也。肾气既绝。则不能荣骨髓。故肉濡而却。却、结缩也。谓齿龈之肉结缩。而（按此而字疑衍。）故齿渐长而枯燥也。
谓齿干燥色不泽也。肾为津液之主。今无津液。故使发不润焉。戊己、土也。肾、水也。土能克水。故云戊日笃。己日
死也。虞曰。阴阳有少壮。故有三阴三阳。以通气血。以养人身。是故三阴乃有离合。太阴为开。厥阴为阖。少阴为枢。
开者、司动静之基。阖者执禁固之权。枢者、主动转之微。三经不得相失。今足少阴肾脉已绝。是故一经相失。少阴不
得为枢。动转之微不主矣。故曰死也。诊要经终论曰。少阴终者。面黑齿长而垢。腹胀闭。上下不通而终矣。此之谓也。
足太阴气绝。则脉不荣其口唇。口唇者、肌肉之本也。脉不荣。则肌肉不滑泽。肌肉不滑泽。则肉满。肉满则唇反。
唇反则肉先死。甲日笃。乙日死。
丁曰。足太阴经者。脾之脉也。属土。王季夏。其气内养肌肉。外华卫于口唇。其气绝则唇反肉满。故甲日笃而乙
日死也。此是足太阴绝之形也。杨曰。足太阴。脾脉也。脾主肌肉。其气既绝。故肌肉粗涩而唇反。甲乙、木也。脾、
土也。木能克土。故云甲日笃乙日死也。虞曰。口唇、肉之所终。亦曰脾之华。今唇反色青。木贼土也。故曰死矣。阴
阳之离合。以太阴为开。谓司动静之基。今脉已绝。则动静之基乃失司存。故曰死也。素问曰。太阴终者。腹胀闭不得
息。善呕。呕则逆。逆则面赤也。
足厥阴气绝。即筋缩引卵与舌卷。厥阴者、肝脉也。肝者、筋之合也。筋者、聚于阴器。而络于舌本。故脉不荣。
则筋缩急。筋缩急。即引卵与舌。故舌卷卵缩。此筋先死。庚日笃。辛日死。
丁曰。足厥阴经者。肝之脉也。属木。王春。气内养于筋。外则上系舌本。下环于阴器。其气绝。则舌卷卵缩。故
庚日笃而辛日死也。此足厥阴绝之形也。杨曰。足厥阴。肝脉也。肝主筋。其气既绝。故筋缩急而舌卷卵缩。庚辛、金
也。肝、木也。金能克木。故云庚日笃而辛日死也。
手太阴气绝。即皮毛焦。太阴者、肺也。行气温于皮毛者也。气弗荣、则皮毛焦。皮毛焦、则津液去。津液去、即
皮节伤。皮节伤、则皮枯毛折。毛折者。则气先死。丙日笃。丁日死。
丁曰。手太阴经者、肺之脉也。属金。王秋。其气内主于气。外荣于皮毛。其气绝。则津液去。皮毛焦。故丙日笃
而丁日死也。杨曰。手太阴。肺脉也。肺主行气。故曰温皮毛。丙丁、火也。肺、金也。火能克金。故云丙日笃丁日死
也。虞曰。肺行卫气以养皮毛。今皮毛焦。则知火来烁金。皮枯毛折脉绝。其为离合。与足太阴同法也。
手少阴气绝。则脉不通。脉不通。则血不流。血不流。则色泽去。故面黑如梨。此血先死。壬日笃。癸日死。
丁曰。手少阴经者。真心脉也。属君火。王夏。主于荣。通于脉也。其经非不言手厥阴心包络为主相火。相行君命。
主通荣气。今真心气绝。则荣气不行。荣气不行。则血不流行。是以色泽去。故面黑如黧。壬日笃而癸日死。此者是病。
非老惫也。梨字当作此黧字。杨曰。经云手三阴。今此惟释太阴少阴。而心主一经不言之。何也。然。心主者、心包络
之脉也。少阴者、心脉也。二经同候于心。故言少阴绝则心主亦绝，其诊既同。故不别解也。本经云。面黑如漆柴。此
云如梨。漆柴者、恒山苗也。其草色黄黑。无润泽。故以为喻。梨者、即人之所食之果也。亦取其黄黑焉。言人即无血。
则色黄黑。似此二物无光华也。壬癸、水也。心火也。水克火。故云壬日笃癸日死也。虞曰。心主血。血乃为荣。荣华
人身。故有光华之色。今脉已绝。血乃不行。故人色夭。面黑如梨。是知水来贼火。离合与足少阴同。
三阴气俱绝者。则目眩转目瞑。目瞑者为失志。失志者、则志先死。死即目瞑也。
丁曰。所言三阴者。独是言足三阴也。足少阴者。肾也。肾藏精与志。足厥阴。肝也。肝藏魂。通于目。故绝则失
志而乱。魂去目眩也。杨曰。三阴者、是手足三阴脉也。此五脏之脉也。五脏者、人之根本也。故三阴俱绝。则目瞑。
瞑、闭也。言根绝于内。而华□于外。目者、人之光华也。眩、乱也。言目乱不识人也。肾藏精与志。精气已竭。故曰
失志也。三阴绝。皆止得一日半死也。虞曰。五脏之脉皆属三阴。五脏之脉。皆会于目。今三阴俱绝。故目眩目瞑也。
人之五志皆属于阴。谓肝志怒。心志喜。脾志思。肺志忧。肾志恐。今三阴已绝。五脏皆失其志。故无喜怒忧思恐。五
志俱亡。故曰失志也。杨氏言失志。乃止言肾一脏也。本经曰。阴阳相离则怅然失志。此之谓也。
六阳气俱绝者。则阴与阳相离。阴阳相离。则腠理泄。绝汗乃出。大如贯珠。转出不流。即气先死。旦占夕死。夕
占旦死。
丁曰。所言六阳。是手足三阳也。后言阴与阳相离者。谓手三阳通天气。故曰阳也。足三阳通地气。故云阴也。天
地阴阳痞隔。所以言阴阳相离也。是故腠理泄。绝汗乃出。大如贯珠。故其死不移旦夕也。杨曰。此六阳气绝。不出日
死。六阳气绝之状。今略条之。经云。太阳脉绝者。其绝也。戴眼、反折、螈 。其色白。绝汗乃出。出则终矣。少阳
脉绝者。其绝也。耳聋、百节尽纵、目环绝系、绝系一日半死。其色青者乃死。阳明脉绝者。其绝也。口耳张、善惊、
