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Huangdi asked Qibo: I wish to diagnose without observing the complexion or feeling the pulse, but solely by examining the cubit (chi) to determine the disease, understanding the internal from the external. How can this be done? Qibo replied: By carefully examining the relaxation, tension, size, smoothness, or roughness of the cubit, and the firmness or fragility of the flesh, the form of the disease can be determined.

• If one observes a person's eye socket with a slight swelling as if newly risen from sleep, with pulsation of the neck vessels, occasional coughing, and upon pressing the hands and feet, the depression does not rise, it indicates wind edema anasarca.
• If the skin of the cubit is smooth and moist, it indicates wind.
• If the flesh of the cubit is weak, it indicates lassitude; if one lies comfortably and the flesh is wasted, it indicates cold and heat, which is incurable.
• If the skin of the cubit is smooth and glossy, it indicates wind.
• If the skin of the cubit is rough, it indicates migratory impediment.
• If the skin of the cubit is coarse like the scales of a dried fish, it indicates water retention.
• If the skin of the cubit is very hot and the pulse is strong and agitated, it indicates a warm disease. If the pulse is strong and smooth, the disease is about to manifest.
• If the skin of the cubit is cold and the pulse is small, it indicates diarrhea and shortness of breath.
• If the skin of the cubit is first hot and then cold, it indicates cold and heat.
• If the skin of the cubit is first cold and then becomes hot after a long time, it also indicates cold and heat.
• If the elbow alone is hot, it indicates heat above the waist.
• If the hand alone is hot, it indicates heat below the waist.
• If the front of the elbow alone is hot, it indicates heat in the chest.
• If the back of the elbow alone is hot, it indicates heat in the shoulders and back.
• If the Bizhong alone is hot, it indicates heat in the waist and abdomen.
• If the area three to four inches below the back of the elbow is hot, it indicates worms in the intestines.
• If the palm is hot, it indicates heat in the abdomen.
• If the palm is cold in the middle, it indicates cold in the middle of the abdomen.
• If there are green blood vessels on the white flesh of the fish (thenar eminence), it indicates cold in the stomach.
• If the cubit is very hot and the Renying (ST9) pulse is large, it indicates blood loss.
• If the cubit is firm and large, and the pulse is very small, with increasing shortness of breath and distress, it indicates imminent death.

If the eyes are red, the disease is in the heart; if white, in the lungs; if green, in the liver; if yellow, in the spleen; if black, in the kidneys. If the color is yellow and cannot be named, the disease is in the chest. For eye pain, if the red vessels run from top to bottom, it is Taiyang disease; if from bottom to top, it is Yangming disease; if from outside to inside, it is Shaoyang disease. For diagnosing cold and heat, if red vessels run up and down to the pupil, seeing one vessel indicates death in one year; one and a half vessels, death in one and a half years; two vessels, death in two years; two and a half vessels, death in two and a half years; three vessels, death in three years. For diagnosing dental caries pain, pressing the yang (outer) side, if there is excess heat, it indicates heat on the left if on the left, on the right if on the right, above if above, below if below.

For diagnosing blood vessels, more red indicates more heat; more green indicates more pain; more black indicates long-standing bi (blockage). If red, black, and green are all seen, it indicates cold and heat with body pain, slightly yellow complexion, yellow tooth plaque, and yellow nails, indicating jaundice. If one lies comfortably with yellow-red urine and a small, rough pulse, it indicates lack of appetite.

In a sick person, if the pulse at the cus kou is equal in size and floating or sinking to the Renying (ST9) pulse, the disease is difficult to cure. In women, if the shaoyin pulse at the hand is very active, it indicates pregnancy. In infants, if all the head hair stands up, it indicates certain death. If green vessels appear between the ears, it indicates pulling pain; red stools indicate lienteric diarrhea; a small pulse with cold hands and feet indicates difficulty in curing. Lienteric diarrhea with a small pulse and warm hands and feet indicates easy recovery.

The changes of the four seasons and the alternation of cold and heat are due to extreme yin turning into yang and extreme yang turning into yin. Thus, yin governs cold and yang governs heat. Therefore, extreme cold leads to heat, and extreme heat leads to cold. Thus it is said: cold generates heat, and heat generates cold. This is the transformation of yin and yang. Thus it is said: injury by cold in winter leads to fever in spring; injury by wind in spring leads to lienteric diarrhea and dysentery in summer; injury by summer heat leads to malaria in autumn; injury by dampness in autumn leads to cough in winter. This is the sequence of the four seasons.