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The twelve meridians of the human body have established pathways for communication and a specific order of circulation. Qi leads the way, while Blood follows within; they circulate and turn continuously without stopping day or night. When physicians palpate the pulse, they use the three positions—Cun (Inch), Guan (Bar), and Chi (Cubit)—on both the left and right wrists. The physician uses three fingers to sense the pulse, measuring the patient's pulse beats against the physician's own single exhalation and inhalation.

The pulse moves in response to the finger pressure; one beat is called one "Zhi" (beat). Within one exhalation and inhalation, if the pulse beats four times or more, but five times or less, neither rapid nor slow, it is called a Ping Mai (Normal Pulse). If within one exhalation and inhalation the pulse beats three times or slightly more than three, it is called a Chi Mai (Slow Pulse); if it beats six times or slightly more than six, it is called a Shu Mai (Rapid Pulse). The classics state: "Chi indicates deficiency-cold, Shu indicates deficiency-heat." This is a method for identifying disease nature, not merely pulse morphology classification.

However, pulse images also vary into Fu (Floating), Chen (Sinking), Hua (Slippery), Se (Choppy), Xian (Wiry), Jin (Tight), Da (Large), and Xiao (Small). Fu pulse floats superficially, detectable with light pressure, like wood floating on water, hence named Fu. Chen pulse sinks deep, detectable only with heavy pressure, like a stone sinking, hence named Chen. Hua pulse flows smoothly back and forth, like pearls rolling on a plate. Se pulse flows roughly and obstructedly, like a knife scraping bamboo. Xian pulse feels like a bowstring, firm and unyielding upon pressure. Jin pulse feels like a twisting rope, tense and urgent upon pressure. Da pulse has a voluminous body, exceeding the normal position. Xiao pulse has a constricted body, falling short of the normal width.

Beyond these, there are Wei (Micro), Xi (Fine), Kou (Hollow), and Ge (Leather) pulses. Wei pulse is extremely weak, seeming present yet absent. Xi pulse is thin and small, like a hair or silk thread. Kou pulse feels firm on the surface but hollow in the middle, like pressing an onion stalk. Ge pulse is hard and taut on the outside, like pressing a drumhead. Since pulse images are diverse, one must distinguish them clearly under the fingers and correlate them with symptoms to form a definite judgment.

However, it is crucial to examine whether the pulse is round and relaxed, and whether it possesses "Wei Qi" (Stomach Qi, representing digestive vitality). A "round and relaxed" pulse responds to the finger with uniform rhythm and equal strength across the Cun, Guan, and Chi positions. "Wei Qi" means the pulse responds to light pressure and feels soft and harmonious upon heavy pressure. If the pulse lacks roundness and relaxation, and has no Wei Qi, mild illness will become severe, and severe illness will lead to death.

Besides pathological pulses, there are also "Death Pulses." Medical texts describe Xia You (Shrimp Swimming), Yu Xiang (Fish Gliding), Wu Lou (House Leaking), Que Zhuo (Sparrow Pecking), and Dan Shi (Finger Striking Stone). Xia You resembles a shrimp swimming (erratic and faint); Yu Xiang resembles a fish gliding (head still, tail trembling). Wu Lou beats irregularly, sparse and intermittent like dripping water. Que Zhuo resembles a sparrow pecking food, rapid and scattered. Dan Shi is hard and solid, like a finger striking a stone. Xia You, Yu Xiang, and Wu Lou are scattered and disordered pulses; Que Zhuo and Dan Shi are rigid and discordant pulses. These descriptions in medical texts are apt simulations; all indicate a lack of Wei Qi and Shen (Spirit) in the pulse, appearing inevitably fatal.

Furthermore, the pulses at the three positions of both hands constitute the "Earth Pulse," palpable by fingers; facial complexion constitutes the "Heaven Pulse," observable by eyes. When the Six Qi are harmonious and the Five Elements are balanced, a normal complexion appears naturally. If the face lacks normal color, spirit is dim, and signs of premature aging appear externally, longevity will be short.

Besides various pulses, there is also Dong Mai (Moving Pulse). There are two types of Dong Mai: First, the pulses at the three positions tremble vigorously, round and rapid like a bean. Second, vessels in the head, forehead, beside the throat, chest, abdomen, shins, and feet jump visibly. This occurs because meridians circulate through gaps between tissues, slightly revealing their ends, known as "overflowing from the flow."

