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Diseases have distinctions between life and death, and treatments vary in difficulty. Mild illnesses may heal without medication, while critical illnesses may remain incurable even with treatment. Why is this? It lies in the prosperity or decline of Yin and Yang, as well as the balance between pathogenic factors (Xie) and healthy Qi (Zheng). When healthy Qi is prosperous and pathogenic factors are weak, life is sustained; when Yin is prosperous and Yang is weak, death ensues.

In Taiyang disease (Taiyang syndrome), if Yang-pattern pulses such as Floating (Fu), Large (Da), Rapid (Shu), Agitated (Dong), or Slippery (Hua) are observed, recovery is likely and life is preserved; however, if Yin-pattern pulses such as Deep (Chen), Minute (Wei), Choppy (Se), Weak (Ruo), or Taut (Xian) are seen, the condition is difficult to treat and leads to death. For instance, persistent high fever where pathogenic factors are excessive and the pulse loses its "spirit" indicates deficiency of healthy Qi and excess of pathogens, which invariably signifies death. Similarly, in severe Yin-toxin or Yang-toxin conditions, hyperactivity reaches an extreme, preventing normal physiological transformation. Cases where complexion is withered and voice is hoarse indicate a dual depletion of internal and external essence. A form resembling smoke-darkened soot, accompanied by coma, fixed staring, and head shaking, indicates that Yang-pathogens alone remain and attack the Heart, leading to extinction. Blackening around the mouth, abdominal distension, unremitting diarrhea, soft sweating, and yellowish discoloration of the skin indicate failure of the Spleen (Pi Jue). A pulse that is merely floating, lacking Stomach Qi, accompanied by sweat like oil and ceaseless panting, indicates failure of the Lung (Fei Jue). Cyanosis of the lips and corners of the mouth, cold sweat on the four limbs, curled tongue, and retracted testicles indicate failure of the Liver (Gan Jue). A black, withered, and dirty facial complexion, elongated teeth, and incontinence of urine and feces indicate failure of the Kidney (Shen Jue). Other signs include the inability to ingest water or gruel, indicating loss of vital support; a Dai (intermittent) or San (scattered) pulse, indicating dispersion of true Qi; or incessant hiccups, indicating the failure of Yuan Qi to be contained.

Errors in treatment can also lead to fatal outcomes: mistakenly inducing sweat in Wind-Warmth diseases may result in Spasm (Jing); mistakenly inducing sweat in Damp-Warmth diseases results in Zhong Yue (severe heat stroke); forcibly inducing sweat in Shaoyin disease may disturb channel blood, causing bleeding from the mouth, nose, and eyes, termed Xia Jue Shang Jie (Lower Cold and Upper Exhaustion). Post-sweat delirium, refusal to eat, persistent fever unrelieved by sweating, and a rapid, restless pulse constitute Yang-Jiao-Yin (Yin-Yang Intersection), all of which are ominous signs of death.

If cold extremities do not recover, and after seven or eight days the entire body becomes cold with restlessness and no moment of peace, it is called Zang Jue (Visceral Cold Extremity), caused by extreme excess of Yin pathogens and flight of True Yang. In cases of severe cold extremities where the pulse is absent, formulas such as Sini Tang (Frigid Extremities Decoction) or Baitong Tang (White Cinnamon and Egg Yolk Decoction) are administered. If the pulse gradually returns, it indicates the gradual recovery of True Yang; if the pulse suddenly bursts forth, it is a sign of terminal lucidity (returning light before death).

Typically, cold extremities are accompanied by diarrhea and an inability to eat. If the patient suddenly gains the ability to eat, it is called Chu Zhong (Removal of the Middle). "Zhong" refers to the Stomach, and "Chu" means removal; this implies that Stomach Qi has been exhausted. Although the patient can eat, it does not nourish the Stomach. Thus, Zhang Zhongjing stated: "Death follows the Chu Zhong pattern." Any chronic illness where the patient cannot eat, but suddenly eats voraciously only to die shortly after, belongs to this category.