I responded to these complaints by telling him that instead of saying “duck” we should call that sound “water chicken,” after a description of his condition written in a medical book almost 1,800 years ago. I took his pulse and I let him know I could not find the lung pulse. I concluded that phlegm was blocking both the meridian and the pulse. I looked at his tongue, but at that moment could not make up my mind as there just was not enough evidence to give a definitive diagnosis. I examined his complexion which was pale. While we talked his eyelids partially closed. His eyes began to roll back in his head until all I could see were the whites! This occurred because his phlegm was blocking his bronchi, and he was not getting enough oxygen. (In TCM we say, “the mucus puzzles the orifice.”)
I asked him quite seriously, “Do you prefer hot water or cold water?” He answered, “I drink lots of hot tea.” By then, I realized what I could do for him, but I also asked, “What is the color of your phlegm?” He said, “Green.” I began to realize that the nature of his problem was cold but there was also some heat because too much phlegm already blocked his lungs. So I used the 1,800 year-old prescription and changed it accordingly. I gave him three packages of herbs to try.
Three days later he came again. He told me that he felt much better. His face looked better than before and his complexion was no longer pale. He walked with more ease, and the water chicken sound was gone. I gave him two more packages of herbs with slightly different ingredients.
After he finished those two packages, he reported that he was even better. He told me, “The first three packages of herbs were not good enough.” I said, “But it chased out the water chicken for you.” He asked again, “How come there were so many ducks or water chickens in my chest?” I responded, “The excessive amount of mucus or phlegm that had accumulated created that noise.” I also told him, “The first day you came in for treatment your pulse should have been “superficial” and “slippery” according to the nature of the problem but that day you did not even have a pulse!” The patient asked, “Why?” I told him that the mucus was blocking the passage. But in TCM we say, “Even without the pulse evidence we can sill act according to the symptom.” His condition can be classified as a flu, in which case the pulse can seem superficial because the defensive power of the lung is being attached, the mucus has blocked the passage, and it becomes narrower. The pulse will then have a slippery sensation.
“Let’s say you have a flu, but a medical check-up is negative and you feel o.k. If I take your pulse, and it is slippery, then accordingly I will say, ‘You sometimes feel dizzy, have a bad memory, and get angry easily.’ You might not admit it at the beginning, but later, after treatments you will admit it, and will say, ‘No wonder.’” “Now I understand!” he said. “How were you able to you make up your mind?” I laughed, “The only way is to learn widely and listen broadly.”
Diagnostic Principle:
Reading the Slippery Pulse. Visualize a rubber pipe with fluid moving through it. The sensation of the fluid moving through it is smooth and steady. But, if you clog up the pipe with gelatinous stuff (e.g., mucus), the fluid will have to move around it in order to get through the pipe. Slight pressure will build up as the fluid first encounters the mucus and then pushes against it before managing to course around it. The pulse sensation produced for the doctor is one of ‘rolling,’ and as if the pulse is ‘getting away from you.’
No comments:
Post a Comment