者，死（转豆者，心真脏脉。偃刀者，肝真脏脉。忽去忽来者，脾真脏脉也）。三部脉如釜中
汤沸，朝得暮死，半夜得日中死，日中得半夜死。
〔《难》〕寸口脉平而死者，何谓也？然，诸十二经脉者，皆系于生气之原。所谓生气之
原者，谓十二经之根本也，谓肾间动气也，此五脏六腑之本，十二经脉之根，呼吸之门，三
焦之原，一名守邪之神。故气者，人之根本也，根绝则茎叶枯矣。寸口脉平死者，生气独绝
于内也。（《八难》谓两手寸关尺脉皆平而难也）
〔《素》〕五脏相通，移皆有次，五脏有病，则各传其所胜。不治，法三月若六月，若三
日若六日，传五脏而当死。风者，百病之长也。今风寒客于人，使人毫毛毕直，皮肤闭而为
热，当是之时，可汗而发也。或痹不仁肿痛，当是之时，可汤熨及火灸，刺而去之。弗治，
病入舍于肺，名曰肺痹，发咳上气。弗治，肺即传而行之肝，病名曰肝痹，一名曰厥，胁痛
出食，当是之时，可按若刺耳。弗治，肝传之脾，病名曰脾风，发瘅，腹中热，烦心，出黄
，当此之时，可按可药可浴（王注云∶出黄谓黄色出于便泻之所是也）。弗治，脾传之肾，病
名曰疝瘕，少腹冤热而痛，出白，一名曰蛊，当此之时，可按可药。弗治，肾传之心，病筋
脉相引而急，病名曰 ，当此之时，可灸可药。弗治，满十日者法当死。肾因传之心，心即
复反传而行之肺，发寒热，法当三岁死，此病之次也。然其卒发者，不必治于传，或其传化
有不以次，不以次入者，忧恐悲喜怒，令不得以其次，故令人有大病矣。因而喜大虚则肾气
乘矣，怒则肝气乘矣，悲则肺气乘矣，恐则脾气乘矣，忧则心气乘矣，此其道也。故病有五
，五五二十五变，及其传化。传，乘之名也。（《玉机真藏论》）
上邪初入表，盖传之缓者也。
夫病传者，心病先心痛，一日而咳（心火传肺金也）。三日胁支痛（肺金传肝木也），五日
闭塞不通，身痛体重（肝木传肺金也），三日不已死，冬夜半，夏日中。肺病喘咳，三日而胁
支满痛（肺金传肝木也），一日身重体痛，五日而胀（肝木一日传脾土，脾五日传胃也）。十日
不已死，冬日入，夏日出。肝病头目眩，胁支满，三日体重身痛，五日而胀（肝木三日传脾
土，脾五日传胃也），三日腰脊少腹痛，胫酸（脾胃土传肾水也），三日不已死，冬日入，夏
早食。脾病身痛体重，一日而胀，（脾自传胃），二日少腹腰脊痛，胫酸。三日背KT 筋痛
，小便闭（脾土三日传肾水，肾三日传膀胱也），十日不已死，冬人定，夏晏食。肾病少腹腰
脊痛， 酸，三日背KT 筋痛，小便闭（肾传膀胱也）。三日腹胀（膀胱水传小肠火也）
，三日两胁支痛（小肠传心也，两胁恐错），二日不已死，冬大晨，夏晏晡。胃病胀满，五日
少腹腰脊痛， 酸（胃土传肾水也）。三日背KT 筋痛，小便闭（肾传膀胱也）。五日身
体重（膀胱水传心火，身体重亦错简），六日不已死，冬夜半后，夏日 。膀胱病小便闭
，五日少腹胀腰脊痛， 酸（膀胱传肾也）。一日腹胀（肾水传小肠火也），二日身体痛
（小肠传心也，身体痛亦错简）。二日不已死，冬鸡鸣，夏下晡。诸病以次是（《灵枢》无“
是”字）。相传如是者，皆有死期。不可刺，间一脏止（《灵枢》无止字）。及至三四脏者，
乃可刺也。（《标本病传论》）
上《灵枢》谓之大气入脏，盖传之急者也。王注云∶有缓传者，有急传者，缓者或一岁
、二岁、三岁而死，其次或三月若六月而死。急者一日、二日、三日、四日或五、六日而死
，则此类也。王氏此言，甚能推展经意，然不能验日数者，但验病之次传。如心先病心痛，
次传于肺，或咳或喘。次传于肝，或胁痛，或头眩。次传于脾胃，或闭塞不通，或身痛体重
，或胀或泄。次传于肾膀胱，或少腹腰脊痛，胫酸，或背KT 筋痛，小便闭。如此曰必死
无疑，累验有准。邻人赵氏，始肝病胁痛半载，次传之脾，腹胀而死。又卜叔英嫂氏，始肺
病咳喘，次传之肝，头眩不寐。次传之脾，腹胀而死。又杨白鹿师，始脾病腹痛，次传之膀
胱，小便淋闭。次传之心，胸痹痛，通身青脉而死矣，盖心主血脉故也。
〔《难》〕经言七传者，死；间脏者，生，何谓也？然，七传者，传其所胜也。间脏者，
传其子也。何以言之。假令心病传于肺，肺传于肝，肝传于脾，脾传于肾，肾传于心，一脏
不再伤，故言七传者，死也。间脏者，传其所生也，假令心病传脾，脾传肺，肺传肾，肾传
肝，肝传心，是母子自相传，周而复始，如环之无端，故言生也。（《五十三难》）
