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Pulse. The *Neijing* (Yellow Emperor's Inner Classic) states: "When pressed, it does not surge; this applies to all Yang conditions." This refers to the aforementioned concept. Therefore, any pulse that is surging and large but lacks *Shen* (Spirit/Vitality) indicates Yin Deficiency (Yin Xu); any pulse that is fine and small but lacks *Shen* indicates Yang Deficiency (Yang Xu). Yin Deficiency leads to the depletion of Lung Metal and Kidney Water, causing the Dragon and Thunder Fire (Ministerial Fire/Xiang Huo) to easily blaze, thereby generating diseases of the Five Fluids (Wu Ye) and the Soul/Spirit (Hun/Shen). Symptoms may include night sweats and seminal emission, bleeding from upper or lower orifices, palpitations with fright and restlessness, or coughing, wheezing, and consumptive fever. Yang Deficiency damages Heart Fire and Spleen Earth, causing the True Qi to diminish daily, thereby generating diseases of the Source of Lord Minister Fire (Jun Xiang Hua Yuan). Symptoms may include dizziness and blurred vision, chest diaphragm obstruction and distension, vomiting and nausea leading to Yang Collapse, or diarrhea and dysentery accompanied by pain. To rescue Yin, one must strengthen the master of Water (Zhuang Shui Zhi Zhu); to rescue Yang, one must benefit the source of Fire (Yi Huo Zhi Yuan). If the pulse gradually grows, life is preserved; if it gradually fades, death ensues. If deficiency is not tonified, how can the Original Qi (Yuan Qi) recover? This is truly the pass between life and death. If a physician does not understand this, what hope is there for them to understand anything else?

Excess Pulse (Shi Mai): Indicates an excess of pathogenic factors. It feels strong upon both superficial and deep pressure, with vigorous movement. Excess pulses have Yin and Yang aspects. Pulses such as String-taut (Xian), Surging (Hong), Tight (Jin), and Slippery (Hua) are similar in nature and indicate stagnation in the Triple Burner (San Jiao). For exterior excess pathogens, the pulse is floating, large, and forceful, caused by external contraction of Wind-Cold, Summer-Heat, or Dampness in the meridians, manifesting as Cold Damage (Shang Han), Miasmic Malaria, fever, headache, nasal congestion, head swelling, soreness and pain of sinews, bones, and limbs, carbuncles, and toxic sores. For interior excess pathogens, the pulse is deep, solid, and forceful, caused by internal injury to the Zang organs due to dietary irregularities or Seven Emotions, manifesting as distension and fullness, constipation and urinary retention, masses (Zheng/Jia), blood stasis, phlegm-fluid retention, abdominal pain, wheezing, vomiting, coughing, and rebellious Qi. For Fire excess pathogens, the pulse is surging, slippery, and forceful, manifesting as various excess-heat conditions. For Cold excess pathogens, the pulse is deep, string-taut, and forceful, manifesting as various painful stagnations. Whether the pathology lies in Qi or Blood, if the pulse shows combined characteristics, one should deduce based on categories. However, Excess pulses have true and false forms. True excess is easy to know; false excess is prone to misdiagnosis. Thus, one must inquire into the etiology and simultaneously observe physical signs and symptoms, grasping the *Shen* (Spirit) of the pulse, to be considered a master practitioner.

The method of taking the pulse requires understanding the Normal (Chang) and the Variable (Bian). The pulses of ordinary people may naturally be large or small, Yin-type or Yang-type; this is their innate endowment, each forming its own pattern. Pulses altered by pathogens may suddenly become slow or rapid, advancing or retreating abruptly; this indicates the sudden arrival of disease, where the pulse manifests according to Qi changes. Therefore, any practitioner diagnosing pulses must first recognize the normal Zang organ pulses before they can detect pathological pulses; they must first recognize normal pulses before they can detect variable pulses. From normal pulses, one can observe a person's constitutional structure and longevity; from variable pulses, one can observe the auspicious or ominous prognosis of illness. These are the major essentials of pulse diagnosis, which must be recognized first.