《素问·大奇论》曰∶脾脉外鼓沉，为肠 ，久自已；肝脉小缓，为肠 ，易治；肾脉小搏沉，为肠 下
血，血温身热者，死；心肝 ，亦下血，二脏同病者，可治，其脉小沉涩，为肠 ，其身热者死，热现七日死。
脾脉外鼓沉者，鼓动于本部之外，其形扁阔也，所以沉者，脾湿下注大肠，为肠 ，大便无关闭，常流粪
水，然脉形阔，脾气不亏，久则湿去自愈也；肝脉小缓，为肠 ，木弱土强，故亦
易治；如肾脉小搏沉，肠 兼下血者，湿热流于下焦，且伤阴血，故肾脉小搏不和，沉而不鼓，血温身热者，
邪热深真阴涸也，故死；若由心肝风火动，而肠 下血者，其非脾伤，故可治，若其两手脉小且沉涩，而肠
者，气血两伤，身不当热，而反热者，虚阳外露，七日阳复之期，阳竭不复则死矣。盖阳生于子，阴生于午，
自子到午为七，自午到子为七，若阴阳之气相生，其病以七日可愈，不相生而绝，故其死亦以七日也。
胃脉沉鼓涩，胃外鼓大，心脉小坚急，皆膈偏枯。男子发左，女子发右，不喑舌转，可治，三十日起；其
从者，喑，三岁起，年不满二十者，三岁死。
胃脉沉鼓涩，而又鼓大于脉路之外，此痰涎阻滞甚矣，心脉应浮洪而软，乃反小且坚急，其营血大伤也。
营起于中焦，并胃口，故二者之脉皆为膈病，中宫阻格，其阴阳气血不得流通经脉，遂成偏枯。男子阳气由左
转，故发左为逆，女子由右转，故发右为逆，如不喑，舌能转，其脏未伤，但伤经脉，故可治，三十日日月合
壁，人身之气，亦三十日阴阳会于本元，故偏枯可愈；其从者，言男子发右，女子发左也，脾肾经脉络舌根，
连舌本，喑者，脾肾之气不能上达于舌本，其外证虽从，而五内伤，如未全脱，调补三岁可愈，若年不满二十，
正在长旺之时而得此病，其本弱质而虚损，虽调补不过苟延三岁而死。
脉至而搏，血衄身热者，死。脉来悬钩浮，为常脉。
此条以下，皆言两手脉象，不分部位也。衄者，热伤气血，从阳道上溢也，脉搏，无柔和之象，而又身热，
则是孤阳发越之真脏脉也，故死。脉来悬钩浮者，心脏本脉之象，而加虚软，此为衄病之常脉，可治而愈。因
衄热在清道阳分，故脉浮而虚软，若吐血由浊道阴分而来，脉应沉弱，如脉浮即为凶矣。此又不可
不知也。
脉至如喘，名曰暴厥，暴厥者，不知与人言。脉至如数，使人暴惊，三四日自已。
如喘者，脉势激湍，其气暴逆而厥，不省人事，如气顺厥回可苏，厥不回即死矣。脉至如数者，似数非数
而虚软，此心肝血虚气动，使人暴惊者，如欲寐忽惊惕而醒，所谓魂梦不安也，但静养可已。
脉至浮合，浮合如数，一息十至以上，是经气予不足也，微见，九十日死。
脉至浮合者，如浮萍之浮于水面而合，其下全空，如数，一息十至以上，是脱脉，立死，焉能延至九十日？
其中必有错讹。或谓微现浮合下空之脉，是经气不足，九十日当死，如数，一息十至以上，则即死不能计日，
此倒装文法也。
脉至如火薪然，是心精之予夺也，草干而死；脉至如散叶，是肝气予虚也，木叶落而死，脉至如省客，省
客者，脉塞而鼓，是肾气予不足也，悬去枣花而死；脉至如丸泥，是胃精予不足也，榆荚落而死；脉至如横
格，是胆气予不足也，禾熟而死；脉至如弦缕，是包精予不足也，病善言，下霜而死，不言，可治；脉至如交
漆，交漆者，左右傍至也，微见，三十日死。
脉至如火薪然者，腾沸动摇，心精夺而心火散，草干冬深时，水旺火绝而死也；脉至如散叶者，轻虚浮泛
无根也，肝之气血皆枯，木叶落，金气旺，则肝木绝而死也；脉至如省客者，欲出不出，故曰塞、曰鼓者，
有出而无入，是肾气夺而精血枯，故脉形如是，悬去枣花，夏令土旺，则水绝而死也；脉至如丸泥者，应指圆旋，
而无出入来去，松软如泥，此胃中精气不足，榆
荚落，春深木旺时，则土气绝而死也；脉至如横格者，其气横逆相格，失少阳柔和调达之象，是胆气不足，胆
为甲木，禾熟，秋深金旺，则木气绝而死也；脉至如弦缕者，细长急强也，包精不足，包为心包络，代心用事，