经言者，《素问》《灵枢》二经之病传论所言也。七传当作次传，次传者，死，即《素
》《灵》二经病传论言诸病以次相传，皆有死期，不可刺者是也。心火传所胜之肺金，肺金
传所胜之肝木，故曰传其所胜也。间脏者，生，即《素》《灵》二经病传论言间一脏及至三
四脏乃可刺者是也。盖心病本传肺，肺本传肝，肝本传脾。今心病间肺一脏传肝，或间肺肝
二脏传脾，肝木生心火，心火生脾土，故曰传其所生也。《难经》诸证，惟吕广释七传为次
传，为得经旨，虞庶父非是注而穿凿释之，实秦越人吕广之罪人也。
〔《活》〕伤寒入里，见标脉则生，假令胃病下之，脉浮而汗出是也。杂病出表，见标脉
则死，假令脾病补之，脉弦而面青者是也。
〔《素》〕九候之脉，皆沉细悬绝者为阴，主冬，故以夜半死。盛躁喘数者为阳，主夏，
故以日中死。寒热病者，以平旦死。热中及热病者，以日中死。病风者，以日夕死。病水者
，以夜半死。脉乍疏乍数乍迟乍疾者，日乘四季死（《三部九候论》）。肝见庚辛死，心见壬
癸死，脾见甲乙死，肺见丙丁死，肾见戊己死，是谓真藏见皆死（《平人气象论》）。五脏受
气于其所生，传之于其所胜，气舍于其所生，死于其所不胜。病之且死，必先传行，至其所
不胜，病乃死。此言气之逆行也，故死。（同下）
肝受气于心，传之于脾，气舍于肾，至肺而死。
缓者，秋死；急者，庚辛日及日晡死是也。
心受气于脾，传之于肺，气舍于肝，至肾而死。
缓者，冬死；急者，壬癸日及夜半死也。
脾受气于肺，传之于肾，气舍于心，至肝而死。
缓者，春死；急者，甲乙日及朝死也。
肺受气于肾，传之于肝，气舍于脾，至心而死。
缓者，夏死；急者，丙丁日及日中死也。
肾受气于肝，传之于心，气舍于肺，至脾而死。
缓者，长夏死；急者，戊己日及戌辰丑未死也。
此皆逆死也，一日一夜五分之，此所以占死生之早暮也。（《玉机真藏论》《甲乙经》
“死生”作“死者”。一日一夜五分之，谓朝主肝，昼主心，辰戌丑未主脾，晡主肺，夜主
肾也）
大骨枯槁，大肉陷下，胸中气满，喘息不便，其气动形，期六月死。真脏脉见，乃予之
期日。（王注云∶皮肤干着，骨间肉陷，谓人骨枯槁，大肉陷下也。真脏脉形见前按脉条）
大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，期一月死。真脏见，乃予之
期日。
大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，身热，脱肉破 ，真脏
见，十月之内死。（王注云∶ 谓肘膝后肉也如块者。 ，渠损切）
大骨枯槁，大肉陷下，肩髓内消，动作益衰，真脏未见，期一岁死。见其真脏，乃予之
期日（王注云∶肩髓内消，谓缺盆深也。动作衰，谓交接微也）。
大骨枯槁，大肉陷下，胸中气满，腹内痛，心中不便，肩项身热，破 脱肉，目眶
陷，真脏见，目不见人，立死。其见人者，至其所不胜之时则死。急虚身中卒至，五脏绝闭
，脉道不通，气不往来，譬于堕溺，不可为期。其脉绝不来，若人一息五六至，其形肉不脱
，真脏虽不见，犹死也。（林注云∶一息当作一呼。以上并《玉机真脏论》）
〔《灵》〕是故怵惕思虑者则伤神，神伤则恐惧，流淫而不止。因悲哀动中者，竭绝而失
生。喜乐者，神惮散而不藏。愁忧者，气闭塞而不行。盛怒者，迷惑而不治。恐惧者，神荡
惮而不收。（《本神篇》。下同）
心怵惕思虑则伤神，神伤则恐惧自失，破 脱肉，毛悴色夭，死于冬。
脾忧愁而不解则伤意，意伤则 乱，四肢不举，毛悴色夭，死于春。
肝悲哀动中则伤魂，魂伤则狂忘不精，不精则不正，当人阴缩而挛筋，两胁骨不举，毛
悴色夭，死于秋。
肺喜乐无极则伤魄，魄伤则狂，狂者意不存人，皮革焦，毛悴色夭，死于夏。
肾盛怒而不止则伤志，志伤则喜忘其前言，腰脊不可以俯仰屈伸，毛悴色夭，死于季夏
。
恐惧而不解则伤精，精伤则骨酸痿厥，精时自下，是故五脏主藏精者也，不可伤，伤则
失守而阴虚，阴虚则无气，无气则死矣。
〔《素》〕瞳子高者，太阳不足。戴眼者，太阳已绝。此决死生之要，不可不察。（《三
部九候论》。下同）
足太阳气绝者，其足不可屈仲，死必戴眼。太阳之脉，其终也，戴眼反折螈 ，其
色白，绝汗乃出，出则死矣。（《诊要经终篇》。下同。凡痫 亦戴眼，灸昆仑穴，即
随下不戴也。若灸昆仑仍眼戴不下者，是为太阳终也。王注∶绝汗谓出汗如珠不流复旋干也
