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This refers to the pulse of sudden onset due to extreme deficiency, and judging it as a death pulse is incorrect. Wang Bing's edition states "one breath," but according to the New Corrections (Xin Zheng), "If a person's pulse beats five or six times per breath, how can it be considered a death pulse? The character 'xi' (breath) should be interpreted as 'hu' (exhalation)." This is correct, and we adopt this interpretation here.)

When the True Liver Pulse appears, the pulse is tense both internally and externally, sharp like touching a blade, or tight like pressing the string of a qin or se; the complexion is blue-white without luster, and the body hair withers and breaks—this indicates death. When the True Heart Pulse appears, the pulse is hard and pounding, granular like rolling Yi Yi Zi (Coicis Semen, Job's tears); the complexion is red-black without luster, and the body hair withers and breaks—this indicates death. When the True Lung Pulse appears, the pulse is large and empty, light like a feather brushing against the skin; the complexion is white-red without luster, and the body hair withers and breaks—this indicates death. When the True Kidney Pulse appears, the pulse is forceful yet intermittent, sounding like fingers snapping on stone (pi pi sound); the complexion is black-yellow without luster, and the body hair withers and breaks—this indicates death. When the True Spleen Pulse appears, the pulse is weak and irregular, alternating between rapid and slow; the complexion is yellow-green without luster, and the body hair withers and breaks—this indicates death. Whenever any of the True Zang Pulses manifest, the condition is fatal and untreatable. (Note: Yang Shangshan stated, "Because there are no other mixed energies, it is called 'True.' The Qi of the Five Zang organs relies on Stomach Qi for harmony and cannot function independently. Just as rigid energy cannot function alone—if used exclusively, it breaks; if used harmoniously, it stabilizes. For instance, the Xian (Wiry) pulse belongs to the Liver; a slight wiriness indicates health. 'Slight wiriness' means two parts Stomach Qi and one part Wiry Qi. If all three parts are purely Wiry without Stomach Qi, it is the manifestation of the True Zang. The rest follow this logic. Yang's explanation is correct, though using fractions as a metaphor is somewhat fragmented. What is meant by Stomach Qi is gentleness and moderation. A Wiry pulse that is also gentle possesses Stomach Qi. If it is purely Wiry and urgent, it is named the True Zang pulse.)

The Yellow Emperor asked, "Seeing the True Zang Pulse indicates death; why is this?" Qi Bo replied, "The Five Zang organs all derive their Qi from the Stomach; the Stomach is the root of the Five Zang. (The Stomach is the Sea of Water and Grain, thus the Five Zang rely on it.) The Qi of the Zang organs cannot reach the Hand-Taiyin (Lung Meridian) on its own; it must arrive via the assistance of Stomach Qi. (Note: Hand-Taiyin refers to the Cun, Guan, and Chi positions at the Shou Taiyuan acupoint. Humans cannot survive without water and grain; thus, the Five Zang must rely on Stomach Qi for nourishment. Only when the Qi of water and grain circulates do the conditions of the Five Zang become visible at the Cun Kou pulse. The *Jia Yi Jing* states, 'Humans take Stomach Qi as their root, and pulses also take Stomach Qi as their root.' This is correct.) Therefore, each of the Five Zang manifests at its respective season, carrying Stomach Qi to the Hand-Taiyin. (Note: Each Zang governs a specific season. If Stomach Qi is present, the pulse conforms to the season and appears smooth; if Stomach Qi is lost, the pulse contradicts the season and appears as a death pulse.) Thus, when pathogenic factors prevail, Essence-Qi declines. In severe illness, Stomach Qi cannot accompany the Zang Qi to the Hand-Taiyin, so the True Zang Qi appears alone. Its solitary appearance means disease has overcome the Zang, hence death is declared.

The Yellow Emperor said, "Excellent! (Note: Because pathogenic factors prevail, the disease is severe; when severe, food and drink do not enter the Stomach, and the pulse naturally loses its gentle quality. At this point, the form of the thief-pathogen appears alone, presenting as a Dai [intermittent] pulse without Stomach Qi.)"

The Yellow Emperor said, "In treating diseases, one must observe the patient's form and Qi, color and luster, the excess or deficiency of the pulse, and whether the disease is new or old, then treat accordingly without missing the timing. (One must intervene before the disease becomes incurable.) If form and Qi are in harmony, it is called treatable. (Excess Qi with excess form, or deficient Qi with deficient form, constitutes harmony.) If the color and luster are floating and moist, it is called easily curable. (...Floating and moist color and luster indicate that Qi and Blood are mutually nourishing, hence easy to cure.) If the pulse is weak and slippery, this indicates the presence of Stomach Qi, designated as easy to treat; treatment should be applied at the appropriate time... (Waiting for the right moment to treat ensures success. Note: The terms 'weak' and 'slippery' here are favorable indicators. 'Weak' implies no rigidity or urgency; 'slippery' implies no dryness or roughness.) If the pulse is excess and firm, it indicates worsening condition. (Note: Excess and firm imply rigidity without gentleness. Pure Yang without Yin suggests the disease will progress daily.) If the pulse contradicts the Four Seasons, it is called untreatable.... Specifically, contradicting the Four Seasons refers to... sinking and choppy pulses in Spring and Summer, or floating and large pulses in Autumn and Winter; this is called contradicting the Four Seasons. (Note: This describes pulses opposite to the seasonal norms.) Heat disease with a quiet pulse; diarrhea with a large pulse; hemorrhage with an excess pulse; interior disease with an excess/firm pulse; exterior disease with a non-excess/non-firm pulse. All these are difficult to treat. (Note: This describes pulses contrary to symptoms. Regarding the two sentences about 'disease in the interior,' they differ from the *Ping Ren Qi Xiang Lun*. That text says interior disease should have a deficient pulse, implying internal excess with a falsely deficient pulse. Here, it refers to original deficiency with a falsely strong pulse. That text says exterior disease should have a choppy/firm pulse, implying external pathogen with an inappropriately choppy pulse. Here, it means external pathogen should not have a weak pulse. Although the wording differs, both convey the principle of contradiction between excess and deficiency. The New Corrections mistakenly labeled this as an error, which itself is the true error.)"

The Yellow Emperor said, "I have heard that excess and deficiency determine life and death; I wish to hear the details." Qi Bo said, "Five Excesses lead to death; Five Deficiencies lead to death." The Yellow Emperor said, "I wish to hear what the Five Excesses and Five Deficiencies are." Qi Bo said, "Pulse is surging, skin is hot, abdomen is distended, urination and defecation are obstructed, chest fullness and dizziness occur; this is called Five Excesses. (Excess refers to flourishing pathogenic factors. Among them, surging pulse corresponds to the Heart; hot skin to the Lung; abdominal distension to the Spleen; obstruction of front and back to the Kidney; chest fullness and dizziness to the Liver.) Pulse is fine/thin, skin is cold, Qi is scant, anterior and posterior passages leak/flow freely, food and drink are not taken in; this is called Five Deficiencies. Deficiency refers to insufficiency of True Qi. Among them, fine pulse corresponds to the Heart; cold skin to the Lung; scant Qi to the Liver; leakage of front and back to the Kidney; inability to eat to the Spleen." The Yellow Emperor said, "Under what circumstances can survival occur?" Qi Bo said, "If fermented grain liquid enters the Stomach and dysentery/diarrhea stops, the deficient patient lives; if sweat is produced and bowels/bladder open, the excess patient lives. These are the prognostic signs. (Note: For deficient patients, what is precious is Yuan Qi; for excess patients, what is dreaded is thief-pathogens, hence this distinction.)"