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The superficial manifestation of a floating pulse has been discussed above. Why does this floating pulse occur? This is because pathogenic factors invade the exterior, and the Yang Qi responds by emerging to the exterior to resist the pathogens; consequently, the pulse floats outward following the Yang Qi. From this, we can deduce that where the pathogen resides, there is the Yang Qi; and where the Yang Qi resides, there is the disease. Therefore, wherever the pulse is located, the disease is also located there. For instance, if the pulse is in the Three Yang meridians, the disease is also in the Three Yang meridians; if the pulse is in the Three Yin meridians, the disease is also in the Three Yin meridians.

Yi. "Man Imitates the Earth"

When discussing the meaning of Taiyang (Taiyang, one of the Six Meridians, governing Cold-Water and occupying the highest position), we mentioned that Taiyang governs Cold-Water and its position is supreme. According to Laozi's teaching, when discussing human issues, one should always connect them with the Earth. So, on this Earth, what place can be considered the highest? Naturally, it is the Himalayas. The Himalayas are the highest mountain range in the world, and Mount Everest, located on the border between China and Nepal, has an altitude of 8,848 meters, making it the highest peak in the world. The peak is covered with snow all year round; its height is evident, its coldness is evident, and its association with water is evident. Following the principle of "Man Imitates the Earth" from *Laozi*, if one were to seek evidence of Taiyang Cold-Water on Earth, this evidence would undoubtedly be found in the Himalayas and Mount Everest. This is the place most corresponding to Taiyang. Why does Taiyang disease first mention a floating pulse? The reason lies here as well. In terms of pulse momentum, the floating pulse is also at the highest position. Thus, high corresponds to high, and the floating pulse becomes the primary evidence for Taiyang disease (a condition caused by wind-cold pathogenic factors invading the body's exterior).

Bing. Taiyang Emphasizes the Pulse

The titles of the chapters on the Six Meridian diseases all emphasize pulse differentiation, presenting a trinity of disease, pulse, and symptoms. However, if we approach from the outline clauses, i.e., pathogenesis clauses, we find that among the Six Meridian diseases, Taiyang disease and Shaoyin disease particularly emphasize this pulse aspect. The outline clauses for Taiyang and Shaoyin diseases begin by discussing the pulse: Taiyang presents with a "floating pulse," while Shaoyin disease (a condition caused by deficiency of Heart-Kidney Yang and internal excess of Yin-Cold) presents with a "thready and fine pulse." The outline clauses for the other four meridians do not mention the pulse. This emphasis on the pulse in the outline clauses of Taiyang and Shaoyin indicates that in the differentiation and treatment of Taiyang and Shaoyin diseases, the pulse often plays a decisive role, delivering the final verdict. For example, Clause 42 of the Taiyang chapter states: "In Taiyang disease, if the external manifestations have not resolved and the pulse is floating and weak, it should be resolved through sweating, using Guizhi Tang (Cinnamon Twig Decoction)." Clause 52 states: "If the pulse is floating and rapid, sweating may be induced, using Mahuang Tang (Ephedra Decoction)." Clause 323 of the Shaoyin chapter states: "In Shaoyin disease, if the pulse is deep, urgent warming is required, using Sini Tang (Frigid Extremities Decoction)." Of course, the application of Guizhi Tang is not limited solely to a "floating and weak pulse," nor is Mahuang Tang limited to a "floating and rapid pulse," nor is Sini Tang limited to a "deep pulse." However, from this structure of the clauses, we should see that the pulse is decisive; the pulse is the "key" of the clause. Such situations are rare in other meridians. We rarely see statements like: "If the pulse is wiry, use Xiaochaihu Tang (Minor Bupleurum Decoction)" or "If the pulse is large, use Baihu Tang (White Tiger Decoction)." This shows that pulse characteristics have considerable specificity in Taiyang and Shaoyin diseases. Why does Taiyang and Shaoyin have such a special relationship with the pulse? From the previous explanation of the pulse, we know that the pulse is formed by the union of Water and Moon; "Yang added to Yin is called the pulse." Without Yin-Water, the pulse cannot form; without Yang-Fire, the pulse cannot move. Thus, one Water and one Fire, one Yin and one Yang, constitute the key elements of the pulse. Taiyang governs Water and is the Taiyang within Yang; Shaoyin is the repository of Water and Fire. The meaning of Tai-Shao (Taiyang and Shaoyin) fits perfectly with the meaning of the pulse. Hence it is said: The pulse combines with Taiyang, the pulse combines with Shaoyin. From this, we also know that changes in the pulse best reflect changes in Taiyang and Shaoyin.

