When the pulse is tight in both Yin and Yang positions (Yin: cun, Yang: chi), the patient exhales hot air from the mouth, the lips and mouth are dry, the body curls up while lying down, the feet are cold, there is runny nose with clear mucus, and a slippery coating on the tongue. Do not treat recklessly at this time. If, after seven days, the person exhibits slight fever and warm hands and feet, this indicates that the disease is about to resolve. If, however, after eight days, there is severe fever instead, this is difficult to treat. If accompanied by aversion to cold, vomiting is inevitable; if accompanied by abdominal pain, diarrhea is inevitable.

Exterior cold binds externally, causing the pulse at both cun and chi positions to be tight. Tightness at the cun position indicates Yang constraint leading to upper heat, while tightness at the chi position indicates Yin constraint leading to lower cold. Upper heat causes hot breath, dry lips and mouth, runny nose, and slippery tongue coating; lower cold causes curling of the body and cold feet. In such cases, do not treat recklessly. Six days constitute one cycle of meridian qi. By the seventh day, if the person has slight fever and warm extremities, it means the exterior and interior cold pathogens have retreated, indicating the disease is about to resolve. If, after eight days, severe fever appears instead, it signifies that exterior and interior cold pathogens are abundant, and Yang Qi is constrained and forced to generate heat; this is difficult to treat. If accompanied by aversion to cold, exterior cold binding causes Stomach Qi constraint and rebellion, leading to vomiting. If accompanied by abdominal pain, interior cold coagulation causes Spleen Qi constraint and sinking, leading to diarrhea.

When the pulse is tight in both Yin and Yang positions, if vomiting or diarrhea occurs but the pulse remains tight without resolving, and the tightness disappears while the pulse becomes calm and harmonious, the disease is about to resolve. If the pulse becomes slow, and by the sixth or seventh day the patient loses appetite, this is a late onset due to water retention inside, so the disease has not resolved. If eating is normal, the disease is about to resolve.

When the pulse is tight in both Yin and Yang positions, constriction of meridians and stagnation of Fu organs lead to vomiting and diarrhea. At this point, the interior Qi relaxes and harmonizes, and the disease should resolve. However, if the tight pulse persists, the disease will not resolve. Only when the tight pulse disappears and the pulse becomes calm and harmonious does it indicate the disease is about to resolve. If the tight pulse disappears but the pulse becomes slow, and by the sixth or seventh day the patient loses appetite, this is a late onset due to internal water retention. Generally, excess Yin leads to a slow pulse; although there may be no obvious symptoms initially, disease will inevitably arise later, merely delayed. Since water retention inside invariably causes pathology, this is judged as unresolved. If the tight pulse disappears and appetite remains normal, it indicates no internal water retention, signifying the disease is about to resolve.

The Duzhong pulse (Stomach pulse) is floating and choppy, while the Shaoyin pulse (Kidney pulse) follows the regular pattern. The disease is located in the Spleen, and according to principles, diarrhea should occur. Why? If the pulse were floating and large, it would indicate Qi excess and Blood deficiency. Now, since the Duzhong pulse is floating and choppy, we know there is Spleen Qi insufficiency and Stomach Qi deficiency. The Shaoyin pulse being wiry and floating, when just appearing, is considered a balanced pulse, hence termed "like the classic" (following the norm). If it were instead slippery and rapid, we would know pus and blood would appear in the stool.

The Duzhong pulse being floating and choppy indicates abnormality in the Yangming pulse while the Shaoyin pulse remains normal ("jing" means normal). The pathology lies in the Spleen; Spleen disease typically manifests as sinking and diarrhea. Why? A floating and large pulse indicates Qi excess and Blood deficiency, representing Yang excess, which prevents Spleen disease. Since the Duzhong pulse is now floating and choppy rather than large, we know Spleen Qi is insufficient and Stomach Qi is deficient. Stomach Yang deficiency leads to Spleen Yin excess, causing the Spleen to sink and result in diarrhea. When Yang is excessive, the Fu-Yang governs and the Spleen is inactive, so the disease is in the Stomach; when Yin pathology prevails, the Zang-Yin governs and the Stomach is inactive, so the disease is in the Spleen. Regarding the Shaoyin pulse being wiry and floating: Shaoyin disease arises because Water fails to generate Wood, causing Wood to stagnate within Water, resulting in a wiry and floating pulse, which is an unbalanced Shaoyin pulse. A floating and choppy pulse is considered balanced, hence "like the classic." Shaoyin governs storage and consolidation; a choppy pulse reflects proper Zang Qi function. Choppy with floating indicates warm Water nurturing Wood Qi, which is the most harmonious Shaoyin pulse. If it were instead slippery and rapid, Wood stagnation would generate lower heat, damaging the Yin aspect and causing bloody purulent stools, which represents an abnormal Shaoyin pulse.