指下如汤沸涌时，旦占夕死定无疑，尾掉摇摇头不动，鱼翔肾绝亦如期，去疾来
迟势劈劈，命绝脉来如弹石，三阳谷气久虚空，胃气分明屋漏滴，散乱还同解索形，
髓竭骨枯见两尺，虾游状如蛤蟆游，魂去行尸定生忧，雀啄连连来数急，脾无谷气
定难留，欲知心绝并荣绝，如刀压刀细推求，更有肺枯并胃乏，如麻戚促至无休，指
下浑然如转豆，三光正气已漂流。
洞虚子曰∶虾游雀啄，代止之脉，故名死证。须知痰气关格者，时复有之，若
非谙练数历，未免根据经断病，不无贻笑大方也。盖病势消烁殆尽者，其气不能相续，
如虾游水动，屋漏滴点而无至者，死脉也，其或痰凝气滞，关格不通，则其脉固有不
动者，有三两路乱动，时有时无者，或尺寸一有一无者，有关脉绝骨不见者，或时
动而大小不常者，有平居之人忽然而然者，有素禀痰病而不时而然者，有僵仆卒中而
然者，皆非死脉也。学人当细心参探。
五十不止身无病，数内有止皆知定。（止，犹代脉也。脉来五十动而不见一止者，无病也。五
十配天地造化之数，《易·系辞》曰∶大衍之数五十，五十乃备，一乃数之始，十乃数之极，人之脉息，昼夜循
环五脏，脉一动，循环一脏，五动循环五脏遍，五十动
是十次五数循环遍，则数皆极处而不见止者，五脏皆平，故无病也。）
四十一止一脏绝，却后四年多没命，三十一止即三年，二十一止二年应，十五一
止一年殂，已下有止看暴病。（四十动而见一止者，是一脏欠动，脉之极数，故知一脏绝也，先绝肾经，
所以言之。夫天一生水，肾属水，生成之一数也。人之五脏所生，先生乎肾，肾水生肝木，木生心火，命门火
生脾土，土生肺金，所以先绝肾，期应四年而死。三十动而见止者，两脏欠动，脉之极数，是知肾与肝二经无
气，期应三年而死。二十动而止者，三脏欠动，脉之极数，是肾肝心三脏无气，期应二年而死。十五动而一止
者，知肾肝心脾四脏皆无气，期一年而绝也。）
新注云∶上言脉之动止，未知诊切何部而取据，谨按《素问》《难经》云∶每于平旦寅时，日未出，饮食未
进，血气未乱，医者可以存神定意，心无外驰，诊于指下，右手寸口，默数脉息至止，以决之。夫寸口者，右
手气口也。《内经》曰∶气口何以独为五脏主？岐伯曰∶胃者，水谷之海，六腑之大源也。五味入口，藏于胃，变
现于气口。又曰∶脉会大渊，寸口是太渊穴也。是知寸口为脉大会之处，故能决断五脏六腑生死吉凶矣。
当手指下感觉脉搏像沸腾的热水一样汹涌澎湃时，早晨诊断出此脉象，傍晚病人就会死亡，这是确定的无疑。如果脉搏跳动时尾巴摇摆、头部摇动而身体不动，如同鱼在水中游动（鱼翔脉），这是肾气绝的表现，死期也是确定的。脉搏去得快来得慢，势态劈劈作响，命绝之脉来时像弹石一样坚硬急促。三阳经的谷气长久空虚，胃气明显微弱，像屋漏滴水一样点滴难续且间隔不均。脉象散乱无章，如同解开绳索的形状，这是髓竭骨枯在两尺部显现。虾游脉状如蛤蟆游动，这是神魂离去、行尸走肉般的征兆，必定令人担忧。雀啄脉连连急数，这是脾脏没有谷气，必定难以留存。如果想要知道心气绝和营气绝的情况，需要像刀压刀那样细致地推求诊察。还有肺气枯竭和胃气匮乏的脉象，如麻子般细促，至数没有休止。手指下感觉浑然一体如同转动豆子，这是三光正气已经漂流消散。
洞虚子说：虾游脉和雀啄脉，属于代止类的脉象，所以命名为死证。必须知道痰气关格的患者，时常也会出现这种脉象，如果不是经验丰富、阅历深厚的人，难免会拘泥于经典条文来判断疾病，从而被内行人嘲笑。大概病情消耗殆尽的人，其气不能相续，就像虾游水动、屋漏滴点而没有规律，这是死脉；如果是痰凝气滞，关格不通，那么脉象固然会有不动的时候，有三两条路乱动，时有时无的时候，或者寸部和尺部一有一无的时候，有关脉绝而骨脉不见的时候，或者时而跳动而大小不恒定的人，有平时健康的人突然出现这种情况的，有素来禀赋痰病而不定时出现的，有僵仆卒中后出现的，这些都不是死脉。学习中医的人应当细心参详探究。
五十次搏动中不停止，身体没有疾病，次数中有停止都知道是定局。（“止”，就是代脉的意思。脉搏来五十次而不见一次停止的，是没有病的。五十次配合天地造化的数目，《易经·系辞》说：大衍之数五十，五十才完备，一是数的开始，十是数的极点。人的脉息，昼夜循环五脏，脉搏每动一次，循环一脏，五动循环五脏遍，五十动是十次五数循环遍，则数都在极处而不见停止的，说明五脏都平和，所以没有病。）
