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The *Nan Jing* (Classic of Difficult Issues) states: When the pulse does not correspond to the disease, it is a sign of a fatal condition. Zhang Zhongjing stated: Pathogenic factors do not appear without cause; there must be hidden pathogenic factors within. If there is a discrepancy between pulse and symptoms, one must understand the origin of the variation. The meanings of these two statements are different. "Understanding the origin of the variation" implies that there must be underlying chronic diseases or latent illnesses. Although the pulse may not correspond to the overtly manifesting symptoms, it still corresponds to the latent disease; hence, it is said that "there must be hidden pathogenic factors." In contrast, when the *Nan Jing* directly refers to a fatal condition, it describes a situation where there are neither concurrent nor latent diseases, but rather a true non-correspondence. Why? Generally, when a disease manifests in the pulse, it is because the pathogen is in the meridians, battling the healthy Qi (Vital Energy), causing the healthy Qi to lose its normal state, and thus the pulse loses its normal form. If the Zang-organ Qi is collapsing and Yin and Yang lose their mutual support, the smoothness or reversal, slowness or speed of ascending, descending, exiting, and entering all follow the whims of the pathogen. At this stage, the power of the healthy Qi is insufficient to battle or stimulate the pathogen. Consequently, the pulse often appears smooth and normal, with regular rising and falling, showing no signs of pathogenic obstruction. It merely feels slightly stiff and long under the fingers, lacking spiritual vitality. At this point, the True Qi has already dissipated. The patient will inevitably feel weak and fatigued, have little appetite yet sometimes feel hungry and urgently desire food, pant upon movement, exhibit a sallow complexion, or suffer from sudden deafness or blindness. Additionally, there are cases of old phlegm stagnation or masses located in peripheral areas, which do not obstruct the main channels of Qi and Blood flow. Since Qi and Blood avoid these masses without clashing, the pulse naturally flows smoothly and rapidly. This represents a chronic, intractable disease. Therefore, it is often observed that in patients with separating Yin and Yang, where Kidney Water is deficient and cold, Spleen Yang is dry and exhausted, and Liver Wind stirs internally, the pulses at both Chi positions are long, slow, and flowing smoothly. This is referred to as "Slow Pulse arriving at the Water Palace." Under the fingers, it may seem abundant and sufficient, but it is round without clarity, stiff without agility. Moreover, whether on the left or right, Cun or Guan position, there is invariably one section that appears slightly deep, weak, and insufficient. This is seen months before death in patients with long-standing deficiency consumptive diseases or in the elderly whose Qi is exhausted. Such conditions generally begin around the Winter Solstice and lead to death around the Spring Equinox, because the dried-up Water cannot nourish Wood. Initially, Liver Wind burns internally; subsequently, Liver Qi escapes externally. Predecessors considered both "Slow Pulse at the Water Palace" and "Wiry Pulse at the Earth Position" as failing pulses. Based on my lifelong diagnostic experience, a Wiry Pulse at the Earth position can sometimes be reversed; however, a Slow Pulse entering the Water Palace has never been successfully treated. Is this not because the Slow Pulse signifies the dispersion of True Yin and True Yang? When Yin disperses, the pulse cannot become Tight; when Yang disperses, the pulse cannot become Full (Hong). Lacking both Tightness and Fullness, it resembles a Slow Pulse. The *Nan Jing* also states: "When a person is diseased but the pulse is normal, although distressed, there is no danger." This wording is imprecise regarding severity. "Pulse not diseased" means the pulse has not failed. If a patient has been ill for a long time, is distressed, unable to eat, and unable to turn over, even if their consciousness is clear and speech is coherent, and the pulse comes evenly, smoothly, long, and slow, it will ultimately fail. Why? Because the essence of the Five Zang organs is dried up, so consciousness remains undisturbed; the Great Qi moves alone, so the pulse remains unchanged; the blood collaterals are exhausted, so the body cannot move. Thus, the *Nan Jing* further states: "When the Cunkou pulse is peaceful but the patient dies, it is because the Source of Life is exclusively severed within." Regarding old phlegm and chronic diseases that do not manifest in the pulse, it is because they do not obstruct the main channels of Qi and Blood. Therefore, some patients with accumulations (Ji Ju) who are in critical condition and near death have their pathology directly in the main channel; others who attack frequently have pathology close to the main channel; those who are stable and asymptomatic have pathology far from the main channel. Predecessors attributed this to Qi and Blood becoming accustomed to the pathogen, which is incorrect. If Qi and Blood were truly accustomed to the pathogen, it would mean Yin and Yang have lost their support and healthy Qi has lost its authority.