Pulsynergy Made Easy, Part II: Leading Acupuncture CE Provider

Pulsynergy Made Easy, Part II
By
Dr. Jimmy Wei-Yen Chang

MPH, PhD, OMD, LAc
Leading Acupuncture CE Provider

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Index Page (3 rd to the last page in the notes)
Pulsynergy Made Easy Part II
Jimmy Chang, L.Ac., O.M.D.

Doctor of Chinese Medicine
Licensed in NY, CA, NCCAOM
Founder of Chang’s Pulse Diagnosis
Lotus Institute Of Integrative Medicine

www.eLotus.org [email protected]
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See the enlarged picture at the end of the file
© Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715 © Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute. Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
Course Outline Course Outline
• Course Objective • Discussion of Pulse definitions

• Review of what makes up a complete – Shapes
• Convex-shaped pulses (10)
pulse
• Straight
g wiry
yppulses ((13))
• Concave pulse (1)
• Shapeless pulses (4)
– Jumps (12)
– Levels (5)
Review of what makes up a

Course Objective
complete pulse
• 3 criteria that makes up a COMPLETE PULSE
• Be able to summarize the different pulses – Shape
found in Jimmy’s pulse diagnosis • Structural aspects of a pulse; shape of the vessel
– Jump
• Know which pulses are shapes, jumps, • Pulsation aspects of a pulse; sensation of the force
llevels,
l or complete
l t pulse
l signs
i i t your fi
against finger
• 4 aspects of jump:
• Know the descriptions of each of the pulses – 1) Velocity (speed – fast or slow)
– 2) Strength (forceful or weak)
• Know the general indications of each of the – 3) Resistance
pulses – 4) Amplitude
– Level
• Depth at which the pulse is felt
Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Tel: 626-780-7182 • Fax: 626-363-9751 • Website: www.eLotus.org • Email: [email protected]
Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute. 1
Course Outline
• Discussion of Pulse definitions

– Shapes
• Convex-shaped pulses (10)
SHAPE
• g wiryy pulses
Straight p (13)
( ) CONVEX-SHAPED PULSES
• Concave pulse (1)
• Shapeless pulses (4)
– Jumps (12)
– Levels (5)
Shape - Convex-shaped
Shape - Convex-shaped Introduction
1. Bird’s beak = Pen tip • Describes only the shape aspect of pulses – bulges
2. Bean upward/outward, rounded feeling under your finger
3. Short = Yangming pulse • Lengths of convex-shaped pulses vary from 0.1-2.0 cm
4. Convex • Usually indicative of pathology in the vessels (stagnation),
5
5. T t
Tent mass swelling,
mass, swelling or obstruction of the organs reflected by
the position of the pulse
6. Turtle
• Larger the convex-shaped pulse, the larger the stagnation,
7. Spindle mass, or obstruction
8. Rainbow • Harder the convex-shaped pulse, the harder the stagnation,
9. Sea turtle the more compact the mass, and the longer it will take to
10. Bump dissolve
Shape - Convex-shaped Shape - Convex-shaped

Introduction (2 to last page in the notes) nd Bird’s beak = Pen tip
• Description
– Shortest of all convex-shaped pulses
– Approximately 0.1 cm in length
• Additional comments
Th feel
– The f l off this
hi pulse
l isi pointy
i
like a pen's tip
– If hard and can’t be pushed away
with pressure, severe condition
– If soft and weak, milder and usually a
temporary condition

Bird’s beak = Pen tip Bird’s beak = Pen tip
• Additional comments (con’t) • Herbal prescriptions
– Deep on left guan - gallstones
– Kidney stones
– Deep on chi positions – kidney stones in the ureters
(Stones still in the kidneys, can’t be detected by pulse dx)
• Dissolve KS
– Superficial
p on right
g cun – can be LU and/or LI conditions – Gallstones
• For LU: Constriction of upper respiratory system; • Dissolve GS
Accumulation of fluid in the LU (pulmonary edema)
• For LI: Bird’s beak pulse is considered a short pulse, which
is related to LI; Right cun is also related to LI; therefore,
Bird’s beak pulse on the right cun can indicate congestion
of LI (cyst, fibroids, tumor, or even cancer if hard)
– Bird’s beak never is found in between positions
Bean
• Description
– Convex-shaped pulse that is shorter than the width of one
pulse position
– A little bigger than the bird’s
bird s beak
beak.
– Feels like a small round BB
– Can be found in any location or in between locations
– Denotes stagnation, something swollen - the harder the Bean
pulse, the more solid the stagnation (mass) and the harder it
is to dissolve

Bean Bean
• Additional comments (con’t) • Herbal prescriptions. Use herbs to break it up

– Hard – indicates tumor or possible cancer – Cold Breaker (San Leng, E Zhu, Wang Bu Liu Xing)
– Soft – feels like a pimple, soft and bulging, and can – Hot Breaker (Xuan Shen, Xia Ku Cao, Huai Hua)
be pushed away when pressure is applied – Resolve (Lower)
– Strong-inflammation, excess heat. – Astringent Complex (He Zi, Wu Bei Zi, Ma Chi Xian,
– Usually you find 1 or 2 beans, rarely 3 at a time and Tian Hua Fen, Bai Wei, Ce Bai Ye) shrinks the
in all positions. The chart above means bean swelling, reduce inflammation.
pulses can appear in any of the 3 positions.

Short = Yangming pulse Short = Yangming pulse
• Description • Additional comments (con’t)
– Convex-shaped pulse; shorter than the width of one pulse position
– This pulse is always floating and usually forceful
• Indicates both dryness and heat
– 3-dimensionally round, not 2-D
• Additional Comments – (R) cun – dryness in upper respiratory system; allergy; skin
problems;; LI dryness;
p y ; in general,
g , DRYNESS
– Bi /l
Bigger/longer th
than B
Bean, iindicating
di ti th t ti ((mass)) iis llarger
the stagnation
– Yangming must be floating – one of the 6 Qi pulses. See • Need to nourish yin – use herbs/formulas such as
Pulsynergy book for detailed description. This pulse is from the Shi Gao, Mai Men Dong Tang, Gan Lu Yin
Yellow Emperor’s Classic Huang Di Nei Jing – Soft – like a pimple, soft and bulging, and can be pushed
– Denotes stagnation away when pressure is applied
– Yangming refers to 1) LI, ST channels and 2) superficial (surface) – Hard – can be tumor or cancer
– Respiratory & Skin problems – The stronger the pulse, the more heat / severe the stagnation

Short = Yangming pulse Short = Yangming pulse
• Herbal prescriptions • Herbal prescriptions
– Cold Breaker (San Leng, E Zhu, Wang Bu Liu Xing) for
cold type of blockage, swelling. – Cancer
– Hot Breaker (Xuan Shen-salty herbs clear fire, Xia Ku Cao, • Shi Quan Da Bu Tang
Huai Hua) for hot type of blockage, swelling.
– How do you know from the pulse if the swelling/blockage is • Ru Xiang
g
cold or heat? From the jump. • Mo Yao
• If forceful – heat  use hot breaker.
• If there is not much jump and you feel the shape only and the
amplitude of the jump is low (not pounding like the heat
type) – cold  use cold breaker.
– Resolve (Lower)
– Resolve (AI)
– Astringent Complex

Convex Convex
• Description • Additional comments
– This whole group we are discussing is the convex- – Jump – usually forceful indicating excess heat expanding
shaped pulses. And this pulse, specifically is also the vessels in the Liver
called convex. – Convex and weak – can be described as “tent”
– Convex shaped pulse that is the width of the guan
Convex-shaped – If a convex pulse appears on the left guan,
guan what does it
position. Jimmy uses the term “convex” to describe a mean?
bulging pulse ONLY on the GUAN positions. On other • Stressed out, emotional ups and downs, agitated –
positions, it has another name. Liver fire / Liver excess. Don’t give them a gun pulse.
– Approximately 1.0 cm in length – Convex pulse on the right guan and forceful. What is that?
• Acid reflux, H.pylori. Stomach fire
– Usually floating and expanding/forceful  indicates
bigger fire than the short pulse

