〔《素》〕凡治病，察其形气色泽，脉之盛衰，病之新故，乃治之，无后其时。形气相得
，谓之可治。色泽以浮，谓之易已。脉从四时，谓之可治。脉弱以滑，是有胃气，命曰易治
，取之以时。形气相失，谓之难治。色夭不泽，谓之难已。脉实以坚，谓之益甚。脉逆四时
，为不可治，必察四难而明告之。所谓逆四时者，春得肺脉，夏得肾脉，秋得心脉，冬得脾
脉。其至皆悬绝沉涩者，命曰逆四时（《玉机真脏论》）。气实形实，气虚形虚，此其常也，
反此者病。谷盛气盛，谷虚气虚，此其常也，反此者病。脉实血实，脉虚血虚，此其常也，
反此者病（《刺志论》）。气虚身热，此谓反也。谷入多而气少，此谓反也。谷不入而气多，
此谓反也。脉盛血少，此谓反也。脉少血多，此谓反也。气盛身寒，得之伤寒。气虚身热，
得之伤暑。谷入多而气少者，得之有所脱血，湿居下也。谷入少而气多者，邪在胃及与肺也
。脉少血多者，饮中热也。脉大血少者，脉有风气，水浆不入，此之谓也（同上）。形盛脉细
，少气不足以息者，危。形疲脉大，胸中多气者，死。形气相得者，生；参互不调者，病；
三部九候皆相失者，死。上下左右之脉相应如参舂者，病甚；上下左右相失不可数者，死。
中部之候虽独调，与众脏相失者，死。中部之候相减者，死。目内陷者，死（全文见前上下
条，下同）。形肉已脱，九候虽调，犹死。
〔《灵》〕热病脉静，汗已出，脉盛躁，是一逆也。病泄，脉洪大，是二逆也。着痹不移
，肉破，身热，脉偏绝，是三逆也。淫而夺形，身热，色夭然白，及后下血 ，
血笃重，是谓四逆也。寒热夺形，脉坚搏，是谓五逆也。（《五禁篇》。 ，渠
损切。肘膝后肉如块者）
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。咳且溲血脱形，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，不及一时而死矣。工不察此者而
刺之，是谓逆治。（《玉版篇》。搏，蒲谷切）
〔《素》〕热而脉静，泄而脱血，脉实，病在中；脉虚，病在外；脉坚涩者，皆难治。（
《平人气象论》）
〔仲〕脉曰∶脉病患不病，名曰行尸，以无旺气。卒眩仆不识人者，短命则死。人病
脉不病，名曰内虚，以有正气，虽困无苦。左有病而右痛，右有病而左痛，下有病而上痛，
上有病而下痛，此为逆，逆者，死，不可治。肥人脉细小如丝，欲绝者，死。羸人脉躁者，
死。人身涩而脉往来滑者，死。人身小而脉往来大者，死。人身大而脉往来小者，死。人身
短而脉往来长者，死。人身长而脉往来短者，死。人身滑而脉往来涩者，死。
〔《素》〕五脏者，中之守也。中盛脏满，气胜伤恐者，声如从室中言，是中气之湿也。
言而微，终日乃复言者，此夺气也。衣被不 ，言语善恶不避亲疏者，此神明之乱也。
仓廪不藏者，是门户不要也。水泉不止者，是膀胱不藏也。得守者，生；失守者，死（《脉
要精微论》）。五脏者，身之强也。头者精神之府，头倾视深，精神将夺矣。背者，胸中之
府，背曲肩垂，府将坏矣。腰者，肾之府，转摇不能，肾将惫矣。膝者，筋之府，屈伸不能
，行则偻俯，筋将惫矣。骨者，髓之府，不能久立，行则振掉，骨将惫矣。得强者，生；失
强者，死（同上）。五脏之气，故色见青如草兹者，死；黄如枳实者，死；黑如 者，死
；赤如 血者，死；白如枯骨者，死，此五色之见死也（《五脏生成篇》。 ，芳
杯切，凝血也）。青如翠羽者，生；赤如鸡冠者，生；黄如蟹腹者，生；白如豕膏者，生；
黑如乌羽者，生；此五色之见生也（同上）。生于心如以缟裹朱，生于肺如以缟裹红，生于肝
如以缟裹绀，生于脾如以缟裹栝蒌实，生于肾如以缟裹紫，此五脏所生之外荣也（同上）。夫
精明五色者，气之华也。赤欲如白裹朱，不欲如赭。白欲如鹅羽，不欲如盐。青欲如苍璧之
泽，不欲如蓝。黄欲如罗裹雄黄，不欲如黄土。黑欲如重漆色，不欲如地苍。（《脉要精微
论》
华佗∶病患面目俱等者，不死。
〔《素》〕面黄目青，面黄目赤，面黄目白，面黄目黑者，皆不死也。面青目赤，面赤目
白，面青目黑，面黑目白，面赤目青，皆死也。（王注云∶凡色见黄者，为有胃气，故不死
。五脏以胃为本，故无黄色皆自死焉。《五脏生成篇》）
华佗∶病患面青目白者，死。病患面青目黄者，五日死。病患着床，心痛短气，脾竭内
伤，百日后愈。能起 徨，因坐于地，其立倚床，能治此者，可谓神良。病患面赤目白
者，十日死，忧恚思虑，心气内索，面色反好，急求棺椁。病患面赤目青者，六日死。
病患面黑目白者，八日死，肾气内伤，病因留积。病患面黑，目直视，恶风者死。病患面白
目黑者，死，此谓荣华已去，血脉空虚。赤色出两颧，大如母指者，病虽小愈，必卒死。（
全文见暴死。颧，额骨也。东垣曰∶《脉诀》言面赤如妆不久居。面显赤色于两颊。
若涂胭脂之状，而又且圆也。病至于此，不可久居于世。譬犹根本已竭，枝叶未即衰落，赤
如红霞满天者是也）
〔扁鹊、华佗〕病患耳目及颧颊赤者，死在五日中。黑色出于庭，大如母指，必不病而卒
死（全文见暴死。额中也）。病患黑出于额上发际，下直鼻脊两颧上者，亦死在五日中。病患
黑气出天中，下至年上颧上者，死。病患及健人，或黑色及白色起入目及鼻口者，死在三日
中。病患耳目鼻口有黑色起入于口者，必死。病患面黑，两胁下满，不能自转反者，死。病
人面黑唇青者，死。病患面青唇黑者，死。病患及健人面忽如马肝色，望之如青，近之如焦
黑者，死。病患面无精光若土色，不受饮食者，四日死。病患目无精光，及牙齿黑色者，不
治。
〔《素》〕五邪所见，春得秋脉，夏得冬脉，长夏得春脉，秋得夏脉，冬得长夏脉，是谓
五邪，皆同命，死不治（《宣明五气篇》。仲景云∶二月得毛脉，何以言至秋当死？答曰∶二
月之时脉当濡弱，反得毛浮者，故知至秋死。二月肝用事，肝脉属木，应濡弱反得毛脉者，
是肺脉也。肺属金，金来克木，故知死是也）。春胃微弦曰平，弦多胃少曰肝病，但弦无胃
曰死。胃而有毛曰秋病，毛甚曰今病，藏真散于肝，肝藏筋脉之气也。平肝脉来， 弱招招
，如揭长竿末梢，曰肝平，春以胃气为本。病肝脉来，盈实而滑，如循长竿，曰肝病，死。
肝脉来，急益劲，如新张弓弦，曰肝死。
夏胃微钩曰平，钩多胃少曰心病，但钩无胃曰死。胃而有石曰冬病，石甚曰今病。藏真
通于心，心藏血脉之气也。平心脉来，累累如连珠，如循琅 ，曰心平，夏以胃气为本。病
心脉来，喘喘连属，其中微曲曰心病。死心脉来，前曲后居，如操带钩，曰心死。
秋胃微毛曰平，毛多胃少曰肺病，但毛无胃曰死。毛而有弦曰春病，弦甚曰今病。藏真
高于肺，以行荣卫阴阳也。平肺脉来，厌厌聂聂，如落榆荚，曰肺平，秋以胃气为本。病肺
脉来，不上不下，如循鸡羽，曰肺病。死肺脉来，如物之浮，如风吹毛，曰肺死。
冬胃微石曰平，石多胃少曰肾病，但石无胃曰死。石而有钩曰夏病，钩甚曰今病。藏真
