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The pulse of hernia (Shan Qi, a condition characterized by abdominal pain and distension) is wiry (Xian, indicating tension or pain) and rapid. If there is an accumulation in the interior and the pulse is firm (Lao, indicating excess and solidity) and rapid, survival is indicated; if the pulse is weak and rapid, death is indicated. This discusses the pulse and symptoms of hernia, which should be distinguished. Hernia refers to the gathering of Qi internally, while the exterior remains constricted; thus, the pulse appears wiry and rapid. This usually results from cold-dampness accumulating and stagnating in the interior. If the pulse is wiry, rapid, and firm, it indicates that the accumulation has a root, signifying robust Yuan Qi (Original Qi). Since the pulse and symptoms are consistent, survival is indicated. However, if the pulse is merely rapid but weak, rapidness indicates excess pathogenic factors, while weakness indicates deficiency of healthy Qi. This is inconsistent with internal accumulation, hence death is indicated.

The pulse for lower back pain (Yao Tong) is mostly deep (Chen, indicating interior conditions) and wiry. A superficial (Fu, indicating exterior conditions) pulse suggests wind; a tight (Jin, indicating cold or pain) pulse suggests cold; a slippery (Hua, indicating phlegm or dampness) pulse indicates phlegm-fluids (Tan Yin); a soggy-thin (Ru Xi, indicating dampness or deficiency) pulse indicates Kidney-Involution (Shen Zhuo, a condition where dampness adheres to the lower back); a large (Da, indicating deficiency or heat) pulse indicates Kidney Deficiency (Shen Xu); a deep-firm (Chen Shi) pulse indicates sprain/strain (Shan Na). This elucidates the principles of pulse and symptoms in lower back pain. Lower back pain is a disease of the six meridians of the foot. The three Yang meridians of the foot travel from the head to the feet, while the three Yin meridians travel from the feet into the abdomen. When each meridian is invaded by pathogens, pain occurs along its pathway. For lower back pain involving various meridians, the pulse is mostly deep and wiry because deepness indicates interior involvement and wiriness indicates pain. A superficial component indicates wind, manifesting as a floating tendency within the deep-wiry pulse, representing the image of wind-deficiency. A tight component indicates cold, as cold causes contraction and tightening. A slippery component indicates phlegm-fluids, which are slippery in nature. A soggy-thin component indicates Kidney-Involution, where dampness infiltrates and adheres. A large component indicates Kidney Deficiency, where the Kidney fails to consolidate and becomes empty and loose. A firm component indicates sprain/strain; whether due to blood stasis or Qi stagnation, both lead to obstruction, resulting in a deep-firm pulse.

Hong Kong Foot (Xiang Gang Jiao, commonly known as Beriberi or gouty arthritis in TCM context) presents with a slow (Chi, indicating cold) pulse for cold, a rapid (Shu, indicating heat) pulse for heat, a floating-slippery pulse for wind, and a soggy-thin pulse for dampness. This explains the pulse and symptomology of Hong Kong Foot. Eight or nine out of ten cases of this condition arise from cold-dampness. As stated in the *Neijing* (Inner Canon): "Clear dampness attacks the body, and diseases originate from below." This is indeed true. Initially, the onset is subtle and easily resolved; however, if not treated early, it worsens with each recurrence, potentially leading to flaccidity, bi-syndrome (painful obstruction), and anesthesia. Manifestations in the Three Yang meridians are mild, while those in the Three Yin meridians are severe. At onset, symptoms resemble Taiyang Cold Damage (Shang Han), including headache, fever, aversion to cold, and vomiting. The distinguishing features are the inability to flex or extend the feet, or pain/redness. In the Yang aspect, there is often aversion to cold, high fever, headache, redness/purple discoloration, and hot swelling. The lesions are mostly on the lateral side of the leg (pathway of the Three Yang meridians), the complexion is lustrous, and the pulse is mostly superficial. In the Yin aspect, there is severe aversion to cold, possibly with cold extremities (Jue Ni) and no fever, or vomiting/reversal of Qi, abdominal pain, and diarrhea. There may be slight redness and heat, or extreme cold. Lesions are mostly on the medial side of the leg (pathway of the Three Yin meridians), the complexion is dark/gloomy, and the pulse is mostly deep. This outlines the general distinction between Yin and Yang aspects. Hong Kong Foot generally involves cold, heat, wind, and dampness. A pulse arriving at three beats per breath cycle is slow, indicating cold. A pulse arriving at six beats per breath cycle is rapid, indicating heat. Wind invasion typically presents with a floating-slippery pulse, while dampness invasion presents with a soggy-thin pulse. Success depends on flexible application of principles, careful observation of pulses and symptoms, and appropriate differentiation.