精不足，则心火动散，言者心声，故善言，即多言也，下霜冬令，寒水旺，则火绝而死，如不言，心火尚静，
大补心血，可治也；脉至如交漆，左右傍至者，营气不循经脉，阴阳散乱，微现此象，至三十日阴阳会合之时，
不能相生，则气绝而死也。
脉至如涌泉，浮鼓肌中，太阳气予不足也，少气，味韭英而死。
太阳与少阴，为表里者，脉至如涌泉，腾沸而浮鼓肌中，其沉部空矣。浮为阳，沉为阴，阳根于阴者也，
沉部空，则根败而生气少，至韭英得味，春阳上升时，其根脱绝而死也。此下各条皆死脉。
脉至如颓土之状，按之不得，是肌气予不足，五色先见黑，白垒发而死。
脉至如颓土者，应指全无鼓动之力，故按之不得，而无根底，是肌气不足也。五色先见黑者，肾水涸，所
谓面如漆柴者。 有五种，白者发于春。土既先败，肾水涸而无春生之气，焉得不死？
脉至如悬雍，悬雍者，浮揣切之益大，是十二俞之予不足也，水凝而死。
喉间下垂之帝中，根于肾脏，伤损即死，又名悬雍，脉形似之，而浮揣切之益大者，表气有余，五内不固，
为十二俞之不足者，其阳气发泄日甚，故至冬寒水凝时，则阳竭而死。俞皆在背，是十二经脉脏腑之气穴也。
脉至如偃刀，偃刀者，浮之小急，按之坚大急，五脏菀热，寒热独并于肾也，如此其人不得坐，立春而死。
浮部小急，如刀口，按之坚大急，如刀背，绝无柔和之气。菀者，郁结也。以五脏久郁邪气，独并于肾，
肾伤腰折，可卧不得坐，肾败不能生肝，立春而木无生气，则绝而死。
脉至如丸，滑不直手，不直者，按之不可得也，是大肠气予不足也，枣叶生而死。
直同值，不值手者，谓应指圆滑，按之即无，但虚浮之气动滑也。大肠为庚金，枣叶生于夏，火旺则金绝
而死。
脉至如华者，令人善恐，不欲坐卧，行立常听，是小肠气予不足也，季秋而死。
如华者，如花开放而无收束，与心脉之如火薪然相类。盖小肠为丙火，心为丁火，脏腑为表里，而气相通，
故脉相类。火无收束，是阴精枯而阳外泄，心气怯则令人恐，恐则多疑，故不欲坐卧，行立常听，至季秋阳气
泄尽而死，丙火墓于戌也。
《素问·大奇论》中说：脾脉在外部鼓动而呈现沉象，这是肠澼（痢疾或泄泻伴有脓血），时间久了会自然痊愈；肝脉细小而缓和，也是肠澼，容易治疗；肾脉细小、搏指有力且沉，是肠澼下血，如果血液温热且身体发热，属于死证；心、肝二脏受邪，也出现下血，如果两脏同时患病，可以治疗，但如果脉象细小、沉涩，是肠澼，如果身体发热则死，发热持续七天就会死亡。
脾脉在外部鼓动而呈现沉象，是指脉气在脾经本部之外鼓动，脉形扁阔。之所以呈现沉象，是因为脾湿下注到大肠，导致肠澼，大便失去控制，经常流出粪水。然而脉形宽阔，说明脾气没有亏损，时间久了湿气去除就会自愈；肝脉细小而缓和，是肠澼，这是因为木弱土强，所以也容易治疗；如果肾脉细小、搏指有力且沉，肠澼兼有下血，这是湿热流注到下焦，并且损伤了阴血，所以肾脉细小搏指不和，沉而不鼓，如果血液温热且身体发热，说明邪热深入真阴枯竭，所以死亡；如果是由于心肝的风火妄动，导致肠澼下血，这就不是脾脏受伤，所以可以治疗，但是如果两手脉象细小且沉涩，又是肠澼，这是气血两伤，身体本不应该发热，反而发热的，是虚阳外露，七天是阳气恢复的周期，如果阳气竭绝无法恢复就会死亡。大概阳气生于子时，阴气生于午时，从子到午为七个时辰，从午到子也为七个时辰，如果阴阳之气能够相生，病在七天可以痊愈，如果不能相生而断绝，那么死亡也是在七天。
胃脉沉取鼓动且涩滞，胃脉在外部鼓动且大，心脉细小坚硬紧急，这些都是膈塞和偏枯（半身不遂）。男子发病在左侧，女子发病在右侧，如果不失语且舌头转动灵活，可以治疗，三十天起效；如果病情顺从常规（指男右女左的反常情况），出现失语，三年起效，年龄不满二十岁的，三年后死亡。
