五行针灸 我的诊脉方式

五行针灸我的诊脉方式很荣幸最近收到Peter Eckman新书的书稿，这本书旨在讨论脉象，即将由吟龙出版社（Singing Dragon Press）出版（我的书也将由这家出版社出版）1。

书名我非常喜欢——《针灸脉法大全：体质针灸和辨证针灸脉诊指南》2效仿了1653年Isaak Walton的著作《垂钓大全》的书名。

这本书详尽讨论了各种不同的诊脉和参脉方式。

这让我想起自己的诊脉方式，也许可以用我在五行针灸学校最后一次临床课程上的话来作为总结——事实上，我半开玩笑地跟学员们说“忘掉脉象”。

这样的话我经常跟针灸师们说起，以使他们在学习诊脉时卸下一些不必要的负担。

相反地，我建议他们把注意力集中在病人身上，把病人看作一个整体，而脉象只是五行纷繁表现的其中之一。

我总是反复强调，12脉的脉象如此微妙，需要多年的磨练方可掌握，且技巧之类，都是精益求精，永无止境的。

我的这种方式来自我在Leamington攻读研究生学位时老师的教导，在Leamington，他们从不过分强调诊脉的重要性。

我们只是被告知尽可能地多摸脉（如果我没有记错的话，大约是每个月100个），然后逐渐学习感受各种关联脉力量强弱的不同。

目的主要是为了发现有无阻滞，比如出入阻滞或夫妻不和。

我们被坚定地反复灌输这一理念——脉象对护持一行的诊断毫无益处，因为即使我们治疗的是正确的那一行，也有可能这一行的脉象对于治疗是最不敏感的，因为它的职责在于庇护其余四行使其归于平衡。

著名的27种脉象JR只提过一次，且几乎如同题外话一般匆匆带过。

那是有一次，为了完成教学大纲的任务，27种脉象又正巧包含其中，于是JR只用了15分钟的时间便快速将各种脉象介绍完毕，显然对此毫无兴致，讲完时还告诉我们：“你们对于27种脉象的了解仅限于此便可。

”看上去这扇门我们的通过与否，对他来说无关紧要。

另一次与JR的谈话对我有着更为深刻的影响。

有一次我告诉他，有时候我接收不到任何手指传递给我的信息，他说：“我明白你的意思。

我也会有这种感觉，但也许一个月之后我会发现自己诊脉的水平又上升到另一个层次了。

”即便是现在，每当我诊脉时，他这一席话语也时常绕然指间。

我从不会花过长时间诊脉以参其中含义，有时甚至会边说话边诊脉，仿佛我想让自己的心通过语言来思考，而神则被解放出来用以感觉。

然后我会综合我其他感官的感受来帮助自己理解病人一言一行所传递给我的信息。

我对诊脉的担忧在于，五行针灸很少重视病人身体方面的反馈，而脉诊恰是其中之一。

其他方式的诊断都只在瞬息之间。

我们不能去触摸味道，声音，颜色或情绪，但却可以实实在在地摸到病人的脉象。

当我们其他的感官感到迷惑，觉得难以捉摸，我们似乎可以回避去寻求身体层面的庇护。

我认为这就是为什么所有初学者（也包括一些熟练的针灸师）都会在病人一躺到病床上便急着伸手去摸脉，而不是把注意力集中在病人这个整体上面，好像一开始便急需让自己与病人的身体建立联系。

有时我会觉得，这就像一个溺水之人紧紧抓住救生圈，有点滑稽不是吗？诊断有无阻滞时我固然会用到脉诊，但我也会综合其他信息而不是仅凭手指感受，除此之外，我更重视病人在我眼中呈现的那幅全景图，与其所带给我的感受相比，脉象只是附属。

