| Three portions & nine pulse-takings is a pulse diagnostic method of Chinese medicine since ancient times. Traditionally, by the theory of three portions & nine pulse-takings, the person was regarded as a microcosm of nature. By using the point of view about sky-earth-human, the human body can be divided into three parts as the upper, the middle and the lower which can reflect the situation of human in nature. By observing whether the pulse corresponds to body and whether the three parts conciliate with each other, the situation of the whole body was observed. This kind of method, called the general pulse diagnostic method of three portions & nine pulse-takings, is the only pulse diagnostic method listed in Neijing. Compared with the other kind of methods, this one emphasized the meaning of location, enriched the pulse theory in Neijing, is the essence of the pulse theory in Neijing, and established the theory foundation for the development of pulse theory.On the other hand, the three portions & nine pulse-takings can also be used for wrist pulse-taking method. Based on Neijing, the wrist pulse-taking method was established in Canon of Difficult Issues and given much more content. The wrist pulse was divided into cun-section, guan-section and chi-section. Each section was divided into the float, the medium and the sunken. It is also known as three portions & nine pulse-takings. This kind of method emphasizes the coherence of the nine symptoms by comprehensive analysis, reflects the holistic mode of thinking, especially the reference meaning between each department and designate.Therefore, the study of the source, the development of specific application, clinical significance and the related awareness about the three portions & nine pulse-takings has very important significance for the Chinese medicine pulse diagnosis theory and practice. However, the current literature about three portions & nine pulse-takings is very little. In this study, the contents about three portions & nine pulse-takings were sort out, extracted and analyzed and discussed from the theory, method, clinical application and modern objective study. Based on these works and combined with some own clinical experiences, some new ideas and a sort of six-meridian incorporative graphical method were brought up for supplement of study on the objectivity and accuracy of Chinese pulse-taking method.ObjectiveIn this study, some materials about pulse in Huangdi's Internal Classic, Classic of Difficult Issues and Ttreatise on Febrile Diseases were extracted and analyzed from the theory, method, clinical application and modern objective study. Based on these works and combined with some own clinical experiences, some new ideas and a sort of six-meridian incorporative graphical method were brought up for supplement of study on the objectivity and accuracy of Chinese pulse-taking method.MethodsThrough literature study, the source, theory, method, clinical application and modern objective study of the three portions & nine pulse-takings were analuzed and discussed.Based on the theory of three portions & nine pulse-takings, a sort of six-meridian incorporative graphical method, zang-fu pulse-locating method were brought up, and some new idea about the four Categorization of wrist pulse.Cupping method was used to stimulate the subjects to observe the changes of pulse manifestation, pulse rate, temperature, and blood-pressure, electric conductivity before and after treatment.ResultsThrough literature study, the general pulse diagnostic method is recorded in detail and used widely. The location of pulse-taking is based on the theory of meridians and collaterals, but also different with it. Acupuncture focus on the exact position of acupoints on the body surface, while for the general pulse diagnostic method, it is meridian; as far as the method of diagnose is concerned, there were four different but interrelated diagnostic method, such as taking, searching, palpation and pressing which can reflect the disease of the internal organs, be helpful to diagnose the troubles by pulse syndrome, to distinguish heat and cold, to determine the severity, life and death, and miscellaneous disease diagnosis. Modern research has found that the diagnostic method can be used for diagnosis of circulatory system diseases, guidance acupuncture treatment. And some scholars studied the information from wrist pulse to confirm the information acquired from the whole body is much more than that from the wrist by using bionic flexible pressure sensor and B-probe complex multi-pressure sensors. But compared with the other methods, this general pulse diagnostic method is not so convenient in clinic, so it is rarely used later;The three portions& nine pulse-takings in wrist is sourced from Neijing, established in Classic of Difficult Issues and finished in Pulse Classic. The formation and mechanism were discussed in different materials. The taking position is wrist and can be divided into the cun, the guan, the chi. each section was divided into the float, the medium and the sunken. About the location of the cun, the guan and chi as well as the zang-fu position there are many different descriptions. In Nei jing, the right time for taking pulse is morning; In Classic of Difficult Issues, the pulse-taking methods are lifting, pressing and searching. The normal pulse manifestation has stomach, vitality and root; for the abnormal pulse manifestation, different clinical practitioners have different opinions. For the objectivity of pulse diagnosis, modern scholars had done much effort to study.After cupping, the three portions & nine pulse-takings were changed, the pulse rates reduced and the changing rate was 61.3%; in 76.1% of the subjects, it was shown that the temperature of the cun was highest and that of the chi was the lowest; after cupping, the temperature of 26.9% of the subjects raised; the temperature of 11.9% of the subjects reduced; the temperature of 61.1% of the subjects didn't change; after cupping, the rate of systolic blood pressure or diastolic blood pressure remained unchanging in the same account was 36.3%; 37.5% of the subjects was with systolic blood pressure increased or systolic blood pressure decreased; 26.1% of the subjects with diastolic blood pressure increased and diastolic blood pressure decreased; six digital pulse integration points with the second by the original value of the sum of the changes in conductivity and conductance changes in the value of the five internal organs of the sum of the pulse. There was no any relevance.ConclusionCompared with the other methods, the three portions & nine pulse-takings emphasized the meaning of location, enriched the pulse theory in Neijing, is the essence of the pulse theory in Neijing, and established the theory foundation for the development of pulse theory.The three portions & nine pulse-takings in wrist were developed from the theory of wrist-pulse diagnostic method and finished gradually. This kind of method is not only based on the essence of Neijing, but also has new creation. It is widely used in clinic and helpful for distinguish the position and nature of diseases, guidance of treatment and prognosis. The objective studies of it are the important researching aspect for the standardizing and visualization of pulse diagnosis.Changing of temperature before and after cupping shows that the temperature of the cun was highest and that of the chi was the lowest. When the temperature of the three parts is high which indicates excess and fever; while on the contrary, which indicates insufficiency and cold; when that of single one section is high, which indicates the one-hot; on the contrary, which indicates independent cold.Six-pulse integration graphic method provides a new train of thought for the objective study of traditional pulse and is worthy of further investigation research.
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