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The pulse of the human body (General discussion on Qi, Blood, and Pulse), originates from Ying (Nutrient) and Wei (Defensive). Ying refers to Yin Blood, while Wei refers to Yang Qi. Ying circulates within the vessels, and Wei circulates outside the vessels. The vessels do not move by themselves but follow the movement of Qi; when Qi moves, the pulse responds, embodying the principle of Yin and Yang. Qi is like a bellows, and blood is like waves; the pulse and breath circulate continuously up and down.

Among the twelve meridians, there are arterial pulses in all, but the pulse of the Hand-Taiyin Lung Meridian can be clearly palpated (The Lung meridian is the meeting point of the twelve meridians' arteries). This meridian belongs to the Lung, hence it is said: "The pulse meets at Taiyuan." Taiyuan is an acupoint name (also known as Cun Kou), located superiorly connected to the throat, serving as the great convergence of pulse Qi and the exit/entry point of respiration.

When initially palpating the pulse (Pulse diagnosis method), instruct the patient to extend their palm upward. The prominent bone behind the wrist is called the Guan (Bar). The area anterior to the Guan is Yang, called Cun (Inch); the area posterior to the Guan is Yin, called Chi (Cubit). By sequentially exploring the Cun, Guan, and Chi positions, one can feel the prominent bones in both hands. Considering the upper/lower and left/right aspects: the Left hand corresponds to Yang, and the Right hand to Yin; light pressure represents Yang, deep pressure represents Yin; rapid and restless pulse indicates Yang, slow and delayed pulse indicates Yin; forceful pulse indicates Yang, weak pulse indicates Yin; long and large pulse shape indicates Yang, short and small pulse shape indicates Yin.

For men's pulses (Differences in pulse pathology between genders), a larger pulse on the Left side is favorable; for women's pulses, a larger pulse on the Right side is favorable. Men typically have a deficient Chi pulse, while women typically have a robust Chi pulse.

Whenever diagnosing disease pulses, the time of early morning (Ping Dan) is taken as the standard. The physician must maintain mental stillness and clarity, regulate their own breathing, and examine carefully. One exhalation and one inhalation constitute one respiratory cycle (Xi). Four to five beats per respiratory cycle represent the standard of a healthy pulse. Three beats per cycle constitute a Delayed (Chi) pulse (Delayed/Frequent indicate Cold/Heat); a Delayed pulse indicates Cold. Six beats per cycle constitute a Frequent (Shu) pulse; a Frequent pulse indicates Heat. The slower the pulse, the colder the condition; the faster the pulse, the hotter the condition. This requires careful differentiation by the practitioner. Once the information on Delayed or Frequent is obtained, proceed to distinguish Floating (Fu) and Sinking (Chen). Floating indicates Exterior, Sinking indicates Interior (Floating/Sinking correspond to Exterior/Interior); one must weigh the depth. Floating-Frequent indicates Exterior Heat, Sinking-Frequent indicates Interior Heat, Floating-Delayed indicates Exterior Deficiency, Sinking-Delayed indicates Cold accumulation.

Observe the six positions (Six positions govern Zang-Fu organs) to determine the exact location. Each position corresponds to two meridians, one Zang and one Fu organ. The Left Cun belongs to the Heart, harmonizing with the Small Intestine; the Guan belongs to the Liver and Gallbladder; the Chi belongs to the Kidney and Bladder. The Right Cun governs the Lung, sharing a connection with the Large Intestine; the Guan belongs to the Spleen and Stomach; the Chi belongs to the Mingmen and Sanjiao. This applies not only to Zang-Fu organs (the body is divided into three sections) but also generally. The Upper, Middle, and Lower parts each cover a section: Cun observes the chest and above, Guan observes below the diaphragm, and Chi observes from the umbilicus down to the heels and ankles. The Left pulse observes the left side of the body, the Right pulse observes the right side. Disease manifests where the abnormality lies; where there is no disease, there is no abnormality.

