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Difficulty 20 states: The classic texts mention that pulses may be "hidden" (Fu Ni). Regarding which zang organ is this hiddenness discussed? The answer is: it refers to the mutual overcoming and hiding of yin and yang. When a pulse appears in the yin position (cun chi, specifically chi) but reveals yang characteristics (such as floating, large, or rapid), this is described as "yang overcoming yin." Although the pulse may occasionally present as deep, choppy, and short, this is termed "yin hidden within yang." Conversely, when a pulse appears in the yang position (cun chi, specifically cun) but reveals yin characteristics (such as deep, fine, or slow), this is described as "yin overcoming yang." Although the pulse may occasionally present as floating, slippery, and long, this is termed "yang hidden within yin."

Excess of yang leads to mania (Kuang); excess of yin leads to depression/epilepsy (Dian). Loss of yang results in hallucinations (seeing ghosts); loss of yin results in blindness.

Difficulty 21 states: The classic texts say that if the body shows signs of disease but the pulse does not, the prognosis is survival; if the pulse shows signs of disease but the body does not, the prognosis is death. What does this mean? The answer is: "Body diseased, pulse healthy" does not mean there is absolutely no disease. It refers to a discrepancy between the respiratory rate and the pulse rate. This is a general principle for determining life and death.

Difficulty 22 states: The classic texts mention that pulses involve both "Shi Dong" (Is Moving) and "Suo Sheng Bing" (So-Called Generated Diseases). Why can one meridian manifest as two types of disease? The answer is: The classics state that "Shi Dong" relates to Qi disorders, while "Suo Sheng Bing" relates to Blood disorders. When pathogenic factors are in the Qi level, Qi disturbance causes "Shi Dong"; when pathogenic factors are in the Blood level, Blood stasis causes "Suo Sheng Bing." Qi primarily moves and warms the body, while Blood primarily moistens and nourishes it. When Qi stagnates and fails to circulate, it is a primary Qi disorder; when Blood becomes obstructed and fails to nourish, it is a secondary Blood disorder. Therefore, "Shi Dong" occurs first, followed by "Suo Sheng Bing."

Difficulty 23 asks: Can the lengths and measurements of the twelve meridians of the hand and foot, yin and yang, be explained? The answer is: The three yang meridians of the hand run from the hand to the head, each measuring five chi. Six times five equals three zhang. The three yin meridians of the hand run from the hand to the chest, each measuring three chi and five cun. Three times six yields one zhang and eight chi; adding five times six (three chi) results in a total of two zhang and one chi. The three yang meridians of the foot run from the foot to the head, each measuring eight chi. Six times eight yields four zhang and eight chi. The three yin meridians of the foot run from the foot to the chest, each measuring six chi and five cun. Six times six yields three zhang and six chi; adding five times six (three chi) results in a total of three zhang and nine chi. The two Qiao meridians (Yin and Yang Qiao) run from the foot to the eyes, each measuring seven chi and five cun. Two times seven yields one zhang and four chi; adding two times five (one chi) results in a total of one zhang and five chi. The Du Mai (Governing Vessel) and Ren Mai (Conception Vessel) each measure four chi and five cun. Two times four yields eight chi; adding two times five (one chi) results in a total of nine chi. The total length of all these vessels is sixteen zhang and two chi. This constitutes the measurement of the twelve main meridians.

There are twelve main meridians and fifteen collaterals. Where do they begin and where do they end? The answer is: The meridians transport Qi and Blood, connect yin and yang, and nourish the body. They originate at the Middle Jiao (Middle Burner), flowing into the Hand Taiyin Lung Meridian and Hand Yangming Large Intestine Meridian; the Hand Yangming flows into the Foot Yangming Stomach Meridian and Foot Taiyin Spleen Meridian; the Foot Taiyin flows into the Hand Shaoyin Heart Meridian and Hand Taiyang Small Intestine Meridian; the Hand Taiyang flows into the Foot Taiyang Bladder Meridian and Foot Shaoyin Kidney Meridian; the Foot Shaoyin flows into the Hand Jueyin Pericardium Meridian and Hand Shaoyang Sanjiao Meridian; the Hand Shaoyang flows into the Foot Shaoyang Gallbladder Meridian and Foot Jueyin Liver Meridian; the Foot Jueyin returns to flow into the Hand Taiyin Lung Meridian. The fifteen collateral vessels all arise from their respective Yuan-Source points, forming a continuous circle without beginning or end, irrigating each other, and converging at the Cun Kou (Radial Artery) and Ren Ying (Carotid Artery) to diagnose various diseases and determine life and death.

The classics state: "If one clearly understands the beginning and end, yin and yang can be determined." What does this mean? The answer is: "Beginning and End" refers to the cycle of pulse Qi. The Cun Kou and Ren Ying represent the connection of yin and yang Qi, circulating like messors to the court, forming a circle without end; thus, this is called the "Beginning." The "End" refers to the cessation of Qi in the three yin and three yang meridians. Cessation leads to death. Death presents with specific forms, thus it is called the "End."