Ding. Reflections on "The Lungs Direct All Pulses"

After clarifying the special relationship between the pulse and Taiyang, and the pulse and Shaoyin, we now turn to the issue of the pulse and the Lungs. *Suwen: Chapter on Distinct Discussions of Meridian Qi* states: "Meridian Qi returns to the Lungs; the Lungs direct all pulses." Regarding this "Lungs direct all pulses," *Basic Theory of Traditional Chinese Medicine* explains it from the perspective of assisting the Heart in circulating blood. Explaining from this angle requires linking it to modern pulmonary circulation, or the "small circulation." After passing through systemic circulation, blood oxygen is depleted; the right ventricle injects this deoxygenated venous blood into pulmonary circulation, where sufficient gas exchange occurs, after which it enters the left heart via pulmonary veins and then re-enters systemic circulation. Thus, every portion of blood in the body must pass through pulmonary circulation and undergo gas exchange here. Only after this process does blood flow to various parts of the body. In this sense, "the Lungs direct all pulses" is easy to understand. However, such an understanding raises another question: How did the ancients know of this "pulmonary circulation"? How did they know "the Lungs direct all pulses"? Was it based on experiments or rational thinking? On the other hand, regarding the original meaning of the pulse, as mentioned earlier, the pulse is formed by the union of Water and Moon. We clearly understand the meaning of Water; the meaning of the Moon was discussed above. *Shuowen Jiezi* states: "The Moon is the essence of Great Yin." *Huainanzi: Treatise on Astronomy* states: "The essence of Water Qi is the Moon." The essence of Great Yin is the Moon, and the Lungs govern Great Yin; the essence of Water Qi is the Moon, and the Lungs are the upper source of Water. From the relationship between the Lungs and Water, and the Lungs and the Moon, the Lungs fully possess the nature of Water-Moon union, i.e., they fully possess the nature of the pulse. Why does *Suwen* say "the Lungs direct all pulses"? Why does *Nanjing* take only the "Cunkou" (Radial Artery at the wrist), governed by the Lungs, for pulse diagnosis? This is obviously related to the aforementioned nature of the Lungs. This discusses the relationship between the pulse and the Lungs from another traditional perspective. In the past, studying *Basic Theory of TCM*, I could not comprehend the statement "the Lungs are the upper source of Water." How could the Lungs be the "upper source of Water"? In the summer of 1996, when I first visited the West; when I first saw snow-capped high mountains; when I first saw snow water from high altitudes flowing down rapidly and turbulently into the Jinsha River, my doubts suddenly dissolved. Is this not the "upper source of Water"? At this moment, one truly understands the ancients' saying: "Read ten thousand books, travel ten thousand miles." Is reading alone enough without traveling? No! Reading is learning, traveling is thinking; "Learning without thinking leads to confusion." Therefore, "traveling ten thousand miles" is also very important. Only then do you feel why Laozi emphasized: "Man imitates the Earth, Earth imitates Heaven, Heaven imitates the Dao, and the Dao imitates Nature." These four imitations of Laozi constitute the true holistic view. The characteristic of TCM is the holistic concept and syndrome differentiation and treatment. Many people claim to understand this holistic concept, but if one does not grasp Laozi's "four imitations," the holistic concept cannot truly be realized