呼 出心 與 肺 exhalation rises to the heart and lung
四 難 forth difficulty
論 脈 explains that pulse 有 陰 陽 之 法 follows rules of yin and yang 四 難 曰 ：forth difficulty says 脈 有 pulse follows 陰 陽 之 法 ，rules of yin and yang 何 謂 也 ？ what does it mean 然 ： explanation 呼 出 exhalation rises to 心 與 肺 ，heart and lung 吸入 inhalation enters 腎 與 肝 ，into kidney and liver 呼 吸 之 間 ，between exhalation and inhalation 脾 受 is pancreas which 穀 味 也 ，receives food and flavors 其 脈 在 中 。its pulse is in the middle 浮 者 ，what is superficial 陽 也 ；is yang 沉 者 ，what is deep 陰 也 。is yin 故 曰 ：it is why we say 陰 陽 也 。yin and yang 心 肺 heart and lung 俱 浮 ，together are on surface 何 以 別 之 ？How differentiate them? 然 ：explanation 浮 而 大 散 者 ，superficial fu and large da dispercing san 心 也 ；are pulses of heart 浮 而 短 濇 者 ，superficial fu and short duan grating se 肺 也 。are pulses of the lung 腎 肝 kidney and liver 俱 沉 ，together are deep 何 以 別 之 ？how differentiate them? 然 ：explanation 牢 而 長 者 ，firm lao and long zhan 肝 也 ；are pulses of liver 按 之 濡 ，pressing down 舉 指 來 實 者 ，finger is rising from the bone 腎 也 。it is pulse of kidney 脾 者 中 州 ，pancreas is in the middle 故 其 脈在 中 ，it is why it's pulse is in the middle 是 陰 陽 之 法 也 。there are rules of yin and yang 脈 有 一 陰 一 陽 ，pulse may be one yin and one yang 一 陰 二 陽 ，may be one yin and two yang 一 陰 三 陽 ，may be one yin and three yang 有 一 陽 一 陰 ，may be one yang and one yin 一 陽 二 陰 ，may be one yang and two yin 一 陽 三 陰 。may be one yang and three yin 如 此 之 言 ，there is saying 寸 口 有 六 脈 cunkou has 6 pulsations 俱 動 邪 ？is it correct or wrong? 然 ：explanation 此 言 者 ，there is saying 非 有 六 脈 there aren't six pulsations 俱 動 也 ，all together 謂 浮 、but there are superficial fu 沉 、deep chen 長 、long zhang 短 、 short duan 滑、slippery hua 濇 也 。grating se 浮 者 ， 陽 也 。superficial is yang 滑 者 ， 陽 也 。slippery is yang 長 者 ， 陽 也 。long is yang 沉 者， 陰 也 。deep is yin 短 者 ， 陰 也 。short is yin 濇 者 ， 陰 也 。grating is yin 所 謂 so they say 一 陰 一 陽 者 ，one yin and one yang 謂 脈 來 沉 而 滑 也 ；meaning deep shen and slippery hua 一 陰 二 陽 者 ，one yin and two yang 謂 脈 來 沉 滑 而 長 也 ；meaning deep shen slippery hua and long zhang 一陰 三 陽 者 ，one yin and three yang 謂 脈 來 浮 滑 而 長 ，meaning superficial fu slippery hua and long zhang 時 一 沉 也 。occasionally deep 所 謂 一 陽 一 陰者 ，when say one yang one yin 謂 脈 來 浮 而 濇 也 ；meaning pulse is superficial fu and grating se 一 陽 二 陰 者 ，one yang and two yin 謂 脈 來 長 而 沉 濇 也；meaning pulse is long zhang and deep chen and grating se 一 陽 三 陰 者 ，one yang and three yin 謂 脈 來 沉 濇 而 短 ，meaning pulse is deep chen grating se and short duan 時 一 浮 也 。occasionally superficial 各 以 其 經 所 在 ，each pulse belongs to its meridian 名 病 逆 順 也 。which shows if disease exists or not |
Fourth difficulty of Nanjing, classic of difficult issues4th difficulty of NanJing explains that exhalation rises from kidney and liver to heart and lung. Inhalation enters into the kidney and liver from the heart and lung. Practitioners of archaic acupuncture palpate these pulse breaths on the wrist
It is an explanation of pulse's breathing mentioned in the first difficulty of NanJing. It may be controlled by pressure of the finger
Practitioner observes change of the pulse from one yang and one yin to one yang and three yin pressing the finger from the surface down. Pulse from superficial changes to the deep, keeping it's permanent characteristic as grating or choppy.
Practitioner observes change of the pulse from one yin and one yang to one yin and three yang releasing the finger from the depth to surface. Pulse from deep changes to superficial keeping it's permanent characteristic as slippery. It is known as explanation of pulse's breathing from the first difficulty of NanJing 
Acupuncture pulse diagnosis observes this characteristic of pulse's breathing during yin and yang periods. When one extremity produces inhalation and another one exhalation, this phenomena was used for successful needling for "stimulation" or "sedation"
You may be interested to know more about pulse's breathing as exhalation and inhalation for successful needling as ancient acupuncturists where doing thousands and thousands years ago, taking my seminar about acupuncture pulse diagnosis and related acupuncture treatments.
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Pulse Diagnosis For Practitioners from easy to difficult
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