It can be useful to correlate the patient's report of whether he or she feels hot or cold by feeling the skin, generally.

If the skin feels cold, then this suggests a Cold disharmony.

If the skin is hot to the touch, then this may suggest an invasion by external Heat.

Again, it can be useful to correlate the patient's report of sweating and moisture by direct feeling of the skin.

Moist skin may suggest a Lung disharmony.

Dry skin may suggest a deficiency of Blood or Body Fluids.

An important indicator of areas of stagnation can be gained by palpating along the meridians looking for possible tender spots - "Ashi" points as they are called in Chinese medicine. They may indicate a local channel problem or may be indicative of a more deep-seated Zangfu disharmony.

THE TAKING of the pulse is considered to be of prime diagnostic importance in Chinese medicine. The emphasis is on the quality of the pulse in various positions on the wrist. It is recognized that there are about twenty-eight different pulse qualities that can be felt on three different positions and at three different depths on the wrist of each hand - each with its own subtle nuance of interpretation.

Clearly, conveying a complete and full understanding of the nature and significance of pulses in Chinese medicine is beyond the scope of this book. Any fledgling practitioner of Chinese medicine soon learns that feeling and understanding pulses is something more of an art, requiring practical experience under the guidance of a qualified physician.

There are three positions near each wrist on the radial artery. Each position relates to a specific aspect of the Zang organs. These positions are shown diagramatically below.

The depth at which the pulse is felt is also considered important. There are three levels, each requiring slightly increased pressure. These levels are the superficial level near the skin, the middle level, and the deep level close to the bone.

As in Western medicine, the speed of the pulse is taken and compared with the average of about 68-75 beats per minute.

The width of the pulse between fingers is noted.

An important indicator of whether a disharmony is an excess or a deficiency can be gained from judging the strength of the pulse.

There is a variety of qualities of the "feel" of the pulse, and these are considered indicators of a particular disharmony pattern.

The consistency of the pulse flow and the nature of any inconsistency are considered important.

The major features of the most common pulses are shown opposite. Again, it should be remembered that this is offered as a summary of a topic that is considerably more complex. There are other less common pulse qualities that could

also be described, but the table gives a breakdown of those most commonly observed. It should also be noted that an individual's pulse can exhibit a variety of qualities in different positions and depths, and a full diagnosis may involve having to consider the qualities observed in relation to the appropriate organ defined by the position.

There are stories of Chinese physicians who can diagnose the whole pattern of