弹石脉，在筋肉间，按举劈劈然，肾绝也。雀啄脉，如雀之啄食，连连凑指，忽然止绝，良久复来。屋漏
脉，如残漏之下，良久一滴，溅起无力。啄漏二脉皆脾胃衰弱之绝脉也。解索脉，指下散乱，无
复次序。虾游脉，在皮肤，始则冉冉不动，少焉而去，久之倏而复来。鱼翔脉，其脉本不动而未
强摇。釜沸脉，在皮肤，有出无入，涌涌如羹上之波。皆死脉也。
《脉经》云∶热病脉四至，三日死矣。脉四至，无病患一至，病患脉四至也。热病脉五至，
一日死矣，时一大至，半日死矣。忽忽闷乱者死。
热病脉六至，半日死矣，急疾大至有顷死。
热病脉四损，三日死。所谓四损，无病患四至，病患脉一至，名曰四损。热病脉五损，一日
死。所谓五损，无病患脉五至，病患脉一至，名曰五损。热病脉六损，一时死。所谓六损，无病
人脉六至，病患一至，名曰六损。若绝不至，或久乃至，立死。
久病反候，春沉、夏微、秋洪、冬浮，过时命终。尺脉上不至关，阴绝，死于春夏；寸脉下
不至关，阳绝，死于秋冬。
细数无力，虚劳非宜。数而有间，月断死期。独审盛衰，三合相欺。（三合见前。）如心独
盛，申子辰危。数而无间，日断死期。旬余之内，如月而推。
帝曰∶见真藏曰死，何也？岐伯曰∶五脏皆禀气于胃，胃者五脏之本也。藏气者不能自致于
手太阴，必因于胃气乃致于手太阴也，故五脏各以其时自为而致于手太阴也。故邪胜者精气衰也。
故病甚者胃气不能与之俱致于手太阴，故真藏之气独见者，病胜藏也，故曰死。
人以水谷为本，故人绝水谷则死。脉无胃气者死，所谓无胃气者，但得真藏脉，不见胃气也。
所谓阴者，真藏也，见则为败，败必死也。凡持真脉之藏脉者，肝至悬绝急，十八日死；心至悬
绝，九日死；肺至悬绝，十二日死；肾至悬绝，七日死；脾至悬绝，四日死。三阴俱搏，二十日
夜半死；二阴俱搏，十三日夕时死；一阴俱搏，十日平旦死。所谓真藏脉见皆死也。
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。真心脉至，坚
而搏，如循薏苡子累累然，色赤黑不泽，毛折乃死。真脾脉至，弱而乍疏乍数，色黄青不泽，毛
折乃死。真肺脉至，大而虚，如以毛羽中人肤，色白赤不泽，毛折乃死。真肾脉至，搏而绝，如
指弹石辟辟然，色黄黑不泽，毛折乃死。诸真藏脉见皆死不治也。
玉机真藏篇曰∶五脏受气于其所生，传之于其所胜，气舍于其所生，死于其所不胜。病之且
死，必先传行至其所不胜，病乃死。此气之逆行也，故死。肝受气于心，传之于脾，气舍于肾，
至肺而死。（缓者秋死，急者庚辛日
及日脯死也。）心受气于脾，传之于肺，气舍于肝，至肾而死。（缓者冬死，急者壬癸日及夜半
死也。）脾受气于肺，传之于肾，气舍于心，至肝而死。（缓者春死，急者甲乙日及朝死也。）
肺受气于肾，传之于肝，气舍于脾，至心而死。（缓者夏死，急者丙丁日及日中死也。）肾受气
于肝，传之于心，气舍于肺，至脾而死。（缓者长夏死，急者戊己日及辰戌丑未日死也。）此皆
逆死也。一日一夜五分之，此所以占生死之早暮也。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，真藏见，乃予之期日。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 ，真藏见，十月之内死。大骨枯槁，大肉陷下，肩髓肉消，动作益衰，
真藏来见，期一岁死。大骨枯槁，大肉陷下，胸中气满，心中不便，肩项身热，破 肉脱，目眶
