Pulse & Tongue.doc

The 28 Pulse Qualities Strength

Depth

Width

EMPTY  Big but soft and weak  Feels empty on heavier palpation  Qi (& Blood) deficiency

FLOATING  Superficial, buoyant with very light palpation but obscured with heavier palpation  floating & tight or rapid = EPF  floating & empty = yin def. (rarely, extreme qi deficiency)  + Hollow & Leather

THIN/FINE  Distinct & clear, like a fine thread  Blood deficiency (will fill out with tx, esp. with moxa)

[SOFT]  Empty + very soft, slightly floating  Disappears with heavy palpation  Yin and Jing deficiency [SCATTERE D]  Empty + very small, superficial, broken up  Severe Qi and blood deficiency FULL  Big, strong, pounding against palpation  Excess condition

DEEP  Sinking, found with heavier palpation  Yin organ conditions: qi & yang def. (weak) or qi or blood stasis (full) [WEAK]  Deep + soft  Yang def. [FIRM]  Deep, hard, wiry  Stasis and pain (from cold if slow) [HIDDEN]  Deep as if below bone  Severe yang def.

[MINUTE]  Thin/fine + extremely thin and small  Severe qi and blood deficiency WIDE/ OVERFLOWING  Distinct & broad  Acute conditions with heat [LONG]  Wide/overf lowing + long  Heat [SHORT]  Wide/overf lowing + short  Qi deficient

Rate RAPID  More than 5 beats per respiration or higher than the given normal rate  Heat [HURRIED]  Rapid + agitated & urgent  Fire exhausting the yin [MOVING]  Rapid + trembling, shaking, rapid, somewhat slippery  Shock, anxiety, fright or pain

Shape

Rhythm

SLIPPERY  Slides under the finger, smooth & oily  Full = damp or phlegm  Empty = damp or phlegm with qi deficiency  Pregnancy

KNOTTED  Slow pulse that misses beats irregularly  Cold obstructing qi or heart deficiency (qi, blood or yang)

CHOPPY  Uneven, rough, jagged edges  Can be irregular in rhythm & strength  Blood deficiency

[SLOWED DOWN]  + 4 beats per respiration

WIRY  Taut, hard, like a guitar string pushing against the fingers  Can be deficient or full  LR/GB problems or pain or phlegm causing obstructions

Normal Pulse Rates Age Rate 0-4 90+ 4-10 84 10-35 76-80 35-50 70-72 50+ 68

TIGHT  Like a twisted rope, thick, full, elastic, vibrating, can seem faster than it is  Cold/pain

SLOW  Less than 4 beats per respiration or lower than the normal rate  Cold

HASTY  Fast pulse that misses beats irregularly  Heat agitating qi and blood INTERMITTENT  Misses beats in a regular rhythm  Yin organ deficiency/ exhaustion

Normal Pulse  Has Stomach qi o Feels gentle (there’s a connection but it in no way invades another person; not insubstantial) o Feels calm (tress nicely swaying in the wind, no disturbance or agitation; cow chewing cud) o Has 4 beats per respiration (can use the rhythm of your breath to count if the person’s is erratic)  Has Spirit o Soft (shouldn’t be malleable—soft on outside and strong and resilient on inside) o Neither big nor small o Regular in rhythm & quality (not intermittent or missing beats, no speed changes)  Has a Root

o Clarity in deep position (yin), and 3rd pulse positions, (clarity = pulse should be a distinct entity)

Tongue Diagnosis: Body Shape Body Shape Thin Swollen Swollen edges Swollen sides Swollen tip Swollen bet. tip & center Swollen along center crack Hammer-shaped Stiff Flaccid Long

Short

Cracked

Loose Numb Moving Quivering Rolled Tooth marked Ulcerated

                                                 

Clinical Significance Deficient blood (pale body) Deficient yin (red body) SP and/or KI yang deficiency with dampness Damp-heat in ST and SP HT and ST heat (red body) Alcoholic toxin (red body) SP qi deficiency Rising LR yang or LR fire HT Fire blazing (red body) HT qi deficiency (normal color) LU qi def. with phlegm retention HT fire blazing (red body) HT qi deficiency (normal color) ST, SP and KI deficiency Exterior heat invading PC (red or dark red body) Heat injuring body fluids (red body) or HT Fire blazing Internal wind (normal color) Exhausted qi & blood (pale body) Extreme heat injuring fluids (red body) KI yin deficiency with heat (deep red body) Blazing HT Fire or Phlegm-Fire in HT SP yang defiency, internal cold (pale body) Heat stirring LR wind (red body) Deficient body fluids due to heat from excess (red body w/coating) Deficient heat (red body w/out coat) SP yang deficiency with damp and phlegm (pale body and slippery coating) Horizontal cracks: yin deficiency Cracks like ice floaes: ST yin deficiency Transverse cracks on sides: SP qi deficiency Vertical cracks in center: HT yin deficiency or blazing HT fire Transverse cracks behind tip: LU yin deficiency Very deep central crack with other small cracks: KI yin deficiency with heat Interior excess heat (red body) Phlegm-fire clouding HT (red body with slippery coating) HT qi deficiency (pale body) HT Blood deficient (pale body) LR Wind (red or normal color) Wind-phlegm (slippery coating) HT Fire and internal wind (red body) SP heat with exhaustion of body fluids (red & dry body) SP qi deficiency (pale body) Extreme heat generating internal wind (red body) Collapse of HT and SP qi (pale body) Collapse of yang (pale and thin body) Heat from excess (tip rolled over) Def. heat (tip rolled under) SP qi deficiency Blazing HT fire (red body) HT heat from KI yin def. (red and peeled body) SP and KI heat (red body)