in your practice. If you only place TCM within the circle of humans, or only combine it with some modern medical concepts, many problems will remain unclear, and you will always feel uneasy about this theory. But once you place it in Heaven and Earth, in Nature, many problems are solved easily. You will also feel the theory is substantial and reliable. *Suwen: Golden Cabinet True Word Discussion* states: "The North generates Cold, Cold generates Water." Water originally belongs to the North; how does it now relate to the West? This involves two issues: one is the issue of mutual generation, "Metal generates beautiful Water" originates from here. We will discuss this specifically below. The other is the issue of Pre-Heaven and Post-Heaven. Observing the Pre-Heaven and Post-Heaven Bagua systems of Yi, in the Post-Heaven Bagua, Kan Water occupies the due North. Therefore, our knowledge that "the North generates Water, Water belongs to the North" is discussed from the Post-Heaven perspective. What about Pre-Heaven? In the Pre-Heaven Bagua, Kan Water does not occupy the North; it occupies the due West Metal position. Kan Water residing in the West exactly illustrates the sources of the Yangtze and Yellow Rivers; it exactly corroborates the statement "the Lungs are the upper source of Water." Thus, the relationship between West Metal and Water, and the Lungs being the upper source of Water, are all discussed from the Pre-Heaven perspective. Pre-Heaven is Substance, Post-Heaven is Function; Pre-Heaven is Source, Post-Heaven is Flow. One Substance and Function, one Source and Flow; these are all issues worth noting in our study of TCM. *Yi Yuan: Essay on Man as a Small Heaven and Earth* states: "In the human body, the Lungs are the Canopy, occupying the highest position." The Lungs belong to Metal; among the Five Elements, Metal has the heaviest quality. Why does this heaviest Lung, in terms of attributes, instead occupy the position of the "Canopy"? Why are most high-altitude mountain ranges located in the West? These are profound questions; reflecting on them will certainly help us understand TCM and the entire traditional culture. The Lungs occupy the Canopy position, the Lungs are the upper source of Water, the Lungs direct all pulses; the principles concerning the Lungs align closely with the connotations of Taiyang. Why do Lung-related diseases occupy a significant portion of the Taiyang chapter? One important factor lies here. Therefore, when considering the Zang-Fu significance related to Taiyang, we cannot limit ourselves to Foot-Taiyang Bladder and Hand-Taiyang Small Intestine. Professor Subrahmanyan Chandrasekhar, an Indian-American astrophysicist and 1983 Nobel Laureate in Physics, wrote in his book *Shakespeare, Newton, and Beethoven: The Pattern of Creative Activity*: "Sometimes we apply the same kind of thought to various problems, which at first glance may seem completely unrelated. For example, the basic concepts used to explain the motion of microscopic colloidal particles in solution (i.e., Brownian motion) can also be used to explain the motion of star clusters. Realizing this fact is astonishing. The fundamental consistency of these two types of problems—which has profound implications—is one of the most surprising phenomena I have encountered in my life." After seeing this wonderful exclamation by Professor Chandrasekhar, do you also feel equally astonished when we link the sources of the Yangtze and Yellow Rivers, the Tanggula Mountains, the Himalayas, with seemingly unrelated issues such as "the Lungs are the Canopy" and "the Lungs are the upper source of Water"?

