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[Body Image] The Hong pulse (Surging Pulse) is extremely large in form, resembling floodwater; it arrives with vigor and departs with weakness, flowing continuously and filling the fingers.

[Main Diseases] The Hong pulse indicates qi abundance and hyperactive fire. If the left Cun position shows a large Hong pulse, it indicates mental restlessness and tongue ulceration. If the right Cun position shows a large Hong pulse, it indicates chest fullness and rebellious qi. If a Hong pulse is seen at the left Guan position, it indicates excessive Liver Wood qi. If a Hong pulse is seen at the right Guan position, it indicates Spleen Earth distension and heat. If the left Chi position shows a large Hong pulse, it indicates depletion of Kidney Water and difficult defecation. If the right Chi position shows a large Hong pulse, it indicates blazing Mingmen Fire (Dragon Fire).

[Commentary] The Hong pulse is synonymous with the Da pulse (Large Pulse). Like the floods during the reign of Emperor Yao, it metaphorically describes its abundant and expansive nature. In the Eight Trigrams, it corresponds to Li (Fire); in the seasons, it corresponds to Summer; in the human body, it corresponds to the Heart. During midsummer, the qi of heaven and earth is saturated, full, and smoothly flowing; the pulse is the precursor sound of qi, thus responding with the Hong pulse. "Hong" means large, using water as a metaphor. It is also called "Gou" (Hook), using wood as a metaphor. In summer, trees flourish and grow, spreading branches and leaves that hang heavily downward, thus resembling a hook. Gou is essentially Hong; the names differ but the reality is the same. *Su Wen* states that the Hong pulse arrives with vigor and departs with weakness, containing profound significance. Generally, the Hong pulse has a broad base but is not hard; if it is large and hard, it is a Shi pulse (Excess Pulse) rather than a Hong pulse. *Nei Jing* states "Large indicates disease progression," because the qi is currently expanding vigorously. The Yellow Emperor asked: "The summer pulse resembles a hook; how does one recognize a hook?" Qibo replied: "The summer pulse corresponds to the Heart and Southern Fire, representing the flourishing growth of all things. Its qi arrives strongly and departs weakly, hence it is called a Hook. Deviating from this indicates disease." The Yellow Emperor asked: "How does it deviate?" Qibo said: "If the qi arrives strongly and departs strongly, this is termed 'Excess' (Tai Guo), indicating disease in the exterior. If the qi arrives weakly and departs strongly, this is termed 'Deficiency' (Bu Ji), indicating disease in the interior. Excess causes fever and skin pain, leading to oozing sores. Deficiency causes mental restlessness, upper symptoms like coughing and expectoration, and lower symptoms like Qi leakage." Wang Shuhe stated: "In summer, a pulse that is Hong, large, and scattered is considered a Ping Mai (Normal Pulse). If instead one finds a Chen Ru Er Hua pulse (Deep, Soft, and Slippery), this is Kidney Water overcoming Heart Fire, known as Zei Xie (Robber Evil), which is fatal and untreatable. If instead one finds a Da Huan pulse (Large and Slow), this is Spleen Earth supporting Heart Fire (Child supporting Mother), known as Shi Xie (Real Evil); although sick, recovery will occur spontaneously. If instead one finds a Xian Xi Er Chang pulse (Wiry, Fine, and Long), this is Liver Wood returning to Heart Fire (Mother benefiting Child), known as Xu Xie (Empty Evil); although sick, it is easy to treat. If instead one finds a Fu Se Er Duan pulse (Floating, Choppy, and Short), this is Lung Metal oppressing Heart Fire (Metal suppressing Fire), known as Wei Xie (Minor Evil); although sick, it will heal quickly. For patients with blood loss, diarrhea, chronic cough, or long-term illness, a Hong pulse is contraindicated." *Mai Jing* states: "Those who are emaciated yet have a large pulse with abundant Qi will die." This shows that when physical signs do not match the pulse, it is generally an inauspicious omen.