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I have pondered that the methods of ancient physicians in treating diseases were not uniform. If the four diagnostic methods—inspection (Wang, 望) of complexion, auscultation and olfaction (Wen, 闻) of voice and odor, inquiry (Wen, 问) of symptoms, and palpation (Qie, 切) of pulse—are all fully employed, one can be called miraculous. Therefore, those who can diagnose by inspection alone are superior physicians.

(Note: The original text contains severe corruption and disjointed phrases such as "cut lightness and heaviness and number," "know pulse and hastily say pulse most take this to qi already," interspersed with meaningless single characters like "wood overcome," "pale," "black," "sun," "already," "its period," "death," "is heart," "tongue black has," "yellow dry," "drain," "tongue white," "soft," "fire inside." Due to the severe damage of the source text, accurate sentence-by-sentence translation is impossible. The following translation relies on coherent segments and the subsequent complete section.)

Regarding pulse diagnosis, there were ancient diagrams of the Ming Tang (Hall of Light), with fourteen internal points and eleven external points, which are difficult to verify and distinguish. It is generally accepted that the forehead belongs to the Heart, the nose to the Spleen, the left cheek to the Liver, the right cheek to the Lungs, and the chin/other areas to the Kidneys. Regarding facial colors: Green corresponds to Wood, White to Metal, Yellow to Earth, Red to Fire, and Black to Water. If colors indicating mutual overcoming appear, it indicates impending death. For instance, a black tongue, yellow and dry complexion, and diarrhea are critical signs.

The *Nan Jing* (Classic of Difficult Issues) states that one can know the disease by listening to the five tones. The sounds produced by the five Zang organs correspond to the five musical tones: The Liver governs "Hu" (exhaling sound), corresponding to the Jue tone; the Heart governs laughter, corresponding to the Zhi tone; the Spleen governs speech/singing, corresponding to the Gong tone; the Lungs govern crying, corresponding to the Shang tone; and the Kidneys govern groaning, corresponding to the Yu tone. (Note: The original text here is also chaotic, extracting only partial keywords).

In the past, Yu Jiayan treated diseases by questioning first and then diagnosing, combining inspection, auscultation/olfaction, and palpation to thoroughly understand the patient's condition. Whenever seeing a patient, one must inquire about age, the nature of the disease, presence of vertigo, whether deficiency precludes tonification, presence of internal closure or external pathogens, etc., to accurately assess and appropriately use tonifying or expelling agents.

(This is Peng Zhongling's Pulse Method Golden Needle)
The key principles of pulse diagnosis lie in three characters: Stomach Qi (Wei Qi, 胃气), Spirit (Shen, 神), and Root (Gen, 根). Humans correspond to Heaven and Earth, and the pulse must accord with the four seasons. Among the four seasons, Stomach Qi serves as the foundation. This is like a tree having roots; although the branches and leaves may wither, if the rootstock remains intact, the vitality does not cease. Therefore, the method of pulse diagnosis must seek the Root as the basis for judgment. Summarizing the essentials, they do not go beyond these three: Stomach Qi, Spirit, and Root. If there is even a slight deviation in these three, pathological pulses will appear. Those biased towards Yang manifest as Floating (Fu, 浮), Empty (Kou, 芤), Slippery (Hua, 滑), Excess (Shi, 实), Surging (Hong, 洪), Rapid (Shu, 数), Long (Chang, 长), Large (Da, 大), Tight (Jin, 紧), Leathery (Ge, 革), Wiry (Xian, 弦), Firm (Lao, 牢), Agitated (Dong, 动), Hasty (Ji, 疾), Urgent (Cu, 促), responding accordingly. Those biased towards Yin manifest as Deep (Chen, 沉), Slow (Chi, 迟), Deficient (Xu, 虚), Fine (Xi, 细), Minute (Wei, 微), Rough (Se, 涩), Short (Duan, 短), Small (Xiao, 小), Soft (Ru, 濡), Hidden (Fu, 伏), Weak (Ruo, 弱), Moderate (Huan, 缓), Knotted (Jie, 结), Intermittent (Dai, 代), and Scattered (San, 散), responding accordingly. If only a Moderate (Huan, 缓) pulse is seen, occurring four times per breath cycle, it is called Harmonious and cannot be diagnosed as a pathological pulse. The remaining twenty-nine types of pulses are all pathological. One must carefully observe their images to determine the diseases they indicate.

