Five Quarts: A Personal and Natural History of Blood by Bill Hayes Read Free Book Online Page B

motion was translated simultaneously onto a strip of paper, forming a steady sequence of squiggles. To the medical community, an instrument that could provide an objective reading of the pulse was an important advance (the modern blood pressure cuff is the sphygmograph’s direct descendant). However, while Broadbent used various models throughout his career, he was never a full convert. In
The Pulse
he praised the machine’s ability to mimic what a skilled physician could do by hand but emphasized that it was “not an infallible court of appeal.” The device was tricky to operate—it wasn’t like placing a thermometer under a tongue. In fact, Broadbent maintained, many of the “niceties of information” were out of its reach; no machine could ever replace the power of human touch.
    In mastering the language of the pulse, Broadbent was linked to a timeless tradition, one transcending cultures and medical philosophies. The physician-priests loyal to the lion-headed Egyptian goddess Sekhmet relied on pulse palpation to reach their diagnoses, as evidenced by tomb inscriptions circa 2000 B.C. , and medical papyri from this same era contain repeated reference to the pulse. “The heart speaks out of the vessels of every limb,” one particularly lovely line translates. In the history of medicine, however, the literature of ancient China is unmatched in its extravagant attention to deciphering the body’s rhythmic code.
    The Chinese text called
Huang Ti Nei Ching Su Wen
(
The Yellow Emperor’s Classic of Internal Medicine
) is one of the world’s earliest and most famous medical guides. Although the work is attributed to the legendary first ancestor of the Chinese nation, historians concede that it is the product of neither a single writer nor single time period but rather a compilation of many teachings over hundreds of years. The oldest portions may date as far back as the fifth century B.C. To me
The Yellow Emperor’s Classic
is best appreciated not for its physiological accuracy but for its richness of ideas. All of the disciplines of traditional Chinese medicine sprang from its theories.
    The entirety of what Broadbent could read at the wrist pulse was just the starting point for what
The Yellow Emperor’s Classic
describes. By applying varying pressure to different points along that single stretch of artery, an accomplished physician could derive a full accounting of every internal organ as well as a sense of the subtlest qualities of yin and yang, the positive and negative cosmic forces that balance in good health. The physician intuitively correlated into his reading a bewildering string of external factors—the climate, the direction of the wind, colors, odors, tastes, sounds, the natural elements, the positions of constellations, and more—and arrived at a diagnosis. To a Westerner such as myself, this ability seems almost supernatural and far-fetched. I find a stronger resonance in the text’s evocative characterizations. The resting pulse rate of a healthy heart will resemble “a piece of wood floating on water,” for instance, and the throb of a vigorous heart “should feel like continuous hammer blows.” The pulses relating to unhealthy conditions are also lyrical. A sickly pulse might reverberate like “the notes of a string instrument” or feel like “fish gliding through waves”—descriptions that nonetheless thrum and flicker with life.
    Dr. Broadbent was never so poetic. On the contrary, he encouraged physicians to express no personal style whatsoever when writing about a patient’s pulse, thus eliminating the risk of ambiguity. The rate of pulse beats should be described as either
frequent
or
infrequent,
he insisted, with no shades in between. Arteries were
large
or
small,
and the “tension” or blood pressure within them
high
or
low.
What’s interesting is that this colorless vocabulary obviously did not reflect his wonder at the pulse. “It is impossible to examine a large number of