病患肝绝，八日死，何以知之？面青但欲伏眠，目视不见人，汗（一作泣）出如水不止。
（一曰、二日死。） 病患胆绝，七日死，何以知之？眉为之倾。 病患筋绝，九日死，何
以
知之？手足爪甲青，呼骂不休。（一曰∶八日死。） 病患心绝，一日死，何以知之？肩息回
视立死。（一曰∶目亭亭二日死。） 病患肠（云小肠）绝，六日死，何以知之？发直如干麻，
不得屈伸，自汗不止。 病患脾绝，十二日死，何以知之？口冷足肿，腹热胪胀、泄利不觉，
出无时度（一曰∶五日死。） 病患胃绝，五日死，何以知之？脊痛，腰中重，不可反复。（一
曰∶腓肠平九日死。） 病患肉绝，六日死，何以知之？耳干舌肿，溺血，大便赤泄。（一曰∶
足肿九日死。） 病患肺绝，三日死，何以知之？口张，但气出而不还。（一曰∶鼻口虚张短
气。） 病患大肠绝，不治，何以知之？泄利无度，利绝则死。 病患肾绝，四日死，何以
知之？齿为暴枯，面为正黑，目中黄色，腰中欲折，自汗出如流水。（一曰∶人中平七日死。
）病患骨绝，齿黄落，十日死。 诸浮脉无根者皆死，以上五脏六腑为根也。
春三月木旺，肝脉治当先至，心脉次之，肺脉次之，肾脉次之，此为王相顺脉也。 到
六月土旺，脾脉当先至而反不至，反得肾脉，此为肾反脾也，七十日死。何谓肾反脾？夏火
旺，心脉当先至，肺脉次之，而反得肾脉，是谓肾反脾。期五月、六月，忌丙丁。 脾反肝
，三十日死。何谓脾反肝？春肝脉当先至，而反不至，脾脉先至，是谓脾反肝。期正月、二
月，忌甲乙。 肾反肝，三岁死。何谓肾反肝？春肝脉当先至，而反不至，肾脉先至，是谓
肾反肝。期七月、八月，忌庚辛。 肾反心，二岁死。何谓肾反心？夏心脉当先至，而反不
至，肾脉先至，是谓肾反心。期六月，忌戊己。
此中不论肺金之气，疏略未谕，指南又推五行，亦颇颠倒，待求别录上。
凡疗病，察其形貌、神气、色泽、脉之盛衰，病之新故，乃可治之。 形气相得，色泽
以浮，脉从四时，此为易治。 形气相失，色夭不泽，脉实坚甚，脉逆四时，此为难治。
逆四时者，春得肺脉，夏得肾脉，秋得心脉，冬得脾脉，其至皆悬绝涩者，曰逆。 春
夏沉涩，秋冬浮大，病热，脉静泄痢，脉大脱血，脉实病在中，脉坚实病在外，脉不实，名
逆四时，皆难疗也。 凡四时脉皆以胃气为本，虽有四时王相之脉，无胃气者难瘥也。何为
胃气？脉来弱而滑者是也，命曰易治。
【背景信息】
书名：备急千金要方 作者：孙思邈 朝代：唐·永徽三年 章节：诊五脏六腑气绝证候第十一 / 诊四时相反脉第十二 类别：方剂
【待处理原文】
如果病人的肝脏之气衰竭，八天后会死亡，怎么知道呢？面色发青，只想趴着睡觉，眼睛看着人却看不见，汗水像水一样不停地流出。
（另一种说法是：一两天内死亡。）
如果病人的胆腑之气衰竭，七天后会死亡，怎么知道呢？眉毛下垂。
如果病人的筋气衰竭，九天后会死亡，怎么知道呢？手脚指甲发青，呼叫谩骂不停止。（另一种说法是：八天内死亡。）
如果病人的心脏之气衰竭，一天后就会死亡，怎么知道呢？呼吸时肩膀耸动，目光呆滞直视，立刻死亡。（另一种说法是：眼球固定不动，两天内死亡。）
如果病人的小肠之气衰竭，六天后会死亡，怎么知道呢？头发直立像干枯的麻草，身体不能屈伸，自汗不止。
如果病人的脾脏之气衰竭，十二天后会死亡，怎么知道呢？口冷脚肿，腹部发热且胀满，腹泻失禁，排泄没有定时。（另一种说法是：五天内死亡。）
如果病人的胃腑之气衰竭，五天后会死亡，怎么知道呢？脊柱疼痛，腰部沉重，无法翻身转动。（另一种说法是：小腿肚平坦，九天内死亡。）
如果病人的肉气衰竭，六天后会死亡，怎么知道呢？耳朵干燥，舌头肿胀，尿血，大便呈红色稀泄。（另一种说法是：足肿，九天内死亡。）
如果病人的肺脏之气衰竭，三天后死亡，怎么知道呢？嘴巴张开，只有气呼出而吸不回来。（另一种说法是：鼻口虚张，呼吸短促。）
如果病人的大肠之气衰竭，无法治疗，怎么知道呢？腹泻没有节制，泻利停止后就会死亡。
如果病人的肾脏之气衰竭，四天后死亡，怎么知道呢？牙齿突然枯槁，面色正黑，眼中呈现黄色，腰部感觉要折断，自汗流出像流水一样。（另一种说法是：人中穴部位平坦，七天内死亡。）
如果病人的骨气衰竭，牙齿发黄脱落，十天后死亡。
所有浮取无根的脉象都会导致死亡，以上是以五脏六腑为根本而言的。
春季三个月，木气旺盛，肝脉应当最先出现，心脉次之，肺脉次之，肾脉再次之，这是王相顺脉（正常的相生顺序脉象）。
到了六月土气旺盛，脾脉应当最先出现却反而没有出现，反而得到肾脉，这叫做肾反脾，七十天后死亡。什么叫肾反脾？夏季火气旺盛，心脉应当最先出现，肺脉次之，却反而得到肾脉，这就是肾反脾。应期在五月、六月，忌讳丙丁日。
脾反肝，三十天后死亡。什么叫脾反肝？春季肝脉应当最先出现，却反而没有出现，脾脉先出现，这就叫脾反肝。应期在正月、二月，忌讳甲乙日。
肾反肝，三年后死亡。什么叫肾反肝？春季肝脉应当最先出现，却反而没有出现，肾脉先出现，这就叫肾反肝。应期在七月、八月，忌讳庚辛日。
肾反心，两年后死亡。什么叫肾反心？夏季心脉应当最先出现，却反而没有出现，肾脉先出现，这就叫肾反心。应期在六月，忌讳戊己日。
这段文字中未讨论肺金之气，疏漏不明，指南又推演五行，也有颠倒之处，等待另行记录在上。
凡是治疗疾病，必须观察病人的形体容貌、神气、色泽、脉象的盛衰，以及疾病的久暂，然后才可以进行治疗。
