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The Dan Shi (Stone-Tapping) pulse is located between the muscles and tendons; upon pressing, it feels like cracking stones, indicating the exhaustion of Kidney Qi. The Que Zhuo (Sparrow-Pecking) pulse resembles a sparrow pecking at food, striking the fingers continuously and rapidly, then suddenly stopping, only to return after a long interval. The Wu Lou (House-Leak) pulse is like water dripping from a leaking roof, falling only once after a long time, splashing up with no strength. Both the Que Zhuo and Wu Lou pulses are signs of the exhaustion of Spleen and Stomach Qi. The Jie Suo (Untying Knots) pulse feels scattered and chaotic under the fingers, lacking any order. The Xia You (Shrimp-Traveling) pulse is felt at the skin level; initially it remains still, then disappears, and after a long while suddenly reappears. The Yu Xiang (Fish-Swimming) pulse is essentially still but trembles weakly. The Fu Fei (Cauldron-Boiling) pulse is felt at the skin level, having only outward movement without inward retreat, surging like waves on boiling soup. All these are death pulses.

The *Mai Jing* (Pulse Classic) states: In febrile diseases, if the pulse beats four times per respiration, death occurs in three days. "Four beats" means that while a healthy person's pulse beats once per respiration, the patient's beats four times. If the pulse beats five times per respiration in febrile disease, death occurs in one day; if occasionally there is a particularly strong beat, death occurs in half a day. If the patient experiences confusion and mental agitation, death ensues.
If the pulse beats six times per respiration in febrile disease, death occurs in half a day; if the pulse is rapid and occasionally exhibits a particularly strong beat, death occurs shortly thereafter.
If the pulse shows "Si Sun" (Four Damages) in febrile disease, death occurs in three days. "Four Damages" refers to a condition where a healthy person's pulse beats four times per respiration, but the patient's pulse beats only once. If the pulse shows "Wu Sun" (Five Damages), death occurs in one day. "Five Damages" means a healthy person's pulse beats five times per respiration, while the patient's beats once. If the pulse shows "Liu Sun" (Six Damages), death occurs within one shichen (two hours). "Six Damages" means a healthy person's pulse beats six times per respiration, while the patient's beats once. If the pulse is completely imperceptible or appears only after a long delay, immediate death occurs.

In chronic diseases, contrary pulse patterns indicate death when they exceed the season: deep pulse in Spring, faint pulse in Summer, large pulse in Autumn, and floating pulse in Winter. If the Chi (Cun) pulse does not reach the Guan (Bar) point upwards, Yin is exhausted, leading to death in Spring or Summer; if the Cun (Inch) pulse does not reach the Guan point downwards, Yang is exhausted, leading to death in Autumn or Winter.

A fine, rapid, and forceless pulse is unfavorable for Xu Lao (Deficiency Consumption). A rapid pulse with intervals suggests death within a month. By examining the excess and deficiency alone and combining them with the San He (Three Harmonies) theory (see previous text), one can predict outcomes. For instance, if the Heart pulse is exclusively excessive, danger arises on Shen, Zi, or Chen days. A rapid pulse without intervals suggests death within days, calculable within ten-plus days using monthly deduction methods.

The Emperor asked: Why does the appearance of Zhen Zang Mai (True Viscera Pulse) indicate death? Qibo replied: The Five Zang organs all derive their Qi from the Stomach; the Stomach is the root of the Five Zang. Visceral Qi cannot reach the Hand Taiyin Lung Meridian on its own; it must rely on Stomach Qi to do so. Thus, each Zang transmits its Qi to the Hand Taiyin during its respective season. Therefore, when pathogenic factors are excessive, essence and Qi decline. When the disease is severe, Stomach Qi cannot accompany the Visceral Qi to the Hand Taiyin. Consequently, the isolated appearance of True Viscera Qi indicates that the disease has overcome the Zang, signifying death.
Humans rely on water and grain as their foundation; thus, humans die when water and grain are cut off. Those whose pulses lack Stomach Qi die. Lacking Stomach Qi means exhibiting only Zhen Zang Mai without any sign of Stomach Qi. What is called "Yin" here refers to the True Viscera pulse; its appearance signifies failure and inevitable death. Regarding specific timelines for Zhen Zang pulses: if the Liver pulse appears suspended and urgent, death occurs in 18 days; if the Heart pulse appears suspended, death occurs in 9 days; if the Lung pulse appears suspended, death occurs in 12 days; if the Kidney pulse appears suspended, death occurs in 7 days; if the Spleen pulse appears suspended, death occurs in 4 days. If the Three Yin pulses all throb strongly, death occurs at midnight on the 20th day; if the Two Yin pulses throb strongly, death occurs at dusk on the 13th day; if the One Yin pulse throbs strongly, death occurs at dawn on the 10th day. The appearance of True Viscera pulses always indicates death.

