【素】五脏受气（病气。）于其所生。（我所生者。）传之于其所胜。（我所克者。）气舍于其所生。（生我者。经曰至
其所生而持。）死于其所不胜。（克我者。）病之且死。必先传行。至其所不胜。病乃死。此言气之逆行也。故死。（五脏
顺行则生。）肝受气于心。（我生者。子盛反乘其母。故为逆行。）传之于脾。（我克者。木克土。）气舍于肾。（生我者。
水生木。然脾传肾。为土克水。）至肺而死。（克我者。金克木。下同。）心受气于脾。传之于肺。气舍于肝。至肾而死。
脾受气于肺。传之于肾。气舍于心至肝而死。肺受气于肾。传之于肝。气舍于脾。至心而死。肾受气于肝。传之于心。
气舍于肺。至脾而死。此皆逆死也。（逆行。）一日一夜五分之。此所以占死生之早暮也。（朝甲乙寅卯。昼丙丁巳午。四
季戊己辰戌丑未。晡庚辛申酉。夜壬癸亥子。甲乙经生字作者。王氏改者作生。）五实死。五虚死。脉盛。（心实。）皮热。
（肺实。）腹胀。（脾实。）前后不通。（肾实。）闷瞀。（肝实。）此谓五实。脉细。（心虚。）皮寒。（肺虚。）气少。（肝虚。）
泄利前后。（肾虚。）饮食不入。（脾虚。）此谓五虚。其时有生者何也。浆粥入胃。泄注止。则虚者活。身汗得后利。则
实者活。此其候也。大骨枯槁。（肾衰。）大肉陷下。（脾衰。）胸中气满。喘息不便。（肺衰。）其气动形。（气不相续。远
求报气。故耸肩而动形。）期六月死。真藏脉见。乃与之期日。（死日。）急虚身中卒至。（卒急虚邪。中于身内。）五脏绝
闭。脉道不通。气不往来。譬于堕溺。不可为期。（暴死之候。与堕溺同。）（玉机真藏论）
【素】五脏者。中之守也。（王注。五神安守之所。）中藏盛满。气胜伤恐者。声如从室中言。是中气之湿也。（腹中
气盛。肺脏充满。气胜息高。伤于忧恐。故声不发扬。湿土刑肾。则恐。）言而微。终日乃复言者。此夺气也。（气不相
续。）衣被不敛。言语善恶。不避亲疏者。此神明之乱也。仓廪不藏者。是门户不要也。（仓廪。脾胃也。胃之下口为幽
门。大小肠之交为阑门。肛门为魄门。）水泉不止者。是膀胱不藏也。得守者生。失守者死。夫五脏者。身之强也。头者。
精明之府。头倾视深。精神将夺矣。背者。胸中之府。（脏腑之俞。皆属于背。）背曲肩随。府将坏矣。腰者。肾之府。
转摇不能。肾将惫矣。膝者。筋之府。屈伸不能。行则偻附。筋将惫矣。骨者。髓之府。不能久立。行则振掉。骨将惫
矣。得强则生。失强则死。夫精明五色者。气之华也。赤欲如帛裹朱。不欲如赭。白欲如鹅羽。不欲如盐。青欲如苍碧
之泽。不欲如蓝。黄欲如罗裹雄黄。不欲如黄土。黑欲如重漆色。不欲如地苍。五色精微象见矣。其寿不久也。（脉要精
微论）
【素】色见青如草兹（滋。）者死。黄如枳实者死。黑如 （音苔。烟煤。）者死。赤如 血（败血凝聚）者死。白
如枯骨者死。此五色之见死也。青如翠羽者生。赤如鸡冠者生。黄如蟹腹者生。白如豕膏者生。黑如乌羽者生。此五色
之见生也。（五脏生成论）
【素】太阳之脉。其终也戴眼（上视。）反折（身反向后。）螈 。（音炽纵。手足抽掣也。足太阳起目内 。上额交
巅。下循肩膊。挟脊抵腰。手太阳交肩循项。至目锐 。故戴眼反折。足太阳起于足。手太阳起于手。故螈 。）其色白。
绝汗乃出。（如珠不流。）出则死矣。（小肠主液。膀胱者。津液藏焉。津液外脱。则血内亡。灵枢曰。阴阳相离。则腠理
发泄。绝汗乃出。）少阳终者耳聋。（手足少阳脉皆入耳。）百节皆纵。（甲本主筋。筋痿故纵。）目环绝系。绝系一日半死。
（手足少阳脉。皆至目锐 。故环视。目系属心。未绝则正视。已绝则环视矣。）色先青。白乃死矣。（金克木。）阳明终
者。口目动作。（手阳明挟口交人中。足阳明挟口环唇。系目系。）善惊妄言。（足阳明胃病。闻木音而惊。骂詈不避亲疏。）
色黄。其上下经盛。不仁则终矣。（阳明主肌肉。不仁为肉绝。）少阴终者。面黑（心之华在面。黑为肾色。）齿长而垢。
（肾主骨。齿者骨之余。牙龈宣露。故长。）腹胀闭。上下不通而终矣。（肾开窍于二阴。下闭故上胀。如是则心肾不交。
上下痞膈而死矣。）太阴终者。腹胀闭。不得息。善噫善呕。呕则逆。逆则面赤。不逆则上下不通。不通则面黑。皮毛焦
而终矣。（吴注。足太阴脾。主行气于三阴。手太阴肺。主治节而降下。二经病则升降之令不行。故胀闭。升降难。故不
得息。而噫呕以通之。若不呕逆。则上下不通。土实克木。故面黑。肺主皮毛。故焦。）厥阴终者。中热嗌干。善溺心烦。
甚则舌卷。卵上缩而终矣。（手厥阴心包脉起胸中。属心包。足厥阴肝脉。循喉咙。入颃颡。故中热嗌干而心烦。肝脉环
阴器。故善溺。甚则囊缩而舌卷也。舌为心苗。灵枢经脉篇。肝者。筋之合。筋者。聚于阴器而脉络于舌本。）（诊要经
终篇）（灵枢终始篇与此同。）
【素】脉不往来者死。皮肤着者死。（血液枯亡。）瞳子高者。太阳不足。戴眼者。太阳已绝。此决死生之要也。（三
部九候论）
【灵】手太阴气绝（肺。）则皮毛焦。太阴者。行气温于皮毛者也。故气不荣则皮毛焦。皮毛焦则津液去皮节。津液
去皮节者则爪枯毛折。毛折者则毛先死。丙笃丁死。火胜金也。手少阴气绝（心。）则脉不通。脉不通则血不流。血不流
则髦色不泽。故其面黑如漆柴者。血先死。壬笃癸死。水胜火也。足太阴气绝者（脾。）则脉（血。）不荣肌肉。唇舌者
肌肉之本也。脉不荣则肌肉软。肌肉软则舌萎。人中满。人中满则唇反。唇反者肉先死。甲笃乙死。木胜土也。足少阴
气绝（肾。）则骨枯。少阴者冬脉也。伏行而濡骨髓者也。故骨不濡则肉不能着也。骨肉不相亲则肉软却。肉软却故齿长
而垢。发无泽。发无泽者骨先死。戊笃己死。土胜水也。足厥阴气绝则筋绝。厥阴者肝脉也。肝者筋之合也。筋者聚于
阴气。（当作器。）而脉络于舌本也。故脉弗荣则筋急。筋急则引舌与卵。故唇青舌卷卵缩则筋先死。庚笃辛死。金胜木
也。五阴气俱绝则目系转。转则目运。（五阴属五脏。目受五脏之传精。）目运者。为志先死。志先死则远一日半死矣。
六阳气绝（六腑。）则阴与阳相离。离则腠理发泄。绝汗乃出。（如珠不流。）故旦占夕死。夕占旦死。（经脉篇）
【素】肝见庚辛死。心见壬癸死。脾见甲乙死。肺见丙丁死。肾见戊己死。（五行相克。死于其所不胜。）是谓真藏
见。皆死。（平人气象论）
【灵】三虚者。其死暴疾也。得三实者。邪不能伤人也。（年盛。月满。时和。）乘年之衰。（岁气不足。则外邪凑之。
如火不足。则外有寒邪。土不足。则外有风邪也。）逢月之空。（本篇曰。月满则海水西盛。人血气积。肌肉充。皮肤致。
毛发坚。虽遇贼风。入浅不深。月郭空。则海水东盛。人气血虚。其卫气去。形独居。肌肉减。皮肤纵。腠理开。遇贼
风则其入深。其病患也卒暴。）失时之和。（如夏应热而反寒。冬应寒而反温。）因为贼风所伤。（本经九宫八风篇。有大
弱风。谋风。刚风。折风。大刚风。凶风。婴儿风。弱风。谓之八风之邪。圣人避风。如避矢石焉。）是谓三虚。（素问
至真要大论。乘年之虚。则邪甚也。失时之和。亦邪甚也。遇月之空。亦邪甚也。重感于邪。则病危矣。）（岁露篇）
