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Ping Ren Qi Xiang (The Pulse and Manifestation of a Healthy Person) refers to the pulse qi and pulse manifestation of a person without disease. To understand the pulse of a healthy person, one should refer to the pulses of the sick and the dying; to identify the pulses of the sick and the dying, one must use the Stomach pulse (Stomach Qi pulse) as the standard. The pulses of the Five Zang organs across the four seasons are all rooted in Stomach Qi, because the Qi of the Five Zang organs is generated by the Stomach, and the Qi of the Stomach Fu organ is generated from water and grain (nutrients).

Huang Di asked: What constitutes a Ping Ren (healthy person)?

This follows the previous chapter "Mai Yao Jing Wei" (Essential Refinements of Pulse Diagnosis), inquiring about the pulse of a healthy person.

Qi Bo replied: When a person exhales once, the pulse beats twice; when they inhale once, the pulse also beats twice. During the pause between inhalation and exhalation (Ding Xi), the pulse beats one more time. Adding occasional deep sighs (Tai Xi) as a supplement, much like accumulating remainders to form a leap month in the calendar, this is called a Ping Ren. A Ping Ren is one who is not diseased.

One exhalation and one inhalation constitute one Xi (respiratory cycle). For a healthy person, the pulse beats twice per exhalation and twice per inhalation. Including the beat during the transition pause of breathing, the total is five beats. The reason it is described as five beats is due to the "leap via deep sigh," meaning it manifests in slightly longer breaths. This is termed a non-diseased Ping Ren.

Typically, one uses the respiratory rhythm of a healthy, disease-free individual to calibrate and assess the pulse of a patient. Since the physician is free of disease, they use their own steady breathing rate as a standard to regulate and judge the patient's pulse; this is the method of pulse diagnosis.

"The upper" (Shang) is pronounced with the departing tone. A healthy person has uniform and harmonious respiration, whereas a sick person has irregular and disordered breathing. Therefore, one commonly uses the physician's disease-free state and steady breathing as a benchmark to adjust the patient's pulse, which constitutes the method of diagnostic observation.

If a person's pulse beats only once per exhalation and once per inhalation, it is called Shao Qi (Deficient Qi).

Pulse beating once per exhalation and once per inhalation is more than half less than that of a healthy person, hence called Shao Qi, indicating that the Zheng Qi (Upright Qi) is weak and declining.

If a person's pulse beats three times per exhalation and three times per inhalation, and the pulse is restless (Zao), with heat in the Chi (wrist crease area), it is called Wen Bing (Warm Disease). If the Chi area is not hot, but the pulse is slippery (Hua), it is called Feng Bing (Wind Disease). If the pulse is choppy (Se), it is called Bi Syndrome (Obstruction Syndrome).

"Zao" means rapid/frenetic. "Hua" means smooth/fluent. "Se" means stagnant/coarse. A pulse beating three times per exhalation and three times per inhalation belongs to the frenetic pulse category. If the pulse is frenetic and the skin at the Chi area is hot, it is termed Warm Disease. If the Chi skin is not hot and the pulse is not frenetic, but rather fluent and slippery, it is termed Wind Disease. If the pulse is not slippery but instead stagnant and choppy, it is termed Bi Syndrome.

If a person's pulse beats four or more times per exhalation, it is called Si Mai (Death Pulse). If the pulse ceases completely and does not return, it is called Death. If the pulse is intermittently slow and rapid, chaotic, it is called Death.

"Shuo" (rapid) is pronounced like "Shuo," same for subsequent mentions. A pulse beating four or more times per exhalation represents excess reaching the extreme. Absence of pulse represents deficiency reaching the extreme. Intermittent slowness and rapidity represent disorder reaching the extreme. Thus, all are termed Death.

The normal Qi of a healthy person is derived from the Stomach; the Stomach is the normal Qi of a healthy person. If a person lacks Stomach Qi, it is called Ni (Rebellion/Contrary), and those with Ni will die.

