五脏者，中之守也。中脏盛满，气胜伤恐者，声如从室中言，是中气之湿也。言而微，
终日
乃复言者，此夺气也。衣被不敛，言语善恶不避亲疏者，此神明之乱也。仓廪不藏，是门户
不要也。水泉不止者，是膀胱不藏也。得守者生，失守者死。五脏者，身之强也。头者精明
之府，头倾视深，精神将夺矣。背者胸中之府，背曲肩随，府将坏矣。腰者肾之府，转摇不
能，肾将惫矣。膝者筋之府，屈伸不能，行则偻附，筋将惫矣。骨者髓之府，不能久立，行
则振掉，骨将惫矣。得强则生，失强则死。（《脉要精微论》）
人一呼脉四动以上曰死，脉绝不至曰死，乍疏乍数曰死。
人无胃气曰逆，逆者死。脉从阴阳病易已，脉逆阳阳病难已。脉得四时之顺，曰病无他
，脉反四时，及不间藏，曰难已。
春夏而脉瘦，秋冬而脉浮大，命曰逆四时也，风热而脉静，泄而脱血，脉实病在中。脉
虚病
在外。脉涩坚者，皆难治。命曰反四时也。水谷为本，故人绝水谷则死，脉无胃气亦死，所
谓无胃气者，但得真脏脉，不得胃气也。
平心脉来，累累如连珠，如循琅 ，曰心平。夏以胃气为本，肺心脉来，喘喘连属，其
中微
曰肺平。秋以胃气为本，病肺脉来，不上不下，如循鸡羽，曰肺病。死肺脉来，如物之浮，
如风吹毛，曰肺死。平肝脉来，软弱招招，如揭长竿末梢，曰肝平。春以胃气为本，病肝脉
来，盈实而滑，如循长竿，曰肝病。死肝脉来，急益劲，如新张弓弦，曰肝死。平脾脉来，
和柔相离，如鸡践地，曰脾平。长夏以胃气为本，病脾脉来，实而盈数，如鸡举足，曰脾病
。死脾脉来，锐坚如鸟之喙，如鸟之距，如屋之漏，如水之流，曰脾死。平肾脉来，喘喘累
累如钩。按之而坚，曰肾平。冬以胃气为本，病肾脉来，如引葛，按之益坚，曰肾病。死肾
脉来，发如夺索，辟辟如弹石，曰肾死。（《平人气象论》）
形气相得，谓之可治。色泽以浮，谓之易已。脉从四时，谓之可治。脉弱以滑，是有胃
气，
命曰易治，取之以时。形气相失，谓之难治。色夭不泽，谓之难已。脉实以坚，谓之益甚。
脉逆四时，为不可治。所谓逆四时者，春得肺脉，夏得肾脉，秋得心脉，冬得脾脉，其至皆
悬绝沉涩者，名曰逆四时。
五实死，五虚死。脉盛，皮热，腹胀，前后不通，闷瞀，此为五实。脉细，皮寒，气少
，泄
利前后，饮食不入，此谓五虚。浆粥入胃，泄注止，则虚者活。身汗，得后利，则实者活。
（《玉机真藏论》）
形盛脉细，少气不足以息者危。形瘦脉大，胸中多气者死。形气相得者生，参伍不调者
病。
三部九候，皆相失者死。上下左右之脉，相应如参舂者病甚；上下左右相失，不可数者死。
中部之候虽独调，与众脏相失者死。中部之候相减者死。目内陷者死。脱肉身不去者死，真
脏脉见者死。
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。病风者以日夕死。病水者以夜半死。其脉
乍疏乍数，乍迟乍疾者，日乘四季死。形肉已脱，九候虽调犹死。七症虽见，九候皆从者不
死。脉不往来者死。皮肤着者死。
瞳子高者，太阳不足；戴眼者，太阳已绝，此决死生之要也。（《三部九候论》）
乳子而病热，脉悬小者，手足温则生，寒则死。乳子中风热，喘鸣肩息者，脉实大也，
缓则生，急则死。肠 便血，身热则死，寒则生。脉 下白沫，脉沉则生，浮则死。肠 下脓血
，脉悬绝则死，滑大则生。肠 之属，身不热，脉不悬绝者，滑大者曰生；悬涩者曰死。
癫疾脉搏大滑，久自已；脉小坚急，死不治。癫疾之脉，虚则可治，实则死。
