真脏死脉、经。真肝脉至。中外急。如循刀刃。责责然如按琴瑟弦。真心脉至坚而搏。如循薏苡子。累累然。真肺
脉至大而虚。如以毛羽中人肤。真肾脉至。搏而绝。如指弹石。辟辟然。真脾脉至。弱而乍数乍疏。见真脏乃死。何也。
五脏皆禀气于胃。胃者五脏之本也。脏气不能自至于手太阴。因胃气乃至于手太阴。（肺朝百脉。故脏气必先会于手太阴。
而后行于诸经也。）故经谓五脏各以其时自为而至于手太阴。皆胃气为之也。（五脏各以其时。自为弦钩毛石之象。因胃
气而至于手太阴之脉口。）若邪气胜者。精气衰。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。按五脏之气为阴。胃气为阳。五脏有胃气。则其脉和。如微弦微钩之类是也。若无胃气。但见弦钩等本脏之脉。
曰真脏。见真脏则阳气绝故死。
四时贼邪死脉。经。五邪所见。春得秋脉。夏得冬脉。长夏得春脉。冬得长夏脉。名曰阴出之阳。不治。按所谓阴
者真脏也。故死。脉经谓夏脉沉 而滑者。为肾乘心。水克火。十死不治。不知夏月停水停痰之人。其脉有沉 而滑者。
未必即为死病也。且滑为阳脉。沉 而滑。是有阳也。有阳者亦不死也。经所谓夏得冬脉。乃沉而坚硬。如指弹石。纯
阴无阳者也。又谓长夏脉弦细而长。为肝乘脾。木克土。十死不治。不知长夏病疟之人。其脉多弦细而长者。未必即为
死病也。且长为阳脉。弦细而长。是有阳也。有阳者亦不死也。经所谓长夏得春脉。乃弦而坚硬。如循刀刃。纯阴无阳
者也。脉经之说误。李士材曰。一岁之中。脉象不可再见。如春宜弦而得洪脉者。至夏必死。得涩脉者。至秋必死得沉
脉者。至冬必死。为真脏之气先泄也。当其时不能再见矣。按士材之说。本脉经死脉要诀篇。然亦有不可泥者。经以春
不沉谓之塞。则春得沉脉。未可即以为死脉也。春脉弦。未交夏之时。便得钩脉。经谓未去而去者病。亦未可即以为死
脉也。又当以病症合辨之。庶几始确。且所谓真脏者。纯阴无阳之脉也。非夏脉钩。或见于春时。即为真脏也。又当以
有神无神细辨之。庶几始确。大抵惟春得秋脉而涩者。乃经所谓贼邪。为不宜耳。余仿此。
三部死脉。脉经尺脉上不至关。为阴绝。寸脉下不至关。为阳绝。死不治。上部有脉。下部无脉。其人当吐。不吐
者死。上部无脉。下部有脉。虽困无害。所以然者。如树之有根也。按上部无脉。下部有脉。若其脉微细如丝。按之无
有者。此肾脏将尽未尽之气也。亦死。
形盛形瘕死脉。经形盛脉细。少气不足以息者死。形瘕脉大。胸中多气者死。
死脉名状。脉如屋漏雀啄者死。（屋漏者。脉一来忽绝。久又来也。雀啄者脉。来疾时绝又一来也。）脉来如弹石。
去如解索者死。（弹石者。急而劲也。解索者。散乳无结也。）脉如鱼翔虾游者死。（鱼翔。虾游者。脉浮而无根也。）脉
如涌泉者死。（涌泉者。燥乱而有来无去也。）脉一息二至以下。八至以上者死。
真脏死脉，出自《内经》。真肝脉到来时，脉象中外皆急，如同触摸刀刃，又急促如按琴瑟之弦。真心脉到来时，脉象坚硬而搏指，如同触摸薏苡子，颗粒累累分明。真肺脉到来时，脉象大而虚浮，如同羽毛中人肌肤。真肾脉到来时，脉象搏动有力却似断绝，如同手指弹石，辟辟作响。真脾脉到来时，脉象微弱且忽快忽慢。见到真脏脉就会死亡，为什么呢？
五脏之气都禀受于胃气，胃是五脏的根本。脏气不能独自到达手太阴肺经的寸口脉，必须依靠胃气才能到达手太阴。（肺朝百脉，所以脏气必须先汇聚于手太阴肺经，然后才运行到各条经脉。）所以《内经》说，五脏各自在其所主的时节呈现相应的脉象并到达手太阴寸口，这都是因为有胃气的缘故。（五脏各自在其所主之时，自然呈现出弦、钩、毛、石等脉象，凭借胃气而显现于手太阴脉口。）如果邪气亢盛，精气衰败，胃气就不能随同脏气一起到达手太阴寸口，所以真脏之气单独显露。单独显露，说明病邪胜过脏气，所以说会死亡。
按：五脏之气属阴，胃气属阳。五脏有胃气，脉象就调和，比如微弦、微钩之类的脉象就是如此。如果没有胃气，只见到弦、钩等本脏的脉象，就叫真脏脉。见到真脏脉，说明阳气已绝，所以死亡。
