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To predict the life and death prognosis of a disease, one must carefully investigate the subtle changes in the pulse. Modern physicians often hastily determine a patient's time of death, yet the patient does not actually die; or they predict survival, yet the patient fails to live. What is the reason for this?
It is simply that they have not conducted a careful and detailed examination of the pulse. If one were indeed to examine it meticulously, then the timing of life and death could even be predicted with precision down to the year, month, day, and hour. How could the pulse lack its spiritual efficacy?
On the left hand, one discerns the principles of the Heart (Xin) and Liver (Gan); on the right hand, one observes the conditions of the Spleen (Pi) and Lung (Fei). This pertains to the regions governed by the Cun (Inch), Guan (Bar), and Chi (Cubit) positions.
Specifically, to palpate the Heart pulse, one should focus on the Cun position of the left wrist; to palpate the Liver pulse, the Guan position of the left wrist; to palpate the Lung pulse, the Cun position of the right wrist; and to palpate the Spleen pulse, the Guan position of the right wrist.
The Kidney (Shen) is distributed across both Chi positions.
Among the Five Zang Organs, the other four each occupy one position, while the Kidney uniquely occupies two positions because it is a Yin organ (Nun Zang). It resides in the Lower Jiao (Lower Burner), hence it is palped at both Chi positions. Although there is a distinction between Kidney Water (Yin) and Kidney Fire (Yang), ultimately they both belong to the Kidney. Although divided for diagnosis, they are essentially unified.
Identifying the Five Zang Organs through the Three Positions (Cun, Guan, Chi) is relatively easy, but the theories of the Seven Diagnoses (Qi Zhen) and Nine Palpations (Jiu Hou) are difficult to elucidate.
This follows from the previous discussion: within the three positions (Cun, Guan, Chi) of both hands, palpating the Five Zang Organs (Heart, Liver, Spleen, Lung, Kidney) is something people easily understand. However, regarding the Seven Diagnoses and Nine Palpations, understanding them is quite difficult. Let us attempt to explain them. The "Three Positions, Five Zang Organs" and "Seven Diagnoses, Nine Palpations" mentioned by the ancients do not refer to what modern practitioners understand by these terms. According to the *Su Wen* chapter "San Bu Jiu Hou" of the *Huangdi Neijing* (Yellow Emperor's Inner Canon): "The supreme laws of Heaven and Earth begin with One and end with Nine. One is Heaven, Two is Earth, Three is Humanity. Multiplying three by three yields nine, corresponding to the Nine Regions of the earth. Thus, humans have three major sections (Bu), each containing three palpation points (Hou), used to determine life and death, treat various diseases, regulate deficiency and excess, and eliminate pathogenic factors." The Yellow Emperor asked, "What are the three sections?" Qibo replied, "There are the Lower Section, Middle Section, and Upper Section. Each has three palpation points. These three points represent Heaven, Earth, and Humanity. One must point them out clearly to grasp the truth. The Heaven of the Upper Section corresponds to the arteries at the temples; the Earth of the Upper Section corresponds to the arteries at the cheeks; the Humanity of the Upper Section corresponds to the arteries in front of the ears. The Heaven of the Middle Section corresponds to the Hand-Taiyin Lung Meridian; the Earth of the Middle Section corresponds to the Hand-Yangming Large Intestine Meridian; the Humanity of the Middle Section corresponds to the Hand-Shaoyin Heart Meridian. The Heaven of the Lower Section corresponds to the Foot-Jueyin Liver Meridian; the Earth of the Lower Section corresponds to the Foot-Shaoyin Kidney Meridian; the Humanity of the Lower Section corresponds to the Foot-Taiyin Spleen Meridian." Therefore, the Heaven of the Lower Section palpates the Liver, the Earth palpates the Kidney, and the Humanity palpates the Qi of the Spleen and Stomach. The Yellow Emperor asked, "How are the pulses of the Middle Section?" Qibo said, "They also have Heaven, Earth, and Humanity. Heaven palpates the Lung, Earth palpates the Qi of the Chest, and Humanity palpates the Heart." The Yellow Emperor asked, "What does the Upper Section palpate?" Qibo said, "It also has Heaven, Earth, and Humanity. Heaven palpates the Qi of the head and horns, Earth palpates the Qi of the mouth and teeth, and Humanity palpates the Qi of the eyes and