tai Xi 太谿 with the Dan Tian 丹田. If one presses too hard, the neck and shoulders will tense up; avoid this stress by allowing Ren Ying 人迎 to remain open, connecting with the divine energy through its
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correspondence as a point on the Window of Heaven. When these four Xue 穴 are activated and the Four Seas 四海 move smoothly, one will be able to write with flowing energy as the blood carries one’s internal expression to the pen and onto the rice paper. Thus, calligraphy is a natural expression of the four pulses and is the same creative process that is required of a practitioner when he or she attempts to regulate the rhythm of energy. Remember that although user-friendly Western diagnostic techniques have surpassed Eastern methods in terms of qualitative analysis, the ancient systems provide deeper insight into the complexities of human life. In the future, perhaps one will be able to combine calligraphic techniques of the pulse with sonograms to increase the diagnostic precision of pregnancies. When treating women, it is important not only to help them get pregnant (if that is what they wish), but also to detect pregnancies in general, as it brings about enormous change in a woman’s body, mind, and spirit. It is interesting that the uterus is a component of the lower Jiao 下三焦, commonly referred to as the Dan Tian 丹田. Thus, the determination of a pregnancy can be based on the measurement of the Dan Tian 丹田 pulse; simply place the thumb on Shen Que 神闕 and allow the small finger to naturally fall on Zhong Ji 中極. It is important to note that the positioning of each finger has a specific meaning, so be sure to quiet the mind and focus on feeling the energy. Generally speaking, there are two results within a pregnancy pulse that can signify problems: in the first case, the pulse will feel hard, elevated, and lumpy. This condition can usually be felt at a location 1” down and 1” across from Shen Que 神闕 in either direction, corresponding to the two ovaries. It is amazing to think that there were no biomedical diagnostic tools in ancient China, yet they were still able to diagnose disease with much the same results. If one uses the center of the index finger to push into these
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two locations below Shen Que 神闕, one will be able to determine if a tumor is present; furthermore, it determines if a pregnancy will be possible or not, given the current conditions inside the patient’s body. The second case one may have when reading the Dan Tian 丹田 pulse is a feeling of ‘sogginess,’ indicating Damp 濕 conditions inside the womb. Because of the importance of diagnosing female disorders both accurately and in a timely manner, one must practice these methods; be sure not to get discouraged, as OB/GYN skills require 15 years of practical clinical experience to train the hands to measure such complex Qi 氣 rhythms. Therefore, start simple and begin by analyzing the first thing you feel; from there, one can learn to measure the twenty-eight pulse qualities, which can then be used in the practice of Taoist meditation to regulate the circulation of Qi 氣. It is stated many times in the Da Mai Lun 大脈論 that one will improve in the art of pulse-taking after one feels the many different kinds of pulses on various types of patients. Instead of relying on external sources, use your intuition at first and palpate different areas of the body, like a detective searching for clues, ultimately combining all gathered data together to arrive at a comprehensive diagnosis. REN YING 人迎/SEA OF QI In emergency situations, there is one definitive place to verify whether the patient still has a pulse or not: Ren Ying 人迎. If one cannot feel a pulse at Ren Ying 人 迎 and the patient is unconscious, call 911 immediately. It is interesting to note the connection between Western medicine and the ancient traditions promulgated in the Huang Di Nei Jing 黃帝内經. Because Ren Ying 人 迎 resides in the upper third of the body, it corresponds to Heaven and Yang 陽; thus it represents a point on the Sea of Qi 氣

