阳盛格阴身肢厥，恶热烦渴大便难，沉滑爪赤小便赤，汗下清宜阴自完。
【注】经曰∶阳气太盛，阴气不得相营也。不相营者，不相入也。既不相入，则格阴于
外，故曰阳盛格阴也。其外证虽身肢厥冷，颇似阴寒，而内则烦渴，大便难，小便赤，恶
热不欲近衣，爪甲赤，脉沉滑，一派阳实热证。汗下清三法得宜，则阳得以消，阴得以
完全也。表实无汗，三黄石膏汤。里实不便，三承气汤。热盛无表里证，宜解毒白虎汤。
【集注】刘完素曰∶蓄热内甚，脉须疾数，以其极热蓄甚而脉道不利，反致脉沉细欲绝，
俗未明造化之理。反谓传为寒极阴毒者，或始得之，阳热暴甚，而便有此证候者，或两
感热甚者，通宜解毒加大承气汤下之。后热稍退而未愈者，黄连解毒汤调之。或微热未
除者，凉膈散调之。或失下热极，以至身冷脉微而昏冒将死，若急下之，则残阴暴绝必
死，盖阳后竭而然也。不下亦死，宜凉膈散或黄连解毒汤，养阴退阳，积热渐以消散，则
心胸再暖而脉渐以生也。
阴盛格阳色浅赤，发热不渴厥而烦，下利尿清爪青白，浮微通脉复阳还。
【注】经曰∶阴气太盛，阳气不得相营也。不相营者，不相入也。既不相入，则格阳于
外，故曰阴盛格阳也。色浅赤，谓面色见浮浅之红赤色也。其外证面赤发热而烦，颇类
阳热，其内则不渴，下利清谷，小便清白，爪甲青白，四肢厥冷，脉浮微欲绝，一派阴寒
虚证。宜通脉四逆汤冷服之，从其阴而复其阳也。利止脉不出，加倍人参。下利无脉，宜
白通加猪胆汁人尿汤。厥烦欲死，宜吴茱萸汤。
阳盛格阴证表现为四肢厥冷，伴有恶热、心烦口渴、大便干结难解，脉象沉滑，指甲颜色红赤，小便短赤，治疗宜采用发汗、攻下或清热法，使阴阳恢复平衡。
【注】《内经》说：阳气过于亢盛，阴气无法与之相互营运。所谓“不相营”，即指阴阳不能相互交入。既然不能交入，就会将阴气格拒于体表之外，所以称为“阳盛格阴”。其外在症状虽然出现四肢厥冷，看似阴寒之证，但内部却有心烦口渴、大便困难、小便色赤、怕热且不愿穿衣、指甲发红、脉象沉滑等一派阳实热证的典型表现。若汗法、下法、清法运用得当，则亢盛的阳气得以消退，阴液得以保全。若表实无汗者，用三黄石膏汤；若里实便秘者，用三承气汤；若热势炽盛而无表里实证者，宜用解毒白虎汤。
【集注】刘完素说：体内蓄积的热邪极重，脉搏应当急促而数，但由于极度热邪蕴结导致脉道不利，反而出现脉象沉细欲绝的情况，世俗之人不明造化之理，反而误认为是传变为寒极阴毒之证。有的患者初起时阳热暴盛，便出现此类证候；有的两感病热势严重者，均宜用解毒加大承气汤攻下。待热势稍退但未痊愈者，用黄连解毒汤调理。若有微热未除者，用凉膈散调理。若因失于攻下导致热极，出现身冷脉微、神志昏蒙濒临死亡，此时若急用攻下，残存的阴液会骤然断绝必死无疑，这是因为阳气先竭所致。若不攻下也会死亡，宜用凉膈散或黄连解毒汤，以滋养阴液、退制阳气，使积热逐渐消散，心胸重新温暖，脉象逐渐恢复。
阴盛格阳证表现为面色淡红，发热但不口渴，四肢厥冷且心烦，下利清谷，小便清长，指甲青白，脉象浮微，治宜通脉四逆汤回阳救逆。
【注】《内经》说：阴气过于亢盛，阳气无法与之相互营运。所谓“不相营”，即指阴阳不能相互交入。既然不能交入，就会将阳气格拒于体表之外，所以称为“阴盛格阳”。“色浅赤”，是指面色呈现浮浅的红赤色。其外在症状见面部发红、发热且心烦，颇似阳热证，但其内在表现是不口渴、下利清谷、小便清白、指甲青白、四肢厥冷、脉象浮微欲绝，这是一派阴寒虚证的典型表现。宜用通脉四逆汤冷服，以顺从其阴寒之势而回复阳气。若腹泻停止但脉搏仍不出，应加倍使用人参。若下利且无脉，宜用白通加猪胆汁人尿汤。若四肢厥冷、心烦欲死者，宜用吴茱萸汤。
Yang Excess Repelling Yin presents with coldness of the body and limbs, aversion to heat, vexation, thirst, and difficult defecation. The pulse is deep and slippery, the fingernails are red, and the urine is red. Treatment with sweating, purging, or clearing methods is appropriate to restore yin integrity.
