《玉机真脏论》曰∶见真脏曰死,何也?岐伯曰∶五脏者,皆禀气于胃,胃者五脏之本也。
(胃为水谷之海,故五脏禀焉。)脏气者,不能自至于手太阴,必因于胃气,乃至于手太阴也。(人
禀气于胃,脏气者,平人之常气,故脏气因胃乃能至于手太阴也。)故五脏各以其时,自为而至
于手太阴也。(自为其状,至于手太阴也。)故邪气盛者,精气衰也。故病甚者,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。(是所谓脉无胃气也。)形气相
得,谓之可治,(气盛形盛,气虚形虚,上相得也。)色泽以浮,谓相易已,(气色浮润,血气相营,
故易已。)脉从四时,谓之可治,(脉春弦夏钩秋浮冬石,谓顺四时,从,顺也。)脉弱以滑是有胃
气,命曰易治,取之以时,(候可取之时而取之,则万举万全,当以四时血气所在,而为疗耳。)
形气相失,谓之难已∶(形盛气虚,气盛形虚,皆相头也。)色夭不泽,谓之难已;(夭,谓不明而晦。
不泽,谓枯燥也。)脉实以坚,谓之益胜;胜实以坚,是邪气盛,故益甚也。)脉逆四时,谓不可
治。(以气逆故不治。)五实死,五虚死,(五实,谓五脏实。五虚,谓五脏虚脉盛,皮热,腹胀,
前后不通,闷瞀,此谓五实。(实,谓邪气盛实。脉盛,心也。皮热,肺也。腹胀,脾也。前后不通,
肾也。闷瞀,肝也。)脉细,皮寒,气少,泄利前后,饮食不入,此谓五虚。(虚,谓真气不足也。
脉细,心也。皮寒,肺也。气少,肝也。饮食不入,脾也。)其时有生者,何也?浆粥入胃,泄注止,
则虚者话;身汗得后利,则实者活,此其候也。(饮粥得入于胃,胃气和调其利渐止,胃气得实,虚
者得活,言实者得汗外通,后得便利自然调平。)
《玉机真脏论》说:出现真脏脉象就预示死亡,这是为什么呢?岐伯回答说:五脏的功能都依赖于胃气,胃是五脏的根本。(胃是水谷精微汇聚的海,所以五脏都禀受于此。)脏气本身不能直接到达手太阴肺经的脉搏部位,必须借助于胃气,才能到达手太阴肺经。(人禀受气于胃,脏气是常人的正常脉气,所以脏气必须依靠胃气才能显现于手太阴肺经。)因此,五脏各自在其对应的时令,独自显现于手太阴肺经的脉位上。(呈现出各自特有的脉象,显现于手太阴肺经。)所以邪气亢盛时,精气就会衰败。因此病情严重时,胃气不能伴随脏气一起到达手太阴肺经,所以真脏之气单独显露,单独显露,说明病邪胜过脏气,所以预示死亡。(这就是所谓的脉象中没有胃气。)形体与正气相协调,称为可以治疗,(气盛则形盛,气虚则形虚,上下相协调。)面色光泽明润,称为容易痊愈,(气色浮而润泽,血气相互营卫,所以容易痊愈。)脉象顺应四时变化,称为可以治疗,(春脉弦、夏脉钩、秋脉浮、冬脉石,称为顺应四时,从即顺的意思。)脉象弱而滑利是有胃气的表现,命名为容易治疗,应把握治疗时机,(等待可施治的时机进行治疗,就能万无一失,应当根据四时气血所在之处来进行治疗。)形体与正气不相协调,称为难以痊愈:(形盛而气虚,或气盛而形虚,都不相协调。)面色枯槁无光泽,称为难以痊愈;(夭,指不明亮且晦暗。不泽,指干枯粗糙。)脉象实而坚硬,称为病势加重;(胜实而坚硬,是邪气亢盛,所以病情更加严重。)脉象违背四时规律,称为不可治疗。(因为气机逆乱所以无法治疗。)五实证死,五虚证死,(五实,指五脏邪气壅实。五虚,指五脏真气虚弱。脉象盛大,皮肤发热,腹部胀满,大小便不通,胸闷目眩,这叫做五实。(实,指邪气盛实。脉盛,对应心。皮热,对应肺。腹胀,对应脾。前后不通,对应肾。闷瞀,对应肝。)脉象细弱,皮肤发冷,气短,大小便泄利不止,饮食无法入口,这叫做五虚。(虚,指真气不足。脉细,对应心。皮寒,对应肺。气少,对应肝。饮食不入,对应脾。)其中有时能存活的,是什么原因呢?如果浆粥能进入胃中,泄泻停止,那么虚证患者就能存活;如果身体出汗且二便通畅,那么实证患者就能存活,这就是判断预后的征象。(喝粥能进入胃中,说明胃气和调,泄利逐渐停止,胃气得复,虚证者得以存活;说实证者得汗外通,后阴得便利自然调平。)
The *Yu Ji Zhen Zang Lun* (Treatise on the True Viscera and Vital Mechanisms) states: "The appearance of the True Visceral Pulse indicates death." Why is this? Qibo replied: "The Qi of the Five Viscera (Zang Organs) all derives from the Stomach; the Stomach is the root of the Five Viscera. (The Stomach is the Sea of Water and Grain, thus the Five Viscera derive from it.) The Qi of the Viscera cannot reach the Lung Meridian of Hand-Taiyin (Hand-Taiyin Lung Channel) by itself; it must rely on Stomach Qi to reach the Lung Meridian of Hand-Taiyin. (Humans derive Qi from the Stomach; the Visceral Qi is the normal Qi of a healthy person, thus Visceral Qi relies on Stomach Qi to manifest at the Lung Meridian of Hand-Taiyin.) Therefore, each of the Five Viscera manifests at the Lung Meridian of Hand-Taiyin during its respective season. (Manifesting its specific pulse pattern at the Lung Meridian of Hand-Taiyin.) Thus, when Pathogenic Qi is excessive, Essence-Qi is deficient. When the disease is severe, Stomach Qi cannot accompany the Visceral Qi to reach the Lung Meridian of Hand-Taiyin; consequently, the True Visceral Qi appears alone. Its solitary appearance means that Pathogenic Qi overcomes the Visceral Qi, hence it indicates death. (This refers to a pulse lacking