妄言、色黄、其上下经盛而不仁则终矣。此是三阳绝之状也。前云六阳。今经曰三阳绝状者。手足诸阳脉绝。其绝状并
同。所以不别出。阴与阳相离者。阴阳隔绝不相朝使也。腠理泄者。阳气已下。毛孔皆开。所以然也。绝汗。乃汗出如
珠。言身体汗出着肉。如缀珠而不流散。故曰贯珠也。旦占夕死。夕占旦死者。正得半日也。惟少阳绝得一日半矣。虞
曰。阴阳相离。气位隔绝。腠理开疏。汗乃大出。夫如是。则六阳皆绝。其死明矣。况三阳之脉。亦有离合。太阳为开。
阳明为阖。少阳为枢。开者、司动静之基。阖者、执禁固之权。枢者、明转动之微。三经不得相失。今六阳已绝。失其
动静之司。弛其禁固之枢。止其动转之微。三经相失。故曰死也。六阳者。素问曰。上下经乃成六也。
When the Kidney Qi (Kidney Energy) is exhausted, it cannot nourish the bone marrow. Therefore, the flesh becomes flaccid and retracts. "Retract" means contraction; it refers to the contraction of the gingival flesh, causing the teeth to appear gradually longer and become dry and withered. Dryness of the teeth indicates a lack of luster. The Kidney is the master of body fluids (Jin-Ye). Now that there are no body fluids, the hair loses its moisture. Wu and Ji belong to Earth, while the Kidney belongs to Water. Earth overcomes Water; therefore, it is said that the condition worsens on Wu days and death occurs on Ji days. Yu stated: Yin and Yang have stages of youth and maturity, hence there are three Yin and three Yang channels to circulate Qi and Blood and nourish the human body. Thus, the three Yin channels have the functions of Opening (Kai), Closing (He), and Pivot (Shu). The Taiyin serves as the Opening, the Jueyin as the Closing, and the Shaoyin as the Pivot. The Opening governs the foundation of movement and stillness; the Closing holds the authority of restriction; the Pivot manages the subtleties of rotation and transformation. These three channels must not be separated from one another. Now that the Foot-Shaoyin Kidney channel has ceased, one channel has been lost. Since the Shaoyin cannot function as the Pivot, the subtleties of movement and rotation are no longer dominant, hence it is said that death will occur. The *Zhenyao Jingzhong Lun* states: "When the Shaoyin ends, the face turns black, the teeth appear long and dirty, the abdomen is distended and closed, and there is no communication between the upper and lower parts, leading to death." This is what is meant.
