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Damage upon damage, until there is only one pulse beat per two breaths. In this case, for a healthy person's two breaths, the patient's pulse beats only once. Thus, in one day and night, the pulse beats only 6,750 times. Calculated according to the "Fifty Circulations" (Wushi Ying, the circulation of Qi and Blood through the whole body fifty times), it is insufficient even to complete one full circuit around the body; therefore, death is inevitable. It is like a rider who usually travels one hundred li per day. Now, as strength gradually declines, traveling only sixty or seventy li per day might still allow hope for recovery. But if he can travel only ten or twenty li per day, and cannot even do that, his exhaustion is extreme. How can one expect him to recover?

Slow pulse indicates cold, rapid pulse indicates heat, passed down from ancient times to modern days. The *Nan Jing* (Classic of Difficult Issues) clearly records these distinctions.
This summarizes the preceding text regarding slow (Chi), rapid (Shu), diminished (Sun), and excessive (Zhi) pulses. It means: a slow pulse implies coldness, while a rapid pulse implies heat. The person's respiration rate, the dimensions of the Cun and Chi positions on the wrist, and the degrees of meridian flow are all detailed in the *Nan Jing* by Qin Yueren (Bian Que).

Heat generates wind, cold generates Qi; keep this firmly in mind when palpating with your fingers.
The Liver governs wind. If heat is excessive, Fire flourishes and Metal weakens, failing to control Wood; thus, Wood becomes hyperactive and generates wind. The Lungs govern Qi. If cold is excessive, Water flourishes and Fire weakens, having no leisure to control Metal; thus, Metal becomes hyperactive and generates Qi.

Spring pulses are wiry (Xian), Summer pulses are surging (Hong), Autumn pulses resemble feathers (Mao), and Winter pulses resemble stones (Shi), based on the classical division of solar terms.
"Wiry" in Spring refers to the *Su Wen: Yu Ji Zhen Zang Lun*. Qibo said: The Spring pulse corresponds to the Liver, which belongs to East Wood, the season when all things begin to grow. Therefore, its Qi arrives weak, light, void, yet smooth, straight and long, hence called "wiry." Deviation from this indicates disease. The Yellow Emperor asked: How does it deviate? Qibo said: If the Qi arrives solid and strong, this is called "Excess" (Tai Guo), indicating disease in the exterior. If the Qi arrives not solid but faint, this is called "Deficiency" (Bu Ji), indicating disease in the interior. The Yellow Emperor asked: What are the symptoms of Excess and Deficiency in Spring pulses? Qibo said: Excess causes forgetfulness, dizziness, vertigo, and epileptic fits. Deficiency causes chest pain radiating to the back, and distension/fullness below in both hypochondriac regions.

"Surging" in Summer refers to the *Su Wen: Yu Ji Zhen Zang Lun*. Qibo said: The Summer pulse corresponds to the Heart, which belongs to South Fire, the season when all things flourish and grow. Therefore, its Qi arrives vigorous and departs declining, hence called "hook" (Gou, describing the pulse coming strong and going weak). Deviation from this indicates disease. The Yellow Emperor asked: How does it deviate? Qibo said: If the Qi arrives vigorous and departs also vigorous, this is called "Excess," disease in the exterior. If the Qi arrives not vigorous but departs vigorously, this is called "Deficiency," disease in the interior. The Yellow Emperor asked: What are the symptoms? Qibo said: Excess causes body heat and skin pain, leading to spreading sores (Jin Yin). Deficiency causes vexation, upward coughing and spitting, and downward leakage of Qi (such as incontinence).

"Feather-like" in Autumn refers to the *Su Wen: Yu Ji Zhen Zang Lun*. Qibo said: The Autumn pulse corresponds to the Lungs, which belong to West Metal, the season of harvest. Therefore, its Qi arrives light, void, and floating, coming swiftly and scattering upon departure, hence called "floating" (Fu). Deviation from this indicates disease. The Yellow Emperor asked: How does it deviate? Qibo said: If the Qi feels like a feather but is firm in the center and empty on the sides, this is called "Excess," disease in the exterior. If the Qi feels like a feather but is faint, this is called "Deficiency," disease in the interior. The Yellow Emperor asked: What are the symptoms? Qibo said: Excess causes rebellious Qi and back pain, with a feeling of oppression. Deficiency causes panting, shortness of breath, coughing, upward hemoptysis, and audible pathological sounds below.