胃脉沉取鼓动且涩滞，而且脉势鼓大于脉路之外，这是痰涎阻滞非常严重；心脉应该浮洪而柔软，现在反而细小且坚硬紧急，这说明营血大伤。营气起源于中焦，并经过胃口，所以这两种脉象都主膈病，中焦阻隔，阴阳气血不能在经脉中流通，于是形成偏枯。男子的阳气由左转，所以发病在左侧为逆证；女子的阳气由右转，所以发病在右侧为逆证。如果不失语，舌头能转动，说明内脏未伤，只是伤了经脉，所以可以治疗，三十天日月合璧，人身之气也在三十天阴阳会合于本源，所以偏枯可以痊愈；所谓“从者”，是指男子发病在右侧，女子发病在左侧。脾肾经络连接舌根，连系舌本，失语的人，是脾肾之气不能上达于舌本，虽然外证看似顺从（指发病部位符合常规性别规律），但五脏内伤，如果尚未完全脱绝，调理补养三年可以痊愈，如果年龄不满二十岁，正是生长旺盛的时候却得了这种病，其根本虚弱体质亏虚，即使调理补养也不过苟延残喘三年而死。
脉搏来势搏击有力，伴有鼻出血且身体发热，属于死证。脉搏来势悬钩而浮，是正常的脉象。
这一条以下，都是讲两手脉象，不分具体部位。衄血，是热邪损伤气血，从阳道向上溢出。脉搏搏击有力，没有柔和之象，又加上身体发热，这就是孤阳发越的真脏脉，所以死亡。脉搏来势悬钩而浮，这是心脏本来的脉象，再加上虚软，这是衄病的常见脉象，可以治疗而痊愈。因为衄血的热邪在清道阳分，所以脉浮而虚软，如果吐血是从浊道阴分而来，脉象应该沉弱，如果脉浮就是凶兆了。这一点又不可不知道。
脉搏来势像喘息一样急促，名叫暴厥，暴厥的人，不知道与人说话。脉搏来势像数脉（快速），使人突然惊恐，三四天会自然痊愈。
像喘息一样，是指脉势湍急，气机暴逆而厥逆，不省人事，如果气顺厥回就可以苏醒，如果厥逆不回就会死亡。脉搏来势像数脉，似数非数而虚软，这是心肝血虚气动，使人突然惊恐，比如想睡觉时忽然惊惕醒来，这就是魂梦不安，只要静养就可以停止。
脉搏来势如浮萍聚合，浮合脉象像数脉，一呼吸十次以上，这是经气给予不足，稍微见到这种脉象，九十天后死亡。
脉搏来势如浮萍聚合，像浮萍浮在水面而聚合，下面全是空的，像数脉，一呼吸十次以上，这是脱脉，应当立即死亡，怎么能延续到九十天呢？其中一定有错误。或者认为稍微显现浮合下空的脉象，是经气不足，九十天后应当死亡，如果像数脉，一呼吸十次以上，那就立即死亡不能计算日子，这是倒装的文法。
脉搏来势像火烧柴薪一样猛烈，这是心精被剥夺，草干枯时死亡；脉搏来势像散落的树叶，这是肝气给予虚弱，树木叶子落下时死亡；脉搏来势像访问客人的样子（忽隐忽现），所谓省客，脉道堵塞而鼓动，这是肾气给予不足，等到枣花开时离开（死亡）；脉搏来势像丸泥一样，这是胃精给予不足，榆荚落下时死亡；脉搏来势像横着的格栅，这是胆气给予不足，庄稼成熟时死亡；脉搏来势像弦线丝缕，这是心包精给予不足，病人喜欢说话，下霜时死亡，如果不说话，可以治疗；脉搏来势像交漆（一种树脂，滴落时左右旁溢），交漆，是指左右旁边至，稍微见到这种脉象，三十天后死亡。
脉搏来势像火烧柴薪，腾沸动摇，心精被剥夺而心火散乱，在草干枯冬深时，水旺火绝而死亡；脉搏来势像散落的树叶，轻虚浮泛无根，肝的气血都枯竭，木叶落下，金气旺盛，则肝木绝而死亡；脉搏来势像省客，欲出不出，所以说堵塞、说鼓动，是有出而无入，这是肾气被剥夺而精血枯竭，所以脉形如此，等到枣花开放时离开（死亡），夏令土旺，则水绝而死亡；脉搏来势像丸泥，应指圆滑旋转，而没有出入来去，松软如泥，这是胃中精气不足，榆荚落下，春深木旺时，则土气绝而死亡；脉搏来势像横格，其气横逆相格，失去了少阳柔和调达的象，这是胆气不足，胆属甲木，禾熟，秋深金旺，则木气绝而死亡；脉搏来势像弦缕，细长急强，心包精不足，心包代心行使职能，精不足，则心火动散，言语是心声的表现，所以喜欢说话即多言，下霜冬令，寒水旺盛，则火绝而死亡，如果不说话，心火尚且安静，大补心血，可以治疗；脉搏来势像交漆，左右旁至，营气不循行经脉，阴阳散乱，稍微显现这种象，到三十天阴阳会合之时，不能相生，则气绝而死亡。
