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The method of pulse diagnosis is usually based on the time of dawn (Pingdan). At this time, Yin Qi has not yet dissipated, Yang Qi has not yet moved, food and drink have not yet entered the body, Blood and Qi are not yet chaotic, and the meridians and collaterals are harmonious and even. Therefore, it is possible to diagnose the pulse of a sick person. If encountering an urgent patient, one does not strictly adhere to this theory. As stated in *Neijing* (*Inner Canon*), holding the pulse requires a method, with emptiness and tranquility as the fundamental guarantee. One must only clarify the spirit, calm the thoughts, regulate the breath, concentrate the mind, observe the clarity of the eyes, examine the five colors of the face, listen to the voice, inquire about the suffering, and only then begin to palpate the Cun (Inch) and Chi (Cubit) positions, distinguishing between floating (Fu, 浮) and sinking (Chen, 沉) pulses, thereby referring to these signs to determine the division between life and death. Furthermore, observe the patient's body length, fatness, or thinness, age, gender, and temperament, which vary greatly. Thus it is said: "When form and Qi match, there is life; when the numbers three, four, and five do not harmonize, there is disease." For example: the pulse of an unmarried woman or nun should be soft (Ru, 濡) and weak; the pulse of infants and children is fine (Xi, 细) and rapid (Ji, 疾); for children aged three or four, seven to eight beats per breath cycle is normal. This is particularly different from adults! Generally, for men, the left hand pulse is examined first; for women, the right hand pulse is examined first. In men, a larger left-hand pulse is favorable; in women, a larger right-hand pulse is favorable.

Generally, in pulse diagnosis, use the middle finger to locate the high bone behind the wrist; below this bone is the Guan (Gate, 关) position. Once the Guan position is found, place the index and ring fingers of both hands simultaneously. If the patient's arm is long, space the fingers widely; if the arm is short, place them closely. With the three fingers steady, first examine the uppermost position called Cun Kou (Cun Port, 寸口). Lightly press to investigate the pulse, moderately press to investigate, heavily press to investigate, push upwards to investigate, push downwards to investigate, push outwards to investigate, and push inwards to investigate. Then examine the Guan and Chi positions similarly. If the pulse in the three positions shows irregularities in floating/sinking, slippery/rough, slow/rapid, what disease does it indicate? Observe the external appearance and color, internally inspect the pulse condition, refer to detailed analysis, and advise faithfully. Do not speak lightly, laugh, gossip, look around, or act carelessly; this is the behavior of a mediocre physician.

The way of pulse diagnosis is difficult for physicians to master. Unless one works hard under the lamp, diligently memorizes, consults teachers and friends, day and night without rest, and keeps this in mind whether awake or asleep, bowing or looking up, how can one know the subtleties of divine medicine? The ancients said: "Palpating the pulse and knowing the disease is called 'Shen' (Divine/Spiritual)," reflecting the wonder of exploring profound mysteries. It is also said: "Cutting the pulse and treating the disease is called 'Qiao' (Skillful)," clarifying the merit of finger differentiation. The distance between the three fingers is merely a hair's breadth, yet the diseases they indicate differ by a thousand miles. Observing this skill of finger differentiation, people naturally find it difficult to achieve the state of 'Shen'.

