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Huangdi asked: How can one determine life and death? Qibo replied: Observe the reflection in the patient's eyes. If there are red vessels penetrating vertically through the pupil, seeing one red vessel indicates death within one year; seeing one and a half red vessels indicates death within one and a half years; seeing two red vessels indicates death within two years; seeing two and a half red vessels indicates death within two and a half years; seeing three red vessels indicates death within three years. If the red vessels do not penetrate downward through the pupil, it is treatable. The black part of the eye (cornea/iris area) belongs to the Liver, and the pupil belongs to the Kidney. Red vessels penetrating the pupil indicate that pathogenic toxins have deeply invaded the Zang organs of the Liver and Kidney, which is invariably fatal. An abundance of red vessels suggests abundant Qi and Blood, thus delaying the time of death. If there are red vessels but they do not penetrate downward through the pupil, the toxin remains in the meridians and has not entered the Zang organs, so it can be treated.

In the *Suwen: Re Lun* chapter: Huangdi asked: Current febrile diseases all belong to the category of Cold Damage (Shanghan). Some recover, some die; those who die usually do so between the sixth and seventh days, while those who recover usually take more than ten days. Why is this? Qibo replied: Ju Yang (Giant Yang), which refers to the Taiyang Meridian, is the leader of all Yang meridians. Its vessels connect to the Fengfu acupoint, thus governing the Qi of all Yang meridians. When humans are injured by Cold pathogens, they develop febrile diseases. Even if the heat is severe, it will not cause death; however, for those suffering from "Liang Gan" (simultaneous infection of Yin and Yang meridians) due to Cold, death is inevitable.

This section summarizes marked febrile diseases, stating they all belong to the category of Cold Damage, meaning they mostly arise from the transformation of Cold Damage pathogens into heat, rather than solely from direct heat invasion. Ju Yang refers to the Taiyang Meridian. Fengfu is an acupoint on the Du Meridian at the back of the neck. The Du Meridian is the commander of all Yang meridians. The Taiyang Meridian governs the exterior of the body and connects with the Du Meridian, thus serving as the master of Qi for all Yang meridians.

Those injured by Cold and developing heat do so because their internal Yang Qi is robust, which is constrained by the pathogen and transforms into heat. Because Yang Qi is robust, even severe heat will not cause death. "Liang Gan on Cold" refers to the simultaneous injury of the exterior Taiyang and interior Shaoyin meridians by pathogens, leading to the exhaustion of primordial Yuan Qi, hence death is inevitable.

On the first day of Cold Damage, the Ju Yang meridian receives the pathogen, resulting in headache, stiff neck, and stiffness/pain in the lower back and spine. On the second day, the Yangming meridian receives the pathogen. Yangming governs flesh, and its vessels run alongside the nose and connect to the eyes, resulting in fever, eye pain, dry nose, and inability to lie down. On the third day, the Shaoyang meridian receives the pathogen. Shaoyang governs the Gallbladder, and its vessels follow the costal region and connect to the ears, resulting in hypochondriac pain and deafness. If the meridians of the Three Yang are diseased but have not yet entered the Zang organs, they can be cured by inducing sweating. On the fourth day, the Taiyin meridian receives the pathogen. Taiyin vessels distribute in the stomach and connect to the throat, resulting in abdominal fullness and dry throat. On the fifth day, the Shaoyin meridian receives the pathogen. Shaoyin vessels pass through the Kidneys, connect to the Lungs, and attach to the root of the tongue, resulting in dry mouth, dry tongue, and thirst. On the sixth day, the Jueyin meridian receives the pathogen. Jueyin vessels follow the genitalia and connect to the Liver, resulting in irritability, abdominal fullness, and retraction of the scrotum. If the Three Yin and Three Yang, as well as the Five Zang and Six Fu organs, are all diseased, and Ying and Wei Qi cease to circulate, and the Qi of the Five Zang becomes blocked, death ensues. For those not suffering from Liang Gan, on the seventh day, the disease in the Ju Yang meridian declines, and headache slightly improves. On the eighth day, the disease in the Yangming meridian declines, and fever slightly subsides. On the ninth day, the disease in the Shaoyang meridian declines, and hearing slightly returns. On the tenth day, the disease in the Taiyin meridian declines, abdominal distension decreases to normal, and appetite returns. On the eleventh day, the disease in the Shaoyin meridian declines, thirst stops, abdominal fullness resolves, tongue dryness improves, and sneezing occurs. On the twelfth day, the disease in the Juevin meridian declines, the scrotum relaxes, slight lower abdominal depression occurs, major pathogenic factors are expelled, and the disease heals day by day. Huangdi asked: How should it be treated? Qibo replied: Treatment requires unblocking the meridians of each respective Zang organ, so the disease will decline and heal day by day. If the duration is less than three days, it can be cured by sweating; if the duration is three days or more, it can be cured by purging/draining.

This clarifies the sequence of external pathogens moving from shallow to deep. Generally, the body's Yang Qi protects the exterior and maintains solidity. Wei Qi travels in the Yang aspects during the day and in the Yin aspects at night. When traveling in the Yin, the exterior Yang becomes deficient, allowing pathogens to invade internally due to deficiency. Wei Qi completes one cycle of entry and exit daily; thus, pathogens invade one meridian per day. The Six Meridians represent layers of depth. By the sixth day, the pathogen reaches the deepest layer, the Jueyin meridian. Taiyang is the first layer; its vessels travel from the foot, up the waist and back, to the head, causing headache, stiff neck, and back stiffness. In other cases, observing symptoms reveals which meridian is affected. If all Six Meridians and Zang-Fu organs are invaded, and Ying-Wei circulation is blocked with Zang Qi uncommunicated, death results. Hence, death often occurs around the sixth or seventh day, indicating heavy pathogenic influence. If not Liang Gan, but merely sequential transmission from Yang to Yin meridians without damaging Zang organs, Yuan Qi recovers on the seventh day, and pathogens decline daily, allowing recovery after twelve days. Treatment must unblock meridians to facilitate the flow of Zang Qi, thereby reducing pathogens. If less than three days, with pathogens in Yang meridians, release the exterior via sweating; if three days or more, with pathogens in Yin meridians, drain them from the Yin aspect. Draining may involve unblocking Fu Qi if there is obstruction, allowing Yin meridian pathogens to be expelled. Since Yin meridians are interior, sweating is inappropriate. The *Lingshu: Xie Ke Bing Xing* chapter states: When pathogens enter Yin meridians and reach Zang organs, if Zang Qi is solid, pathogens cannot reside and return to the Fu organs. This implies that when pathogens move from Yin meridians to the Stomach Fu, Zang Qi must be solid. This aligns with Zhang Zhongjing’s discussion of using Chengqi Tang for Shaoyin patterns. If Zang Qi is deficient, pathogens entering Zang organs from Yin meridians lead to death. Pathogens entering Fu organs from Yang meridians also constitute excess patterns. However, the classic text only outlines general principles; pathogenic transmission is variable and cannot be rigidly bound by day counts. Therefore, Zhang Zhongjing emphasized differentiating pulse and symptoms first to identify the meridian and Fu/Zang involvement, and whether the pattern is deficiency or excess, applying treatment accordingly. His legislation is most precise and detailed, making it essential for students to study and adopt as a standard.