玉机真藏篇曰∶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。至其所不胜乃死。此气之逆行也。故死。肝受气于心。传之于脾。气舍于肾
。至肺乃死。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。一日一夜五分之。所以占生死之早暮也。大骨枯槁大肉
陷下。胸中气满。喘息不便。内痛引肩项。期一月死。真藏见。乃予之期日。大骨枯槁。大
肉陷下。胸中气满。喘息不便。内痛引肩项。身热脱肉破KT 。真藏见。十日之内死。大骨枯
槁。大肉陷下。肩髓肉消。动作益衰。真藏未见。期一岁死。大骨枯槁。大肉陷下。胸中气
满。心中不便。肩项身热破KT 。肉脱目眶陷。真藏见。目不见人立死。其见人者。至其
所不
胜之时则死。急虚身中卒至。五脏绝闭。脉道不通。气不往来。譬于堕不可为期。其脉绝不
来。若人一息五六至。其形肉不脱。真藏虽不见。犹死也。三部九候皆相失者死。上下左右
之脉。相应如参舂者病甚。上下左右之脉。相失不可数者死。中部之候虽独调。众藏相失者
死。中部之候相减者死。目眶内陷者死。肉脱身不去者死。乍数乍疏者死。真脏见形者胜死
。形气相得者生。三五不调者病。形肉已脱。九候虽调。犹死脉。无胃曰逆。逆则死。肝见
庚辛死。心见壬癸死。肺见丙丁死。肾见戊己死。脾见甲乙死。浑浑革。至如涌泉。病进而
色弊。绵绵其去如悬绝者死。脉忽去忽来。暂止复来者死。脉中侈者死。脉分绝者死。三部
脉如釜中汤沸。朝得暮死。半夜得。日中死。日中得。夜半死。九候之脉皆沉细悬绝者为阴
。主冬。故以夜半死盛躁喘数者为阳。主夏。故以日中死。寒热病者以平旦死。热中及热病
者以日中死。风病者以日夕死。病水者以夜半死。其脉乍数乍疏。乍迟乍疾。日乘四季者死
。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。汗出发润。喘不
休。肺气绝也死。阳病独留。体如烟熏。直视摇头。口不能言。心先绝也。唇吻青。四肢
汗出。肝先绝也环口黧黑。虚汗发黄。脾先绝也。身热喘粗。见阴多躁。或目眶深陷。瞳
不转移。戴阳上视。肾绝也。皆死。头目痛。卒视无见者死。三部脉紧盛。大汗出不解者死
。阴阳尺寸俱虚者死。温病汗不出。出不至足者死。温病禳禳大热。脉细小者死。咳而形脱
发热。脉坚急者死。皮肉着骨者死。发直如麻者死。口臭不可近者死。舌卷卵缩者死。目不
回直视。一日死。阴结阳绝。目精脱恍惚者死。面无光。齿龈黑者死。热病七八日当汗。不
得汗。脉绝者死。遗尿不知者死。口如鱼口。不能闭。而气出多不入者死。肛门如竹筒。大
便不禁。及不知者死。病患卧有边不宁者死。吐痰如蟹沫者死。面肿色苍黑者死。表里俱病
者死。在伤寒则为两感。病已汗。身体不凉。加喘泻者死。病久妄言。及不能言者不治。热
病者可治。病患阴阳俱绝。撮空摸衣者死。汗出不流。舌卷黑者死。发与肩冲起者死。病患
爪甲青者死。病患爪甲白者不治。病患脉绝口张足肿者。五日死。病患足跗上肿。两膝大如
斗者十日死。病患阴囊及茎肿者死。病患爪甲及肉黑者。八日死。病患卧难着枕。气升如喘
者死。病患每日夜小便十数次而滴沥者死。病患形气俱虚。安谷者过期而死。不安谷者不及
期而死。
《素问·玉机真藏论》说：五脏的病气来源于其所生的脏腑（即母脏）。病气传送给它所克的脏腑。病气停留于生它的脏腑。最终死于克制它的脏腑。疾病即将导致死亡时，病气必定先进行传变，传到被它克制的脏腑时就死亡了。这是气机的逆行，所以会导致死亡。肝的病气来源于心，传送给脾，病气停留在肾，传到肺就死亡。心的病气来源于脾，传送给肺，病气停留在肝，传到肾就死亡。脾的病气来源于肺，传送给肾，病气停留在心，传到肝就死亡。肺的病气来源于肾，传送给肝，病气停留在脾，传到心就死亡。肾的病气来源于肝，传送给心，病气停留在肺，传到脾就死亡。这些都属于逆证而死。将一昼夜分为五个时段，用来占断生死发生的时间早晚。
如果大骨枯槁，大肉陷下，胸中气满，呼吸喘息困难，内部疼痛牵引肩颈，预计一个月后死亡。如果出现真脏脉（无胃气的脉象），就可以给出确切的死期日期。如果大骨枯槁，大肉陷下，胸中气满，呼吸喘息困难，内部疼痛牵引肩颈，身体发热，肌肉脱失，皮肤破裂，出现真脏脉，预计十日内死亡。如果大骨枯槁，大肉陷下，肩部和髓部肌肉消瘦，活动能力日益衰退，但尚未出现真脏脉，预计一年后死亡。
如果大骨枯槁，大肉陷下，胸中气满，心中痞闷不适，肩颈及身体发热，皮肤破裂，肌肉脱失，眼眶深陷，出现真脏脉，且患者看不见人，则立即死亡；如果还能看见人，则在被克制的时辰到来时死亡。突然遭受虚邪侵袭，病气猝然发作，五脏气绝闭塞，脉道不通，气机不能往来，这种情况如同从高处坠落，无法预测具体死期。如果脉搏完全停止不来，即使人一呼一吸间脉搏跳动五六次，形体肌肉没有脱失，真脏脉虽然未现，也仍然会死亡。
如果三部九候的脉象都失常错乱，就会死亡。上下左右各处的脉象，搏动节奏一致如同舂米般整齐有力，说明病情严重。上下左右各处的脉象，相互失调且无法计数，就会死亡。中部脉象虽然单独调和，但其他脏腑脉象失常，就会死亡。中部脉象减弱，就会死亡。眼眶内陷，就会死亡。肌肉脱失而身体不消瘦（指精气耗尽之假象），就会死亡。脉率忽快忽慢，忽迟忽疾，就会死亡。真脏脉显现且形体衰败者胜（指邪胜正败）而死。形气相得者生。三五不调者病。形体肌肉已经脱失，即使九候脉象调和，也会死亡。没有胃气的脉称为逆，逆则死。
肝脏脉象在庚辛日（金日）死亡。心脏脉象在壬癸日（水日）死亡。肺脏脉象在丙丁日（火日）死亡。肾脏脉象在戊己日（土日）死亡。脾脏脉象在甲乙日（木日）死亡。脉象浑浊急迫，来势如涌泉般汹涌，病情进展且面色败坏。脉象连绵不断，去势如悬丝绝断者死。脉象忽去忽来，暂时停止后又复来的，死。脉象盛大外溢的，死。脉气分绝的，死。三部脉象如同锅中汤水沸腾，早晨诊得傍晚死，半夜诊得中午死，中午诊得半夜死。