）
少阳终者，耳聋，百节皆纵，目HT 绝系，绝系一日半死。其死也色先青白，乃死矣
。（HT 音琼。王注云∶目HT ，谓直视如惊貌）
阳明终者，口目作动，善惊妄言，色黄，其上下经盛不仁，则终矣。（王注云∶经盛谓
面目颈额足跗腕胫皆躁盛而动也。不仁谓不知善恶也）
少阴终者，面黑齿长而垢，腹胀闭，上下不通而终矣。（面黑者手少阴绝，齿长者足少
阴绝）
太阴终者，腹胀闭不得息，善噫善呕，呕则逆，逆则面赤，不逆则上下不通，不通则面
黑，皮毛焦而终矣。
厥阴终者，中热嗌干，善溺心烦，甚则舌卷卵上缩而终矣。此十二经之所败也。
〔《灵》〕手太阴气绝，则皮毛焦。太阴者，行气温于皮毛者也。故气不荣则皮毛焦，皮
毛焦则津液去皮节，津液去皮节者，则爪枯毛折，毛折者则毛先死。丙笃丁死，火胜金也。
（《经脉篇》。下同）
手少阴气绝，则脉不通，脉不通则血不流，血不流则髦色不泽，故其面黑如漆柴者，血
先死。壬笃癸死，水胜火也。
足太阴气绝者，则脉不荣肌肉，唇舌者，肌肉之本也。脉不荣则肌肉软，肌肉软则舌痿
，人中满，人中满则唇反，唇反者肉先死。甲笃乙死，木胜土也。
足少阴气绝则骨枯，少阴者，冬脉也，伏行而濡骨髓者也，故骨不濡则肉不能着也。骨
肉不相亲，则肉软却，肉软却故齿长而垢，发无泽，发无泽者骨先死。戊笃己死，土胜水也
。
足厥阳气绝，则筋绝。厥阴者，肝脉也。肝者筋之合也，筋者聚于阴器而脉络于舌本，
故脉弗荣则筋急，筋急则引舌与卵，故唇青舌卷卵宿，则筋先死。庚笃辛死，金胜木也。
五阴气俱绝则目系转，转则目运。目运者为志先死，志先死则远一日半死矣。六阳气绝
则阴与阳相离，离则腠理发泄，绝汗乃出，故旦占夕死，夕占旦死。
仲∶脉浮而洪，身汗如油，喘不休，水浆不下，体形不仁，乍静乍乱者，此为命门绝也
，又未知何脏先受其灾。若汗出发润，喘不休者，此为肺先绝也。阳反独留，形体如烟煤，
直视摇头者，此为心绝也。唇吻反青，四肢 汗出者，此为肝绝也。环口黧黑
，柔汗发黄者，此为脾绝也。溲便遗屎，狂言，目反直视者，此为肾绝也。又未知何脏阴阳
相绝，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
黄，腋下温，心下热也。六腑气绝于外者，手足寒，上气脚缩。五脏气绝于内者，利不禁，
下甚，手足不仁。
〔《脉》〕病患肝绝，八日死。何以知之？面青但欲伏眠，目视而不见人，汗出如水不止（
一云∶二日死也）。病患胆绝，七日死，何以知之？眉为之倾。病患筋绝，九日死，何以知之
？手足爪甲青，呼骂不休（一云∶八日死）。病患心绝，一日死，何以知之？肩息回视立死（一
云∶目停停二日死）。病患肠绝，六日死，何以知之？发直如干麻，不得屈伸，自汗不止（一
云∶小肠绝）。病患脾绝，十二日死，何以知之？口冷足肿，腹热胪胀，泄利不觉，出无时
度（一云∶五日死）。病患胃绝，五日死，何以知之？脊痛腰中重，不可反复（一曰∶腓肠平，
九日死）。病患肉绝，六日死，何以知之？耳干舌背肿，溺血，大便赤泄（一曰∶足肿九日死）
。病患肺绝，三日死，何以知之？口张，但气出而不还（一曰∶鼻口虚张短气）。病患大肠绝
不治，何以知之？泄痢无度，痢绝则死。病患肾绝，四日死，何以知之？齿为暴枯，面为正黑
Those pulse conditions indicate death (The Zhuan Dou pulse is the Zang True Pulse of the Heart. The Yan Dao pulse is the Zang True Pulse of the Liver. The Hu Qu Hu Lai pulse is the Zang True Pulse of the Spleen). When the pulses in the three positions are like boiling soup in a pot, if obtained in the morning, death occurs in the evening; if obtained at midnight, death occurs at noon; if obtained at noon, death occurs at midnight.