下于肾，肾藏骨髓之气也。平肾脉来，喘喘累累如钩，按之而坚，曰肾平，冬以胃气为本。
病肾脉来，如引葛，按之益坚，曰肾病。死肾脉来，发如夺索，辟辟如弹石，曰肾死。
长夏胃微 弱曰平，弱多胃少曰脾病，但代无胃曰死。 弱有石曰冬病，弱甚曰今病。
藏真濡于脾，脾藏肌肉之气也。平脾脉来，和柔相离，如鸡践地，曰脾平，长夏以胃气为本
。病脾脉来，实而盈数，如鸡举足，曰脾病。死脾脉来，锐坚如乌之啄，如鸟之距，如屋之
漏，如水之流，曰脾死。（以上并见《平人气象论》）
真肝脉至，中外急。如循刀刃，责责然，如按琴瑟弦，色青白不泽，毛折乃死（仲景云
∶肝死藏，浮之弱，按之如索不来，或曲如蛇形者死）。真心脉至，坚而搏，如循薏苡子累
累然，色赤黑不泽，毛折乃死（仲景云∶心死藏，浮之脉实如豆麻击手，按之益躁疾者死）。
真肺脉至，大而虚，如以毛羽中人肤，色白赤不泽，毛折乃死（仲景云∶肺死藏，浮之虚，
按之弱，如葱叶下无根者死）。真肾脉至，搏而绝，如指弹石辟辟然，色黑黄不泽，毛折乃
死（仲景云∶肾死藏，浮之坚，按之乱如转丸，益下入尺中者死）。真脾脉至，弱而乍疏乍数
，色黄青不泽，毛折乃死（仲景云∶脾死藏，浮之大坚，按之中如覆杯，洁洁然如
摇者死）。诸真藏脉见，皆为死不治也。黄帝曰∶见真藏曰死，何也？岐伯曰∶五脏者皆禀气
于胃，胃者五脏之本也。脏气者，不能自致于手太阴，必因于胃气乃至于手太阴也，故五脏
各以其时，自为而至于手太阴也。故邪气胜者，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。独见者病胜藏也，故曰死（以上并《玉机真藏篇》）。人以水谷为
本，故人绝水谷则死。脉无胃气亦死，所谓无胃气者，但得真藏脉不得胃气也（《平人气象
论》）。所谓阴者，真藏也，见则为败，败必死也。所谓阳者，胃脘之阳也（《阴阳别论》）
。凡持真脉之藏脉者，肝至悬绝急，十八日死。心至悬绝，九日死。肺至悬绝，十二日死。
肾至悬绝，七日死。脾至悬绝，四日死。（同上）
〔仲〕寸脉下不至关为阳绝，尺脉上不至关为阴绝，此皆不治，决死也。若计其余命死生
之期，以月节克之也（王注云∶阳绝死于春夏，阴绝死于秋冬，此言甚应）。
〔《灵》〕∶所谓五十荣者，五脏皆受气，持其脉口，数其至也。五十动而不一代者，五脏
皆受气。四十动一代者，一脏无气（《脉经》云∶却后四岁，春草生而死）。三十动一代者，
二脏无气（《脉经》云∶却后三岁，麦熟而死）。二十动一代者，三脏无气（《脉经》云∶却
后二岁，桑椹赤而死）。十动一代者，四脏无气（《脉经》云∶岁中死，得节不动出清明日
死，远不出谷雨死矣）。不满十动一代者，五脏无气（《脉经》云∶却后五日死）。予之短期
，要在终始。所谓五十动而不一代者，以为常也。以知五脏之期，予之短期者，乍数乍疏也
。（《根结篇》）
〔《难经》〕云∶脉不满五十动而一止，一脏无气者，何脏也？然，人吸者，随阴入；呼者
，因阳出。今吸不能至肾，至肝而还，故知一脏无气者，肾气先尽也。
〔仲〕∶按脉之来缓而时一止复来者，名曰结，阴也。又脉来动而中止，更来小数，中有还
者及动，名曰促，阳也。脉来动而中止，不能自还者，动而中止，复来如前，名曰代，阴也
。得此脉者，必难治。
自还者，动而中止复来，数于前动也。不能自还者，动而中止，复来如前，动同而不数
也。
〔《活》〕有结脉，有促脉，有代脉。结者，阴也，阴盛则结，脉来缓，时一止复来曰结
，主胸满烦躁。促者，阳也，阳盛则促脉来数，时一止复来曰促，主积聚气痞，忧思所成。
大抵结促之脉，虽时一止，为病脉，非死脉也。唯代脉者，真死矣。往来缓动，中止不能自
还，因而复动，名曰代也，代者，死也。仲景伤寒脉结代，心动悸，炙甘草汤主之。
〔《脉》〕热病脉四至，三日死。脉四至者，平人一至，病患脉四至也。热病脉五至，一
日死。时一大至，半日死。忽忽闷乱者，死。热病脉六至，半日死。忽忽疾大至，有顷死。
热病脉四损，三日死。所谓四损者，平人四至，病患脉一至，名曰四损。热病脉五损，一日
死。所谓五损者，平人脉五至，病患脉一至，名曰五损。热病脉六损，一时死。所谓六损者
，平人脉六至，病患脉一至，名曰六损。若绝不至，良久乃至，立死。
〔《脉》〕平人不病，脉来如屋漏雀啄者，死（此脾真藏脉也。王注云∶屋漏者，其来既
绝而止，时时复起而不相连属也。雀啄者，如啄米甚数频来是也）。脉来如弹石，去如解索
者，死（此肾真藏脉也。王注云∶弹石者，辟辟急也。解索者，动数而随散乱无复次第也）。
病患脉如虾之游，如鱼之翔者，死（王注云∶虾游者，冉冉而起，寻复退没不知所至，久乃
复起，起辄迟而没去速者是也。鱼翔者，似鱼不行，而但掉尾动头身摇而久住者是也）。脉
如转豆者，死。脉如偃刀者，死。脉涌涌不去者，死。脉忽去忽来暂止复来者，死。脉分绝
【《素问》】凡是治病，必须观察病人的形体与正气、面色光泽、脉搏的强弱盛衰，以及疾病的新久，然后进行治疗，不要错过最佳时机。如果形体与正气相协调，称为可治。面色光泽明润，称为容易痊愈。脉象顺应四季变化，称为可治。脉象弱而滑利，说明有胃气，命名为易治，治疗要把握时机。如果形体与正气不相协调，称为难治。面色枯槁无光泽，称为难以痊愈。脉象实而坚劲，称为病情加重。脉象违背四季规律，称为不可治，必须仔细审查这四种难治的情况并明确告知病人。所谓违背四季规律，是指春季出现肺脉（毛脉），夏季出现肾脉（石脉），秋季出现心脉（钩脉），冬季出现脾脉（代脉）。这些脉象如果都表现为悬绝沉涩，就叫做违背四季规律（出自《玉机真脏论》）。
正气充实则形体壮实，正气虚弱则形体消瘦，这是正常情况，与此相反的就是病态。饮食充足则正气旺盛，饮食匮乏则正气虚弱，这是正常情况，与此相反的就是病态。脉象盛大则血液充盈，脉象虚弱则血液亏虚，这是正常情况，与此相反的就是病态（出自《刺志论》）。正气虚弱却身体发热，这叫反常。饮食摄入多但正气少，这叫反常。饮食摄入少但正气多，这叫反常。脉象盛大但血液少，这叫反常。脉象微弱但血液多，这叫反常。正气旺盛却身体发冷，是由于感受寒邪所致。正气虚弱却身体发热，是由于感受暑邪所致。饮食摄入多但正气少的，是由于失血或湿气滞留下部所致。饮食摄入少但正气多的，是由于邪气在胃和肺所致。脉象微弱但血液多的，是由于体内有热饮所致。脉象大但血液少的，是由于脉中有风邪，且水浆不能入口，说的就是这种情况（同上篇）。
形体壮盛但脉象细微，气息短促不足以呼吸的，危险。形体疲惫但脉象洪大，胸中气盛的，死亡。形体与正气相协调的，能生；参互不调的，生病；三部九候脉象都失常的，死亡。上下左右脉象相应如舂米般节奏一致的，病情严重；上下左右脉象失调无法计数的，死亡。中部脉象虽然单独调和，但与其余脏腑脉象失调的，死亡。中部脉象减弱的，死亡。眼睛内陷的，死亡（全文见前文上下条，下同）。肌肉已经脱消，即使九候脉象调和，仍然死亡。
