| In Chinese medical diagnosis, the pulse pattern of coughing always manifests as "Floating Pulse". Generally, the diseases reflected by floating and soft pulses are minor and curable, while those with deep and tense pulse patterns are critical and fatal. Why is that? Because coughing is the manifestation of lung meridian which controls Qi, and with the channel of Palm TaiYin (手太阴),the ultimate Yin. Once this Yin is invaded by predominance and causes illness, Yang Qi could be introduced to cure the illness by balancing the interaction between Yin and Yang.The "floating" pulse, with attribute of Yang, lifts to the surface, and its pattern is like a log floating on the water surface, lifting but not solid. The tactile impression is like feeling a feather slightly touching skin, gentle and lifting. The floating pulse does not refer to illnesses in autumn due to it is just corresponding with the nature of the season and timing. However, we need to keep alert when we diagnose those patients who are ill for long, because their floating pulses with thin and slow patterns may indicate that the declining vital Qi is not able to sustain long inside their bodies. As documented in "The Poem of Determining Illness Upon its Pulse Patterns(脉象主病诗)â€,“The floating pulse is the manifestation of illness resulted from Yang excess issue, with delayed wind and acute heat, constrained with tense and cold issues. Floating but supportive pulse refers to wind fever syndrome while the weak and floating pulse indicates the issue of blood deficiency."In this circumstance, diagnosis upon the "Inch Pulse(寸脉)â€is the best way to determine the various lung-related illness from its floating pulse patterns. If floating pulse is found at the Inch Pulse, you can tell that the patient is suffering from headache, vertigo, got winded, or coughing resulted from phlegm clotted in lungs. That is HuaBoRen’s(滑伯ä»)saying,"Patients with floating pulses, always have the syndromes of got winded, empty (weak), lump, full, poor appetite, exterior heat, and asthma.’Lung that masters the manifestation of skin and fur, and its pulse channels routing along our body surface, is the first gateway facing wind-cold and exterior pathogenic factors. It is important to learn floating pulse in details before diagnosing pulse patterns of coughing. In addition, there are always parallel pulses patterns appear with floating pulse, which indicate various illnesses. Therefore, we must get into the core and its manifestation of floating pulse before diagnose the pulse patterns of coughing:powerful pulse is solid, weak pulse is empty; pulse of floating-loose means wind fever, floating-tense means wind cold, floating-smooth means wind phlegm, floating-short refers to Qi illness, floating-dragged refers to phlegm heat, floating-infused refers to Yin empty, floating-hollow refers to blood deficiency, floating-delayed refers to stroke, floating-slow refers to rheumatism, floating-empty refers to damage by heat, floating-strong refers to false fever, floating-distributed refers to strain and floating-rough refers to blood damage. Based on "Bible of Pulse Patterns (脉鉴)â€ï¼Œ"each pulse pattern has its parallel floating pulse, like the Surging Pulse with floating pulse presents full and huge, Empty Pulse with floating pulse presents soft and huge, Soft Pulse with floating pulse present soft and thin, Tympanic Pulse with floating pulse presents taut and hollow, Scattered Pulse with floating pulse is rootless, Hollow pulse with floating pulse is hollow-like. The patterns above are all lung-related coughing resulted from the wind cold and pathogenic factors that resident in other organsIn Chinese theories, with the attribute of Metal, direction of West and rhythm of Shang tone, lungs can perform like metallic bell with a loud and resonant sound, which correspond to the floating pulse. Due to Qi is also controlled by lungs, doctors must observe patients’Qi before diagnosing upon the pulse conditions; the pulse can perform well only if sufficient Qi exists. Moreover, a comprehensive diagnosis must consider the diversities for the overall pulse observation:Genuine Pulse Channel(真脉)andGenuine Organ Pulse Channel(真è„脉),Yin and Yang in pathogenesis and pathology, inferences based on mathematical analysis, combined cross-reference on color and pulse patterns, and various sources that generate pulse and Qi. From the usages of finger touch to the theory of "Five elements transition and engendering, restraining, overwhelming and reverse restriction", diagnosis upon pulse pattern could be used well to identify root cause of illness and syndromes.Various syndromes resulted from "Coughing from the Lung meridians" may look like the illnesses related to lung problems if we merely observe the exterior manifestations such as coughing, chest stuffiness, asthma, chest pain and so on. However, it is much more complicated than lung-related illness. According to the theory in "Book of Difficulties(éš¾ç»)â€,there are10varieties in each pulse pattern. Due to each of the5organs has its rigid and flexible properties interacting within human body, the manifestations of lung coughing are actually triggered by other potential diseases/illnesses from related organs. In this way, doctors can deduce other illnesses in different meridians through one of known issues. This phenomenon also proves the theme of10difficulties in "Book of Difficulties". In addition, we will discuss the syndrome analysis for the modern medical term, pneumothorax from our modern medicine view to support this thesis with abundant contents.The main topic of this article is about "Determining pathogenesis and pathology on pulse