Special usage of TCM feeling pulse in paediatric clinical practice

Feeling children’ pulse is wholly different from the adult’s. Because cunkou of infants is very short and infants often cry in clinical examination which can causes Qi disorder and affect feeling pulse. How to take children’ pulse? In TCM, It is called infantile index finger veins, which means to examine the length, color and shape of the veins along the palmar margin to differentiate syndrome. To inspect the infantile index finger veins is applicable for the infants who are under three-year old. It is called three passes, namely wind pass, qi pass and life pass.

The first stem of the index finger, the part between metacarpophalangeal transverse lines and the transverse lines on the second stem, is wind pass. The part between the transverse line on the second stem and the transverse line on the third stem, is qi pass. The third stem, the part between the transverse line on the third stem and the top of the index finger is life pass.

The normal infantile index finger vein is light red, dimly visible within the wind pass. Thicker and longer in hot weather, thinner and shorter in clod weather. 7 to 8 beats in a cycle of breath is normal condition for under three-year old chilren.

Methods: the doctor grasps the end of the infantile index finger with the left hand, and pushes the infantile index finger from the anterior palmar margin of the index finger to the palm direction for several times with the side of the right thumb.

Diagnosis:

1. Length:

Infantile index finger vein on the wind pass means mild diseases.

Infantile index finger vein extends to the qi pass means serious diseases.

Infantile index finger vein extends to the life pass, namely to the tip of the finger means critical condition.

2. Color:

Light-color and whitish vein means insufficiency of qi and blood.

Reddish vein means exogenous wind and cold.

Purplish vein means exuberance of heat.

Bluish vein means pain syndrome or convulsion.

Purplish dark vein means blood stasis, critical condition.

3. Floating and sinking:

Visible and floating vein means superficial diseases.

Deep and indistinct vein means internal diseases, or internal impairment.

Lightness and stagnancy:

Light-colored vein means insufficiency of qi and blood.

Stagnancy and dull colored vein means excess of pathogenic factors and stagnation of qi and blood.

4. Form:

Thin vein means asthenia of blood and yin.

Thick vein means sthenia and heat syndrome.

Gradual extension of vein means progression of diseases.

Gradual shrinkage of vein means alleviation diseases.

Generally speaking, floating and fast pulse pertains to yang, deep and slow pulse pertains to yin, strong pulse pertains to sthenia syndrome, weak pulse pertains to asthenia syndrome.

Inspection of infantile index finger veins is called an infantile index finger, three passes in TCM. To differentiate syndrome should be combined with inspection, inquiry to the parents, listening and olfaction. The doctors will not be confined in twenty-eight pulses.

Written by Hu Xiaohua
Medboo TCM training center