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The pulse at the left and right wrists must be examined in accordance with the four seasons.
The Classics state: "Left and right are the pathways of Yin and Yang." Therefore, in the human body, Water at the Left Chi (Kidney Water) generates Wood at the Left Guan (Liver Wood); Wood at the Left Guan generates Fire at the Left Cun (Heart Fire); Fire at the Left Cun generates Fire at the Right Chi (Ministerial Fire); Fire at the Right Chi generates Earth at the Right Guan (Spleen Earth); Earth at the Right Guan generates Metal at the Right Cun (Lung Metal); and Metal at the Right Cun generates Water at the Left Chi. Furthermore, Fire at the Left Cun controls Metal at the Right Cun; Metal at the Right Cun controls Wood at the Left Guan; Wood at the Left Guan controls Earth at the Right Guan; Earth at the Right Guan controls Water at the Left Chi; and Water at the Left Chi controls Fire at the Left Cun. Moving back and forth, the left and right sides mutually generate and control each other, just as the Nine Categories of Hongfan utilize left and right coordination to elucidate the principles of auspiciousness and inauspiciousness. However, examination must also follow the changes of the four seasons. For instance, the Liver pulse at the Left Guan is inherently suitable for a Wiry and Long quality (Xian Chang). Yet, during the three months of Spring, all six positions of both hands should also exhibit a Wiry quality. Similarly, the Lung pulse at the Right Cun is inherently suitable for a Floating and Choppy quality (Fu Se). During the three months of Autumn, all six positions of both hands should also exhibit a Choppy quality. Thus it is said that the pulses at the left and right must be examined in relation to the four seasons.

Forty-five pulsations constitute one "Xi" (a small cycle of Qi circulation).
Zhang Shixian stated: "Dong Mai (Pulsating Pulse) refers to arrival; Xi Mai refers to cessation." Here, "Xi" does not refer to respiration. I believe that in a healthy person, the pulse circulates endlessly without cessation. Even beyond forty-five pulsations, there is no stopping point. The statement "forty-five pulsations constitute one Xi" refers to a small cycle of the pulse's Qi movement. This is analogous to considering 360 days as one year; it does not mean that after 360 days, one day passes before entering the second year. The concept of "forty-five pulsations as one Xi" aligns with the numerology of the Nine Categories of Hongfan, where five times nine equals forty-five. Five represents the completeness of the Five Elements' Qi, and nine represents the completeness of the Nine Categories.

When the pulse feels Wiry and Urgent (Xian Ji), or Surging and Tight (Hong Jin) under the fingers, it indicates the presence of Wind combined with Extreme Heat.
"Wiry and Urgent" means not relaxed; "Surging and Tight" means large but not harmonious. The four pulse qualities—Wiry, Urgent, Surging, and Tight—all belong to Yang pulses. All Yang relates to Heat, and Heat generates Wind. Therefore, it is said that this indicates Wind combined with Extreme Heat.

If suddenly the pulse becomes Hidden (Ni Ni), Slow (Man), Deep (Chen), and Fine (Xi), it indicates Cold extreme entangling the body accompanied by Qi disorders.
"Hidden" means the pulse is concealed and not visible; "Slow" refers to the Sluggish pulse (Chi). The four pulse qualities—Hidden, Slow, Deep, and Fine—all belong to Yin pulses. All Yin relates to Cold, and Cold leads to Qi stagnation. Therefore, it is said that this indicates Cold diseases entangling the body accompanied by Qi disorders.

When the Thief Pulse (Ze Mai) frequently appears, one must inquire into the Five Elements' controlling relationships.
The Thief Pulse is a pulse controlled by the "Ghost" (the element that controls me). For example: the Heart pulse should appear Deep and Fine; the Liver pulse should appear Choppy and Small; the Spleen pulse should appear Wiry and Urgent; the Lung pulse should appear Surging and Large; the Kidney pulse should appear Sluggish and Moderate. Additionally: the Spring pulse should appear Choppy and Short; the Summer pulse should appear Deep and Sluggish; the Late Summer pulse should appear Wiry and Long; the Autumn pulse should appear Surging and Scattered; the Winter pulse should appear Slow and Moderate. These are all Thief Pulses, referring to the pulses of the element that controls the respective organ according to the Five Elements.

The House-Leak Pulse (Wu Lou) and the Sparrow-Pecking Pulse (Que Zhuo) are ultimately incurable.
The House-Leak Pulse is slow with occasional pauses; the Sparrow-Pecking Pulse is rapid with occasional pauses. Both indicate the exhaustion of Spleen Qi. The House-Leak Pulse reflects the exhaustion of Spleen Yang Qi, where Yang moves quickly causing intermittent stops; the Sparrow-Pecking Pulse reflects the exhaustion of Spleen Yin Qi, where Yin moves slowly causing intermittent stops. The Spleen governs the Central Region and irrigates the Five Zang and Six Fu organs. Once the Primordial Yin and Yang of the Spleen are exhausted, the Twelve Meridians are all in danger. Therefore, it is said that they are ultimately incurable.
According to the Classics: "If the pulse matches the disease while the patient appears well, or if the pulse resembles the House-Leak or Sparrow-Pecking, death ensues." The commentary notes: The House-Leak pulse comes to an end and stops, occasionally rising again but not connecting continuously. The Sparrow-Pecking pulse comes very rapidly and abruptly stops, then suddenly returns. Furthermore, the Classics state: "After seven or eight days of illness, if the pulse resembles the House-Leak or Sparrow-Pecking, death ensues." The commentary notes: The pulse feels like millet grains striking the hand.