风痹淫泺，病不可已者，（病在阳，命曰“风”，病在阴，命曰“痹”，阴阳俱病，命曰“风痹”；
淫泺者，浸淫日深之谓。泺，音漉。）足如履冰，时如入汤中，股胫淫泺，烦心头痛，时呕时 ，眩
已汗出，久则目眩，悲以喜恐，短气不乐，不出三年死也。（足如履冰之寒，又如入汤之热，下而股胫，中
而腹心，上而头目，无所不病；在表则汗出，在里则短气不乐，或为悲哀，或为喜恐，此阴阳俱病之
候，虽尚可支持，然不能出三年也。）导引、行气、乔摩、灸熨、刺 、饮药诸方者，众人之方也，非一
人之所尽行也。（谓当因
人所宜以施治，是众人各有其方也。）守一勿失，万物以毕。（人得其一则万变之道可毕矣。）而阴阳之要，
虚实之理，倾移之过，可治之属；其病之变化、淫传，绝败而不可治者。（淫邪传变，未必
即危，正气绝败，则不可治矣。）昭乎如日醒，窘乎如夜瞑。何为日醒？明于阴阳，如惑之解，如醉之醒。
何谓夜瞑？喑乎其无声，漠乎其无形，折毛发理，正气横倾，淫邪泮衍，血脉传溜，大气入脏，腹痛下淫，可
以致死，不可以致生。（昭乎如醒，道之明也；窘乎如瞑，察之难也。大气，大邪之气也。凡邪之中人，
喑乎其无声，不可得而闻也；漠乎其无形，不可得而见也。至其绝败，则为折毛发理、正气横倾等症，故有
死无生也。）大气入脏，病先发于心，一日而之肺，三日而之肝，五日而之脾；三日不已死，冬夜半，
夏日中。（病发于心而传于肺，火乘金也；三日而金复乘术，故传之肝也，五日而木复乘土，故传之脾也；再
三日而邪气不退，其甚则死，冬月夜半，水王之极也；夏月日中，火王之极也。心火畏水，故冬则
死于夜半；阳邪亢极，故夏则死于日中。盖衰极亦死，盛极亦死，有所偏胜，则有所偏绝也；五行之气无不
皆然。下文之义皆仿此。）病先发于肺，三日而之肝，一日而之脾，五日而之胃；十日不已死，
冬日入，夏日出。（自肺而肝，自肝而脾，皆传所胜也。自脾而胃，表里相传也。肺邪壬于申、酉，故冬
则死于日入，金气绝于寅、卯，故夏则死于日出。）病先发于肝，三日而之脾，五日而之胃，三日而之
肾；三日不已死，冬日入，夏早食。（此肝木传土，而土邪复传水脏也。木受伤者，金胜则危，故冬畏日入，
肝发病者，木强则剧，故夏畏早食时也。）病先发于脾，一日而之胃，二日而之肾，三日而之
膂、膀胱；十日不已死，冬人定，夏晏食。（此土邪乘水，而表里俱相传也。人定在亥，而土病于冬者畏之，
寒水反能侮土也，晏食在巳，而脾病于夏者畏之，以戊巳王乡而合邪为患也。）病先发于胃，五
日而之肾，三日而之膂、膀胱，五日而上之心，二日不已死，冬夜半，夏日 ，（此土邪传水，而水复传火，
故自膀胱以及于心也。冬夜半后，丑也，夏日 ，未也，皆土王之时，故胃病逢之，气极则败。 ，音迭。）
病先发于肾，三日而之膂、膀胱，三日而上之心，三日而之小肠，三日不已死，冬大晨，夏晏晡。（此水
病乘火，而表里皆相传也。大晨，辰刻也，为水之库，晏晡，戌时也，土能伐水，故病发于肾者，不能出乎此
也。病先发于膀胱，五日而之肾，一日而之小肠，一日而之心；二日不已死，冬鸡鸣，夏下晡。（此亦水
火两脏，自表而里之相传也。冬之鸡鸣在丑，阴之极也，夏之下晡在未，水所畏也。膀胱为水腑，故其盛
极衰极皆能死。）诸病以次相传如是者，皆有死期，不可与治也。间一脏及二三四脏者，乃可与治也。
夫病传者，心病先心痛，（此下皆详明病传之见症也，故病发于心者，其症必先为心痛。）一日而咳，（
心病传肺也。上文病传论所谓一日而之肺者，即其义也，余脏准此。）三日胁支痛，（肺复传肝，故胁支痛，
即所谓三日而之肝也。）五日闭塞不通，身痛体重；（所谓五日而之脾也，脾病则不能运化，故闭塞不通。）
三日不已死，（再三日不已，则脾又传肾，五脏俱伤，故死。）冬夜半，夏日中。（此子、午时也，释义虽如
上文，然少阴君火，主子、午正对之化，心通其气，失守则死，亦一义也。）肺病喘咳，（肺主息，故病为喘
咳。）三日而胁支满痛，（三日而之肝也。）一日身重体痛，（一日而之脾也。）五日而胀；（五日而之胃，自
脏传腑也。）十日不已死，（十日不已，则胃复传肾，而五行生成之数已极，故死。）冬日入，夏日出。（此
卯、酉时也，属燥金之化。肺主气，失守则死。）肝病头目眩，胁支满，（肝开窍于目，而经脉布于胁肋也。）
三日体重身痛，（即三日而之脾也。）五日而胀，（即五日而之胃也。）三日腰脊少腹痛，胫 ；（即三日
而之肾也。）三日不已死，（三日不
已，则肾复传心，故死。）冬日入，夏早食。（酉、卯时也，燥金主之，为木所畏。）脾病身痛体重，（脾主
肌肉也。）一日而胀，（即一日而之胃也。）二日少腹腰脊痛，胫 ，（即二日而之肾也。）三日背膂筋痛，
小便闭；（即三日而之膂、膀胱也。）十日不已死，（十日不已，则复传于心，故死。）冬人定，夏晏食。（
此巳、亥时也，司风木之化，脾病畏之也。）肾病少腹腰脊痛， ，（肾主下部，其经脉行于少腹、腰脊、
骨之间也。）三日背膂筋痛，小便闭，（即三日而之膂、膀胱也。）三日腹胀，（即三日而之小肠也。）
三日两胁支痛；（即三日而上之心也，手心主之正，别下渊液三寸，入胸中，故两胁支痛。）三日不已死，（
复伤肺金也。）冬大晨，夏晏晡。（此辰、戌时也，土主四季，为水所畏，故肾病主之。）胃病胀满，（胃脉
布于腹里也。）五日少腹腰脊痛， ，（即五日而之肾也。）三日背膂筋痛，小便闭，（即三日而之膂、膀
胱也。）五日身体重；（五日而上之心，血脉伤，身体重痛。重字下疑有一痛字。）六日不已死，（心复传
肺也。）冬夜半后，夏日 。（丑、未司湿土之化，气通于胃，失守则死，理之自然。）膀胱病小便闭，（膀
胱为津液之府也。）五日少腹胀，腰脊痛， ，（即五日而至肾也。）一日腹胀，（即一日而之小肠也。）
一日身体痛；（即一日而之心，腑传脏也。心主血脉，故为身体痛。）二日不已死，（心病不已，必又传金脏，
故死。）冬鸡鸣，夏下晡。（丑、未时也，土能克水，故膀胱之病畏之。）诸病以死是相传，如是者，皆
有死期，不可刺；（上文相传死期，各有远近，盖其脏有要害，气有虚实也。仓公曰∶能谷者过期，不能
