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Pulse diagnosis is typically performed in the early morning, when Yin Qi (Yin energy) has not yet stirred, Yang Qi (Yang energy) has not yet dispersed, food and drink have not been ingested, the Jing Mai (Meridians) are not yet full, the Luo Mai (Collaterals) are harmonious and even, and the Qi and Blood are not yet chaotic. Therefore, only at this time can abnormal pulses be diagnosed.

By palpating the movement and stillness of the pulse, observing the clarity of the eyes (Jing Ming), examining the five colors of the face, assessing the excess or deficiency of the Zang Organs (Solid Organs), the strength or weakness of the Fu Organs (Hollow Organs), and the flourishing or declining state of the body, these factors are cross-referenced to determine the division between life and death.

Palpating the pulse's movement and stillness diagnoses the state of Yin and Yang. Observing the clarity of the eyes diagnoses the presence of Shen Qi (Spiritual Energy). Examining the manifestation of the five colors diagnoses the interactions of Five Elements (Wu Xing) generation and restriction, as well as the struggle between pathogenic factors and righteous Qi. Observing the deficiency and excess of the Zang and Fu organs diagnoses internal conditions; distinguishing the flourishing and decline of physical appearance diagnoses external manifestations. Thus, anyone diagnosing illness must combine pulse and color, seeking truth through internal and external cross-reference. In doing so, the true nature of Yin/Yang, interior/exterior, cold/heat will be revealed, and treatments regarding priority, urgency, authenticity, and reversal will not fail, allowing one to decide the division of life and death.

Knowing the difference between ugly and good, knowing the difference between sick and healthy, knowing high and low positions, knowing sitting and standing, knowing walking and stopping—applying these with discipline ensures that the Way of Diagnosis is complete.

All these matters involve principles of opposition; a difference of a hair's breadth leads to an error of a thousand miles. Therefore, the goodness or badness of diseases and the movement or stillness of the form must all be distinguished. Understanding this principle and applying it with discipline makes the methods of diagnosis fully prepared.

The subtlety lies in the pulse, which must not be neglected. Examination must follow a discipline, starting from Yin and Yang. The beginning follows the Jing Mai (Meridians), generating according to the Five Elements (Wu Xing). There is a measure to growth, suited to the Four Seasons. Tonification and Purging (Bu Xie) must not be missed, aligning with Heaven and Earth as one. Grasping the essence of "One" allows one to know life and death.

Yin and Yang, the Five Elements (Wu Xing), and the Four Seasons are inseparable from the correct and incorrect aspects of the pulse; without them, tonification and purging cannot be performed. The "essence of One" refers to the subtlety of the principle that Heaven and Humanity share the same logic. Therefore, knowing the reason behind this is called "obtaining One," which allows one to know human life and death.

There is a Way to hold the pulse, where emptiness and stillness serve as the guarantee.

The terms "emptiness" and "stillness" are crucial for pulse diagnosticians: "Emptiness" means being open-minded and selfless, having no preconceived notions in the mind; "Stillness" means wandering the spirit in solitude, free from any distracting thoughts before you. Only then can abnormal pulses be diagnosed.

In Spring, the pulse floats like a fish swimming in waves; in Summer, it is on the skin surface, abundant like all things in vitality; in Autumn, it sinks below the skin, like hibernating insects preparing to leave; in Winter, it is deep in the bones, like hibernating insects tightly sealed, while gentlemen stay indoors. Thus it is said: Those who understand the interior record by pressing; those who understand the exterior examine from end to start. These six aspects are the great methods of holding the pulse.

Pulses conform to the Four Seasons: Wiry (Xian), Surging (Hong), Hairy (Mao), and Stone (Shi). *Nei Jing* integrates Wei Qi (Stomach Qi) into these descriptions, making them profound and understandable, while also diagnosing both interior and exterior: Internally, Zang Qi and Zang Xiang (Visceral Manifestations) have their places, so they can be recorded by pressing; Externally, Jing Qi and Jing Mai (Meridian Channels) have order, so they can be examined from end to start. Through the methods of the Four Seasons and Interior/Exterior, these six approaches allow one to know the timing of pulse movements and the location of diseases, whether inside or outside.

