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The *Neijing·Mai Yao Jing Wei Lun Pian* (Treatise on the Essential Subtleties of Pulse Diagnosis in the Yellow Emperor's Inner Canon) states: When pushing the pulse outwardly and carefully observing it, if the pulse presents as "internal but not external" (strong upon deep pressure, weak upon superficial pressure), it indicates accumulation in the heart and abdomen. When pushing the pulse inwardly (applying deep pressure) and carefully observing it, if the pulse presents as "external but not internal" (strong upon superficial pressure, weak upon deep pressure), it indicates fever in the body. When pushing the pulse upwardly and carefully observing it, if the pulse presents as "upper but not lower" (excess in the Cun position, deficiency in the Chi position), it indicates coldness in the waist and feet. When pushing the pulse downwardly and carefully observing it, if the pulse presents as "lower but not upper" (excess in the Chi position, deficiency in the Cun position), it indicates pain in the head and neck.

At the Cun position of the left wrist, the exterior corresponds to the Heart, and the interior corresponds to the Danzhong region. At the Guan position of the left wrist, the exterior corresponds to the Liver, and the interior corresponds to the diaphragm. At the Cun position of the right wrist, the exterior corresponds to the Lung, and the interior corresponds to the chest center. At the Guan position of the right wrist, the exterior corresponds to the Stomach, and the interior corresponds to the Spleen. At the two Chi positions, the exterior corresponds to the Kidney, and the interior corresponds to the abdominal cavity. Thus, there exists a diagnostic method of examining conditions by pushing inwardly or outwardly and carefully observing the pulse.

Another interpretation states: For the left Cun position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, headache and neck pain occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, chest and hypochondriac pain occur. If pushed inwardly (deep pressure) resulting in an internal-excess/external-deficient pattern, heart and abdominal accumulations are present; if pushed outwardly (superficial pressure) resulting in an external-excess/internal-deficient pattern, blurred vision occurs.

For the left Guan position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, coldness in the waist and feet occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, gastrointestinal pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, bone and tendon pain occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, fever in the body occurs.

For the left Chi position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, small intestine pain occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, calf pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, turbid urine occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, waist and foot pain occurs.

For the right Cun position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, panting and rapid breathing occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, chest pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, sore throat occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, back and spine pain occurs.

For the right Guan position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, vomiting and regurgitation occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, lower bleeding is indicated. If pushed inwardly resulting in an internal-excess/external-deficient pattern, abdominal distension due to accumulation (Gu) occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, muscle pain occurs.

For the right Chi position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, lower abdominal distension occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, leg pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, hernia or masses (Shan Jia) occur; if pushed outwardly resulting in an external-excess/internal-deficient pattern, urinary retention occurs.

Wang Shishan stated: The term "Xiao Xi" refers to detailed examination. The term "Tui" refers to moving the fingers up and down across the pulse positions to diagnose, aiming to distinguish features such as long or short pulses; moving the fingers inside and outside the pulse position to diagnose, aiming to distinguish between double-wiry or single-wiry pulses; and pressing aside the tendons to diagnose, aiming to identify pulses that are sunken, hidden, intermittent, or absent. The *Kan Wu* commentary suggests that "interior and exterior" refer to the lightness or heaviness of finger pressure, and "Tui" has multiple meanings, hence it is specifically elaborated upon, rather than merely referring to simple correspondences like "exterior for Heart, interior for Danzhong."