Four Examinations: Stage 4 – Palpating/Touching

Foundations of Chinese Medicine (continued) – The Four Examinations

The four examinations are:-

1. Inspection/looking

2. Listening and smelling

3. Inquiry/asking

4. Palpating/touching

This week I will focus on stage 4 – palpation/touching


Palpation includes pulse-feeling and feeling of other places on the body.


The Heart dominates blood and the blood vessels and all the blood vessels converge in the Lung. The Lung dominates Qi and through the function of Lung-Qi the blood is able to spread throughout the body. The Spleen and Stomach produce Qi and blood. The Spleen
controls the Blood and keeps the blood circulating in the vessels under the control of Spleen- qi. The Liver stores the blood and ensures the free flow of qi, regulating the amount of blood. The Kidney stores essence a fundamental factor of Yang Qi to aid the activities of the zang-fu organs. Thus, the pulse is closely related to the Qi, Blood and organs and tends to change when there is illness, pain, disease etc. in the body.

The pulse is felt in three positions on the wrist (same side as the thumb). This is called the Cunkou diagnostic method. The Cunkou pulse is divided into three portions: behind the wrist is a prominent bone (styloid process of the radius) which marks the guan position, behind the guan is the chi position and in front of the guan is the cun position.  On each of the cun-guan-chi positions a light, medium and heavy pressure is exerted, hence, 9 pulse feelings.

The left wrist cun position relates to the Heart, the right wrist cun position the Lung.

The left wrist guan position relates to the Liver and Gall bladder, the right wrist guan position the Stomach and Spleen.

The left wrist chi position relates to Kidney Yang, the right wrist chi position Kidney Yin.

There are approximately 27 different pulse types!

Palpation of other regions

This method of diagnosis can be divided into 3 types:

  1. Touching – places hands gently on a person’s body or head to identify
  2. Feeling – stroking an area on the body to find the shape, mass and texture.
  3. Compression – to press a local area, specific acupuncture points or along the
    channel/meridian to determine if there are any changes such as tenderness,
    warmth, eruptions, nodules etc.

I hope you have found my explanations of the Four Examinations useful. Next week I will
start to explain how causes of disease are viewed in Chinese medicine.

Review of my week

I have had another good week which has been busy and productive. Unfortunately I have not found time to explain EFT on my website. I will try to do this next week.

What did I learn?

I learned about a course called ‘Mental Health First Aid’ which teaches people:

  • To recognise the symptoms of mental health problems
  • To provide initial help
  • To guide a person towards appropriate professional help

The aims of the course are to educate individuals to:

  • Preserve life where a person may be a danger to themselves
  • Provide help to prevent the mental health problems developing into a more serious state
  • Promote recovery of good mental health
  • Provide comfort to a person experiencing mental ill health
  • Raise awareness of mental health issues in the community
  • Reduce stigma and discrimination

First aid for physical injuries teaches people to give initial care until medical treatment is accessed and Mental Health first aid does the same for someone experiencing mental ill
health. For more information I am aware that Beacon Counselling and Psychotherapy Services Ltd provide training. They can be found at . In
the New Year it is my intention to attend one of their courses.

Speak to you soon.

Lorraine x

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