谷者不及期。正此之谓，既有死期，不可刺矣。）间一脏止及至三四脏者，乃可刺也。（间三四脏者，皆非以
次相传者也，治之则愈，故可用针刺之。此云“可刺”、“不可刺”，即前所云“可与治”、“不可与
治”同义也。）
手太阴气绝，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；（手太阴者，肺也。肺主皮毛，故其气绝则津液去于
皮节，而症在爪枯毛折也，肺金畏火，故危于丙、丁。）手少阴气绝，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；（手少阴者，心也。心主血脉，
故心脉绝则血先死，其症在髦色不泽而面黑如漆也，心火畏水，故危于壬、癸。髦，音毛，发
也。）足太阴气绝者，则脉不荣肌肉，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；（足太阴者，脾也。脾主肌肉，故脾气绝则肉先死，其症在
人中满而舌萎唇反也。脾土畏木，故死于甲、乙。）足少阴气绝则骨枯，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；（足少阴者，肾也。肾属水，故为冬脉，肾主骨，故肾气绝则骨先死，其症在骨肉不
相亲附，则齿长而垢，精髓不能濡润，则发枯无泽也。肾水畏土，故死于戊、己。）足厥阴气绝，则筋绝。
厥阴者，肝木也，肝者筋之合也，筋者聚于阴器，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。（肝气绝者筋先死，其症则唇青舌卷而
卵缩囊拳也。肝木畏金，故死于庚、辛。）五阴气俱绝，则目系转，转则目运，目运者为志先死，志先死则
远一日半死矣。（五脏之精皆上注于目，故五阴气绝则目转而运，志先死矣。盖志藏于肾，阴之
神也。真阴已竭，死在周日间耳。今有病剧而忽尔目无所见者，正阴气竭绝之候。）六阳气绝，则阴与阳
相离，离则腠理发泄，绝汗乃出，故旦占夕死，夕占旦死。（汗本阴精，固于阳气，阳气绝则阴阳
相离而腠理不闭，脱汗乃出，其死在顷刻间也。）
病有短期，冬三月之病，病合于阳者，至春正月，脉有死征，皆归出春。（冬三月者，阴盛时也。病合
于阳者，阳症、阳脉也，出春，春尽夏初也。以水王之时而病合于阳者，时气不足，病气有余也。及至孟春
正月，阳气发生，则阳邪愈胜，阴气愈竭，若脉有死征，则出春交夏，而阳盛阴衰，俱已至极，无所逃矣。）
冬三月之病，在理已尽，草与柳叶皆杀。（在理已尽，谓察其脉症之理已无生意也。以冬月之病而得此，则
凡草色之青，柳叶之见，阴阳气易，皆其死期，故云“皆杀”也，杀，少戒切。）春阴阳皆绝，期在孟春。（
阴阳皆绝，谓阴中无阳，阳中无阴，彼此相绝，不交通也。病由冬月，而春犹若此，是生
气之竭也，短期当在孟春矣。）春三月之病曰阳杀。（春月阳气方升，而病在阳者，故曰“阳杀”。杀者，
衰也。）阴阳皆绝，期在草干。（以三春阳杀之病，而阴阳痞绝者，期在深秋草干之时，金气胜而病发于春
者死矣。）夏三月之病至阴，不过十日。（脾肾皆为至阴。夏三月以阳盛之时，而脾肾伤极，则真阴败绝，天
干易气，不能堪矣，故不过十日也。）阴阳交，期在濂水。（阴阳交者，阴脉见于阳则阳气失守，阳
脉见于阴则阴气失守。若是者虽无危症，而脉象已逆，见于夏月，则危于仲秋濂水之时也。濂，音敛，清也。）
秋三月之病，三阳俱起，不治自已。（秋时阳气渐衰，阴气渐长，虽三阳脉病俱起，而阳不胜阴。故自已也。）
阴阳交合者，立不能坐，坐不能起。（秋气将敛未敛，故有阴阳交合为病者，则或精或气，必有所伤，而致
动止不利。盖阳胜阴，故立不能坐；阴胜阳，故坐不能起。）三阳独至，期在石水。（三阳独至，即二
阳并至，阳亢阴竭之候也。阴竭在冬，本无生意，而孤阳遇水，终为扑灭，故期在水坚如石之时也。）
三阴独至，期在盛水。（三阴独至，有阴无阳也。盛水者。正月雨水之候，孤阴难以独立，故遇阳盛之时
则不能保其有也。）
风痹与淫泺，病情严重无法治愈的，（病在阳经称为“风”，病在阴经称为“痹”，阴阳两经都患病称为“风痹”；淫泺，是指病邪浸淫、日益加深的说法。泺，读音同漉。）患者感觉双脚像踩在冰上一样寒冷，有时又像浸入热水中一样灼热，大腿和小腿部位浸淫酸痛无力，心中烦乱，头痛，时而呕吐，时而呃逆，头晕目眩，已经出汗，时间久了会出现眼睛昏花，情绪悲喜无常、易惊恐，气短且心情不愉快，这种病症不出三年就会死亡。（双脚如履冰之寒，又如入汤之热，从下肢的大腿小腿，到中间的腹部心脏，再到头目，无处不受病邪侵害；在体表则表现为出汗，在体内则表现为气短心情不乐，或悲伤，或喜怒惊恐，这是阴阳两经俱病的征候，虽然暂时还可以支撑，但终究逃不过三年的死期。）导引、行气、乔摩（按摩）、灸熨、针刺、服药等各种治疗方法，是普通大众通用的方术，并非某一个人能全部精通并施行的。（意思是应当根据每个人的具体情况适宜地施治，所以众人各有其适用的方法。）坚守这一原则不要失误，万事万物的道理就可以穷尽了。（人若能掌握这个根本原理，那么变化万千的治疗之道也就完备了。）而阴阳的关键，虚实的道理，邪气转移的过错，属于可以治疗的范畴；那些病邪变化、浸淫传变，正气败绝而无法治疗的，（邪气传变不一定立即危及生命，但如果正气彻底败绝，就无法治疗了。）这就好比白天醒来那样清晰明白，又如同黑夜闭眼那样昏暗难辨。什么是白天醒来？就是通晓阴阳道理，就像解开了迷惑，像酒醉后清醒过来。什么是黑夜闭眼？就是寂静无声，漠然无形，毛发腠理受损，正气横溢倾覆，邪气散漫蔓延，血脉流传阻滞，大邪之气侵入内脏，腹痛下利不止，这会导致死亡，不可能恢复生机。（清晰如醒，说明医道光明；昏暗如瞑，说明诊察困难。大邪之气，指强烈的致病邪气。凡是邪气中人，寂静无声，听不到声响；漠然无形，看不见形状。等到正气败绝时，就会出现折断毛发、损伤腠理、正气横倾等症状，所以只有死路一条。）