消瘅虚实，脉悬小坚，病久不可治。脉实大，病久可治。（《通评虚实论》）
阳从左，阴从右，老从上，少从下，是以春夏归阳为生，归秋冬为死；反之则归秋冬为
一上一下，寒厥到膝，少者秋冬死，老者秋冬生。
形弱气虚死。形气有余，脉气不足死。脉气有余，形气不足生。（《方盛衰论》）
得守者生，失守者死；得神者昌，失神者亡。（《本病论》）
平人而气胜形者寿；病而形肉脱，气胜形者死，形胜气者危。（《寿夭刚柔篇》）
热病七八日，脉微小，病者溲血，口中干，一日半死，脉代者一日死。
热病已得汗出，而脉尚躁，喘且复热，喘甚者死。
热病七八日，脉不躁，躁不数散，后三日中有汗，三日不汗，四日死。
热病不知所痛，耳聋不能自收，口干阳热甚，阴颇有寒者，热在髓，死不可治。
热病已得汗而脉尚躁盛，此阴脉之极也，死。其得汗而脉静者生。热病脉盛躁而不得汗
者，此阳脉之极也，死。脉盛躁得汗静者生。
热病不可刺者有九∶一曰汗不出，大颧发赤，哕者死。二曰泄而腹满盛者死。三曰目不
明、
止者死。七曰咳而衄，汗不出，出不至足者死。八曰髓热者死。九曰热而痉者死。腰折、螈
、齿噤 也。凡此九者，不可刺也。（《热病篇》）
热病脉静，汗出已，脉盛躁，是一逆也。病泄脉洪大，是二逆也。着痹不移， 肉破，
身热
夺形，脉坚搏，是谓五逆也。
脉一呼再至曰平，三至曰离经，四至曰夺精，五至曰死，六至曰命绝，此至之脉也。一
呼一至曰离经，再呼一至曰夺精，三呼一至曰死，四呼一至曰绝命，此损之脉也。损之为病，一
损损于皮毛，皮聚而毛落；二损损于血脉，血脉虚少，不能荣于五脏六腑；三损损于肌肉，
肌
反此者至脉之病也，从上下者，骨痿不能起于床者死。从下上者，皮聚而毛落者死。按脉来
一呼再至，一吸再至，不大不小曰平。一呼三至，一吸三至，为适得病。前大后小，即头痛
目眩，前小后大，即胸满短气。一呼四至，一吸四至，病欲甚，脉洪大者，苦烦满；沉细者
，腹中痛。滑者伤热；涩者中雾露。一呼五至，一吸五至，其人当困，沉细夜加，浮大昼加
，不大不小，虽困可治，其有大小者难治。一呼六至，一吸六至，为死脉也。沉细夜死，浮
大昼死。一呼一至，一吸一至，名曰损，人虽能行，犹当着床，所以然者，血气皆不足故也
。再呼一至，再吸一至，名曰无魂，无魂者当死也，人虽能行，名曰行尸。上部有脉，下部
无脉，其人当吐，不吐者死。上部无脉，下部有脉，虽困无能为害。所以然者，人之有尺，
譬如树之有根，枝叶虽枯槁，根本将自生，脉有根本，人有元气，故知不死。
扁鹊云∶筋绝不治，九日死。手足爪甲青黑，呼骂口不息也。
五脏是人体内守持生命活动的根本。如果中焦脏腑邪气盛满，气机亢盛而损伤肾志（恐），患者声音沉闷，如同在室内说话一样，这是中焦湿气阻滞的表现。如果言语声音低微，说半天才能再说一句，这是元气大伤的表现。如果穿衣盖被不知收敛整理，说话不分好坏、不顾及亲疏关系，这是心神混乱的表现。如果肠胃不能固摄食物和水液，这是幽门和肛门失去约束能力的表现。如果小便失禁不止，这是膀胱不能固摄尿液的表现。能够守住这些根本的就能生存，失去这些根本的就会死亡。
五脏也是支撑身体强健的基础。头部是精神意识汇聚的府库，如果头低垂、眼神深陷，说明精神即将耗竭。背部是胸中宗气汇聚的府库，如果背部弯曲、肩膀下垂，说明胸中之府将要败坏。腰部是肾脏所在的府库，如果腰部转动困难，说明肾脏功能即将衰竭。膝盖是筋脉汇聚的府库，如果膝盖屈伸不利，走路时弯腰驼背依附他物，说明筋脉功能即将衰竭。骨骼是骨髓汇聚的府库，如果不能久站，走路时身体颤抖摇晃，说明骨骼功能即将衰竭。身体保持强健就能生存，失去强健就会死亡。（出自《素问·脉要精微论》）
