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When the pulse feels like boiling water surging under the fingers, if diagnosed in the morning, death will occur by evening; this is certain and beyond doubt. If the pulse tail wags and the head shakes while the body remains still, resembling a fish swimming (Fish-swimming Pulse), this indicates the exhaustion of Kidney Qi, and the time of death is also fixed. When the pulse departs quickly and arrives slowly, with a cracking sound, the pulse of life exhaustion comes hard and rapid like flicking stones. The Grain Qi of the Three Yang channels has been empty for a long time, and the Stomach Qi is clearly weak, dripping like water from a leaking roof, irregular and sparse. The pulse is chaotic and disordered, resembling the shape of untying ropes; this manifests as exhaustion of marrow and withering of bones at both Chi positions. The Shrimp-swimming Pulse resembles a frog swimming; this indicates the departure of the Soul and the state of a walking corpse, causing definite worry. The Sparrow-pecking Pulse comes rapidly and frequently; this indicates that the Spleen lacks Grain Qi and will surely not be retained. To know about Heart Qi exhaustion and Ying (Nutritive) Qi exhaustion, one must examine carefully as if pressing a knife against a knife. Furthermore, Lung dryness and Stomach deficiency present with pulses like hemp seeds—fine, rapid, and continuous without rest. Under the fingers, it feels homogeneous like rolling beans; this indicates that the Zheng Qi of the Three Lights has already drifted away.

Dongxu Zi said: The Shrimp-swimming and Sparrow-pecking pulses belong to the category of intermittent pulses (Dai Mai), hence named "death signs." One must know that patients with Phlegm-Qi obstruction often exhibit such pulses. Unless one is experienced and knowledgeable, relying solely on classical texts to diagnose may lead to ridicule by experts. Generally, when a disease consumes vitality to the point of exhaustion, Qi cannot continue smoothly, resembling shrimp swimming or water dripping from a leaky roof without regularity; these are death pulses. However, if there is Phlegm condensation and Qi stagnation causing obstruction, the pulse may indeed remain motionless at times, move chaotically across three or two pathways, appear intermittently, have presence at Cun but absence at Chi (or vice versa), show absent Guan pulse but visible Gu pulse, vary in size and rhythm, occur suddenly in healthy individuals, appear irregularly in those constitutionally prone to Phlegm diseases, or arise after sudden collapse or stroke. These are not death pulses. Students should investigate them with great care.

Fifty beats without stopping indicate no illness in the body; any stopping within the count signifies a determined outcome. ("Stopping" refers to the Dai Mai/Intermittent Pulse. Fifty beats without any stop indicate health. The number fifty corresponds to the creative numbers of Heaven and Earth. The *I Ching · Xi Ci* states: "The Great Expansion Number is fifty; only then is it complete. One is the beginning of counting, ten is the ultimate limit." Human pulse circulation follows the Five Zang organs day and night. Each beat circulates through one organ; five beats complete the cycle through all five Zang organs. Fifty beats represent ten cycles of five, reaching the ultimate limit without stopping, indicating that all Five Zang organs are balanced, thus free from disease.)

A stop at forty-one beats indicates one Zang organ's exhaustion, leading to death after approximately four years. A stop at thirty-one beats corresponds to three years. A stop at twenty-one beats corresponds to two years. A stop at fifteen beats leads to death within one year. Stops occurring below this threshold should be evaluated based on acute illnesses. (One stop at forty beats indicates one Zang organ failed to beat, representing the extreme limit of the pulse, thus indicating one Zang organ's exhaustion. It begins with the Kidney channel, hence stated so. Heaven generates Water; the Kidney belongs to Water, corresponding to the generative number one. The Five Zang organs are generated starting with the Kidney; Kidney Water generates Liver Wood, Wood generates Heart Fire, Mingmen Fire generates Spleen Earth, and Earth generates Lung Metal. Therefore, Kidney exhaustion occurs first, with death expected in four years. A stop at thirty beats indicates two Zang organs failed to beat, the extreme limit, showing Qi exhaustion in Kidney and Liver channels, with death expected in three years. A stop at twenty beats indicates three Zang organs failed to beat, the extreme limit, showing Qi exhaustion in Kidney, Liver, and Heart channels, with death expected in two years. A stop at fifteen beats indicates Qi exhaustion in Kidney, Liver, Heart, and Spleen, with death expected in one year.)

New commentary notes: The above discussion on pulse stops does not specify which position to palpate for evidence. According to the *Su Wen* and *Nan Jing*: One should examine during the Yin hour of dawn, before sunrise and food intake, when blood and Qi are undisturbed. The physician should concentrate spirit and intent, keeping the mind free from external distractions, and palpate the Right Hand Cun Kou (Radial Artery), silently counting the pulse beats until a stop occurs to make a judgment. Cun Kou is the Qi Kou of the right hand. The *Nei Jing* asks: Why does Qi Kou alone serve as the master of the Five Zang? Qibo answers: The Stomach is the sea of water and grain, the great source of the Six Fu organs. Flavors enter the mouth, store in the Stomach, and manifest at the Qi Kou. It also states: Pulses meet at Dayuan; Cun Kou is the Taiyuan acupoint. Thus, Cun Kou is where pulses converge, enabling the determination of life and death, auspiciousness and misfortune for the Five Zang and Six Fu organs.