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Chapter 21 states: The classics say that if a person's physical form shows signs of disease but the pulse does not, they will survive; if the pulse shows signs of disease but the physical form does not, they will die. What is the meaning of this?
The response is: When a person's physical form appears diseased but the pulse seems normal, it does not mean there is no disease; rather, it refers to a discrepancy between the respiratory rate and the pulse rate. This is a general principle.
Regarding "physical form diseased, pulse normal indicates survival": The pulse is primary. If a person is emaciated and mentally exhausted, one cannot claim they are without disease. Upon examining their pulse, if only the respiratory rate fails to correspond with the pulse rate, although the Ying (Nutritive) and Wei (Defensive) Qi are damaged, as long as critical or terminal pulses (such as Zhi Sun or Si Jue pulses) are not observed, the patient will likely survive because the Zang-Fu organs remain intact.
Regarding "pulse diseased, physical form normal indicates death": If a person's muscles have not wasted away and their diet remains normal, one might assume they are healthy. However, if examination reveals frequent Dai (intermittent) and Ge (floating, large, and hollow) pulses, death is inevitable despite the apparent lack of somatic symptoms, because the Zang-Fu organs are already ruined and incurable. This specific phrasing is difficult to verify in ancient texts. Zhang Zhongjing's *Pulse Differentiation Chapter* states: "When the pulse indicates disease but the body does not, it is called 'Walking Corpse' (Xing Shi); lacking Wang Qi (Prosperous Qi), sudden dizziness, collapse, and loss of consciousness lead to early death. When the body shows disease but the pulse does not, it is called 'Internal Deficiency' (Nei Xu); lacking Gu Qi (Grain Qi), though distressed, immediate death is avoided." Does this align with the previous explanation?

Chapter 22 states: The classics mention that pulses exhibit "Shi Dong" (Is Moving) and "Suo Sheng Bing" (Diseases Produced). Why does a single meridian often manifest as two types of diseases?
The response is: The classics state that "Shi Dong" pertains to Qi, while "Suo Sheng Bing" pertains to Blood. When pathogenic factors affect Qi, Qi undergoes movement/change, constituting "Shi Dong"; when pathogenic factors affect Blood, Blood becomes diseased, constituting "Suo Sheng Bing". Qi primarily provides warming (Yu), while Blood primarily provides moistening (Ru).
When Qi stagnates and fails to circulate, it is considered an initial Qi disorder; when Blood is obstructed and fails to moisten, it is considered a subsequent Blood disorder. Therefore, "Shi Dong" occurs first, followed by "Suo Sheng Bing".
Here, "pulse" refers to the vessels of the Twelve Meridians. Each vessel presents two types of disorders, distinguished by whether they reside in the Qi level or the Blood level. Pathogens in Qi cause Qi to move abnormally; pathogens in Blood cause Blood to become diseased. Thus, the movement of the pulse is driven by Qi, while the resulting pathology is driven by Blood. As Qi disorders transmit to Blood, it is said that one meridian transforms into two diseases.
"Yu" means warmth. "Qi primarily provides Yu" refers to the inhalation and exhalation of Qi, steaming and warming the skin and muscle layers. "Ru" means moistening. "Blood primarily provides Ru" refers to Blood moistening sinews and bones, lubricating joints, and nourishing the Zang-Fu organs.
However, if Qi stagnates and fails to circulate, Blood will also become obstructed and fail to moisten. Qi resides externally, and Blood resides internally. If the exterior is first affected by pathogens, the interior will subsequently follow suit in becoming diseased. Hence, "Shi Dong" occurs first, followed by "Suo Sheng Bing".
This concludes Volume I, Chapters 1 through 22, which discuss Pulse Diagnosis.