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[Suwen] The pulse is the residence of blood. (Ying Qi circulates within the vessels. *Ci Zhi Lun* states: A full pulse indicates abundant blood, while a deficient pulse indicates depleted blood.) A long pulse signifies regulated Qi. (A long pulse represents sufficient Qi.) A short pulse indicates pathological Qi. (A short pulse represents insufficient Qi.) A rapid pulse indicates vexation in the heart. (A rapid and hurried pulse indicates heat.) A large pulse indicates disease progression. (A large pulse indicates excess pathogenic factors.) Excess at the upper part (Cun position) indicates ascending Qi; excess at the lower part (Chi position), as Ma Shi notes referring to below Guan, indicates Qi distension. (Distension belongs to the middle region. Wang Ang notes: The Kidney can also have distension. The Kidney is the gate of the Stomach; if the gate is not functional, distension occurs.) A choppy or intermittent pulse (Dai pulse) indicates Qi deficiency. (The pulse beats and then stops; this is called Dai.) A thin pulse indicates Qi depletion. A choppy pulse indicates Heart pain. (A choppy pulse indicates blood deficiency.) A turbid,革 (Ge) pulse arriving like a gushing spring indicates disease progression and deteriorated complexion. A faint, continuous pulse departing like a broken string indicates death. (The pulse is faint and then ceases.) (*Mai Yao Jing Wei Lun*)

[Suwen] What are Deficiency and Excess? It is said: Excess arises from the flourishing of pathogenic factors; Deficiency arises from the depletion of essential Qi. How do they manifest? It is said: Qi deficiency corresponds to Lung deficiency. (The Lung governs Qi.) Qi rebellion manifests as cold feet. (Excess above, deficiency below.) If it occurs during a non-clashing time, there is survival; if it occurs during a clashing time, there is death. (Encountering times of Five Elements mutual overcoming.) The same applies to other Zang organs. "Chong Shi" (Double Excess) refers to severe heat diseases where Qi is hot and the pulse is full and large. When both meridians and collaterals are excess, the Cun pulse is urgent and the Chi pulse is slow. (Urgent Cun indicates Yang meridian excess; slow Chi indicates Yin collateral excess. Wang Bing notes: Yin governs collaterals, Yang governs meridians.) A slippery pulse indicates favorable prognosis; a choppy pulse indicates unfavorable prognosis. Therefore, if the five Zang organs and bones/flesh are slippery and smooth, longevity is possible. (Dead things become withered and choppy.) When collateral Qi is deficient and meridian Qi is excess, the Mai Kou (Cun position) is hot and the Chi position is cold. This is unfavorable in Autumn/Winter but favorable in Spring/Summer. Treat the primary diseased area. (In Spring/Summer, Yang Qi is high, so Mai Kou should be hot and Chi cold; observe which meridian/collateral is affected and treat accordingly.) When meridian Qi is deficient and collateral Qi is excess, the Chi pulse is full, and the Mai Kou is cold and choppy. This leads to death in Spring/Summer but survival in Autumn/Winter. (In Autumn/Winter, Yang Qi descends, so Chi should be hot and Mai Kou cold.) What is "Chong Xu" (Double Deficiency)? It is said: Upper Qi deficiency and Chi deficiency constitute Chong Xu. (Both Cun and Chi are deficient.) In such cases, a slippery pulse indicates survival, while a choppy pulse indicates death. Regarding Chang Pi (Intestinal Dysentery) with bloody stool: (Chang Feng and dysentery are both named Chang Pi. This question seems to specifically refer to dysentery, as seen below. Bloody stool refers to pure blood, caused by heat injuring the Blood level.) If the body is hot, death ensues; if cold, survival ensues. Regarding Chang Pi with white mucus discharge: (Not pus nor blood, but white mucus, caused by heat injuring the Qi level.) A deep pulse indicates survival; a floating pulse indicates death. (Floating pulse in Yin syndrome presents Yang pulse signs; generally, dysentery contraindicates body heat and floating pulse.) Regarding Chang Pi with pus and blood discharge: (Red and white mixed, injuring both Qi and Blood.) A suspended and severed pulse indicates death; a slippery and large pulse indicates survival. (Slippery represents Yin Blood; Large represents Yang Qi.) Regarding Epilepsy (Dian Ji): A pulse that is large and slippery allows for self-recovery over time. (Yang syndrome obtaining Yang pulse.) A small, firm, and urgent pulse indicates death and untreatability. (Yang syndrome obtaining Yin pulse.) Regarding the pulse of Dian Ji, what about deficiency and excess? Deficiency is treatable; excess indicates death. (Excess indicates pathogenic excess.) Regarding Xiao Dan (Wasting-Thirst, characterized by stomach heat, excessive eating, and hunger), what about deficiency and excess? A large and solid pulse in a chronic case is treatable. (Blood and Qi are still abundant.) A suspended, small, and firm pulse in a chronic case is untreatable. (*Tong Ping Xu Shi Lun*)

