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Xuan (String-like) pulse refers to a pulse that is rigid, forceful, straight, and long. It indicates hyperactivity of Liver Yang or the stagnation of Phlegm-Fluids. Jin (Tight) pulse refers to a pulse that is fixed, firm, and vertical, resisting pressure without yielding. It indicates external constraint by Cold pathogen or internal coagulation of Excess pathogens. The *Suwen* mentions the concept of "pulse being solid and firm." In the *Ping Mai Pian* (Chapter on Normal Pulse Diagnosis) of the *Shanghan Lun*, it states: "Cold leads to firmness and solidity." The *Mai Jing* cites this as "Cold leads to Jin and Xuan pulses," suggesting that the Jin pulse can also be termed a Jian (Firm) pulse; both terms describe the sensation of force felt under the fingers. Wang Shuhe's description of the Jin pulse as "like a twisted rope, irregular" is incorrect. Essentially, the Jin pulse is forceful and not scattered, resembling the Shi (Excess) pulse in the context of Deficiency-Excess differentiation. Ge (Leather) pulse is characterized by firmness, largeness, and forcefulness upon superficial palpation (Fu position); Lao (Deep-Firm) pulse is characterized by firmness, largeness, and forcefulness upon deep palpation (Chen position). The former represents the floating outward of isolated Yang, while the latter represents the condensation of Yin-Cold within. Although their pathological implications are opposite, the physical sensation of firmness and force is identical. These four types all belong to the category of Excess pulses. When patients with surgical diseases present these pulses, it invariably indicates that the disease process is vigorous and the toxicity is severe; one may refer to the principles outlined for Excess pulses in the preceding section.

Ruo (Weak) and Ruan (Soft) pulses refer to pulses that lack force upon palpation. Ancients often distinguished them as follows: floating, thin, and forceless is Ruan (Soft); sunken, thin, and forceless is Ruo (Weak), treating them as two distinct types. I consider that, semantically, "Ruan" and "Ruo" are difficult to distinguish. If defined strictly by superficial versus deep positions, it is acceptable merely as a positional distinction. However, regarding the diseases they indicate, both essentially reflect insufficiency of Qi and Blood. Therefore, it is more appropriate to discuss them collectively for a more comprehensive understanding. The *Qianjin Yi Fang* introduced the Ru (Soggy) pulse, after which most pulse theorists categorized Ru and Ruan as separate classes. Examining the *Ping Ren Qi Xiang Lun* chapter of the *Suwen*, the normal Liver pulse is described as "Ruan Ruan Zhao Zhao" (Soft and gentle). The *Mai Jing* cites this as "Ru Ruan." It appears that "Ru" is a variant form of "Ruan." The oldest character was likely '耎' (ruan), later evolving into other forms, and eventually becoming the common character '软'. In Han dynasty clerical script, many characters derived from the phonetic component 'Xu' (需). Although the pronunciations differed, the shapes and meanings were similar, leading to confusion that could no longer be rectified. Thus, the character in the *Neijing* was later written as "Ru" in "Ru Mai," but this "Ru" does not mean moist or stagnant. Zhang Shouyi stated that among the pulses—Ruan, Wu, Ru, and Wei—the Ruan pulse represents a more pronounced degree of weakness. If the pulse becomes even more scattered and unrestrained, feeling as if it exists and yet does not under the fingers, it is called the San (Scattered) pulse. These four types all belong to the category of Deficiency pulses.
Regarding external surgical sores, before ulceration, the condition is Excess, so a Ruo/Ruan pulse is generally inappropriate. However, if the disease severity is mild and the sore is small, the occasional appearance of a Ruo/Ruan pulse does not necessarily indicate immediate collapse. After ulceration, when the healthy Qi has been damaged, a Ruo/Ruan pulse is particularly consistent with the pathology. A Wei (Micro) pulse, however, indicates excessive weakness, suggesting that Yuan Qi (Original Qi) cannot sustain itself. A San (Scattered) pulse, being diffuse and unrestrained, usually indicates prior destruction of the root foundation. Whether in the case of a swelling (Zhong Yang) or an ulcerated sore (Kui Yang), it presents no auspicious signs. These should be inferred by referring to the principles of Deficiency pulses in the preceding section, allowing one to deduce other cases from this example.