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The chapter "Pathogenic Factors, Zang-Fu Organs, Disease Forms" in the *Ling Shu* (Spiritual Pivot) states: Pulse tension (Ji, 急) indicates cold; pulse relaxation (Huan, 缓) indicates heat; a large pulse indicates excess Qi and deficient Blood; a small pulse indicates deficiency of both Qi and Blood; a slippery pulse (Hua, 滑) indicates abundant Yang Qi with slight heat; a choppy pulse (Se, 涩) indicates deficient Blood and Qi with slight cold. In cases where the pulse is consistently small, it indicates deficiency in Yin-Yang, physical form, and Qi. Acupuncture should not be used in such cases; instead, sweet herbs (Gan Yao, 甘药) should be employed to regulate the condition.

Commentary: The main text of this chapter states: "A choppy pulse indicates abundant Blood and deficient Qi, with slight cold." The phrase "abundant Blood" is a transcription error. As stated later in the same chapter: "When needling a choppy pulse, do not allow blood to flow out." This confirms that it indicates deficient Blood. Zhang Zhongjing stated: "A choppy pulse signifies insufficiency of Ying Qi (Nutritive Qi)," which also refers to deficient Blood.

The chapter "Essential Subtleties of the Pulse" in the *Su Wen* (Basic Questions) states: When pushing the pulse outward (investigating the exterior/Yang), if the pulse is found inwardly (deep upon pressure), it indicates accumulation in the heart and abdomen. When pushing the pulse inward (investigating the interior/Yin), if the pulse is found outwardly (superficial upon light touch), it indicates fever in the body. When pushing the pulse upward (investigating the upper body), if the pulse is present above but absent below, it indicates coldness in the waist and feet. When pushing the pulse downward (investigating the lower body), if the pulse is present below but absent above, it indicates pain in the head and neck.

The chapter "Pathogenic Factors, Zang-Fu Organs, Disease Forms" in the *Ling Shu* states: Observing the complexion to know the disease is called "Ming" (Bright/Perceptive); palpating the pulse to know the disease is called "Shen" (Divine/Miraculous); asking about the symptoms to know the location is called "Gong" (Skilled). The correspondence between complexion, pulse, and Chi skin (skin on the inner forearm) is like the striking of a drum or the shadow following an object; they never fail to correspond. This reflects the relationship between root and branches; if the root dies, the branches wither. Therefore, knowing one aspect makes one a "Gong" (Skilled practitioner); knowing two aspects makes one "Shen" (Divine); knowing three aspects makes one both Shen and Ming. A bluish complexion corresponds to a Xian pulse (Wiry); a reddish complexion corresponds to a Gou pulse (Hook/Crimson); a yellowish complexion corresponds to a Dai pulse (Intermittent); a whitish complexion corresponds to a Mao pulse (Feather/Floating); a blackish complexion corresponds to a Shi pulse (Stone/Deep). If the complexion is seen but the corresponding pulse is not obtained, and instead a controlling (clashing) pulse is found, death will ensue. If a generating pulse is found, the disease will resolve.

In the chapter "Five Colors" in the *Ling Shu*, Lei Gong asked: How can one distinguish between worsening and improving conditions? Huang Di replied: It depends on whether the pathogen is in the interior or exterior. Palpating the Mai Kou (Pulse Gate/Radial artery): if the pulse is slippery, small, tight, and deep, the disease is worsening and located in the interior. If the Ren Ying pulse (Carotid artery at the neck) is large, tight, and floating, the disease is worsening and located in the exterior. If the Mai Kou is floating and slippery, the disease progresses daily; if the Ren Ying is deep and slippery, the disease diminishes daily. If the Mai Kou is slippery and deep, the disease progresses daily and is internal; if the Ren Ying pulse is slippery, vigorous, and floating, the disease progresses daily and is external. A Ren Ying pulse that is vigorous and firm indicates injury by Cold; a Qi Kou (Radial pulse) pulse that is vigorous and firm indicates injury by food stagnation.

Detailed analysis: The Ren Ying point belongs to the Foot Yangming Stomach Meridian, located on both sides of the Adam's apple. The Qi Kou refers to the Hand Taiyin Lung Meridian at the Cun Kou (Radial pulse) on both wrists. The Ren Ying pulse governs Fu organs and is used to inspect the exterior; the Qi Kou pulse governs Zang organs and is used to inspect the interior. Thus, it is said that "the Qi Kou alone serves as the master of the five Zang organs," which is the principle of the *Nei Jing*. Consequently, later generations only palpated the Qi Kou and not the Ren Ying. This is because pulse Qi flows through the meridians, and meridian Qi returns to the Lung; since the Lung oversees all vessels, the Cun Kou is the great assembly of pulses, capable of determining life and death. All diseases, whether in the exterior or interior, can be discerned through various positions of the Cun Kou. Since Wang Shuhe erroneously designated the left wrist as Ren Ying and the right wrist as Qi Kou, claiming the left inspects the exterior and the right inspects the interior, he implied that there is no interior on the left and no exterior on the right. This error has been transmitted to the present day and is significant. For detailed meaning, see Volume XVI, section on Fatigue and Internal Injury, and *Lei Jing* (Classified Classic), Chapter 11 of the Zang-Xiang category.