【《灵枢》】热病脉象安静，汗出之后，脉象反而盛大躁动，这是一逆。患泄泻病，脉象洪大，这是二逆。着痹症疼痛固定不移，肌肉溃破，身体发热，脉象一侧断绝，这是三逆。淫邪导致形体消瘦，身体发热，面色枯白，随后下血，血色深重，这叫四逆。寒热导致形体消瘦，脉象坚硬搏指，这叫五逆。（出自《五禁篇》。“䐜”，音渠损切，指肘膝后方肌肉隆起如块状）
腹部胀满，身体发热，脉象盛大，是一逆。腹中鸣响且胀满，四肢清冷泄泻，脉象盛大，是二逆。鼻出血不止，脉象盛大，是三逆。咳嗽且小便带血，形体脱消，脉象小而强劲，是四逆。咳嗽形体脱消，身体发热，脉象小且疾速，这叫五逆。像这样的病症，不超过十五天就会死亡。腹部胀大，四肢清冷，形体脱消，泄泻严重，是一逆。腹部胀满伴大便出血，脉象盛大，时而断绝，是二逆。咳嗽小便带血，形体肌肉脱消，脉象搏指有力，是三逆。呕血，胸部胀满牵引背部，脉象小而疾速，是四逆。咳嗽呕吐，腹部胀满且完谷不化的泄泻，脉象断绝，是五逆。像这样的病症，不到一个时辰就会死亡。医生如果不察知这些情况而进行针刺，叫做逆治。（出自《玉版篇》。“搏”，音蒲谷切）
【《素问》】发热而脉象安静，泄泻且失血，脉象实，病在内；脉象虚，病在外；脉象坚涩的，都难治。（出自《平人气象论》）
【张仲景】脉象说：脉象有病而人没有病，叫做“行尸”，因为没有旺盛的正气。突然眩晕跌倒不识人的，寿命短则会死。人有病而脉象没有病，叫做“内虚”，因为有正气，虽然困顿但没有痛苦。左边有病右边痛，右边有病左边痛，下面有病上面痛，上面有病下面痛，这叫逆，逆者死，不可治。肥胖的人脉象细小如丝，欲断绝的，死。消瘦的人脉象躁动的，死。人体感觉涩滞而脉象往来滑利的，死。人体瘦小但脉象往来大的，死。人体高大但脉象往来小的，死。人体短小但脉象来去长的，死。人体高大但脉象来去短的，死。人体滑利但脉象往来涩滞的，死。
【《素问》】五脏是体内的守御者。如果中焦壅盛，脏腑胀满，气盛伤及惊恐，说话声音像在室内一样沉闷，这是中气湿阻。说话声音微弱，整天才说几句话，这是夺气。穿衣盖被不当，言语不分善恶、不顾亲疏，这是神明混乱。仓廪（脾胃）不能藏纳，是幽门阑门约束失职。水泉（尿液）不止，是膀胱不能固藏。能够守住正气的，生；失去守御能力的，死（出自《脉要精微论》）。五脏是身体强健的根本。头是精神的外府，头倾视深，精神将要耗竭。背是胸中之府，背曲肩垂，府将败坏。腰是肾之府，转动摇动困难，肾将疲惫。膝是筋之府，屈伸困难，行走时弯腰俯身，筋将疲惫。骨是髓之府，不能久立，行走时颤抖摇晃，骨将疲惫。能够保持强健的，生；失去强健的，死（同上篇）。
五脏之气，所以面色呈现青如死草的，死；黄如枳实的，死；黑如煤灰的，死；赤如凝血块的，死；白如枯骨的，死，这是五色呈现的死征（出自《五脏生成篇》。“炲”，音芳杯切，指凝结的血块）。青如翠鸟羽毛的，生；赤如鸡冠的，生；黄如蟹腹的，生；白如猪油的，生；黑如乌鸦羽毛的，生，这是五色呈现的生征（同上）。生于心的颜色像白绢裹着朱砂，生于肺的颜色像白绢裹着红，生于肝的颜色像白绢裹着青，生于脾的颜色像白绢裹着栝楼实，生于肾的颜色像白绢裹着紫，这是五脏所生的外部荣华表现（同上）。精明五色，是气的精华。红色想要像白绢裹着朱砂，不想要像赭石。白色想要像鹅羽，不想要像盐。青色想要像苍璧的光泽，不想要像蓝靛。黄色想要像罗纱裹着雄黄，不想要像黄土。黑色想要像重漆色，不想要像地苍。（出自《脉要精微论》）
【《素问》】面黄目青，面黄目赤，面黄目白，面黄目黑的，都不死。面青目赤，面赤目白，面青目黑，面黑目白，面赤目青，都死。（王冰注云：凡色见黄的，是有胃气，故不死。五脏以胃为本，所以没有黄色的都自死焉。出自《五脏生成篇》）
华佗说：病患面青目白的，死。病患面青目黄的，五日死。病患卧床不起，心痛短气，脾竭内伤的，百日后痊愈。如果能起身徘徊，随即坐于地上，站立倚靠床铺，能治好这种病的，可谓神良。病患面赤目白的，十日死，因忧恚思虑，心气内索，面色反而好转，应急忙准备棺椁。病患面赤目青的，六日死。病患面黑目白的，八日死，肾气内伤，病因留积。病患面黑，目直视，恶风的，死。病患面白目黑的，死，这叫荣华已去，血脉空虚。红色出现在两颧，大如拇指的，病虽小愈，必卒然死亡。（全文见暴死篇。颧，即额骨。东垣曰：《脉诀》言面赤如妆不久居。面显赤色于两颊，若涂胭脂之状，而又圆也。病至于此，不可久居于世。譬犹根本已竭，枝叶未即衰落，赤如红霞满天者是也）
【扁鹊、华佗】病患耳目及颧颊发红的，死在五日内。黑色出现在天庭（额头中央），大如拇指，必定不是病而卒死（全文见暴死篇。庭，指额中也）。病患黑色从额上发际出现，向下直抵鼻脊两颧上方，也死在五日内。病患黑气从天中（印堂）出现，下到年上（鼻准）、颧上，死。病患及健康人，或黑色及白色进入目及鼻口者，死在三日内。病患耳目鼻口有黑色进入口中，必死。病患面黑，两胁下满，不能自行转身反侧的，死。病人面黑唇青的，死。病患面青唇黑的，死。病患及健康人面忽如马肝色，远看如青，近看如焦黑的，死。病患面无精光若土色，不受饮食的，四日死。病患目无精光，及牙齿黑色的，不治。
【《素问】所见到的五种邪脉，春季得秋脉，夏季得冬脉，长夏得春脉，秋季得夏脉，冬季得长夏脉，这叫五邪，都同属命绝，死不治（出自《宣明五气篇》。仲景云：二月得毛脉，何以言至秋当死？答曰：二月之时脉当濡弱，反得毛浮者，故知至秋死。二月肝用事，肝脉属木，应濡弱反得毛脉者，是肺脉也。肺属金，金来克木，故知死是也）。
春季脉象微弦而有胃气叫平，弦多胃少叫肝病，只有弦而无胃气叫死。胃气而有毛脉，叫秋季病，毛脉甚叫当前病。脏真之气散于肝，肝藏筋脉之气。平肝脉来，软弱招招，如揭长竿末梢，叫肝平，春以胃气为本。病肝脉来，盈实而滑，如循长竿，叫肝病，死。肝脉来，急益劲，如新张弓弦，叫肝死。
夏季脉象微钩而有胃气叫平，钩多胃少叫心病，只有钩而无胃气叫死。胃气而有石脉，叫冬季病，石脉甚叫当前病。脏真之气通于心，心藏血脉之气。平心脉来，累累如连珠，如循琅玕，叫心平，夏以胃气为本。病心脉来，喘喘连属，其中微曲叫心病。死心脉来，前曲后居，如操带钩，叫心死。
秋季脉象微毛而有胃气叫平，毛多胃少叫肺病，只有毛而无胃气叫死。毛脉而有弦脉，叫春季病，弦脉甚叫当前病。脏真之气高于肺，以行营卫阴阳。平肺脉来，厌厌聂聂，如落榆荚，叫肺平，秋以胃气为本。病肺脉来，不上不下，如循鸡羽，叫肺病。死肺脉来，如物之浮，如风吹毛，叫肺死。