脉搏来势像涌泉，浮取鼓动于肌中，这是太阳气给予不足，少气，吃到韭菜花时死亡。
太阳与少阴，互为表里，脉搏来势像涌泉，腾沸而浮鼓于肌中，沉取部空了。浮为阳，沉为阴，阳根于阴，沉部空，则根败而生气少，到韭菜花有味时，春阳上升时，其根脱绝而死亡。这下面的各条都是死脉。
脉搏来势像倒塌的土堆，按之不得力，这是肌气给予不足，五色先见黑色，白癞发作时死亡。
脉搏来势像倒塌的土堆，应指完全没有鼓动之力，所以按之不得，而无根底，这是肌气不足。五色先见黑色，是肾水枯竭，所谓面色如漆柴。白癞有五种，白色发于春季。土既然先败，肾水枯竭而没有春生之气，怎么能不死？
脉搏来势像悬雍（喉头下垂部分），悬雍，浮取切按时更加变大，这是十二俞穴给予不足，水凝冻时死亡。
喉间下垂的帝中，根于肾脏，伤损即死，又名悬雍，脉形类似它，而浮取切按时更加变大的，是表气有余，五脏内部不固，为十二俞不足的，其阳气发泄日益严重，所以到冬天寒冷水凝时，则阳竭而死亡。俞都在背部，是十二经脉脏腑之气汇聚的穴位。
脉搏来势像仰卧的刀，仰卧的刀，浮取小而急，重按坚实大而急，五脏郁热，寒热独并于肾，这样的人不能坐立，立春时死亡。
浮部小急，像刀口，重按坚实大而急，像刀背，绝无柔和之气。菀，是郁结的意思。因为五脏久郁邪气，独并于肾，肾伤腰折，可卧不可坐，肾败不能生肝，立春而木无生气，则绝而死亡。
脉搏来势像弹丸，滑利但不直手（按之即无），不直，是指按之不可得，这是大肠气给予不足，枣叶生出时死亡。
直同值，不值手，是指应指圆滑，按之即无，只有虚浮之气动画滑。大肠为庚金，枣叶生于夏季，火旺则金绝而死亡。
脉搏来势像花朵，使人容易恐惧，不想坐卧，行走站立时常听动静，这是小肠气给予不足，季秋时死亡。
像花朵，如花开放而无收束，与心脉如火烧柴薪相似。大概小肠为丙火，心为丁火，脏腑为表里，而气相通，所以脉象相似。火无收束，是阴精枯竭而阳外泄，心气怯则令人恐惧，恐惧则多疑，所以不想坐卧，行走站立时常听，到季秋阳气泄尽时死亡，丙火墓于戌。
The *Suwen: Daqi Lun* states: When the spleen pulse beats externally and presents a deep (*Chen*) image, it indicates Changpi (dysentery or diarrhea with pus and blood); after a long time, it will heal itself. When the liver pulse is small and slow, it also indicates Changpi, which is easy to treat. When the kidney pulse is small, bounding (*Bo*), and deep, it indicates Changpi with bloody stool; if the blood is warm and the body is feverish, it is a fatal condition. If the heart and liver are affected, there is also bloody stool; if both organs are diseased simultaneously, it is treatable. However, if the pulse is small, deep, and choppy (*Se*), indicating Changpi, and the body is feverish, it is fatal; death occurs within seven days of fever appearing.
