Pulse Quality

Possible Indication

Notes & Formulas:

Right Cun: Lung and Upper Respiratory (above throat)

Forceful in superficial and
deep level (Ren 22 warm to
hot)

-Excess heat (wind heat), dryness, fire in the

LI, yamgming stage, dermatological disorders,
upper respiratory infection, cough, dyspnea

-Qing Rei Tang 20, Yin Qiao San 20, Qian Hu 10, Niu Bang Zi
10, Zhi Mu 10, Huang Bai 10, Da Qing Ye 10, Fu Hua Shi 10
-With lots of Cough: + Sang Bai Pi 10, Zhe Bei Mu 10, Ding
Chuan Tang 20, and take out Yin Qiao San

Forceful & superficial w/ cold

Ren 22

Bronchitis or acute wind cold

Forceful & superficial w/ hot

Ren 22

Asthma

Deep

Damp/phlegm in the Lung- causing respiratory

dysfunction

-Xiao Qing Long Tang 20, Ge Gen Tang 20, Zi Wan 15, Bai
Bu 15, Dun Sou San 15, Qing Fei Tang 15
-w/ dampness add Hai Ge Fen20
-w/ more heat add Fu Hua Shi 20
-Cold herbs
-Qing Fei Tang 20, Dun Sou San 20, Da Qing Ye 15, Niu Bang
Zi 15, Qian Hu 15, Xuan Shen 15
-Very superficial w/ cough (dryness)- increase dose of Niu
Bang Zi 20, Qian Hu 20
-If ST12 is also hot, heat in lungs may be result of ST fire, add
Tian Hua Fen 15
-w/ dampness add Fu Hai Shi 20, Hai Ge Fen 20
-If a lot of coughing add: Zhi Bei Mu, Sang Bai Pi
-If wheezing add: Ting Li Zi, Yu Xing Cao, Ma Huang
Add to Fx: Fu Hai Shi 20, Hai Ge Fen 20

Weak (and forceless) w/

common cold symptoms
Forceless and weak

(Spring 07)

-Fu Hai Shi if more heat

-Hai Ge Fen if more phlegm

Viral infection, flu

w/ no cold symptoms is weak immune system

-Ren Shen Yang Ying Tang w/ other diaphoretic fx

-Qing Shu Yi Qi Tang for summer heat
- Bu Zhong Yi Qi Tang, Yu Ping Feng San to tonify Wei Qi
Forceless and weak in all 3
-Qi deficiency, nasal allergy, weak immune
-Sheng Mai San 30, Huang Qi Jian Zhong Tang 35, Ba Zhen
levels
system, deficient wei qi, rhinitis
Tang 35
Gu Pulse
-Gu can be on right or left cun position, systolic and diastolic
pulses can both be felt
-Easily felt on right cun w/ msg, coffee, tea, coke and caffeine
intake. Or heart murmur
Copyright 2008 Lotus Institute of Integrative Medicine: Jimmys Changs Pulse Diagnosis organized by Robert Doane

-Can use Mao Dong Qing 20 if it is strong

-Can use Sheng Mai San if weak

Right Guan: Sp/ST & digestive system- Mostly Stomach (can be convex or concave)
Forceful
Floating and forceful

H. Pylori, yangming syndrome, ST Fire, acid

reflux

Floating and forceful, LI area

is hot

H. Pylori, yangming syndrome, ST Fire, acid

reflux, patient eats too much spicy food, garlic,
onions, ginger, etc

Wiry and forceful in

superficial or deep level
Wiry and forceful in
superficial or deep level

-Too much sugar

-Wood overacting on earth (duodenal ulcer)
-Too much sugar
-Wood overacting on earth (duodenal ulcer)
-Stomach problems w/ emotional cause/stress
1) Damp heat, chronic superficial gastritis
2) dermatological disorders

Deep and concave, may be

forceful or forceless

Deep and concave, may be

forceful or forceless
Deep and thin

Convex

Stomach Fire, stomach ulcer, H. pylori

infection, gastritis

-Emotional disturbance
-May be pain (thin/constricted)

Huang Lian Jie Du Tang (11/07)

