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(The discussions on Hong [Surging] and Xi [Fine] pulses are attached here.)

Da [Large] and Xiao [Small] refer to the physical form of the pulse. When Qi and Blood are abundant and sufficient, the sensation under the fingers is robust and vigorous; this is called Da [Large]. If it is large and forceful, it is termed Hong [Surging]. When Qi and Blood are insufficient, the sensation under the fingers is like a single thread; this is called Xiao [Small], also referred to as Xi [Fine]. (The distinction between Da [Large] and Hong [Surging] lies in that one refers to the coarseness of the form, while the other refers to the ferocity of the momentum. Since form and spirit can be analyzed separately, ancient physicians often combined them into one category.) The pulse of a healthy person may be either large or small, generally determined by their innate constitution, and initially not altered by disease. In cases of external sores caused by Qi stagnation and Blood stasis, where the pathology is excess, the pulse should be large rather than small. However, if the lesion is not hard and massive, or if the patient's habitual pulse is small, then a small pulse with Shen [Spirit] is auspicious everywhere. Conversely, if the pulse is large and forceful, hard and beating against the fingers, surging and fierce, rushing violently, it indicates that the pathogenic factor is too excessive, which is not an auspicious sign. In the ulcerative stage, with leakage of Qi and consumption of Blood, the pathology is deficiency, and the pulse should be small rather than large. Yet, if the consumption is not yet significant, or if the patient has a robust physique, a large pulse with Shen [Spirit] is indeed a sign that the pathogen is retreating and the Yuan Qi [Original Qi] remains intact. If the pulse is small and formless without Shen [Spirit], the external sore will be difficult to heal, which is particularly worrying. Only when the swelling is severe but the pulse is excessively small, weak, and unarising, does it indicate that Zheng Qi [Upright Qi] cannot overcome the Xie Qi [Pathogenic Qi], constituting a critical condition. After the expulsion of severe toxins, if the pulse becomes vast and rootless, it indicates that Yuan Qi [Original Qi] has been depleted, representing a failing sign. All these situations must be evaluated by cross-referencing physical symptoms with the Shen [Spirit] of the pulse to determine auspiciousness or inauspiciousness. One cannot merely seek the physical resemblance under the fingers and assume that the key to pulse diagnosis lies solely therein.

Hua [Slippery] and Se [Rough] refer to the momentum of the pulse. When Qi and Blood are vigorous, the pulse flows smoothly; this is called Hua [Slippery]. When Qi and Blood are deficient, the pulse is stagnant; this is called Se [Rough]. In cases of carbuncles and ulcers during the phase of hard swelling, the pulse is often Se [Rough], indicating that Qi is gathered and Blood is congealed, with roots firmly established and knots unresolved, which is its characteristic sign. Additionally, patients suffering from Dampness invading the meridians, or Phlegm-Dampness clouding the Middle Jiao [Middle Burner], leading to gastric stagnation and mental cloudiness, invariably present with a Se [Rough] pulse. These are all cases of Excess pathogens blocking flow, causing Qi movement to be unfavorable. Treatment with dredging and venting will cause the Se [Rough] pulse to disappear. If the sore has formed pus, Qi and Blood contend, and the momentum is at its peak; the pulse corresponds to this with Hua [Slippery] and Shu [Rapid] qualities. Therefore, the timing of whether the swelling has formed pus or not can be determined by the Hua [Slippery] or Se [Rough] nature of the pulse. A Se [Rough] pulse indicates no pus inside yet, allowing for resolution; a Hua [Slippery] pulse indicates that pus has matured and will inevitably suppurate externally. If the carbuncle or ulcer has already ruptured, Qi stagnation has cleared, and Blood stasis has drained; the pulse should be Hua [Slippery] and smooth as favorable, and Se [Rough] as unfavorable. A Hua [Slippery] pulse indicates sufficient Zheng Qi [Upright Qi], making the clearing of pathogens and recovery easy. Only a Hua [Slippery] and Large pulse suggests that residual heat is still vigorous, which is not the normal track of recovery. A Se [Rough] pulse indicates that Blood has been consumed, and the complexion and spirit must be fatigued. Nourishing and supporting Yuan Qi [Original Qi] cannot be delayed. If accompanied by Se [Rough], Small, and Weak qualities, along with loss of luster and emaciation, it is particularly worrying.