When the spleen pulse beats externally and presents a deep image, it means the pulse qi beats outside the main site of the spleen meridian, and the pulse shape is flat and broad. The reason for the deep image is that spleen dampness flows downward into the large intestine, causing Changpi, where bowel movements lose control and fecal water often flows out. However, because the pulse shape is broad, it indicates that spleen qi is not deficient; after a long time, when the dampness dissipates, it will heal itself. When the liver pulse is small and slow, it indicates Changpi, caused by weak wood and strong earth, so it is also easy to treat. If the kidney pulse is small, bounding, and deep, and Changpi is accompanied by bloody stool, this is damp-heat flowing into the lower jiao and damaging yin blood. Thus, the kidney pulse is small, bounding, and discordant, deep without beating outwardly. If the blood is warm and the body is feverish, it indicates that pathogenic heat has penetrated deeply and the true yin is exhausted, leading to death. If the bleeding from Changpi is caused by the movement of wind-fire in the heart and liver, it is not an injury to the spleen, so it is treatable. But if both hands present small, deep, and choppy pulses along with Changpi, this indicates a dual deficiency of qi and blood. The body should not be feverish; if it is feverish, it indicates floating deficient yang. Seven days is the cycle for yang recovery; if yang is exhausted and cannot recover, death ensues. Generally, yang is born at Zi hour, and yin is born at Wu hour. From Zi to Wu is seven periods, and from Wu to Zi is also seven periods. If the qi of yin and yang can generate each other, the disease can heal in seven days; if they do not generate each other and become severed, death also occurs within seven days.
If the stomach pulse is deep, beating, and choppy, and beats externally larger than normal, and the heart pulse is small, firm, and urgent, these all indicate Ge syndrome (obstruction in the chest/diaphragm) and Pianku (hemiplegia). In men, it manifests on the left; in women, on the right. If there is no aphasia and the tongue can move, it is treatable, with improvement starting after thirty days. If the condition follows the "conforming" pattern (men on the right, women on the left), and aphasia occurs, improvement starts after three years. For those under twenty years old, death occurs after three years.
A stomach pulse that is deep, beating, and choppy, yet beats externally larger than the vessel path, indicates severe obstruction by phlegm-saliva. The heart pulse should be floating,洪 (Hong), and soft, but now it is small, firm, and urgent, indicating severe damage to Ying blood (nutritive blood). Ying blood originates in the middle jiao and passes through the stomach opening. Therefore, both pulse images indicate Ge syndrome. Obstruction in the central palace prevents the free flow of yin-yang, qi, and blood in the meridians, resulting in hemiplegia. Men's yang qi turns from the left, so manifestation on the left is adverse; women's yang qi turns from the right, so manifestation on the right is adverse. If there is no aphasia and the tongue moves, it indicates the zang organs are not injured, only the meridians, so it is treatable. After thirty days, when the sun and moon align, the qi of the human body also reunites its yin and yang at the source, so hemiplegia can heal. The term "conforming" refers to men manifesting on the right and women on the left. The spleen and kidney meridians connect to the root of the tongue and the tongue base. Those with aphasia have spleen and kidney qi unable to reach the tongue base. Although the external symptoms seem conforming, the five internal organs are damaged. If not completely depleted, regulation and tonification over three years can lead to recovery. However, for those under twenty, who are in their prime growth period, getting this disease indicates a weak constitution and deficiency. Even with regulation and tonification, life may only be prolonged for three years before death.
If the pulse arrives with a beating force, accompanied by nasal bleeding (Xu) and body fever, it is a fatal condition. If the pulse arrives hanging like a hook and floating, it is a normal pulse.
