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What Does Pulse-Taking Actually Tell Us — Reading Pulse Diagnosis in the Language of Circulation

Dr. Dr. Heo Ji-young, Director of Kyunghee Meerae Korean Medicine Clinic, Gwangjin
Written by Dr. Heo Ji-young Representative Director · KMD

The short answer

What can pulse-taking tell us? Rate, strength, and rhythm may offer clues about circulation and tension, but a pulse alone cannot diagnose disease or determine a prescription; abnormal signals need appropriate testing.

When a Korean medicine doctor rests their fingers on your wrist and takes your pulse, what exactly are they reading?

I understand pulse diagnosis as very concrete information. The pulse is, after all, the pressure wave created as the blood pushed out by the heart passes through the vessels. But there is a limit to what can be read from that wave. In this piece I want to say what I actually look for in a pulse, and what I do not.

The pulse is a "pressure wave"

When water flows through a pipe, the feeling at your fingertips changes with the volume of water, the pressure, and the elasticity of the pipe. Blood vessels are no different.

What I mainly look at is the rate and the strength of the pulse. Alongside those I look at the elasticity of the vessel itself and whether the rhythm wavers. If the pulse is uneven I suggest having the heart checked; if the pressure differs between the two arms, the vessels.

That said, I do not think illness can be sorted by dividing what the fingertips feel into fine categories. Rate and strength shift with tension, fever and dehydration too. The pulse is a clue, not the place where an illness is decided.

Why numbers from a machine alone aren't enough

A blood pressure monitor shows you a single number at a specific moment. Pulse diagnosis reads the texture of that person's blood flow and the tendency of its flow. The two do not replace each other; they complement each other.

I match the clues gained from the pulse against the symptoms, body type, and daily life the patient describes. When information like "the pulse is like this, and the hands and feet are cold, and sleep is shallow" comes together, a picture forms of which link in circulation and the autonomic nervous system has been disturbed. Pulse diagnosis is one piece of that picture.

I do not set direction from the pulse alone

What the pulse gives me is a fragment. A direction only takes shape when that fragment is set against symptoms, build and daily life. I do not decide a prescription from the pulse alone.

What the pulse can tell and what it cannot

Pulse diagnosis does not sort out every disease. The pulse gives useful clues about the state of circulation and tension, but confirming an organic disease requires imaging or blood tests. When I read an abnormal signal in the pulse, I in fact recommend the appropriate examination first.

Reading an old diagnostic method anew, in the language of circulation — that is how I approach pulse-taking.


Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)

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Dr. Dr. Heo Ji-young, Director of Kyunghee Meerae Korean Medicine Clinic, Gwangjin

Dr. Heo Ji-young Representative Director · KMD

Kyunghee Meerae Korean Medicine Clinic — Jayang-dong, Gwangjin-gu, Seoul (Guui Stn. Exit 4)

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A graduate of the College of Korean Medicine at Kyung Hee University, with master's and doctoral degrees in pathology — the mechanisms of disease — from its graduate school. Later served as a research professor in the university's Herbology department, studying medicinal substances. Studying both disease and medicine from both sides is the foundation of this practice: explaining "why a given medicine works for a given illness" in the language of both pathology and pharmacology.

Explains autonomic, chronic, and intractable conditions — and structural problems of the body — in the language of modern science, and proposes treatment matched to the cause. Has taught prescribing and clinical practice to Korean medicine doctors for over ten years, and is a co-author of "Korean Medicine, Explained by Korean Medicine Doctors," selected for the 2018 Sejong Books list (general category).