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The pulse is floating and large, the epigastrium is rigid, there is heat in the interior. If the pathogen belongs to the Zang organs, purgation should be used, and sweating should not be induced; if the pathogen belongs to the Fu organs, frequent urination should not be allowed. Frequent urination leads to fluid depletion and hard stool; excessive sweating increases the heat; insufficient sweating makes defecation difficult. A slow pulse indicates that purgation is not yet appropriate.

A floating and large pulse is characteristic of the Taiyang and Yangming channels. If the epigastrium is rigid, it indicates Yangming Fu-organ excess pathogens. This occurs because the Shaoyang channel runs from the stomach opening through the hypochondrium. When Shaoyang channel qi invades the Yangming Fu organs, it causes stagnation and obstruction of Fu organ qi, which rebels upward, blocking the downward pathway of Shaoyang qi. The stagnation and pressure of channel and Fu qi knot in the chest and hypochondrium, resulting in epigastric fullness and rigidity. If Fu heat injures Zang yin, purgation is indicated, but sweating must be avoided. If it is merely Fu heat, purgation need not be urgent, and frequent urination must be avoided. Frequent urination depletes fluids causing hard stool; excessive sweating consumes Ying blood and intensifies heat; scant sweating traps Fu heat making defecation difficult. Therefore, neither sweating nor frequent urination is permitted; instead, purgation is employed. However, the timing of purgation matters: Zang diseases require urgent purgation (the three urgent purgation indications for Yangming and Shaoyang; delayed purgation allows Fu heat to injure Zang yin irreparably), while Fu diseases are suited for gradual purgation. Upon observing a slow pulse, indicating that internal heat has not yet solidified, purgation is contraindicated. (This clarifies the principle of distinguishing Zang and Fu conditions.)

The Master said: In obese individuals, the pulse should be deep; if it is superficial, it is abnormal. In emaciated individuals, the pulse should be superficial; if it is deep, it is abnormal. Obese people have thick muscles, so their pulse qi is deep. Emaciated people have thin muscles, so their pulse qi is superficial. A deep pulse appearing superficial, or a superficial pulse appearing deep, is called contrary to normal. Contrary pulses indicate disease, hence they are investigated.

The Dubyang pulse is tight and floating. Floating indicates rebellious Qi; tight indicates Cold. Floating manifests as abdominal fullness; tight manifests as colicky pain. The combination of floating and tight causes intestinal borborygmus and rolling sensations, followed by Qi moving the diaphragm. After the Qi descends, if the Shaoyin pulse does not emerge, the genitalia become swollen and flaccid.

Dubyang refers to the arterial pulse of the Foot-Yangming Stomach channel, including Chongyang, Renying, and Daying points. Chongyang is located on the dorsum of the foot, hence the name Dubyang. A tight and floating Dubyang pulse indicates rebellious Qi (floating) and Cold Qi (tight). Earth resides in the center, and its pulse should lie between floating and deep; Qi should not float. Floating indicates Stomach Qi rebellion. Earth nature is gentle and moderate, so the pulse should not be tight. Tightness indicates Stomach Cold. The Stomach governs descending turbid Qi. Rebellious Stomach Qi causes floating pulse, leading to Stomach Qi stagnation and failure of turbid Qi to descend, resulting in abdominal fullness. The Stomach governs reception and decomposition. Stomach Cold causes tight pulse, narrowing Stomach Qi and allowing Wood pathogen invasion, resulting in colicky pain. The combination of floating and tight causes intestinal borborygmus and Qi stagnation. The obstructed Qi in the diaphragm then descends. When Cold pathogen conflicts and flows posteriorly to the Po Men (anus), causing diarrhea, the fullness and pain temporarily subside. Shortly after, Cold coagulation and Qi stagnation cause the pain and fullness to recur. This is due to Kidney Yang deficiency. If the Shaoyin pulse re-emerges, Kidney Yang recovers; if it does not emerge, Kidney Yang perishes, causing swelling and flaccidity of the genitalia. This is because Water Cold and Wood depression cause Qi to sink rather than ascend, leading to genital swelling. (The arterial pulses of the Foot-Shaoyin Kidney channel are Taixi and Yinggu; Taixi is behind the medial malleolus, Yinggu is behind the knee on the medial side.)