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[Verse] The rationale behind the hidden pulse (Fu Mai, a deep pulse felt only with heavy pressure) in carbuncles and sores should be understood: when pathogenic toxins block the meridians, the six pulses may cease to be palpable. Upon careful examination of the syndrome, if no ominous signs are present, it is appropriate to employ methods to penetrate and expel pus; once the Qi flows freely, the pulse channels will naturally resume their movement.

[Note] In cases of carbuncle or sore, the appearance of a hidden pulse is due to toxic qi blocking the meridians and the stagnation of Ying (Nutritive) and Wei (Defensive) qi, causing the six pulses to sink and become imperceptible. If a careful review of the symptoms reveals no fatal indications, it is not a death pulse. Treatment should focus on unblocking the meridians and disseminating Ying and Wei qi, allowing Qi to flow freely so that the pulse channels naturally recover.

[Verse] A floating pulse (Fu Mai, a superficial pulse felt lightly) in an unruptured abscess suggests deficiency or the presence of wind-cold at the exterior. After rupture, a floating pulse indicates the leakage of Qi outward; frequent use of tonifying agents is then appropriate.

[Note] A floating pulse in an unruptured abscess, unless due to Qi and Blood deficiency, indicates wind-cold at the exterior; treatment must be tailored after detailed syndrome differentiation. A floating pulse after rupture signifies the outward leakage of Qi, requiring tonification for proper management.

[Verse] A deep pulse (Chen Mai, a deep pulse felt with heavy pressure) in an unruptured abscess often indicates blocked toxins; in a ruptured ulcer, it suggests toxins remaining inside. If the deep pulse is forceless, one must carefully examine whether internal deficiency has led to toxin sinking. A deep pulse with a slow rate (Chi Mai, <4 beats per respiration) indicates concomitant cold, while a deep pulse with a rapid rate (Shu Mai, >5 beats per respiration) indicates concomitant heat; these must be distinguished.

[Note] A deep pulse in an unruptured abscess is caused by toxin blockage. A deep pulse after rupture indicates that toxins remain within. If the deep pulse is forceless, it may indicate internal deficiency leading to toxin sinking, which requires careful assessment. A deep and slow pulse indicates concomitant cold, while a deep and rapid pulse indicates concomitant heat; these must be differentiated.

[Verse] A rapid pulse (Shu Mai) in an unruptured abscess suggests heat-toxin; if rapid and accompanied by a surging pulse (Hong Mai, wide and full), suppuration is imminent. A surging pulse after rupture indicates disease progression; if the pulse remains surging and rapid after pus discharge, treatment is likely ineffective.

[Note] A rapid pulse in an unruptured abscess, especially when becoming surging during suppuration, corresponds appropriately to the condition. However, a surging pulse after rupture, or a surging and rapid pulse after pus discharge, indicates excess pathogen and deficient healthy Qi, representing a mismatch between pulse and disease state. The disease will worsen daily, and treatment will likely fail.

[Verse] A slippery pulse (Hua Mai, smooth and rolling pulse) in an unruptured abscess is generally favorable; if phlegm is present at the onset, treating phlegm is indicated. After rupture, excessive phlegm suggests Qi exhaustion; if wheezing develops, it signals toxin sinking and impending death.

[Note] The slippery pulse indicates free flow. In the early stage of an unruptured abscess, a slippery pulse without phlegm is favorable. If phlegm is present, urgent treatment of phlegm is required to prevent post-rupture complications where excessive phlegm leads to Qi exhaustion, resulting in wheezing, toxin sinking, and death.