眼上赤脉下贯瞳人。
池氏曰。赤脉属心。瞳人属肾。乃心火胜肾水。水干则不能生木。致肾肝皆绝故也。
囟门肿起兼及作坑。
曾氏曰。囟肿皆以为热。殊不知有阴阳二证。切宜详辨。坚硬为阴。红软
为阳。故婴孩宝书曰。寒气上冲则牢HT 。热气上冲则柔软。正此之谓。若
阴证以匀气散。理中汤主之。阳证用玉露饮。当归散。防风汤为治。玉环
集歌曰。囟门肿起定为便。此候应须也不中。或若加坑如盏足。七日之
间命必终。曾氏又曰。囟陷者。虚之极也。胃气虚寒。则囟陷。慢惊中有之。
胃寒脾困。吐泻者为虚极。急以金液丹固真阳。及诸般救元等药治之。
外贴以乌附膏。有后枕陷者。其证尤重。治法与陷囟药同。不效亦为难
疗。此大虚极。百无一活耳。
鼻干黑燥。
勿听子曰。鼻乃肺之窍。黑燥而干。是为肺绝。云岐子云。火克金也。愚曰。即所谓人病鼻如烟煤者。死也。
肚大青筋。
肚胀腹大。脾虚也。肝主筋。其色青。今肚大而现青筋。是肝木克脾土也。目多直视。睹不转睛。
热入于目。牵其筋脉。两 俱紧。不能转视。故直视也。勿听子曰。睛不能
转动而直视。是太阳已绝也。云岐子曰。经云。回则不转是也。
指甲黑色。
勿听子曰。爪甲。肝之荣。华于外者也。肝绝则不能荫。故色现黑。愚谓肝
主血。其华在爪。爪甲而现。黑色是血先死。故其色现如是。忽作鸦声。
勿听子曰。肺主气发声为言。肺既绝。故声如鸦叫。虚舌退场门。
准绳作舒舌退场门。乃心绝。并壬葵日死。或曰。舌乃心之苗。心气散。则出不得收。
啮齿咬人。
肾主骨。齿乃骨之余。虚则痒。实则痛。肾水虚竭。则无以荣养其齿。而齿痒。故欲啮齿咬人也。准绳云。咬乳戛
齿。此肾绝也。并戊己日死。又小儿欲生齿亦然。不在其例。
鱼口气急。
勿听子曰。口是脾之窍气。是肺所主。脾败而见。鱼口。肺绝而息喘急。啼不作声。
云岐子谓哭而无声。是谓肺绝。据准绳云。肝病重啼哭无泪。及病不哭下泪。乃肝绝。并庚辛日死。
蛔虫既出。必是死形。
李 范曰。蛔虫生于脾胃之间。全赖谷气以为养。故逆出于口鼻。是胃绝也。愚谓人身之有蛔虫。犹天地间之有龙
也。故蛔虫谓之人龙。夫龙何以秋冬则伏藏。而春夏则升腾也。盖以龙之性。喜暖而畏寒。秋冬则阴气在上。阳气在下。
故龙乐其暖。而伏藏于九渊。春夏则阳气在上。阴气在下。故龙畏其冷。而不能安其身。故升腾而上也，夫蛔虫亦然。
人身中之元阳足。则蛔乐其暖。以安其身。而无扰动之患。脏腑之阳气衰。而阴气盛。则蛔畏冷。而不能安其身。故逼
迫而出于口鼻之上。倘仁人用心求生于万一。切勿峻用苦寒之药。以速其亡焉可也。
用药速救。百无一生。
眼睛上出现赤色脉络，向下贯穿瞳孔。
池氏说：赤色脉络归属于心，瞳孔归属于肾，这是心火亢盛克制肾水，肾水枯竭则不能滋养肝木，导致肾和肝的功能都衰竭的缘故。
囟门肿胀突起，甚至凹陷成坑。
曾氏说：囟门肿胀都认为是热证，殊不知有阴证和阳证两种情况，务必仔细辨别。坚硬的是阴证，红软的是阳证。所以《婴孩宝书》说：“寒气上冲则囟门坚硬，热气上冲则囟门柔软”，正是这个意思。如果是阴证，用匀气散、理中汤为主治疗；阳证用玉露饮、当归散、防风汤治疗。《玉环集歌》说：“囟门肿起定为大便不通之候，此症应当是不治之症。如果加上凹陷像杯底一样，七天之内性命必终。”曾氏又说：囟门凹陷的，是虚损到了极点。胃气虚寒，就会导致囟门凹陷，慢惊风中有这种情况。胃寒脾困，伴有呕吐腹泻的，属于极度虚损，急需使用金液丹固护真阳，以及各类救元等药物治疗。外用乌附膏贴敷。如果有后枕部凹陷的，病情尤其严重，治疗方法与囟门凹陷的药方相同，如果不见效也难以治疗，这是大虚极，百无一活的死症。