Floating, Sinking, Delayed, and Frequent pulses have internal and external causes (Floating/Sinking/Delayed/Frequent correspond to Heaven/Human, Internal/External factors such as Wind, Cold, Summer-heat, Dampness, Dryness, Fire). External causes stem from Heaven, internal causes from Human. Heaven has Yin/Yang, wind/rain, darkness/brightness; Humans have joy, anger, worry, thought, fear, grief, fright. An external cause leading to a Floating pulse presents as an Exterior syndrome; Sinking indicates Interior, Delayed indicates Cold, Frequent indicates Excess Heat. An internal cause leading to a Floating pulse is often due to Empty Wind; Sinking indicates Qi stagnation, Delayed indicates Cold, Frequent and restless—what doubt remains? To distinguish internal and external causes, refer to symptoms alongside the pulse (Weight of Zang pulse diagnosis).

There is a natural logic to Floating and Sinking pulses. Floating belongs to the Heart and Lung; Sinking belongs to the Kidney and Liver; the Spleen belongs to the Central Earth, its pulse lying between Floating and Sinking. Palpating the Lung pulse with the weight of three bean seeds should yield sensation at the skin level; six bean seeds at the blood vessel level (Heart); nine bean seeds at the muscle level (Spleen); twelve bean seeds at the tendon level (Liver). Only the Kidney pulse sinks extremely, requiring palpation to the bone. With quick movements of lifting fingers, the principles of pulse are vast, summarized in four basic types. Chapters 6 and 7 of the *Nan Jing* specifically expand on these meanings. Analyzing further, there are Seven Superficial (Qi Biao), Eight Interior (Ba Li), and Nine Distinctive (Jiu Dao) categories (Seven Superficial, Eight Interior, Nine Distinctive describe pulse/pathology shapes), completing the six names.

Floating but forceless is the Knife-cut (Kou) pulse (Combined they make four); forceful is the Surging (Hong) pulse, recognizable by its image. Sinking and forceful is the Full (Shi) pulse; forceless and weak is the Hidden (Fu) pulse, the extreme of sinking. Delayed but forceful is Slippery (Hua) and fluent; forceless, Slow (Huan) and Choppy (Se) are similar. Frequent and forceful is Tight (Jin); small and tight is Wiry (Xian), which requires careful distinction, combining to make four. Separated as seven and eight, these are heavenly secrets and divine instructions. Lifting reveals excess, pressing reveals deficiency (Separated as seven and eight), floating vaguely like wood drifting on water. What does the Kou pulse resemble? It is very much like a scallion stalk, forming a hollow under the finger, with edges but no center. Slippery pulse is like a bead, rolling back and forth, abundant upon both lifting and pressing; this is the Full pulse. Wiry pulse is like a stretched string; Tight pulse is like a thin thread. Surging pulse compared to Floating is larger and stronger. Faint and elusive, hard to find, absent on lifting but present on pressing, this is the Sinking pulse. Seeming delayed but not quite, it is called Slow (Huan), like rain soaking into sand. Choppy pulse is difficult and short; Delayed is extremely slow. Hidden pulse presses to the bone. Soft (Ru) pulse is soft; Weak (Ruo) pulse is fleeting. Having known the Seven Superficial, one must know the Eight Interior. The forms of the Nine Approaches must not be forgotten. Various schools' Nine Distinctive pulses have mutual exclusions and inclusions; neither can be entirely absent nor entirely present. Extending beyond its proper position and pulling is called Long (Chang); Short (Duan) is insufficient. Coming and going irregularly, large form but thin force indicates Deficiency. Do not diagnose Long and Short at the Guan, because Cun, Guan, and Chi are connected by one Qi, how could they be interrupted? Long and Short traces are found mainly at the Cun and Chi. Cu (Surging), Jie (Knotted), and Dai (Intermittent) all have pauses. Cu is frequent with pauses, Jie is delayed with pauses, Dai pauses are hard to recover. All three have pauses, requiring meticulous examination. Lao (Firm) is harder and stronger than Wiry and Tight. Dong (Moving) shakes and is unstable. Xi (Fine) is like a single line, small but forceful. Xian, Da, Xu, and Kou combine to form the Ge (Leather) pulse. Scattered and unrestrained is the San (Scattered) pulse. Rapid and urgent is Gai (Change - *note: likely a specific term or typo in original, interpreted contextually*), the easiest pulse to see. Seeking disease through pulse makes disease clear; referring disease to pulse determines life and death. However, some pulses correspond to disease, others do not; this must be detailed, not rigidly fixed. If the person is healthy but the pulse shows disease, it is called "Walking Corpse"; if the person is diseased but the pulse is harmonious, danger can be avoided.