ears." Each of the three sections has Heaven, Earth, and Humanity. Three threes constitute Heaven, three threes constitute Earth, and three threes constitute Humanity. Three multiplied by three equals nine. The nine divisions correspond to the Nine Regions, which correspond to the Nine Viscera. Thus, there are five Spirit Viscera and four Form Viscera, totaling nine. If the essence of the Five Zang Organs is exhausted, the complexion will become dull and lifeless; a dull and lifeless complexion indicates impending death. The Yellow Emperor further asked, "How can one locate the disease?" Qibo said, "Observe the nine palpation points: if one is exclusively small, it indicates disease; if exclusively large, disease; if exclusively rapid, disease; if exclusively slow, disease; if exclusively hot, disease; if exclusively cold, disease; if exclusively depressed/sunken, disease." Qibo added, "If the flesh and muscles are already wasted away, even if the nine pulses are harmonious, death is inevitable. If the signs of the Seven Diagnoses appear, but the nine pulses all conform to the seasonal norms without contradiction, death will not occur. The 'non-death' referred to applies to wind-related disorders and menstrual disorders, which may resemble the fatal signs of the Seven Diagnoses but are not truly so, hence they are not fatal. However, if the signs of the Seven Diagnoses are present AND the pulse qualities are also exhausted, death will occur, accompanied by hiccups and belching. The classic states this, implying that within the Nine Palpations, there is also the method of the Seven Diagnoses. The 'Three Sections' discussed today are not the ancient Head, Hand, and Foot sections, but rather the Cun, Guan, and Chi sections. The 'Seven Diagnoses' discussed today are not the ancient concepts of exclusively large, small, rapid, slow, hot, cold, or sunken pulses, but rather: 1. Calm the mind and concentrate the spirit; 2. Avoid distractions and clear thoughts; 3. Regulate breathing and stabilize Qi; 4. Lightly press at the skin level to palpate the Fu (Yang) pulses; 5. Press slightly deeper into the muscle level to assess Stomach Qi; 6. Press deeply to the bone to palpate the Zang (Yin) pulses; 7. Observe the frequency and rhythm of the patient's pulse beats. This constitutes the method of the Seven Diagnoses. The 'Nine Palpations' discussed today are not the ancient Head-Heaven/Earth/Humanity, Hand-Heaven/Earth/Humanity, Foot-Heaven/Earth/Humanity, but rather taking Floating, Moderate, and Deep pressures at the Cun, Guan, and Chi positions respectively. In summary, ancient physicians did not restrict pulse diagnosis solely to the Cun, Guan, and Chi areas of the wrist but examined all arterial pulses on the head, face, hands, and feet. Nevertheless, one should not revere modern methods while discarding ancient ones, nor criticize ancient methods while affirming only modern ones. Combining ancient and modern methods allows one to achieve more than half the effectiveness.

Day and night cycle continuously, and the movement of Ying (Nutrient) Qi and Wei (Defensive) Qi must follow fixed numerical patterns.
Modern physicians frequently discuss Ying and Wei, yet when asked about the principles of their circulation, they remain ignorant. Under such circumstances, attempting to identify the exterior-interior and Yin-Yang nature of diseases is indeed difficult. Ying refers to Blood, which is Yin; Wei refers to Qi, which is Yang. This is common knowledge. It is known that Ying circulates within the vessels, while Wei circulates outside the vessels. In one day and night, each circulates fifty times around the body. Many people misunderstand the principle of "Wei circulating outside the vessels," believing that Wei Qi follows Ying Qi externally. They fail to realize that Ying follows its own path, and Wei follows its own path; Wei does not actually follow Ying Qi. Let us first discuss the circulation of Ying Qi. The *Ling Shu* chapter "Ying Qi" records: The Yellow Emperor said, "The way of Ying Qi treasures internal nourishment from grains. Grains enter the Stomach, transmit to the Lung, overflow internally, and spread externally. The purest and most concentrated part travels through the meridians, circulating endlessly, ending where it begins, which is called the norm of Heaven and Earth. Thus, Qi emerges from the Hand-Taiyin Lung Meridian, enters the Hand-Yangming Large Intestine Meridian, ascends to enter the Foot-Yangming Stomach Meridian, descends to the dorsum of the foot, exits between the toes, joins the Foot-Taiyin Spleen Meridian, ascends