大邪之气侵入内脏，如果病先发于心，一天后传到肺，三天后传到肝，五天后传到脾；再过三天病情不愈就会死亡，冬季死于半夜，夏季死于中午。（病发于心传给肺，是火克金；三天后金复克木，所以传到肝；五天后木复克土，所以传到脾；再过三天邪气不退，病情加重就会死亡，冬季半夜是水气极盛之时；夏季中午是火气极盛之时。心火畏惧水，所以在冬季死于半夜；阳邪亢盛至极，所以在夏季死于中午。大概衰极也会死，盛极也会死，有所偏胜，就有所偏绝；五行之气没有不是这样的。下文的意义都仿照此例。）病先发于肺，三天后传到肝，一天后传到脾，五天后传到胃；十天病情不愈就会死亡，冬季死于日落时分，夏季死于日出时分。（从肺传到肝，从肝传到脾，都是传给被己所克的脏腑。从脾传到胃，是表里相传。肺邪旺于申、酉时，所以冬季死于日落，金气绝于寅、卯时，所以夏季死于日出。）病先发于肝，三天后传到脾，五天后传到胃，三天后传到肾；三天病情不愈就会死亡，冬季死于日落时分，夏季死于早饭时分。（这是肝木传给脾土，而土邪又传给肾水脏。木受伤者，金胜则危险，所以冬季畏惧日落，肝发病者，木强则剧烈，所以夏季畏惧早饭时分。）病先发于脾，一天后传到胃，两天后传到肾，三天后传到脊背肌肉和膀胱；十天病情不愈就会死亡，冬季死于黄昏人静时，夏季死于晚饭时分。（这是土邪乘袭水，而且表里互相传染。人定在亥时，而脾土病在冬季畏惧它，因为寒水反能侮土；晏食在巳时，而脾病在夏季畏惧它，因为戊己王乡而合邪为患。）病先发于胃，五天后传到肾，三天后传到脊背肌肉和膀胱，五天后上行传到心，两天病情不愈就会死亡，冬季半夜，夏季未时，（这是土邪传给水，而水又传给火，所以从膀胱一直到心。冬季半夜后是丑时，夏季未时，都是土旺之时，所以胃病遇到这些时辰，气极则败。 ，音迭。）病先发于肾，三天后传到脊背肌肉和膀胱，三天后上行传到心，三天后传到小肠，三天病情不愈就会死亡，冬季大晨（清晨），夏季晏晡（傍晚）。（这是水病乘袭火，而且表里互相传染。大晨是辰刻，为水之库；晏晡是戌时，土能伐水，所以病发于肾者，不能超出这个时间范围。病先发于膀胱，五天后传到肾，一天后传到小肠，一天后传到心；两天病情不愈就会死亡，冬季鸡鸣时，夏季下午时分。（这也是水火两脏，自表而里的互相传染。冬季鸡鸣在丑时，是阴之极；夏季下午在未时，是水所畏惧的时辰。膀胱为水腑，所以其盛极衰极都能致死。）各种疾病按顺序这样互相传染的，都有固定的死期，不可治疗。间隔一脏及二三四脏才传的，才可以治疗。
所谓病传，心病先心痛，（以下详细阐明病传的见症，所以病发于心者，症状必定先出现心痛。）一天后咳嗽，（心病传肺。上文病传论所说的一天后传到肺，就是这个意思，其他脏腑以此类推。）三天后胁肋胀痛，（肺复传肝，所以胁肋胀痛，即所谓三天后传到肝。）五天后闭塞不通，身体疼痛沉重；（即所谓五天后传到脾，脾病则不能运化，所以闭塞不通。）三天病情不愈就会死亡，（再三天不愈，则脾又传肾，五脏俱伤，所以死亡。）冬季半夜，夏季中午。（这是子、午时，释义虽如上文，但少阴君火，主子、午正对之化，心通其气，失守则死，这也是一个解释。）肺病喘咳，（肺主呼吸，所以病表现为喘咳。）三天后胁肋胀满疼痛，（三天后传到肝。）一天后身体沉重疼痛，（一天后传到脾。）五天后腹胀；（五天后传到胃，由脏传腑。）十天病情不愈就会死亡，（十天不愈，则胃复传肾，而五行生成之数已极，所以死亡。）冬季日落，夏季日出。（这是卯、酉时，属燥金之化。肺主气，失守则死。）肝病头目眩晕，胁肋胀满，（肝开窍于目，而经脉布于胁肋。）三天后身体沉重疼痛，（即三天后传到脾。）五天后腹胀，（即五天后传到胃。）三天后腰脊少腹疼痛，小腿酸软无力；（即三天后传到肾。）三天病情不愈就会死亡，（三天不愈，则肾复传心，所以死亡。）冬季日落，夏季早饭时分。（酉、卯时，燥金主令，为木所畏惧。）脾病身体疼痛沉重，（脾主肌肉。）一天后腹胀，（即一天后传到胃。）两天后少腹腰脊疼痛，小腿酸软无力，（即两天后传到肾。）三天后背部脊肉筋脉疼痛，小便闭塞；（即三天后传到脊背肌肉和膀胱。）十天病情不愈就会死亡，（十天不愈，则复传于心，所以死亡。）冬季黄昏人静，夏季晚饭时分。（这是巳、亥时，司风木之化，脾病畏惧它。）肾病少腹腰脊疼痛，小腿酸软无力，（肾主下部，其经脉行于少腹、腰脊、骨之间。）三天后背部脊肉筋脉疼痛，小便闭塞，（即三天后传到脊背肌肉和膀胱。）三天后腹胀，（即三天后传到小肠。）三天后两胁肋胀痛；（即三天后上行传到心，手心主的正经，别行向下渊液三寸，进入胸中，所以两胁肋胀痛。）三天病情不愈就会死亡，（复伤肺金。）冬季大晨，夏季晏晡。（这是辰、戌时，土主四季，为水所畏惧，所以肾病主之。）胃病胀满，（胃脉布于腹里。）五天后少腹腰脊疼痛，小腿酸软无力，（即五天后传到肾。）三天后背部脊肉筋脉疼痛，小便闭塞，（即三天后传到脊背肌肉和膀胱。）五天身体沉重；（五天后上行传到心，血脉受伤，身体沉重疼痛。重字下疑有一个痛字。）六天病情不愈就会死亡，（心复传肺。）冬季半夜后，夏季未时。（丑、未司湿土之化，气通于胃，失守则死，这是理所当然的。）膀胱病小便闭塞，（膀胱为津液之腑。）五天后少腹胀，腰脊疼痛，小腿酸软无力，（即五天后传到肾。）一天后腹胀，（即一天后传到小肠。）一天后身体疼痛；（即一天后传到心，由腑传脏。心主血脉，所以表现为身体疼痛。）两天病情不愈就会死亡，（心病不愈，必又传金脏，所以死亡。）冬季鸡鸣，夏季下午时分。（丑、未时，土能克水，所以膀胱的病畏惧它。）各种疾病按上述顺序互相传染致死的，都有死期，不可针刺；（上文所述的死期，各有远近，大概是因为脏腑有要害，气有虚实。仓公说：能进食的超过死期，不能进食的不及死期。正是这个意思，既然有了死期，就不可针刺。）间隔一脏及至三四脏才传的，才可以针刺。（间隔三四脏者，都不是按顺序互相传染的，治疗就能痊愈，所以可以用针刺。这里说的“可刺”、“不可刺”，即前面所说的“可与治”、“不可与治”同义。）