人一呼脉搏跳动四次以上，称为死脉；脉搏断绝不再跳动，称为死脉；脉搏忽快忽慢，称为死脉。
人如果没有胃气，就是逆证，逆证者死。脉象顺应阴阳变化，病容易痊愈；脉象违背阴阳规律，病难痊愈。脉象顺应四季气候的变化，称为病情没有其它变数；脉象违背四季规律，以及出现相克脏腑传变（不间藏），称为病难痊愈。
春夏季节脉象反而瘦小，秋冬季节脉象反而浮大，这叫做违背四时规律。患风热病脉象却安静无力，患泄泻或失血病脉象却实大，这是病邪在里的表现。脉象虚软，这是病邪在外的表现。脉象涩而坚硬的，都难以治疗，这叫做违背四时规律。水谷精气是人体生命的根本，所以人断绝水谷就会死亡，脉象没有胃气也会死亡。所谓没有胃气，是指只见到真脏脉，而见不到柔和的胃气脉。
正常的心脉，来势连续如连珠，像抚摸美玉一样温润，这叫心脉平和。夏季以胃气为本，肺脉和心脉来时，急促相连属，其中带有轻微柔和之象，这叫肺脉平和。秋季以胃气为本，病变的肺脉来势，不上不下，像抚摸鸡羽毛一样轻浮虚软，这叫肺病。死亡的肺脉来势，像物体漂浮水面，像风吹毛发一样散乱无根，这叫肺死。正常的肝脉来势，软弱连绵，像举起长竿末梢那样柔韧，这叫肝脉平和。春季以胃气为本，病变的肝脉来势，充盈实滑，像抚摸长竿那样坚硬，这叫肝病。死亡的肝脉来势，急迫强劲，像新拉开的弓弦那样紧绷，这叫肝死。正常的脾脉来势，和缓柔软且节律分明，像鸡踩地一样从容，这叫脾脉平和。长夏季节以胃气为本，病变的脾脉来势，实大而数，像鸡抬脚那样急促，这叫脾病。死亡的脾脉来势，尖锐坚硬像鸟嘴，像鸟爪，像屋顶漏雨滴落断续，像水流逝去不停，这叫脾死。正常的肾脉来势，急促连绵像钩状，按之坚实，这叫肾脉平和。冬季以胃气为本，病变的肾脉来势，像牵引葛藤那样紧束，按之更加坚硬，这叫肾病。死亡的肾脉来势，像两人争夺绳索那样紧劲，像弹石一样坚硬搏指，这叫肾死。（出自《素问·平人气象论》）
形体与气息相协调，称为可治。面色光泽明润，称为容易痊愈。脉象顺应四时变化，称为可治。脉象弱而滑利，这是有胃气的表现，命名为易治，治疗要把握时机。形体与气息不相协调，称为难治。面色枯槁无光泽，称为难以痊愈。脉象实而坚硬，称为病情加重。脉象违背四时规律，称为不可治。所谓违背四时规律，是指春季见到肺脉（金克木），夏季见到肾脉（水克火），秋季见到心脉（火克金），冬季见到脾脉（土克水），这些脉象都表现为悬绝沉涩，名叫违背四时规律。
五实症会死，五虚症会死。脉象盛大，皮肤发热，腹部胀满，大小便不通，胸闷目眩，这叫做五实。脉象细弱，皮肤发冷，气短少气，大小便失禁，饮食不进，这叫做五虚。如果稀粥进入胃中，泄泻停止，那么虚证患者可以存活。如果身体出汗，大小便通畅，那么实证患者可以存活。（出自《素问·玉机真藏论》）
形体壮实但脉象细弱，气短不足以呼吸的，病情危重。形体消瘦但脉象洪大，胸中气多壅滞的，预后不良。形体与气息相协调的能生存，参差错乱不调和的生病。三部九候的脉象都失常的，预后不良。上下左右各处的脉象，相互呼应如捣米般整齐有力的，病情严重；上下左右脉象失调，无法计数的，预后不良。中部脉象虽然单独调和，但与其余脏腑脉象失调的，预后不良。中部脉象减弱的，预后不良。眼睛内陷的，预后不良。身体极度消瘦脱肉但肢体还能动的，预后不良；出现真脏脉的，预后不良。
