太阳脉似少阴。少阴症似太阳。虽曰相似。治法不同。脉沉发热。同也。以其有头疼。
故名太阳病。阳症脉当浮。今反不浮而沉。里必虚寒也。身体疼痛。但宜救里。使正气内强。逼
邪出外。用干姜生附出汗而解。若里不虚寒。则必脉浮。正属太阳麻黄汤症矣。脉沉发热。
同也。以其无头疼。故名少阴病。阴症当不热。今反发热。寒邪在表。未传于里。但皮肤郁
闭而为热。如在里无热。用麻黄附子细辛汤。麻黄发表间之汗。附子温少阴之经。假使寒邪
在里。则外必无热。当见吐利厥逆等症。正属少阴四逆症矣。盖少阴表邪浮浅。发热反为轻
。太阳正气衰微。脉沉反为重。熟附配麻黄。发中有补。生附配干姜补中有发。仲景之旨微
脉浮为表。治宜汗之。若脉浮大。心下硬有热。属脏者攻之。不令发汗。脉沉为里。治
宜下之。若少阴病。始得之反发热脉沉者。麻黄附子细辛汤微汗之。脉促为阳。治宜清之。若脉促
而厥冷。炙之温之。此又非促为阳盛之论矣。脉迟为寒。治宜温之。若阳明脉迟。不恶寒。
身体 汗出。用大承气下之。此又非迟为阴寒之论矣。四者皆从症不从脉也。
表症宜汗。此其常也。然发热头痛。脉反沉身体疼痛。当救其里。用四逆汤。里症宜下
。此其常也。日晡发热属阳明。脉浮者宜汗。用桂枝汤。结胸症具。宜陷胸汤下之。然脉浮大者
不可下。下之则死。当治其表。身疼痛者。宜桂枝麻黄解之。然尺中迟者不可汗。营血不
足故也。当调其营四者皆从脉不从症也。
太阳病的脉象与少阴病相似，少阴病的症状与太阳病相似。虽然表面看似相同，但治疗方法却不同。
脉象沉而伴有发热，这是两者共同的表现。如果患者同时有头痛，就称为太阳病。阳证（阳气受邪的病症）的脉象应当浮起，现在反而不浮而沉，说明体内必然存在虚寒。身体疼痛，此时只宜救治里虚，使正气在内部增强，从而逼迫邪气从体表排出。使用干姜和生附子，通过发汗来解除病邪。如果体内不虚寒，那么脉象必定是浮的，这就属于太阳病的麻黄汤证了。
脉象沉而伴有发热，这也是两者的共同表现。如果患者没有头痛，就称为少阴病。阴证（阴气受邪或阳气不足的病症）通常不应发热，现在反而发热，是因为寒邪停留在体表，尚未传入体内。仅仅是因为皮肤毛孔郁闭而导致发热。如果热邪在体内，则体表不会有热感。此时使用麻黄附子细辛汤。麻黄发散表层的汗液，附子温通少阴经的阳气。假使寒邪已经在体内，那么体表必然没有发热，应当出现呕吐、腹泻、四肢厥冷等症状，这就属于少阴病的四逆汤证了。大概来说，少阴病的表邪浮浅，发热反而算是轻症；太阳病正气衰微，脉象沉反而算是重症。熟附子配合麻黄，是在发汗中兼有补益；生附子配合干姜，是在补益中兼有发散。这是张仲景的深意所在。
脉象浮表示病在表，治疗适宜用发汗法。如果脉象浮大，且心下部位坚硬并有热感，属于脏实者应当攻下，不要发汗。脉象沉表示病在里，治疗适宜用攻下法。如果是少阴病，刚得病就反常地发热且脉象沉，应用麻黄附子细辛汤微微发汗。脉象促（数而时止）属阳，治疗适宜用清热法。如果脉象促且伴有四肢厥冷，应当用艾灸等方法温之。这又不同于认为促脉就是阳盛的理论了。脉象迟（缓慢）主寒，治疗适宜用温法。如果是阳明病脉迟，但不恶寒，身体出汗，应用大承气汤攻下。这又不同于认为迟脉就是阴寒的理论了。以上四种情况都是依据症状而不依据脉象来判断的。
表证适宜发汗，这是常规治法。然而如果出现发热头痛，脉象反而沉，身体疼痛，应当先救其里虚，使用四逆汤。里证适宜攻下，这是常规治法。日晡时分（下午3-5点）发热属于阳明病，如果脉象浮，适宜发汗，使用桂枝汤。结胸证具备，适宜用陷胸汤攻下。然而如果脉象浮大，则不可攻下，攻下会导致死亡，应当治疗其表证。身体疼痛者，适宜用桂枝麻黄各半汤等解表。然而如果尺部脉象迟，则不可发汗，这是因为营血不足的缘故，应当调理营血。以上四种情况都是依据脉象而不依据症状来判断的。
Taiyang (Greater Yang) pulse resembles Shaoyin (Lesser Yin), and Shaoyin symptoms resemble Taiyang. Although they appear similar, the treatment methods differ.