"Stone-like" in Winter refers to the *Su Wen: Yu Ji Zhen Zang Lun*. Qibo said: The Winter pulse corresponds to the Kidneys, which belong to North Water, the season of storage. Therefore, its Qi arrives deep and pounding, hence called "ying" (referring to the deep/stony quality). Deviation from this indicates disease. The Yellow Emperor asked: How does it deviate? Qibo said: If the Qi arrives hard like bouncing stones, this is called "Excess," disease in the exterior. If the Qi arrives rapid, this is called "Deficiency," disease in the interior. The Yellow Emperor asked: What are the symptoms? Qibo said: Excess causes lethargy, pain in the spinal meridians, shortness of breath, and reluctance to speak. Deficiency causes a sensation of emptiness in the heart, as if hungry, coldness in the epigastrium, pain in the spine, fullness in the lower abdomen, and abnormal urination.

Pulses that are soft, slow, and weak like willow branches in spring indicate the Spleen dwelling centrally and governing the four seasons.
According to the *Su Wen: Yu Ji Zhen Zang Lun*, Qibo said: The Spleen pulse belongs to Earth. It is the solitary organ that irrigates the four surrounding organs. The Yellow Emperor asked: Can the good and bad states of the Spleen be seen? Qibo said: The good state cannot be seen; the bad state can be seen. The Yellow Emperor asked: How is the bad state seen? Qibo said: If the Qi arrives flowing like water, this is "Excess," disease in the exterior. If it arrives pecking like a bird, this is "Deficiency," disease in the interior. The Yellow Emperor asked: You stated the Spleen is the solitary organ, central Earth irrigating the four sides. What are the symptoms of Excess and Deficiency? Qibo said: Excess causes inability to lift the limbs. Deficiency causes obstruction of the nine orifices, named "Zhong Qiang" (heavy stiffness).

Focus your attention to observe subtleties; adapt flexibly to comprehend profound principles and remember them.
Zhang Shixian said: "Focus your attention" means concentrating without distraction. Do not let other matters clutter your mind. By meticulously examining the subtleties of pulse logic, the agile mechanism (Ling Ji) will naturally become clear. The profound and subtle principles will connect and be remembered. "Ling Ji" refers to pulse logic. Pulse logic is dynamic and not rigid, hence called "Ling Ji."

Floating (Fu), Knifelike (Kou), Slippery (Hua), Solid (Shi), Wiry (Xian), Tight (Jin), and Surging (Hong)—these seven belong to the "Seven Tables" (Yang pulses).
These seven pulses—Floating, Knifelike, Slippery, Solid, Wiry, Tight, and Surging—are all obtained with light pressure. Floating pulse diagnoses exterior conditions, hence they are called the "Seven Tables."

Micro (Wei), Deep (Chen), Slow (Huan), Rough (Se), Slow (Chi), Hidden (Fu), Soft (Ru), and Weak (Ruo)—these eight belong to the "Eight Li" (Yin pulses).
These eight pulses—Micro, Deep, Slow, Rough, Slow, Hidden, Soft, and Weak—are not felt with light pressure but require heavy pressure. Deep pulse diagnoses interior conditions, hence they are called the "Eight Li."

Blood is Ying (Nutrient), Qi is Wei (Defensive); counting breaths, 13,500 cycles pass smoothly.
Humans receive Qi from grain. Grain enters the Stomach and is transmitted to the Five Zang and Six Fu organs, all receiving Qi. The pure part becomes Ying Qi (Nutrient Qi), and the turbid part becomes Wei Qi (Defensive Qi). Ying Qi circulates within the vessels, while Wei Qi circulates outside. Ying and Wei Qi flow continuously, completing fifty circuits before meeting again. Yin and Yang interpenetrate like a circle without end. Thus, blood is Ying, and Qi is Wei. Humans preserve their life and nature through Qi and Blood. Qi is Yang, and Yang is Wei; Blood is Yin, and Yin is Ying. These two Qi flows constantly, ensuring health. The Classics state: With one exhalation, pulse Qi moves three cun; with one inhalation, it also moves three cun. At the pause between breaths, it moves six cun total. In one day and night, there are 13,500 breaths. The pulse Qi moves fifty times around the body, corresponding to one hundred water-clock divisions. Ying and Wei Qi move externally through the Yang aspects twenty-five times and internally through the Yin aspects twenty-five times, constituting one full cycle. Thus, after fifty cycles, they reconvene at the Cun Kou point of the Hand Taiyin Lung Meridian, which is where the Qi of the Five Zang and Six Fu organs ends and begins.