者，又非不死之比。然其死也，必发哕噫，盖哕出于胃，土气败也，噫出于心，阴邪胜也。哕，于决切，呃
逆也。噫，伊芳、隘二音，嗳气也。）必审问其所始病，与今之所方病，而后各切循其脉，视其经络
浮沉，以上下逆从循之。（凡诊病之道，必问其始病者，察致病之由也。求今之方病者，察见在之诊也。
本末既明，而后切按其脉，以参合其在经在络，或浮或沉，上下逆从，各因其次以治之也。）其脉疾者不病，
其脉迟者病，脉不往来者死，皮肤着者死。（疾言力强有神，迟言气衰不足。若脉不往来者，阴阳俱脱。皮
肤着者，血液已尽，谓皮肤枯槁着骨也。）经病者治其经，（经脉为里，支而横者为络。治其经，谓即
其经而刺之也。）孙络病者治其孙络血。（络之小者为孙，即络脉之别而浮于肌肤者也。诸刺络脉者，急
取之以泻其邪而出其血，留之发为痹也，故曰治其血。）血病身有痛者，治其经络。（血病而身痛者，不止
于孙络，而经亦有滞也。当随其经络而刺之。）其病者在奇邪，奇邪之脉，则缪刺之。（奇邪者，不入于经，
而病于络也。邪客大络则左注右，右注左，其气无常处，故当缪刺之。）留瘦不移，节而刺之，（留，
病留滞也。瘦，形消瘦也。不移，不迁动也。凡病邪久留不移者，必于四肢八溪之间有所结聚，故当于节之
会处索而刺之，期可平也。）上实下虚，切而从之，索其结络脉，刺出其血，以见通之。（上实下虚，有
所隔也，故当切其脉以求之，从其经以取之，索其络脉之有结滞者刺出其血，结滞去而通达见矣。）瞳子高
者太阳不足，戴眼者太阳已绝，此决死生之要，不可不察也。（瞳子高者，目上视也。戴眼者，上视之
甚而定直不动也。此重明上文足太阳之证而分其轻重，以决死生也。）脉有阴阳，知阳者知阴，知阴者知
阳。（知阳脉之体而后能察阴脉，知阴脉之体而后能察阳脉。阳中有阴，似阳非阳也；阴中有阳，似阴非阴
也。所当详辨，误者杀人。）凡阳有五，五五二十五阳。（阳者，所谓胃脘之阳，即胃气也。五者，即
五脏之脉，如肝弦，心钩、脾 、肺毛、
肾石也。以一脏而兼五脉，即五脏互见，是为五五二十五脉也。然五脏之脉，皆不可以无胃气，故曰“凡阳
有五”，而二十五脉，即二十五阳也。）所谓阴者，真脏也，见则为败，败必死也。（阴者，无阳之谓。
无阳者，即无阳明之胃气，而本脏之阴脉独见，如但弦、但钩之类，是谓真脏，胃气败也，故必死。）所谓
阳者，胃脘之阳也。（胃属阳明。胃脘之阳，言胃中阳和之气，即胃气也，五脏赖之以为根本者也。故人无胃
气曰逆，逆者死，脉无胃气亦死。）别于阳者，知病处也；别于阴者，知死生之期。（能别阳和之胃气，则
一有不和，便可知疾病之所；能别纯阴之真脏，则凡遇生克，便可知死生之期也。）三阳在头，三阴在
手，所谓一也。（三阳在头，指人迎也。三阴在手，指气口也。上文以真脏、胃气言阴阳，此节以人迎、气口
言阴阳，盖彼言脉体，此言脉位，二者相根据，所谓一也。）别于阳者，知病忌时；别于阴者，知死生
之期。（此与前节稍同，而复言之者，盖前以真脏、胃气言，而此以阴阳表里言，二义相关，皆不可缺。忌
时，言气有衰王，病有时忌也。）谨熟阴阳，无与众谋。（阴阳之理，不可不熟，故曰“谨”；独闻独见，非众
所知，故“无与谋”。）所谓阴阳者，去者为阴，至者为阳；静者为阴，动者为阳；迟者为阴，数者为阳。（
脉之阴阳，其概如此。得阳者生，得阴者死，此其要也。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，其气动形，期六月死，真脏脉见，乃予之期日。（大骨、
大肉，皆以通身而言，如肩脊腰膝，皆大骨也，尺肤臀肉，皆大肉也。肩垂项倾、腰重膝败者，
大骨之枯槁也；尺肤既削，臀肉必枯，大肉之陷下也。肾主骨，骨枯则肾败矣；脾主肉，肉陷则脾败矣；肺
主气，气满喘息则肺败矣。气不归原形体振动，孤阳外浮而真阴亏矣。三阴亏损，死期不出六月。六月者，一
岁阴阳之更变也。若其真脏脉已见，则不在六月之例，可因克贼之日而定其期矣。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩
项，期一月死，真脏见，乃予之期日。（内痛引肩项，病及心经矣，较前已甚，期一月死。一月者，斗建
移而气易也。）大骨枯槁，大肉陷下，胸中气满，喘息不便，内痛引肩项，身热，脱肉破 ，
真脏见，十日之内死。（身热者，阴气去也；脱肉者，肌肉消尽也；破 者，卧久骨露而筋肉败也。是为
五脏俱伤而真脏又见，当十日内死。十日者，天干尽而旬气易也。 ，筋肉结聚之处，肘膝后肉如块者。）
大骨枯槁，大肉陷下，骨髓内消，动作益衰，真脏未见，期一岁死，见其真脏，乃予之期日。（骨枯肉陷，
脾肾已亏，兼之骨髓内消，动作益衰，虽诸证未全，真脏未见，然败竭已兆，仅支一年，岁
易气新，不能再振矣。若一见真脏，乃可必其死期也。）大骨枯槁，大肉陷下，胸中气满，腹内痛，心中不便，
肩项身热，破 脱肉，目眶陷，真脏见，目不见人，立死；其见人者，至其所不胜之时则死。（五脏败
证俱见，而目眶陷，真脏见，目不见人者。神气已脱，故当立死。若其见人者，神气犹在，故必待克贼之时而
死也。）急虚身中卒至，五脏绝闭，脉道不通，气不往来，譬于堕溺，不可为期。其脉绝不来，若人一呼
五六至，其形肉不脱，真脏虽不见，犹死也。（急虚者，言元气暴伤而忽甚也，故其邪中于
身，必猝然而至，譬之坠者溺者，旦时莫测，有不可以常期论也。若脉绝不至，或一呼五六至者，皆脏气竭
而命当尽也，故不必其形肉脱而真脏见也。）真肝脉至，中外急，如循刀刃，责责然，如
按琴瑟弦，色青白不泽，毛折乃死；（此下皆言真脏脉也。肝之真脏如刀刃，如琴瑟弦者，言细急坚搏，而
非微弦之本体也。青本木色，而兼白不泽者，金克木也。五脏率以毛折死者，皮毛得血气而充，毛折则
精气败矣，故皆死。）真心脉至，坚而搏，如循薏苡子，累累然，色赤黑不泽，毛折乃死；（坚而搏，如循薏苡
子者，短实坚强而非微钩之本体，心脉之真脏也。赤本火色，而兼黑不泽者，水克火也，故死。）
真肺脉至，大而虚，如以毛羽中人肤，色白赤不泽，毛折乃死；（大而虚，如以毛羽中人肤，浮虚无力之甚
而非微毛之本体，肺脉之真脏也。白本金色，而兼赤不泽者，火克金也，故死。）真肾脉至，搏
而绝，如指弹石，辟辟然，色黑黄不泽，毛折乃死。（搏而绝，搏之甚也，如指弹石，辟辟然，沉而坚也，
皆非微石之本体，而为肾脉之真脏也。黑本水色，兼黄不泽者，土克水也，故死。）真脾脉至，弱而
乍数乍疏，色黄青不泽，毛折乃死。（弱而乍数乍疏，则和缓全无而非微 弱之本体，脾脉之真脏也。黄本土
色，而兼青不泽者，木克土也，故死。）诸真脏脉见者，皆死不治也。（无胃气者，即名真脏，皆
为不治之脉。）五脏者皆禀气于胃，胃者五脏之本也。脏气者不能自致于手太阴，必因于胃气，乃至于手
太阴也。（谷入于胃，以传于肺，五脏六腑，皆以受气，故脏气必因于胃气乃得至于手太阴，而脉
则见于气口，此所以五脏之脉必赖胃气以为之主也。）故五脏各以其时自为，而至于手太阴也。（以时自为，
如春而但弦、夏而但钩之类，皆五脏不因于胃气，即真脏之见也。）故邪气胜者，精气衰也。病甚
者，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。（凡邪气甚而正气竭者，是
病胜脏也，故真脏之邪独见。真脏独见者，胃气必败，故不能与之俱至于手太阴，则胃气不见
于脉，此所以为危兆也。）
凡持真脉之脏脉者，肝至悬绝急，十八日死；（真脉之脏脉，即真脏也。悬绝急者，全失和平而弦搏异
常也。十八日者，为木金成数之余，金胜木而死也。此下死期，悉按《河图》，或言生数，或言成数。）
心至悬绝，九日死；（九日者，为火水生成数之余，水胜火也。）肺至悬绝，十二日死；（十二日者，为金火
生成数之余，火胜金也。）肾至悬绝，七日死；（七日者，为水土生数之余，土胜水也。）脾至悬绝，
四日死。（四日者，为木生数之余，木胜土也。此者皆不胜克贼之气，
故真脏独见者，气败而危矣，）肝见庚辛死，（庚辛为金，伐肝木也。）心见壬癸死，（壬癸属水，灭心火也。）
脾见甲乙死，（甲乙属木，克脾土也。）肺见丙丁死，（丙丁属火，铄肺金也。）肾见戊己死，（戊己属土，
伤肾水也。）是谓真脏见，皆死。
阴阳虚，肠辟死。（阴阳虚者，尺寸俱虚也。肠辟，利脓血也。胃气不留，魄门不禁，而阴阳虚者，脏
气竭也，故死。滑大者曰生，悬涩者曰死。）阳加于阴谓之汗，（阳言脉体，阴言脉位。汗液属阴，而阳加
于阴，阴气泄矣，故阴脉多阳者多汗。）阴虚阳搏谓之崩。（阴虚者，沉取不足。阳搏者，浮取有余。阳
实阴虚，故为内崩失血之证。）三阴俱搏，二十日夜半死；（三阴，手太阴肺、足太阴脾也。搏，即真脏之