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海, which is Yang 陽 in nature. Remember that Taoist meditation begins at the Dan Tian 丹田 before proceeding up to the Zhong Lou Gong 衆 樓 宮 and the Sea of Qi 氣 海 at Ren Ying 人 迎 ; oftentimes, the neck is moved from side to side in meditation to stimulate the activity of this pulse point. It should be noted that Ren Ying 人迎 is contraindicated for needling. If one must put a needle in it, the point should be moved and adjusted up or down; to needle this point on an elderly patient, pull the energy up to the jawbone line near Jia Che 頰車 for it to become a safe place for insertion. The manipulation of a point’s location is useful whenever a forbidden point must be needled; simply move the Qi 氣 around and ‘go through the back door.’ Traditionally, the Ren Ying 人迎 pulse is taken while standing behind the patient; place the thumb on the opposite Ren Ying 人 迎 position (thus, if taking the pulse on the right side, place the thumb on the left Ren Ying 人迎 point) and turn the head slightly to find the Ren Ying 人迎 pulse on the right side using the tip of the center finger at Zhong Chong 中衝. Be careful in that the location of this point varies from patient to patient, so it may be higher or lower than expected. Remember that the thumb must be on the opposite side, and the pulse is felt with the middle finger of the same hand, ‘pinching’ the energy in a manner similar to Taoist Magic Finger meditation forms. Be sure to take this pulse on one’s own body to perfect this delicate procedure, as it is important to learn how to feel both sides of Ren Ying 人迎 simultaneously in order to gain the most accurate of readings. One can imagine that the neck is a big wrist that one must palpate on either side, turning the head slightly to stimulate the energetic frequencies. When first locating the point on the opposite side with the thumb, it corresponds to the center of the person and their Heavenly core (one thumb corresponds to odd and Yang 陽 ; four fingers

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correspond to even and Yin 陰). Thus, use the thumb to connect Yang 陽 with Yang 陽, activating the Window of Heaven, which is used to open up levels of consciousness. After feeling one side with the thumb, feel the other side with the center finger. Finally, measure the pulse of both points together; then one can measure the energetic frequency of the entire body landscape, as this point represents ‘Man’s Receptor.’ If a patient is losing blood very fast, Ren Ying 人迎 will feel rushing; this is because blood leaks out of the main artery that runs through this Xue 穴 (cave) on the body. TAI XI 太谿/SEA OF MARROW Once the energy has circulated out to the upper extremities, energy is digested back into the Dan Tian 丹田 before moving down the legs to Tai Xi 太谿, located on the medial and posterior aspect of each ankle. This point corresponds to the Shao Yin 少陰 and the Sea of Marrow 髓海. To measure the energy at this point, the practitioner should wrap their opposite hand around the ankle of the patient, placing the thumb on Tai Xi 太谿 and the center finger on Jie Xi 解谿 (ST-41). While positioned in front of the patient, place the center finger on Jie Xi 解谿; then, turn the ankle outward as the thumb comes down onto Tai Xi 太谿. One can also measure this pulse from behind, much the same as one takes the Tai Xi 太谿 pulse on one’s own ankle (see next page). This pulse represents the ‘true’ pulse of the body, measuring the foundation of Yin 陰 and Yang 陽 embodied within the Kidney 腎. Because the Kidney 腎 dominates the bones and marrow, this point is used to measure the energetic qualities of the Sea of Marrow 髓海, which extends up to the brain through the spinal cord. The better one can line up Jie Xi 解谿 and Tai Xi 太谿, the more accurate the pulse reading will be.

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TAI YUAN 太淵/SEA OF BLOOD After moving from below to above, the circulation of energy extends outwards to Tai Yuan 太淵 as one’s meditation progresses, corresponding to the radial aspects of the wrists, linking with the Western direction and the Lung 肺. It is interesting to note that the left Tai Yuan 太淵 is often called Ren Ying 人迎, illustrating the ability of this location to provide an accurate measurement of the flow of Qi 氣 in the body. This point is palpated using the index finger, which is the master finger containing the practitioner’s Wood energy, manipulating the energies of Dragon 龍 (Po 魄) and Tiger 虎 (Hun 魂) in the body landscape. The measurement of the pulse at Tai Yuan 太淵 is interesting because it is the influential point of the blood vessels, directly corresponding to the Sea of Blood 血海 as the Wei Qi 衛氣 and Ying Qi 營氣 exchange information at this point. Because it is the Ying Qi 營氣 that gives the blood is flowing quality and ability to move, the pulse location for the Sea of Blood 血海 resides at the Yuan 原 point of the meridian most closely connected with the Qi 氣. Thus, most Qi Gong 氣功 forms contain movements that activate this point at the wrist to stimulate the flow of Qi 氣 through the body landscape.