Healthy people survive by ingesting grains; thus, their normal Qi is derived from the Stomach. The Stomach is indeed the normal Qi of a healthy person. Food enters the Stomach, and the Five Zang and Six Fu organs all receive its Qi. Therefore, if a person loses Stomach Qi and stops eating, it is called Ni, and those with Ni will die.

In Spring, the pulse with a slight string-like quality (Xian) accompanied by Stomach Qi is called Ping Mai (Normal Pulse). If the string-like quality is excessive and Stomach Qi is deficient, it indicates Liver Disease. If there is only string-like quality without Stomach Qi, it indicates Death. If the pulse has Stomach Qi but also exhibits a floating/hair-like (Mao) quality, illness will occur in Autumn. If the Mao quality is severe, illness occurs immediately. The Zhen Zhen Shen Qi (True Spirit Qi of the Zang) disperses into the Liver, and the Liver stores the Qi of the sinews and fascia.

"Cang" (store) is read according to its original pronunciation; the "Cang" characters for Heart, Spleen, and Kidney follow the same rule. Stomach Qi is the gentle and soft Qi of Central Earth, which is necessary for the Five Zang organs across the four seasons. In Spring, obtaining the Stomach pulse with a slight string-like quality is a Normal Pulse. Excessive string-like quality and deficient Stomach Qi indicate Liver Disease. Only string-like quality without Stomach Qi indicates a Death Pulse. A pulse with Mao quality means it is slightly string-like yet possesses the light and floating Mao pulse. The Mao pulse is the pulse of Autumn appearing in Spring; since Metal occupies a deficient position, illness will occur in Autumn. If the Mao pulse is excessive, Wood suffers Metal's punishment, and illness will occur immediately, not waiting for Autumn. The reason the Liver presents a string-like pulse is that the True Spirit Qi of the Zang disperses into the Liver, and the Liver stores the Qi of the sinews and fascia.

In Summer, the pulse with a slight hook-like (Gou/Hong) quality accompanied by Stomach Qi is called Normal Pulse. If the hook-like quality is excessive and Stomach Qi is deficient, it indicates Heart Disease. If there is only hook-like quality without Stomach Qi, it indicates Death. If the pulse has Stomach Qi but also exhibits a stone-like (Shi/Chen) quality, illness will occur in Winter. If the Shi quality is severe, illness occurs immediately. The Zhen Zhen Shen Qi connects to the Heart, and the Heart stores the Qi of the blood vessels.

In Summer, obtaining the Stomach pulse with a slight hook-like quality is a Normal Pulse. Excessive hook-like quality and deficient Stomach Qi indicate Heart Disease. Only hook-like quality without Stomach Qi indicates a Death Pulse. A pulse with Shi quality means it is slightly hook-like yet possesses the sinking Shi pulse. Obtaining a Winter pulse in Summer indicates Water occupies a deficient position, hence termed Winter Disease. If the Shi quality is excessive, Fire suffers Water's punishment, hence illness occurs immediately. The reason the Heart presents a hook-like pulse is that the True Spirit Qi of the Zang connects to the Heart, and the Heart stores the Qi of the blood vessels.

In Late Summer, the pulse with a slight soft and weak (Ruan Ruo) quality accompanied by Stomach Qi is called Normal Pulse. If the weak quality is excessive and Stomach Qi is deficient, it indicates Spleen Disease. If there is only Dai (extreme weakness/intermittent) quality without Stomach Qi, it indicates Death. If the softness/weakness has a Stone quality, illness will occur in Winter. If the weakness is severe, illness occurs immediately. The Zhen Zhen Shen Qi moistens the Spleen, and the Spleen stores the Qi of the muscles.

In Late Summer, obtaining the Stomach pulse with a slight soft and weak quality is a Normal Pulse. Excessive weakness and deficient Stomach Qi indicate Spleen Disease. Dai represents the extreme of weakness. Extreme weakness without Stomach Qi indicates a Death Pulse. Softness/weakness with Stone quality indicates Water Qi attacking Earth; when Winter arrives and Water Qi is internally deficient, illness occurs, hence termed Winter Disease. Severe weakness indicates the Spleen pulse is greatly deficient, hence illness occurs immediately. The reason the Spleen pulse presents as soft and weak is that the True Spirit Qi of the Zang moistens the Spleen, and the Spleen stores the Qi of the muscles.