九候脉象都沉细悬绝的属于阴脉，主冬季，所以常在夜半死亡。脉象盛大躁动、喘促数急的属于阳脉，主夏季，所以常在中日（正午）死亡。寒热病患者常在平旦（清晨）死亡。热中及热病患者常在中日（正午）死亡。风病患者常在日夕（黄昏）死亡。水肿病患者常在夜半死亡。脉象忽快忽慢，忽迟忽疾，且在四季末各十八天（辰戌丑未时）加重的，死。
脉象浮滑，身体出汗如油，喘息不止，水浆不能入口，身体麻木不仁，时而安静时而喘促的，死。汗出后头发湿润，喘息不止，是肺气绝的表现，会死亡。阳病独留，身体如烟熏色，两眼直视摇头，口不能言，是心先绝的表现。嘴唇和口吻发青，四肢出汗，是肝先绝的表现。环绕口唇颜色黑黄，虚汗发黄，是脾先绝的表现。身体发热，呼吸粗重，见到阴证却烦躁不安，或者眼眶深陷，瞳孔不转动，戴阳（面赤如妆）向上视，是肾绝的表现。以上情况都会死亡。
头痛目痛，突然视物却看不见东西的，死。三部脉紧盛，大汗出而病不解的，死。阴阳尺寸各部脉都虚弱的，死。温病不出汗，或出汗不到足部的，死。温病高热不退，脉象细小的，死。咳嗽且形体脱失，发热，脉象坚急的，死。皮肉紧贴骨骼的，死。头发直立如麻的，死。口臭不可靠近的，死。舌头卷缩，睾丸上缩的，死。眼睛不转动，直视，一天后死亡。阴结阳绝，眼球脱离，神情恍惚的，死。面部无光泽，齿龈发黑的，死。热病七八天应当出汗，却不得汗，脉绝的，死。遗尿且不知晓的，死。口开如鱼口，不能闭合，气出多入少的，死。肛门松弛如竹筒，大便失禁且不知晓的，死。病患卧床不安宁，在床边辗转反侧的，死。吐痰如蟹沫的，死。面部浮肿，面色苍黑的，死。表里俱病的，死。在伤寒病中称为两感（表里同病）。患病已出汗，身体不凉，反而加重气喘腹泻的，死。患病日久胡言乱语，以及不能言语的，不治。热病尚可治疗。
病患阴阳俱绝，撮空摸衣（手在空中抓摸衣物）的，死。汗出不流，舌头卷缩发黑的，死。头发与肩部冲起直立的，死。病患爪甲青色的，死。病患爪甲白色的，不治。病患脉绝，口张足肿的，五日死。病患足背肿胀，双膝肿大如斗的，十日死。病患阴囊及阴茎肿胀的，死。病患爪甲及肌肉发黑的，八日死。病患卧难着枕，气升如喘的，死。病患每日夜间小便十几次且滴沥不尽的，死。病患形气俱虚，能进食的超过预期时间而死，不能进食的不到预期时间而死。
The *Jade Machine True Viscera Chapter* (Yuji Zhenzang Pian) states: The pathogenic qi of the five zang organs is received from the organ that generates it (the mother organ). It transmits to the organ it controls. The qi stays in the organ that generates it. Death occurs at the organ that overcomes it. When a disease is about to cause death, the pathogenic qi must first transmit and circulate; death occurs when it reaches the organ it overcomes. This is a retrograde movement of qi, hence death.
The liver receives qi from the heart, transmits it to the spleen, the qi stays in the kidney, and death occurs upon reaching the lung. The heart receives qi from the spleen, transmits it to the lung, the qi stays in the liver, and death occurs upon reaching the kidney. The spleen receives qi from the lung, transmits it to the kidney, the qi stays in the heart, and death occurs upon reaching the liver. The lung receives qi from the kidney, transmits it to the liver, the qi stays in the spleen, and death occurs upon reaching the heart. The kidney receives qi from the liver, transmits it to the heart, the qi stays in the lung, and death occurs upon reaching the spleen. All these are deaths due to retrograde transmission. By dividing a day and night into five parts, one can predict the early or late timing of death.
