The palpation examination covers taking pulse and pressing the skin, hands, feet, chest, abdomen and other areas to check for pathological changes. Pulse examination is perhaps the most important aspect of the whole examination.

Feeling the pulse
According to TCM, the pulse is the palace of blood; it is governed by the heart and commanded by qi (vital energy). Whatever the causes of the disease, abnormalities or pathological changes can be reflected by the pulse, and from this arise changes in the pulse image. Pulse-taking helps in judging the location and nature of a disease and the prosperity and decline of qi (vital energy) and pathogens to infer prognosis of the disease and form the basis for treatment.

The common location for pulse taking is above the wrist where the radial artery throbs; the first three fingers are pressed on it, which are named: the cun, guan and chi regions. (Please see picture for reference). There are various descriptions concerning the relationship between these three regions and their corresponding organs. It is generally acknowledged that the three regions of the left hand reflect respectively the conditions of the heart, liver and kidney; and those of the right hand reflect the conditions of the lung, spleen and kidney.

The different points of the pulse felt on the wrist represent the functions of different organs.

TCM names Chu Guan Chi Left side Heart Liver Kidney Right side Lung Spleen Vital Gate When feeling the pulse, the patient places the arm at the same level with the heart. The wrist is extended and the palm faces upward. This position facilitates smooth circulation of qi (vital energy) and blood. The physician usually uses his left hand to check the right side's pulse, and the right hand to check the left side's pulse. Generally, fingers are pressed on the three regions with the same strength, and then each region is felt separately according to the actual pathological conditions. Each pulse reading should be at least 50 pulse counts.

Method for pulse taking

The common abnormal pulse signs

As the development of disease is complicated, the above abnormal pulses do not often appear in their pure form; two or more forms may be felt at the same time. For example, a floating and tense pulse indiactes exterior cold syndromes, and a floating and rapid pulse indicates exterior heat syndromes.

Pressing examination
This methods enables a doctor to infer the location, nature and state of an illness by touching, feeling, pushing and pressing certain parts of the patient's body. Its content includes: pressing the skin and muscles, chest and abdomen, acu-points.

Organs in the chest and abdomen. Skin and muscles: Cold, feverish, moist or dry or swollen skin and muscles tell about the conditions of yang qi or pathogens that have invaded the body. In general, if pathogens are in excess, the temperature is high; when the yang qi is depleted, the temperature is low. Chest and abdomen: Important organs reside here and symptoms of fullness, hardness, heat or pain in specific areas can indicate which organ is not functioning properly. For example, in the case of liver deficiency, the patient may experience hypochondriac pain (pain beneath the ribs), which is comforted by massage, and the area feels weak and empty when it is pressed. Acupressure points of the human body. Acu-points: Chinese medicine believes that the internal mechanisms of the body are mutually connected; therefore, a given area of the body can be a reflection of the entire body. Moreover, the acu-points are places for the organs' qi to meet; abnormal sensation in these points reflects disease of the organs. For example, pressure point pain in the acu-point of "dan-shu" indicates gall-bladder disease, pressure point pain in "gan-shu" and "qi-men" indicates liver disease.

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Pressure point pain in the Qimen & Ganshu acupoints can indicate liver disease and in the Danshu point gall bladder disease.