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In a healthy person (Pingren, an individual without disease), if the pulse is displaced to the external collaterals and the "younger brother" position usurps the "elder brother" position, appearing at the Yangxi and Lieque acupoints, this is referred to as the Fan Guan Mai (Reverse Gate Pulse). The statement that a healthy person has no pulse does not mean the complete absence of pulsation; rather, it indicates that the Cun Kou (Inch Port) pulse is not palpable at its standard location but instead passes from beside the Chi (Cubit) position, emerging obliquely through the Lieque point of the Lung Meridian and the Yangxi point of the Large Intestine Meridian into the external collaterals. Its depth and positioning within the Three Positions (Cun, Guan, Chi) and Nine Probes are identical to those normally found at the Cun Kou. It is akin to a younger brother usurping the elder brother's rightful place. This is an anomalous pulse differing from the majority, occurring in only one or two out of a thousand people.

Once pathological pulses are understood, auspicious and inauspicious signs must be distinguished. Beyond the regular meridians, there exist Zhen Zang Mai (True Visceral Pulses). The pulse indicating Liver failure feels under the fingers like tracing a knife edge (Ze Ze sound); the pulse indicating Heart failure feels like beans rolling, restless and rapid; the pulse indicating Spleen failure resembles a sparrow pecking, or water leaking from a roof, flowing away without return, or a cup overturned; the pulse indicating Lung failure is like floating feathers with no root, desolate and listless, like numerous small hemp seeds trembling, or like floating waves opening and closing; when the Kidney pulse is about to fail, it comes occasionally like a visiting guest (Sheng Ke), goes like stones being flicked (heavy and striking the finger), or like untying a knot (rope unraveling); when the Ming Men (Gate of Life) pulse is about to fail, it appears like a shrimp swimming (suddenly advancing then retreating) or a fish gliding (initially floating and wagging its tail, then leisurely disappearing); resembling a gushing spring overflowing upwards indicates Bladder failure. Once the True Visceral Pulse manifests, it signifies that Stomach Qi is exhausted. Diagnosis requires observing facial complexion and symptoms, making judgments based on medical principles; this describes the True Visceral Pulse.

The term "True Visceral Pulse" refers to conditions such as the Liver showing a pure Xian (Wiry) pulse without Stomach Qi. When the Liver pulse fails, it feels under the fingers like touching a knife blade—tense and urgent, completely lacking a harmonious and gentle quality—thus indicating death. The Heart failure pulse feels like rolling beans, trembling and restless, indicating Heart failure. The Spleen failure pulse resembles a bird pecking at wood: frequent pecks followed by occasional pauses; like water leaking from a roof, dropping slowly; like flowing water that does not return; or like an overturned cup. These are all Spleen failure pulses. The Lung failure pulse is like wind blowing feathers, light and rootless, desolate and weak; like many tiny hemp seeds; or like floating waves opening and closing. These are Lung failure pulses. The Kidney failure pulse comes occasionally like a visitor; feels heavy and hard like flicking stones; or unravels like a loosened rope. These are Kidney failure pulses. "Xia You" (Shrimp Swimming) resembles a shrimp moving forward slowly then suddenly retreating; "Yu Xiang" (Fish Gliding) resembles a fish floating and wagging its tail before leisurely vanishing. These are Ming Men failure pulses. "Yong Quan" (Gushing Spring) resembles water surging upward from below, indicating Bladder failure. The human True Visceral Pulse refers to the Liver showing pure Wiry, Heart showing pure Rapid/Full, Lung showing pure Floating/Hair-like, and Kidney showing pure Deep/Stony pulses, devoid of the harmonious Stomach Qi. Hence, they are called True Visceral Pulses. If the True Pulse manifests, it confirms the absence of Stomach Qi. Since the pulse relies on Stomach Qi as its foundation, the absence of Stomach Qi signifies death. However, once the principles of pulse diagnosis are clear, one must further examine facial colors and clinical manifestations, judging each case according to principle. Then, the methods for determining life and death, fortune and misfortune, will be as accurate as a shadow following a form or an echo responding to a sound. The difficulty of medicine lies primarily in unclear principles; the difficulty of principles lies especially in imprecise pulse theory. Among pulse theories, the most detailed and easiest to comprehend is Cui Jiayan's Si Yan Ju Yao (Four-Character Essentials). Scholars should study it thoroughly, memorize it deeply, and reflect upon it, so that their understanding becomes clear and intuitive. The skill of "heart attuning with the hand" resides here.