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Cheng Wuji's commentary: Differentiating Yin and Yang by the floating (Fu) and sinking (Chen) qualities of the pulse, it is stated that both Taiyang (Greater Yang) and Shaoyin (Lesser Yin) syndromes present with a tight (Jin) pulse. However, a floating and tight pulse indicates a Taiyang syndrome, while a sinking and tight pulse indicates a Shaoyin syndrome. Furthermore, since the text only mentions the Cun Kou (Inch Port), one cannot simply define the area anterior to the Guan (Bar) as Yang and the area posterior to the Guan as Yin; thus, differentiation must rely on floating versus sinking. Nevertheless, what the ancients referred to as "Cun Kou" often included the Guan and Chi (Cubit) positions. For instance, as mentioned in the *Nan Jing* (Classic of Difficult Issues) and later in this chapter: "When water drops two marks, the circulation completes one cycle, returning to the Cun Kou, where deficiency and excess become apparent." This refers to the Jing-Well point Jingqu (LU8) of the Hand-Taiyin Lung Meridian. Understanding this avoids forced interpretations and prevents the error of diagnosing the Lower Jiao at the Cun position. The pathogenic factor described here seems to be dampness, likely referring to heavenly dampness such as fog, dew, and rain. Heaven is based on Qi; thus, invasion affects the Upper and Middle Jiao, manifesting in the exterior and meridians. Earth is based on Form; thus, invasion affects the Lower Jiao, manifesting in the interior and sinews/bones. Since it is explicitly stated that clear pathogenic factors are fog and dew, the so-called turbid pathogenic factor is not earthly dampness. The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Wind pathogens affect the upper part first; damp pathogens affect the lower part first." It also says: "Invasion by clear cold and damp earthy qi always begins from the feet." If the turbid pathogen were cold, the Foot-Taiyang Bladder Meridian should be affected first, rather than solely affecting the Lower Jiao with symptoms of coldness in the feet and knees and incontinence of urine and feces. One might ask: If so, how does this differ from the pulse and symptoms of Damp Bi (Dampness Obstruction)? The answer is: Damp Bi is severe, whereas this condition is mild. Only when severe does dampness flow inward and tend downward, resulting in a sinking and fine pulse, joint pain with restlessness, and a body color resembling smoked yellow. When mild, only the Yin-cold qi is injured, resulting in a tight pulse, headache, neck stiffness, and lower back pain, similar to Cold Damage (Shanghan). Only when the turbid pathogen attacks the Lower Jiao does it differ from Cold Damage, because it directly invades the Zang-Fu organs, sinews, bones, muscles, and skin, not merely the meridians.

The patient feels inner trembling, without bodily shivering, but with mental palpitations and fear. The *Nan Jing* discusses the Five Pathogens, identifying dampness invasion as a Kidney pathogen, with symptoms of coldness and reversal in the lower legs and calves. Thus, the mention of coldness and reversal in the feet and knees clearly indicates dampness in the Kidney. Regarding incontinence, Liu Hejian stated: "When pathogens invade the Kidney region and the Jueyin meridians of the hand and foot, the urethral orifice becomes extremely congested, preventing the free flow of Qi and Blood, leading to flaccidity and paralysis. With no functional use of the Shen (Spirit), fluids seep into the Bladder, causing involuntary urination and loss of control." How then should it be treated? The answer is: To treat heavenly dampness, follow the method of Si Tian (Sovereign Heaven): "For dampness excessive above with heat, level it with bitter-warm herbs, assist with sweet-acrid ones, aiming for sweating as the effect and stopping thereafter." Select from Cold Damage treatments. To treat earthly dampness, follow the method of Zai Quan (Host Earth): "For dampness overflowing within, treat with bitter-hot herbs, assist with sour-pale ones, dry with bitter, drain with pale." Decoctions like Sini Tang (Frigid Extremities Decoction) or Baitong Tang may also be used.