九候脉象都沉细悬绝的，属于阴脉主冬，所以在夜半时分死亡。脉象盛大躁动、喘息急促的，属于阳脉主夏，所以在日中时分死亡。
寒热病患者，在平旦（清晨）死亡。热中病及热病患者，在日中（中午）死亡。患风病的患者在日夕（傍晚）死亡。患水肿病的患者在夜半死亡。脉象忽快忽慢、忽迟忽疾的，在四季交替之时（辰戌丑未时）死亡。形体肌肉已经脱失，即使九候脉象调和也必死无疑。七诊脉象虽有异常，但九候脉象顺应四时的，不会死亡。脉气完全断绝不通的，预后不良。皮肤干枯紧贴骨头的，预后不良。
瞳孔上视不能下转的，是太阳经气不足；眼球固定向上凝视不动的，是太阳经气已绝，这是判断生死的关键。（出自《素问·三部九候论》）
婴儿患热病，脉象悬小而细弱的，如果手足温暖则生，手足寒冷则死。婴儿患风热病，出现喘鸣、耸肩呼吸的症状，脉象实大的，脉势缓和则生，脉势紧急则死。大肠出血，身体发热则死，身体不发热则生。直肠下排白沫，脉象沉则生，脉象浮则死。大肠下排脓血，脉象悬绝则死，脉象滑大则生。大肠病变类同者，身体不发热，脉象不悬绝的，脉象滑大为生，脉象悬涩为死。（出自《素问·通评虚实论》）
阳气从左升发，阴气从右沉降，老年人病势从上而下顺，年轻人病势从下而上顺。因此，春夏季节顺应阳气生长为生存之道，顺应秋冬收藏之气为死亡之道；反之，顺应秋冬则为死，顺应春夏则为生。寒厥证发展到膝盖以下，年轻人在秋冬季节死亡，老年人在秋冬季节生存。
形体虚弱、正气不足的会死亡。形体和气有余，但脉气不足的会死亡。脉气有余，但形体和正气不足的能生存。（出自《素问·方盛衰论》）
能够守住神气者生，失去神气者死；得到神气者昌盛，失去神气者灭亡。（出自《素问·本病论》）
健康人如果气胜形（气强于形），寿命长；病人如果形体肌肉脱失，气胜形的会死亡，形胜气（形强于气，即邪气盛而正气衰）的病情危重。（出自《灵枢·寿夭刚柔篇》）
热病经过七八天，脉象微小，患者尿血，口中干燥，一天半后死亡；如果出现代脉，一天后死亡。
热病已经出汗，但脉象仍然躁动，气喘并且再次发热，气喘严重的会死亡。
热病经过七八天，脉象不躁动，躁动但不数急，如果在之后三天内有汗出，三天无汗出，第四天死亡。
热病不知道疼痛部位，耳聋不能自主收摄肢体，口干且阳热极盛，阴分却有寒象的，这是热邪深入骨髓，死亡不可治愈。
热病已经出汗但脉象仍然躁盛，这是阴脉的极端表现，预后不良。如果出汗后脉象平静，则生存。热病脉象盛躁但不出汗的，这是阳脉的极端表现，预后不良。脉象盛躁而出汗后平静的，则生存。
热病有九种情况不可针刺：一曰不出汗，两颧发红，呃逆的，预后不良。二曰泄泻且腹部胀满坚实的，预后不良。三曰眼睛不明，（原文此处似有缺漏，通常指目盲或直视等危象），预后不良。七曰咳嗽兼鼻衄，不出汗，或者汗出不到足部的，预后不良。八曰髓热的，预后不良。九曰热病并发痉症的，预后不良。表现为腰背反折、抽搐、牙关紧闭。凡此九种情况，不可针刺。（出自《素问·热病篇》）
热病脉象平静，出汗后脉象反而盛躁，这是一逆。病泄泻而脉象洪大，是二逆。着痹不移，肌肉萎缩破溃，身体发热且形体消瘦，脉象坚搏有力，这是五逆。（注：原文列举不全，通常六逆或五逆，此处依原文提取）。