冬季脉象微石而有胃气叫平，石多胃少叫肾病，只有石而无胃气叫死。石脉而有钩脉，叫夏季病，钩脉甚叫当前病。脏真之气下于肾，肾藏骨髓之气。平肾脉来，喘喘累累如钩，按之而坚，叫肾平，冬以胃气为本。病肾脉来，如引葛，按之益坚，叫肾病。死肾脉来，发如夺索，辟辟如弹石，叫肾死。
长夏脉象微弱而有胃气叫平，弱多胃少叫脾病，只有代脉而无胃气叫死。弱脉而有石脉，叫冬季病，弱脉甚叫当前病。脏真之气濡于脾，脾藏肌肉之气。平脾脉来，和柔相离，如鸡践地，叫脾平，长夏以胃气为本。病脾脉来，实而盈数，如鸡举足，叫脾病。死脾脉来，锐坚如乌之啄，如鸟之距，如屋之漏，如水之流，叫脾死。（以上并见《平人气象论》）
真肝脉至，中外紧急。如循刀刃，责责然，如按琴瑟弦，色青白不泽，毛发折落乃死（仲景云：肝死藏，浮之弱，按之如索不来，或曲如蛇形者死）。真心脉至，坚而搏，如循薏苡子累累然，色赤黑不泽，毛发折落乃死（仲景云：心死藏，浮之脉实如豆麻击手，按之益躁疾者死）。真肺脉至，大而虚，如以毛羽中人肤，色白赤不泽，毛发折落乃死（仲景云：肺死藏，浮之虚，按之弱，如葱叶下无根者死）。真肾脉至，搏而绝，如指弹石辟辟然，色黑黄不泽，毛发折落乃死（仲景云：肾死藏，浮之坚，按之乱如转丸，益下入尺中者死）。真脾脉至，弱而乍疏乍数，色黄青不泽，毛发折落乃死（仲景云：脾死藏，浮之大坚，按之中如覆杯，洁洁然如摇者死）。所有真脏脉出现，都是死证不治。黄帝曰：见到真脏脉就说死，为什么呢？岐伯曰：五脏都禀受气于胃，胃是五脏的根本。脏气不能自己到达手太阴肺经，必须依赖胃气才能到达手太阴，所以五脏各以其时令，自然至于手太阴。所以邪气胜者，精气衰也。所以病甚者，胃气不能与之俱至于手太阴，故真脏之气独见。独见者病胜藏也，所以说死（以上并《玉机真脏篇》）。人以水谷为本，故人绝水谷则死。脉无胃气亦死，所谓无胃气者，但得真脏脉不得胃气也（《平人气象论》）。所谓阴者，是真脏脉，见则为败，败必死也。所谓阳者，是胃脘之阳（《阴阳别论》）。凡是持真脉之藏脉者，肝至悬绝急，十八日死。心至悬绝，九日死。肺至悬绝，十二日死。肾至悬绝，七日死。脾至悬绝，四日死。（同上）
【张仲景】寸脉下不至关为阳绝，尺脉上不至关为阴绝，这都是不治之症，决断死期。如果要计算剩余寿命的死生之期，以月节克之（王注云：阳绝死于春夏，阴绝死于秋冬，此言甚应）。
【《灵枢】所谓五十荣者，五脏都受气，持其脉口，数其跳动次数。五十动而不一止的，五脏皆受气。四十动一止的，一脏无气（《脉经》云：四年后，春草生时死）。三十动一止的，二脏无气（《脉经》云：三年后，麦熟时死）。二十动一止的，三脏无气（《脉经》云：两年后，桑椹赤时死）。十动一止的，四脏无气（《脉经》云：当年死，逢节气不动出清明日死，远不出谷雨死矣）。不满十动一止的，五脏无气（《脉经》云：五日后死）。给予短期预后，关键在于始终。所谓五十动而不一止的，作为常态。以此知晓五脏之期，给予短期预后的，是脉象乍数乍疏。（《根结篇》）
【《难经】云：脉不满五十动而一止，一脏无气者，是哪一脏呢？回答说：人吸气时，随阴入；呼气时，因阳出。现在吸气不能至肾，至肝而还，故知一脏无气者，肾气先尽也。
【张仲景】按脉来缓而时一止复来的，名叫结，属阴。又脉来动而中止，更来小数，中有还者及动，名叫促，属阳。脉来动而中止，不能自还者，动而中止，复来如前，名叫代，属阴。得此脉者，必难治。
自还者，动而中止复来，次数多于前动。不能自还者，动而中止，复来如前，动同而不数也。
【《活人书】有结脉，有促脉，有代脉。结者，阴也，阴盛则结，脉来缓，时一止复来曰结，主胸满烦躁。促者，阳也，阳盛则促，脉来数，时一止复来曰促，主积聚气痞，忧思所成。大抵结促之脉，虽时一止，为病脉，非死脉也。唯代脉者，真死矣。往来缓动，中止不能自还，因而复动，名叫代也，代者，死也。仲景伤寒脉结代，心动悸，炙甘草汤主之。
【《脉经】热病脉四至，三日死。脉四至者，平人一至，病患脉四至也。热病脉五至，一日死。时一大至，半日死。忽忽闷乱者，死。热病脉六至，半日死。忽忽疾大至，有顷死。热病脉四损，三日死。所谓四损者，平人四至，病患脉一至，名叫四损。热病脉五损，一日死。所谓五损者，平人脉五至，病患脉一至，名叫五损。热病脉六损，一时死。所谓六损者，平人脉六至，病患脉一至，名叫六损。若绝不至，良久乃至，立死。
【《脉经】平人不病，脉来如屋漏雀啄的，死（此脾真脏脉也。王注云：屋漏者，其来既绝而止，时时复起而不相连属也。雀啄者，如啄米甚数频来是也）。脉来如弹石，去如解索的，死（此肾真脏脉也。王注云：弹石者，辟辟急也。解索者，动数而随散乱无复次第也）。病患脉如虾之游，如鱼之翔的，死（王注云：虾游者，冉冉而起，寻复退没不知所至，久乃复起，起辄迟而没去速者是也。鱼翔者，似鱼不行，而但掉尾动头身摇而久住者是也）。脉如转豆的，死。脉如偃刀的，死。脉涌涌不去的，死。脉忽去忽来暂止复来的，死。脉分绝
[Suwen] In treating any disease, one must observe the patient's physical constitution and Zhengqi (vital energy), facial luster, pulse strength and fullness, as well as the novelty or chronicity of the disease, before initiating treatment, without delaying the opportune moment. If the physical constitution and Zhengqi are harmonious, it is termed treatable. If the facial color is bright and lustrous, it is termed easily curable. If the pulse conforms to the four seasons, it is termed treatable. A weak and slippery pulse indicates the presence of Stomach Qi (the vital energy derived from food and drink that sustains life), named easily treated, and treatment should be timed appropriately. If the physical constitution and Zhengqi are discordant, it is termed difficult to treat. If the complexion is dull