（素问玉机真藏论）
五脏受气于其所生，传之于其所胜，气舍于其所生，死于其所不胜。病之且死，必先传行至其所不胜，病乃死。（凡
五脏病气，有所受，有所传，有所舍，有所死。舍，留止也。受气所生者，受于己之所生者也。传所胜者，传于己之所
克者也。气舍所生者，舍于生己者也。死所不胜者，死于克己者也。）此言气之逆行也，故死。（不胜则逆，故曰逆行，
逆则当死。）肝受气于心，传之于脾，气舍于肾，至肺而死。（此详言一脏之气，皆能遍及诸脏也。肝受气于心，心者肝
之子，受气于其所生也。脾者肝之克，传其所胜也。肾者肝之母，气舍所生也。肺者肝之畏，死所不胜也。）心受气于脾，
传之于肺，气舍于肝，至肾而死。脾受气于肺，传之于肾，气舍于心，至肝而死。肺受气于肾，传之于肝，气舍于脾，
至心而死。肾受气于肝，传之于心，气舍于肺，至脾而死。此皆逆死也。（逆死之义如上文，下言顺传之序也。）一日一
夜五分之，此所以占死生之早暮也。（五分者，朝主甲乙，昼主丙丁，四季土主戊己，晡主庚辛，夜主壬癸。此一日五行
之次，而脏有不胜，即其死生之期也。）黄帝曰∶五脏相通，移皆有次，五脏有病，则各传其所胜。（传其所胜者，如本
篇下文云，风入于肺为肺痹，弗治，则肺传之肝为肝痹，弗治，则肝传之脾为脾风，弗治，则脾传之肾曰疝瘕，弗治，
则肾传之心曰螈，弗治，则心复反传而行之肺，法当死者是也。见疾病类二十九，原与此同篇，所当并考。）不治，法三
月若六月，若三日若六日，传五脏而当死，（病不早治，必至相传，远则三月六月，近则三日六日，五脏传遍，于法当死。
所谓三六者，盖天地之气，以六为节。如三阴三阳，是为六气，六阴六阳，是为十二月，故五脏相传之数，亦以三六为
尽。若三月而传遍，一气一脏也；六月而传遍，一月一脏也。三日者，昼夜各一脏也；六日者，一日一脏也。脏惟五而
传遍以六者，假令病始于肺，一也；肺传肝，二也；肝传脾，三也；脾传肾，四也；肾传心，五也；心复传肺，六也。
是谓六传。六传已尽，不可再传，故五十三难曰∶一脏不再伤，七传者死也。又如以三阴三阳言三六之数，则三者阴阳
之合数，六者阴阳之拆数，合者奇偶交其气，拆者牝牡异其象也。观热论云，伤寒一日巨阳受之，二日阳明，三日少阳，
四日太阴，五日少阴，六日厥阴，亦六数也；至若日传二经，病名两感者，则三数也。启玄子曰∶三月者，谓一岁之迁
移。六月者，谓至其所胜之位。三日者，三阳之数以合日也。六日者，谓兼三阴以数之尔。是亦三六之义也。故有七日
而病退得生者，以真元未至大伤，故六传毕而经尽气复，乃得生也。易曰∶七日来复，天行也。义无二焉。）是顺传所胜
之次。（上文言逆者，言脏之气。盖五脏受克，其气必逆，故曰逆行。此言顺者，言病之传。凡传所胜，必循次序，故曰
顺传。是顺传者，即气之逆也，故五脏传遍者当死。）故曰别于阳者，知病从来；别于阴者，知死生之期。（阳者言表，
谓外候也；阴者言里，谓脏气也。凡邪中于身，必证形于外，察其外证，即可知病在何经，故别于阳者，知病从来；病
伤脏气，必败真阴，察其根本，即可知危在何日，故别于阴者，知死生之期。此以表里言阴阳也。如阴阳别论曰∶所谓
阴者，真脏也，见则为败，败必死也。所谓阳者，胃脘之阳也。别于阳者，知病处也；别于阴者，知死生之期。乃以脉
言阴阳也。详脉色类二十六。）言知至其所困而死。（至其所困而死，死于其所不胜也。凡年月日时，其候皆然。）
《素问·玉机真藏论》
五脏之气从其所生的脏腑接受，传送给它所克的脏腑，气停留于生它的脏腑，死于克它的脏腑。疾病即将致死时，必定先传行至它所不胜（即克它）的脏腑，病人才会死亡。（大凡五脏的病气，有受气的来源，有传送的去处，有留止的地方，有致死的原因。“舍”意为停留、止息。受气于所生者，是指接受由自己脏腑所生的子脏之气。传于所胜者，是指传送给自己所克的脏腑。气舍于所生者，是指停留在生养自己的母脏那里。死於所不胜者，是指死于克制自己的脏腑。）这是说气的逆行，所以会导致死亡。（不能相胜则气逆，所以称为逆行，逆行则应当死亡。）例如肝接受心（子脏）传来的气，传送给脾（所克之脏），气停留于肾（母脏），传到肺（所不胜之脏）时就会死亡。（这里详细阐述了一脏之气能够遍及其他各脏的情况。肝接受心传来的气，因为心是肝的子脏，符合“受气于其所生”的原则。脾是肝所克的脏腑，符合“传其所胜”的原则。肾是肝的母亲，气停留于此，符合“气舍于所生”的原则。肺是肝畏惧的脏腑（即克肝者），在此处死亡，符合“死于所不胜”的原则。）心接受脾传来的气，传送给肺，气停留于肝，传到肾时就会死亡。脾接受肺传来的气，传送给肾，气停留于心，传到肝时就会死亡。肺接受肾传来的气，传送给肝，气停留于脾，传到心时就会死亡。肾接受肝传来的气，传送给心，气停留于肺，传到脾时就会死亡。这些都属于逆传致死的情况。（逆传致死的含义如上文所述，下文将讲述顺传的次序。）将一日一夜分为五个时段，借此可以占测死亡的早晚。（五个时段分别对应：早晨主甲乙木，白天主丙丁火，四季末月主戊己土，傍晚主庚辛金，夜晚主壬癸水。这是一日之中五行运行的次序，而五脏之间存在相克关系，根据这一规律即可判断生死的时间。）黄帝说：五脏之间是相通的，病变转移都有固定的次序，五脏发生疾病，就会各自传给它所克的脏腑。（所谓传给它所克的脏腑，如本篇后文所说，风邪侵入肺脏导致肺痹，如果不治疗，肺脏的病气传给肝脏导致肝痹，如果不治疗，肝脏的病气传给脾脏导致脾风，如果不治疗，脾脏的病气传给肾脏导致疝瘕，如果不治疗，肾脏的病气传给心脏导致抽搐痉挛，如果不治疗，心脏的病气又反向传回肺脏，按照法则应当死亡。详见疾病类第二十九篇，原文与此篇同属一篇，应当一并考证。）如果不治疗，按照法则可能在三个月或六个月后，也可能在三天或六天后，当病气传遍五脏时就必然死亡。（疾病不早治，必然导致相互传变，远的情况需要三个月或六个月，近的情况只需要三天或六天，五脏全部传遍，按法则应当死亡。所谓的“三”和“六”，是因为天地之气以六为节律。比如三阴三阳，合称六气；六阴六阳，合称十二月，所以五脏相传的次数，也以三六为极限。如果三个月传遍，是一气一脏；如果六个月传遍，是一月一脏。如果是三天，是昼夜各传一脏；如果是六天，是一天传一脏。脏只有五个，但传遍却用六个数来表述，举例来说：假如病始于肺，这是第一次；肺传肝，这是第二次；肝传脾，这是第三次；脾传肾，这是第四次；肾传心，这是第五次；心再传肺，这是第六次。这叫做六传。六传已经穷尽，不能再继续传了，所以《难经·五十三难》说：“一脏不再受两次伤害，第七次传变就会死亡。”又如从三阴三阳的角度来看待三六之数，三是阴阳的合数，六是阴阳的拆分数。合数是奇偶交互其气，拆分数是雌雄异其象。观察《热论》中说，伤寒第一天太阳经受邪，第二天阳明经，第三天少阳经，第四天太阴经，第五天少阴经，第六天厥阴经，这也是六数的体现；至于每天传两经，病名两感的情况，则是三数。启玄子王冰注解说：三个月，指的是一年的迁移变化。六个月，指的是到达它所克的方位。三天，是三阳之数结合天数而言。六天，是兼有三阴之数来计算罢了。这也符合三六的含义。所以有的七天病情消退得以生存，是因为真元之气没有受到极大损伤，所以六传完毕而经脉之气恢复，才得以生存。《易经》说：“七日来复”，这是天道运行的规律。其中的义理没有二致。）这就是顺传所克的次序。（上文所说的“逆”，讲的是脏气的状态。因为五脏受到克制，其气必然逆乱，所以叫逆行。这里所说的“顺”，讲的是疾病的传变。凡是传给它所克的脏腑，必然遵循一定的次序，所以叫顺传。这种顺传，实际上就是气的逆行，所以五脏传遍的人应当死亡。）所以说，辨别阳分（表证），就能知道疾病的由来；辨别阴分（里证/脏气），就能知道死生的期限。（阳分指体表，即外在的表现；阴分指体内，即脏气的状态。凡是邪气侵袭身体，必然在外在症状上表现出来，观察外在证候，就可以知道病在哪个经络，所以辨别阳分，就能知道疾病的由来；疾病损伤脏气，必然败坏真阴，观察根本所在，就可以知道危险在哪一天，所以辨别阴分，就能知道死生的期限。这里是从表里的角度来讲阴阳。如《阴阳别论》中说：所谓阴，是指真脏脉，出现真脏脉就是败绝，败绝必然死亡。所谓阳，是指胃脘的阳气。辨别阳分，能知道病位在哪里；辨别阴分，能知道死生的期限。这里是从脉象的角度来讲阴阳。详见脉色类第二十六篇。）说的是知道疾病发展到其所困顿（被克）的脏腑时就会死亡。（发展到其所困顿而死，就是死于它所不胜的脏腑。无论是年、月、日、时的征候，都是如此。）