四时贼邪死脉，出自《内经》。五邪所见到的脉象：春季见到秋季的脉（毛脉），夏季见到冬季的脉（石脉），长夏见到春季的脉（弦脉），冬季见到长夏的脉（缓脉），名叫“阴出之阳”，无法治疗。按：所谓“阴”指的是真脏脉，所以会死亡。《脉经》说夏季脉象沉涩而滑，是肾水乘袭心火，水克火，十死无救。却不知道夏季体内有水饮或痰湿停滞的人，其脉象也有沉涩而滑的，未必就是死病。而且滑脉属于阳脉，沉涩而滑，说明还有阳气存在。有阳气的就不会死亡。《内经》所说的“夏季见到冬季脉”，是指脉象沉而坚硬，如同手指弹石，纯阴而无阳。又说长夏脉象弦细而长，是肝木乘袭脾土，木克土，十死无救。却不知道长夏患疟疾的人，其脉象多呈弦细而长，未必就是死病。而且长脉属于阳脉，弦细而长，说明还有阳气存在。有阳气的就不会死亡。《内经》所说的“长夏见到春季脉”，是指脉象弦而坚硬，如同触摸刀刃，纯阴而无阳。《脉经》的说法有误。李士材说：一年之中，脉象不可再见反季节之象。比如春季宜见弦脉而见到洪脉，到了夏季必死；见到涩脉，到了秋季必死；见到沉脉，到了冬季必死。这是因为真脏之气已经先泄漏了。在当令的季节不能再见到这些脉象了。按：李士材的说法，原本依据《脉经·死脉要诀篇》，但也有不可拘泥的地方。《内经》认为春季脉不沉称为“塞”，那么春季见到沉脉，未必立即就是死脉。春季脉应弦，在未进入夏季之前，便见到钩脉，《内经》说“未去而去者病”，也未必立即就是死脉。还应当结合病症来辨别，这样才能准确。况且所谓真脏脉，是纯阴无阳的脉象，并非夏季的钩脉出现在春季，就是真脏脉。还应当仔细辨别脉是否有神，这样才能准确。大抵只有春季见到秋季脉且兼涩象的，才是《内经》所说的贼邪，是不适宜的。其余类推。
三部死脉：《脉经》说尺脉上不到关部，为阴绝；寸脉下不到关部，为阳绝。这两种情况都会死亡，无法治疗。上部有脉，下部无脉，病人应当呕吐，如果不呕吐，就会死亡。上部无脉，下部有脉，虽然困顿但无大碍。之所以这样，就像树木有根一样。按：上部无脉，下部有脉，如果脉象微细如丝，重按感觉不到，这是肾脏将尽未尽之气，也会死亡。
形盛形瘕死脉：《内经》说形体壮盛但脉象细微，气息短少不足以呼吸的，会死亡。形体消瘦但脉象宏大，胸中气多的，会死亡。
死脉名状：脉象如屋漏滴水般断续，或如雀啄食般急促间歇的，会死亡。（屋漏脉，指脉来一次忽然中断，很久才再来一次。雀啄脉，指脉来急促时而中断，然后又来一次。）脉来如弹石般急劲，去如解索般散乱无结的，会死亡。（弹石，指脉急而劲硬。解索，指脉散乱如解开绳索。）脉如鱼翔虾游般浮泛无根的，会死亡。（鱼翔、虾游，指脉浮浅而无根基。）脉如涌泉般躁乱而有来无去的，会死亡。（涌泉，指脉躁乱且有来无去。）一息脉跳两次以下的，或八次以上的，会死亡。
True Zang Dead Pulse, from the Classic. When the True Liver pulse arrives, it is tense inside and outside, like tracing the edge of a blade, rapid and sharp like pressing the strings of a qin or se. When the True Heart pulse arrives, it is firm and beating, like tracing Coicis Semen (Job's tears), distinct and piled up. When the True Lung pulse arrives, it is large and empty, like a feather brushing against human skin. When the True