On the Life and Death Determined by Pulse and Symptoms

On the Life and Death Determined by Pulse and Symptoms

Physicians are responsible for saving people's lives; if they do not know death, how can they know life? If a patient is beyond saving, then as long as there is even a trace of vitality, every possible effort should be made to revive them. To distinguish between life and death, one must first understand pulse and symptoms. Gao Shizong (1) classified cases with heavy bleeding as "collateral blood," and those with light bleeding as "mainstream blood." He believed that heavy bleeding indicated a milder illness, while light bleeding indicated a more severe one. In reality, however, the mainstream blood branches out into collateral blood, and the collateral blood further splits into smaller branches, much like a tree trunk splitting into branches, and these branches in turn split into smaller branches—all ultimately converging into one main trunk. Therefore, judging the severity of blood based on whether it is mainstream or collateral is meaningless. According to "Medical Principles" (2), external injuries causing bleeding are easier to treat, while internal injuries causing bleeding are harder to cure. According to "Three-Finger Zen" (3), tooth bleeding is the mildest, followed by nosebleeds, then vomiting, and finally coughing, spitting, and hemoptysis, which are the most severe. These conditions all originate from the five viscera, and the blood involved comes from deeper within the body, unlike vomiting, whose blood comes from the stomach and is relatively superficial. This aligns with Zhang Zhongjing's distinction between "near blood" and "far blood," and dividing the severity accordingly is not unreasonable. However, even though nosebleeds and vomiting are relatively mild, if the bleeding does not stop, and the blood is accompanied by a loss of qi, one can die instantly. Coughing and spitting blood, though far away and more severe, may still have a small amount of blood coming out, perhaps only a few mouthfuls, and even without medication, one might recover. Nevertheless, we should not use this as a definitive criterion for determining life and death. After all, blood carries qi, and qi drives blood. Human life depends entirely on qi; if blood is lost but qi remains, the person is still alive, even if in critical condition. As long as there is a trace of qi, blood can gradually regenerate and return to its original state. If blood is lost but qi remains, the person is still alive, even if in danger. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even if in critical condition. If blood is lost but qi remains, the person is still alive, even......In summary, the central idea of "On Yin and Yang, Water and Fire, Qi and Blood" is the product of combining the theory of Yin and Yang with clinical practice, further elaborating on the perspectives of the opposition and unity, as well as the waxing and waning and transformation of Yin and Yang. Through abundant clinical examples, the author reveals the dialectical relationships among Qi, blood, water, and fire, particularly providing an in-depth discussion on the mutual generation between Qi and water, and between blood and fire, thereby enriching the diagnostic content of traditional Chinese medicine in this regard.