In Autumn, the pulse with a slight hair-like (Mao/Floating) quality accompanied by Stomach Qi is called Normal Pulse. If the Mao quality is excessive and Stomach Qi is deficient, it indicates Lung Disease. If there is only Mao quality without Stomach Qi, it indicates Death. If the Mao quality has a String-like (Xian) quality, illness will occur in Spring. If the Xian quality is severe, illness occurs immediately. The Zhen Zhen Shen Qi is superior to the Lungs, facilitating the circulation of Ying (Nutrient) and Wei (Defensive) Qi and Yin-Yang.

In Autumn, obtaining the Stomach pulse with a slight Mao quality is a Normal Pulse. Excessive Mao quality and deficient Stomach Qi indicate Lung Disease. Only Mao quality without Stomach Qi indicates a Death Pulse. Mao quality with String-like quality indicates Wood Qi attacking Metal; when Spring arrives and Wood Qi is internally deficient, illness occurs, hence termed Spring Disease. If the Xian quality is excessive, Wood Qi is deficient and subjected to attack/rebellion, hence illness occurs immediately. The reason the Lungs present a Mao pulse is that the True Spirit Qi of the Zang is superior to the Lungs; the Lungs govern all vessels and circulate Ying, Wei, and Yin-Yang Qi.

In Winter, the pulse with a slight stone-like (Shi/Sinking) quality accompanied by Stomach Qi is called Normal Pulse. If the Shi quality is excessive and Stomach Qi is deficient, it indicates Kidney Disease. If there is only Shi quality without Stomach Qi, it indicates Death. If the Shi quality has a Hook-like (Gou) quality, illness will occur in Summer. If the Gou quality is severe, illness occurs immediately. The Zhen Zhen Shen Qi descends to the Kidneys, and the Kidneys store the Qi of the bone marrow.

In Winter, obtaining the Stomach pulse with a slight Shi quality is a Normal Pulse. Excessive Shi quality and deficient Stomach Qi indicate Kidney Disease. Only Shi quality without Stomach Qi indicates a Death Pulse. Shi quality with Hook-like quality indicates Fire Qi attacking Water; when Summer arrives and Fire Qi is internally deficient, illness occurs, hence termed Summer Disease. If the Gou quality is excessive, it is also due to root Qi deficiency leading to attack/rebellion, hence illness occurs immediately. The reason the Kidneys present a Shi pulse is that the True Spirit Qi of the Zang descends to the Kidneys, and the Kidneys store the Qi of the bone marrow.

Generally, the Liver governs dispersion and drainage, hence termed "San" (Disperse). The Heart governs blood vessels, hence termed "Tong" (Connect/Flow). The Spleen governs irrigation, hence termed "Ru" (Moisten). The Lungs reside in the upper jiao, hence termed "Gao" (High). The Kidneys are Water organs located inferiorly, hence termed "Xia" (Low). In Spring, mentioning Mao in the pulse indicates Metal punishing Wood. In Summer, mentioning Shi indicates Water punishing Fire. In Late Summer and the autumn/winter seasons, mentioning softness/weakness with Stone, Mao with String, or Stone with Hook, all indicate the element that normally conquers me is counter-attacking. Generally, the element that conquers me punishes me due to my root Qi deficiency; the element I normally conquer attacks me also due to my root Qi deficiency. Furthermore, in Spring and Summer, mentioning immediate illness refers to being conquered; in Late Summer, mentioning immediate illness refers to root deficiency; in Autumn and Winter, mentioning immediate illness refers to attack/rebellion. This clarifies that being conquered or attacked/rebelled against is all due to root Qi deficiency. The meanings are interwoven to encourage mutual deduction, so one may understand the cause.

The great collateral of the Stomach is named Xu Li (Empty Well). It penetrates the diaphragm, connects to the Lungs, and emerges below the left breast. Its movement can be seen through the clothing; this is the Zong Qi (Gathering Qi).

