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Intelligence in Pulse Feeling
Suggestions for Application of Artificial
Intelligence in Pulse Feeling
Tong Zheng Hong*
As You Wish Healthcare Institute, Taiwan
Submission:January 24, 2019; Published: March 08, 2019
*Corresponding author: Tong Zheng Hong, As-You-Wish Healthcare Institute, MS in Acupuncture awarded by National University of Health Sciences in IL, Taiwan
How to cite this article: Tong Zheng Hong. Suggestions for Application of Artificial Intelligence in Pulse Feeling. J Complement Med Alt Healthcare. 2019; 9(1): 555755. DOI:10.19080/JCMAH.2019.09.555755
Pulse feeling is one of the four skills in the traditional Chinese medicine (TCM) as the information for diagnosis and treatment, which seems to be the most possible way for the application of artificial intelligence in integrating traditional Chinese medicine with the Western medicine. However, it surely deserves much attention because the issues like the definition and the norm of the normal pulse, science-based evidence for the use of automatic sphygmography for the optimal decision-making method in face of subjective and objective information remain uncertain and need further research.
Zeng (Pattern), which is based on the information gathered from the fours skills of Looking, Smelling, Asking, and Pulse feeling, is the unique concept that distinguishes traditional Chinese medicine (TCM) and acupuncture from the Western medicine. Fundamental principles of exterior signs and symptoms in the TCM can reflect to some extent how internal organs function within the body, which is broader than the theories in the Western medicine. It is difficult for TCM physicians or acupuncturists in clinic to screen the information gathered through the four skills because there will be three confusing conditions:
I. Pattern corresponding to Pulse
II. Pattern against Pulse
III. selecting either Pattern or Pulse
In other words, TCM physicians or acupuncturists may face the challenges to pinpoint the key pattern for the best treatment outcomes. In the era of artificial intelligence (AI) progressing rapidly, it seems to be beneficial for the integration of AI with Pulse feeling in terms of saving time, costs and the best outcomes. However, this study aims to present that there are issues for TCM physicians, acupuncturists, and researchers to consider for the application of AI in the Pulse feeling skill.
AI is recognized as “a system’s ability to correctly interpret external data, to learn from such data, and to use those learnings to achieve specific goals and tasks through flexible adaptation” at present , which indicates that the data established for use is the key for applying AI to Pulse feeling. Pulse diagnosis is an extremely difficult and complex subject but important since it can provide very detailed information on the organs inside the body, reflecting the real conditions of the whole picture of concrete organs and abstract meridians. The pulse in the Western medicine is only viewed as a minor tool for diagnosis; however, Pulse diagnosis in the TCM plays one of the important roles for gathering information on.
1) The balance between Zang-Fu organs in the body as a whole to get the whole picture of the vital substance like Qi, Blood, Essence, Yin-Yang, body fluids, and even the constitution.
2) The functions of the specific organ for the diagnosis based on the Five Elements.
Both TCM physicians and acupuncturists feel the pulses to discern width, amplitude, length, and particularly note the rate to differentiate the positions, the strength, and other qualities which is different from observing the rhythm, intensity, rate, and
whether any blood vessel tenderness, tortuosity, or nodularity
in the Western medicine . Information gathered from the
Pulse diagnosis by the TCM physicians or acupuncturists can
be complex and extremely subjective, even though there are in
general 28 pulse qualities. Pulse in TCM bears the representations
of Stomach qi, Spirit, and Root, which can be included in the
data for diagnosis and treatment. However, it is truly difficult to
define the normal pulse and interpreter properly Pulse without
sufficient scientific evidence.
