| Summary: | 碩士 === 長庚大學 === 中醫學系傳統中醫學 === 100 === Pulse examination is an important tool in traditional Chinese medicine for diagnosis, prescription, and prognosis. Despite many different approaching systems of pulse examination, “the stomach, spirit, and root of pulse” are simple but useful approaching models.
We try to identify the descriptions of stomach, spirit, and root of pulse from the Inner Classic (Nei Jing) and the Classic of Difficult Issues (Nan Jing), and then apply the principle of “exegesis through the Classic itself” and referring to opinions of later medical scholars, in order to recover the clinical criteria for determining the stomach, spirit, and root of pulse, and clarify its meaning. Furthermore, we try to explain the possible mechanisms of the stomach, spirit, and root of pulse according to cardiovascular physiology, and verify its significance through research in journal literature.
The clinical method of determining the root of pulse is to “gently lift fingertip, in the same position, after pressing fully to the deep level at the cubit pulse,” and the definition of pulse with root is “rapidly forceful rebounding with full shape” when slightly lifting fingertip. Physiologically, the root of pulse means the changes before and after the critical point in hemodynamics, which is created by lifting fingertip slightly. The possible projective physiological signal is diastolic blood pressure or cardiac output.
The stomach of pulse is not a specific pulse manifestation, but the characteristics of calm and gentle pulse sensation. A pulse with stomach qi is described as “weak but slippery pulse.” The “weak pulse,” which represents “stability” instead of ups and downs, means the pulsation has gone through the buffer system in the body. The “slippery pulse,” which is “continuous with clear margins” as opposed to intermittent or fuzzy, means the pulsation has gone through the modification of the high-frequency stomach qi. Physiologically, the stomach of pulse reflects the ability of autoregulation. The possible projective physiological signal is blood pressure variability.
The spirit of pulse has broad meanings, sometimes including the contents of the root and stomach of pulse. When it specifically reflects spiritual awareness, the two aspects can be described in, which are “arrival and departure” and “appearance and end.” In the aspect of “arrival and departure,” pulse with spirit means “structured and ranked pulsation” without disorder. In the aspect of “appearance and end,” pulse with spirit means “steady” without rash. Physiologically, the spirit of pulse is close to the concept of entropy. The possible projective physiological signal is heart rate variability.
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