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When accumulated Yin pathogen gathers in the lower part, the slight Yang Qi dissipates in the upper part; thus, the manifestation is heaviness of the body. The four limbs are cold and reversed (cold extremities), abdominal pain intensifies, or there is throat obstruction, or fullness and distension in the epigastrium (Stomach region).

This treats the severe conditions of Yin Poison (Yin Du) attacking upward causing abdominal pain and cold extremities.
Take Chuanwu (Radix Aconiti Kusnezoffii), remove the skin and navel, soak in cold water for seven days, slice thinly, dry in the sun, and store in a paper bag. For a patient, take one large qian (approx. 3-5g) of the powdered form, add one small qian of salt, and one dan (approx. 200ml) of water. Decoct until reduced to seven parts, and administer orally in one dose. This suppresses the Yin Poison pathogen. The expelled pathogenic material resembles pig blood. If symptoms persist, administer another dose after a while.

This treats Yin Poison presenting with a bluish complexion, cold extremities, mental restlessness, and abdominal pain.
Take Sulfur powder, mix with newly drawn cold water, and administer two qian. After some time, if there is a sensation of cold or heat, observe the pulse tightness or slowness, and administer again if necessary. Recovery occurs with sweating.

This is a state of deep lethargy. It is similar to the previously described progressive deepening syndrome but more severe. All six pulses are only palpable when pressed deeply against the bone and disappear with light pressure. There are eight or more beats per respiration cycle.

I once recorded a case where a person suffered from Taiyang Cold Damage (Shanghan) for six or seven days, experiencing mental irritability, drowsiness, frequent vomiting, white urine, and spontaneous sweating. Upon diagnosis, both the Cun (inch) and Chi (cubit) positions at the radial artery were tight. I said: [Cold pathogen...] I also said: Dry lips and mouth, curling up in bed with cold feet, runny nose, and a slippery tongue coating indicate that one should not treat rashly. It is also stated: Tight pulse indicates Cold. Furthermore: Various tight pulses... Also: Once asked how the tight pulse arises? The Master said: Suppose sweating or emesis has already occurred; due to Cold in the Lung, the pulse becomes tight. Suppose coughing exists; it is caused by drinking cold water, hence the tight pulse. Suppose diarrhea exists; it is caused by Stomach deficiency, hence the tight pulse. Also: Cun position pulse is faint, Chi position pulse is tight; the person suffers from deficiency and excessive sweating. From this, we see that Cold pathogen entering the meridians results in deficiency-Cold pulses. If in the Yang meridians, the pulse is floating and tight; if in the Yin meridians... it is sinking and tight. Slow and rapid are fixed... [Text missing regarding musical pitch analogy]... Large, Floating, Rapid, Moving, and Slippery are Yang pulses; if Yin disease presents Yang pulses, life is possible. Sinking, Choppy, Weak, String-taut, and Faint belong to Yin; if Yang disease presents Yin pulses, death is inevitable.

Jingue (Zhang Zhongjing) said: Large, Floating, Rapid, Moving, and Slippery pulses are named Yang. Sinking, Choppy, Weak, String-taut, and Faint pulses are named Yin. In Yin diseases, the appearance of Yang pulses indicates survival; in Yang diseases, the appearance of Yin pulses indicates death. The interaction of Yin and Yang is hardest to clarify; one must carefully weigh the severity and distinguish clearly.

Although pulses have Yin and Yang distinctions, one must examine their depth/force to differentiate Exterior and Interior.
Light pressure revealing a Floating pulse indicates the disease is in the Exterior. Exterior Excess presents as Floating and forceful; merely Floating without force indicates Exterior Deficiency, accompanied by spontaneous sweating, aversion to wind, and a chilly sensation.
In Cold Damage, distinguishing Exterior/Interior and Excess/Deficiency is urgent. Jingue said: Floating indicates Exterior, Sinking indicates Interior. However, Exterior syndromes can be Excess or Deficient. Floating and forceful indicates Exterior Excess, hence no sweating and no aversion to wind. Floating and non-forceful indicates Exterior Deficiency, hence spontaneous sweating and aversion to wind.
Heavy pressure revealing a Sinking pulse indicates the disease is in the Interior. Interior Excess presents as Sinking and solid; heavy pressure revealing weakness and largeness indicates Interior Deficiency, which requires careful examination.
Interior syndromes also have Excess and Deficiency. Sinking and forceful indicates Interior Excess, hence abdominal fullness and constipation. Sinking and non-forceful indicates Interior Deficiency, possibly diarrhea or Yin syndromes. The above eight sentences exhaustively distinguish Exterior/Interior and Excess/Deficiency.

Wind causes Empty-Floaty pulses; Cold causes Firm-Fixed pulses; Water retention causes Deep-Sunken pulses. Moving pulse indicates Pain; Rapid pulse indicates Heat; Fluid retention (Zhi Yin) requires String-taut pulses. Excessive pulses are strange; insufficient pulses are likewise so.
Jingue said: Wind causes Empty-Floaty pulses; Cold causes Firm-Fixed pulses; Deep-Sunken Water causes Deep-Sunken pulses; Zhi Yin causes String-taut pulses; Moving indicates Pain; Rapid indicates Heat/Vexation; Excessive is strange; Insufficient is so. Pathogens do not appear empty; there must be internal deviation.

