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When pathogenic factors are exuberant, it manifests as Excess (Shi). When essential qi is depleted, it manifests as Deficiency (Xu). Qi deficiency refers to Lung Qi deficiency. Qi rebellion results in cold feet (when Qi rebels and fails to descend, it cannot reach the four extremities; due to Yang deficiency in the lower part, the feet become cold). If these symptoms occur when it is not the season of the Lung's prosperity, the patient may survive; if they occur during the season of the Lung's prosperity, the patient will die. The same principle applies to other Zang organs (the Heart, Liver, Spleen, and Kidney each have their respective seasons of prosperity and decline, as illustrated by the examples above. Wu’s commentary: "Dang" refers to the time when the organ is naturally prosperous. For instance, in summer, people tend to have Qi deficiency; in winter, they tend to have cold feet. These are not times when the Lung is prosperous, so survival is possible. However, if Qi deficiency occurs in autumn, it means Metal Qi is weak during its time of natural prosperity, leading to death. *Ling Shu* commentary states: Because the Lung is deficient and encounters Autumn or Winter, which are not seasons of mutual overcoming, the patient survives. If encountering Spring, Metal and Wood are disharmonious, and the disease will worsen. If encountering Summer, the deficient Metal suffers from Fire overcoming it, and the disease will be fatal. This interpretation seems logically sound).

The term "Chong Shi" (Double Excess) refers to a severe heat disease where Qi is hot and the pulse is full and excess. This is called Double Excess (both syndrome and pulse indicate Heat). When both meridians and collaterals are in an Excess state, the pulse at the Cun Kou (radial artery) is rapid/tight while the Chi position is slow (Wu’s commentary reads "tight"). A slippery pulse indicates a favorable prognosis (Yang Qi prevails), whereas a choppy pulse indicates an unfavorable prognosis (Yin pathogen prevails). In cases where Collateral Qi is deficient but Meridian Qi is excessive, the pulse at the Cun Kou is hot while the Chi position is cold. This pattern is unfavorable in Autumn and Winter (those with Yang deficiency fear the Yin-exuberant seasons) but favorable in Spring and Summer. Treatment should target the primary pathology (see below for explanation). In cases of Meridian Deficiency and Collateral Excess, the Chi position is hot and full, while the Cun Kou is cold and choppy. Such patients will die in Spring and Summer but survive in Autumn and Winter (those with Yin deficiency fear the Yang-exuberant seasons). For Collateral Excess and Meridian Deficiency, moxa should be applied to Yin meridians and needles used on Yang meridians. For Meridian Excess and Collateral Deficiency, needles should be used on Yin meridians and moxa applied to Yang meridians (this follows the principle that Collaterals govern Yang and Meridians govern Yin; moxibustion tonifies, while needle discharge reduces). When both upper pulse Qi and Chi pulse are deficient (as recorded in *Jia Yi Jing* as pulse deficiency, Qi deficiency, and Chi deficiency, consistent with Wu’s commentary), this is called "Chong Xu" (Double Deficiency).

Qi deficiency manifests as abnormal speech (upper deficiency leads to Qi deficiency, resulting in faint speech). Chi deficiency manifests as unsteady gait (Chi deficiency implies Yin deficiency, leading to timid and weak walking).

For an infant suffering from heat disease with a pulse that is suspended and small, what is the prognosis? It is said: If the hands and feet are warm, the infant will survive; if cold, the infant will die. If an infant contracts wind-heat, experiences wheezing, and sweats, they will survive (Yin Qi remains undamaged); however, if the pulse is floating, they will die. Regarding dysentery with pus and blood in the stool (mixed red and white discharge): if the pulse is suspended, death ensues; if the pulse is slippery and large, survival is expected (slipperiness indicates sufficient Yin blood, largeness indicates sufficient Yang Qi). What about epilepsy? If the pulse is large and slippery, the condition will resolve spontaneously over time (indicating abundant Qi and Blood). If the pulse is small and firm, it is a fatal and untreatable condition (this is the True Organ Pulse of the Liver). For epilepsy, a deficient pulse indicates treatability (pathogenic factors are mild), while an excess pulse indicates death (pathogenic factors are extremely vigorous). Regarding the Excess and Deficiency patterns of Xiao Dan (Wasting-Thirst/Emaciation disorders, characterized by internal heat, polydipsia, and polyphagia): if the pulse is Excess and Large (Blood and Qi are still robust), even long-standing cases can be treated. If the pulse is Suspended, Small, and Firm, long-standing cases are untreatable.