The pulses of the Five Zang organs are nourished by the Stomach. The Stomach belongs to Central Earth, and its Qi communicates to all directions. Thus, the great collateral of the Stomach is named Xu Li. Great collateral refers to the collaterals outside the Stomach. Xu Li implies four-way communication. This collateral penetrates the diaphragm centrally, connects to the Lungs superiorly, and emerges horizontally below the left breast. Its movement responds externally to the clothing; this is the Zong Qi of the meridians. From this, we know that the Stomach collateral not only communicates to all directions and penetrates/connects to the diaphragm and Lungs, but also combines with Zong Qi. This describes the normal Qi of the Stomach collateral.

If the movement is vigorous, panting, and frequently interrupted, the disease is in the middle jiao. If the pulse is knotted and horizontal, there is an accumulation (Ji).

Vigorous and frequent panting with impending cessation indicates that Zong Qi cannot ascend out of the Lungs to govern respiration; thus, the disease is in the diaphragm region. With disease in the diaphragm, Zong Qi knots internally and rebels horizontally. Knotting and horizontal rebellion indicate accumulation in the diaphragm. This describes the pathological Qi of the Stomach collateral.

If the pulse ceases completely and does not return, it is called Death. Below the breast, if the movement is vigorous enough to move the clothing, it indicates leakage of Zong Qi.

If Zong Qi escapes and ceases completely, it is called Death. The reason is that Zong Qi emerges below the breast, and its movement responds to the clothing. Now, if it ceases completely, it indicates leakage of Zong Qi. "Xie" (leak) means escape/depletion. This describes the death Qi of the Stomach collateral. This shows that not only do the pulses of the Five Zang organs have normal, pathological, and death states, but the pulse of Zong Qi also has normal, pathological, and death states.

To know whether the Cun Kou (Radial artery at the wrist) pulse is excessive or deficient: If the Cun Kou pulse feels short upon palpation, it indicates Headache. If the Cun Kou pulse feels long upon palpation, it indicates Pain in the lower legs and shins. If the Cun Kou pulse feels rapid/crisp (Cu) and strikes upward, it indicates Shoulder and Back Pain. If the Cun Kou pulse is deep (Chen) and firm, it indicates Disease in the interior (Middle Jiao). If the Cun Kou pulse is superficial (Fu) and vigorous, it indicates Disease in the exterior. If the Cun Kou pulse is deep and weak, it indicates Cold-Heat alternations, as well as Shan Jia (Hernia/Mass) and pain in the lower abdomen. If the Cun Kou pulse is deep and horizontal, it indicates Accumulation under the hypochondrium and horizontal accumulation pain in the abdomen. If the Cun Kou pulse is deep and panting/rushing (Chuan), it indicates Cold-Heat alternations.

"Shang" and "Heng" are both pronounced with the departing tone. The Stomach pulse belongs to Earth and resides at the Guan position, connecting above to Cun and below to Chi, also rooted in Stomach Qi. Thus, the pulses of Cun and Chi are cited to clarify this. To know the excessive and deficient pulse diseases of Cun Kou, one must discern them through short/long, superficial/deep pulses. If the Cun Kou pulse feels short under the fingers, shortness indicates Qi deficiency, failing to reach the upper part, hence headache (deficiency in the upper part). If the Cun Kou pulse feels long under the fingers, length indicates Qi excess, exceeding the lower part, hence pain in the lower legs/shins (excess pathogen in the lower part). If the Cun Kou pulse feels rapid/crisp and strikes upward under the fingers, crispness indicates internal deficiency, failing inward, while striking upward indicates external excess, exceeding outward, hence shoulder and back pain (internal deficiency, external excess). If the Cun Kou pulse is deep and firm, it is excessive inward, hence disease in the interior. If the Cun Kou pulse is superficial and vigorous, it is excessive outward, hence disease in the exterior. If the Cun Kou pulse is deep and weak, it is deficient inward, hence cold-heat, Shan Jia, and lower abdominal pain. If the Cun Kou pulse is deep and horizontal, it is excessive inward, hence accumulation under the hypochondrium and horizontal accumulation pain in the abdomen. If the Cun Kou pulse is deep and rushing, it is either excessive or deficient, hence merely cold-heat (which has excess and deficiency aspects). "Heng" means horizontal rebellion. "Chuan" means rushing/panting. Heng and Chuan describe the pulse image, not the disease itself.

