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The Master said: Respiration is the guideline of the pulse. When initially palpating, if the pulse comes rapidly and departs slowly, this is rapid exit and slow entry, named "Internal Deficiency and External Excess". When initially palpating, if the pulse comes slowly and departs rapidly, this is slow exit and rapid entry, named "Internal Excess and External Deficiency".

The circulation of the pulse is driven by Qi. In one respiration cycle (one breath), the pulse beats six times, and Qi travels six cun. The meridians of the human body, including six Yang meridians, six Yin meridians, plus the Ren Mai (Conception Vessel), Du Mai (Governing Vessel), and the two Qiao vessels, have a total length of sixteen zhang and two chi. A healthy person breathes thirteen thousand five hundred times in a day and night. One day is divided into one hundred ke (water clock units); each ke consists of two hundred seventy breaths. When the water clock drops two ke, the pulse travels sixteen zhang and two chi, which constitutes one circuit. After thirteen thousand five hundred breaths, when the water clock has dropped one hundred ke, the pulse has circulated fifty circuits, totaling eight hundred ten zhang. Thus, the measure of one day is completed. (For detailed meaning, refer to chapters such as *Mai Du*, *Ying Qi*, and *Wu Shi Ying* in the *Ling Shu*). Therefore, respiration is the guideline of the pulse ("head" here refers to the guideline). Physicians use the respiration rate of a healthy person as a standard to judge the slowness or rapidity of a sick person's pulse, thereby revealing the deficiency or excess of Yin and Yang. For instance, when initially palpating, if the pulse comes rapidly and departs slowly, "coming" refers to the outward movement of pulse Qi, and "departing" refers to its inward movement. This situation of rapid exit and slow entry implies that since the exit occurs from the exterior, observing the exit reveals the state of the exterior; since the entry occurs into the interior, observing the entry reveals the state of the interior. Because the exit is rapid and the entry is slow, it is named "Internal Deficiency and External Excess". When initially palpating, if the pulse comes slowly and departs rapidly, this is slow exit and rapid entry, hence named "Internal Excess and External Deficiency". (This clarifies the meaning of respiration and entry/exit stated in the first chapter).

A floating pulse at the Cun Kou (Radial Artery) indicates the disease is in the Exterior; a deep pulse indicates it is in the Interior; a rapid pulse indicates it is in the Fu organs; a slow pulse indicates it is in the Zang organs. If the pulse is slow, this indicates the disease is in the Zang organs.

The Exterior belongs to Yang, and the Interior belongs to Yin; therefore, the Exterior pulse is floating and the Interior pulse is deep. The Fu organs belong to Yang, and the Zang organs belong to Yin; therefore, the Fu pulse is rapid and the Zang pulse is slow. Floating/Rapid and Deep/Slow are the natural characteristics of Yin and Yang. (This explains the principle of examining the Exterior/Interior and estimating the condition of the Zang/Fu organs).

A floating and tight pulse at the Cun Kou: floating indicates Wind pathogen, and tight indicates Cold pathogen. Wind damages the Wei Qi (Defensive Qi), and Cold damages the Ying Qi (Nutritive Blood). When both Ying and Wei are damaged, it causes vexation and pain in the bones and joints, and sweating should be induced to treat it.

A floating and tight pulse at the Cun Kou indicates the disease is in the Exterior. Floating indicates Wind Strike (Zhong Feng), and tight indicates Cold Damage (Shang Han). Since the nature of Wind is floating and deficient, and the nature of Cold is tight and firm, it is said that "Wind presents as floating and deficient, Cold presents as firm and solid." Wind Strike damages the Wei Qi, and Cold Damage damages the Ying Blood. When Ying and Wei are both damaged, causing vexation and pain in the bones and joints, sweating should be induced to resolve the Wind and Cold. This is a pattern for Guizhi Mahuang Ge Ban Tang (Cinnamon Twig and Ephedra Half-Combined Decoction). (This clarifies the principle of examining the Exterior/Interior).