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Internal injury from diet results in a rapid and slippery pulse at the Qi Kou (radial artery site); internal injury from fatigue results in a large and weak pulse at the Spleen position. This discusses diseases caused by internal injuries from diet and fatigue. (*Neijing* states): If food intake doubles, the intestines and stomach will be injured. If the injury is due to diet, the Qi Kou pulse will necessarily be urgent and slippery; if the injury is due to overexertion, the Spleen pulse at the right Guan position will necessarily appear large and weak. This is what is meant by "diet and fatigue injure the Spleen."

To understand diseases caused by the Seven Qi (seven types of emotional/physiological qi disturbances), the pulse is extremely deep, even hiding beneath the bone, with a choppy, weak, and feeble quality. This discusses the pathology of the Seven Qi. As the Seven Qi are internal causes, the pulse is extremely deep; even when pressed to the bone, it does not reveal itself, which is called a Hidden Pulse (Fu Mai). Alternatively, one may observe a Choppy Pulse (Se Mai) indicating obstructed flow, or a Weak Pulse (Ruo Mai) indicating extreme feebleness. Unless the Seven Qi have caused internal injury for a long time, the pulse would not reach this state.

The Six Stagnations (Liu Yu) often present with a Deep (Chen) pulse: Phlegm stagnation is Slippery (Hua) and Tight (Jin); Food stagnation is Tight (Jin); Qi stagnation is Choppy (Se); Blood deficiency stagnation is Empty (Kou); Fire stagnation is Rapid (Shu); Dampness stagnation is Fine (Xi). This discusses the pulses associated with the Six Stagnations. There are six types of stagnation, also considered internal causes, so the pulse is mostly Deep, though not exclusively. A Deep and Slippery pulse indicates Phlegm stagnation; a Deep and Tight pulse indicates Food stagnation; a Deep and Choppy pulse indicates Qi deficiency and lack of free flow; a Deep and Empty pulse indicates Blood deficiency failing to nourish; a Deep and Rapid pulse indicates latent Fire; a Deep and Fine pulse indicates lingering Dampness. (*Neijing* states): Wood stagnation should be dispersed; Fire stagnation should be vented; Earth stagnation should be purged; Metal stagnation should be drained; Water stagnation should be broken. However, when regulating Qi, for excess conditions, use what the pathogen fears to subdue it; this is called Draining (Xie). These five methods address stagnation caused by the mutual overcoming of the Five Connected Qi. (Zhu Zhenheng stated): When Qi and Blood are harmonious, no disease arises; once there is depression/stagnation (Fu Yu), various diseases emerge. He formulated the theory of the Six Stagnations and created Yueju Wan to treat stagnation, stating that Qi stagnation leads to Dampness retention; Dampness retention generates Heat; Heat stagnation produces Phlegm; Phlegm obstruction impedes Blood circulation; impaired Blood circulation prevents digestion of food. These six factors cause disease mutually.

A Slippery pulse primarily indicates excessive Phlegm; a Wiry (Xian) pulse indicates retained Fluids (Yin); Heat presents with a Slippery-Rapid pulse; Cold presents with a Wiry-Tight pulse; Floating-Slippery indicates concurrent Wind; Deep-Slippery indicates concurrent Qi stagnation; Food injury presents with a Short-Rapid pulse; lingering Dampness presents with a soggy-Fine pulse. This discusses the syndromes associated with the Slippery pulse combined with other pulses. The Slippery pulse flows smoothly like pearls rolling under the finger, thus indicating excessive Phlegm. The Wiry pulse indicates excessive Liver Wood, which necessarily constrains Spleen Earth, thus indicating retained Fluids. Retained Fluids manifest as coldness on the back the size of a palm, shortness of breath resembling thirst, pain in the limbs and joints, fullness in the hypochondrium radiating to the Clavicular Fossa (Quepen), and aggravated coughing; this is termed Retained Fluids. If there is internal Heat, the pulse will be Slippery-Rapid; if there is internal Cold, the pulse will be Wiry-Tight. If the pulse beats and floats outward, it indicates concurrent Wind; if it sinks downward, it indicates concurrent Qi stagnation. Food stagnation in the middle jiao obstructs Qi movement, causing the pulse to become Short and Rapid; Dampness is a Yin pathogen that lingers and seeps, causing the pulse to appear Soggy and Fine.