陷，真藏见，目不见人，立死，其见人者，至其所不胜之时则死。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，若人一息五六至，其形肉不脱，真藏虽
不见，犹死也。
三部九候皆相失者死。上下左右之脉相应如参舂者病甚。上下左右之脉相失不可数者死。中
部之候虽独调，众脏相失者死。中部之候相减者死。目眶内陷者死。肉脱身不去者死。乍疏乍数
者死。真藏见形者胜死。形气相得者生，三五不调者病。以左手足上，上去踝五寸按之，庶右手
足当踝而弹之，其应过五寸以上，蠕蠕然者不病；其应疾，中手浑浑然者病；中手徐徐然者病；
其应上不能至五寸，弹之不应者死。形肉已脱，九候虽调犹死。形盛脉细，少气不足以息者危。
形瘦脉大，胸中多气者死。脉无胃气曰逆，逆则死。肝见庚辛死，心见壬癸死，肺见丙丁死，肾
见戊己死，脾见甲乙死。浑浑革至如涌泉，病进而色弊，绵绵其去如弦绝者死。脉如转豆者死。
脉如偃刀者死。脉涌涌不去者死。脉忽去忽来，暂止复来者死。脉中侈者死，脉分绝者死。（转
豆者为心真藏脉，偃刀者为肝真藏脉，忽去忽来者为脾真藏脉也。）
三部脉如釜中汤沸，朝得暮死，半夜得日中死，日中得半夜死。九候之脉皆沉细悬绝者，为
阴主冬，故以
夜半死。盛躁喘数者，为阳主夏，故以日中死。寒热病者以平旦死。热中及热病者以日中死。病
风者以日夕死，病水者以夜半死。其脉乍疏乍数乍迟乍疾，日乘四季者死。脉浮而滑，身汗如油，
喘息不休，水浆不入，身体不仁，乍静乍喘者死。汗出发润，喘不休，肺气绝也，主死。阳病独
留，体如烟熏，直视摇头，口不能言，心先绝也。唇吻青，四肢 汗出，肝先绝也。环口黧黑，
虚汗发黄，脾先绝也。身热喘粗，见阴而多躁者死。头目痛，卒视无见者死。三部脉紧盛，大汗
出不解者死。阴阳尺寸俱虚者死。温病汗不出，出不至足者死。温病禳禳大热，脉细小者死。咳
而脱形，发热脉坚急者死。皮肉着骨者死。发直如麻者死。口臭不可近者死。热病七八日，当汗
不得汗，脉绝者死。面无光，牙齿黑者死。舌卷卵缩者死。目不回，直视一日死。阴结阳绝，目
精脱，恍惚者死。阴阳竭绝，目眶陷者死。遗尿不知者死。口如鱼口不能闭，而气出多不及者死。
肛门如竹筒，大便不禁不知者死。病患卧有边不宁者死。吐痰如蟹沫者死。面肿色苍黑者死。表
里俱病者死。病已汗，身体不凉，加喘泻者死。病久妄言及不能言者不治，热病者可治。病患阴
阳俱绝，撮空摸衣者死。汗出不流，舌卷黑者死。发与肩冲起者死。病患爪甲青者死。病患爪甲
白者不治。病患脉绝口张足肿者，五日死。病患足跗上肿，两膝大如斗者，十日死。病患阴囊及
茎肿者死。病患爪甲及肉黑者八日死。
弹石脉，位于筋肉之间，按压时感觉劈劈作响，这是肾气绝的表现。雀啄脉，像麻雀啄食一样，连续急促地撞击手指，突然停止，过了很久又出现。屋漏脉，像残破的屋顶漏水一样，很久才滴下一滴水，溅起时毫无力量。雀啄和屋漏这两种脉象都是脾胃之气衰败绝灭的死脉。解索脉，指下感觉散乱无章，没有次序。虾游脉，位于皮肤表层，开始时微微不动，一会儿消失，很久之后突然又出现。鱼翔脉，脉搏本应不动却微弱地摇动。釜沸脉，位于皮肤表层，只有出气没有入气，涌涌而动像羹汤上面的波浪。这些都是死脉。
《脉经》说：热病患者脉象每息四至，三天后会死亡。所谓“脉四至”，是指正常人的脉搏一息一至，而病人的脉搏一息四至。热病患者脉象每息五至，一天后会死亡；如果偶尔出现一次特别大的搏动，半天后就会死亡。如果患者感到恍惚、烦闷混乱，则会死亡。
