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Spring pulse is wiry (Xian), summer pulse is surging (Hong), autumn pulse is floating/misty (Mao), winter pulse is deep/stony (Shi), and the pulse during late summer and the transition of seasons is slow and moderate.

Exhalation reaches the Heart and Lungs, inhalation reaches the Kidneys and Liver; between breaths, the Spleen receives the essence of grains, and its pulse position is in the middle. The pulses of the Heart and Lungs are both superficial (Fu); among them, superficial and large/scattered indicates the Heart pulse, while superficial and short/choppy indicates the Lung pulse. The pulses of the Kidneys and Liver are both deep (Chen); among them, firm and long indicates the Liver pulse, while soft/relaxed with a solid incoming force indicates the Kidney pulse. The Spleen resides in the central region (Earth element), and its pulse position is in the middle.

This refers to what was previously mentioned as the pressure of three beans or five beans.

The Cun (Inch) position is Yang, located at the upper part, primarily governing the area from the head and neck down to the chest and heart. The Guan (Bar) position is in the middle of Yin and Yang, belonging to the middle section, primarily governing the area of the umbilicus, abdomen, and hypochondrium. The Chi (Cubit) position is Yin, located at the lower part, primarily governing the waist, feet, shins, and thighs. Within these three positions, each has three levels of palpation: superficial (Fu), middle (Zhong), and deep (Chen). Three times three equals nine examinations (Jiu Hou). Superficial palpation primarily examines the skin, indicating exterior conditions and Fu organ diseases; middle palpation primarily examines the muscles, indicating Stomach Qi; deep palpation reaches the sinews and bones, indicating interior conditions and Zang organ diseases.

In all methods of pulse diagnosis, one must first regulate one's own breathing. For men, diagnose the left hand; for women, the right hand. First, use the middle finger to locate the Guan position, then place the index and ring fingers simultaneously before and after it. Initially, press lightly to observe the pulse, then press moderately to observe it, and finally press heavily to observe it. Then, investigate each position sequentially from Cun, Guan to Chi. In one exhalation and inhalation cycle, four pulse beats are considered normal. Occasionally, with a deep sigh (Tai Xi), five beats occur, which is also considered a normal pulse (Ping Mai). If the pulse is excessive or deficient, it is a pathological pulse; depending on which position it appears in, judge the condition according to that specific position.

When diagnosing the pulse, one must first understand seasonal pulses. Understand the normal pulses of the Stomach and the Zang-Fu organs before identifying pathological pulses. Seasonal pulses refer to: in the three months of spring, all six positions carry a wiry quality; in summer, all carry a surging quality; in autumn, all carry a floating quality; in winter, all carry a deep quality. The Stomach pulse refers to a pulse that feels harmonious and moderate when pressed moderately. The normal pulses of Zang and Fu organs have been seen in previous chapters. When a person's Zang-Fu pulses are harmonious, the Stomach pulse is moderate, and it corresponds to the seasonal pulse, they are disease-free; the opposite indicates illness.

During pulse diagnosis, if the arm is long, space the fingers wider; if the arm is short, place the fingers closer together. Within the three positions, if the size, depth, speed, and frequency are equal, the Yin-Yang height of Cun and Chi matches, the strength of left and right corresponds to gender norms, and the seasonal pulse does not contradict the season, this is called a "Ping Ren" (healthy person). If any single position is distinctly larger or smaller, slower or faster, if left and right strengths oppose each other, or if the pulse contradicts seasonal or gender norms, these are all pathological pulses. Diseases manifesting in the upper part are called upper diseases; in the lower part, lower diseases; on the left, left diseases; on the right, right diseases. Disharmony in the left pulse indicates disease in the exterior, Yang, governing the four limbs; disharmony in the right pulse indicates disease in the interior, Yin, governing the abdominal organs. Deduce accordingly.

The principles of taking the pulse vary; the shapes of pulses are also diverse.

