真脏死脉、经。真肝脉至。中外急。如循刀刃。责责然如按琴瑟弦。真心脉至坚而搏。如循薏苡子。累累然。真肺
脉至大而虚。如以毛羽中人肤。真肾脉至。搏而绝。如指弹石。辟辟然。真脾脉至。弱而乍数乍疏。见真脏乃死。何也。
五脏皆禀气于胃。胃者五脏之本也。脏气不能自至于手太阴。因胃气乃至于手太阴。（肺朝百脉。故脏气必先会于手太阴。
而后行于诸经也。）故经谓五脏各以其时自为而至于手太阴。皆胃气为之也。（五脏各以其时。自为弦钩毛石之象。因胃
气而至于手太阴之脉口。）若邪气胜者。精气衰。胃气不能与之俱至于手太阴。故真脏之气独见。独见者。病胜脏也。故
曰死。按五脏之气为阴。胃气为阳。五脏有胃气。则其脉和。如微弦微钩之类是也。若无胃气。但见弦钩等本脏之脉。
曰真脏。见真脏则阳气绝故死。
四时贼邪死脉。经。五邪所见。春得秋脉。夏得冬脉。长夏得春脉。冬得长夏脉。名曰阴出之阳。不治。按所谓阴
者真脏也。故死。脉经谓夏脉沉 而滑者。为肾乘心。水克火。十死不治。不知夏月停水停痰之人。其脉有沉 而滑者。
未必即为死病也。且滑为阳脉。沉 而滑。是有阳也。有阳者亦不死也。经所谓夏得冬脉。乃沉而坚硬。如指弹石。纯
阴无阳者也。又谓长夏脉弦细而长。为肝乘脾。木克土。十死不治。不知长夏病疟之人。其脉多弦细而长者。未必即为
死病也。且长为阳脉。弦细而长。是有阳也。有阳者亦不死也。经所谓长夏得春脉。乃弦而坚硬。如循刀刃。纯阴无阳
者也。脉经之说误。李士材曰。一岁之中。脉象不可再见。如春宜弦而得洪脉者。至夏必死。得涩脉者。至秋必死得沉
脉者。至冬必死。为真脏之气先泄也。当其时不能再见矣。按士材之说。本脉经死脉要诀篇。然亦有不可泥者。经以春
不沉谓之塞。则春得沉脉。未可即以为死脉也。春脉弦。未交夏之时。便得钩脉。经谓未去而去者病。亦未可即以为死
脉也。又当以病症合辨之。庶几始确。且所谓真脏者。纯阴无阳之脉也。非夏脉钩。或见于春时。即为真脏也。又当以
有神无神细辨之。庶几始确。大抵惟春得秋脉而涩者。乃经所谓贼邪。为不宜耳。余仿此。
三部死脉。脉经尺脉上不至关。为阴绝。寸脉下不至关。为阳绝。死不治。上部有脉。下部无脉。其人当吐。不吐
者死。上部无脉。下部有脉。虽困无害。所以然者。如树之有根也。按上部无脉。下部有脉。若其脉微细如丝。按之无
有者。此肾脏将尽未尽之气也。亦死。
形盛形瘕死脉。经形盛脉细。少气不足以息者死。形瘕脉大。胸中多气者死。
死脉名状。脉如屋漏雀啄者死。（屋漏者。脉一来忽绝。久又来也。雀啄者脉。来疾时绝又一来也。）脉来如弹石。
去如解索者死。（弹石者。急而劲也。解索者。散乳无结也。）脉如鱼翔虾游者死。（鱼翔。虾游者。脉浮而无根也。）脉
如涌泉者死。（涌泉者。燥乱而有来无去也。）脉一息二至以下。八至以上者死。
True Zang Dead Pulse, from the Classic. When the True Liver pulse arrives, it is tense inside and outside, like tracing the edge of a blade, rapid and sharp like pressing the strings of a qin or se. When the True Heart pulse arrives, it is firm and beating, like tracing Coicis Semen (Job's tears), distinct and piled up. When the True Lung pulse arrives, it is large and empty, like a feather brushing against human skin. When the True Kidney pulse arrives, it beats forcefully yet seems severed, like fingers striking a stone, crisp and loud. When the True Spleen pulse arrives, it is weak and alternates between rapid and slow. The appearance of the True Zang pulse indicates death. Why?
The Qi of the Five Zang organs is derived from Stomach Qi; the Stomach is the root of the Five Zang. The Zang Qi cannot reach the Hand-Taiyin Lung meridian on its own but relies on Stomach Qi to arrive at the Hand-Taiyin. (The Lungs govern all vessels, so Zang Qi must first converge at the Hand-Taiyin before circulating through the other meridians.) Thus, the Classic states that each Zang organ presents its respective seasonal pulse image at the Hand-Taiyin cun-kou point due to the presence of Stomach Qi. (Each Zang organ naturally manifests its characteristic pulse—Liver as Wen [stringy], Heart as Zhuo [hooking], Lung as Fu [floating], Kidney as An [sunken]—at their respective seasons, appearing at the Hand-Taiyin pulse site via Stomach Qi.) If pathogenic factors prevail and Essence-Qi declines, Stomach Qi cannot accompany the Zang Qi to the Hand-Taiyin. Consequently, the True Zang Qi appears alone. Its solitary appearance means disease overcomes the Zang, hence death.