Convex Convex
• Acid reflux, regurgitation (stubborn type) • Additional comments (con’t)

– Wu Mei Wan 25% – If left guan is convex and forceful, it is the
• Also good for forceful convex pulse on the left guan emotional aspect of the Liver involved.
 Liver fire with emotional conditions – If the left guan is wiry
wiry, it is the actual liver
– Pulse is floating and empty  Yin-deficient
affected, e.g. hepatitis (viral, from lipitor,
– Need to nourish yin to lower fire
chemicals, alcohol, paint, Tylenol, etc.).
– This formula is sour, so good for Liver and yin.
• Wu Wei Zi is a must when treating actual
liver problems

Convex Convex
• Emotional Liver qi stagnation (convex, forceful)
• Herbal prescriptions: Jimmy gives 100g to – Jia Wei Xiao Yao San (major role) 30%
his patients for 1 week supply. 3 spoons – Yi Gan San (% depends on velocity of pulse. The faster the
TID. pulse, the higher the % to use) 30%
– Ge Xia Zhu Yu Tang (blood moving formula for the
hypochondriac area) 20%
– Long Dan Xie Gan Tang (very bitter and more expensive,
so use less if possible) 20%
– Wu Mei Wan (if there is parasite) 20%
– He Huan Pi (if patient is very emotional) 20%
– If patient still has same emotional issues after 1 week,
use Circulation SJ 100% for 1-2 weeks.

Convex Tent
– Actual Liver dysfunction (wiry, forceful pulse). • Description
• Liver DTX 30% – Convex-shaped
• Chai Hu Qing Gan Tang 20%
pulse that collapses
• Ge Xia Zhu Yu Tang 20%
p p
upon pressure
– If liver enzyme is high
high, use 30% Wu Wei Zi (make sure
the Wu Wei Zi you use is not cooked over 100 degree. – Its length is the width of one pulse position –
The active component that lowers liver enzyme is approximately 1.0 cm in length
destroyed when it’s cooked over 100 degrees) • Additional comments
– Modify if necessary according to patients condition. – Like an yurt (Mongolian tent)- round on top, empty
underneath

Tent Turtle
• Most of the time found on the right cun, = low • Description
immune system, weak lung, low energy, shallow – Turtle, named this way for the curve of turtle shell.
respiration, etc. In this case, use the first 2 – Turtle is the same size as a convex pulse
formulas listed below. – Turtle is the combination of 2 pulses: Convex-shaped
l that
pulse h h has a ""tail"
il"
• Herbal prescriptions • “Tail” – thin, forceful, wiry pulse, proximal to the chi position
– Tent on left guan – 3-D, but flat on the bottom
• Ren Shen Yang Ying Tang 30% – Found on the chi position, either or both sides
• Shi Quan Da Bu Tang 30%
– Length is the width of the chi position, which is
• Shan Zhu Yu 20% for liver approximately 1.0 cm in length
• Wu Wei Zi 20% for liver

Turtle Turtle
• Additional comments • Herbal prescriptions
– Generally, the turtle indicates swelling from – General: Astringent Combo and Resolve Lower
inflammation, such as soft tissue injuries; • If forceful: add Gardenia Complex
the "tail" indicating disk problems, bone spurs, and • If low amplitude: add Cold Breaker (E Zhu, San Leng,
l i
neuralgia Wang Bu Liu Xing
Xing,))
– On right chi and proximal – neck and shoulder – For bone spur/disk problems
problems/injuries • Lower body (left chi) – Dang Gui Nian Tong Tang
– On left chi and proximal – lower body • Upper body (right chi) – Flex (Spur)
problems/injuries, such as lumbar area – Gout/joint pain due to heat/swelling. Turtle on (L) chi.
• Dang Gui Nian Tong Tang 50%
• Astringent Complex 50%

Turtle Spindle
• Additional comments (con’t) • Description
– Forceful – acute inflammation and greater pain – Convex-shaped pulse that is 3-D
– Weak – chronic condition with less inflammation
and pain
– Length is the width of the chi position, which is
approximately 1 0 cm in length
1.0
– Similar to a Convex pulse, but a Turtle pulse is
round, 3-D; has a "tail“ and found on the chi • Additional comments
positions
– Spindle differs from Turtle in that the bulge of
– Turtle and Spindle are essentially the same,
the Spindle pulse can be felt from the side;
except Spindle has more swelling and
inflammation therefore inflammation / swelling more severe

Spindle Spindle
• Herbal prescriptions • Additional comments (con’t)

– Prostate enlargement – On both chi – enlargement of the prostate
• Resolve (Lower) 50% – In women, if spindle is found on both chi –
• Astringent Complex 50%: anti inflammatory
anti-inflammatory some part of the reproductive system is
formula to reduce acute and chronic inflammation swollen
signs of swelling, redness, pain, etc. It is used
• Can’t tell from the pulse so check the ear to see
usually in combination with other herbs to treat
which part is red and inflamed
whatever problem.
• Treatment is the same, even though we don’t
know exactly what part is swollen

Rainbow Rainbow
• Description
• Additional comments (con’t)
– Convex-shaped pulse
that extends distally to the cun position
– Indications: Taiyang pulse on (L) cun – Small
Intestine problems, such as gas, bloating,
– Longer than the cun position, about 1.5-2.0 cm in
l
length
th poisoning enteritis
food poisoning,
• Additional comments – Rainbow and Sea Turtle feel the same
– Usually found distally to the left cun • Rainbow – when the pulse is found on the cun
position
– A taiyang pulse, therefore big, long, and expanding
• Sea turtle – when the pulse has a “tail” (like the
– Jump – forceful
Turtle pulse) and is found on the chi position
– Diameter – thick and expanding

Rainbow Rainbow
• Herbal prescriptions • Additional comments (con’t)

– For SI problems, enteritis, gas, bloating – 6 evil (pathogenic): qi, wind, cold, damp, heat, etc.
• GI Care II or Ge Gen Huang Qin Huang Lian Tang – Taiyang is cold but why is a taiyang pulse forceful
and big?
• Shao Yao Tang
• Constitution (zheng qi) is weak and cold;
• Herbal ABX Evil (pathogenic) qi is hot.
• Probiotics – Ba Wei Di Huang Wan and Long Dan Xie Gan
Tang for protein loss from the kidney, such as
proteinuria, kidney infection, swollen kidney, etc.

Sea turtle Sea turtle
• Description – Usually found on the left chi. Same condition as turtle but
– Longer Turtle pulse more severe
– Jump is forceful
(convex-shaped pulse
– Diameter is thick and expanding
p g
ith a “t
with il”) that
“tail”) th t extends
t d
• Herbal prescriptions
proximally to the chi position – Use the same formulas for turtle pulse.
– Approximately 1.5-2.0 cm in length, same size Or
as rainbow. – 100% Astringent Complex to shrink the swelling or add
some blood mover to break up the stagnation if the sea
– Sea turtle, for chi position; rainbow for left cun. turtle is harder.