手太阴经气绝，则皮毛枯焦，太阴经是运行气以温煦皮毛的，所以气不荣养则皮毛枯焦，皮毛枯焦则津液脱离皮节，津液脱离皮节则指甲干枯、毛发折断，毛发折断说明毛先死，丙日加重丁日死，因为火胜金；（手太阴经即肺经。肺主皮毛，所以其气绝则津液去于皮节，而症状在指甲干枯、毛发折断。肺金畏惧火，所以在丙、丁日危重。）手少阴经气绝，则脉道不通，脉道不通则血液不流动，血液不流动则毛发色泽不润泽，所以面色黑得像漆柴一样，血先死，壬日加重癸日死，因为水胜火；（手少阴经即心经。心主血脉，所以心脉绝则血先死，症状在毛发色泽不润泽而面色黑如漆，心火畏惧水，所以在壬、癸日危重。髦，音毛，指头发。）足太阴经气绝，则脉不荣养肌肉，唇舌是肌肉的根本，脉不荣养则肌肉软弱，肌肉软弱则舌萎缩、人中饱满，人中饱满则嘴唇翻卷，嘴唇翻卷说明肉先死，甲日加重乙日死，因为木胜土；（足太阴经即脾经。脾主肌肉，所以脾气绝则肉先死，症状在人中饱满而舌萎唇翻。脾土畏惧木，所以在甲、乙日死亡。）足少阴经气绝则骨骼枯槁，少阴经是冬脉。潜行而濡润骨髓的，所以骨不濡润则肉不能附着，骨肉不相亲附则肌肉松软退缩，肌肉松软退缩所以牙齿显得长且有污垢，头发无光泽，头发无光泽说明骨先死，戊日加重己日死，因为土胜水；（足少阴经即肾经。肾属水，所以为冬脉，肾主骨，所以肾气绝则骨先死，症状在骨肉不相亲附，则牙齿显得长且有污垢，精髓不能濡润，则头发枯槁无光泽。肾水畏惧土，所以在戊、己日死亡。）足厥阴经气绝，则筋脉断绝。厥阴经是肝木，肝是筋的汇聚处，筋聚于生殖器，而脉络连于舌根，所以脉不荣养则筋脉拘急，筋脉拘急则牵引舌头和睾丸，所以嘴唇青紫、舌头卷曲、睾丸收缩，则筋先死，庚日加重辛日死，因为金胜木。（肝气绝者筋先死，症状则嘴唇青紫、舌头卷曲而睾丸收缩囊拳。肝木畏惧金，所以在庚、辛日死亡。）五脏阴气都绝，则目系扭转，扭转则视物旋转，视物旋转说明神志先死，神志先死则过一天半就死了。（五脏的精气都上注于目，所以五阴气绝则目转而运，神志先死。大概神志藏于肾，是阴之神。真阴已竭，死在周日间耳。现在有病重而忽然眼睛看不见东西的，正是阴气竭绝的征候。）六阳气绝，则阴与阳分离，分离则腠理发泄，绝汗乃出，所以早晨占测晚上死，晚上占测早晨死。（汗本为阴精，固摄于阳气，阳气绝则阴阳分离而腠理不闭，脱汗乃出，其死在顷刻间也。）
疾病有短期的，冬季三个月的疾病，病势属阳的，到了春季正月，脉象出现死征，都将在春末夏初死亡。（冬季三个月，是阴气盛的时候。病合于阳者，指阳症、阳脉。出春，指春尽夏初。在水旺之时而病合于阳者，是时令之气不足，病气有余。等到孟春正月，阳气发生，则阳邪更胜，阴气更竭，如果脉象有死征，则出春交夏，而阳盛阴衰，都已达到极点，无处可逃了。）冬季三个月的疾病，在医理上已经穷尽，草木柳叶发芽变绿时都会导致死亡。（在理已尽，谓观察其脉症的医理已经没有生机。以冬季的疾病而得到这种情况，则凡草色之青，柳叶之见，阴阳气转换，都是其死期，所以说“皆杀”。杀，读少戒切。）春季阴阳都绝，死期在孟春。（阴阳皆绝，谓阴中没有阳，阳中没有阴，彼此隔绝，不交通。病由冬季延续而来，而春季仍然如此，是生气的竭尽，短期应当在孟春了。）春季三个月的疾病称为阳杀。（春月阳气方升，而病在阳者，所以叫“阳杀”。杀，是衰退的意思。）阴阳都绝，死期在草干之时。（以三春阳杀之病，而阴阳痞绝者，死期在深秋草干之时，金气胜而病发于春者死矣。）夏季三个月的疾病至阴，不超过十天。（脾肾皆为至阴。夏三月以阳盛之时，而脾肾伤极，则真阴败绝，天干易气，不能承受了，所以不超过十天。）阴阳交，死期在濂水之时。（阴阳交者，阴脉见于阳则阳气失守，阳脉见于阴则阴气失守。若是者虽无危症，而脉象已逆，见于夏月，则危于仲秋濂水之时也。濂，音敛，清也。）秋季三个月的疾病，三阳脉俱起，不治自己会好。（秋时阳气渐衰，阴气渐长，虽三阳脉病俱起，而阳不胜阴。所以自己会好。）阴阳交合者，站立不能坐下，坐下不能站起。（秋气将敛未敛，故有阴阳交合为病者，则或精或气，必有所伤，而导致动止不利。盖阳胜阴，故立不能坐；阴胜阳，故坐不能起。）三阳独至，死期在石水之时。（三阳独至，即二阳并至，阳亢阴竭之候也。阴竭在冬，本无生意，而孤阳遇水，终为扑灭，所以死期在水坚如石之时。）三阴独至，死期在盛水之时。（三阴独至，有阴无阳也。盛水者，正月雨水之候，孤阴难以独立，所以遇阳盛之时则不能保其有也。）
Wind-bi and Yinluo, conditions that are severe and incurable, (When the disease is in the Yang meridians, it is called "Wind"; when in the Yin meridians, it is called "Bi"; when both Yin and Yang meridians are affected, it is called "Wind-Bi"; Yinluo refers to the progressive deepening of pathogenic factors over time. Luo sounds like Lu.) The patient feels cold in the feet as if walking on ice, and at times hot as if immersed in boiling water; there is aching and weakness in the thighs and calves (Yinluo), mental restlessness, headache, occasional vomiting, occasional hiccuping, dizziness, sweating has already occurred, and after a long time, visual blurring occurs. Emotions fluctuate between