Poster Session II

A SYSTBN FOR PULSE MEASUREMENT AND ANALYSIS OF CHINESE MEDICINE

S.B.

FU

AND

S.P.

LAI

D e p a r t m e n t of B i o m e d i c a l Engineering
C h u n g Y u a n C h r i s t i a n University
C h u n g l i , T a i w a n , R. 0. C.

ABSTRACT
T h e pulse diagnosis is t h e most fmportant c o m p o n e n t of t r a d i t i o n a l
C h i n e s e medicine. An o b j e c t i v e S y s t e m
for pulse diagnosis of Chinese medicine
h a s been d e v e l o p e d by us.
W e h a v e designed a c o m p u t e r c o n t r o l l e d r o b o t i c
f i n g e r s t o d e t e c t pulses. A c c o r d i n g t o
t h e preliminary s y s t e m e v a l u a t i o n , an
very i m p r e s s i v e result h a s been o b t a f n ed

l o c a t i o n s , v a r i a t i o n w a s n o t seen.
N e v e r t h e l e s s , when p a l p a t i o n w a s used,
d i f f e r e n c e in p r e s s u r e c h a n g e s w e r e
s e e n , which may be related t o anatom i c a l differences.

INTRODUCTION
For t h e traditional Chinese medicine,
there are inspection,
auscultation,
q u e s t i o n i n g and p a l p a t i o n f o u r diagnost i c methods.
Nhile, t h e p u l s e d i a g n o s i s of p a l p a t i o n is t h e m o s t i m p o r t a n t
but d i f f i c u l t one. W i t h t h i s t e c h n i q u e ,
t h e physician places his fndex,middle
a n d ring f i n g e r s o v e r t h e radial artery
of t h e patient's w r i s t in a c c o r d a n c e
with three locations called Chun, Guan
and Chy. By a p p l y i n g light and d e e p
p r e s s u r e s , t h e p h y s i c i a n is supposed t o
be a b l e t o d e t e c t at h i s f i n g e r t i p s
t h e h e a l t h c o n d i t i o n s of t h e i n t e r n a l
o r g a n s of t h e p a t i e n t , a s shown in F i g
1.
According t o the Chinese medical
l i t e r a t u r e s [ 1,Z I, it i s said t h a t
t h e r e a r e 29 w a v e p a t t e r n s of t h e pulse,
e a c h h a v i n g a s p e c i f i c name. U n f o r t u n a t e l y , very l i t t l e k n o w l e d g e about t h e
p u l s e c a n be f o u n d f r o m books of modern
p h y s i o l o g [3]. F r o m t h e Westerner's
view, t h e C h i n e s e sphygmology s e e m s t o
be inconceivable[41.
However, the
p h e n o m e n a of t h e p u l s e
a r e not
as
s i m p l e as p e o p l e might think.
The
p u l s e , a l t h o u g h d r i v e n by t h e h e a r t , f s
t r a n s m i t t e d by blood flow t h r o u g h
a r t e r i e s and g o e s a long way f r o m t h e
heart. T h u s , it i s affected not only by
t h e c o n d i t i o n of t h e h e a r t , but a l s o
by t h e c o n d i t i o n of o t h e r organs. F o r
t h e s i g n i f i c a n c e of
three
palpating
l o c a t i o n s , S.H. Yoon et a 1 had pointed
out [5]:they inserted i n d w e l l i n g cat h e t e r i n t o radial artery and measured
t h e radial a r t e r i a l p r e s s u r e in
three

Fig.1 P o s i t i o n s f o r p u l s e d i a g n o s i s
used in t r a d i t i o n a l C h i n e s e medicine.
T h e r e l a t i o n s of t h e p o s i t i o n s with
t h e o r g a n s a r e based on t h e " C l a s s i c
on Pulse" w r i t t e n by Wang S u H o
(265-317 A.D. ).
T o p a l p a t e by h u m a n f i n g e r t i p s , it
i s s u r e t o be a very hard t a s k without at least f i v e years e x p e r i e n c e , n o
o n e c o u l d be e x p e c t e d t o m a s t e r t h e
p u l s e d i a g n o s t i c s k i l l [ 4 J . Besides.
t h e r e a r e t h r e e p r o b l e m s l3.51, w h i c h
r e m a i n p u z z l i n g t o both l a y m e n
and
scientists. F i r s t , feeling 29 d i f f e r e n t
w a v e p a t t e r n s by t h e f i n g e r t i p s i s t o o
d i f f i c u l t and t o o subjective. S e c o n d ,
t h e location-organ r e l a t i o n s h i p , a s
s h o w n in f i g u r e 1 , c a n n o t be understood and n e e d s t o be s u b s t a n t i a t e d
by a s c i e n t i f i c method. T h i r d , a s t h e
method is based on t h e s u b j e c t i v e findi n g s of t h e p h y s i c i a n , it is d i f f i c u l t
for different physicians t o obtain the
s a m e diagnosis.To s o l v e a b o v e p r o b l e m s ,
an o b j e c t i v e method f o r p u l s e d i a g n o s i s
of C h i n e s e m e d i c i n e s h o u l d be w o r t h t o
develop

