Case Study of Liver Pulse Prognosis
The patient was the father of my clansman Wang Danwen (called “Maocai” – an imperial examination title equivalent to scholar). I always treated him with the respect due to an elder. In his youth, he had been an astute businessman, particularly skilled in profit calculations (ancient Chinese referred to managing principal and interest as “weighing parent and child money”). His financial acumen allowed him to accumulate substantial wealth.
In later years, he deposited funds at a Yongning Prefecture bank for interest earnings. Unexpectedly, a business partner defaulted on 1,000 taels of silver (a substantial ancient currency unit). Despite filing lawsuits with local authorities, the money was never recovered. Coupled with family conflicts, these stresses triggered what Chinese medicine terms “qi disorder syndrome.”
Symptoms included:
- Abdominal distension resembling a drum
- Whole-body pain
- Restlessness preventing proper rest
Previous doctors prescribed tonics, which worsened the condition. When I examined him, I noted peculiar pulse characteristics:
- Most pulse positions felt faint
- The liver pulse position (corresponding to the radial artery’s middle segment) felt deep, hard, and irregular
- Every 2-3 beats showed missed pulsations
I diagnosed chronic liver qi stagnation from emotional suppression. Prescribed:
- Su Zi Jiang Qi Tang (Perilla Fruit Qi-Descending Decoction) – Classic formula for regulating rebellious qi
- Zuo Jin Wan (Left Metal Pill) – Liver-fire regulating formula
After 3 doses, breathing improved slightly.
Second examination revealed wiry, elongated liver pulses. Added:
3. Dian Dao Mu Jin San (Reversed Wood-Metal Powder) – Specialized formula for stubborn liver stagnation
After 10 days:
- Abdominal swelling subsided
- Normal breathing resumed
- Appetite returned
- Mental clarity improved
During a dinner checkup months later, I detected unchanged pulse patterns. Privately, I warned relatives: “Third Uncle’s liver pulses show terminal signs. This condition is incurable.” When questioned (“But he’s recovering!”), I explained:
“Symptom relief is temporary. His liver pulses indicate irreparable organ damage – like a flowering tree with rotting roots. According to pulse prognosis, survival beyond Start of Spring (usually early February) is unlikely.”
The family dismissed this as exaggeration. Later, while I traveled north, the patient relapsed in winter. All treatments failed. He passed on the 24th of Lunar December. Upon my return from the capital, astonished relatives verified the prediction.
Key medical principle:
Traditional Chinese medicine recognizes “true organ pulse” – an irreversible failure signal comparable to a car engine’s death knell. This case demonstrates ancient physicians’ ability to predict disease progression through pulse diagnosis, where modern medicine might rely on lab tests.
(Note: 1 tael ≈37.5g; Lunar December corresponds to January in solar calendar)
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