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Qibo said: The spring pulse corresponds to the Liver, which belongs to Wood in the East and represents the time when all things begin to grow. Therefore, the Qi of the spring pulse arrives soft, light, empty, and slippery, straight and long; thus it is called "Xian" (Cord-like). If it is contrary to this, it indicates disease. If the Qi arrives solid and long, this is called "Excess" (Tai Guo), and the disease is external; if the Qi arrives insubstantial and faint, this is called "Deficiency" (Bu Ji), and the disease is internal.

When the Stomach Qi of the human body is sufficient and the Supreme Harmony (Tai He) overflows, by spring, the Shaoyang (Lesser Yang) Qi generates, and there is no instance that does not correspond to this. Generally, humans inherit Qi from Heaven; since they exist within Yin and Yang, when the Heavenly Qi (seasonal climate) arrives, Human Qi also conforms to it. Thus, all six pulses obey it, thereby governing spring and presenting a Xian character. The Xian pulse is the Qi of Shaoyang Wood in the East, representing the beginning of all things, governed by the Liver in humans. Because the Yang Qi is still young (Shaoyang), its Qi is soft, light, empty, straight, and long; this is the harmony of righteous Qi. Contrary to this indicates disease. Excessive strength is the excess of Xian; insubstantiality and faintness are the deficiency of Xian. Excess implies disease in the exterior, where exterior signifies surplus, often due to external pathogens; deficiency implies disease in the interior, where interior signifies insufficiency, often due to internal injury. The same logic applies to other seasons.

Spring pulse excess causes sudden dizziness, vertigo, and diseases of the vertex (top of the head); its deficiency causes chest pain radiating to the back, and downward, fullness in both hypochondria.

The summer pulse corresponds to the Heart, which belongs to Fire in the South and represents the time when all things flourish and grow. Therefore, the Qi of the summer pulse arrives vigorous and departs weak; thus it is called "Gou" (Hook-like). If it is contrary to this, it indicates disease. If the Qi arrives vigorous and departs vigorous, this is called "Excess," and the disease is external; if the Qi arrives not vigorous but departs vigorously, this is called "Deficiency," and the disease is internal. Excess causes fever and skin pain, developing into spreading sores (Jin Yin); deficiency causes vexation in the heart, upward manifestation of coughing and expectoration, and downward manifestation of Qi leakage (e.g., incontinence or excessive flatus).

The autumn pulse corresponds to the Lung, which belongs to Metal in the West and represents the time when all things are harvested and mature. Therefore, the Qi of the autumn pulse arrives light, empty, and floating, coming urgently and dispersing upon departure; thus it is called "Mao" (Feather-like, noted as Floating in the text). If it is contrary to this, it indicates disease. If the Qi arrives like a feather but firm in the center and void on both sides, this is called "Excess," and the disease is external; if the Qi arrives like a feather but faint, this is called "Deficiency," and the disease is internal. Excess causes rebellious Qi and back pain, with a feeling of oppression; deficiency causes panting, shortness of breath, and cough, with blood appearing from above (hemoptysis) and pathological sounds heard from below.

The winter pulse corresponds to the Kidney, which belongs to Water in the North and represents the time when all things store and hide. Therefore, the Qi of the winter pulse arrives deep and pounding; thus it is called "Shi" (Stone-like). If it is contrary to this, it indicates disease. If the Qi arrives like bouncing stones, this is called "Excess," and the disease is external; if the departure is rapid/numerous, this is called "Deficiency," and the disease is internal.

"Departure is rapid/numerous" refers to the pulse stopping quickly and being hurried, indicating a loss of True Yin, resembling a tight and rapid pulse. However, the more deficient one is, the more rapid the pulse appears; originally, it is not the rapidness caused by strong Yang and excess heat, hence it is described as "like rapid." This demonstrates profound differentiation of pulses.

Winter pulse excess causes lethargy (Jie Jue), spinal pain, shortness of breath, and reluctance to speak; its deficiency causes a sensation of emptiness in the heart as if hungry, coldness in the lateral hypochondrium, spinal pain, lower abdominal fullness, and changes in urination.

The Yellow Emperor said: The order of the four seasons involves variations of compliance and rebellion. But what governs the Spleen pulse alone? Qibo said: The Spleen pulse corresponds to Earth. It is the solitary Zang organ that irrigates the four directions (other organs). A healthy Spleen pulse cannot be distinctly seen; only an abnormal one is visible. If the arrival resembles flowing water, this is called "Excess," and the disease is external; if the arrival resembles a bird pecking, this is called "Deficiency," and the disease is internal. Excess causes inability to lift the limbs; deficiency causes obstruction of the nine orifices, named "Zhong Qiang" (Heavy Rigidity).

The above explains the principle of seasonal pulses. Humans exist within the intersection of Qi, cycling through the Six Qi, experiencing warmth, heat, coolness, and cold, based on growth, flourishing, harvesting, and storing. Thus, the human Zang organs must respond accordingly. For the four seasons, one Zang is highlighted as primary for each, without separate diagnostic discussions for the other four because when the season arrives, the Qi of the four Zang organs follows it. This shows that heavenly timing cannot be violated, and nothing fails to obey the command. The Xian, Gou, Mao, and Shi pulses each reflect their subtle characteristics, relying on the sufficiency of Stomach Qi to achieve harmony. If not so, both excess and deficiency become diseases. Excess of Qi implies external pathogens, hence "disease in the exterior"; deficiency of Qi implies internal injury, hence "disease in the interior." The key lies in the presence or absence of Stomach Qi, which determines success or failure in complying with the seasons. If there is failure, even the regulatory mechanisms cannot save the patient.