Stomach Qi.) When Form and Qi are harmonious, it is called treatable. (When Qi is abundant, Form is robust; when Qi is deficient, Form is emaciated; they correspond with each other.) When the complexion is lustrous and floating, it is called easily curable. (The Qi and Color are floating and moist, Blood and Qi nourish each other, hence it is easily cured.) When the pulse conforms to the Four Seasons, it is called treatable. (Spring pulse is Wiry [Xian], Summer pulse is Hooked [Gou], Autumn pulse is Floating [Fu], Winter pulse is Stone-like [Shi]; this is said to conform to the Four Seasons; 'conform' means to follow.) A pulse that is weak and slippery indicates the presence of Stomach Qi, named as easily treatable; treatment should be timed appropriately. (Wait for the appropriate time to intervene, then every action will be successful; one should treat according to the location of Qi and Blood in the Four Seasons.) When Form and Qi are discordant, it is called difficult to cure: (Robust Form with deficient Qi, or abundant Qi with emaciated Form, both indicate disharmony.) When the complexion is dull and lacks luster, it is called difficult to cure. ('Dull' means not bright and obscure. 'Lacking luster' means dry and rough.) A pulse that is excess and hard indicates worsening condition. (Excess and hard means Pathogenic Qi is excessive, hence the condition worsens.) A pulse that goes against the Four Seasons is called untreatable. (Because Qi is rebellious, it is untreatable.) Death occurs in cases of Five Excesses and Five Deficiencies. (Five Excesses refer to Excess in the Five Viscera. Five Deficiencies refer to Deficiency in the Five Viscera. Excessive pulse, hot skin, abdominal distension, obstruction of urination and defecation, chest oppression and dizziness—this is called Five Excesses. (Excess refers to excessive Pathogenic Qi. Excessive pulse corresponds to Heart. Hot skin corresponds to Lung. Abdominal distension corresponds to Spleen. Obstruction of urination and defecation corresponds to Kidney. Chest oppression and dizziness corresponds to Liver.) Fine pulse, cold skin, shortness of breath, diarrhea and incontinence of urine and stool, inability to eat or drink—this is called Five Deficiencies. (Deficiency refers to insufficiency of True Qi. Fine pulse corresponds to Heart. Cold skin corresponds to Lung. Shortness of breath corresponds to Liver. Inability to eat corresponds to Spleen.) Among these, why do some survive? If gruel enters the Stomach and diarrhea stops, the Deficient case survives; if sweating occurs and bowel movements become free, the Excess case survives. These are the prognostic signs. (If porridge can enter the Stomach, Stomach Qi is harmonious, diarrhea gradually stops, Stomach Qi becomes substantial, and the Deficient case survives. For the Excess case, sweating allows external release, and free bowel movements restore internal balance naturally.)