四十一动出现一次停止，一脏气绝，过后四年多就会丧命；三十一动出现一次停止，三年应验；二十一动出现一次停止，二年应验；十五动出现一次停止，一年殂落；以下有停止的要看是否是暴病。（四十动而见一次停止的，是一脏欠动，脉的极数，所以知道一脏气绝。先绝的是肾经，所以这样说。天一生水，肾属水，是生成之一数。人的五脏所生，先生于肾，肾水生肝木，木生心火，命门火生脾土，土生肺金，所以先绝肾，期应在四年而死。三十动而见停止的，两脏欠动，脉的极数，是知道肾与肝二经无气，期应在三年而死。二十动而停止的，三脏欠动，脉的极数，是肾肝心三脏无气，期应在二年而死。十五动而一次停止的，知道肾肝心脾四脏皆无气，期在一年而绝也。）
新注说：上面所说的脉的动止，不知道诊切哪一部作为依据，谨按《素问》《难经》说：每当平旦寅时，太阳未出，饮食未进，血气未乱，医者可以存神定意，心无外驰，在指下诊察，右手寸口，默数脉息至停止，以此决断。夫寸口，就是右手气口。《内经》说：气口为什么独为五脏主？岐伯说：胃是水谷之海，六腑的大源。五味入口，藏于胃，变现于气口。又说：脉会大渊，寸口就是太渊穴。因此知道寸口是脉大会聚的地方，所以能决断五脏六腑生死吉凶了。
When the pulse feels like boiling water surging under the fingers, if diagnosed in the morning, death will occur by evening; this is certain and beyond doubt. If the pulse tail wags and the head shakes while the body remains still, resembling a fish swimming (Fish-swimming Pulse), this indicates the exhaustion of Kidney Qi, and the time of death is also fixed. When the pulse departs quickly and arrives slowly, with a cracking sound, the pulse of life exhaustion comes hard and rapid like flicking stones. The Grain Qi of the Three Yang channels has been empty for a long time, and the Stomach Qi is clearly weak, dripping like water from a leaking roof, irregular and sparse. The pulse is chaotic and disordered, resembling the shape of untying ropes; this manifests as exhaustion of marrow and withering of bones at both Chi positions. The Shrimp-swimming Pulse resembles a frog swimming; this indicates the departure of the Soul and the state of a walking corpse, causing definite worry. The Sparrow-pecking Pulse comes rapidly and frequently; this indicates that the Spleen lacks Grain Qi and will surely not be retained. To know about Heart Qi exhaustion and Ying (Nutritive) Qi exhaustion, one must examine carefully as if pressing a knife against a knife. Furthermore, Lung dryness and Stomach deficiency present with pulses like hemp seeds—fine, rapid, and continuous without rest. Under the fingers, it feels homogeneous like rolling beans; this indicates that the Zheng Qi of the Three Lights has already drifted away.