The Right Cun is Qi Kou, the Left Cun is Ren Ying. A large Qi Kou pulse indicates food retention internally; a large Ren Ying pulse indicates external Wind pathogen (Some say Liver is the Wind organ, Stomach is the sea of water and grain, thus using Guan positions for Ren Ying and Qi Kou to observe internal and external causes, without distinguishing Wind by Heart or Food by Lung). For internal injury and external contraction, search according to this. (Wind-stroke with Phlegm-Qi) Wind-stroke pulse is Floating, Slippery combined with Phlegm-Qi; if Sinking-Slippery, do not treat as Wind. Whether Floating or Sinking, if Fine and Deficient, support the critical state and treat Phlegm; Wind should not be dispersed. Hard, large, and urgent indicates凶 (ominous).

Cold damage and heat diseases favor Floating-Hong pulses; if Sinking, Micro, Choppy, or Small, the prognosis is mostly ominous. After sweating, if the pulse is quiet and body cool, safety is ensured; if pulse is restless after sweating, heat is severe and difficult to treat. Yang syndrome showing Yin pulse means life is in danger; Yin syndrome showing Yang pulse, though difficult, is harmless. (Wind-cold) Yang position Floating and Slippery, Yin position Ru and Weak, this is named Wind-cold, do not use Cold medicines. Yang position Ru and Weak, Yin position Small and Urgent, this is not Wind-Cold, but Damp-Warmth pulse. If both Yin and Yang are excessive, the disease is extreme heat. Floating reveals Slippery, Sinking reveals Scattered-Choppy; only Warmth disease has pulses scattered across meridians, following their locations, impossible to specify directly.

(Summer-heat) Summer-heat damages Qi, therefore the pulse is Deficient. Wiry, Fine, Kou, Delayed, the characteristics are complete. Or Choppy or Fine, or Ru or Huan, all indicate Dampness invasion, which can be determined. Labor and fatigue internal injury shows Weak Spleen pulse; sweating with restless pulse indicates death. Malaria pulse is naturally Wiry; Wiry-Delayed indicates more Cold, Wiry-Frequent indicates more Heat, Dai-San indicates severance. Long-standing disease pulse is Deficient, Micro, and forceless, seemingly not Wiry, but obtainable through fine diagnosis.

(Five Bi syndromes) Wind, Cold, and Dampness combine to form Bi; Floating, Choppy, and Tight, these three pulses are prepared. Hong Kong foot (Podagra/Gout-like) pulse has four states: Floating-Wiry is Wind, Ru-Weak is Dampness, Delayed-Choppy is Cold, Hong-Frequent is Heat stagnation. Wind-sweat, Damp-warmth, Heat-lower, Cold-upper. Low back pain pulse is all Sinking and Wiry; combined with Floating is Wind, combined with Tight is Cold, Ru-Fine is Dampness, Full is sprain. Once the finger understanding is clear, treatment will not err.

Chi pulse Weak, (Wei Tong) Huan-Se-Jin, disease is foot pain, or Wei disease. Se indicates lack of blood, Jue cold is severe. Chi Micro indicates lack of Yin, dysentery with reverse cold. No accumulation but no stool, pulse should be Slippery-Large; Floating-Wiry-Urgent leads to death, Sinking-Fine is harmless. Heat Jue pulse is Hidden (Constipation), occasionally Frequent; constipation is difficult, treatment must not be wrong. Hernia pulse is Wiry-Urgent, accumulation inside; Firm-Urgent lives, Weak-Urgent dies. Sinking-Delayed, Floating-Choppy, hernia-mass cold pain, pain severe leads to Hidden, or Fine or Moving.

