（素问阴阳别论）
凡持真脉之脏脉者，肝至悬绝急，十八日死；（素问阴阳别论。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，悉遵王氏之意，以河图计数，诚为得理；然或言生数，
或言成数，若不归一，弗能无疑，别有愚按在针刺六十四，亦当参正。）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，士胜水也。）脾至悬绝，四日死。（四日者，为木生数之余，木胜土也。凡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，（素问平人气象论。此言真脏脉见者，遇克贼之日而死。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，烁肺金也。）肾见戊己死，（戊己属土，
伤肾水也。）见谓真脏见皆死。（此即三部九候论所谓真脏脉见者胜死之义。）
（素问阴阳别论）
阴搏阳别，谓之有子。（注见前二十三。）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。通评虚实论曰∶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。搏即真藏之击搏也。
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。此篇独缺一阳搏者，必脱简也。六经次序义，详
疾病类七。）
（出自《素问·阴阳别论》）
凡是诊察到真脏脉的，如果肝脏的真脏脉出现悬绝急劲之象，十八天后会死亡；（《素问·阴阳别论》指出：所谓真脏脉，就是真脏脉。所谓悬绝急，是指完全失去了平和之气，而弦急搏指异常剧烈。十八天这个期限，是依据河图数理中木与金成数之余数推算的，因为金克木，所以木气尽而死。以下关于死期的论述，都遵循王冰的观点，采用河图计数法，确实合乎道理；然而有的用生数，有的用成数，如果不统一，难免让人产生疑问，另有我的按语在《针刺》第六十四篇中，也应当参考校正。）心脏的真脏脉出现悬绝，九天后会死亡；（九天这个期限，是依据火与水生成数之余数推算的，因为水克火。）肺脏的真脏脉出现悬绝，十二天后会死亡；（十二天这个期限，是依据金与火生成数之余数推算的，因为火克金。）肾脏的真脏脉出现悬绝，七天后会死亡；（七天这个期限，是依据水与土生数之余数推算的，因为土克水。）脾脏的真脏脉出现悬绝，四天后会死亡。（四天这个期限，是依据木生数之余数推算的，因为木克土。以上这些情况，都是因为不胜受克贼害之气，所以真脏脉单独显露，意味着脏气败坏而危及生命。）
肝脏的真脏脉见于庚日或辛日会死亡，（《素问·平人气象论》指出：这是说真脏脉出现时，遇到克制它的日子就会死亡。庚辛属金，金能伐伤肝木。）心脏的真脏脉见于壬日或癸日会死亡，（壬癸属水，水能灭伤心火。）脾脏的真脏脉见于甲日或乙日会死亡，（甲乙属木，木能克伤脾土。）肺脏的真脏脉见于丙日或丁日会死亡，（丙丁属火，火能灼烧肺金。）肾脏的真脏脉见于戊日或己日会死亡，（戊己属土，土能损伤肾水。）所谓“见”，就是指真脏脉出现，凡出现此类脉象者皆主死亡。（这就是《素问·三部九候论》中所说的真脏脉出现则死于被克之日的意思。）
（出自《素问·阴阳别论》）
阴脉搏动有力而与阳脉有别，称为怀孕。（注释见前文第二十三篇。）阴阳俱虚且伴有肠辟（痢疾），会导致死亡。（阴阳俱虚，是指寸尺两部脉象都虚弱无力。肠辟，是指排泄脓血的痢疾。胃气不能留驻，肛门失禁，加上阴阳俱虚，说明脏气竭绝，所以死亡。《素问·通评虚实论》说：脉象滑大者为生，脉象悬涩者为死。）阳气加于阴分，称为出汗。这里“阳”指脉体的特征，“阴”指脉位。汗液属于阴，若阳气加于阴分，导致阴气外泄，所以阴脉中多见阳象的人容易出汗。）阴气虚弱而阳气搏指有力，称为崩漏（妇女非经期大量出血）。（阴虚，是指沉取脉力不足。阳搏，是指浮取脉力有余。阳实阴虚，所以表现为体内崩漏失血的病证。）手太阴肺经和足太阴脾经的脉气都搏击有力，二十天后的半夜会死亡。（三阴，指手太阴肺经和足太阴脾经。搏，即真脏脉的击搏之象。二十天这个期限，是脾肺成数之余数。半夜是阴极之时，气尽故死。）手少阴心经和足少阴肾经的脉气都搏击有力，十三天后的傍晚会死亡。（二阴，指手少阴心经和足少阴肾经。十三天这个期限，是心肾的成数。傍晚时分，阴阳各半，是水火相争的时刻。）手厥阴心包经和足厥阴肝经的脉气都搏击有力，十天后的清晨会死亡。（一阴，指手厥阴心包经和足厥阴肝经。十天这个期限，是肝心生成之数。清晨时分，木火旺盛至极而邪气更盛，所以死亡。）手太阳小肠经和足太阳膀胱经的脉气都搏击且鼓动有力，三天后死亡。（三阳，指手太阳小肠经和足太阳膀胱经。水一数二，火二数三，所以死在第三天。死亡迅速的原因，是因为脉既搏且鼓，表明阳邪盛极。）手太阴肺、足太阴脾、手太阳小肠、足太阳膀胱这四经的脉气都搏击有力，心腹胀满症状全部发作，大小便不通利，五天后死亡。（三阴三阳，指脾、肺、小肠、膀胱。四脏脉气都搏击，说明上下都患病，所以在上则心腹胀满，甚至胀至极点。发尽，指胀满到了极点。在下则大小便不利，阴道不通畅。四脏都患病，关键在于胃气，土数为五，五数耗尽而死。）手阳明大肠经和足阳明胃经的脉气都搏击有力，患温病，无法治愈，不超过十天死亡。（二阳，指手阳明大肠经和足阳明胃经。十天这个期限，是肠胃生数之余数。本篇唯独缺少一阳搏的内容，必定是简牍脱漏。六经次序的含义，详见疾病类第七篇。）
(From *Suwen: Yin Yang Bie Lun*)
