《黃帝八十一難經纂圖句解》Vol. 2

The second volume of the Yellow Emperor's Classic of Eighty-One Difficulties records the discourses of Qin Yueren (an ancient renowned physician), with annotations by Li Jiong.

The Eighth Difficulty examines why someone might have a calm cunkou pulse (wrist pulse) yet suddenly die. This occurs because all twelve meridians in the human body rely on the vital energy (life force) rooted in the kidneys as their fundamental source. What we call the source of vital energy refers to the primordial Qi (innate Qi) flowing between the two kidneys. This serves as the foundation for the five zang and six fu organs, the twelve meridians, as well as the origin of respiratory function and the triple burner system (upper, middle, and lower burners). Kidney Qi acts like a guardian deity defending against external pathogenic invasions. If pathogenic factors penetrate the Zhishi acupoint of the kidneys, death ensues. Thus we say kidney Qi is the root of human life, just as roots sustain a tree—when the roots are severed, the branches wither. A calm cunkou pulse accompanied by sudden death indicates the internal vital energy has already been cut off.

The Ninth Difficulty explores how to differentiate diseases of the zang-fu organs: a rapid pulse (shu mai) typically reflects disorders in the six fu organs, while a slow pulse (chi mai) indicates diseases of the five zang organs. Here, "shu" refers to fast pulse frequency and "chi" to slow pulse frequency—these were crucial diagnostic markers in ancient Chinese medicine.

In traditional Chinese pulse diagnosis, the speed of the pulse reflects disease conditions of the five viscera. A rapid pulse (Shu Mai) indicates heat patterns in the body, representing Yang pulse manifestations, while a slow pulse (Chi Mai) suggests cold patterns, characteristic of Yin pulses. Disordered Yang Qi accelerates the pulse rate, making all Yang-type pulses indicative of heat syndromes, whereas deficient Yin Qi slows the pulse, thus associating Yin pulses with cold syndromes. By discerning these variations in pulse speed, one can diagnose pathological changes in the viscera.

The tenth question in the Classic of Difficulties (Nanjing) asks: Why do ten variations occur at a single pulse position? This results from the interaction between the five viscera affected by five pathogenic influences (deficiency evil, excess evil, upright evil, minor evil, and thief evil) and the dual forces of Yin-Yang. The term "encounter" refers to the appearance of another organ's pulse characteristics at a given visceral position. Each of the five viscera has internal-external relationships, and their mutual influences produce ten pulse variations—essentially reflecting the Five Phase (Wood, Fire, Earth, Metal, Water) cycles of generation and restriction in pulse diagnosis. "Pathogenic Qi" broadly denotes any aberrant energy disrupting normal physiological functions.

For example: If the heart pulse displays pronounced stringlike tension (a liver pulse trait), this signifies liver evil invading the heart. In Five Phase theory, the liver (Wood) is the mother of the heart (Fire), making this a "deficiency evil" scenario where maternal illness affects the child. Slight stringlike tension in the heart pulse indicates gallbladder evil influencing the small intestine (the heart's externally paired organ). An excessively surging heart pulse lacking harmonious stomach Qi reflects the heart's own pathology, termed "upright evil." A moderately enlarged heart pulse suggests small intestine disorders. Marked sluggishness (a spleen pulse trait) in the heart pulse reveals spleen evil attacking the heart—a "excess evil" case of the child organ afflicting the mother. Mild sluggishness points to stomach evil affecting the small intestine.

This passage illustrates, through diverse heart pulse manifestations, the intricate pathological mechanisms by which the five viscera and six bowels interact via Five Phase dynamics and internal-external relationships.

This passage explains how to diagnose pathogenic influences on the internal organs through pulse variations. When abnormal changes appear in the heart pulse (the pulse corresponding to the heart), it often indicates interference from other organs:

When the heart pulse shows pronounced sluggishness (se pulse), it signifies lung pathogens disturbing the heart. Since the se pulse inherently belongs to the lung, its appearance at the heart pulse position represents metal (lung's element) oppressing fire (heart's element) - this is termed "minor pathogen."

A slightly sluggish heart pulse indicates large intestine pathogens affecting the small intestine. The subtle se pulse appearing in the heart region reflects large intestine pathogens disturbing its paired yang organ.

When the heart pulse becomes abnormally deep and sunken (chen pulse), it reveals kidney pathogens attacking the heart. The chen pulse naturally belongs to the kidney, while the heart fire should manifest as full and surging. This reversal represents water (kidney) overwhelming fire (heart) - known as "thief pathogen."

