Dr. Xiao Bailang:Reference Articles on TCM Cases/Discussions/Clinical Studies
Introduction
Professor Gao Shuzhong specializes in using the theories from the “Huangdi Neijing” and “Nanjing” as a foundation, often employing classical and traditional diagnostic methods to differentiate and treat diseases. This article presents Professor Gao’s unique experience in pulse diagnosis: “The diaphragm and navel determine the regulation of the three burners; where does the pulse escape? By assessing the acupoints, one can discern the true and false, and the differentiation will not be mistaken.” This method combines palpation and pulse diagnosis, using pulse diagnosis to reflect the dynamic process of abnormal Qi dynamics and palpation to obtain the relatively static results of these abnormalities.In ancient times, pulse diagnosis specifically referred to the examination of the pulse, also known as “qie mai”. According to the “Lingshu: Nine Needles and Twelve Origins”, “Before using needles, one must first diagnose the pulse to observe the severity of Qi, and only then can treatment be administered.” Pulse diagnosis is the primary method for assessing the strength and weakness of Qi, presenting dynamic and changing information about the condition, and can intuitively reflect abnormalities in Qi dynamics.The theory of Qi dynamics is a crucial support for Professor Gao’s clinical diagnosis and treatment, diligently seeking ancient teachings and extracting meaning from the unspoken, he proposes a unique insight that the Qi dynamics of the body are primarily governed by the Qi dynamics of the organs, revolving around the navel as the center, believing that the operation of organ Qi primarily involves three ascensions and three descents: the liver ascends while the lung descends, the spleen ascends while the stomach descends, and water ascends while fire descends.Abnormalities in Yin-Yang Qi dynamics are the source of all diseases; closely examining the ascension and descension is the criterion for differentiation, and regulating the ascension and descension is the key to treatment. Professor Gao summarizes his unique experience in determining abnormalities in Qi dynamics as:“The diaphragm and navel determine the regulation of the three burners; where does the pulse escape? By assessing the acupoints, one can discern the true and false, and the differentiation will not be mistaken.” This means that palpation and pulse diagnosis reflect the dynamic process of abnormal Qi dynamics through pulse diagnosis and obtain the relatively static results of these abnormalities through palpation. In modern times, these two methods of obtaining information about the condition are collectively referred to as pulse diagnosis.Abdominal palpation: “The diaphragm and navel determine the regulation of the three burners” The abdomen is the convergence point of the body’s organs and meridians, and is the primary site for the operation of the three burners’ Qi dynamics.Professor Gao creatively interprets the theory of “the twelve origins arising from the four gates” as the four key points of connection: the wrist, ankle, diaphragm, and navel, where the diaphragm gate separates the upper burner from the middle burner, and the navel gate separates the middle burner from the lower burner.The three burners serve as the channels for the body’s Qi to ascend and descend, gathering the original Qi deep within the navel, which first ascends from the lower burner through the navel gate, combining with the nutritive and defensive Qi generated in the middle burner, ascending through the diaphragm gate, and merging with the ancestral Qi gathered in the upper burner, dispersing throughout the body through the lungs to nourish the organs and limbs.If the diaphragm gate and navel gate are obstructed, the original Qi, nutritive and defensive Qi, and ancestral Qi cannot be properly distributed, leading to abnormalities in the ascension and descension of organ Qi, where liver Qi cannot ascend to the left, lung Qi cannot descend to the right, spleen and stomach cannot pivot, and the heart and kidneys cannot interact, resulting in a multitude of diseases.Abdominal palpation is an important method for determining whether the diaphragm and navel gates are unobstructed, primarily by comparing the temperature differences above and below the diaphragm and navel, as well as palpating around the navel to assess whether there are abnormalities in the body’s Qi dynamics.1. Temperature Measurement: The patient lies flat, and the physician touches the skin temperature above and below the diaphragm and navel. Based on the temperature differences, one can assess the coldness and heat of the upper, middle, and lower burners, as well as whether the Qi dynamics at the navel and diaphragm gates are unobstructed.If there is a significant temperature difference between the diaphragm and navel, it suggests that the diaphragm gate is obstructed; if there is a significant temperature difference above and below the navel, it suggests that the navel gate is obstructed. The “origin of the fat” is located below the diaphragm, and the “origin of the hwang” (Qihai) is located below the navel; if the diaphragm and navel are obstructed for a long time, the disease will enter the fat and hwang. The “Suwen: On Prohibitions of Acupuncture” states: “Above the diaphragm and hwang, there