[Suwen] A Cun Kou pulse that feels short upon palpation indicates headache. A long one indicates pain in the shins. (Wang Bing notes: Short indicates Yang deficiency, hence disease in the head; Long indicates Yin excess, hence disease in the feet.) A Cun Kou pulse that feels rapid and strikes upward indicates shoulder and back pain. (Yang excess in the upper body.) A Cun Kou pulse that is deep and firm indicates disease in the interior. A floating and vigorous pulse indicates disease in the exterior. A Cun Kou pulse that is deep and horizontal indicates accumulation under the hypochondrium and horizontal abdominal pain. A Cun Kou pulse that is deep and panting-like indicates alternating chills and fever. (Deep is Yin, panting is Yang, indicating alternating chills and fever.) A vigorous, slippery, and firm pulse indicates exterior disease. A small, solid, and firm pulse indicates interior disease. A small, weak, and choppy pulse indicates chronic disease. (Small and weak indicate Qi deficiency; choppy indicates blood deficiency.) A slippery, floating, and rapid pulse indicates new-onset disease. (Sufficient Qi and Yang excess.) An urgent pulse indicates Hernia-Jia (masses) and lower abdominal pain. (Urgent indicates cold and pain.) A slippery pulse indicates Wind. (Slippery is a Yang pulse; Wind is also a Yang pathogen.) A choppy pulse indicates Bi Syndrome. (Choppy indicates lack of blood, hence Bi.) A slow and slippery pulse indicates Heat in the Middle. (Stomach heat.) A vigorous and tight pulse indicates distension. (Tight indicates cold distension.) A Chi pulse that is slow and choppy indicates lethargy/sluggishness. (Zhang Jingyue notes: Sluggishness.) A pulse that is vigorous while resting indicates blood loss. (While resting, the pulse should be faint; if vigorous instead, blood has departed and Qi has no master.) A Chi position that is choppy with a slippery overall pulse indicates profuse sweating. (Blood deficiency with Yang excess.) A Chi position that is cold with a fine pulse indicates posterior diarrhea. (The Kidney governs urination and defecation; deficiency-cold fails to secure.) A Chi position that is coarse and constantly hot indicates Heat in the Middle. (Wang Bing notes: Zhong refers to the Lower Jiao.) (*Ping Ren Qi Xiang Lun*)

