凡看伤寒，要识死证死脉亲切，一一理会，免致临病疑惑。但见死证，须以脉参
之。如果不治，切莫下药。倘有锉失，咎将谁归？
汗后热退脉静者瘥。
阴阳诸证脉平，吉。
阳证见阴脉者死。
阴阳毒过六七日者不治。
脉浮而滑，身汗如油，喘息不休，水浆不入，身体不仁，乍静乍喘者死。
伤寒咳逆上气脉散者凶。
阳反独留，体如烟熏，直视摇头，心先绝也。
汗后发润喘不休者，肺先绝。
唇吻反青，四肢 汗出，肝气先绝也。
环口黎黑，虚汗发黄，脾气绝。
三部紧盛，大汗出不解者死。
阴阳尺寸俱虚，热不止者死。
身热喘粗，见阳脉而躁者死。
汗后微热不解，未可言死，如转索者，即日死也。
谵语微热，脉浮大，手足温欲汗出，脉暴出者死。
阴衰欲绝而阳暴独胜，则脉出。一曰阴气先绝，阳气后竭，死；逆冷脉沉细者，一日死。
赤斑者五死五生。
黑斑者十死一生。
两感伤寒者死。
大发湿家汗则成 。又曰热而 者死。
发少阳汗则谵语。发少阴汗则动血者死，名下厥上竭。
发动气汗者死。
发风温汗者死。
汗后为愈，今汗不为汗衰，谓之阴阳交，交者死。
不得汗者死。
发热脉躁疾，狂言，不能食，谓之三死。
咳逆不止者死。
脏结者死。（结胸证而舌上有白胎者是也。）
厥阴舌卷囊缩者死。
脉代者死。
少阴吐利烦躁四逆者死。
结胸证悉具烦躁者死。
发厥至七八日，肤冷而躁，无时暂安者，曰脏厥，不治。
阴阳头痛重，眼花，四肢拘急，小腹绞痛手足挛者死。
厥而下利，当不能食者，曰除中，不治。
少阴病厥逆无脉，与白通猪胆汤，脉暴出者死，微续者生。
若病患寒热而厥，面色不泽，冒昧，两手忽无脉，或一手无脉，必是正汗出
多，用绵被盖覆，包手足温暖，急投五味子汤，服之 时，必大汗而解矣。投药无汗，脉不
至者死。
死者虽多，凡至危极处皆是死也。
凡是诊治伤寒，必须对死证和死脉有清晰、深刻的认识，逐一仔细辨析，以免在临证时产生疑惑。只要见到死证，就必须结合脉象进行参详。如果确属不治之症，切勿轻易使用攻下药物。倘若因误治造成过失，责任由谁承担？
发汗后热退且脉象平静的，病情向愈。
阴阳各类病证的脉象平和的，预后良好。
阳证出现阴脉的，主死。
阴阳毒邪超过六七日不愈的，属不治之症。
脉象浮滑，身体出汗如油，喘息不止，饮食水浆无法入口，身体麻木不仁，时而安静时而喘促的，主死。
伤寒咳嗽气逆上冲，脉象散乱的，预后凶险。
阳气独留于内，身体颜色如烟熏般晦暗，两眼直视且摇头，这是心气先绝的表现。
发汗后头发湿润且喘息不止的，是肺气先绝。
口唇周围反现青色，四肢冷汗淋漓，这是肝气先绝。
口周发黑，虚汗出而面色发黄，这是脾气绝。
寸关尺三部脉象紧盛，大汗出后病情不解的，主死。
寸关尺阴阳各部脉象俱虚，发热不止的，主死。
身体发热，呼吸粗重，见阳脉且伴有躁动不安的，主死。
发汗后仍有轻微发热未解，尚不能断言为死证；但如果脉象如转索般紧急，则当日即死。
说胡话（谵语），微热，脉象浮大，手足温暖欲出汗，若脉象突然暴出无根的，主死。
阴气衰败欲绝，而阳气突然亢盛独胜，则脉象外越而出。另一种说法是：阴气先绝，阳气随后枯竭，主死；若四肢逆冷，脉象沉细的，一日内即死。
出现赤色斑疹的，五成死亡五成生存。
出现黑色斑疹的，十成死亡一成生存。
两感伤寒（表里两经同时受邪）的，主死。
大发其汗使湿家患者出汗过多则会形成变证。又说：发热且出现某种危重症状者死。（注：原文此处可能有脱字或异体字，依上下文推测指汗出不止或特定危象）。
误发少阳病患者的汗，会导致说胡话。误发少阴病患者的汗导致动血的，主死，名为“下厥上竭”。
误发动气病患者的汗，主死。
误发风温病患者的汗，主死。
发汗后本应痊愈，如今汗出而不能使热势衰减，这称为“阴阳交”，阴阳交者主死。
完全不得汗出的，主死。
发热，脉象躁疾，狂言乱语，不能进食，这称为“三死”之候。
咳嗽气逆不止的，主死。
脏结证，主死。（注：即结胸证且舌苔白腻者即是此证）。
厥阴病出现舌卷缩、睾丸上缩的，主死。
脉象代（间歇规律或不规律）的，主死。
少阴病出现呕吐、腹泻、烦躁、四肢逆冷的，主死。
结胸证症状全部具备且伴有烦躁的，主死。
发生厥逆达七八天，皮肤冰冷且躁动不安，没有片刻安宁的，称为“脏厥”，属不治之症。
阴阳头痛剧烈，眼花，四肢拘挛急迫，小腹绞痛，手足抽搐的，主死。
厥逆并伴有下利，本当不能进食却反而能食的，称为“除中”，属不治之症。
少阴病出现厥逆无脉，给予白通加猪胆汁汤治疗后，若脉象突然暴出的，主死；若脉象微微续接的，可生。
如果病人寒热交替且厥逆，面色无光泽，头昏目眩，两手突然摸不到脉搏，或仅一手无脉，必定是因为正汗出得太多，应用绵被覆盖，包裹手足使其温暖，急投五味子汤，服药片刻后，必然大汗出而病解。若投药后仍无汗，脉象不至的，主死。
虽然致死的情况很多，但凡是达到极度危重的地步，都是死证。
In the management of Shanghan (Cold Damage), one must have a clear and profound understanding of terminal syndromes and terminal pulses, analyzing each case meticulously to avoid confusion during clinical practice. Whenever a terminal syndrome is observed, it must be correlated with the pulse condition. If the disease is deemed incurable, one must strictly avoid using purgative therapies. Should any error occur due to mismanagement, who shall bear the responsibility?