热病患者脉象每息六至，半天后会死亡；如果脉象急疾且偶尔出现特别大的搏动，不久后就会死亡。
热病患者脉象出现“四损”，三天后会死亡。所谓“四损”，是指正常人脉搏一息四至，而病人脉搏一息仅一至，这叫做“四损”。热病患者脉象出现“五损”，一天后会死亡。所谓“五损”，是指正常人脉搏一息五至，而病人脉搏一息仅一至，这叫做“五损”。热病患者脉象出现“六损”，一个时辰（两小时）内会死亡。所谓“六损”，是指正常人脉搏一息六至，而病人脉搏一息仅一至，这叫做“六损”。如果脉搏完全摸不到，或者很久才跳动一次，会立即死亡。
久病之人如果出现反常的脉象：春季脉沉、夏季脉微、秋季脉洪大、冬季脉浮，超过时令则性命终结。尺部脉搏向上不能到达关部，是阴气绝，死于春夏季节；寸部脉搏向下不能到达关部，是阳气绝，死于秋冬季节。
脉细数且无力，不适合虚劳病（若出现则预后不良）。脉数且有间歇，可推断在一个月内死亡。单独审视盛衰变化，结合三合理论互相验证。（三合理论见前文。）如果心脉独盛，逢申、子、辰日有危险。脉数且无间歇，可推断在几天内死亡。在十几天之内，可以按月推算法来推算。
黄帝问：见到真脏脉就说会死亡，为什么呢？岐伯回答：五脏都依赖胃气生存，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，所以五脏各自在其所主的时令将精气输送到手太阴肺经。所以邪气盛则精气衰。因此病情严重时，胃气不能与脏气一起到达手太阴肺经，所以真脏之气单独显现，说明病邪胜过脏气，所以说会死亡。
人以水谷为根本，所以人断绝水谷摄入就会死亡。脉象中没有胃气的人也会死亡。所谓没有胃气，就是只见到真脏脉，而看不到胃气的表现。所谓“阴”，指的是真脏脉，见到真脏脉就说明脏腑败坏，败坏必然死亡。凡是诊察到真脉的真脏脉，肝脏真脏脉出现悬绝紧急，十八天后死亡；心脏真脏脉出现悬绝，九天后死亡；肺脏真脏脉出现悬绝，十二天后死亡；肾脏真脏脉出现悬绝，七天后死亡；脾脏真脏脉出现悬绝，四天后死亡。三阴经脉俱搏动，二十天半夜时死亡；二阴经脉俱搏动，十三天傍晚时死亡；一阴经脉俱搏动，十天清晨时死亡。所谓真脏脉出现，都是死亡的征兆。
真肝脉到来，脉象中外紧急，像触摸刀刃那样锐利，像按压琴瑟弦那样紧绷，面色青白而无光泽，毫毛枯折就会死亡。真心脉到来，坚硬而搏指，像触摸薏苡子那样颗粒累累，面色赤黑而无光泽，毫毛枯折就会死亡。真脾脉到来，软弱而忽疏忽数，面色黄青而无光泽，毫毛枯折就会死亡。真肺脉到来，大而空虚，像羽毛中人肌肤那样轻浮，面色白赤而无光泽，毫毛枯折就会死亡。真肾脉到来，搏动而断绝，像手指弹石头那样辟辟作响，面色黄黑而无光泽，毫毛枯折就会死亡。所有真脏脉出现，都是无法治愈的死证。
《玉机真脏论》说：五脏的病气从其所生的脏腑传来，传给它所克的脏腑，气停留于它所生的脏腑，最终死于它所不胜（克）的脏腑。病将要死亡时，必定先传行至它所不胜的脏腑，病人才会死亡。这是气的逆行，所以会导致死亡。肝受气于心，传之于脾，气舍于肾，传到肺而死。（病情缓和者秋天死亡，急重者在庚辛日及傍晚死亡。）心受气于脾，传之于肺，气舍于肝，传到肾而死。（病情缓和者冬天死亡，急重者在壬癸日及半夜死亡。）脾受气于肺，传之于肾，气舍于心，传到肝而死。（病情缓和者春天死亡，急重者在甲乙日及清晨死亡。）肺受气于肾，传之于肝，气舍于脾，传到心而死。（病情缓和者夏天死亡，急重者在丙丁日及中午死亡。）