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The *Jade Machine True Viscera Chapter* (Yuji Zhenzang Pian) states: The pathogenic qi of the five zang organs is received from the organ that generates it (the mother organ). It transmits to the organ it controls. The qi stays in the organ that generates it. Death occurs at the organ that overcomes it. When a disease is about to cause death, the pathogenic qi must first transmit and circulate; death occurs when it reaches the organ it overcomes. This is a retrograde movement of qi, hence death.

The liver receives qi from the heart, transmits it to the spleen, the qi stays in the kidney, and death occurs upon reaching the lung. The heart receives qi from the spleen, transmits it to the lung, the qi stays in the liver, and death occurs upon reaching the kidney. The spleen receives qi from the lung, transmits it to the kidney, the qi stays in the heart, and death occurs upon reaching the liver. The lung receives qi from the kidney, transmits it to the liver, the qi stays in the spleen, and death occurs upon reaching the heart. The kidney receives qi from the liver, transmits it to the heart, the qi stays in the lung, and death occurs upon reaching the spleen. All these are deaths due to retrograde transmission. By dividing a day and night into five parts, one can predict the early or late timing of death.

If the large bones are withered and the large muscles have collapsed, the chest is full of qi, breathing is difficult and panting, internal pain radiates to the shoulders and neck, death is expected within one month. If the *Zangmai* (True Viscera Pulse, i.e., pulse without Stomach Qi) appears, the specific date of death can be given. If the large bones are withered, the large muscles have collapsed, the chest is full of qi, breathing is difficult and panting, internal pain radiates to the shoulders and neck, the body is hot, muscles are wasted, and the skin is broken, and the *Zangmai* appears, death is expected within ten days. If the large bones are withered, the large muscles have collapsed, the shoulder and marrow muscles are consumed, physical activity declines further, but the *Zangmai* has not yet appeared, death is expected within one year.

If the large bones are withered, the large muscles have collapsed, the chest is full of qi, the heart feels obstructed, the shoulders, neck, and body are hot, the skin is broken, muscles are wasted, and the eye sockets are sunken, and the *Zangmai* appears, if the patient cannot see people, they will die immediately; if they can still see people, they will die when the time of the overcoming element arrives. Sudden deficiency and sudden invasion of the body, where the five zang organs become closed and blocked, the pulse channels are unblocked, and qi does not flow back and forth, this situation is like falling from a height and cannot be predicted for a specific time. If the pulse completely stops and does not return, even if the pulse beats five or six times per breath, and the form and flesh have not wasted away, although the *Zangmai* is not seen, death will still occur.

If the pulses of the three divisions and nine positions are all disordered and lost, death ensues. If the pulses above and below, left and right, respond uniformly like the pounding of a mortar, the disease is severe. If the pulses above and below, left and right, are disordered and cannot be counted, death ensues. If the pulse of the middle division is harmonious alone, but the pulses of the other viscera are disordered, death ensues. If the pulse of the middle division diminishes, death ensues. If the eye sockets are sunken, death ensues. If muscles are wasted while the body remains (indicating exhaustion of essence), death ensues. If the pulse rate is suddenly rapid and suddenly slow, suddenly delayed and suddenly quick, death ensues. If the true viscera pulse appears and the form is defeated, death ensues. If form and qi are compatible, life ensues. If the numbers three and five are irregular, disease ensues. If the form and flesh have already wasted away, even if the nine pulses are harmonious, death ensues. A pulse without Stomach Qi is called retrograde; retrogression leads to death.

The liver pulse dies on Geng-Xin days (Metal days). The heart pulse dies on Ren-Gui days (Water days). The lung pulse dies on Bing-Ding days (Fire days). The kidney pulse dies on Wu-Ji days (Earth days). The spleen pulse dies on Jia-Yi days (Wood days). If the pulse is turbid and urgent, coming like a surging spring, the disease progresses and the complexion deteriorates. If the pulse goes continuously and leaves like a hanging thread (suspended extinction), death ensues. If the pulse suddenly disappears and returns, stopping temporarily and then returning, death ensues. If the pulse is excessively expansive, death ensues. If the pulse energy is severed, death ensues. If the pulses of the three divisions resemble boiling soup in a pot, death occurs in the evening if diagnosed in the morning, at noon if diagnosed at midnight, and at midnight if diagnosed at noon.

