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The Hong (Surging) pulse feels extremely large under the fingers. It comes vigorously and departs weakly; it is broad upon arrival and prolonged upon departure. Its nature belongs to Yang, corresponds to the Heart (Xin), is associated with the Summer season, and governs the Fire element. It indicates a disease of Yang excess and Yin deficiency. If encountered in the炎炎 (scorching) summer, provided there is a Stomach Qi (Wei Qi, indicating harmony and health) present in the pulse, it is a pulse corresponding to the season. However, if seen in cases of diarrhea/dysentery, blood loss, chronic cough, as well as fullness/stagnation (Pi Man) or regurgitation (Fan Wei), it exacerbates the condition and makes recovery difficult. If the pulse is deep and combined with Hong, Xian (Wiry), and Se (Choppy) qualities, it indicates symptoms of Phlegm-Fire blazing. If the body is emaciated yet the pulse is large, accompanied by Qi deficiency, it is a sign of death. It is also said that a large pulse indicates the progression of the disease. If seen in Spring, Autumn, or Winter, treatment should focus on raising Yang and dispersing Fire. If the Hong pulse is forceful, it is a Shi (Excess) pulse rather than a true Hong pulse, requiring cold-cooling herbs; these two are similar and must be carefully distinguished. There is also a pulse resembling Hong, which appears in Yin deficiency with false heat or sudden Yang deficiency syndromes. Although the pulse is large and surging, it is powerless upon pressure. In such cases, cooling agents must not be administered, lest they damage Stomach Qi. Furthermore, when a person is near death and Yang Qi scatters and severs from the exterior, the pulse first appears large, surging, slippery, and vigorous, indicating that the True Qi has completely escaped to the exterior. This must not be overlooked.

The Xi (Fine/Thready) pulse resembles the Wei (Micro) pulse but is continuous. It is fine, straight, and soft, responding to the finger like a silk thread. It is suitable for Autumn and Winter, and for the elderly and weak, indicating a disease of dual deficiency of Blood and Qi. It may result from injury to Essence and excessive sweating, invasion of Dampness from below, leakage/depletion of Yin through diarrhea, deficiency-cold of the Dantian, Stomach deficiency with abdominal distension, dizziness, or flaccidity of sinews. The Mai Jing (Classic of Pulse Diagnosis) states that a Fine pulse indicates little Blood and declining Qi; if accompanied by these symptoms, the prognosis is favorable (Shun); otherwise, it is unfavorable (Ni). Therefore, patients with hematemesis or epistaxis who have a deep and fine pulse will survive. Those suffering from excessive worry and fatigue also have a fine pulse, and treatment requires warming and tonification. As for a pulse resembling Xi, it may occur due to sudden exposure to cold, extreme pain causing obstruction of collaterals and meridians, resulting in a deep and fine pulse that cannot circulate freely. Thus, the Fine pulse cannot be generalized; if applied to excess patterns, tonifying methods will consolidate pathogenic factors. In cases of consumption (Lao Que) with critical weakness, the pulse may appear Xian, Xi, and Shu (Rapid). Xian indicates Qi decline, Xi indicates Blood deficiency, and Shu indicates torridity from deficient fire. The patient is lingering and awaiting death; it is lamentable that physicians at this stage still attempt to clear and level the condition.

The Fu (Hidden) pulse is deeper than the Chen (Deep) pulse. Diagnosis requires pushing the tendons down to the bone and searching carefully to perceive it. It indicates Cold stagnation in collaterals, meridians, Zang-Fu organs, or Huoluan (cholera-like syndrome) with vomiting and diarrhea, severe abdominal pain and heaviness, retained food accumulation, old Phlegm congealing, or Jue Ni (cold extremities) with Heavy Yin. Treatment should urgently focus on dispelling Cold and warming the interior. In the initial stage of Taiyang syndrome in Shanghan (Cold Damage), encountering this pulse is a very auspicious omen. Therefore, Li Shizhen (Binhu) stated: In Shanghan, a Fu pulse in one hand is called Dan Fu (Single Hidden), and in both hands is called Shuang Fu (Double Hidden). One should not diagnose it as a Yin syndrome simply because a Yin pulse appears in a Yang syndrome. Rather, it is due to Fire pathogen being internally constrained and unable to vent out; Extreme Yang resembles Yin, hence the pulse is hidden. Resolution must come through profuse sweating, just as after a long drought, the sky becomes dark before rain, and all things revive after the rain. There is also "Jiao Yin Shanghan" (Shanghan with concealed Yin), where latent Yin exists internally, and external Cold is contracted. With Yin excess and Yang decline, leading to cold extremities and six pulses being deep and hidden, one must administer Ginger and Aconite decoctions and moxa the Guanyuan (CV4) acupoint until the pulse reappears. If the Taixi (KI3) and Chongyang (ST42) pulses are absent, death is certain. These are all standard Fu pulses. There is also a pulse resembling Fu, occurring in prolonged illness with dual deficiency of Yin and Yang, where the pulse is intermittent, sunken, sinking, appearing and disappearing intermittently, with True Qi perishing. This is not comparable to the dispersion of acute illness; it is Pulse Depletion (Mai Tuo), not Pulse Hidden. Sudden fright, rage, or syncope may also present with deep and hidden pulses; after a short while, as meridian Qi recovers, self-healing occurs without treatment. If a person over forty, whose Yuan Qi has always been weak, suddenly faints and loses consciousness, this is Lei Zhong Feng (Stroke-like syndrome), not true Zhong Feng (Wind Stroke). With a rattling sound in the throat like a saw, and six pulses deep and hidden, urgent treatment with Sansheng Yin (Three-Life Decoction) plus one liang of Renshen (Ginseng) may save the life. However, if incontinence, sweating, open mouth, closed eyes, and fecal incontinence occur, it is incurable. When diagnosing either the standard Fu pulse or the pulse resembling Fu, one must simultaneously investigate the etiology to avoid misdiagnosis and mistreatment.