人一呼脉搏跳动两次叫平脉，三次叫离经脉，四次叫夺精脉，五次叫死脉，六次叫命绝脉，这是至脉（数脉）的情况。人一呼脉搏跳动一次叫离经脉，两呼才跳动一次叫夺精脉，三呼才跳动一次叫死脉，四呼才跳动一次叫绝命脉，这是损脉（迟脉）的情况。损脉导致的疾病，一损损害皮毛，皮肤皱缩、毛发脱落；二损损害血脉，血脉虚少，不能滋养五脏六腑；三损损害肌肉，肌肉消瘦。反过来的情况是至脉导致的疾病，从上往下发展的，骨痿不能起床的死亡；从下往上发展的，皮肤皱缩毛发脱落的死亡。诊脉时，一呼再至，一吸再至，脉不大不小，叫平脉。一呼三至，一吸三至，是刚刚得病。前部脉大后部脉小，会出现头痛目眩；前部脉小后部脉大，会出现胸满短气。一呼四至，一吸四至，病情想要加重，脉象洪大的，苦于烦闷；脉象沉细的，腹中痛。脉滑的伤于热；脉涩的中了雾露湿气。一呼五至，一吸五至，其人应当困倦，脉沉细的夜间加重，脉浮大的白天加重，脉不大不小，虽然困倦也可治，脉有大小不一的难治。一呼六至，一吸六至，是死脉。脉沉细的夜间死亡，脉浮大的白天死亡。一呼一至，一吸一至，名叫损脉，人虽然能行走，但也应当卧床，这是因为气血都不足的原因。两呼一至，两吸一至，名叫无魂，无魂的人应当死亡，人虽然能行走，名叫行尸。上部有脉，下部无脉，其人应当呕吐，如果不呕吐的死亡。上部无脉，下部有脉，虽然困倦但无大害。这是因为人有尺脉，就像树有根一样，枝叶虽然枯槁，根本还会自己生长，脉有根本，人有元气，所以知道不会死亡。
The Five Zang organs are the guardians within. If the middle Jiao (Middle Burner) organs are filled with excess pathogens, and Qi is hyperactive damaging the Kidney's will (Fear), the voice will sound muffled as if speaking from inside a room; this indicates dampness obstructing the Middle Qi. If speech is faint and one can only speak again after a long time, this indicates depletion of Qi. If one does not dress or cover oneself properly, and speaks without distinguishing between good and bad or close and distant relatives, this indicates chaos of the Shen (Spirit). If the granaries (Stomach and Intestines) cannot store contents, it means the gates (pylorus and anus) have lost their control. If urine flows incessantly, it means the Bladder cannot store urine. Those who retain these functions live; those who lose them die.