Wind, Cold, Summer-heat, Dampness, Qi stagnation generates phlegm-fluid, lower Deficiency upper Excess, all result in dizziness and vertigo. Wind is Floating, Cold is Tight, Dampness is Fine, Summer-heat is Deficient, Phlegm-fluid is Wiry-Slippery, Deficient pulse is absent. Treating dizziness requires careful scrutiny: first regulate Phlegm-Qi, then treat according to symptoms. Vomiting and regurgitation: Floating-Slippery indicates recovery, Wiry-Frequent-Tight-Choppy indicates intestinal blockage and death. Slippery-Frequent is vomiting, Dai is Cholera, Micro-Slippery indicates life, Choppy-Frequent indicates凶 (ominous).

Summer diarrhea pulse should reflect Summer-heat and Dampness; Hong and Frequent urination, pulse must be extremely Deficient. Treat summer-heat dampness diarrhea by separating urine; for collapse, consolidate intestines, no cure not achieved. Slippery but uneven indicates vomiting/diarrhea; Cholera sign, Dai pulse do not startle. Jue Ni with Delayed-Micro is lamentable. Oblique Wiry indicates fluid retention, or Sinking-Wiry-Slippery, or Knotted or Hidden; refer to fluid retention rhythm, total Phlegm pulse is necessarily Wiry-Slippery. Asthma pulse is Floating-Slippery, hand warmth is good; if limbs are cold, Sinking-Choppy is hard to treat.

Cough causes: Floating is Wind, Tight is Cold, Frequent is Heat, Huan is Dampness, sexual exhaustion is Choppy-difficult. Right Guan Ru indicates diet injuring Spleen; Left Guan Wiry-Short indicates extreme fatigue and Liver decline. Floating-Short indicates Lung injury, method should [treat] cough. Five Zang coughs, each viewed by its own position: Floating-Tight-Deficient-Cold, Sinking-Frequent-Excess-Heat, Hong-Slippery indicates much Phlegm, Wiry-Choppy indicates little Blood. Large body but Fine pulse, insufficient breath, Sinking-Hidden-Tight are all death pulses; only Floating-Large with cough indicates life. External symptoms and internal pulse, reference balance.

Starting with Sinking pulse, know it is Qi; extreme Sinking becomes Hidden, Choppy-Weak is hard to treat. If Sinking-Slippery, Qi combined with Phlegm-Fluid. Sinking-Wiry-Fine-Moving are all Pain syndromes. Heart pain at Cun, Abdominal pain at Guan, Lower part at Chi, pulse image is obvious. Heart palpitations from fright, pulse must be Dai-Knotted. Diet-induced palpitations, Sinking-Float-Slippery. Epilepsy pulse: Floating-Hong-Large-Long, Slippery-Large-Firm-Urgent, Phlegm accumulating in Heart causing madness. Dian is Heavy Yin, Kuang is Heavy Yang; Floating-Hong is auspicious, Sinking-Urgent is ominous. Xian should be Deficient-Slow; Sinking-Small-Urgent-Full, or measuring Wiry-Urgent, all die untreatable. Ghost possession pulse: Left and Right unequal, suddenly large/small, suddenly long/short, these are evil pulses, spirit confused.

Sweat pulse is Floating-Deficient, or Choppy-Ru, Soft-Scattered-Hong, thirst drinking without relief. Three Xiao (Wasting-Thirst) pulse: Frequent-Large indicates life, Micro-Fine-Short-Choppy, shocking to touch. Spermatorrhea and white turbidity, verify at Chi; Knotted-Kou-Moving-Tight are definitive for these two conditions. Nose tip yellow, urination must be difficult; Full-Large can be treated, Choppy-Small knows demise. Hematochezia shows Kou pulse, Frequent indicates red/yellow, Full pulse indicates strangury, heat in Bladder. All bleeding symptoms show Kou pulse, depending on upper/lower to verify source; pulse prefers Slow-Small, Frequent-Large is hard to treat.