*Suwen: Yujizhenzang Lun* (Plain Questions: Treatise on the True Visceral Manifestations of the Jade Machine)
The Qi of the Five Zang organs receives from the organ it generates, transmits to the organ it overcomes, stays in the organ that generates it, and dies at the organ that overcomes it. When a disease is about to cause death, it must first transmit to the organ that overcomes it (the organ it cannot control), and only then does the patient die. (Generally speaking, the pathological Qi of the Five Zang organs has a source of reception, a destination of transmission, a place of retention, and a cause of death. "She" (retention) means staying or halting. Receiving Qi from what it generates refers to receiving Qi from the offspring organ generated by itself. Transmitting to what it overcomes refers to transmitting to the organ it controls via the controlling cycle. Qi staying in what generates it refers to staying in the mother organ that generates itself. Dying from what overcomes it refers to dying due to the organ that controls it.) This describes the retrograde movement of Qi, which leads to death. (When one cannot overcome another, Qi moves retrogradely; hence it is called retrograde movement, and retrograde movement implies death.) For example, the Liver receives Qi from the Heart (its offspring), transmits it to the Spleen (the organ it overcomes), retains it in the Kidney (its mother), and dies when it reaches the Lung (the organ that overcomes it). (This elaborates on how the Qi of one Zang organ can pervade all other Zang organs. The Liver receives Qi from the Heart because the Heart is the offspring of the Liver, fulfilling the principle of "receiving Qi from what it generates." The Spleen is the organ overcome by the Liver, fulfilling the principle of "transmitting to what it overcomes." The Kidney is the mother of the Liver, so Qi stays here, fulfilling the principle of "Qi staying in what generates it." The Lung is the feared organ for the Liver (i.e., the one that overcomes it), so death occurs here, fulfilling the principle of "dying from what overcomes it.") The Heart receives Qi from the Spleen, transmits it to the Lung, retains it in the Liver, and dies when it reaches the Kidney. The Spleen receives Qi from the Lung, transmits it to the Kidney, retains it in the Heart, and dies when it reaches the Liver. The Lung receives Qi from the Kidney, transmits it to the Liver, retains it in the Spleen, and dies when it reaches the Heart. The Kidney receives Qi from the Liver, transmits it to the Heart, retains it in the Lung, and dies when it reaches the Spleen. All