《内经·脉要精微论篇》曰∶推而外之，消息之，内而不外，有心腹积也。推而内之，消息之，
外而不内，身有热也。推而上之，消息之，上而不下，腰足清也。推而下之，消息之，下而不上，头
项痛也。
左寸，外以候心，内以候膻中。左关，外以候肝，内以候膈。右寸，外以候肺，内以候胸中。右
关，外以候胃，内以候脾。两尺，外以候肾，里以候腹中。是以有推而内，推而外消息之法也。
一说∶左寸，推而上之，上而不下，头项痛；推而下之，下而不上，胸胁痛也。推而内之，内而不
外，心腹积也；推而外之，外而不内，眼目昏也。
左关，推而上之，上而不下，腰足清也；推而下
之，下而不上，肠胃痛也。推而内之，内而不外，筋骨痛也；推而外之，外而不内，身有热也。
左尺，推而上之，上而不下，小肠痛也；推而下
之，下而不上，足胫痛也。推而内之，内而不外，小便浊也；推而外之，外而不内，腰足痛也。
右寸，推而上之，上而不下，气喘急也；推而下之，下而不上，胸中痛也。推而内之，内而不
外，咽喉痛也；推而外之，外而不内，背脊痛也。
右关，推而上之，上而不下，吐逆也；推而下之，下而不上，主下血也。推而内之，内而不外
，腹有蛊也；推而外之，外而不内，肌肉痛也。
右尺，推而上之，上而不下，小腹胀也；推而下之，下而不上，足腿痛也。推而内之，内而不
外，疝瘕也；推而外之，外而不内，小便秘也。
汪石山曰∶按消息，谓详细审察也。推，谓以指那移于部之上下而诊之，以脉有长短之类也；又
以指那移于部之内外而诊之，以脉有双弦单弦之类也；又以指推开其筋而诊之，以脉有沉伏止绝之
类也。《刊误》谓内外以指按轻重言，推有数义，故特着之，非但外以候心，内以候膻中之类也。
《黄帝内经·脉要精微论篇》说：将指力向外推按，并仔细审察脉象，如果脉象表现为“内而不外”（即重按有力而轻取无力），说明心腹部有积滞。将指力向内推按（重按），并仔细审察脉象，如果脉象表现为“外而不内”（即轻取有力而重按无力），说明身体发热。将指力向上推按，并仔细审察脉象，如果脉象表现为“上而不下”（即寸部脉盛而尺部脉弱），说明腰部和足部发凉。将指力向下推按，并仔细审察脉象，如果脉象表现为“下而不上”（即尺部脉盛而寸部脉弱），说明头部和项部疼痛。
左手寸口脉，外部候应心脏，内部候应膻中穴所在区域。左手关部脉，外部候应肝脏，内部候应膈膜。右手寸口脉，外部候应肺脏，内部候应胸中。右手关部脉，外部候应胃腑，内部候应脾脏。两尺部脉，外部候应肾脏，内部候应腹中。因此，就有了通过推按内外来审察病情的诊法。
另一种说法是：左手寸口脉，若推而上之，表现为上盛下虚，则出现头项痛；若推而下之，表现为下盛上虚，则出现胸胁痛。若推而内之（重按），表现为内实外虚，则有心腹积滞；若推而外之（轻取），表现为外实内虚，则出现眼目昏花。
左手关部脉，若推而上之，表现为上盛下虚，则腰足发凉；若推而下之，表现为下盛上虚，则肠胃疼痛。若推而内之，表现为内实外虚，则筋骨疼痛；若推而外之，表现为外实内虚，则身体发热。
左手尺部脉，若推而上之，表现为上盛下虚，则小肠疼痛；若推而下之，表现为下盛上虚，则足胫疼痛。若推而内之，表现为内实外虚，则小便浑浊；若推而外之，表现为外实内虚，则腰足疼痛。
右手寸口脉，若推而上之，表现为上盛下虚，则气喘急促；若推而下之，表现为下盛上虚，则胸中疼痛。若推而内之，表现为内实外虚，则咽喉疼痛；若推而外之，表现为外实内虚，则背脊疼痛。
右手关部脉，若推而上之，表现为上盛下虚，则呕吐逆气；若推而下之，表现为下盛上虚，主下部出血。若推而内之，表现为内实外虚，则腹中有蛊胀（积聚）；若推而外之，表现为外实内虚，则肌肉疼痛。
右手尺部脉，若推而上之，表现为上盛下虚，则小腹胀满；若推而下之，表现为下盛上虚，则足腿疼痛。若推而内之，表现为内实外虚，则有疝气或瘕块；若推而外之，表现为外实内虚，则小便闭塞不通。
汪石山说：所谓“消息”，是指详细审察。所谓“推”，是指用手指在脉部的上下位置移动按压以诊断病情，这是为了辨别脉象的长短等特征；又用手指在脉部的内外侧移动按压以诊断病情，这是为了辨别脉象是双弦还是单弦等特征；又用手指推开筋络进行诊察，这是为了辨别脉象是否有沉伏、止绝等特征。《刊误》认为，“内外”是指手指按压轻重而言，“推”有多种含义，所以特别阐述这一点，不仅仅是指“外以候心，内以候膻中”这类简单的对应关系。
The *Neijing·Mai Yao Jing Wei Lun Pian* (Treatise on the Essential Subtleties of Pulse Diagnosis in the Yellow Emperor's Inner Canon) states: When pushing the pulse outwardly and carefully observing it, if the pulse presents as "internal but not external" (strong upon deep pressure, weak upon superficial pressure), it indicates accumulation in the heart and abdomen. When pushing the pulse inwardly (applying deep pressure) and carefully observing it, if the pulse presents as "external but not internal" (strong upon superficial pressure, weak upon deep pressure), it indicates fever in the body. When pushing the pulse upwardly and carefully observing it, if the pulse presents as "upper but not lower" (excess in the Cun position, deficiency in the Chi position), it indicates coldness in the waist and feet. When pushing the pulse downwardly and carefully observing it, if the pulse presents as "lower but not upper" (excess in the Chi position, deficiency in the Cun position), it indicates pain in the head and neck.
At the Cun position of the left wrist, the exterior corresponds to the Heart, and the interior corresponds to the Danzhong region. At the Guan position of the left wrist, the exterior corresponds to the Liver, and the interior corresponds to the diaphragm. At the Cun position of the right wrist, the exterior corresponds to the Lung, and the interior corresponds to the chest center. At the Guan position of the right wrist, the exterior corresponds to the Stomach, and the interior corresponds to the Spleen. At the two Chi positions, the exterior corresponds to the Kidney, and the interior corresponds to the abdominal cavity. Thus, there exists a diagnostic method of examining conditions by pushing inwardly or outwardly and carefully observing the pulse.