The following clauses all discuss the pulse images of both hands, without distinguishing specific locations. Xu (nasal bleeding) results from heat damaging qi and blood, overflowing from the yang pathways. A beating pulse without a gentle quality, combined with body fever, indicates the Zang-Fu pulse of isolated yang surging outward, hence fatal. A pulse arriving hanging like a hook and floating is the intrinsic image of the heart pulse; added with emptiness and softness, it is the common pulse for Xu disease, which is treatable and curable. Since the heat of Xu is in the clear pathways and yang divisions, the pulse is floating and empty/soft. If vomiting blood comes from the turbid pathways and yin divisions, the pulse should be deep and weak; if the pulse is floating, it is ominous. This must be known.
If the pulse arrives as if panting, it is called Bao Jue (sudden syncope). Patients with Bao Jue do not know how to speak with others. If the pulse arrives as if rapid (Shu), causing sudden fright, it will heal itself in three to four days.
"Panting" means the pulse momentum is turbulent, qi suddenly rebels and causes jue (cold extremities/syncope), leading to loss of consciousness. If qi smooths and jue reverses, the patient revives; if jue does not reverse, death ensues. A pulse arriving as if rapid, but seemingly rapid yet non-rapid and empty/soft, indicates deficiency of heart and liver blood with moving qi, causing sudden fright (e.g., waking up startled from sleep). This is described as unsettled soul and dreams; quiet rest can stop it.
If the pulse arrives floating and gathering (Fu He), resembling a rapid pulse, with more than ten beats per respiration, this indicates insufficiency of Jing qi (meridian qi). If slightly visible, death occurs in ninety days.
A pulse arriving like Fu He resembles duckweed floating and gathering on water, empty underneath. Resembling a rapid pulse with more than ten beats per respiration is a Tuo pulse (collapse pulse), which should cause immediate death, not prolongation to ninety days. There must be an error here. Alternatively, it may mean that if the Fu He pulse with emptiness underneath appears slightly, indicating insufficient Jing qi, death occurs in ninety days; but if it resembles a rapid pulse with more than ten beats per respiration, death is immediate and not calculated by days. This is an inverted grammatical structure.
If the pulse arrives like burning firewood, it indicates the deprivation of Heart Jing essence; death occurs when grass dries. If the pulse arrives like scattered leaves, it indicates deficiency of Liver qi; death occurs when tree leaves fall. If the pulse arrives like a visiting guest (Sheng Ke), meaning the pulse is blocked yet beating, it indicates insufficiency of Kidney qi; death occurs when dates bloom. If the pulse arrives like pill-shaped mud, it indicates insufficiency of Stomach Jing essence; death occurs when elm catkins fall. If the pulse arrives like a horizontal grid, it indicates insufficiency of Gallbladder qi; death occurs when grains ripen. If the pulse arrives like string threads, it indicates insufficiency of Pericardium Jing essence; if the patient speaks excessively, death occurs when frost falls; if silent, it is treatable. If the pulse arrives like Jiao Qi (a resin dripping sideways), meaning it arrives from both sides laterally, if slightly visible, death occurs in thirty days.
A pulse arriving like burning firewood boils and shakes, indicating Heart Jing deprivation and scattering of Heart fire; death occurs in winter when grass is dry, water is prosperous, and fire is extinct. A pulse arriving like scattered leaves is light, empty, floating, and rootless, indicating exhaustion of Liver qi and blood; when leaves fall and Metal qi is prosperous, Liver Wood is extinct, leading to death. A pulse arriving like Sheng Ke wants to emerge but does not; saying it is "blocked" and "beating" means there is exit without entry. This indicates Kidney qi deprivation and exhaustion of essence and blood, hence the pulse shape. Death occurs when dates bloom; in summer when Earth is prosperous, Water is extinct. A pulse arriving like pill-shaped mud is round and rotating upon pressure, without coming or going, soft like mud, indicating insufficiency of Stomach essence and qi. Death occurs when elm catkins fall; in late spring when Wood is prosperous, Earth qi is extinct. A pulse arriving like a horizontal grid shows qi rebelling against each other, losing the gentle and unblocking image of Shaoyang; this indicates insufficiency of Gallbladder qi. Gallbladder belongs to Jia Wood; when grains ripen in late autumn when Metal is prosperous, Wood qi is extinct, leading to death. A pulse arriving like string threads is thin, long, urgent, and strong. Insufficiency of Pericardium Jing: the Pericardium acts on behalf of the Heart. Insufficiency of essence leads to movement and scattering of Heart fire. Speech is the voice of the heart; thus, excessive speech indicates this. In winter when frost falls and Cold Water is prosperous, Fire is extinct, leading to death. If silent, Heart fire is still calm; major tonification of Heart blood can treat it. A pulse arriving like Jiao Qi, arriving from both sides laterally, indicates Ying qi not circulating in meridians and chaotic yin-yang. If this image appears slightly, at the time of yin-yang convergence in thirty days, if they cannot generate each other, qi exhausts and death ensues.
