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In interior syndromes, the pulse must appear either rapid or moderate, or neither floating nor deep but rapid, or soggy and moderate yet vague, with an indistinguishable rate; all these are manifestations of obstruction (Obstruction: pathogenic factors blocking the flow of Qi and Blood). As for Wind, it has no fixed form. When combined with Cold and Dryness, the pulse is tight, rapid, and floating; when combined with Summerheat and Dampness, the pulse is soggy, moderate, and floating (since Wind is a Yang pathogen, the pulse tends to be floating). Fire has no neutral state; the Six Qi all transform into Fire. If Fire transforms in the meridians or in the Qi level, the pulse must be surging and moderate; if Fire enters the Stomach Fu organ and contends with residue, the pulse must be deep, solid, and small, and in severe cases, deep, minute, and hidden. Solid and small, minute and hidden, are also signs of obstruction. Once the interior pathogens have been purged downward, the pulse turns floating and moderate without being deep and obstructed, and sweating will resolve the condition within the day. If the pulse remains deep and rapid after sweating, the pathogens are not yet exhausted; if the pulse becomes floating and restless after sweating, the pathogens are overcoming the healthy Qi; only when the body cools and the pulse becomes calm after sweating can it be said that the pathogens are fully eliminated. "Calm" refers to a deep and fine pulse. However, although the pulse is deep and fine, its rate is distinct, differing from the previous choppy and vague quality. Within a few days, as appetite returns and deficiency recovers, the pulse turns round and floating. A round pulse is contrary to an obstructed pulse. Obstruction means pathogenic factors are suppressed; roundness indicates that Qi and Blood are unobstructed and Spirit is concentrated—what disease could exist?

Ancients regarded "Stomach", "Root", and "Spirit" as the secret keys of pulse diagnosis. Gao Gufeng considered a round pulse as a sign of recovery. This character "round" captures the essence of the three characters "Stomach", "Root", and "Spirit". However, the terms "Stomach", "Root", and "Spirit" are not entirely precise. Essentially, having "Stomach" implies having "Spirit": the pulse is soft, gentle, light, and slow, even and clear, like a chicken treading on the ground, unhurried and composed. This is what is meant by "Stomach Qi" (Stomach Qi: the vital energy derived from digestion, reflecting the body's resistance), and this is also what is meant by the principle that the pulse values having "Spirit" (Spirit: vitality and responsiveness reflected in the pulse). Regarding the concept of "Root", ancients considered deep palpation as the root, and the Chi position (Chi position: the deepest pulse position at the wrist, corresponding to the Kidneys) as the root of the root. The rhyme says: "Though branches and leaves wither, the root will naturally regenerate." In diagnosing critical pulses, one must seek the root for judgment. Yet, defining the root merely by deep palpation or the Chi position does not capture the true Qi within the root. I have observed the pulses of the Five Zang organs failing; only in Lung failure is the pulse like wind blowing feathers, empty and rootless. In failures of other Zang organs, the pulse at deep palpation of the Chi position beats strongly against the finger, exceptionally firm and pounding, like flicking a stone, like running along a blade, like a sparrow pecking, or like grasping a belt hook. These are pulses without Spirit but with Root. Yet, some with a Root still die. Why? It is akin to tree roots dying while deep in the earth because they lack Qi. Although tree roots hang down, their lateral fibers surround them in all directions, absorbing Earth Qi from the four quarters; only when Qi is abundant can they extend sideways and branch out. Human pulses hide within the muscles. Not only do they extend down to the Chi position and deeply to the sinews and bones, but when pressed in the middle, they must connect seamlessly with the muscle tissue. Only then do Qi and Blood interlock, and Ying and Wei (Ying and Wei: Nutritive and Defensive Qi) remain united. This is called having Qi; having Qi is having Root. I have seen individuals with Yin deficiency or the elderly whose pulses rise distinctly like a single bar, seemingly disconnected from the muscles, separating Yin from Yang. This is called lacking Qi. All things cannot integrate and connect without Qi. Therefore, speaking of "Qi" is better than speaking of "Root", and speaking of "Stomach" is better than speaking of "Spirit". The Heart governs Spirit, and the Lung governs Qi. Are not Spirit and Qi the great sources of the pulse?