搏击也。二十日者，脾肺成数之余也，夜半阴极气尽，故死。）二阴俱搏，十三日夕时死；（二阴，手少阴
心，足少阴肾也。十三日者，心肾之成数也。夕时者，阴阳相半，水火分争之会也。）一阴俱搏，十日平
旦死；（一阴、手厥阴心主足厥阴肝也。十日者，肝心生成之数也。平旦者，木火王极而邪更甚，故死。）
三阳俱搏且鼓，三日死；（三阳，手太阳小肠、足太阳膀胱也。水一火二，故死在三日。其死之速者，以既
搏且鼓，阳邪之盛极也。）三阴三阳俱搏，心腹满发尽，不得隐曲，五日死；（三阴三阳，脾、肺、小肠、
膀胱也，四脏俱搏，则上下俱病。故在上则心腹胀满，至于发尽。发尽者，胀之极也。在下则不得隐曲，阴道
不利也。四脏俱病，惟以胃气为主，土数五，五数尽而死矣。）二阳俱搏，其病温，死不治，不过十日死。
（二阳，手阳明大肠、足阳明胃也。十日者，肠胃生数之余也。不举一阳，非与一阴同推，必脱简也。）
精明五色者，气之华也。（精明见于目，五色显于面，皆五气之精华也。切脉动静，而视精明，察五
色，以此参伍，决死生之分。）赤欲如白裹朱，不欲如赭；（白裹朱，隐然红润而不露也。赭，代赭也，色
方而紫。此火色之善恶也。）白欲如鹅羽，不欲如盐；（鹅羽白而明，
盐色白而暗，此金色之善恶也。）青欲如苍璧之泽，不欲如蓝；（苍璧之泽，青而明润；蓝色，青而深晦，
此木色之善恶也。）黄欲如罗裹雄黄，不欲如黄土；（罗裹雄黄，光泽而隐；黄土之色，沉滞无神，此土
色之善恶也。）黑欲如重漆色，不欲如地苍。（重漆之色，光彩而润；地之苍黑，枯暗如尘，此水色之
善恶也。）此皆五色精微之象也，凶兆见，寿不远矣。夫精明者，所以视万物，别白黑，审短长，
以长为短，以白为黑，则精衰矣。（五脏六腑之精气皆上注于目而为之精，故精聚则神全，若其颠倒错乱，
是精衰而神衰矣，岂久安之兆哉！）刺有五官五阅，以观五气。五气者，五脏之使也，五时
之副也。（刺法当知脏气，欲知脏气，当于五官五阅而察之。阅，外候也。使，所使也。副，配合也。）
五官者，五脏之阅也。（五脏藏于中，五官见于外，内外相应，故为五脏之阅。）脉出于气口，色见于明堂。
五色更出，以应五时，各如其常。经气入脏，必当治里。（可为常者，常行之法。五脏之脉，察于气口，
五脏之色，察于明堂。明堂者，鼻也。色应其时，乃其常也。然色见于外而病在内，是为精气入脏，
故当治里。）五官以辨，阙庭必张，乃立明堂，明堂广大，蕃蔽见外，方壁高基，引垂居外。（此言五官诸
部，皆当详辨，不惟察色于明堂也。阙，眉间也。庭，颜也。张，布列也。蕃，颊侧也。蔽，
耳门也。壁，墙壁也。基，骨骼也。引垂居外，谓明显开豁也。此于五色之外而言其部位之隆浓也。）
五色乃治，平博广大，寿中百岁。（形色皆佳，乃为寿具，故中百岁。治，不乱也。中，宜也，堪也。）见此
者，刺之必已。如是之人者，血气有余，肌肉坚 ，故可苦以针。（若此之人，是为血气充实，形色坚固，
故刺之则病已而可苦以针也。然则血气内虚，形色外弱者，其不宜用针可知，药饵亦然。 ，音致，
密也。）鼻者肺之官也，目者肝之官也，口唇者脾之官也，舌者心之官也，耳者肾之官也。（鼻为肺窍，
目为肝窍，口唇为脾窍，
舌为心窍，耳为肾窍。官者，职守之谓，所以司呼吸，辨颜色，纳水谷，别滋味，听声音者也。五脏五窍，
（这种情况，）又不属于必死的范畴。然而如果患者死亡，必定会出现呃逆和嗳气，因为呃逆源于胃，是土气败坏的表现；嗳气源于心，是阴邪亢盛的表现。（呃逆，音“决”，即打嗝、气逆上冲的症状。嗳气，音“伊”、“隘”，即饱食后气体从胃中上出咽喉发出的声音。）必须详细询问患者最初发病的情况，以及现在正在出现的病症，然后分别切按他们的脉搏，观察其经络脉象的浮沉变化，从而上下推究病气的顺逆走向。（凡是诊察疾病的方法，必须询问最初发病的原因，以考察致病的缘由；探求现在正在出现的症状，以考察当前的诊断依据。既然病因和现状都已明了，然后才切按脉搏，结合病邪在经还是在络，脉象或浮或沉，以及病气的上下逆从，各自根据病情次序进行治疗。）脉象疾速有力的不一定有病，脉象迟滞无力的才是有病，脉象断绝不相往来的是死证，皮肤枯槁紧贴骨骼的也是死证。（疾速有力说明元气强盛且有神，迟滞无力说明气衰不足。如果脉象断绝不相往来，说明阴阳之气都耗脱了。皮肤枯槁紧贴骨骼，说明血液已经枯竭，指皮肤干枯萎缩附着在骨头上。）经脉发生病变的，治疗其经脉；（经脉位于深层，分支横行的称为络脉。治疗其经脉，意指直接在经脉上进行针刺。）孙络发生病变的，治疗其孙络的血分。（络脉中细小的称为孙络，即络脉的分支而浮行于肌肤表面的部分。凡刺络脉，应迅速取穴以泻除邪气并放出瘀血，若留针过久会导致痹症，所以说治疗其血分。）血分病变且身体疼痛的，治疗其经络。（血分病变而身体疼痛的，不仅仅局限于孙络，经脉中也存在阻滞。应当顺着其经络进行针刺。）病邪在于奇邪（非正途之邪），奇邪所致的脉象异常，应用缪刺法治疗。（奇邪，指不进入经脉，而病在于络脉的病邪。邪气客居于大络，则左边的邪气注向右边的络脉，右边的注向左边的络脉，其气机没有固定的位置，所以应当采用缪刺法。）病邪留滞日久、形体消瘦且病位不移动的，在关节处针刺；（留，指病邪留滞。瘦，指形体消瘦。不移，指病位不迁移。凡是病邪久留且不移动的患者，必定在四肢八溪之间有所结聚，所以应当在关节交会处寻找并针刺，期望能治愈。）上部实而下部虚的，切按脉象并顺其经气推寻，寻找有结滞的络脉，刺出其瘀血，以使气血通达。（上部实下部虚，说明中间有阻隔，所以应当切按脉象以求索病因，顺着经脉取穴，寻找络脉中有结滞的地方刺出瘀血，结滞去除后通达之象就会显现。）瞳孔上视不能下转的是太阳经气不足，两眼直视固定不动的是太阳经气已绝，这是判断生死的关键，不可不仔细考察。（瞳孔上视，指眼睛向上看。戴眼，指向上看得非常厉害且固定不动。这是重申上文足太阳膀胱经的证候并区分其轻重，以判断生死。）脉象有阴阳之分，懂得阳脉就能懂得阴脉，懂得阴脉就能懂得阳脉。（懂得阳脉的本质后才能察知阴脉，懂得阴脉的本质后才能察知阳脉。阳中有阴，看似阳而非纯阳；阴中有阳，看似阴而非纯阴。应当详细辨别，误判会害人性命。）凡阳脉有五种，五五二十五种阳脉。（阳，所谓胃脘之阳，即胃气。五，即五脏的脉象，如肝脉弦、心脉钩、脾脉代、肺脉毛、肾脉石。以一脏兼见五种脉象，即五脏互见，称为五五二十五脉。然而五脏的脉象，都不能没有胃气，所以说“凡阳有五”，而二十五脉就是二十五阳。）所谓阴脉，是指真脏脉，出现真脏脉就说明脏腑败坏，败坏必然死亡。（阴，是没有阳气的表现。无阳，即没有阳明胃气，只有本脏的阴脉单独出现，如只见弦脉、只见钩脉等，这叫做真脏脉，说明胃气败坏，所以必然死亡。）所谓阳脉，是指胃脘之阳。（胃属阳明经。胃脘之阳，指胃中的阳和之气，即胃气，是五脏赖以生存的根本。所以人没有胃气叫作逆证，逆证者死，脉象中没有胃气也死。）能够辨别阳脉（胃气）的，知道病邪所在部位；能够辨别阴脉（真脏）的，知道死亡的期限。（能辨别阳和的胃气，一旦不和，就知道疾病所在的部位；能辨别纯阴的真脏脉，遇到相克之时，就知道死亡的期限。）三阳经脉在头部（人迎穴），三阴经脉在手腕部（气口穴），这就是所谓的统一。（三阳在头，指人迎穴。三阴在手，指气口穴。上文用真脏和胃气来论述阴阳，本节用人迎和气口来论述阴阳，前者讲脉体，后者讲脉位，两者相互印证，所谓一致。）辨别阳脉的，知道疾病的禁忌时辰；辨别阴脉的，知道死亡的期限。（这与前一节大致相同，但再次陈述，是因为前节用真脏和胃气论述，此节用阴阳表里论述，两种含义相关，都不可缺漏。忌时，指气有盛衰，病有忌讳的时辰。）谨慎熟习阴阳道理，不要与众人商议。（阴阳的道理，不可不熟习，所以说“谨”；独自听闻独自看见，不是众人所能知道的，所以说“不与谋”。）所谓阴阳，指脉去者为阴，脉来者为阳；脉静者为阴，脉动者为阳；脉迟者为阴，脉数者为阳。（脉象的阴阳，大概就是这样。得到阳脉者生，得到阴脉者死，这是关键。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，呼吸时身体随之震动，预期六个月死亡，如果见到真脏脉，就给予具体的死期日期。（大骨、大肉，都是指全身而言，如肩脊腰膝，都是大骨；尺肤臀肉，都是大肉。肩膀下垂、脖子倾斜、腰部沉重、膝盖无力，是大骨的枯槁；尺肤削薄、臀部肌肉枯萎，是大肉的陷下。肾主骨，骨枯则肾败；脾主肉，肉陷则脾败；肺主气，气满喘息则肺败。气不归元，形体振动，孤阳外浮而真阴亏损。三阴亏损，死期不出六个月。六个月，是一年中阴阳更替变化的周期。如果真脏脉已经出现，就不在六个月的例子里，可以根据相克的日子来确定死期。）