所以尽管Peter和我都毕业于同一学校，但和我不一样的是，他所受的训练涉及其他更广泛的领域，因此我们对脉象的重视程度会有所不同。

尽管如此，我对他新书的其他内容很感兴趣，但是我知道这种欣赏可能只在理论上，而不会运用于实践。

译者注：1.Nora老师的四本书现已由Singing Dragon Pressing出版。

2.体质针灸是以辨别体质为治疗基础的针灸流派，此体质一般为先天而成。

Peter Eckman 在书中讨论了多种类型的体质针灸，如韩国四象体质医学，五行针灸，日本经络疗法等。

而辩证针灸与其相对，以患者当时的辨证结果为治疗基础，主要与后天因素相关。

My approach to pulse-takingI have been privileged to receive from Peter Eckman a draft of his latest book which is about pulses and is about to be published, like my books, by Singing Dragon Press. I love its title, The Compleat Acupuncturist: a guide to constitutional and conditional pulse diagnosis, an echo of Is aak Walton’s The Compleat Angler (1653). The book discusses in great detail the many, many different ways in which pulses are taken and the many, many different ways in which they are interpreted.This has set me thinking about my own approach to pulse-taking, best summed up, I feel, by something I said to those attending my last SOFEA clinical seminar. In effect I told them, a bit tongue in cheek, to “forget the pulses”. This is something I often find myself saying to practitioners in an attempt to remove some of the unnecessary burden they feel when trying to interpret pulses. I suggest, instead, that they should concentrate on looking at the patient as a whole whose pulses are only one of many manifestations of the elements. I always labour the point that the extreme subtlety of what these 12 pulses are telling us makes their interpretation an art which has to be honed over many years, and like all arts is a skill that is never perfected.My approach is based upon what I was taught as an undergraduate at Leamington, where the importance of pulse-taking was neverover-emphasized. We were told simply to take as many pulses as we could(100 a month, if I remember correctly), and gradually learn to assess the strengths and weaknesses of the different pulses in relation to oneanother. The aim was mainly to detect energy blocks, such as Entry-Exit blocks or those occurring in a Husband-Wife imbalance. It was firmly drilled into us that pulses never told us what the Guardian Element (CF) was, because even if treatment was directed at the right element, it might well be this element’s pulses which showed the least response to treatment because of its role in shepherding the other elements into balance.The famous 27 pulse qualities were only mentioned once by JR, almost as an aside, when, as part of what was apparently considered necessary to complete the syllabus, he raced through the different pulse qualities in about 15 minutes with obvious disinterest, ending with telling us, “and that’s all you need to know about the 27 pulses qualities”. This appeared to be a doorway through which he did not think it necessary for us to pass.Another occasion with JR had a much more profound effect on me. I told him at one point that sometimes I felt that I couldn’t interpret anything my fingers were trying to tell me. He said, “I know what you mean. I will feel the same, and then perhaps a month later I will realise that my pulse-taking has moved to another level.”These words of his hover over my fingers as I take pulses even now. I never wait too long to try and interpret what I feel, and can even find myself talking as I take them, almost as if I want to allow my mind to do its thinking through words so that it sets my spirit free just to feel. And then I try to add what I am feeling to what my other senses are telling me to help me interpret the signals the patients is sending me through everything they do or say.What worries me about approaches to pulse-taking is that pulses represent one of the few aspects of five element practice where we ask for a physical response from a patient’s body. All the other forms of diagnosis are much more ephemeral. We can’t physically touch a smell, a sound of voice, a colour or an emotion, but we can certainly physically touch a hand to feel apulse. And the physical appears to provide a reassuring refuge to which we can retreat if our other senses confuse us and prove too elusive. I have decided that this is the reason why all novice practitioners (and quite a fewexperienced practitioners, too!) immediately reach for the hands of the patient lying there on the couch, rather than paying attention to the patient as a whole, as though needing to anchor themselves immediately in thephysical. Sometimes I feel, rather wickedly, that this is a bit like a drowning person grasping a lifebuoy.Except in the case of blocks, where I always try to add other information to what my fingers may be telling me, pulses play an almost subsidiary role compared with what I learn from the total picture presented by the patient. So Peter and I, both trained in the same school, but he, unlike me, having received much more extensive training in other disciplines, have arrived at somewhat different points on the scale of the importance we attribute to what our fingers can tell us. I am nonetheless fascinated by all those other approaches his new book covers, but which I know I may only ever appreciate in theory, not in practice.。