The pulse may feel different when taken individually or collectively. Sometimes, it feels strong when taken individually but weak when taken collectively, or vice versa. It may feel thin when taken individually but large when taken collectively, or the opposite. If the pulse feels weak when taken individually but strong when taken collectively, it is likely a wiry and slippery pulse. When pressing with a single finger, the qi flows smoothly without obstruction, but when pressing with three fingers, the larger area pressed causes the qi to flow less smoothly, resulting in a stronger pulse when taken collectively. Conversely, if the pulse feels strong when taken individually but weak when taken collectively, it indicates a fundamentally weak pulse. The index finger is more sensitive, making the pulse feel stronger when pressed individually, while the middle and ring fingers are less sensitive, making the pulse feel weaker when pressed collectively. If the pulse feels thin when taken individually but large when taken collectively, it suggests a wiry and thin pulse with surrounding vibrations. When pressing collectively, the larger area pressed causes the vibrations to become more pronounced. If the pulse feels large when taken individually but thin when taken collectively, it indicates blood deficiency and qi dryness, with a thin and weak pulse accompanied by strong surrounding vibrations. The index finger, being more sensitive, can detect the vibrations, while the middle and ring fingers cannot. There are also cases where the pulse feels floating when taken individually but sinking when taken collectively, or vice versa. The floating sensation may be due to the surrounding vibrations. Alternatively, if the pulse is fundamentally weak, light pressure may not detect the pulsation, while heavier pressure may reveal it. Additionally, the physician's own pulse or the condition of their fingers (e.g., from prolonged standing or exertion) may interfere with the accuracy of the pulse diagnosis. In general, when there is a noticeable difference in size or strength between individual and collective pulse readings, the apparent excess is often a false indication. In healthy individuals, it may indicate a decline in healthy qi, while in patients, it may suggest that the healthy qi is unable to fully manifest the pathogenic qi, revealing only a faint trace. Such cases should be treated as deficiency-type pathogen conditions, avoiding excessive use of purging methods or assuming that the pathogenic qi is mild and focusing solely on tonification. For example, if the pulse feels large when taken collectively but thin when taken individually, the thinness often feels wiry and lacks significant fluctuation, indicating weakness in the middle qi. Conversely, if the pulse feels large when taken individually but thin when taken collectively, the thinness may feel rapid and slippery, suggesting insufficient qi to fully rise, indicating exhaustion of the middle qi. The same principles apply to strength and weakness. These patterns are often seen in individuals with weak constitutions, internal damage from overexertion, or prolonged exposure to pestilent qi, leading to blood exhaustion, chest tightness, and lack of energy. This reflects a condition where deficiency gives rise to excess, with clear and turbid qi mixed and qi depression.