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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Humans derive Qi from grain. Grain enters the stomach and is transmitted to the lungs; the Zang and Fu organs all receive Qi from it. The clear portion becomes Ying Qi (Nutritive Qi), and the turbid portion becomes Wei Qi (Defensive Qi); Ying Qi circulates within the vessels, while Wei Qi circulates outside the vessels." (This clarifies that Stomach Qi is the root of the pulse channels and the foundation of the Zang-Fu organs, from which Qi and Blood originate. All living beings derive Qi from grain, which is the fundamental basis for their existence. When grain enters the body, it must first reach the stomach, reflecting the principle that all things return to Earth. Kun Earth [Spleen/Stomach] does not act arbitrarily but transports the essence upward to the Lungs, embodying the principle that the earthly path is humble yet ascends. The Lung belongs to Metal; having received the essence, it irrigates the Zang-Fu organs downward, embodying the principle that the heavenly path descends to bring illumination. Metal and Earth exchange transmission, Heaven and Earth interact in harmony. The clear ascending portion becomes Ying Blood, where Yin is born from Yang; the turbid descending portion becomes Wei Qi, where Yang is rooted in Yin. Since Ying Blood is Yin, it circulates within the vessels; since Wei Qi is Yang, it circulates outside the vessels.)

[Commentary] To examine the disease and palpate the pulse in order to determine life and death, if one does not have a clear perception under the fingers, what can one rely upon? I deeply lament that contemporary physicians do not know what the pulse actually is. If one considers the pulse to be Qi, yet Qi manifests as Wei Qi, which circulates outside the vessels, then one knows the pulse is not Qi. If one considers the pulse to be Blood, yet Blood manifests as Ying Qi, which circulates within the vessels, then one knows the pulse is not Blood. If one considers the pulse to be the meridians and collaterals, yet there are numerous and complex meridian pathways, then one knows the pulse is not the meridians. Then, what exactly is the pulse? I once pondered this deeply and only after a long time did I comprehend its subtlety. In ancient times, the character for "pulse" (Mai) consisted of "Blood" and "Yong" [permanence/flow], meaning that Qi and Blood flow, each having distinct distributions and following the meridians. In modern times, the character for "pulse" consists of "Flesh" and "Yong", meaning that the Stomach governs the muscles, and the generation of Qi and Blood prolongs one's natural lifespan. Human life consists solely of Essence and Spirit. Essence-Qi is identical to Blood-Qi, whereas Spirit is difficult to perceive. Without Spirit, humans cannot govern Qi and Blood, maintain Great Harmony, allow circulation through the San Jiao (Triple Burner), and irrigate the entire body. Therefore, the pulse is nothing other than an alias for Spirit. Spirit transcends Qi and Blood, serving as their root. As Hua Tuo (Hua Yuanhua) said beautifully: "The pulse is the precursor of Qi and Blood." Being the precursor of Qi and Blood, who else could it be but Spirit! However, Spirit relies on Qi, Qi relies on Blood, Blood depends on Grain, and Grain originates from the Stomach. Thus, ancients discussing the pulse stated: "With Stomach Qi, there is life; without Stomach Qi, there is death." Li Dongyuan also said: "The pulse values Spirit, which precisely refers to Stomach Qi." From this, we know that sufficient Grain Qi leads to abundant Blood, abundant Blood leads to strong Qi, and strong Qi leads to flourishing Spirit. Whether the Spirit flourishes or not is signaled by the pulse. Therefore, the pulse is indeed the precursor of Qi and Blood. The so-called precursor is the Spirit that governs Qi and Blood. The pulse is an alias for Spirit. This is a doubt unresolved for millennia, which I hereby highlight and elucidate.