Body Palpation(chu 触诊)-Palpation Technique

There is palpation, feeling, light and heavy pressing, and tapping.

Palpation is the use of the fingers or palm to feel the forehead, limbs, chest, or abdomen skin for the detection of cold or heat, moisture or dryness, and the presence of swellings. From this we can know the condition of pathogenic factors and the genuine Qi.

Feeling is done to investigate if there are superficial pains and lumps, and to evaluate their shape and size on the chest, abdomen, four limbs, or somewhere else.

Pressing is done to find the boundary, texture, and movement of the lumps and the degree or nature of local swelling; to detect the pain or sore or suppuration in the deep layer.

The important regions is done by tapping certain regions of the patient to detect the nature of pathological changes, by use of the tapping sound and the vibration or waving sensation.

The important regions should be checked carefully:

(1) Palpation of the Chest and Abdomen. This refers to touching, pressing, or percussion applied to the chest and abdominal regions to detect the local pathological changes.
(2) Palpation of the cardiac apex. This is very useful for making a prognosis and judging the state of the genuine Qi by touching the pulsation in this point and avoiding misdiagnosis.
(3) Palpation of the chest and hypochondriac region. The Liver Meridian runs through the hypochondriac region. It can detect pathological changes of the heart, lung, and liver. A distending pain in the hypochondriac region, felt upon pressure, may indicate stagnation of Qi due to phlegm heat or retention of fluid. The liver is in the right hypochondriac region.
(4) Palpation of the abdomen. This is performed to detect cold, heat, softness, hardness, distension, lumps, and tenderness to make an accurate diagnosis. Abdominal pain alleviated by pressure indicates a deficiency syndrome; if it is aggravated by pressure, an excess syndrome. A local intolerable burning pain indicates abscess of internal organs. Abdominal fullness and tenderness with a dull sound is an excess syndrome; abdominal distension with neither a full sensation nor tenderness indicates a deficiency syndrome. The size, shape, and hardness of lumps must be diagnosed.
(5) Palpation of the four limbs. This is to feel the cold and heat of the hands and feet; to palpate the skin from the inside of the elbow to the lines on the wrist; to palpate the swelling and distension.
(6) Palpation of acupoints. This is very helpful for diagnosing the problem of certain viscera according to the change and reaction by pressing certain acupoints. Attention should be paid to finding tenderness, nodules, and sensitive response.


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