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All three positions (cun, guan, chi) presenting a wiry pulse indicates Liver excess. The patient experiences eye pain accompanied by a sensation of deficiency. Anger causes chest fullness and a frequent desire to shout. Vision is obscured as if by a haze, the pupils are uncomfortable, and tears flow like pearls.

Zhang Shixian stated: This refers to pathology in the lower abdomen. A wiry pulse appearing at all three positions signifies excess in the Liver. The eyes are the orifice of the Liver; excess leads to eye pain. The Liver meridian circles the genitalia and reaches the lower abdomen, hence there is suffering from deficiency-pain in the lower abdomen. I believe "xu" (deficiency) should be interpreted as "xuan" (vertigo/dizziness). The wiry pulse is the proper pulse of the Liver. Now that all three positions are wiry, it means the Wood element has failed to maintain its virtue. Since the Liver opens into the eyes, eye pain occurs. The Classic states: "When Wood is excessive, one becomes suddenly irritable and prone to vertigo and diseases of the vertex." This is exactly such a case. Why is it said to be Liver excess, yet also described as deficiency? What is meant by "excess" is the excess of pathogenic factors; what is meant by "deficiency" is that hyperactivity causes harm, requiring control, which leads to self-injury and subsequent deficiency. Anger causes Qi to rebel upward, thus Qi fills the chest, leading to a constant desire to shout. The pupil belongs to the Liver; when Liver Qi is vigorous, it causes visual obscurations and pain, resulting in tearing. All ophthalmological texts often speak of five Shu points in the eye, asserting that the cornea (black part) belongs to the Liver and the pupil belongs to the Kidney. This is incorrect. I assert that the cornea should belong to the Kidney and the pupil to the Liver. Why? Because the cornea is black, corresponding to the Kidney; the pupil is bluish-black, corresponding to the Liver. Moreover, Water generates Wood; precisely because the Water represented by the cornea is external, it can nourish the Wood represented by the pupil internally, keeping vision clear and bright. For a thousand years, only Wang Shuhe has penetrated this secret.

The Liver is soft; the pulse should be wiry but free of pathogens.
The Classic states: "If the pulse comes soft and flexible, like the tip of a long bamboo pole held high, it is called a normal Liver pulse." Thus, it is said to be free of pathogens.

A tight pulse arises from slight tendon tension.
Tightness indicates Cold. The Liver governs the tendons; Cold causes tendon contraction. Therefore, a tight pulse arises from slight tendon tension.

Carefully observing if it is floating, large, and additionally solid, indicating red painful eyes, dim vision, as if obstructed by something.
Floating indicates Wind; Large indicates Fire. Wind and Fire fan each other, rising to cause eye diseases.

Overflowing past the Guan position and extending beyond the Cun position corresponds with dizziness, heavy head, and tendon pain.
The Liver pulse is naturally wiry and long, but it should remain in its proper position. Now, overflowing past the Guan and exceeding the Cun position indicates Wood excess. Excess Wood generates Wind. As the proverb goes, "A big tree attracts much wind," thus causing diseases of dizziness and heaviness of the head.

If a knifelike (Kou) pulse appears, there may be dim vision or hematemesis, and paralysis of the four limbs preventing movement.
The Liver stores Blood. A Kou pulse indicates blood loss. The eyes see when nourished by Blood; the hands grasp when nourished by Blood; the feet walk when nourished by Blood. If the Liver pulse presents as Kou, it results in dim vision and syndromes of four-limb paralysis.

A choppy (Se) pulse is due to Blood deficiency and dispersion. Rib distension and hypochondriac fullness should be known.
The Liver is an organ rich in Blood and poor in Qi. A Choppy pulse is characteristic of abundant Qi and deficient Blood. If the Liver pulse is Choppy, it indicates Liver deficiency and Blood dispersion. The ribs and hypochondrium are areas distributed by the Liver meridian. When the Liver fails to store Blood, Qi takes advantage of the deficiency to occupy these spaces, causing rib distension and hypochondriac fullness.

A slippery (Hua) pulse is due to Liver Heat connecting to the head and eyes. Tight, Solid, Wiry, and Deep pulses form the basis for accumulations (Pi Ji).
The Liver opens into the eyes. If the Liver position presents a Slippery pulse, it indicates Fire in the Liver meridian. Fire nature is flaming upward, so heat connects to the head and eyes. According to medical texts, Deep, Wiry, Tight, and Solid pulses indicate that Kidney Water fails to generate Wood, leading to Liver deficiency and the formation of Pi Ji (accumulations). Pain may occur near the umbilicus or between the two hypochondria. "Ji" (basis/foundation) implies the disease has a deep root and is difficult to eradicate.

Weak, Floating, and Scattered pulses indicate Qi distress. Dim vision with photopsia (seeing spots) makes prolonged viewing intolerable.
The Liver is rich in Blood and poor in Qi. Weak, Floating, and Scattered are pulses of the Lung, representing abundant Qi and deficient Blood. If these four pulses appear in the Liver position, it signifies Blood insufficiency with Qi dominance, hence termed "Qi distress." The Liver opens into the eyes; vision requires Blood. Since Blood is now insufficient, vision becomes dim with photopsia, making prolonged viewing intolerable.

Extremely floating with weak tendons and body weakness. Encountering this still requires attention to four-limb paralysis.
The Liver governs the tendons. Palpation for the Liver pulse should use the weight of twelve beans, assessing the state parallel to the tendons. An extremely floating pulse here indicates floating and forceless qualities. Floating and forceless indicates Deficiency; deficiency means no Blood to nourish the tendons. Without nourishment, tendons cannot bind the bones, leading to four-limb paralysis.