[Nan Jing] Why does one die when the Cun Kou pulse is peaceful? The response is: All twelve regular meridians are connected to the Source of Vital Qi. What is called the Source of Vital Qi is the root of the twelve meridians, also known as the Moving Qi between the Kidneys. This is the root of the five Zang and six Fu organs, the foundation of the twelve meridians, the gate of respiration, and the source of the San Jiao (Triple Burner), also named the Spirit that Guards against Pathogens. Therefore, Qi is the root of human life; if the root is severed, the stems and leaves wither. If the Cun Kou pulse appears peaceful yet the patient dies, it is because the Source of Vital Qi has independently perished within. (Ba Nan states that even if the pulses at the Cun, Guan, and Chi positions on both hands are peaceful, the condition remains difficult.)
[Su Wen] The five Zang organs are interconnected, and their transmission follows a specific order. When disease affects the five Zang organs, it transmits to the organ it overcomes. If untreated, according to the law, death will occur after three or six months, or three or six days, once the disease has transmitted through all five Zang organs. Wind is the leader of a hundred diseases. Now, when wind-cold invades the person, causing all body hairs to stand erect and skin pores to close resulting in heat, at this time, sweating methods can be used to release it. Or if Bi syndrome (obstruction) with numbness, swelling, and pain occurs, at this time, herbal baths, hot compresses, moxibustion, and acupuncture can be used to eliminate it. If untreated, the pathogen enters the Lung, named Fei Bi (Lung Obstruction), manifesting as cough and rebellious Qi. If untreated, the Lung disease transmits to the Liver, named Gan Bi (Liver Obstruction), also known as Jue, with hypochondriac pain and vomiting of food. At this time, massage or ear acupuncture can be used. If untreated, Liver disease transmits to the Spleen, named Pi Feng (Spleen Wind), manifesting as jaundice, abdominal heat, vexation, and yellow urine (Wang Bing's commentary explains: "Yellow urine" refers to yellow discharge from defecation). If untreated, Spleen disease transmits to the Kidney, named Shan Jia (Hernia Mass), with painful, burning oppression in the lower abdomen and white discharge, also known as Gu. At this time, massage or medication can be used. If untreated, Kidney disease transmits to the Heart, manifesting as pulling and acute contraction of sinews and vessels, named [Missing Character]. At this time, moxibustion or medication can be used. If untreated, after ten days, death should occur according to the law. After Kidney disease transmits to the Heart, the Heart disease reversely transmits to the Lung, manifesting as chills and fever, and death should occur after three years. This is the order of disease transmission. However, for sudden onset cases, treatment need not follow the transmission order, or if the transformation does not follow the sequence, due to emotions such as worry, fear, grief, joy, and anger preventing normal sequential transmission, severe disease arises. Excessive joy causes Heart Qi deficiency, allowing Kidney Qi to invade; excessive anger allows Liver Qi to invade; excessive grief allows Lung Qi to invade; excessive fear allows Spleen Qi to invade; excessive worry allows Heart Qi to invade. This is the principle. Thus, there are five types of disease, twenty-five transformations, and their transmission. Transmission is the name for invasion. (Yu Ji Zhen Zang Lun)
The above refers to initial pathogenic invasion at the exterior level, which is a slower type of transmission.