The San Jiao (Triple Burner) is the special envoy of Yuan Qi (Source Qi), responsible for circulating the Qi of the Upper, Middle, and Lower Jiao through the Zang-Fu organs. Circulating these three Qis aligns with Ji Shi's description: the Lower Jiao receives the True Yuan Qi (Primordial Qi), which ascends to the Middle Jiao. The Middle Jiao receives the essence of food and drink, transforming it into Ying (Nutritive) and Wei (Defensive) Qi. Ying and Wei Qi, combined with Primordial Qi, circulate to the Upper Jiao. When the San Jiao is unobstructed, the upper, lower, interior, and exterior, left and right all communicate. Currently, the exterior Qi is slightly deficient, and the interior Qi is slightly urgent. The San Jiao is confused and mixed, leading to obstruction between interior and exterior. Disease in the Upper Jiao causes stagnant heat to arise internally, resulting in mouth ulcers and gum erosion. Disease in the Middle Jiao impairs the Spleen's transformation and Stomach's reception, causing turbidity in the Stomach. Turbidity in the Stomach means there is no essence from food and drink to serve as Ying Qi, nor is there heroic Qi to serve as Wei Qi. How can Ying and Wei Qi then circulate? If Ying and Wei Qi do not circulate, blood coagulates and freezes, ceasing to flow. Human life depends on Ying and Wei Qi. Can one survive long if Ying and Wei Qi do not circulate? Ying circulates within the vessels, and Wei circulates outside; they cannot become unobstructed simultaneously but have a sequence. To know whether Ying or Wei Qi becomes unobstructed first, how can we verify it? If Wei Qi becomes unobstructed first, there will first be dark yellow urine, followed by the formation of abscesses and pus. If Ying Qi becomes unobstructed first, there will first be sneezing and throat blockage, followed by bloody stool resembling pig liver. The *Neijing* states: "The San Jiao is the official of dredging, ensuring the smooth flow of waterways; the Bladder is the official of the capital, storing fluids, which are excreted only after Qi transformation." Does this not imply that it relies solely on the Qi transformation of the Lower Jiao Bladder? The Lungs govern the regulation of waterways, directing them downward to the Bladder. In Spleen disease, the nine orifices are obstructed, and urination is difficult, indicating that urination also depends on the Qi transformation of the Upper and Middle Jiao. Therefore, when Wei Qi is unobstructed, urine is dark yellow. The *Neijing* discusses sneezing: sometimes caused by cold Qi descending and Heart Qi ascending, or hot Qi descending and Lung Qi ascending. Li Dongyuan said: "When Yang Qi cannot exit, it is called 'Se' (Obstruction); when Yin Qi cannot descend, it is called 'Ye' (Choking)." He further stated: "'Se' is governed by the Five Zang organs, belonging to Yin and Blood; 'Ye' is governed by the Six Fu organs, belonging to Yang and Qi." Both arise from Yang hidden within Yin. From this, we see that sneezing and choking are signs of clashing between Yin/Yang and Cold/Heat. Thus, it is said: "Cold jue chasing each other,擁ed by Heat, blood coagulates and flows down, resembling pig liver." Wei Qi warms the flesh, fills the skin, thickens the pores, and controls opening and closing; thus, its unobstruction manifests as pus discharge. Ying Qi injects its fluids into the vessels to transform into blood, nourishing the four extremities and infusing the Zang-Fu organs; thus, its unobstruction manifests as bloody stool. If Ying and Wei Qi ultimately remain obstructed, both Yin and Yang experience jue (reversal/collapse). The Spleen Qi becomes isolated and weak, unable to scatter essence upward to the Lungs to regulate waterways. Consequently, fluids from the Five Zang organs flow downward, the Lower Jiao fails to close, frequent trips to the toilet occur with difficulty in passing, due to lack of Qi to push. The navel feels like being pounded, with tension and pain, indicating the impending extinction of the動 Qi (Moving Qi) between the Kidneys. Thus, it is said that life is hard to preserve.

If the pulse is tight in both Yin and Yang positions, with breath issuing from the mouth, dry lips and tongue, curled-up posture, cold feet, runny nose, and a slippery coating on the tongue, do not treat rashly. After seven days, if the patient has slight fever and warm hands and feet, this indicates recovery. Or, if after eight days, there is instead high fever, this is difficult to treat. If there is aversion to cold, vomiting is likely; if there is abdominal pain, diarrhea is likely. With this pulse and these symptoms, where interior/exterior and Yin/Yang are confused and uncertain, do not administer medicine rashly; wait patiently. If beyond the seventh day, signs of resolution appear—slight fever and warm hands and feet—it means the pathogen is resolving and self-healing. If beyond the eighth day, resolution does not occur, and high fever develops instead, this is a counter-indication and incurable.

