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(Radial pulse palpation,) the Cun position of the right hand corresponds to the Lung, the Guan position to the Spleen, and the Chi position to the Mingmen (Gate of Life), which also refers to "verticality"; light pressure equivalent to three beans' weight assesses Lung Qi, six beans' weight Heart Qi, nine beans' weight Spleen Qi, twelve beans' weight Liver Qi, and pressing to the bone assesses Kidney Qi, which also refers to "horizontalness". The movements of ascending, descending, exiting, and entering, although divided into horizontal and vertical aspects, are ultimately unified by the inhalation and exhalation of Yin and Yang. When a person suffers from Xu Lao (Deficiency Consumption Disease), the vertical Qi cannot distribute throughout the body. If Yin Qi is injured first, the force of inhalation becomes weak first; the Qi fails to reach inwardly to the Kidneys and returns upon reaching the Livers, resulting in Gu Wei (Bone Withering). If Yang Qi is injured first, the force of exhalation becomes weak first; the Qi fails to reach outwardly to the Lungs and returns upon reaching the Hearts, resulting in Pi Ju Mao Cui (Withered Skin, Hair, and Fur). The mention of Liver, Kidney, Heart, and Lung here refers to the superficial and deep levels within their respective territorial domains. In this case, the measurement of pulse Qi circulating sixteen zhang and two chi for one cycle would be insufficient; insufficiency leads to an accelerated cycle of ascending, descending, exiting, and entering, hence the rapid pulse. The *Nan Jing* discusses Sun (Damaged) and Zhi (Excessive) pulses: three beats per exhalation, up to six beats per exhalation, constitute the Zhi pulse; one beat per exhalation, down to one beat per four exhalations, constitutes the Sun pulse. The progression of Zhi disease moves upward from below, while that of Sun disease moves downward from above. Diseases caused by Sun pulses begin with withered skin and falling hair, culminating in bone withering where the patient cannot rise from bed; conversely, diseases caused by Zhi pulses exhibit opposite characteristics. Progression from below upward, if accompanied by withered skin and falling hair, results in death; progression from above downward, if accompanied by bone withering preventing rising from bed, results in death: this is because the pathology has reached its extreme. Lu Ziyu stated: The damage and excess in the arrival of the pulse correspond to the speed and slowness of the pulse's arrival. The Zhi pulse inherently involves "Zhi" (excess/arrival); does the Sun pulse exist outside of "Zhi"? This likely stems from the suspicion that deficiency-damage pulses must always be rapid (Shu) and never slow (Chi). Bian Que also said: Four or more beats per exhalation indicate Bi Syndrome or Tu Mai Qi (Pulse Qi Depletion), signifying a loss of the normal circulation of sixteen zhang and two chi per cycle. However, many deficiency-damage cases present with a slow pulse, though the conditions differ. A rapid pulse indicates that blood has deteriorated first, blocking the Qi channels; the Qi becomes fierce and obstructed, leading to shortness and rapidity. A slow pulse indicates that blood has not yet deteriorated, but the power of True Qi cannot penetrate vigorously, akin to a traveler growing weary after a long journey and wishing to rest. Such illness originates in Qi without damaging有形 (form/blood), making it easier to treat; tonifying Qi allows Blood to generate naturally. When Qi fails to circulate yet presents with a rapid pulse, it signifies that Blood has deteriorated and Qi has no refuge, making it difficult to treat; tonifying Qi causes further Blood stagnation. Therefore, a rapid pulse appearing at the onset of illness indicates Bi causing deficiency, where Blood pathology affects Qi, termed "damage from below affecting above," i.e., from interior to exterior. A slow pulse initially followed by gradual rapidity indicates deficiency causing Bi, where Qi pathology affects Blood, termed "damage from above affecting below," i.e., from exterior to interior. Regarding Qi failing to reach the Kidneys and Lungs, it is not that there is absolutely no Qi, but rather that Zheng Qi (Upright Qi) is occupied by Xie Qi (Pathogenic Qi) and cannot arrive on schedule. If there were truly no Qi, one Zang organ would lose its Qi, and all five Zang organs would fail to sustain themselves. This is the major principle of Lao Bi (Consumption Bi). Accumulations, abscesses, numbness, and pain classified as Bi syndromes reside within the meridians; Qi exists at both ends but is blocked in the middle, while the root remains undamaged. Unblocking restores flow immediately. It is like a tube obstructed by a knot; removing the knot allows Qi to flow freely. This is the major principle of Shi Bi (Excess Bi). Treatment for Shi Bi needs no elaboration. For Lao Bi treatment, the *Nan Jing* states: Damage to the Lung requires augmenting its Qi; damage to the Heart requires regulating Ying and Wei (Nutritive and Defensive Qi); damage to the Spleen requires adjusting diet and adapting to cold and warmth; damage to the Liver requires soothing its center; damage to the Kidney requires augmenting its Essence. These all address deficiency. However, Lao Bi often presents with mixed deficiency and excess. Zhang Zhongjing treated Blood Bi and myriad wind diseases with Shuyu Wan to tonify deficiency, and Dahuang Zhechong Wan to attack excess. Furthermore, prolonged external pathogen accumulation may mimic deficiency consumption, as described by Xu Lingtai regarding wind-cold transforming into consumption. Recently, coughs are invariably diagnosed as Lung Heat, with Sang Ye (Folium Mori) and Maidong (Radix Ophiopogonis) prescribed indiscriminately. Shengdi (Radix Rehmanniae) and Zhimu (Rhizoma Anemarrhenae) fill the prescriptions. Consequently, Yang Qi declines daily, allowing wind-cold and fluid retention to coalesce in the Danzhong (Chest), gradually leading to insomnia, hemoptysis, facial edema, dyspnea, vomiting, diarrhea, and critical danger. Thus, patients presenting with Wu Ling San or Qing Long Tang patterns today inevitably progress to consumption, repeating past mistakes until death without realization. Zhang Jingyue stated: External pathogens lingering in meridians; food stagnation accumulating in viscera; constrained rebellious Qi unresolvable; stubborn phlegm and blood stasis retained. Prolonged illness leads to emaciation, resembling form-deficiency, yet the root cause remains untreated. Misusing tonification will only worsen the condition. Physicians who understand this will commit fewer errors.