Regarding disease transmission: Heart disease first presents with heart pain, transmitting to the Lung after one day causing cough (Heart Fire transmits to Lung Metal). After three days, hypochondriac distension and pain occur (Lung Metal transmits to Liver Wood). After five days, obstruction and blockage with body pain and heaviness occur (Liver Wood transmits to Lung Metal). If not resolved in three days, death occurs, dying at midnight in winter or noon in summer. Lung disease presents with wheezing and cough, transmitting to the Liver after three days causing hypochondriac fullness and pain (Lung Metal transmits to Liver Wood). After one day, body heaviness and pain occur; after five days, abdominal distension occurs (Liver Wood transmits to Spleen Earth in one day, Spleen Earth transmits to Stomach in five days). If not resolved in ten days, death occurs, dying at sunset in winter or sunrise in summer. Liver disease presents with dizziness and vertigo, hypochondriac fullness, transmitting to the Spleen after three days causing body heaviness and pain, and abdominal distension after five days (Liver Wood transmits to Spleen Earth in three days, Spleen Earth transmits to Stomach in five days). After three days, lower abdominal, lumbar, and spinal pain with calf soreness occur (Spleen-Stomach Earth transmits to Kidney Water). If not resolved in three days, death occurs, dying at sunset in winter or early meal time in summer. Spleen disease presents with body pain and heaviness, transmitting to the Stomach after one day causing abdominal distension. After two days, lower abdominal, lumbar, and spinal pain with calf soreness occur. After three days, back [Missing Character] tendon pain and urinary retention occur (Spleen Earth transmits to Kidney Water in three days, Kidney Water transmits to Bladder in three days). If not resolved in ten days, death occurs, dying at Ren Ding hour in winter or Yan Shi hour in summer. Kidney disease presents with lower abdominal, lumbar, and spinal pain, [Missing Character] soreness, transmitting to the Bladder after three days causing back [Missing Character] tendon pain and urinary retention. After three days, abdominal distension occurs (Bladder Water transmits to Small Intestine Fire). After three days, bilateral hypochondriac distension and pain occur (Small Intestine transmits to Heart; "bilateral hypochondriac" may be a textual error). If not resolved in two days, death occurs, dying at Da Chen hour in winter or Yan Bu hour in summer. Stomach disease presents with abdominal fullness, transmitting to the Kidney after five days causing lower abdominal, lumbar, and spinal pain, [Missing Character] soreness (Stomach Earth transmits to Kidney Water). After three days, back [Missing Character] tendon pain and urinary retention occur (Kidney transmits to Bladder). After five days, body heaviness occurs (Bladder Water transmits to Heart Fire; "body heaviness" may also be a textual error). If not resolved in six days, death occurs, dying after midnight in winter or [Missing Character] hour in summer. Bladder disease presents with urinary retention, transmitting to the Kidney after five days causing lower abdominal distension, lumbar and spinal pain, [Missing Character] soreness (Bladder transmits to Kidney). After one day, abdominal distension occurs (Kidney Water transmits to Small Intestine Fire). After two days, body pain occurs (Small Intestine transmits to Heart; "body pain" may also be a textual error). If not resolved in two days, death occurs, dying at Ji Ming hour in winter or Xia Bu hour in summer. Various diseases transmit in this sequence (Ling Shu lacks the character "Shi"). Such sequential transmission always has a fixed time of death. Acupuncture is contraindicated; stop transmission by skipping one Zang organ (Ling Shu lacks the word "stop"). Only when transmission reaches three or four Zang organs can acupuncture be applied. (Biao Ben Bing Chuan Lun)
The above, referred to in Ling Shu as "Large Qi entering the Zang," represents a rapid type of transmission. Wang Bing commented: There are slow transmissions and rapid transmissions. Slow transmissions may result in death after one, two, or three years, or three or six months. Rapid transmissions may result in death after one, two, three, four, five, or six days. This covers such cases. Wang's statement well expands upon the classic meaning, though it cannot verify exact days, only the order of transmission. For example, Heart disease starts with heart pain, then transmits to the Lung causing cough or wheezing. Then transmits to the Liver causing hypochondriac pain or dizziness. Then transmits to the Spleen and Stomach causing obstruction, body pain/heaviness, distension, or diarrhea. Then transmits to the Kidney and Bladder causing lower abdominal/lumbar/spinal pain, calf soreness, back [Missing Character] tendon pain, or urinary retention. In such cases, death is inevitable and verified repeatedly. Neighbor Zhao suffered from Liver disease with hypochondriac pain for half a year, then transmitted to the Spleen, dying of abdominal distension. Also, Aunt Bu Shuying initially had Lung disease with cough and wheezing, then transmitted to the Liver causing dizziness and insomnia. Then transmitted to the Spleen, dying of abdominal distension. Also, Teacher Yang Bailu initially had Spleen disease with abdominal pain, then transmitted to the Bladder causing dysuria and retention. Then transmitted to the Heart causing chest Bi pain, turning blue all over, and dying, because the Heart governs blood vessels.
