When taking pulse, the fingers examining the cun, guan, and chi positions should be primarily focused among three aspects of the vessel: shape, jump, and level. These three criteria make up a complete pulse, and must be evaluated in order to accurately form TCM and biomedical diagnoses in patients.
The shape of the pulse primarily accounts for structural aspects such as topography and width. Some common examples of shape are Wiry, Dispersing, and Convex. Jump refers specifically to the pulsation aspect of the vessel and accounts for qualities such as rate, strength, and flow. In addition, there are four aspects of jump, and they are velocity (fast or slow), strength (forceful or weak), resistance, and amplitude. The third criterion is level, and level is simply the depth at which the pulse is felt.
A comprehensive discussion of all three criteria may be found in my Pulsynergy Made Easy Part II and III courses. This article details only the convex-shaped pulse known as the Bird’s Beak or Pen-Tip pulse, which, among the many different shapes detectable within the pulse, is one of the most interesting, and most remarkable when properly detected.
Convex pulses as a whole are pulses that tend to bulge upward and outward, with a definitive rounded feeling underneath the finger. The lengths of convex-shaped pulses vary from 0.1-2.0 cm. Convex pulses are usually indicative of pathology in the vessels in the form of stagnation, as indicated by a mass, swelling, or obstruction of the organs. The location of the stagnation may be reflected by the position of the pulse. The larger the convex-shaped pulse, the bigger the stagnation, mass, or obstruction. The harder the convex-shaped pulse, the harder the stagnation, the more compact the mass, and the longer it will take to dissolve.
Among the convex-shaped pulses, the shortest pulse is known as the Bird’s Beak or Pen-Tip pulse. This type of pulse is approximately 0.1 cm in length. Like its name, the feel of this pulse underneath the finger is pointy and small, like that of a bird’s beak or pen tip. If this pulse is hard and cannot be pushed away with pressure, the condition is generally more severe. If this pulse is soft and weak, it indicates a milder condition, and one that is more temporary.
The Bird's Beak pulse may be found at all positions, but it is most commonly found in the left guan position or the chi positions. In the left guan position, this pulse is often found with the deep and concave pulse, and is an indication of gallbladder stones. If this pulse is found deep in either the left or right chi positions, it is an indication of kidney stones. More specifically, this indicates stones that are in the ureters. (Kidney stones that are still within the kidneys are not reflected on the pulse.) When the pulse is found on the right chi, it indicates that the stones are in the right ureter; and when found on the left chi, the stones are in the left ureter. Patients with this kind of pulse may experience back pain.
For treatment of stone conditions, I recommend two formulas: for gallstones, use the formula Dissolve GS; and for kidney stones, use the formula Dissolve KS. Dissolve GS is a formula that is suitable for non-acute situations of gallstones. It consists of herbs that clear damp heat, dissolve stones, and relieve abdominal and epigastric pain. Dissolve GS should be taken at 2 grams, three times daily on an empty stomach with warm water, and must be taken continuously for at least three months. In cases of multiple or large stones, the treatment should be continued until the stones are dissolved or passed out. Dissolve GS may also be taken after surgery to prevent the formation of new stones. In such cases, take 1 gram per day for three months immediately following the surgery, and 0.5 grams per day for another six months.
Dissolve KS is suitable for kidney stones that are small enough to be passed, and should be cautioned in patients with concurrent kidney infection. This formula consists of herbs to dissolve stones, promote normal urination, and relieve spasms and pain. Dissolve KS should be taken at 1.5-2 grams, three times daily on an empty stomach, with warm water. If necessary, the dosage may be increased up to 3-4 grams three times daily. Patients should continue to take these herbs until the stones are dissolved or passed out in the urine. Dissolve KS can also be taken prophylactically at 0.5-1 gram per day for six months.
About the Author
Master Jimmy Wei-Yen Chang is a Doctor of Oriental Medicine trained in Taiwan and a licensed acupuncturist in California and New York. He has over 30 years of concentrated clinical experience, applying his expertise in differential diagnosis and herbal prescription. Master Chang is the author of the pulse diagnosis manual, Pulsynergy, and he currently pursues his specialties in private practice in Hacienda Heights, California. He is widely recognized for his skills in correlating definitive pulse diagnoses with herbal prescription.
To learn more about pulse diagnosis and herbs, click here [2] to view a complete list of courses by Jimmy Chang.