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In various diseases, the pulse of blood loss (massive hemorrhage) must manifest as a Kou pulse (floating, large, and empty in the middle, like pressing a scallion stalk), a Huan pulse (slow and relaxed), or a Xiao pulse (small); these are auspicious signs. If a Shu pulse (rapid) and Da pulse (large) appear, they are ominous. This statement elucidates the meaning of pulse patterns in blood loss syndromes. In cases of blood loss, if a Kou image is observed, or if the pulse is slow, small, and insufficient, indicating that the pathogenic factor is not severe, this is auspicious. However, if the pulse is rapid and large, it indicates that the pathogenic factor is exuberant while the healthy Qi is deficient, and fire is scorching the true Yin; this is indeed a cause for concern.

When blood stasis accumulates internally, the pulse should ideally be Lao (deep, solid, string-taut, and long), Da, Shen (deep), or Xiao. Conversely, if it manifests as Se (rough and hesitant) or Wei (extremely fine and faint), it will exacerbate the condition. This statement elucidates the meaning of pulse patterns in blood stasis syndromes. When blood accumulates internally and stagnates without flowing, the pulse tends to present as Lao and Da, reflecting the manifestation of the disease. It is not difficult to expel the stasis and generate new blood. However, if the pulse appears as Shen, Xiao, Se, or Wei, it signifies that the pathogenic factor is excessive while the healthy Qi is deficient, which ironically becomes detrimental.

Spermatorrhea and Bai Zhuo (white turbid discharge from the urethra) typically present with Wei (fine), Se, or Ruo (weak) pulses. If there is excess fire and Yin deficiency, the pulse may appear as Kou, Ru (floating and fine and soft), Hong (surging at the beginning and declining at the end), or Shu. This statement elucidates the pulse patterns associated with spermatorrhea and turbidity syndromes. The Kidney stores essence and should only release it during sexual intercourse. Currently, emission occurs upon mere mental arousal or spontaneous leakage without desire; this is due to Kidney deficiency failing to consolidate and retain. Bai Zhuo refers to urine that is white and turbid, belonging morphologically to essence but pathologically representing depletion and loss. How can the pulse not be Wei, Se, and Ruo? If Kou, Ru, Hong, or Shu pulses are observed, Kou and Ru certainly indicate Yin deficiency, but Hong and Shu actually result from excess fire. This differs from the case of Kidney deficiency-cold failing to store essence.

For San Xiao (the three types of Xiao syndrome: thirst-impairment), a Fu (floating) and Da pulse indicates survival, whereas Xi (thin), Xiao, Wei, and Se pulses with physical emaciation are alarming. This statement elucidates the significance of pulse patterns in San Xiao diseases. San Xiao is divided into Upper, Middle, and Lower Jiao. Excessive thirst and drinking characterize Upper Xiao; excessive hunger and digestion characterize Middle Xiao; excessive thirst with frequent urination containing fatty substances characterizes Lower Xiao. If the pulse is Fu and Da, it implies that body fluids are generated and not depleted, and Qi and Blood are harmonious and unobstructed, suggesting a possibility of recovery. If the pulse is Xi, Xiao, Wei, or Se, it indicates the depletion and withering of Qi and Blood, with both form and Qi exhausted; this is far more than just alarming.

Regarding Xiao Bian Lin (dysuria with dribbling), a yellowish nose tip, a Se and Xiao pulse without blood signs, or a Shu and Da pulse are not necessarily problematic. This statement elucidates the severity indicated by pulse patterns in dysuria. Lin syndrome involves dribbling without completion, while Bi syndrome involves complete obstruction. These conditions manifest as scanty and frequent urination, with stiffness and pain in the lower abdomen radiating to the umbilicus, caused by Kidney deficiency combined with Bladder heat. Lin syndrome is categorized into five types: Shi Lin (stone), Lao Lin (labor/fatigue), Xue Lin (blood), Qi Lin (qi), and Gao Lin (fatty). Additionally, there are Han Lin (cold) and Re Lin (heat). Cold Lin arises from Kidney Qi deficiency and cold invading the Lower Jiao, where excess cold causes shivering and leads to Lin. Heat Lin results from heat in the Three Jiao clashing with the Kidney and flowing into the Bao (bladder/uterus). Generally, although Lin syndrome has various types, it is invariably caused by labor-induced fire, where excess fire clashes with Qi. Heat steams body fluids, obstructing the water passages; internal heat stagnates and steams, causing yellow discoloration to emerge externally on the nose, as the nose is the opening of the Lung. A Se and Xiao pulse indicates roughness, minuteness, and lack of smoothness. Observing deficient healthy Qi and absence of blood signs, if a Shu and Da pulse appears indicating fire, what harm does this pose? Compared to the absence of blood (severe deficiency), this is easier to treat.