to the thigh, enters the heart from the thigh, follows the Hand-Shaoyin Heart Meridian, exits the axilla and arm, enters the little finger, joins the Hand-Taiyang Small Intestine Meridian, ascends through the axilla, exits the inner canthus, reaches the vertex, descends the neck, joins the Foot-Taiyang Bladder Meridian, follows the spine to the sacrum, descends to the tip of the little toe, follows the sole, enters the Foot-Shaoyin Kidney Meridian, ascends to the Kidney, from the Kidney enters the Heart, spreads outward to the chest, follows the Pericardium Meridian, exits the axilla and arm, emerges between the tendons, enters the palm, exits the middle finger tip, returns to the tip of the ring finger, joins the Hand-Shaoyang Sanjiao Meridian, ascends to the Danzhong (Conception Vessel), disperses in the Sanjiao, enters the Gallbladder from the Sanjiao, exits the hypochondrium, enters the Foot-Shaoyang Gallbladder Meridian, descends to the dorsum of the foot, again enters between the big toe, joins the Foot-Jueyin Liver Meridian, ascends to the Liver, from the Liver ascends to the Lung, follows the throat, enters the pharynx/nasopharynx aperture, and terminates at the Chumen (root of the nose). Its branch ascends the forehead, follows the vertex, descends the neck, follows the spine, enters the Du Mai (Governing Vessel), connects with the genitalia, passes above the pubic hair, enters the umbilicus, ascends along the abdominal interior, enters the Clavicular region, descends into the Lung, and re-emerges into the Taiyin Lung Meridian. This is the pathway of Ying Qi, the normal order of flow. As for the circulation of Wei Qi, it is different. Wei Qi originates from the Lower Jiao and also circulates fifty times around the body in a day and night. However, during the day it travels twenty-five cycles in the Yang aspects, and during the night twenty-five cycles in the Yin aspects. From sunrise when Yang Qi is strong, the sun enters the Fang constellation, approximately at Mao hour (5-7 AM), at the first drop of water from the clepsydra, it begins from the Foot-Taiyang and Hand-Taiyang meridians. At the second drop, it travels the Foot-Shaoyang and Hand-Shaoyang meridians. At the third drop, the Foot-Yangming and Hand-Yangming meridians. At the fourth drop, it enters the Yin aspects. At the fifth drop, it resumes the Foot-Taiyang and Hand-Taiyang meridians. At the sixth drop, Foot-Shaoyang and Hand-Shaoyang. At the seventh drop, Foot-Yangming and Hand-Yangming. At the eighth drop, it re-enters the Yin aspects. This cycle repeats until the fifty-drop mark, where Qi has circulated twenty-five times in the Yang aspects. At sunset when Yin Qi prevails, the sun enters the Bi constellation, approximately at You hour (5-7 PM), it just enters the Yin aspects. Initially starting from the Foot-Shaoyin Kidney Meridian, then Hand-Shaoyin Heart, then Hand-Taiyin Lung, then Foot-Jueyin Liver, then Foot-Taiyin Spleen, then back to Foot-Shaoyin, Hand-Shaoyin, Hand-Taiyin, Foot-Jueyin, and Foot-Taiyin. This cycle repeats until the hundred-drop mark, having circulated twenty-five times in the Yin aspects. Combined with the twenty-five daytime Yang cycles, it totals fifty cycles around the body. This is how Wei Qi circulates. Regarding the alignment of Wei Qi with years, months, days, hours, star constellations, and water drops, one can understand this by carefully observing the dialogue of Bo Gao in the *Wei Qi Xing* chapter. Unfortunately, later scholars created diagrams and theories claiming Wei Qi follows Ying Qi, misunderstanding the principle that Ying is inside the vessels and Wei is outside. They failed to understand that "Wei outside the vessels" means cycling twenty-five times in Yang during the day and twenty-five times in Yin during the night, not following Ying Qi externally. Some might argue, "The *Ying Qi* chapter implies there is Qi within Ying. Why do you insist Wei does not enter the meridians? Does Ying not contain Qi?" I say no. The classic states: "The clear becomes Ying, the turbid becomes Wei." Wei is like wind, Ying is like water. Ying blood travels within the meridians, relying on Qi to move it, just as water flows underground. While rivers rely on wind to move, wind does not exclusively follow the rivers. Moreover, Ma Yuantai has detailed why Wei Qi does not follow Ying Qi. However, in the *Wei Qi Xing* chapter, interpretations of entering the Yin aspects at the fourth, eighth, and twenty-fourth water drops mistakenly claim entry into the Foot-Shaoyin Kidney Meridian, citing the *Xie Ke* chapter: "Always traveling through