《素问·六节脏象论》岐伯曰∶人迎一盛，病在少阳；二盛，病在太阳，三盛，病在阳明；四盛以上为
格阳。寸口一盛，病在厥阴；二盛，病在少阴，三盛，病在太阴；四盛以上为关阴。人迎与寸口，俱盛四倍以
上为关格，关格之脉赢，不能极于天地之精气，则死矣。
人迎主六腑之阳，寸口主五脏之阴，故二脉统一身之阴阳也。而分三阴三阳者，明二气流行，皆有生旺之
序也。然偏旺则偏胜而病，偏甚则偏绝矣。人迎一盛者，少阳偏旺，故病在少阳；二盛偏甚，病在太阳；三
盛偏极，病在阳明也。寸口阴盛亦然。其言盛者，偏邪之气，非阴阳气旺之谓也。故至四盛以上，则邪气盛极，
而成关格之病。阴阳不相交通，故关者，不得小便；格者，格拒吐逆，食不下。关格之脉赢满四盛以上，不能
尽其所禀天地之精气而死也。《灵枢·终始篇》曰∶人迎一盛，病在足少阳，一盛而躁，病在手少阳，以至二
盛、三盛，及寸口一盛、二盛、三盛，皆兼足手，大抵盛在足经，病或可治，兼躁而及手经，则病深不可治也。
惟《难经》以尺寸之脉下覆上溢名
关格，为真脏脉，其人不病而死，与《内经》互明其理也。
《素问·腹中论》帝曰∶病热而有所痛，何也？岐伯曰∶病热者，阳脉也，以三阳之动也，人迎一盛少
阳，二盛太阳，三盛阳明，入阴也。夫阳入于阴，故病在头与腹，乃 胀而头痛也。
人迎主阳，热病阳邪，故人迎脉盛，盛甚则阳邪入阴。盖太阳主开，犹可外泄，阳明主阖，则邪必入阴，
以阳明与太阴为表里也。未离阳明，邪热上冲而头痛，已入太阴，故腹胀。上节言兼躁是足传手，此节言从阳
入阴，皆谓病邪深重，当急治之，勿使成关格死证也。
In the *Suwen: Chapter 6 - Six Sections and Viscera Manifestations*, Qibo stated: When the Renying pulse (located at the neck, reflecting Yang of the Fu organs) is one-fold stronger than the Cunkou pulse (located at the wrist, reflecting Yin of the Zang organs), the disease is in Shaoyang; two-fold stronger, it is in Taiyang; three-fold stronger, it is in Yangming; four-fold or more stronger is termed Ge Yang (Yang rebellion). When the Cunkou pulse is one-fold stronger than the Renying pulse, the disease is in Jueyin; two-fold stronger, it is in Shaoyin; three-fold stronger, it is in Taiyin; four-fold or more stronger is termed Guan Yin (Yin obstruction). If both the Renying and Cunkou pulses are four-fold or more stronger, it is termed Guan Ge (Obstruction and Rebellion, a critical condition of Yin-Yang separation). The Guan Ge pulse indicates extreme depletion; unable to sustain the essence and Qi of Heaven and Earth, death ensues.
The Renying pulse governs the Yang of the six Fu organs, while the Cunkou pulse governs the Yin of the five Zang organs; thus, these two pulses collectively regulate the Yin and Yang of the whole body. The differentiation into Three Yin and Three Yang clarifies that the circulation of these two Qi has an order of growth and prosperity. However, excessive prosperity leads to dominance and disease, and extreme excess leads to extinction. A Renying pulse one-fold stronger indicates Shaoyang excess, hence disease in Shaoyang; two-fold stronger indicates greater excess, disease in Taiyang; three-fold stronger indicates extreme excess, disease in Yangming. The same logic applies to Cunkou Yin excess. The term "excess" here refers to the predominance of pathogenic factors, not the vigorous state of normal Yin and Yang Qi. Therefore, when it reaches four-fold or more, pathogenic Qi becomes extremely abundant, resulting in Guan Ge disease. Due to the lack of communication between Yin and Yang, "Guan" refers to urinary retention, and "Ge" refers to vomiting and regurgitation with inability to ingest food. Although the Guan Ge pulse appears full and strong (four-fold or more), the body's righteous Qi is depleted and cannot exhaust its endowment of Heaven and Earth's essence, leading to death.
The *Lingshu: Chapter on End and Beginning* states: A Renying pulse one-fold stronger indicates disease in the Foot-Shaoyang channel; if one-fold and restless, the disease involves the Hand-Shaoyang channel. This extends to two-fold and three-fold strengths for both Renying and Cunkou, involving both foot and hand channels generally. Roughly speaking, if the excess is confined to the foot channels, the disease may be treatable; if accompanied by restlessness and involving the hand channels, the disease is deep and incurable.
Only the *Nanjing* defines Guan Ge as the overflowing and sinking of the Cun and Chi pulses, identifying it as a True Zang pulse (pulse of exposed organ essence), where the patient dies without apparent illness. This elucidates the principle mutually with the *Neijing*.
In the *Suwen: Chapter on Abdominal Disorders*, the Yellow Emperor asked: Why does heat disease present with pain? Qibo replied: Heat disease involves Yang pulses due to the movement of the Three Yang channels. A Renying pulse one-fold stronger corresponds to Shaoyang, two-fold to Taiyang, and three-fold to Yangming, indicating Yang entering Yin. Since Yang enters Yin, the disease manifests in the head and abdomen, causing distension and headache.
The Renying pulse governs Yang. As heat disease is caused by Yang pathogens, the Renying pulse becomes strong; when excessively strong, Yang pathogens enter Yin. Taiyang governs opening, allowing pathogens to be released externally; Yangming governs closing, so pathogens must enter Yin, as Yangming and Taiyin are exterior-interior pairs. Before leaving Yangming, pathogenic heat rushes upward causing headache; upon entering Taiyin, abdominal distension occurs. The previous section discussed transmission from foot to hand channels via restlessness; this section discusses transmission from Yang to Yin. Both indicate severe pathogenic depth, requiring urgent treatment to prevent progression to fatal Guan Ge syndrome.