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Heterodox pulses refer to pulse conditions that are discordant and inharmonious, lacking vitality, and do not resemble ordinary pulse patterns. The *Da Qi Lun* (Treatise on Great Anomalies) in the *Neijing* lists various abnormal pulses with exquisite description. Unless one investigates them one by one, how can one grasp their essence intuitively? For instance, a full and large heart pulse accompanied by epilepsy, convulsions, and tendon spasms; or a small and urgent liver pulse also presenting with epilepsy, convulsions, and tendon spasms. Although these two cases present identical symptoms, their pulse images are vastly different, and the affected organs vary. This approach of treating the same disease differently is indeed based on such distinctions. If the liver pulse is suddenly startled and erratic due to fright or shock, resulting in an imperceptible pulse or aphonia, this is caused by the dysfunction of qi due to fear. Thus, when the liver pulse is erratic, once the qi calms down, the condition will resolve spontaneously without treatment.

A small and urgent kidney pulse, a small and urgent liver pulse, or a small and urgent heart pulse, if they feel weak upon pressure (non-pounding), all indicate *jia* masses (abdominal lumps). This means that while various meridians may exhibit small and urgent pulses, those that feel non-pounding upon pressure are classified as *jia* masses. However, if they feel pounding upon pressure, it indicates latent fire pathology, not a *jia* mass. When both the kidney and liver pulses are deep, it indicates *Shi Shui* (Stone Water edema); when both are floating, it indicates *Feng Shui* (Wind Water edema); when both are empty, it indicates death; and when both are small and wiry, it suggests impending fright. "Both" implies that this pattern appears across all six positions (cun, guan, chi on both hands), not just in one or two positions. Water-related pulses should be deep; however, due to the stirring effect of wind, they become floating. A floating pulse still has root upon heavy pressure, whereas an empty pulse feels hollow immediately upon pressure. Since water qi accumulates internally, it should not present with an empty pulse simultaneously; thus, it indicates death. When both are small and wiry with a sensation of impending fright, it is because the Shao Yang (Lesser Yang) generating qi is buried by yin pathogens, causing palpitations resembling fright, though it is not actual fright.

A large, urgent, and deep kidney pulse, or a large, urgent, and deep liver pulse, both indicate *shan* hernias. A slippery, urgent heart pulse indicates Heart Hernia (*Xin Shan*). A deep and pounding lung pulse indicates Lung Hernia (*Fei Shan*). Pulses associated with hernias are invariably wiry and urgent. Referring to the later text stating "Urgency in the Three Yang meridians leads to *jia* masses, urgency in the Three Yin meridians leads to *shan* hernias," the differentiation and treatment of *shan* and *jia* based on Yin and Yang become clear. Urgency in the Two Yin meridians indicates epilepsy and厥 (Jue/cold extremities); Jue belongs to the Kidney, while epilepsy belongs to the Pericardium. Urgency in the Two Yang meridians indicates fright; hearing the sound of water causes sudden alarm. An external-full and internal-deep spleen pulse indicates Chang Pi (dysentery or bloody stools), which may resolve spontaneously after a long duration. A small and slow liver pulse indicates Chang Pi, which is easy to treat. A small, pounding, and deep kidney pulse indicates Chang Pi with blood loss; if the blood is warm and the body is feverish, it indicates death. Liver and Heart diseases can also cause blood loss; cases involving both organs are treatable. If the pulse is small, deep, and choppy indicating Chang Pi, and the body is feverish, it indicates death; fever persisting for seven days leads to death. Generally, pulses for Chang Pi are easier to treat if small and slow, but difficult if firm and pounding. "External-full and internal-deep" means that although the pulse is superficial and large, the root qi is not depleted. "Small, pounding, and deep" indicates yin pathogens invading internally, manifesting yin signs; it should not coexist with floating yang disturbance. The Heart and Liver share the nature of water and fire, so concurrent disease in these two organs is easier to treat. Concurrent disease in the Spleen and Kidney resembles the collapse of earth and exhaustion of water, indicating untreatable death.

A stomach pulse that is deep and choppy yet superficially full, or a stomach pulse that is superficially full and large, combined with a small, firm, and urgent heart pulse, all indicate Ge Syndrome (dysphagia/chest obstruction). Hemiplegia (Pian Ku) manifests on the left side in men and the right side in women. If there is no aphonia and the tongue moves freely, it is treatable, with improvement expected within thirty days. If accompanied by aphonia, recovery may take three years. For patients under twenty years old, death occurs within three years. This describes a stomach pulse that is choppy upon deep pressure and large upon light pressure, indicating injury to yin blood and loss of yang qi protection. A small, firm, and urgent heart pulse indicates yin pathogens overcoming and insulting the Sovereign (Heart). With damaged stomach qi and diseased blood vessels, epigastric fullness and hemiplegia occur. Hemiplegia appearing on the left in men and right in women is considered a adverse sign (Ni), yet it is not necessarily untreatable. If there is no aphonia and the tongue moves, indicating no internal organ damage, treatment is effective despite the adverse sign. If aphonia is present, it indicates internal deficiency of Kidney qi; even if not adverse, recovery is difficult. In patients under twenty, during peak qi and blood development, hemiplegia indicates congenital root depletion, leading to death within three years.