The Five Zang organs are the strength of the body. The head is the mansion of clear Yang and spirit. If the head droops and eyes are sunken, the spirit is about to be depleted. The back is the mansion of the chest. If the back is curved and shoulders sag, the mansion of the chest is about to collapse. The waist is the mansion of the Kidneys. If turning and shaking is difficult, the Kidneys are about to fail. The knees are the mansion of the sinews. If flexion and extension are impossible, and walking requires bending over and leaning on something, the sinews are about to fail. The bones are the mansion of the marrow. If one cannot stand for long, and walking causes trembling, the bones are about to fail. Those who maintain strength live; those who lose strength die. (From *Su Wen: Treatise on the Essentials of Pulse Diagnosis*)
If in one exhalation the pulse beats four times or more, it is called death. If the pulse ceases and does not return, it is called death. If the pulse is intermittently slow and rapid, it is called death.
If a person lacks Stomach Qi, it is a reversal, and reversal leads to death. If the pulse follows Yin and Yang principles, the disease is easy to cure; if the pulse reverses Yin and Yang, the disease is hard to cure. If the pulse conforms to the four seasons, it is said that there are no other complications. If it reverses the four seasons, or involves transmission between non-adjacent organs (interfering with the generating cycle), it is said to be hard to cure.
If the pulse is thin in Spring and Summer, and floating and large in Autumn and Winter, it is called reversing the four seasons. If wind-heat presents with a quiet pulse, or diarrhea and blood loss present with a full pulse, the disease is internal. If the pulse is empty, the disease is external. Pulses that are choppy and firm are all difficult to treat; this is called reversing the four seasons. Water and grain are the root; therefore, if a person cuts off water and grain, they die. If the pulse lacks Stomach Qi, they also die. What is meant by lacking Stomach Qi is that only the True Zang pulse is seen, without the gentle Stomach Qi.
A normal Heart pulse comes continuously like linked pearls, smooth like touching jade; this is a peaceful Heart pulse. Summer relies on Stomach Qi as the root. When Lung and Heart pulses come, rapid and connected, but with a slight gentleness, this is a peaceful Lung pulse. Autumn relies on Stomach Qi as the root. A diseased Lung pulse comes neither up nor down, feeling like touching a chicken feather; this is Lung disease. A dying Lung pulse floats like an object on water, or scatters like hair blown by the wind; this is Lung death. A normal Liver pulse comes soft and continuous, like holding the tip of a long bamboo pole; this is a peaceful Liver pulse. Spring relies on Stomach Qi as the root. A diseased Liver pulse comes full, solid, and slippery, like touching a long pole; this is Liver disease. A dying Liver pulse comes urgent and strong, like a newly drawn bowstring; this is Liver death. A normal Spleen pulse comes harmonious and soft, distinct like a chicken stepping on the ground; this is a peaceful Spleen pulse. Late Summer relies on Stomach Qi as the root. A diseased Spleen pulse comes solid, full, and rapid, like a chicken lifting its foot; this is Spleen disease. A dying Spleen pulse is sharp and firm like a bird's beak, or claw, or like water leaking from a roof, or flowing away; this is Spleen death. A normal Kidney pulse comes rapid and continuous like a hook, firm upon pressure; this is a peaceful Kidney pulse. Winter relies on Stomach Qi as the root. A diseased Kidney pulse feels like pulling a vine, becoming firmer upon pressure; this is Kidney disease. A dying Kidney pulse feels like two people pulling a rope against each other, or like stones being flicked; this is Kidney death. (From *Su Wen: Treatise on the Phenomena of Normal People*)
When form and Qi are in harmony, it is called treatable. When complexion is bright and floating, it is called easily curable. When the pulse follows the four seasons, it is called treatable. When the pulse is weak and slippery, it indicates the presence of Stomach Qi, named easy to treat, and treatment should be timed appropriately. When form and Qi are discordant, it is called difficult to treat. When the color is dull and lacks luster, it is called difficult to cure. When the pulse is full and hard, it indicates worsening. When the pulse reverses the four seasons, it is untreatable. Reversing the four seasons refers to: Spring presenting with Lung pulse, Summer with Kidney pulse, Autumn with Heart pulse, Winter with Spleen pulse; if these pulses are suspended, extreme, deep, and choppy, it is named reversing the four seasons.