A pulse that is vigorous, slippery, and firm indicates Disease in the exterior. A pulse that is small, solid, and firm indicates Disease in the interior. A pulse that is small, weak, and choppy indicates Chronic Disease. A pulse that is slippery, superficial, and rapid indicates New Disease. A tense pulse indicates Shan Jia and lower abdominal pain. A slippery pulse indicates Wind Disease. A choppy pulse indicates Bi Syndrome. A slow and slippery pulse indicates Heat in the Middle. A vigorous and tight pulse indicates Distension.

This reiterates the pulse diseases of excess and deficiency to complete the meaning of the previous text. A vigorous, slippery, and firm pulse indicates Yang Qi excess, hence disease in the exterior. A small, solid, and firm pulse indicates Yin Qi excess, hence disease in the interior. A small, weak, and choppy pulse indicates Qi and Blood deficiency, hence chronic disease. A slippery, superficial, and rapid pulse indicates Qi and Blood excess, hence new disease. Shan Jia and lower abdominal pain can be either deficient or excess. The earlier mention of deep and weak Cun Kou pulse causing Shan Jia/lower abdominal pain was due to righteous Qi deficiency. Here, a tense pulse causing Shan Jia/lower abdominal pain is due to pathogenic excess. A slippery pulse indicates Wind because Wind is a Yang pathogen that moves quickly and changes often, hence the pulse is slippery. A choppy pulse indicates Bi because Bi involves blockage and rejection, with coagulated Qi and Blood, hence the pulse is choppy. A slow and slippery pulse indicates internal deficiency of Earth Qi and excessive Yang Heat, hence Heat in the Middle. A vigorous and tight pulse indicates excess Earth Qi and internal pathogenic solidity, hence distension. This discusses knowing excess/deficiency diseases through excess/deficiency pulses. This applies not only to Cun Kou, thereby completing the previous text's meaning.

If the pulse follows Yin-Yang principles, the disease is easy to cure. If the pulse opposes Yin-Yang principles, the disease is difficult to cure. If the pulse conforms to the順 (Shun/Smoothness) of the four seasons, it is said the disease has no other complications. If the pulse reverses the four seasons, or if the transmission skips the intervening Zang (Jian Zang), it is said to be difficult to cure.

"Yi" and "Jian" are both pronounced with the departing tone. Regarding excessive/deficient pulses with excess/deficiency diseases, it is crucial that Yin and Yang correspond. Thus, if the pulse follows Yin-Yang, the disease is easily cured; if it opposes, it is difficult. "Following Yin-Yang" means the pulse conforms to the four seasons. Smoothness refers to Spring String, Summer Hook, Autumn Hair, Winter Stone. Conforming to smoothness means even if diseased, there are no other complications (no other transformations). "Opposing Yin-Yang" means the pulse reverses the four seasons. Reversal refers to Stomach pulse with Mao, Stomach pulse with Shi, Mao pulse with Xian, Shi pulse with Gou. Jian Zang (intervening Zang) means external evil initially damages the skin and hair, and the Lungs are affected first. If the Lungs transmit to the Liver, the Kidney intervenes; if the Kidneys transmit to the Heart, the Liver intervenes; if the Liver transmits to the Spleen, the Heart intervenes; if the Heart transmits to the Lungs, the Spleen intervenes; if the Spleen transmits to the Kidneys, the Lungs intervene. This is mother-son generation, where Zang organs do not suffer punishment. Now, if there is no intervening Zang, the Zang suffers punishment directly, hence the disease is difficult to cure.

Prominent blue veins on the arms indicate Blood Loss. A slow and choppy Chi pulse indicates Lassitude and desire to lie down. A vigorous pulse indicates Blood Loss. A coarse Chi skin with a slippery pulse indicates Profuse Sweating. A cold Chi skin with a fine pulse indicates Delayed Diarrhea (Hou Xie). A coarse pulse at the Chi position with constant heat indicates Heat in the Middle.

