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The pulse is floating and slippery. Floating indicates Yang, and slippery indicates Excess. When Yang and Excess contend with each other, the pulse becomes rapid and hurried, causing the Wei Qi (Defensive Qi) to lose its normal regulation. If a floating and slippery pulse is accompanied by rapidity and hurrying, along with fever and sweating, this constitutes an intractable condition that is difficult to treat.

The pulse is floating and slippery. Floating represents Yang, and slippery represents Excess. When Yang combines with Excess, the pulse must become rapid and hurried, causing the Wei Qi (Defensive Qi) to deviate from its norm. If the floating and slippery pulse is further complicated by rapidity and hurrying, and if fever and sweating recur, this signifies the exhaustion of both Yin and Yang, making it a difficult or untreatable case. The *Nan Jing* (Classic of Difficult Issues) states: A pulse rate of three beats per breath is called "Li Jing" (Departing from the Normal); four beats is "Duo Jing" (Depletion of Essence); five beats is "Si" (Death); six beats is "Ming Jue" (Extinction of Life). This precisely describes the critical nature of the floating, slippery, rapid, and hurried pulse.

Pulse theory is profound and subtle, having been discussed in the earlier chapters. However, regarding the complexity of its nomenclature, the variability of its manifestations, the mechanisms of diagnosis, and the subtleties of observation and palpation, which were not fully detailed, questions and answers are set forth in this chapter to clarify these profound principles. It requires clearing the mind and focusing one's thoughts, serving as a ladder for seeking the Dao on Mount Kongtong and a secret ferry for seeking pearls by the Chi River. In later generations, medical theories have not been transmitted, partly because pulse methods were not understood. Zhang Zhongjing’s pulse methods were treasured by families and collected by households; yet, if one remains ignorant until old age, their lifelong medical practice will be ineffective, akin to superfluous fingers or toes that do not respond to breathing. Does this align with Zhang Zhongjing’s intention in transmitting pulse methodology?

The waxing and waning of Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) manifest in various ways, and the interactions among Zang-Fu organs follow diverse patterns. While branches and distinctions are countless, tracing them to their source reveals only two aspects: Yin and Yang. By diagnosing the similarities and differences between Yin and Yang, one can judge the vast difference between life and death. Which is preferable, life or death? Which is more noble, Yin or Yang? Understanding the meaning of this chapter encompasses all subsequent chapters’ methods for determining life and death, and techniques for reviving the seemingly dead.

Question: What is meant by Yin and Yang pulses?
Answer: Pulses that are large, floating, rapid, moving, and slippery are named Yang pulses. Pulses that are deep, choppy, weak, string-taut, and minute are named Yin pulses. In Yin diseases, the appearance of Yang pulses indicates survival; in Yang diseases, the appearance of Yin pulses indicates death. The Path of Yang tends toward Excess, while the Path of Yin tends toward Deficiency. Large, floating, rapid, moving, and slippery pulses are Yang; deep, choppy, weak, string-taut, and minute pulses are Yin. Yang governs life/generation, while Yin governs death/termination. In Yin disease, seeing Yang pulses indicates that Yang Qi is returning to counteract severe Yin Cold. In Yang disease, seeing Yin pulses indicates that Yang is floating outward while Yin Cold is surging inward. The return of Yang leads to life; the dominance of Yin leads to death. The principle that Yang is noble and Yin is base was handed down by the Sages; even women and children know that humans belong to Yang and ghosts belong to Yin. Yet, in later generations, physicians have reversed the classics and confused the Way, valuing Yin over Yang. Vulgar and absurd practitioners have followed one after another, misleading the world. Since the Song and Yuan dynasties, spanning a millennium, not a single person has slightly understood this principle. Why are there so many of the profoundly ignorant and so few of the wise?