《灵枢》曰∶腹胀身热脉大，是一逆也。腹鸣而满，四肢清泄，其脉大，是二逆也。
衄而不止，脉大，是三逆也。咳则溲血脱形，其脉小劲，是四逆也。咳脱形，身热脉
小以疾，是谓五逆也。如是者，不过十五日而死矣。其腹大胀，四末清，脱形泄甚，是
一逆也。腹胀便血，其脉大时绝，是二逆也。咳溲血形肉脱脉搏，是三逆也。呕血，
胸满引背，脉小而疾，是四逆也。咳呕腹胀，且飧泄，其脉绝，是五逆也。如是者，
不过一时而死矣。
凡面目俱黄而泽者，面黄目赤者，目睛光明彩润者，诸热神清安静者，虚症受补能
食者，病势难危太冲有脉，补气不脱，囟门不陷，颜色爪甲，皆不昏黯者，皆为可治。
若目睛无光，瞳人不转，爪甲唇背俱黑，啼哭无泪，不哭下泪，吃乳不收，舌退场门外，
汗出如珠者，唇不盖齿，口无津液，四肢垂冷，下泻黑血者，口作鸦声，喉中声嘶，口
鼻干黑，手足口鼻皆冷者；面黑咬人，鼻黑身热，气喘不回，瞳人中陷，鼻孔如煤，眼
眶青色，脚直肚大而现青筋者∶耳叶廓黑，
唇青黑色或如枯骨，赤贯瞳人，囟突及陷，鱼口舒舌，不能啼哭，啼哭无声，胸陷及
突，吐出蛔虫者；身主青黑等斑，遍体不暖，长嘘出气者∶伤寒连剂无汗，诸病天柱
骨倒者；小儿百日内外发搐，愈而复作，面黑神昏者；目白面黑，或面目俱赤卒叫者，
面青唇黑，或面黑目直视者∶手掌无纹，口唇满反，人中无痕，寻衣摸缝，汗出不流，
而舌卷者；阴结阳结，目无光若恍惚者；遗泄不觉，牙齿黑色，妄语错乱者；卒肿面苍
色黑者；手足爪甲肌肉俱黑者；热吐目赤，泻如屋漏水者；按脉无根，阴囊俱肿者，面
目俱白，神色枯槁者；面无精光，不能饮食，身有尸臭气者；面黄目黑，面赤目黑，
口不能闭，呻吟不止者；病久而身有印疮点子起者；发直如麻，舌肿发惊，肉无面色
者；发搐目斜，唇口俱动，脚面上直，手如抱头之状，身不知痛痒者；撮口如囊，泻粪
赤黑，头汗肢冷，舌唇或紫肿者；头皮冷而按爪不起者；非时弄色，面色如装者；汤下
药食入喉，腹中随有响声者，汗出发润，其身如洗者；青色从眉入目，青色连目入耳，
青色入口鼻者；黑色多绕口鼻，青色从眉绕耳，鼻上青色腹痛，耳目口鼻起黑色或白色
者；汗不出，出不止，热病得汗而热不去，久不食，忽食之而倍常者；及诸病大肉脱
去，虎口三关，纹色通度者；发际一路青筋或紫青筋如乱纹者；目胞上下青紫乱纹，或
紫黑色者；自尾一条青黑筋直入鬓者；面色如死鸡肝，或如蓝色而无血润者；口鼻耳舌
如土，目睛下陷不光者；鼻孔紫黑，其舌短缩，而唇焦黄或黑者；目白忽如火赤，后脑
赤肿如鸡卵者；唇口目鼻，常常青黑者；鼻头向上，生青黑筋如罗纹无数者；并为不
治。其克日之诀，以耳属肾，鼻属肺，唇属脾，舌属心，目属肝，肝部见此，忌庚辛日
时；肺部见此，忌丙丁日时；心部见此，忌壬癸日时；脾部见此，忌甲乙日时；肾部见
此，忌戊已日时。此推五行中绝以验者，然候甚繁，各载本门。
《灵枢》说：腹部胀满，身体发热，脉象洪大，这是第一种逆证。腹部肠鸣且胀满，四肢厥冷并伴有泄泻，脉象洪大，这是第二种逆证。
鼻出血不止，脉象洪大，这是第三种逆证。咳嗽且小便带血，形体消瘦脱失，脉象细小而强劲，这是第四种逆证。咳嗽、形体消瘦脱失，身体发热，脉象细小而快速，这称为第五种逆证。出现这种情况的，不超过十五天就会死亡。
如果腹部极度胀大，四肢厥冷，形体极度消瘦，泄泻严重，这是第一种逆证。腹部胀满且大便出血，脉象洪大但时有间歇（或指脉搏断续不接），这是第二种逆证。咳嗽、小便带血，形体肌肉脱失，脉搏躁动不安，这是第三种逆证。呕血，胸部胀满牵引背部疼痛，脉象细小而快速，这是第四种逆证。咳嗽、呕吐、腹部胀满，并且伴有完谷不化的泄泻，脉象断绝，这是第五种逆证。出现这种情况的，不超过一个时辰（两小时）就会死亡。