肾受气于肝，传之于心，气舍于肺，传到脾而死。（病情缓和者长夏死亡，急重者在戊己日及辰戌丑未日死亡。）这些都是逆传而死。一日一夜分为五个时段，这就是用来占测生死早晚的方法。如果大骨枯槁，大肉陷下，胸中气满，喘息不便，内部疼痛牵引肩项，预期一个月后死亡；如果见到真脏脉，就给予具体的死亡日期。如果大骨枯槁，大肉陷下，胸中气满，喘息不便，内部疼痛牵引肩项，身体发热，肌肉脱失，皮肤破裂，见到真脏脉，预期在十个月内死亡。如果大骨枯槁，大肉陷下，肩部肌肉消瘦，动作更加衰弱，真脏脉出现，预期一年后死亡。如果大骨枯槁，大肉陷下，胸中气满，心中憋闷，肩项身热，肌肉脱失，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，到了它所不胜的时辰就会死亡。如果突然遭受虚邪侵袭，五脏闭绝，脉道不通，气不往来，就像坠落溺水一样，无法预测具体死亡时间。如果脉搏完全不来，或者人一呼一吸间脉搏跳动五六次，虽然形体肌肉没有脱失，真脏脉也没有出现，也是死证。
三部九候脉象都失常的会死亡。上下左右脉象相应如杵臼舂米般规律的，病情严重。上下左右脉象失常且无法计数的，会死亡。中部脉候虽然单独调和，但其他脏腑脉象失常的，会死亡。中部脉候减弱的，会死亡。眼眶内陷的会死亡。肌肉脱失身体尚存的会死亡。脉象忽疏忽数的会死亡。真脏脉显现形状的，胜则死。形气相得的能生存，三五不调的生病。用左手足上，距离脚踝五寸处按住，同时用右手足在脚踝处弹击，如果反应超过五寸以上，蠕蠕然柔和的，没有病；如果反应快，手感浑浑然的，有病；手感徐徐然的，有病；如果反应向上不能达到五寸，弹击没有反应的，会死亡。形体肌肉已经脱失，即使九候脉象调和也会死亡。形体壮实但脉象细弱，气息短少不足以呼吸的，危险。形体瘦弱但脉象洪大，胸中多气的，会死亡。脉象没有胃气叫做逆，逆则死亡。肝脏脉象见于庚辛日死亡，心脏脉象见于壬癸日死亡，肺脏脉象见于丙丁日死亡，肾脏脉象见于戊己日死亡，脾脏脉象见于甲乙日死亡。脉象浑浊革急如涌泉，病情进展且面色败坏，脉去绵绵如弦断绝的，会死亡。脉象如转豆的会死亡。脉象如偃刀的会死亡。脉象涌涌不去的会死亡。脉象忽去忽来，暂时停止后又出现的，会死亡。脉象中侈的会死亡，脉象分绝的会死亡。（转豆脉是心的真脏脉，偃刀脉是肝的真脏脉，忽去忽来脉是脾的真脏脉。）
三部脉象像锅中汤水沸腾，早晨得到这种脉象晚上死亡，半夜得到日中死亡，日中得到半夜死亡。九候脉象都沉细悬绝的，属于阴主冬，所以以半夜死亡。脉象盛躁喘数的，属于阳主夏，所以以日中死亡。寒热病者在平旦（清晨）死亡。热中和热病者在日中（中午）死亡。患风病者在日夕（傍晚）死亡，患水肿病者在夜半死亡。脉象乍疏乍数乍迟乍疾，遇到四季末各十八天（土旺之时）死亡的。脉浮而滑，身体出汗如油，喘息不停，水浆不进，身体麻木不仁，时而安静时而喘促的，会死亡。汗出发润，喘息不停，是肺气绝，主死。阳病独留，身体如烟熏色，直视摇头，口不能言，是心先绝。唇吻发青，四肢冷汗出，是肝先绝。环口黧黑，虚汗发黄，是脾先绝。身体发热喘粗，见到阴症而多烦躁的，会死亡。头目痛，突然视物不见的，会死亡。三部脉紧盛，大汗出而病不解的，会死亡。阴阳尺寸俱虚的，会死亡。温病不出汗，汗出不达足的，会死亡。温病禳禳大热，脉细小的，会死亡。咳嗽且形体脱失，发热脉坚急的，会死亡。皮肉着骨的，会死亡。头发直如麻的，会死亡。口臭不可靠近的，会死亡。热病七八天，应当出汗却不得汗，脉绝的，会死亡。