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[Characteristics of Pulse Image]
The Shu (Rapid) pulse belongs to Yang; its image manifests as excessive haste. It beats six times per respiration, exceeding the normal limit of Qi and blood circulation.

The meaning of "Shu" refers to a restless and urgent quality that fails to maintain harmony and balance. Under normal conditions, during one exhalation, the pulse beats twice, and Qi moves three cun; during one inhalation, the pulse beats twice, and Qi moves three cun. One full respiration (exhalation and inhalation) constitutes one "Xi," during which Qi moves six cun. In a day and night, there are 13,500 respirations, allowing the Qi of the meridians to circulate fifty times through the body, covering a distance of 810 zhang. This is the standard measure for the continuous flow of Qi and blood in the meridians. If the pulse beats six times per Xi, does it not exceed this normal limit? Because the speed of Qi and blood circulation accelerates, it is classified as belonging to Yang.

[Main Diseases]
The Shu pulse primarily indicates Fu-organ diseases, with the pathological nature being Heat.
If the Shu pulse appears at the Left Cun position, symptoms include headache, upper body heat, tongue ulcers, mental restlessness, and thirst.
If the Shu pulse appears at the Left Guan position, symptoms include tearing, tinnitus, and redness on the left cheekbone.
If the Shu pulse is found at the Left Chi position, symptoms include unceasing Xiao Ke (Wasting-Thirst syndrome), and yellow-red urine.
If the Shu pulse appears at the Right Cun position, symptoms include cough, hemoptysis (coughing up blood), foul-smelling throat, and sore throat.
If the Shu pulse appears at the Right Guan position, symptoms include spleen-heat with bad breath, and stomach Qi rebellion causing vomiting.
If the Shu pulse is found at the Right Chi position, symptoms include constipation with dryness and difficulty, seminal emission with turbid urine, or strangury with retention.

Fire has a rapid nature; therefore, in syndromes of Yang excess, the pulse must be rapid. The Six Fu organs belong to Yang, and the Shu pulse also belongs to Yang; hence, the Shu pulse governs Fu-organ diseases. *Nan Jing* (Classic of Difficult Issues), Chapter 9, states: "Shu corresponds to the Fu organs." It further states: "Shu indicates Heat." *Shang Han Lun* (Treatise on Cold Damage) also says: "Shu indicates disease in the Fu organs." This classification uses Chi (Slow) and Shu (Rapid) to distinguish Yin and Yang, thereby associating them with Zang and Fu organs, which is merely a generalization. However, pulses can be complex and intermixed; there may be Chi pulses in Fu diseases and Shu pulses in Zang diseases, Chi pulses in exterior syndromes, and Shu pulses in interior syndromes. How can one rigidly confine these concepts solely to "Zang and Fu"?

When Fire is hyperactive in the Upper Jiao (Upper Burner), the Clear Yang is disturbed, leading to headaches. The tongue is the sprout of the Heart; Heat causes ulcers and results in mental restlessness and thirst. The Liver opens into the eyes; severe Heat forces tears outward. Tinnitus occurs because Fire flaunts its inflammatory, ascending tyranny. The left cheekbone corresponds to the Liver; Heat manifests as redness in this area. The Kidney is the root of Tian Yi (Heavenly One) and governs Yin Water. When affected by Heat, Yin cannot overcome Yang. The fluids (Huachi water) fail to reach the base of the tongue, causing thirst and a desire to drink. Urine becomes like oil paste, and reddish stool is a minor manifestation. The Lung belongs to Metal and is a delicate organ; Fire is the enemy of Metal. When Fire attacks Metal, it becomes the medium for cough. If Lung Fire burns alone, the throat feels bloody, and swallowing saliva causes pain, indicating an impending hemorrhage. Although the Spleen and Stomach prefer dryness, excessive Heat poses a risk of aridity. The Stomach is the sea of water and grain; severe Heat brews foul qi, causing food to be vomited upon entry, indicating the presence of Fire. The Kidneys govern the Five Fluids. Hunger, satiety, labor, and consumption of spicy and rich flavors cause Fire pathogens to lurk in the blood, reducing body fluids and leading to constipation.

[Combined Pulses]
A Shu pulse with force indicates Excess Fire; without force, it indicates Deficiency Fire. A Floating-Shu pulse indicates Exterior Heat; a Deep-Shu pulse indicates Interior Heat.

A Shu pulse with force is caused by accumulated Heat; a Shu pulse without force indicates Heat combined with Deficiency. The Floating pulse governs exterior syndromes, and the Deep pulse governs interior syndromes; when combined with Shu, Heat is evident.

Note: The Shu pulse and the Chi (Slow) pulse represent one Yin and one Yang, serving as the guideline for all pulses. The false regulations established Seven Superficial and Eight Interior pulses but omitted the Shu pulse, mentioning it only in the Heart chapter; this omission is significant. A Shu pulse combined with wiry and urgent qualities becomes the Jin (Tight) pulse; combined with smooth and slippery qualities, it becomes the Hua (Slippery) pulse; combined with pauses, it becomes the Cu (Surging/Intermittent) pulse; when extremely rapid, it becomes the Ji (Rapid/Fatal) pulse; and when resembling a bean rolling, it becomes the Dong (Moving) pulse. These distinctions require deep contemplation to discern. Wang Shuhe stated: "Two beats per exhalation is a Normal pulse; three beats is Li Jing (Departing from the Channel); four beats is Duo Jing (Depleting Essence); five beats is Si (Death); six beats is Ming Jin (End of Life)." Thus, the more rapid the pulse form, the hotter the pathology. If seen in the Lung, it is a "Thief Pulse" for Metal; if encountered in Autumn, it is an ominous sign counteracting the seasonal command.

The Dao of pulse diagnosis, broadly speaking, presents diverse images; simply put, they do not extend beyond Floating, Deep, Slow, and Rapid. Floating indicates disease in the Exterior; Deep indicates disease in the Interior; Rapid indicates Heat disease; Slow indicates Cold disease. By combining these with assessments of Force and No Force to determine Excess and Deficiency, one can exhaust the variations of pulses. However, one pulse type may correspond to multiple syndromes, and one syndrome may present with multiple pulse types. There are also cases where Yang syndromes resemble Yin, Yin syndromes resemble Yang, extreme Deficiency presents with Excess signs, and extreme Excess presents with Withered signs. The ambiguity between these subtle differences is minute yet critical, especially during treatments such as sweating, vomiting, or purging. If one adheres rigidly to the Four Images (Floating, Deep, Slow, Rapid), the diagnosis becomes narrow and incomplete. One must meticulously study every character of the fundamental twenty-eight characters (referring to basic pulse descriptors), allowing the mind to encompass all phenomena. Starting from the coarse to the refined, and finally returning from the extensive to the concise, one may be called a skilled diagnostician, worthy of the title.