Generally, treating disease requires first identifying the path of the pathogen's entry, then opening the path of its exit. For disorders of ascending/descending, employ lifting or suppressing methods; for disorders of exiting/entering, employ dispersing or consolidating methods. One may regulate exiting/entering to resolve ascending/descending issues, or regulate ascending/descending to resolve exiting/entering issues. Rebellious Qi fails to be grasped by the lower Jiao; sinking Qi fails to be dispersed by the upper Jiao; internal stagnation fails to be dispersed externally; external leakage fails to harmonize internally. Zhao Qingchu stated: The human body functions in two layers (inner/outer) and two sections (upper/lower), with inner/outer and upper/lower interacting like respiration. For instance, purgation causing diarrhea drains the lower-inner section, causing upper-inner Qi to sink, creating emptiness above, allowing exterior Qi and pathogens to enter internally, forming the root of Jie Xiong (Chest Binding). Dispersion inducing sweat drains the upper-outer section, causing internal Qi to follow outward, creating emptiness above internally, allowing lower-inner Yin Qi to block upward, forming the root of Pi Men (Stagnant Oppression). Therefore, excessive sweating is prohibited for upper disorders, and cautious purgation is required for interior disorders, reflecting the principles of Yin-Yang fullness/emptiness and waxing/waning.

Furthermore, I have insights understood silently, which I do not wish to share with outsiders, yet feel compelled to reveal. Why does the *Nei Jing* link ascending/descending/exiting/entering to growth, strength, aging, and decline? Materia Medica notes that sunlight loosens objects; cotton exposed to sun for long periods becomes loose, indicating the Sun possesses a lifting/grasping force. All things face the sun, not just sunflowers and beans. Objects lack consciousness, but the Sun has a grasping power. Humans under the sun have their Qi lifted by it. Objects placed on earth sink over time due to Earth's gravitational attraction; humans on earth have their Qi attracted by it. Qi moving through the air never ceases for even a breath. Zhuangzi said: "Humans are in the wind." Zhang Zhongjing said: "Humans grow due to wind energy." Humans are buffeted by wind, so their exiting/entering is self-evident. Human birth combines father's essence and mother's blood to form the body. The body resembles earth, possessing inherent attractive forces. These forces reside mostly within the five Zang organs and bone marrow, allowing Qi to remain secure within the body without scattering. Upon life, the upper is grasped by the Sun, the lower attracted by the Earth, and the middle buffeted by wind, leading to daily strengthening. Upon decline, prolonged grasping causes Qi to escape upward; prolonged attraction causes Qi to escape downward; prolonged buffeting causes Qi to scatter outward, resulting in old age and death. Among these three forces, Earth's attraction is strongest; thus, corpses are heavy because the body loses autonomy and is fully absorbed by the Earth. Corpse exposure to sunlight is avoided lest Sun Qi lift the corpse again. Living persons should not ride oxen facing corpses; living persons possess attractive force, potentially attracting residual Qi from the corpse, possibly causing corpse movement. This theory was unspoken by predecessors and may shock the vulgar. Labor agitates Qi; mental labor scatters the attractive forces of the five Zang organs, causing Qi to scatter easily, leading to early aging and death. Stillness consolidates Qi; mental stillness strengthens the attractive forces of the five Zang organs, preserving Qi, promoting longevity, and delaying aging. Understanding this aids health preservation; why fear it? The *Bi Lun* states: "Yin Qi, when still, guards the Spirit; when restless, dissipates." The *Sheng Qi Tong Tian Lun* states: "Yang Qi, when still, nourishes the Spirit; when soft, nourishes the sinews." The *Da Huo Lun* states: "Mental labor scatters Hun and Po, confuses Zhi and Yi." Thus, the *Jing Mai Bie Lun* describes panting and sweating of the five Zang organs, warning: "Diseases of the four seasons often arise from overuse." Hence: "Formless and free of harm, agreeing with the Dao, only the True Person achieves this."