[Suwen] If the Heart pulse beats firmly and is long, the patient will suffer from tongue retraction and inability to speak. (Beating the hand is called Bo. The tongue is the sprout of the Heart; Heart Fire excess causes this.) If the pulse is scattered, it will dissipate and heal spontaneously around the circumference. (Wang Bing notes: Scattered pulses indicate Qi excess and Blood deficiency. Xiao means dissipate; Huan means circumference. Zhang Jingyue notes: Xiao refers to Xiao Ke [Wasting-Thirst], which is incorrect here.) If the Lung pulse beats firmly and is long, the patient will expectorate blood. (Blood rebels upward following fire.) If the pulse is scattered, the patient will suffer from profuse sweating (Guan Han) and will no longer be able to undergo dispersing treatments due to fear of Yang collapse. (Ma Shi notes: Interpreting 'San' as resolving the disease is incorrect.) If the Liver pulse beats firmly and is long, but the complexion is not green, the injury is due to falling or beating. (Trauma from falling or striking; the complexion does not match the pulse, indicating external injury.) Blood stasis in the hypochondrium causes wheezing and rebellious Qi. (The Liver governs the hypochondrium; injured blood accumulates there and steams the Lung, causing wheezing.) If the pulse is scattered and the complexion lustrous, the patient suffers from Yi Yin (Overflowing Drink). Yi Yin involves sudden thirst and excessive drinking, with water fluids entering the muscles, skin, and outside the intestines/stomach. (Blood deficiency with dampness invasion, failure to metabolize fluids.) If the Stomach pulse beats firmly and is long, and the complexion is red, the patient suffers from pain in the thigh as if broken. (The Stomach meridian passes through the thigh.) If the pulse is scattered, the patient suffers from Food Bi (stagnation). (Stomach deficiency causes Bi obstruction and difficulty digesting.) If the Spleen pulse beats firmly and is long, and the complexion is yellow, the patient suffers from shortness of breath. (Spleen disharmony fails to nourish the Lung, causing Qi deficiency.) If the pulse is scattered and the complexion dull, the patient suffers from edema of the feet/shins resembling water retention. (The Spleen governs the four limbs; the meridian passes through the shins; Spleen deficiency fails to transport, causing swelling.) If the Kidney pulse beats firmly and is long, and the complexion is yellow and red, the patient suffers from waist pain as if broken. (Wang Bing notes: Yellow and red complexions indicate Heart/Spleen affecting the Kidney; the waist is the mansion of the Kidney.) If the pulse is scattered, the patient suffers from blood deficiency that does not recover. A coarse pulse indicates Yin deficiency and Yang excess, resulting in Heat in the Middle. A pulse arriving rapidly and departing slowly indicates Upper Excess and Lower Deficiency. (Rapid arrival due to Upper Excess; slow departure due to Lower Deficiency.) This indicates Jue (Reversal Cold/Heat) and Dian Ding (Vertex) diseases. (Pathogenic excess rising causes collapse and vertex ailments.) A pulse arriving slowly and departing rapidly indicates Upper Deficiency and Lower Excess, leading to aversion to wind. Thus, those struck by evil wind have their Yang Qi affected. (Wind is a Yang pathogen; Upper Deficiency makes it susceptible first.) Pulses that are all deep, fine, and scattered indicate Shaoyin Jue. (Deep and fine are Kidney pulses; rapid indicates heat. Wang Bing notes: Rapid should not appear in Chi; deep, fine, and rapid indicates Heat Jue.) Deep, fine, rapid, and scattered pulses indicate alternating chills and fever. (Deep and fine are Yin; rapid and scattered are Yang.) Floating and scattered pulses indicate collapse/fainting. (Floating indicates deficiency; scattered indicates lack of spirit.) All floating pulses without agitation are in the Yang channels, indicating heat. (Floating is Yang; floating without agitation is Yin within Yang, disease in Foot Yang meridians.) If there is agitation, it is in the Hand meridians. (Agitation implies Fire rising, Yang within Yang, disease in Hand meridians. Agitation is extreme floating.) All fine and deep pulses are in the Yin channels, indicating bone pain. (Fine and deep are Yin pulses; Yin governs bones and pain.) If there is stillness, it is in the feet. (Extreme depth indicates disease in lower Foot Yin meridians.) A rapid, moving pulse with intermittent beats (Dai) indicates disease in Yang pulses, involving diarrhea and bloody stools. (Dai indicates Qi deficiency, but stagnation can also cause Dai, hence diarrhea/blood. Ma Shi notes: Read 'Shu' as entering tone; Shu means heat, hence bloody stool, which is incorrect interpretation here.) Choppy pulses indicate Yang excess. Slippery pulses indicate Yin excess. Yang excess causes body heat and anhidrosis. (Qi abundant, Blood scarce.) Yin excess causes profuse sweating and cold body. (Yang deficient, Yin abundant.) Excess in both Yin and Yang results in anhidrosis and cold body. (Yang excess causes anhidrosis; Yin excess causes cold body.) (*Mai Yao Jing Wei Lun*)

