Is Chinese Pulse Diagnosis the Key to Preventive Medicine?
"Good news. We didn't find anything." The doctor delivered her verdict from the doorway of my room in the emergency ward of a hospital in Troy, New York, where I'd gone a few weeks ago for sharp abdominal pain. But after $700 in tests, I still didn't know what was wrong with me. Further examination by a gynecologist ($400) didn't turn up anything either. The next step would be to see a gastroenterologist ($200) for a CT scan ($500).
During a year-long search for the problem, I'd seen two family doctors, a naturopathic physician, a nurse practitioner and an acupuncturist, who in the absence of a diagnosis inserted needles into my hands, arms, feet, legs, forehead and solar plexus based on my description of the pain. Cost: some $1,000 and plenty of worry.
So, two weeks after the emergency room episode, I was relieved to find myself finally seated across from Leon Hammer, a master of the Chinese technique of pulse diagnosis, at his rustic cedar home down an unmarked driveway in New York's Adirondack Mountains. The 84-year-old Cornell University med school graduate enjoyed a long career as a psychiatrist, heading a child guidance clinic and studying with Gestalt founder Fritz Perls. But he was frustrated by the profession's inattention to the role of the body and physical touch in healing the mind. When he first met an acupuncturist in 1971, he recalls, "I'd always wanted to be a doctor, since I was a boy, and when I stepped into his consultation room, I knew this was what I'd had in mind."
Since then, Hammer has played the leading role in introducing pulse diagnosis, which has thousands of years of history in China, to the West. Modernized to incorporate the ills of the post-industrial age, contemporary Chinese pulse diagnosis (CCPD) enables practitioners to identify an extraordinary range of states -- mental, spiritual, emotional and physical -- simply by feeling a person's pulse. A typical session costs $50 to $100.
Pulse diagnosis can also find trouble before symptoms arise. So Hammer and other CCPD practitioners -- who only number in the hundreds in North America, Europe, Australia and New Zealand -- say that along with modern medical technology, acupuncture, herbs, exercise and a good diet, it's a crucial part of effective preventive medicine. "You can access any part of the body or function of the body and pick up where something is beginning to go wrong at a very, very, very early stage," Hammer says. "So in the hands of a skilled person, it's the best preventive medicine that exists. If I was in charge of the health-care system, I'd have every single person get their pulse taken twice a year."
Sounds great, but does it work? Hammer and I spent the next hour in an intimate silence, my arms stretched across a table in Hammer's upstairs office, his fingers playing across both wrists, then one, then the other, then both again. Could he find out what was causing my abdominal pain?
Two thousand years ago, during the Han Dynasty, everyone from rulers to peasants paid doctors to keep them healthy with the pulse diagnosis and treatments first described in the Nei Jing ("inner classic") circa 100 BCE. Eastern medicine, like Eastern philosophy, has always subscribed to the idea that the whole is found in its parts. In China, this is the basis of therapies like foot reflexology, tongue reading (in which the tongue's colour, texture and markings are attributed to conditions in the body) and pulse diagnosis. Acupuncturists trained in this subtle method say you can tell the condition of every body function by feeling the rhythm and qualities of the pulse at different positions on the wrist.
The spot on your right wrist at the base of your thumb, for example, reveals something -- though not everything -- about your lungs, especially their condition in the past. If a student of Chinese medicine feels a narrowing there, your lungs aren't expanding enough. If it feels slippery -- like pebbles rolling on a plate -- it may indicate evidence of a bacterial infection, past or present. And if it feels choppy -- like scraping bamboo with a knife -- there's probably some toxicity.
Typically, a doctor of Chinese medicine uses other tools of the trade, like tongue diagnosis, alongside pulse readings. Treatment involves regular stints on a massage table, with needles inserted anywhere from your eyebrows to the balls of your feet, and tonics brewed from herbs to strengthen the body's healing process. Western medicines and medical techniques are also suggested when appropriate.
Historically, these techniques attracted little attention in the West. But during the Communist takeover of China after World War II, some Chinese masters fled to the U.S. and Europe. One of these was John Shen, and Hammer knew when their paths crossed in 1974 that he'd found his teacher. For eight years, he spent weekends with the acupuncturist at his practise in New York City. There, he learned to lay his fingers on the wrist in 28 positions, varying the pressure to feel some 80 pulse qualities.
Shen died in 2000 at the age of 87. A year later, Hammer, then 76, published Chinese Pulse Diagnosis: A Contemporary Approach, an 800-page primer, and founded the Dragon Rises School of Oriental Medicine in Gainesville, Florida (dragonrises.edu), where he remains clinical director and principal instructor. It's the only U.S. school at which CCPD is taught. Students spend 435 hours covering the four areas of diagnosis -- asking, looking, listening and touching -- including 150 hours learning the pulse. Some students have gone on to teach. One of these is Scott Tower, who with colleague Sybill Hussein has introduced CCPD to thousands in Switzerland, Germany, the UK and the Netherlands.
If enough people learn the technique, Hammer believes it could be integrated worldwide. "Right now, the health-care system is designed to treat diseases," he says. "But let's say you come to see me first. I see a lot in your pulse that indicates cancer. I can't distinguish between the uterus and the ovary. I can't distinguish between a fibroid and a malignant tumour. Western diagnostic tools can refine mine. I can pick up what's wrong with you far before they can, and they have the tools to pinpoint the problem." Hammer would like pulse diagnosticians to replace general practitioners as the doctors you see regularly.