[Annotation] The Classic states: "When yang qi is excessively abundant, yin qi cannot circulate mutually." "Not circulating mutually" means they do not enter each other. Since they do not enter each other, yin is repelled to the exterior, hence it is called "Yang Excess Repelling Yin." Although the external signs include coldness of the body and limbs, resembling a yin-cold pattern, internally there is vexation, thirst, difficulty in defecation, red urine, aversion to heat, unwillingness to wear clothes, red fingernails, and a deep, slippery pulse—a full set of excess-heat signs of yang. If sweating, purging, and clearing methods are applied appropriately, excess yang will diminish, and yin will be preserved. For exterior excess with no sweating, use Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction). For interior excess with constipation, use the Three Chengqi Decoctions. For intense heat without exterior or interior excess signs, use Jiedu Baihu Tang (Detoxifying White Tiger Decoction).
[Collected Annotations] Liu Wansu said: "When heat accumulates severely within, the pulse should be rapid and frequent. However, due to extreme heat accumulation obstructing the pulse vessels, the pulse may instead appear deep, thin, and nearly imperceptible. Laypeople, unaware of the principles of transformation, mistakenly consider this as transmission to extreme cold and yin toxicity. In cases where yang-heat becomes suddenly severe at onset, presenting such symptoms, or in simultaneous cold-heat syndromes with severe heat, one should generally use Jiedu Plus Dachengqi Tang (Detoxifying Plus Great Order the Qi Decoction) to purge. After the heat subsides slightly but recovery is incomplete, use Huanglian Jiedu Tang (Coptis Detoxification Decoction) to regulate. If slight heat remains, use Liangge San (Cooling Chest Powder) to regulate. If failure to purge leads to extreme heat, resulting in cold body, faint pulse, and coma approaching death, urgent purging would cause the residual yin to abruptly cease, leading to certain death, as yang has already exhausted. Not purging also leads to death; one should use Liangge San or Huanglian Jiedu Tang to nourish yin and retreat yang, allowing accumulated heat to gradually dissipate, so that the chest and heart become warm again and the pulse gradually returns."
Yin Excess Repelling Yang presents with pale-red complexion, fever without thirst, cold limbs with vexation, clear watery diarrhea, clear urine, and cyan-white fingernails. The pulse is floating and faint. Treatment involves Tongmai Sini Tang (Pulse-Returning Cinnamon and Aconite Decoction) to restore yang.
[Annotation] The Classic states: "When yin qi is excessively abundant, yang qi cannot circulate mutually." "Not circulating mutually" means they do not enter each other. Since they do not enter each other, yang is repelled to the exterior, hence it is called "Yin Excess Repelling Yang." "Pale-red complexion" refers to a floating, superficial reddish hue on the face. Externally, there is facial redness, fever, and vexation, resembling a yang-heat pattern. Internally, however, there is no thirst, clear watery diarrhea, clear urine, cyan-white fingernails, cold limbs, and a floating, faint, nearly imperceptible pulse—a full set of yin-cold deficiency signs. One should use Tongmai Sini Tang taken cold to follow the yin-cold nature and restore yang. If diarrhea stops but the pulse does not return, double the dosage of Renshen (Ginseng Radix et Rhizoma). If there is diarrhea and no pulse, use Baitong Plus Pig Gallbladder Bile and Human Urine Decoction. For cold limbs and severe vexation approaching death, use Wuzhuyu Tang (Evodia Decoction).