Bump Bump
• Description
– Convex-shaped pulse
– Found between 2 pulse positions
– Cold Breaker (Wang Bu Liu Xing, San Leng,
E Zhu in equal proportions)
• Between cun and guan: hiatal hernia
• Between guan and chi: vasectomy – Hot Breaker (Huai Hua
Hua, Xia Ku Cao,
Cao Xuan
– Length of Bumps varies Shen in equal proportions)
• Additional comments – Resolve Lower
– Denotes stagnation between the upper and middle
jiaos, or between the middle and lower jiaos

Summary Summary
• Indicate qi and blood stagnation, but more specifically, • The stronger the jump of convex-shaped pulse, the more
swelling, stagnation, mass, and obstruction, like a rock acute, inflamed, blocked, stagnated, or painful the
that is blocking a road condition
• Most important objective: recognize a convex, bulging – Use heat clearing herbs (Herbal ABX or Gardenia Complex)
shape of a vessel • Soft bulges usually are temporary
temporary, and the stagnation or
– Not necessary to spend too much time trying to figure mass is light
out the size, if it is Convex, Bump, Turtle, Spindle, etc. • Harder the bulge, no matter what the size, the harder the
• Convex-shaped and bulging pulse  swelling or stagnation, the more compact the mass, and the longer it
stagnation in the body  treatment is to "remove the rock will take to dissolve
from the road – Use stronger herbs
– Longer course of treatment

Summary
• Jin Ling Zi San (Yan Hu Suo and Chuan

Lian Zi, 2:1 ratio) SHAPE
– For curved soft vessel from muscle spasm. STRAIGHT WIRY PULSES
Muscle tightness causes the artery to
change from straight to curved shape
– For spasmodic duct condition from gallstone
or kidney stone – use about 20%
Shape – Straight Wiry Shape – Straight Wiry

1. Wiry = Jueyin pulse Thick Straight
Thin Straight Wiry 8. CHONG PULSE
2. Blade 9. TAIYANG PULSE
3
3. Roof 10. SHAOYANG PULSE
4. REN PULSE 11. DU PULSE
5. YINQIAO PULSE 12. BIG PULSE = EXPANDING PULSE
6. Guitar string = Steel wire 13. BRACHIAL PULSE
7. CONSTRICTING PULSE = PULSE WITHIN A
PULSE

Introduction (Last page in the notes) Introduction
• Straight describes only the shape aspect of pulses –
straight with no curvature (neither convex nor concave)
• Wiry indicating the tension or tightness of the pulse
• Thin straight pulses
– Usually taut, with the tautness of these pulses dependent on
their diameters - the thinner the pulse, the more taut the pulse
– Indicative of constriction! Don’t think back to what you lean in
school that thin is deficiency. Thin is just a shape. Thin and
forceful is excess cold causing constriction. Thin and weak is
deficiency.

Introduction Introduction
• A pulse that is “straight wiry” must be at the same • Thick straight pulses
level in all locations – May or may not be taut
• “Straight wiry” can describe the general pulse where – Indicative of excess heat or inflammation
the cun, guan, and chi are all at the same level
– When the cun is most superficial and chi is deepest 
hooked pulse
– When the cun is most superficial and chi is deepest 
reverse hook pulse
• “Straight wiry” can also describe a pulse found in one
position if it is straight across on the same level

Wiry = Jueyin pulse Wiry = Jueyin pulse
– Tight, straight pulse – Slightly Wiry pulse – normal occurring pulse on
– Pulse is at the same level in all 3 pulse left guan, indicating normal Liver functions
positions
pos t o s – Too wiry on left guan – pathology of the actual
Liver, e.g. hepatitis.
– Can be thin or thick
– Wiry pulse on another pulse position, like the
• Additional comments right guan, indicates Liver overacting on the
– One of the 5 Zang (Organ) pulses and 6 Qi Spleen/Stomach
pulses • Duodenal ulcer
Shape – Straight Wiry Shape – Thin Straight Wiry

Wiry = Jueyin pulse Blade
• Herbal prescriptions • Description
– Hepatitis – Thin, straight, and extremely tight
• Liver DTX – Tautest of the thin, straight pulses
• Long Dan Xie Gan Tang – Most severe condition. Deadly pulse if found on the liver
position = cirrhosis, liver cancer
• Chai Hu Qing Gan Tang
– Duodenal ulcer – Very tight/taut that upon pressure it feels like a paper cut
• Chai Hu Jia Long Mu Tang 25%
– Indicates severe constriction. Liver is the organ that likes to be
• Jia Wei Xiao Yao San 25% free and growing. So when it’s severely constricted, it will die.
• GI Care 25% So when a blade pulse, the most severe pulse for constriction
• Astringent Complex 25% appears on the liver, it’s cirrhosis, or cancer.

Shape – Thin Straight Wiry Shape – Thin Straight Wiry
Blade Blade
• Herbal prescriptions • Q: Why are children’s pulses thin and tight?
– Openers
– Refrigerator syndrome: eat too much cold food,
• Dang Gui + Chuan Xiong 25%-30%
drinks, ice cream. Will have thin tight pulses.
• Dang Gui + Sheng Ma 25%-30%
– Give them ginger soup
• Si Ni Tang to address the cold causing the
constriction. • Nervousness in children with tight pulses:
– Other herbs depending on where the pulse is found Jia Wei Xiao Yao San and Yi Gan San.
– Add Yan Hu Suo, Chuan Lian Zi if spasm is also
involved. Ok to add Shao Yao Gan Cao Tang too.

Blade Roof
• Blade on (L) guan – a very deadly pulse • Description

– A pulse that is pinched on top
• Use Openers and warmer herbs – forming a thin, straight pulse
NOT cold herbs (like a paper cut feeling)
on the superficial level,
level
– Open channels  blood goes through  with increase in diameter
bring blood/nutrients to the Liver (becomes round) as it moves down to the deeper level
– Only pulse that increases in diameter as you feel the
• Q: Why not use blood movers? deeper level
– Not strong enough. Ok to add, but need – Not pure Blade – Has inflammation involved 
Openers Need to use Openers and cool herbs
Shape – Thin Straight Wiry

Extra Information
Roof
• Additional comments • Q: Push lightly – thin pulse; Push more – feel a
– Indication: constriction thick pulse that is a little to the side of the thin
– Mostly found on the left guan – Liver cirrhosis pulse. What is that?
– When a Roof becomes even more constricted, it • 9 channel pulse. New discovery by Jimmy.
turns into a Blade
• A pulse next to a pulse. A thin pulse can be felt
– Autumn qi is “Jin” = constriction, metal element.
next to a thick pulse.
– Same as Blade • Right chi = migraine. Cross section
– Q: Can Openers and Astringent Complex be used at view of vessel
the same time?

REN PULSE REN PULSE
• Description
– Complete pulse sign
– Thin, straight, tight pulse that is found and/or extends
proximally to the chi positions
– One of the 8 extra meridian pulses
– Slightly more taut and deeper than the Yinqiao pulse
• Ren pulse is right on the bone so it feels like it cannot be
pushed down any deeper. So feels like a needle on the desk.

REN PULSE REN PULSE

– On the right side – bone or disk problems on – Disk herniation, bone spur, spine related pain
the neck • Flex (Spur)
– On the left side – endometriosis
endometriosis, adhesions
adhesions, – Lower jiao blood stasis
prolapse, ovarian cysts, small fibroid (not • Resolve (Lower)
myoma. No big mass, only small ones), uterine • When taking Ren pulse, need to push down
prolapse. For men, bone spur
hard to the bone and release immediately;
– Q: Thickening of uterine lining, is it this pulse?
then repeat and take the pulse again.
No

YINQIAO PULSE YINQIAO PULSE
– Complete pulse sign – Not as deep as the Ren pulse
– Thin, straight, tight pulse that is found and/or extends – Indications: hemorrhoid, constipation, dermatological disorders
proximally to the chi positions and skin allergy, and poor peripheral circulation from constriction
– Tautness is similar to that of the Guitar string/Steel
g wire • Herbal prescriptions
– Not as deep as REN pulse. Yinqiao pulse still has a little – Dry skin rash
room in between the pulse and the bone. • Wen Qing Yin 20%
• Additional comments • Yi Yi Ren 20%
– One of the 8 extra meridian pulses • Liver DTX 20%
– Amplitude is low but tension can still be felt. • Gardenia Complex 20%
• Astringent Complex 20%