鼻子干燥发黑。
勿听子说：鼻是肺的窍道，发黑干燥，这是肺气衰竭的表现。云岐子说：这是火克金。我说：这就是所谓病人鼻孔如烟煤一样，是死症。
肚子大，青筋暴露。
肚胀腹大，是脾虚。肝主筋，其色为青。现在肚子大而现出青筋，这是肝木克制脾土。
眼睛多直视，看东西不转眼珠。
热邪侵入眼部，牵引筋脉，两眼拘紧，不能转动视物，所以表现为直视。勿听子说：眼球不能转动而直视，是太阳经气已绝。云岐子说：经文所说“回则不转”就是这个意思。
指甲变黑。
勿听子说：爪甲是肝的外荣，表现于外部。肝气衰竭则不能滋养爪甲，所以颜色现黑。我认为肝主血，其华在爪，爪甲呈现黑色，说明血先死，所以颜色呈现这样。
突然发出乌鸦般的叫声。
勿听子说：肺主气，发声为言。肺既已衰竭，所以声音像乌鸦叫。
舌头舒张退出口外（场门）。
《准绳》作“舒舌退出场门”，这是心气衰竭，并在壬日或癸日死亡。有人说：舌是心的苗窍，心气涣散，则舌头伸出收不回来。
咬牙咬人。
肾主骨，齿是骨的余气。肾虚则牙痒，实热则牙痛。肾水虚竭，则无法荣养牙齿，导致牙痒，所以想要咬牙咬人。《准绳》说：咬乳头或磨牙，这是肾气衰竭，并在戊日或己日死亡。另外小儿长牙时也有类似情况，不在上述死症之列。
口开如鱼嘴，气息急促。
勿听子说：口是脾的窍道，气是肺所主。脾败则口开如鱼口，肺绝则呼吸喘急，啼哭没有声音。云岐子认为哭而无声，称为肺绝。据《准绳》说：肝病重时啼哭无泪，以及病重不哭下泪，这是肝气衰竭，并在庚日或辛日死亡。
蛔虫排出体外，必定是死形。
李范说：蛔虫生于脾胃之间，全靠谷气来供养。所以逆出于口鼻，这是胃气衰竭。我认为人身中的蛔虫，就像天地间有龙一样。所以称蛔虫为人龙。龙为什么秋冬潜伏，春夏升腾呢？大概因为龙的习性，喜欢温暖而畏惧寒冷。秋冬时节阴气在上，阳气在下，所以龙喜爱温暖，潜伏在深渊中。春夏时节阳气在上，阴气在下，所以龙畏惧寒冷，不能安身，于是升腾而上。蛔虫也是如此。人体中元阳充足，则蛔虫喜爱温暖，安身而不扰动。脏腑阳气衰弱而阴气旺盛，则蛔虫畏惧寒冷，不能安身，所以被迫出于口鼻之上。如果仁人志士想从万分之一的希望中求生，千万不要峻烈地使用苦寒药物，以加速其死亡，就可以了。
用药迅速救治，百人中难活一个。
Red vessels appear on the eyes, extending downwards through the pupils.
Chi Shi said: Red vessels belong to the Heart (Xin), and the pupils belong to the Kidney (Shen). This indicates that Heart Fire overcomes Kidney Water. When Kidney Water is exhausted, it cannot generate Liver Wood, leading to the exhaustion of both the Kidney and Liver.
The fontanelle swells and protrudes, or even sinks into a pit.
