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In cases of deficiency-cold presenting with a rapid pulse (Shu Mai, rapid pulse), the Yuan Qi (Original Qi) fails to reside securely within its "house" (root), akin to a person feeling panicked and without support. The pulse form is floating, large, and hollow (Kou Mai, hollow pulse); upon palpation, it rebounds immediately upon contact, lacking any sense of abundance or excess. The reason why Yuan Qi fails to reside securely is due to Wind, Cold, and Dampness pathogens rushing upward from the sole of the foot or the waist and umbilicus, directly attacking the root of the Yuan Qi; or it may result from mistakenly administering formulas that clear the Lungs and promote urination during illness, causing excessive leakage of the True Qi of the San Jiao (Triple Burner) and Bladder downward, leading to symptoms of upper asthma and lower urinary retention. This constitutes the withdrawal of the foundation of Yuan Qi from the lower and interior aspects. Therefore, when Qi floats outward resulting in a rapid pulse, it is appropriate to use sour-astringent herbs within acrid-warm formulas. If, however, labor fatigue or excessive worry damages the Great Qi (Da Qi, vital energy in the chest), causing Qi to sink inward, resulting in a deep, fine, and rapid pulse, this indicates Yang deficiency at the exterior and Yin deficiency at the interior. This differs from the aforementioned scenario where Yang is injured internally and floats outward. In such cases, not only should sour-astringent herbs be avoided, but acrid-warm herbs are also inappropriate; instead, sweet-warm herbs should be used, following the principles of Li Dongyuan's Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Zhang Zhongjing's Xiaojianzhong Tang (Minor Construct the Middle Decoction). As stated in the *Neijing* (Inner Canon): "When both Yin and Yang are exhausted, regulate them with sweet medicines." Thus, regarding a floating and rapid pulse: if it arises because Yang is injured internally and naturally floats outward, sour-warm herbs should be used to consolidate Yang; if it arises because Yin is abundant internally and repels Yang to the exterior, acrid-warm herbs should be used to dissipate Yin cold. Regarding a deep and rapid pulse: if it arises because Yin is deficient internally while Yang sinks inward, sweet-moistening herbs should be used to benefit Yin, with salty-warm herbs added in severe cases; if it arises because Yang is injured at the exterior and naturally sinks inward, sweet-warm herbs should be used to assist Yang, aided by aromatic Qi-moving herbs to encourage and boost it. These four scenarios all represent rapid pulses caused by internal injury, predominantly belonging to deficiency-cold, and have no relation to excess-heat. Their treatment all suits tonification and warming, differing only in their emphasis on acrid, sweet, or sour properties.

Zhu Danxi considered the Wiry (Xian Mai, wiry pulse) and Choppy (Se Mai, choppy pulse) difficult to treat, whereas Shen Rou stated: "For elderly patients or those with chronic illnesses, if all six positions of the pulse present as Floating and Slow (Fu Huan Mai, floating and slow pulse), a major illness or death may occur within two to three years." Why? A floating pulse without root indicates Yang Qi dispersing outward while the interior is filled with Yin Fire. After administering Sijunzi Tang (Four Gentlemen Decoction) and Xiaojianzhong Tang, as Yang Qi retracts inward, the pulse may revert to a Deficient pulse, or manifest as Wiry or Choppy; this represents the normal pulse state. By examining the pulse and prescribing medication accordingly, waiting for the pulse Qi to harmonize, the illness will heal and longevity will be extended. The Floating and Slow pulse is described as straight, long, and soft, like a curved string standing firm under the fingers; its rise and fall are sluggish and slow, appearing as if it wants to stop and not advance midway; upon heavy pressure, it feels empty, or it may divide into two lines on either side. This type of pulse is commonly seen in individuals suffering from Cold-Dampness, massive blood loss, exhaustion of Blood and dispersion of Qi, and those near death. For elderly people without apparent illness who exhibit this pulse, it signifies that their Essence and Qi have been completely exhausted.