YINQIAO PULSE YINQIAO PULSE

– Wet skin rash – Poor peripheral circulation
• Wen Qing Yin 20% • Openers
• Yi Yi Ren 20% – Dang Gui and Chuan Xiong
• Jing Fang Bai Du San 20% – Dang Gui and Sheng Ma
• Liver DTX 20%
• Circulation SJ or Gardenia Complex or
Astringent Combo 20%

YINQIAO PULSE Guitar string = Steel wire

– Thin, straight pulse that is the least taut of the thin, straight
– Hemorrhoid pulses
• Hot breaker (xia ku cao, xuan shen, huai hua), 25% – Feels about the same as the REN pulse and the yinqiao pulse.
• Zhen Ren Huo Ming Yin, 25% - for pus Level is different. REN can be felt on the bone. Yinqiao and
guitar string are both a little higher.
• Astringent Complex, 25% - to shrink the hemorrhoid
• Shao Yao Tang, 25% to lift
– Mostly found on the chi positions
• (add some Da Huang type formula if hemorrhoid is – Indications: bone spur, hemorrhoids, constipation, and
due to constipation) skin allergy
– Tighter the pulse  the more the constriction – pain

CONSTRICTING PULSE =
Guitar string = Steel wire PULSE WITHIN A PULSE
• Additional comments (con’t)
• Description
– In younger patients  disk problem
– In older patients  bone spurs – Complete pulse sign
– Treatment is the same – This pulse feels like there
• Herbal prescriptions i ab
is bundle
dl off electric
l t i wiresi
– Bone spurs
• Flex (Spur) – (See clinical manual for detailed explanation)
(that are thin, straight, tight)
– For all spine related disorders and spurs within the artery
– Not good for gout, arthritis – Use Dang Gui Nian Tong Tang and
Astringent Complex instead – Tautness/tightness of the outside artery
– If the patient has both problems, then combine all formulas varies
together

CONSTRICTING PULSE = CONSTRICTING PULSE =
PULSE WITHIN A PULSE PULSE WITHIN A PULSE
• Additional comments • Additional comments (con’t)
– One of the 6 Bing (Pathological) pulses – Severe coldness
– Feel by flattening the artery and feeling the thin, – Usually found on the left cun – severe coldness in
g tight
straight, g wires inside, which cannot be rubbed the heart (i.e., Xiong Bi, myocardial infarction,
away coronary heart conditions)
– Wires inside feel Tight and Strong – excess cold; – On the right cun – Lung-cold
tighter = more cold, sharper the feeling, the more – Can Often be felt in the summer too because people
severe it is are in an air-conditioned room for too long or are
– Wires inside feel not too tight – yang-deficiency right in front of the air conditioner in the car

CONSTRICTING PULSE =
Shape – Thick Straight Wiry
CHONG PULSE
PULSE WITHIN A PULSE
• Description
• Herbal prescription (Xiong Bi)
– Running piglet, dashing dolphin syndrome. “ben tun”,
– Si Ni Tang 20% pounding heart,
– Circulation 50% – Complete pulse sign
– Forceful,
Forceful thick
thick, straight pulse that is found and/or extends
D
– Dang G
Guii 15% proximally to the chi positions, about 1/4 up the forearm
– Chuan Xiong 15% – Taut like the Guitar string/Steel wire
– One of the 8 extra meridian pulses
– Not as thick or as long as the Du channel pulse
Shape – Thick Straight Wiry Shape – Thick Straight Wiry

CHONG PULSE TAIYANG PULSE
– Indications: reversal disorders; when combined with the – Complete pulse sign
Gu pulse, heart conditions
– Big and long – straight, thick, expanding, and forceful
• Herbal prescriptions in all three levels, but mostly felt in the middle
– Chest,, cardiovascular,, palpitation,
p p , valve problems
p
Th ttaiyang
– The i l proximally
pulse i ll tto th hi position
the chi iti ffeels
l
• Tian Wang Bu Xin Dan 30%
like a plastic tube while the regular cun, guan chi
• Xing Ren 15%
vessels feel normal
• Hou Po 15%
• Wan Dian Jin 20% – Extends distally beyond the cun positions known as
• Mao Dong Qing 20% rainbow if convex (bulged)
– Extends proximally to the chi positions known as sea
turtle if convex (bulged)

TAIYANG PULSE TAIYANG PULSE
• Additional comments • Taiyang pulse on both chi or left chi with cold
– Thickness of this pulse is between the Chong pulse signs, cold palms
and the Du pulse; however, it is not as long as either • Shan Yao 50%
one of them. • You Gui Wan 20%
– Taiyang pulse on BOTH chi positions = hormonal • B G
Bu Gu Zhi 15%
problems, hot flashes, menopause, PMS, MPS • Jiu Cai Zi 15%
(menopause), or hormonal acne; Possible high risk for
breast cancer  Ask patient to stop their hormone
• Taiyang pulse on both chi or left chi with hot
supplement immediately.
symptoms and may be taking hormones
• Shan Yao 50%
• Zhi Bai Di Huang Wan or Gardenia Complex 50%

TAIYANG PULSE TAIYANG PULSE

– Taiyang pulse that is convex and found on the cun – Gardenia Complex 60%
positions = Rainbow pulse
– Astringent Combo 20%
• Gas,, bloating,
g, enteritis,, food poisoning
p g
R i i 20% off h
– Remaining b d
herbs d on which
depends hi h
– Taiyang pulse that is convex and found on the chi
position the pulse is found
positions = Sea turtle pulse
• Soft tissue injury, swelling, inflammation

SHAOYANG PULSE SHAOYANG PULSE
• Description • Herbal prescriptions

– Complete pulse sign – Gardenia Complex
– Big and floating – straight, thick, and expanding – Astringent Combo
– Found on the superficial
p level – Salty herbs (use salty because it’s
it s not drying
drying.
– Big dry fire (fire causing dryness) Bitter herbs can clear fire but too drying)
– High BP patient with high cholesterol and shows this – Liver DTX 50%
pulse, will get stroke soon
– Tight and taut – Big Liver and Gallbladder fire

DU PULSE DU PULSE

– Complete pulse sign – Taiyang pulse vs. Du pulse
– Forceful, thick, straight • Taiyang – thicker, stronger; BIG and Long
– Extends pass the chi positions
positions, approximately up • Du – can be stagnant (dead blood); can be
1/2 of the forearm inflamed and swollen; can even be weak
– Taut like the Guitar string/Steel wire – On or proximal to the left chi – back pain
– One of the 8 extra meridian pulses – On or proximal to the right chi – UB channel
dysfunction (neck stiffness) or UB organ
– Thicker and longer than the Chong pulse
dysfunction (UTI)

DU PULSE BIG PULSE = EXPANDING PULSE
• Description
– Gardenia Complex and Astringent Combo
– Thickest of the straight pulses
• For neck pain: add Ge Gen Tang
– Jump – expanding, forceful, and fast on all levels
• For back and knee pain: add Dang Gui Nian
Tong Tang • Additional comments
– One of the 6 Bing (Pathological) pulses
– Indications: excess fire, inflammation, high blood
pressure, sign of someone who might be about to
have a stroke

BIG PULSE = EXPANDING PULSE BRACHIAL PULSE
– The hardness of this pulse depends on the blood
pressure
• The higher the blood pressure, the harder the pulse, and – A Big pulse/Expanding pulse found on the
the more severe the condition inside of the upper arm near the elbow
• Herbal prescriptions • Additional comments
– Gardenia Complex 60%
– Used to detect Kidney type hypertension
– Astringent Combo 20%
• When all the signs and symptoms of the patient
– Remaining 20% of herbs depends on the position indicates hypertension but the radial pulses are
where the pulse is found weak