面无光泽，牙齿发黑的，会死亡。舌卷缩卵缩的，会死亡。眼睛不回转，直视一天的，会死亡。阴结阳绝，眼球脱出，神志恍惚的，会死亡。阴阳竭绝，眼眶凹陷的，会死亡。遗尿不知晓的，会死亡。口张如鱼口不能闭合，气出多不及的，会死亡。肛门如竹筒，大便不禁不知的，会死亡。病患卧床不安宁的，会死亡。吐痰如蟹沫的，会死亡。面肿色苍黑的，会死亡。表里俱病的，会死亡。病已出汗，身体不凉，加上喘泻的，会死亡。病久胡言乱语及不能言语的，不治；热病导致的可以治疗。病患阴阳俱绝，撮空摸衣的，会死亡。汗出不流，舌卷黑的，会死亡。头发与肩冲起的，会死亡。病患爪甲青的，会死亡。病患爪甲白的，不治。病患脉绝口张足肿的，五天死亡。病患足背肿胀，两膝大如斗的，十天死亡。病患阴囊及阴茎肿胀的，会死亡。病患爪甲及肌肉发黑的，八天死亡。
The Dan Shi (Stone-Tapping) pulse is located between the muscles and tendons; upon pressing, it feels like cracking stones, indicating the exhaustion of Kidney Qi. The Que Zhuo (Sparrow-Pecking) pulse resembles a sparrow pecking at food, striking the fingers continuously and rapidly, then suddenly stopping, only to return after a long interval. The Wu Lou (House-Leak) pulse is like water dripping from a leaking roof, falling only once after a long time, splashing up with no strength. Both the Que Zhuo and Wu Lou pulses are signs of the exhaustion of Spleen and Stomach Qi. The Jie Suo (Untying Knots) pulse feels scattered and chaotic under the fingers, lacking any order. The Xia You (Shrimp-Traveling) pulse is felt at the skin level; initially it remains still, then disappears, and after a long while suddenly reappears. The Yu Xiang (Fish-Swimming) pulse is essentially still but trembles weakly. The Fu Fei (Cauldron-Boiling) pulse is felt at the skin level, having only outward movement without inward retreat, surging like waves on boiling soup. All these are death pulses.