Huang Lian Jie Du Tang + An Zhong San
-Or M3 w/ a little An Zhong San
-Note: if LI10 is cold always use An Zhong San 20
-If ST pain pt doesnt show disease in right guan pulse, check
left guan, most likely Lr is invading the ST
-If LI area is cold w/ this pulse= body constitution is
cold/weak, heat in the ST is temporary
-Bai Wei 15, Tian Hua Fen 15, Da Qinig Ye 15, Xuan Shen 15,
Huang Lian Jie Du Tang 20, Astringent 1 20
Jia Wei Xiao Yao San or Yi Gan San 40, Huang Lian Jie Du
Tang 20, Lr Dtx 40 (11/07)
Xia Ku Cao 15, Cha Chi Huang 15, Huang Shui Qie 15, Huang
LIan Jie Du Tang 15, Xie Huang San 20 OR Gan Lu Yin 20, Yi
Gan San OR Jia Wei Xiao Yao San OR Suan Zao Ren Tang 20
-To dispel Damp: bitter and acrid Huang Lian Jie Du Tang (use
An Zhong San if LI10 is cold)
- Use sour herbs Bai Wei, Wu Wei Zi, Shan Zhu Yu, Tian Hua
Fen, Ge Gen to strengthen the Lr to indirectly control the Sp to
dispel damp
- Wu Ling San
Bai Wei 15, Tian Hua Fen 15, Da Qing Ye 15, Xuan Shen 15,
Huang LIan Jie Du Tang 20, Astringent1 20
-The harder/tighter the vessel=worse
-Usually appears on right guan, may appear on left guan as well
-Constriction is from emotional disturbance causing stagnation
and constriction
-Use sweet herbs (softens, relaxes, helps ease pain and
constriction) 20%
-Gan Mai Da Zao Tang for Stomach pain w/ deep and thin
pulse
-M3 30, AST1 20, Bai Wei 15, Tian Hua Fen 15, ST Fx 20
-Can use Huang Lian Jie Du Tang instead of M3

Copyright 2008 Lotus Institute of Integrative Medicine: Jimmys Changs Pulse Diagnosis organized by Robert Doane

Right Chi: Kidney: (Urinary Function)- BL/KD, UTI, shoulder, neck area
Thin, long, wiry and forceful
(like a wire)
Thick, long, wiry and forceful

Long and Wiry, shape of

vessel is clear
Thin and wiry
Convex (turtle), up pulse
Deep, forceful or weak w/
vague vessel border

Bone spur in the neck, hemorrhoid,

constipation or dermatological disorders

-Bone Spur= Flex Spur 100 (2 scoops, 3x)

-If Tight Lr or Lr Fire add: Chai Hu Jia Long Mu Tang or Long
Dan Xie Gan Tang
-Kidney fire, disease in the taiyang/UB channel -Ba Zheng San 33, Long Dan Xie Gan Tang 33, ABX 33
or urinary dysfunction Bone spur in the neck,
-If just Kd Fire (might be taking too many hormones): Seattle1
hemorrhoid, constipation or dermatological
50, Ba Zheng San 20, M3 30
disorders
Tendon problem of the neck and shoulder
Bone spur, disk problem
Prostate or gout, soft tissue damage
Frozen shoulder w/ blood stasis

Flex Spur
-Seattle1 60, Xuan Shen 20, Wu Bei Zi 20
-Er Zhu Tang 40, Stress1 20
-If numbness on arms: Di Long 20, Dan Shen 20

Scattered-No shape of vessel

Frozen shoulder
-Just feeling of meat, no feel of vessel

Sharp point
Turtle pulse- feels like marble
under your finger
Turtle pulse w/ tail (additional
pulse found proximally)
Strong beat on Chi position

Kidney stone
Soft tissue damage, shoulder and back injuries

-Fx: Shan Zha 20, He Ye 20, Jue Ming Zi 20, Chai Hu Jia Long
Gu Mu Li Tang 20, Hu Zhang 20
-numbness and shoulder pain = frozen shoulder from damp
- Fx: Er Zhu Tang, Wu Wei Zi, Shan Zhu Yu, Da Qing Ye, Bai
Wei, Tian Hua Fen, Huang Lian Jie Du Tang (11/07)
-Dissolve KS
-Shu Jing Huo Xue Tang 70, Shen Tong Zhu Yu Tang 30