Shape – Thick Straight Wiry Shape – Straight Wiry
BRACHIAL PULSE Summary
• Herbal prescriptions • The qi and blood stagnation associated with a

straight, wiry, tight pulse is different than that of
– Kidney type hypertension or peripheral stenosis
the qi and blood stagnation found in convex
• Shui Ding Xiang 20%
pulses
• Xian Feng Cao 20%
– The constriction in straight, wiry pulses is much like
• Li Zhi He 20% a 4-lane freeway that has narrowed and become 2
• Di Long 20% lanes
• Dan Shen 20% – Convex pulses reflect an actual blockage, like a rock
on the road
– Completely different herbal treatment strategy

Summary Summary
• Thin and taut pulses indicate qi and blood • Constriction is usually due to cold
stagnation, but more specifically, constriction – Add (approximately 20%) Si Ni Tang, You Gui Wan or
Ba Wei Di Huang Wan to the formula
and thus poor blood flow
– Low amplitude – more stagnation
– The tighter or thinner a pulse, the more severe the
• Circulation SJ and Resolve Lower
constriction
• Certain conditions (ex. bone spurs) showing a thin and
– Treatment focus is on opening up the constricted
tight, constricted pulse is due to stagnation (not cold)
vessel
– This stagnation can cause excess heat accumulation –
• Use "openers“
pulse becomes forceful
– Dang Gui and Sheng Ma
• Use heat clearing formulas – Gardenia Complex – to
– Dang Gui and Chuan Xiong clear the heat
Shape – Straight Wiry

Summary
• Thick and expanding pulse (or forceful and high
amplitude) most commonly indicates fire and
inflammation SHAPE
– Use heat-clearing formulas that target the location in which
you
y felt the thick,, expanding
p g pulse
p CONCAVE-SHAPED PULSES
– To achieve fastest effect, use Gardenia Complex to clear
heat in all 3 jiaos
– Astringent Combo is commonly used at 25%-50% to help
bring down the fire and inflammation
– If amplitude is low, then there is more stagnation; therefore,
add blood movers

Shape – Concave-shaped
Shape – Concave-shaped Introduction
1. Concave • Describes only the shape aspect of pulses –
dips and are curved downward
• Curves on the sides of this pulse can be felt,
almost as if the vessel walls are thinner so that
when it is pressed, it sinks down
• Mostly found on the deep level
Shape – Concave-shaped Shape – Concave-shaped

Concave Concave

– Refers to the shape of a pulse that is curved – Right guan – superficial gastritis
downward – Left guan
– Able to feel the curvature along the side and • Concave and Deep – fatty liver
bottom of the pulse • Concave and Weak – exhaustion
• Additional comments • Concave and Bird's beak/Pen tip – gallstones or
– Usually found on the left guan or the right guan temporary bile duct spasm.
– Concave and Deep are not the same • Concave, Wiry thin like a blade, and Forceful pulse
at the bottom of the curvature – Liver cirrhosis
• Concave – Shape ; Deep – Level
Shape – Concave-shaped Shape – Concave-shaped

Concave Concave

– Fatty Liver – Exhaustion of Liver
• Yin Chen Hao Tang 20% • Sheng Mai San 20%
• Liver DTX 30% • Wu Wei Zi 15%
• Astringent Combo 30% • Shan Zhu Yu 15%
• Ge Xia Zhu Yu Tang 20% • Ren Shen Yang Ying Tang 25%
• Shi Quan Da Bu Tang 25%

Shape – Concave-shaped
Concave
– Liver cirrhosis
• Resolve Lower 40% SHAPE
• Yin Chen Hao Tang 30% SHAPELESS PULSES
• Chai Hu Shu Gan Tang 30%
– Superficial gastritis
• Astringent Combo 25%
• GI Care 25%
• Herbal ABX 25%
• Chai Hu Jia Long Gu Mu Li Tang 25%
Shape - Shapeless
Shape - Shapeless Introduction
1. DISPERSING PULSE • Describes only the shape aspect of pulses –
2. SCATTERED PULSE shapelessness and indistinguishable borders
3. GREASY PULSE • Arterial borders and cylindrical shape of these
4. STAGNATING PULSE = Dirty = Muddy pulses cannot be felt
• Shapeless pulses that are weak: use Sheng
Mai San and Wu Wei Zi.
Shape - Shapeless Shape - Shapeless

DISPERSING PULSE DISPERSING PULSE
– Complete pulse sign – Indications: pure weakness; blood stasis causing
– Border of vessel is difficult to perceive deficiency heat, or damp accumulation causing
– Thick (wide)
(wide), soft
soft, slow
slow, weak and deep deficiency heat
– Right cun – dead blood in the chest
• Caused by 1) traumatic injuries, 2) holding ones
– One of the 6 Bing (Pathological) pulses breath too long, 3) drinking cold water on a hot day
– Feels like cotton candy – Left chi – Lower back pain, patient had lower
abdominal surgery, abortion, C-section, IUD

DISPERSING PULSE SCATTERED PULSE

– For weak and dispersing from exhaustion and – Complete pulse sign
very low BP – Border of vessel is difficult to perceive
• Sheng Mai San – Thick (wide), soft, slow, very weak, and deep
Or • Additional comments
• Wu Wei Zi and Ren Shen – Same as a Dispersing pulse except Scattered
– For blood stasis: pulse is weaker
• Circulation SJ – Found on or proximal to the chi positions –
• Resolve (Lower) chronic injury with blood stasis

SCATTERED PULSE GREASY PULSE
• Herbal prescription • Description

– Circulation SJ – Complete pulse sign
– Resolve (Lower) – Border is not clear due
t plaque
to l b ilt
built-up th
on the
arterial wall
– Wall of this pulse becomes hard and forceful
when the plaque built-up worsens

GREASY PULSE GREASY PULSE
– Indication: high cholesterol
– Circulation SJ or Circulation 40%
– In the beginning when the cholesterol is not so high, the
feeling of the vessel will feel greasy, oily, no – Shan Zha 15%
distinguishable border.
border – Shen
Sh Q Qu 15%
– But later when the condition worsens and the hardened
arterial walls can be felt, it denotes atherosclerosis – Mai Ya 15%
• Harder the vessel, the lower the amplitude, the worse the – Da Huang 15%
sclerosis. Use more blood movers
• More forceful the jump, the higher the blood pressure. Use
– Change the diet! Very difficult with just herbs
more heat clearing herbs

STAGNATING PULSE = Dirty = Muddy STAGNATING PULSE = Dirty = Muddy

– Complete pulse sign – One of the 6 Bing (Pathological) pulses.
– Has high viscosity (not moving) due to the – More severe form of Greasy pulse
dirtiness of the blood caused by cholesterol – Feels sluggish (key word for this pulse) due to the
dirtiness of the blood caused by cholesterol and
and fat found in the blood
anything that should not be in it that impedes the
– Forceful but with a low amplitude smooth flow of the blood
– Deep + Not moving = Dirty pulse – Indication: qi and blood stagnation.
Shape – Shapeless Shape – Shapeless

Summary Summary
• Key point: shapelessness and indistinguishable • Diagnosis: blood stasis, damp accumulation, or
borders of the radial artery high cholesterol
– Feels like wiggling jello
• General herbal strategy
• Difficult to feel the fine differences between all – Astringent Combo 50% (collects shape of artery)
the shapeless pulses listed above – Circulation SJ 50% (removes the stagnation)
– If you feel a pulse that "doesn't really feel like anything
or there is no clear definition of vessel shape, yet
there is a jump and low amplitude," most likely you
have found one of the above shapeless pulse
Shape - Others
Diameter
1. Thin = Fine = Thready
SHAPE 2. Thick
OTHERS 3. Wide
Length
4. Long

Shape – Others Shape – Others - Diameter
Introduction Thin = Fine = Thready
• The pulse descriptions listed in this category • Description
refers to only the shape – diameter or length – – The diameter of a pulse is thinner than 2.5 mm
of pulses
• The jump (i.e., forceful or weak / fast or slow)
and level (superficial or deep) of these pulses – Can be forceful or weak which would indicate
must also be determined in order to create a different diagnosis
complete pulse picture and to reach a
diagnosis
Shape – Others - Diameter Shape – Others - Diameter