and lacks luster, it is termed difficult to cure. A solid and hard pulse indicates worsening condition. A pulse that violates the laws of the four seasons is termed untreatable; one must carefully examine these four difficult conditions and clearly inform the patient. What is meant by violating the four seasons is: obtaining a Lung Pulse (Hairy/Mao pulse) in Spring, a Kidney Pulse (Stone/Shi pulse) in Summer, a Heart Pulse (Hook/Gou pulse) in Autumn, and a Spleen Pulse (Wavy/Dai pulse) in Winter. If these pulses are all suspended, extreme, deep, and choppy, they are called violating the four seasons (from *Yu Ji Zhen Zang Lun*). When Zhengqi is excess, the body is robust; when Zhengqi is deficient, the body is emaciated; this is the norm. The opposite indicates disease. Abundant food intake leads to abundant Zhengqi; scant food intake leads to scant Zhengqi; this is the norm. The opposite indicates disease. A full pulse corresponds to abundant blood; a deficient pulse corresponds to deficient blood; this is the norm. The opposite indicates disease (from *Ci Zhi Lun*). Deficient Zhengqi with body heat is called contrary. Abundant food intake but scant Zhengqi is called contrary. Scant food intake but abundant Zhengqi is called contrary. Full pulse but scant blood is called contrary. Weak pulse but abundant blood is called contrary. Excess Zhengqi with cold body is caused by Cold Injury (Shang Han). Deficient Zhengqi with body heat is caused by Summerheat Injury (Shang Shu). Abundant food intake but scant Zhengqi is caused by blood loss or dampness residing in the lower jiao. Scant food intake but abundant Zhengqi is caused by pathogenic factors in the Stomach and Lungs. Weak pulse but abundant blood is caused by internal heat from drinking. Full pulse but scant blood is caused by wind pathogen in the vessels and inability to ingest fluids, as described above (ibid.). Robust physique with fine pulse, shortness of breath insufficient for respiration, is critical. Emaciated physique with large pulse, excessive qi in the chest, is death. Harmonious physique and Zhengqi indicate life; discordant interplay indicates disease; loss of harmony in all three positions and nine inspections indicates death. Pulses at upper, lower, left, and right corresponding rhythmically like pestle pounding indicate severe disease; pulses at upper, lower, left, and right being discordant and uncountable indicate death. Although the central pulse alone may be harmonious, if it is discordant with the other zang organs, it indicates death. Diminution of the central pulse indicates death. Sunken eyes indicate death (full text see previous sections on upper and lower lines, same below). Even if the nine pulses are harmonious after muscle wasting has occurred, death ensues.