If the large bones are withered and the large muscles have collapsed, the chest is full of qi, breathing is difficult and panting, internal pain radiates to the shoulders and neck, death is expected within one month. If the *Zangmai* (True Viscera Pulse, i.e., pulse without Stomach Qi) appears, the specific date of death can be given. If the large bones are withered, the large muscles have collapsed, the chest is full of qi, breathing is difficult and panting, internal pain radiates to the shoulders and neck, the body is hot, muscles are wasted, and the skin is broken, and the *Zangmai* appears, death is expected within ten days. If the large bones are withered, the large muscles have collapsed, the shoulder and marrow muscles are consumed, physical activity declines further, but the *Zangmai* has not yet appeared, death is expected within one year.
If the large bones are withered, the large muscles have collapsed, the chest is full of qi, the heart feels obstructed, the shoulders, neck, and body are hot, the skin is broken, muscles are wasted, and the eye sockets are sunken, and the *Zangmai* appears, if the patient cannot see people, they will die immediately; if they can still see people, they will die when the time of the overcoming element arrives. Sudden deficiency and sudden invasion of the body, where the five zang organs become closed and blocked, the pulse channels are unblocked, and qi does not flow back and forth, this situation is like falling from a height and cannot be predicted for a specific time. If the pulse completely stops and does not return, even if the pulse beats five or six times per breath, and the form and flesh have not wasted away, although the *Zangmai* is not seen, death will still occur.
If the pulses of the three divisions and nine positions are all disordered and lost, death ensues. If the pulses above and below, left and right, respond uniformly like the pounding of a mortar, the disease is severe. If the pulses above and below, left and right, are disordered and cannot be counted, death ensues. If the pulse of the middle division is harmonious alone, but the pulses of the other viscera are disordered, death ensues. If the pulse of the middle division diminishes, death ensues. If the eye sockets are sunken, death ensues. If muscles are wasted while the body remains (indicating exhaustion of essence), death ensues. If the pulse rate is suddenly rapid and suddenly slow, suddenly delayed and suddenly quick, death ensues. If the true viscera pulse appears and the form is defeated, death ensues. If form and qi are compatible, life ensues. If the numbers three and five are irregular, disease ensues. If the form and flesh have already wasted away, even if the nine pulses are harmonious, death ensues. A pulse without Stomach Qi is called retrograde; retrogression leads to death.