sorrow, joy, and fear; there is shortness of breath and dysphoria. Such a condition will lead to death within three years. (The coldness of walking on ice and the heat of entering boiling water affect the lower limbs (thighs and calves), the middle (abdomen and heart), and the upper (head and eyes), leaving no part unaffected; exteriorly there is sweating, interiorly there is shortness of breath and dysphoria, or sorrow, or erratic emotions. This is a sign of simultaneous disease in Yin and Yang. Although supportable for a time, death is inevitable within three years.) Methods such as Dao Yin (qigong exercises), Xing Qi (circulating qi), Qiao Mo (massage), Jiu Yun (moxibustion and warming), Ci (acupuncture), and drinking medicinal decoctions are common methods used by the general public, not all of which can be mastered or applied by a single individual. (This means treatment should be tailored to the individual's suitability; thus, everyone has their own applicable method.) Adhere to this principle without deviation, and the principles of all things can be comprehended. (If one grasps this fundamental principle, the myriad ways of treatment can be fully understood.) However, the key to Yin and Yang, the logic of Deficiency and Excess, and the errors of pathogenic migration belong to treatable categories; whereas diseases involving transformation, progressive transmission, and collapse of healthy Qi are incurable. (Pathogenic transmission does not necessarily imply immediate danger; however, if healthy Qi collapses completely, it becomes incurable.) This clarity is like waking up in the day, while confusion is like closing one's eyes at night. What is "waking up"? It is understanding Yin and Yang clearly, like resolving confusion or sobering from drunkenness. What is "closing eyes at night"? It is silence without sound, formless and indistinct; hair follicles and skin pores are damaged, healthy Qi is disrupted and overturned, pathogenic factors spread diffusely, blood vessels transmit stagnation, and major pathogenic Qi enters the Zang organs, causing abdominal pain and profuse diarrhea, leading to death rather than life. (Clarity like waking signifies enlightenment of the Dao; obscurity like sleeping signifies difficulty in examination. Major pathogenic Qi refers to strong evil pathogens. When pathogens invade humans, they are silent and invisible. Upon collapse, symptoms include damaged hair/follicles and disrupted healthy Qi, leading only to death.)
