Picture: Miriam’s room is at the very far left of the building.
It’s been a whirlwind few weeks. Sorry to be out of touch. The classes in Australia and Hawaii went beautifully, thanks to their amazing hosts, Mei Li and Jordan. It’s been so lovely to meet many new people eager to engage the medicine.
Tonight we had dinner with Paul and Sue Reynolds, the wonderful hosts of the Edinburgh pulse diagnosis class I’ll start tomorrow. Paul turned up in a kilt, which was really something. We could have stayed in the restaurant chatting all night, but earlier today we moved our daughter Miriam into her dorm, nay, her residence hall at St Andrews University, a couple of hours drive away. I had no idea Edinburgh was such a beautiful city. Driving through the city, you keep thinking that the glorious Georgian architecture must surely come to a stop at some point, but no, the entire city is a massive, preserved, 19th-century metropolis. It’s stunning, especially if you love old buildings with deeply worn front steps on winding roads.
At dinner we discussed some ideas encountered here during the promotion of tomorrow’s class. Some people said that they didn’t think they needed pulse training because they were satisfied treating without pulse information, and some said they felt intimidated or overwhelmed by the very thought of pulse diagnosis.
I think people get the idea that pulse diagnosis is intimidating because they have been actively discouraged by teachers: “it takes at least ten, maybe twenty years to learn” and “it a very difficult and antique skill” or “you don’t need it anyway” and “you should diagnose from what the patient tells you” or even “you have to be Chinese and already have it in your bones” and “it cannot be taught”….
Pulse diagnosis is the jewel in the crown of the practice. It’s breathtaking in its capacity. And, it is eminently learnable. Wherever I am in the world, at the end of the classes, practitioners do have a clear understanding of the beautiful workings of reading pulses, even as they may also feel some degree of information overload that will take its own time to digest. They know that all they need to do is to stay engaged and practice day to day, as one does when practicing a musical instrument, allowing the skill to develop naturally.
Pulse taking leads a practitioner to the core of an issue. Without it, all we can do is address the patient’s symptoms. Symptoms are complex clues to identifying the underlying mechanisms that are out of tune, but symptoms are not the underlying mechanisms themselves. A complaint can have root causes that are a degree or a couple of degrees of separation from the presentation. For example, a person reports asthma, and we may be tempted to treat the lungs, but that individual’s pulses are focused on a tightness in the lower torso, rendering the lower belly incapable of receiving qi from the lungs, thus leaving the lungs in a state of intense stagnation. Or a person reports pain in the temples, and that individual’s pulses point to a deficiency of blood causing tightness in the gallbladder channel as it tries to bring blood back to the liver to conserve it. Similarly, a person reports chronic depression, and that particular individual’s pulses point to spleen qi not ascending to the lungs, or kidney yang not ascending to the spleen in the first place, or both. With extraordinary clarity, pulses point the practitioner to the individual’s unique circumstances. A single symptom that is common across numerous patients can have an utterly different cause in each case—one of perhaps thousands of permutations and scenarios. None of these can be determined by only listening to the words of the patient—if we do that, then every back pain would be treated in the same way, every migraine in the same way, every asthma case in the same way. We’d become technicians rather than medical artists. When practiced with its gleaming jewel in place, acupuncture is a complete, far-reaching, marvel of humanity.
Ann Cecil-Sterman
Edinburgh, Scotland
7 September, 2024.