When the pulse of a Zang organ manifests as its true pulse (Zhen Zang Mai, the pulse of a failing organ devoid of Stomach Qi), if the Liver's true pulse appears suspended, severed, and rapid/tense (Xuan Jue Ji), death will occur in eighteen days; (The *Suwen: Yin Yang Bie Lun* states that the "true pulse of a Zang organ" refers to the Zhen Zang Mai. "Suspended, severed, and tense" means a complete loss of harmony, with abnormal string-like and forceful pulsation. The period of eighteen days is derived from the remainder of the completed numbers of Wood and Metal in the Hetu numerology; since Metal overcomes Wood, Wood qi perishes. The subsequent mortality periods follow Wang Bing’s interpretation using Hetu counting, which is logically sound; however, the inconsistent use of generating versus completed numbers raises doubts. Further commentary can be found in Chapter 64 of *Acupuncture*, which should also be consulted for verification.) If the Heart's true pulse appears suspended and severed, death will occur in nine days; (Nine days corresponds to the remainder of the generating and completed numbers of Fire and Water; since Water overcomes Fire.) If the Lung's true pulse appears suspended and severed, death will occur in twelve days; (Twelve days corresponds to the remainder of the generating and completed numbers of Metal and Fire; since Fire overcomes Metal.) If the Kidney's true pulse appears suspended and severed, death will occur in seven days; (Seven days corresponds to the remainder of the generating numbers of Water and Earth; since Earth overcomes Water.) If the Spleen's true pulse appears suspended and severed, death will occur in four days. (Four days corresponds to the remainder of the generating number of Wood; since Wood overcomes Earth. In all these cases, the organs cannot withstand the conquering and injuring pathogenic qi; thus, the isolated appearance of the Zhen Zang Mai indicates the collapse of organ qi and critical danger.)
If the Liver's true pulse appears on Geng or Xin days, death will occur; (The *Suwen: Ping Ren Qi Xiang Lun* explains that this refers to death occurring when the true pulse appears on days that overcome it. Geng and Xin belong to Metal, which attacks Liver Wood.) If the Heart's true pulse appears on Ren or Gui days, death will occur; (Ren and Gui belong to Water, which extinguishes Heart Fire.) If the Spleen's true pulse appears on Jia or Yi days, death will occur; (Jia and Yi belong to Wood, which overcomes Spleen Earth.) If the Lung's true pulse appears on Bing or Ding days, death will occur; (Bing and Ding belong to Fire, which scorches Lung Metal.) If the Kidney's true pulse appears on Wu or Ji days, death will occur; (Wu and Ji belong to Earth, which damages Kidney Water.) "Appearance" here means the manifestation of the Zhen Zang Mai; such manifestations indicate death. (This aligns with the principle in *Suwen: San Bu Jiu Hou Lun* that the appearance of the Zhen Zang Mai leads to death on the day of the overcoming element.)