[Suwen] Full and large Heart pulses indicate epilepsy, convulsions, and tendon cramping. (Xian Yuan sounds like han yi; Fire excess generates Wind, causing dizziness, collapse, and twitching.) Small and urgent Liver pulses indicate epilepsy, convulsions, and tendon cramping. (Small due to Blood deficiency; urgent due to Cold. Blood deficiency with Fire excess causes epilepsy; urgency causes tendon cramping.) A chaotic and violent Liver pulse after fright, with absent pulse or aphasia, will resolve spontaneously without treatment. (Violence obstructs pulses and congests Qi, causing aphasia; Qi recovery leads to spontaneous healing.) Small, urgent Kidney, Liver, and Heart pulses (without pulsation force) all indicate Jia masses. (Small and urgent indicate deficiency-cold; lack of force indicates stagnant blood, forming internal masses.) Concurrent deep Kidney and Liver pulses indicate Stone Water. (Deep indicates interior; hard abdominal distension like stone.) Concurrent floating pulses indicate Wind Water. (Floating indicates exterior; fluid retention with Wind causes edema.) Concurrent deficient pulses indicate death. (Kidney is root of five Zang; Liver is master of growth.) Concurrent small and wiry pulses indicate fear. (Wiry and small indicate deficiency.) Large, urgent, and deep Kidney and Liver pulses all indicate Shan (Hernia). (Jia and Shan are both結聚 of Cold Qi; Large indicates deficiency, Urgent indicates Cold, Deep indicates interior.) Slippery and urgent Heart pulses indicate Heart Shan. (*Mai Yao Jing Wei Lun*: Urgent Heart pulse indicates Heart Shan, tangible mass in lower abdomen, Qi rebelling to Heart.) Deep and pounding Lung pulses indicate Lung Shan. (Lung pulse should be floating; deep and pounding indicates Cold Qi invading the organ.) Urgent San Yang pulses indicate Jia; urgent San Yin pulses indicate Shan. (San Yang: Taiyang Bladder; San Yin: Taiyin Spleen. Wang Bing: Cold congealing blood forms Jia; Qi congestion forms Shan. Ma Shi: Both involve Qi and Blood.) Urgent Er Yin pulses indicate Epileptic Jue; urgent Er Yang pulses indicate Fright. (Er Yin: Shaoyin Kidney; Er Yang: Yangming Stomach. All due to Cold.) External-pulsing and deep Spleen pulses indicate Chang Pi, resolving over time. (Wu Kun notes: Deep indicates interior; external pulsing suggests emerging to exterior.) Small and slow Liver pulses indicate Chang Pi, easily treated. (Slow is Spleen pulse; Spleen overacting on Liver is mild pathogen; small/slow indicates gradual harmonization.) Small, pounding, and deep Kidney pulses indicate Chang Pi with bloody stool. (Small indicates Yin deficiency; pounding indicates Yang-heat invasion; deep indicates lower location, hence bloody stool.) Warm blood with body heat indicates death. (All dysentery, bloody stool, or mucus discharge are named Chang Pi; all contraindicate body heat.) Heart and Liver involvement also causes bloody stool. (Heart generates blood; Liver stores blood; heat transfers to intestine causing dysentery.) Simultaneous disease of these two Zang organs is treatable. (Wood and Fire generate each other.) Small, deep, and choppy Heart/Liver pulses indicate Chang Pi. (Small, deep, choppy indicates Cold dysentery.) Body heat indicates death. (Internal Yin exhaustion, external floating Yang.) Deep, pulsing, and choppy Stomach pulses. (Deep should not pulse; pulsing should not be choppy; indicates Blood deficiency with Fire.) External-pulsing and large Stomach pulses. (Yang excess, Yin insufficiency.) Small, firm, and urgent Heart pulses. (Small indicates Blood deficiency; firm indicates disharmony; urgent indicates Cold excess.) All indicate Ge (Diaphragm obstruction) and Pian Ku (Hemiplegia). (There is a diaphragm membrane between the sternum tip and 11th thoracic vertebra, separating turbid Qi from Heart/Lung. Disease here blocks food/drink, named Ge. Hemiplegia is half-body paralysis due to blocked Qi/Blood. Stomach disease prevents intake; Heart disease prevents blood generation, causing Ge and Hemiplegia.) Left-sided onset in men, right-sided in women, without aphasia and with tongue mobility, is treatable. (Shaoyin meridian flanks the tongue base; if evil has not entered Kidney, it is treatable.) Beating pulse with epistaxis and body heat indicates death. (Epistaxis is Nu; blood loss/Yin deficiency makes beating pulse taboo; body heat is taboo.) Suspended, hook-like, and floating pulses are normal pulses. (Indicates exterior pathogen, common in those with history of bleeding.) (*Da Qi Lun*)

