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The pulse movement is difficult and unsmooth, thin, short, and choppy (Se), described accurately as if a light knife were scraping bamboo. This indicates insufficient blood and excess qi. If the Cun (inch) position shows a choppy pulse, it signifies heart region pain and a timid spirit. (The Stomach belongs to the Yangming channel, possessing abundant blood and qi; its upper opening corresponds to the heart area. When blood is deficient, qi congregates there; the attack of qi and blood causes pain in the heart region. Yangming also governs fright; when fright qi returns to the Heart, the spirit becomes timid.) At the Guan (bar) position, it signifies distension in the hypochondrium and vomiting due to stomach deficiency. (The Liver stores blood and belongs to the Jueyin channel; its vessels distribute along the hypochondrium. With insufficient blood and excess qi, hypochondriac distension occurs. The Stomach is the sea of water and grain; insufficient blood leads to dryness, while excess qi leads to rebellion. Dryness results in blood exhaustion, and rebellion results in qi counterflow, thus failing to receive food and drink, leading to vomiting.) At the Chi (cubit) position, it signifies intestinal dryness and heat in the five centers (palms, soles, and chest). (Blood deficiency leads to intestinal dryness and choppiness; blood deficiency triggers the hyperactivity of ministerial fire, causing Liver heat. Liver heat transfers downward to the Kidney (mother), causing Kidney heat; Kidney heat transfers upward to the Heart (child), causing Heart heat. The Kidney meridian originates from the sole of the foot, and the Heart meridian enters the palm; hence, heat in the palms and soles occurs.) In women, this may indicate amenorrhea or pregnancy pathology, which must be distinguished. (Blood nourishes the fetus, hence the pulse appears choppy.) Cui Zixu stated that a choppy pulse governs spontaneous sweating, a view endorsed by Li Shizhen (Binhu) and Zhang Jingyue (Shicai). However, I hold that the *Neijing* states: "A choppy pulse indicates excess yang." Excess yang manifests as body heat without sweating; therefore, the statement in the *Neijing* should be considered correct.

A smooth and flowing pulse like rolling pearls is the Slippery (Hua) pulse. It indicates excessive sweating and excess yin, allowing for the observation of wind-phlegm. (The *Jing* says: "A slippery pulse indicates excess yin qi." Excess yin qi manifests as excessive sweating and cold body. The slippery pulse governs wind and also phlegm.) At the Cun position, it signifies acid regurgitation, cough, and vomiting. (The slippery pulse also governs heat. Dampness and heat in the Stomach steam each other, accumulating to cause acid regurgitation stagnating in the epigastrium. Damp-heat generates phlegm, causing cough and vomiting.) At the Guan position, it indicates accumulated heat and heat in the palms. (Food accumulation in the Stomach generates heat; stomach heat steams upward, affecting the Pericardium, Heart, and Lung. The Pericardium meridian enters the palm, the Lung meridian runs anteriorly, and the Heart meridian runs posteriorly, resulting in heat in the palm. The classic saying "heat in the palm" refers to heat in the abdomen.) At the Chi position, it indicates dysentery, hernia, and strangury. (The slippery pulse also governs retained food; food accumulation leads to dysentery. Hernia refers to swollen and painful testicles radiating to the lower abdomen. Strangury refers to urinary retention. The *Mai Jing* states that a slippery Chi pulse indicates hematuria.) In women, it may indicate amenorrhea or blood stasis. (The *Mai Jing* states that a slippery Chi pulse in women indicates irregular menstruation. Since a slippery pulse indicates excess blood, if it is slippery and knotted, or floating-slippery or slow-slippery, it indicates blood stasis. Otherwise, it is a pregnancy pulse.)