Another interpretation states: For the left Cun position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, headache and neck pain occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, chest and hypochondriac pain occur. If pushed inwardly (deep pressure) resulting in an internal-excess/external-deficient pattern, heart and abdominal accumulations are present; if pushed outwardly (superficial pressure) resulting in an external-excess/internal-deficient pattern, blurred vision occurs.
For the left Guan position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, coldness in the waist and feet occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, gastrointestinal pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, bone and tendon pain occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, fever in the body occurs.
For the left Chi position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, small intestine pain occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, calf pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, turbid urine occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, waist and foot pain occurs.
For the right Cun position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, panting and rapid breathing occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, chest pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, sore throat occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, back and spine pain occurs.
For the right Guan position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, vomiting and regurgitation occur; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, lower bleeding is indicated. If pushed inwardly resulting in an internal-excess/external-deficient pattern, abdominal distension due to accumulation (Gu) occurs; if pushed outwardly resulting in an external-excess/internal-deficient pattern, muscle pain occurs.
For the right Chi position, if pushed upwardly resulting in an upper-excess/lower-deficient pattern, lower abdominal distension occurs; if pushed downwardly resulting in a lower-excess/upper-deficient pattern, leg pain occurs. If pushed inwardly resulting in an internal-excess/external-deficient pattern, hernia or masses (Shan Jia) occur; if pushed outwardly resulting in an external-excess/internal-deficient pattern, urinary retention occurs.
Wang Shishan stated: The term "Xiao Xi" refers to detailed examination. The term "Tui" refers to moving the fingers up and down across the pulse positions to diagnose, aiming to distinguish features such as long or short pulses; moving the fingers inside and outside the pulse position to diagnose, aiming to distinguish between double-wiry or single-wiry pulses; and pressing aside the tendons to diagnose, aiming to identify pulses that are sunken, hidden, intermittent, or absent. The *Kan Wu* commentary suggests that "interior and exterior" refer to the lightness or heaviness of finger pressure, and "Tui" has multiple meanings, hence it is specifically elaborated upon, rather than merely referring to simple correspondences like "exterior for Heart, interior for Danzhong."