are parents… following this brings blessings, going against it brings misfortune.”Comparing the temperature of the chest and abdomen with the extremities, if the patient’s hands and feet are cool while the chest and abdomen are warm, this indicates that Yang Qi is trapped in the chest and abdomen and cannot reach the extremities; if the hands, feet, and chest and abdomen are all cool, this indicates Yang deficiency or excess cold; if the hands, feet, and chest and abdomen are all warm, this indicates Yin deficiency or excess heat.2. Navel Diagnosis: The navel is the hub for the entry and exit of Qi dynamics in the body, the location of the Taiji. The “Nanjing: Sixteen Difficulties” specifically records the corresponding relationships of the five organs around the navel based on the principles of Taiji and the Eight Trigrams, and explains how to determine the diseased organs through palpation. Professor Gao establishes this theory by defining the tender points 0.5-1 inch above, below, left, and right of the navel as the Navel Heart Point, Navel Kidney Point, Navel Liver Point, and Navel Lung Point. The patient lies flat with knees bent, and the physician palpates the Navel Heart Point, Navel Kidney Point, Navel Liver Point, and Navel Lung Point for tenderness, while also feeling for any movement of Qi (arterial pulsation), correlating the tenderness and movement of Qi with the five organs to identify which organ is diseased.Clinically, tenderness at the Navel Liver Point and a soft Navel Kidney Point are the most common findings, indicating liver Qi stagnation and kidney deficiency, respectively.Pulse Diagnosis: “Where does the pulse escape?” “The pulse is unique to the disease” first appears in the “Suwen: On the Three Parts and Nine Conditions”, stating: “Observe the nine conditions; the unique small pulse indicates disease, the unique large pulse indicates disease, the unique rapid pulse indicates disease, the unique slow pulse indicates disease, the unique hot pulse indicates disease, the unique cold pulse indicates disease, the unique sinking pulse indicates disease,” Zhang Jingyue elaborates on the multiple meanings of “unique” in the “Complete Works of Zhang Jingyue: Pulse Spirit Chapter”, stating, “The meaning of unique includes uniqueness in location, uniqueness in organ Qi, and uniqueness in pulse body.” Based on this, Professor Gao summarizes his clinical findings as:① Uniqueness in location, where the pulse is abnormal while the rest are normal, indicates disease in that location. Different parts of the body correspond to different locations at the pulse point; the “Nanjing: Eighteen Difficulties” divides the pulse point into upper, middle, and lower sections, corresponding to the area above the chest to the head, below the diaphragm to the navel, and below the navel to the feet, respectively. The “Jinkui Yaolue: Wind and Cold Accumulation in the Five Organs” discusses the specific locations of the pulse at the pulse point corresponding to different body parts, which can be referenced clinically; ② A unique pulse in one of the three sections, as recorded in the “Suwen: On the True Organs of the Jade Machine”, each organ has five pulses corresponding to it: the liver pulse is wiry, the heart pulse is surging, the lung pulse is floating, the spleen pulse is slow, and the kidney pulse is deep; if a unique pulse is found, it indicates disease in that organ; ③ Uniqueness in pulse body, if the same pulse shape, pulse count, and pulse quality are seen in all three sections, it indicates a pathological pulse, which corresponds to the statement in the “Suwen: On the Mechanisms of Disease and Qi: Preserving Life: Original Pulse Theory”: “The pulse cannot be uniquely floating or sinking, uniquely small or large, uniquely strong or weak, uniquely Yin or Yang.” The three layers of “unique pulse” often appear together in clinical practice, and here are examples of common abnormal pulse patterns: A large pulse at the left guan indicates liver disease, suggesting liver Qi stagnation; A slippery large pulse at both guans indicates liver and stomach disease, suggesting disharmony between liver and stomach; A floating pulse at both cun indicates lung disease, suggesting lung Qi not descending.Acupoint Diagnosis: “Assessing the True and False of Acupoints”Acupoints serve as both reflection points for diseases and treatment points for acupuncture, thus possessing both diagnostic and therapeutic properties. In modern clinical practice, there is a greater emphasis on their therapeutic role, often neglecting their diagnostic function. Acupoint diagnosis, as a unique diagnostic method within the framework of acupuncture theory, holds significant theoretical and clinical value.Diagnosing Internal Diseases through External AcupointsThere are primarily three pathways for connection:First, acupoints connect with organs through meridians, reflecting internal organ and meridian diseases; second, the direct infusion of organ Qi into acupoints, such as lower he-sea points, source points, back-shu points, and front-mu points, which are special areas where organ Qi directly infuses into the body surface, reflecting the strength and weakness of organ Qi; third, through the body’s surface holographic projection directly reflecting diseases, such as facial holography. The “Neijing” records two major acupoint systems, including