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The *Suwen: Daqi Lun* states: When the spleen pulse beats externally and presents a deep (*Chen*) image, it indicates Changpi (dysentery or diarrhea with pus and blood); after a long time, it will heal itself. When the liver pulse is small and slow, it also indicates Changpi, which is easy to treat. When the kidney pulse is small, bounding (*Bo*), and deep, it indicates Changpi with bloody stool; if the blood is warm and the body is feverish, it is a fatal condition. If the heart and liver are affected, there is also bloody stool; if both organs are diseased simultaneously, it is treatable. However, if the pulse is small, deep, and choppy (*Se*), indicating Changpi, and the body is feverish, it is fatal; death occurs within seven days of fever appearing.

When the spleen pulse beats externally and presents a deep image, it means the pulse qi beats outside the main site of the spleen meridian, and the pulse shape is flat and broad. The reason for the deep image is that spleen dampness flows downward into the large intestine, causing Changpi, where bowel movements lose control and fecal water often flows out. However, because the pulse shape is broad, it indicates that spleen qi is not deficient; after a long time, when the dampness dissipates, it will heal itself. When the liver pulse is small and slow, it indicates Changpi, caused by weak wood and strong earth, so it is also easy to treat. If the kidney pulse is small, bounding, and deep, and Changpi is accompanied by bloody stool, this is damp-heat flowing into the lower jiao and damaging yin blood. Thus, the kidney pulse is small, bounding, and discordant, deep without beating outwardly. If the blood is warm and the body is feverish, it indicates that pathogenic heat has penetrated deeply and the true yin is exhausted, leading to death. If the bleeding from Changpi is caused by the movement of wind-fire in the heart and liver, it is not an injury to the spleen, so it is treatable. But if both hands present small, deep, and choppy pulses along with Changpi, this indicates a dual deficiency of qi and blood. The body should not be feverish; if it is feverish, it indicates floating deficient yang. Seven days is the cycle for yang recovery; if yang is exhausted and cannot recover, death ensues. Generally, yang is born at Zi hour, and yin is born at Wu hour. From Zi to Wu is seven periods, and from Wu to Zi is also seven periods. If the qi of yin and yang can generate each other, the disease can heal in seven days; if they do not generate each other and become severed, death also occurs within seven days.

If the stomach pulse is deep, beating, and choppy, and beats externally larger than normal, and the heart pulse is small, firm, and urgent, these all indicate Ge syndrome (obstruction in the chest/diaphragm) and Pianku (hemiplegia). In men, it manifests on the left; in women, on the right. If there is no aphasia and the tongue can move, it is treatable, with improvement starting after thirty days. If the condition follows the "conforming" pattern (men on the right, women on the left), and aphasia occurs, improvement starts after three years. For those under twenty years old, death occurs after three years.

A stomach pulse that is deep, beating, and choppy, yet beats externally larger than the vessel path, indicates severe obstruction by phlegm-saliva. The heart pulse should be floating,洪 (Hong), and soft, but now it is small, firm, and urgent, indicating severe damage to Ying blood (nutritive blood). Ying blood originates in the middle jiao and passes through the stomach opening. Therefore, both pulse images indicate Ge syndrome. Obstruction in the central palace prevents the free flow of yin-yang, qi, and blood in the meridians, resulting in hemiplegia. Men's yang qi turns from the left, so manifestation on the left is adverse; women's yang qi turns from the right, so manifestation on the right is adverse. If there is no aphasia and the tongue moves, it indicates the zang organs are not injured, only the meridians, so it is treatable. After thirty days, when the sun and moon align, the qi of the human body also reunites its yin and yang at the source, so hemiplegia can heal. The term "conforming" refers to men manifesting on the right and women on the left. The spleen and kidney meridians connect to the root of the tongue and the tongue base. Those with aphasia have spleen and kidney qi unable to reach the tongue base. Although the external symptoms seem conforming, the five internal organs are damaged. If not completely depleted, regulation and tonification over three years can lead to recovery. However, for those under twenty, who are in their prime growth period, getting this disease indicates a weak constitution and deficiency. Even with regulation and tonification, life may only be prolonged for three years before death.

If the pulse arrives with a beating force, accompanied by nasal bleeding (Xu) and body fever, it is a fatal condition. If the pulse arrives hanging like a hook and floating, it is a normal pulse.

