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The statement "where there is this disease, there is this pulse" is a generalization. Its subtle nuances cannot necessarily be relied upon solely by pulse diagnosis (Qiezhen, cutting the pulse). For instance, in eye diseases (Mubing), one must observe whether it is an internal obstruction (Neizhang) or an external obstruction (Waizhang).

Internal obstructions have their own symptoms, and external obstructions have theirs. One must clearly distinguish which symptom pattern it is, the depth of the injury, and precisely which wheel (Lun, referring to the Five Wheels theory in ophthalmology) and area it affects. Only after clear differentiation can treatment be appropriate. Nowadays, women in secluded quarters and families of high status merely extend their hands outside the curtains; the physician takes the pulse and immediately intends to treat the disease, demanding that the medication be effective and act quickly. They do not realize that even physicians who specialize in pulse diagnosis emphasize inspection (Wang), listening/smelling (Wen), and inquiry (Wen) before palpation (Qie). Pulse diagnosis alone is merely considered a skill. Moreover, severe conditions concern life and death; relying solely on such skills to hit the mark is to slight life itself. One must examine and differentiate with precision and detail before treating. Those who value life should agree with this statement. How much more so since the eyes are the most important among the five sense organs? Suppose a blind person hides within the curtains and extends their hand outside; their six pulses would not differ from those of a person with sight. From which pulse can a practitioner know they are blind? Even a master of pulse diagnosis would find it difficult to ascertain. How could junior practitioners achieve such subtlety? They would inevitably resort to guessing and speculation, and the medications prescribed would also be based on speculation. To expect them to be accurate and quick-acting is truly difficult. Comparatively speaking, among two types of errors, the patient's self-mismanagement is even more severe. Here, I specifically highlight these flaws: one must look carefully in addition to taking the pulse to avoid mistakes.

I again said to Huizi: "Previously, a guest asked my father, 'It is the same disease, the symptoms are identical, why do you treat them differently and use different medicines? Why does efficacy vary—some fast, some slow, some cured, some not? Some are treated, while others are refused treatment. What is the reason?' My father replied upon hearing this: 'Ancient skilled physicians first mastered their profession and then understood human affairs. They acted according to circumstances, were flexible and adaptable, did not stick to one corner, and did not adhere rigidly to one formula. You say I treat the same disease differently; you do not realize that human circumstances vary greatly. There are men and women, infants and virgins, widowers and widows, the elderly and the weak, monks, nuns, maidservants, and relatives. Additionally, there are pre-natal and post-natal states, gentle or violent temperaments, varying amounts of diet, unobstructed or obstructed urination and defecation, the cold, heat, warmth, and coolness of the four seasons, the deficiency-excess and cold-heat nature of diseases, the duration and depth of the illness, whether one can or cannot maintain abstinence, and whether medication has damaged the primordial Qi (Yuanqi). These forms are myriad and countless. How can treatment be uniform? Furthermore, the paths of the rich and the poor differ. Generally, wealthy people have happy minds and proud dispositions; they may not abstain from alcohol and lust, worry over household affairs, or suffer liver injury from violent anger, causing fire in the five zang organs to flare up. Moreover, they entrust decoction to servants, leading to improper heat control, making it hard to achieve efficacy. As for the poor, their minds are bitter, their bodies laborious; they may suffer from worries about food and fuel or injuries from anger. Their financial resources for medicine may be insufficient, making it even harder to cure their ailments. The reason I treat the same symptoms differently is precisely due to these factors. Reflecting on my father's words, one indeed should not be confined to one aspect nor rigidly adhere to one formula. However, advising others to abstain from alcohol, lust, labor, and anger for other diseases is relatively easy; for eye diseases, it is difficult. In other diseases, the body feels weak and limbs tired, making distracting thoughts less likely. But in eye diseases, the body is strong, yet thoughts are easily stirred. Once stirred, essence flows out through the orifices. Heaven and Earth regard the sun as Yang and rain as Yin; humans regard fire as Yang and water as Yin. Stillness generates Yin, movement generates Yang. Does not generating Yang mean generating fire? Anger is also one of the Seven Emotions (Qiqing) and most easily injures the Liver. When the Liver is injured, the eyes are inevitably damaged because the Liver opens into the eyes. Indulging in alcohol boosts Yang, stirs damp-heat, and scorches Yin; indulging in lust is key to injuring the Kidney. All organs and bowels in the human body contain fire, restrained only by a drop of Kidney Water. How can one be negligent? Mr. Danxi stated, 'When the Minister Fire (Junhuo) of the Heart moves, the Ministerial Fire (Xianghuo) arises; even without sexual intercourse, essence secretly flows.' There are also ignorant men and women who, suffering from eye disease, do not cherish themselves, claiming this is a way to vent fire. I believe this is not removing fire but adding firewood to a blaze. The fire will not extinguish, but the flames will intensify. If those with eye diseases do not understand this, mild cases become severe, and severe cases become incurable, all due to this. Practitioners of this specialty should use words to warn them deeply.'"