[Ling Shu] In heat diseases, if the pulse is quiet, but becomes盛大 and restless after sweating, this is the first reversal (Ni). In diarrhea, if the pulse is洪大 (Hongda/large and forceful), this is the second reversal. In fixed Bi syndrome with immobility, muscle erosion, body heat, and unilateral pulse absence, this is the third reversal. In depletion due to excessive pathogens with emaciation, body heat, pale and dull complexion, followed by heavy bloody stool, this is called the fourth reversal. In emaciation due to alternating cold and heat with a firm and beating pulse, this is called the fifth reversal. (From *Wu Jin Pian*. "Cheng" is pronounced 'qu sun', referring to flesh masses behind elbows and knees).
Abdominal distension, body heat, and large pulse constitute the first reversal. Abdominal borborygmi and fullness, cold extremities with diarrhea, and large pulse constitute the second reversal. Unstopping epistaxis with large pulse constitutes the third reversal. Coughing with hematuria, emaciation, and small yet vigorous pulse constitute the fourth reversal. Coughing with emaciation, body heat, and small yet rapid pulse constitute the fifth reversal. Such cases result in death within fifteen days. Abdominal distension, cold extremities, emaciation, and severe diarrhea constitute the first reversal. Abdominal distension with hematochezia, large pulse, and intermittent absence constitute the second reversal. Coughing with hematuria, muscle wasting, and beating pulse constitute the third reversal. Hematemesis with chest fullness radiating to the back, and small yet rapid pulse constitute the fourth reversal. Coughing, vomiting, abdominal distension, and undigested stool diarrhea with absent pulse constitute the fifth reversal. Such cases result in death within less than one shichen (two hours). If physicians fail to observe these and apply acupuncture, it is called reverse treatment. (From *Yu Ban Pian*. "Bo" is pronounced 'pu gu').
[Suwen] Heat with quiet pulse, diarrhea with blood loss, full pulse indicating interior disease, empty pulse indicating exterior disease, and firm-choppy pulse indicating difficulty in treatment are all noted. (From *Ping Ren Qi Xiang Lun*)
[Zhang Zhongjing] The pulse states: When the pulse shows pathology but the person does not, it is called "Walking Corpse" due to lack of vigorous Qi. Sudden dizziness and collapse with unconsciousness indicates short lifespan and death. When the person is ill but the pulse is normal, it is called "Interior Deficiency"; because there is righteous Qi, although distressed, there is no suffering. Left-sided pathology causing right-sided pain, right-sided pathology causing left-sided pain, lower pathology causing upper pain, upper pathology causing lower pain, this is called Reverse; Reverse means death, untreatable. In obese persons, a pulse fine as silk and nearly absent indicates death. In emaciated persons, a restless pulse indicates death. In persons feeling rough/stagnant but with a smooth pulse flow, death occurs. In small persons with a large pulse flow, death occurs. In large persons with a small pulse flow, death occurs. In short persons with a long pulse flow, death occurs. In tall persons with a short pulse flow, death occurs. In smooth persons with a choppy pulse flow, death occurs.
[Suwen] The Five Zang organs are the guardians within. If the middle jiao is full and stagnant, with Qi excess injuring fearfulness, speech sounding muffled as if from inside a room, this is dampness obstructing Middle Qi. Speech that is faint, repeating only after a whole day, indicates Qi depletion. Inability to dress warmly or coolly appropriately, and speech lacking discrimination between good/evil or kin/stranger, indicates confusion of Shen Ming (Spirit-Mind). Inability of the Granary (Spleen/Stomach) to store indicates failure of the gates (sphincters) to control. Unceasing urination indicates Bladder failure to store. Those who maintain guardianship live; those who lose it die. (From *Mai Yao Jing Wei Lun*). The Five Zang organs are the strength of the body. The head is the mansion of Spirit; head drooping and deep-set eyes indicate Spirit depletion. The back is the mansion of the Chest; curved back and drooping shoulders indicate mansion destruction. The waist is the mansion of the Kidney; inability to twist and turn indicates Kidney exhaustion. The knees are the mansion of Sinews; inability to flex and extend, stooping while walking, indicates Sinew exhaustion. The bones are the mansion of Marrow; inability to stand long, trembling while walking, indicates Bone exhaustion. Those who retain strength live; those who lose strength die. (Ibid.). Regarding colors manifesting from Zang Qi: Green like dead grass indicates death; Yellow like Fructus Aurantii Immaturus indicates death; Black like soot indicates death; Red like clotted blood indicates death; White like dry bone indicates death; these are the death signs of the five colors. (From *Wu Zang Sheng Cheng Pian*. "Tai" is pronounced 'fang bei', meaning clotted blood). Green like kingfisher feathers indicates life; Red like chicken comb indicates life; Yellow like crab belly indicates life; White like pig fat indicates life; Black like crow feathers indicates life; these are the life signs of the five colors. (Ibid.). Life in the Heart resembles white silk wrapping cinnabar; Life in the Lung resembles white silk wrapping red; Life in the Liver resembles white silk wrapping cyan; Life in the Spleen resembles white silk wrapping Trichosanthes fruit; Life in the Kidney resembles white silk wrapping purple; these are the external glory generated by the Five Zang. (Ibid.). Brightness and five colors are the splendor of Qi. Red should resemble white silk wrapping cinnabar, not ochre. White should resemble goose feathers, not salt. Green should resemble the luster of dark jade, not indigo. Yellow should resemble silk wrapping realgar, not yellow earth. Black should resemble double-lacquered color, not earthy gray. (From *Mai Yao Jing Wei Lun*).
Hua Tuo stated: If the patient's face and eyes show uniform coloration, they will not die.