大骨枯槁，大肉陷下，胸中气满，喘息不便，内部疼痛牵引肩颈，预期一个月死亡，如果见到真脏脉，就给予具体的死期日期。（内部疼痛牵引肩颈，病邪波及心经了，比前面更严重，预期一个月死亡。一个月，是斗建移位而气机变换的时间。）大骨枯槁，大肉陷下，胸中气满，喘息不便，内部疼痛牵引肩颈，身体发热，肌肉消尽，皮肤破裂露出筋骨，见到真脏脉，十日内死亡。（身体发热，说明阴气离去；肌肉消尽，说明肌肉完全消失；皮肤破裂露出筋骨，说明久卧导致骨头暴露而筋肉败坏。这是五脏都受伤且真脏脉出现，应当在十日内死亡。十日，是天干轮完而旬气变换的时间。腠理，是筋肉结聚之处，肘膝后方肉块隆起的地方。）
大骨枯槁，大肉陷下，骨髓内部消减，活动能力日益衰退，真脏脉尚未出现，预期一年死亡，如果见到真脏脉，就给予具体的死期日期。（骨枯肉陷，脾肾已经亏损，加上骨髓内部消减，活动能力日益衰退，虽然诸证未全，真脏脉未见，但败竭的迹象已经显露，仅能支撑一年，岁末气新，不能再振作了。如果一见真脏脉，才可以确定其死期。）大骨枯槁，大肉陷下，胸中气满，腹内疼痛，心中烦闷不适，肩颈身体发热，皮肤破裂肌肉消尽，眼眶凹陷，见到真脏脉，眼睛看不见人，立即死亡；如果还能看见人，等到其所不胜的时辰就会死亡。（五脏败坏的证候全部出现，且眼眶凹陷，见到真脏脉，眼睛看不见人，说明神气已经脱失，所以应当立即死亡。如果还能看见人，说明神气还在，所以必须等到相克的时辰而死。）急虚身中卒至，五脏绝闭，脉道不通，气不往来，如同坠落溺水一样，无法预测死期。如果脉象断绝不来，或者人一呼一吸间脉搏跳动五六次，虽然形体肌肉没有消脱，真脏脉也没有出现，也是死证。（急虚，指元气突然重伤而且极其严重，所以邪气侵袭身体，必定猝然到来，如同坠物溺水，早晚难测，不能用常规期限来论断。如果脉象断绝不至，或者一呼一吸间脉搏跳动五六次的，都是脏气衰竭而生命将尽，所以不必等到形肉脱失和真脏脉出现。）
真肝脉至，中外紧急，像触摸刀刃，锐利扎手，又像按压琴瑟的弦，面色青白而无光泽，毛发枯折才会死亡；（以下都在讲述真脏脉。肝脏的真脏脉像刀刃、像琴瑟弦，是说脉象细急坚搏，而不是微弦的正常本体。青色本是木色，却兼见白色且无光泽，是金克木的表现。五脏大多以毛发枯折为死兆，因为皮毛依赖血气充盈，毛发枯折说明精气败坏了，所以都会死。）真心脉至，坚硬而搏击手指，像触摸薏苡子，颗粒累累，面色赤黑而无光泽，毛发枯折才会死亡；（坚硬而搏击手指，像触摸薏苡子，短实坚强而不是微钩的正常本体，是心脉的真脏脉。红色本是火色，却兼见黑色且无光泽，是水克火的表现，所以死。）真肺脉至，大而空虚，像羽毛中人肌肤，面色白赤而无光泽，毛发枯折才会死亡；（大而空虚，像羽毛中人肌肤，浮虚无力到了极点而不是微毛的正常本体，是肺脉的真脏脉。白色本是金色，却兼见红色且无光泽，是火克金的表現，所以死。）真肾脉至，搏动强劲而似断绝，像手指弹石头，辟辟作响，面色黑黄而无光泽，毛发枯折才会死亡。（搏动强劲而似断绝，搏动非常剧烈，像手指弹石头，辟辟作响，沉而坚硬，都不是微石的正常本体，而是肾脉的真脏脉。黑色本是水色，兼见黄色且无光泽，是土克水的表现，所以死。）真脾脉至，软弱且忽快忽慢，面色黄青而无光泽，毛发枯折才会死亡。（软弱且忽快忽慢，完全没有和缓之象，而不是微弱正常的本体，是脾脉的真脏脉。黄色本是土色，却兼见青色且无光泽，是木克土的表现，所以死。）所有真脏脉出现的，都是死证且无法医治。（没有胃气的，就叫做真脏，都是无法医治的脉象。）五脏都禀受气于胃，胃是五脏的根本。脏气不能自己到达手太阴肺经，必须依靠胃气，才能到达手太阴肺经。（食物进入胃，传送给肺，五脏六腑都从中受气，所以脏气必须依靠胃气才能到达手太阴肺经，而脉象则显现在气口，这就是五脏的脉象必须依赖胃气作为主宰的原因。）所以五脏各自在其当令之时自行显现，而至于手太阴肺经。（在其当令之时自行显现，如春天只见弦脉、夏天只见钩脉等，都是五脏不依赖胃气，即真脏脉的出现。）所以邪气胜则精气衰。病重的，胃气不能与脏气一起到达手太阴肺经，所以真脏之气单独出现。单独出现，说明病邪胜过脏气，所以说死。（凡是邪气很盛而正气衰竭的，是病胜过脏，所以真脏的邪气单独出现。真脏单独出现，说明胃气必然败坏，所以不能与脏气一起到达手太阴肺经，那么胃气就不显现在脉象中，这就是危重的征兆。）
凡是持守真脉的脏脉，肝脉悬绝紧急，十八日死；（真脉的脏脉，就是真脏脉。悬绝紧急，是完全失去和平之象，弦搏异常。十八日，是木金成数的余数，金胜木而死。以下的死期，都按照《河图》推算，有的说生数，有的说成数。）心脉悬绝，九日死；（九日，是火水生成数的余数，水胜火而死。）肺脉悬绝，十二日死；（十二日，是金火生成数的余数，火胜金而死。）肾脉悬绝，七日死；（七日，是水土生数的余数，土胜水而死。）脾脉悬绝，四日死。（四日，是木生数的余数，木胜土而死。这些都是不胜克制之气，所以真脏独见，气败而危。）肝脉见庚辛日死，（庚辛属金，伐肝木。）心脉见壬癸日死，（壬癸属水，灭心火。）脾脉见甲乙日死，（甲乙属木，克脾土。）肺脉见丙丁日死，（丙丁属火，熔肺金。）肾脉见戊己日死，（戊己属土，伤肾水。）这叫真脏脉出现，都会死亡。
阴阳俱虚，患肠辟（痢疾）会死。（阴阳俱虚，指寸尺脉都虚弱。肠辟，指拉脓血便。胃气不留存，魄门（肛门）不禁固，而阴阳俱虚，说明脏气竭尽，所以死。脉滑大者曰生，脉悬涩者曰死。）阳加于阴谓之汗，（阳指脉体，阴指脉位。汗液属阴，而阳加于阴，阴气泄越了，所以阴脉多阳者多汗。）阴虚阳搏谓之崩。（阴虚，指沉取不足。阳搏，指浮取有余。阳实阴虚，所以是内崩失血的证候。）三阴脉俱搏击，二十日夜半死；（三阴，指手太阴肺、足太阴脾。搏，即真脏脉的搏击。二十日，是脾肺成数的余数，夜半阴极气尽，所以死。）二阴脉俱搏击，十三日夕时死；（二阴，指手少阴心、足少阴肾。十三日，是心肾的成数。夕时，是阴阳相半，水火分争的时刻。）一阴脉俱搏击，十日平旦死；（一阴，指手厥阴心主、足厥阴肝。十日，是肝心生成之数。平旦，是木火王极而邪气更甚的时候，所以死。）三阳脉俱搏击且鼓动，三日死；（三阳，指手太阳小肠、足太阳膀胱。水一数二，所以死在三日。死得这么快，是因为既搏且鼓，阳邪盛极。）三阴三阳脉俱搏击，心腹胀满发作殆尽，大小便不利，五日死；（三阴三阳，指脾、肺、小肠、膀胱，四脏俱搏，则上下都生病。所以在上的话心腹胀满，直到胀至极点。胀至极点叫发尽。在下的话大小便不利，阴道不通。四脏都病，以胃气为主，土数为五，五数尽而死。）二阳脉俱搏击，患温病，死不治，不超过十日死。（二阳，指手阳明大肠、足阳明胃。十日，是肠胃生数的余数。不举一阳，不是和一阴同推，一定是脱简遗漏了。）
精明五色，是气的精华。（精明见于眼睛，五色显于面部，都是五气之精华。切脉动静，观察眼睛的精明，察面部的五色，以此参合验证，决定生死的界限。）赤色想要像白布包裹朱砂，不想要像赭石；（白裹朱，隐约红润而不外露。赭，代赭石，色方而紫。这是火色的善恶表现。）白色想要像鹅羽，不想要像盐；（鹅羽白而明亮，盐色白而昏暗，这是金色的善恶表现。）青色想要像苍玉的光泽，不想要像蓝草；（苍玉的光泽，青而明润；蓝色，青而深晦，这是木色的善恶表现。）黄色想要像罗纱包裹雄黄，不想要像黄土；（罗纱包裹雄黄，光泽而隐蔽；黄土之色，沉滞无神，这是土色的善恶表现。）黑色想要像重漆的颜色，不想要像地苍。（重漆之色，光彩而润泽；地的苍黑，枯暗如尘，这是水色的善恶表现。）这都是五色精微的形象，凶兆出现，寿命不远了。精明，是用来观看万物，辨别黑白，审察长短的，如果把长看作短，把白看作黑，那就是精衰了。（五脏六腑的精气都上注于眼睛而形成精明，所以精聚则神全，如果颠倒错乱，就是精衰而神衰了，难道是长久安宁的征兆吗！）针刺有五官五阅，用来观察五气。五气，是五脏的使者，是五时的配合。（针刺方法应当了解脏气，要了解脏气，应当在五官五阅上察知。阅，是外部征候。使，是所派遣的。副，是配合。）五官，是五脏的窗口。（五脏藏于体内，五官见于体外，内外相应，所以是五脏的窗口。）脉象出于气口，颜色见于明堂（鼻部）。五色更替出现，以对应五时，各如其常。经气入脏，必须治里。（可以作为常规的，是常行之法。五脏的脉象，在气口察知，五脏的颜色，在明堂察知。明堂，指鼻子。颜色顺应时节，是其常态。然而颜色见于外表而病在内，这是精气入脏，所以应当治里。）五官辨明，阙庭（眉间、额部）舒展，于是确立明堂，明堂广大，蕃蔽（颊侧、耳门）显露在外，墙壁高基（骨骼隆起），引垂居外（明显开豁）。（这是说五官各部，都应当详细辨别，不仅是在明堂察色。阙，眉间。庭，额部。张，布列。蕃，颊侧。蔽，耳门。壁，墙壁。基，骨骼。引垂居外，谓明显开豁。这是在五色之外谈论部位的隆浓。）五色调理得当，平坦博大广大，寿命可达百岁。（形色皆佳，才是长寿具备的条件，所以适宜活到百岁。治，不乱。中，宜，堪。见此等人，针刺必能痊愈。像这样的人，血气有余，肌肉坚实，所以可以用苦味针法（强刺激）。（如果是这种人，就是血气充实，形色坚固，所以针刺则病愈且可用强刺激。然而血气内虚，形色外弱的，就不宜用针，药物也是如此。緻，音致，密。）鼻是肺的官窍，目是肝的官窍，口唇是脾的官窍，舌是心的官窍，耳是肾的官窍。（鼻为肺窍，目为肝窍，口唇为脾窍，舌为心窍，耳为肾窍。官，指职守，所以主管呼吸，辨颜色，纳水谷，别滋味，听声音。五脏五窍，）