A mildly sunken heart pulse suggests bladder pathogens disturbing the small intestine. When light pressure detects slight chen pulse in the heart region, it indicates bladder pathogens affecting its paired yang organ.

Each organ possesses distinct yin-yang and hard-soft qualities. Using the heart as our example, similar diagnostic principles apply to other organs. Thus a single pulse quality can manifest ten variations, with six pulse positions each showing five pathogenic transformations - totaling sixty possible combinations.

The Eleventh Difficulty states: Medical classics describe pulses that skip beats before completing fifty cycles. Normally, each organ should contribute fifty pulsations, with five organs totaling two hundred fifty beats constituting balanced pulse. Skipped beats before fifty cycles indicate primordial qi deficiency in an organ. Here "skipped" refers to perceptible interruptions during pulse palpation.

Which organ's primordial qi is deficient? During inhalation, qi enters through yin channels (associated with yin meridians), relating to kidney and liver - these sub-diaphragmatic organs belong to yin. Exhalation follows yang channels, connecting to heart and lung - these supra-diaphragmatic organs belong to yang.

In healthy individuals, yin-yang qi should circulate unimpeded through all organs. When exhalation still emerges from heart-lung but inhalation only reaches liver before reversing, unable to descend to kidney, this reveals depletion of congenital kidney qi inherited from parents. Thus pulses skipping before fifty cycles portend mortal danger. This confirms the deficient organ as kidney - when kidney qi fails first, such pulse manifestations appear.

This passage discusses the fundamental principles of diagnosis and treatment in ancient medical practice. It begins by describing a critical error in therapeutic approach: when the liver and kidneys (yin organs below the diaphragm) show severed pulse conditions, physicians mistakenly use acupuncture and herbs to tonify the heart and lungs (yang organs above the diaphragm); conversely, when the heart and lung pulses are severed, they erroneously tonify the liver and kidneys. This practice of "supplementing yin when yang is exhausted, and supplementing yang when yin is exhausted" is likened to administering purgatives to an already deficient patient (further depleting deficiency) or giving tonics to someone with excess conditions (aggravating excess). Such mistreatment not only worsens the illness but may prove fatal—constituting medical negligence that endangers life.

The text then explains how to assess disease progression by observing the relationship between facial complexion and pulse diagnosis: if the observed pulse conflicts with the facial hue (e.g., a blue liver-associated complexion appearing with a lung-associated floating pulse, representing Metal overcoming Wood), this signals critical danger; whereas if the pulse and complexion show a generative relationship (e.g., blue complexion with a kidney-associated deep pulse, representing Water generating Wood), the illness will naturally resolve despite present symptoms. It emphasizes the diagnostic necessity of evaluating whether facial colors and pulse conditions harmonize—a crucial criterion for determining prognosis. The term "diaphragm" (ge) refers to the thoracic diaphragm, while "tonifying excess or purging deficiency" (shi shi xu xu) denotes the prohibited therapeutic practice of mistakenly applying tonification to excess syndromes or purgation to deficiency syndromes.

This passage explains the principle of "correspondence between complexion and pulse" in traditional Chinese medicine diagnosis. The five internal organs manifest distinct colors on the face: the heart corresponds to red, the liver to greenish-blue, the spleen to yellow, the lungs to white, and the kidneys to black. These facial color changes should align with the pulse characteristics at the cunkou position (the pulse-taking location in Chinese medicine).

Specifically: When the complexion appears greenish-blue, the pulse should be wiry and rapid, as this color corresponds to the liver and a wiry, tense pulse is characteristic of liver qi; when the face turns red, the pulse should be floating, large and scattered, matching the heart's attributes; a yellow complexion should accompany a moderate, relaxed and full pulse, corresponding to the spleen; a white face should correlate with a floating, uneven and short pulse, indicating lung conditions; while a dark complexion should pair with a deep, soft and slippery pulse, characteristic of kidney qi.

This correspondence extends beyond pulse to the skin condition on the inner forearm (chifu): when the pulse is rapid (shuo), the skin feels hot; a tense pulse (ji) accompanies tight skin; a relaxed pulse (huan) corresponds to loose skin; an uneven pulse (se) matches dry skin; and a slippery pulse (hua) aligns with smooth skin.