Pulse Forms and Appearances3
According to The Lakeside Master’s Study of the Pulse 瀕湖脈學 (bīn hú mài xué), the Tai Yuan position represents the location where the vessels of Qi and blood dwell, moving through tunnels that flow with each inhalation and exhalation. The pulse is modeled after the rivers of the earth and thus represents a home for the blood. They unite with the heart and dwell at the level of the skin.
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Flaws, Bob.. Bin Hu Mai Xue (The Lakeside Master’s Study of the Pulse). Blue Poppy Press. 19

The pulse is supplied with energy from the kidney and is supplemented by energy from the stomach. The pulse is considered yin within yang, rooted in the Wei (protective) and Ying (constructive) levels. The Ying level represents all the Yin and blood, while the Wei level represents all the Yang and Qi. The Ying moves internally within the vessels, while the Wei moves externally outside the vessels. The pulse cannot move by itself; it only follows the Qi as it arrives. When the Qi stirs, the pulse responds, forming a Yin/Yang relationship. Qi is like the push; blood is like the pull. Blood connects to the vessels, Qi connects to the breath. As they ascend and descend, circulation in the body results. Within each of the twelve major channels there is a pulse; however, only the hand Tai Yin meridian is chosen to measure them all. This meridian connects to the Lung, opens to the throat, and is the great meeting point of all the vessels, controlling the ebb and flow of respiration. During one inhalation and one exhalation, the pulse should arrive four times in normalcy. Over the course of one day and one night, the pulse should arrive 13,500 times. During one inhalation and one exhalation, the pulse should move six cun in length. Over the course of one day and one night, the pulse should move 810 zhang in length. The floating pulse [浮 FÚ] is based on Heaven. Use a light hand and it can be obtained. Not deep, located above, like wood drifting on water. If it is floating and has force, it is flooding [洪 HÓNG]. It comes on strong and departs slowly. If it is floating, has no force, and slow, it is empty [虛 XŪ]. If extremely deficient, it is scattered [ 散 SÀN]; this pulse has no edges, melting and
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overflowing without restraint. If it has force but is without center, it is called the scallion stalk [芤 KŌU]. This pulse is tense and wiry. The drumskin pulse [革 GÉ] is even more so. When the pulse is floating and small it is called soft [濡 RÚ], like a thread floating on the water’s surface. If extremely soft, it is faint [微 WĒI]. This pulse does not assume its post when searched for with pressure. The sinking pulse [沉 CHÉN] is based on Earth. It is near to the sinews and bones. Not floating, it is located in the depth. If extremely sunken, it is hidden [伏 FÚ]. If it has force, it is confined [牢 LÁO]; this pulse is also full, large, wiry, and long. If extremely confined, it is full [實 SHÍ], strongly beating. If it is forceless, the pulse is weak [弱 RUÒ], feeling soft and small, like a thread. If extremely weak, it is thin [細 XÌ], which feels like a single silk thread. The slow pulse [遲 CHÍ] is categorized as Yin. One respiration, three arrivals. A little more rapid than slow is called moderate or relaxed [緩 HUǍN], which reaches in four beats. If the pulse has two beats or less, it is defeated and the disease cannot be treated. If there is only one beat for every two breaths, the essence is depleted and the pulse already has no Qi. Slow and thin is called choppy [澀 SÈ]; it pours and comes with extreme difficulty. It appears to stop but does not stop; thus, it is both short and scattered simultaneously. The knotted pulse [結 JIÉ] comes moderately; it stops and then resumes its coming. The intermittent pulse [ 代 DÀI] comes moderately; it stops and is not able to recover. The rapid pulse [數 SHÙO] is categorized as Yang. Six arrivals, one respiration. Seven is racing [疾 JÍ], eight is extreme. Nine arrivals signify desertion. Pouring and coming, flowing uninhibitedly, this is called slippery [滑 HUÁ]. If it has force, it is tight [緊 JǏN]; this pulse is round like a bead or rope. If rapid appears at the cun position and stops, this is hurried [促 CÙ]. If rapid appears at the guan
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position, a moving [動 DÒNG] pulse can be indicated; it must also stir and shake with a form like that of a spinning bean. The long pulse [長 CHÁNG] illustrates that the Qi is in counterflow; thus, it exceeds its position. Long and extremely straight, the wiry pulse [弦 XIÁN] responds tensely to the fingers. The short pulse [短 DUǍN] illustrates that the Qi is diseased. It is unable to fill its position; it only shows itself at the guan position, and does not extend to the cun or chi positions. When investigating the Eight Spiritual Meridians, the examination of their pulses is different from that of the regular channels. • Straight up, straight down and floating [浮 FÚ] is the pulse of the Du Mai or Governing Vessel. • The pulse of the Chong Mai or Penetrating Vessel is confined [牢 LÁO]. The pulse of the Ren Mai or Conception Vessel is tight [緊 JǏN]. • At the Cun position, moving left to right, one can feel the pulse of the Yang Qiao Mai or Yang Bridge Vessel as ‘pellet-like,’ which can be considered slippery [滑 HUÁ] and long [長 CHÁNG] or round and hard, respectively. At the Chi position, moving left to right, one can feel the pulse of the Yin Qiao Mai or Yin Bridge Vessel as ‘pellet-like.’ • At the Guan position, moving left to right, one can feel the pulse of the Dai Mai or Belt Vessel as ‘pellet like.’ This pulse should also feel quite capable. • The pulse of the Yin Wei Mai or Yin Linking Vessel begins on the outside or lateral aspect of the Chi position and slants upward to arrive at the inside or medial aspect of the Cun position. The pulse of the Yang Wei Mai or Yang Linking Vessel begins at the inside or medial aspect of the Chi position and slants upward to arrive at the outside or lateral aspect of the Cun position.

