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The pulse has two types: "Sun" (Loss/Deficiency) and "Zhi" (Excess/Increase). What does this mean? The answer is: For the Zhi pulse, if the pulse beats twice per exhalation, it is a Ping pulse (normal); three times per exhalation indicates Li Jing (deviation from the normal course); four times indicates Duo Jing (exhaustion of essence); five times indicates Si pulse (death); six times indicates Ming Jue (termination of life). This constitutes the Zhi pulse.

What is the Sun pulse? If the pulse beats once per exhalation, it is Li Jing; once every two exhalations indicates Duo Jing; once every three exhalations indicates Si pulse; once every four exhalations indicates Ming Jue. This constitutes the Sun pulse. The pathology of the Zhi pulse progresses from below upwards, while the pathology of the Sun pulse progresses from above downwards.

How does the Sun pulse manifest in disease? The answer is: First-degree Sun damage affects the skin and hair, resulting in wrinkled skin and falling hair; second-degree Sun damage affects the blood vessels, leading to deficient and scanty vessels that cannot nourish the five zang organs and six fu organs; third-degree Sun damage affects the muscles, causing muscle emaciation where food and drink fail to transform into flesh; fourth-degree Sun damage affects the sinews, causing flaccidity and inability to control movement; fifth-degree Sun damage affects the bones, causing bone atrophy and inability to rise from bed. If reversed, the disease becomes entrenched. In cases progressing from above downwards (Sun), bone atrophy preventing rising from bed indicates death; in cases progressing from below upwards (Zhi), wrinkled skin and falling hair indicate death. How should Sun damage be treated? The answer is: For lung damage, tonify its qi; for heart damage, regulate Ying and Wei (nutritive and defensive qi); for spleen damage, regulate diet and adapt to cold and warmth; for liver damage, soothe the middle jiao; for kidney damage, benefit the essence and qi. This is the method for treating Sun damage.

Regarding pulses with two beats per breath cycle (one inhalation/exhalation), three beats, four beats, five beats, six beats, one beat, or even slower rates: how can one distinguish the disease? The answer is: Two beats per inhalation and two per exhalation, neither large nor small, is a Ping pulse. Three beats per inhalation and three per exhalation indicates recent onset of disease. If the pulse is larger anteriorly and smaller posteriorly, there is headache and dizziness; if smaller anteriorly and larger posteriorly, there is chest fullness and shortness of breath. Four beats per inhalation and four per exhalation indicates worsening disease. A洪大 (Hong Da / Surging and Large) pulse causes vexation and fullness; a 沉细 (Chen Xi / Deep and Fine) pulse causes abdominal pain; a 滑 (Hua / Slippery) pulse indicates heat injury; a 涩 (Se / Choppy) pulse indicates injury by fog and dew. Five beats per inhalation and five per exhalation indicates the patient is exhausted. A 沉细 (Deep and Fine) pulse worsens at night; a 浮大 (Fu Da / Floating and Large) pulse worsens during the day. If the pulse is not excessively large or small, although exhausting, it is treatable; if the pulse varies greatly in size, it is difficult to treat. Six beats per inhalation and six per exhalation is a pulse of ten deaths (fatal). A 沉细 (Deep and Fine) pulse leads to death at night; a 浮大 (Floating and Large) pulse leads to death during the day. One beat per inhalation and one per exhalation is named Sun pulse. Although the person can walk, they must lie in bed because both blood and qi are deficient. One beat every two inhalations and two exhalations is named Wu Hun (Soulless). Those without soul will die; although they can walk, they are walking corpses. Bian Que said: One outflow and one inflow is Ping; two outflows and one inflow relates to Shao Yin; three outflows and one inflow relates