Excessive Ying and Wei Qi is named Gao Zhang; Gao Zhang clashing is named Gang. When Ying and Wei are weak, it is named Bei; Bei clashing and damaging is named Yang. When Ying and Wei are harmonious, it is named Huan Chi; Huan Chi named Chen is best. Distinguishing diseases among nine types of pulses, Changsha's [Zhang Zhongjing's] secrets are immeasurable.
Jingue said: Cun position Wei Qi excess is named Gao; Ying Qi excess is named Zhang; Gao Zhang clashing is named Gang; Wei Qi weakness is named [Missing]; Ying Qi weakness [Missing]. Jingue [Missing].

Pulse flickering like fat on soup surface indicates deficient Yang Qi. Pulse winding like spider silk indicates declining Yin Qi. Pulse cutting off like dripping lacquer indicates loss of Blood.
Jingue said: Pulse flickering like fat on soup indicates deficient Yang Qi. Pulse winding like spider silk indicates declining Yang Qi. Pulse continuous yet cutting off like dripping lacquer indicates loss of Blood. Declining Yang Qi. *Qianjin Fang* reads declining Yin Qi.

Yang Knotting appears lush like a carriage canopy; Yin Knotting resembles walking along a bamboo pole.
Jingue said: Lush like a carriage canopy is Yang Knotting. Cumulative like walking along a pole is Yin Knotting.

Yang Excess leads to Cu (Hasty) pulse with occasional stops; Yin Excess leads to Jie (Knotted) pulse, slow and delayed.
These refer to Cu and Jie pulses. Jingue said: Pulse arriving slowly with occasional stops is named Jie; pulse arriving rapidly with occasional stops is named Cu. Yang Excess leads to Cu; Yin Excess leads to Jie. One must examine longitudinal/lateral and reverse/oblique patterns; know the destructive and abnormal pulses.
Jingue said: Pulses have mutual overacting, with Vertical (Zong) and Horizontal (Heng), Reverse (Ni) and Oblique (Shun). What does this mean? Answer: Water overacting on Fire, Metal overacting on Wood is named Zong; Fire overacting [Missing] Shun. Make [Missing].

Quiet pulse with sick person indicates Internal Deficiency; healthy person with sick pulse is called "Walking Corpse" (Xing Shi).
Jingue said: Pulse indicates sickness but person is healthy is called Xing Shi, lacking master Qi, suddenly collapsing and unconscious. Person is sick but pulse is normal is named Internal Deficiency, lacking Grain Spirit, though distressed, without suffering. Right hand Qikou position governs Qi; Renying governing Blood is on the Left. Qikou tight and full indicates Food injury; Renying tight and full indicates fierce Cold pathogen.
Left is Renying, Right is Qikou. Renying tight/full injures by Cold; Qikou tight/full injures by Food.

Rapid indicates Fu organs; Delayed indicates Zang organs; Floating indicates Exterior; Sinking indicates Interior.
Jingue said: Floating indicates Exterior, Sinking indicates Interior, Rapid indicates Fu, Delayed indicates Zang.

Floating and Slow pulse indicates Wind injuring Wei; Floating, Tight, Firm, and Choppy pulse indicates Cold injuring Ying. Large and Faint pulse prohibits vomiting; if purging is desired, guard against Deficiency and Thinness.
Jingue said: Faint pulse cannot be vomited; Thin and Fine pulse cannot be purged.

Sinking, Faint, and Qi weakness make sweating difficult; these three must be carefully remembered.
Sun Yonghe said: In Yin Deficiency with Sinking-Faint pulse and Qi weakness, sweating is contraindicated. For Sweating, Purging, and Vomiting methods, if the pulse indicates they cannot be performed, one must strictly examine.

Yang adding to Yin produces sweating; Left hand Sinking-Faint should not [appear/be treated with sweating].
*Suzhou* says: Yang adding to Yin is called Sweat.

Duyang Stomach pulse determines life and death.
*Zhongjing Lun* mentions Duyang pulse in eighteen out of twenty cases.

Taixi Kidney pulse is the root.
In Cold Damage, Taixi and Duyang pulses must always be examined because the human body relies on Kidney and Stomach pulses. Jingue mocked those who only checked hands and not feet for this reason.

Pulse arriving six or seven times per breath indicates deepening pathogen; attention is required. Floating and Large worsening during day belongs to Yang; Sinking and Fine worsening during night belongs to Yin. Nine or more beats per breath, short and hasty, resembling a gushing spring with no return qi. Further extreme separation and gradual loss of root indicate life extinction and death.
Sun Yonghe said: Pulse reaching six or seven beats or more, Floating-Large worsening by day, Sinking-Fine worsening by night. Reaching eight beats, essence and Qi dissipate, spirit and Qi become chaotic, inevitably [Missing] Extreme Separation.

If the three positions of the patient's pulse are uniform, similar in size, floating/sinking, slow/rapid, this indicates Yin and Yang Qi are harmonious; without medication, recovery is naturally expected.
Jingue said: At Cun, Guan, and Chi positions, if size, floating/sinking, slow/rapid are equal, even if cold/heat are not resolved, the pulse is harmonious, indicating certain recovery.

Fever and aversion to cold, resembling Cold Damage, have five types. Pulse Floating and Rapid, with fever and aversion to cold, is the sign of Cold Damage. Pulse Floating and Tight [Missing] Vomiting [Missing] String-taut [Missing]