凡是面目都发黄且有光泽的，面色黄而目睛赤红的，眼珠明亮光彩润泽的，各种热病中神志清醒安静的，虚证能够接受补益并能进食的，病情虽危重但太冲穴仍有脉搏跳动，补气后正气不致耗散脱失，囟门没有凹陷，面色和爪甲都不昏沉晦暗的，都属于可治之症。
如果是眼珠无光，瞳孔不转动，爪甲、嘴唇、背部都发黑，啼哭时没有眼泪，不哭时却流泪，吃奶时乳汁不收留，舌头伸出超过口唇之外，出汗像珍珠一样颗粒状，嘴唇不能覆盖牙齿，口中没有津液，四肢下垂冰冷，下泻黑色血液的，口中发出乌鸦般的叫声，喉中声音嘶哑，口鼻干燥发黑，手足口鼻都冰冷的；面色发黑且咬人，鼻头发黑身体发热，气喘无法平复，瞳孔深陷，鼻孔颜色如煤烟，眼眶呈现青色，双腿伸直肚子大而显露青筋的；耳廓发黑，嘴唇青黑或像枯骨一样，红丝贯穿瞳孔，囟门突起或凹陷，鱼口张开舌头吐出，不能啼哭，或者啼哭无声，胸窝处凹陷或突起，吐出蛔虫的；身上出现青黑色的斑纹，遍体不温暖，长吁短叹出气的；伤寒病连续服药仍无汗出，各种疾病中出现天柱骨（颈项部）倒伏的；小儿在百日内外发生抽搐，痊愈后又复发，面色发黑神志昏迷的；眼白部分发白而面部发黑，或者面目都发红突然大叫的，面色青嘴唇黑的，或者面色黑眼睛直视的；手掌没有纹路，口唇满反（上唇翻卷），人中沟没有痕迹，伸手摸缝（无意识动作），出汗但不流淌，并且舌头卷缩的；阴结和阳结病症，眼神无光如同恍惚状态的；遗精泄泻自己不知道，牙齿发黑，胡言乱语错乱的；突然浮肿面色苍黑发黑的；手足爪甲肌肉都发黑的；热性呕吐且眼红，腹泻像屋漏雨水滴落不断的；按脉没有根底，阴囊全部肿胀的，面目都苍白，神色枯槁的；面无精光，不能饮食，身上有尸臭气味的；面色黄眼睛黑，面色红眼睛黑的，嘴巴不能闭合，呻吟不止的；患病日久身上出现痘疮斑点起发的；头发直竖像麻草一样，舌肿并发惊风，肌肉失去正常颜色的；抽搐时眼睛斜视，嘴唇口角抽动，脚背绷直，手像抱头一样的姿势，身体不知痛痒的；撮口如囊状，排泄粪便赤黑色，头部出汗四肢冰冷，舌头嘴唇或紫或肿的；头皮冰冷按压后不起反应的；非正常时间做出怪异表情，面色像化妆一样的；汤药食物咽下喉咙，腹中随即有响声的，出汗后头发湿润，身体像洗过一样的；青色从眉毛进入眼睛，青色连着眼睛进入耳朵，青色进入口鼻的；黑色多环绕口鼻，青色从眉毛环绕耳朵，鼻子上方青色且腹痛，耳目口鼻出现黑色或白色的；不出汗，或者汗出不止，热病得汗后热势不退，长久不进食，忽然进食且食量加倍的；以及各种疾病中大肉（大腿臀部肌肉）脱去的，虎口三关（食指桡侧脉络）纹理颜色直通度过的；发际一路青筋或紫青筋像乱纹一样的；眼睑上下青紫乱纹，或紫黑色的；从尾闾一条青黑筋直入鬓角的；面色像死鸡肝一样，或者像蓝色而没有血色滋润的；口鼻耳舌像泥土一样，眼珠下陷无光的；鼻孔紫黑，舌头短缩，嘴唇焦黄或黑的；眼白忽然如火般赤红，后脑勺红肿像鸡蛋大小的；嘴唇口鼻常常青黑的；鼻头向上，生出无数青黑筋络像罗纹一样的；以上这些都属于不治之症。关于判定死亡日期的秘诀，依据耳朵属肾，鼻子属肺，嘴唇属脾，舌头属心，眼睛属肝的理论，如果在肝部见到这些征象，忌讳庚辛日（金日）；如果在肺部见到这些征象，忌讳丙丁日（火日）；如果在心部见到这些征象，忌讳壬癸日（水日）；如果在脾部见到这些征象，忌讳甲乙日（木日）；如果在肾部见到这些征象，忌讳戊己日（土日）。这是推演五行中绝以验证的方法，然而候诊方法非常繁杂，各自记载在本篇门类之中。
According to the *Ling Shu* (Spiritual Pivot): Abdominal distension with body heat and a large pulse is the first adverse condition. Abdominal borborygmus accompanied by fullness, cold limbs, and diarrhea, with a large pulse, is the second adverse condition.