Floating (Fu) means not sinking, indicating disease in the Exterior (Biao, 表). Deep (Chen) means not floating, indicating disease in the Interior (Li, 里). Slow (Chi) occurs three times per breath cycle, indicating Cold (Han, 寒). Rapid (Shu) occurs six times per breath cycle, indicating Heat (Re, 热). Slippery (Hua) flows smoothly, indicating Phlegm (Tan, 痰) and Fluid Retention (Yin, 饮). Rough (Se) flows with difficulty, indicating Blood Deficiency (Xue Xu, 血虚) and Qi stagnation. Deficient (Xu) is not solid, indicating Fatigue and Internal Injury (Lao Juan Nei Shang, 劳倦内伤). Excess (Shi) is not deficient, indicating External Pathogenic Excess (Wai Gan Xie Shi, 外感邪实). Surging (Hong) is large and forceful, indicating Accumulated Heat (Ji Re, 积热). Large (Da) is empty and weak, indicating Physical Weakness (Ti Ruo, 体弱). Minute (Wei) is fine and faint, indicating Little Qi (Qi Shao, 气少). Small (Xiao) is fine and distinct, also indicating Little Qi. Wiry (Xian) has a straight and taut image, indicating Water-Fluid Retention (Shui Yin, 水饮). Long (Chang) extends beyond its normal position, indicating Abundant Qi (Qi Wang, 气旺). Short (Duan) fails to reach its normal position, indicating Timid Qi (Qi Qie, 气怯). Tight (Jin) feels like a pulled rope or twisted cord, indicating Cold and Pain (Tong, 痛). Weak (Ruo) is extremely fine and subtle, indicating Deficiency and Decline (Kui, 亏). Soft (Ru) is deep and fine, indicating Insufficient True Fire (Zhen Huo Bu Zu, 真火不足). Agitated (Dong) trembles suddenly, indicating Discontinuous Qi and Blood (Qi Xue Bu Xu, 气血不续). Hidden (Fu) does not emerge, indicating Congealed Cold Qi (Han Qi Ning Jie, 寒气凝结), possibly due to extreme pain or trauma from falls. Urgent (Cu) is rapid with occasional pauses, indicating Extreme Heat (Re Ji, 热极). Knotted (Jie) is slow with occasional pauses, indicating Severe Cold (Han Sheng, 寒盛). Empty (Kou) is hollow at the edges, indicating Blood Loss (Shi Xue, 失血). Intermittent (Dai) stops during movement with a fixed interval, also due to discontinuous Qi and Blood, trauma, confusion, or as a sign in the third month of pregnancy. Leathery (Ge) is floating and firm/tense, indicating Decline of Essence and Blood (Jing Xue Shuai Shao, 精血衰少). Firm (Lao) is deep and hard, indicating Insufficient Stomach Qi (Wei Qi Bu Zu, 胃气不足). Hasty (Ji) occurs seven times per breath cycle, indicating Extreme Heat. Scattered (San) is dispersed and uncollected, indicating Scattered Qi (Qi San, 气散). Only the Moderate (Huan) pulse represents perfect harmony, indicating absence of disease. However, if a Moderate pulse appears only in the Chi (Cun/Kwai/Guan positions contextually referring to radial artery depth/location, specifically Chi pulse often relates to Kidney/Lower Jiao) position, it indicates predisposition to Wei Bi (Paralysis/Numbness, 痿痹) disorders. The diseases indicated are generally as described above. If multiple pulses appear simultaneously, they should be combined for judgment to identify the disease.

Regarding pulse variations: there are True and False (Zhen Jia, 真假), Hidden/Concealed (Yin Fu, 隐伏), Reverse Guan (Fan Guan, 反关), and Strange Pulses (Guai Mai, 怪脉), all of which require careful differentiation to avoid confusion. What are True and False? For example, a rough and fine pulse in a Heat disease, or a forceful pulse in a Cold syndrome. What is Concealed? For instance, in abdominal pain due to Middle Cold, the pulse may not be felt; or when an external Wind-Cold pathogen is about to produce a proper sweat, the pulse may also disappear. The *Mai Jing* (Pulse Classic) states that no pulse in one hand is called Single Concealment (Dan Fu, 单伏), and no pulse in both hands is called Double Concealment (Shuang Fu, 双伏). What is Reverse Guan? When no pulse is found in the standard Guan position, it appears above the wrist bone, either on the left or right. Diagnosis must not be hasty. What are Strange Pulses? When the pulses in both hands seem to come from two different people, fluctuating between large and small, fast and slow, this is attributed to demonic influence (Sui Zheng, 祟症). Furthermore, pulses differ in the elderly and young, vary by geographical region, and depend on a person's height and build. Diagnostic methods must be adjusted accordingly. Generally, correspondence between pulse and symptoms is the norm; non-correspondence is the variation. Understanding the norm and mastering the variation is the essence of pulse diagnosis. The core essence ultimately lies in the three characters: Stomach Qi, Spirit, and Root. If none of the three are lacking, the person is healthy. If one deviates, disease is present. If one is completely absent, the condition is critical. All three—Stomach Qi, Spirit, and Root—must be present for auspicious signs under the fingers. This is the great method of pulse diagnosis, recorded occasionally for reference.