Weaker beat on Chi position

Deep and slow
Deep and slippery

Bone problems, ie: herniated disk, bone spur,

etc
The stronger the beat, the more inflammation,
most likely an acute condition
May be chronic injury
Old injury w/ blood stasis
Dampness in Pericardium

Flex Spur
Use 80% heat clearing to reduce inflammation (11/07)
-Zhen Ren Huo Ming Yin 40, Da Ding Huang 20, Shu Jing
Huo Xue Tang 20, Seattle1 20
Stress1 35, Flex Spur 35, M3 30
-Wen Dan Tang 40, Gua Luo Xie Bai Ban Xia Tang 20, He Zi
15, Wu Bei Zi 15, Zhu Ru 10
-If Gu add Mao Dong Qing 20

Left Cun: Heart/SI, (cardiac, angina, MI), SI=taiyang= big and long, Ht=shaoyin=hook
Rainbow pulse- long and big,
curves under finger, extends

Usually gas in the Small Intestine

If pulse jumps really fast may indicate colitis,

Ge Gen Huang Lian Huang Qin Tang 25, Shao Yao Tang 25,
AST1 20, Da Qing Ye 15, Xuan Shen 15

Copyright 2008 Lotus Institute of Integrative Medicine: Jimmys Changs Pulse Diagnosis organized by Robert Doane

distally toward palm

Pulse w/in a pulse

food poisoning
-Coronary Heart Disorder, angina pectoris,
myocardial infarct
-Damp Cold

Gu Pulse

Valve problem w/ the Heart

-prolapse, mitral valve regurgitation or stenosis
- palpitation

Small Pulse- forceless or weak

in all levels

- Heart Qi Deficiency (eastern, western)

- Poor concentration, decreased mental
function
Ht Fire

Hook Pulse

-Mostly felt on L-cun

-Severe pulse condition, body is too cold, vessels are
constricted
The harder the pulse w/in pulse, the more sever the condition
- Xie Bai: blood opener (11/07)
-Dang Gui 10, Sheng Ma 10, Stress1 30, Si Ni Tang 20, Gua
Luo Xie Bai Ban Xia Tang 30
-Gu can be on right or left cun position, systolic and diastolic
pulses can both be felt
-Tian Wang Bu Xin Dan 60, Dan Shen 20, Ci Shao 20 (11/07)
-Can be weak Gu: Tian Wang Bu Xin Dan 33, Zhi Gan Cao
Tang 33, Yang Xin Tang 33
-Can be strong Gu w/ HBP: Mao Dong Qing 20, + HBP Fx
-Or if no HBP: Mao Dong Qing 40, AST1 20, Liang Ge San
20, San Huang Xie Xin Tang 20 (if constipation)
-Reverse Hook: Tian Wanb Bu Xin Dan 33, Yang Xin Tang 33,
Zhi Bai Di Huang Wan 33
-Tian Wang Bu Xin Dan 25, Yang Xin Tang 25
-Tonify Kd: You Gui Wan or Zuo Gui Wan 25, Shi Qian Da
Bu Wan 25
-Liang Ge San 50, Huang Lian Sheng Qin Wan 50
-If HBP: Xiao Feng Cao, Cardiac Car 40, Hu Zhang 15, Shu
Wei Huang 15, Shui Ding Xiang 15

Left Guan: LR/GB, emotional, gallstone, fatty liver, Hep, (Lr can be convex or concave, or flat and wiry)
Convex pulse

-Liver fire, emotional and psychological

dysfunction (stress, mood swing, insomnia)
-emotional disturbance
-pressing down to feel concave indicating fatty
liver

Wiry and forceful (superficial

or deep concave)
Deep and Concave

Liver Fire, actual organ dysfunction like

hepatitis
Anxiety

Deep and Concave (forceful or

forceless)

