The Pulse

Feeling the pulse is the strangest part of what I do. Utterly subjective impressions of 27 possible qualities at 12 more or less specific points on the radial artery are one of the primary sources of diagnostic information. As a student, of course, you're terrified you won't ever be able to feel it, and I could only feel thump-thump-thump for about a year. Finally one night I could feel qualities in the pulse. My wife and I had gotten into bed and turned out the lights before I remembered that I needed to feel a 12th pulse for the next day's homework assignment. I reached out under the covers and held her wrist. I was relaxed and she was at a point in her menstrual cycle when her pulse was more active than usual. Clear as day there in the dark, her heart pulse was thin! Liver was soft, Kidney was..soft, too!

That was a cool moment, but come on. Really. How can you justify making diagnoses of mental, physical or spiritual illness by feeling the pulse on each wrist at three points on the radial artery?

I can't. And so once I could feel it I kind of ignored it. I'd feel the pulse and write a note, but I gave it very little attention in diagnosing the people I was treating. But after a couple of years I noticed that people with healthy heart pulses did okay. That is, I worked with a number of people who had real physical issues and very weak pulses at all of the other pulse positions, but were robust at the heart position. All such people tended to have fairly positive outcomes. On the other hand, I noticed some people had all decent pulses except for a weak heart pulse and they tended to not do as well as expected. The shen is called the Emperor or Empress, and is the spirit associated with the heart. The shen has to do with your fate, destiny or karma. Knowing you are on the right track, whatever it looks like on the outside and however it affects others, is a sign of heart health. Knowing you are on the right track, even if you have significant health issues, seems to give you better health. And being unsure of your path, even in the absence of physical or mental issues, seems to have a depressing impact on your health.

After proving to my satisfaction that there was this correlation between the heart pulse and the status of my patient's spirit, I started to pay more attention to all the pulses and to see how the qualities I felt did or did not help with accurately diagnosing conditions. By this point, ten years along, I feel pretty confident that what I feel at my patients' radial arteries is real and really does indicate something pretty much like what the Chinese tell us it does.

However, I still have no idea why.