[Lingshu] All diseases have Ni (Rebellious/Adverse) and Shun (Smooth/Favorable) patterns. Can you explain? Abdominal distension, body heat, and large pulse constitute the first Ni. Abdominal rumbling and fullness, cold limbs, diarrhea, and large pulse constitute the second Ni. Unstopping epistaxis and large pulse constitute the third Ni. (All are Yin syndromes presenting Yang pulses.) Cough with hematuria, emaciation, and small but forceful pulse constitutes the fourth Ni. (Small should not be forceful.) Cough with emaciation, body heat, and small but rapid pulse constitutes the fifth Ni. (Small should not be rapid.) Such patients die within fifteen days. Severe abdominal distension, cold extremities, emaciation, and severe diarrhea constitute the first Ni. Abdominal distension with bloody stool, large pulse with intermittent cessation constitutes the second Ni. Cough (upper), hematuria (lower), emaciation (external), and beating pulse (internal) constitute the third Ni. Hematemesis, chest fullness radiating to back, small and rapid pulse constitutes the fourth Ni. (Deficiency with Fire excess.) Cough/vomiting (upper), abdominal distension (middle), and undigested food diarrhea (lower) with absent pulse constitute the fifth Ni. Such patients die within one double-hour. (*Yu Ban*)

[Lingshu] What are the Five Nis? Heat disease with quiet pulse (Yang syndrome presenting Yin pulse) is the first Ni. Sweating followed by vigorous and restless pulse (disease not subsiding with sweat) is the first Ni. Diarrhea with洪大 (Hong Da/Great) pulse is the second Ni. Fixed Bi with immobility, muscle wasting, body heat, and unilateral absent pulse is the third Ni. Chronic disease with emaciation, body heat, pale and dull complexion, and subsequent black bloody stool is the fourth Ni. Cold/Heat disease with emaciation and firm, grasping pulse (True Zang pulse appearance) is the fifth Ni. (*Wu Jin*)

[Lingshu] Urgent pulses generally indicate Cold. Slow pulses generally indicate Heat. (Note: Heat should correspond to Rapid.) Large pulses indicate Qi excess and Blood deficiency. Small pulses indicate both Qi and Blood deficiency. Slippery pulses indicate Yang abundance with slight heat. Choppy pulses indicate Blood excess and Qi deficiency with slight cold. (Note: Choppy should indicate Blood deficiency.) Small pulses in all categories indicate deficiency of Yin-Yang, Form, and Qi. (*Xie Qi Zang Fu Bing Xing*)

[Lingshu] One day and night consists of fifty circuits. (Day travels Yang twenty-five degrees; Night travels Yin twenty-five degrees.) To nourish the essence of the five Zang organs. Those not matching the number are called "Kuang Sheng" (Fortuitous Survival). The so-called fifty circuits mean all five Zang receive Qi. Hold the Mai Kou and count the beats. Fifty beats without a single Dai (intermittent) beat means all five Zang receive Qi. (Stopping mid-beat is Dai.) Forty beats with one Dai beat means one Zang lacks Qi. Thirty beats with one Dai beat means two Zang lack Qi. Twenty beats with one Dai beat means three Zang lack Qi. Ten beats with one Dai beat means four Zang lack Qi. Less than ten beats with one Dai beat means five Zang lack Qi, giving a short-term prognosis (knowing death is imminent). (*Gen Jie*)

