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According to the *Ling Shu* (Spiritual Pivot): Abdominal distension with body heat and a large pulse is the first adverse condition. Abdominal borborygmus accompanied by fullness, cold limbs, and diarrhea, with a large pulse, is the second adverse condition.
Nosebleed that does not stop, with a large pulse, is the third adverse condition. Coughing with hematuria and emaciation, with a small and forceful pulse, is the fourth adverse condition. Coughing, emaciation, body heat, and a small and rapid pulse are referred to as the fifth adverse condition. Those presenting thus will die within fifteen days.
If the abdomen is massively distended, extremities are cold, form is severely emaciated, and diarrhea is severe, this is the first adverse condition. Abdominal distension with hematochezia, where the pulse is large but intermittent (or desultory), is the second adverse condition. Coughing with hematuria, loss of flesh and muscle, and a surging pulse is the third adverse condition. Hematemesis, chest fullness radiating to the back, with a small and rapid pulse, is the fourth adverse condition. Coughing, vomiting, abdominal distension, accompanied by undigested food in stool (canalization diarrhea), and an absent pulse is the fifth adverse condition. Those presenting thus will die within one shichen (two hours).

Any case where both face and eyes are yellow yet lustrous; face yellow with red eyes; eyeballs bright and lustrous; various febrile diseases where spirit is clear and calm; deficiency syndromes that can tolerate tonification and allow for eating; critical illness where the Taichong point (LR3) still has a pulse; Qi tonification does not lead to collapse; fontanelle is not sunken; complexion and nail beds are not dull or dark—all these are treatable.

However, if the eyeballs lack luster, pupils do not rotate, nails, lips, and back are all black, crying without tears, or weeping when not crying, inability to retain milk while feeding, tongue protruding beyond the lips, sweat beading like pearls, lips unable to cover teeth, no saliva in the mouth, limbs hanging cold, passing black blood, making crow-like sounds, hoarseness in the throat, dry and black nose and mouth, cold hands, feet, nose, and mouth; face black with biting behavior, black nose with body heat, panting that cannot subside, sunken pupils, nostrils black like coal, cyanosis around eye sockets, legs straight with distended belly showing blue veins; black earlobes, lips cyanotic-black or bone-dry, red vessels crossing the pupil, fontanelle bulging or sunken, fish-mouth opening with tongue protrusion, inability to cry or silent crying, sunken or bulging chest, vomiting roundworms; green-black macules on the body, whole body cold, long sighing breaths; Shanghan (Cold Damage) with continuous medication but no sweat, any disease with collapse of the Tianzhu bone (neck); infant convulsions within 100 days of birth, recurring after remission, with black face and coma; white sclera with black face, or red face and eyes with sudden screaming, cyanotic face with black lips, or black face with fixed gaze; palm lines absent, lips everted, philtrum indistinct, picking at seams (fidgeting), sweating without flow, and rolled-up tongue; Yin-Jie and Yang-Jie syndromes with vacant gaze resembling trance; involuntary seminal emission or diarrhea, black teeth, delirious speech; sudden edema with pale black face; black hands, feet, nails, and muscles; hot vomiting with red eyes, diarrhea dripping like leaking roof water; pulse rootless, scrotum fully swollen; pale face and eyes with withered spirit; lack of luster in face, inability to eat, corpse-like odor; yellow face with black eyes, red face with black eyes, inability to close mouth, incessant moaning; chronic illness with emerging pustular spots; hair standing straight like hemp, swollen tongue with fright, flesh lacking normal color; convulsions with strabismus, twitching lips and mouth, stiff dorsum pedis, hands holding head posture, insensitivity to pain; mouth puckered like a bag, passage of red-black feces, head sweat with cold limbs, purple or swollen tongue and lips; cold scalp that remains depressed upon pressure; abnormal facial expressions, face looking painted; sound in abdomen immediately after swallowing medicine/food; sweat causing wet hair, body feeling washed; cyanosis entering eyes from eyebrows, connecting eyes to ears, entering nose and mouth; black encircling nose and mouth, cyanosis from eyebrows circling ears, cyanosis above nose with abdominal pain, black or white discoloration around ears, eyes, nose, and mouth; anhidrosis or hyperhidrosis; febrile disease with sweat but persistent heat; prolonged fasting followed by sudden double appetite; and any disease with loss of Da Rou (large muscles of thighs/buttocks), Tong Du (passing through) of the Three Passages (San Guan) pattern in the Tiger's Mouth; blue or purple veins along hairline like chaotic patterns; chaotic blue-purple or purple-black patterns on upper and lower eyelids; a single blue-black vein straight from the coccyx into the temples; face color like dead chicken liver, or blue without blood luster; mouth, nose, ears, tongue like earth, sunken and dull eyeballs; purple-black nostrils, short retracted tongue, scorched yellow or black lips; sclera suddenly fiery red, posterior head swollen red like an egg; constant cyanosis of lips, mouth, nose; upward-turned nasal tip with numerous blue-black reticular veins; all these are untreatable.

The secret for predicting the day of death relies on: ears belonging to Kidney, nose to Lung, lips to Spleen, tongue to Heart, eyes to Liver. If signs appear in the Liver sector, avoid Geng-Xin days (Metal days); if in the Lung sector, avoid Bing-Ding days (Fire days); if in the Heart sector, avoid Ren-Gui days (Water days); if in the Spleen sector, avoid Jia-Yi days (Wood days); if in the Kidney sector, avoid Wu-Ji days (Earth days). This deduces the extinction of the Five Elements to verify prognosis. However, observation methods are numerous and detailed in their respective sections.