形体与气机协调，色泽明润浮泽，脉象顺应四时变化，这属于容易治疗的病症。
形体与气机失调，色泽枯槁无光泽，脉象实坚甚大，脉象违背四时规律，这属于难以治疗的病症。
所谓违背四时规律，是指春季得肺脉，夏季得肾脉，秋季得心脉，冬季得脾脉，其脉象都悬绝涩滞的，称为逆。
春夏季节脉象应浮大却见沉涩，秋冬季节脉象应沉细却见浮大；患热病而脉象静小，患泄痢而脉象盛大，失血而脉象实大，病在中焦而脉象实大，病在外表而脉象坚实，脉象不实，这些都称为违背四时规律，都属于难治之症。
凡是四季的脉象都以胃气为本，即使有符合四时王相规律的脉象，如果没有胃气，也难以痊愈。什么是胃气？就是脉来弱而滑利的，命曰易治。
[Background Information]
Book: *Beiji Qianjin Yaofang* (Essential Prescriptions Worth a Thousand Gold for Emergencies)
Author: Sun Simiao
Dynasty: Tang Dynasty, Yonghui 3rd Year
Chapter: Diagnosis of Symptoms of Qi Exhaustion in the Five Zang and Six Fu Organs XI / Diagnosis of Pulses Opposite to the Four Seasons XII
Category: Formulas
[Original Text Processing]
If the Liver Qi of a patient is exhausted, death will occur after eight days. How do we know this? The face appears cyanotic, the patient desires to lie prone and sleep, eyes gaze at people but fail to see them, and sweat flows continuously like water.
(Another version states: death occurs within one or two days.)
If the Gallbladder Qi of a patient is exhausted, death will occur after seven days. How do we know this? The eyebrows droop.
If the Sinew Qi of a patient is exhausted, death will occur after nine days. How do we know this? The fingernails and toenails turn cyanotic, and the patient calls out and curses incessantly. (Another version states: death occurs within eight days.)
If the Heart Qi of a patient is exhausted, death will occur after one day. How do we know this? There is shoulder breathing (accessory muscle use in respiration), fixed staring gaze, leading to immediate death. (Another version states: fixed eyeballs, death occurs within two days.)
If the Small Intestine Qi of a patient is exhausted, death will occur after six days. How do we know this? The hair stands straight like dry hemp, the body cannot flex or extend, and spontaneous sweating continues without stop.
If the Spleen Qi of a patient is exhausted, death will occur after twelve days. How do we know this? The mouth feels cold, feet swell, the abdomen is hot and distended, diarrhea occurs with loss of control, and excretion happens at unpredictable times. (Another version states: death occurs within five days.)
