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The pulse is generated by blood and belongs to Yin. The "large" pulse is an alias for the "surging" (Hong) pulse, representing the image of Fire, and belongs to Yang. If the disease arises from internal injury, where Yin deficiency is invaded by Yang pathogenic factors, a large pulse should be treated as a deficiency syndrome. If the disease arises from external injury, where pathogens lodge in the meridians, the pulse will also become large, and it should be treated as excess of pathogenic factors. Observing both cases together, they represent a trend where the disease condition is progressing; thus, calling it "disease progression" is appropriate. Haizang (Zhang Yuansu) stated: "This is the matter of the Sovereign invading the Minister." Who is correct? I hope someone can instruct me.

The *Book of Rites* states: "In the first year, examine their ability to separate and analyze the principles." This means dissecting medical theory, which lies in the segmentation of chapters and sentences. In the *Neijing · Shengqi Tongtian Lun*, there are four chapters on etiology. The first chapter discusses cold pathogenesis, containing the phrase "like turning a pivot." The following three sentences do not align with the preceding context and are likely interpolations. The two sentences "Body like burning charcoal, dispersal through sweating" should be moved here. When cold pathogens initially lodge in the muscle and surface, pathogenic stagnation transforms into heat, resembling burning charcoal; relief occurs through sweating. This corresponds to formulas such as Ma Huang Tang by Zhang Zhongjing. The second chapter discusses summer-heat pathogenesis. Summer-heat is caused by Sovereign Fire; since Fire is active and dissipative, symptoms include spontaneous sweating, irritability, thirst, and excessive talking. The third chapter discusses dampness pathogenesis. Dampness is the turbid Qi of Earth. The head is the convergence of all Yang meridians; its position is high, its Qi is clear, and its constitution is deficient, so clarity and consciousness depend upon it. Turbid Qi steams upward, blocking the clear orifices, causing heaviness and lack of crispness, as if something were covering the head. If left untreated, dampness stagnates and transforms into heat. If heat lingers, the large tendons become soft and short due to heat injuring Blood, which fails to nourish the tendons, resulting in contracture. The small tendons become lax and long because dampness injures the tendons, failing to bind the bones, resulting in flaccidity. The phrase "Yin Yu, shou ru guo" (Due to dampness, the head feels wrapped) consists of three characters per clause; the subsequent phrases starting with "Shi re bu rang" consist of four characters per clause, making the text correct and the meaning clear. The fourth chapter discusses Qi pathogenesis leading to swelling. The subsequent text lacks symptom description, suggesting missing bamboo slips. The two sentences "Si wei xiang dai" (Four corners substitute for each other) do not align with the preceding context and are also interpolations. Wang Taibu (Wang Bing) stated: "Summer-heat, heat, and dampness diseases are all considered to originate from the toxin of cold damage, succeeding one another sequentially, generating diseases in turn." Combining these five segments into one chapter raises my doubts. It is true that untreated summer-heat may lie dormant and generate heat; prolonged heat may generate dampness; prolonged dampness may affect Qi. However, the *Neijing* only mentions winter cold damage that does not manifest immediately but results in summer heat disease later. I have never heard of cold toxins lying dormant until summer to manifest as summer-heat disease. As for dampness disease, it seems to follow the previous mention of "heat," suggesting the head becomes wet as if wrapped in damp material. One should remove the character "heat" and read "Yin Yu shou" (Due to dampness, the head...) as one sentence. If "Ru Guo Shi" (Like wrapping dampness) is taken as a separate sentence, then the "dampness" in "dampness head" and "wrapping dampness" are artificial errors. This contradicts the textual logic listing cold and summer-heat diseases above and below, necessitating refutation. Some say: "Ancient sages spoke of warm-damp, cold-damp, and wind-damp. I have never heard of 'heat-damp' disease. Searching the *Neijing*, it is not mentioned. Are you not being pedantic and absurd?" I reply: Among the Six Qi, heat-damp diseases account for eight or nine out of ten. The *Neijing* elucidates heat-damp theory here for the first time. The *Suwen · Zhi Zhen Yao Da Lun* states: "When dampness is severe in the upper part, heat follows," sometimes mentioning dampness with heat in the middle, or heat with dampness in the middle. This represents the utmost extent of the Sage's benevolence and discussion of the Dao. Those who fail to understand heat-damp treatment methods today owe this misunderstanding to Wang Taibu. I urge you to retrieve the *Yuan Bing Shi*, read it thoroughly, and ponder it carefully. That would be greatly appreciated!