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(Su Wen, Ping Ren Qi Xiang Lun)

To understand the excess (Tai Guo) and deficiency (Bu Ji) of Cun Kou pulse: if the Cun Kou pulse feels short upon palpation, it is called headache. (Cun Kou, also known as Qi Kou. See detailed explanation in Zang Xiang Category 11. A short pulse indicates Yang deficiency; when Yang is deficient, Yin gathers thereupon, thus causing headache. Another view states that "short" refers to being short at the lower part. If the pulse is short at the lower part, pathogenic factors congregate in the upper part, thus causing headache. "Zhong" is pronounced with the departing tone, same for subsequent instances.) If the Cun Kou pulse feels long upon palpation, it is called pain in the shins. (A long pulse indicates Yin insufficiency; when Yin is insufficient, Yang gathers thereupon, thus causing pain in the shins.) If the Cun Kou pulse comes rapidly and strikes the fingers upward, it is called shoulder and back pain. (The pulse comes rapidly and strikes the hand at the upper position, indicating abundant Yang pathogenic factors in the upper part, thus resulting in shoulder and back pain.) If the Cun Kou pulse is deep (Chen) and firm, it indicates disease inside the body. (Deep pulse indicates interior syndrome; firmness indicates Yin excess, thus disease is inside.) If the Cun Kou pulse is floating (Fu) and vigorous, it indicates disease outside the body. (Floating pulse indicates exterior syndrome; vigor indicates strong Yang, thus disease is outside.) If the Cun Kou pulse is deep and weak, it indicates alternating chills and fever, as well as Shan (hernia-like disorders), Jia (masses), and lower abdominal pain. (Deep pulse indicates Yang deficiency; weak pulse indicates Yin/Blood deficiency. Yang deficiency leads to external cold; Yin deficiency leads to internal heat, thus alternating chills and fever occur. However, deep and weak pulses often have more Yin and less Yang; Yin-cold is below, thus forming Shan and Jia, causing lower abdominal pain. The following text states: "Rapid/tight pulse indicates Shan, Jia, and lower abdominal pain." This should be cross-referenced. Jia refers to accumulation masses. Shan is pronounced 'shan', also departing tone; Jia is pronounced 'jia', also departing tone.) If the Cun Kou pulse is deep and transverse (Heng), it indicates accumulations under the hypochondrium and horizontal accumulation pain in the abdomen. (Heng refers to rapid and frequent pulsation. Deep pulse governs internal conditions; Heng pulse governs the presence of accumulations, thus accumulations in the hypochondrium and abdomen cause Shan-like pain. Zhang Zhongjing stated: Accumulation (Ji) is a disease of the Zang organs, ultimately immobile. Gathering (Ju) is a disease of the Fu organs, occurring at specific times, with shifting pain migration, which is treatable. The general principles for diagnosing accumulations: When the pulse is fine and adheres closely to the bone, it is an accumulation. At Cun Kou, the accumulation is in the chest; slightly emerging from Cun Kou, the accumulation is in the throat; at Guan, the accumulation is beside the navel; above Guan, the accumulation is below the heart; slightly below Guan, the accumulation is in the lower abdomen; at Chi, the accumulation is at the Qichong point. If the pulse appears on the left, the accumulation is on the left; if on the right, the accumulation is on the right; if appearing on both, the accumulation is in the center. Determine the location based on the pulse position.) If the Cun Kou pulse is deep and panting (Chuan), it indicates alternating chills and fever. (Chuan here means rapid/tense. Deep and tense pulse indicates heat inside. Heat inside causing alternating chills and fever corresponds to the principle that "all spasms, drumming, and trembling belong to Fire.") If the pulse is vigorous, slippery (Hua), and firm, it indicates disease outside the body. (Yang pulse and firm, thus disease is outside.) If the pulse is small, solid, and firm, the disease is inside. (Yin pulse and firm, thus disease is inside.) If the pulse is small, weak, and choppy (Se), it is called chronic disease. (Small and weak indicate Qi deficiency; choppy indicates Blood deficiency. Qi and Blood deficiency result from prolonged illness.) If the pulse is slippery, floating, and rapid, it is called new disease. (Slippery and floating are Yang pulses. Yang pulse and rapid indicate abundant pathogens. Abundant pathogens with vigorous momentum signify new disease.) If the pulse is tight/urgent, it indicates Shan, Jia, and lower abdominal pain. (Tight pulse indicates abundant Yin pathogens, thus Shan, Jia, and lower abdominal pain.) If the pulse is slippery, it indicates Wind. (Slippery pulse is smooth and fluent, belonging to Yang. Wind's nature is moving, also belonging to Yang. Thus, slippery pulse indicates Wind.) If the pulse is choppy, it indicates Bi syndrome. (Choppy is a Yin pulse, indicating Blood insufficiency, thus Bi syndrome occurs.) If the pulse is slow and slippery, it indicates Heat in the Middle. (Slow due to Stomach heat; slippery due to Yang excess, thus Heat in the Middle. Qi Xuan Zi stated: Slow refers to a relaxed/lax state, not a slow movement rate.) If the pulse is vigorous and tight, it indicates distension. (Vigorous indicates stagnation of Middle Qi; tight indicates excess pathogens, thus distension occurs.) Prominent blue vessels on the arm indicate Blood loss. (When Blood is lost, Qi departs; when Qi departs, Cold coagulates; coagulation causes bluish-black discoloration, hence blue color on the arm. Mentioning the arm implies other areas are similar; this is also the meaning of diagnosing Chi skin.) If Chi pulse is slow and choppy, it indicates lethargy/sluggishness. (Chi pulse governs the Yin aspect. Slow indicates Qi decline; choppy indicates Blood deficiency, thus lethargy/sluggishness occurs. Le Yu is a name for unbearable fatigue. Pronounced 'ji'.) Resting quietly but with a vigorous pulse indicates Blood loss. (Generally, vigorous pulse means abundant pathogens; abundant pathogens mean restless sleep. Now, vigorous pulse with quiet sleep indicates this is not Yang pathogen in the Qi level, but Yin deficiency with Blood loss. This continues from the previous discussion on Chi pulse; generally, vigorous Chi pulse indicates Yin deficiency, thus Blood loss.) If Chi skin is rough/choppy and Chi pulse is slippery, it indicates excessive sweating. (Refers to rough Chi skin and slippery Chi pulse. Rough Chi skin indicates deficient Ying Blood. Slippery Chi pulse indicates abundant Yin Fire. Yang excess and Yin deficiency lead to excessive sweating. Yin Yang Bie Lun states: Yang added to Yin is called sweat.) If Chi skin is cold and pulse is fine, it indicates posterior discharge/diarrhea. (Cold Chi skin indicates Spleen Yang decline, as Spleen governs muscles and four limbs. Fine Chi pulse indicates Kidney Yang decline, as Kidney governs the two yin openings and lower body. Spleen and Kidney deficiency-cold lead to posterior discharge.) If the Chi pulse is coarse and accompanied by constant heat, it is called Heat in the Middle. (Coarse Chi indicates deficiency of True Yin; constant heat indicates excess of Yin Fire, thus called Heat in the Middle.)