The *Mai Jing* (Pulse Classic) states: In febrile diseases, if the pulse beats four times per respiration, death occurs in three days. "Four beats" means that while a healthy person's pulse beats once per respiration, the patient's beats four times. If the pulse beats five times per respiration in febrile disease, death occurs in one day; if occasionally there is a particularly strong beat, death occurs in half a day. If the patient experiences confusion and mental agitation, death ensues.
If the pulse beats six times per respiration in febrile disease, death occurs in half a day; if the pulse is rapid and occasionally exhibits a particularly strong beat, death occurs shortly thereafter.
If the pulse shows "Si Sun" (Four Damages) in febrile disease, death occurs in three days. "Four Damages" refers to a condition where a healthy person's pulse beats four times per respiration, but the patient's pulse beats only once. If the pulse shows "Wu Sun" (Five Damages), death occurs in one day. "Five Damages" means a healthy person's pulse beats five times per respiration, while the patient's beats once. If the pulse shows "Liu Sun" (Six Damages), death occurs within one shichen (two hours). "Six Damages" means a healthy person's pulse beats six times per respiration, while the patient's beats once. If the pulse is completely imperceptible or appears only after a long delay, immediate death occurs.
In chronic diseases, contrary pulse patterns indicate death when they exceed the season: deep pulse in Spring, faint pulse in Summer, large pulse in Autumn, and floating pulse in Winter. If the Chi (Cun) pulse does not reach the Guan (Bar) point upwards, Yin is exhausted, leading to death in Spring or Summer; if the Cun (Inch) pulse does not reach the Guan point downwards, Yang is exhausted, leading to death in Autumn or Winter.
A fine, rapid, and forceless pulse is unfavorable for Xu Lao (Deficiency Consumption). A rapid pulse with intervals suggests death within a month. By examining the excess and deficiency alone and combining them with the San He (Three Harmonies) theory (see previous text), one can predict outcomes. For instance, if the Heart pulse is exclusively excessive, danger arises on Shen, Zi, or Chen days. A rapid pulse without intervals suggests death within days, calculable within ten-plus days using monthly deduction methods.
The Emperor asked: Why does the appearance of Zhen Zang Mai (True Viscera Pulse) indicate death? Qibo replied: The Five Zang organs all derive their Qi from the Stomach; the Stomach is the root of the Five Zang. Visceral Qi cannot reach the Hand Taiyin Lung Meridian on its own; it must rely on Stomach Qi to do so. Thus, each Zang transmits its Qi to the Hand Taiyin during its respective season. Therefore, when pathogenic factors are excessive, essence and Qi decline. When the disease is severe, Stomach Qi cannot accompany the Visceral Qi to the Hand Taiyin. Consequently, the isolated appearance of True Viscera Qi indicates that the disease has overcome the Zang, signifying death.
Humans rely on water and grain as their foundation; thus, humans die when water and grain are cut off. Those whose pulses lack Stomach Qi die. Lacking Stomach Qi means exhibiting only Zhen Zang Mai without any sign of Stomach Qi. What is called "Yin" here refers to the True Viscera pulse; its appearance signifies failure and inevitable death. Regarding specific timelines for Zhen Zang pulses: if the Liver pulse appears suspended and urgent, death occurs in 18 days; if the Heart pulse appears suspended, death occurs in 9 days; if the Lung pulse appears suspended, death occurs in 12 days; if the Kidney pulse appears suspended, death occurs in 7 days; if the Spleen pulse appears suspended, death occurs in 4 days. If the Three Yin pulses all throb strongly, death occurs at midnight on the 20th day; if the Two Yin pulses throb strongly, death occurs at dusk on the 13th day; if the One Yin pulse throbs strongly, death occurs at dawn on the 10th day. The appearance of True Viscera pulses always indicates death.