If major pathogenic Qi enters the Zang organs, and the disease originates in the Heart, after one day it transmits to the Lung, after three days to the Liver, and after five days to the Spleen; if it persists for another three days without improvement, death occurs. In winter, death occurs at midnight; in summer, at noon. (Disease originating in the Heart transmitting to the Lung represents Fire overcoming Metal; after three days, Metal overcomes Wood, so it transmits to the Liver; after five days, Wood overcomes Earth, so it transmits to the Spleen. If the pathogen remains after three more days and worsens, death ensues. Winter midnight is the peak of Water energy; summer noon is the peak of Fire energy. Heart Fire fears Water, hence death in winter at midnight; Yang pathogen reaches extreme excess, hence death in summer at noon. Generally, extreme deficiency leads to death, and extreme excess leads to death; bias in dominance leads to bias in extinction. This applies to all Five Elements. The following meanings follow this pattern.) If the disease originates in the Lung, after three days it transmits to the Liver, after one day to the Spleen, and after five days to the Stomach; if it persists for ten days without improvement, death occurs. In winter, death occurs at sunset; in summer, at sunrise. (Transmission from Lung to Liver, and Liver to Spleen, follows the cycle of overcoming. Transmission from Spleen to Stomach is between Interior and Exterior. Lung pathogen prospers at Shen and You hours, hence death in winter at sunset; Metal energy fails at Yin and Mao hours, hence death in summer at sunrise.) If the disease originates in the Liver, after three days it transmits to the Spleen, after five days to the Stomach, and after three days to the Kidney; if it persists for three days without improvement, death occurs. In winter, death occurs at sunset; in summer, at breakfast time. (This is Liver Wood transmitting to Spleen Earth, and Earth pathogen transmitting to Kidney Water. When Wood is injured, Metal dominance brings danger, hence fearing sunset in winter; when Liver disease occurs, Wood strength intensifies, hence fearing breakfast time in summer.) If the disease originates in the Spleen, after one day it transmits to the Stomach, after two days to the Kidney, and after three days to the Back Muscles and Bladder; if it persists for ten days without improvement, death occurs. In winter, death occurs at dusk (Ren Ding); in summer, at dinner time (Yan Shi). (This is Earth pathogen attacking Water, with mutual transmission between Interior and Exterior. Ren Ding is Hai hour; Spleen Earth disease in winter fears it because Cold Water insults Earth. Yan Shi is Si hour; Spleen disease in summer fears it because Wu and Ji hours dominate and combine with pathogens.) If the disease originates in the Stomach, after five days it transmits to the Kidney, after three days to the Back Muscles and Bladder, and after five days upward to the Heart; if it persists for two days without improvement, death occurs. In winter at midnight, in summer at Wei hour. (This is Earth pathogen transmitting to Water, and Water transmitting to Fire, thus from Bladder to Heart. Winter midnight after Chou hour, and summer Wei hour, are both times of Earth dominance; thus Stomach disease meets these times, Qi exhausts and fails. [Character], pronounced Die.) If the disease originates in the Kidney, after three days it transmits to the Back Muscles and Bladder, after three days upward to the Heart, and after three days to the Small Intestine; if it persists for three days without improvement, death occurs. In winter at early morning (Da Chen), in summer at late afternoon (Yan Bu). (This is Water disease attacking Fire, with mutual transmission between Interior and Exterior. Da Chen is Chen hour, the storehouse of Water; Yan Bu is Xu hour, where Earth controls Water. Thus, Kidney disease cannot exceed this timeframe.) If the disease originates in the Bladder, after five days it transmits to the Kidney, after one day to the Small Intestine, and after one day to the Heart; if it persists for two days without improvement, death occurs. In winter at cockcrow, in summer at late afternoon. (This is also mutual transmission between Water and Fire organs, from Exterior to Interior. Winter cockcrow is Chou hour, the extreme of Yin; summer late afternoon is Wei hour, feared by Water. Bladder is the Water Fu organ, so both extreme excess and extreme deficiency lead to death.) Various diseases transmitted sequentially in this manner all have fixed death periods and are untreatable. Those transmitting by skipping one Zang, or two, three, or four Zangs, may be treated.
