诸病皆有逆顺，腹胀、身热、脉大，是一逆也；（身热、脉大，而加以腹胀，表里之邪俱盛也，是为
一逆。）腹鸣而满，四肢清泄，其脉大，是二逆也；（腹鸣而满，四肢清冷而兼后泄，阴症也，
脉不宜大而大者，脉症相反也，是为二逆。）衄而不止，脉大，是三逆也；（鼻衄在阴，脉大为阳，阳实
阴虚，是为三逆。）咳且溲血，脱
形，其脉小劲，是四逆也；（咳而溲血脱形者，正气已衰，脉小而急者，邪气仍在，邪正不能相当，是为
四逆。）咳、脱形、身热，脉小以疾，是谓五逆也。（脱形身热，真阴已亏，而火独不清也。其脉细小
疾数者，邪盛正衰之候，是为五逆。）如是者，不过十五日而死矣。（一节之更，时移气易，客强主弱，
则不能胜，故不过十五日而死。）其腹大胀，四末清、脱形、泄甚，是一逆也；（此下言五逆之急
症也。腹大胀者，最忌中虚，若见四肢清冷而脱形泄甚者，脾元败而阳气去也，故为一逆。）腹胀便血，
其脉大时绝，是二逆也；（腹胀便血，阴病也，脉大时绝，孤阳将脱也，故为二逆。）咳、溲血、形肉
脱、脉搏，是三逆也；（咳而溲血者，气血俱病，形肉脱者，败在脾，脉搏者，真脏也，败在胃气，故为
三逆。）呕血，胸满引背，脉小而疾，是四逆也；（呕血，胸满引于背者，脏气连乎背也，脉见细小疾
数，则真元大亏矣，故为四逆。）咳呕腹胀，且飧泄，其脉绝，是五逆也。（上为咳呕，中为胀满，下为
飧泄，三焦俱病，而脉至于绝者，有邪无正也，故五逆也。）如是者，不及一时而死矣。（不及一时，谓
不能周一日之时也。）工不察此者，是为逆治。（病不可治而强治之，非惟无益，适以资害，是谓逆治也。）
各种疾病都有顺证和逆证的区别。腹部胀满、身体发热、脉象宏大，这是第一种逆证；（身体发热、脉象宏大，再加上腹部胀满，说明表邪和里邪都亢盛，这就是第一种逆证。）腹部肠鸣且胀满，四肢清冷并伴有腹泻，脉象宏大，这是第二种逆证；（腹部肠鸣胀满，四肢清冷兼有后泄，属于阴证，脉象本不应宏大却宏大，脉症相反，这就是第二种逆证。）鼻出血不止，脉象宏大，这是第三种逆证；（鼻衄在阴分，脉大为阳象，阳实阴虚，这就是第三种逆证。）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、小便带血、形体消瘦脱失，说明正气已经衰败，脉象细小而急迫，说明邪气仍然存在，邪气与正气不能相当，这就是第四种逆证。）咳嗽、形体消瘦脱失、身体发热，脉象细小且快速，这称为第五种逆证。（形体消瘦脱失且身体发热，说明真阴已经亏损，而虚火独旺不清。脉象细小疾数，是邪气盛而正气衰的征候，这就是第五种逆证。）像这种情况，不超过十五天就会死亡。（一节节气令更替，时间推移，气候改变，客邪强盛而主气虚弱，就不能胜任抵御，所以不超过十五天就会死亡。）腹部高度胀满，四肢清冷，形体消瘦脱失，腹泻严重，这是第一种逆证；（以下讲述五逆中的急症。腹部高度胀满，最忌讳中气虚弱，如果见到四肢清冷且形体消瘦腹泻严重的，说明脾元败坏而阳气离去，所以列为第一种逆证。）腹部胀满且大便带血，脉象宏大但时有中断，这是第二种逆证；（腹部胀满且大便带血，属于阴病，脉象宏大但时有中断，说明孤阳即将脱失，所以列为第二种逆证。）咳嗽、小便带血、肌肉消瘦脱失、脉搏动急促无根，这是第三种逆证；（咳嗽且小便带血，说明气血都有病变，肌肉消瘦脱失，说明败坏在于脾，脉搏动急促无根，说明是真脏脉现，败坏在于胃气丧失，所以列为第三种逆证。）呕血，胸部胀满牵引背部疼痛，脉象细小且快速，这是第四种逆证；（呕血，胸部胀满牵引至背部，说明脏气连及背部，脉象出现细小疾数，说明真元大亏，所以列为第四种逆证。）咳嗽、呕吐、腹部胀满，并且伴有完谷不化的腹泻，脉象断绝，这是第五种逆证。（上部为咳嗽呕吐，中部为胀满，下部为完谷不化的腹泻，三焦全部发病，而脉象至于断绝，是有邪气而无正气，所以列为第五种逆证。）像这种情况，不到一个时辰就会死亡。（“不及一时”，指不能满一整天。）医生如果不明察这些情况，就叫做逆治。（病情不可治愈却强行治疗，不仅没有益处，反而增加危害，这就叫做逆治。）
All diseases have favorable (shun) and unfavorable (ni) prognoses. Abdominal distension, fever, and a large pulse constitute the first unfavorable condition; (Fever and a large pulse, compounded by abdominal distension, indicate that both exterior and interior pathogens are flourishing, thus constituting the first unfavorable condition.) Abdominal borborygmus with fullness, cold extremities accompanied by diarrhea, and a large pulse constitute the second unfavorable condition; (Abdominal borborygmus and fullness, cold extremities, and posterior discharge indicate a Yin syndrome. A large pulse is inappropriate for this presentation; the mismatch between pulse and symptoms constitutes the second unfavorable condition.) Epistaxis that does not stop, with a large pulse, constitutes the third unfavorable condition; (Epistaxis relates to Yin, while a large pulse relates to Yang. This represents excess Yang and deficiency of Yin, constituting the third unfavorable condition.) Coughing combined with hematuria, emaciation, and a small yet forceful pulse constitutes the fourth unfavorable condition; (Coughing, hematuria, and emaciation indicate that healthy Qi has declined. A small and rapid pulse indicates that pathogenic factors remain. The inability of pathogenic