Edema disease has Yin and Yang; observe pulse, color, ask symptoms in detail. Yin pulse Sinking-Delayed, color blue-white, not thirsty yet feels thirsty, urine clear-choppy. Pulse may be Sinking-Frequent, then red-yellow, dry stool red urine, combined with thirst is Yang. Distension-fullness pulse Wiry, Spleen controlled by Liver, Hong-Frequent heat distension, Delayed-Weak Yin cold. Floating is empty fullness, Tight is central solid, Floating-Large is treatable, Weak-Fine is critical. Accumulated blood in middle, Firm-Large is suitable; Sinking-Choppy-Micro, quick recovery is rare. Chest stuffiness pulse Slippery indicates Phlegm knot, Wiry-Hidden also knotted, Choppy indicates inferior Qi.

Liver accumulation Fei Qi, Wiry-Fine blue color; Heart Fu Liang, Sinking-Kou red color; Spleen accumulation Pi Qi, Floating-Large-Long, color Spleen Earth, central Yellow; Lung accumulation Xi Ben, Floating-Hair white color; Ben Tun belongs to Kidney, Sinking-Urgent black face. Five Zang are accumulations, Six Fu are aggregations. Accumulation is in its proper place, Aggregation has no fixed place. Fast-Tight-Float-Firm, Small-Sinking-Full, or Knotted or Hidden, for aggregation or accumulation, Full-Strong lives, Sinking-Small dies. Difference between life and death, same disease different pulse, outline says, must know. Accumulation pulse Hong-Tight, Depression pulse Sinking-Choppy.

Qi Kou Tight-Abundant indicates food injury, food not digesting, Floating-Slippery-Urgent, belching distinct smell, chest-diaphragm stuffiness, also headache, body fever, but body not painful, this is food anomaly. Five Jaundice Excess-Heat, pulse must be Hong-Frequent, if Micro-Choppy, syndrome belongs to Weakness. Bone-steaming劳热 (Labor-heat), pulse Frequent-Deficient, Heat-Choppy-Small, must perish body. Extreme labor various deficiencies, Floating-Soft-Weak, Earth failure double Wiry, Fire flare Frequent, add sweat add cough, not medicine can remove.

Headache Yang Wiry, Floating Wind Tight Cold, Wind-Heat Hong-Frequent, Dampness Fine-Firm. Qi Deficiency headache, though Wiry must be Choppy, Phlegm Jue is Slippery, Kidney Jue Firm-Solid. Men long-term disease, verify at Qi Kou, pulse Strong lives, pulse Weak dies. Women long-term disease, verify at Ren Ying, pulse Weak dies, pulse Strong lives.

Carbuncle-furuncle Floating-Frequent, aversion to cold fever, if painful area, carbuncle-furuncle develops. Before pus rupture, pulse should be Hong-Large; after rupture, Hong-Large begins to warn. Pulse Frequent fever, and painful is Yang, not Frequent not hot, not painful Yin sore. Developing carbuncle pulse, Wiry-Hong collide, Fine-Sinking-Straight. Lung-Liver both Frequent, Cun Frequent-Full, Lung abscess formed, Frequent but forceless, Lung萎 (Atrophy) shape. Lung abscess color White, pulse should Short-Choppy, dying is Floating-Large, not white but Red.

Various deficiencies pulse Fine, or Slow-forceless. Hands divide left-right, deficiency divides Blood-Qi, Right hand pulse Weak, or Frequent or Large, heavy press forceless, Blood Deficiency must consider. Left hand Weak-Delayed, Yang Deficiency trend, pulse if Tight finger, True Qi Deficient extreme. Pulse Wiry combined Frequent, Yin Deficiency Heat disease. Intestinal abscess hard to know, Slippery-Frequent can deduce, Frequent but not hot, intestinal abscess what doubt? Delayed-Tight no pus, purge to level it, Hong-Frequent pus formed, not purging is suitable, Sinking-Fine rootless, death known.