[Suwen] Face yellow with eye green, face yellow with eye red, face yellow with eye white, face yellow with eye black—all do not die. Face green with eye red, face red with eye white, face green with eye black, face black with eye white, face red with eye green—all die. (Wang Bing notes: Any color showing yellow indicates Stomach Qi, thus not dying. The Five Zang take the Stomach as root; thus, absence of yellow leads to self-death. From *Wu Zang Sheng Cheng Pian*).
Hua Tuo stated: Patient with green face and white eyes dies. Patient with green face and yellow eyes dies in five days. Patient bedridden with heart pain and shortness of breath, Spleen exhaustion and internal injury, recovers after one hundred days. If able to rise and pace, then sit on ground, stand leaning on bed, such cases can be cured by divine skill. Patient with red face and white eyes dies in ten days; due to worry and anxiety, Heart Qi is internally depleted, yet facial color appears good; prepare coffin immediately. Patient with red face and green eyes dies in six days. Patient with black face and white eyes dies in eight days; Kidney Qi internally injured, pathogen retained. Patient with black face, staring eyes, and aversion to wind dies. Patient with white face and black eyes dies; this signifies loss of glory and emptiness of blood vessels. Red appearing on both cheekbones, size of a thumb, indicates that even if the disease slightly improves, sudden death will follow. (Full text see Sudden Death section. Quan refers to cheekbone. Dong Yuan said: *Mai Jue* states face red like makeup implies short life. Redness appears on cheeks like rouge, round. Disease reaching this state cannot last long. Like roots exhausted but branches not yet withered, red like rosy clouds filling the sky).
[Bian Que, Hua Tuo] Patient with red ears, eyes, and cheekbones dies within five days. Black appearing in the Tian Ting (center of forehead), size of a thumb, indicates non-disease sudden death. (Full text see Sudden Death. Ting is center of forehead). Black appearing from hairline on forehead, straight down to nose bridge and above cheekbones, also dies within five days. Black Qi appearing from Tian Zhong (Yintang), descending to Nian Shang (tip of nose) and above cheekbones, indicates death. Patient or healthy person with black or white color entering eyes, nose, or mouth dies within three days. Black appearing in ears, eyes, nose, mouth entering the mouth indicates inevitable death. Patient with black face, fullness under both hypochondria, inability to turn over, dies. Patient with black face and blue lips dies. Patient with green face and black lips dies. Patient or healthy person with sudden liver-colored face, looking green from afar, black scorched up close, dies. Patient with face lacking luster, earthy color, unable to eat, dies in four days. Patient with eyes lacking luster and black teeth is incurable.
[Suwen] The five pathological pulses seen are: Autumn pulse in Spring, Winter pulse in Summer, Spring pulse in Late Summer, Summer pulse in Autumn, Late Summer pulse in Winter; these are called Five Evils, all leading to death and untreatable. (From *Xuan Ming Wu Qi Pian*. Zhongjing said: Why say death in autumn if Mao pulse is obtained in February? Answer: In February, pulse should be soft and weak; obtaining floating Mao pulse indicates death in autumn. February governs Liver Wood; Liver pulse should be soft/weak. Obtaining Mao pulse (Lung/Metal) indicates Metal overcoming Wood, hence death). Spring pulse slightly wiry with Stomach Qi is Ping (Normal); Wiry exceeding Stomach Qi indicates Liver disease; Only wiry without Stomach Qi indicates death. Stomach Qi with Mao pulse indicates Autumn disease; Excessive Mao pulse indicates current disease. True Zang Qi scatters to Liver, which stores Sinew-Vessel Qi. Normal Liver pulse comes soft and waving, like holding the tip of a long pole, called Liver Ping, Spring relies on Stomach Qi. Diseased Liver pulse comes full, solid, and slippery, like tracing a long pole, called Liver disease, death. Liver pulse coming urgent and strong, like a newly strung bowstring, called Liver death.
Summer pulse slightly hook-shaped with Stomach Qi is Ping; Hook exceeding Stomach Qi indicates Heart disease; Only hook without Stomach Qi indicates death. Stomach Qi with Shi (Stone/Kidney) pulse indicates Winter disease; Excessive Shi pulse indicates current disease. True Zang Qi connects to Heart, which stores Blood-Vessel Qi. Normal Heart pulse comes continuous like pearls, like tracing Langgan jade, called Heart Ping, Summer relies on Stomach Qi. Diseased Heart pulse comes panting and connected, slightly curved inside, called Heart disease. Dead Heart pulse comes curved front and rigid back, like handling a belt hook, called Heart death.
Autumn pulse slightly hairy with Stomach Qi is Ping; Hairy exceeding Stomach Qi indicates Lung disease; Only hairy without Stomach Qi indicates death. Mao pulse with Wiriness indicates Spring disease; Excessive Wiriness indicates current disease. True Zang Qi rises high in Lung to circulate Ying and Wei, Yin and Yang. Normal Lung pulse comes gentle and fluttering, like falling elm seeds, called Lung Ping, Autumn relies on Stomach Qi. Diseased Lung pulse comes neither rising nor falling, like tracing chicken feather, called Lung disease. Dead Lung pulse comes floating like an object, like wind blowing hair, called Lung death.
Winter pulse slightly stone-like with Stomach Qi is Ping; Stone exceeding Stomach Qi indicates Kidney disease; Only stone without Stomach Qi indicates death. Shi pulse with Hook indicates Summer disease; Excessive Hook indicates current disease. True Zang Qi descends to Kidney, which stores Marrow-Bone Qi. Normal Kidney pulse comes continuous like a hook, firm upon pressure, called Kidney Ping, Winter relies on Stomach Qi. Diseased Kidney pulse comes like pulling vines, firmer upon pressure, called Kidney disease. Dead Kidney pulse comes like seizing a rope, cracking like striking stone, called Kidney death.
Late Summer pulse slightly weak with Stomach Qi is Ping; Weak exceeding Stomach Qi indicates Spleen disease; Only Dai (Intermittent) without Stomach Qi indicates death. Weak pulse with Stone indicates Winter disease; Excessive Weak indicates current disease. True Zang Qi moistens Spleen, which stores Muscle Qi. Normal Spleen pulse comes harmonious and distinct, like chicken stepping on ground, called Spleen Ping, Late Summer relies on Stomach Qi. Diseased Spleen pulse comes solid, full, and rapid, like chicken lifting foot, called Spleen disease. Dead Spleen pulse comes sharp and hard like bird pecking, like bird claw, like roof leak, like flowing water, called Spleen death. (All above from *Ping Ren Qi Xiang Lun*).
