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Huangdi asked: What are the pathological manifestations reflected by the pulse conditions of slow (Huan), rapid/urgent (Ji), small (Xiao), large (Da), slippery (Hua), and choppy (Se)? Qibo replied: When the Heart pulse is extremely urgent (Ji), it manifests as convulsions; slightly urgent, it causes heart pain radiating to the back and difficulty in swallowing food; extremely slow (Huan), it leads to manic laughter; slightly slow, it results in Fu Liang (a mass fixed in the epigastrium) located below the heart, moving up and down, sometimes accompanied by hemoptysis. Extremely large, it causes throat obstruction (Hou Bi); slightly large, it leads to Xin Bi (Heart Bi syndrome) with pain radiating to the back and frequent tearing. Extremely small, it predisposes to hiccups; slightly small, it causes Xiao Dan (wasting-thirst). Extremely slippery, it causes excessive thirst; slightly slippery, it results in Xin Shan (Heart Hernia) with radiation to the umbilicus and borborygmus in the lower abdomen. Extremely choppy, it causes aphonia; slightly choppy, it leads to blood extravasation, Jue (reversal cold/heat) involving the Yang Wei and Yin Wei vessels, tinnitus, and Dian Ji (epilepsy).

When the Lung pulse is extremely urgent, it causes Dian Ji; slightly urgent, it presents with Lung cold-heat, lethargy, coughing with bloody sputum, pain radiating to the waist, back, and chest, or nasal polyps causing obstruction. Extremely slow, it causes profuse sweating; slightly slow, it leads to Wei Pi Feng (flaccidity with hemiplegia) with continuous sweating from the head downwards. Extremely large, it causes neck swelling; slightly large, it results in Fei Bi (Lung Bi syndrome) with radiation to the chest and back, and aversion to sunlight. Extremely small, it causes diarrhea; slightly small, it causes Xiao Dan. Extremely slippery, it causes Xi Ben Shang Qi (rapid breathing and rebellious Qi); slightly slippery, it causes bleeding from above and below. Extremely choppy, it causes hematemesis; slightly choppy, it leads to Shu Lou (scrofula) between the neck and axilla, weakness of the lower limbs unable to support the upper body, and severe soreness.

When the Liver pulse is extremely urgent, it causes foul speech (or forgetfulness); slightly urgent, it results in Fei Qi (a mass resembling an inverted cup) under the hypochondrium. Extremely slow, it causes frequent vomiting; slightly slow, it leads to Shui Jia Bi (water retention and bi-syndrome). Extremely large, it causes internal abscesses with frequent vomiting and epistaxis; slightly large, it results in Gan Bi (Liver Bi syndrome) with retraction of the genitals and cough radiating to the lower abdomen. Extremely small, it causes polydipsia; slightly small, it causes Xiao Dan. Extremely slippery, it causes Shan (hernia); slightly slippery, it causes enuresis. Extremely choppy, it causes Yi Yin (overflowing fluid); slightly choppy, it leads to convulsions and tendon cramping.

When the Spleen pulse is extremely urgent, it causes convulsions; slightly urgent, it causes discomfort in the diaphragm, regurgitation of food after eating, and passage of frothy stool. Extremely slow, it causes flaccidity and cold extremities; slightly slow, it leads to Feng Wei (wind-induced flaccidity) with inability to use the four limbs, yet the mind remains clear as if healthy. Extremely large, it causes being struck and falling; slightly large, it results in Shan Qi (hernia) with large accumulations of pus and blood outside the intestines and stomach. Extremely small, it causes alternating chills and fever; slightly small, it causes Xiao Dan. Extremely slippery, it causes Long (difficulty in urination); slightly slippery, it causes abdominal heat due to insect toxins. Extremely choppy, it causes intestinal ulceration; slightly choppy, it leads to internal溃败 (collapse) with passage of pus and blood.