The five organs also correspond to specific sounds, odors and tastes: the liver relates to shouting, a rancid smell and sour taste; the heart connects with laughter, a scorched odor and bitter taste; the spleen corresponds to singing, a fragrant smell and sweet taste; the lungs associate with crying, a fishy smell and pungent taste; while the kidneys relate to groaning, a putrid smell and salty taste. When these characteristics mutually correspond, it indicates a harmonious state of the body.

This medical classic discusses methods for assessing the severity and prognosis of illness by observing a patient's facial complexion, pulse manifestations, and other external signs. When symptoms contradict the mutual conquest relationships of the Five Phases (Wood, Fire, Earth, Metal, Water) corresponding to the zang-fu organs, the condition will worsen and may become fatal.

For example, a liver disorder should manifest with a greenish complexion. If instead the patient shows a whitish complexion (lung symptom), frequent crying, and cravings for pungent or fishy foods—all signs of lung pathology—this indicates Metal (lung) conquering Wood (liver). In Five Phases theory, this antagonistic relationship is termed "thief evil" (zeixie), where contradictory symptoms signal critical danger.

Similarly, a greenish complexion (liver manifestation) coupled with a floating, rough, and short pulse (lung pulse) indicates Metal conquering Wood as "thief evil." A large, moderate pulse (spleen pulse) shows Wood conquering Earth as "minor evil" (weixie). A floating, expansive, and scattered pulse (heart pulse) reflects the generative Wood-Fire relationship, while a small, slippery pulse (kidney pulse) demonstrates Water generating Wood.

Medical skill divides into three grades: The inferior physician (zhiyi, "knowing one") masters only one diagnostic method; the middling physician (zhier, "knowing two") commands two approaches; the superior physician (zhisan, "knowing three") comprehensively understands complexion diagnosis, pulse reading, and skin examination while grasping the fundamental principles of Five Phases generation and conquest. Consequently, their cure rates stand at six, eight, and nine out of ten cases respectively.

The fourteenth difficulty specifically examines pulse "depletion" (insufficiency) and "excess" (hyperactivity):

• Normal pulse beats four times per breath cycle
• Three beats indicate "departure from regularity" (lijing)—coarse deviation from norms
• Four beats signify "essence robbery" (duojing)—vital essence dissipation
• Five beats foretell mortal termination

Here "Hand Taiyin" refers to the Lung Meridian of Hand-Taiyin, the starting point of the twelve meridian circulation. Physicians determine qi-blood circulation abnormalities by calculating pulse beats per breath and blood flow velocity (e.g., pulse traveling nine cun).

This scripture passage discusses pulse diagnosis methods, focusing on two primary conditions: "excessive pulse" and "deficient pulse."

First, the "excessive pulse" (abnormally rapid pulse):

A healthy person's pulse beats five times per inhalation and five times per exhalation, totaling ten beats per complete breath cycle. Exceeding this standard—such as six beats per inhalation (twelve beats per breath cycle)—signals critical danger. This accelerated pulse pattern indicates excessive Yang energy, with the illness progressing upward from the lower body.

Next, the "deficient pulse" (abnormally slow pulse):

A single pulse beat per complete breath cycle is called "departure from the meridians," showing halved circulatory function. One beat every two breath cycles is termed "essence depletion," indicating severe Qi and blood deficiency where circulation cannot complete thirteen full-body cycles in twenty-four hours. One beat every three breaths marks a moribund state with even slower circulation, while one beat every four breaths signifies life's end through complete Qi-blood exhaustion. This sluggish pulse reflects excessive Yin energy, with illness descending from the upper body.

Specific manifestations of "deficient pulse" pathologies:

First-stage deficiency affects the lungs, causing loose skin and hair loss;

Second-stage deficiency impacts the heart, leading to weakened blood vessels incapable of nourishing the five viscera and six bowels;

Third-stage deficiency damages the spleen, resulting in muscle wasting as food fails to transform into tissue nourishment.

Through analyzing pulse speed variations, this text demonstrates traditional Chinese medicine's crucial diagnostic method of pulse examination. Both excessive and deficient pulses serve as critical warning signs requiring timely regulation and treatment.

This passage explains the manifestations and recuperation methods for damage to the five internal organs, sequentially termed the "Five Impairments" from lungs to kidneys:

The third impairment involves spleen damage. The spleen governs digestion and commands the muscles. When food cannot be properly digested, it leads to muscular emaciation.

The fourth impairment manifests as slackened and weakened sinews, corresponding to liver damage. Since the liver governs the sinews, its impairment results in flaccid connective tissues incapable of supporting the body.