If the pulse is tight in both Yin and Yang positions, continuing through vomiting and diarrhea, if the pulse remains tight (unresolved), the person can only find peace when the tightness disappears, indicating recovery. If the pulse is slow, reaching six or seven days with anorexia, this is a late onset due to fluid retention, indicating non-recovery. If appetite returns, it indicates recovery.

Cheng Wuji's commentary: A tight pulse in both Yin and Yang positions indicates severe cold affecting the upper and lower. After vomiting and diarrhea, if the tight pulse persists, it is because the pulse alone remains unresolved. When the tightness disappears, the person finds peace, indicating recovery. If the pulse is slow, reaching six or seven days with anorexia, it is due to great deficiency of the Spleen and Stomach after vomiting and diarrhea. The *Neijing* states: "Fluids enter the Stomach, their essence floats up, is transported to the Spleen, scattered by the Spleen, returned to the Lungs, regulates waterways, descends to the Bladder, distributes water essence everywhere, and runs through the five meridians." If Spleen and Stomach Qi are strong, they can transport and disperse fluid-dampness. If Spleen and Stomach Qi are deficient, fluid-dampness stagnates internally. "Late onset" refers to subsequent illness. If by six or seven days the patient desires food, the Spleen and Stomach have harmonized, and cold pathogens have dispersed, hence "recovery." ○ The tight pulse disease should be read in three sections.

After six or seven days of disease, if the pulses at the three positions of the hands and feet are all present (strong), accompanied by great vexation, lockjaw, inability to speak, and restlessness, recovery is certain.

Cheng Wuji's commentary: Vexation and heat. During transmission of meridians, if the patient has great bodily vexation, lockjaw, inability to speak, and internal restlessness, this is a struggle between Yin and Yang. If the pulses at the three positions of the hands and feet are all present, it indicates righteous Qi prevails, pathogenic Qi is weak, Yang Qi recovers, and cold disperses; recovery is certain.

If the pulse is harmonious, and although the patient is greatly vexed, the inner aspect of the eyelids shows yellow, this indicates recovery.

Cheng Wuji's commentary: The *Mai Jing* (Pulse Classic) states: "If yellow appears in the eyes of the patient, the disease is about to heal." Treatment prioritizes the pulse. If the eyes are yellow, there is great vexation, and the pulse is discordant, pathogenic Qi prevails, and the disease progresses. If the eyes are yellow, there is great vexation, but the pulse is harmonious, righteous Qi has harmonized, hence "recovery."

A floating and rapid pulse. Floating indicates Wind; Rapid indicates Deficiency. Wind generates Heat; Deficiency generates Cold. The clash of Wind and Deficiency causes chills and shivering.

Cheng Wuji's commentary: The *Neijing* states: "Having is Excess; Not having is Deficiency." When Qi combines, Blood is lacking; when Blood combines, Qi is lacking. Wind injures Wei (Defensive) Qi; Rapid pulse indicates lack of Blood. In a floating-rapid pulse, Wind pathogen combines with Wei Qi, making Wei Qi victorious and Ying (Nutritive) Qi deficient. Wei is Yang; Wind combats Wei, causing Heat. Ying is Yin; Ying Qi deficiency causes Cold. Wind combining with Wei results in both fever and aversion to cold.

Zhang Jingyue's commentary: Ancient and modern practitioners consider the rapid pulse as Heat. Why does Zhang Zhongjing consider it Deficient-Cold? Rapid indicates Deficiency, reflecting the principle of Yin-Yang imbalance, not exclusively Cold or Heat. Floating is Yang; floating-rapid indicates Yang deficiency. Sinking is Yin; sinking-rapid indicates Yin deficiency. Yang deficiency causes aversion to cold; treat with warm-hot herbs to suppress Yin and support Yang. Yin deficiency causes fever; treat with cool-cold herbs to suppress Yang and support Yin. Balance the two Qi, and the disease heals naturally. Moreover, if the disease is in the exterior with a floating-rapid pulse, it is Yin excess and Yang deficiency; sweating cures it, purgation kills it. If the disease is in the interior with a sinking-rapid pulse, it is Yang excess and Yin deficiency; purgation cures it, sweating kills it. The classics are clear; there is no difference.