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• When the Du Mai is diseased, there is upper back stiffness, emotional withdrawal, and mania. When the Ren Mai is diseased, there are the seven accumulations, stagnation, and hardness. • When the Chong Mai is diseased, the Qi flows in rebellion and interior tension results. Because the Dai Mai rules the area below the waist, there is navel pain and loss of Jing when it is diseased. • When the Yang Wei Mai is diseased, cold and heat can invade, causing vision problems, vertigo, stiffness, and loss of balance. When the Yin Wei Mai is diseased, there is Heart pain, chest pain, palpitations, and tightness in the lateral costal region. • When the Yang Qiao Mai is diseased, the outside of the legs (e.g., Yang) are flaccid and the inside of the legs (e.g., Yin) are tense and stiff. When the Yin Qiao Mai is diseased, the inside of the legs are flaccid and the outside of the legs are tense and stiff. Overall, the Eight Spiritual Meridians can cause separation of Yin and Yang such as withdrawal and mania, tightness and looseness, cold and heat. Each meridian has its own pulses and symptoms that occur when in health and disease.

Song of the 28 Pulses4
PART ONE 浮 FÚ This can be felt without pressing down much, at the surface, like wood ‘floating’ on top of water; represents exterior disorders.

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Dr. Chang Yi Hsiang, David C. Mainenti, ed. “Taoist Medicine Lectures.” Tai Hsuan Foundation. 2000-2006.

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沉 CHÉN One must press down to feel it, at the ‘depth,’ like a stone dropped in water; represents interior disorders. 遲 CHÍ This pulse 'arrives late' (3 arrivals per respiration), meaning it takes a while to feel; it represents cold conditions. 數 SHÙO This movement 'arrives often' (6 arrivals per respiration) meaning that there is something interfering with the Heart, which normally beats steadily; represents heat conditions. 虛 XŪ This feels like an empty valley and corresponds to a deficient or ‘empty’ condition (such as blood), causing weakness in the body. 實 SHÍ This solid, forceful movement represents an excess or ‘ full ’ condition, usually caused by an individual being uptight and holding back emotions. 滑 HUÁ The ‘slippery’ pulse is like feeling a pearl; it indicates mucous in the body layers and symbolizes dampness or phlegm. PART TWO 澀 SÈ This pulse feels like a tart fruit in that it is sticky to the fingers; the radical in the top right corner refers to two rusty knives, which cut roughly (e.g., ‘choppy’), referring to blood stagnation.

