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Regarding the "swaying pulse" (Yao Mai), *Mai Jian Bu Yi* has discussed it in detail. When pathogenic factors are entrenched externally, the pulse sways, primarily manifesting during the rising and coming phase of the pulse; this is merely due to the obstruction by pathogenic factors, phlegm, or blood stasis. When healthy qi is deficient internally, the pulse sways, primarily manifesting during the returning and departing phase of the pulse; this necessarily indicates that the Yuan Qi (Original Qi) has lost its root, internal suction is weak, and thus the qi cannot be deep and stable. This represents an extreme deficiency of Middle Qi (Zhong Qi), or cold in the lower jiao/internal jiao where True Yang (Zhen Yang) lacks a master; or heat in the lower jiao/internal jiao where True Yin (Zhen Yin) lacks a master. The condition seems reluctant to return inward, yet its momentum is weak; it also seems urgently trying to settle downward, hence the swaying descent. It is like a person with weak strength lifting a heavy weight: when lifting, they can still support it, but when lowering it, they tremble and cannot sustain it. In acute diseases caused by internal cold, emergency rescue is still possible; however, in chronic diseases or those caused by internal heat, internal exhaustion is already extreme, so what else can be done?

This type of pulse occurs in acute diseases due to long-distance travel, excessive sexual activity, or direct invasion of cold pathogens into the Mingmen (Gate of Life); in chronic diseases, it occurs due to deficiency consumption with bone-steaming fever, or marrow depletion from warm-heat diseases, accompanied by spasms, locked jaw, or Hongxiangjiao (Gouty Carditis/Heart involvement in Beriberi). Zhang Shiwan discussed shortness of breath due to phlegm-fluid retention, distinguishing between inhalation and exhalation, and used Shenqi Wan (Kidney Qi Pill) and Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction). His reasoning is very profound and should be read in conjunction with this text. *Shiji: Biography of Cang Gong* states: "A pulse that is solid and large, with a difficult coming phase, indicates movement in the Jueyin channel." The reason for this is that qi is stagnant within the blood, causing swaying during the coming phase. It further states: "A pulse that comes rapidly and frequently, but departs with difficulty and irregularity, indicates the disease is primarily in the Heart." This refers to the swaying pulse during the departing phase. Saying the disease is in the Heart is because the Heart governs the vessels. Restlessness in the pulse reflects the inability of Heart Qi to remain tranquil. When body fluids and qi are consumed and scorched, dry-phlegm occupies the Heart collaterals, leading to palpitations (Zhengchong) and delirious speech (Chanyu); this is referred to as "delirious words and loss of will," which signifies death. If the ascending and exiting of qi is obstructed, the coming phase sways; if the descending and entering of qi is obstructed, the departing phase sways. External constraint by pathogenic factors makes obstructed ascending and exiting expected; however, obstructed descending and entering indicates either pathogenic factors occupying the interior or exhaustion of healthy qi within, how critical is this situation?