Pulse Reading and Diagnosis is one of the major clinical diagnostic methods among Muslim Doctors (Hakeems) of our great planet and has been used/practiced by Hakeems (in Latin “doctors”) to assess patients’ health conditions for several thousand years.
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Article below is copied and edited by Dr. Qaisar Ahmed MD, DHMS from following books:
1- Medicine in China (Hakeem Saeed Khan, Pakistan).
2- kanzul Mujarrabat (Hakeem Muhammad Abdullah, Pakistan).
3- Al-Qanoon (Hakeem Shaikh Bu Ali Ibne Senna, Saudi Arabia).
A good doctor palpates six locations, three on each wrist, with the three points called “cun”, “guan”, and “chi” (رئة – طحال – الكلى) and describes pulses in terms of various characteristics.
By comparing the pulses at left and right cun, guan, and chi (رئة – طحال – الكلى) the health status of individual organs and of the whole body can be determined.
As specified in the ancient texts, the heart, liver, and kidneys are assessed at the left cun, guan, and chi (رئة – طحال – الكلى) respectively, while the lungs, spleen, and kidneys are assessed at the right cun, guan, and chi (رئة – طحال – الكلى)respectively.
The pulse qualities:
The pulse qualities are floating, sunken, slow, rapid, surging, fine, vacuous, replete, long, short, slippery, rough, string-like, tight, soggy, moderate, faint, weak, dissipated, hollow, drum skin, firm, hidden, stirred, intermittent, bound, skipping, and racing.
These pulse qualities are largely described qualitatively and are not clearly defined.
For instance, the slippery is compared to “beads rolling” and the string-like is like pressing the string of a musical instrument.
The magnitude of a pulse quality is, similarly, not precisely defined.
The difference between a fine pulse and a faint pulse is that the Fine Pulse is a “little bit stronger” than the Faint Pulse.
“A little” does not precisely determine what differentiates fine from faint; Thus, descriptions of pulse are subject to the interpretation of individual doctors, and this lack of quantitative standardization undoubtedly contributes to the low inter- and interrater reliability among doctors.
Modern science tried to quantify pulse diagnosis but did not reflect pulse qualities adequately for several reasons.
First, the six items included in their scale-depth, width, force, relative force, rhythm, and pulse occlusion are not widely accepted as core items in traditional pulse diagnosis.
Second, their scale was an ordinal scale anchored with descriptors to measure the items. For example, depth was measured at three levels: superficial, middle, and deep. However, an ordinal scale is not a sufficiently sensitive measure, as there are an insufficient number of available response categories to rate the items, and the words used to describe each ordinal level are not universal.
THE ORIGINAL PLACE of Pulse Reading and Diagnosis in TRADITIONAL MEDICINE
Pulse diagnosis is one of the original sets of four diagnostic methods that are described as an essential part of our traditional medical practice.
The other three diagnostic methods are:
- inspection: general observations of the patient, including facial expression; skin color and texture; general appearance, and the shape, color, and distinctive markings of the tongue and the nature of tongues coating; and smell of the body, mouth, and urine.
- listening: to the quality of speech (including responsiveness to questions, rapidity of talking, volume of the voice); to the respiration; and to sounds of illness, such as coughing, gurgling from the intestines etc.
- inquiring: obtaining information about the patient’s medical history and their symptoms and signs, such as chills/fever, perspiration, appetite and dietary habits, elimination, sleep, and any pains; also, for women inquiring about menstruation, pregnancy, leukorrhea and other gyno-obstetric concerns.
All of these diagnostic methods yield information that helps to determine the syndrome and constitution to be treated.
Muslim Hakeem’s Pulse Reading and Diagnosis:
While the Muslim Hakeem’s pulse reading and diagnosis and tongue diagnosis methods, because of their frequent mention and somewhat unique quality among traditional medical systems, receive much attention, the other aspects of diagnosis cannot be ignored or downplayed.
The Muslim Hakeems term indicating a blood vessel or a meridian which are two interlinked concepts is “mai/Buy” (يشتري), and the same term is used to describe the pulse.
Pulse Reading and Diagnosis is mentioned in ancient texts, but with only sporadic mention of various pulse forms and their meaning.
A stomach pulse or “Life pulse” that shows no stomach is called the “Matoofi”(متوفى) in other words “decaying pulse” and the prognosis is usually death.
If you can distinguish the presence or absence of the stomach pulse (Life pulse), you can know where the disease is located and give the prognosis for life or death, and even know when death might occur.