Gao Yangsheng's *Mai Jue* (Pulse Classic) states: Left side corresponds to Heart, Small Intestine, Liver, Gallbladder, Kidney, Bladder; Right side corresponds to Lung, Large Intestine, Spleen, Stomach, Pericardium, San Jiao (Triple Burner). This pairing of Zang and Fu organs aligns with the pulse methods in the *Ling Shu* (Spiritual Pivot). However, the pulse method in the *Su Wen* (Basic Questions) uses the Cun position to inspect the Upper Jiao, Guan for the Middle Jiao, and Chi for the Lower Jiao. Briefly, Right Cun inspects the Lung, Left Cun inspects the Heart, while Dan Zhong and Upper Jiao attach to both Cun positions; Right Guan inspects the Spleen, Left Guan inspects the Liver, while Diaphragm, Middle Jiao, Stomach, and Large/Small Intestines attach to both Guan positions; Chi inspects Kidney and Bladder,不分左右 (without distinguishing left/right), while Hypochondrium, Blood Sea, and Lower Jiao attach to both Chi positions. This "upper inspects upper, middle inspects middle, lower inspects lower" approach is characteristic of the *Su Wen* pulse method.

Additionally, Zhang Zhongjing’s *Shang Han Lun* (Treatise on Cold Damage), Chapter on Leveling Pulses, offers another diagnostic method using increasing weight equivalent to three, six, nine, and twelve beans, moving from light lifting to pressing, to inspect the Qi of the five Zang organs. Thus, light pressure like three beans inspects Lung Qi; six beans inspects Heart Qi; nine beans inspects Spleen Qi; twelve beans inspects Liver Qi; pressing to the bone inspects Kidney Qi. This utilizes Floating, Middle, and Deep techniques to diagnose Zang Qi, consistent with the *Shang Han Lun* pulse method.

If one masters the classic discussions on pulse methods mentally, then diagnosing and discussing diseases will be appropriate in all aspects. However, some individuals have no pulse at the three standard positions, with the pulse shifting to external collaterals, known as Fan Guan Mai (Reverse Passage Pulse); this must also be known. In summary, the pulse is the great root of the five Zang and six Fu organs. Presence of pulse means life, absence means death. If the three positions are balanced, even severe illness may survive; if unbalanced, even mild illness may be critical.

Furthermore, pulses are divided left and right: Left governs Blood, Right governs Qi. Men are Yang, and Yang refers to Qi, so men's pulses should be stronger on the right. Women are Yin, and Yin refers to Blood, so women's pulses should be stronger on the left. If a man's right pulse is harmonious, he is safe even if ill; if a woman's left pulse is harmonious, she is safe even if ill. This is because the positions of the five Zang organs differ: what is on the left in men is on the right in women, and vice versa. The *Su Wen* states: "For men, left is Ni (adverse/unfavorable), right is Cong (favorable); for women, right is Ni, left is Cong." Since the favorable sides differ, the organ associations for the left and right hands must also differ accordingly.

Regarding diagnosing disease via pulse, stating that "a certain pulse belongs to a certain disease" or "a certain disease yields a certain pulse" is superfluous and difficult to rely upon clinically. It is better to simply discuss whether the pulse has Shen (Spirit) or lacks it, and whether it is harmonious/relaxed or not.

For children's pulses, the same method applies. However, children cry and resist, making detailed diagnosis difficult. Using one or two fingers, if the pulse beats four or five times per breath cycle, it is considered harmonious. If it feels faint or rapid and spiritless, combined with severe illness, survival is unlikely. Observing the Tiger's Mouth (web between thumb and index finger) for color changes, or claiming children's pulses beat six or seven times per breath, are all absurd theories. When diagnosing children's pulses, one must know that children breathe rapidly and adjust expectations accordingly.

From this deduction, regardless of age or gender, internal deficiency diseases suit weak pulses, while large/voluminous pulses are contraindicated. Initial exterior contraction diseases suit Yang pulses (floating/rapid), while Yin pulses (deep/slow) are contrainddicated. Other statements in the *Mai Jue* are mostly baseless and unreliable. Those seeking pulse diagnosis methods should verify them in the *Ling Shu*, study them in detail in the *Su Wen*, and integrate them with the differentiation and leveling of pulses discussed herein to grasp the essentials.