Wu. The Highest Good is Like Water

Before concluding the discussion on the outline "Floating Pulse," we wish to follow the above line of thought and discuss a bit more about Water. *Laozi, Chapter 8* states: "The highest good is like Water. Water benefits all things without contending, dwelling in places that others disdain; thus it is close to the Dao." Why did Laozi use Water to metaphorize the most excellent thing in his mind? It is precisely because although Water is born noble and benefits all things, it does not contend with objects, yet dwells in places that others disdain. What are the places that others disdain? This is the lowest position. People always yearn for heights; those in officialdom want promotion, scholars want to stand out, and business millionaires aspire to become tens of millions or hundreds of millions. Look at these nobly born princes and young masters; isn't everyone superior to others? Who is willing to dwell below others? Those who can demand of their descendants as Zeng Guofan did are too few. If officials could truly act as public servants of the people as their slogans proclaim, that would indeed be remarkable. Human greed makes it difficult to do so; this is not "close to the Dao." Not close to the Dao means going against the Dao; how can something contrary to the Dao last long? The ancients said: Wealth does not pass three generations. This is reasonable. Even Li Ka-shing cannot escape this. Because humans find it hard to be "close to the Dao." It is hard to have habits like Water. Without such habits, how can one have a long history and broad influence? Being wealthy for three generations is already good enough. Looking at Water in the human body, the Kidneys govern Water; the Kidneys are the Water repository. Among the Five Zang Organs, the Kidneys are in the lowest position, while the bloom of the Kidneys is in the hair, which is in the highest position of the human body. One supreme, one lowest; the profound meaning of Water is fully manifested. Mr. Yue Meishan, referencing ancient principles, liked to use a single-herb Poria Drink to treat hair loss. Previously, this was incomprehensible; today, viewing it from the distribution of Water, it is no longer strange.

(2) Stiffness and Pain of the Head and Neck

Jia. The Position of Taiyang Governs the Head and Neck

The position of Taiyang is supreme. As mentioned earlier when discussing the floating pulse, the floating pulse is also the highest pulse in terms of position. Here, discussing the head and neck, the head and neck are again the highest position in the human body. Therefore, besides explaining mechanisms, TCM also looks at correspondences; correspondence is also an important aspect. All Six Meridians can have headaches, but why do only the outline clauses for Taiyang mention this headache? This is clearly because correspondence plays an important role.

Yi. The Neck is the Exclusive Domain of Taiyang

The term "Neck" (Xiang), explained in *Shuowen*, is: "The back of the head." *Shiming* says: "Firm, the place where the pillow rests firmly." Physicians mostly refer to the back of the neck as Xiang. There is no doubt that the position of Xiang is at the back, but the specific segment at the back described above is somewhat vague. So, where is the exact position of Xiang best defined? Everyone touch the depression under the occiput; this depression is like the mouth of a river, where snow water from high mountains flows into the river. I believe this place should be the true location of Xiang. Xiang extends appropriately up and down from this center. Taiyang governs Water; Foot-Taiyang Bladder Meridian starts at Jingming, goes up the forehead to intersect at the vertex, and then descends to the neck. Therefore, Wu Renju said: "The neck is the exclusive domain of Taiyang." Headaches of Taiyang often extend to the neck; this is a significant characteristic of Taiyang headaches. Other headaches generally do not extend to the neck. Besides mentioning headache and neck pain, the term "stiffness" (Qiang) is added. The opposite of relaxed and gentle is stiffness; therefore, the stiffness and pain of the head and neck in Taiyang also includes the aspect of the neck being unrelaxed and ungentle. This is mainly related to Cold Qi; objects become tight when encountering cold and relaxed when encountering warmth. On the other hand, the symptom of neck stiffness appears in the Nineteen Pathogenesis Mechanisms, namely: "All spasms and neck stiffness belong to Dampness." The neck is the mouth of the river; the mouth of water must be controlled by Earth. Therefore, apart from being related to Taiyang, neck stiffness is also related to Taoyin Earth-Dampness. Today, we see many cases of "cervical spondylosis" with neck stiffness; these can be considered for treatment from Taiyang and Taoyin perspectives.

(3) Aversion to Cold

Jia. The Primary Symptom

When the exterior is invaded by pathogens, the opening mechanism of Taiyang must be obstructed, hindering the outward movement of Yang Qi, preventing it from nourishing the muscle surface, thus resulting in aversion to cold. This aversion to cold is also known as Exterior Cold; it is not entirely the same as the cold of weather. This aversion to cold is of great significance for proving that the body suffers from an Exterior Syndrome and that the Taiyang system is invaded by pathogens. Therefore, the ancients said: "For every point of aversion to cold, there is a point of Exterior Syndrome." Upon seeing aversion to cold, one should consider treating from the Exterior, from Taiyang.

Yi. Emphasis on Subjective Feeling