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Yu Chang stated: Regarding the pulse of Phlegm-Fluid (Tan Yin), the *Jin Gui Yao Lue* presents inconsistent descriptions, making it difficult to harmonize. In my humble opinion, there are differences in depth and severity, which can be clarified in advance. The chapter "Mai Yao Jing Wei" states: "When the Liver pulse is soft and scattered, and the complexion is lustrous, one should suffer from Overflowing Fluid (Yi Yin). Overflowing Fluid refers to a condition where thirst suddenly drives excessive drinking, and fluids easily enter beyond the muscles, skin, and intestines/stomach." This merely cites the case of sudden water intake overflowing, representing the most superficial type of fluid disease. Zhang Zhongjing grasped its meaning and divided fluid syndromes into four categories, summarizing their general principles as: Phlegm-Fluid (Tan Yin), Hanging Fluid (Xuan Yin), Overflowing Fluid (Yi Yin), and Supporting Fluid (Zhi Yin). Generally, treatment is discussed based on progression from superficial to deep; if left untreated at this stage, leading to flooding waters, even these four types of fluid diseases will present conditions that cannot be compared.

The text mentions "If the fluid pulse is not wiry, but suffers from panting and shortness of breath," indicating that while the fluid pulse is typically wiry, a non-wiry pulse suggests the accumulation of water is not dense. However, it still damages Yang Qi, resulting only in slight panting and shortness of breath. The text states "Zhi Yin also causes panting with inability to lie down, plus shortness of breath, and its pulse is normal." This indicates that when Zhi Yin rises to the chest and diaphragm, causing panting and shortness of breath, the pulse remains calm. It appears present yet absent because the stagnation has just occurred and has not yet become entrenched or latent, hence it does not manifest in the pulse. The text says "A floating, fine, and slippery pulse indicates injury by fluid." This means a floating, fine, and slippery pulse is not comparable to wind-stroke or cold-injury; it also represents fluid pathogen initially stagnating in the Qi level without having penetrated deeply. At this time, physicians should promptly consider the disaster of submersion and harbor the intention to save those drowning, employing methods that facilitate the natural course of the disease, thus resolving the illness. Otherwise, the syndrome becomes deeply entrenched, branches multiply, and the root of the latent pathogen becomes increasingly unrecognizable. Waiting a year to review prescriptions and ask about medicines, blindly seeking success, is impossible. Therefore, whenever the pulse transforms into a sinking and wiry pattern, one must investigate according to the laws.

The text states "A sinking pulse indicates retained fluid in the chest, accompanied by shortness of breath, thirst, and pain in all joints of the limbs." This signifies that the Lung's regulatory function fails, and Zong Qi (Gathering Qi) does not disperse, causing shortness of breath; since Qi does not disperse, body fluids are not transformed, leading to dryness in the diaphragm and thirst; Spleen Qi fails to transport, allowing water-fluids to flow into the limbs and joints, causing pain. In such a case, both the Lung and Spleen are diseased. The normal physiological process described as 'fluid enters the Stomach, overflows with essence and Qi, transports upward to the Spleen; Spleen Qi scatters essence, returning it upward to the Lung' is instead turned into lending weapons to enemies and providing grain to thieves (i.e., damaging healthy Qi and aiding pathogens). How could peace be sought?

Regarding the discussion of the Wiry Pulse (Xian Mai), it states: "Those who cough have a wiry pulse, indicating the presence of water." It states: "Double wiry pulse indicates Cold, occurring after severe purgation leading to a deficient pulse." It states: "Unilateral wiry pulse indicates fluid." For panting and fullness, it states: "A wiry-numerous pulse with cold-fluid is difficult to treat in winter and summer." It states: "A sinking and wiry pulse indicates internal pain from Xuan Yin," which is the accumulation of submerged water. Zhi Yin presents an urgent wiry pulse, expanding the theory; compared to the double wiry pulse after severe purgation, there is a distinction between deficiency-cold. Unilateral wiry pulses all indicate water-fluid. Difficulty in treating during winter and summer is due to the principle of avoiding cold in cold seasons and heat in hot seasons, unlike spring and autumn which are easier to treat. "Internal pain from Xuan Yin" means Xuan Yin accumulates internally, and in severe cases, causes pain. There is also a sinking-tight pulse, governing symptoms of epigastric stuffiness and hardness, and darkened facial complexion. This implies Kidney Cold mixes with Heart-Lung regions, causing epigastric hardness and dark complexion. A hidden pulse manifests as retained fluid; accumulated fluid obstructs the pulse so it does not reveal itself, being more severe than a choppy pulse. It further states: "Hidden pulse with free bowel movement and continuous epigastric hardness indicates retained fluid attempting to exit." It also states: "Chronic cough for years, if the pulse is weak, is treatable; if solid, large, and rapid, it is fatal; if the pulse is deficient, the patient surely suffers from dizziness, because there was originally Zhi Yin in the chest." All these represent deep disease with pulse changes, requiring tracing the flow to find the source. When Tian Shu opens and Stomach Qi harmonizes, the pulse harmonizes. Now, condensed phlegm-fluid obstructs this, making opening and closing mechanisms unfavorable, causing the pulse to transform into sinking-wiry, urgent-wiry, unilateral-wiry, wiry-numerous, wiry-tight, or hidden and invisible. Unless phlegm-fluid is urgently removed, how can the pulse return to normal? Superficial cases are treated superficially; deep cases are treated deeply; intermediate cases are treated moderately. Retained fluid can be attacked; latent fluid can be guided; hardened fluid can be reduced. If one continues to delay, the disease deepens, Qi is depleted, chills and fright occur intermittently, and it becomes incurable.