The fifth impairment appears as bone weakness preventing rising from bed, reflecting kidney damage. The kidneys govern bones, and their deficiency reduces marrow production, causing atrophy syndromes (muscular weakness). In severe cases, one becomes unable to stand upright.

When the disease progresses in reverse order (ascending from lower to upper organs), it's called "arrival vessel disorder." The original text states that when impairment descends from lungs to kidneys—affecting all five organs until the kidneys lose their bone-governing function—the resulting bone atrophy leads to death. Conversely, when impairment ascends from kidneys to lungs (also affecting all organs), the lungs lose their skin-and-hair governance, causing wrinkled skin and hair loss that similarly proves fatal.

Recuperation methods for specific organs:

• Lung impairment requires Qi supplementation (lungs govern Qi; damaged by cold foods, they need Qi replenishment);
• Heart impairment demands harmony between nutritive and defensive Qi (heart governs blood; harmed by melancholy, it requires blood-Qi regulation);
• Spleen impairment necessitates dietary temperature adjustment (spleen suffers from dietary overexertion; food warmth should vary seasonally);
• Liver impairment should be soothed with sweet-flavored foods (liver governs anger; sweet flavors belonging to spleen-earth provide centering balance);
• Kidney impairment requires essence-Qi (Jing-Qi) tonification (kidneys govern essence; warm-natured foods counteract cold-damp damage).

Finally, the text mentions pulse diagnosis: a healthy person's pulse beats twice per exhalation and twice per inhalation ("one exhalation two arrivals, one inhalation two arrivals"), which serves as the standard for assessing vitality.

This passage explains the method of diagnosing illness through pulse examination. When taking the pulse, the physician counts the number of pulse beats between the patient's inhalations and exhalations to assess their health condition.

Under normal circumstances, the pulse should beat twice during inhalation and twice during exhalation (totaling four beats per breath cycle), which is called "balanced pulse" (pingmai), indicating good health. If the pulse beats three times during inhalation and three times during exhalation (totaling six beats), this signifies the initial stage of illness, where the pulse appears large and is termed "departing channel pulse" (lijinmai).

Specific manifestations include: if the radial pulse (at the wrist) is stronger on the outer side than the inner side, the patient will experience headaches and dizziness; if weaker on the outer side and stronger on the inner side, symptoms like chest tightness and shortness of breath will occur.

When the pulse beats four times during inhalation and four times during exhalation (totaling eight beats), this indicates worsening illness. Generally, the more frequent the pulse beats, the more severe the condition. Conversely, if the pulse beats fewer times than normal (such as only once per two breath cycles), this also represents an unhealthy pulse pattern.

The text also mentions some special conditions like "double-return pulse" (huxi zai zhi), noting that these phenomena require further study by later physicians. Overall, this passage systematically explains the fundamental principles of diagnosing diseases through observing changes in pulse frequency and morphology.

This passage explains methods for assessing the severity and prognosis of illnesses through pulse diagnosis. When the pulse rate becomes abnormally rapid, different pulse qualities correspond to specific conditions:

A flooding-hongda pulse (strong and wide) indicates excessive yang heat, causing patients to experience restlessness and chest oppression. A deep-xi pulse (weak and thin) signifies disease in the yin channels, manifesting as abdominal pain. A slippery-hua pulse (smooth flow) shows heat syndrome, while a choppy-se pulse (hesitant rhythm) indicates exposure to cold-dampness or mist.

When ten pulse beats occur per breath cycle (far exceeding the normal four), a deep-xi pulse at night suggests worsening nocturnal symptoms, while a floating-hongda pulse during daytime indicates daytime exacerbation. Moderate pulse intensity suggests serious but treatable illness, whereas erratic pulse size fluctuations indicate poor prognosis - extreme floating indicates excessive fire qi, while extreme depth shows kidney qi exhaustion.

A single pulse beat per breath is called "diminution-sun pulse" - though patients may walk about, they actually suffer dual deficiency of qi and blood requiring bed rest. When only one pulse beat occurs every two breaths, this "soulless-wuhun pulse" resembles a walking corpse and is invariably fatal.

If the cunkou (wrist position) shows pulse while the chi region (forearm position) shows none, the patient requires emetic therapy. When the reverse occurs (pulse at chi but not cunkou), the condition is serious but not life-threatening. These principles demonstrate how pulse rate, strength, and positional characteristics reveal disease depth and life-or-death prognosis.

