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The pulse is floating and rapid. Floating indicates wind pathogen in the exterior; rapid indicates deficiency. Wind is associated with heat, while deficiency generates cold. The interplay of wind and deficiency leads to shivering and aversion to cold.

A floating and rapid pulse: floating signifies wind pathogen in the exterior, while rapid indicates yang deficiency allowing yin to invade. Wind causes yang to be constrained, generating heat; deficiency causes yin to bind, generating cold. When wind and deficiency combine, yang is internally closed leading to heat, and yin is externally bound leading to cold. This is the cause of shivering and aversion to cold.

The Master said: If a patient's pulse is faint (Wei) and choppy (Se), this is iatrogenic injury caused by the physician. Excessive sweating was induced, followed repeatedly by severe purgation, resulting in blood loss. The patient should experience aversion to cold first, followed by fever, with no cessation. In midsummer when it is intensely hot, the patient desires to wear heavy clothing; in midwinter when it is intensely cold, the patient desires to expose their body. The reason for this is that faint yang causes aversion to cold, and weak yin causes fever. The physician's excessive sweating weakened the yang qi, and repeated purgation weakened the yin qi. In the fifth month, yang qi is in the exterior, and the stomach is cold due to deficiency; because internal yang is faint and cannot overcome the cold, the patient desires heavy clothing. In the eleventh month, yang qi is in the interior, and there is vexing heat in the stomach; because internal yin is weak and cannot overcome the heat, the patient desires to expose their body. Furthermore, the yin pulse is slow and choppy, indicating blood loss.

If the cun position pulse is faint and the chi position pulse is choppy, this is also iatrogenic injury. Excessive sweating and repeated severe purgation have not only depleted qi but also caused blood loss. The patient should initially present with aversion to cold, followed by fever without cessation. The aversion to cold is more severe than in summer; despite the intense heat of midsummer, the patient desires heavy clothing. The fever is more severe than in winter; despite the intense cold of midwinter, the patient desires to expose their body. The reason is that internally faint yang causes aversion to cold, and internally weak yin causes fever. The physician's sweating made internal yang faint, and repeated purgation made internal yin weak. In the fifth month, summer yang is at its peak, yet yang is in the exterior and the stomach is cold due to deficiency; internal yang being faint cannot overcome the cold, hence the desire for heavy clothing. In the eleventh month, winter yang is at its peak, yet yang is in the interior and there is vexing heat in the stomach; internal yin being weak cannot overcome the heat, hence the desire to expose the body. Additionally, the pulse is slow and choppy, confirming blood loss.

When various pulses are floating and rapid, fever accompanied by shivering and aversion to cold should occur. If there is a painful area but appetite remains normal, this indicates internal accumulation of heat leading to carbuncle and pus formation.

When various pulses are floating and rapid, fever accompanied by shivering and aversion to cold should occur. If there is a painful area but appetite remains normal, this indicates internal accumulation of heat leading to carbuncle and pus formation. This is because stagnant heat within cannot diffuse outward, causing internal corruption into pus, while yang is obstructed and fails to reach the exterior, resulting in aversion to cold.