The inner sides of the Chi position correspond to the Jixie (Hypochondriac region).

This describes the method of palpating the three positions on the radial artery (Qikou).

Ke Yunbo stated: The position of Jixie is at Zhangmen (LR13), wrapping around the abdomen posteriorly and meeting the umbilicus anteriorly, at the boundary of Tianshu (ST25), bound by the Dai Mai (Girdle Vessel). The ancient sages wished to clarify the meaning of Qikou forming the Cun position, intending to divide the Lung pulse into three parts to inspect the Five Zang Organs. They mentioned this sentence first because Qikou alone serves as the master of the Five Zang Organs, and Zang Qi converges at Jixie. The Chi portion of the pulse is like the root of a tree. Jixie wraps around the exterior of the Kidneys; human Yuan Qi resides in the Kidneys, relying entirely on Jixie for containment. Former experts only discussed the pulse meeting at Taiyuan (LU9), failing to examine that Zang Qi meets at Jixie. This is what Zhang Zhongjing meant by "pressing Cun but not reaching Chi." The Classic says: "Those skilled in regulating Chi do not rely on Cun." Here, the inner sides of Chi diagnose Jixie.

The outer side of Chi inspects the Kidneys; the inner side of Chi inspects the Spleen center.

The human body has the back wrapped externally and the chest/abdomen hidden internally relative to the limbs. Thus, the two Kidneys attached to the spine are considered external. The Large Intestine, Small Intestine, Bladder, and Sanjiao (Triple Burner) in the abdomen are considered internal. Therefore, the inner side inspects the abdominal cavity, which includes the Large Intestine, Small Intestine, Bladder, and Mingmen (Gate of Life).

Moving up from the middle attachment: The left outer side inspects the Liver; the inner side inspects the Diaphragm. The right outer side inspects the Stomach; the inner side inspects the Lungs.

Ke Yunbo stated: Moving up from Chi is called Shangfu, referring to the bone anterior to Chi, known as Guan. The Liver is on the left and close to the back, hence inspected externally; the Diaphragm is in the chest, hence inspected internally. Humans have a diaphragm, level anteriorly with Jiutui (CV15) and posteriorly with Quangu, which prevents turbid Qi from the Lower Jiao from ascending to熏 (smoke/burn) the Heart and Lungs, thereby injuring Clear Yang Qi. The Heart and Lungs reside above the diaphragm; the Liver, Spleen, and Kidneys reside below. Qi from the Five Zang Organs pours into the diaphragm. The meridians of the Lungs, Spleen, Kidneys, and Gallbladder penetrate the diaphragm upward; the meridians of the intestines, stomach, heart, kidneys, Pericardium, and Sanjiao descend from the diaphragm. This is the necessary path for the eleven meridians. Yue Ren (Bian Que) discarded this discussion, so later generations did not understand this meaning.

Moving up further: The right outer side inspects the Lungs; the inner side inspects the Chest Center (Xiongzhong). The left outer side inspects the Heart; the inner side inspects the Danzhong (Chest Hall/Pericardium area).

Ke stated: Shangfu refers to the Cun position. The Heart is below the Lungs and centrally located; the Lungs are偏 (biased) to the right, so the Heart is to the left of the Lungs. Both Heart and Lungs are close to the back, hence both are inspected externally. The Chest Center governs Zong Qi (Gathering Qi); Danzhong governs the Ministerial Fire of the Pericardium, located in the middle, hence inspected internally. This is the method of Tianyi inspection in the upper part of the three positions. *Nan Jing* failed to examine that Qikou inspects Yin, pairing the Six Fu Organs with the middle of the three positions, causing the inspection of Chest, Danzhong, Diaphragm, and Abdomen to be discarded.