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長 CHÁNG This pulse feels ‘longer’ than the three finger positions upon measurement; it signifies a normal or excessive condition, and is not as bad as its counterpart Duan [短]. 短 DUǍN This pulse feels ‘shorter’ than the three finger positions upon measurement; it signifies a deficient condition, and is worse than its counterpart Chang [長]. 洪 HÓNG This pulse feels like a powerful lake with lots of ‘flooding’ water, signifying Fire blazing at its fullest; blood also can be 'shooting out,' like the carotid artery bleeding at Ren Ying. 微 WĒI This can be interpreted as light, faint, or ‘minute,’ feeling worn out; it means that the energy is still alive but is slowly dying. 緊 JǏN This feels as if the patient is tied up with wires around their chest, resulting in a constrained or ‘tight’ feeling that makes it difficult to breathe; it appears during excess cold syndromes. 緩 HUǍN The opposite of Jin [緊] in that this pulse is ‘moderate,’ or loose; although slow, it is an even, simultaneous slowness; it signifies a normal condition or weakness of the middle burner PART THREE

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弦 XIÁN This pulse corresponds to the act of tying up the strings of a musical instrument, often referred to as 'wiry;' it corresponds to Liver and Gall Bladder diseases. 芤 KŌ The ‘hollow’ pulse is similar to a leek or green onion in that the sides can be felt but the inside is empty; the deeper you go, the more you lose it, signifying that blood is draining out of the body - an emergency condition that can become very dangerous. 革 GÉ This feels like the tough skin of an Ox stretched over a drum, giving it a tympanic and dry feeling; it corresponds to deteriorating and withering conditions with blood and jing depletion. 牢 LÁO This pulse can be imagined as if the person is in prison or locked up in some way; it is difficult to read and signifies completed excess turning into deficiency, a serious condition. 濡 RÚ This pulse feels ‘soft,’ like a bubble floating on top of water; it results from Spleen Qi deficiency and Dampness. 弱 RUÒ The ‘weak’ pulse feels as if it is on the verge of expiring; it results from the depletion of Wei/Ying levels. 散 SÀN This pulse is ‘scattered’ in that it resembles a fishnet lying in the water, with no pulling together; it is felt in emergency situations.

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PART FOUR 細 XÌ The small or ’thin’ pulse feels like a silk thread; it is caused by blood deficiency. 伏 FÚ The ‘hidden’ pulse feels like something is lurking in the very deep; it corresponds to interior cold conditions. 動 DÒNG This pulse is likened to a traveling scenario, in that it will be throbbing with blood seeming to pound outward with no head or tail, like a ‘ spinning bean; ’ it often results from Yin/Yang imbalances. 促 CÙ This pulse feels abrupt and hasty, like when someone stumbles on the ground while ‘hurrying;’ it results from extreme Yang and Fire pressuring a Yin collapse. 結 JIÉ This pulse is ‘irregularly intermittent’ in that it stops once and then comes again; it results from extreme Yin pressuring a Yang collapse, with Qi and blood stagnation. 代 DÀI This pulse is ‘regularly intermittent’ in that its stirring has stops in it; it is due to a debilitating weakness of Yuan and Zang Qi. 疾 JÍ The swift or ‘ racing ’ pulse feels agitated to the touch; it indicates excessive Yang with exhausted Yin.

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Conclusion
It is interesting that Western medicine relies on the physical component of circulation for their diagnosis, while Daoist healers utilize the subtle aspect of the pulse; in effect, both are correct, as the Wei Qi 衛氣 corresponds with Qi 氣 and the Ying Qi 營氣 corresponds with the blood. When taking a reading of one’s physical blood pressure, the systolic measurement corresponds to inhalation and provides information to the practitioner as to how the blood is moving inside the body. On the other hand, the diastolic result corresponds to exhalation and determines how the blood is being delivered. That being said, one can see that in classical Daoist studies, there is even more to pulse diagnosis than simply measuring the Qi 氣 at the wrist. One must master the art of taking the four pulses through diligent practice, learning from experience. Begin by locating the points; then proceed to feeling the energy, noting qualities and strength. Once you can locate the pulse and measure it, the twenty-eight rhythms of the pulse must be studied in detail. Then, during meditation, one can use the mind to harmonize the flow of Qi 氣 in the body, normalizing the pulse, using the four points as indicators for the Four Seas that comprise the pulsating rhythm of the ‘whole land’ as embodied in the Dan Tian 丹田. By mastering the art of Tiao Qi 調氣, one can learn to harmonize conditions such as Type II diabetes, Stomach Fire 胃火, or dental problems, simply by adjusting the flow of the pulse with energy accumulated at one’s fingertips.

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