Kidney pulse arrives, it beats forcefully yet seems severed, like fingers striking a stone, crisp and loud. When the True Spleen pulse arrives, it is weak and alternates between rapid and slow. The appearance of the True Zang pulse indicates death. Why?
The Qi of the Five Zang organs is derived from Stomach Qi; the Stomach is the root of the Five Zang. The Zang Qi cannot reach the Hand-Taiyin Lung meridian on its own but relies on Stomach Qi to arrive at the Hand-Taiyin. (The Lungs govern all vessels, so Zang Qi must first converge at the Hand-Taiyin before circulating through the other meridians.) Thus, the Classic states that each Zang organ presents its respective seasonal pulse image at the Hand-Taiyin cun-kou point due to the presence of Stomach Qi. (Each Zang organ naturally manifests its characteristic pulse—Liver as Wen [stringy], Heart as Zhuo [hooking], Lung as Fu [floating], Kidney as An [sunken]—at their respective seasons, appearing at the Hand-Taiyin pulse site via Stomach Qi.) If pathogenic factors prevail and Essence-Qi declines, Stomach Qi cannot accompany the Zang Qi to the Hand-Taiyin. Consequently, the True Zang Qi appears alone. Its solitary appearance means disease overcomes the Zang, hence death.
Note: The Qi of the Five Zang is Yin, while Stomach Qi is Yang. When the Five Zang possess Stomach Qi, the pulse is harmonious, such as slightly Wen or slightly Zhuo pulses. Without Stomach Qi, only the intrinsic pulses of the specific Zang (e.g., Wen, Zhuo) are seen, termed True Zang pulses. The appearance of True Zang pulses indicates the exhaustion of Yang Qi, leading to death.
