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The key to pulse diagnosis lies most urgently in examining the Renying (Human Welcome) and Cunkou (Inch Port) pulses. These two pulses correspond to each other like two ropes pulled in opposite directions; if Yin and Yang are balanced, the thickness of these two "ropes" will be equal. Generally, in a healthy person, the Renying pulse is slightly larger during Spring and Summer, while the Cunkou pulse is slightly larger during Autumn and Winter.

What is called "Renying"? It refers to taking the pulse at the side of the throat, as mentioned in the *Neijing* (*Inner Canon*) as "distinguishing from Yang". Bian Que (Yue Ren) did not take pulses from all acupoints throughout the body but only took the position on the course of the Hand-Taiyin Lung Meridian, one cun and nine fen behind the Yuji point (LU10), to match the numerical principles of Yin and Yang, thereby deriving the Guan-Ge (Closing and Refusing) pulse pattern. However, without first understanding the significance of the Renying and Cunkou pulses being like two pulling ropes, one would remain ignorant of the origins of Chi/Cun positions, Yin/Yang dynamics, and Guan-Ge conditions.

If the Cunkou pulse is four times stronger than the Chi pulse, the pulse qi extends upward to the thenar eminence (Yu Ji area), which is called "Yi" (Overflow). Thus, "Yi" signifies that the Cun pulse reaches its extreme limit when it is double the Chi pulse. This "Yi" pulse is also named "Guan" (Closed), "Neige" (Internal Refusal), or "Yin Cheng Zhi Mai" (Pulse of Yin Overcoming Yang). The term "Waiguan" (External Closure) refers to the pulse extending outward above the Guan position. This occurs because Yin rejects Yang from exiting, hence it is called "Wage" (External Refusal). Yin originates at the Cun, moves at the Chi; now, overflowing from above the Guan to the thenar eminence, while the pulse below the Guan runs hidden, this indicates Yin is strong and overcoming Yang, leading to Yang exhaustion. When Yang exhausts, death ensues; those with such a pulse die. This is what is meant by "Cunkou pulse four times that of Renying, constituting the Guan-Yin pulse."

If the pulse at one cun below the Guan position sinks excessively, it is called "Fu" (Covering/Reversal). This means the Chi pulse is one to three times stronger than the Cunkou pulse, causing the pulse qi to extend downward into the Chize area (LU5), which is called "Fu". Thus, "Fu" signifies that the Chi pulse reaches its extreme limit when it is double the Cun pulse. This "Fu" pulse is also named "Neiguan" (Internal Closure), "Waige" (External Refusal), or "Chengyang Zhi Mai" (Pulse of Overcoming Yang). "Neiguan" refers to the pulse inward below the Guan position; "Waige" refers to Yang rejecting Yin from entering internally. Yang originates at the Chi, moves at the Cun; now, covering and sinking below the Guan into the Chize area, while the pulse above the Guan runs hidden, this indicates Yang is hyperactive and overcoming Yin, leading to Yin exhaustion, which also results in death. Those with such a pulse die. This is what is meant by "Renying pulse four times that of Cunkou, constituting the Ge-Yang pulse."

The Classics state: If both the Renying and Cunkou pulses are excessive by more than four times, it is called "Guan-Ge". Patients with Guan-Ge become emaciated and cannot sustain the essence and Qi of Heaven and Earth, leading to death. The so-called "Guan-Ge" refers specifically to "Fu" and "Yi".

Nevertheless, if there is only "Fu" or only "Yi", they can be regulated through tonification and sedation methods. If the Chi portion pulse is one-fold excessive, sedate Foot-Shaoyang Gallbladder Meridian and tonify Foot-Jueyin Liver Meridian; if two-fold excessive, sedate Foot-Taiyin Spleen Meridian and tonify Foot-Shaoyin Kidney Meridian; if three-fold excessive, sedate Foot-Yangming Stomach Meridian and tonify Foot-Taiyin Spleen Meridian. All involve two sedations and one tonification. If four-fold excessive, it represents the extremity of the Three Yang meridians; needle guidance should be used, taking points from Foot-Shaoyang, Foot-Taiyin, and Foot-Yangming meridians. If the pulse becomes calm, select points from the Three Yang meridities on the foot; if the pulse is rapid, select points on the hand. When sedating Yang, the manipulation should be twice that of tonifying Yin.

Pulse diagnosis involves "Nine Palpations," embedding Floating, Middle, and Deep pressures within the Cun, Guan, and Chi positions. Furthermore, Bian Que did not utilize all acupoints of the Twelve Meridians but directly paired two meridians along the course of the Hand-Taiyin Lung Meridian, dividing the one-cun-nine-fen segment from Chi to Cun into three parts, each containing Floating, Middle, and Deep pressures to correspond to Heaven, Earth, and Humanity.

It is also stated: Wind-stroke belongs to Wood; Cold Damage belongs to Metal; Warm diseases originate from Water and Fire; Heat diseases originate from Dampness. Heavy dampness causes disease in the Earth organ (Spleen); when Earth is diseased, all other Zang organs suffer. The root lies in the changes of the Four Zang organs of Metal, Wood, Water, and Fire.

A pulse that is Floating at Yang and Soft at Yin indicates Wind-Warmth; Rapid at Yang and Solid at Yin indicates Warm-Toxicity; Soft at Yang and Tight at Yin indicates Damp-Warmth; Excessive at both Yin and Yang indicates Warm-Malaria. In treatment: For Wind-Dampness, select Foot-Jueyin Liver and Hand-Shaoyin Heart meridians; for Warm-Toxicity, exclusively select Shaoyang Sanjiao and Hand-Shaoyin Heart meridians; for Cold Damage, select Hand-Taiyin Lung and Hand-Shaoyin Heart meridians; for Damp-Warmth, select Foot-Shaoyin Kidney meridian. People generally claim I am capable of discussing Cold Damage. I examine the variations of Cold Damage and the Four Types of Warmth, distinguishing their similarities and differences without confusion. Therefore, I determine Yin and Yang via the Throat and Hand, pair Fu and Yi with Chi and Cun, embed the Nine Palpations in Floating and Deep, and differentiate the Four Warmths within Cold Damage. These concepts were initially outlined by Bian Que, and I have refined them by consulting the *Neijing* and other texts. By applying them prudently and treating according to the principles, diseases cannot escape cure. (From Zhang You Shi Ji)