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Diseases may present as deficiency or excess of the Zang organs, and deficiency or excess of the Fu organs. Upper deficiency with lower excess, or lower deficiency with upper excess, manifest with diverse symptoms; careful investigation is required to discern them. Symptoms such as intestinal rumbling with qi movement, cold feet and hands, food failing to enter the stomach, untimely vomiting and regurgitation, withered and emaciated skin and hair, and wrinkled, cracked muscles indicate deficiency of the Five Zang organs (Zang organs: solid organs in TCM responsible for storing essence). Upon pulse diagnosis, if the pulse feels active when lifted lightly but becomes faint upon heavy pressure, one must observe which position it appears in to determine the affected Zang organ. Furthermore, pulses that are deep, small, weak, minute, short, choppy, soft, or soggy all indicate Zang deficiency. Deficiency conditions should be treated with tonification, which is the standard approach.

Conversely, excessive intake of food leading to difficulty in urination and defecation, chest and diaphragm fullness and oppression, pain in limbs and joints, heaviness of the body, dizziness of head and eyes, swelling of lips and tongue, obstruction of the throat, urgency of qi in the intestines, insensitivity of skin and flesh, sudden onset of asthma and fatigue, occasional alternating chills and fever, concurrent occurrence of sores and carbuncles, spontaneous mood swings between sorrow and joy, spontaneous flaccidity or hyperactivity, stagnation of qi, and stasis of blood indicate excess of the Zang organs. Pulse diagnosis reveals excess when the pulse is strong both upon light lifting and heavy pressing. Additionally, long, floating, rapid, hurried, surging, tight, string-taut, or large pulses all denote excess. By observing which meridian is involved, one can diagnose the specific Zang organ pathology. Headache with red eyes, hot skin but cold bones, relaxed and flaccid hands and feet, congestion and blockage of qi and blood, recurrence of erysipelas-like tumors, sore and swollen throat, pain upon light palpation but relief upon heavy pressure, and normal appetite characterize excess of the Fu organs (Fu organs: hollow organs in TCM responsible for digestion and excretion). The pulse diagnosis for this condition shows a floating and large, substantial quality.

Itching of the skin, distension of muscles, inability to digest food and drink, and slippery, uncontrollable diarrhea indicate deficiency of the Fu organs. The pulse is slippery upon light pressure but becomes level/normal upon heavy pressure. One must observe which meridian is involved to correct the Fu organ dysfunction. Chest and diaphragm stuffiness and fullness, fragmented pain in the head and eyes, inability to swallow food, heaviness and dizziness in the head and neck, throat discomfort, and thick, sticky sputum and nasal discharge indicate upper excess. The pulse at the cunkou position (radial artery site used for diagnosis) on both left and right sides is deep, knotted, substantial, and large. Red cheeks, heart timidity, trembling movements, hoarse voice, dry and cracked lips, dry mouth, asthmatic fatigue, lack of luster in the complexion, and swelling of the chin and jaw indicate upper deficiency. The pulse at the cunkou position on both sides is weak and minute. Difficulty in urination and defecation, normal appetite, heaviness in the waist and legs as if sitting in water, difficult walking, rushing upward sensation of qi, and dangerous dreams indicate lower deficiency. The pulse at the chi position (distal radial artery site) on both sides is slippery and choppy. Generally, patients presenting with minute, choppy, short, and small pulses fall under the category of lower deficiency.