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A floating, superficial, and rootless pulse indicates the outward逸ion of Qi. This type of pulse is actually appropriate for conditions characterized by obstruction and blockage; however, if seen in patients with excessive sweating or slippery diarrhea (incontinence), it indicates the dispersion and collapse of Qi, which is considered incurable.

Therefore, in cases where wind injury transforms into heat, and prolonged inability to sweat leads to heat scorching and drying up body fluids, resulting in dry and rough skin, forced congestion of Lung Qi, and rapid breathing with asthma, the pulse often manifests between the skin and hair without obvious rising and falling fluctuations, making it difficult to count the beats. This corresponds to the concept of "incomplete sweating, with Yang Qi constrained at the exterior"; or as stated, "Zheng Qi retreats and knots within the Zang organs, so pathogenic factors float outward, harmonizing with the skin and hair." By adding sour and sweet herbs to acrid-dispersing formulas, body fluids are restored, and the Great Qi is gathered, leading to natural sweating and a vigorous pulse. Why? Because Qi must inhale before it can exhale.

In warm-heat diseases, if sweating is incessant and the pulse is floating, slippery, rapid, and hurried, this indicates the internal collapse of True Yin. In cold damage with deep-seated pathogens, if the pulse is faint and nearly imperceptible, but suddenly becomes floating after medication, or if severe diarrhea presents with an empty and hollow pulse, this indicates the internal collapse of True Yang. In chronic debilitating illnesses that recur repeatedly, if the pulse gradually becomes thin and floating, this indicates the simultaneous collapse of both Yin and Yang. Generally, such pulses should not be seen in chronic conditions marked by sinking, depression, flaccidity, and fatigue, nor in new external contraction diseases after sweating or purgation therapies have been applied.

For chronic conditions, occasionally caused by dry phlegm leading to phlegm accumulation and constipation, causing Qi to float, this is described as "slippery and floating-scattered," associated with Tan Huan Feng (a precursor or mild form of stroke). Using methods to clear phlegm and regulate Qi, if the pulse turns sinking and weak, there is no need for worry; however, if treatment fails and sweating persists, death is inevitable.

For acute conditions, such as cold damage or malaria, where fasting for several days leads to emptiness of Stomach Qi, urging the patient to eat will cause the pulse to become calm and still. As stated, "When gruel enters the Stomach, the deficient will survive"; conversely, inability to eat or immediate expulsion of food via diarrhea indicates death. Essentially, a thin and floating pulse signifies emptiness of fluids. If fluids are empty but Qi is knotted, survival is possible; if fluids are empty and Qi is dispersed, death ensues.

Whenever a pulse is large, empty, and rootless, scattering upon pressure, it indicates Yin deficiency and impending collapse of Yuan Qi. Using sour and sweet agents to gather Qi and return it to its root, if the pulse gradually becomes firm, collected, and solid, this marks a turning point toward recovery; however, if gathering fails to produce solidity, and the pulse becomes harder yet more hollow, the prognosis worsens significantly.

I once treated a case of damp-warmth complicated by cold-damage from raw foods. The patient was first wrongly induced to sweat, then overly treated with clearing and draining methods, leading to weakness of San Jiao Qi and sinking of Bladder Qi. Symptoms included coughing with upward rushing Qi, profuse whole-body sweating, slight loose stools, scanty and dysuric urination, a pale white tongue without coating, a hard and stone-like distension in the lower abdomen, swelling of both calves, and a large, empty pulse that felt like a void upon slight pressure, beating on both sides, returning immediately upon contact, exceeding ten beats per respiration. Urgently, I used sour and warm herbs: Suan Zao Ren (Ziziphi Spinosae Semen), Long Gu (Fossilia Ossis Mastodi), Shan Yu Rou (Corni Fructus), Nan Zhu (Myrica rubra), Shou Wu (Polygoni Multiflori Radix), and Niu Xi (Achyranthis Bidentatae Radix), incorporated into a formula containing Fu Zi (Aconiti Lateralis Radix Praeparata), Mu Xiang (Aucklandiae Radix), Yuan Zhi (Polygalae Radix), and Tao Ren (Persicae Semen) to resolve stasis. First, the Chi positions (both wrists) became firm; subsequently, the Guan positions became solid. The tongue coating thickened white then turned yellow, and symptoms improved. This case involved erroneous sweating and draining, damaging both interior and exterior, causing True Yang to lose its root and Great Qi to escape outward. Had purely acrid-hot herbs been used, it would have led to collapse via profuse sweating. However, after using sour-warm herbs, if the pulse remained empty and hard but still responded with strength, one should not abandon treatment. One should reduce the amount of sour herbs to induce slight sweating. For severe deficiency, supplement with sweet-warm herbs. Before sweating, chills are expected; afterward, the pulse typically shifts to sinking and weak, requiring adjustment and tonification with sour-warm agents. Generally, floating and rootless pulses benefit from combined use of sour-astringent methods. When True Yang loses its root and the pulse appears Kou (hollow) and Xian (wiry), beating over ten times per respiration, indicating Yuan Yang is unsettled in its residence, sour herbs should be added to acrid-hot formulas. When True Yin loses its root and deficiency manifests as wandering instability, with a floating-scattered pulse, sour herbs should be added to sweet-warm formulas. In warm-summer heat diseases, where heat damages Qi, presenting with a floating, surging, rapid, and scattered pulse accompanied by asthma and sweating, sour herbs should be added to sweet-cold formulas, such as Sheng Mai San (Generate the Pulse Powder). If the pulse gathers after administering sour herbs, it indicates Zheng Qi has control; if it does not gather and becomes faster, it indicates failure of True Qi. These are all treatment principles for floating pulses caused by internal deficiency, unrelated to dispersing exterior pathogens.