If the pulse arrives like a gushing spring, beating floatingly in the muscles, it indicates insufficiency of Taiyang qi. With shortness of breath, death occurs when leek flowers are eaten.
Taiyang and Shaoyin are exterior-interior pairs. A pulse arriving like a gushing spring boils and beats floatingly in the muscles, while the deep portion is empty. Floating is Yang, Deep is Yin; Yang roots in Yin. If the deep portion is empty, the root is ruined and vital qi is scarce. Death occurs when leek flowers have flavor, during spring yang rising, when the root is severed. All subsequent clauses describe fatal pulses.
If the pulse arrives like a pile of collapsed earth, unobtainable upon pressing, it indicates insufficiency of Muscle qi. If the five colors first show black, and Bai Lei (white leukoderma) erupts, death ensues.
A pulse arriving like collapsed earth has no beating force upon pressure, hence unobtainable and rootless, indicating insufficiency of Muscle qi. The five colors showing black first indicates exhaustion of Kidney water, described as a face like lacquered charcoal. Bai Lei has five types; white appears in spring. Since Earth fails first, and Kidney water is exhausted without Spring generating qi, how can one not die?
If the pulse arrives like Xuan Yong (uvula), where pressing floatingly makes it larger, it indicates insufficiency of the Twelve Shu points. Death occurs when water freezes.
The uvula in the throat roots in the Kidney; injury leads to immediate death. Also named Xuan Yong, the pulse shape resembles it, becoming larger upon floating and pressing. This indicates excess exterior qi and insecurity of the five internal organs. Due to insufficiency of the Twelve Shu points, yang qi emission increases daily; thus, in winter cold when water freezes, yang exhausts and death ensues. Shu points are all on the back, being the qi-acupoints of the twelve meridians and zang-fu organs.
If the pulse arrives like an inverted knife: inverted knife means small and urgent upon floating, firm, large, and urgent upon pressing. It indicates Wenyu Re (stagnant heat in five zang organs) and Hanre (cold-heat) combining exclusively in the Kidney. Such a person cannot sit; death occurs at Lichun (Start of Spring).
Small and urgent in the floating layer is like a knife edge; firm, large, and urgent in the pressing layer is like the knife back, lacking any gentle quality. Wenyu means stagnation. Because the five zang organs have long stagnated pathogenic qi, combining exclusively in the Kidney, Kidney injury causes waist collapse; one can lie but not sit. Kidney failure cannot generate Liver; at Lichun, Wood lacks generating qi, leading to extinction and death.
If the pulse arrives like a pellet, slippery but not straight to the hand (meaning unobtainable upon pressing), it indicates insufficiency of Large Intestine qi. Death occurs when jujube leaves grow.
"Zhi" is same as "Zhi". "Bu Zhi Shou" means round and slippery upon pressure but vanishing immediately, with only virtual floating qi moving slipperily. Large Intestine is Geng Metal; jujube leaves grow in summer. When Fire is prosperous, Metal is extinct, leading to death.
If the pulse arrives like a flower, causing frequent fear, unwillingness to sit or lie, and constantly listening while walking or standing, it indicates insufficiency of Small Intestine qi. Death occurs in late autumn.
Like a flower means blooming without contraction, similar to the Heart pulse like burning firewood. Small Intestine is Bing Fire, Heart is Ding Fire; as zang-fu exterior-interior pairs, their qi connects, so the pulses are similar. Fire without contraction indicates exhaustion of yin essence and leakage of yang outward. Timidity of Heart qi causes fear; fear causes suspicion, hence unwillingness to sit or lie, and constantly listening. Death occurs in late autumn when yang qi is fully leaked; Bing Fire is tombed in Xu.