Four-Season Treacherous Evil Dead Pulses, from the Classic. Observations of the Five Evils: Autumnal pulse in Spring, Winter pulse in Summer, Spring pulse in Late Summer, and Late Summer pulse in Winter. This is called "Yin emerging into Yang," which is untreatable. Note: "Yin" refers to the True Zang pulse, hence death. Mai Jing states that a deep, choppy, and slippery pulse in Summer indicates Kidney Water attacking Heart Fire (Water overcoming Fire), resulting in ten deaths with no cure. However, one should not know that individuals with retained water or phlegm in Summer may exhibit deep, choppy, and slippery pulses without necessarily facing a fatal condition. Moreover, Slippery is a Yang pulse; Deep, Choppy, and Slippery indicates the presence of Yang. Presence of Yang implies survival. The Classic's description of "Winter pulse in Summer" refers to a pulse that is Deep and Hard, like fingers striking a stone, representing pure Yin without Yang. It also states that a Stringy, Fine, and Long pulse in Late Summer indicates Liver Wood attacking Spleen Earth (Wood overcoming Earth), resulting in ten deaths with no cure. However, individuals suffering from Malaria in Late Summer often present Stringy, Fine, and Long pulses, which are not necessarily fatal. Furthermore, Long is a Yang pulse; Stringy, Fine, and Long indicates the presence of Yang. Presence of Yang implies survival. The Classic's description of "Spring pulse in Late Summer" refers to a pulse that is Stringy and Hard, like tracing a blade, representing pure Yin without Yang. The statement in Mai Jing is erroneous. Li Shicai stated: Within a year, contrary pulse images should not reappear. For instance, if a Spring-appropriate Wen pulse is replaced by a Hong pulse, death will occur in Summer; if a Se pulse appears, death will occur in Autumn; if a Chen pulse appears, death will occur in Winter. This is because the True Zang Qi has already leaked out. These pulses cannot appear during their respective seasons. Note: Li Shicai's theory originates from the "Key to Dead Pulses" chapter in Mai Jing, but it should not be applied rigidly. The Classic states that a non-Chen pulse in Spring is called "Sa" (obstruction); thus, a Chen pulse in Spring is not immediately fatal. A Spring pulse should be Wen; if a Zhuo pulse appears before Summer begins, the Classic states "what has not passed has passed indicates illness," which is not immediately fatal. One must differentiate based on clinical symptoms to ensure accuracy. Furthermore, the True Zang pulse is defined as pure Yin without Yang. It does not mean that a Summer Zhuo pulse appearing in Spring is automatically a True Zang pulse. One must carefully distinguish whether the pulse has Shen (Spirit). Only then can accuracy be achieved. Generally, only when an Autumnal pulse with Se characteristics appears in Spring does it constitute the "Treacherous Evil" mentioned in the Classic, which is unfavorable. The rest follow this pattern.
Three Regions Dead Pulses: Mai Jing states that if the Chi pulse does not reach the Guan position upwards, it is Yin Extinction; if the Cun pulse does not reach the Guan position downwards, it is Yang Extinction. Both result in death and are untreatable. If there is a pulse in the Upper region but none in the Lower region, the patient should vomit; if they do not vomit, they will die. If there is no pulse in the Upper region but a pulse in the Lower region, although the patient is exhausted, there is no major harm. This is because, like a tree having roots. Note: In the case of no Upper pulse but a Lower pulse, if the pulse is minute and thread-like, disappearing upon heavy pressure, this represents the remaining Qi of the Kidneys nearing exhaustion, which also leads to death.
Dead Pulses for Excessive and Emaciated Forms: The Classic states that excessive physical form with a fine pulse and insufficient Qi causing shortness of breath indicates death. Emaciated physical form with a large pulse and excess Qi in the chest indicates death.
Descriptions of Dead Pulse Names: A pulse resembling a leaking roof (intermittent and irregular) or a sparrow pecking (rapid with sudden interruptions) indicates death. (Leaking roof: the pulse comes once, suddenly stops, and returns after a long interval. Sparrow pecking: the pulse comes rapidly, interrupts, and comes again.) A pulse coming like striking a stone (urgent and forceful) and going like untying a knot (scattered and loose) indicates death. (Striking stone: urgent and stiff. Untying knot: scattered without knots.) A pulse resembling a swimming fish or floating shrimp (floating without root) indicates death. (Swimming fish/Floating shrimp: the pulse is superficial and rootless.) A pulse resembling a gushing spring (chaotic with incoming flow but no outgoing return) indicates death. (Gushing spring: chaotic with arrival but no departure.) A pulse rate of two beats or fewer per respiration cycle, or eight beats or more per respiration cycle, indicates death.