The information obtained from the four diagnosis skills can be
divided into objective and subjective. Pulse-related information
is viewed as subjective because it is abstract and judged only by
TCM physicians and acupuncturists based on their experience,
while objective information is gathered through Looking,
Smelling, and Asking. Mai-jing (Pulse Classic) is one of the TCM
classics on Pulse published in the 3rd century. In this classic,
Floating (or called Superficial) pulse is defined as the pulse that is
felt with light pressure but disappears with heavy pressure. The
scenario of the Floating pulse is depicted as the trunk floating
on the water. The TCM and acupuncture theories are analyzed
and organized with the observations of the nature by the ancient
masters, who are familiar with the inductive reasoning. Some
of concepts are abstract because they are depicted with the
observers’ personal life experience. The first challenging issue
is what the normal pulse really refers to. It is believed that the
normal pulse can indicate the good state of Jing (Essence), Spirit,
and Qi.Qi. However, the representations of Stomach qi, Spirit, and
Root are abstract and obscure, though it is generally accepted that
4 beats per respiratory cycle means the presence of Stomach qi
and accepted to be the normal pulse in the TCM . On the other
hand, Spirit is said to be the combination of Jing (Essence) and Qi.
Spirit refers to the strength in the Pulse that is felt soft. However,
how soft it refers to remains unclear. To what degree the health
and normal pulse is can arouse controversy from the aspect of
the quantitative research. In other words, sampling population
is first concerned in the scientific research. Unfortunately,
the definition of the “normal pulse” seems to be the mission
impossible at present. The second challenging issue shows that
all the descriptions of Pulse are indeed abstract to be interpreted
accurately and challenge TCM physicians and acupuncturists.
We can understand to some extent it is not easy at all to clarify
how light or heavy this Pulse truly refers to, which can be only
determined with the personal experience. The primary principle
for TCM physicians and acupuncturists to follow in feeling
the pulse is that they need to put fingers on the three pulse
positions-Cun, Guan, and Chi at the radial artery of two hands
simultaneously for the differentiation, feeling pulses presented
in each position with light, median, or heavy pressures to make
the differential diagnosis. This is the third issue that challenges
those who follow scientific research methods to understand
with automatic sphygmography [5, 6]. As a matter of fact,
whatthe specific pulse really refers to remains unreal and uncertain.
The current automatic sphygmography cannot meet the clinical
requirements because the real differences of pulse cannot be
understood without light, median, or heavy pressures on each
position on the two hands at the same time, which can surely
make the information incomplete for the differential diagnosis.
The fourth challenge issue TCM physicians and acupuncturists
face is how to select the information obtained from the four
skills for diagnosis and treatment. In a whole, there are several
options for TCM physicians and acupuncturists to make a correct
decision in clinic shown in Figure 1.
Zeng (Pattern) identification plays a key role in the diagnosis
and treatment, which relies on the accurate information
gathered from the four skills. However, how to identify the
correct Zeng indeed requires the experience of TCM physicians
and acupuncturists. Pulse feeling is absolutely subjective and
whether or not the pulses felt can really reflect the health
condition can challenge TCM physicians and acupuncturists in
making an accurate decision for diagnosis in clinic. It is for sure
that the unexpected treatment outcomes may occur as long as
TCM physicians and acupuncturists are not able to distinguish
the minimal differences. Since the real meaning of the “normal
pulse” in TCM is confusing and uncertain, it is absolutely
controversial to the scientific researchers when they are making
decisions. To some extent, this issue seems to be the top priority
for the TCM physicians and acupuncturists to reconsider for the
scientific research. With insufficient evidence gathered from the
evidence-based researches, whether or not the current automatic
sphygmography developed with the scientific and technical
methods can be used to detect the real pulses corresponding to
the patient’s health state may remain uncertain. In other words,
the information provided by the automatic sphygmorgraphy
could be not authentic enough to be included into the AI database.
The dialogue between TCM physicians and acupuncturists
and the scientific researchers is required for the integration of
TCM and the Western medicine. However, we need to understand
that the language barriers may hinder TCM physicians and
acupuncturists and scientific researchers from getting the real
picture of TCM. In addition to Pulse feeling, the information
obtained from the other three skills needs scientific evidence as
well to link TCM physicians and acupuncturists with scientific
researchers, which deserves much more attention.