Library

The pulse at the Cun Kou (Cun position of the radial artery) is floating and large. The physician, in error, applies purgation; this constitutes a major contraindication. A floating pulse indicates a deficiency of Yin blood, while a large pulse indicates internal Cold. When Cold pathogens contend with healthy Qi, it results in abdominal borborygmus (rumbling). Unaware of this, the physician administers cold water to induce profuse sweating. The ingested water encounters the internal Cold, and the two cold energies inevitably contend with each other.

Consequently, the patient develops dysphagia (choking sensation).

Generally, a floating and large pulse at the Cun Kou signifies that there is no excess syndrome in the interior. If the physician erroneously applies purgation, it is a major contraindication. The floating pulse reflects Yin blood deficiency, and the large pulse reflects internal Cold, arising from the deficiency and Cold of the interior Qi. When interior Cold coagulates and causes stagnation, it agitates the Wood Qi (Liver Qi), leading to abdominal borborygmus. Unaware of the pathology, and seeing fever due to Blood Cold, the physician uses cold water to induce sweating. The water combines with the interior Cold, and the cold energies contend and knot without dispersing. Consequently, the patient suffers from throat obstruction, Qi closure, and food impaction. "KT" (a variant character) corresponds to "Ye" (dysphagia/choking). In the *Book of Han*, Jia Shan's *Words of Admonition* states: "Pray for relief from choking on meat before eating, pray for relief from choking on bones after eating."

The pulse at the Fu Yang (Danzhong/Gastric artery) is floating. Floating indicates deficiency. The combination of deficiency and floating leads to Qi stagnation ("KT", corresponding to "Pi", meaning epigastric fullness/stagnation). This describes the exhaustion of Stomach Qi. If the pulse is slippery, hiccups (Yue) occur; this is the fault of the physician. If the pulse is floating and the nose is dry, epistaxis (Nv) will certainly occur.

The pulse at the Fu Yang is floating. Floating indicates deficiency. The combination of deficiency and floating leads to Qi stagnation ("KT", corresponding to "Pi"). This occurs because the exhaustion of Stomach Qi causes blockage and lack of free flow. If the pulse is slippery, it indicates rebellious Stomach Qi causing hiccups (Yue). This is the fault of the medical practitioner: mistaking the floating pulse (indicating deficiency) for an excess condition inside, and thus applying purgation to gain efficacy; mistaking the empty nature indicated by the floating pulse (blood deficiency) for fullness, and thus applying diaphoresis to suppress Yang. The loss of Yang and the rise of Yin fill the clear orifices, resulting either in dysphagia or hiccups. If the pulse is floating and the nasal mucosa is dry, epistaxis (Nv) will inevitably occur. This is because central deficiency leads to rebellious Qi, causing blood to ascend with the Qi, resulting in epistaxis.

A pulse that is floating and large: floating indicates Wind pathogen and deficiency; large indicates strong Qi. When Wind and Qi contend, urticaria (Yin Zhen - transient skin eruptions) will surely form, accompanied by body itching. This condition is called Xie Feng (Leaking Wind). Over time, it may develop into scaly leprosy-like lesions (Jia Lai).

A pulse that is floating and large: floating indicates the deficiency of Wind Qi, with Wind leaking outward; large indicates the strength of Wei Qi (Defensive Qi), with Qi closed inward. External Wind contends with internal Qi. Wind leaks outward while Qi closes inward, causing Ying Qi (Nutritive Qi) to stagnate and fail to disperse. This inevitably forms urticaria. Generally, Wind has a dispersing nature, while Qi has a constricting nature. Wind desires to leak out, but Qi obstructs it. If the leakage is incomplete, Ying Qi stagnates and transforms into Heat. Hot Blood erupts outward as spots but cannot fully penetrate; it remains郁 (stagnant) within the skin and hair follicles, hidden and not obvious, which is the origin of urticaria. With Ying Qi stagnation and Wei Qi closure, the desire to vent cannot be realized, causing body itching. This itching is termed Xie Feng. The *Su Wen: Wind Lun* states that when Wind is external to the Cou Li (interstices), it becomes Xie Feng. Xie Feng refers to Wind that desires to vent but fails to penetrate. If Wind fails to vent, the channel blood stagnates and generates Heat. Over a long period, Ying Qi steams and putrefies, forming scaly lesions. The *Wind Lun* states that Wind enters together with the Taiyang channel, travels through the various acupoints, and scatters between the muscle layers, interfering with Wei Qi. Because the pathway is obstructed, the muscles become swollen and ulcerated; because Wei Qi coagulates and fails to circulate, the flesh becomes insensible. Leprosy-like lesions (Lai) occur because Ying Qi is hot and putrefied, its Qi becoming turbid, causing the nasal bridge to collapse, complexion to deteriorate, and skin to ulcerate. The Lung governs Wei Qi and controls the skin and hair, opening into the nose. Therefore, the nasal bridge collapses and the skin ulcerates.