A floating and slippery pulse. Floating is Yang; Slippery is Excess. Yang and Excess clashing results in a rapid and hurried pulse, with Wei Qi losing its measure. With a floating-slippery pulse, rapid/hurried rate, fever, and sweating, this is untreatable.

Cheng Wuji's commentary: Floating indicates pathogen combining with Wei Qi, making Wei Qi victorious. Slippery indicates pathogen combining with Ying Qi, making Ying Qi excess. Pathogenic victory and excess congest Ying and Wei, accelerating their movement, hence the rapid/hurried pulse. Six beats per respiration is called Rapid. A healthy person has four beats per respiration, with Wei Qi moving six cun. Now, with six beats per respiration, Wei Qi moves nine cun, exceeding the healthy standard by half. Thus, the rapid/hurried pulse indicates Wei Qi has lost its normal measure. With a floating-slippery-rapid/hurried pulse, fever, and sweating, the disease should resolve. If it does not resolve, Essence and Qi are depleted, and it is incurable. The Classics state: "If Yin and Yang pulses are both full and large, and sweating does not resolve the disease, death ensues."

In Cold Damage, coughing and rebellious Qi rising with a scattered pulse indicates death, due to physical depletion.

Cheng Wuji's commentary: The *Qianjin Fang* identifies wheezing and coughing as coughing and rebellious Qi rising, a Lung disease. A scattered pulse is a Heart pulse. This indicates Heart Fire punishing Lung Metal. The *Neijing* states: "Heart affecting the Lung is called Dead Yin. Those belonging to Dead Yin die within three days." This is evident from the physical depletion. This is an internal injury.

Question: The pulse has three positions. Yin and Yang interact. Ying, Wei, Blood, and Qi reside in the body. Through breathing, entering and exiting, moving up and down, distributing via breath, and circulating fluids, they act according to time, showing effects and forms. Spring pulses are wiry, Autumn floating, Winter sinking, Summer surging. Observing color and pulse, sizes differ. Within a moment, changes have no fixed pattern. Cun and Chi vary, short or long, upper and lower mismatched, existing or absent. Diseases change, advancing or retreating. Confused and perplexed, losing guidelines, I wish you to explain fully so I may understand clearly. Master said: Your question touches the root of the Dao. The pulse has three positions: Cun, Chi, and Guan.

Cheng Wuji's commentary: Cun is the Upper position, Guan is the Middle, Chi is the Lower. Later scholars attribute this to Wang Shuhe. However, checking the *Mai Jing*, Zhang Zhongjing's pulse discussion ends with this single passage, proving it was not written by Shuhe himself.

Ying and Wei circulate freely, never losing balance.

Cheng Wuji's commentary: Heng and Quan refer to scales, used to weigh weight. The *Neijing* states: Spring corresponds to the compass, Summer to the square, Autumn to the balance, Winter to the weight. Ying circulates within vessels, Wei outside. Ying and Wei follow the vessels, responding to the four seasons, maintaining constant measures.

Kidney pulse sinks, Heart surges, Lung floats, Liver wiry. These are constant laws, never deviating by a hair's breadth.

Cheng Wuji's commentary: Kidney is Water of the North, flourishing in Winter with a sinking pulse. Heart is Fire of the South, flourishing in Summer with a surging pulse. Lung is Metal of the West, flourishing in Autumn with a floating pulse. Liver is Wood of the East, flourishing in Spring with a wiry pulse. These are constant laws, accurate to the smallest degree.

Entering and exiting, ascending and descending, cycles with water marks. Under two water marks, one complete cycle.

Cheng Wuji's commentary: The human pulse vessel is 16 zhang 2 chi long. One exhalation moves the pulse 3 cun; one inhalation moves it 3 cun. One breath (exhale-inhale) is one respiration, moving 6 cun. In one day and night, water drops 100 marks. The person takes 13,500 respirations, the pulse travels 810 zhang, completing 50 cycles around the body. In one mark, the person takes 135 respirations, the pulse travels 8 zhang 1 chi. Under two water marks, the person takes 270 respirations, the pulse travels 16 zhang 2 chi, completing one cycle around the body. Pulse circulation ends and restarts, like a circle without beginning or end.