Thick Thick / Thin ; Strong / Weak Summary
• Description • Thick and strong = excess heat: high BP, fast HR

• Thick and weak = blood stasis
– The diameter of a pulse is thicker than 2.5 mm
• Thin and strong = constriction
• Additional comments • Thin and weak = deficiency: low BP, slow HR
– Thick pulse that is forceful = Big/Expanding • Then decide floating or deep. Too floating is heat
pulse causing dryness. Too deep is damp.
• Then determine what does that mean in the
– Thick pulse that is weak = Dispersing pulse position.
• Then if the vessel feels hard, sclerosis or hard
mass
Shape – Others – Length Shape – Others – Length

Long Long

– A pulse that extends beyond the normal cun – Long, convex, extends proximally to the chi
and chi positions position = Sea turtle pulse
• Additional comments Long convex,
– Long, convex extends distally to the cun
– Long, Thin, Tight, and proximal to the chi position = Rainbow pulse
position = Yinqiao pulse or Ren pulse
– Long and Thick, and proximal to the chi
position = Du pulse

Jumps
Velocity
1. Fast
JUMPS 2. Slow
Strength
3. Buoyant
4. Forceful = Strong = Pounding
5. Jumpy
6. Weak = Empty
7. SMALL PULSE = SHRINKING PULSE
Jumps
Jumps Introduction
Resistance • Refers only to the jump – the pulsation
8. Tight aspects of a pulse and the force of the pulse
9. Flowing = Slippery pressing up against your fingers
Amplitude • 4 attributes of jump
10. High Amplitude – 1) Velocity (rate)
11. Low Amplitude – 2) Strength
– 3) Resistance (flow)
Others
– 4) Amplitude (magnitude at which the blood vessel
12. Gu expands)
Jumps - Velocity Jumps - Velocity

Fast Fast
• Description
– Yin Abscess, bed sores, in weak patients. Harder to
– Heart rate: faster than 80 beats per minute treat – takes longer to tonify the body to show result.
• Additional comments • Zhen Ren Huo Ming Yin
• Bu Zhong Yi Qi Tang
– Normal heart rate: 72 beats per minute
• Huang Qi
– Indications: thyroid function; nervous tension – Yang (heat) Abscess, bed sores, acute inflammatory,
level; abscess with high fever (>100 beats or infectious. Easy to treat – faster to see result.
per minute); MSG and caffeine intake • Zhen Ren Huo Ming Yin
• Astringent Combo

Jumps - Velocity Jumps - Velocity
Slow Slow
– Heart rate: slower than 60 beats per minute – Ling Gui Zhu Gan Tang
• Additional comments • Hypothyroidism, deep pulse,
– Various indications: stagnation
stagnation, slow metabolism
metabolism, • Also ggood for the face – damp
p in the ears,, nose,,
weakness, and water retention, hypothyroidism mouth (drooling, nasal discharge, too much ear wax,
etc.)
Jumps – Strength Jumps – Strength

Buoyant Forceful = Strong = Pounding
• Description • Description
– True Forceful pulse does not disappear with pressure. A pulse
– Forceful and rebounds against the finger when that feels forceful on the superficial level but not in the mid or
pressed down on all levels deep level is NOT considered a true strong pulse. Write down
on your chart it’s strong on the superficial but weak
• Additional comments underneath
underneath.
– One of the 5 Zang (Organ) pulses – Strong rebound on all 3 levels of the pulse
– Normal pulse of the Lung • Additional comments

– Indication: excess conditions
• On both superficial and deep levels of the right
– The more forceful the pulse, the more severe, acute, or
cun – normal functioning of the Lung excess the condition
– Not too dry (superficial) and not too damp (deep)

Forceful = Strong = Pounding Jumpy

– If true forceful (strong), even if s/s is – Forceful and strong, but lacks consistent rhythm
tiredness, do NOT use tonic herbs – blood – Impetuous
is stagnant  Use blood movers • Additional comments
– Gardenia Complex – Result of the sudden upward (systolic) and
downward (diastolic) movement (beats) of a pulse
– Heat stimulating the heart to beat like this. Mostly
from MSG

Jumpy Weak = Empty

– Gardenia Complex 50% – A pulse that disappears upon pressure and is
– Tian Wang Bu Xin Dan 50% weak on all 3 levels
– Indication: deficient conditions
– On right cun – weak Lung (low immune
system, catches cold easily and frequently,
allergy)

Weak = Empty SMALL PULSE = SHRINKING PULSE
• Description
• Herbal prescriptions for weak on right cun – Complete pulse sign
– Ren Shen Yang Ying Tang – Shape – thin
– Yu Ping Feng San – Jump – weak, and upon pressure, disappears
Additi l comments
• Additional t
– Add Yuan Zhi and Shi Chang Pu if the pulse – One of the 6 Bing (Pathological) pulses
is also scattered and deep (blood stasis, weak – Indications: deficiency, cold conditions; decrease in
+ damp). Jimmy uses this for ADD kids too. physiological functioning of a particular organ; low
immune system; degeneration; or post-surgical
– Immune + convalescent state

SMALL PULSE = SHRINKING PULSE SMALL PULSE = SHRINKING PULSE
• What is yin deficiency? Substance loss. • Additional comments (con’t)
• What is yang deficiency? Yang deficiency is the – On all positions of right hand – qi deficiency
functional decline of an organ – On all positions of left hand – blood deficiency
• Which is worse? Yin deficiency
deficiency. Protein
Protein, jing loss – On both hands – q qi and blood deficiencies
is HARD to replenish. Takes a long time to – Yang deficiency (including qi def)
replenish. • Herbal prescriptions
• Which is easier to treat? Yang deficiency: easy to – Ren Shen Yang Ying Tang
warm up the body. – Shi Quan Da Bu Tang

Jumps – Resistance Jumps – Resistance
Tight Tight
– Low amplitude and does not expand – Openers
– Like a tight rubber band. There is a lot of tension • Dang Gui and Sheng Ma
underneath.
• Dang Gui and Chuan Xiong
– Can be thick or thin
– Tight and Thick = Brachial pulse
– Tight and Thin = Yinqiao pulse, Ren pulse,
Constricted pulse/Pulse within a pulse
Jumps – Resistance Jumps – Resistance

Flowing = Slippery Flowing = Slippery
• Description
– The definition of Jimmy’s slippery is different than the traditional • Additional comments (con’t)
slippery definition in your textbook. – Appears in patients who suffer brain related
– Wave-like movement (flowing) going from the chi position to the
cun position
disorders, such as epilepsy and dementia,
– L
Less th
than 1% off th
the patients
ti t will
ill show
h thi
this. M
More advanced
d d brain damage during birthbirth, weird behavior
pulse dx. – learning difficulties, retarded
• Additional comments – Wind phlegm
– One of the 6 Bing (Pathological) pulses
– Detected by lifting the middle finger off the guan position and
feeling the pulse hit the chi position and then the cun position
Jumps – Resistance Jumps – Amplitude

Flowing = Slippery High Amplitude

– Tian Zhu Huang – Magnitude at which the blood vessel
– Shui Zhi expands
– Ti
Tian M
Ma • Additional comments
– Jiang Can – A pulse with high amplitude is expanding
– Yuan Zhi – Indication: excess heat
– Shi Chang Pu • Herbal prescriptions
– Zhu Dan – Gardenia Complex

Jumps – Amplitude
Low Amplitude
• Description
– Magnitude at which the blood vessel expands
– Forceful – stagnation (may be due to plaque
on the vessel wall or high blood viscosity)
– Weak – deficiency
– Taking beta-blockers shows low amplitude
pulses
Jumps – Amplitude Jumps – Other

