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Round, flat, pointed, and elongated are the physical forms of Metal, Water, Fire, and Wood, respectively. The form of Metal is round. The form of Water is flat. The form of Fire is pointed. The form of Wood is elongated. These four forms are naturally inherent constitutions; how could they lack a fixed form? They flourish in their respective seasons, and their balanced (Zhonghe) form constitutes the form of Earth. A round shape containing balance implies that within the round form lies the essence of Earth; a flat shape containing balance implies that within the flat form lies the essence of Earth. The same applies to pointed and elongated shapes. This is what is meant by "Earth flourishes in all four seasons and is present everywhere." While these four forms are indeed as described, ascending, descending, floating, and sinking are the natures attributed to these forms by human observation. Urgency is the nature of Wood; gathering/concentrating is the nature of Metal; seeping/drainage is the nature of Water. This is consistent with the meaning in the *I Ching* (Book of Changes): "That which originates from Heaven tends toward the upper; that which originates from Earth tends toward the lower."

Within each section of the body, one must recognize that Heavenly Yang and Earthly Yin constitute the fundamental natural entities. If Earthly Yin resides in the upper part while Heavenly Yang is located below, causing Yin stagnation and Yang obstruction, dispersing methods should be employed to scatter the Yin pathogenic factors and restore the normal state of Heavenly Yang.

(Figure: Diagram of Six Qi Combining to Form Abnormal Pulses)

The above six pulse types:
Lower section pulses: Extend from the umbilicus to the legs and feet.
Middle section pulses: Extend from the chest to the umbilicus.
Upper section pulses: Extend from the head to the back and chest.

When discussing the three sections (Cun, Guan, Chi), one must first determine the Yin-Yang attributes and whether the pulse indicates Excess (Tai Guo) or Deficiency (Bu Ji).

A floating pulse at the Left Chi position governs the Kidneys. The pulse extends upward to the Guan position but does not reach downward to the full extent of the Chi position. This indicates Yang excess, representing an Excess condition. It primarily indicates Kidney Yang deficiency and coldness, inevitably leading to timidity and weakness, stiffness and rigidity of the waist and spine, aversion to cold, and pain in the hips and feet.

The Left Guan position governs the Liver. The pulse extends upward to the Cun position but does not respond to pressure downward. This indicates Yang excess, representing an Excess condition. It primarily indicates dim vision, tendon pain, and irritability. Since the Liver belongs to Wood, can it have branches and leaves without roots? (Implying insufficient Liver Blood/Root).

The Left Cun position governs the Heart. The pulse extends upward to the Yuji area but does not respond to pressure downward. This indicates Yang surplus, representing an Excess condition. It primarily indicates palpitations (Zhen Tong), frequent dreaming especially of past events, and forgetfulness. Since the Heart belongs to Fire, it should shine brightly (Li Ming); it should not exhibit excessive Yang.

The Right Chi position governs the Gate of Vitality (Ming Men). The pulse extends upward to the Guan position but does not reach downward to the full extent of the Chi position. This indicates Yang surplus, representing an Excess condition. It primarily indicates seminal emission, frequent dreaming, excessive sexual desire/thoughts, leukorrhea or turbid urine in women, rectal prolapse, and trembling/chills. Since the Gate of Vitality stores Essence (Jing), it should not allow Essence and fluids to flow out like water.

The Right Guan position governs the Spleen. The pulse extends upward to the Cun position but does not maintain stability at the Guan position downward. Yang is in excess, representing an Excess condition. It primarily indicates sallow complexion, puffy eyelids, hypersomnia, lethargy, and fatigue in the four limbs. Since the Spleen governs the Center, it should remain tranquil and should not be agitated.

The Right Cun position governs the Lungs. The pulse extends upward to the Yuji area but does not reach the Guan position downward. This indicates Yang surplus, representing an Excess condition. It primarily indicates shortness of breath, emaciation, coughing up thick and purulent sputum, and symptoms resembling malaria occurring intermittently. The Lung belongs to Metal; in the four seasons, its pulse often presents as floating and hair-like (Fu Mao).