When stomach pulse pulses are absent in a patient, the Matoofi”(متوفى) or the decaying pulse of the liver is like a thin thread on the verge of breaking, or like a tightly wound wire about to snap.
The patient will die within eighteen days. If the decaying pulse of the heart is like a thin fragile thread, the patient will surely die within nine days. If this pulse is found in the lung pulse, the patient will not survive longer than twelve days. If it is found in the kidney pulse, the patient will die in seven days. If it is found in the spleen pulse, the patient will die in four days.
A more complete prognosis involves coupling the information of the pulse with the examination of the facial color and the “spirit” expressed by the facial expressions, especially the eyes.
A pulse too strong or too weak denotes illness. A minute pulse on the Heart site (قلب) and a chordal pulse on the kidney (الكلى) site portends thoracic debility and aching because it reflects an extremely weak condition.
If pulse’s emerging and submerging are equal, this is a normal state; if its submerging is twice as long as its emerging, this is abnormality If its submerging is three time as long as its emerging, this is lunar pulse (قمری).
If its submerging is four times as long as its emerging, this is meridian pulse (خط الطول).
If its emerging is twice as long as its submerging, it’s called leveled pulse (نبض مستوي).
If its emerging is three times as long as submerging, this is brite pulse (مشرق).
If its emerging is four times as long as its submerging, this is Sun-pulse (الشمس).
Studies indicate that wiry, slippery, and rapid pulse, or simply wiry and rapid pulse, often denotes exacerbation of the illness (cancer).
When slippery and rapid pulse, wiry and rapid pulse, or weak and rapid pulse appears post-operatively in patients with carcinoma, one should seriously consider the possibility of an incomplete operation.
In a study of advanced hepatitis patients with cirrhosis or liver cancer carried, it was reported that most of the patients had a weak pulse on the left wrist at the Heart and kidney positions, compared to normal pulse.
In diagnosis, observation of the spirit and facial color, and palpation of the pulses, are the two methods that were emphasized by the ancient Muslim scholar Hakeems and revered teachers.
Today, so called “Modern Doctors”, deviate from the treatment methods of ancient times. They cannot even follow the changes in the four seasons that influence the pulse and other body conditions, they don’t know the importance and principles of the complexion and pulses.
Doctors today should eliminate their bad habits and ignorance, open their minds, and learn the essence of pulse and color diagnosis.
Aim And Method of Pulse Reading and Diagnosis:
The aim of pulse reading and diagnosis, like any other methods of diagnosis, has always been to obtain useful information about what goes on inside the body, what has caused disease, what might be done to rectify the problem, and what are the chances of success.
According to the ancient Arab Health scholar’s understanding, the pulse can reveal whether a syndrome is of hot or cold nature, whether it is of excess or deficiency type, which of the humors (That is moisture, blood) are affected, and which organ systems suffer from dysfunction.
In order to make these determinations, the physician must feel the pulse under the proper conditions-following the established procedures-and must then translate the unique pulse that is felt into one or more of the categories of pulse form.
Pulse Reading and Diagnosis Categories:
| Pulse Type | Interpretation | Comments |
| Scattered pulse [نبض مبعثر] |
An irregular pulse, hardly perceptible, occurring in critical cases showing exhaustion. | These are cases where the patient is critically ill, perhaps near death; such patients are normally hospitalized (or sent home to die) and their diagnosis is usually well-established. The pulse only tells that the patient is severely debilitated; it diffuses on light touch and is faint with heavy pressure. |
| Intermittent pulse [نبض متقطع] |
A slow pulse pausing at regular intervals, often occurring in exhaustion of Viscera organs (أحشاء), severe trauma, or being seized by terror. | As with the scattered pulse, this pulse type is usually only seen in cases where the person is hospitalized or otherwise in an advanced disease stage. It is expected to occur, for example, with those having serious heart disease. |
| Swift pulse [نبض سريع] |
A pulse feeling hasty and swift, 120-140 beats per minute, often occurring in severe acute febrile disease or consumptive conditions. | This pulse is so rapid (twice the normal speed) that it is easily detected; the acute febrile disease involves an easily measured high temperature and is usually subject of pathogen testing. Consumptive conditions with such high pulse rates are generally under emergency medical care. |
| Hollow pulse [نبض أجوف] |
A pulse that feels floating, large, soft, and hollow, like a scallion stalk, occurring in massive loss of blood. | Massive blood loss can easily be reported. This pulse is felt lightly at the superficial level and lightly at the deep level, but barely felt at the intermediate level. The light pulse is like the flexible scallion material, with a hollow center. It means that there is still some flow of … at the vessel surface, but not much blood. |