If fever subsides and the pulse becomes calm after sweating, the patient will recover.
If the pulses in both Yin and Yang aspects are peaceful, the prognosis is auspicious.
If a Yang syndrome presents with a Yin pulse, death ensues.
Yin-Yang Du Toxin (poisonous heat pathogens) persisting beyond six or seven days is incurable.
A floating and slippery pulse, accompanied by sweat like oil, unceasing panting, inability to ingest fluids or food, numbness of the body, and alternating states of tranquility and panting, indicates death.
In Shanghan, coughing with rebellious Qi rising and a scattered pulse indicate a dire prognosis.
If Yang Qi remains isolated within, the body appears dark as if smoked, with fixed staring eyes and head shaking, this signifies the prior exhaustion of Heart Qi.
After sweating, if the hair remains moist and panting continues, this signifies the prior exhaustion of Lung Qi.
If the lips and mouth turn cyanotic and cold sweat pours from the four limbs, this signifies the prior exhaustion of Liver Qi.
If the area around the mouth turns dark black, with deficient sweat and yellowish complexion, this signifies the exhaustion of Spleen Qi.
If the pulses at the three positions (Cun, Guan, Chi) are tight and vigorous, and profuse sweating fails to resolve the condition, death ensues.
If the pulses at both Yin and Yang positions (and Cun-Chi) are deficient, yet fever persists, death ensues.
Body heat with coarse breathing, presenting with a Yang pulse and restlessness, indicates death.
After sweating, if slight fever persists, death cannot yet be declared; however, if the pulse feels like a turning cord (tight and wiry), death occurs on that day.
Delirium with slight fever, a floating and large pulse, warm hands and feet desiring sweat, but if the pulse suddenly emerges without root, death ensues.
When Yin Qi declines towards exhaustion while Yang Qi suddenly overpowers alone, the pulse may emerge externally. Alternatively, if Yin Qi exhausts first followed by Yang Qi, death ensues; if there is cold extremities with a deep and fine pulse, death occurs within one day.
The appearance of red macules indicates a mortality rate of five deaths to five survivals.
The appearance of black macules indicates a mortality rate of ten deaths to one survival.
Lianggan Shanghan (simultaneous involvement of exterior and interior meridians) results in death.
Excessive sweating in patients with dampness constitutions leads to complications. It is also stated that fever accompanied by [specific severe symptom] indicates death.
Inducing sweating in Shaoyang disease leads to delirium. Inducing sweating in Shaoyin disease leading to blood disturbance results in death, termed "Lower Jue and Upper Exhaustion".
Inducing sweating in Dongqi disease results in death.
Inducing sweating in Fengwen (Wind-Warmth) disease results in death.
Sweating should lead to recovery; however, if sweating does not reduce the pathogenic heat, it is called Yin-Yang Jiao (Yin-Yang Intersection/Crossing), which results in death.
Complete absence of sweating indicates death.
Fever with rapid and restless pulse, delirium, and inability to eat constitutes the "Three Deaths" syndrome.
Unceasing coughing and rebellious Qi indicate death.
Zang Jie (Organ Knotting) results in death. (This refers to Jie Xiong syndrome with a white coating on the tongue).
Jueyin disease presenting with curled tongue and retracted testicles results in death.
A Dai pulse (intermittent pulse) indicates death.
Shaoyin disease presenting with vomiting, diarrhea, irritability, and cold extremities results in death.
Jie Xiong syndrome with all symptoms present and accompanied by irritability results in death.
Jue (cold extremities) persisting for seven to eight days, with cold skin and restlessness without any period of peace, is called Zang Jue (Organ Jue) and is incurable.
Severe headache involving Yin and Yang, blurred vision, spasm and stiffness of the four limbs, colicky pain in the lower abdomen, and convulsions of hands and feet result in death.
Jue accompanied by diarrhea, where the patient should not be able to eat but suddenly can, is called Chu Zhong (Elimination of Middle), which is incurable.
In Shaoyin disease with Jue and absent pulse, after administering Baicong Zhu Dan Tang, if the pulse suddenly emerges violently, death ensues; if the pulse slowly resumes, survival is possible.
If a patient presents with alternating chills and fever, Jue, lusterless complexion, and dizziness, with sudden absence of pulse in both hands or one hand, it is likely due to excessive normal sweating. Cover the patient with cotton blankets, keep the extremities warm, and urgently administer Wuweizi Tang. After administration, profuse sweating will occur, resolving the illness. If no sweat occurs after medication and the pulse does not return, death ensues.
Although there are many causes of death, any condition reaching an extreme critical state is fatal.