十七难曰∶经言病或有死，或有不治自愈，或连年月不已。其死生存亡，可切脉而知之耶？
然∶可尽知也。
此引《素问·脉要精微论》、《平人气象论》语错杂言之，非经之全文也。所问三者，答曰可尽知也，
而下文止答病之死证，余无所见，或有阙简欤？抑不治自愈，即十三难之相生脉。连年月不已，即五十五难之积
聚病欤？未可知也，故俟参考。
诊病若闭目不欲见人者，脉当得肝脉弦急而长，而反得肺脉浮短而涩者，死也。
肝开窍于目，闭目不欲见人，肝病也。然肝之病，脉当弦急而长，今以肝病而诊得浮短而涩之肺脉，乃金来
克木也，故主死。
病若开目而渴，心下牢者，脉当得紧实而数，反得沉涩而微者，死也。
开目而渴者，心主热，热甚则开目而渴也。心下牢者，心痛现证，是实邪也，当得紧实而数之脉，今见沉濡
而微之肾脉，乃水来克火，况阳病而得阴脉，不死何待。
病若吐血复鼽衄血者，脉当沉细，而反浮大而牢者，死也。
失血，虚证也，其脉当沉细，而反见浮大牢实之脉，是阴病而得阳脉，病虚脉实，故主死。《灵枢·玉版篇》
曰∶衄而不止，脉大，是三逆。即此义也。
病若谵言妄语，身当有热，脉当洪大，而反手足厥逆，脉沉细而微者，死也。
谵妄，热证也。身当有热，脉当洪大，今反见手足厥冷，脉来沉细而微，此病实脉虚也，故死。
病若大腹而泄者，脉当微细而涩，反紧大而滑者，死也。
大腹而泄者，脾湿下陷，脉当微细，而反见滑大之脉，是亦病虚脉实矣。《灵枢·玉版篇》曰∶腹鸣而满，
四肢清泄，其脉大，是二逆，即此义也。
第十七难说：医经中说，疾病有的会导致死亡，有的不治疗也能自愈，有的则长年累月不好。这些疾病的生死存亡，可以通过切脉来知晓吗？
回答说：可以完全知晓。
这里引用了《素问·脉要精微论》和《平人气象论》中的话语，混杂在一起叙述，并非经典的原文全貌。所问的三种情况，回答说是可以完全知晓的，但下文只回答了疾病死亡的证候，其余两种情况未见解答，或许是简册有缺漏吧？或者“不治自愈”对应的是第十三难中提到的相生之脉？“连年月不已”对应的是第五十五难中的积聚病呢？这不得而知，所以暂且等待参考考证。
如果病人闭着眼睛不想见人，脉象应当出现肝脉（肝脏的脉象）弦急而长，反而出现肺脉（肺脏的脉象）浮短而涩的，是死证。
肝开窍于目，闭眼不想见人，这是肝病。然而肝病，脉象应当是弦急而长的，现在因为肝病却诊得浮短而涩的肺脉，这是金克木（肺金克制肝木），所以主死。
如果病人睁着眼睛并且口渴，心下部位坚硬痞结，脉象应当出现紧实而数的脉象，反而出现沉涩而微的脉象，是死证。
睁眼且口渴，说明心主热盛，热甚则导致睁眼和口渴。心下坚硬痞结，是心痛的表现，属于实邪，应当出现紧实而数的脉象，现在却见到沉濡而微的肾脉（肾脏的脉象），这是水克火（肾水克制心火），况且阳证得了阴脉，不死还等什么。
如果病人吐血又流鼻血，脉象应当沉细，反而出现浮大而牢实的脉象，是死证。
失血属于虚证，其脉象应当沉细，反而见到浮大牢实的脉象，这是阴证（虚证属阴）得了阳脉（实证属阳），病势虚而脉象实，所以主死。《灵枢·玉版篇》说：“鼻出血不止，脉象大，这是三逆。”就是这个道理。
如果病人胡言乱语、神志不清，身体应当发热，脉象应当洪大，反而出现手足厥冷，脉象沉细而微的，是死证。
谵妄属于热证。身体应当发热，脉象应当洪大，现在反而出现手足厥冷，脉象沉细而微，这是病证实而脉象虚，所以死。
如果病人腹部胀大并且腹泻，脉象应当微细而涩，反而出现紧大而滑的脉象，是死证。
腹部胀大并腹泻，是脾湿下陷，脉象应当微细，反而见到滑大的脉象，这也是病势虚而脉象实。《灵枢·玉版篇》说：“腹鸣且腹胀满，四肢清冷腹泻，脉象大，这是二逆。”就是这个道理。
Chapter 17 states: The classic texts mention that diseases may result in death, some may heal spontaneously without treatment, and others may persist for years. Can the life and death outcomes of these conditions be known through pulse diagnosis?