The liver pulse dies on Geng-Xin days (Metal days). The heart pulse dies on Ren-Gui days (Water days). The lung pulse dies on Bing-Ding days (Fire days). The kidney pulse dies on Wu-Ji days (Earth days). The spleen pulse dies on Jia-Yi days (Wood days). If the pulse is turbid and urgent, coming like a surging spring, the disease progresses and the complexion deteriorates. If the pulse goes continuously and leaves like a hanging thread (suspended extinction), death ensues. If the pulse suddenly disappears and returns, stopping temporarily and then returning, death ensues. If the pulse is excessively expansive, death ensues. If the pulse energy is severed, death ensues. If the pulses of the three divisions resemble boiling soup in a pot, death occurs in the evening if diagnosed in the morning, at noon if diagnosed at midnight, and at midnight if diagnosed at noon.
If the pulses of the nine positions are all deep, fine, and suspended/extinct, they belong to Yin, governing Winter, so death occurs at midnight. If the pulses are vigorous, restless, panting, and rapid, they belong to Yang, governing Summer, so death occurs at midday. Patients with cold-heat diseases die at dawn. Patients with heat-in-the-middle and heat diseases die at midday. Patients with wind diseases die at dusk. Patients with water diseases (edema) die at midnight. If the pulse is suddenly rapid and suddenly slow, suddenly delayed and suddenly quick, and worsens during the last eighteen days of each season (Chen, Xu, Chou, Wei hours), death ensues.
If the pulse is floating and slippery, the body sweats like oil, panting does not cease, fluids and food cannot enter, the body is insensible, alternating between quietness and panting, death ensues. Sweat moistens the hair, panting does not cease; this is the exhaustion of Lung Qi, leading to death. Yang disease lingers alone, the body looks like smoke-stained, eyes stare straight, head shakes, mouth cannot speak; this is the prior exhaustion of Heart Qi. Lips and mouth corners are cyanotic, limbs sweat; this is the prior exhaustion of Liver Qi. The ring around the mouth is dark yellow, virtual sweat turns yellow; this is the prior exhaustion of Spleen Qi. Body heat, coarse panting, seeing Yin symptoms but being irritable, or eye sockets sunken, pupils not moving, Daiyang (floating yang) looking upward; this is Kidney exhaustion. All lead to death. Head and eye pain, sudden vision loss, death ensues. Pulses of the three divisions are tight and abundant, profuse sweating does not resolve the condition, death ensues. Yin and Yang, Cun and Chi pulses are both deficient, death ensues. In warm diseases, no sweat occurs, or sweat does not reach the feet, death ensues. Warm diseases with lingering high fever and fine/small pulses, death ensues. Coughing with wasting form and fever, pulse firm and urgent, death ensues. Skin and flesh adhering to bones, death ensues. Hair standing straight like hemp, death ensues. Bad breath that cannot be approached, death ensues. Tongue curled and testicles retracted, death ensues. Eyes not turning, staring straight, death after one day. Yin knotting and Yang severing, eyes protruding and spirit confused, death ensues. Face lacks luster, gums are black, death ensues. Heat diseases lasting seven to eight days should sweat; if sweat does not occur and the pulse ceases, death ensues. Urinary incontinence with lack of awareness, death ensues. Mouth open like a fish mouth, unable to close, with more air exiting than entering, death ensues. Anus loose like a bamboo tube, fecal incontinence with lack of awareness, death ensues. Patient lying in bed restless, tossing near the edge, death ensues. Vomiting phlegm like crab foam, death ensues. Facial swelling with pale-black complexion, death ensues. Exterior and interior both diseased, death ensues. In Shanghan (Cold Damage), this is called Lianggan (simultaneous exterior and interior involvement). After sweating, if the body is not cool but adds panting and diarrhea, death ensues. Long-standing disease with delirium and inability to speak, untreatable. Heat diseases may be treatable.
Patient with exhaustion of both Yin and Yang, grasping at empty air and touching clothes, death ensues. Sweat does not flow, tongue curled and black, death ensues. Hair and shoulders standing upright, death ensues. Patient with cyanotic nail beds, death ensues. Patient with white nail beds, untreatable. Patient with ceased pulse, open mouth, and swollen feet, death in five days. Patient with swollen dorsum pedis, knees as large as a dou (measure), death in ten days. Patient with swollen scrotum and penis, death ensues. Patient with black nail beds and flesh, death in eight days. Patient unable to rest head on pillow, qi rising like panting, death ensues. Patient urinating ten-plus times daily with dribbling, death ensues. Patient with both form and qi deficient, if able to eat, dies beyond the expected period; if unable to eat, dies before the expected period.