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The pulse of spring is Xian (String-like). Its arrival is soft, weak, empty, and slippery, straight and long; this is called Xian. If it is contrary to this, it indicates disease. If its arrival is solid and strong, it is called "Excess" (Tai Guo), indicating disease in the exterior. If its arrival is not solid but faint, it is called "Deficiency" (Bu Ji), indicating disease in the interior. Excess causes one to be prone to forgetfulness, mental confusion, dizziness, and disorders of the head and vertex. Deficiency causes chest pain radiating to the back and fullness in both hypochondriac regions.

The pulse of summer is Gou (Hook-like). Its arrival is vigorous while its departure is weak; if contrary to this, it indicates disease. If its arrival is vigorous and its departure is also vigorous, this is called "Excess," indicating disease in the exterior. If its arrival is not vigorous but its departure is relatively vigorous, this is called "Deficiency," indicating disease in the interior. Excess causes body heat and skin pain, manifesting as dampness infiltration. Deficiency causes vexation and anxiety, with coughing and expectoration appearing above, and Qi leakage (such as enuresis or flatus) below.

The pulse of autumn is Fu (Floating). Its arrival is light, empty, and floating; its arrival is rapid while its departure is scattered; thus it is called Fu. If contrary to this, it indicates disease. The Yellow Emperor asked: How is it contrary? If the arrival feels like a feather but is firm in the center and empty on both sides, this is called "Excess," indicating disease in the exterior. If the arrival is feather-like and faint, this is called "Deficiency," indicating disease in the interior. Excess causes rebellious Qi and back pain, with a feeling of oppression. Deficiency causes panting, shortness of breath, and coughing, with blood appearing due to rebellious Qi, and pathological sounds audible below.

The pulse of winter is Ying (Surging/Deep). Its arrival is deep and broad, thus it is called Ying. If contrary to this, it indicates disease. If the arrival feels like throwing stones, this is called "Excess," indicating disease in the exterior. If the departure is rapid, this is called "Deficiency," indicating disease in the interior. Excess causes muscle relaxation (Xie Ji), pain in the spinal meridians, shortness of breath, and reluctance to speak. Deficiency causes a sensation of the heart hanging empty, as if suffering from hunger, coldness in the lateral costal region, spinal pain, lower abdominal fullness, and changes in urination.

The Spleen has no "auspicious pulse" (perfect pulse); only "inauspicious pulses" (abnormal pulses) are seen, because the Spleen pulse is primarily characterized by harmony and moderation. Therefore, although the pulses of the four seasons differ—Spring Xian, Summer Gou, Autumn Mao (Feather-like), Winter Ying—they must all contain the characteristic of the Spleen pulse. If the Spleen pulse characteristics are absent, it means the True Pulse of the Zang organs is revealed. When the True Pulse is revealed, death ensues. Thus, saying the Spleen has no auspicious pulse means that its normal pulse is itself an auspicious sign. Both Excess and Deficiency are pathological pulses. Excess causes the limbs to be unable to move; its pulse flows like water, which is Excess, caused by excessive Dampness. Deficiency causes the nine orifices to be obstructed, named "Zhong Qiang" (Heavy Stiffness); its pulse is like a bird pecking, which is Deficiency, caused by the failure of Earth Qi to function. When Dampness is excessive, the pulse flows like water, and pathogenic factors injure the Kidney. When Earth Qi fails to function and the nine orifices are obstructed, it is because it is constrained by Wood. Wood constraining leads to the Spleen being harmed by Water. Due to the obstruction of the nine orifices, diseases such as edema, swelling, and fullness often arise, eventually forming fluid retention.