A patient sits down in front of Dr Tian complaining of ‘pain of all bones of the body’. Dr Tian takes the pulse. First the left and then the right hand. After this process, the formula Ma Huang Fu Zi Gan Cao Tang plus Cang Zhu is shouted to a student, who leads the patient off to fill the prescription and also take the pulse themselves. Then the next patient arrives who also complains of pain, or in their words ‘full body bone aches’. Dr Tian again takes the pulse, first, he takes the left then the right. However, the prescription Da Chai Hu Tang plus Yin Chen Hao is shouted to the next student.
The student again takes the patient to fill the prescription and feels the pulse themselves. A number of patients come and go in this fashion until another sits down complaining again of ‘pain of bones and joints’, the pulse is taken, again first left and then right sides, Dr. Tian askes one clear question to which the patient answers in the affirmative with a nod and a grunt, and Dr Tian directs the student to fill a Gui Zhi Tang, minus Bai Shao, plus Long Gu, Mu Li, Fu Zi. This process continues, main complaint, pulse, first left and then right, a confirming question if needed, and then a barked prescription, for 200-300 patients a day, every day for the entirety of Dr Tian He Ming’s seventy years of clinical practice. Sounds like a great day in practice. If you were inspired by that then continue reading.
It sounds fantastic to us practicing today, doesn’t it? So how exactly was Dr Tian able to practice this way? How could he prescribe so accurately with just the main complaint, pulse, and possibly one or two questions? It wasn’t down to intuition. It wasn’t due to decades of experience with over a million patients, this just served to hone his skills. It was the unique pulse system taught to him by his family elder Tian Qi Tai that allowed him to do this. My article will introduce the reader to the Tian lineage system of pulse diagnosis. I have been practicing for over a decade in this style. I will also illustrate how systematic this method of pulse diagnosis is and as such how it can be taught clearly and simply. The primary question - why pulse diagnosis?
But first let’s answer the question, why pulse diagnosis? In an ideal setting, the primary method of diagnosis should be as objective as possible. The truth is that no method of diagnosis used in Chinese medicine is completely objective and all have a certain level of subjectivity. The level of subjectivity depends upon two things, the number of ‘filters’ through which the information has to pass before reaching the practitioner, and how well the practitioner is systematically trained to interpret the information that he is confronted with. Questioning, for example, is extremely subjective. It relies on the patient transmitting information that has passed through their filter and the practitioner interpreting their answers. In stark contrast, pulse findings are the most objective. They bypass the patient's perception and any misunderstanding between practitioner and patient. Pulse findings rely solely on that practitioner’s ability to collect the information. The meaning of pulse diagnosis
Pulse-taking has always been held sovereign in Chinese medicine as it represents the function of the emperor and the influence of this function throughout the body. It accurately reflects the underlying long-term condition of the body, while also changing quickly in response to any more acute influence in the context of this underlying environment. An argument can be made that the tongue achieves the same. It is the sprout of the heart. The tongue is not as acutely reactive or detailed and it shows more material rather than functional changes. This is reflected in the tremendous weight given to the pulse over the tongue in the classics.
The actual pulse finding itself is completely objective. The subjectivity comes on the part of the practitioner’s interpretation of the findings. This is where the importance of a clear, clinically applicable, and teachable system such as the Tian lineage pulse system becomes so important. Chinese Medicine teaches the 4 pillars of diagnosis, but in practice, one must choose a single method that consistently forms the base of what will lead to a treatment plan, i.e. acupuncture and herb prescription. Trying to fill all methods in and changing between systems could potentially lead to inconsistent prescribing and feedback.
So what makes a good pulse system? First, it must serve as a perfect reflection of the physiological model used by the system as a whole. Second, it must be based on solid repeatable principles, and it must adhere to these principles. Third, it must get you to a treatment not just a diagnosis. Fourth, it must be teachable in clear steps, and usable by the student early in the learning process. Pulse may take a lifetime to ‘master’ but it certainly shouldn’t take that long to become useable. And lastly, it needs to have stood the test of time. It needs to go through a number of generations of clinicians to confirm that it is both clinically applicable and teachable, and not just an idea.
Why this? In practice, adherence actually facilitates pulse taking since one can concentrate on basic qualities, so within a relatively short period for example a wiry pulse in certain positions can be understood in its overall context and its presence linked to a diagnostic method, like harmonizing for example. In my next article, we will talk more about the tian pulse-taking system and the importance of finding a teacher. I will also share how you can start accessing this pulse system today!
Yelp. (n.d.). [Image from Campbell Acupuncture]. Yelp. Available here.
About Collin Campbell
Collin received his Masters of Acupuncture and Oriental Medicine from the Pacific College of Oriental Medicine (PCOM) Chicago in 2011. He graduated PCOM with an extra 2,700 hours of clinical experience under the tutelage of two senior professors: Frank Scott, L.Ac, Academic Dean at Pacific College, and Marie France Collin, L.Ac, Department Chair for Acupuncture at PCOM. He then pursued post-graduate studies in herbal medicine exclusively, earning 2 extra qualifications in classical Chinese herbology. He is a Diplomat of The Institute of Classics in East Asian Medicine (ICEAM) and among a select few that have reached fellowship status at ICEAM. Dedicated to continually improving his clinical skills, he is the only student to have amassed over 1,000 visits with his teacher, mentor and ICEAM director, Dr. Arnaud Versluys, an esteemed Western scholar who received his full medical training in China. Collin lectures for ICEAM in Chicago, Boston and internationally.