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A coarse and large pulse indicates insufficient Yin and excess Yang, manifesting as *Re Zhong* (Heat in the Middle) disease. A pulse that arrives swiftly but departs slowly signifies excess in the upper part and deficiency in the lower part, characteristic of *Jue* (Cold Reversal) and diseases of the vertex (*Dian Ji*); a pulse that arrives slowly but departs swiftly signifies deficiency in the upper part and excess in the lower part, characteristic of aversion to wind (*E Feng*). Therefore, those suffering from aversion to wind have their Yang Qi affected by pathogenic factors. If the pulse is simultaneously deep, fine, and rapid, it indicates *Shao Yin* (Lesser Yin) *Jue*; if it is deep, fine, rapid, and scattered, it indicates alternating cold and heat; if it is floating and scattered, it indicates sudden collapse or fainting (*Pu*). All floating pulses without agitation indicate the disease is in the Yang aspect, thus representing heat; if accompanied by agitation, the disease is in the Hand meridians. All fine and deep pulses indicate the disease is in the Yin aspect, manifesting as bone pain; if fine, deep, and still, the disease is in the Foot meridians. A pulse that is rapid, moving, and intermittent indicates a disease in the Yang aspect, with symptoms of diarrhea and pus-blood in the stool.

This section outlines the general principles of Yin-Yang and deficiency-excess in whole-body pulses to differentiate the severity of external contraction and internal injury diseases. The flow of the pulse is like a stream, possessing momentum from its source, containing the principles of Yin-Yang ascending, descending, exiting, and entering. Thus, six characters—Up, Down, Come, Go, Arrive, Stop—are provided for contemplation and understanding. Moving from the Chi position upward to the Cun position is Yang; moving from the Cun downward to the Chi is Yin. Moving from Deep to Floating is Exit and Yang; moving from Floating to Deep is Entry and Yin. Upward and outward movement is "Come"; downward and inward movement is "Go"; feeling the pulse under the fingers is "Arrive"; losing the sensation upon lifting the fingers is "Stop". Therefore, a coarse and large pulse indicates insufficient Yin and excess Yang, with Yang predominating, leading to *Re Zhong* disease. A pulse arriving swiftly and departing slowly means Qi ascends and exits quickly but descends and enters slowly, resulting in vigorous Qi in the upper part, causing excess above and deficiency below. Lower deficiency leads to cold feet (*Jue*), while upper excess causes pain or distension at the vertex. A pulse arriving slowly and departing swiftly means ascending Qi is slow and descending Qi is fast, resulting in vigorous Qi in the lower part, causing excess below and deficiency above. Upper deficiency implies Yang deficiency, hence aversion to wind. Because external wind pathogens invade, and wind is Yang, Yang Qi is diseased due to resonance between similar entities. If the pulse is deep, fine, and rapid, pathogenic heat has entered the Yin compartments, so the disease is in the *Shao Yin Kidney Meridian*. *Jue* refers to rebellious Qi. If deep, fine, rapid, and scattered are present together, indicating blocked Ying Qi, alternating cold and heat occur. As Zhang Zhongjing stated: In *Shao Yin* disease, if there is fever, use *Mahuang Fuzi Xixin Tang* (Ephedra, Aconite, and Asarum Decoction). However, that case involves cold pathogens, hence a micro-fine pulse; this case involves heat pathogens, hence a deep, fine, rapid, and scattered pulse. Both are diseases of *Shao Yin* complicated by Ying-Wei disharmony. If the pulse is floating and scattered, Yuan Qi is escaping externally, causing sudden dizziness and collapse (*Pu*). All floating pulses without agitation indicate the disease is in the Yang compartment, manifesting as heat; if accompanied by agitation, the disease is in the Hand meridians, as the Hand meridians belong to the Heart, Lung, and San Jiao, which are Yang within Yang. Thus, agitation corresponds to the earlier principle of "excess with agitation" pointing to the Hand Shaoyang meridian. All deep and fine pulses indicate the disease is in the Yin compartment, penetrating deeply into the bones, causing bone pain. If deep, fine, and still, the disease is in the Foot meridians, as the Foot meridians are Yin within Yin, contrasting with agitation in the Hand meridians. This stillness or agitation may refer to clinical manifestations and must be carefully examined. A rapid and moving pulse indicates Fire, with the disease in the Yang aspect. If accompanied by intermittent stops, it is named *Cu Mai* (Surging Pulse), indicating Fire pathogen forcing downward causing diarrhea, and Heat pathogen entering the Ying level causing pus-blood in stool. Pathogen stagnation injures Qi and Blood, hence the intermittent pulse. These diseases may arise from external contraction or internal injury; one must inquire into the etiology.

Regarding various excessive pulses during palpation: a Choppy pulse (*Se*) indicates excess Yang Qi; a Slippery pulse (*Hua*) indicates excess Yin Qi. Excess Yang Qi manifests as body heat and absence of sweating; excess Yin Qi manifests as profuse sweating and cold body; excess of both Yin and Yang manifests as absence of sweating and cold body. Pushing the pulse outward (light pressure): if the pulse is felt internally (deep) but not externally (superficial), there is accumulation in the heart and abdomen. Pushing the pulse inward (heavy pressure): if the pulse is felt externally but not internally, there is body heat. Pushing the pulse upward (Cun position): if the pulse is strong above but weak below, the waist and feet are cold. Pushing the pulse downward (Chi position): if the pulse is strong below but weak above, there is headache and neck stiffness. Pressing to the bone with weak pulse Qi indicates lower back and spine pain accompanied by Bi syndrome (obstruction).

"Excessive" refers to the pulse exceeding its normal image. "Excess" refers to pathological Qi, not healthy Yuan Qi. Since the disease is in the Wei (Defensive) Yang, Yang Qi is in excess, causing body heat and no sweat due to closed pores, resulting in a Choppy pulse. Since the disease is in the Ying (Nutritive) Yin, Yin Qi is in excess, causing profuse sweat and cold body due to open pores and flowing fluids, resulting in a Slippery pulse. Disease in both Ying and Wei implies excess of both Yin and Yang, with both levels blocked, causing no sweat and cold body. The above generally discusses pulses of external contraction and internal injury; one must inquire into the cause to differentiate. Pushing outward: pulse felt only on deep pressure indicates internal accumulation in the heart/abdomen, with Qi blocked from reaching the surface. Pushing inward: pulse felt strongly on superficial pressure but weak on deep pressure indicates external pathogen invasion, causing fever. Pushing upward: strong Cun and weak Chi indicate more ascending than descending Qi, leading to cold waist and feet. Pushing downward: weak Cun and strong Chi indicate less ascending than descending Qi, with Yang Qi unable to extend, leading to stiff neck and headache. Pressing to the bone with weak pulse Qi indicates deficiency of Kidney Yuan and insufficiency of Yang Qi, causing lower back/spine pain and Bi syndrome. The waist is the mansion of the Kidney; the spine is the Du Mai (Governing Vessel), the leader of Yang meridians. Bi syndrome formed by Wind, Cold, and Dampness occurs because Yang Qi cannot circulate throughout the body.