All lessons Module 5: Going deeper Lesson 7
Case work: one picture over time
How do tongue and pulse change when things get better or worse, and what do you adjust?
After this lesson you know which feature changes fast and which slowly, you read a progression as favourable, unfavourable or "watch out", you recognise a change that does not fit the progression and therefore calls for medical care first, you compare consultations fairly, and you adjust principle and emphasis at each consultation. Six clients, three or four consultations, each with a drawn tongue and pulse.
Know by heart
- Fast and slow. Rate and coating change in days; strength and shape of the pulse in days to weeks; colour and shape of the body in weeks; cracks hardly at all; mnemonic: the coating is the weather, the body the climate, the cracks the landscape.
- Favourable. Coating from thick to thin and rooted, from yellow to white; a pulse that becomes calmer and more supple and gets its root back; the body follows weeks later; mnemonic: first the weather, then the climate.
- Unfavourable. Coating that suddenly disappears, goes from thin to thick or from white to yellow; a pulse that becomes faster and thinner or loses its root.
- Does it not fit the progression? A change that no pattern explains (rapid and restless with weight loss, newly irregular, newly slow with dizziness, weight loss, night sweats): medical care first.
- Compare like with like. Same time of day, light, before food and coffee, the same phase of the cycle, and the medication noted; mnemonic: same light, same hour, same phase.
- Adjust. Branch gone: emphasis on the root. New branch: the branch first. Nothing changed after a few weeks: review the pattern, look for a mask or a flag.
- Better is not always the treatment. The natural course, the season and a first measurement that happened to be extreme also bring change; write down what else changed.
The rest of this lesson is reference.
Three practice questions from this lesson
Which two features change fastest?
- The rate of the pulse and the coating
- The colour of the body and the cracks
- The root of the pulse and the teeth marks
Answer: The rate of the pulse and the coating. Rate and coating turn in hours to days. The body follows in weeks; cracks are often constitutional.
Which progression of the coating is favourable?
- From thick to thin, and rooted
- From thin to thick
- From thick to suddenly gone completely
Answer: From thick to thin, and rooted. Becoming thinner while keeping its root means that the pathogen is withdrawing and the Stomach-Qi is holding. Suddenly gone is unfavourable.
What is the best reason to hold consultations at the same time, before coffee and in the same light?
- So that a difference comes from the client and not from the circumstances
- Because in the afternoon food makes the pulse impossible to feel
- Because tongue and pulse deviate most clearly in the morning
Answer: So that a difference comes from the client and not from the circumstances. Light, food, coffee and time of day change the fast clocks. Only comparing like with like shows a real progression.
The rest of this lesson
In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 14 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 5: Going deeper.