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Normal heart pulse arrives continuously, like connected pearls, smooth and slippery as if touching a lustrous stone; this is called a normal heart pulse. In summer, the stomach qi (Stomach Qi) serves as the foundation. A diseased heart pulse arrives hurriedly and continuously, with a slight curve within; this is called heart disease. A dying heart pulse arrives with a curve at the beginning and rigidity at the end, like handling a belt hook; this is called heart death.

"Lustrous stone" implies fullness and smoothness like pearls, which is the meaning of a slight hook (Hook Pulse). "Hurriedly and continuously" refers to urgency following one another. "Curve at the beginning" means that upon light palpation, it feels hard and unyielding; "rigidity at the end" means that upon deep palpation, it is firm and immobile, like holding a leather belt hook. It completely loses the harmonious and gentle qi (Harmonious Qi), possessing only the hook quality without stomach qi, hence it is called heart death.

Normal lung pulse arrives gently and softly, like falling elm seeds; this is called a normal lung pulse. In autumn, the stomach qi serves as the foundation. A diseased lung pulse comes neither up nor down, feeling like stroking a chicken feather; this is called lung disease. A dying lung pulse floats like an object adrift or scatters like wind-blown feathers; this is called lung death.

"Gently and softly" describes the appearance of many seedlings growing uniformly. "Like falling elm seeds" describes a light, floating, and slow manner, which is the image of a slight hair (Hair Pulse). "Neither up nor down" indicates rough and stagnant flow. "Like stroking a chicken feather" indicates lightness, floating nature, and emptiness, also signifying much hair quality but little stomach qi. "Like an object floating" indicates emptiness and lack of root. "Like wind-blown feathers" indicates scattering and disarray, also signifying only hair quality without stomach qi.

Normal liver pulse arrives soft and relaxed, like the tip of a long bamboo pole held high; this is called a normal liver pulse. In spring, the stomach qi serves as the foundation. A diseased liver pulse is full, solid, and slippery, like stroking a long pole; this is called liver disease. A dying liver pulse becomes urgent and increasingly stiff, like a newly tightened bowstring; this is called liver death.

Normal spleen pulse arrives in harmony and softness, distinct yet connected, like a chicken treading on the ground; this is called a normal spleen pulse. In late summer, the stomach qi serves as the foundation. A diseased spleen pulse is solid, full, and rapid, like a chicken lifting its foot; this is called spleen disease. A dying spleen pulse is sharp and hard like a bird's beak or claw, like water dripping from a leaking roof in disorder, or like flowing water that does not return; this is called spleen death.

"Soft and harmonious" means dignified and unhurried. "Distinct yet connected" means even, clean, and clear. "Like a chicken treading" means leisurely and slow; this is the meaning of harmonious qi. "Solid, full, and rapid" means strong, urgent, and disharmonious. "Like a chicken lifting its foot" means light, swift, and not slow. The previous section mentioned weak pulse with much stomach qi; here, solid and rapid pulse indicates loss of harmonious qi, thus called spleen disease. Bird beak and claw indicate hardness and sharpness without softness. Leaking roof indicates droplets without order. Flowing water indicates departure without return. These are all strange pulses of spleen exhaustion, possessing only the alternating (Intermittent) quality without stomach qi.

Normal kidney pulse arrives hurriedly and continuously like a hook, firm upon pressure; this is called a normal kidney pulse. In winter, the stomach qi serves as the foundation. A diseased kidney pulse feels like pulling a vine, becoming firmer upon pressure; this is called kidney disease. A dying kidney pulse arrives tense like competing ropes, or strikes like stones being flicked; this is called kidney death.

"Hurriedly and continuously" resembles the hook of the heart pulse, hiding yang within yin, obtaining the meaning of slight stone (Stone Pulse). "Pulling a vine" indicates firmness and connected tension. "Firmer upon pressure" indicates excessive stone quality and disharmony. "Competing ropes" indicates extreme strength and urgency. "Striking stones" reveals its hardness; this is only stone quality without stomach qi.

The true liver pulse arrives urgently, like touching a blade, sounding harsh, like pressing a zither string; with cyan-white complexion lacking luster, death occurs when hair breaks. The true heart pulse arrives firm and beating, like touching coix seeds continuously; with red-black complexion lacking luster, death occurs when hair breaks. The true lung pulse arrives large and empty, like a feather brushing against human skin; with white-red complexion lacking luster, death occurs when hair breaks. The true kidney pulse arrives with interrupted beating, like fingers flicking stones striking sharply; with black-yellow complexion lacking luster, death occurs when hair breaks. The true spleen pulse arrives weak and intermittently rapid and slow; with yellow-cyan complexion lacking luster, death occurs when hair breaks.

Appearance of the true organ pulse indicates death.

Cyan is originally the color of wood; if accompanied by white and lacking luster, it signifies metal overcoming wood. The five organs follow this principle. However, death generally occurs due to broken hair, because the skin and hair are nourished by blood and qi; broken hair indicates failure of essence and qi, hence death ensues.