If the Stomach Qi of a patient is exhausted, death will occur after five days. How do we know this? There is spinal pain, heaviness in the waist, and inability to turn over. (Another version states: flattening of the calf muscles, death occurs within nine days.)
If the Flesh Qi of a patient is exhausted, death will occur after six days. How do we know this? The ears are dry, the tongue is swollen, there is hematuria (blood in urine), and the stool is red and loose. (Another version states: foot swelling, death occurs within nine days.)
If the Lung Qi of a patient is exhausted, death will occur after three days. How do we know this? The mouth is open, only air exits but does not return (inability to inhale). (Another version states: empty opening of nose and mouth, shortness of breath.)
If the Large Intestine Qi of a patient is exhausted, it is incurable. How do we know this? Diarrhea is uncontrolled; when the diarrhea ceases, death follows.
If the Kidney Qi of a patient is exhausted, death will occur after four days. How do we know this? The teeth become suddenly brittle, the face is jet black, the eyes show a yellow hue, the waist feels as if it will break, and spontaneous sweat flows like running water. (Another version states: flattening of the philtrum, death occurs within seven days.)
If the Bone Qi of a patient is exhausted, the teeth turn yellow and fall out, and death will occur after ten days.
All floating pulses lacking a root lead to death; above, the Five Zang and Six Fu organs are considered the root.
During the three months of Spring, Wood Qi is prosperous. The Liver Pulse should arrive first, followed by the Heart Pulse, then the Lung Pulse, and finally the Kidney Pulse. This is called the Wang-Xiang Shun Mai (Wang-Phase Compliant Pulse, indicating normal generative sequence).
When June arrives and Earth Qi is prosperous, the Spleen Pulse should arrive first but fails to do so; instead, the Kidney Pulse is obtained. This is called "Kidney Reversing Spleen," and death will occur in seventy days. What is meant by "Kidney Reversing Spleen"? In Summer, Fire Qi is prosperous, the Heart Pulse should arrive first and the Lung Pulse second, yet the Kidney Pulse is obtained instead. This is termed "Kidney Reversing Spleen." The period of occurrence is May and June; Bing-Ding days are taboo.
"Spleen Reversing Liver" leads to death in thirty days. What is meant by "Spleen Reversing Liver"? In Spring, the Liver Pulse should arrive first but fails to do so; the Spleen Pulse arrives first instead. This is termed "Spleen Reversing Liver." The period of occurrence is January and February; Jia-Yi days are taboo.
"Kidney Reversing Liver" leads to death in three years. What is meant by "Kidney Reversing Liver"? In Spring, the Liver Pulse should arrive first but fails to do so; the Kidney Pulse arrives first instead. This is termed "Kidney Reversing Liver." The period of occurrence is July and August; Geng-Xin days are taboo.
"Kidney Reversing Heart" leads to death in two years. What is meant by "Kidney Reversing Heart"? In Summer, the Heart Pulse should arrive first but fails to do so; the Kidney Pulse arrives first instead. This is termed "Kidney Reversing Heart." The period of occurrence is June; Wu-Ji days are taboo.
This section does not discuss the Qi of Metal (Lung); the omission is unclear. The guide further deduces the Five Elements, which also contains some inversions; these await separate recording above.
In all cases of treating disease, one must observe the patient's physical appearance, Shen (Spirit), complexion/luster, and the excess or deficiency of the pulse, as well as whether the disease is new or old, before proceeding with treatment.
When Xing (Form/Body) and Qi are harmonious, the luster is bright and floating, and the pulse conforms to the Four Seasons, this is easy to treat.
When Xing and Qi are discordant, the color is dull and lacks luster, the pulse is full, firm, and excessive, and the pulse opposes the Four Seasons, this is difficult to treat.
Opposing the Four Seasons refers to: obtaining the Lung Pulse in Spring, the Kidney Pulse in Summer, the Heart Pulse in Autumn, and the Spleen Pulse in Winter, where the pulses are all suspended, isolated, and choppy; this is called "Ni" (Rebellion/Opposition).
In Spring and Summer, the pulse should be floating and large but is instead deep and choppy; in Autumn and Winter, the pulse should be deep but is instead floating and large. For febrile diseases, the pulse should be quiet but is not; for dysentery/diarrhea, the pulse should be small but is large; for blood loss, the pulse should be empty but is full; for interior diseases, the pulse should be substantial but is not; for exterior diseases, the pulse should be firm but is not. If the pulse is not substantial/appropriate, it is named "Opposing the Four Seasons," and all such cases are difficult to heal.
All pulses of the Four Seasons take Wei Qi (Stomach Qi) as their foundation. Even if there are pulses conforming to the Wang-Xiang phases of the seasons, if there is no Wei Qi, recovery is difficult. What is Wei Qi? It is a pulse that comes weak and slippery; this is designated as easy to treat.