| Faint pulse [نبض خافت] |
A pulse feeling thready and soft, scarcely perceptible, showing extreme exhaustion. | Extreme exhaustion is obvious to both the patient and the practitioner. The pulse, lacking substance, volume, and strength, simply reveals the exhaustion of the body essences. It is weaker than the thready (faint) pulse. |
| Surging pulse [تصاعد النبض] |
A pulse beating like dashing waves with forceful rising and gradual decline, indicating excessive heat. | Excess heat syndromes are rarely difficult to detect, so this pulse type adds little information. The force of the pulse indicates that the condition is pathologically excessive, the gradual decline shows that the syndrome is primarily one of heat (qi excess) rather than fluid excess. The pulse is sometimes described as a “full pulse” indicating the excess condition. |
| Hidden pulse [النبض الخفي] |
A pulse that can only be felt by pressing to the bone, located even deeper than the sinking pulse, often appearing in syncope or severe pain. | This pulse is quite extreme, in that one can barely detect it except by applying deep pressure; it gives the sense that the pulse is hidden in the muscles. If there is little musculature, it is as if it is resting on the surface of the bone. The conditions for which it is typical, syncome (fainting) and severe pain, can easily be determined without taking the pulse. |
| Knotted pulse [jiemai] |
A slow pulse pausing at irregular intervals, often occurring in stagnation of qi and blood. | Qi and blood stasis represents a traditional diagnostic category that does not have a direct correlation with modern diagnostics. In this pulse, the irregularity and slowness is due to obstruction. |
| Hurried pulse [نبض معقود] |
A rapid pulse with irregular intermittence, often due to excessive heat with stagnation of qi and blood, or retention of phlegm or undigested food. | This is the excess version of the knotted pulse. It is sometimes called the “running” or “abrupt” pulse. The rapidity indicates heat, and the irregularity indicates the blockage caused by stagnation and/or accumulation. |
| Long pulse [نبضة طويلة] |
A pulse with lengthy extent and prolonged stroke. A long pulse with moderate tension may be found in normal persons, but a long and stringy pulse indicates excess of yang, especially liver yang. | Particularly in young people, the pulse is felt rather easily across all three finger positions, as is characteristic of the long pulse. The prolonged stroke shows that the vessels are both strong and flexible. A stringy quality indicates a certain level of tension, that corresponds with a liver syndrome. In cases of acute disease, a long pulse will occur when there is a strong confrontation between the body’s resistance and the pathogenic factor. |
| Short pulse [نبضة قصيرة] |
A pulse with short extent. A short and forceful pulse is often found in qi stagnation and a short and weak pulse implies consumption of qi. | The short pulse seems to deteriorate from the central pulse position towards the two adjacent pulse positions. It strikes the middle finger sharply and leaves quickly. On the one hand, this can represent contraction of the qi, as in liver qi stagnation, or it can represent deficiency of the qi. |
| Fine pulse [نبض دقيق] or Thready pulse [نبض حاد] |
A pulse felt like a fine thread, but always distinctly perceptible, indicating deficiency of qi and blood or other deficiency states. | Although the deficiency can be easily detected by other means, some patients can show an artificially robust exterior appearance, while having notable deficiency. Essence deficiency, the result of chronic illness, can give rise to this pulse type. |
| Hesitant pulse [نبض متردد] or Uneven pulse [عدم انتظام النبض] or Choppy pulse [نبض متقطع] |
A pulse coming and going choppily with small, fine, slow, joggling tempo like scraping bamboo with a knife, indicating sluggish blood circulation due to deficiency of blood or stagnation of qi and blood. | This has a more irregular pattern than the knotted pulse that also shows stagnation of qi and blood. The severity of the blood disorder is greater. As the knife scrapes across the bamboo, it vibrates and irregularly moves forward, yielding a choppy sensation with brief hesitations or interruptions in movement. |
| Slippery pulse [نبض زلق] |
A pulse like beads rolling on a plate, found in patients with phlegm-damp or food stagnation, and also in normal persons. A slippery and rapid pulse may indicate pregnancy. | While use of the pulse to indicate pregnancy is no longer of value (as more reliable tests are readily available), and while this pulse, like the long pulse is often normal (occurring especially in persons who are somewhat heavy), it is a good confirmation of a diagnosis of phlegm-damp accumulation. It is sometimes referred to as a “smooth pulse.” |
| Relaxed pulse [نبض استرخاء] or Loose pulse [نبض فضفاض] |