When the True Liver pulse arrives, it is tense inside and out, feeling sharp like touching a knife blade or tight like pressing a lute string. With a cyan-white complexion lacking luster, death follows when the body hair breaks. When the True Heart pulse arrives, it is hard and pounding, feeling granular like touching coix seeds. With a red-black complexion lacking luster, death follows when the body hair breaks. When the True Spleen pulse arrives, it is weak and alternates between sparse and rapid. With a yellow-cyan complexion lacking luster, death follows when the body hair breaks. When the True Lung pulse arrives, it is large and empty, feeling light like a feather brushing the skin. With a white-red complexion lacking luster, death follows when the body hair breaks. When the True Kidney pulse arrives, it is pounding yet severed, feeling like fingers tapping on stone. With a yellow-black complexion lacking luster, death follows when the body hair breaks. The appearance of any True Viscera pulse indicates an untreatable fatal condition.

The *Yu Ji Zhen Zang Pian* chapter states: The Five Zang receive Qi from the organ that generates them, transmit it to the organ they control, retain it in the organ that generates them, and die when affected by the organ that controls them. Before death, the disease必先传行至其所不胜 (must first transmit to the organ it cannot overcome), causing death. This is a retrograde flow of Qi, hence fatal. The Liver receives Qi from the Heart, transmits to the Spleen, retains in the Kidney, and dies when affecting the Lung. (Slower cases die in Autumn; acute cases die on Geng/Xin days or at dusk.) The Heart receives Qi from the Spleen, transmits to the Lung, retains in the Liver, and dies when affecting the Kidney. (Slower cases die in Winter; acute cases die on Ren/Gui days or at midnight.) The Spleen receives Qi from the Lung, transmits to the Kidney, retains in the Heart, and dies when affecting the Liver. (Slower cases die in Spring; acute cases die on Jia/Yi days or at dawn.) The Lung receives Qi from the Kidney, transmits to the Liver, retains in the Spleen, and dies when affecting the Heart. (Slower cases die in Summer; acute cases die on Bing/Ding days or at noon.) The Kidney receives Qi from the Liver, transmits to the Heart, retains in the Lung, and dies when affecting the Spleen. (Slower cases die in Late Summer; acute cases die on Wu/Ji days or at Chen/Xu/Chou/Wei hours.) These are all deaths due to retrogression. Dividing the day and night into five parts allows for predicting the timing of death. If the great bones are emaciated, the great muscles sunken, the chest full of Qi, breathing difficult, internal pain radiating to the shoulders and neck, death is expected within one month; if Zhen Zang pulses appear, a specific date is given. If accompanied by fever, muscle wasting, and skin cracking, death occurs within ten months. If shoulder marrow wastes away and movements weaken further, death occurs within one year. If the eyes cannot see people, death is immediate; if they can see, death occurs at the hour of the controlling element. Sudden collapse with closed five Zang and blocked meridians, resembling drowning, cannot be timed precisely. If the pulse ceases entirely, or beats 5-6 times per breath while flesh remains intact, even without visible Zhen Zang pulses, death ensues.