This passage discusses the relationship between the cun and chi pulses in traditional Chinese pulse diagnosis, along with the characteristics of seasonal pulse manifestations.

First explaining the relationship between cun and chi pulses: If the pulse cannot be detected at the wrist's cun position (closer to the palm) but is present at the chi position (nearer to the elbow), even serious illness won't be life-threatening. This resembles a tree - the chi pulse represents the roots while the cun pulse represents the branches and leaves. Even if the foliage withers, the tree can regrow as long as its roots remain intact. In humans, the chi pulse represents primordial Qi (the fundamental life-force energy). As long as the chi pulse remains detectable, the primordial Qi persists, and death won't occur.

Next explaining normal seasonal pulse characteristics: Spring pulses should feel taut like a zither string (xian pulse), summer pulses curved like a hook (gou pulse), autumn pulses light as floating feathers (mao pulse), and winter pulses heavy as sinking stones (shi pulse). These represent normal seasonal pulse patterns rather than pathological ones.

Specifically: Spring corresponds to Wood phase and the liver, when all things begin to grow - hence the pulse manifests as a soft, slender xian pulse. Summer corresponds to Fire phase and the heart, when vegetation flourishes with drooping branches resembling hooks - hence the pulse comes quickly and recedes slowly like a gou pulse. These pulse characteristics all reflect the natural patterns of growth in the natural world.

This passage describes the characteristics of seasonal pulse patterns and their abnormal manifestations. In autumn, the lung pulse (the pulse corresponding to the lungs) should be as light and floating as a feather, because autumn is when all things wither, leaving only fine hairs on tree branches. The lung Qi governs the skin and body hair, so a healthy pulse appears light and empty, like a drifting feather.

In winter, the kidney pulse (the pulse corresponding to the kidneys) should be deep and solid like a stone, as winter is when all things lie dormant and water freezes into ice. A normal kidney pulse is deep yet soft and smooth, and this slightly sunken quality indicates abundant stomach Qi (the body's vital energy).

The text then explains abnormal seasonal pulse patterns: In spring, the pulse should be wiry (like the gentle tension of a plucked string). If the pulse is excessively strong and solid, this is called "excess," manifesting in external symptoms such as a bluish complexion and irritability. If the pulse is weak, this is called "deficiency," leading to internal symptoms like swelling in the limbs and difficulty urinating. A normal spring pulse should be as gentle and even as a spring breeze rustling elm leaves—this smooth, balanced pulse indicates sufficient stomach Qi. However, if the pulse feels overly firm and slippery, stiff like running a hand along a long bamboo pole, it signifies illness.

This passage discusses the diagnostic criteria for pulse conditions in spring and summer according to traditional Chinese medicine.

Regarding spring pulse patterns:

A normal, healthy spring pulse should be slightly wiry (the "wiry pulse" refers to a taut, bowstring-like quality). In this pulse, one part reflects stomach Qi (indicating spleen and stomach digestive function), while two parts show the wiry quality. If the wiry characteristic is overly pronounced with insufficient stomach Qi, it indicates illness. If the pulse shows only wiry characteristics with no stomach Qi at all, it becomes the dangerous "true visceral pulse," signaling critical illness.

The text emphasizes that spring pulses must be rooted in stomach Qi. The Qi of all five viscera requires stomach Qi for harmony, just as the hardest substances cannot be used alone but must be combined with softer materials to achieve durability. The stomach, being the organ of digestion and absorption, provides the body's essential Qi (Jingqi) from food and drink, making it the foundation for the liver and other visceral functions.

Regarding summer pulse patterns:

The normal summer pulse should be "hooked" (a rolling, curving quality resembling a hook). Opposite characteristics indicate illness:

• Excessively strong and replete pulses indicate external disorders, manifesting as flushed face, dry mouth, and excessive laughter
• Weak, thin, and faint pulses indicate internal damage, showing as heart vexation, chest pain, and hot palms—potentially fatal conditions

A normal summer pulse should flow smoothly like connected pearls. A rapid pulse resembling a chicken's quick footsteps indicates heart disease. If the pulse is weak and bending in the front section but stiff and unmoving in the back—like holding a belt hook—it signifies a fatal pulse.

The passage concludes that only a summer pulse with slight hook-like qualities represents the normal condition.

