病患肝绝，八日死，何以知之？面青但欲伏眠，目视不见人，汗（一作泣）出如水不止。
（一曰、二日死。） 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。（一曰∶八日死。） 病患心绝，一日死，何以知之？肩息回
视立死。（一曰∶目亭亭二日死。） 病患肠（云小肠）绝，六日死，何以知之？发直如干麻，
不得屈伸，自汗不止。 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（一曰∶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？泄利无度，利绝则死。 病患肾绝，四日死，何以
知之？齿为暴枯，面为正黑，目中黄色，腰中欲折，自汗出如流水。（一曰∶人中平七日死。
）病患骨绝，齿黄落，十日死。 诸浮脉无根者皆死，以上五脏六腑为根也。
春三月木旺，肝脉治当先至，心脉次之，肺脉次之，肾脉次之，此为王相顺脉也。 到
六月土旺，脾脉当先至而反不至，反得肾脉，此为肾反脾也，七十日死。何谓肾反脾？夏火
旺，心脉当先至，肺脉次之，而反得肾脉，是谓肾反脾。期五月、六月，忌丙丁。 脾反肝
，三十日死。何谓脾反肝？春肝脉当先至，而反不至，脾脉先至，是谓脾反肝。期正月、二
月，忌甲乙。 肾反肝，三岁死。何谓肾反肝？春肝脉当先至，而反不至，肾脉先至，是谓
肾反肝。期七月、八月，忌庚辛。 肾反心，二岁死。何谓肾反心？夏心脉当先至，而反不
至，肾脉先至，是谓肾反心。期六月，忌戊己。
此中不论肺金之气，疏略未谕，指南又推五行，亦颇颠倒，待求别录上。
凡疗病，察其形貌、神气、色泽、脉之盛衰，病之新故，乃可治之。 形气相得，色泽
以浮，脉从四时，此为易治。 形气相失，色夭不泽，脉实坚甚，脉逆四时，此为难治。
逆四时者，春得肺脉，夏得肾脉，秋得心脉，冬得脾脉，其至皆悬绝涩者，曰逆。 春
夏沉涩，秋冬浮大，病热，脉静泄痢，脉大脱血，脉实病在中，脉坚实病在外，脉不实，名
逆四时，皆难疗也。 凡四时脉皆以胃气为本，虽有四时王相之脉，无胃气者难瘥也。何为
胃气？脉来弱而滑者是也，命曰易治。
[Background Information]
Book: *Beiji Qianjin Yaofang* (Essential Prescriptions Worth a Thousand Gold for Emergencies)
Author: Sun Simiao
Dynasty: Tang Dynasty, Yonghui 3rd Year
Chapter: Diagnosis of Symptoms of Qi Exhaustion in the Five Zang and Six Fu Organs XI / Diagnosis of Pulses Opposite to the Four Seasons XII
Category: Formulas
[Original Text Processing]
If the Liver Qi of a patient is exhausted, death will occur after eight days. How do we know this? The face appears cyanotic, the patient desires to lie prone and sleep, eyes gaze at people but fail to see them, and sweat flows continuously like water.
(Another version states: death occurs within one or two days.)
If the Gallbladder Qi of a patient is exhausted, death will occur after seven days. How do we know this? The eyebrows droop.
If the Sinew Qi of a patient is exhausted, death will occur after nine days. How do we know this? The fingernails and toenails turn cyanotic, and the patient calls out and curses incessantly. (Another version states: death occurs within eight days.)
If the Heart Qi of a patient is exhausted, death will occur after one day. How do we know this? There is shoulder breathing (accessory muscle use in respiration), fixed staring gaze, leading to immediate death. (Another version states: fixed eyeballs, death occurs within two days.)
If the Small Intestine Qi of a patient is exhausted, death will occur after six days. How do we know this? The hair stands straight like dry hemp, the body cannot flex or extend, and spontaneous sweating continues without stop.
If the Spleen Qi of a patient is exhausted, death will occur after twelve days. How do we know this? The mouth feels cold, feet swell, the abdomen is hot and distended, diarrhea occurs with loss of control, and excretion happens at unpredictable times. (Another version states: death occurs within five days.)
If the Stomach Qi of a patient is exhausted, death will occur after five days. How do we know this? There is spinal pain, heaviness in the waist, and inability to turn over. (Another version states: flattening of the calf muscles, death occurs within nine days.)
If the Flesh Qi of a patient is exhausted, death will occur after six days. How do we know this? The ears are dry, the tongue is swollen, there is hematuria (blood in urine), and the stool is red and loose. (Another version states: foot swelling, death occurs within nine days.)