The front inspects the front; the back inspects the back. "Shang jing shang" (reaching the top of the upper section) concerns the chest and throat; "Xia jing xia" (reaching the bottom of the lower section) concerns the lower abdomen, waist, thigh, knee, shin, and foot.

Yu Jiayan stated: Ancient sages prioritized pulse diagnosis; *Nei Jing* has clear positions. Later generations, noting the exterior-interior relationship between the Heart and Small Intestine, used Yue Ren's words to fix positions. This misunderstands that such pairings discuss disease mechanisms (e.g., Heart heat transferring to Small Intestine or Large Intestine), not fixed anatomical positions.

*Nei Jing*'s statements "Chi inner inspects abdominal cavity, Chi outer inspects Kidneys" exhaust the meaning. Generally, the Chest Center belongs to Yang, and the Abdominal Cavity belongs to Yin. The residue and fluids transmitted by the Large Intestine, Small Intestine, Sanjiao, and Bladder belong in the abdominal cavity, unlike the Stomach which is the sea of water and grain. Clear Qi is above; the Gallbladder is the organ of decision-making, quietly stored in the Liver, serving as the decision-maker for the eleven organs, corresponding to the Middle Jiao. As for the Upper Jiao, layered membranes house only the Heart and Lungs, as described: "Above the diaphragm and huang, there are Father and Mother" (referring to Heart and Lungs). The Large and Small Intestines are turbid/hollow organs, completely distinct from the Clear Yang above the diaphragm. How can one claim that the Clear Yang floating up in Cun represents Fu Organs and sinking represents Zang Organs simply due to external meridian connections? The Classic states "Zhen Zang (True Zang Qi) is higher than the Lungs," meaning Zang Qi is higher than the Large Intestine. Furthermore, if the left floating pulse is the Small Intestine pulse and the sinking pulse is the Heart pulse, it would be like mud in water floating above a lotus flower—is this logical? If Danzhong is the minister, enveloping and connecting below the Heart, entrusting the Heart Sovereign's tongue and mouth functions, descending through the diaphragm to connect with Sanjiao, and dispersing to the Pericardium via the Hand Shaoyang meridian, this shows the mutual transmission between Pericardium Ministerial Fire and Shaoyang Ministerial Fire. The importance of the Pericardium is such that it distinguishes hand meridians and can be called a Zang Organ.

Luo Dongyi stated: Yu's explanation only clarifies the impropriety of positions, not the fallacy of the pulse itself. Let us analyze using the Yin/Yang concepts in *Mai Jing*. It says: Exhalation is governed by Heart and Lungs; inhalation by Kidneys and Liver. Also: Guan front is Yang, governed by Heart and Lungs; Guan back is Yin, governed by Kidneys and Liver. Also: Floating and large/diffuse pulse belongs to Heart; floating and short/choppy pulse belongs to Lungs. Thus, Heart and Lungs govern Yang, appearing at Guan front, floating and associated with exhalation; Kidneys and Liver govern Yin, appearing at Guan back, sinking and associated with inhalation. Yet, in *Mai Jing*, it states: Left Cun Yang excess indicates Small Intestine excess; Yang deficiency indicates Small Intestine deficiency; Yang absence indicates Small Intestine absence; Left Cun Yin excess indicates Shaoyin excess, etc. Since floating/large/diffuse is the Heart pulse, at Guan front, governing Yang, how can its deficiency/excess/absence be classified as Yin? Fabricating Small Intestine deficiency/excess/absence as Yang and adding it to the Heart pulse—what would the Small Intestine's Yang pulse look like, added to the floating/large/diffuse? Moreover, the right pulse is floating/choppy/short, classified as Yin; what would the Large Intestine's Yang pulse look like, yet it is described as deficiency/excess/absence? Throughout *Mai Jing*, there is not a single reference to Large/Small Intestine pulses. Furthermore, for exterior wind-cold, one must check Left Cun, placing Taiyang, Bladder, and Small Intestine together at Left Cun, all above the Heart. These flaws break down without attack, unnoticed only by ignorance.