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In the management of Shanghan (Cold Damage), one must have a clear and profound understanding of terminal syndromes and terminal pulses, analyzing each case meticulously to avoid confusion during clinical practice. Whenever a terminal syndrome is observed, it must be correlated with the pulse condition. If the disease is deemed incurable, one must strictly avoid using purgative therapies. Should any error occur due to mismanagement, who shall bear the responsibility?

If fever subsides and the pulse becomes calm after sweating, the patient will recover.
If the pulses in both Yin and Yang aspects are peaceful, the prognosis is auspicious.
If a Yang syndrome presents with a Yin pulse, death ensues.
Yin-Yang Du Toxin (poisonous heat pathogens) persisting beyond six or seven days is incurable.
A floating and slippery pulse, accompanied by sweat like oil, unceasing panting, inability to ingest fluids or food, numbness of the body, and alternating states of tranquility and panting, indicates death.
In Shanghan, coughing with rebellious Qi rising and a scattered pulse indicate a dire prognosis.
If Yang Qi remains isolated within, the body appears dark as if smoked, with fixed staring eyes and head shaking, this signifies the prior exhaustion of Heart Qi.
After sweating, if the hair remains moist and panting continues, this signifies the prior exhaustion of Lung Qi.
If the lips and mouth turn cyanotic and cold sweat pours from the four limbs, this signifies the prior exhaustion of Liver Qi.
If the area around the mouth turns dark black, with deficient sweat and yellowish complexion, this signifies the exhaustion of Spleen Qi.
If the pulses at the three positions (Cun, Guan, Chi) are tight and vigorous, and profuse sweating fails to resolve the condition, death ensues.
If the pulses at both Yin and Yang positions (and Cun-Chi) are deficient, yet fever persists, death ensues.
Body heat with coarse breathing, presenting with a Yang pulse and restlessness, indicates death.
After sweating, if slight fever persists, death cannot yet be declared; however, if the pulse feels like a turning cord (tight and wiry), death occurs on that day.
Delirium with slight fever, a floating and large pulse, warm hands and feet desiring sweat, but if the pulse suddenly emerges without root, death ensues.
When Yin Qi declines towards exhaustion while Yang Qi suddenly overpowers alone, the pulse may emerge externally. Alternatively, if Yin Qi exhausts first followed by Yang Qi, death ensues; if there is cold extremities with a deep and fine pulse, death occurs within one day.
The appearance of red macules indicates a mortality rate of five deaths to five survivals.
The appearance of black macules indicates a mortality rate of ten deaths to one survival.
Lianggan Shanghan (simultaneous involvement of exterior and interior meridians) results in death.
Excessive sweating in patients with dampness constitutions leads to complications. It is also stated that fever accompanied by [specific severe symptom] indicates death.
Inducing sweating in Shaoyang disease leads to delirium. Inducing sweating in Shaoyin disease leading to blood disturbance results in death, termed "Lower Jue and Upper Exhaustion".
Inducing sweating in Dongqi disease results in death.
Inducing sweating in Fengwen (Wind-Warmth) disease results in death.
Sweating should lead to recovery; however, if sweating does not reduce the pathogenic heat, it is called Yin-Yang Jiao (Yin-Yang Intersection/Crossing), which results in death.
Complete absence of sweating indicates death.
Fever with rapid and restless pulse, delirium, and inability to eat constitutes the "Three Deaths" syndrome.
Unceasing coughing and rebellious Qi indicate death.
Zang Jie (Organ Knotting) results in death. (This refers to Jie Xiong syndrome with a white coating on the tongue).
Jueyin disease presenting with curled tongue and retracted testicles results in death.
A Dai pulse (intermittent pulse) indicates death.
Shaoyin disease presenting with vomiting, diarrhea, irritability, and cold extremities results in death.
Jie Xiong syndrome with all symptoms present and accompanied by irritability results in death.
Jue (cold extremities) persisting for seven to eight days, with cold skin and restlessness without any period of peace, is called Zang Jue (Organ Jue) and is incurable.
Severe headache involving Yin and Yang, blurred vision, spasm and stiffness of the four limbs, colicky pain in the lower abdomen, and convulsions of hands and feet result in death.
Jue accompanied by diarrhea, where the patient should not be able to eat but suddenly can, is called Chu Zhong (Elimination of Middle), which is incurable.
In Shaoyin disease with Jue and absent pulse, after administering Baicong Zhu Dan Tang, if the pulse suddenly emerges violently, death ensues; if the pulse slowly resumes, survival is possible.
If a patient presents with alternating chills and fever, Jue, lusterless complexion, and dizziness, with sudden absence of pulse in both hands or one hand, it is likely due to excessive normal sweating. Cover the patient with cotton blankets, keep the extremities warm, and urgently administer Wuweizi Tang. After administration, profuse sweating will occur, resolving the illness. If no sweat occurs after medication and the pulse does not return, death ensues.
Although there are many causes of death, any condition reaching an extreme critical state is fatal.