Ke Yunbo said: The classic states, "If one can combine color diagnosis and pulse diagnosis, one can achieve perfection." This refers to the correspondence between color and pulse. It also states, "A dull and lusterless complexion is called difficult to treat." Now, seeing the color of the affected organ combined with the overcoming color, and naturally lacking luster, indicates non-correspondence between color and pulse. Although it is said that the lungs govern all vessels and transmit essence to the skin and hair, combining hair and vessel essence to reside in the five organs, with qi returning to balance, now broken hair indicates that essence is not transmitted to the skin and hair, and the essence of hair and vessels is not united. This is an easily observable aspect of color diagnosis.

Why is seeing the true organ pulse considered fatal? Qibo said: All five organs receive qi from the stomach; the stomach is the root of the five organs. Organ qi cannot reach the Hand-Taiyin Lung Meridian by itself; it must rely on stomach qi to reach the Hand-Taiyin. Thus, each organ reaches the Hand-Taiyin in its respective season through its own mechanism. Therefore, when pathogenic qi prevails, true qi declines. When illness is severe, stomach qi cannot accompany the organ qi to reach the Hand-Taiyin, so the true organ qi appears alone. Appearing alone means disease overcomes the organ, hence it is called death.

This discussion on true organ pulses highlights the stomach qi as the foundation, which is most explicit and pertinent. Although each of the five organs has its own fundamental qi governing the seasons, it must obtain nourishment from stomach qi for its true organ nature to manifest. For example, the continuous pearls of the heart pulse and the hurried continuity of the kidney pulse describe how the organ obtains stomach qi to form its true nature, thus floating but not excessively floating, sinking but not excessively sinking, urgent but not excessively urgent, slow but not excessively slow, with spirit residing within. This allows it to arrive at the Hand-Taiyin according to the seasons. If it is hurried and continuous as described later, it means pathogenic qi of the five organs prevails while true qi declines. If stomach qi is exhausted, it can no longer reach the Hand-Taiyin independently, nor can it store its spirit, causing the true organ to appear. With the stomach's supply cut off, the true spirit becomes isolated and depleted, hence such ominous signs appear. Therefore, ancient sages regarded observing stomach qi as the foundation for the four seasons and five organs.

Beating with one yang is called Hook; beating with one yin is called Hair; yang prevailing and urgent is called Wiry; yang exhausted and urgent is called Stone; yin and yang interacting is called Sliding.

This describes the correct images of Hook, Wiry, Hair, and Stone pulses as standards for various pulses. The classic states: Taiyang acts as the opening, Yangming as the closing, Shaoyang as the pivot. The three yang meridians must not lose their balance. Beating without floating is named One Yang. This One Yang represents the abundance of yang, i.e., Taiyang, which is the main pulse for the Heart master. Its qi is pure, harmonious, and unified, representing the heart pulse achieving equilibrium. The Hook pulse governs summer, hence beating with one yang is called Hook.

It also states: The three yin meridians must not lose their balance. Beating without sinking is named One Yin. Clarity and stillness belong to yin; not sinking refers to clarity and lightness. During the time when dry metal should be收敛 (astringed/collected), its qi does not sink downward but gradually collects upward, reaching extreme clarity, hence beating with one yin is called Hair. This correctly represents the lung pulse corresponding to the harmony of autumn.

As for the Wiry pulse, it originates from the Jueyin pulse in the yin sector. Jueyin is shaoyang within yin; the nature of wood is to expand. Initially sinking below Jueyin, it contends with Jueyin and rises straight up, hence yang prevails and becomes urgent, resulting in a Wiry pulse. However, what governs spring is solely the command of Shaoyang. When spring generates, wood qi has already emerged, being soft, light, void, straight, and long; this is called the Wiry pulse governing spring. Otherwise, yang prevailing and urgent is precisely the harmful pulse mentioned by Zhang Zhongjing. The original image of the Wiry pulse is thus, hence yang prevailing and urgent is called Wiry.

The Kidney is taiyin within yin, the ultimate depth and slipperiness of water. This represents yang exhausting and failing to arrive, while yin arrives exclusively. When yin arrives exclusively, it beats and sinks, moving and becoming firm, hence it is called Stone.

Regarding the interaction of yin and yang, it refers to the interplay of yin and yang. Various commentators consider this to be the spleen pulse. However, speaking of "Sliding," it is not the correct image of the spleen pulse and cannot be defined as spleen. Yet, its pulse is smooth and not adverse, departing without stagnation, slippery without decline, resembling the Shaoyang pulse. Hence it is called Sliding. The text mentions this to illustrate the interaction of yin and yang. As for the spleen pulse among the five organs, its healthy state cannot be distinctly seen, so it is not specifically highlighted, intending for practitioners to realize it through contemplation.