"Jie" is the same as "Xie" (Lassitude). " " (Yi) is pronounced "Yi". In other chapters, "Jie" and " " are the same. The previous section diagnosed disease location via Cun Kou; this section diagnoses via Chi pulse. From here to "Women Pregnant," the meaning is roughly similar to "Ling Shu: Lun Ji Zhen Chi." Prominent blue veins on the arms, from Chi pulse up to the arm, show many blue colors in the arm's collateral vessels. The Liver color is blue, and the Liver stores Blood. Prominent blue veins indicate Liver Blood cannot warm the flesh, fill the skin, or permeate the pores, hence Blood Loss. If the Chi pulse is slow and choppy, it indicates internal deficiency of Qi and Blood, hence lassitude and desire to lie down. Lassitude means slackness; An Wo means嗜卧 (desire to sleep). Not only prominent blue veins indicate Blood Loss; if the Chi pulse is strong, indicating disharmony of Yin Qi, it is also called Blood Loss. Chi Se refers to coarse Chi skin. Mai Hua refers to slippery Chi pulse. Coarse skin and slippery pulse indicate Qi mechanism moving from Yin to Yang, hence profuse sweating. Chi Han refers to cold Chi skin. Mai Xi refers to fine Chi pulse. Cold skin and fine pulse indicate Sheng Yang Qi cannot reach the exterior, hence delayed diarrhea. "Cu" (coarse) means large. Chi Cu means large Chi pulse. Chang Re means constantly hot Chi skin. Large pulse and hot skin indicate excess Yang Qi, hence Heat in the Middle. This diagnoses disease location via Chi pulse and Chi skin.

Movement in the neck pulse with panting and rapid cough indicates Water Disease. Slight swelling inside the eyes, resembling a silkworm lying down, indicates Water Disease. Yellow-red urine with lassitude indicates Jaundice. Feeling hungry after eating indicates Stomach Jaundice. Facial swelling indicates Wind Disease. Swelling of the lower legs and shins indicates Water Disease. Yellow eyes indicate Jaundice.

"Niao" (urine) is pronounced "Niao," departing tone. There are cases where one knows the disease location without diagnosing the Chi pulse, simply by discussing symptoms. Neck pulse movement with panting and rapid cough indicates internal movement of Water Qi, hence Water Disease. Slight eye swelling like a silkworm indicates external manifestation of Water Qi, hence Water Disease. Yellow-red urine with lassitude indicates Damp-Heat in the Middle, resulting in Jaundice. Feeling hungry after eating indicates Pathogenic Heat in the Middle, resulting in Stomach Jaundice. Discussing facial swelling indicates Wind moving upward, hence Wind Disease. Discussing leg swelling indicates Water moving downward, hence Water Disease. Regarding Jaundice, besides yellow-red urine and lassitude, one must have yellow eyes to be termed Jaundice. The previous text did not mention yellow eyes, so it is repeated to clarify. This discusses knowing disease location via symptoms.

If the Shao Yin pulse (on the hand) is vigorous, it indicates Pregnancy.

Shao Yin refers to the Chi pulse. The method of diagnosing the Chi pulse can reveal disease location and also determine if a woman is pregnant. Vigorous Shao Yin pulses in both hands of a woman indicate surplus Kidney Qi, sensing the Qi generated by Tian Yi (Heaven One), hence pregnancy.

Pulses have reversal and conformity. The four seasons lack the corresponding Zang shape. In Spring and Summer, the pulse is thin/small; in Autumn and Winter, the pulse is floating and large. This is called Reversing the Four Seasons.

"Pulse reversal and conformity" refers to the previously mentioned pulse following/opposing Yin-Yang. "Four seasons lack Zang shape" means in Spring and Summer the pulse lacks String/Hook qualities, and in Autumn/Winter it lacks Hair/Stone qualities. Spring generates and Summer grows, with Qi flourishing outward, yet the pulse is thin; Autumn harvests and Winter stores, with Qi converging inward, yet the pulse is floating and large. This does not accord with the season, hence called Reversing the Four Seasons.

