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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "By adjusting the pulse's slow, rapid, large, small, slippery, and choppy qualities, the pathological changes can be determined." This implies that these six qualities are sufficient to serve as the guidelines for all pulses. It further states: "Small, large, slippery, choppy, floating, and sunken." The *Nan Jing* (Classic of Difficult Issues) states: "Floating, sunken, long, short, slippery, and choppy." Zhang Zhongjing states: "Wiry, tight, floating, sunken, slippery, and choppy; these six are named 'harmful pathogens' (pathogenic factors that damage healthy qi and induce other pathological pulses), capable of causing diseases in various pulses." Hua Boren states: "The essence of outlining the pulse does not go beyond the six types: floating, sunken, slow, rapid, slippery, and choppy. The reason they do not go beyond these six is that they are sufficient to govern diseases related to exterior-interior, yin-yang, deficiency-excess, cold-heat, wind-cold-dampness-dryness, and zang-fu organs and blood-qii. Floating indicates yang and exterior, diagnosed as wind or deficiency. Sunken indicates yin and interior, diagnosed as dampness or excess. Slow indicates involvement of the zang organs, cold, and chill. Rapid indicates involvement of the fu organs, heat, and dryness. Slippery indicates an excess of blood. Choppy indicates stagnation of qi alone." Although the wording of these various theories differs slightly, their meanings are essentially consistent. In my opinion, it boils down to distinguishing between the six categories: exterior, interior, cold, heat, deficiency, and excess. For instance, since floating indicates the exterior, the scattered, large, and hollow pulses can be categorized similarly. Since sunken indicates the interior, the fine, small, and deep-hidden pulses can be categorized similarly. Since slow indicates cold, the leisurely, choppy, and knotted pulses can be categorized similarly. Since rapid indicates heat, the surging, slippery, fast, and intermittent pulses can be categorized similarly. Since deficiency indicates insufficiency, the short, soggy, minute, and weak pulses can be categorized similarly. Since excess indicates surplus, the wiry, tight, moving, and leathery pulses can be categorized similarly. These are general principles, easily understood by people. However, among these six, there are crucial distinctions that may not be recognized by some, leading to significant errors of mistaking the similar for the correct. Floating indicates the exterior, yet in cases of yin deficiency, the pulse must be floating but forceless, because true yin has depleted below, leaving lone yang to float above. Therefore, floating cannot be universally equated with the exterior, nor should dispersing and ascending methods be used! Sunken indicates the interior, yet when exterior pathogenic factors are initially contracted and vigorous, with yin-cold binding the skin and hair, preventing yang qi from reaching the exterior, the pulse will first appear sunken and tight. Therefore, sunken cannot be universally equated with the interior, nor should purgative methods be used! Slow indicates cold, yet after the initial decline of cold damage, if residual heat remains unclarified, the pulse is often slow and slippery. Therefore, slow cannot be universally equated with cold, nor should warming middle-jiao methods be used! Rapid indicates heat, yet in conditions of deficiency and wasting, where both yin and yang are depleted and blood and qi are chaotic, the pulse must be urgent and rapid. The more rapid, the more deficient; the more deficient, the more rapid. Therefore, rapid cannot be universally equated with heat, nor should cooling methods be used! Minute and fine resemble deficiency, yet in cases of extreme pain and obstruction, the pulse often hides deeply. Therefore, hidden pulses cannot be universally equated with deficiency, nor should sudden tonification be applied! Surging and wiry resemble excess, yet when true yin is severely depleted, the pulse at the guan position may exceed normal limits significantly. Therefore, wiry cannot be universally equated with excess, nor should resolving methods be used! Thus, we know that within the guidelines of pulse diagnosis, there exists a higher-level guideline. If one does not integrate the four diagnostic methods (inspection, auscultation-olfaction, inquiry, and palpation), but instead acts rashly and arbitrarily, there will inevitably be those who cause harm to patients in the blink of an eye.