The following clauses all discuss the pulse images of both hands, without distinguishing specific locations. Xu (nasal bleeding) results from heat damaging qi and blood, overflowing from the yang pathways. A beating pulse without a gentle quality, combined with body fever, indicates the Zang-Fu pulse of isolated yang surging outward, hence fatal. A pulse arriving hanging like a hook and floating is the intrinsic image of the heart pulse; added with emptiness and softness, it is the common pulse for Xu disease, which is treatable and curable. Since the heat of Xu is in the clear pathways and yang divisions, the pulse is floating and empty/soft. If vomiting blood comes from the turbid pathways and yin divisions, the pulse should be deep and weak; if the pulse is floating, it is ominous. This must be known.

If the pulse arrives as if panting, it is called Bao Jue (sudden syncope). Patients with Bao Jue do not know how to speak with others. If the pulse arrives as if rapid (Shu), causing sudden fright, it will heal itself in three to four days.

"Panting" means the pulse momentum is turbulent, qi suddenly rebels and causes jue (cold extremities/syncope), leading to loss of consciousness. If qi smooths and jue reverses, the patient revives; if jue does not reverse, death ensues. A pulse arriving as if rapid, but seemingly rapid yet non-rapid and empty/soft, indicates deficiency of heart and liver blood with moving qi, causing sudden fright (e.g., waking up startled from sleep). This is described as unsettled soul and dreams; quiet rest can stop it.

If the pulse arrives floating and gathering (Fu He), resembling a rapid pulse, with more than ten beats per respiration, this indicates insufficiency of Jing qi (meridian qi). If slightly visible, death occurs in ninety days.

A pulse arriving like Fu He resembles duckweed floating and gathering on water, empty underneath. Resembling a rapid pulse with more than ten beats per respiration is a Tuo pulse (collapse pulse), which should cause immediate death, not prolongation to ninety days. There must be an error here. Alternatively, it may mean that if the Fu He pulse with emptiness underneath appears slightly, indicating insufficient Jing qi, death occurs in ninety days; but if it resembles a rapid pulse with more than ten beats per respiration, death is immediate and not calculated by days. This is an inverted grammatical structure.

If the pulse arrives like burning firewood, it indicates the deprivation of Heart Jing essence; death occurs when grass dries. If the pulse arrives like scattered leaves, it indicates deficiency of Liver qi; death occurs when tree leaves fall. If the pulse arrives like a visiting guest (Sheng Ke), meaning the pulse is blocked yet beating, it indicates insufficiency of Kidney qi; death occurs when dates bloom. If the pulse arrives like pill-shaped mud, it indicates insufficiency of Stomach Jing essence; death occurs when elm catkins fall. If the pulse arrives like a horizontal grid, it indicates insufficiency of Gallbladder qi; death occurs when grains ripen. If the pulse arrives like string threads, it indicates insufficiency of Pericardium Jing essence; if the patient speaks excessively, death occurs when frost falls; if silent, it is treatable. If the pulse arrives like Jiao Qi (a resin dripping sideways), meaning it arrives from both sides laterally, if slightly visible, death occurs in thirty days.

A pulse arriving like burning firewood boils and shakes, indicating Heart Jing deprivation and scattering of Heart fire; death occurs in winter when grass is dry, water is prosperous, and fire is extinct. A pulse arriving like scattered leaves is light, empty, floating, and rootless, indicating exhaustion of Liver qi and blood; when leaves fall and Metal qi is prosperous, Liver Wood is extinct, leading to death. A pulse arriving like Sheng Ke wants to emerge but does not; saying it is "blocked" and "beating" means there is exit without entry. This indicates Kidney qi deprivation and exhaustion of essence and blood, hence the pulse shape. Death occurs when dates bloom; in summer when Earth is prosperous, Water is extinct. A pulse arriving like pill-shaped mud is round and rotating upon pressure, without coming or going, soft like mud, indicating insufficiency of Stomach essence and qi. Death occurs when elm catkins fall; in late spring when Wood is prosperous, Earth qi is extinct. A pulse arriving like a horizontal grid shows qi rebelling against each other, losing the gentle and unblocking image of Shaoyang; this indicates insufficiency of Gallbladder qi. Gallbladder belongs to Jia Wood; when grains ripen in late autumn when Metal is prosperous, Wood qi is extinct, leading to death. A pulse arriving like string threads is thin, long, urgent, and strong. Insufficiency of Pericardium Jing: the Pericardium acts on behalf of the Heart. Insufficiency of essence leads to movement and scattering of Heart fire. Speech is the voice of the heart; thus, excessive speech indicates this. In winter when frost falls and Cold Water is prosperous, Fire is extinct, leading to death. If silent, Heart fire is still calm; major tonification of Heart blood can treat it. A pulse arriving like Jiao Qi, arriving from both sides laterally, indicates Ying qi not circulating in meridians and chaotic yin-yang. If this image appears slightly, at the time of yin-yang convergence in thirty days, if they cannot generate each other, qi exhausts and death ensues.