these are cases of retrograde transmission leading to death. (The meaning of retrograde death is as described above; below is the sequence of forward transmission.) Dividing a day and night into five parts allows one to predict the early or late time of death. (The five parts correspond as follows: morning governs Jia-Yi Wood, daytime governs Bing-Ding Fire, the last days of each season govern Wu-Ji Earth, dusk governs Geng-Xin Metal, and night governs Ren-Gui Water. This is the sequence of the Five Elements within a day. Since the Five Zang organs have overcoming relationships, this pattern determines the timing of life and death.) Huangdi said: The Five Zang organs are interconnected, and changes occur in a specific order. When diseases arise in the Five Zang organs, they transmit to the organs they overcome. (Transmitting to the organ it overcomes means, as stated later in this chapter, wind pathogen enters the Lung causing Fei Bi (Lung Bi), if untreated, the Lung transmits to the Liver causing Gan Bi (Liver Bi); if untreated, the Liver transmits to the Spleen causing Pi Feng (Spleen Wind); if untreated, the Spleen transmits to the Kidney causing Shan Jia (Hernia Mass); if untreated, the Kidney transmits to the Heart causing Chou Yuan (Convulsions/Spasms); if untreated, the Heart transmits back to the Lung, and according to the law, death ensues. See Disease Category 29, originally in the same chapter, for cross-reference.) If untreated, according to the law, death may occur in three months or six months, or in three days or six days, when the disease has transmitted through all Five Zang organs. (If a disease is not treated early, mutual transmission will inevitably occur. In distant cases, it takes three or six months; in near cases, only three or six days. Once all Five Zang organs are involved, death is inevitable according to the law. The numbers "three" and "six" relate to the rhythm of Heaven and Earth Qi, which uses six as a unit. For instance, Three Yin and Three Yang constitute the Six Qi; Six Yin and Six Yang constitute twelve months. Thus, the number of transmissions among the Five Zang organs also culminates in three and six. If transmission completes in three months, it is one Qi per Zang; if in six months, it is one month per Zang. If in three days, it is one Zang per day and night; if in six days, it is one Zang per day. Although there are only five Zang organs, transmission is counted up to six. For example, if the disease starts in the Lung (1st), transmits to the Liver (2nd), then to the Spleen (3rd), then to the Kidney (4th), then to the Heart (5th), and finally back to the Lung (6th), this is called "Six Transmissions." Once six transmissions are exhausted, no further transmission occurs. Hence, *Nanjing Chapter 53* states: "One Zang is not injured twice; the seventh transmission causes death." Furthermore, viewing the numbers three and six through the lens of Three Yin and Three Yang, three represents the combined number of Yin and Yang, while six represents the split number. Combined