(This condition) does not belong to the category of inevitable death. However, if the patient dies, it will inevitably be accompanied by hiccups (eh-ni, hiccupping/reflux of stomach qi) and belching (ai-qi, belching/eructation). Hiccups originate from the Stomach, indicating the failure of Earth Qi; belching originates from the Heart, indicating the excess of Yin pathogenic factors. (Hiccups, pronounced "jue," refer to the symptom of qi rebelling upward, i.e., hiccupping. Belching, pronounced "yi" or "ai," refers to the sound emitted when gas rises from the stomach through the throat after a full meal.) One must carefully inquire about the initial onset of the disease and the symptoms currently manifesting, then palpate their pulses individually, observing the floating and sinking changes in the meridians and collaterals, thereby deducing the direction and compliance of the pathogenic qi from top to bottom. (The method of diagnosing diseases requires asking about the initial cause to investigate the origin of the illness, and seeking current symptoms to assess the present diagnostic picture. Once the root and branch are clear, one then palpates the pulse, integrating whether the pathogen is in the Jing-mai or Luo-collaterals, whether the pulse is floating or sinking, and the upward/downward rebellion or compliance of the qi, treating each according to its sequence.) A rapid and forceful pulse does not necessarily indicate disease; a slow and sluggish pulse indicates disease; a pulse that ceases to flow indicates death; skin that withers and adheres tightly to the bones also indicates death. (Rapid and forceful indicates strong Yuan Qi and spiritual presence; slow and sluggish indicates Qi deficiency and insufficiency. If the pulse ceases to flow, it means both Yin and Yang Qi have exhausted. Skin withering and adhering to bones indicates blood depletion, where the skin is dry, atrophied, and attached to the bone.) For diseases of the Jing-mai (Primary Meridians), treat the Jing-mai; (Jing-mai are deep, while branching horizontal vessels are called Luo-collaterals. Treating the Jing-mai means needling directly along the meridian.) For diseases of the Sun-luo (Branch Collaterals), treat the blood of the Sun-luo. (Small collaterals are called Sun-luo, which are branches of the Luo-collaterals floating on the skin surface. When needling collaterals, one should quickly select points to drain pathogenic factors and release blood; retaining needles too long may lead to Bi-syndrome, hence "treating the blood.") For blood diseases accompanied by body pain, treat the Jing-mai and Luo-collaterals. (Blood diseases causing body pain are not limited to Sun-luo but also involve stagnation in the Jing-mai. One should needle along the respective meridians.) For diseases caused by Qi-xie (Abnormal Pathogens), where the pulse is abnormal, apply Miao-stimulation (Mirrored Needling). (Qi-xie refers to pathogens that do not enter the Jing-mai but affect the Luo-collaterals. Pathogens lodging in large collaterals shift from left to right and right to left, with no fixed location, thus requiring Miao-stimulation.) For lingering emaciation where the disease site does not move, needle at the joints. (Lingering