吕商得伤寒。自利腹满。不烦。不渴。呕吐。头痛。子诊趺阳脉大而紧。曰太阴证也。若少
阴下利必渴。今不渴。故知太阴证。仲景云自利不渴属太阴。调治数日愈。
论曰。或问伤寒何以诊趺阳。予曰仲景称趺阳脉大而紧者。当即下利。脉经云下利脉大为未
止。脉微细者今日愈。仲景论趺阳脉九十一处。皆因脾胃而设也。且如称趺阳脉滑而紧。则曰滑
乃胃实。紧乃脾弱。趺阳脉浮而涩。则曰浮为吐逆。水谷不化。涩则食不得入。趺阳脉紧而浮。
浮则腹满。紧则绞痛。趺阳脉不出。则曰脾虚。上下体冷。肤硬。则皆脾胃之设可知矣。大抵外
证。腹满自利。呕恶吐逆之类。审是病在脾胃。而又参决以趺阳之脉。则无失矣。其脉见于足趺
之阳。故曰趺阳。仲景讥世人握手而不及足。
李思顺得伤寒。恶寒发热。口中气热如火。不绝七八日矣。而目闭不肯开。予诊其脉。阴阳
俱紧。是必汗之而复下之故也。此坏证矣。病家曰。一医于三日前汗之不愈。一医复下之。而目闭矣。遂投以小
柴胡汤。五啜而愈。
论曰。或问何以知其汗下而目闭。予曰。仲景称伤寒发热。口中气勃勃然。头痛目黄。若下
之则目闭。又云伤寒脉阴阳俱紧。恶寒发热。目赤。脉多睛不慧。医复汗之。咽中伤。若复下。
则两目闭。此坏证。须小柴胡汤。调之愈。
吕商患伤寒。出现自发性腹泻、腹部胀满。没有心烦。没有口渴。呕吐。头痛。许叔微诊察其趺阳脉（足背动脉，反映脾胃状况），脉象大而紧。说这是太阴病证（脾阳虚衰，寒湿内盛）。如果是少阴病下利必然口渴。现在不渴。所以知道是太阴病证。张仲景说自发性腹泻且不口渴的属于太阴病。经过数日的调理治疗痊愈了。
论述说：有人问伤寒为什么诊察趺阳脉？我说张仲景提到趺阳脉大而紧的，应当立即出现下利。《脉经》说下利脉大为病势未止。脉微细的是今日将愈。张仲景论述趺阳脉的地方有九十一处，都是因脾胃而设立的。就像说趺阳脉滑而紧，则说滑乃是胃气实，紧乃是脾气弱。趺阳脉浮而涩，则说浮为呕吐逆气，水谷不化。涩则食物不能入口。趺阳脉紧而浮，浮则腹部胀满，紧则绞痛。趺阳脉摸不到，则说脾虚。上下肢体冷，皮肤僵硬，这些都可知是脾胃病变所设。大抵外感病症中，腹部胀满、自发性腹泻、恶心呕吐逆气之类，审察确定病在脾胃，而又参酌决断以趺阳之脉，就不会有误了。其脉见于足背的阳面，所以叫趺阳。张仲景讥笑世人只诊手腕脉而不诊足脉。
李思顺患伤寒。恶寒发热。口中气息热如火。持续了七八天。而且眼睛闭合不肯睁开。许叔微诊察他的脉象，寸关尺三部脉皆紧。这一定是发汗后又误用泻下法导致的。这是坏病证（因误治导致病情恶化复杂）。病人家属说。一位医生在三日前发汗后病未愈。另一位医生又用泻下法。而导致眼睛闭合。于是投以小柴胡汤（和解少阳方剂）。服用五次后痊愈。
论述说：有人问怎么知道是发汗和泻下后导致眼睛闭合？我说张仲景说伤寒发热，口中气息热气腾腾，头痛目黄，如果误用泻下法则会导致眼睛闭合。又说伤寒脉象寸关尺俱紧，恶寒发热，眼睛红赤，脉象多显示眼神无光。医生又发汗，咽喉受伤。如果再泻下，则两眼闭合。这是坏病证。须用小柴胡汤。调理后痊愈。
Lu Shang contracted Cold Damage (Shanghan). He experienced spontaneous diarrhea (Zili) and abdominal fullness. There was no mental restlessness (Fan). There was no thirst. Vomiting occurred. Headache was present. Xu Shuwei palpated the Duyang pulse (pulse at the dorsum of the foot, reflecting Spleen and Stomach status), which was large and tight. He said this is a Taiyin syndrome (Syndrome of Spleen Yang deficiency with cold-dampness internal accumulation). If Shaoyin syndrome involved diarrhea, there would inevitably be thirst. Since there is no thirst now, it is known to be a Taiyin syndrome. Zhang Zhongjing stated that spontaneous diarrhea without thirst belongs to Taiyin. After several days of regulation and treatment, he recovered.
The commentary states: Someone asked why diagnose the Duyang pulse in Cold Damage? I said Zhang Zhongjing mentioned that when the Duyang pulse is large and tight, diarrhea should immediately occur. The *Mai Jing* (Classic of Pulses) states that for diarrhea, a large pulse indicates the disease has not yet stopped. A fine and minute pulse indicates recovery on that day. Zhang Zhongjing discussed the Duyang pulse in ninety-one places, all established due to the Spleen and Stomach. For instance, if the Duyang pulse is slippery and tight, it is said that slippery indicates Stomach excess, and tight indicates Spleen weakness. If the Duyang pulse is floating and choppy, it is said that floating indicates vomiting and counterflow qi, with undigested food and water. Choppy indicates inability to ingest food. If the Duyang pulse is tight and floating, floating indicates abdominal fullness, and tight indicates colic pain. If the Duyang pulse is imperceptible, it indicates Spleen deficiency. Coldness in the upper and lower body, and hard skin, all indicate these are indications set for Spleen and Stomach diseases. Generally, in exterior syndromes, such as abdominal fullness, spontaneous diarrhea, nausea, vomiting, and counterflow qi, if it is determined that the disease lies in the Spleen and Stomach, and this is corroborated by the Duyang pulse, there will be no error. The pulse appears on the Yang aspect of the dorsum of the foot, hence called Duyang. Zhang Zhongjing ridiculed people who only palpate the wrist pulse and neglect the foot pulse.
Li Sishun contracted Cold Damage. He had aversion to cold and fever. His breath from the mouth was hot like fire. This persisted for seven or eight days. Moreover, his eyes were closed and unwilling to open. Xu Shuwei palpated his pulse; the Yin and Yang pulses (referring to Cunkou/Guan/Kou positions or superficial/deep aspects) were both tight. This must have been caused by sweating followed by purging. This is a Huai Zheng (complicated/deteriorated syndrome due to mis-treatment). The patient's family said, "A physician induced sweating three days ago, but the illness did not resolve. Another physician then used purgation, resulting in closed eyes." Subsequently, Xiao Chaihu Tang (Minor Bupleurum Decoction) was administered. After five doses, he recovered.
The commentary states: Someone asked how one knows that sweating and purging led to closed eyes? I said Zhang Zhongjing stated that in Cold Damage with fever, breath from the mouth is hot and steaming, headache, and yellow eyes; if purged, the eyes will close. It also says that in Cold Damage, if the Yin and Yang pulses are both tight, with aversion to cold and fever, red eyes, and the pulse often shows dull spirit in the eyes, if the physician induces sweating, the throat will be injured. If purgation is applied again, both eyes will close. This is a Huai Zheng (deteriorated syndrome). Xiao Chaihu Tang must be used. Regulation leads to recovery.