When the Kidney pulse is extremely urgent, it causes Gu Wei (bone flaccidity) and Dian Ji; slightly urgent, it results in Ben Tun (running piglet) and Chen Jue (deep reversal cold), with inability to hold the feet and obstruction of urination and defecation. Extremely slow, it causes a sensation of broken spine; slightly slow, it leads to Dong Xie (sieve-like diarrhea). Dong Xie is characterized by undigested food that is swallowed and then vomited out. Extremely large, it causes Yin Wei (impotence); slightly large, it results in Shi Shui (stone water edema) starting from below the umbilicus to the lower abdomen, hanging heavily, extending up to the epigastrium, which is fatal and untreatable. Extremely small, it causes Dong Xie; slightly small, it causes Xiao Dan. Extremely slippery, it causes Yong (abscess); slightly slippery, it leads to Gu Wei with difficulty sitting and rising, blindness upon standing, and blurred vision like seeing black balls. Extremely choppy, it causes large abscesses; slightly choppy, it leads to amenorrhea and deep hemorrhoids.

Huangdi said: Diseases also have six variations; how should they be needled? Qibo said: Urgent pulses indicate mostly cold; slow pulses indicate mostly heat; large pulses indicate excess Qi and deficient Blood; small pulses indicate deficiency of both Qi and Blood; slippery pulses indicate abundant Yang Qi with slight heat; choppy pulses indicate excess Blood and deficient Qi with slight cold. Therefore, when needling urgent pulses, insert deeply and retain for a long time; when needling slow pulses, insert shallowly and withdraw quickly to dispel heat; when needling large pulses, slightly drain Qi without releasing blood; when needling slippery pulses, withdraw quickly and insert shallowly to drain Yang Qi and remove heat; when needling choppy pulses, ensure accurate penetration into the vessel, retain for a long time following the direction of the flow, press and massage beforehand, and after withdrawal, press the puncture site rapidly to prevent bleeding and harmonize the vessels; for small pulses, where Yin-Yang, form, and Qi are all deficient, do not use needles but regulate with sweet medicines.

Huangdi asked: The Qi of the Zang and Fu organs enters at the He-Sea points via Ying and Shu points. From where do they enter, and through what path? Qibo said: This refers to the collateral branches of the Yangming channel entering internally, belonging to the Fu organs. Huangdi asked: Do Ying, Shu, and He points have specific names? Qibo said: Ying and Shu points treat the exterior Zang (referring to Fu organs in this context), while Jing-Stream and He-Sea points treat the interior Fu organs. Huangdi asked: How to treat interior Fu organs? Qibo said: Take the He-Sea points. Do He-Sea points have specific names? Qibo said: The Stomach He-Sea point is Zusanli (ST36); the Large Intestine He-Sea point is Shangjuxu (ST37); the Small Intestine He-Sea point is Xiajuxu (ST39); the Sanjiao He-Sea point is Weiyang (BL39); the Bladder He-Sea point is Weizhong (BL40); the Gallbladder He-Sea point is Yanglingquan (GB34). [Note: In other texts, Large Intestine He is Quchi (LI11), Small Intestine He is Xiaohai (SI8), Sanjiao He is Tianjing (TE10). The difference here reflects ancient alternative methods. Also, Shangjuxu is technically the He-Sea of Foot-Yangming merging with Small Intestine. The standard He-points are Stomach-Zusanli, Bladder-Weizhong, Gallbladder-Yanglingquan. The entry points differ. Sanjiao He is Weiyang, which is the lower assistant of Sanjiao, though rarely cited as a He-point.] Huangdi asked: How to locate them? Qibo said: For Zusanli, flex the dorsum of the foot; for Shangjuxu and Xiajuxu, lift the foot; for Weiyang, flex and extend the leg; for Weizhong, flex the knee; for Yanglingquan, stand upright with knees vertical, align with the body, and locate below Weiyang on its Yang side; for all exterior channels, locate by stretching the limbs.

Huangdi said: I wish to hear about diseases of the Six Fu organs. Qibo said: Heat in the face indicates Foot-Yangming disease; blood in the collaterals of the fish-mound indicates Hand-Yangming disease; hardness or depression of the pulses on the dorsum of both feet indicates Foot-Yangming disease, which is the pulse of the Stomach.