numbers involve the interaction of odd and even Qi, while split numbers involve different manifestations of male and female principles. Observing *Re Lun* (Treatise on Cold Damage): "Cold damage on the first day affects Taiyang; on the second day, Yangming; on the third day, Shaoyang; on the fourth day, Taiyin; on the fifth day, Shaoyin; on the sixth day, Jueyin." This also reflects the number six. However, if two meridians are affected daily, known as "Lianggan" (Double Contraction), it reflects the number three. Wang Bing (Qixuanzi) commented: Three months refer to the migration of a year. Six months refer to reaching the position of the overcome element. Three days refer to combining the number of Three Yang with days. Six days refer to including Three Yin in the count. These also align with the meaning of three and six. Therefore, some patients recover after seven days because their True Yuan (True Origin) Qi was not severely damaged, allowing the meridians to restore their Qi after the completion of six transmissions, thus enabling survival. The *I Ching* says: "Seven days to return," which is the movement of Heaven. The principle is identical.) This is the sequence of forward transmission to the overcome organs. (The "retrograde" mentioned above refers to the state of Zang Qi. Because the Five Zang organs are overcome, their Qi becomes turbulent, hence called retrograde movement. The "forward" mentioned here refers to disease transmission. Whenever transmission occurs to the overcome organ, it follows a specific order, hence called forward transmission. This forward transmission is actually retrograde Qi movement; therefore, those whose Five Zang organs have fully transmitted should die.) It is said: Differentiating Yang allows one to know the origin of the disease; differentiating Yin allows one to know the period of life and death. (Yang refers to the exterior, i.e., external signs; Yin refers to the interior, i.e., Zang Qi status. When pathogens invade the body, they necessarily manifest externally. By observing external signs, one can determine which meridian is affected; thus, differentiating Yang reveals the disease's origin. When disease damages Zang Qi, it necessarily destroys True Yin. By observing the root, one can determine the day of danger; thus, differentiating Yin reveals the timing of life and death. Here, Yin and Yang are discussed in terms of interior and exterior. As stated in *Yinyang Bie Lun*: "What is called Yin is the True Zang manifestation; its appearance indicates failure, and failure leads to death. What is called Yang is the Stomach Qi." Differentiating Yang locates the disease; differentiating Yin predicts life and death. Here, Yin and Yang are discussed in terms of pulse diagnosis. See Pulse and Color Category 26 for details.) This speaks of knowing that death occurs when the disease reaches the point of being trapped (overcome). (Dying when trapped means dying from the organ that overcomes it. Whether considering years, months, days, or hours, the signs remain the same.)