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Pingren (healthy individuals without disease) have no pulse, as the pulse qi has shifted to the external collaterals. The elder position (the normal location of the Cun Kou pulse) is occupied by the younger position (other locations such as Chi), and the pulse appears at the Yangxi (LI5) and Lieque (LU7) acupoints.

The so-called "no pulse in Pingren" does not mean the complete absence of a pulse. It refers to the situation where the Cun Kou pulse (pulse at the radial artery of the wrist) is not palpable upon pressing, but instead passes from beside the Chi position through the Lieque point of the Lung Meridian and the Yangxi point of the Large Intestine Meridian, emerging obliquely into the external collaterals. Their three-position (Cun, Guan, Chi) localization and the depth of the nine inspections (pulse taking at multiple body sites) are identical to those normally seen at the Cun Kou. This is akin to the elder's fixed position being usurped by the younger one. This is an abnormal and unusual pulse pattern, occurring only once in a thousand cases.

Once pathological pulses are clarified, auspicious and inauspicious outcomes must be distinguished. Beyond the regular meridians, there exists what is called the True Zang Pulse (pulse indicating the exposure of the true Qi of the Zang organs).

The pulse of impending Liver failure resembles the hardness and urgency of a knife blade. The pulse of impending Heart failure turns like beans, restless and rapid.

The pulse of impending Spleen failure is like a sparrow pecking grain, or water dripping from a leaking roof, or water flowing away, or an overturned cup.

The pulse of impending Lung failure is like a feather, rootless and desolate, shaking like hemp seeds, or merging like floating waves.

The pulse of impending Kidney failure arrives like a visitor briefly stopping by, comes like a stone being thrown, and departs like a loosened rope.

The pulse of impending Mingmen (Gate of Life) Qi is like a shrimp swimming or a fish gliding; arriving like a gushing spring, with signs of extinction appearing in the Bladder.

Once the True Zang Pulse manifests, Stomach Qi has already vanished. By observing complexion and symptoms, one judges the prognosis based on subjective inference.

The preceding text discusses pulse diagnosis, first tracing its origins and schools, then describing pulse flow, followed by left-right and male-female positioning, and subsequently the integration of Five Zang Yin-Yang with seasonal timing. Cold and heat are attributed to Slow (Chi) and Rapid (Shu) pulses; interior and exterior are distinguished by Floating (Fu) and Deep (Chen) pulses. Thus, various forms of deficiency and excess, and different manifestations of righteous and pathogenic factors, are covered. One understands disease through the pulse, and recognizes the pulse through disease. Diseases encompass sores, ulcers, women's diseases, and pediatric conditions; pulse studies exhaust topics like the Extraordinary Vessels and Reverse-Guan pulses. This can be considered clear and detailed. However, beyond all other pulses, there is the so-called "True Zang Pulse," which concerns life and death, hence it is carefully distinguished at the end of the volume. Humans are born endowed with the Five Elements, which are inherent to our bodies. Externally connected to Heaven and Earth, internally integrated with Gu Shen (essence and spirit derived from grains/digestion), they operate silently without obvious display. If the primordial true Qi of the Five Zang fails and vanishes, and Gu Shen ceases to nourish, then the dying forms of the Five Elements will appear according to each failing Zang. In the Liver, it resembles the hardness and urgency of a knife blade. (Strong, wiry, and urgent, cutting under pressure.) The normal Liver pulse, described as soft, light, void, slippery, straight, and long, is absent. In the Heart, it resembles beans turning, restless and rapid. (Bending forward and backward, completely lacking softness and slipperiness.) The normal Heart pulse, described as clustered like pearls or smooth like jade, is absent. In the Spleen, it resembles sparrow pecking, sharp and continuous. (Sharp and connected.) Like a leaking roof, dropping after a long time, with pulses alternating between sparse and rapid. (Dropping after a long time, alternating sparse and rapid.) Like flowing water, going and not returning. (Going and not returning.) Like an overturned cup, stopping and not rising. (Stopping and not rising.) The normal Spleen pulse, described as harmonious and soft, stepping like a chicken, is absent. In the Lung, it is like a feather, rootless and desolate. (Faint above, severed below.) Shaking like hemp seeds. (Scattered and chaotic.) Merging like floating waves. (Floating, rapid, and rootless.) The normal Lung pulse, described as gentle and quiet, falling like elm catkins, is absent. In the Kidney, arriving like a brief visitor. (Sheng means to ask/inquire. The guest arrives and leaves immediately.) Coming like a thrown stone. (Coming with impact, expelling all stored essence.) Departing like a loosened rope. (Dispersing and leaving, unable to store inward.) The normal Kidney pulse, described as panting and clustered like a hook, firm upon pressure, is absent. In the Mingmen (Right Kidney), same as the Left Kidney, but containing Ministerial Fire. Thus, its extinction appears like a shrimp swimming or a fish gliding, suddenly leaping in stillness, representing the image of fire about to extinguish yet flaring up. In the Bladder, arriving like a gushing spring. (Overflowing and unrestrained.) Because it stores body fluids and serves as the Official of the Capital, its extinction takes this form. Generally, the harmony and propriety of the pulse are due to the presence of Stomach Qi. Stomach Qi is the vital energy generated from food and drink. If Stomach Qi is slightly diminished, illness occurs; how much more so if it is absent? If absent, the root of generation is severed first, and the Five Zang cannot sustain themselves for long. If one further observes complexion and symptoms to make a judgment, the reasoning should be accurate.