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This is the twenty-second chapter of the tenth volume. It contains forty-eight syndromes in total. All of these have been fully recorded in the preceding chapters on the Three Yin and Three Yang meridians. (The meaning here is identical to that in Chapters Seventeen and Eighteen.)

The eleven chapters mentioned above were compiled by Wang Shuhe, who categorized them according to meridians, included extra-textual commentary, and added his own interpretations. Combined with the original text, which also comprises eleven chapters, there are twenty-two chapters in total, purportedly forming a complete legacy preserving Zhang Zhongjing's unfinished work. However, Chapters Seventeen, Eighteen, and Twenty-Two merely hold empty titles and occupy vacant positions; they lack specific clauses for reference. In reality, only nineteen chapters contain actual textual entries. This reflects the old cataloging system established by Wang Shuhe. Some people in later generations have argued that this book is not the complete works of Zhang Zhongjing precisely because of these missing sections. Alas! This book was authored by Zhang Zhongjing during the Jian'an era (a reign title of the Han Dynasty) and compiled by Wang Shuhe (Grand Medical Director of the Jin Dynasty). Although the time gap was not extremely long, it spanned two different dynasties. Thus, whether this constitutes the complete works of Zhang Zhongjing or not remains truly perplexing. Nevertheless, it can be asserted that while it may not be entirely correct, it is certainly not entirely incorrect. The determination of right and wrong rests with us; through self-reflection and introspection, the distinctions between true and false, complete and incomplete will naturally become apparent. By grasping even one aspect, the profound essence of Zhang Zhongjing can be clearly perceived day and night. His spiritual profundity needs no further elaboration. I hope all my colleagues will strive together in this endeavor.

The pulse represents the Qi of innate truth and supreme harmony. Wang Shuhe’s theory of "Seven Superficial Pulses" (Qi Biao) and "Eight Interior Pulses" (Ba Li) is overly complex and cumbersome, leaving students without clear guidelines. The art of pulse diagnosis cannot be fully conveyed through diagrams alone; it depends entirely on mental comprehension. My late master, True Man Cui Zixu, taught me face-to-face and transmitted the method heart-to-heart, distilling the essentials into four primary pulse types: Floating (Fu), Deep (Chen), Slow (Chi), and Rapid (Shu). He taught that Wind, Qi, Cold, and Heat are the primary pathogenic factors. For example:
[Floating] Pulse: If forceful, it indicates Wind; if weak, it indicates Deficiency.
[Deep] Pulse: If forceful, it indicates Accumulation; if weak, it indicates Qi disorder.
[Slow] Pulse: If forceful, it indicates Pain; if weak, it indicates Cold.
[Rapid] Pulse: If forceful, it indicates Heat; if weak, it indicates Sores/Ulcers.
One must also examine the three positions (Cun, Guan, Chi). The Cun position corresponds to diseases of the Upper Jiao (head, face, chest, diaphragm); the Guan position corresponds to diseases of the Middle Jiao (abdomen); and the Chi position corresponds to diseases of the Lower Jiao (waist, legs, feet). Furthermore, one must consider the organs governed by the Five Zang and Six Fu, inferring from the superficial/deep and exterior/interior characteristics. Students should distinguish principles meticulously to avoid criticism for merely holding the wrist without understanding the underlying logic.

[Floating] Pulse: Belongs to Yang and the Exterior. It indicates external contraction. Forcefulness suggests Wind; weakness suggests Deficiency. It is felt lightly at the skin level. It shares similarities with Kong (Hollow), Hua (Slippery), and Hong (Surging) pulses.
[Deep] Pulse: Belongs to Yin and the Interior. It indicates internal disease. Forcefulness suggests Accumulation; weakness suggests Qi disorder. It is felt only upon pressing deeply to the bone. It shares similarities with Ruo (Weak), Fu (Hidden), and Ru (Soggy) pulses.
[Slow] Pulse: Belongs to Yin and indicates Cold. Forcefulness suggests Pain. It shares similarities with Huan (Moderate), Wei (Minute), and Se (Choppy) pulses.
[Rapid] Pulse: Belongs to Yin and indicates Heat. Weakness suggests Sores/Ulcers. It shares similarities with Xian (Wiry), Jin (Tight), and Shi (Excess) pulses.

Diseases of the Upper Jiao correspond to the Cun (Inch) pulse:
Floating [Wind]: Symptoms include swelling of the head, face, eyes; wind-cold; toothache; facial paralysis (mouth and eye deviation).
Deep [Qi]: Symptoms include fullness and oppression in the chest and diaphragm; cough and wheezing; diaphragmatic qi reversal (hiccups/vomiting); chest pain and anorexia.
Slow [Cold]: Symptoms include vomiting and obstruction; inability to retain food and drink; spontaneous sweating with spasms; unremitting pain.
Rapid [Heat]: Symptoms include upper congestion with irritability; bitter taste and dry throat; exogenous heat with thirst; headache and mouth ulcers.

Diseases of the Middle Jiao correspond to the Guan (Bar) pulse:
Floating [Wind]: Symptoms include spasm and contracture of both arms; inability to lift the arms; back muscle pain; body numbness.
Deep [Qi]: Symptoms abdominal distension with borborygmus; epigastric and abdominal pain; upper-lower blockage (guan-ge); loss of appetite.
Slow [Cold]: Symptoms include pi masses (accumulations); wandering pain; stabbing pain moving up and down; vomiting due to stomach reversal.
Rapid [Heat]: Symptoms include thirst and dry throat; vomiting and cholera-like syndrome; restlessness and irritability.

Diseases of the Lower Jiao correspond to the Chi (Cubit) pulse:
Floating [Wind]: Symptoms include lower back pain; numbness of legs and knees; swelling and pain of shins and feet; difficulty in defecation.
Deep [Qi]: Symptoms include edema and pain in the feet; heaviness in the lower limbs; numbness; difficulty in urination.
Slow [Cold]: Symptoms include acute pain in the lower abdomen; hernia (deviation of the external genitalia); frequent urination and defecation; diarrhea.
Rapid [Heat]: Symptoms include urinary retention; constipation; kidney abscess; incessant thirst and irritability.

In Shanghan (Cold Damage) disease, as long as there is a pulse in the foot, death does not ensue. This pulse is located on the dorsum of the foot at the ankle, known as the Chongyang (ST42) pulse. The presence of this pulse indicates robust Stomach Qi. There is also the Da Xi (KI3) pulse, located at the medial malleolus. Additionally, there is a pulse at the Hegu (LI4) acupoint in the web of the thumb. A vigorous pulse here indicates that sweating has occurred in Shanghan. Mr. Liu Fuzhen synthesized the mysteries of the "Seven Superficial and Eight Interior" theories into four basic categories: Wind, Qi, Cold, and Heat. These further diversified into eight types: Deficient Wind, Accumulated Qi, Painful Cold, and Heat Sores. By determining which of the eight categories applies to a specific location, one can identify the site of the disease. Mr. Liu cleared away redundant complexities to reveal the true source directly. Those who receive this transmission should guard it carefully and treasure it.