[Suwen] The five Zang organs receive pathogenic qi from the organ they generate (the "son" organ); then transmit it to the organ they control (the "subjugated" organ); the qi stays in the organ that generates them (the "mother" organ). The classic states: "It holds at the organ it generates." Ultimately, death occurs at the organ that controls them (the "controlling" organ). When a disease is about to cause death, the pathogenic qi must necessarily transmit sequentially until it reaches the controlling organ, at which point the patient dies. This describes the retrograde movement of qi, hence leading to death. (If the qi of the five Zang organs moves in the normal generating sequence, life is sustained.) Liver receives qi from Heart (its generated organ; when the son organ becomes excessive, it counter-attacks the mother, thus termed retrograde), transmits to Spleen (its controlled organ; Wood controls Earth), qi stays in Kidney (generating organ; Water generates Wood, yet Spleen transmitting to Kidney manifests as Earth controlling Water), and death occurs at Lung (controlling organ; Metal controls Wood, similarly for others below). Heart receives qi from Spleen, transmits to Lung, qi stays in Liver, and death occurs at Kidney. Spleen receives qi from Lung, transmits to Kidney, qi stays in Heart, and death occurs at Liver. Lung receives qi from Kidney, transmits to Liver, qi stays in Spleen, and death occurs at Heart. Kidney receives qi from Liver, transmits to Heart, qi stays in Lung, and death occurs at Spleen. These are all cases of retrograde death. (Retrograde movement.) Dividing a day and night into five parts allows one to predict the timing of death. (Morning corresponds to Jia-Yi, Yin-Mao; daytime to Bing-Ding, Si-Wu; the four seasons' transition months to Wu-Ji, Chen-Xu-Chou-Wei; dusk to Geng-Xin, Shen-You; night to Ren-Gui, Hai-Zi. Jia-Yi corresponds to the generating character 'Sheng'; Wang's edition changes this to 'Sheng'.) Five Excess syndromes lead to death; Five Deficiency syndromes lead to death. Pulse is surging (Heart excess), skin is hot (Lung excess), abdomen is distended (Spleen excess), front and back orifices are blocked (Kidney excess), chest is stifled with dizziness (Liver excess); this is called Five Excess. Pulse is fine (Heart deficiency), skin is cold (Lung deficiency), Qi is scanty (Liver deficiency), diarrhea and incontinence of urine and stool (Kidney deficiency), food and drink cannot enter (Spleen deficiency); this is called Five Deficiency. Why might there be survival in such cases? If gruel enters the Stomach and diarrhea stops, the deficient patient will live. If sweat appears and bowels/bladder become unblocked, the excess patient will live. These are the prognostic signs. Great bones are emaciated (Kidney decline), great muscles are sunken (Spleen decline), chest is full of Qi, breathing is labored (Lung decline), body moves with respiration (Qi is discontinuous, seeking replenishment remotely, causing shoulder shrugging and body movement); expected death in six months. If True Organ pulses appear, inform the specific day of death. Sudden deficiency syndrome strikes abruptly (sudden severe deficiency evil, striking internally), five Zang functions are closed off, pulse channels are blocked, Qi does not flow; this is like falling or drowning, making prediction impossible. (Signs of sudden death, similar to drowning.) (From *Yu Ji Zhen Zang Lun*)