A pulsating pulse accompanied by nasal bleeding (Xu Nu) and fever indicates death. A normal pulse is described as Xuan Gou Fu (suspended hook floating). If nasal bleeding and fever accompany a pulsating pulse that strikes the fingers, it indicates external escape of deficient yang and internal loss of yin blood, leading to death. "Xuan Gou Fu" refers to a floating pulse with a hollow center, subtly implied. A pulse feeling like panting is named Bao Jue (Sudden Jue syndrome). Patients with Bao Jue cannot converse due to sudden rebellious qi floating upward, resulting in a weak, panting pulse, indicating the Kidney qi fails to descend and anchor. A pulse resembling a rapid rate causing sudden fright resolves spontaneously in three to four days. This indicates chaotic qi due to sudden fright, making the pulse appear rapid without actually being consistently rapid, requiring no treatment.

A "Fu He" (Floating Convergence) pulse, resembling a rapid pulse, exceeds ten beats per breath, like converging waves where later waves override earlier ones, moving vacuously and rapidly without regular rhythm, indicating insufficiency of Jing Qi. A pulse resembling burning firewood, floating, rapid, and scattered, flickering like fat on soup, indicates insufficiency of Heart Essence. A pulse resembling scattered leaves, drifting without root, indicates insufficiency of Liver Qi. A pulse resembling a visiting guest ("Sheng Ke"), hesitant to speak, described as blocked yet pulsating, indicates insufficiency of Kidney Qi. A pulse resembling a mud pellet, smooth and sliding under the finger like Coix seed, indicates insufficiency of Stomach Essence. A pulse resembling a horizontal grid, hard and resisting like a crossbar, indicates insufficiency of Gallbladder Qi. A pulse resembling a silk thread, wiry, urgent, and strong like twisting rope, indicates insufficiency of Bao Jing (Reproductive Essence). A pulse resembling interlaced lacquer, rough and obstructed, difficult to advance, deviating from the proper path upon heavy pressure, alternating between large anterior/small posterior and thinning like dripping lacquer, indicates severe obstruction. A pulse resembling a gushing spring, vigorous at Cun position like water erupting from a cave but scattering upon pressure, beating superficially in the muscles, indicates insufficiency of Tai Yang (Greater Yang) Qi. A pulse resembling collapsing earth, choppy, large, and blurred like wet mud, indistinct upon pressure, indicates insufficiency of Muscle Qi. A pulse resembling the uvula ("Xuan Yong"), enlarging upon superficial palpation but disappearing upon deep pressure,喻 by the hanging flesh of the throat, indicates insufficiency of the Twelve Shu points' Qi. A pulse resembling a supine knife, small and urgent on superficial touch, firm, large, and urgent on deep touch, indicates pent-up heat in the Five Zang organs and cold-heat merging exclusively in the Kidney. A pulse resembling a pill, slippery and slipping out of hand, unobtainable upon pressure, indicates insufficiency of Large Intestine Qi. A pulse resembling a flower, floating and empty, causing fearfulness, restlessness, and constant listening while standing or walking, indicates insufficiency of Small Intestine Qi.

The above pulses were termed "Great Anomalies" by ancient sages, truly incomparable to ordinary pulses. I have repeatedly cross-referenced them to understand their meaning. The first nine items analyze disease attribution through pulse-symptom similarities and differences. For example, Spleen pulses (external-full/internal-deep) and Stomach pulses (deep-choppy/superficial-large) appear similar but correspond to vastly different diseases. The subsequent fourteen items differentiate insufficiency of Qi in various meridians based on anomalous tactile sensations, providing prognostic timeframes. Modern practitioners only recognize the Six Extinction pulses: Dan Shi (Stone Striking), Jie Suo (Untying Rope), Que Zhuo (Sparrow Pecking), Wu Lou (House Leak), Yu Xiang (Fish Swimming), and Xia You (Shrimp Swimming). They remain ignorant of meanings behind pulses like Fu He or the True Zang and Seven Diagnoses, leading to erroneous treatments and blame. Many cases involve critical illness unresponsive to medicine, presenting extinction pulses and signs. For instance, a patient with fever and large pulse becomes micro-thready and near-extinction after medication, with cold limbs, diarrhea, and intractable hiccups—this indicates death. A turning to rapid/agitated pulse also indicates death. A patient with Jue and diarrhea, micro-thready pulse, suddenly exhibiting a violent pulse after medication indicates death. This parallels the concept of "Chu Zhong" (Elimination of Middle) where a patient unable to eat suddenly gains appetite, indicating death. Pulses that fluctuate between deep and floating, sparse and rapid, irregular in arrival and departure, are untreatable. The Classic states that moderate pulses allow for treatment, while varying sizes make it difficult. True Zang pulses are exclusively Wiry, Hook, Hair, Stone, or Intermitting, feeling hard and rigid without any harmonious quality, representing the merger of organ qi and pathological qi, guaranteeing death. The Seven Diagnoses are exclusively Small, Large, Rapid, or Slow across all positions, not limited to one or two positions. "Exclusive Heat" refers to burning heat in the Chi area; "Exclusive Cold" refers to cold skin in the Chi area. "Exclusive Depression" refers to all positions being depressed and unresponsive. True Zang pulses are all death omens; Seven Diagnoses are still pathological pulses. The crux lies in Stomach Qi. The Stomach governs muscles; thus, even if Nine Pulse inspections are harmonious, if flesh is emaciated, death occurs. Even if Seven Diagnoses appear, if Nine Pulses follow the Stomach Qi, death does not occur. The Stomach is the root of the Five Zang. If Seven Diagnosis diseases exist alongside failed pulse conditions, death ensues. The previous chapter compiled favorable and unfavorable outcomes; this chapter specializes in heterodox pulses, aiming to ensure thorough understanding to avoid premature therapeutic commitments.