In cold damage (Shanghan) disease, if there is diarrhea (Li), cold extremities (Jue Ni), irritability and restlessness, and an inability to lie down, it is a death sign.

In cold damage disease, if cold extremities persist for six or seven days, survival is indicated if accompanied by fever and diarrhea; however, if sweating occurs with unceasing diarrhea, it is a death sign, due to the presence of only Yin cold without Yang Qi.

In cold damage disease, if there is coughing with rebellious Qi rising, and the pulse is scattered and rootless, it is a death sign, indicating severe depletion of physical essence.

Generally, patients with excess conditions exhibit delirious speech (Zhen Yu), while those with deficiency conditions exhibit repetitive murmuring (Zheng Sheng). (Zheng Sheng refers to repetitive speech.) If there is fixed staring gaze combined with delirium and asthmatic chest fullness, or if there is diarrhea, these are death signs.

In cold damage disease, if the pulses at all three positions (Cun, Guan, Chi) are tight, the breath exhaled from the mouth is hot, lips and mouth are dry, feet are cold during sleep, nasal discharge is clear, and the tongue coating is slippery, do not treat recklessly.

In cold damage disease, if the pulse is floating and surging, sweat oozes like oil, asthma continues without cessation, fluids and food cannot be taken in, the body is numb and insensible, and the patient alternates between quietness and chaos, this indicates the end of life. It is unknown which Zang organ suffered the disaster first. If sweat wets the hair and asthma continues, this indicates the Lung failing first; if Yang Qi remains alone externally, the complexion is dark like smoke, eyes stare fixedly, and the head shakes, this indicates the Heart failing first; if lips and corners of the mouth turn cyanotic, and limbs twitch and tremble, this indicates the Liver failing first; if the area around the mouth is dark yellow/black, with soft sweat and yellowish skin, this indicates the Spleen failing first; if urine and stool are incontinent, with delirious speech and eyes rolling upward fixedly, this indicates the Kidney failing first.

If the pulse of cold damage disease conforms to the four seasons, illness contracted at midnight resolves at noon, or illness contracted at noon resolves at midnight, indicating that the disease does not transmit further.

In heat disease, "Yin-Yang Jiao" (interaction/conflict of Yin and Yang pathogens) presents with fever, irritability, and bodily dryness. If the Cun position of the Taiyin pulse is bilateral and surging/restless, this is Yin-Yang Jiao, a death sign; if the pulse becomes quiet, survival is indicated.

In heat disease, after sweating, the body becomes cold and the pulse seems to cease. If the patient is already quiet but drowsy and prone to sleep, administer Si Ni Tang (Four Reversal Decoction) or similar formulas immediately to warm the hands and feet; otherwise, sudden death may occur during deep sleep.

In heat disease, if Yang pathogen advances and Yin recedes, with sweat only on the head, it is a death sign; if Yin advances and Yang recedes, with sweat from below the waist to the feet, it is also a death sign; if both Yin and Yang advance, and heat persists despite sweating, it is a death sign; if both Yin and Yang recede, but chills continue incessantly after sweating, with cold breath from mouth and nose, it is also a death sign.

The term "Bing Yin" (Merging with Yin) in heat disease refers to a state where, after sweating, diarrhea occurs; thus, it can be treated. The term "Bing Yang" (Merging with Yang) refers to a state where, after sweating, the pulse remains restless, high fever and profuse sweating occur, or even without sweating, the body feels harmonious but epistaxis (nosebleed) occurs; thus, it can also be treated.

If a heat disease patient cannot locate pain, cannot control their body voluntarily, suffers from severe dry mouth and thirst with intense heat, and has coldness at the genitalia, the heat toxin has penetrated to the bone marrow; this is a death sign and untreatable.

If a patient exhibits delirious and妄言 (wild talk), the body should have heat, but instead presents with cold extremities and a deep, fine pulse, this is a death sign.

Heat disease affecting the Kidneys causes thirst and dry mouth, a scorched yellow-red tongue coating, incessant drinking day and night, abdominal distension, yet still unsatisfied with drinking, and eyes lacking luster; this is a death sign and untreatable.

The term "Yang Fu Yin" (Yang attaching to Yin) in heat disease refers to heat from below the waist to the feet, with cold above the waist; if Yin Qi struggles downward and returns, accompanied by heart and abdominal fullness, it is a death sign.

The term "Yin Fu Yang" (Yin attaching to Yang) in heat disease refers to heat from above the waist to the head, with cold below the waist; if Yang Qi struggles upward and returns, and sweating occurs, survival is indicated.

In heat disease, if after sweating the pulse changes from restless to calm, the body feels harmonious, and the face is slightly red, this indicates that Ying (Nutritive) Qi has not yet fully interacted; wait for the appropriate time for spontaneous recovery. Liver diseases typically resolve on Jia/Yi days (Wood days in spring). (Su Wen states: On the day Ying Qi has not yet interacted, now that sweat has been obtained, one need only wait for the time.)

In heat disease lasting seven or eight days, if the pulse is minute and small and the condition appears mild, but hematuria and dry mouth occur, death occurs within one and a half days; if a Dai Pulse (intermittent pulse) appears, death occurs within one day.

In heat disease lasting seven or eight days, if the pulse is neither restless nor rapid but asthma is present, sweating occurring within the next three days indicates survival; if no sweating occurs after three days, death occurs on the fourth day. If no sweating has occurred, do not use acupuncture.

If heat disease presents with jaundice of the body and face, facial swelling, internal heat and dry mouth, a curled and scorched yellow-black tongue, body numbness with a foul odor, indicating that latent toxins injure the Lungs and affect the Spleen, it is a death sign.

If heat disease presents with convulsions (Chou Xu), delirium, inability to sweat, and unceasing convulsions, indicating that latent toxins injure the Liver and affect the Gallbladder, it is a death sign.

If heat disease presents with no sweating, or sweating that does not reach the feet, vomiting of bile or blood, frequent fright, and inability to lie down, indicating that latent toxins reside in the Gallbladder (Foot-Shaoyang Gallbladder Meridian), it is a death sign.