If the pulse arrives like a gushing spring, beating floatingly in the muscles, it indicates insufficiency of Taiyang qi. With shortness of breath, death occurs when leek flowers are eaten.

Taiyang and Shaoyin are exterior-interior pairs. A pulse arriving like a gushing spring boils and beats floatingly in the muscles, while the deep portion is empty. Floating is Yang, Deep is Yin; Yang roots in Yin. If the deep portion is empty, the root is ruined and vital qi is scarce. Death occurs when leek flowers have flavor, during spring yang rising, when the root is severed. All subsequent clauses describe fatal pulses.

If the pulse arrives like a pile of collapsed earth, unobtainable upon pressing, it indicates insufficiency of Muscle qi. If the five colors first show black, and Bai Lei (white leukoderma) erupts, death ensues.

A pulse arriving like collapsed earth has no beating force upon pressure, hence unobtainable and rootless, indicating insufficiency of Muscle qi. The five colors showing black first indicates exhaustion of Kidney water, described as a face like lacquered charcoal. Bai Lei has five types; white appears in spring. Since Earth fails first, and Kidney water is exhausted without Spring generating qi, how can one not die?

If the pulse arrives like Xuan Yong (uvula), where pressing floatingly makes it larger, it indicates insufficiency of the Twelve Shu points. Death occurs when water freezes.

The uvula in the throat roots in the Kidney; injury leads to immediate death. Also named Xuan Yong, the pulse shape resembles it, becoming larger upon floating and pressing. This indicates excess exterior qi and insecurity of the five internal organs. Due to insufficiency of the Twelve Shu points, yang qi emission increases daily; thus, in winter cold when water freezes, yang exhausts and death ensues. Shu points are all on the back, being the qi-acupoints of the twelve meridians and zang-fu organs.

If the pulse arrives like an inverted knife: inverted knife means small and urgent upon floating, firm, large, and urgent upon pressing. It indicates Wenyu Re (stagnant heat in five zang organs) and Hanre (cold-heat) combining exclusively in the Kidney. Such a person cannot sit; death occurs at Lichun (Start of Spring).

Small and urgent in the floating layer is like a knife edge; firm, large, and urgent in the pressing layer is like the knife back, lacking any gentle quality. Wenyu means stagnation. Because the five zang organs have long stagnated pathogenic qi, combining exclusively in the Kidney, Kidney injury causes waist collapse; one can lie but not sit. Kidney failure cannot generate Liver; at Lichun, Wood lacks generating qi, leading to extinction and death.

If the pulse arrives like a pellet, slippery but not straight to the hand (meaning unobtainable upon pressing), it indicates insufficiency of Large Intestine qi. Death occurs when jujube leaves grow.

"Zhi" is same as "Zhi". "Bu Zhi Shou" means round and slippery upon pressure but vanishing immediately, with only virtual floating qi moving slipperily. Large Intestine is Geng Metal; jujube leaves grow in summer. When Fire is prosperous, Metal is extinct, leading to death.

If the pulse arrives like a flower, causing frequent fear, unwillingness to sit or lie, and constantly listening while walking or standing, it indicates insufficiency of Small Intestine qi. Death occurs in late autumn.

Like a flower means blooming without contraction, similar to the Heart pulse like burning firewood. Small Intestine is Bing Fire, Heart is Ding Fire; as zang-fu exterior-interior pairs, their qi connects, so the pulses are similar. Fire without contraction indicates exhaustion of yin essence and leakage of yang outward. Timidity of Heart qi causes fear; fear causes suspicion, hence unwillingness to sit or lie, and constantly listening. Death occurs in late autumn when yang qi is fully leaked; Bing Fire is tombed in Xu.