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Pulses with intermittent pauses may not necessarily indicate organ failure; they can result from Qi stagnation. Alternatively, they may appear when Yang Qi is about to expand, where the righteous Qi attempts to extend but the pathogenic factor refuses to subside. This is described as "the dragon fights in the wild, its blood is black and yellow" (a metaphor for intense struggle between Yin and Yang). The general principle is similar to the discussion on Hidden Pulse (Fu Mai, a pulse that lies deep and requires heavy pressure to feel) in the previous section, but with distinctions: some pulses are already floating and full yet remain irregular or uneven in rhythm, occasionally interspersed with one or two weak beats, or simply stopping for one or two beats. Another scenario involves excessive use of cold and descending herbs, causing Stomach Yang to sink inward, resulting in a solitary sinking pulse at the Right Guan position (which reflects the Spleen and Stomach), or a pulse that initially appears large, gradually becomes small, and then grows large again upon subsequent palpation; this corresponds to what Zhang Zhongjing referred to as Jue Pulse (pulse changes associated with limb coldness). During the phase where the pulse gradually diminishes, it may become so faint as to be imperceptible, pausing for twenty to thirty beats before gradually reappearing. This type of pulse must be correlated with clinical manifestations. If there are signs of Yin-Yang repulsion (mutual rejection between Yin cold and Yang heat), and under the fingers the pulse feels neither scattered nor interrupted, with a wiry quality at the Chi position (reflecting the Kidney), possessing force and spirit, it indicates that Yang Qi has just begun to extend but is not yet smooth, representing a state of advancing and retreating conflict. Conversely, if the Chi pulse is scattered, interrupted, and weak, is there any doubt that it signifies Qi collapse? I have also observed that in severe conditions such as smallpox/rubella, epidemic febrile diseases, carbuncles, and jaundice, when latent pathogenic factors are about to erupt but have not yet fully manifested, the pulse often suddenly presents as Knotted (Jie Mai, slow with irregular pauses) and Choppy (Se Mai, rough and hesitant) half a month or ten days prior to onset. The pulse frequency varies, appearing irregular and uneven, indicating an internal struggle between righteous and pathogenic Qi. This is also a sign that the Qi mechanism is about to mobilize, though auspicious or ominous outcomes remain undetermined. Generally, wiry, thin, and rapid pulses often portend bad prognosis, warranting preemptive supplementation of Qi and nourishment of Blood; whereas surging, slow, and frequent pulses less commonly indicate danger, requiring preemptive generation of fluids and promotion of blood circulation.

"Mai Jian Bu Yi" provides a detailed exposition on Short Pulse (Duan Mai, a pulse that is short at both ends and does not fill its proper position), yet some aspects remain unclarified. Whenever the pulse form is shortened and fails to reach the Cun position (distal wrist position), differentiation must be made between Qi deficiency and Qi stagnation. If the anterior half of the Guan position (middle wrist position) feels tight and forceful, seemingly attempting to surge upward but failing to do so, this indicates Qi stagnation accompanied by excess pathogens; one must differentiate between Wind-Cold and Phlegm-Fluid retention and treat according to exterior or interior patterns. If the pulse is soft, scattered, and weak, lacking any upward surging tendency, it indicates Qi deficiency. Within Qi deficiency, further differentiation exists among Lung, Spleen, and Kidney. In cases of Spleen and Lung Qi deficiency, the posterior pulse (Chi position) remains normal; in Kidney Qi deficiency, the Chi position will inevitably present as depressed with small amplitude fluctuations. Furthermore, a pulse that feels like beads or pearls piled up is also considered a Short Pulse; if it is firm and forceful, it signifies the struggle between Yin-Yang, righteous, and pathogenic factors. However, if the pulse feels slippery yet detached, rapid yet weak, indicating declining Qi unable to continue, and especially if seen at the posterior Guan and Chi positions, it is a particularly ominous sign of Qi collapse and rootlessness.