Low Amplitude Gu

– When both the upward (systolic) and downward (diastolic)
– Low amplitude and Forceful
beat of the pulse can be felt. Normally, only the upward
• Circulation SJ or Shu Jing Huo Xue Tang or Shen beat can be felt.
Tong Zhu Yu Tang or Gui Zhi Fu Ling Wan – Can be created by doing 50 jumping jacks and suddenly
sit down. The pulse you feel is the Gu Mai feeling. You
can feel both the upward and downward beat of the pulse.
– Low amplitude and Weak It should go away in a few minutes.The downward beat
• Ren Shen Yang Ying Tang can be felt is because you are feeling the regurgitation of
the blood due to valve problem
Jumps – Other Jumps – Other

Gu Gu

– Mostly it is found on the right cun – Arteriosclerosis (Gu on right cun with high BP)
– With high blood pressure – arteriosclerosis • Di Long 20%
• Dan
a SShen
e 20%
0%
– With llow bl d pressure – weakness
blood k off th
the • Li Zhi He 20%
heart and valve problems • Xian Feng Cao 20%
– Can also be due to MSG, soda, or coffee intake • Shui Ding Xiang 20%

Jumps – Other
Gu
– Weakness of the Heart (Gu on right cun with
low BP) LEVELS
• Tian Wang Bu Xin Dan
• Yang Xin Tang
Levels
Levels Introduction
1. Floating = Superficial • Refers to the depth at what which the pulse

2. Deep = Sunken = Taiyin pulse can be felt
3. Hooked = Shaoyin pulse • Normally, the cun is the most superficial (right
4
4. Reverse hook pulse below the skin), guan in the mid level, and chi
5. Step is the deepest (but not deep to the bone)
• Evaluating the relative level gives you an idea
of which organ is out of balance
Levels Levels
Floating = Superficial Floating = Superficial
• Description
– Can be detected at the VERY 1st (top) level • If there is imbalance, such as floating on
– Not obvious on the 2nd or 3rd levels cun (dryness in upper jiao) and deep on
– In Huang Di Nei Jing, it means dryness from heat. guan and chi (damp in the lower body),
– Floating pulse means exterior condition ONLY when it’s found
on the right cun! use Xiao Chai Hu Tang and Wu Mei Wan. Wan
– Indication: dryness from heat. The more superficial it is, the
more heat and dryness there is.
– Gardenia Complex

Levels Levels
Deep = Sunken = Taiyin pulse Deep = Sunken = Taiyin pulse
– Can be felt upon pressure in the 3rd level – Dry skin rash
– Cannot be felt on the superficial or middle level • Wen Qing Yin 20%
• Additional comments • Yi Yi Ren 20%
– One of the 5 Zang (Organ) pulses • Liver DTX 20%
– Also one of the 6 Qi pulses • Gardenia Complex 20%
– Indication: damp; most patients usually suffer from • Astringent Combo 20%
skin problems (maybe because dampness may be
fungus, yeast, etc. jimmy doesn’t know but its true
from his clinical findings)
Levels Levels
Deep = Sunken = Taiyin pulse Deep = Sunken = Taiyin pulse
• Herbal prescriptions • Pimple due to hormone imbalance
– Wet skin lesions
• Use the above formulas listed above and
• Wen Qing Yin 20%
• Yi Yi Ren 20%
add Shan Yao, 30-50%
• Jing Fang Bai Du San 20%
• Liver DTX 20%
• Gardenia Complex, Circulation SJ or Astringent
Combo 20%
Levels Levels
Deep = Sunken = Taiyin pulse Hooked = Shaoyin pulse
– Edema of the ankle caused by heart problem, high – Normally, cun position is higher than the guan and
BP, risk for congestive heart failure chi positions
• Mao Dong Qing 100% – But if the cun is excessively higher, then diagnosis is
• Wh
When usingi MMao DDong Qi
Qing, d ’t use
don’t listed below #3
Astringent Complex • Additional comments
– Edema – 1. One of the 5 Zang (Organ) pulses
• Ling Gui Zhu Gan Tang – 2. Also one of the 6 Qi pulses
• Ba Zheng San – 3. An excessive Hooked/Shaoyin pulse on the left
• Astringent Complex cun – nervousness, palpitation, headache

Levels Levels
Hooked = Shaoyin pulse Reverse hooked pulse
– Tian Wang Bu Xin Dan – Chi position is higher than the cun and guan
– Liu Wei Di Huang Wan 30% or Huan Shao Dan positions
30%
– Indications: neurasthenia, emotional
– Shaoyin = HT and KD
weakness, someone who is easily frightened,
– So….when treating the heart, treat the kidney and excess Kidney
too to have better result.
Levels Levels
Reverse hooked pulse Reverse hooked pulse
– Also appears in someone who’s adrenaline – Emotional weakness, neuroasthenia,
is always high, such as being under constant someone easily frightened
frightening and scary situations • Tian Wang g Bu Xin Dan 40% lift the cun/heart
• Check the veins in the eyes for dark spots • Sheng Mai San 40% lift the cun/heart
(exhausted stage) or bright red spots (active
• Nourish 20% (Zhi Bai Di Huang Wan) lower
stage)
the chi/kidney
Levels Levels
Step Step
– A sudden drop in level like a waterfall
– Resolve (Lower) or Circulation SJ
– Chi disconnected from guan and cun from the dead blood
blocking the circulation from middle to lower jiao
– Indications: blood stasis, scar tissue, and post-surgical
adhesions
– Often combined with a Dispersing pulse on the guan and
chi positions – past history of back or abdominal surgery,
abortion, C-section, and miscarriage, epidural

Question
• What’s the diagnosis for a thick and forceful

pulse?
Questions for Pulsynergy II
Question Question
• What’s the diagnosis for a thin and forceful • Compare a sea turtle and a rainbow pulse
pulse?
Question Question
• Compare a fast and a forceful pulse • Compare a tent, a weak pulse and a small
pulse

Question Question
• Name a thin and soft pulse and some thin • Compare a weak pulse and a low
amplitude pulse
and tight pulses and compare them.
• Does
oes a weak
ea pulse
pu se always
a ays have
a e low
o
amplitude?
• Is a low amplitude pulse always weak?
Question Question
• Compare a big pulse and a high amplitude pulse • In a patient with a forceful and low
• Does a big pulse always have high amplitude?
amplitude pulse, should there be a higher
• Is a high amplitude pulse always big?
percentage of herbs used for clearing heat
(treat forceful) or moving blood (low
amplitude)?
• A. Clear Heat
• B. Move Blood
Question Question
• Conversely, in a patient with a forceful, high • If thin and tight pulse is due to excess cold,
amplitude (thick and explanding pulse), why is the pulse for bone spurs thin and
should a higher percentage of heat clearing tight? Bone spurs are not caused by
herbs be used or the Astringent Combo to excess cold
cold.
reduce inflammation and swelling?