refers to pathogenic stagnation; emaciation refers to physical wasting; non-moving refers to a fixed location. For pathogens lingering for a long time without moving, there is likely accumulation between the eight溪 (valleys/creeks) of the four limbs; thus, one should seek and needle at the joint intersections to expect recovery.) For upper excess and lower deficiency, palpate the pulse and follow the meridian qi to locate, find obstructed collaterals, needle them to release blood, thereby restoring circulation. (Upper excess and lower deficiency indicate an obstruction; thus, one must palpate the pulse to find the cause, follow the meridian to select points, locate obstructed collaterals, needle them to release blood, and once the obstruction is removed, patency will be restored.) High gaze (eyes looking upward and unable to look down) indicates Taiyang insufficiency; Dai-yan (eyes staring straight up and fixed) indicates Taiyang exhaustion. This is the key to determining life and death and must be carefully examined. (High gaze refers to eyes looking upward. Dai-yan refers to extreme upward gazing that is fixed and immobile. This reiterates the symptoms of Foot-Taiyang Bladder Meridian and distinguishes their severity to determine prognosis.) Pulses have Yin and Yang aspects; knowing Yang allows one to know Yin, and knowing Yin allows one to know Yang. (Understanding the nature of Yang pulses enables the observation of Yin pulses, and vice versa. Yang contains Yin, appearing Yang but not purely Yang; Yin contains Yang, appearing Yin but not purely Yin. Detailed differentiation is required; misjudgment can be fatal.) Generally, there are five Yang pulses, and five times five make twenty-five Yang pulses. (Yang refers to the Yang of the Wei-wan (epigastrium), i.e., Stomach Qi. Five refers to the pulses of the Five Zang organs: Liver [Xian/String-like], Heart [Gou/Hook-like], Spleen [Dai/Alternating], Lung [Mao/Feather-like], Kidney [Shi/Stone-like]. Each Zang organ exhibiting five pulse qualities constitutes mutual visibility among the Five Zang, termed twenty-five pulses. However, all Zang pulses must possess Stomach Qi; hence "Five Yangs," and the twenty-five pulses are the twenty-five Yangs.) The so-called Yin pulse refers to the Zhen-Zang pulse (True Organ Pulse); its appearance indicates organ failure, and failure leads to death. (Yin means the absence of Yang. Absence of Yang means the absence of Yangming Stomach Qi, leaving only the isolated Yin pulse of the primary organ, such as exclusively Xian or exclusively Gou pulses. This is called Zhen-Zang pulse, indicating Stomach Qi failure, hence death.) The so-called Yang pulse refers to the Yang of the Wei-wan. (The Stomach belongs to the Yangming channel. The Yang of the Wei-wan refers to the warm Yang Qi within the Stomach, i.e., Stomach Qi, which serves as the foundation for the Five Zang organs. Thus, humans without Stomach Qi are said to have Ni-reversal, and reversal leads to death; similarly, pulses lacking Stomach Qi also indicate death.) Differentiating Yang allows one to know the location of the disease; differentiating Yin allows one to know the timing of death. (Being able to differentiate the harmonious Stomach Qi reveals the disease location upon any disharmony; being able to differentiate the pure Yin Zhen-Zang pulse reveals the timing of death based on generative and controlling cycles.) The Three Yang meridians are located at the head, and the Three Yin meridians are located at the hand; this is referred to as unity. (Three Yang