To illustrate the point, he tells the story of a 72-year-old friend who came for a reading. "It was very clear he was in imminent danger," says Hammer, who felt in his pulse qualities he terms "ropy," "leathery," "yielding-hollow" and "choppy." Hammer sent him to a cardiologist for a stress test. "They stopped the test immediately and put in a stent," he says. "The principle artery that goes to the left ventricle was 95 percent blocked. He's now seeing a very good acupuncturist who's dealing with the issues that caused the problem."
But not everyone is sure the West is ready for pulse diagnosis. While Ted Kaptchuk -- associate director of Harvard's Division for Research and Education in Complementary and Integrative Medical Therapies and author of the Chinese medicine classic The Web That Has No Weaver -- calls Chinese medicine in the West "a whole emerging kind of health care" and Hammer "a great healer," he says that as with any treatment, before pulse diagnosis goes mainstream, we need scientific evidence that it works.
Hammer strongly opposes that perspective, arguing in a June 2008 article in Acupuncture Today that to measure Chinese medicine by Western standards of statistical significance and double-blind studies would be a mistake. "We're at a crossroad between embracing the everlasting mystery of the ancient medicine or escaping into the certainties of a Western-style paradigm that has taken the heart out of its medicine," he writes. Yet Hammer doesn't deny his satisfaction at the results of a recent study by one of his students, acupuncturist and Ph.D. candidate Karen Bilton, at the University of Technology in Sydney, Australia. After testing and retesting by different pulse diagnosis practitioners on 15 patients 30 days apart, Bilton reports preliminary analysis showing consistent results no matter who did the reading.
There's no shortage of anecdotal evidence in support of pulse diagnosis' effects, either. Just ask 67-year-old acupuncturist Anne Adams. After a series of classes with Hammer in her hometown of Columbia, Maryland, Adams flew to Florida last year for a pulse diagnosis. Hammer diagnosed a "retained pathogen," maybe from a bout of hepatitis years prior, dehydration, stagnant qi (the Chinese word for the body's energy), unusual activity in her lower abdomen and perhaps low levels of thyroid hormone. "The findings sobered me," says Adams. Not only did she take the prescribed herbs and get regular acupuncture, she began to exercise, changed her diet, slept more and took time for herself.
At her appointment this spring, she saw a dramatic change; she and Hammer were delighted. "The correlations Dr. Hammer makes from patterns he sees in one's pulse are borne out by lab work and patient experience," Adams says. "His background allows him to understand and make Western diagnoses, which as a physician he was trained to do, and Eastern diagnoses from another angle. He's built a bridge between Western health care and acupuncture and herbal health care, which is invaluable."
At Hammer's house after my pulse session, we go downstairs and he begins to prepare food: chicken soup, oven-roasted corn, chocolate ice cream. We sit in the kitchen, surrounded by his own paintings and pictures of his spiritual teacher, Indian mystic Meher Baba, to go over his findings. He knows nothing of my personal or medical history.
"Your digestive system isn't very strong," he begins. "Overall, that's the most obvious thing." This fits with the gastroenterology referral. I describe the ER visit. Could be the problem, says Hammer.
"There's a muffled quality in the area of the pulse corresponding to the large intestine that indicates neo-plastic activity," he adds. My heart sinks: cancer. "It doesn't necessarily mean you have cancer," he says quickly. It could be an early warning sign, like a polyp. But he suggests I have it checked out with a colonoscopy.
"Also, there's widespread toxicity in your body," he continues, "though that doesn't differentiate you from anyone else at this point." In the first edition of Chinese Pulse Diagnosis, he says, toxicity is listed as rare. Four years later, the revised edition identifies it as common. "Allopathic science has found between 50 and 170 substances in the blood that weren't there 50 to 100 years ago," he adds. "Most are from plastic. But there are ways of detoxifying with herbs and needles."
Then he pauses. "Now," he says quietly, "at the risk of scaring you" -- oh no! -- "your heart isn't as strong as I'd like to have it. In fact, I'm a little worried about it. You're someone I have to insist see a cardiologist for an evaluation."
He says more, but it doesn't register. I'm scared. I've seen cardiologists for heart pain since my 20s, never finding anything. Nevertheless, I hear Hammer say "treatable." He wants me to rule out heart disease, then address the problem with herbs and acupuncture. A cure could take a year or more. "We can get rid of symptoms quickly, but to deal with the underlying pattern," he says, "that's another matter."
He felt a quality known as "rough vibration," he says, that corresponds to the heart at the base of the left thumb, and it came through in bursts, suggesting unstable heart qi. The pulse on my left side was much stronger than on my right; that sent up the red flag about my digestive system. And the toxicity showed up when he pressed the radial artery down hard, as what he calls a "retained damp heat condition." He laughs. "It sounds pretty bad, doesn't it? What it means is the body has a way of taking certain pathogens that could kill you and hiding them in joints, muscles or other places where they do more gradual damage." Hammer points to arthritis or chronic headaches as examples.
It's overwhelming. Still, as I leave Hammer's wildflower-fringed driveway, I feel hopeful. I'll get the cardiogram and the colonoscopy, as well as a hair test for toxicity, see a Chinese medicine doctor who understands Hammer's findings and follow a course of treatment. In a year, maybe I, like Adams, will be delighted by the changes in my health. Already I see the benefit of supplementing the standard physical with this kind of in-depth diagnosis. As Hammer said over lunch: "The reality here is that everything is affecting everything else. The trick is to figure out how."