UETHODS
S e v e r a l m e t h o d s of o b j e c t i v e measurem e n t o f pulse d i a n o s i s h a v e been reported 12-51. H o w e v e r , t h e ideal c o n s e -

IEEE m G I m E U # ( I I# MEDICINE L BIOXAOY SOCIETY 1lTH ANNUAL INTBRNATIOklAL CO#BERENCE--1695

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guence was not obtained. Among those

methods, the arrangements of Using one
pressure transducer as pulse sensor are
adopted mostly.This is a simulation Of
only one finger palpation. Although S.
yoon on et a1 gave some improvement 151.
they used a set of three pressure
transducers to sense three location
pulses, yet the transducers
should
place underneath the humen(physicians1
finter tips. Due to the touch of physician's finger. it will surely reduce
the degree of objective.In the present
of our study, we have used three pressure sensors to detect pulses underneath computer controlled robotic fingers.

domain. Five computer programs were

written for those analyses. In preliminary study,20 healthy young students
and 3 0 patients were served a s
subjects for evaluation our systems. The
patients which were diagnoses and classified by Dr. of western medicine
consisted of four disease groups : 1 8
persons with rhinitis, 5 with asthma,
4 with hepatitis, and 3 with laryngitis.
RESULTS AND DJSCUSSJON
According to our preliminary test,
the result is very impressive and excitable.Table 1 is a summary of pulse
wave analyzed results. although,we do
not have enough quantity of test subjects for firm conclusion, yet, you
should not ignore this result, which
agrees with the facts of Chinese medical experience for more than
1600
years. This shall encourage us
to
study further.

Fig. 2 The block diagram of the measurement system.

A set of three subminiature pressure
sensors which has a diameter of 6mm and
a thickness of 0.6mm is used to form as
robotic finger tips.This sensor is able
to measure point pressure with its convertion sensitivity up to 1.4 uV/ mmHg
under 3-volt excitation. The individual
finger is constituted besides pressure
sensor by a thin metal cylinder. a pressure force indicator,
a rack-pinion
assembly, a step-motor, and an optical
force guider. For forming a
sensitive
finger tip,
the pressure
sensor is
sticked on by adhesive at lower end of
the cylinder. We install those individual fingers together on an adjustable
post with heavy supported base to form
robotic fingers for pulse acquisition.
Each finger may be adjusted vertically
and horizontally
to correspond
the
three locations of Chun, Guan and Chy.
After the location alignment with the
patient's wrist,each of robotic fingers
can be ascended or desended independently to march the light or deep pressure by step-motor,which is controlled
by computer instruction.

As the pulse wave signals which are

taken from patient by robotic finger
tips must be preprocessed before input
to the computer. The block diagram of
the whole system is as shown in Fig. 2.
The pulse wave is rich in harmonics. A
scientific way of studying the pulse,
then, should be to analyze it not only
in time domain but also in
frequency

1696--1EEE ENGINEERING IN MEDICINE

Tab. 1 A summary of pulse wave analyzed results.

REFERENCES
Su Ho Wang (265-317AD) The classic
of the Pulse(in Chinese) reprinted
by Wen Kuan Publishing C O . , Taipei
Taiwan, ROC. 1972.
[2
S . Y. Wang et al,Graphical Expression
of pulse-wave pattern in Pulsology
in orthodox Chinese medicine (in
Chinese),National Science Council
Monthly, Vol.5,No.8, P.688-697 ,
Taiwan, ROC. Aug. 1977.
[3] L. Y. Wei et al,Electronic Diagnoser
of Arterial Pulse,J. of Wedical Engineering & Technology, Vol. 9,No. 4
P.183-186 JUly/AUg. 1985
[41 C.T.Lee et a1,Spectrum Analysis of
Human Pulse,JEEE Transaction on BIB
vol .BME-~O,NO.
6,P348-351 June 1983.
[SI S.H.Yoon et a1,An objective Method
of Pulse Diagnosis,American J .
of
Chinese Medicine,Vol.XV, No. 3-4,
PJ.47-163, 1987

[l

BIOLOGY BOCIETY llTH ANNUAL INTERNATIONAL CONFERENCE