at the head refers to the Renying point. Three Yin at the hand refers to the Qikou point. The previous section discussed Yin and Yang via Zhen-Zang and Stomach Qi; this section discusses them via Renying and Qikou. The former concerns pulse quality, the latter pulse position; they corroborate each other, hence "unity.") Differentiating Yang allows one to know the contraindicated times for the disease; differentiating Yin allows one to know the timing of death. (This is slightly similar to the previous section but restated because the former used Zhen-Zang and Stomach Qi, while this uses Yin-Yang and Exterior-Interior. Both meanings are related and indispensable. Contraindicated times refer to the waxing and waning of Qi and specific times when the disease is aggravated.) Carefully master the principles of Yin and Yang, and do not consult with others. (The principles of Yin and Yang must be mastered thoroughly, hence "carefully"; unique insight is unknown to the masses, hence "do not consult.") The so-called Yin and Yang in pulses: departure is Yin, arrival is Yang; stillness is Yin, movement is Yang; slowness is Yin, frequency is Yang. (The Yin and Yang of pulses are summarized thus. Obtaining Yang pulses indicates life; obtaining Yin pulses indicates death; this is the essence.)
Great bones withered, great muscles sunken, chest full of Qi, difficult breathing, movements causing the body to tremble, expected death in six months; if Zhen-Zang pulses appear, assign a specific date of death. (Great bones and great muscles refer to the whole body: shoulder, spine, waist, knees are great bones; forearm skin and buttock muscles are great muscles. Drooping shoulders, tilted neck, heavy waist, failing knees indicate withered great bones; thinned forearm skin and withered buttocks indicate sunken great muscles. Kidneys govern bones; bone withering means Kidney failure. Spleen governs flesh; muscle sunken means Spleen failure. Lungs govern Qi; chest fullness and panting mean Lung failure. Qi fails to return to its source, body trembles, solitary Yang floats externally while True Yin is deficient. Deficiency of Three Yin leads to death within six months. Six months represents the cycle of Yin-Yang transformation in a year. If Zhen-Zang pulses have already appeared, the six-month rule does not apply; death can be predicted based on days of elemental overcoming.)
Great bones withered, great muscles sunken, chest full of Qi, difficult breathing, internal pain radiating to shoulders and neck, expected death in one month; if Zhen-Zang pulses appear, assign a specific date of death. (Internal pain radiating to shoulders and neck indicates the disease has affected the Heart meridian, which is more severe than before, leading to death in one month. One month corresponds to the shift of the Dipper star and change of Qi.) Great bones withered, great muscles sunken, chest full of Qi, difficult breathing, internal pain radiating to shoulders and neck, body heat, flesh shedding, skin cracking revealing bones, Zhen-Zang pulses appear, death within ten days. (Body heat indicates Yin Qi departure; flesh shedding indicates complete muscle loss; skin cracking revealing bones indicates prolonged recumbency leading to bone exposure and muscle decay. This indicates injury to all Five Zang organs with Zhen-Zang pulses, leading to death within ten days. Ten days correspond to the completion of the Heavenly Stems and change of the ten-day period. Cou-li refers to areas where muscles and sinews gather, such as lumps behind elbows and knees.)
