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When the Spleen is diseased, there is unrest in both the upper and lower parts of the body. What does this mean? The Spleen is below the Mother organ (Heart) and above the Child organ (Lung). 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. If the Mother organ is unsettled, it indicates a deficiency of Yin. A deficiency of Yin leads to fever. Furthermore, when the Spleen is diseased, the lower Child organ also becomes unsettled. If the Child organ is unsettled, it indicates a deficiency of Yang. A deficiency of Yang leads to cold sensations. When the Spleen is diseased, both Blood and Qi become unsettled. When Blood and Qi are not harmonious, alternating chills and fever occur without rest. Therefore, Spleen disease resembles Malaria (Nue). This is said because 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 Mother organ (Heart) above and a Child organ (Lung) below. The Spleen resides in the middle, and its pathology manifests as described. The relationships of other Zang organs follow this same principle.

The Pulse is the precursor of Qi and Blood. When Qi and Blood are abundant, the pulse is vigorous; when they are depleted, the pulse is weak. When Qi and Blood are hot, the pulse is rapid (Shu); when they are cold, the pulse is slow (Chi). When Qi and Blood are faint, the pulse is weak; when they are balanced, the pulse is moderate (Huan). Additionally, tall people have long pulses, and short people have short pulses (Zhao manuscript note: an irritable temperament leads to a tense pulse). An irritable temperament results in a tense pulse, while a gentle temperament results in a relaxed pulse. Deviating from this is considered adverse (Ni), while conforming to it is considered favorable (Cong). Moreover, rapid pulses generally indicate Heat, slow pulses generally indicate Cold, tight pulses generally indicate Pain, floating pulses generally indicate Wind, slippery pulses generally indicate Deficiency, deep-hidden pulses generally indicate Accumulation, long pulses generally indicate Excess, and short pulses generally indicate Deficiency. Furthermore, short, choppy, deep, slow, and hidden pulses belong to Yin; rapid, slippery, long, floating, and tight pulses belong to Yang. Yin pulses matching Yin conditions are compliant (Cong); Yang pulses matching Yang conditions are smooth/favorable (Shun). Violating these rules is adverse. One must judge the situation based on the waxing and waning of Yin and Yang within the meridians. For example, if the pulse at the left hand is rapid, a floating position indicates Heat entering the Small Intestine, while a deep position indicates Heat entering the Heart. The rest can be inferred by analogy.

If the complexion is green but the Right Guan pulse is absent, it indicates the exhaustion of the Spleen. If the complexion is red but the Right Cun pulse is absent, it indicates the exhaustion of the Lung. If the complexion is pale but the Left Guan pulse is absent, it indicates the exhaustion of the Liver. If the complexion is yellowish but the Left Chi pulse is absent, it indicates the exhaustion of the Kidney. If the complexion is dark/black but the Left Cun pulse is absent, it indicates the exhaustion of the Heart. Death occurs with these five types of exhaustion pulses. If they appear at the onset of the disease, death is immediate; if they do not appear at the onset, death occurs within half a year. However, although the five colors may be visible on the face, if the corresponding five pulses are not absent, it is not a case of true exhaustion/death (The following section is missing in the Zhao manuscript).