If the Lung Qi of a patient is exhausted, death will occur after three days. How do we know this? The mouth is open, only air exits but does not return (inability to inhale). (Another version states: empty opening of nose and mouth, shortness of breath.)
If the Large Intestine Qi of a patient is exhausted, it is incurable. How do we know this? Diarrhea is uncontrolled; when the diarrhea ceases, death follows.
If the Kidney Qi of a patient is exhausted, death will occur after four days. How do we know this? The teeth become suddenly brittle, the face is jet black, the eyes show a yellow hue, the waist feels as if it will break, and spontaneous sweat flows like running water. (Another version states: flattening of the philtrum, death occurs within seven days.)
If the Bone Qi of a patient is exhausted, the teeth turn yellow and fall out, and death will occur after ten days.
All floating pulses lacking a root lead to death; above, the Five Zang and Six Fu organs are considered the root.
During the three months of Spring, Wood Qi is prosperous. The Liver Pulse should arrive first, followed by the Heart Pulse, then the Lung Pulse, and finally the Kidney Pulse. This is called the Wang-Xiang Shun Mai (Wang-Phase Compliant Pulse, indicating normal generative sequence).
When June arrives and Earth Qi is prosperous, the Spleen Pulse should arrive first but fails to do so; instead, the Kidney Pulse is obtained. This is called "Kidney Reversing Spleen," and death will occur in seventy days. What is meant by "Kidney Reversing Spleen"? In Summer, Fire Qi is prosperous, the Heart Pulse should arrive first and the Lung Pulse second, yet the Kidney Pulse is obtained instead. This is termed "Kidney Reversing Spleen." The period of occurrence is May and June; Bing-Ding days are taboo.
"Spleen Reversing Liver" leads to death in thirty days. What is meant by "Spleen Reversing Liver"? In Spring, the Liver Pulse should arrive first but fails to do so; the Spleen Pulse arrives first instead. This is termed "Spleen Reversing Liver." The period of occurrence is January and February; Jia-Yi days are taboo.
"Kidney Reversing Liver" leads to death in three years. What is meant by "Kidney Reversing Liver"? In Spring, the Liver Pulse should arrive first but fails to do so; the Kidney Pulse arrives first instead. This is termed "Kidney Reversing Liver." The period of occurrence is July and August; Geng-Xin days are taboo.
"Kidney Reversing Heart" leads to death in two years. What is meant by "Kidney Reversing Heart"? In Summer, the Heart Pulse should arrive first but fails to do so; the Kidney Pulse arrives first instead. This is termed "Kidney Reversing Heart." The period of occurrence is June; Wu-Ji days are taboo.
This section does not discuss the Qi of Metal (Lung); the omission is unclear. The guide further deduces the Five Elements, which also contains some inversions; these await separate recording above.
In all cases of treating disease, one must observe the patient's physical appearance, Shen (Spirit), complexion/luster, and the excess or deficiency of the pulse, as well as whether the disease is new or old, before proceeding with treatment.
When Xing (Form/Body) and Qi are harmonious, the luster is bright and floating, and the pulse conforms to the Four Seasons, this is easy to treat.
When Xing and Qi are discordant, the color is dull and lacks luster, the pulse is full, firm, and excessive, and the pulse opposes the Four Seasons, this is difficult to treat.
Opposing the Four Seasons refers to: obtaining the Lung Pulse in Spring, the Kidney Pulse in Summer, the Heart Pulse in Autumn, and the Spleen Pulse in Winter, where the pulses are all suspended, isolated, and choppy; this is called "Ni" (Rebellion/Opposition).
In Spring and Summer, the pulse should be floating and large but is instead deep and choppy; in Autumn and Winter, the pulse should be deep but is instead floating and large. For febrile diseases, the pulse should be quiet but is not; for dysentery/diarrhea, the pulse should be small but is large; for blood loss, the pulse should be empty but is full; for interior diseases, the pulse should be substantial but is not; for exterior diseases, the pulse should be firm but is not. If the pulse is not substantial/appropriate, it is named "Opposing the Four Seasons," and all such cases are difficult to heal.
All pulses of the Four Seasons take Wei Qi (Stomach Qi) as their foundation. Even if there are pulses conforming to the Wang-Xiang phases of the seasons, if there is no Wei Qi, recovery is difficult. What is Wei Qi? It is a pulse that comes weak and slippery; this is designated as easy to treat.