Great bones withered, great muscles sunken, marrow internally consumed, motor function increasingly declining, Zhen-Zang pulses not yet seen, expected death in one year; if Zhen-Zang pulses appear, assign a specific date of death. (Bone withering and muscle sunken indicate Spleen and Kidney deficiency; combined with internal marrow consumption and declining motor function, although not all signs are present and Zhen-Zang pulses are absent, the signs of collapse are evident. It can only support one year until the year ends and new Qi arises, unable to recover. If Zhen-Zang pulses appear, death can be definitively predicted.) Great bones withered, great muscles sunken, chest full of Qi, abdominal pain, heart discomfort, shoulder/neck/body heat, skin cracking, flesh shedding, eye sockets sunken, Zhen-Zang pulses appear, eyes cannot see people, immediate death; if eyes can still see people, death occurs at the time of elemental overcoming. (All signs of Zang organ failure are present, eye sockets are sunken, Zhen-Zang pulses appear, and eyes cannot see people, indicating Shen-spirit has departed, hence immediate death. If eyes can still see people, Shen-spirit remains, so death waits for the overcoming time.) Sudden invasion of Ji-Xu (Acute Deficiency), where the body is struck abruptly, Five Zang orifices close, pulse channels block, Qi ceases to flow, resembling falling or drowning, making prediction impossible. If the pulse cuts off completely, or if the pulse beats five to six times per breath, even if flesh is not shed and Zhen-Zang pulses are not seen, it is still death. (Ji-Xu refers to sudden severe injury to Yuan Qi, so pathogens strike abruptly like falling or drowning, unpredictable. Pulse cessation or excessive rate (5-6 beats per breath) indicates Zang Qi exhaustion and impending death, regardless of flesh condition or Zhen-Zang pulses.)
True Liver pulse arrives, tense inside and out, like touching a knife edge, sharp and piercing, like pressing a zither string, complexion blue-white and dull, hair breaks before death; (Below describes Zhen-Zang pulses. The True Liver pulse like a knife edge or zither string indicates thin, tense, and firm quality, not the normal mild String pulse. Blue is Wood color; accompanying white and dullness indicates Metal overcoming Wood. All Zang organs typically die when hair breaks, as skin/hair depend on Blood/Qi; hair breaking indicates Essence depletion.) True Heart pulse arrives, hard and beating, like touching Coix seeds, grain-like, complexion red-black and dull, hair breaks before death; (Hard and beating like Coix seeds indicates short, solid, and firm quality, not the normal mild Hook pulse, constituting the True Heart pulse. Red is Fire color; accompanying black and dullness indicates Water overcoming Fire, hence death.) True Lung pulse arrives, large and empty, like feathers brushing human skin, complexion white-red and dull, hair breaks before death; (Large and empty like feathers brushing skin indicates extreme floating and weakness, not the normal mild Feather pulse, constituting the True Lung pulse. White is Metal color; accompanying red and dullness indicates Fire overcoming Metal, hence death.) True Kidney pulse arrives, beating strongly and seemingly cutting off, like fingers snapping stones, crackling, complexion black-yellow and dull, hair breaks before death. (Beating strongly and seemingly cutting off indicates intense pulsation, like snapping stones, crackling, deep and firm, not the normal mild Stone pulse, constituting the True Kidney pulse. Black is Water color; accompanying yellow and dullness indicates Earth overcoming Water, hence death.) True Spleen pulse arrives, weak and intermittently fast and slow, complexion yellow-green and dull, hair breaks before death. (Weak and intermittent fast/slow lacks all harmony, not the normal mild Alternating pulse, constituting the True Spleen pulse. Yellow is Earth color; accompanying green and dullness indicates Wood overcoming Earth, hence death.) All appearances of Zhen-Zang pulses indicate death and incurability. (Absence of Stomach Qi is named Zhen-Zang; all are incurable pulses.) The Five Zang organs all derive Qi from the Stomach; the Stomach is the root of the Five Zang. Zang Qi cannot reach the Hand-Taiyin Lung meridian on its own; it must rely on Stomach Qi to arrive at the Hand-Taiyin. (Food enters the Stomach and transmits to the Lung; all Five Zang and Six Fu organs receive Qi from it. Thus, Zang Qi must rely on Stomach Qi to reach the Hand-Taiyin, where the pulse manifests at the Qikou. This is why Zang pulses rely on Stomach Qi as their master.) Therefore, the Five Zang organs manifest themselves in their respective seasons and reach the Hand-Taiyin. (Manifesting in their respective seasons, e.g., Spring showing only String pulse, Summer showing only Hook pulse, indicates the Five Zang operating without Stomach Qi, i.e., appearance of Zhen-Zang pulses.) Therefore, when pathogenic factors prevail, Essence-Qi declines. In severe illness, Stomach Qi cannot accompany Zang Qi to the Hand-Taiyin, so Zhen-Zang Qi appears alone. Alone appearance means disease overcomes the Zang, hence death. (When pathogens are strong and Zheng Qi is exhausted, disease overcomes the Zang, so Zhen-Zang pathogens appear alone. Zhen-Zang appearing alone means Stomach Qi has failed and cannot accompany Zang Qi to the Hand-Taiyin; thus, Stomach Qi is absent from the pulse, marking a critical sign.)
For those holding Zhen pulses of the Zang organs: Liver pulse hanging and extremely tense, death in eighteen days; (Zhen pulse of the Zang organ is the Zhen-Zang pulse. Hanging and extremely tense means complete loss of harmony and abnormal String-beat. Eighteen days is the remainder of the Metal-Wood completion numbers; Metal overcomes Wood, leading to death. Death periods below follow the He Tu numerology, using either generating or completion numbers.) Heart pulse hanging, death in nine days; (Nine days is the remainder of the Fire-Water generating/completion numbers; Water overcomes Fire.) Lung pulse hanging, death in twelve days; (Twelve days is the remainder of the Metal-Fire generating/completion numbers; Fire overcomes Metal.) Kidney pulse hanging, death in seven days; (Seven days is the remainder of the Water-Earth generating numbers; Earth overcomes Water.) Spleen pulse hanging, death in four days. (Four days is the remainder of the Wood generating number; Wood overcomes Earth. These cases cannot withstand the overcoming Qi, so Zhen-Zang appears alone, Qi fails, and danger ensues.) Liver pulse appears on Geng/Xin days, death; (Geng/Xin belong to Metal, attacking Liver Wood.) Heart pulse appears on Ren/Gui days, death; (Ren/Gui belong to Water, extinguishing Heart Fire.) Spleen pulse appears on Jia/Yi days, death; (Jia/Yi belong to Wood, overcoming Spleen Earth.) Lung pulse appears on Bing/Ding days, death; (Bing/Ding belong to Fire, smelting Lung Metal.) Kidney pulse appears on Wu/Ji days, death; (Wu/Ji belong to Earth, injuring Kidney Water.) This is called Zhen-Zang appearance, all result in death.
