Not sure about how to relate the other descriptions of the pulse within my own CM framework but the pulse rate is interesting if only 45bpm. Rate is coordinated by the heart Yang (heart rhythm is coordinated by the heart qi).  the heart within a Five Phase (Wu Xing) context relates to joy.  In this sense, is it the heart Yang - the internal emotional warmth aspect, that is vacuous/deficient and so being reflected in the pulse?

Additionally, if heart Yang is vacuous then the pulse wave will not expand and so the pulse may additionally be felt deep - of course this also relates to the level of depth of the 'illness' ie internal.  Tense (as in increased tension in the arterial wall?) could in this instance relate to the constrained flow of Qi (or hyperactivity of the Liver Yang) - ie Liver related.  From a Five Phase context is this constrained Liver Qi not feeding the Fire phase. 

But, increase arterial tension (ie tense?) could equally indicate pain or Cold - this could confirm the Yang vacuous diagnosis (but Yang vacuity is often accompanied by cold signs and symptoms - not to mention fluid or oedematous type conditions if heart function is being affected).

Restful sleep requires the Shen to be nourished/housed.  Again this relates to the heart and the Blood.  Disturbed sleep results when the Shen isn't housed, Blood isn't suitably nourishing (ie aneamia) or there is emotional constraint agitating the Shen (ie Liver).  (More information is required on the actual pattern of sleep disturbance to understand to which pattern it is relating to). 

Dr Sean Walsh, Ph.D.
Lecturer
College of TCM
Dept Medical and Molecular Biosciences
University of Technology, Sydney



Dr Sean Walsh, Ph.D.
Lecturer
College of TCM
Dept Medical and Molecular Biosciences
University of Technology, Sydney

----- Original Message -----
From: Carl Henryk Wallmark <carlhenryk.wallmark@...>
Date: Thursday, August 31, 2006 10:33 pm
Subject: [PulseDiagnosis] Question on a pulse picture
To: PulseDiagnosis@yahoogroups.com

>
> Hi all
>
> I have a question for you regarding the pulse picture of a patient of
> mine..
>
> The rate is about 45 bpm
> LDP is deep, feeble (4), no vibrations
> The entire pulse is tight (4)
>
> The patient does not have any physical symptoms except some sleep
> difficulties (never sleeps through a whole night), and appears to be
> well. Her main complaint is a feeling of not being able to be
> happy, no
> matter what good happens to her. She (and I) do not classify her as
> depressive, but more a "lack of joy" .
>
> Any suggestions regarding the pulse?
>
> BR
> Carl Wallmark
>