[Suwen] What is the diagnosis when the pulse conforms but the disease contradicts? It is said: The pulse appears conforming, but pressing it reveals no pulsation force; this applies to all Yang conditions. (This is Yang Excess repelling Yin. Internal heat is severe, yet the pulse does not surge; this is extreme Yang excess repelling Yin to the exterior, not true Cold. Wang Bing notes: This interprets as 'not heat', and below 'not cold', seemingly reversing the text.) What about the contradiction in Yin conditions? It is said: The pulse appears conforming, but pressing it reveals vigorous pulsation. (This is Yin Excess repelling Yang. Internal cold is severe, yet the pulse surges vigorously; this is extreme Yin excess repelling Yang to the exterior, not true Heat. These two conditions are most confusing; physicians must be cautious.) (*Zhi Zhen Yao Da Lun*)

[Suwen] Ren Ying pulse one-fold larger than Cun Kou indicates disease in Shaoyang. Two-fold indicates Taiyang. Three-fold indicates Yangming. (Left hand Cun Kou named Ren Ying, governing Six Yang meridians/zang-fu. Four-fold or more indicates Ge Yang. (One-fold: Ren Ying is one times larger than Qi Kou. Zhang Zhongjing: Ge implies vomiting/regurgitation. Wang Bing: Extreme Yang excess repels food entry. Dong Yuan: Ge is extreme cold qi. Ma Shi: Ge keeps six Yins inside, preventing exit.) Cun Kou pulse one-fold larger than Ren Ying indicates disease in Jueyin. Two-fold indicates Shaoyin. Three-fold indicates Taiyin. Four-fold or more indicates Guan Yin. (Right hand Cun named Cun Kou, governing Six Yin meridians/zang. One-fold: Cun Kou is one times larger than Ren Ying. Zhang Zhongjing: Guan implies urinary retention. Wang Bing: Extreme Yin excess closes passage, preventing urination. Dong Yuan: Guan is extreme heat qi. Ma Shi: Guan keeps six Yangs outside, preventing entry.) When Ren Ying and Cun Kou are both excessive, four-fold or more indicates Guan Ge. The Guan Ge pulse is盈 (Ying/Full/Extreme), unable to reach the essence of Heaven and Earth, leading to death. (New Correction: Ying should be written as 盈, meaning extreme fullness, not 羸 [weak]. Lingshu Jin Fu: Cun Kou governs interior, Ren Ying exterior; they should correspond... Spring/Summer Ren Ying slightly large, Autumn/Winter Cun Kou slightly large is Ping Ren [Normal Person]. Also Zhong Shi: Ren Ying one-fold, disease Foot Shaoyang... Ren Ying four-fold, large and rapid, named Yi Yang, Yi Yang is External Ge. Pulse Kou one-fold, disease Foot Jueyin... Pulse Kou four-fold, large and rapid, named Yi Yin, Yi Yin is Internal Guan. Internal Guan unblocked, death untreatable. Ren Ying and Taiyin Pulse Kou both four-fold large is Guan Ge. Guan Ge gives short-term prognosis. Wang Bing Suwen Zhu: Mentions foot meridians only. Zhang Zhongjing, Dong Yuan, Dan Xi all treat Guan Ge as a disease. Ma Xuantai opposes this, treating it as a pulse form. Wang Ang argues: If disease, it shouldn't be limited to dysphagia/constipation. If pulse form, Neijing/Mai Jing lack basis. Having this pulse implies having this disease; why doesn't Ma specify?) (*Liu Jie Zang Xiang Lun*)

[Suwen] How to know pregnancy is near delivery? The body has symptoms (illness) but the pulse is not pathological. (Wang Bing interprets 'Bing' as amenorrhea. Wang Ang notes: Pregnant women often have nausea, headache, etc. Though the body shows illness signs, the pulse is normal. Amenorrhea is usual, not illness.) (*Fu Zhong Lun*)

[Suwen] If a woman's Hand Shaoyin pulse is vigorous/moving, she is pregnant. (Wang Bing interprets as having a child. Ma Shi interprets as male fetus. Wang Ang notes: This likely refers to the time of impending labor. Hand Shaoyin refers...)