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The sensation of the Choppy pulse (Se Mai, 涩脉) is like scraping bamboo with a light knife, like raindrops adhering to sand, or like a diseased silkworm eating leaves. It primarily indicates disorders where Qi and Blood are irregular and uncoordinated (Can Wu Bu Tiao), as well as diseases resulting from the depletion of Essence and Blood (Shang Jing Wang Xue). It is seen in Blood Bi (Xue Bi, blood stasis obstruction), Cold-Dampness invading the Ying level (Ying Fen), Heartache (Xin Tong), Hypochondriac pain (Xie Tong), physical lassitude and weakness (Jie Dai), Regurgitation (Fan Wei), Collapse of Yang (Wang Yang), intestinal constipation (Chang Jie), amenorrhea (Bu Yue), pregnancy-related disorders (Tai Bing), dysuria (Suo Lin), and also in Qi stagnation (Qi Zhi). The Classics state: "A pulse that is weak and choppy indicates a chronic disease." However, there are differences. In some cases, it arises from innate constitutional deficiency causing poor meridian circulation; from emotional injuries where feelings are unresolved; from excessive intake of tonics leading to Qi and Blood congestion and excess; from overeating causing failure of immediate transformation and transportation; from excessive phlegm presenting as an isolated choppy pulse; or from prolonged lying down or sitting, causing physical stiffness and lack of movement. These situations do not exclusively indicate diseases of Essence and Blood depletion. As for consumptive diseases presenting with a Fine, Rapid, and Choppy pulse, or one combined with Intermittent (Jie) and Knotted (Dai) pulses, the time of death can be predicted. When diagnosing this pulse, one must examine the pathogenesis to avoid erroneous treatment.

The Slow pulse (Chi Mai, 迟脉) and the Rapid pulse (Shu Mai, 数脉) are opposites in Yin and Yang. The Rapid pulse beats six times per respiration cycle, while the Slow pulse beats three times, showing a significant disparity in respiratory rate. The Moderate pulse (Huan Mai, 缓脉) resembles the Slow pulse but differs slightly: the Slow pulse has three beats per cycle, whereas the Moderate pulse has four. Although similar, they indicate different diseases. The Pulse Deviating from the Normal Course (Li Jing Zhi Mai) has only two beats per cycle and is referred to as Shortness of Qi (Shao Qi) in the *Nei Jing*. The Slow pulse primarily indicates Zang organ diseases, mostly belonging to Cold patterns. Floating Slow indicates Exterior Cold; Deep Slow indicates Interior Cold. Forceful Slow indicates cold pain; Deficient Slow indicates deficiency-cold. It may also indicate amenorrhea, Yin Hernia (Yin Han), coagulation and stagnation of blood vessels, or deep-seated masses (Jia Jia). All these indicate diseases of Yang deficiency and Yin excess. However, there are pulses resembling the Slow pulse. When a person has just recovered from Cold Damage (Shang Han), with residual heat unclarified, meridians not yet filled, and Stomach Qi not yet restored, the pulse may appear Slow and Slippery (Chi Hua) or Slow and Moderate (Chi Huan). Can warm-middle herbs be administered then, potentially aiding the residual pathogenic factors? This distinction between Deficiency and Excess cannot be ignored.

The Tight pulse (Jin Mai, 紧脉) feels like a twisting rope changing constantly, or like cutting a rope. It is the pulse of Heat constrained by Cold. Thus, it appears urgent but does not beat forcefully. In acute conditions, its appearance indicates abdominal pain and body ache. If Cold invades the Taiyang channel, it may indicate Wind-Spasm or Epilepsy. At the Chi position, it indicates cold genital hernia. At the Guan position, it indicates deep abdominal pain. A Tight pulse at the Left Cun/Guan positions indicates Cold Damage; at the Right positions, it indicates Food Injury. If Evil Qi strikes suddenly, a Floating-Tight pulse indicates death; if accompanied by cough, a Deep-Tight pulse also indicates death. This represents a contradiction between syndrome and pulse. There is also a pulse resembling Tightness occurring between the seventh and ninth days of Cold Damage Yin syndromes where Yang is severed. Zhang Zhongjing stated: "If the pulse feels like a twisting rope, death occurs on that day." Generally, the Tight pulse belongs to pathological pulses rather than terminal ones; the distinction between new and old diseases determines life and death, which requires careful examination.