Regarding disease transmission: Heart disease first presents with chest pain. (The following details the visible symptoms of transmission. Thus, Heart disease must first present with chest pain.) After one day, coughing occurs. (Heart disease transmits to Lung. As mentioned earlier, "transmitting to Lung after one day" implies this meaning; other Zangs follow this rule.) After three days, distending pain in the hypochondrium occurs. (Lung transmits back to Liver, hence distending pain in the hypochondrium, i.e., "transmitting to Liver after three days.") After five days, obstruction and blockage occur, with body pain and heaviness. (This is "transmitting to Spleen after five days." Spleen disease fails to transform and transport, causing obstruction.) If it persists for three days without improvement, death occurs. (After three more days without improvement, Spleen transmits to Kidney, injuring all five Zangs, hence death.) Death occurs in winter at midnight, in summer at noon. (These are Zi and Wu hours. Although explained above, Shaoyin Jun Fire governs Zi and Wu opposite transformations; Heart connects to its Qi, loss of control leads to death, which is another interpretation.) Lung disease presents with wheezing and coughing. (Lung governs respiration, hence disease manifests as wheezing and coughing.) After three days, distending fullness and pain in the hypochondrium occur. (Transmitting to Liver after three days.) After one day, body heaviness and pain occur. (Transmitting to Spleen after one day.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days, from Zang to Fu.) If it persists for ten days without improvement, death occurs. (After ten days without improvement, Stomach transmits to Kidney, and the numbers of generation and completion of Five Elements reach their limit, hence death.) Death occurs in winter at sunset, in summer at sunrise. (These are Mao and You hours, belonging to Dry Metal transformation. Lung governs Qi; loss of control leads to death.) Liver disease presents with dizziness of head and eyes, and distending fullness in the hypochondrium. (Liver opens into the eyes, and meridians distribute along the hypochondrium.) After three days, body heaviness and pain occur. (Transmitting to Spleen after three days.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days.) After three days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after three days.) If it persists for three days without improvement, death occurs. (After three days without improvement, Kidney transmits back to Heart, hence death.) Death occurs in winter at sunset, in summer at breakfast time. (You and Mao hours, governed by Dry Metal, feared by Wood.) Spleen disease presents with body pain and heaviness. (Spleen governs muscles.) After one day, abdominal distension occurs. (Transmitting to Stomach after one day.) After two days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after two days.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) If it persists for ten days without improvement, death occurs. (After ten days without improvement, it transmits back to Heart, hence death.) Death occurs in winter at dusk, in summer at dinner time. (These are Si and Hai hours, governing Wind Wood transformation, feared by Spleen disease.) Kidney disease presents with pain in the lower abdomen, waist, and spine, and weakness in the shins. (Kidney governs the lower part; its meridians run through the lower abdomen, waist, spine, and bones.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) After three days, abdominal distension occurs. (Transmitting to Small Intestine after three days.) After three days, distending pain in both hypochondria occurs. (Transmitting upward to Heart after three days. The regular meridian of Hand Jueyin pericardium branches downward three cun below Yuan Ye, entering the chest, hence distending pain in both hypochondria.) If it persists for three days without improvement, death occurs. (Injuring Lung Metal again.) Death occurs in winter at early morning, in summer at late afternoon. (These are Chen and Xu hours, Earth governs the four seasons, feared by Water, hence governing Kidney disease.) Stomach disease presents with abdominal distension and fullness. (Stomach meridian distributes inside the abdomen.) After five days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after five days.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) After five days, body heaviness occurs. (Transmitting upward to Heart after five days; blood vessels are injured, causing body heaviness and pain. There may be a missing character "pain" after "heaviness".) If it persists for six days without improvement, death occurs. (Heart transmits back to Lung.) Death occurs in winter after midnight, in summer at Wei hour. (Chou and Wei govern Wet Earth transformation, Qi connects to Stomach; loss of control leads to death, naturally so.) Bladder disease presents with urinary retention. (Bladder is the Fu organ of fluids.) After five days, lower abdominal distension, pain in the waist and spine, and weakness in the shins occur. (Transmitting to Kidney after five days.) After one day, abdominal distension occurs. (Transmitting to Small Intestine after one day.) After one day, body pain occurs. (Transmitting to Heart after one day, from Fu to Zang. Heart governs blood vessels, hence body pain.) If it persists for two days without improvement, death occurs. (Heart disease unimproved will inevitably transmit to Metal Zang, hence death.) Death occurs in winter at cockcrow, in summer at late afternoon. (Chou and Wei hours, Earth controls Water, hence feared by Bladder disease.) Various diseases transmitted sequentially to death as described above all have death periods and are untreatable by acupuncture. (The aforementioned death periods vary in proximity, likely due to vital organs and Qi deficiency/excess. Cang Gong said: those who can eat die past the period, those who cannot eat die before the period. This is exactly what is meant. Since there is a death period, acupuncture is contraindicated.) Those transmitting by skipping one Zang or up to three or four Zangs may be treated with acupuncture. (Skipping three or four Zangs means transmission is not sequential; treatment leads to recovery, hence acupuncture can be used. "Treatable/Untreatable" here is synonymous with "Acupuncturable/Contraindicated" mentioned earlier.)