True Liver pulse arrives tense inside and out. Like tracing knife edge, crisp, like pressing lute strings, color cyan-white without luster, hair falls off then death. (Zhongjing said: Liver death organ, superficially weak, pressing like a cord not returning, or curved like snake shape indicates death). True Heart pulse arrives firm and beating, like tracing Coix seeds continuously, color red-black without luster, hair falls off then death. (Zhongjing said: Heart death organ, superficially solid like bean/hemp hitting hand, pressing increasingly restless indicates death). True Lung pulse arrives large and empty, like feather penetrating skin, color white-red without luster, hair falls off then death. (Zhongjing said: Lung death organ, superficially empty, pressing weak like scallion leaf without root indicates death). True Kidney pulse arrives beating and severed, like finger striking stone cracking, color black-yellow without luster, hair falls off then death. (Zhongjing said: Kidney death organ, superficially firm, pressing chaotic like rolling ball, sinking into Chi position indicates death). True Spleen pulse arrives weak and intermittently sparse/rapid, color yellow-cyan without luster, hair falls off then death. (Zhongjing said: Spleen death organ, superficially large/firm, pressing inside like inverted cup, clean/shaking indicates death). All True Zang pulses appearing indicate death untreatable. Yellow帝 asked: Seeing True Zang means death, why? Qi Bo answered: Five Zang all receive Qi from Stomach; Stomach is root of Five Zang. Zang Qi cannot reach Hand Taiyin independently; it must rely on Stomach Qi to reach Hand Taiyin. Thus, each Zang naturally reaches Hand Taiyin at its respective season. Therefore, when Pathogenic Qi wins, Essence Qi declines. In severe disease, Stomach Qi cannot accompany Zang Qi to Hand Taiyin, so True Zang Qi appears alone. Appearing alone means disease overwhelms Zang, hence death. (Above from *Yu Ji Zhen Zang Pian*). Humans rely on Water and Grain as root; thus, humans cut off from Water and Grain die. Pulse without Stomach Qi also dies; what is called no Stomach Qi is obtaining only True Zang pulse without Stomach Qi (*Ping Ren Qi Xiang Lun*). What is called Yin is True Zang; appearing indicates ruin, ruin means death. What is called Yang is the Yang of Stomach Fu (*Yin Yang Bie Lun*). Generally, holding True Pulse of Zang: Liver suspension extreme urgent, dies in 18 days. Heart suspension extreme, dies in 9 days. Lung suspension extreme, dies in 12 days. Kidney suspension extreme, dies in 7 days. Spleen suspension extreme, dies in 4 days. (Ibid.)
[Zhang Zhongjing] Cun pulse not reaching Guan below is Yang Absolute; Chi pulse not reaching Guan above is Yin Absolute; these are all untreatable, determining death. If calculating remaining life span, use Month/Jie overcoming. (Wang note: Yang Absolute dies in Spring/Summer, Yin Absolute dies in Autumn/Winter, this statement is very appropriate).
[Ling Shu] What is called Fifty Prosperity: Five Zang all receive Qi. Hold Mai Kou, count beats. Fifty beats without one interruption: Five Zang all receive Qi. Forty beats with one interruption: One Zang has no Qi. (*Mai Jing* says: Dies four years later when spring grass grows). Thirty beats with one interruption: Two Zang have no Qi. (*Mai Jing* says: Dies three years later when wheat ripens). Twenty beats with one interruption: Three Zang have no Qi. (*Mai Jing* says: Dies two years later when mulberry berries turn red). Ten beats with one interruption: Four Zang have no Qi. (*Mai Jing* says: Dies within year, still during Qingming, far not beyond Guyu). Less than ten beats with one interruption: Five Zang have no Qi. (*Mai Jing* says: Dies five days later). Giving short-term prognosis lies in beginning and end. Fifty beats without interruption is normal. Knowing Five Zang periods, giving short-term prognosis involves rapid and slow irregularities. (From *Gen Jie Pian*).
[Nan Jing] states: Pulse stops once before fifty beats, one Zang has no Qi, which Zang? Reply: Inhalation follows Yin entering; exhalation follows Yang exiting. Now inhalation cannot reach Kidney, returns at Liver; thus knowing one Zang has no Qi, Kidney Qi is exhausted first.
[Zhang Zhongjing] Pulse coming slow with occasional stop then return is named Jie (Knot), Yin. Pulse coming moving then stopping, returning slightly faster, with intermediate return and movement, named Cu (Urgency), Yang. Pulse coming moving then stopping, unable to return itself, stopping then returning as before, named Dai (Replacement), Yin. Obtaining this pulse indicates difficult treatment.
Returning itself: Moving then stopping then returning, frequency higher than previous movement. Unable to return itself: Moving then stopping, returning as before, movement same but not frequent.
[Huo Ren Shu] Has Jie pulse, Cu pulse, Dai pulse. Jie is Yin, Yin excess causes Jie, pulse slow, occasional stop then return, main chest fullness and irritability. Cu is Yang, Yang excess causes Cu, pulse rapid, occasional stop then return, main accumulation and Qi痞 (blockage), formed by worry/thought. Generally Jie/Cu pulses, though occasionally stopping, are disease pulses, not death pulses. Only Dai pulse is true death. Slow movement, stopping unable to return itself, then moving again, named Dai; Dai means death. Zhongjing's Cold Damage pulse Jie Dai, Heart palpitation, Zhi Gan Cao Tang governs.
[Mai Jing] Heat disease pulse four beats, dies in three days. Four beats means normal person one beat, patient four beats. Heat disease pulse five beats, dies in one day. Occasionally large beat, dies in half day. Suddenly confused/disturbed, dies. Heat disease pulse six beats, dies in half day. Suddenly rapid large beat, dies shortly after. Heat disease pulse four losses, dies in three days. Four losses means normal person four beats, patient one beat, named four losses. Heat disease pulse five losses, dies in one day. Five losses means normal person five beats, patient one beat, named five losses. Heat disease pulse six losses, dies in one shichen. Six losses means normal person six beats, patient one beat, named six losses. If absolutely absent, arriving after long time, immediate death.
[Mai Jing] Healthy person not ill, pulse like leaking roof or sparrow pecking, dies (This is Spleen True Zang pulse. Wang note: Leaking roof, arrival ceases then stops, occasionally rises again not connecting. Sparrow pecking, like pecking rice very frequently). Pulse like striking stone, departing like untying cord, dies (This is Kidney True Zang pulse. Wang note: Striking stone, cracking urgent. Untying cord, moving rapid then scattered disorderly without order). Patient pulse like shrimp swimming, like fish gliding, dies. (Wang note: Shrimp swimming, slowly rising then retreating disappearing unknown where, long time then rising again, rising slow retreating fast. Fish gliding, like fish not moving, but tail wagging head shaking body swaying staying long). Pulse like turning bean, dies. Pulse like inverted knife, dies. Pulse surging not leaving, dies. Pulse suddenly leaving suddenly coming temporarily stopping then returning, dies. Pulse dividing absolute