factors and healthy Qi to balance each other constitutes the fourth unfavorable condition.) Coughing, emaciation, fever, and a small and rapid pulse constitute the fifth unfavorable condition. (Emaciation and fever indicate the depletion of True Yin, leaving fire unquenched. A small, thin, and rapid pulse is a sign of flourishing pathogens and declining healthy Qi, constituting the fifth unfavorable condition.) In such cases, death will occur within fifteen days. (As solar terms change and time passes, Qi shifts. If the external pathogen is strong and the host Qi weak, resistance fails, hence death occurs within fifteen days.) Severe abdominal distension, cold extremities, emaciation, and severe diarrhea constitute the first unfavorable condition; (The following describes acute presentations of the five unfavorable conditions. Severe abdominal distension most fears deficiency of Middle Jiao Qi. If accompanied by cold extremities, emaciation, and severe diarrhea, it indicates the collapse of Spleen Yuan and the departure of Yang Qi, thus constituting the first unfavorable condition.) Abdominal distension with hematochezia, and a large pulse that intermittently ceases, constitute the second unfavorable condition; (Abdominal distension with hematochezia is a Yin disease. A large pulse that intermittently ceases indicates impending collapse of solitary Yang, thus constituting the second unfavorable condition.) Coughing, hematuria, loss of flesh and muscle, and a pulsating pulse (bo le) constitute the third unfavorable condition; (Coughing and hematuria indicate pathology in both Qi and Blood. Loss of flesh and muscle indicates deterioration of the Spleen. A pulsating pulse indicates the manifestation of the Zang organs' true pulse, signifying the loss of Stomach Qi, thus constituting the third unfavorable condition.) Hematemesis, chest fullness radiating to the back, and a small, rapid pulse constitute the fourth unfavorable condition; (Hematemesis and chest fullness radiating to the back indicate that Zang Qi connects to the back. A small, thin, and rapid pulse indicates severe depletion of True Yuan, thus constituting the fourth unfavorable condition.) Cough, vomiting, abdominal distension, and sputtering diarrhea (sun xie), with a pulse that is absent, constitute the fifth unfavorable condition. (Upper Jiao presents with cough and vomiting, Middle Jiao with distension, and Lower Jiao with sputtering diarrhea. Pathology in all three Jiaos with an absent pulse indicates the presence of pathogens but absence of healthy Qi, thus constituting the fifth unfavorable condition.) In such cases, death will occur in less than one shi (two hours). ("Less than one shi" means unable to complete a full day.) If physicians do not discern these signs, it is called "treating contrary to the disease" (ni zhi). (Forcing treatment on an incurable disease yields no benefit and only exacerbates harm, which is termed ni zhi.)