A pulse with diminished tension, occurring in dampness or insufficiency of the spleen. | The pulse has a softness or looseness that is due to the weakness of the qi and the obstructing effect of dampness. The dampness differs from phlegm-damp in having no solidity. |
| Moderate pulse [نبض معتدل] |
A pulse with even rhythm and moderate tension, indicating a normal condition. | This is similar to the loose pulse, above (and the Chinese name is the same), except that it has a better tension, showing that the qi is adequate. As a normal pulse, it indicates that the disease condition being treated is localized and has not disturbed or been caused by disturbance of the viscera. |
| Tense pulse [نبض متوتر] or Tight pulse [نبض ضيق] |
A pulse felt like a tightly stretched cord, indicating cold or pain. | This is similar to the wiry pulse, but not as long. While pain can be easily reported, a cold syndrome is sometimes disguised by localized heat symptoms; this pulse can indicate either exterior or interior chill. |
| Stringy pulse [نبض خيطي] or Wiry pulse [نبض سلكي] |
A pulse that feels straight and long, like a musical instrument string, usually occurring in liver and gallbladder disorders or severe pain. | This is similar to the tense pulse, but longer and more tremulous. While severe pain can be easily reported, the wiry pulse confirms the liver and/or gallbladder as the focal point of the internal disharmony. |
| Replete pulse [نبض مكثف] or Forceful pulse [نبض قوي] |
A pulse felt vigorously and forcefully on both light and heavy pressure, implying excessiveness. | This pulse gives relatively little information other than that the condition is one of excess; one must further determine the nature of the excess in order to select a therapeutic strategy. This pulse, however, generally rejects the use of tonification strategies, as it indicates that the body resistance is undamaged. |
| Weak pulse [نبض ضعيف] |
A pulse feeling deep and soft, usually due to deficiency of qi and blood. | This pulse is similar to the fine pulse but has a softer quality. Usually, this indicates a weakness of the spleen qi, leading to deficiency of both qi and blood. In the system of pulse taking, it serves as the opposite of the replete pulse. |
| Soggy pulse [نبض مندي] |
A superficial, thin, and soft pulse which can be felt on light touch like a thread floating on water, but grows faint on hard pressuring, indicating deficiency conditions or damp retention. | This pulse is similar to the fine and weak pulses. The thready pulse sensation felt on light touch gives the impression of being easily moved, as if floating on water; hence, it tends to indicate spleen-qi deficiency with accumulation of dampness. It is sometimes referred to as the “soft pulse.” |
| Feeble pulse [ضعف النبض] |
A pulse feeling feeble and void, indicating deficiency of qi and blood or impairment of body fluid. | This pulse is similar to the weak, fine, and faint pulses. It occurs when the deficiency of blood is more severe than in the case of weak and fine pulses, but not so deficient as with the faint pulse. |
| Rapid pulse [سرعة النبض] |
A pulse with increased frequency (more than 90 beats per minute), usually indicating the presence of heat. | The rapid pulse is quite a bit more rapid than a normal pulse, and usually occurs only when there is a serious illness and mainly when there is a fever. The pulse can become rapid from activity prior to pulse taking. |
| Slow pulse [نبض بطيء] |
A pulse with reduced frequency (less than 60 beats per minute), usually indicating endogenous cold. | A slow pulse may also indicate a person at rest who normally has a high level of physical activity, so must be interpreted in light of other diagnostic information. |
| Sinking pulse [نبض الغرق] |
A pulse that can only be felt by pressing hard, usually indicating that the illness is located deep in the interior of the body. | The circulation of qi and blood from the internal viscera to the surface is weak; it is usually confined to the interior as part of the body’s attempt to deal with a serious disorder threatening the viscera. Sometimes referred to as the deep pulse. |
| Floating pulse [نبضة عائمة] |
A pulse that is palpable by light touch and grows faint on hard pressure, usually indicating that the illness is in the exterior portion of the body. | The circulation of qi and blood is focused in the body’s surface to deal with an external pathogenic agent. The internal circulation is temporarily sacrificed to assure that the pathogen is eliminated before it can enter more deeply and cause serious problems at the visceral level. Debilitated patients may show a floating pulse that is feeble, indicating the inability to retain the qi and yang in the interior due to the deficiency of the vital organs. |
P.S: Four kinds of pulse are the key criteria in examination: the floating, deep, slow, and rapid.
A well-trained physician is able to make a diagnosis almost entirely by pulse reading and diagnostic, while asking virtually no questions of the patient. As a result, pulse analysis sometimes took on a certain mystical aura and should be a major focus of doctor-patient interaction.
P. S: This article is only for doctors having good knowledge about Homeopathy and allopathy, for learning purpose(s).
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