A deep pulse accompanied by fever is a common manifestation in both conditions. If headache is present, it is designated as Taiyang disease. Yang syndromes typically present with a floating pulse; however, if the pulse is deep rather than floating, it indicates internal deficiency-cold. With body pain, the priority should be to treat the interior deficiency, strengthening the healthy qi internally to expel pathogenic factors outward. Ganjiang Sheng Fuzi Decoction (Dried Ginger and Raw Aconite Decoction) may be used to resolve the condition through sweating. If there is no internal deficiency-cold, the pulse will necessarily be floating, which corresponds to the Mahuang Tang (Ephedra Decoction) syndrome of Taiyang.
A deep pulse accompanied by fever is also a shared feature. If headache is absent, it is designated as Shaoyin disease. Yin syndromes typically do not involve fever; thus, the presence of fever suggests that cold pathogens remain at the exterior and have not yet transmitted inward. The fever arises merely from the stagnation and closure of the skin pores. If heat were located within the interior, there would be no external fever. In this scenario, Ma Huang Fu Zi Xi Xin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) is indicated. Mahuang (Ephedrae Herba) releases the exterior slightly, while Fuzi (Aconiti Lateralis Radix Preparata) warms the Shaoyin meridians. Conversely, if cold pathogens are located in the interior, there will certainly be no external fever, and symptoms such as vomiting, diarrhea, and cold extremities (Jue Ni) will appear, corresponding to the Sini Tang (Recovery Decoction) syndrome of Shaoyin. Generally speaking, for Shaoyin exterior pathogens that are superficial, the presence of fever is considered a milder condition; whereas for Taiyang disease where healthy qi is significantly depleted, a deep pulse is considered a more severe condition. Shu Fuzi (Prepared Aconite) combined with Mahuang provides tonification amidst release; Sheng Fuzi (Raw Aconite) combined with Ganjiang provides release amidst tonification. This reflects the profound intent of Zhang Zhongjing.
A floating pulse indicates an exterior condition, for which diaphoresis (sweating) is the appropriate treatment. However, if the pulse is large and floating, accompanied by hardness and heat in the epigastrium (Xin Xia), indicating excess in the zang organs, purgation should be employed, and diaphoresis avoided. A deep pulse indicates an interior condition, for which purgation is the appropriate treatment. If Shaoyin disease presents initially with fever and a deep pulse, Ma Huang Fu Zi Xi Xin Tang should be used to induce slight sweating. An accelerated pulse (Cu Mai) generally indicates yang, for which clearing heat is the appropriate treatment. However, if an accelerated pulse is accompanied by cold extremities, moxibustion or warming methods should be used. This contradicts the theory that an accelerated pulse always signifies yang excess. A slow pulse (Chi Mai) indicates cold, for which warming is the appropriate treatment. However, in Yangming disease, if the pulse is slow but there is no aversion to cold and the body sweats, Da Cheng Qi Tang (Major Order the Qi Decoction) should be used for purgation. This contradicts the theory that a slow pulse always signifies yin-cold. These four scenarios illustrate prioritizing symptoms over pulses.
Exterior syndromes typically require diaphoresis, which is the standard approach. However, if there is fever and headache with a deep pulse and body pain, the interior must be treated first using Sini Tang (Recovery Decoction). Interior syndromes typically require purgation, which is the standard approach. Fever occurring during the You hour (17:00–19:00) belongs to Yangming; if the pulse is floating, diaphoresis with Guizhi Tang (Cinnamon Twig Decoction) is appropriate. If Jie Xiong (Chest Binding) syndrome is fully manifested, Xian Xiong Tang (Sinking Chest Decoction) is indicated for purgation. However, if the pulse is large and floating, purgation is contraindicated as it may lead to death; instead, the exterior should be treated. For body pain, Guizhi Mahuang Ge Ban Tang (Decoction of Half Dosage of Cinnamon Twig and Ephedra) is suitable for resolution. However, if the radial pulse at the cun position is slow, diaphoresis is contraindicated due to insufficient Ying blood (Nutritive Blood); instead, the Ying blood should be regulated. These four scenarios illustrate prioritizing pulses over symptoms.