the spaces of the Foot-Shaoyin among the Five Zang and Six Fu organs." They miss that "Foot-Shaoyin fen" (region/division) merely refers to passing through that geographical area once, not actual travel along the meridian. If it truly traveled the Foot-Shaoyin meridian, then during the day it would follow the Six Fu organs in Yang, and at night follow the Five Zang organs in Yin, meaning the Kidney would be traversed twice in one day-night cycle, while others only once. In fact, during the day, it passes through the Yin aspects; at night, it travels through the Yin meridians. The *Xie Ke* chapter's statement that it travels "through the spaces of Foot-Shaoyin among the Five Zang and Six Fu" is because Wei Qi originates from the Lower Jiao, which is the domain of the Kidney. However, the mentions of "Qi in the Yin aspects" at the fourth, eighth, twelfth, sixteenth, twentieth, and twenty-fourth drops in the *Wei Qi Xing* chapter need not specifically refer to the Kidney Meridian. Only the twenty-five nighttime Yin cycles can be directly attributed to the Kidney Meridian. Despite this being detailed in the *Neijing*, later students still struggle to comprehend it for three reasons: First, Qin Yueren's *Nan Jing* claims Ying Qi always accompanies Wei Qi, contradicting the classics and creating misleading diagrams. Second, the calculations in the *Wei Qi Xing* chapter involving water drops, fifty cycles, forty-eight mansions, twenty-eight constellations, and twelve earthly branches involve complex fractions that are hard to reconcile without astronomical expertise. Third, the unequal circulation of Wei Qi, where nighttime Yin travel differs from daytime Yang travel which exceeds Yin, creates confusion. These factors have kept the theory of Ying and Wei obscure for millennia. After deep reflection, I propose three models to clarify this: First, the *Ying Qi Circulation Diagram*, showing Ying Qi starting from the Middle Jiao at Yin hour (3-5 AM), entering the Hand-Taiyin Lung Meridian, cycling through the organs endlessly, fifty times daily. Second, the *Chong Qi Circulation Diagram*, circular in nature, cycling Yang twenty-five times from drop 1 to 50, and Yin twenty-five times from drop 51 to 100, accommodating both night and day movements. Third, the *Wei Qi and Celestial Sphere Diagram*, using Zi-Wu as longitude and Mao-You as latitude, aligning the fifty human cycles with solar mansions, earthly branches, and constellations. With these three diagrams, future readers may understand the principles without feeling overwhelmed.
However, there is another perspective on Ying and Wei circulation. Ancient sages believed Ying Qi starts at Yin hour in the Hand-Taiyin Lung Meridian and immediately enters the Hand-Yangming Large Intestine Meridian at Mao hour, mapping the twelve earthly branches sequentially to the twelve organs. If this were true, Ying Qi would only complete one cycle per day, contradicting the "fifty cycles" statement. Furthermore, meridians vary in length; e.g., the Hand-Taiyin Lung Meridian (Zhongfu to Shaoshang) is short, while the Foot-Taiyang Bladder Meridian (Inner Canthus to Zhiyin) is long. If one meridian were assigned to one hour, would pulse speed adjust based on meridian length? I believe not. Ying and Wei are formless Yin and Yang, not有形 (form/material) blood and Qi. If they were material blood/Qi, amputation would block flow and cause death, which we do not observe. The use of the character "Qi" in both *Wei Qi Xing* and *Ying Qi* chapters confirms their formless nature. Being formless Yin and Yang, they are not bound by physical dimensions or meridian lengths, so assigning one hour to one organ is acceptable, but assigning one hour to traverse one entire meridian is not.

According to Ying Qi originating from the Middle Jiao, starting at Yin hour in the Hand-Taiyin Lung Meridian, it sequentially fills the twelve meridians, cycling endlessly, fifty times in a day and night, corresponding to one hundred water drops. In the subsequent diagram, the inner circle represents Interior/Zang, and the outer circle represents Exterior/Fu. Within one cycle, it enters the Interior three times and reaches the Exterior three times, illustrating the "fifty circuits per day and night." Wei Qi also circulates fifty times daily but follows a different path independent of Ying Qi, as shown in the following diagram.
[Image: Ying Qi Interior-Exterior Diagram]
[Image: Wei Qi Circulation and Water Drop Alignment Diagram]
[Image: Ying and Wei Celestial Degrees Diagram]

Men and women, old and young, have distinct physical forms.
