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The deep pulse (Chen Mai, 沉脉) indicates interior syndromes, cold syndromes, and accumulation. If forceful, it indicates phlegm or food retention; if forceless, it indicates qi stagnation. A deep and slow pulse (Shen Chi Mai, 沉迟脉) indicates deficiency-cold; a deep and rapid pulse (Shen Shu Mai, 沉数脉) indicates latent heat; a deep and tight pulse (Shen Jin Mai, 沉紧脉) indicates cold pain; a deep and moderate pulse (Shen Huan Mai, 沉缓脉) indicates water retention; a deep and firm pulse (Shen Lao Mai, 沉牢脉) indicates entrenched cold; a deep and excess pulse (Shen Shi Mai, 沉实脉) indicates extreme heat; a deep and weak pulse (Shen Ruo Mai, 沉弱脉) indicates yin deficiency; a deep and fine pulse (Shen Xi Mai, 沉细脉) indicates bi-syndrome and dampness; a deep and wiry pulse (Shen Xian Mai, 沉弦脉) indicates fluid retention and pain; a deep and slippery pulse (Shen Hua Mai, 沉滑脉) indicates retained food; a deep and hidden pulse (Shen Fu Mai, 沉伏脉) indicates vomiting, diarrhea, and accumulation of yin-toxin. This discusses the principle of diseases indicated by the deep pulse combined with other pulses.

A pulse felt only when pressed to the bone is called deep, hence indicating interior syndromes. Cold refers to water-cold accumulation, and accumulation refers to organ accumulation, both presenting with a deep pulse. If deep and forceful, there is a pathogenic substance in the interior, either phlegm or food; if deep and forceless, the interior was originally not excess, but merely qi failing to flow smoothly. Since the deep pulse indicates an interior location, combined with a slow rate, deficiency-cold is certain; since the deep pulse indicates an interior location, combined with a rapid rate, latent heat is undeniable. If deep and tight, cold contracts and becomes solid, thus causing cold pain; if deep and moderate, yang fails to circulate vigorously, thus water accumulates; if deep and firm, it is stagnation of yin-cold, indicating entrenched cold; if deep and excess, yang qi gathers and struggles, suitable for deep-seated heat. Deep and yin-weak indicates deficiency; deep and weak must indicate yin deficiency. Deep indicates interior, fine indicates dampness; deep and fine definitely form bi-syndrome and dampness. Deep is yin, wiry indicates fluid retention; deep and wiry means fluid retention stops in the abdominal yin region, causing intermittent pain. Deep indicates interior, slippery indicates food; deep and slippery means retained food stays in the intestines and is difficult to expel. The qi of the deep pulse has sunk to the bone; the hidden pulse feels as if absent even at the bone, indicating a critical and severe condition. One must distinguish between acute and chronic cases: in acute cases, with sudden vomiting and diarrhea leading to collapse, warming and tonification can restore health; in chronic cases, long-standing accumulation of yin-toxin blocks the body, requiring harsh purgation to cure.

The slow pulse (Chi Mai, 迟脉) indicates zang-organ diseases due to latent yang qi. Forceful indicates pain; forceless indicates deficiency-cold. This discusses diseases caused by the slow pulse. The slow pulse is a yin pulse, and the five zang organs are yin, hence it indicates zang diseases (as stated in *Nan Jing* Chapter 9: "Slow indicates zang"), and also "Slow indicates cold" (*Shang Han Lun* also states): slow pulse indicates disease in the zang organs because yang qi is latent and cannot circulate vigorously, resulting in a slow pulse rate. Slow and forceful implies obstruction and excess preventing free flow, so pain can be imagined; slow with latent yang and forceless must be deficiency-cold.

The rapid pulse (Shu Mai, 数脉) indicates fu-organ diseases, vomiting, and mania. Forceful indicates heat; forceless indicates sores/ulcers. This discusses diseases caused by the rapid pulse. The rapid pulse is a yang pulse, and the six fu organs are also yang, hence it indicates fu-organ diseases (as stated in *Nan Jing*: "Rapid indicates fu"), and also "Rapid indicates heat" (*Shang Han Lun* also states): rapid pulse indicates disease in the fu organs. This distinguishes yin and yang by slow and rapid rates, matching them to zang and fu organs. The rapid pulse indicates vomiting because vomiting involves rebellion of stomach qi; it indicates mania because mania involves confusion of spirit and mind (as stated in *Nan Jing* Chapter 20: "Extreme yang leads to mania"), and also (*Su Wen* Chapter on Disease Capabilities): "Mania arises from yang." From this, it is clear that mania presents with a rapid pulse. Rapid and forceful indicates heat gathering and driving; rapid and forceless, although there is heat, it is deficient heat, dissipating outward, which is a sign of developing sores/ulcers.