the fourteen meridian acupoint system based on meridian theory and the holographic acupoint system based on holographic theory. Meridian acupoints are reflection points for the first two pathways on the body surface, while holographic acupoints are projection points for organs and limbs on the body surface. The diagnostic results reflected by these two systems differ based on their acupoint attributes and theoretical foundations.1. Specific Acupoint Diagnosis Based on the different relationships between specific acupoints and organ meridians, the source points, lower he-sea points, back-shu points, and front-mu points among the fourteen meridian acupoints have the closest relationship with organ meridians, making their reflection of organ meridian Qi more accurate in both theoretical and practical significance. The diagnostic structure is shown in Table 1.Table 1: Diagnostic Structure of Specific Acupoints
Table 1 lists the clinical significance of the source points, back-shu points, front-mu points, and lower he-sea points based on Professor Gao’s clinical experience, while other specific acupoints such as the six fu organ source points, luo points, and xi points are not included due to their limited application in clinical diagnosis and lack of systematic theoretical summaries. In clinical application, it is important to note that different attributes of specific acupoints can be used for diagnosing disease location and nature, but due to the complexity of the condition, their differential diagnostic significance may be insufficient and should be correlated with pulse diagnosis, tongue diagnosis, and other diagnostic methods.2. Holographic Acupoint Diagnosis Each relatively independent part of the body has an overall projection, a principle already recorded in the “Neijing” and applied in disease diagnosis. Over time, various holographic correspondences such as the pulse point, ear, and eye have emerged, integrating with diagnosis and treatment. Professor Gao, based on the “Lingshu: Five Colors” and “Suwen: Key Points of the Pulse”, has located a series of holographic acupoints corresponding to facial and wrist areas, combining modern biological holographic theory.Facial holographic acupoints for the five organs primarily diagnose diseases through observing color and luster, while other facial holographic acupoints corresponding to the six fu organs and limbs, as well as wrist holographic acupoints, primarily diagnose diseases through palpation to assess the presence or absence of tenderness. The six fu organs “transmit and transform substances but do not store them”; meridians are the pathways for Qi and blood circulation, and limbs are distributed throughout the meridians. Therefore, both the six fu organs and meridians are utilized for their function; if there is obstruction, it may lead to Qi stagnation, and over time, blood stasis, with Qi and blood stagnation in local holographic acupoints often reflecting as tenderness or nodules.These holographic acupoints primarily diagnose disease locations through palpation for tenderness, nodules, or cord-like structures, reflecting corresponding diseases of the six fu organs and limbs, commonly used for diagnosing disease locations, such as the breast reflecting chest diseases and breast diseases, the nose reflecting stomach diseases, the wrist reflecting thyroid diseases, and the genitals reflecting reproductive and urinary system diseases; the nature of the disease requires correlation with other diagnostic methods for clarification. This content is selected from the Chinese Journal of Traditional Chinese Medicine (formerly the Chinese Medical Journal), Volume 36, Issue 10, October 2021, and the copyright belongs to the original author. If there is any infringement, please contact us.Recommended Reading, click to read the original text: Xue Boshou: How to Diagnose and Treat Sweating on One Side of the Body? Xu Yueyuan: 27 Characteristics of Female Pulse Patterns Summarized by a Pulse Diagnosis Expert//////////【 Read Previous Highlights 】#TCM Introduction Collection #Twelve Meridians Explained #Donghai Medical Collection #Old TCM Practitioners’ Experiences #TCM Formulas #Secret Formulas #Masters of Traditional Chinese Medicine#Famous Cases of Cold Damage #Selected Famous Cases from Jinkui#Four Gentlemen Decoction #Etiology Assignment #Herbal Properties Assignment #Herbal Properties Song for 400 Herbs #Medical Three-Character Classic #Daily Insights from Mentorship# Daily Insights from Mentorship on Principles, Methods, Formulas, and Herbs#TCM Serialized CollectionMaster He Ren: What is the Essence of Using Warming Meridian Decoction?Zhou Zhongying: Insights and Techniques from 60 Years of TCM Diagnosis (All Essentials)Ding Guangdi: Qianghuo Shengshi Decoction for Treating “Five Morning Diarrhea”Unexpectedly, “Qinggu San” is indeed the remedy for fever after bone fractures!Dan Zha San for Treating Hyperlipidemia (Including Four Recipes for Hyperlipidemia)Shanghai Shen’s Gynecology 600-Year Family Secret Recipe Amazing! A Wonderful Experience of Using Ancient Formulas to Treat Tooth Decay! The Ancient Formula “San Liang Ban” is Effective for Quick Recovery from Lumbar Muscle Strain! 【Collect and Save】 Eight Recipes from Nanshi for Treating Insomnia, Hypertension, and Gastrointestinal Diseases!
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