[Nan Jing] The classic says "Seven Transmissions lead to death; Inter-Zang transmissions lead to survival." What does this mean? The answer is: Seven Transmissions refer to transmitting to the organ it overcomes. Inter-Zang transmission refers to transmitting to the organ it generates. Why say this? Suppose Heart disease transmits to the Lung, Lung to the Liver, Liver to the Spleen, Spleen to the Kidney, and Kidney back to the Heart. Each Zang is injured only once, hence "Seven Transmissions lead to death." Inter-Zang transmission involves transmitting to what it generates. Suppose Heart disease transmits to the Spleen, Spleen to the Lung, Lung to the Kidney, Kidney to the Liver, and Liver back to the Heart. This is mother-son mutual transmission, cycling endlessly like a ring without beginning or end, hence "leads to survival." (Wu Shi San Nan)
The term "Classic" refers to the disease transmission theories in Su Wen and Ling Shu. "Seven Transmissions" should be read as "Sequential Transmission." Sequential transmission leads to death, referring to the theory in Su Wen and Ling Shu that diseases transmitted sequentially all have a death time and are unsuitable for acupuncture. Heart Fire transmits to its overcome Lung Metal, Lung Metal transmits to its overcome Liver Wood, hence "transmitting to what it overcomes." Inter-Zang transmission leads to survival, referring to the theory in Su Wen and Ling Shu that skipping one Zang or reaching three/four Zangs makes acupuncture suitable. Generally, Heart disease transmits to Lung, Lung to Liver, Liver to Spleen. Now, if Heart disease skips Lung to transmit to Liver, or skips Lung and Liver to transmit to Spleen, since Liver Wood generates Heart Fire and Heart Fire generates Spleen Earth, it is called "transmitting to what it generates." Among explanations in Nan Jing, only Lu Guang's interpretation of Seven Transmissions as Sequential Transmission aligns with the classic intent. Yu Shu's father was incorrect in his annotation, offering forced interpretations, making him a sinner to Qin Yueren (Bian Que) and Lu Guang.
[Huo Ren Shu] When Shang Han (Cold Damage) enters the interior, seeing the Biao (Exterior/Mark) pulse indicates survival. For example, treating Stomach disease with purgatives results in a floating pulse and sweating. When Za Bing (Miscellaneous Diseases) exits to the exterior, seeing the Biao pulse indicates death. For example, tonifying Spleen disease results in a wiry pulse and green face.
[Su Wen] When all nine pulse positions are deep, thin, and suspended/cut off, they are Yin pulses, associated with Winter, so death occurs at midnight. When they are vigorous, restless, panting, and rapid, they are Yang pulses, associated with Summer, so death occurs at noon. Those with cold-heat diseases die at dawn. Those with internal heat or heat diseases die at noon. Those with wind diseases die at dusk. Those with water diseases die at midnight. Pulses that are suddenly sparse, rapid, slow, or fast die during the transition periods of the four seasons (San Bu Jiu Hou Lun). Liver dies on Geng/Xin days, Heart on Ren/Gui days, Spleen on Jia/Yi days, Lung on Bing/Ding days, Kidney on Wu/Ji days. This is called True Zang appearance, all indicating death (Ping Ren Qi Xiang Lun). The five Zang receive Qi from what generates them, transmit to what they overcome, store Qi in what generates them, and die from what overcomes them. Before death, disease must transmit until it reaches the organ it cannot overcome, then death occurs. This describes reverse Qi movement, hence death. (Same source)
Liver receives Qi from Heart, transmits to Spleen, stores Qi in Kidney, and dies at Lung.
Slow death: Autumn; Rapid death: Geng/Xin days or Shen hour (3-5 PM).
Heart receives Qi from Spleen, transmits to Lung, stores Qi in Liver, and dies at Kidney.
Slow death: Winter; Rapid death: Ren/Gui days or Zi hour (11 PM-1 AM).
Spleen receives Qi from Lung, transmits to Kidney, stores Qi in Heart, and dies at Liver.
Slow death: Spring; Rapid death: Jia/Yi days or Mao hour (5-7 AM).
Lung receives Qi from Kidney, transmits to Liver, stores Qi in Spleen, and dies at Heart.
Slow death: Summer; Rapid death: Bing/Ding days or Wu hour (11 AM-1 PM).
Kidney receives Qi from Liver, transmits to Heart, stores Qi in Lung, and dies at Spleen.
Slow death: Late Summer; Rapid death: Wu/Ji days or Xu/Chen/Chou/Wei hours.
These are all reverse deaths. Dividing a day and night into five parts allows predicting early or late death. (Yu Ji Zhen Zang Lun / Jia Yi Jing reads "death" instead of "life and death". Dividing a day into five parts means: Morning governs Liver, Day governs Heart, Xu/Chen/Chou/Wei hours govern Spleen, Shen hour governs Lung, Night governs Kidney).
When the large bones are withered and large muscles are sunken, chest Qi is full, breathing is difficult, and movement agitates the form, death is expected in six months. Appearance of the True Zang pulse confirms the date. (Wang Bing commentary: Skin dry and adhering, muscle sinking between bones indicates withered bones and sunken large muscles. True Zang pulse forms seen in previous pulse sections).
When large bones are withered and large muscles are sunken, chest Qi is full, breathing is difficult, internal pain radiates to shoulders and neck, death is expected in one month. Appearance of True Zang pulse confirms the date.