When the True Liver pulse arrives, it is tense inside and out, feeling sharp like touching a knife blade or tight like pressing a lute string. With a cyan-white complexion lacking luster, death follows when the body hair breaks. When the True Heart pulse arrives, it is hard and pounding, feeling granular like touching coix seeds. With a red-black complexion lacking luster, death follows when the body hair breaks. When the True Spleen pulse arrives, it is weak and alternates between sparse and rapid. With a yellow-cyan complexion lacking luster, death follows when the body hair breaks. When the True Lung pulse arrives, it is large and empty, feeling light like a feather brushing the skin. With a white-red complexion lacking luster, death follows when the body hair breaks. When the True Kidney pulse arrives, it is pounding yet severed, feeling like fingers tapping on stone. With a yellow-black complexion lacking luster, death follows when the body hair breaks. The appearance of any True Viscera pulse indicates an untreatable fatal condition.
The *Yu Ji Zhen Zang Pian* chapter states: The Five Zang receive Qi from the organ that generates them, transmit it to the organ they control, retain it in the organ that generates them, and die when affected by the organ that controls them. Before death, the disease必先传行至其所不胜 (must first transmit to the organ it cannot overcome), causing death. This is a retrograde flow of Qi, hence fatal. The Liver receives Qi from the Heart, transmits to the Spleen, retains in the Kidney, and dies when affecting the Lung. (Slower cases die in Autumn; acute cases die on Geng/Xin days or at dusk.) The Heart receives Qi from the Spleen, transmits to the Lung, retains in the Liver, and dies when affecting the Kidney. (Slower cases die in Winter; acute cases die on Ren/Gui days or at midnight.) The Spleen receives Qi from the Lung, transmits to the Kidney, retains in the Heart, and dies when affecting the Liver. (Slower cases die in Spring; acute cases die on Jia/Yi days or at dawn.) The Lung receives Qi from the Kidney, transmits to the Liver, retains in the Spleen, and dies when affecting the Heart. (Slower cases die in Summer; acute cases die on Bing/Ding days or at noon.) The Kidney receives Qi from the Liver, transmits to the Heart, retains in the Lung, and dies when affecting the Spleen. (Slower cases die in Late Summer; acute cases die on Wu/Ji days or at Chen/Xu/Chou/Wei hours.) These are all deaths due to retrogression. Dividing the day and night into five parts allows for predicting the timing of death. If the great bones are emaciated, the great muscles sunken, the chest full of Qi, breathing difficult, internal pain radiating to the shoulders and neck, death is expected within one month; if Zhen Zang pulses appear, a specific date is given. If accompanied by fever, muscle wasting, and skin cracking, death occurs within ten months. If shoulder marrow wastes away and movements weaken further, death occurs within one year. If the eyes cannot see people, death is immediate; if they can see, death occurs at the hour of the controlling element. Sudden collapse with closed five Zang and blocked meridians, resembling drowning, cannot be timed precisely. If the pulse ceases entirely, or beats 5-6 times per breath while flesh remains intact, even without visible Zhen Zang pulses, death ensues.