Yin pulses below, Yang separates above, Blood-Qi harmonious, pregnancy image. Hand Shaoyin, its pulse moves greatly, Chi press not exhausted, this is pregnancy. Shaoyin belongs to Heart, Heart governs Blood-Vessels, Kidney is Uterus gate, pulse responds at Chi. Or Cun pulse Micro, Guan Slippery Chi Frequent, coming-going fluent, like sparrow pecking. Or diagnose San Du, Floating-Sinking one stop, or Flat-Deficient, must ask menstruation. Woman has disease, but no evil pulse, this pregnancy no disease, so no month. Slippery-Urgent not scatter, fetus must three months, only urgent not scatter, five months can distinguish. Male-female difference, take by left-right, Left urgent is male, Right urgent is female, Sinking-Solid at Left, Floating-Large at Right, Right female Left male, can predict. Li Jing six beats, Sinking-Fine-Slippery,阵痛 (paroxysmal pain) connects waist, fetus real-time falls off. New postpartum pulse, Small-Slow is Deficient, Full-Large-Wiry-Firm, its凶 (ominous) can be clear. Blood mass Wiry-Urgent, and Large lives, Weak-Small-Weak, is death shape. Half-birth leakage, Ge pulse governs it, Weak is blood consumption, immediately see collapse.

Diagnose child pulse, Floating-Sinking first, Floating Exterior Sinking Interior, know source. Large-Small Slippery-Choppy, Deficient-Full Delayed-Urgent, each according to pulse shape, to examine syndrome-treatment. Generally women, and infants, disease same husband, pulse same example. Only women, fetal syndrome Blood-Qi, children惊疳 (Convulsion-Marasmus), Bian Zheng etc., each has methods, different from husband. Know women-infants, value recognize syndrome-shape, ask beginning details, pulse hard fully rely. Look-Hear-Ask-Cut, Divine-Saint-Work-Skill, foolish obscure, bright clear.

Disease chant diagnosis method, general like this. If holding pulse, especially should know. Say like Spring Wiry, Summer named Hook pulse, Autumn then Hair, Winter then Stone. Full-Strong too much, disease appears outside; Weak-Micro insufficient, disease decided inside. Four pulses each different, four seasons each discuss, all with Stomach Qi, as its root. Stomach Qi is what? Pulse neutral-harmonious, Slow-and-even, not fast-not slow, not large-not small, not Floating-not Sinking, meaning joyful, leisurely-yangyang, long press has Shen (Spirit), hard to name. Excess and insufficient, all are bias.

Spring governs Liver Wood, Summer governs Heart Fire, Spleen Earth rides prosperity, then in Late Summer, Autumn governs Lung Metal, Winter governs Kidney Water. Five Zang pulse images (Five pulses match Five Movements), match Five Movements. Liver pulse Wiry-Long, Yan-Yan Nie-Nie, finger seek, like touching elm leaves, increasingly firm-sliding, like touching long bamboo, is called Excessive. Sick at Liver, urgent like stretched string, again like touching handle, like pressing zither-se, Liver death response, Floating-Large like Scatter. Heart peaceful and safe, piled like ring, like touching Lang Gan, sick then increasingly frequent, like chicken lifting foot, death then carries Hook, rear squat front curve. Floating-Choppy-no, Ai-Ai like cover, this Lung peace. Press increasingly large, sick like touching feather, not down-not up, death then consumes, blowing hair flying. Sinking-Ru-Slippery, Kidney peace then if, Upper large Lower sharp, Slippery like sparrow peck. Kidney sick pulse, Peck-peck connect, connect among, however slightly curved, come like untying rope, go like shooting stone, dead Kidney, in people examine know. Spleen is Central Earth, peace not seen, but also can observe, Middle large and Slow, come like sparrow peck, like dripping leak water, Spleen organ decay, pulse then sees this.

Also have fat-thin, tall-short, Fat Float Thin Gather, Short-Urgent Long-Sparse. Quick nature person, five beats is peace, Slow nature person, four beats is standard. Tall person, finger press should sparse, Short person, finger press should dense. Northern people, often see Full-Strong, Southern people, always many Weak-Soft. Young-strong pulse Large, Old pulse Deficient. After wine pulse Frequent, after meal pulse Hong, far travel pulse Urgent, long hunger pulse Empty. Virgin-nun, pulse many Ru-Weak, Pure Yang son, pulse many Hong-Frequent. Each divide diagnosis method, cannot one path. Pulse has Reverse Gate, moves at arm back, separate via Lie Que, not interfere syndrome. Hard finish meaning, hard exhaust reason, get in heart, respond at finger.