Tongue Diagnosis: Body Color, Tip-Root/Left Right Body Color Pale Pale, bright and shiny Red Red and wet Red and dry Red and shiny Red with red points or spots Red with pricles Red w/a purple spot in center Red and peeled Dark red with a dry center Reddish purple Reddish purple and distended

               

Bluish purple and moist

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Blue Blue without coating Blue central surface Blue in a pregnant woman Distended veins on underside of tongue

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Bluish purple

Clinical Significance Slightly dry: blood deficiency Wet: yang deficiency Qi and blood deficiency, particular of ST and SP With coating: heat in the nutritive or blood levels Without coating: yin deficiency with heat Heat with retention of damp With coating: heat from excess burning body fluids Without coating: deficiency heat and exhaustion of body fluids Stomach or KI yin deficiency Heat with blood stasis Heat in the nutritive level or in the upper or middle burner Blood stasis and heat in ST Heat from ST and KI yin deficiency ST fire blazing or ST yin deficiency with heat Heat and blood stasis Extreme heat with blood stasis and toxin from alcohol injuring the Heart Blood stasis from internal cold Blood stasis from internal cold stiffening the tendons and bones Severe internal cold with blood stasis Severe internal cold with stasis and exhaustion of blood SP yang deficiency with retention of phlegm in chest Danger of imminent miscarriage Deficiency and stagnation of qi If veins also dark: blood stasis

Tip-Root Body Color Body Shape

Tip and root of different color: stagnation of qi or blood A) Whole tongue swollen, tip more so: long-term problem, imbalance between HT and KI B) Only tip swollen: overwork

Left-Right Different color on left and right: qi stagnation Only one side swollen with red points: ipsilateral malnourishment of channels Yellow coating on one side only: A) GB heat affecting the ST B) Ipsilateral phlegm in the chest

Coating

Moisture

Tip red & dry, root dirty & swollen: defective transformation of body fluids

One side wetter: movement of fluids in the chest; Lung qi problem

A healthy tongue body has the following qualities:    

It is supple in shape It is pale red & fresh looking/vibrant in color (due to healthy heart qi and blood) (the color of fresh lamb). The color should be coming from the back of the tongue with consistency. It has a thin white coating (due to healthy ST qi regulating digestion) It is rooted (due to inherited qi from the kidney and acquired qi from the stomach)

Tongue Diagnosis: Coating Coating

o White or white and thin White, thin and slippery White, thick and slippery

White, thin and dry

White, thick and wet White, thick and dry White, thick and greasy White, thick, greasy and slippery White, thick,, greasy and dry White, rough and cracked White, sticky and greasy White and moldy Yellow or pale yellow Yellow and slippery Dirty yellow Yellow, sticky and greasy Yellow root, white tip Bilateral yellow strips (rest white) Half-yellow, half-white (L and R) Gray/Gray, wet and slippery Gray and dry Black/Black, slippery and greasy Bilateral black on white White coat, black points White coating, black prickles Black cntr, white & slippery sides Black, dry and cracked

White and yellow

White and gray

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White, gray and black (white in

Clinical Significance Wind, cold or damp in the exterior (or normal) Exterior attack of damp-cold Damp in the middle jiao Cold w/food retention in the ST Blood deficiency (body pale) Yang deficiency (body pale) Exterior attack of wind-cold or wind-heat, LU fluids injured (body color normal) Exterior attack of dryness (body color normal) Exterior attack of wind-cold (body color normal) Interior damp-cold in the middle jiao (body color normal) Dirty fluids in the interior with heat Yang deficiency with food retention or dampness SP yang deficiency with damp-cold or phlegm Damp with exhaustion of body fluids or heat Attack of summer heat injuring the qi (qi level) Damp or phlegm in middle jiao Exterior attack of damp at the qi level KI and ST yin deficiency Damp-toxin in the interior Exterior attack of wind-heat Wind-cold turning into heat Damp-heat in the chest and middle jiao Damp heat Damp-heat in the ST and intestines Heat and phlegm EPF just changing to heat and penetrating the interior Heat in the LR and GB Heat in the LR/GB Damp-cold in the SP Heat from excess Damp-cold in the ST and intestines Cold from deficiency of middle burner (wet) Heat from excess in the ST and SP (dry) EPI penetrating to the interior and transforming into heat True cold, false heat Cold turned into heat SP yang deficiency with damp-cold in the interior Exhaustion of KI Yang deficiency with interior cold White center, yellow rest: EPF just penetrating interior & changing to heat Yellow in center, white around: interior heat just starting to clear White, gray and moist: damp cold on the interior White, gray and dirty: damp-cold or phlegm of long © Niki H. Bilton 1999 standing Half white, half gray: cold half exterior, half interior

 Damp in SP