Dongxu Zi said: The Shrimp-swimming and Sparrow-pecking pulses belong to the category of intermittent pulses (Dai Mai), hence named "death signs." One must know that patients with Phlegm-Qi obstruction often exhibit such pulses. Unless one is experienced and knowledgeable, relying solely on classical texts to diagnose may lead to ridicule by experts. Generally, when a disease consumes vitality to the point of exhaustion, Qi cannot continue smoothly, resembling shrimp swimming or water dripping from a leaky roof without regularity; these are death pulses. However, if there is Phlegm condensation and Qi stagnation causing obstruction, the pulse may indeed remain motionless at times, move chaotically across three or two pathways, appear intermittently, have presence at Cun but absence at Chi (or vice versa), show absent Guan pulse but visible Gu pulse, vary in size and rhythm, occur suddenly in healthy individuals, appear irregularly in those constitutionally prone to Phlegm diseases, or arise after sudden collapse or stroke. These are not death pulses. Students should investigate them with great care.
Fifty beats without stopping indicate no illness in the body; any stopping within the count signifies a determined outcome. ("Stopping" refers to the Dai Mai/Intermittent Pulse. Fifty beats without any stop indicate health. The number fifty corresponds to the creative numbers of Heaven and Earth. The *I Ching · Xi Ci* states: "The Great Expansion Number is fifty; only then is it complete. One is the beginning of counting, ten is the ultimate limit." Human pulse circulation follows the Five Zang organs day and night. Each beat circulates through one organ; five beats complete the cycle through all five Zang organs. Fifty beats represent ten cycles of five, reaching the ultimate limit without stopping, indicating that all Five Zang organs are balanced, thus free from disease.)
A stop at forty-one beats indicates one Zang organ's exhaustion, leading to death after approximately four years. A stop at thirty-one beats corresponds to three years. A stop at twenty-one beats corresponds to two years. A stop at fifteen beats leads to death within one year. Stops occurring below this threshold should be evaluated based on acute illnesses. (One stop at forty beats indicates one Zang organ failed to beat, representing the extreme limit of the pulse, thus indicating one Zang organ's exhaustion. It begins with the Kidney channel, hence stated so. Heaven generates Water; the Kidney belongs to Water, corresponding to the generative number one. The Five Zang organs are generated starting with the Kidney; Kidney Water generates Liver Wood, Wood generates Heart Fire, Mingmen Fire generates Spleen Earth, and Earth generates Lung Metal. Therefore, Kidney exhaustion occurs first, with death expected in four years. A stop at thirty beats indicates two Zang organs failed to beat, the extreme limit, showing Qi exhaustion in Kidney and Liver channels, with death expected in three years. A stop at twenty beats indicates three Zang organs failed to beat, the extreme limit, showing Qi exhaustion in Kidney, Liver, and Heart channels, with death expected in two years. A stop at fifteen beats indicates Qi exhaustion in Kidney, Liver, Heart, and Spleen, with death expected in one year.)
New commentary notes: The above discussion on pulse stops does not specify which position to palpate for evidence. According to the *Su Wen* and *Nan Jing*: One should examine during the Yin hour of dawn, before sunrise and food intake, when blood and Qi are undisturbed. The physician should concentrate spirit and intent, keeping the mind free from external distractions, and palpate the Right Hand Cun Kou (Radial Artery), silently counting the pulse beats until a stop occurs to make a judgment. Cun Kou is the Qi Kou of the right hand. The *Nei Jing* asks: Why does Qi Kou alone serve as the master of the Five Zang? Qibo answers: The Stomach is the sea of water and grain, the great source of the Six Fu organs. Flavors enter the mouth, store in the Stomach, and manifest at the Qi Kou. It also states: Pulses meet at Dayuan; Cun Kou is the Taiyuan acupoint. Thus, Cun Kou is where pulses converge, enabling the determination of life and death, auspiciousness and misfortune for the Five Zang and Six Fu organs.