Five Excess conditions lead to death; Five Deficiency conditions lead to death. Full pulse, hot skin, abdominal distension, blockage of front and back (urination and defecation), and stifling dizziness constitute Five Excess. Thin pulse, cold skin, shortness of breath, leakage of front and back (incontinence), and inability to eat constitute Five Deficiency. If gruel enters the stomach and diarrhea stops, the deficient patient lives. If sweat appears and bowels/urine become free, the excess patient lives. (From *Su Wen: Treatise on the True Hidden Zang Pulses*)
Full form but thin pulse, with insufficient Qi to breathe, is critical. Thin form but large pulse, with excessive Qi in the chest, is fatal. Harmonious form and Qi indicate life; chaotic and uncoordinated form and Qi indicate disease. If all three parts and nine positions of the pulse are discordant, death ensues. If pulses above and below, left and right, respond to each other like pounding grain, the disease is severe; if they are discordant and uncountable, death ensues. If the central pulse alone is harmonious but discordant with the other viscera, death ensues. If the central pulse diminishes, death ensues. Sunken eyes indicate death. Emaciation with limbs still moving indicates death. Appearance of True Zang pulses indicates death.
If all nine positions of the pulse are deep, thin, and suspended/extreme, this is Yin ruling Winter, so death occurs at midnight. If the pulse is full, restless, panting, and rapid, this is Yang ruling Summer, so death occurs at noon.
Patients with cold-heat diseases die at dawn. Patients with heat-in-the-middle and heat diseases die at noon. Patients with wind diseases die at dusk. Patients with edema die at midnight. Those whose pulse is intermittently slow and rapid, or intermittent and fast, die during the transition periods of the four seasons (Chen, Xu, Chou, Wei hours). If flesh and muscle are already depleted, even if the nine positions are harmonious, death ensues. If the seven diagnostic signs appear but the nine positions follow the seasons, death does not ensue. Absence of pulse flow indicates death. Skin adhering tightly to bone indicates death.
Elevated pupils indicate insufficiency of the Taiyang channel. Fixed upward gaze indicates exhaustion of the Taiyang channel; this is key to determining life and death. (From *Su Wen: Treatise on Three Parts and Nine Positions*)
For infants with heat disease, if the pulse is suspended and small, warmth of hands and feet indicates life, coldness indicates death. For infants with wind-heat, wheezing, and shoulder breathing, if the pulse is full and large, slowness indicates life, urgency indicates death. For intestinal bleeding, fever indicates death, absence of fever indicates life. For passage of white foam from the rectum, deep pulse indicates life, floating pulse indicates death. For pus and blood from the intestines, suspended/extreme pulse indicates death, slippery and large pulse indicates life. For intestinal disorders, if there is no fever and the pulse is not suspended/extreme, slippery and large indicates life, suspended and choppy indicates death. (From *Su Wen: Treatise on Comprehensive Evaluation of Excess and Deficiency*)
Yang rises from the left, Yin descends from the right. For the elderly, disease proceeds from top to bottom; for the young, from bottom to top. Thus, following Yang in Spring and Summer leads to life, following Yin in Autumn and Winter leads to death; reversing this, following Autumn/Winter leads to death, following Spring/Summer leads to life. In Cold-Jue reaching the knees, the young die in Autumn/Winter, the elderly survive in Autumn/Winter.
Weak form and deficient Qi lead to death. Full form and Qi but deficient pulse Qi lead to death. Full pulse Qi but deficient form and Qi lead to survival. (From *Su Wen: Treatise on Fullness and Emptiness*)
Those who retain their guarding function live; those who lose it die. Those who possess Shen prosper; those who lose Shen perish. (From *Su Wen: Treatise on Basic Disease*)
In healthy people, Qi exceeding Form indicates longevity. In sick people, if flesh and muscle are depleted, Qi exceeding Form indicates death; Form exceeding Qi indicates danger. (From *Ling Shu: Treatise on Longevity and Shortness of Life*)
In heat disease lasting 7-8 days, if the pulse is minute, the patient urinates blood, and the mouth is dry, death occurs in one and a half days. If the pulse is Intermitting (Dai), death occurs in one day.