(From *Suwen: Yin Yang Bie Lun*)
A Yin pulse that beats forcefully and differs distinctly from the Yang pulse indicates pregnancy. (See annotation in previous Chapter 23.) If both Yin and Yang are deficient and accompanied by Chang Pi (Intestinal Dysentery, characterized by pus and blood in stool), death will ensue. (Deficiency of both Yin and Yang refers to weakness in both Cun and Chi positions. Chang Pi involves the discharge of pus and blood. With Stomach Qi unable to remain and the魄门 (anus) losing control, combined with the exhaustion of Yin and Yang, the organ qi is depleted, leading to death. The *Suwen: Tong Ping Xu Shi Lun* states: "Slippery and large pulses indicate life; suspended and choppy pulses indicate death.") When Yang adds to Yin, it is called sweating. Here, "Yang" refers to the pulse body/quality, and "Yin" refers to the pulse position. Sweat belongs to Yin; when Yang acts upon Yin, Yin qi leaks out; therefore, those whose Yin pulses show Yang characteristics tend to sweat. If Yin is deficient and Yang is forceful/pounding, it is called Beng (Metrorrhagia/Metrorrhesis, excessive uterine bleeding). (Yin deficiency means insufficient force upon deep palpation. Yang forcefulness means excess force upon superficial palpation. Excess Yang and deficient Yin result in internal collapse and blood loss.) If the pulses of the Three Yin channels (Hand Taiyin Lung and Foot Taiyin Spleen) both beat forcefully, death will occur at midnight on the twentieth day. (The "Three Yin" refers to the Hand Taiyin Lung and Foot Taiyin Spleen meridians. "Bo" refers to the striking nature of the Zhen Zang pulse. Twenty days corresponds to the remainder of the completed numbers of Spleen and Lung. Midnight is the extreme of Yin, where qi is exhausted, leading to death.) If the pulses of the Two Yin channels (Hand Shaoyin Heart and Foot Shaoyin Kidney) both beat forcefully, death will occur at dusk on the thirteenth day. (The "Two Yin" refers to the Hand Shaoyin Heart and Foot Shaoyin Kidney meridians. Thirteen days corresponds to the completed numbers of Heart and Kidney. Dusk is when Yin and Yang are equal, a time of conflict between Water and Fire.) If the pulses of the One Yin channel (Hand Jueyin Pericardium and Foot Jueyin Liver) both beat forcefully, death will occur at dawn on the tenth day. (The "One Yin" refers to the Hand Jueyin Pericardium and Foot Jueyin Liver meridians. Ten days corresponds to the generating and completed numbers of Liver and Heart. Dawn is when Wood and Fire reach their peak, exacerbating the pathogen, leading to death.) If the pulses of the Three Yang channels (Hand Taiyang Small Intestine and Foot Taiyang Bladder) both beat forcefully and are drum-like, death will occur in three days. (The "Three Yang" refers to the Hand Taiyang Small Intestine and Foot Taiyang Bladder meridians. Water has one, Fire has two; thus, death occurs on the third day. The rapidity of death is due to the pulse being both pounding and drumming, indicating the extreme excess of Yang pathogenic qi.) If the pulses of the Three Yin and Three Yang channels (Spleen, Lung, Small Intestine, Bladder) all beat forcefully, with fullness in the heart and abdomen manifesting completely, and inability to pass urine or feces (Yin Dao obstruction), death will occur in five days. (The "Three Yin and Three Yang" refer to the Spleen, Lung, Small Intestine, and Bladder. When four organs' pulses are pounding, both upper and lower parts are diseased. Thus, in the upper part, there is abdominal distension to the extreme ("Fa Jin"). In the lower part, there is obstruction of the Yin passages (bowel/bladder dysfunction). With four organs diseased, the key is the Stomach Qi; Earth's number is five, so death occurs when the number five is exhausted.) If the pulses of the Two Yang channels (Hand Yangming Large Intestine and Foot Yangming Stomach) both beat forcefully, and the disease is Wen Bing (Warm Disease), it is untreatable, and death will not exceed ten days. (The "Two Yang" refers to the Hand Yangming Large Intestine and Foot Yangming Stomach meridians. Ten days corresponds to the remainder of the generating numbers of the intestines and stomach. This chapter uniquely lacks a section on One Yang Bo, which must be a lacuna in the bamboo slips. The logic of the six-meridian sequence is detailed in Disease Category 7.)