Jimmy Chang’s Contact Info
• Jian-Tai Acupuncture Clinic • To read articles by today’s speaker, watch

3133 S. Hacienda Blvd, Hacienda Heights,
CA 91745 online videos, or to see his/her complete
(626) 820-8859 seminar/webinar schedule for this year,
M
M, W
W, Th
Th, S
Sat:
t 10
10am-1pm
1 please visit www.elotus.org
www elotus org
[email protected]
• To intern ($210/day), send an email to

[email protected].
© Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shall not be copied, duplicated, or distributed in any format or be used for teaching without prior written consent from Lotus Institute.
• More information on the classic single herbs mentioned • Herbs mentioned in this seminar/webinar,
in this seminar/webinar can be found in the Chinese
Medical Herbology and Pharmacology are available through our sponsor
Evergreen Herbs & Medical Supplies.
• More information on the classic formulas can be found Please contact them for a catalog and
in the Chinese Herbal Formulas and Applications
pricing information.
• Collection formulas can be found in the Lotus Clinical
Manual of Oriental Medicine
• All the above texts are available through www.elotus.org
This webinar is sponsored by:
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Index Page
Pulses Category Page Pulses Category Page

Bean Shape - Convex 3 Pulse within a pulse Shape - Straight 13
Big pulse Shape - Straight 16 Rainbow Shape - Convex 7
Bird's beak Shape - Convex 2 Ren pulse Shape - Straight 12
Blade Shape - Straight 10 Reverse hook pulse Level 30
Brachial pulse Shape - Straight 16 Roof Shape - Straight 11
Bump Shape - Convex 8 Scattered pulse Shape - Shapeless 20
Buoyant Jump 24 Sea turtle Shape - Convex 8
Chong pulse Shape - Straight 14 Shaoyang pulse Shape - Straight 15
Concave Shape - Concave 18 Shaoyin pulse Level 29
Constricting pulse Shape - Straight 13 Short Shape - Convex 4
Convex Shape - Convex 4 Shrinking pulse Jump 25
Deep Level 29 Slippery Jump 26
Dirty Shape - Shapeless 21 Slow Jump 24
Dispersing pulse Shape - Shapeless 19 Small pulse Jump 25
Du pulse Shape - Straight 16 Spindle Shape - Convex 6
Empty Jump 25 Stagnating pulse Shape - Shapeless 21
Expanding pulse Shape - Straight 16 Steel wire Shape - Straight 13
Fast Jump 23 Step Level 30
Fine Shape - Other 22 Strong Jump 24
Floating Level 28 Sunken Level 29
Flowing Jump 26 Superficial Level 28
Forceful Jump 24 Taiyang pulse Shape - Straight 14
Greasy pulse Shape - Shapeless 20 Taiyin pulse Level 29
Gu Jump 26 Tent Shape - Convex 5
Guitar string Shape - Straight 13 Thick Shape - Other 22
High Amplitude Jump 26 Thin Shape - Other 22
Hooked pulse Level 29 Thready Shape - Other 22
Jueyin pulse Shape - Straight 10 Tight Jump 26
Jumpy Jump 24 Turtle Shape - Convex 6
Long Shape - Other 22 Weak Jump 25
Low Amplitude Jump 26 Wide Shape - Other
Muddy Shape - Shapeless 21 Wiry Shape - Straight 10
Pen tip Shape - Convex 2 Yangming pulse Shape - Convex 4
Pounding Jump 24 Yinqiao pulse Shape - Straight 12
SHAPE – CONVEX-SHAPED BULGING PULSES
Comparison of Convex- shaped pules from Shortest --> Longest
Bird's beak = Pen tip (≈0.1 cm)
Short / Yangming
Bean (≈0.3 cm) Rainbow Convex l Tent
Sea Turtle
Short = Yangming pulse (≈0.5 cm)
Convex (≈1.0 cm)
Tent (≈1.0 cm) Bean Bump
Bird's Beak
Spindle (3-D) (≈1.0 cm) / Pen Tip
Turtle (3-D w/o Bottom) (≈1.0 cm)
Turtle Spindle
Rainbow (≈1.5-2.0 cm)
Sea turtle (≈1.5-2.0 cm)
Bump (Various lengths)
Graphs above are drawn approximately to the actual size of the convex-shaped pulses and actual
width of the cun, guan, chi positions; however, a normal pulse width is relative to each person’s size
and constitution. Locations (pulse positions and levels) of the pulses are drawn for comparative
purposes. In actuality, these pulses can appear in any position and at any level.
Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715 Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
SHAPE – STRAIGHT, WIRY PULSES
Comparison of the Diameter of Straight Pulses
Normal
0.1 mm 1.25 mm 2.5 mm 3.75 mm 5 mm
Roof Chong
Blade Ren Du Big
Yinqiao Shaoyang
Guitar string / Steel wire Taiyang
Wiry
Thin Straight pulses from 1 - Tautest --> 5 - Least Taut Pictures are not
Blad Guitar string / Steel wire drawn to scale.
Blade (≈0.1 mm) - 1 Roof
Roof (≈0.5 mm) - 1.5 Estimated for
Ren pulse (≈1.25 mm) - 2 Yinqiao pulse* reference only.
Yinqiao pulse (≈1.25 mm) - 2 5 Drawn to show
Guitar string = Steel wire (≈1.25-2.5 mm) - 2-4 Ren pulse* 4 comparison of pulse
3 diameter within the
Thick Straight pulses from 1 - Thinnest --> 5 - Thickest 2 straight, wiry pulses.
Shaoyang pulse
Chong pulse (≈3.25 mm) - 3 Big pulse 1
Taiyang pulse
Taiyang pulse (≈3.25-3.75 mm) - 3-4 Chong pulse* *These pulses always
Du pulse (≈3.75 mm) - 4 Du pulse* appear proximal to
Big pulse (≈5 mm) - 5 the chi positions.
Shaoyang (≈5 mm) - 5
Brachial
Brachial (>5 mm) - 6 Pulses without * may
appear in any of the
cun, guan, chi
positions.
Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715 Tel: 626-780-7182 • Fax: 626-609-2929 • Website: www.eLotus.org • Email: [email protected]
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Evergreen is a family business that is run by professionals like you
who care about Chinese medicine. And as a family business, we
have the well-being and satisfaction of our customers at the top
of our list. We care about the quality of our herbs, because we
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To learn more about Evergreen Herbs and our products, please

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Pulsynergy Made Easy, Part II

Dr. Jimmy Wei-Yen Chang

Leading Acupuncture CE Provider

Lotus Institute of Integrative Medicine

GENERAL POLICIES / GUIDELINES

1. Consent and Disclaimer Part I (Copyrighted Information)

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LotusInstitute Of Integrative Medicine Website: www.eLotus.org

Jimmy Chang, L.Ac., O.M.D.

Lotus Institute Of Integrative Medicine

Course Outline Course Outline

• Course Objective • Discussion of Pulse definitions

Review of what makes up a

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

• Discussion of Pulse definitions

Shape - Convex-shaped Shape - Convex-shaped

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape - Convex-shaped Shape - Convex-shaped

• Additional comments (con’t) • Herbal prescriptions. Use herbs to break it up

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape - Convex-shaped Shape - Convex-shaped

Shape - Convex-shaped Shape - Convex-shaped

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

• Acid reflux, regurgitation (stubborn type) • Additional comments (con’t)

Shape - Convex-shaped Shape - Convex-shaped

Shape - Convex-shaped Shape - Convex-shaped

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape - Convex-shaped Shape - Convex-shaped

Shape - Convex-shaped Shape - Convex-shaped

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

• Herbal prescriptions • Additional comments (con’t)

Shape - Convex-shaped Shape - Convex-shaped

Shape - Convex-shaped Shape - Convex-shaped

• Herbal prescriptions • Additional comments (con’t)

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape - Convex-shaped Shape - Convex-shaped

Shape - Convex-shaped Shape - Convex-shaped

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

• Jin Ling Zi San (Yan Hu Suo and Chuan

Shape – Straight Wiry Shape – Straight Wiry

Shape – Straight Wiry Shape – Straight Wiry

See the enlarged picture at the end of the file

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape – Straight Wiry Shape – Straight Wiry

Shape – Straight Wiry Shape – Thin Straight Wiry

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

Shape – Thin Straight Wiry Shape – Thin Straight Wiry

• Blade on (L) guan – a very deadly pulse • Description

Shape – Thin Straight Wiry

Lotus Institute of Integrative Medicine, PO Box 92493, City of Industry, CA 91715

See the enlarged picture at the end of the file

Shape – Thin Straight Wiry Shape – Thin Straight Wiry

• Additional comments (con’t) • Herbal prescriptions

Shape – Thin Straight Wiry Shape – Thin Straight Wiry