Nosebleed that does not stop, with a large pulse, is the third adverse condition. Coughing with hematuria and emaciation, with a small and forceful pulse, is the fourth adverse condition. Coughing, emaciation, body heat, and a small and rapid pulse are referred to as the fifth adverse condition. Those presenting thus will die within fifteen days.
If the abdomen is massively distended, extremities are cold, form is severely emaciated, and diarrhea is severe, this is the first adverse condition. Abdominal distension with hematochezia, where the pulse is large but intermittent (or desultory), is the second adverse condition. Coughing with hematuria, loss of flesh and muscle, and a surging pulse is the third adverse condition. Hematemesis, chest fullness radiating to the back, with a small and rapid pulse, is the fourth adverse condition. Coughing, vomiting, abdominal distension, accompanied by undigested food in stool (canalization diarrhea), and an absent pulse is the fifth adverse condition. Those presenting thus will die within one shichen (two hours).
Any case where both face and eyes are yellow yet lustrous; face yellow with red eyes; eyeballs bright and lustrous; various febrile diseases where spirit is clear and calm; deficiency syndromes that can tolerate tonification and allow for eating; critical illness where the Taichong point (LR3) still has a pulse; Qi tonification does not lead to collapse; fontanelle is not sunken; complexion and nail beds are not dull or dark—all these are treatable.