When the Qi of the Foot-Taiyin Spleen channel ceases, the vessels fail to nourish the lips. The lips are the root of the muscles. If the vessels do not nourish, the muscles lose their smoothness and luster. If the muscles lack luster, they become full and swollen. When the muscles are full, the lips evert. When the lips evert, the flesh dies first. The condition worsens on Jia days, and death occurs on Yi days.
Ding stated: The Foot-Taiyin channel is the Spleen vessel, belonging to Earth, and is prosperous in the late summer. Its Qi internally nourishes the muscles and externally protects and manifests in the lips. When its Qi ceases, the lips evert and the muscles become full; thus, the condition worsens on Jia days and death occurs on Yi days. This is the manifestation of the cessation of the Foot-Taiyin Qi. Yang stated: The Foot-Taiyin is the Spleen vessel; the Spleen governs the muscles. Since its Qi has ceased, the muscles become rough and coarse, and the lips evert. Jia and Yi belong to Wood, while the Spleen belongs to Earth. Wood overcomes Earth; therefore, it is said that the condition worsens on Jia days and death occurs on Yi days. Yu stated: The lips are the termination of the flesh and are also called the external manifestation of the Spleen. Now, with everted lips and a bluish color, Wood is attacking Earth; therefore, it is said that death will occur. Regarding the separation and combination of Yin and Yang, the Taiyin serves as the Opening, governing the foundation of movement and stillness. Now that the vessel Qi has ceased, the foundation of movement and stillness has lost its governance, hence it is said that death will occur. The *Suwen* states: "When the Taiyin ends, there is abdominal distension and closure, difficulty breathing, frequent vomiting, reversal of Qi upon vomiting, and redness of the face due to reversal."
When the Qi of the Foot-Jueyin Liver channel ceases, the sinews contract, pulling the testicles upward and curling the tongue. Jueyin is the Liver vessel; the Liver harmonizes with the sinews. The sinews gather at the genital organs and connect to the base of the tongue. Therefore, if the vessels do not nourish, the sinews contract and tighten. Tightened sinews pull the testicles and tongue, resulting in a curled tongue and retracted testicles. This indicates that the sinews die first. The condition worsens on Geng days, and death occurs on Xin days.
Ding stated: The Foot-Jueyin channel is the Liver vessel, belonging to Wood, and is prosperous in spring. Its Qi internally nourishes the sinews and externally connects upward to the base of the tongue and circles downward around the genital organs. When its Qi ceases, the tongue curls and the testicles retract; thus, the condition worsens on Geng days and death occurs on Xin days. This is the manifestation of the cessation of the Foot-Jueyin Qi. Yang stated: The Foot-Jueyin is the Liver vessel; the Liver governs the sinews. Since its Qi has ceased, the sinews contract and tighten, resulting in a curled tongue and retracted testicles. Geng and Xin belong to Metal, while the Liver belongs to Wood. Metal overcomes Wood; therefore, it is said that the condition worsens on Geng days and death occurs on Xin days.
When the Qi of the Hand-Taiyin Lung channel ceases, the skin and hair become scorched and dry. Taiyin is the Lung, which circulates Qi to warm the skin and hair. If Qi does not nourish, the skin and hair become scorched. If the skin and hair are scorched, body fluids are depleted. If body fluids are depleted, the skin joints are damaged. If the skin joints are damaged, the skin becomes withered and the hair breaks. Hair breaking indicates that Qi dies first. The condition worsens on Bing days, and death occurs on Ding days.