Examining the classics, the pulse has three positions: Cun, Guan, and Chi. From the Yuji point (L10, 鱼际) to the high bone, moving back one cun is called 'Cun'; one fen above Cun is 'Yuji'; from Cun to the Chize point (LU5, 尺泽) is 'Chi'; the area between Cun and Chi is 'Guan'. Anterior to Guan is Yang, i.e., Cun Kou; posterior to Guan is Yin, i.e., Chi Mai. Yang emerges, Yin enters, with Guan as the boundary. Cun governs the Upper Jiao (Upper Burner), head, hands, and skin/hair; Guan governs the Middle Jiao, abdomen, and waist; Chi governs the Lower Jiao, lower abdomen, and feet. This is the general rule of the three positions. There are also the six pulses of the three positions on both left and right hands; additionally, Renying (ST9, 人迎), Qikou (Lu5, 气口), and Shenmen (HT7, 神门) have different indications. Generally, the position anterior to the Guan on the left hand is called Renying; anterior to the Guan on the right hand is called Qikou; one fen posterior to both Guans is called Shenmen. Thus the praise of pulse methods states: "Liver and Heart emerge from the left, Lung and Spleen from the right; Kidney and Mingmen (Gate of Life) both emerge from the Chi position; Hun, Po, Gu, and Shen are all seen at Cun Kou." Specifically, the position anterior to Guan on the left hand is the region of the Heart; its meridian is Hand Shaoyin (Heart Meridian) and Hand Taiyang (Small Intestine Meridian) as interior-exterior pairs, with the Small Intestine as the Fu organ. The position at Guan on the left hand is the region of the Liver; its meridian is Foot Jueyin (Liver Meridian) and Foot Shaoyang (Gallbladder Meridian) as interior-exterior pairs, with the Gallbladder as the Fu organ. The position posterior to Guan on the left hand is the region of the Kidney; its meridian is Foot Shaoyin (Kidney Meridian) and Foot Taiyang (Bladder Meridian) as interior-exterior pairs, with the Bladder as the Fu organ. The position anterior to Guan on the right hand is the region of the Lung; its meridian is Hand Taiyin (Lung Meridian) and Hand Yangming (Large Intestine Meridian) as interior-exterior pairs, with the Large Intestine as the Fu organ. The position at Guan on the right hand is the region of the Spleen; its meridian is Foot Taiyin (Spleen Meridian) and Foot Yangming (Stomach Meridian) as interior-exterior pairs, with the Stomach as the Fu organ. The position posterior to Guan on the right hand is the region of Mingmen; its meridian is Hand Jueyin (Pericardium Meridian) and Hand Shaoyang (Sanjiao/Triple Burner Meridian) as interior-exterior pairs, with the Sanjiao as the Fu organ. This explains the meaning of the twelve meridians governed by the Zang-Fu organs in the six positions.

Furthermore, *Mai Yao Jing Wei Lun* (*Treatise on the Essential Secrets of Pulse Diagnosis*) states: "The inner sides of the Chi position correspond to the hypochondrium; the outer side of Chi observes the Kidney, the inner side of Chi observes the abdomen; attaching to the middle, the outer side of the left observes the Liver, the inner side observes the Diaphragm; the outer side of the right observes the Stomach, the inner side observes the Spleen; attaching to the upper, the outer side of the right observes the Lung, the inner side observes the Chest Center; the outer side of the left observes the Heart, the inner side observes the Danzhong (Conception Vessel point CV17, 膻中); the front observes the anterior body, the rear observes the posterior body; 'Shang Jing Shang' (reaching the end upwards) corresponds to matters of the chest and throat; 'Xia Jing Xia' (reaching the end downwards) corresponds to matters of the lower abdomen, waist, thighs, knees, and shins. A coarse pulse indicates insufficient Yin and excess Yang, constituting Heat Zhong (Heat in the Middle). A pulse that comes rapidly and goes rapidly indicates excess above and deficiency below, leading to Jue Ni (Reversal Cold) and Dian Ji (Epilepsy/Crazy Disease); a pulse that comes slowly and goes rapidly indicates deficiency above and excess below, constituting E Feng (Aversion to Wind). Thus, Zhong Feng (Wind Stroke) is caused by the invasion of Yang Qi. If the pulse is both deep (Chen, 沉), fine (Xi, 细), and rapid (Shu, 数), it is Shao Yin Jue (Shaoyin Reversal); if deep, fine, rapid, and scattered, it is Han Re (Cold-Heat); if floating and scattered, it is Xun Pu (Fright/Palpitations). All floating and rapid pulses belong to Yang, indicating Heat; if accompanied by restlessness, it is in the Hand meridians. All fine and sinking pulses belong to Yin, causing Bone Pain; if accompanied by stillness, it is in the Foot meridians. A pulse that is rapid, moving, and intermittent indicates disease in the Yang pulse categories. For diarrhea and dysentery with pus and blood, a rough (Se, 涩) pulse indicates excess Yang Qi; a slippery (Hua, 滑) pulse indicates excess Yin Qi. Excess Yang Qi manifests as body heat and no sweat; excess Yin Qi manifests as profuse sweating and cold body; excess of both Yin and Yang manifests as no sweat and cold body. Pushing outwards, if the pulse energy is internal and not external, there is accumulation in the heart and abdomen; pushing inwards, if the pulse energy is external and not internal, there is heat in the body; pushing upwards, if the pulse energy goes up but not down, the waist and feet are cold; pushing downwards, if the pulse energy goes down but not up, there is headache and neck pain. Pressing to the bone, if pulse energy is scarce, there is lower back/spine pain and Bi Syndrome (Obstruction). Regarding the aforementioned diseases, unless one has clear insight, how can one achieve such subtlety?"

