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**Physical Manifestation** The *Chi* pulse (Slow Pulse) belongs to Yin; its image represents deficiency. The flow is slow and sluggish, occurring three times per respiration cycle (*Yi Xi*).

The meaning of the *Chi* pulse is stagnation and failure to achieve harmony. A healthy pulse beats four times per respiration cycle; if it beats only three times, it is a *Chi* pulse. This is because Qi fails to rise and propagate, and its movement does not follow the proper measure, hence it is classified as belonging to Yin.

**Predominant Diseases** The *Chi* pulse primarily indicates Zang organ diseases, with Cold syndromes being the pathology. If the *Chi* pulse is found at the Left Cun position, it indicates Heart pain with stagnation. If found at the Left Guan position, it indicates tendon spasm and contraction. If found at the Left Chi position, it indicates Kidney deficiency, turbid urine, and amenorrhea in women. If found at the Right Cun position, it indicates Lung Cold with phlegm accumulation. If found at the Right Guan position, it indicates Stomach injury from cold substances. If found at the Right Chi position, it indicates internal Cold leading to diarrhea and cold pain in the lower abdomen.

The Five Zang organs belong to Yin, and the *Chi* pulse also belongs to Yin; therefore, it primarily indicates Zang diseases. Yin nature tends toward stagnation, so in Yin-Cold syndromes, the pulse must appear slow. Just as when the Sun is associated with the Southern Continent, it follows the Fire degree and moves rapidly; when associated with the Northern Continent, it follows the Water degree and moves slowly, this illustrates the reason for the speed or slowness of Yin and Yang. The *Nan Jing · Chapter 9* states: "Slow indicates Zang." It also states: "Slow indicates Cold." The *Shang Han Lun* also says: "Slow indicates involvement of the Zang." This is because Yang Qi is latent and unable to function vigorously, resulting in a slow rate. The diseases indicated by this pulse are approximately the same as those of the *Chen* pulse (Deep Pulse). However, the pathology of the *Chen* pulse is Yin rebellion with Yang depression, whereas the pathology of the *Chi* pulse is Yin excess with Yang deficiency. While the *Chen* pulse may sometimes require purgative or dispersing methods, the *Chi* pulse invariably requires warming and tonifying treatments.

**Combined Pulses** With force indicates Cold pain; without force indicates Deficiency Cold. Floating and Slow indicates Exterior Cold; Deep and Slow indicates Interior Cold. Slow and Choppy indicates Blood deficiency; Slow and Moderate indicates Damp-Cold.

A Slow pulse with force suggests obstruction and lack of free flow, implying pain can be imagined. A Slow pulse indicating latent Yang yet lacking force is undoubtedly Deficiency Cold. Floating indicates an Exterior sign; Deep indicates an Interior sign; combined with Slow, Cold is certain. Blood flows when warmed by Heat; Dampness dissipates when warmed by Heat. Since Slow is an image of Cold, how can it nourish Ying (Nutrient) blood or dry Dampness?

Note: In the manifestation of the Slow pulse, the rate is slow across the Upper, Middle, and Lower positions. Apocryphal texts state: "It is felt only with heavy pressure." This describes the *Chen* (Deep) pulse, not the *Chi* (Slow) pulse. They also state: "The shape is difficult." This describes the *Se* (Choppy) pulse, not the *Chi* pulse. Three beats per respiration is clearly defined, yet describing it as "faint" refers to the *Wei* (Fine/Micro) pulse, not the *Chi* pulse. Slow and unsmooth is the *Se* (Choppy) pulse; Slow with intermittent pauses is the *Jie* (Knotted) pulse; Slow, floating, large, and relaxed is the *Xu* (Deficient) pulse. As for the *Huan* (Moderate) pulse, it is completely dissimilar. The *Huan* pulse gets its name from being broad and loose; the *Chi* pulse is defined by having fewer beats than normal. Thus, the *Huan* pulse has four beats per respiration, being broad, moderate, and peaceful; the *Chi* pulse has three beats per respiration, being slow and stagnant. Therefore, these two pulses are distinct, and how can they be confused? Even Li Binhu, known for his clarity, stated that the *Huan* pulse is slightly faster than the *Chi*. Using beat frequency to discuss the *Huan* pulse was a lapse in his otherwise thorough analysis. Shuhe said: "One beat per exhalation is called Li Jing (Departing from the Normal); two beats per exhalation is called Duo Jing (Loss of Essence); three beats per exhalation is Death; four beats per exhalation is Life Extinction. These are Damage pulses. First damage affects skin and hair; second damage affects blood vessels; third damage affects muscles; fourth damage affects sinews; fifth damage affects bones." From this, we know that the slower the pulse rate, the more depleted the Zheng Qi (Upright Qi), the more severe the Yin Cold, resembling the remaining flame of an extinguishing lamp, which will vanish in the blink of an eye!