Ding stated: The Hand-Taiyin channel is the Lung vessel, belonging to Metal, and is prosperous in autumn. Its Qi internally governs Qi and externally nourishes the skin and hair. When its Qi ceases, body fluids are depleted, and the skin and hair become scorched; thus, the condition worsens on Bing days and death occurs on Ding days. Yang stated: The Hand-Taiyin is the Lung vessel; the Lung governs the circulation of Qi, hence it warms the skin and hair. Bing and Ding belong to Fire, while the Lung belongs to Metal. Fire overcomes Metal; therefore, it is said that the condition worsens on Bing days and death occurs on Ding days. Yu stated: The Lung circulates Defensive Qi (Wei-Qi) to nourish the skin and hair. Now that the skin and hair are scorched, it is known that Fire is scorching Metal. Withered skin, broken hair, and ceased vessels follow the same principles of separation and combination as the Foot-Taiyin.
When the Qi of the Hand-Shaoyin Heart channel ceases, the vessels become blocked. If the vessels are blocked, Blood does not flow. If Blood does not flow, luster disappears, so the face turns black like a pear (li). This indicates that Blood dies first. The condition worsens on Ren days, and death occurs on Gui days.
Ding stated: The Hand-Shaoyin channel is the True Heart vessel, belonging to Ministerial Fire (Jun-Huo), and is prosperous in summer. It primarily governs Nutritive Qi (Ying-Qi) and connects to the vessels. The text does not explicitly mention the Hand-Jueyin Pericardium as the primary Ministerial Fire (Xiang-Huo); Ministerial Fire executes the orders of the Sovereign Fire and primarily regulates Nutritive Qi. Now that the True Heart Qi has ceased, Nutritive Qi does not circulate. If Nutritive Qi does not circulate, Blood does not flow freely, hence luster disappears, and the face turns black like dark earth (ni). The condition worsens on Ren days and death occurs on Gui days. This is due to disease, not old age. The character "pear" (li) should be read as "dark earth" (ni). Yang stated: The classic discusses the Three Yin channels of the hand, but here only the Taiyin and Shaoyin are explained, while the Heart Master (Heart Governor) channel is not mentioned. Why? The Heart Master is the Pericardium vessel, and the Shaoyin is the Heart vessel. Both channels correspond to the Heart. Therefore, when the Shaoyin ceases, the Heart Master also ceases. Since the diagnosis is the same, it is not explained separately. The original classic states: "The face turns black like lacquered charcoal." Here it says "like a pear." Lacquered charcoal refers to the seedling of *Dichroa febrifuga*, which is yellow-black and lacks luster, used here as a metaphor. A pear is a fruit eaten by humans, also taken for its yellow-black color. It means that without blood, the complexion is yellow-black, lacking the luster of these two objects. Ren and Gui belong to Water, while the Heart belongs to Fire. Water overcomes Fire; therefore, it is said that the condition worsens on Ren days and death occurs on Gui days. Yu stated: The Heart governs Blood, and Blood is Nutritive Qi, which nourishes the human body and provides luster. Now that the vessels have ceased, Blood does not flow, so the person's vitality fades, and the face turns black like a pear. This shows that Water is attacking Fire, and the principle of separation and combination is the same as the Foot-Shaoyin.
When the Qi of all three Yin channels ceases, dizziness and spinning sensations occur, and the eyes close. Eye closing is due to the loss of Will (Zhi). Loss of Will means the Will dies first. Death results in eye closing.