[Suwen] The five Zang organs are the seats of internal preservation. (Wang Bing's commentary: The place where the five spirits reside peacefully.) When the middle organs are full and Qi is excessive, injuring fear, speech sounds muffled as if from inside a room; this is dampness in the middle Qi. (Abdominal Qi is excessive, Lung is full, Qi is excessive with high respiration, injured by sorrow/fear, so voice is not resonant. Damp Earth attacks Kidney, causing fear.) Speech is faint, repeating only after a whole day; this is loss of Qi. (Qi is discontinuous.) Inability to manage clothing, speaking good and bad without avoiding kin or strangers; this is chaos of the Spirit. Inability to store grain and water (referring to Spleen and Stomach) means the gates cannot hold. (Granary refers to Spleen and Stomach. The lower opening of Stomach is Youmen; the junction of large and small intestines is Lanmen; the anus is Pomen.) Unceasing discharge of water (urinary incontinence) means Bladder cannot store. Preservation leads to life; loss of preservation leads to death. The five Zang organs are the strength of the body. The head is the mansion of clarity; head drooping and deep-set eyes indicate spirit is being depleted. The back is the mansion of the chest (acupoints of zang-fu all belong to the back); curved back and drooping shoulders indicate the mansion is failing. The waist is the mansion of Kidney; inability to turn or shake indicates Kidney is exhausted. Knees are the mansion of sinews; inability to flex/extend, walking with stoop, indicates sinews are exhausted. Bones are the mansion of marrow; inability to stand long, trembling while walking, indicates bones are exhausted. Strength leads to life; loss of strength leads to death. The clear colors are the brilliance of Qi. Red should resemble white silk wrapping cinnabar, not ochre; white should resemble goose feathers, not salt; green should resemble the luster of dark jade, not indigo; yellow should resemble silk wrapping realgar, not loess; black should resemble heavy lacquer, not earth grey. If the subtle essence of the five colors appears externally, lifespan is short. (From *Mai Yao Jing Wei Lun*)
[Suwen] Complexion cyan like dead grass indicates death; yellow like dried orange peel indicates death; black like soot indicates death; red like clotted blood indicates death; white like dry bone indicates death. These are the dying appearances of the five colors. Cyan like kingfisher feathers indicates life; red like chicken comb indicates life; yellow like crab belly indicates life; white like pig fat indicates life; black like crow feathers indicates life. These are the living appearances of the five colors. (From *Wu Zang Sheng Cheng Lun*)
[Suwen] When Taiyang meridian qi ends, there is upward gaze (dai yan), opisthotonos (body bent backward), and convulsions. Foot Taiyang starts at inner canthus, goes to vertex, down shoulder/back to waist; Hand Taiyang meets at shoulder, down neck to outer canthus, hence upward gaze and opisthotonos. Foot Taiyang starts at foot, Hand Taiyang at hand, hence convulsions. Complexion is pale, absolute sweat appears (beads not flowing). Once appearing, death follows. (Small Intestine governs fluids, Bladder stores