However, if the eyeballs lack luster, pupils do not rotate, nails, lips, and back are all black, crying without tears, or weeping when not crying, inability to retain milk while feeding, tongue protruding beyond the lips, sweat beading like pearls, lips unable to cover teeth, no saliva in the mouth, limbs hanging cold, passing black blood, making crow-like sounds, hoarseness in the throat, dry and black nose and mouth, cold hands, feet, nose, and mouth; face black with biting behavior, black nose with body heat, panting that cannot subside, sunken pupils, nostrils black like coal, cyanosis around eye sockets, legs straight with distended belly showing blue veins; black earlobes, lips cyanotic-black or bone-dry, red vessels crossing the pupil, fontanelle bulging or sunken, fish-mouth opening with tongue protrusion, inability to cry or silent crying, sunken or bulging chest, vomiting roundworms; green-black macules on the body, whole body cold, long sighing breaths; Shanghan (Cold Damage) with continuous medication but no sweat, any disease with collapse of the Tianzhu bone (neck); infant convulsions within 100 days of birth, recurring after remission, with black face and coma; white sclera with black face, or red face and eyes with sudden screaming, cyanotic face with black lips, or black face with fixed gaze; palm lines absent, lips everted, philtrum indistinct, picking at seams (fidgeting), sweating without flow, and rolled-up tongue; Yin-Jie and Yang-Jie syndromes with vacant gaze resembling trance; involuntary seminal emission or diarrhea, black teeth, delirious speech; sudden edema with pale black face; black hands, feet, nails, and muscles; hot vomiting with red eyes, diarrhea dripping like leaking roof water; pulse rootless, scrotum fully swollen; pale face and eyes with withered spirit; lack of luster in face, inability to eat, corpse-like odor; yellow face with black eyes, red face with black eyes, inability to close mouth, incessant moaning; chronic illness with emerging pustular spots; hair standing straight like hemp, swollen tongue with fright, flesh lacking normal color; convulsions with strabismus, twitching lips and mouth, stiff dorsum pedis, hands holding head posture, insensitivity to pain; mouth puckered like a bag, passage of red-black feces, head sweat with cold limbs, purple or swollen tongue and lips; cold scalp that remains depressed upon pressure; abnormal facial expressions, face looking painted; sound in abdomen immediately after swallowing medicine/food; sweat causing wet hair, body feeling washed; cyanosis entering eyes from eyebrows, connecting eyes to ears, entering nose and mouth; black encircling nose and mouth, cyanosis from eyebrows circling ears, cyanosis above nose with abdominal pain, black or white discoloration around ears, eyes, nose, and mouth; anhidrosis or hyperhidrosis; febrile disease with sweat but persistent heat; prolonged fasting followed by sudden double appetite; and any disease with loss of Da Rou (large muscles of thighs/buttocks), Tong Du (passing through) of the Three Passages (San Guan) pattern in the Tiger's Mouth; blue or purple veins along hairline like chaotic patterns; chaotic blue-purple or purple-black patterns on upper and lower eyelids; a single blue-black vein straight from the coccyx into the temples; face color like dead chicken liver, or blue without blood luster; mouth, nose, ears, tongue like earth, sunken and dull eyeballs; purple-black nostrils, short retracted tongue, scorched yellow or black lips; sclera suddenly fiery red, posterior head swollen red like an egg; constant cyanosis of lips, mouth, nose; upward-turned nasal tip with numerous blue-black reticular veins; all these are untreatable.
The secret for predicting the day of death relies on: ears belonging to Kidney, nose to Lung, lips to Spleen, tongue to Heart, eyes to Liver. If signs appear in the Liver sector, avoid Geng-Xin days (Metal days); if in the Lung sector, avoid Bing-Ding days (Fire days); if in the Heart sector, avoid Ren-Gui days (Water days); if in the Spleen sector, avoid Jia-Yi days (Wood days); if in the Kidney sector, avoid Wu-Ji days (Earth days). This deduces the extinction of the Five Elements to verify prognosis. However, observation methods are numerous and detailed in their respective sections.