Zeng Shi said: Fontanelle swelling is generally considered a Heat syndrome, but one must not ignore the distinction between Yin and Yang syndromes; careful differentiation is essential. Hardness indicates a Yin syndrome, while redness and softness indicate a Yang syndrome. Therefore, *Yinghan Baoshu* states: "Cold Qi rushing upward causes hardness; Hot Qi rushing upward causes softness." This is precisely what is meant. For Yin syndromes, treat with Yunqi San and Lizhong Tang as the primary formula. For Yang syndromes, use Yulu Yin, Danggui San, and Fangfeng Tang. The song in *Huanjuji* says: "Fontanelle swelling fixedly indicates stool retention; this sign should be deemed untreatable. If accompanied by a pit like a cup bottom, life will end within seven days." Zeng Shi further stated: Fontanelle depression signifies extreme deficiency. Stomach Qi deficiency and Cold lead to fontanelle depression, seen in slow convulsions. Stomach Cold and Spleen stagnation with vomiting and diarrhea represent extreme deficiency; urgently administer Jin Ye Dan to consolidate True Yang, along with various Yuan-saving medicines. Externally apply Wufu Gao. Depression at the back of the occiput indicates an even more severe condition; the treatment method is the same as for fontanelle depression. If ineffective, it is difficult to treat, representing extreme deficiency where survival is unlikely.
Nose dry and black.
Wuting Zi said: The nose is the aperture of the Lung (Fei). Blackness, dryness, and roughness indicate Lung Qi exhaustion. Yunqizi said: This is Fire overcoming Metal. I say: This refers to the case where a patient's nostrils look like soot from smoke, which is a death sign.
Abdominal distension with visible blue veins.
Abdominal distension and enlargement are due to Spleen deficiency. The Liver governs sinews, and its color is blue. Now, the abdomen is large with visible blue veins, indicating Liver Wood overcoming Spleen Earth.
Eyes staring straight ahead without moving.
Heat enters the eyes, pulling the sinews, causing both eyes to become tight and unable to turn, resulting in staring. Wuting Zi said: Eyes unable to rotate and staring straight indicates the exhaustion of the Taiyang channel. Yunqizi said: As the classics state, "reversal leads to immobility," which is exactly this.
Nails turning black.
Wuting Zi said: Nails are the flourishing aspect of the Liver, manifesting externally. When Liver Qi exhausts, it fails to nourish the nails, hence the black color appears. I believe the Liver governs Blood, and its flourishing aspect is in the nails. Black nails indicate that Blood has died first, hence the color appears thus.
Sudden crow-like voice.
Wuting Zi said: The Lung governs Qi and produces speech. Since Lung Qi is exhausted, the voice sounds like a crow's caw.
Tongue protruding out of the mouth (Changmen).
*Zhunsheng* describes it as "tongue extending out of the mouth gate," indicating Heart Qi exhaustion, with death occurring on Ren or Gui days. Some say: The tongue is the sprout of the Heart. When Heart Qi scatters, the tongue extends and cannot retract.
Teeth gnashing and biting.
The Kidneys govern bones, and teeth are the surplus of bones. Deficiency causes itching, excess causes pain. When Kidney Water is exhausted, it cannot nourish the teeth, causing itching, hence the desire to gnash teeth and bite. *Zhunsheng* states: Biting the nipple or grinding teeth indicates Kidney Qi exhaustion, with death occurring on Wu or Ji days. Additionally, infants teething may show similar signs, which are not included in this category.
Mouth open like a fish's gills, rapid breathing.
Wuting Zi said: The mouth is the aperture of the Spleen, and Qi is governed by the Lung. Spleen failure manifests as a mouth open like a fish's gill; Lung exhaustion manifests as panting breath. Crying without sound indicates Lung exhaustion according to Yunqizi. According to *Zhunsheng*: Severe Liver disease involves crying without tears, or illness with no crying and no tearing, indicating Liver Qi exhaustion, with death occurring on Geng or Xin days.
Roundworms expelled, necessarily in a dead state.
Li Fan said: Roundworms live between the Spleen and Stomach, relying entirely on grain Qi for nourishment. Thus, if they reverse and exit through the mouth or nose, it indicates Stomach Qi exhaustion. I consider roundworms in the human body akin to dragons in the world. Hence, roundworms are called "human dragons." Why do dragons hide in autumn and winter and rise in spring and summer? It is because dragons prefer warmth and fear cold. In autumn and winter, Yin Qi is above and Yang Qi is below, so dragons enjoy the warmth and hide in deep abysses. In spring and summer, Yang Qi is above and Yin Qi is below, so dragons fear the cold and cannot settle, thus rising upwards. Roundworms are the same. When the original Yang Qi in the body is sufficient, roundworms enjoy the warmth and remain settled without disturbance. When Zang-Fu Yang Qi declines and Yin Qi prevails, roundworms fear the cold and cannot settle, thus being forced out through the mouth and nose. If benevolent physicians seek salvation in a million chances, they must never harshly use bitter-cold medicines to hasten death.
Medicines administered hastily for rescue: less than one in a hundred survives.