fluids; fluid depletion leads to blood loss. *Ling Shu* says: When Yin and Yang separate, pores open, absolute sweat appears.) Shaoyang ending involves deafness (Hand/Foot Shaoyang enter ears), flaccidity of all joints (Jia text governs sinews, sinew flaccidity causes laxity), eyes rolling or staring fixedly, severance of eye connections. Severance leads to death in 1.5 days. (Hand/Foot Shaoyang reach outer canthus, hence rolling eyes. Eye connection belongs to Heart; unsevered looks straight, severed looks around.) Complexion first turns cyan, then white before death (Metal controls Wood). Yangming ending involves mouth/eye twitching (Hand Yangming crosses mouth/nose, Foot Yangming circles lips/eyes), fright and delirious speech (Foot Yangming stomach disease, frightened by wood sound, cursing without discrimination), yellow complexion, excess in upper/lower meridians, insensibility marks the end (Yangming governs flesh, insensibility is flesh extinction). Shaoyin ending involves black face (Heart's bloom is on face, black is Kidney color), teeth appearing long with dirt (Kidney governs bone, teeth are surplus of bone, gum recession makes teeth look long), abdominal distension and closure, upper/lower blockage marks the end (Kidney opens to two yin orifices, lower blockage causes upper distension; Heart-Kidney non-interaction leads to stagnation and death). Taiyin ending involves abdominal distension/closure, dyspnea, belching/vomiting. Vomiting causes reversal, reversal causes red face; no reversal causes blockage, blockage causes black face, dry skin/hair marks the end. (Wu's note: Foot Taiyin Spleen moves Qi through three Yin; Hand Taiyin Lung regulates and descends. Disease here stops ascending/descending, causing distension/blockage. Difficulty ascending/descending causes dyspnea, belching/vomiting to vent. No vomiting/reversal means blockage, Earth excess controls Wood causing black face. Lung governs skin/hair, hence dryness.) Jueyin ending involves internal heat, dry throat, frequent urination, vexation; severely, tongue curling and testicular retraction mark the end. (Hand Juexin Pericardium starts in chest, connects to Pericardium; Foot Jueyin Liver channel follows throat, enters nasopharynx, hence heat/dryness/vexation. Liver channel surrounds genitalia, hence frequent urination. Severe cases involve scrotal retraction and tongue curling. Tongue is Heart sprout; *Ling Shu* states Liver combines with sinews, sinews gather at genitalia and connect to tongue root.) (From *Zhen Yao Jing Zhong Pian*, same as *Ling Shu: Zhong Shi Pian*)
[Suwen] Pulse without flow indicates death; skin adhering to bone indicates death (blood/fluid exhaustion). Pupils elevated indicate Taiyang insufficiency; upward gaze indicates Taiyang extinction. This is key to determining life and death. (From *San Bu Jiu Hou Lun*)