Yin and Yang both deficient, suffering from Chang-Pi (Intestinal Dysentery), death. (Yin and Yang both deficient means Cun and Chi pulses are both weak. Chang-Pi refers to dysentery with pus and blood. Stomach Qi does not retain, Pormen (anus) loses control, and Yin/Yang deficiency indicates Zang Qi exhaustion, hence death. Slippery and large pulses indicate life; hanging and choppy pulses indicate death.) Yang added to Yin is called Sweat. (Yang refers to pulse quality, Yin refers to pulse position. Sweat fluid belongs to Yin; Yang added to Yin causes Yin Qi to leak, so Yin pulses with Yang characteristics indicate sweating.) Yin deficient, Yang pounding is called Beng (Metrorrhagia/Metrorrhea). (Yin deficient means insufficient deep pressure. Yang pounding means excessive superficial pressure. Yang excess and Yin deficiency lead to internal bleeding disorders.) Three Yin pulses all beating, death at midnight on the twentieth day; (Three Yin refers to Hand-Taiyin Lung and Foot-Taiyin Spleen. Beating refers to Zhen-Zang striking. Twenty days is the remainder of Spleen-Lung completion numbers; midnight is extreme Yin and end of Qi, hence death.) Two Yin pulses all beating, death at dusk on the thirteenth day; (Two Yin refers to Hand-Shaoyin Heart and Foot-Shaoyin Kidney. Thirteen days is the completion number of Heart-Kidney. Dusk is when Yin and Yang are equal, a time of Water-Fire conflict.) One Yin pulse all beating, death at dawn on the tenth day; (One Yin refers to Hand-Jueyin Pericardium and Foot-Jueyin Liver. Ten days is the generating number of Liver-Heart. Dawn is when Wood-Fire peak and pathogens worsen, hence death.) Three Yang pulses all beating and鼓 (drumming/pulsating), death in three days; (Three Yang refers to Hand-Taiyang Small Intestine and Foot-Taiyang Bladder. Water is 1, Fire is 2, hence death in three days. Rapid death is due to beating and drumming indicating extreme Yang pathogen excess.) Three Yin and Three Yang pulses all beating, abdominal distension fully developed, inability to pass urine/feces, death in five days; (Three Yin and Three Yang refer to Spleen, Lung, Small Intestine, Bladder. Four Zang organs beating means pathology above and below. Above: heart/abdominal distension to extreme (Fa-Jin). Below: inability to pass urine/feces, Yin pathway blocked. Four Zang diseased relies on Stomach Qi; Earth number is five; five completes, hence death.) Two Yang pulses all beating, suffering from Wen-bing (Warm Disease), incurable, death within ten days. (Two Yang refers to Hand-Mingyang Large Intestine and Foot-Mingyang Stomach. Ten days is the remainder of Gastrointestinal generating numbers. Not mentioning One Yang is not for comparison with One Yin, but likely a missing slip.)
Jing-Ming (Spiritual Clarity) and Five Colors are the splendor of Qi. (Jing-Ming is seen in the eyes; Five Colors manifest on the face; all are the essence of Five Qi. Palpating pulse dynamics, observing Jing-Ming, examining Five Colors, and cross-referencing determines the boundary of life and death.) Red desires to be like white silk wrapping cinnabar, not like hematite; (White silk wrapping cinnabar implies hidden ruddiness without exposure. Hematite is square and purple. This describes the good and bad of Fire color.) White desires to be like goose feathers, not like salt; (Goose feathers are white and bright; salt is white and dim. This describes the good and bad of Metal color.) Green desires to be like the luster of dark jade, not like indigo; (Dark jade luster is green and bright/moist; indigo is green and deep/dull. This describes the good and bad of Wood color.) Yellow desires to be like raw silk wrapping realgar, not like yellow earth; (Raw silk wrapping realgar is glossy and hidden; yellow earth color is stagnant and spiritless. This describes the good and bad of Earth color.) Black desires to be like double-lacquered color, not like earthy cyan. (Double-lacquered color is radiant and moist; earthy cyan is withered and dark like dust. This describes the good and bad of Water color.) These are all images of the subtle essence of Five Colors; ominous signs appear, lifespan is near its end. Jing-Ming is used to view all things, distinguish black and white, judge long and short. If long is seen as short, and white as black, Jing is depleted. (Essence of all Five Zang and Six Fu organs ascends to the eyes to form Jing-Ming; thus, Jing gathers and Shen is whole. If inverted and confused, Jing is depleted and Shen is weak, certainly not a sign of long-term stability!) Acupuncture has Five Orifices and Five Views to observe Five Qi. Five Qi are the messengers of the Five Zang, and the counterparts of the Five Seasons. (Acupuncture methods require knowing Zang Qi; to know Zang Qi, one must observe the Five Orifices and Five Views. View refers to external signs. Messenger refers to what is dispatched. Counterpart refers to correspondence.) Five Orifices are the windows of the Five Zang. (Five Zang are stored internally; Five Orifices manifest externally; interior and exterior correspond, hence they are windows of the Five Zang.) Pulses emerge from Qikou; colors appear at Ming-Tang (Nose). Five Colors alternate to correspond to Five Seasons, each following its norm. When Jing Qi enters the Zang, treatment must focus on the Interior. (Norms are standard practices. Zang pulses are observed at Qikou; Zang colors at Ming-Tang. Ming-Tang is the nose. Colors corresponding to seasons are normal. However, color appearing externally while disease is internal indicates Essence entering the Zang, so treatment must focus on the Interior.) Five Orifices distinguished, Que-Ting (glabella and forehead) spread open, thus establishing Ming-Tang. Ming-Tang is broad, Fan-Bi (cheek sides and ear gates) visible externally, walls high and bases firm,垂 (hanging parts) prominent outside. (This states that all parts of the Five Orifices must be detailed, not just color at Ming-Tang. Que is glabella. Ting is forehead. Zhang is spread. Fan is cheek side. Bi is ear gate. Wall is wall. Base is bone structure. Prominent outside means clearly open. This discusses the prominence of部位 (locations) beyond Five Colors.) Five Colors regulated, flat, broad, and vast, lifespan reaches one hundred years. (Excellent shape and color constitute longevity, hence suitable for living to a hundred. Regulated means orderly. Suitable means capable. Seeing such people, acupuncture will surely cure. Such people have abundant Blood-Qi and firm muscles, so they can endure bitter acupuncture (strong stimulation). (Such people have substantial Blood-Qi and firm shape/color, so acupuncture cures and strong stimulation is tolerated. Conversely, internal Blood-Qi deficiency and external shape/color weakness are unsuitable for acupuncture, and likewise for herbs. Zhi means dense/firm.) Nose is the official organ of the Lung; Eye is the official organ of the Liver; Mouth/Lips are the official organ of the Spleen; Tongue is the official organ of the Heart; Ear is the official organ of the Kidney. (Nose is Lung orifice, Eye is Liver orifice, Lips are Spleen orifice, Tongue is Heart orifice, Ear is Kidney orifice. Official refers to duty, governing respiration, distinguishing colors, accepting food/water, tasting flavors, hearing sounds. Five Zang and Five Orifices,)