When large bones are withered and large muscles are sunken, chest Qi is full, breathing is difficult, internal pain radiates to shoulders and neck, body heat, flesh wasting and breaking [Missing Character], appearance of True Zang pulse indicates death within ten months. (Wang Bing commentary: [Missing Character] refers to flesh behind elbows and knees like lumps. Pronunciation: Qu Sun Qie).
When large bones are withered and large muscles are sunken, shoulder marrow internally diminishes, movement declines further, True Zang pulse not yet seen, death is expected in one year. Appearance of True Zang pulse confirms the date. (Wang Bing commentary: Shoulder marrow diminishing refers to deep clavicular fossa. Movement decline refers to weak sexual intercourse).
When large bones are withered and large muscles are sunken, chest Qi is full, abdominal pain, heart discomfort, shoulder/neck/body heat, flesh wasting and breaking [Missing Character], eye sockets sunken, appearance of True Zang pulse, eyes unable to see people, immediate death. If able to see people, death occurs at the time of the organ it cannot overcome. Sudden extreme deficiency and abrupt illness, five Zang closure, meridian blockage, Qi stagnation, similar to falling or drowning, cannot predict time. If pulse stops completely, or one breath has five to six beats, if flesh is not wasted and True Zang pulse not seen, still indicates death. (Lin Yi commentary: One breath should be one exhalation. Above all from Yu Ji Zhen Zang Lun).
[Ling Shu] Therefore, fright and worry injure Shen (Spirit). Shen injury causes fear, leading to uncontrolled leakage. Sorrow moving internally exhausts and loses life. Joy scatters Shen preventing storage. Worry closes Qi preventing circulation. Extreme anger causes confusion and disorder. Fear agitates Shen preventing gathering. (Ben Shen Pian. Same below)
Heart fright/worry injures Shen; Shen injury causes fear and loss of control, flesh wasting, hair withering and complexion dull, dying in Winter.
Spleen worry unresolved injures Yi (Intellect); Yi injury causes [Missing Character] disorder, limbs unable to lift, hair withering and complexion dull, dying in Spring.
Liver sorrow moving internally injures Hun (Ethereal Soul); Hun injury causes madness and forgetfulness, lack of precision leading to deviation, genital retraction and tendon contraction, inability to raise bilateral ribs, hair withering and complexion dull, dying in Autumn.
Lung extreme joy injures Po (Corporeal Soul); Po injury causes madness, madness lacking regard for others, skin/fur scorched, hair withering and complexion dull, dying in Summer.
Kidney extreme anger unresolved injures Zhi (Will); Zhi injury causes forgetting previous words, inability to bend/extend waist/spine, hair withering and complexion dull, dying in Late Summer.
Unresolved fear injures Jing (Essence); Jing injury causes bone soreness, flaccidity, and cold limbs, spontaneous essence loss. Thus, the five Zang store Essence and must not be injured. Injury leads to loss of control and Yin deficiency. Yin deficiency leads to lack of Qi. Lack of Qi leads to death.
[Su Wen] High pupil position indicates Tai Yang insufficiency. Eyes staring upward (Dai Yan) indicates Tai Yang exhaustion. This is key to determining life and death, must be examined carefully. (San Bu Jiu Hou Lun. Same below)
Exhaustion of Foot Tai Yang Qi: Legs cannot flex/extend, death必然 accompanied by Dai Yan. End of Tai Yang Meridian: Dai Yan, opisthotonos, convulsions, white complexion, absolute sweat appears, death follows. (Zhen Yao Jing Zhong Pian. Same below. Epilepsy [Missing Character] also features Dai Yan; moxibustion Kunlun point resolves it. If moxibustion fails to resolve Dai Yan, it is Tai Yang exhaustion. Wang Bing commentary: Absolute sweat refers to sweat like beads not flowing, spinning and drying).
End of Shao Yang: Deafness, all joints limp, eyes [Missing Character] severing connection, death in one and a half days. Death color first turns cyan-white. ([Missing Character] pronounced Qiong. Wang Bing commentary: Eye [Missing Character] means staring straight like frightened look).
End of Yang Ming: Mouth and eyes twitching, frequent fright, delirious speech, yellow complexion, upper/lower meridians vigorous and insensate, then death. (Wang Bing commentary: Meridian vigorous means face, eyes, neck, forehead, foot dorsum, wrist, shin all restless/vigorous. Insensate means unaware of good/evil).
End of Shao Yin: Black face, long dirty teeth, abdominal fullness/blockage, upper/lower blockage, then death. (Black face: Hand Shao Yin exhaustion; Long teeth: Foot Shao Yin exhaustion).
End of Tai Yin: Abdominal fullness/blockage, inability to breathe, frequent belching/vomiting. Vomiting leads to rebellion, rebellion leads to red face. No rebellion leads to upper/lower blockage, blockage leads to black face, dry skin/hair, then death.
End of Jue Yin: Internal heat, dry throat, frequent urination, vexation. Severe cases: tongue curling and testicles retracting, then death. This is the failure of the twelve meridians.