If the pulses of the nine positions are all deep, fine, and suspended/extinct, they belong to Yin, governing Winter, so death occurs at midnight. If the pulses are vigorous, restless, panting, and rapid, they belong to Yang, governing Summer, so death occurs at midday. Patients with cold-heat diseases die at dawn. Patients with heat-in-the-middle and heat diseases die at midday. Patients with wind diseases die at dusk. Patients with water diseases (edema) die at midnight. If the pulse is suddenly rapid and suddenly slow, suddenly delayed and suddenly quick, and worsens during the last eighteen days of each season (Chen, Xu, Chou, Wei hours), death ensues.

If the pulse is floating and slippery, the body sweats like oil, panting does not cease, fluids and food cannot enter, the body is insensible, alternating between quietness and panting, death ensues. Sweat moistens the hair, panting does not cease; this is the exhaustion of Lung Qi, leading to death. Yang disease lingers alone, the body looks like smoke-stained, eyes stare straight, head shakes, mouth cannot speak; this is the prior exhaustion of Heart Qi. Lips and mouth corners are cyanotic, limbs sweat; this is the prior exhaustion of Liver Qi. The ring around the mouth is dark yellow, virtual sweat turns yellow; this is the prior exhaustion of Spleen Qi. Body heat, coarse panting, seeing Yin symptoms but being irritable, or eye sockets sunken, pupils not moving, Daiyang (floating yang) looking upward; this is Kidney exhaustion. All lead to death. Head and eye pain, sudden vision loss, death ensues. Pulses of the three divisions are tight and abundant, profuse sweating does not resolve the condition, death ensues. Yin and Yang, Cun and Chi pulses are both deficient, death ensues. In warm diseases, no sweat occurs, or sweat does not reach the feet, death ensues. Warm diseases with lingering high fever and fine/small pulses, death ensues. Coughing with wasting form and fever, pulse firm and urgent, death ensues. Skin and flesh adhering to bones, death ensues. Hair standing straight like hemp, death ensues. Bad breath that cannot be approached, death ensues. Tongue curled and testicles retracted, death ensues. Eyes not turning, staring straight, death after one day. Yin knotting and Yang severing, eyes protruding and spirit confused, death ensues. Face lacks luster, gums are black, death ensues. Heat diseases lasting seven to eight days should sweat; if sweat does not occur and the pulse ceases, death ensues. Urinary incontinence with lack of awareness, death ensues. Mouth open like a fish mouth, unable to close, with more air exiting than entering, death ensues. Anus loose like a bamboo tube, fecal incontinence with lack of awareness, death ensues. Patient lying in bed restless, tossing near the edge, death ensues. Vomiting phlegm like crab foam, death ensues. Facial swelling with pale-black complexion, death ensues. Exterior and interior both diseased, death ensues. In Shanghan (Cold Damage), this is called Lianggan (simultaneous exterior and interior involvement). After sweating, if the body is not cool but adds panting and diarrhea, death ensues. Long-standing disease with delirium and inability to speak, untreatable. Heat diseases may be treatable.

Patient with exhaustion of both Yin and Yang, grasping at empty air and touching clothes, death ensues. Sweat does not flow, tongue curled and black, death ensues. Hair and shoulders standing upright, death ensues. Patient with cyanotic nail beds, death ensues. Patient with white nail beds, untreatable. Patient with ceased pulse, open mouth, and swollen feet, death in five days. Patient with swollen dorsum pedis, knees as large as a dou (measure), death in ten days. Patient with swollen scrotum and penis, death ensues. Patient with black nail beds and flesh, death in eight days. Patient unable to rest head on pillow, qi rising like panting, death ensues. Patient urinating ten-plus times daily with dribbling, death ensues. Patient with both form and qi deficient, if able to eat, dies beyond the expected period; if unable to eat, dies before the expected period.