Part 76

6. The sinking P. Fou, when the pulse, although pressed hard, sinks under the finger.

7. The soft P. Sin, which feels like a drop of water one might press upon.

8. The weak P. Yo, which yields the sensation of feeling like a worn-out texture, and ceases to be observed when pressed upon for any time.

To these are added nine other varieties, called Tao.

1. The long P. Tehang, full, smooth--feeling like a full tube.

2. The short P. Toan, presenting a pointed surface, that seems indivisible.

3. The empty P. Hin, insensible under moderate pressure.

4. The tight P. Tsou, which the finger feels with difficulty.

5. The embarrassed P. Kie, languid and occasionally stopping.

6. The intermittent P. Tai, when several pulsations appear to be missing.

7. The slender P. Sie, so slow and weak, that it feels like a hair.

8. The moving P. Tong, that one might compare to stones under water.

9. The tense P. Ke, feeling like a distended drum-head.

But as many Chinese doctors were not satisfied with this confusion in the classification of pulses, and, like practitioners in other countries, sought to render darkness still more visible--they sought to strike out a new career by increasing the multiplication, and introduced the following addenda:

1. The strong pulse, Ta, filling the vessel, yet yielding to pressure.

2. The precipitate P. Son, in which the pulsation was rapid in succession.

3. The scattered P. San, soft, slow, and non-resisting.

4. The stray P. Li-king, strong--not pulsating three times in each inspiration.

5. The firm P. Tun, consistent and resisting.

6. The lively P. Ki, pulsation rapid in succession.

7. The skipping P. Teng, pulsation unequal, sudden, and frequent.

In this minute attention to the many variations of the pulses, the Chinese aided their study, by attending to age, sex, stature, constitution, the seasons, the passions, and the comparative state of health and disease.

In a person of high stature, the pulse was full--concentrated in diminished individuals--deep and embarrassed in fat subjects--long and superficial in the meager--soft in the phlegmatic temperament--tremulous in the lively and the active--slower in man than in woman, excepting when threatened with disease--full and firm in the adult--slow and feeble in old age--soft and vivacious in infancy.

The rhythm of the pulse was affected by the passions, though chiefly in a transient manner:--moderately slow, in joy--short, in grief--deep, under the impression of fear--precipitate and regurgitating, in anger. In the spring, they maintained that the pulsation was tremulous--replete, in summer--spare and superficial, in autumn--dry and deep, in winter. Much mysterious ceremony was observed by the Chinese physicians in this investigation; they felt the pulse with four fingers, which they alternately raised or dropped on the vessel, as if playing on a musical instrument.

In this profound study, they attributed to every disease a peculiar state of the pulse by which it could be recognised and ascertained, and at the same time it enabled them to form a favourable or unfavourable prognostic. Some of these rules are curious. If the pulses stop before fifty pulsations have been counted, disease is at hand; when an interruption in the course of the circulation takes place after forty pulsations, the patient has not more than four years to live; when an interruption takes place after the third pulsation, three or four days are the probable term of existence; but the patient may linger on for six or seven days more, when the interruption only succeeds the fourth pulsation.

Idle as these speculations may appear, it is to be feared that while the Chinese paid such minute attention to the state of the circulation, more distinguished and learned schools do not consider this powerful indication of the strength or weakness of the vital functions with sufficient care and discrimination, and perhaps a translation of the works of Ouang-chou-ho, might not be altogether useless in the present enlightened age. I have no hesitation in saying that this important investigation is sadly neglected in medical education--so much so indeed, that the different appellations given to the varied state of the pulse, are neither well defined nor generally understood. The French physician Bordeu has given much valuable information on this subject, which occupied the ancients as much as it seems to have fixed the attention of the Chinese. We find that the Indians, in the time of Alexander, accurately studied this important point.

Notwithstanding the assertion of Sprengel, Hippocrates was a most attentive observer of the state of the pulse. Thus we find him giving the name of [Greek: sphygmos] to that violent and spasmodic beating of the artery, which was not only sensible to the touch, but evident to the bystander's eye--in more than forty passages of his immortal works do we find important references to the pulse, which he also declared could enable us to detect the secret workings of the passions. Many were the ancient physicians who have minutely entered into these investigations, amongst them we may name Herophilus, Erasistratus, Zeno, Alexander Philalethes, Heraclides of Erythrae, Heraclides of Tarentum, Aristoxenes. Several of the doctrines founded on these observations were most absurd, attributing the various conditions of the circulation to the Pneuma of the heart and arteries; such were the doctrines of Asclepiades, Agathinus, Galen, and many others; and amongst the Arabians we find Thabeth Ebn Ibrahim asserting that by the state of the pulse he could ascertain what articles of food had been taken--in more modern times Baillou, Wierns, Boerhaave, Hoffmann, have sedulously applied themselves to this most essential study, and Schelhammenn asserts that the pulse never once deceived him.

The effect of our passions on the circulation is much more powerful than is generally believed, and they are a more fertile source of our maladies than is commonly apprehended. We can readily conceive why the Spartan Chilo died through excess of joy whilst embracing his victorious son.