[Ling Shu] Exhaustion of Hand Tai Yin Qi: Dry skin/hair. Tai Yin circulates Qi to nourish skin/hair. Without Qi nourishment, skin/hair dry. Dry skin/hair loses fluid from joints. Loss of fluid leads to withered nails and broken hair. Broken hair means Hair dies first. Bing deterioration, Ding death, Fire overcomes Metal. (Jing Mai Pian. Same below)
Exhaustion of Hand Shao Yin Qi: Meridian blockage, blood stasis. Stasis leads to dull hair/color. Face black like lacquered charcoal means Blood dies first. Ren deterioration, Gui death, Water overcomes Fire.
Exhaustion of Foot Tai Yin Qi: Meridian fails to nourish muscles. Lips/tongue are roots of muscles. Failure to nourish leads to soft muscles. Soft muscles lead to flaccid tongue, full renzhong (philtrum). Full renzhong leads to everted lips. Everted lips mean Flesh dies first. Jia deterioration, Yi death, Wood overcomes Earth.
Exhaustion of Foot Shao Yin Qi: Bone withering. Shao Yin is Winter pulse, hidden nourishing marrow. Unnourished bones cannot attach flesh. Flesh detaching leads to soft/receding flesh. Receding flesh causes long/dirty teeth and lusterless hair. Lusterless hair means Bone dies first. Wu deterioration, Ji death, Earth overcomes Water.
Exhaustion of Foot Jue Yang Qi: Tendon exhaustion. Jue Yin is Liver Meridian. Liver governs tendons. Tendons gather at genitals and connect to tongue root. Meridian failure leads to tight tendons. Tight tendons pull tongue and genitals. Cyan lips, curled tongue, retracted genitals mean Tendons die first. Geng deterioration, Xin death, Metal overcomes Wood.
Exhaustion of all five Yin Qi: Eye axis rotates, causing dizziness. Dizziness means Zhi (Will) dies first. Zhi death means death in up to one and a half days. Exhaustion of all six Yang Qi: Yin and Yang separate. Separation leads to pore opening and sweating. Absolute sweat appears. Predicted morning, dies evening; predicted evening, dies morning.
Zhong Jing said: Floating and vigorous pulse, sweat like oil, continuous wheezing, inability to take fluids, body insensibility, alternating calm/restlessness, this is Life Gate exhaustion, unknown which Zang suffered first. Sweat with wet hair, continuous wheezing, this is Lung exhaustion first. Yang alone remaining, body like smoke coal, staring straight, shaking head, this is Heart exhaustion. Lips reversed cyan, limb [Missing Character] sweating, this is Liver exhaustion. Ring around mouth black, soft sweat yellow, this is Spleen exhaustion. Urine/feces incontinence, delirium, eyes staring straight backward, this is Kidney exhaustion. Unknown which Zang Yin/Yang exhausted. If Yang exhausts first, Yin later, corpse color must be cyan; if Yin exhausts first, Yang later, corpse color must be yellow, axilla warm, epigastrium hot. Six Fu Qi exhaustion externally: cold limbs, rebellious Qi, leg retraction. Five Zang Qi exhaustion internally: uncontrollable diarrhea, severe lower symptoms, limb insensibility.
[Mai Jing] Patient Liver exhaustion: dies in eight days. How to know? Green face, desire to lie prone, eyes looking but not seeing person, sweat flowing like water continuously (One version: dies in two days). Patient Gallbladder exhaustion: dies in seven days. How to know? Eyebrows droop. Patient Tendon exhaustion: dies in nine days. How to know? Cyan finger/toe nails, shouting/cursing incessantly (One version: dies in eight days). Patient Heart exhaustion: dies in one day. How to know? Shoulder breathing, looking back, immediate death (One version: eyes stopping for two days). Patient Intestine exhaustion: dies in six days. How to know? Hair standing straight like dry hemp, unable to flex/extend, spontaneous sweating incessantly (One version: Small Intestine exhaustion). Patient Spleen exhaustion: dies in twelve days. How to know? Cold mouth, swollen feet, abdominal heat/distension, unconscious diarrhea, unpredictable timing (One version: dies in five days). Patient Stomach exhaustion: dies in five days. How to know? Spine pain, heavy waist, inability to turn over (One version: flat calf muscles, dies in nine days). Patient Flesh exhaustion: dies in six days. How to know? Dry ears, swollen tongue back, hematuria, red loose stool (One version: swollen feet, dies in nine days). Patient Lung exhaustion: dies in three days. How to know? Open mouth, only air exiting without returning (One version: empty nose/mouth, shortness of breath). Patient Large Intestine exhaustion untreatable. How to know? Uncontrollable diarrhea/dysentery. Dysentery exhaustion leads to death. Patient Kidney exhaustion: dies in four days. How to know? Teeth suddenly withered, face strictly black