Reading Pulses at the End of Life

Pulse diagnosis Credit unknown
Pulse diagnosis
Credit unknown

In Chinese Medicine reading the pulse is one of the two key diagnostic methods, tongue diagnosis being the other. We use 3 fingers below each wrist where we can access different depths of the radial artery as it lies over the curved bone. The different positions under each finger have been correlated over the centuries with different organs. We listen to the movement of blood in the blood vessels and note the speed, shape and any rhythmical irregularities coming from the heart or other tissues. We feel the thickness or thinness of the blood vessels, how deeply they lie, how full of blood they are and note their resilience and vitality. And we note the tension of the tissue around the blood vessel. Radio signals communicated between the brain and heart gives information we may not be able to verbalize. It is a deep listening.

Too often we practitioners draw from a pool of similar patients and are not able to experience the vast information potentially read from pulses. Even more infrequent is the pulse experienced at the end of life when many are in hospitals hooked up to machines that may interfere with natural death.

I was fortunate to be able to listen to my father’s pulse as he passed away at home and I thought you might find it interesting.

Burton Vaughan 1927-2015
Burton Vaughan 1927-2015

Ever the teacher he would not mind my sharing this with you.

My dad was an 89 year old man in otherwise good health who had leaky heart valves. He had chosen not to get them repaired as it usually involves some mental impairment and he was teaching graduate school classes until last year. So the ability of his heart to support his activities was substantially reduced as the valves were unable to push blood through the heart.

During his last day his pulse was very rapid as his heart was compensating for the low force. Qi could not command blood. The beat started strong then fizzled out as the weak valves could not push the blood. It was regularly irregular but the “fizzle” took a third to a half of the beat. He was so hot he required fanning, but his hands and feet were icy cold. This would be what we call false heat caused by the stagnation of blood due to low qi/ force. The force of the pulse was low but curiously his Kidney pulses were not inordinately weak compared to the others.

As he died his breathing was reduced and it was hard to find what had become a feeble pulse. The pulse got deeper and deeper until it was hidden. His forehead was still hot as was his vertex but the warm area moved up and the cold overtook him. The pulse diminished and he peacefully died.

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