[Lingshu] When Hand Taiyin (Lung) Qi perishes, skin/hair become dry. Taiyin circulates Qi to nourish skin/hair. Without Qi, skin/hair dry; without fluids, nails wither, hair breaks. Hair breaking indicates hair dies first; Bing day worsens, Ding day dies (Fire overcomes Metal). When Hand Shaoyin (Heart) Qi perishes, vessels do not flow. No vessel flow means no blood flow. No blood flow means hair loses luster; face turns black like lacquered charcoal, indicating blood dies first; Ren day worsens, Gui day dies (Water overcomes Fire). When Foot Taiyin (Spleen) Qi perishes, vessels do not nourish muscle. Lips/tongue are roots of muscle. Vessel lack of nourishment causes soft muscle; soft muscle causes tongue atrophy, fullness in philtrum, full philtrum causes lip eversion. Lip eversion indicates flesh dies first; Jia day worsens, Yi day dies (Wood overcomes Earth). When Foot Shaoyin (Kidney) Qi perishes, bones wither. Shaoyin is Winter pulse, hidden to moisten marrow. Bone not moistened means flesh cannot attach; flesh detaches becomes soft/retracted. Soft retraction makes teeth look long/dirty, hair lacks luster. Hair lacking luster indicates bone dies first; Wu day worsens, Ji day dies (Earth overcomes Water). Foot Jueyin (Liver) Qi perishing means sinew perishing. Jueyin is Liver pulse, Liver combines with sinews. Sinews gather at genitalia, connect to tongue root. Vessel lack of nourishment causes sinew tension; tension pulls tongue and genitals. Cyan lips, curled tongue, retracted genitals indicate sinew dies first; Geng day worsens, Xin day dies (Metal overcomes Wood). When five Yin Qi perishes together, eye connections twist, causing vertigo (Five Yin belong to Zang, eyes receive essence from Zang). Vertigo indicates Will (Zhi) dies first; Will dying first leads to death in 1.5 days. When six Yang Qi perishes (Six Fu), Yin and Yang separate. Separation causes pore leakage, absolute sweat appears (beads not flowing). Thus, morning prediction means evening death, evening prediction means morning death. (From *Jing Mai Pian*)
[Suwen] Liver dies on Geng/Xin days, Heart on Ren/Gui, Spleen on Jia/Yi, Lung on Bing/Ding, Kidney on Wu/Ji (Five Elements mutual control, dying at the controlling element). This is called True Organ appearance, all indicate death. (From *Ping Ren Qi Xiang Lun*)
[Lingshu] Those encountering "Three Deficiencies" die suddenly. Those obtaining "Three Excesses" are not harmed by evil. (Three Excesses: Prime age, Full moon, Harmonious season.) Riding the year's decline (Yearly Qi insufficient, external evil gathers; e.g., Fire insufficient brings Cold, Earth insufficient brings Wind). Meeting the moon's void (Text says: Moon full, sea water west-heavy, human Qi/blood accumulate, muscles firm, skin tight, hair strong; even with wind evil, penetration is shallow. Moon empty, sea water east-heavy, human Qi/blood deficient, Wei Qi departs, form alone remains, muscles reduce, skin loose, pores open; wind evil penetrates deep, illness is sudden.) Losing seasonal harmony (e.g., Summer should be hot but is cold, Winter should be cold but is warm). Then injured by wind evil. (*Ben Jing: Jiu Gong Ba Feng Pian* lists eight winds: Da Ruo, Mou, Gang, Zhe, Da Gang, Xiong, Ying Er, Ruo. Sages avoid wind as arrows/stones.) This is called Three Deficiencies. (*Su Wen: Zhi Zhen Yao Da Lun*: Riding year deficiency, evil is severe; losing seasonal harmony, evil is severe; meeting moon void, evil is severe. Repeated evil contact, illness is critical.) (From *Sui Lu Pian*)