Returning to the Cun Kou, deficiency and excess become apparent.

Cheng Wuji's commentary: Meridian Qi starts from the Middle Jiao, flowing to the Hand-Taiyin Cun Kou. In 270 respirations, the pulse completes one cycle around the body and returns to the Cun Kou. Cun Kou is the starting point of pulse diagnosis, thus used to examine deficiency and excess. The Classics state: The essentials of life and death in deficiency and excess are all seen in the Cun Kou.

Changes multiply upon each other; Yin and Yang interfere. Wind presents as floating-deficient; Cold as firm-solid. Sinking and submerged indicate water accumulation; branch-fluid presents as urgent-tight. Movement indicates pain; Rapid indicates heat and vexation.

Cheng Wuji's commentary: Wind injures Yang, hence the pulse is floating-deficient. Cold injures Yin, hence the pulse is firm-solid. Accumulated internally is called water accumulation, hence sinking/submerged pulse. Scattered externally is called branch-fluid, hence urgent-tight pulse. Movement indicates Yin-Yang clashing; clashing generates pain. Rapid indicates Yang pathogen victory; Yang victory generates heat and vexation.

If there is inconsistency, know the cause of change. Three positions differ; diseases have different origins.

Cheng Wuji's commentary: When pulse and disease do not correspond, it must be due to transmission changes. The three positions observe the Qi of the Five Zang organs; examine deficiency and excess according to the position.

Excess is strange; deficiency is likewise so. Pathogens do not appear empty; there must be treachery within. Examine interior and exterior; distinguish the San Jiao. Know where it resides, observe and diagnose, estimate the Zang-Fu, seeing uniquely like a spirit. Record these details for you, to pass on to worthy men.

Cheng Wuji's commentary: Excess and deficiency pulses all involve pathogens interfering with righteous Qi. Examine whether it is in the exterior or interior, entering Fu or Zang organs, and treat according to where it resides.

Master said: Respiration is the head of the pulse.

Cheng Wuji's commentary: The *Nan Jing* states: One exhalation moves the pulse 3 cun; one inhalation moves it 3 cun. Because the pulse follows respiration, it is called the head of the pulse. This is the essential method for entering pulse diagnosis.

Initially holding the pulse, coming fast and going slow. This comes fast and goes slow, named Interior Excess and Exterior Deficiency.

Cheng Wuji's commentary: Exterior is Yang, Interior is Yin. The *Neijing* states: Coming is Yang, Going is Yin. Coming observes the exterior, Going observes the interior. Fast indicates surplus, surplus means Excess. Slow indicates insufficiency, insufficiency means Deficiency. Coming fast and going slow indicates Yang surplus and Yin insufficiency, hence Interior Deficiency and Exterior Excess. Coming slow and going fast indicates Yang insufficiency and Yin surplus, hence Interior Excess and Exterior Deficiency.

Question: The superior physician knows by observation, the average physician by inquiry, the inferior physician by pulse. I wish to hear your explanation. Master said: The patient's family reports: The patient suffers from fever and body pain. The patient lies down voluntarily. When the master arrives, feeling the pulse sinking and slow, he knows the patient is recovering. Why do I know this? When there is disease in the exterior, the pulse should be floating and large. Now the pulse is contrary, sinking and slow, hence I know it is healing.

Cheng Wuji's commentary: Observation examines form and symptoms; inquiry learns of suffering; pulse distinguishes interior and exterior. Suffering from fever and body pain indicates pathogen in the exterior. One should lie down uncomfortably with a floating-rapid pulse. Now the patient lies down voluntarily with a sinking-slow pulse, indicating the exterior pathogen is slackening. There is an interior pulse but no exterior symptom, hence knowing the exterior pathogen will heal.

Suppose the patient says: Sudden abdominal pain. The patient sits voluntarily. When the master arrives, feeling the pulse floating and large, he knows the patient is recovering. Why do I know this? If there is disease in the interior, the pulse should be sinking and fine. Now the pulse is floating and large, hence I know it is healing.