The summer pulse should curve slightly like a fishhook, but not too prominently, while maintaining the soft and flowing quality of "stomach qi" (Weiqi, referring to the vitality present in a healthy person's pulse). This is considered the normal pulse condition. If the hook-like characteristic is overly pronounced with insufficient stomach qi, it indicates illness. A pulse that appears purely hook-shaped with no stomach qi at all is the dangerous "true visceral pulse" (Zhenzangmai, reflecting organ failure), signaling a life-threatening condition. The key to diagnosing summer pulses lies in assessing the strength of stomach qi.

The autumn pulse should naturally feel as light as a feather. Any contrary characteristics indicate illness. Specifically: an excessively firm and rigid pulse suggests external pathogen invasion, with symptoms including pale complexion, frequent sneezing, and depressive emotions with a tendency to weep; an overly weak and fine pulse indicates internal organ damage, manifesting as panting, coughing, and chills with trembling.

A normal autumn pulse should feel as light and floating as the canopy of a small carriage, with a sense of vessel fullness upon pressure—this is the sign of stomach qi. If the pulse neither rises nor falls properly, feeling as sluggish as touching a chicken feather, it is a diseased pulse. If pressing it feels like scattered feathers in the wind—erratic and without pattern—this is the true visceral pulse devoid of stomach qi, a highly dangerous sign.

The autumn pulse should retain a slight feather-like lightness while maintaining a balance of three parts stomach qi and two parts feather-like quality to be considered normal. If the feather-like characteristic is too strong with insufficient stomach qi, it indicates illness; a purely feather-like pulse with no stomach qi is a fatal pulse. This is because the qi of all five organs relies on stomach qi to transmit to the hand's Taiyin pulse. If stomach qi fails, the true pathological state of the organs is exposed.

This passage discusses the characteristics of winter pulse diagnosis in traditional Chinese medicine and their corresponding health implications. The normal winter pulse should feel deep and strong like a stone; any deviation indicates physical imbalance.

If the winter pulse feels excessively firm and rigid, this is called "excess" (tai guo), signifying invasion by external pathogens. The patient may exhibit symptoms such as dark facial complexion, susceptibility to fear, and frequent yawning. Conversely, if the pulse is weak and faint, this is termed "deficiency" (bu ji), indicating internal organ damage with symptoms like rebellious qi (reverse flow of vital energy), lower abdominal pain, diarrhea, and cold feet.

A healthy winter pulse should resemble a sparrow's beak—wider at the top and narrower at the bottom—with a deep yet smooth quality. If the pulse feels continuous but slightly curved in the middle, it suggests spleen dysfunction affecting the kidneys, which is pathological. The most critical warning sign is a pulse that arrives loosely like an untied rope and departs abruptly like a shot stone, foretelling a fatal prognosis.

The standard for winter health is a pulse subtly imbued with a stony depth, reflecting the harmonious balance between stomach qi (the body's righteous energy) and kidney qi. If the stony quality dominates while stomach qi is insufficient, this indicates illness; complete absence of stomach qi with only a stony pulse signals impending death. The stomach acts as the "sea of nourishment," storing food and serving as the foundation of health throughout all four seasons.

The vitality of all four seasons—spring, summer, autumn, and winter—depends on stomach qi. Pathological patterns include: spring pulses being wiry with scant stomach qi, summer pulses surging with deficient stomach qi, autumn pulses floating like fur with excessive stomach qi, and winter pulses stony-deep with insufficient stomach qi. The waxing and waning of stomach qi directly determines life and death.

The essence (Jing) of the five viscera relies on the nourishing Qi of the stomach to sustain life. If the true Qi of the viscera leaks outward (referring to the distinctive pulse signs that appear during severe functional exhaustion of the organs), death is certain. The pivotal point of life and death in the human body lies in the stomach.

The spleen occupies the central position in the body (known as the "Central Region"). Under normal conditions, the pulse of the spleen channel is balanced and subtle, making it difficult to detect, as the spleen's peak vitality disperses across the four seasons. Only when the spleen channel weakens do abnormal pulse signs become apparent.

When the pulse resembles a bird pecking (referred to as "Sparrow Pecking Pulse"), appearing large at the top and sharp at the bottom with a slippery quality, it indicates the kidney pulse overpowering the spleen channel—a sign of deficiency. If the pulse is like water dripping from a roof (known as "Roof Leakage Pulse"), beating intermittently with pauses, it signifies excessive kidney Qi encroaching on the spleen channel—a sign of excess. Both these abnormal pulse patterns reflect spleen deficiency.

The appearance of either the Sparrow Pecking Pulse or the Roof Leakage Pulse foretells the decline of the spleen channel.