然有真正外感初起，阳（阳气）为阴（阴邪）蔽，脉反不浮者，亦有紧数而略兼浮者，审其发热
、无汗、头身疼痛，为表邪而开达之，阳气得通，脉始转浮。更有里邪解后，表邪外达，沉
小数实之脉，转为浮缓，浮缓为外解之征，日内可冀得汗，此先里后表病也；其有里邪解后
，而脉反浮躁者。此邪火伤阴，病胜脏也，名阴阳交（阳邪交于阴分），不治。又有内伤阳气
虚者，脉必浮而无力；阴血虚者，脉必浮而空豁，浮而弦数。是浮不可概言表。即谓浮而无
力为虚，浮而有力为实，似可不误，然有浮大弦硬之极，甚至四倍以上者，又非有力之谓，
乃真阴涸极，孤阳无根，胃气已无，真脏脉见，不可不知。又有兼脉，如浮紧风寒，浮数风
热，浮虚伤暑（暑月汗多，伤阴、伤气，所以脉虚），浮缓伤湿，浮大伤热，浮滑宿食，浮芤
失血之类，更宜参看。
However, in the initial stage of a true external contraction (exogenous disease), when Yang Qi (vital energy) is obstructed by Yin Evil (pathogenic cold/dampness), the pulse may paradoxically not be floating; it may also be tight and rapid with a slight floating quality. Upon carefully examining symptoms such as fever, absence of sweating, and pain in the head and body, if determined to be an exterior pathogen (external evil invading the surface), treatment should employ methods to open and disperse (ventilate and release). Once Yang Qi becomes unobstructed, the pulse will then transform into a floating quality.
Furthermore, after interior pathogens are resolved and exterior pathogens move outward, a pulse that was previously deep, small, rapid, and solid transforms into a floating and moderate (relaxed) pulse. A floating and moderate pulse is a sign of exterior resolution, with perspiration expected within a day; this characterizes a disease pattern treated first from the interior and subsequently from the exterior. Conversely, if after the resolution of interior pathogens, the pulse becomes instead floating and restless, this indicates that pathogenic fire has damaged Yin fluids, and the disease has overcome the Zang organs. This condition is named "Yin-Yang Jiao" (interaction of Yang pathogen with the Yin level) and is considered untreatable.
In cases of internal injury leading to deficiency of Yang Qi, the pulse must be floating but forceless; in cases of deficiency of Yin Blood, the pulse must be floating and empty/hollow, often accompanied by wiry and rapid qualities. Therefore, one cannot generalize that a floating pulse invariably indicates an exterior syndrome. Even if one posits that a floating pulse that is forceless indicates deficiency, while one that is forceful indicates excess—seemingly avoiding error—one must recognize that a pulse that is extremely floating, large, wiry, and hard, even exceeding four times the normal magnitude, does not signify "forcefulness." Rather, it signifies extreme depletion of True Yin, rootless solitary Yang, exhaustion of Stomach Qi, and the appearance of the True Zang Pulse (pulse reflecting the protrusion of organ essence without stomach qi support); this fact must not be overlooked.
Additionally, there are combined pulse patterns: floating-tight indicates Wind-Cold; floating-rapid indicates Wind-Heat; floating-empty indicates damage from Summerheat (due to excessive sweating in summer months damaging Yin and Qi, resulting in an empty pulse); floating-moderate indicates damage from Dampness; floating-large indicates damage from Heat; floating-slippery indicates retained food (food stagnation); and floating-hollow indicates blood loss. These cases require further reference and examination.