-Fatty Lr, Damp Heat in the Lr/GB

- Lipitor, zocor and allergy medication

-Mostly in guan, hyperactive

- Liver Fire
-Mostly in skinny people, they are more stressed out
-If convex in right guan is St Fire, etc
-Yi Gan San 20, Jia Wei Xiao Yao San 20, He Huan Pi 20,
Tian Zhu Huang 20 (11/07)
-If ST Fire: Lvr DTX 20 or M3
-LVR DTX 15, Jia Wei Xiao Yao San 40, Huang Shui Qie 15,
Cha Chi Huang 15, Xia Ku Cao 15
Circulation San Jiao 50 (not for more than 1 month), Zhe
Chong Yin 30, Jia Wei Xiao Yao San 20 (11/07)
Same as above Add: Yin Chen Hao Tang 20

Copyright 2008 Lotus Institute of Integrative Medicine: Jimmys Changs Pulse Diagnosis organized by Robert Doane

Concave Pulse

- Fatty liver
- Drinker
- Liver cirrhosis (thin like knife blade)
-High Cholesterol (concave w/ greasy)

- lower than other positions, mostly seen in left guan

- Pts w/ this pulse are often drinkers, the thinner the pulse the
worse the condition
- Concave Pulse usually w/ greasy pulse (high cholesterol)

Left Chi: Kidney: (Reproductive function)- fertility, endometriosis, lower region/back (esp low back)
Thick, long, wiry and forceful

Kd Fire, reproductive dysfunction or disease in

the taiyang/UB channel

-Thin, long, wiry, forceful

-Steel wire/guitar string

-Bone Spur (flex spur)

-polycystic ovaries, uterine myomas, fibroids
(Resolve lower), constipation, hemorrhoids
-dermatological disorders

Turtle

-Back pain
-Acute Pain (strong turtle)
-Dead blood/chronic injury (dead turtle)

-Strong turtle is acute pain: Zhen Ren Huo Ming Yin 25, Da Ding Huang
15, Bai Wei 15, Xuan Shen 15, Hu Yao Huang 15, Pao Zi Cao 15
-Dead turtle--doesnt move much, dead blood/chronic injury: Shu Jing Huo
Xue Tang + Shen Tong Zhu Yu Tang, if wrist is hot add Zhi Bai Di Huang
Wan, if wrist is cold add Ba Wei Di Huang Wan
- Back of hand, close to wrist is the back, check temperature to determine fx
to use, hot or cold constitution
-turtle can be forceful or weak, superficial or deep

Strong Turtle Pulse

- Back and leg injuries

- Varicocele
- Prostate enlargement (if strong turtle pulse on
both chi)
- Myoma, fibroid
-Blood stasis from old injuries
-ask if hysterectomy, c-section, lower abd
surgery

- Varicocele: Resolve EM 30, Seattle1 30, AST1 20, Sheng Ma

10, Dang Gui 10
-Prostate: Resolve EM 50, He Zi 17, Ce Bai Ye 17, Bai Wei 17
- Myoma, fibroid: Resolve EM 100

- Deep and weak or forceful

-Scattered, muddy

Reproductive deficiency
-impotence, low libido, etc
Osteoporosis, jing deficiency, bone structure
deficiency

-If present on both sides, hormonal abnormality is indicated,

possible breast cancer (11/07)
-Might be taking to many hormones
-Ba Zheng San 20, Seattle1 50, M3 30
-Flex Spur
-Resolve Lower
-Circulation SJ- leech inside to move dead blood (11/07)
- Dang Gui and Sheng Ma (25% together):opener for thin pulse
(circulation is shrunk), improves peripheral and micro vessel
circulation (11/07)

-Circulation SJ
-Tonify the Kd Yang after blood stasis is removed: She Chuang
Zi, Xian Mao, Er Xiang Tang, Yin Yang Huo
- Flex Spur for disk injury after surgery
Use acrid & warm herbs
To tonify Kidney Yang
Use bitter and warm herbs
Osteo 8

Copyright 2008 Lotus Institute of Integrative Medicine: Jimmys Changs Pulse Diagnosis organized by Robert Doane