Note: The Qi of the Five Zang is Yin, while Stomach Qi is Yang. When the Five Zang possess Stomach Qi, the pulse is harmonious, such as slightly Wen or slightly Zhuo pulses. Without Stomach Qi, only the intrinsic pulses of the specific Zang (e.g., Wen, Zhuo) are seen, termed True Zang pulses. The appearance of True Zang pulses indicates the exhaustion of Yang Qi, leading to death.
Four-Season Treacherous Evil Dead Pulses, from the Classic. Observations of the Five Evils: Autumnal pulse in Spring, Winter pulse in Summer, Spring pulse in Late Summer, and Late Summer pulse in Winter. This is called "Yin emerging into Yang," which is untreatable. Note: "Yin" refers to the True Zang pulse, hence death. Mai Jing states that a deep, choppy, and slippery pulse in Summer indicates Kidney Water attacking Heart Fire (Water overcoming Fire), resulting in ten deaths with no cure. However, one should not know that individuals with retained water or phlegm in Summer may exhibit deep, choppy, and slippery pulses without necessarily facing a fatal condition. Moreover, Slippery is a Yang pulse; Deep, Choppy, and Slippery indicates the presence of Yang. Presence of Yang implies survival. The Classic's description of "Winter pulse in Summer" refers to a pulse that is Deep and Hard, like fingers striking a stone, representing pure Yin without Yang. It also states that a Stringy, Fine, and Long pulse in Late Summer indicates Liver Wood attacking Spleen Earth (Wood overcoming Earth), resulting in ten deaths with no cure. However, individuals suffering from Malaria in Late Summer often present Stringy, Fine, and Long pulses, which are not necessarily fatal. Furthermore, Long is a Yang pulse; Stringy, Fine, and Long indicates the presence of Yang. Presence of Yang implies survival. The Classic's description of "Spring pulse in Late Summer" refers to a pulse that is Stringy and Hard, like tracing a blade, representing pure Yin without Yang. The statement in Mai Jing is erroneous. Li Shicai stated: Within a year, contrary pulse images should not reappear. For instance, if a Spring-appropriate Wen pulse is replaced by a Hong pulse, death will occur in Summer; if a Se pulse appears, death will occur in Autumn; if a Chen pulse appears, death will occur in Winter. This is because the True Zang Qi has already leaked out. These pulses cannot appear during their respective seasons. Note: Li Shicai's theory originates from the "Key to Dead Pulses" chapter in Mai Jing, but it should not be applied rigidly. The Classic states that a non-Chen pulse in Spring is called "Sa" (obstruction); thus, a Chen pulse in Spring is not immediately fatal. A Spring pulse should be Wen; if a Zhuo pulse appears before Summer begins, the Classic states "what has not passed has passed indicates illness," which is not immediately fatal. One must differentiate based on clinical symptoms to ensure accuracy. Furthermore, the True Zang pulse is defined as pure Yin without Yang. It does not mean that a Summer Zhuo pulse appearing in Spring is automatically a True Zang pulse. One must carefully distinguish whether the pulse has Shen (Spirit). Only then can accuracy be achieved. Generally, only when an Autumnal pulse with Se characteristics appears in Spring does it constitute the "Treacherous Evil" mentioned in the Classic, which is unfavorable. The rest follow this pattern.
Three Regions Dead Pulses: Mai Jing states that if the Chi pulse does not reach the Guan position upwards, it is Yin Extinction; if the Cun pulse does not reach the Guan position downwards, it is Yang Extinction. Both result in death and are untreatable. If there is a pulse in the Upper region but none in the Lower region, the patient should vomit; if they do not vomit, they will die. If there is no pulse in the Upper region but a pulse in the Lower region, although the patient is exhausted, there is no major harm. This is because, like a tree having roots. Note: In the case of no Upper pulse but a Lower pulse, if the pulse is minute and thread-like, disappearing upon heavy pressure, this represents the remaining Qi of the Kidneys nearing exhaustion, which also leads to death.
Dead Pulses for Excessive and Emaciated Forms: The Classic states that excessive physical form with a fine pulse and insufficient Qi causing shortness of breath indicates death. Emaciated physical form with a large pulse and excess Qi in the chest indicates death.
Descriptions of Dead Pulse Names: A pulse resembling a leaking roof (intermittent and irregular) or a sparrow pecking (rapid with sudden interruptions) indicates death. (Leaking roof: the pulse comes once, suddenly stops, and returns after a long interval. Sparrow pecking: the pulse comes rapidly, interrupts, and comes again.) A pulse coming like striking a stone (urgent and forceful) and going like untying a knot (scattered and loose) indicates death. (Striking stone: urgent and stiff. Untying knot: scattered without knots.) A pulse resembling a swimming fish or floating shrimp (floating without root) indicates death. (Swimming fish/Floating shrimp: the pulse is superficial and rootless.) A pulse resembling a gushing spring (chaotic with incoming flow but no outgoing return) indicates death. (Gushing spring: chaotic with arrival but no departure.) A pulse rate of two beats or fewer per respiration cycle, or eight beats or more per respiration cycle, indicates death.