patterns(脉解机ç†)â€,so we will describe the pulse patterns in details but also involve the theories of "Observation on Qi(候气)â€,"Manifestation(æˆè±¡)â€While we probe the fundamental issue, we found that "Pulse" is originated by kidney and accomplished by stomach. That means, all phenomena could be concluded into the issue caused by spleen and stomach (with attribute of earth), as mentioned in "Book of Difficulties-15Difficulties (éš¾ç»å五难)":"Stomach, the sea of water and grains, controls the four seasons, based on the core-Stomach Qi. Stomach is the critical organ that could determine illnesses around four seasons, death and life."Based on the theory, human beings obtain Qi from grains. The procedure that grains are digested in stomach and then transmitted to the organs (5zhang organs and6fu organs) is completely activated by stomach Qi (胃气)Stomach and spleen produce delicate materials for blood through the complicated procedure of digestion. The clear flow(清)is running within pulse channels for flourishing purpose while the turbid flow(浊)is running outside of pulse channels for defense. The cycle continuously operates throughout5organs and integrates at Palm TaiYin, the lung meridian, as these two flows complete50rounds of circulations respectively at midnight. This endless circulation is always running seamlessly under Qi’s guidance.Once grains are digested, the stomach will transport the abundant energy and Qi up to spleen that governs ascending and descending Qi to distribute this energy to5interior organs. The energy generated after the noon is so-called "Nourishingè£â€and the one generated after the midnight is "Defenseå«". That is the saying in "Yin-Yang Treatise (阴阳别论)":"The Yang is positive factor of stomach and abdomen. Differentiated by Yang, we can figure out the cause of illness while we learning the critical deadline from Yin.The timing of afternoon belongs to Li Trigram in YiJing, with attribute of Fire, that accordingly matches to Heart as blood. It is classified as Yin-Descending in Trigram as Yin generation. YiJing says,"Qi from earth is steaming upward as clouds and Qi from sky is condensed as rain falling down." Under this logic circulation, the Yin-Descending attribute in Li trigram(离å¦)is seen as a turbid one in the clear type, also seen "triving Qi(æ‚æ°”)â€in grains. As for the period after midnight, it belongs to Kan trigram(åŽå¦),with attribute of water, that matches to Kidney as Energy. It is classified as Yang-Generating in trigram as Yang, is the clear flow in turbid, the "energy Qi" of grain. Therefore, the clear Li with the turbid thriving power defending outside the pulse channels, and the turbid Kan with the clear and smooth power nourishing within the pulse channels-"nourishing within the pulse channels" and "defending outside the pulse channels ", just work like the functional nature of lakes to rivers and atmospheric changes on this planet.As the Chinese proverb saying, the brightest lily is nourished from the grimiest mud, Yin is generated from the ultimate Yang and vise versa. We can see the same interactions circulated throughout human body, within meridians and vessels, organs, and channels of Qi and blood. Our organs are all nourished by the balanced Qi from stomach along with four seasons because stomach’s Yang attribute can generate Yin factor for five organs. In addition, stomach located at ZhongJiao(ä¸ç„¦)-the central part of human body, belongs to Earth, whereas act as a hub connecting the upper and lower part of human body. The five organs are activated by Yang Qi from stomach according to the changes of5seasons (Spring, Summer, Long Summer, Autumn and Winter). Therefore, this combination of5organs and5seasons is just supporting the thesis of "25types of Yang combinations(五五二å五阳)" mentioned in "Yin-Yang Treatise(阴阳别论)â€The ancient Chinese doctor, ZhongJing Zhang also utilized the diagnosis upon pulse channel of DeYang(跌阳脉)(ChongYang acupoint) to determine illness severity through stomach syndromes.In conclusion, stomach is the source of Qi generation for5organs, the energy center within human body and also the upstream origin of lung. The concept of12meridians and vessels could be concluded into a single thesis that each pulse channel and meridian interacts and interlocks with each other all the time. Earth Qi that generates the element Metal, directs all pulse channels toward to lung(with attribute of metal). The pulse channel of lung manifests itself at CunKo(寸å£)and integrated into the center. From this sophisticated connection between organs, we’ve learned that stomach Qi is the original source driving the operation of pulse channels within human body.In the last part of this article, we also discuss that we can take advantages by combing cross-reference of syndromes and pulse diagnosis. The main topics include:1. Comprehensive consideration of both complexion and pulse patterns2. Trustable description about pathogenesis and pathology of the ill organs3. Clarification for syndrome transmission and procedure, e.g. the causes and effects of generation, inhibition, overwhelming and reverse restriction between the five elementsConclusion:The theme of this research concludes discussions on "pulse patterns","syndromes","diagnosis" and "pathomechanism" to illustrate the human-oriented logic and philosophy in Chinese Medicine, as well as realization of harmony between human and the nature. Human body is acting like a micro-universe, that generated by the universe, with its operation and metabolism corresponding to the nature. The modern Chinese medical professionals are following the ancient philosophy and academic concepts to realize this harmony and balanced nature. |