Cheng Wuji's commentary: Abdominal pain indicates interior cold. Severe pain prevents rising, with a sinking-fine pulse. Now the patient sits voluntarily with a floating-large pulse, indicating interior cold has dispersed. There is an exterior pulse but no interior symptom, hence knowing the interior pathogen will heal. By combining observation of symptoms, inquiry of disease, and palpation of pulse, one can be a perfect physician. The *Needle Classic* states: Knowing one is superior, knowing two is divine, knowing three is enlightened and bright.

Master said: The patient's family comes requesting: The patient has fever and extreme vexation. Tomorrow, when the master arrives, the patient faces the wall lying down. This heat has gone. The pulse is harmonious, hence saying healed. Extreme fever and vexation prevent quiet lying. Now facing the wall quietly lying, knowing the heat has gone.

If facing the wall lying down, hearing the master arrive, not startling up but looking around, speaking three words then stopping three times, swallowing saliva when feeling the pulse, this is feigned illness. Suppose the pulse is naturally harmonious, yet claims the disease is severe, requiring emetic/purgative drugs and dozens or hundreds of acupuncture points to cure.

Cheng Wuji's commentary: Feigned illness is performed by those not good-hearted. Use words to frighten them, making them fearful, and they will heal. The physician uses intuition; is this correct? This is not a treatment method. Setting up a framework for feigned illness, they feign illness, and I feign treatment.

When the master holds the pulse, if the patient yawns, there is no disease.

Cheng Wuji's commentary: The *Needle Classic* states: Yang draws upward, Yin draws downward; Yin and Yang draw each other, hence yawning. If Yin and Yang do not draw each other, there is disease; if they draw each other, there is harmony. Thus, yawning indicates no disease.

If the pulse reveals groaning, there is disease.

Cheng Wuji's commentary: Groaning is the sound of moaning. The body suffers, hence this occurs.

Speaking slowly indicates Wind.

Cheng Wuji's commentary: Wind lodging in the interior causes meridians and collaterals to tighten, the tongue becomes stiff, and movement is difficult.

Shaking the head while speaking indicates interior pain.

Cheng Wuji's commentary: Disease in the interior causes the head to tremble when speaking.

Walking slowly indicates exterior stiffness.

Cheng Wuji's commentary: Exterior stiffness, caused by tendon and collateral contraction, makes walking difficult.

Sitting and bending forward indicates shortness of breath.

Cheng Wuji's commentary: Shortness of breath indicates interior disharmony. Hence sitting and preferring to bend forward.

Sitting with one leg extended indicates lower back pain.

Cheng Wuji's commentary: The *Neijing* states: The waist is the major joint of the body. Lower back pain causes major joint dysfunction, preventing proper sitting. Extending one leg relieves the pain in the waist.

Interior excess, protecting the abdomen as if holding an egg, indicates heart pain.

Cheng Wuji's commentary: Heart pain prevents extending and lying flat; protecting the abdomen presses the pain.

Master said: Latent Qi disease is anticipated by intention. Within this month, latent Qi is expected. Suppose there was old latent Qi; one must feel the pulse. If the pulse is weak and faint, there should be throat pain, resembling injury but not throat bi. The patient says there is real throat pain, and now desires diarrhea.

Cheng Wuji's commentary: Feeling cold in winter, hiding in the meridians without immediate onset, is called latent Qi. At the Spring Equinox, latent cold desires to emerge, hence "within this month latent Qi is expected." Suppose latent Qi has emerged; one must feel the pulse to determine the meridian. Obtaining a weak and faint pulse indicates the pathogen is in Shaoyin. The Shaoyin meridian runs along the throat; cold lodging there必然 causes throat pain. The Kidney governs opening and closing; Shaoyin manages the Lower Jiao. Severe internal cold disrupts opening and closing, the Lower Jiao fails to constrain,必然 causing diarrhea. Hence, even with throat pain, diarrhea is expected.

Question: When a person suffers from terror, what is the pulse shape? Master said: The pulse shape resembles tracing threads continuously; the face is pale and loses color.

Cheng Wuji's commentary: The *Neijing* states: Blood and Qi are the Spirit of man. Terror indicates insufficient Blood and Qi and weak Shen Qi. The pulse resembles tracing threads continuously; the face is pale and loses color. The *Needle Classic* states: When Blood is stolen, the complexion is dull and lusterless, and the pulse is empty. Thus, terror indicates insufficient Blood and Qi.

