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Floating pulse, placing the fingers initially on the surface of the skin, touching it with light pressure is called Floating pulse. This indicates that cold pathogen has just invaded the Taiyang Yang meridian, and the disease is at the superficial level of the exterior; it can be treated by inducing sweating to expel the pathogen. Although so, there are two treatment approaches: if cold damages Ying (Nutritive Qi), presenting as anhidrosis and aversion to cold, use Mahuang Tang (Ephedra Decoction); if wind damages Wei (Defensive Qi), presenting as spontaneous sweating and aversion to wind, use Guizhi Tang (Cinnamon Twig Decoction). One involves opening the blocked pores, the other harmonizing the deficiency, they cannot be treated identically.

Floating, tight, and forceful pulse, with anhidrosis, aversion to cold, headache and stiffness of the head and neck, back stiffness, fever, this is Shanghan (Cold Damage) at the exterior, suitable for dispersing and releasing the exterior. In winter, use Mahuang Tang; in spring, summer, and autumn, use Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction).

Floating and slow pulse, with sweating, aversion to wind, headache and stiffness of the head and neck, back stiffness, fever, this is Shangfeng (Wind Strike) at the exterior. In winter, use Guizhi Tang; in the other three seasons, use Jiajian Chonghe Tang (Modified Harmonizing Decoction). If accompanied by abdominal pain, use Xiaojianzhong Tang (Minor Construct the Middle Decoction); if the pain is severe, use Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction).

Middle pulse, pressing the fingers below the skin, between muscle and bone, requiring slightly heavier pressure to perceive, is referred to as Shaobiao Banli Syndrome (Half-Exterior Half-Interior Syndrome). However, there are also two types, because the Yangming and Shaoyang meridians follow the "Zhong" (Middle) aspect rather than the Biao (Exterior) or Ben (Root).

Long and forceful pulse, which is a slightly Hong (Surging) pulse, indicates Yangming disease in the meridian. The symptoms include slight headache, orbital pain, dry nose, insomnia, fever, and anhidrosis; use Gegen Jiemi Tang (Pueraria Relieving Muscle Decoction). If there is thirst with sweating but the condition does not resolve, or if thirst persists after sweating therapy, use Baihu Tang (White Tiger Decoction) plus Renshen (Ginseng). If there is no thirst, do not take this medicine; it is a major contraindication.

Wiry and rapid pulse indicates Shaoyang meridian disease. The symptoms include hypochondriac pain, deafness, alternating chills and fever, vomiting, and bitter taste in the mouth; all are treated with Xiaochaihu Tang (Minor Bupleurum Decoction). (This formula has its own modifications.) If both meridians are involved simultaneously, the pulse is wiry and long; add Gegen and Shaoyao to this decoction. Since the Gallbladder has no direct exit or entry pathways, there are three prohibitions, and only harmonizing the interior and exterior is appropriate.

Deep pulse, pressing heavily until below the muscle, between tendon and bone, is the Deep pulse. There are also two types; Yin-Yang and Cold-Heat are distinguished within the Deep pulse. Few know this method; is it truly a secret technique?

Deep, rapid, and forceful pulse indicates the root of Yangming. The exterior syndrome has resolved, and heat has entered the interior. Aversion to cold and headache have completely disappeared; instead, there is fear of heat, desire to remove clothes and blankets, throwing hands and feet about, delirium and mania, dry thirst, tidal fever, or spontaneous sweating. If there is constipation for five to six days, mild cases use Dachaihu Tang (Major Bupleurum Decoction), and severe cases select among the three Chengqi Decoctions (Chengqi Formulas).

Deep, slow, and weak pulse indicates Cold. Exterior symptoms include no headache, no body heat, no thirst. Initially, there is aversion to cold, cold extremities, and curling up in bed. Accompanying symptoms may include abdominal pain, vomiting, and diarrhea, or shivering, a face pale as if scraped by a knife, or spitting out white foam and cold saliva. These are all True Cold syndromes originating from the Yin meridians. Mild cases use Lizhong Tang (Regulate the Middle Decoction); severe cases use Jiangfu Sini Tang (Ginger and Aconite Reversing the Collapse Decoction) to warm them.

Only when Shanghan presents with a Deep pulse should Yin and Yang be distinguished; careful perception is required. Administering purgatives must not be hasty. If errors occur, the responsibility lies with oneself. When diagnosing pulses, one must divide into Three Regions and Nine Positions. For each region, first perform Floating observation for three beats: light pressure on the skin to observe three pulsations. Then Middle observation for three beats: slightly heavier pressure below the skin, above the muscle, to observe three pulsations. Finally, Deep observation for three beats: heavy pressure below the muscle, above the bone, to observe three pulsations. Three times three makes nine positions. Only then can one know the depth and location (exterior/interior) of the disease, establishing the target for treatment. How can one ignore the pulse and attempt to locate the disease? Pulse diagnosis is called skillful; when the mind grasps the finger sensation, natural miraculous effects occur. I do not believe in deaths caused by such negligence. If one does not understand pulse recognition and syndrome differentiation, practicing medicine recklessly, treating human life like grass, I do not believe they will escape heavenly retribution in the future.