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<Suwen: Pulse Essentials and Subtleties>

The Yellow Emperor asked: How do the pulses move in accordance with the four seasons? How can one know the location of the disease? How can one know the transformation of the disease? How can one know when the pathogen is suddenly inside? How can one know when the pathogen is suddenly outside? I ask if these five points can be explained to me. Qibo replied: Please allow me to speak of their correspondence with the great movement of the heavens. (These five points are essentially the principles of Yin-Yang and Wu Xing (Five Elements), which constitute the fundamental elements and their interactions, and Yin-Yang and Wu Xing are the way of Heaven and Earth. Thus, Qibo responds with the grand movement of the heavens, so that the changes of these five points are fully contained within it.) Outside all things, within the Six Directions (referring to up, down, east, west, south, north, generally meaning the universe or world), the changes of Heaven and Earth, and the responses of Yin and Yang, the warmth of spring becomes the heat of summer; the severity of autumn becomes the cold of winter. The movements of the four seasonal changes cause the pulses to rise and fall accordingly. (Things exist within Heaven and Earth, and Heaven envelops things from without. Heaven, Earth, and all things originate from the same Qi. Therefore, any change in Heaven and Earth is a response of Yin and Yang. Thus, the warmth of spring is the gradual onset of summer's heat; the severity of autumn is the gradual onset of winter's cold. Spring generates, Summer grows, Autumn harvests, Winter stores; this is the movement of Yin-Yang through the four seasons, and the pulse also rises and falls with it.) In spring, the pulse corresponds to the Gui (compass for drawing circles), [indicating roundness]. (The Gui is an instrument for drawing circles. The Qi of Spring arises, moving in a round and lively manner, thus corresponding to the Gui. Human pulses correspond to this, appearing smooth and round.) In summer, the pulse corresponds to the Ju (square ruler), [indicating squareness]. (The Ju is an instrument for drawing squares. The Qi of Summer flourishes, reaching its peak and then stopping, thus corresponding to the Ju. Human pulses correspond to this, appearing surging, large, and upright.) In autumn, the pulse corresponds to the Heng (balance beam), [indicating balance]. (Heng means level, referring to the horizontal beam of a scale. In autumn, all treasures mature, becoming level with the ground, thus corresponding to the Heng. Human pulses correspond to this, appearing floating like hair on the surface.) In winter, the pulse corresponds to the Quan (steelyard weight), [indicating sinking]. (Quan refers to the weight of a steelyard. The Qi of Winter closes and stores, thus corresponding to the Quan. Human pulses correspond to this, appearing deep and heavy like stone, hidden within.) All these rules of Gui, Ju, Heng, and Quan serve to elucidate the principles of Yin-Yang ascending and descending, aligning with the changing images of pulse Qi in the four seasons.) Therefore, forty-five days after the Winter Solstice, Yang Qi slightly ascends, and Yin Qi slightly descends; forty-five days after the Summer Solstice, Yin Qi slightly ascends, and Yang Qi slightly descends. Yin and Yang have their specific times, matching the pulses. If they miss their timing, according to the division of the pulse [to organs], and knowing that decline and flourishing each have their periods, one can know the time of death. (At the Winter Solstice, one Yang is born. Thus, from 45 days after the Winter Solstice until Li Chun (Start of Spring), Yang Qi gradually and slightly ascends; as Yang slightly ascends, Yin slightly descends. At the Summer Solstice, one Yin is born. Thus, from 45 days after the Summer Solstice until Li Qiu (Start of Autumn), Yin Qi gradually and slightly ascends; as Yin slightly ascends, Yang slightly descends. This is what is meant by Yin and Yang having their specific times. "Matching the pulse" means the pulse changes with the seasons. "Missing the timing" means the Spring-Gui, Summer-Ju, Autumn-Heng, and Winter-Quan do not conform to the standard. "According to the division of the pulse" means the pulses