Five Element Training

HISTORY

The Huang-ti-nei-ching (100 B.C.) discussed the circulation of the twelve conduits as an entire circuit of the movement of ch'i which were connected. In the Nan Ching the first 22 chapters are devoted to discussing the assessment of the twelve conduits, depots and palaces based on the diagnosis of this circulation of ch'i. Of special importance were jen-yeng "holes" on both sides of the larynx (carotid arteries) and the ch-i-k'ou 'holes' near the wrists of both hands (radial arteries).

Numerous diagnostic patterns emerged based on the system of correspondences and the Five Elements. The use of the radial artery to assess the twelve conduits became accepted since the ch'i was continuously circulating it was possible to assess this at any "hole" where the pulse was available. What eventually emerged as the standard organization of the pulse diagnosis was based on anatomical and energetic considerations.

The radial artery at the wrist was divided into three positions with the radial styloid being the demarcation of the middle position. The organs above the diaphragm were in the distal position and include the heart and the lung, the middle position reflected the organs of digestion and those organs below the diaphragm (liver, spleen), the proximal position were the organs of filtering and elimination ( kidney, bladder) and by convention the function of triple heater and pericardium.

The hollow (yang officials) organs were paired with the appropriate coupled yin organ and the pulses of these officials were in the same distribution. The zang (yin) pulses are deeper in palpation toward the radial bone and the fu (yang organs) are superficial toward the skin. This corresponds to the concept of depth of the different functions energetically and not anatomically.

USE OF PULSE DIAGNOSIS

The quality of the energy felt at each position can be influenced by the correspondences of the organ at this position. If the energy is not healthy at the organ involved the following "qualities can be felt: the wood is tense, taut ,wiry, ropy; fire is accelerated, rapid, thin; earth is languid, relaxed; metal is superficial, rough; water is submerged, smooth.

In Five Element Acupuncture the quantity of energy at each position is the critical assessment. We are focused on each Official as we take the pulse. There is less focus on the overall nature of the pulse quality. Each position can vary as to the quantity of energy present. The quality of the energy also can vary with the specific qualities for each Element be identified at any of the positions.

The pulse is used to confirm the impression of the Causative Factor. It is not a diagnostic tool per se, but should reflect a coherency with the other findings of the traditional diagnosis. The pulse diagnosis is used to follow the effects of the treatment. The assessment of the effectiveness of a specific acupuncture point stimulation is immediately ascertained by taking the pulse after the bilateral treatment of the point.

It is necessary for successful Five Element treatment that the pulse diagnosis be accurate and reliable. The pulse is taken after each point is stimulated and decisions about additional point choices is dependent of the effect of the treated point on the pulse. The changes from the treatment are both in quantity (volume) of energy and quality of energy. When a point is effective there is an obvious change in the pulse towards a state of better balance. If this change is not felt then further points must be stimulated.

The improvement from the previous treatment is assessed through several methods including the pulse diagnosis. The recognition of improvement on the pulse diagnosis is at times, the only recognizable change seen in the patient. The decisions which frame the subsequent treatment are partially based on the pulse picture. The accurate assessment of the pulse is critical in the formulation and implementation of the acupuncture treatments.

TECHNIQUE OF PULSE DIAGNOSIS

Pulse diagnosis is a technique which requires a quiet mind and a clear focus on the assessment from your own sensation of touch and feel. In pulse diagnosis, you are actually sensing a global energetic pattern of the person and organizing it through the structure of the pulse. It is not simply a use of your finger tips, but the use of yourself as an instrument to feel and sense what the status of the energy is in the patient.

To be the best instrument requires being focused entirely on the task at hand. It is not possible to be accurate in pulse taking if you are distracted or focused on something else. The goal is to create a quiet, still and non-judgmental state in which you are receptive, empty and clear. Quieting your own mental chatter will be helpful as well as giving yourself an uninterrupted period of time to do this work. Practicing meditation or other quieting techniques will be particularly helpful in working with the Five Element acupuncture approach.

KEYS TO PULSE DIAGNOSIS:

this technique requires practice repeatedly - take at least 10 pulses per day
take the patientís pulse completely at least three times before you write down your assessment
quiet yourself and be receptive to this experience
hold the patientís hand firmly and note the response to this
the preferred position of the patient is prone
the arm should be extended with no bend at the elbow
watches or tight bracelets need to be removed
position the height of the treatment table so you do not have to bend over
start with the left hand, holding with your left hand
find the radial styloid and position your middle finger over the radial pulse
use your thumb as an anchor over the styloid
this is the middle position over the artery
use the tip of your finger not the pad
the index finger is over the distal position
the middle position is the middle finger
the fourth finger is the proximal position
use one finger at a time
use very gentle pressure and establish the superficial pulse at each position
press slightly deeper to access the deep position

The Official at each position is the following:

LEFT DISTAL-SUPERFICIAL-II	DEEP-I
LEFT MIDDLE-SUPERFICIAL-VII	DEEP-VIII
LEFT PROXIMAL- SUPERFICIAL-III	DEEP-IV
RIGHT DISTAL- SUPERFICIAL-X	DEEP-IX
RIGHT MIDDLE-SUPERFICIAL-XI	DEEP-XII
RIGHT PROXIMAL-SUPERFICIAL-VI	DEEP-V