Pulses never arrive singly; they are described as floating and wiry, floating and rapid, deep and tight, deep and thin, etc. How to distinguish them? Generally, the key categories do not exceed the six pulses: Floating (Fu), Deep (Chen), Slow (Chi), Rapid (Shuo), Slippery (Hua), and Choppy (Se). Floating and Deep pulses are obtained by light and heavy pressure, respectively. Slow and Rapid pulses are determined by counting beats per respiration. Slippery and Choppy pulses are distinguished by observing the shape of the flow. Floating is Yang, obtained with light pressure; Kun, Hong, San, Da, Chang, Ru, and Xian belong to this category. Deep is Yin, obtained with heavy pressure; Fu, Shi, Duan, Xi, Lao, and Shi belong to this category. Chi (Slow) is two beats per respiration; Huan, Jie, Wei, and Ruo belong to this category. One might ask: Why is Hua similar to Shuo, and Se similar to Chi? Although they seem similar, their principles differ. Chi and Shuo are judged by the frequency of beats relative to respiration, whereas Hua and Se are judged by the shape of the flow. Shuo indicates Heat, Chi indicates Cold, Hua indicates excess Blood and deficient Qi, and Se indicates excess Qi and deficient Blood. The reason the summary involves only these six characters is that they encompass Exterior/Interior, Yin/Yang, Cold/Heat, Deficiency/Excess, Wind/Cold/Dampness/Dryness, and Zang-Fu/Qi-Blood changes. Floating is Yang and Exterior, diagnosing Wind and Deficiency; Deep is Yin and Interior, diagnosing Dampness and Excess; Chi indicates Zang involvement, Cold, and Chill; Shuo indicates Fu involvement, Heat, and Dryness; Hua indicates Blood excess; Se indicates Qi stagnation. All variations in the human body do not exceed these. By seeking within these six pulses, no disease in the person can escape detection.

There are three essentials in holding the pulse: Ju (Lift), An (Press), and Xun (Seek). Lightly tracing is Ju; pressing heavily is An; neither light nor heavy, seeking through curvature, is Xun. Initially, hold the pulse lightly; if the pulse is felt between the skin, it is Yang, Fu, and corresponds to the Heart and Lungs. If felt heavily under the flesh, it is Yin, Zang, and corresponds to the Liver and Kidneys. Moderate pressure reveals the pulse between flesh and blood, representing the harmonious balance of Yin and Yang, corresponding to the Spleen and Stomach. If the pulse is not visible in Floating, Middle, or Deep positions, seek it carefully. If it is faintly visible, it is a pulse of hidden Yin and Yang. This applies to all three positions.

To examine the pulse, one must understand the six terms: Up/Down, Come/Go, Arrival/Stop. Without understanding these, one cannot distinguish Yin/Yang and Deficiency/Excess. Up is Yang, Come is Yang, Arrival is Yang; Down is Yin, Go is Yin, Stop is Yin. Up means moving from Chi to Cun, where Yang is born from Yin. Down means moving from Cun to Chi, where Yin is born from Yang. Come means emerging from the bone/flesh level to the skin surface, representing the ascending of Qi. Go means returning from the skin surface to the bone/flesh level, representing the descending of Qi. Responding to the breath is Arrival; stopping the breath is Stop.

To clearly understand the pulse, one must distinguish the four terms: Exterior/Interior, Deficiency/Excess. Exterior is Yang and Fu; any pathogenic factors of the Six Evils invading the meridians but not yet entering the Stomach/Fu organs or Zang organs belong to the Exterior. Interior is Yin and Zang; any emotional stagnation of the Seven Emotions郁结 in the heart/abdomen unable to disperse, or injury from food/flavors flowing into the Zang-Fu unable to be excreted, belongs to the Interior. Deficiency refers to the self-deficiency of Yuan Qi, with dissipation of spirit and exhaustion of strength. Excess refers to the solidity of Pathogenic Qi; due to original righteous Qi being weak, pathogenic Qi takes advantage, which is not the self-solidity of Yuan Qi. Therefore, deficiency requires tonifying righteous Qi, and excess requires purging pathogenic Qi. The Classics state: "When pathogenic Qi is abundant, it is Excess; when essential Qi is depleted, it is Deficiency." This is the general principle.

When the pulse arrives above the muscles and emerges between the skins, it is Yang and Fu; when it travels below the muscles, it is Yin and Zang. If the pulse is short and small and appears between the skins, it is Yin encroaching on Yang. If the pulse is surging and large and appears below the muscles, it is Yang encroaching on Yin. This applies to both Cun and Chi positions.