of the Five Zang Organs each have their respective affiliations. "Having periods for decline and flourishing" means they each have their proper times. Understanding this allows one to know the times of life and death.) The subtlety and profundity of the pulse must not go unexamined. Examination has its discipline, starting with Yin-Yang. Discipline has its classics, arising from Wu Xing (Wood, Fire, Earth, Metal, Water and their generating/controlling relationships). Generation has its measure, suited to the four seasons. (The subtlety of the pulse is governed by Yin-Yang and Wu Xing. The generation of Yin-Yang and Wu Xing has its own measures. For example, Yang is born at the Winter Solstice, Yin at the Summer Solstice, Wood in the Hai month, Fire in the Yin month, Metal in the Si month, and Earth/Water in the Shen month. The generation and flourishing in the four seasons each have their appropriateness. Ji refers to discipline/guidelines. Jing refers to constants/classics. This implies the meaning of major outlines and minor guidelines.) Tonification and reduction should not be missed, aligning with the Way of Heaven and Earth. (The Way of Heaven and Earth reduces the excess and supplements the deficient. The I Ching states: The Way of Heaven diminishes the full and benefits the humble; the Way of Earth transforms the full and flows to the humble. Thus, deficiency requires tonification, and excess requires reduction. If tonification and reduction are applied appropriately, they align with the Way of Heaven and Earth.) Grasping the essence of "One" allows one to know life and death. (The essence of "One" is the subtlety of the unity of Heaven and Humanity. The Way of Heaven and Earth: Yang governs movement, Yin governs stillness. When Yang comes, there is life; when Yang goes, there is death. Knowing why the Way of Heaven does not cease allows one to understand human life and death.) Therefore, sounds correspond to the Five Tones (Gong, Shang, Jue, Zhi, Yu); complexions correspond to Wu Xing; pulses correspond to Yin and Yang. (Sounds correspond to Gong, Shang, Jue, Zhi, Yu; complexions correspond to Metal, Wood, Water, Fire, Earth; pulses correspond to the Yin and Yang of the four seasons. Although these three seem distinct, their principle is one.) Therefore, holding the pulse follows a Dao, where Xu Jing (Empty Mind and Quiet Will) serves as the guarantee. (In the art of pulse diagnosis, sincere focus is paramount, and disturbance is most to be avoided. Thus, one must empty the mind and quiet the will, attending to every minute detail without gap, so that the Dao of diagnosis is complete. Bao means not losing or failing.) In spring, the pulse floats, like a fish swimming in waves. (The pulse receives Spring Qi; although floating, it is not fully exposed, thus resembling a fish swimming in waves.) In summer, the pulse is at the skin level, abundant and overflowing like all things in plenty. (The pulse receives Summer Qi, becoming surging and external, thus appearing abundant like the plenitude of all things.) In autumn, the pulse sinks below the skin, like hibernating insects about to depart. (The pulse receives Autumn Qi, and its surging nature gradually收敛 [converges/restrains], thus resembling insects about to hibernate.) In winter, the pulse is in the bones, like hibernating insects tightly concealed, and gentlemen reside indoors. (The pulse receives Winter Qi, sinking and hidden in the bones, thus resembling hibernating insects tightly concealed. Gentlemen at this time should also embody the Way of Heaven and Earth's closure and storage, residing indoors.) Thus it is said: To know the interior, press the pulse and record its patterns; to know the exterior, trace it from end to beginning. These six points are the great methods of holding the pulse. (Interior refers to Zang Qi; Zang Xiang [Visceral Manifestations] have fixed positions, so they can be pressed and recorded. Exterior refers to Jing Qi [Meridian Qi]; Meridians have order, so they can be traced from start to finish. However, one must understand these six methods of the four seasons' interior and exterior. Then, the pulse's seasonal movements, the location of diseases, and whether pathological changes are internal or external can all be known. Hence, they are called the great methods of pulse diagnosis.)