Wind-Heat with a quiet pulse, Diarrhea/Blood Loss with a solid pulse, Interior Disease with a deficient pulse, Exterior Disease with a coarse and firm pulse—these are all difficult to treat. This is called Reversing the Four Seasons.

Disease pulses require correspondence between Yin/Yang and Interior/Exterior. For Wind-Heat, Yang Qi is abundant; the pulse should be洪大 (Hong Da/Vigorous and Large), but is quiet. For Diarrhea/Blood Loss, Yin Qi is deficient; the pulse should be internally deficient, but is solid. For Interior Disease, pathogen is solid inside; the pulse should be deep and solid, but is deficient. For Exterior Disease, pathogen is abundant outside; the pulse should be superficial and large, but is coarse and firm. These pulses do not match the disease, and the disease does not match the pulse; all are difficult to treat. Also called Reversing the Four Seasons.

Humans rely on water and grain as their foundation; thus, if humans cut off water and grain, they die. If the pulse lacks Stomach Qi, it also dies.所谓 "No Stomach Qi" means obtaining only the True Zang Pulse without Stomach Qi.所谓 "Pulse lacking Stomach Qi" means the Liver pulse is not String-like, and the Kidney pulse is not Stone-like.

Humans depend on water and grain for life; thus, humans take water and grain as their foundation. Without water and grain, humans cannot live; thus, cutting off water and grain leads to death. Cutting off water and grain leads to death, and pulse lacking Stomach Qi also leads to death. "No Stomach Qi" means obtaining only the True Zang Pulse, lacking the gentle Stomach Qi. "Pulse lacking Stomach Qi" means in Spring the Liver pulse is not slightly String-like, and in Winter the Kidney pulse is not slightly Stone-like. This pulse originates from the Stomach, and the Stomach originates from water and grain.

The Tai Yang pulse arrives: Vigorous, Large, and Long. The Shao Yang pulse arrives: Intermittently rapid and slow, intermittently short and long. The Yang Ming pulse arrives: Superficial, Large, and Short.

This lists the pulse images of the Three Yang meridians to clarify how Stomach Qi combines with the Six Fu organs of the Three Yang. The following discussion of normal, pathological, and death pulses clarifies how Stomach Qi combines with the Five Zang organs of the Three Yin. Tai Yang is Ju Yang (Great Yang). Tai Yang pulse arriving is Vigorous, Large, and Long; this is an image of excess Yang Qi governing opening. Shao Yang is Chu Yang (Initial Yang). Shao Yang pulse arriving is intermittent rapid/slow, short/long; this is an image of initial Yang gradually generating, governing pivoting. Yang Ming is Er Yang (Second Yang). Yang Ming pulse arriving is Superficial, Large, and Short; Superficial and Large are Yang; Superficial, Large, and Short is the image of Yang Ming governing closing. The Three Yang govern the Six Fu organs; Stomach Qi combines with the Six Fu organs, hence the Three Yang pulses are cited to clarify this.

The normal Heart pulse comes: Cumulative like connected pearls, like smoothing Lang Gan jade, called Heart Ping (Normal). In Summer, Stomach Qi is the foundation. The pathological Heart pulse comes: Panting and continuous, slightly curved within, called Heart Bing (Disease). The death Heart pulse comes: Curved at the front and fixed at the back, like handling a belt hook, called Heart Si (Death).

The Five Zang organs have normal, pathological, and death pulses, all rooted in Stomach Qi. The normal Heart pulse comes: Cumulatively like connected pearls, smooth, and like smoothing Lang Gan jade, peaceful. If the Heart pulse is like this, Heart Qi is unobstructed, called Heart Ping. The Heart governs Summer Fire, hence Summer takes Stomach Qi as the foundation. If it is the pathological Heart pulse, coming panting and continuous, slightly curved within, it is called Heart Disease. The death Heart pulse comes: Curved at the front and fixed at the back, like handling a belt hook, called Heart Death.