Gender and age differences are obvious. "Size" refers to fatness or leanness. The *Nan Jing* Chapter 19 states: "Pulses have compliance and inversion. Men and women have constants, but what if they reverse?" The answer is: "Men are born under Yin (Wood, Yang); Women are born under Shen (Metal, Yin). Therefore, men's pulses are stronger at the Guan position, while women's are stronger at the Chi position. Thus, men typically have weak Chi pulses, and women have strong Chi pulses. This is the norm. Reversal occurs when men exhibit women's pulses or women exhibit men's pulses. What diseases result?" The answer: "Men exhibiting women's pulses indicate Deficiency, with disease internal. Left-side manifestation indicates left-sided disease; right-side indicates right-sided. Women exhibiting men's pulses indicate Excess, with disease in the limbs. Left-side indicates left-sided disease; right-side indicates right-sided. This is the principle. The *Mai Jing* says: "When diagnosing, observe height, size, and temperament. Pulse speed, size, and length matching the person's form and character is auspicious; reversal is inauspicious." Generally, the three pulse positions should be balanced. However, small individuals and women typically have fine, soft pulses. Children aged four to five usually have rapid, fine pulses (eight beats per breath), which is auspicious. The *Qian Jin Yi Fang* states: Large body with fine pulse, small body with large pulse, happy person with solid pulse, suffering person with empty pulse, irritable person with slow pulse, calm person with rapid pulse, robust person with fine pulse, emaciated person with large pulse—all are inversions (Ni), indicating difficult treatment. The reverse is compliance (Shun), indicating easier treatment. Women's pulses should generally be softer/weaker than men's. Children aged four to five naturally have rapid pulses (eight beats per breath). Male left-pulse dominance is compliant; female right-pulse dominance is compliant. Fat people have deep pulses; thin people have floating pulses. However, one should not adhere rigidly to these rules. I once questioned the *Nan Jing* statement "Men getting women's pulse is deficiency, women getting men's pulse is excess." Specifically, "Men getting women's pulse" implies excessive Chi pulse (Water failing to control Fire), indicating deficiency. But "Women getting men's pulse" implies weak Chi pulse, which contradicts the term "excess." I believe the ancients meant "Men getting women's pulse" signifies True Yin deficiency, while "Women getting men's pulse" signifies Yang Pathogen excess. Treating weak Chi pulse in women solely with Yin-nourishing herbs is incorrect. I treated a woman with rapid/large pulses anterior to the Guan and weak pulses posterior to the Guan, with internal heat, irritability, and pain in the head, teeth, shoulders, and arms. Previous doctors prescribed Yin-nourishing formulas (Si Wu Tang, Sha Shen, Bie Jia, Qing Hao, Yin Chai Hu) for over a hundred doses without effect. Recalling "Women getting men's pulse is excess," I prescribed Bo He, Fang Feng, Shan Zhi to suppress Yang, and Di Huang, Dan Pi, Dang Gui, Shao Yao, Gan Cao to support Yin. She improved after a few doses, confirming the ancients' wisdom. However, if men have strong pulses everywhere or women have weak pulses everywhere, generalizations fail. I critique the *Qian Jin Yi Fang*: While "small body/large pulse" etc. as inversions makes sense, labeling "large body/fine pulse," "happy/solid pulse," "irritable/slow pulse," or "robust/fine pulse" as inversions is questionable. I treated a dignitary who was physically imposing but had an imperceptible pulse; minor illness caused his pulse to become prominent. Is large body/fine pulse necessarily an inversion? Happy people with proper care may have solid pulses, not necessarily deficient. Irritable people with harmonious pulses may be long-lived. Robust people with fine pulses may have clear constitutions and dense muscles, leading to narrow pulse channels. The *Qian Jin Yi Fang* relies too heavily on binary oppositions, harming the true meaning, and thus cannot be fully trusted.
Regarding seasonal variations, one must understand Spring, Summer, Autumn, and Winter. See below.

In the months of Yin and Mao (1st and 2nd lunar months), Wood Qi is prosperous, and the Liver pulse is string-like (Xian) and long, following suit.
This refers to the 1st month (Yin) and 2nd month (Mao). During peak Wood Qi, the pulse should be string-like. The *Nan Jing* Chapter 15 states: "Spring pulse is string-like because the Liver belongs to Eastern Wood. Things begin to grow but lack branches/leaves, so the pulse comes soft, weak, and long, hence 'string-like.' What if it changes? A spring pulse that is string-like is normal; deviation indicates disease. Deviation means: Strong/replete arrival indicates Excess (Tai Guo), disease in the Exterior; weak/faint arrival indicates Deficiency (Bu Ji), disease in the Interior. Soft and gentle like touching elm leaves is Normal; becoming more solid and slippery like a long pole is Sick; becoming stiff and tight like a drawn bowstring is Death. Thus, 'slightly string-like' is Normal; 'more string-like with less Stomach Qi' is Sick; 'only string-like with no Stomach Qi' is Death. Spring relies on Stomach Qi as its foundation."