When the Qi of Hand Taiyin (Lung) ceases, the skin and hair become dry and brittle. Taiyin circulates Qi to warm the skin and hair; thus, without Qi nourishment, skin and hair become brittle. Without nourishment at the skin joints, fluids depart, nails wither, and hair breaks. Hair breaking indicates hair dies first; Bing day brings aggravation, Ding day brings death, as Fire overcomes Metal. (Hand Taiyin is Lung. Lung governs skin and hair; thus, Qi cessation causes fluid departure from skin joints, manifesting as withered nails and broken hair. Lung Metal fears Fire, hence critical on Bing/Ding days.) When the Qi of Hand Shaoyin (Heart) ceases, the vessels become obstructed. Obstruction prevents blood flow; lack of blood flow causes hair color to lose luster. Thus, the face turns black like lacquered charcoal, indicating blood dies first; Ren day brings aggravation, Gui day brings death, as Water overcomes Fire. (Hand Shaoyin is Heart. Heart governs blood vessels; thus, vessel cessation causes blood death first, manifesting as dull hair and black face. Heart Fire fears Water, hence critical on Ren/Gui days. Mao sounds like Mao, meaning hair.) When the Qi of Foot Taiyin (Spleen) ceases, the vessels fail to nourish muscles. Lips and tongue are the root of muscles; without vessel nourishment, muscles soften. Soft muscles cause tongue atrophy and fullness in the philtrum. Fullness in the philtrum causes lip eversion. Lip eversion indicates flesh dies first; Jia day brings aggravation, Yi day brings death, as Wood overcomes Earth. (Foot Taiyin is Spleen. Spleen governs muscles; thus, Qi cessation causes flesh death first, manifesting as full philtrum, atrophied tongue, and everted lips. Spleen Earth fears Wood, hence death on Jia/Yi days.) When the Qi of Foot Shaoyin (Kidney) ceases, bones become withered. Shaoyin is the Winter pulse, submerging to moisten bone marrow. Thus, without bone moisture, flesh cannot adhere. Lack of flesh-bone affinity causes flesh to soften and recede. Receding flesh makes teeth appear long and dirty, and hair loses luster. Hair losing luster indicates bone dies first; Wu day brings aggravation, Ji day brings death, as Earth overcomes Water. (Foot Shaoyin is Kidney. Kidney belongs to Water, hence Winter pulse. Kidney governs bones; thus, Qi cessation causes bone death first, manifesting as non-adherent flesh/bone, long/dirty teeth, and withered/lusterless hair due to essence failure. Kidney Water fears Earth, hence death on Wu/Ji days.) When the Qi of Foot Jueyin (Liver) ceases, tendons sever. Jueyin is Liver Wood; Liver is the convergence of tendons. Tendons gather at the genitalia and connect to the base of the tongue. Thus, without vessel nourishment, tendons contract. Contraction pulls the tongue and testicles, causing blue lips, curled tongue, and retracted testicles. This indicates tendons die first; Geng day brings aggravation, Xin day brings death, as Metal overcomes Wood. (Liver Qi cessation causes tendon death first, manifesting as blue lips, curled tongue, and retracted testicles/scrotum. Liver Wood fears Metal, hence death on Geng/Xin days.) When the Yin Qi of all five Zangs ceases, the eye system twists, causing vertigo. Vertigo indicates Spirit (Zhi) dies first. Spirit death leads to death in one and a half days. (Essence of all five Zangs ascends to the eyes; thus, Yin Qi cessation causes eye twisting/vertigo and Spirit death. Spirit resides in Kidney, the spirit of Yin. True Yin exhausted, death occurs within a day and a half. Now, patients with severe illness suddenly losing vision is precisely the sign of Yin Qi exhaustion.) When the Yang Qi of the six Fu organs ceases, Yin and Yang separate. Separation causes pores to open and sweat to leak out (Jue Han). Thus, prognostication in the morning indicates death in the evening, and vice versa. (Sweat is originally Yin essence, secured by Yang Qi. Yang Qi cessation causes Yin-Yang separation and open pores, leading to collapse sweat. Death occurs instantly.)
Diseases have short-term prognoses. Diseases in the three winter months that align with Yang will, if pulse signs of death appear in the first month of spring, result in death by the end of spring. (Three winter months are Yin abundance. Disease aligning with Yang refers to Yang syndrome/pulse. End of spring is early summer. At the time of Water dominance, disease aligning with Yang indicates insufficient seasonal Qi and excessive pathogenic Qi. By Meng Chun (first lunar month), Yang Qi arises, making Yang pathogen stronger and Yin Qi more depleted. If pulse shows death signs, by the transition from Spring to Summer, Yang excess and Yin deficiency reach extremes, leaving no escape.) Diseases in the three winter months where medical reasoning is exhausted (no hope of life) will die when grass turns green and willow leaves sprout. (Reasoning exhausted means observation of pulse/symptoms shows no vitality. Winter disease with this prognosis dies when grass turns green and willow leaves appear, marking the change of Yin/Yang Qi, hence "all perish." Sha reads Shaojie.) Spring diseases where Yin and Yang are both severed have a death period in Meng Chun. (Yin/Yang severed means no Yang in Yin, no Yin in Yang, no communication. Disease persisting from winter into spring with this state indicates exhaustion of generating Qi, with short-term death in Meng Chun.) Spring diseases are called "Yang Sha" (Yang Decline). (Spring Yang Qi rises, but disease is in Yang, hence "Yang Sha." Sha means decline.) Yin/Yang severed diseases have a death period when grass dries. (For Spring Yang Sha diseases with Yin/Yang blockage, death occurs in late autumn when grass dries, as Metal Qi dominates and kills Spring-originating disease.) Summer diseases reaching "Zhi Yin" (Extreme Yin) do not last more than ten days. (Spleen and Kidney are Zhi Yin. In Summer Yang abundance, extreme injury to Spleen/Kidney causes true Yin collapse. Heavenly stems change Qi, which cannot be endured, hence not exceeding ten days.) "Yin Yang Jiao" (Interaction) has a death period at Lian Shui. (Yin Yang Jiao: Yin pulse appearing in Yang means Yang Qi loses control; Yang pulse appearing in Yin means Yin Qi loses control. Though no critical symptoms, the pulse is inverted. Appearing in summer, it is critical at Lian Shui time in mid-autumn. Lian sounds like Lian, meaning clear.) Autumn diseases where Three Yang pulses rise simultaneously will resolve spontaneously. (Autumn Yang declines, Yin grows. Even if Three Yang pulses rise, Yang cannot overcome Yin, hence spontaneous resolution.) Diseases of Yin Yang interaction present as inability to sit while standing, or unable to stand while sitting. (Autumn Qi is gathering but not yet gathered. Yin Yang interaction disease injures Jing or Qi, causing movement impairment. Yang overcoming Yin causes inability to sit; Yin overcoming Yang causes inability to stand.) "San Yang Du Zhi" (Three Yang Alone Arriving) has a death period at Shi Shui (Stone Water). (San Yang Du Zhi is Two Yang arriving together, indicating Yang hyperactivity and Yin exhaustion. Yin exhaustion in winter has no life potential; lone Yang meeting water is extinguished, hence death at Stone Water time.) "San Yin Du Zhi" (Three Yin Alone Arriving) has a death period at Sheng Shui (Abundant Water). (San Yin Du Zhi is Yin without Yang. Sheng Shui is the rainy season of the first lunar month. Lone Yin cannot survive alone; thus, it cannot maintain existence during Yang abundance.)