to Tai Yin; four outflows and one inflow relates to Jue Yin. Two inflows and one outflow relates to Shao Yang; three inflows and one outflow relates to Yang Ming; four inflows and one outflow relates to Tai Yang. Outflow is Yang, inflow is Yin. Thus, with each exhalation the pulse moves twice, and qi travels three cun; with each inhalation the pulse moves twice, and qi travels three cun. At the pause between breaths, the pulse moves five times. One exhalation and one inhalation constitute one Xi (breath cycle), during which qi travels six cun. In ten Xi cycles, the pulse moves fifty times, and qi travels six chi. In twenty Xi cycles, the pulse moves one hundred times, constituting one Bei Qi (complete cycle), corresponding to the four seasons. Heaven has 365 days, and the human body has 365 joints. Day and night consist of 100 water clock divisions. In one Bei Qi cycle, the pulse travels one zhang and two chi. In one day and night, it traverses the twelve Earthly Branches; when qi circulation completes, it pervades the body, harmonizing with the Way of Heaven, thus called Ping (normal), meaning no disease, i.e., balance of Yin and Yang. Two pulse movements constitute one Zhi (beat unit); if consecutive and tight, it steals Qi. In one Ke (quarter hour), there are 135 Xi cycles; in ten Ke, 1,350; in 100 Ke, 13,500. Two Ke constitute one Du (degree); in one Du, qi circulates once around the body; in day and night, 50 Du. Three pulse movements indicate Li Jing. With one exhalation, the pulse moves three times, and qi travels 4.5 cun. In one Xi cycle, the pulse moves seven times, and qi travels nine cun. In ten Xi cycles, the pulse moves seventy times, and qi travels nine chi. In one Bei Qi cycle, the pulse moves 140 times, and qi travels one zhang and eight chi. Circulating once around the body, qi exceeds 180 degrees, hence called Li Jing. Li Jing implies disease, specifically imbalance of one Yin and two Yangs. Three movements and tightness steals Blood. Four pulse movements indicate Duo Jing. With one exhalation, the pulse moves four times, and qi travels six cun. In one Xi cycle, the pulse moves nine times, and qi travels one chi and two cun. In ten Xi cycles, the pulse moves ninety times, and qi travels one zhang and two chi. In one Bei Qi cycle, the pulse moves 180 times, and qi travels two zhang and four chi. Circulating once around the body, qi exceeds 360 degrees, passing through the body twice but failing to reach five joints, indicating repeated arrival of seasonal qi. Pulses that are floating and choppy indicate lack of essence in the five zang organs and are difficult to treat, representing imbalance of one Yin and three Yangs (four movements and tightness steals Form). Five pulse movements indicate death. With one exhalation, the pulse moves five times, and qi travels 6.5 cun (should be 7.5 cun). In one Xi cycle, the pulse moves eleven times, and qi travels one chi and three cun (should be one chi and five cun). In ten Xi cycles, the pulse moves 110 times, and qi travels one zhang and three chi (should be one zhang and five chi). In one Bei Qi cycle, the pulse moves 220 times, and qi travels two zhang and six chi (should be three zhang). Circulating once around the 365 joints, qi exceeds 540 degrees. Circulating again, it exceeds 170 degrees. Reaching this level at one joint, the qi is floating and choppy, meridians run dry, blood and qi are exhausted, unable to remain within, five zang organs atrophy, and spirit scatters. Five movements and tightness lead to death, representing imbalance of three Yin (or two) and three Yangs. Although five movements, why is it so? Pulse with one Sun and one Cheng: one exhalation, pulse moves once; one Xi cycle, pulse moves twice, qi travels three cun. Ten Xi cycles, pulse moves twenty times, qi travels three chi. One Bei Qi cycle, pulse moves forty times, qi travels six chi, insufficient to reach the 180 joints of the body. Shortness of breath prevents pervading the body, suffering