If the pulses at the Three Bu and Nine Hou sections are all disordered, death occurs. If the pulses above and below, left and right correspond rhythmically like a mortar and pestle, the disease is severe. If they are disordered and uncountable, death occurs. If the Middle section pulses are harmonious alone but other Zang pulses are disordered, death occurs. If the Middle section pulses diminish, death occurs. Sunken eye orbits indicate death. Muscle wasting with remaining body indicates death. Alternating sparse and rapid pulses indicate death. Visible forms of Zhen Zang pulses indicate death. Harmony between Form and Qi leads to life; discordance leads to disease. Pressing five cun above the ankle on the left foot while tapping the right ankle: if the response travels over five cun gently, there is no disease; if rapid and chaotic, there is disease; if slow, there is disease; if it fails to reach five cun or shows no response, death occurs. Even if Nine Hou pulses are harmonious, if form and flesh are wasted, death occurs. Robust form with fine pulse and shortness of breath indicates danger. Emaciated form with large pulse and chest fullness indicates death. Pulses lacking Stomach Qi are termed Ni (Rebellious) and lead to death. Liver pulse appearing on Geng/Xin days causes death; Heart on Ren/Gui; Lung on Bing/Ding; Kidney on Wu/Ji; Spleen on Jia/Yi. Chaotic,革 (Leather-like) pulses surging like springs with deteriorating color, or fading like a breaking string, indicate death. Pulses like rolling beans indicate death. Pulses like an inverted knife indicate death. Surging pulses that do not recede indicate death. Pulses that come and go intermittently indicate death. Excessively wide pulses indicate death. Severed branch pulses indicate death. (Rolling bean pulse is the Heart's Zhen Zang pulse; inverted knife pulse is the Liver's; intermittent pulse is the Spleen's.)

If the pulses at the Three Bu sections resemble boiling soup in a cauldron, morning onset leads to evening death, midnight onset leads to noon death, and noon onset leads to midnight death. If all Nine Hou pulses are deep, fine, and suspended/extreme, belonging to Yin/Winter, death occurs at midnight. If pulses are excessive, restless, panting, and rapid, belonging to Yang/Summer, death occurs at noon. Cold-heat diseases die at dawn. Heat-in-the-middle and febrile diseases die at noon. Wind diseases die at dusk. Water retention diseases die at midnight. Pulses alternating sparse/rapid/slow/fast die during the Earth phases of the day. Floating and slippery pulses with oily sweat, ceaseless panting, inability to swallow, numbness, and alternating calm/panting states indicate death. Sweating with wet hair and ceaseless panting indicates Lung Qi exhaustion and death. Yang disease lingering alone, with a smoky complexion, fixed gaze, head shaking, and inability to speak indicates Heart exhaustion. Cyan lips and cold sweat on limbs indicate Liver exhaustion. Black ring around the mouth and yellowish sweat indicate Spleen exhaustion. Fever, coarse breathing, Yin symptoms, and restlessness indicate death. Head/eye pain and sudden blindness indicate death. Tight and abundant pulses at all three positions with unremitting massive sweating indicate death. Deficiency of both Yin and Yang at Cun and Chi indicates death. Warm diseases without sweat, or sweat failing to reach the feet, indicate death. Warm diseases with intense heat and fine/small pulses indicate death. Coughing with emaciation, fever, and firm/rigid pulses indicate death. Skin and flesh adhering to bone indicate death. Straight hair like hemp indicates death. Foul breath indicates death. Febrile diseases lasting 7-8 days without sweat and with absent pulses indicate death. Lack of luster on the face and black teeth indicate death. Rolled tongue and retracted testicles indicate death. Fixed gaze without blinking leads to death in one day. Yin knotting with Yang severing, eyeball protrusion, and confusion indicate death. Exhaustion of Yin and Yang with sunken orbits indicates death. Incontinence with unawareness indicates death. Mouth open like a fish unable to close, with exhaled air insufficient, indicates death. Anus like a bamboo tube with uncontrollable bowel movements indicates death. Restlessness in bed indicates death. Sputum like crab foam indicates death. Swollen face with cyan-black color indicates death. Simultaneous exterior and interior disease indicates death. Post-sweat fever with worsening panting/diarrhea indicates death. Chronic delirium or muteness is untreatable, though febrile causes may be treated. Yin/Yang exhaustion with grasping at empty air or clothes indicates death. Non-flowing sweat and black rolled tongue indicate death. Hair standing up towards the shoulders indicates death. Cyan nail beds indicate death. White nail beds are untreatable. Absent pulse, open mouth, and swollen feet lead to death in five days. Swollen dorsum pedis and knees as large as buckets lead to death in ten days. Swollen scrotum and penis indicate death. Black nails and flesh lead to death in eight days.