Ding stated: The "three Yin" mentioned refers specifically to the Foot-Three Yin channels. The Foot-Shaoyin is the Kidney, which stores Essence and Will. The Foot-Jueyin is the Liver, which stores the Soul (Hun) and connects to the eyes. Therefore, when Qi ceases, the Will is lost and chaotic, and the Soul departs, causing dizziness. Yang stated: The three Yin refer to the Three Yin channels of both hands and feet, which are the vessels of the Five Zang organs. The Five Zang organs are the root of humanity. Therefore, when all three Yin cease, the eyes close. "Ming" means closing. It means the root is severed internally, and the external manifestations are lost. The eyes are the brilliance of the human body. "Xuan" means disorder. It means the eyes are disordered and cannot recognize people. The Kidney stores Essence and Will; since Essence and Qi are exhausted, it is called loss of Will. When the three Yin cease, death occurs within one and a half days. Yu stated: The vessels of the Five Zang organs all belong to the three Yin. The vessels of the Five Zang organs converge at the eyes. Now that all three Yin have ceased, there is dizziness and eye closing. The five mental activities (Wu-Zhi) of humans all belong to Yin: anger belongs to the Liver, joy to the Heart, thought to the Spleen, sorrow to the Lung, and fear to the Kidney. Now that the three Yin have ceased, the Five Zang organs have lost their respective mental activities, so there is no anger, joy, sorrow, thought, or fear. With all five mental activities perished, it is called loss of Will. Yang's statement on loss of Will referred only to the Kidney organ. The original classic states: "When Yin and Yang separate, one feels bereft and loses their Will." This is what is meant.
When the Qi of all six Yang channels ceases, Yin and Yang separate. When Yin and Yang separate, the interstices (Cou-Li) leak, and absolute sweat (Jue-Han) emerges. The sweat drops are large like beads strung together, turning but not flowing. This indicates that Qi dies first. One predicted in the morning dies in the evening; one predicted in the evening dies in the morning.
Ding stated: The "six Yang" refers to the Three Yang channels of both hands and feet. The subsequent mention of Yin and Yang separating refers to the Hand-Three Yang connecting to Heaven Qi, hence called Yang; and the Foot-Three Yang connecting to Earth Qi, hence called Yin. The blockage and separation of Heaven and Earth Yin and Yang result in the statement that Yin and Yang separate. Therefore, the interstices leak, and absolute sweat emerges, large like beads, so death will not exceed morning or evening. Yang stated: This describes the cessation of Six Yang Qi, leading to death within a day. The symptoms of Six Yang Qi cessation are briefly listed below. The classic states: "When the Taiyang vessel ceases," the symptoms are staring upward (Dai-Yan), opisthotonos (Fan-Zhe), convulsions (Chou-Chu), white complexion, and emergence of absolute sweat. Once the sweat emerges, life ends. "When the Shaoyang vessel ceases," the symptoms are deafness, complete relaxation of all joints, fixed staring eyes, and severance of the connection. Severance leads to death in one and a half days; if the complexion is green, death occurs. "When the Yangming vessel ceases," the symptoms are gaping of the mouth and ears, fright, delirious speech, yellow complexion, and if the upper and lower vessels are full yet insensitive, life ends. These are the symptoms of the cessation of the Three Yang channels. The earlier text mentions Six Yang, while the current text describes the cessation of the Three Yang because the cessation symptoms of all hand and foot Yang vessels are identical, so they are not listed separately. "Yin and Yang separating" means Yin and Yang are isolated and do not interact. "Interstices leaking" means Yang Qi has sunk and the pores are all open, which is why this happens. "Absolute sweat" refers to sweat emerging like beads, adhering to the flesh like attached pearls without flowing away, hence called "beads strung together." "Predicted in the morning, dying in the evening; predicted in the evening, dying in the morning" refers to a period of half a day. Only the cessation of Shaoyang allows for one and a half days. Yu stated: When Yin and Yang separate, Qi positions are isolated, and the interstices become loose and open, causing massive sweating. In such a case, all Six Yang channels have ceased, and death is evident. Moreover, the Three Yang channels also have the functions of Opening, Closing, and Pivot. The Taiyang serves as the Opening, the Yangming as the Closing, and the Shaoyang as the Pivot. The Opening governs the foundation of movement and stillness; the Closing holds the authority of restriction; the Pivot manages the subtleties of rotation and transformation. These three channels must not be separated. Now that all Six Yang channels have ceased, the governance of movement and stillness is lost, the authority of restriction is relaxed, and the subtleties of rotation and transformation stop. The three channels are separated from each other, hence it is said that death will occur. Regarding the Six Yang, the *Suwen* states: Upper and lower vessels combine to form six.