又未知何脏阴阳先绝若阳气前绝阴气后竭者其人死身色必青阴气前绝阳气后竭者其人死身色必赤腋下温心下热也
青者木色肝肾皆阴也赤者火色心肺皆阳也腋下心下者阳之部温热者阳之气也
师曰寸脉下不至关为阳绝尺脉上不至关为阴绝此皆不治决死也若计其余命生死之期期以月节克之也
尺寸之脉发现于上下而气根于中焦中焦者所以升降阴阳而使之相交其脉现于关上若寸脉下不至关则阳根下断是谓阳
绝尺脉上不至关则阴根上断是谓阴绝此皆不治决死也此际虽生命之余耳若计算其余命生死之期期以月之节气克之如木弱
忌金火弱忌水一交金水之节气则死期至矣
伤寒咳逆上气其脉散者死谓其形损故也
咳逆上气是胃土上逆肺金不降肺主气而性收脉散者金气之不收也气败则死盖气所以薰肤而充身气散则骨枯肉陷而形
损故也
师曰脉病患不病名曰行尸以无王气卒眩仆不识人者短命则死人病脉不病名曰内虚以无谷神虽困无苦
脉病患不病名曰行尸以其脉病而无王气倘卒然眩仆不识人者值其人之短命则死矣人病脉不病者名曰内虚以其谷神之
不旺病在形骸而不在精神虽困无妨也
问曰上工望而知之中工问而知之下工脉而知之愿闻其说师曰病家人请云病患若发热身体疼病患自卧师到诊其脉沉而
迟者知其瘥也何以知之表有病者脉当浮大今脉反沉迟故知其愈也假令病患云腹内卒痛病患自坐师到脉之浮而大者知其瘥
也何以知之里有病者脉当沉而细今脉浮大故知其愈也
发热身痛自卧是表病也诊脉沉迟知表病瘥也以表有病者脉当浮大今不浮大而反沉迟故知其愈也腹痛是里病也诊脉浮
大知里病瘥也以里有病者脉当沉细今不沉细而反浮大故知其愈也(此提望闻问切之纲下章详发)
It is unknown which organ's Yin and Yang first ceased. If Yang Qi (vital energy) ceases first and Yin (substance/cooling energy) exhausts later, the deceased's body color will inevitably be green; if Yin ceases first and Yang exhausts later, the deceased's body color will be red, with warmth in the axillae and heat below the heart (epigastrium).
Green is the color of Wood; the Liver and Kidney both belong to Yin. Red is the color of Fire; the Heart and Lung both belong to Yang. The axillae and the area below the heart are regions of Yang; warmth and heat are manifestations of Yang Qi.
The Master said: If the Cun pulse (inch position) does not extend downward to the Guan position (bar position), it is called Yang Absence (Yang Jue); if the Chi pulse (cubit position) does not extend upward to the Guan position, it is called Yin Absence (Yin Jue). These are all untreatable conditions destined for death. If one calculates the remaining lifespan and the time of death, it is determined by the mutual overcoming relationships of the Five Phases during the monthly solar terms.
The Cun and Chi pulses manifest at the upper and lower ends, but the root of Qi lies in the Middle Jiao (middle burner). The Middle Jiao is responsible for ascending and descending Yin and Yang, causing them to intersect. The pulse should normally manifest at the Guan position. If the Cun pulse does not extend downward to the Guan, the root of Yang is severed at the bottom, which is termed Yang Absence. If the Chi pulse does not extend upward to the Guan, the root of Yin is severed at the top, which is termed Yin Absence. These are all untreatable conditions destined for death. At this stage, although there is a remnant of life, if one calculates the remaining lifespan and the time of death, it is inferred based on the mutual overcoming of the Five Phases in the monthly solar terms. For example, if Wood Qi is weak, it fears Metal; if Fire Qi is weak, it fears Water. Once the solar terms of Metal or Water arrive, the time of death arrives.
In Taiyang disease (Cold Damage), if there is coughing, rebellious Qi, and upward rushing of breath, and the pulse is scattered, it is a sign of death because the physical form has been damaged.
Coughing and rebellious Qi indicate that Stomach Earth Qi rebels upward, preventing Lung Metal Qi from descending. The Lung governs Qi and has a contracting nature. A scattered pulse indicates the loss of Metal Qi's contracting function. When Qi fails, death occurs. Qi functions to warm the skin and fill the body; when Qi scatters, bones become withered and muscles collapse, damaging the physical form, hence it is a sign of death.
The Master said: When the pulse indicates disease but the person appears healthy, it is called "Walking Corpse." If such a person suddenly suffers from vertigo and falls unconscious, and their lifespan is short, they will die. Conversely, when the person is diseased but the pulse appears normal, it is called "Internal Deficiency," due to the lack of Grain Spirit (Gu Shen, vital energy derived from food). Although distressed, they will suffer no harm.
"Pulse diseased, person healthy" is called "Walking Corpse" because the pulse shows pathology without vigorous Wang Qi (prosperous Qi). If sudden vertigo and unconsciousness occur, and the person's lifespan is short, they will die. "Person diseased, pulse healthy" is called "Internal Deficiency" because the Grain Spirit is not vigorous. The disease is in the physical form, not in the spirit/mind; thus, although distressed, there is no danger.
Question: An expert physician knows through observation (Wang), an average physician through inquiry (Wen), and a poor physician through palpation (Mai). I wish to hear the explanation. The Master said: If the patient's family reports fever and body pain, and the patient lies quietly, and upon examination, the pulse is deep and slow, one knows the disease is resolving. Why? Because for exterior diseases, the pulse should be floating and large. Now that it is instead deep and slow, one knows recovery has occurred. Suppose the patient reports sudden abdominal pain and sits quietly. Upon examination, the pulse is floating and large, one knows the disease is resolving. Why? Because for interior diseases, the pulse should be deep and fine. Now that it is instead floating and large, one knows recovery has occurred.
Fever, body pain, and lying quietly are signs of an exterior disease. Palpating a deep and slow pulse indicates the exterior disease is resolving. Since exterior diseases typically present with floating and large pulses, the absence thereof and the presence of deep and slow pulses indicate healing. Abdominal pain is an interior disease. Palpating a floating and large pulse indicates the interior disease is resolving. Since interior diseases typically present with deep and fine pulses, the absence thereof and the presence of floating and large pulses indicate healing. (This section outlines the principles of Observation, Listening/Smelling, Inquiry, and Palpation; the next chapter will elaborate in detail.)