If the pulses at the Three Bu and Nine Hou sections are all disordered, death occurs. If the pulses above and below, left and right correspond rhythmically like a mortar and pestle, the disease is severe. If they are disordered and uncountable, death occurs. If the Middle section pulses are harmonious alone but other Zang pulses are disordered, death occurs. If the Middle section pulses diminish, death occurs. Sunken eye orbits indicate death. Muscle wasting with remaining body indicates death. Alternating sparse and rapid pulses indicate death. Visible forms of Zhen Zang pulses indicate death. Harmony between Form and Qi leads to life; discordance leads to disease. Pressing five cun above the ankle on the left foot while tapping the right ankle: if the response travels over five cun gently, there is no disease; if rapid and chaotic, there is disease; if slow, there is disease; if it fails to reach five cun or shows no response, death occurs. Even if Nine Hou pulses are harmonious, if form and flesh are wasted, death occurs. Robust form with fine pulse and shortness of breath indicates danger. Emaciated form with large pulse and chest fullness indicates death. Pulses lacking Stomach Qi are termed Ni (Rebellious) and lead to death. Liver pulse appearing on Geng/Xin days causes death; Heart on Ren/Gui; Lung on Bing/Ding; Kidney on Wu/Ji; Spleen on Jia/Yi. Chaotic,革 (Leather-like) pulses surging like springs with deteriorating color, or fading like a breaking string, indicate death. Pulses like rolling beans indicate death. Pulses like an inverted knife indicate death. Surging pulses that do not recede indicate death. Pulses that come and go intermittently indicate death. Excessively wide pulses indicate death. Severed branch pulses indicate death. (Rolling bean pulse is the Heart's Zhen Zang pulse; inverted knife pulse is the Liver's; intermittent pulse is the Spleen's.)
If the pulses at the Three Bu sections resemble boiling soup in a cauldron, morning onset leads to evening death, midnight onset leads to noon death, and noon onset leads to midnight death. If all Nine Hou pulses are deep, fine, and suspended/extreme, belonging to Yin/Winter, death occurs at midnight. If pulses are excessive, restless, panting, and rapid, belonging to Yang/Summer, death occurs at noon. Cold-heat diseases die at dawn. Heat-in-the-middle and febrile diseases die at noon. Wind diseases die at dusk. Water retention diseases die at midnight. Pulses alternating sparse/rapid/slow/fast die during the Earth phases of the day. Floating and slippery pulses with oily sweat, ceaseless panting, inability to swallow, numbness, and alternating calm/panting states indicate death. Sweating with wet hair and ceaseless panting indicates Lung Qi exhaustion and death. Yang disease lingering alone, with a smoky complexion, fixed gaze, head shaking, and inability to speak indicates Heart exhaustion. Cyan lips and cold sweat on limbs indicate Liver exhaustion. Black ring around the mouth and yellowish sweat indicate Spleen exhaustion. Fever, coarse breathing, Yin symptoms, and restlessness indicate death. Head/eye pain and sudden blindness indicate death. Tight and abundant pulses at all three positions with unremitting massive sweating indicate death. Deficiency of both Yin and Yang at Cun and Chi indicates death. Warm diseases without sweat, or sweat failing to reach the feet, indicate death. Warm diseases with intense heat and fine/small pulses indicate death. Coughing with emaciation, fever, and firm/rigid pulses indicate death. Skin and flesh adhering to bone indicate death. Straight hair like hemp indicates death. Foul breath indicates death. Febrile diseases lasting 7-8 days without sweat and with absent pulses indicate death. Lack of luster on the face and black teeth indicate death. Rolled tongue and retracted testicles indicate death. Fixed gaze without blinking leads to death in one day. Yin knotting with Yang severing, eyeball protrusion, and confusion indicate death. Exhaustion of Yin and Yang with sunken orbits indicates death. Incontinence with unawareness indicates death. Mouth open like a fish unable to close, with exhaled air insufficient, indicates death. Anus like a bamboo tube with uncontrollable bowel movements indicates death. Restlessness in bed indicates death. Sputum like crab foam indicates death. Swollen face with cyan-black color indicates death. Simultaneous exterior and interior disease indicates death. Post-sweat fever with worsening panting/diarrhea indicates death. Chronic delirium or muteness is untreatable, though febrile causes may be treated. Yin/Yang exhaustion with grasping at empty air or clothes indicates death. Non-flowing sweat and black rolled tongue indicate death. Hair standing up towards the shoulders indicates death. Cyan nail beds indicate death. White nail beds are untreatable. Absent pulse, open mouth, and swollen feet lead to death in five days. Swollen dorsum pedis and knees as large as buckets lead to death in ten days. Swollen scrotum and penis indicate death. Black nails and flesh lead to death in eight days.