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Morphology: The characteristic of Dai pulse (Intermittent Pulse) is its alternation; the pauses occur with a constant number. It cannot return spontaneously, and resumes beating only after a long interval.

Dai pulse also belongs to the category of intermittent pulses. However, in Cu pulse (Rapid Intermittent Pulse) and Jie pulse (Knotted Pulse), the pauses are caused by internal obstructions; although they pause, they do not completely sever, retaining a sense of returning flow. In contrast, Dai pulse pauses without returning, resuming only after a long interval, much like the succession of the four seasons, which never misses its due time. Furthermore, the pauses in Cu and Jie pulses lack a fixed frequency, whereas the pauses in Dai pulse follow a regular cycle.

Pathogenesis: Dai pulse primarily indicates the decline of Zang organ Qi, representing a critical and ominous prognosis. If Spleen Earth fails, it results in vomiting and diarrhea. If Cold invades the Middle causing anorexia and abdominal pain that is difficult to treat, rescue is unlikely.

The reason for pauses having a fixed period lies in the fact that the Spleen governs trustworthiness (regularity). Therefore, the *Nei Jing* (Inner Canon) states that the appearance of Dai pulse is a diagnostic sign of declining Zang Qi and the exhaustion of Spleen Qi.

Regarding the meaning of Dai pulse, interpretations vary. For instance, the *Su Wen · Xuan Ming Wu Qi Pian* states: "The Spleen pulse is Dai." The *Ling Shu · Xie Qi Zang Fu Bing Xing Pian* states: "Those with yellow complexion have a Dai pulse." These refer to the normal manifestations of Zang Qi, not implying that Dai pulse signifies cessation. The *Su Wen · Ping Ren Qi Xiang Lun* states: "In late summer, if the Stomach Qi is soft and weak, it is considered normal; but if there is only Dai pulse without Stomach Qi, it is fatal." This refers to death due to the absence of Stomach Qi, not defining Dai pulse as cessation. When Spleen Qi dominates the four seasons and changes accordingly, this is the succession of climate, as mentioned in the *Xuan Ming Wu Qi* chapter. If the pulse is balanced and uniform but suddenly becomes strong or weak, this is the succession of physical forms, also discussed in those chapters. When pulses lack fixed characteristics and change unpredictably, all are termed Dai, requiring examination of the changing condition. For example, "fifty beats without one Dai" refers to the numerical aspect of Dai. Generally, five beats per breath indicate sufficient Qi in the Lung, Heart, Spleen, Liver, and Kidney. Thus, fifty beats without a pause align with the Great Expansion Number (Da Yan Zhi Shu) and are called Normal Pulse. Conversely, pauses appear. If Kidney Qi is insufficient, there is a pause every forty beats; if Liver Qi is insufficient, every thirty beats; if Spleen Qi is insufficient, every twenty beats; if Heart Qi is insufficient, every ten beats; if Lung Qi is insufficient, every four or five beats. These pauses should progress from distant to near, shortening sequentially: from Kidney to Liver, Liver to Spleen, Spleen to Heart, and Heart to Lung. Therefore, patients nearing death invariably experience rapid breathing and panting, able to breathe only within a few inches of the chest. At this stage, True Yin is exhausted below, and Lone Yang floats above; breathlessness reaches its extreme. If physicians still attempt to treat with dispersing methods, death will inevitably follow. Dai Tongfu stated: "The Three Regions and Nine Positions method requires counting at least fifty beats, originating from the *Nan Jing*. However, the apocryphal *Five Zang Song* uses forty-five beats as standard, deviating from canonical principles. It also claims: 'One pause in forty-one beats indicates one Zang's Qi is exhausted, leading to death after four years.' This is particularly absurd. How can a person survive four years after one Zang's Qi is exhausted? Hehe also said: 'A pause in forty beats indicates one Zang lacks Qi, leading to death when spring grass grows four years later.' Did the *Ling Shu · Gen Jie Pian* explicitly predict death dates? It merely discusses beat counts to diagnose the absence of Zang Qi." Hua Borin stated: "Emaciation with Dai pulse in healthy individuals is a critical sign. In sick individuals with sudden Qi and Blood damage, it is merely a pathological pulse." This refers to acute illnesses. For chronic diseases presenting with Dai pulse, recovery is extremely rare.

In Shang Han (Cold Damage), palpitations may arise from deficiency of Middle Qi, retention of fluid, or post-sweating/purging conditions. Deficiency of Middle Qi causes Yang to sink; since Yang receives Qi in the chest, sinking Yang cannot ascend to fill the chest, causing palpitations. Retention of fluid involves excessive water intake stagnating in the epigastrium. Water stagnation allows Water Qi to harass the Heart, causing insecurity and palpitations. Sweating depletes interior fluids. Since sweat is the fluid of the Heart, depletion leads to Heart deficiency and palpitations. Not all palpitations present with Dai pulse; however, Dai pulse specifically points to palpitations following sweating, as sweat is Heart fluid and the pulse is the manifestation of the Heart.

Female fetuses develop over ten months, nourished by the true Qi transmitted by the Zang-Fu organs. If the meridians responsible for nourishment at term are imbalanced in excess or deficiency, fetal instability occurs, potentially leading to bleeding and miscarriage. During the third month, the Pericardium nourishes the fetus. The *Ling Shu · Jing Mai Pian* states: "The Pericardium governs the vessels." If Qi is shared with the fetus, the pulse must be deficient and intermittent. The *Ling Shu · Wu Zang Sheng Cheng Pian* states: "The Heart combines with the vessels." Although the Heart and Pericardium are distinct meridians, they belong to the same Zang organ. The pathogenesis of Dai pulse highlights Spleen deficiency without mentioning other symptoms, so it is listed here for reference.