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In cases of Spleen disease, the Qi in the upper and lower parts is unsettled. This is because above the Spleen lies the Heart, its "Mother" organ (Fire generates Earth), and below it lies the Lung, its "Child" organ (Earth generates Metal). The Heart governs Blood and belongs to Yin; the Lung governs Qi and belongs to Yang. When the Spleen is diseased, the upper Mother organ becomes unsettled; when the Mother is unsettled, Yin is insufficient, leading to fever. Furthermore, when the Spleen is diseased, the lower Child organ becomes unsettled; when the Child is unsettled, Yang is insufficient, leading to chills. Therefore, Spleen disease causes both Blood and Qi to be unsettled. When Blood and Qi are unsettled, there will be alternating chills and fever without rest, so the illness resembles Malaria (Nue Ji).

Generally, the Spleen belongs to Earth, the Heart to Fire, and the Lung to Metal; Fire generates Earth, and Earth generates Metal. Thus, it is said that there is a Heart Mother above and a Lung Child below, with the Spleen residing in the middle. When diseased, the condition manifests as described. The relationships of other Zang organs above and below follow this same principle.

The Pulse is the precursor of Blood and Qi. When Blood and Qi are abundant, the pulse is full; when deficient, the pulse is weak. When Blood and Qi are hot, the pulse is Rapid (Shu); when cold, the pulse is Slow (Chi). When Blood and Qi are minute, the pulse is Weak; when balanced, the pulse is Moderate (Huan). Additionally, tall people have long pulses, and short people have short pulses. Those with an irritable temperament have urgent pulses, while those with a calm temperament have relaxed pulses. Deviating from these norms indicates a Rebellious pattern (Ni), while conforming to them indicates a Compliant pattern (Cong). Moreover, all Rapid pulses indicate Heat, all Slow pulses indicate Cold, all Tight pulses indicate Pain, all Floating pulses indicate Wind, all Slippery pulses indicate Deficiency (Note: Classical texts often associate Slippery with Phlegm or Excess, but here it denotes Deficiency in specific contexts), all Hidden pulses indicate Accumulation, all Long pulses indicate Excess, and all Short pulses indicate Deficiency. Furthermore, Short, Choppy, Deep, Slow, and Hidden pulses belong to Yin; Rapid, Slippery, Long, Floating, and Tight pulses belong to Yang. If a Yin pulse matches a Yin syndrome, it is compliant; if a Yang pulse matches a Yang syndrome, it is compliant. Violating this indicates rebellion.

A green complexion without the Right Guan pulse (Spleen pulse) indicates Spleen Extinction, due to Wood overcoming Earth. A red complexion without the Right Cun pulse (Lung pulse) indicates Lung Extinction, due to Fire overcoming Metal. A white complexion without the Left Guan pulse (Liver pulse) indicates Liver Extinction, due to Metal overcoming Wood. A yellow complexion without the Left Chi pulse (Kidney pulse) indicates Kidney Extinction, due to Earth overcoming Water. A black complexion without the Left Cun pulse (Heart pulse) indicates Heart Extinction, due to Water overcoming Fire. These five "Extinctions" result in death. If the Five Extinctions occur, death happens immediately; if not at the critical time, death occurs within half a year. However, if the five colors appear but the corresponding five pulses are absent, it is not a fatal case.

For patients with Feng disease (epilepsy or spasmodic disorders), if the pulse is Tight and Rapid, whether Floating or Deep, accompanied by incessant sweating and audible respiration, it is a death sign; otherwise, survival is possible. For patients with Qi distension disease, if the whole body is swollen, limbs cannot be controlled, breathing is irregular, limbs are cold and unwarmed, and the pulse is Deep and Small, it is a death sign; if the pulse is Floating and Large, it is a survival sign. For patients with Lao disease (consumption/chronic deficiency), presenting with rectal prolapse, emaciation, hoarse voice, hematemesis, sexual dysfunction, frequent nocturnal emissions, disordered respiration, daytime coolness and nighttime heat, it is a death sign; expectoration of pus and blood is also a death sign. If the pulse is not Rapid, has a root, and the cheeks are not red, it is a survival sign. For patients with Chang Pi (dysentery or intestinal suppuration), presenting with bloody purulent stool, urgent pulse, hot skin, inability to digest food, and fixed staring eyes, it is a death sign; or if the whole body is cold, the pulse is Deep and Fine with no vitality, it is also a death sign. If diet remains normal, and the pulse is Forceful in both Floating and Deep positions without ceasing, it is a survival sign. For patients with Heat disease, presenting with cold limbs, weak pulse, aversion to people, inability to eat, and incessant diarrhea, it is a death sign. If they can eat, limbs are warm, pulse is Large, with delirium and insomnia, it is a survival sign. For patients with Cold disease, presenting with delirium, insomnia, cold body, Rapid pulse, panting, and fixed eyes, it is a death sign; if the pulse is Forceful without panting, it is a survival sign. For Yang disease patients with mental confusion, unclear sleep, and disordered speech, if the pulse is Forceful in Floating and Deep positions, it is a survival sign; if food cannot enter the stomach and the condition is unstable, it is a death sign. For chronic patients with a Large pulse but thin body, food failing to fill the intestines, speech resembling health but sitting/lying with exhaustion, it is a death sign; if diet is regular, pulse is Small but Forceful, speech is slightly hoarse, forehead lacks black qi, and stool is dry and difficult, it is a survival sign. Generally, Yang diseases presenting Yin syndromes, or Yin diseases presenting Yang syndromes, severe body heat, weak pulse in obese individuals, chaotic upper and lower Qi, inverted Yin and Yang, and mutual aggression of cold and warmth, are all inauspicious signs. Compliance leads to life, rebellion leads to death. The methods of treatment and medication should be detailed and comprehensive.