Furthermore, *Ping Ren Qi Xiang Lun* (*Treatise on the Manifestations of Normal People*) states: "With one exhalation, the pulse moves twice; with one inhalation, the pulse also moves twice. Between the completion of breath cycles, the pulse moves five times, which is called Ping Mai (Normal Pulse). The pulses of the four seasons are all rooted in Stomach Qi, described as Spring String-like (Xian, 弦), Summer Surging (Hong, 洪), Autumn Hairy (Mao, 毛), and Winter Stone-like (Shi, 石). The Stomach Qi pulse in Spring, slightly string-like, is called Normal. The others follow this pattern. Violating the four seasons indicates disease. When diagnosing women's pulses, if pregnant, one must not indiscriminately administer decoctions or powders. In women, if the Shaoyin pulse beats vigorously, it indicates pregnancy; it is also said: if Yin pulses beat against Yang, it indicates pregnancy; it is also said: if the body sweats and there is no pulse, it indicates pregnancy. Generally, for pregnant women, ask about menstruation, observe physical appearance, and then treat; this cannot be ignored. Also, the classics say: Inspect color and palpate pulse, first distinguish Yin and Yang; Yin and Yang are the Way of Heaven and Earth. Therefore, those who treat diseases must seek their root, which lies in Yin-Yang, Cold-Heat, and the Four Seasons, the foundation of the Five Zang Organs. Speaking of pulses, this refers to Floating and Sinking; speaking of positions, this refers to Cun and Chi. Thus the classics say: Pulses are the method of Yin-Yang, corresponding to the Five Zang Organs. Exhalation comes from Heart and Lung; inhalation returns to Kidney and Liver. Between breaths, the Spleen receives grain flavors, and its pulse is in the Middle. Discussing Floating and Sinking: Floating is Yang, Sinking is Yin. Corresponding to Fu organs, a floating, large, and scattered pulse belongs to the Heart; a floating, short, and rough pulse belongs to the Lung; thus Heart and Lung are both Floating. Firm and long belongs to the Liver; pressing reveals largeness, lifting feels solid belongs to the Kidney; thus Liver and Kidney are both Sinking. Slow, moderate, and long belongs to the Spleen; Spleen is the Central State, thus the pulse is in the Middle. Zhang Zhongjing said: Large, Floating, Rapid, Moving, Slippery are all Yang pulses; Deep, Rough, Weak, String-taut, Minute are all Yin pulses. Yang represents Heat, Yin represents Cold. Thus, Cold results in a deep and slow pulse; Heat results in a floating and rapid pulse. Therefore, it is said: All rapid pulses indicate Heat, all slow pulses indicate Cold; there is no more accurate verification than this. *Mai Jing* (*Pulse Classic*) says: All floating pulses indicate Wind, all tight pulses indicate Pain, all hidden pulses indicate Accumulation, all string-taut pulses indicate Fluid Retention, Knife-blade (Kou, 芤) pulse indicates Blood Loss, Long pulse indicates Qi Regulation, Short pulse indicates Qi Disease, Rough pulse indicates Vexed Heart, Large pulse indicates Disease Progression, Floating indicates Exterior, Deep indicates Interior, Slow indicates Zang, Rapid indicates Fu. Additionally, a robust body with a fine pulse and shortness of breath is critical; a emaciated body with a large pulse and excessive chest Qi leads to death. When form and Qi match, there is life; when the numbers three, four, and five do not harmonize, there is disease; when all three positions and nine inspections are discordant, there is death. This is the great method of pulse diagnosis by the sages. Therefore, it is said: In treating any disease, inspect form, Qi, color, and luster; treatment need not wait for specific timing. Thus, when form and Qi match, there is life; when color and luster are floating/lustrous, the disease is easy to cure; when the pulse follows the four seasons, it is treatable; when the pulse is weak yet seems slippery, there is Stomach Qi; these are all easy to treat. If form and Qi are discordant, or color is dull and lacking luster, or the pulse violates the four seasons, or the pulse is full and becomes harder, these are untreatable. The classics say one must examine the four difficulties and clearly inform the patient. Also, if heat disease presents with a quiet pulse, diarrhea with a large pulse, blood loss with a full pulse, or agitation after sweating, these are all difficult to treat. For patients with sores and carbuncles, with massive discharge of pus and blood, if the pulse is slippery and rapid, it is difficult to treat; if there is much pus, or like clear rice water, with a slippery, large, and scattered pulse, accompanied by chills, fever, and thirst, treatment will be ineffective. If suffering from Lung Abscess, with coughing up pus and blood, and the pulse appears surging and slippery, recovery is difficult. Generally, if the pulse is floating and rapid, one should expect fever but instead experiences aversion to cold; although there is stiffness in the head and neck, irritability and pain in the limbs, or even trembling and severe thirst, if there is a painful area, it indicates the impending development of a sore or swelling."