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Question: The pulse at the Cun Kou (Inch Port) is deep, large, and slippery. A deep pulse indicates excess [solidity], and a slippery pulse indicates qi [prosperity/excess]. When excess and qi contend with each other, if qi and blood enter the Zang organs, death ensues; if they enter the Fu organs, recovery occurs. This is called sudden syncope (Cu Jue). What does this mean?

The Master replied: If the lips and mouth are cyanotic and the body is cold, it indicates entry into the Zang organs, leading to death. If the body is harmonious/warm and sweat issues spontaneously, it indicates entry into the Fu organs, leading to recovery.

Question: Regarding the pulse disappearing [suddenly vanishing or deep hiding] where entry into Zang leads to death and entry into Fu leads to recovery, what does this mean?

The Master said: This does not apply to only one disease; all diseases follow this principle. For example, in impetigo-like sores (Jin Yin Chuang), if the lesion starts from the mouth and flows toward the limbs, it is treatable; if it starts from the limbs and flows back to the mouth, it is untreatable. Diseases remaining on the exterior are treatable; those entering the interior lead to death.

The five pathogenic factors attacking humans have their respective patterns: Wind attacks in the morning, Cold attacks in the evening, Dampness injures the lower part, and Fog injures the upper part. Wind causes the pulse to be floating; Cold causes the pulse to be tight/urgent. Fog injures the skin and interstices; Dampness flows into the joints; Food stagnation injures the Spleen and Stomach; Extreme Cold injures the Channels; Extreme Heat injures the Collaterals.

In a healthy man, a large pulse indicates consumption/labor (Lao); extreme deficiency also indicates consumption. In men, a floating, weak, and choppy pulse indicates infertility due to clear and cold essence. A pulse presenting with Kong (scallion-stalk), Dong (agitated), Wei (faint), or Jin (tight) characteristics indicates seminal emission in men and nocturnal intercourse dreams in women.

In a healthy man, a weak, deficient, and fine pulse predisposes to night sweats. A deep, small, and slow pulse is named Qi Depletion (Tuo Qi); such individuals pant heavily when walking quickly, experience cold extremities, abdominal fullness, and in severe cases, loose stools and indigestion. A wiry and large pulse: wiry indicates decline/reduction, large indicates hollow like Kong. Decline implies Cold, hollow implies Deficiency. The contention of Deficiency and Cold is named Ge (Leather) pulse. In women, this manifests as spontaneous abortion and uterine bleeding; in men, it manifests as blood loss and seminal emission.

In general, pulse diagnosis requires first understanding the Seasonal Pulse (Shi Mai), Stomach Pulse (Wei Mai), and the Normal Pulses of the Zang-Fu organs, before proceeding to pathological pulses. Seasonal pulses refer to the six positions all exhibiting a Wiry (Xuan) quality in spring, a Surging (Hong) quality in summer, a Floating (Fu) quality in autumn, and a Deep (Chen) quality in winter. The Stomach Pulse refers to a harmonious and moderate quality felt at medium pressure. When a person's Zang-Fu and Stomach pulses are balanced and correspond to the seasonal pulse, they are disease-free; deviation from this indicates disease.

There are three essentials in holding the pulse: Ju (Lifting), An (Pressing), and Xun (Searching). Lightly touching the surface is Ju; pressing heavily to obtain the pulse is An; neither light nor heavy, seeking carefully through the layers is Xun. Upon initially holding the pulse, if the pulse is felt lightly at the skin level, it is Yang, pertains to the Fu organs, and corresponds to the Heart and Lung. If obtained with heavy pressure, attached beneath the muscle, it is Yin, pertains to the Zang organs, and corresponds to the Liver and Kidney. At medium pressure, felt between flesh and blood, it represents the harmony of Yin and Yang, the Zhong He (Neutral Harmony) response, corresponding to the Spleen and Stomach. If searching carefully reveals the pulse as faint or intermittent, it indicates hidden Yin and Yang.