Question: When a person does not drink, what is the pulse like? Master said: The pulse is naturally choppy; lips and mouth are dry.

Cheng Wuji's commentary: Choppy is Yin. Although it mainly governs loss of body fluids, dry lips and mouth are dominated by Yin internally, hence no drinking. This section likely has missing text.

Question: When a person feels ashamed, what is the pulse like? Master said: The pulse is floating, and the face alternates between white and red.

Cheng Wuji's commentary: Shame is embarrassment. Shame causes the Shen Qi to be timid and weak, hence the pulse is floating, and the face changes irregularly.

Question: The Classics say the pulse has weights of three beans and six beans. What does this mean? Master said: The pulse: when pressed with the finger with the weight of three beans, it is Lung Qi; with six beans, Heart Qi; with nine beans, Spleen Qi; with twelve beans, Liver Qi; pressed to the bone, Kidney Qi.

Cheng Wuji's commentary: Dou means bean. The *Nan Jing* states: Weight of three beans, touching skin and hair, is Lung position. Weight of six beans, touching blood vessels, is Heart position. Weight of nine beans, touching muscle, is Spleen position. Weight of twelve beans, level with sinew, is Liver position. Pressed to the bone, lifting the finger quickly, is Kidney position. Each corresponds to its respective division to observe Zang Qi.

Suppose diarrhea, with no pulse seen at Cun, Guan, or Chi. However, at Chi, occasionally a small appearance, with the pulse raising its head twice, indicates Kidney Qi. If damaged pulses appear, it is difficult to treat.

Cheng Wuji's commentary: The *Mai Jing* states: Cold qi in the Stomach causes pulse obstruction. Diarrhea without pulse indicates cold qi lodging in Spleen and Stomach. Now, occasional small appearance at Chi indicates Spleen deficiency attacked by Kidney Qi. Pulse raising its head twice indicates Spleen is overcome by Kidney. If the Chi pulse diminishes further, Kidney Qi also declines, Spleen overcomes again, ghost and thief oppose each other, hence difficult to treat. This is Spleen overcoming at an inappropriate time.

Question: The pulse has multiplication, vertical, horizontal, reverse, and順 (smooth). What does this mean? Master said: Water multiplying Fire, Metal multiplying Wood is called Vertical (Zong). Fire multiplying Water, Wood multiplying Metal is called Horizontal (Heng). Water multiplying Metal, Fire multiplying Wood is called Reverse (Ni). Metal multiplying Water, Wood multiplying Fire is called Smooth (Shun).

Cheng Wuji's commentary: Metal overcoming Wood, Water overcoming Fire: Vertical means allowing Qi to multiply what it overcomes. Horizontal means Qi rebels horizontally, multiplying what it does not overcome. Zong/Heng shares meaning with Zi Zong/Zi Heng. Water is son of Metal; Fire is son of Wood. Son multiplying mother is Reverse; Mother multiplying son is Smooth.

Question: The pulse has destructive and harmful elements. What does this mean? Master said: The pulse has wiry, tight, floating, slippery, sinking, and choppy. These six are called destructive and harmful, capable of causing disease in various pulses.

Cheng Wuji's commentary: For human disease, called Eight Evils. Wind, Cold, Summerheat, Dampness injure externally; hunger, fullness, fatigue, labor injure internally. Meridians are Ying and Wei; Ying and Wei are Yin and Yang. For causing disease in various meridians, it must be by Wind, Cold, Summerheat, Dampness injuring Ying and Wei, lodging in Yin and Yang. Wind causes floating pulse; Cold causes tight pulse; Summerheat causes slippery pulse; Dampness causes choppy pulse; Injury to Yin causes sinking pulse; Injury to Yang causes floating pulse. Called destructive and harmful because harming goodness is called Can (damage), harming goodness is called Zei (thief), as they harm righteous Qi.

Question: The pulse has disaster and strangeness. What does this mean? Master said: Suppose a person is ill, pulse obtains Taiyang, corresponding to form and symptoms, therefore administering decoction. After taking the decoction, shortly after eating, the patient suddenly vomits greatly, or has diarrhea, abdominal pain. Master said: I