After heat disease has sweated, if the pulse remains restless, panting occurs, and fever returns, severe panting leads to death.
In heat disease lasting 7-8 days, if the pulse is not restless, or restless but not rapid, and sweating occurs within the next three days, but no sweating occurs after three days, death occurs on the fourth day.
If the patient with heat disease does not know where the pain is, is deaf, cannot control their limbs, has a dry mouth, extreme Yang heat, yet significant Yin cold, the heat is in the marrow; this is incurable and fatal.
If heat disease has sweated but the pulse remains full and restless, this is the extreme of Yin pulses, leading to death. If sweating results in a calm pulse, life ensues. If heat disease presents with full, restless pulse but no sweating, this is the extreme of Yang pulses, leading to death. If the full, restless pulse becomes calm after sweating, life ensues.
There are nine types of heat disease that should not be treated with acupuncture: 1. No sweat, red cheeks, and hiccups lead to death. 2. Diarrhea with full abdominal distension leads to death. 3. Blindness... [text missing] ...leads to death. 7. Coughing with epistaxis, no sweat, or sweat not reaching the feet leads to death. 8. Marrow heat leads to death. 9. Heat with spasms leads to death. This includes opisthotonos, convulsions, and lockjaw. All nine are untreatable by acupuncture. (From *Su Wen: Treatise on Heat Disease*)
Heat disease with calm pulse, which becomes full and restless after sweating, is the first reversal. Diarrhea with洪大 (Hong Da / Surging) pulse is the second reversal. Fixed Bi syndrome without migration, muscle wasting, fever, emaciation, and firm/pounding pulse is the fifth reversal.
One exhalation with two beats is Ping (Normal); three beats is Li Jing (Departing from the Channel); four beats is Duo Jing (Depleting Essence); five beats is Si (Death); six beats is Ming Jue (Life Extinction). These are Zhi (Rapid) pulses. One exhalation with one beat is Li Jing; two exhalations for one beat is Duo Jing; three exhalations for one beat is Si; four exhalations for one beat is Jue Ming (Extinction of Life). These are Sun (Damaged/Slow) pulses. Disease of Sun damage: First damage affects skin and hair, causing wrinkled skin and falling hair. Second damage affects blood vessels, causing deficiency unable to nourish the Zang-Fu. Third damage affects muscles, causing emaciation. Conversely, disease of Zhi pulses: Progressing from top to bottom, bone痿 (Wei / Atrophy) preventing getting out of bed leads to death. Progressing from bottom to top, wrinkled skin and falling hair leads to death. Palpating pulse: Two beats per inhalation/exhalation, neither large nor small, is Ping. Three beats per inhalation/exhalation indicates recent onset. Anterior large/posterior small causes headache and vertigo; anterior small/posterior large causes chest fullness and shortness of breath. Four beats per inhalation/exhalation indicates worsening; Hong Da pulse causes vexation and fullness; Chen Xi (Deep and Fine) pulse causes abdominal pain. Hua (Slippery) pulse indicates heat injury; Se (Choppy) pulse indicates mist/dampness injury. Five beats per inhalation/exhalation indicates fatigue; Chen Xi worsens at night, Fu Da (Floating and Large) worsens by day; neither large nor small is treatable despite fatigue; varying sizes are difficult to treat. Six beats per inhalation/exhalation is a Death Pulse; Chen Xi dies at night, Fu Da dies by day. One beat per inhalation/exhalation is named Sun; although the person can walk, they must lie in bed because Qi and Blood are insufficient. Two exhalations/inhalations for one beat is named Wu Hun (No Soul); such persons should die, though they may walk, they are called "walking corpses." Upper pulse present, lower absent, indicates vomiting; if no vomiting, death ensues. Upper absent, lower present, though difficult, poses no major threat because the Chi position is like tree roots; even if branches wither, roots regenerate. Pulse has roots, person has Yuan Qi, thus knowing they will not die.
Bian Que said: Sinew exhaustion is untreatable, death occurs in nine days. Signs include green-black fingernails/toenails, shouting and cursing incessantly.