from shortness of qi, body lax and collapsing. Second-degree Sun: one Xi cycle, pulse moves once, qi travels 1.5 cun. Ten Xi cycles, pulse moves ten times, qi travels one chi and five cun. One Bei Qi cycle, pulse moves twenty times, qi travels three chi, insufficient for 200 joints. Suspected exhaustion of blood and qi, meridians cannot reach, hence called Li Jing. Blood leaves its place, stool and urine contain blood. Third-degree Sun: one Xi cycle plus one exhalation, pulse moves once. Ten Xi cycles, pulse moves seven times, qi travels one chi and five cun (should be 0.5 chi). One Bei Qi cycle, pulse moves fourteen times, qi travels three chi and one cun (should be two chi and one cun). Insufficient for 297 joints, hence called Zheng (Struggle). Qi moves, blood stays, unable to diminish together. Qi closure and excess cause chest fullness and organ withering, struggling in the middle, qi does not ascend, blood coagulates in the middle, leading to death. Fourth-degree Sun: two Xi cycles, pulse moves once. Ten Xi cycles, pulse moves five times, qi travels 7.5 cun. One Bei Qi cycle, pulse moves ten times, qi travels one chi and five cun. Insufficient for 315 joints, hence called Wang Xue (Blood Loss). Blood loss means losing measure, body emaciated and fatigued, skin wrapping bone. Thus blood and qi are exhausted, five zang organs lose spirit, death is evident. Fifth-degree Sun: two Xi cycles plus one exhalation, pulse moves once. Ten Xi cycles, pulse moves four times, qi travels six cun. One Bei Qi cycle, pulse moves eight times, qi travels one chi and two cun. Insufficient for 324 joints, hence called Jue (Extinction). Extinction means rapid breathing, inability to leave bed, cold breath, all pulses extinct, leading to death.

Qi Bo said: Pulses violating the four seasons are called Zhi Qi. Zhi Qi refers to Sun and Zhi pulses. Sun: Shao Yin governs bones as heavy, this is Zhi (Will) damage; decreased diet and muscle wasting is Yi (Intellect) damage; lying down comfortably, difficulty sleeping, unclear hearing and vision is Hun (Ethereal Soul) damage; respiration not connecting, five colors lacking luster is Po (Corporeal Soul) damage; limbs showing chaotic pulses is Shen (Spirit) damage. Major Sun reduces lifespan by 30 years; moderate Sun by 20 years; minor Sun by 10 years. Sun corresponds to Spring, Summer, Autumn, Winter. In healthy people, tall stature with short pulse is major Sun, reducing 30 years; short stature with long pulse is moderate Sun, reducing 20 years; thin hands and feet is minor Sun, reducing 10 years; loss of essence and qi reduces lifespan by one year. In men, short left pulse and long right pulse is Yang damage, reducing half a year; in women, short right pulse and long left pulse is Yin damage, reducing half a year. In Spring, the pulse should reflect Liver, but reflecting Spleen or Lung is damage; in Summer, reflecting Heart, but reflecting Kidney or Lung is damage; in Autumn, reflecting Lung, but reflecting Liver or Heart is damage; in Winter, reflecting Kidney, but reflecting Heart or Spleen is damage. Carefully palpate the Cun Kou pulse to know if extinction occurs. Anterior and posterior absence indicates extinction. Striking the palm, hard like a bouncing stone, indicates upper pulse void and lower pulse present, meaning Stomach Qi remains (if upper pulse vanishes and lower is hard like stone, Stomach Qi exists). If both upper and lower pulses vanish, death; if not extinct and not diminishing, survival. This is the Sun pulse. Zhi: deep voice, blurred vision, is Zhi (Will) Zhi; coarse body and sudden excessive eating is Yi (Intellect) Zhi; delirious speech and pulling of limbs is Hun (Ethereal Soul) Zhi; lush and colorful complexion is Po (Corporeal Soul) Zhi; tiny and unresponsive pulse with loud breathing is Shen (Spirit) Zhi. These are the methods of Zhi pulse. Life and death correspond; diseases obtaining their proper qi survive, those obtaining only half survive poorly. Huang Di said: Excellent.