The answer is: It can be fully known.
This passage cites and mixes language from *Suwen: Pulse Essentials and Subtle Principles* (Ling Shu Jing Wei Lun) and *Ping Ren Qi Xiang Lun* (Treatise on the Qi Manifestations of Healthy People), rather than quoting the full original text verbatim. The question addresses three scenarios, and the answer asserts they can all be known; however, the subsequent text only discusses the fatal signs of disease, with no explanation for the other two cases. Perhaps there are missing bamboo slips? Or does "healing spontaneously without treatment" correspond to the mutually generating pulses mentioned in Chapter 13? And does "persisting for years" correspond to the accumulation disorders (Ji Ju Bing) described in Chapter 55? This remains uncertain, so further reference is awaited.
If a patient keeps their eyes closed and does not wish to see people, the pulse should reflect the Liver pulse (Gan Mai), which is wiry, rapid, long, and tense. If instead, the Lung pulse (Fei Mai) appears—floating, short, and choppy—it indicates death.
The liver opens into the eyes. Keeping the eyes closed and avoiding sight indicates liver pathology. However, in liver disease, the pulse should be wiry, rapid, long, and tense. Here, due to liver disease, a floating, short, and choppy lung pulse is diagnosed. This represents Metal overcoming Wood (Lung Metal suppressing Liver Wood), hence it signifies death.
If a patient has their eyes open and feels thirsty, with hardness and stagnation below the heart (Xin Xia), the pulse should be tight, solid, and rapid. If instead, the pulse is deep, choppy, and faint, it indicates death.
Having eyes open and feeling thirsty indicates excessive heat governed by the Heart. Severe heat causes the eyes to remain open and induces thirst. Hardness below the heart is a manifestation of heart pain, indicating an excess pathogen. The pulse should therefore be tight, solid, and rapid. Instead, a deep, soft, and faint Kidney pulse (Shen Mai) is observed. This represents Water overcoming Fire (Kidney Water suppressing Heart Fire). Moreover, a Yang condition presenting with a Yin pulse suggests that death is inevitable.
If a patient vomits blood and also suffers from epistaxis (nosebleed), the pulse should be deep and fine. If instead, the pulse is floating, large, and firm, it indicates death.
Blood loss constitutes a deficiency syndrome; thus, the pulse should be deep and fine. Observing a floating, large, and firm pulse indicates that a Yin condition (deficiency) presents with a Yang pulse (excess). A deficient disease manifesting with an excess pulse signifies death. As stated in *Lingshu: Yu Ban Pian*: "Epistaxis that does not stop, accompanied by a large pulse, constitutes one of the 'Three Reversals'." This illustrates the same principle.
If a patient speaks deliriously and acts irrationally, the body should have fever, and the pulse should be surging and large. If instead, the hands and feet are cold (Jue Ni), and the pulse is deep, fine, and faint, it indicates death.
Delirium belongs to heat syndromes. The body should be hot, and the pulse should be surging and large. Instead, cold extremities and a deep, fine, faint pulse are observed. This represents an excess disease presenting with a deficient pulse, hence it leads to death.
If a patient has abdominal distension accompanied by diarrhea, the pulse should be faint, fine, and choppy. If instead, the pulse is tight, large, and slippery, it indicates death.
Abdominal distension with diarrhea indicates Spleen dampness sinking downward; the pulse should be faint and fine. Instead, a slippery and large pulse is seen. This too represents a deficient disease manifesting with an excess pulse. As stated in *Lingshu: Yu Ban Pian*: "Borborygmus and abdominal fullness, cold limbs with diarrhea, accompanied by a large pulse, constitute one of the 'Two Reversals'." This illustrates the same principle.