凡瘟疫脉洪大滑数。而数中兼缓者可治。紧数甚者难治。
邵评∶瘟疫是阳症。洪大滑数是阳脉。更兼缓。是有胃气。故可治。紧则无胃气。故难治。
身大热。而脉沉涩细小。足冷者危。
邵评∶大热是阳邪。沉涩细小为阴脉。阳病见阴脉。故危。足冷者。邪盛而阳衰也。
瘟病四五日。身热腹满而吐。脉细而弦强者。十二日死。
邵评∶瘟病四五日。邪已入里。腹满而吐。病在脾胃。身热脉细。阳症见阴脉。弦强
是邪盛而无胃气。故死。
瘟病二三日。头痛腹满。脉直而疾者。八日死。
邵评∶病起二三日。表里症俱见。脉见直而疾。是邪盛而正衰。故死。
瘟病八九日。头身不痛。色不变而利不止。心下坚而脉大者。十七日死。
邵评∶病至八九日。邪去表而入里矣。利不止而心下坚。是虚邪结。其脉反大。久
病脉大。则为病进。正虚邪盛。迁延必死。
又评∶此种瘟疫。是天行之疠气从口鼻而入。风热与湿浊熏蒸。其气流布三焦。
在上焦者。为大头瘟、捻颈瘟。在中焦者。为瓜瓤瘟。杨梅瘟、疙瘩瘟。在下焦者。为绞肠瘟、软脚瘟
等症。治法当宗河间三焦立论。分心营肺卫。用手经辛凉之药。清热解毒。是为正治。不可用伤寒表
里分界。而用足经辛温发散之剂也。所列诸方。学人以意参之可也。
凡是瘟疫病的脉象表现为洪大、滑利且数，而在数脉中兼有缓象的，属于可治之证。若脉象紧而数且程度严重的，则难以治疗。
邵评：瘟疫属于阳证。洪大、滑、数是阳脉。如果更兼有缓象，说明胃气尚存，所以可以治疗。脉紧则说明没有胃气，所以难治。
身体高热，但脉象沉涩、细小，且足部发冷的，病情危重。
邵评：大热是阳邪的表现。沉、涩、细小属于阴脉。阳病出现阴脉，所以病情危重。足部发冷，是因为邪气盛而阳气衰败。
瘟病发展到四五日时，身体发热、腹部胀满并伴有呕吐，脉象细弱且弦硬的，预后不良，预计十二日后死亡。
邵评：瘟病到四五日，邪气已经入里。腹部胀满且呕吐，说明病变部位在脾胃。身体发热却见细脉，这是阳证出现阴脉。脉象弦硬，表明邪气盛而缺乏胃气，所以会导致死亡。
瘟病二三日时，出现头痛、腹部胀满，脉象直而急疾的，预后不良，预计八日后死亡。
邵评：病起于二三日，表证和里证同时出现。脉象呈现直而急疾的状态，说明邪气盛而正气衰败，所以会导致死亡。
瘟病八九日时，头部和身体不再疼痛，面色没有改变但腹泻不止，心下（胃脘部）坚硬且脉象大的，预后不良，预计十七日后死亡。
邵评：病至八九日，邪气已离开体表而深入体内。腹泻不止且心下坚硬，这是虚邪结聚。脉象反而变大，久病而脉大，说明病情进展。正气虚弱而邪气强盛，拖延下去必然导致死亡。
又评：这类瘟疫，是天行疠气从口鼻侵入人体，风热与湿浊相互熏蒸，其气流布于三焦。在上焦部位的，表现为大头瘟、捻颈瘟；在中焦部位的，表现为瓜瓤瘟、杨梅瘟、疙瘩瘟等症；在下焦部位的，表现为绞肠瘟、软脚瘟等症。治疗方法应当遵循河间学派关于三焦的理论，区分心营、肺卫，使用手经的辛凉药物，以清热解毒，这才是正确的治法。不可套用伤寒病的表里分界理论，而使用足经的辛温发散方剂。所列出的各方，学习者可以根据自己的理解参详即可。
In cases of plague (Wenyi), if the pulse is surging (Hong), large (Da), slippery (Hua), and rapid (Shu), but with a moderate/slack (Huan) quality intermixed within the rapidity, it is treatable. If the pulse is tight (Jin) and rapid to a severe degree, it is difficult to treat.
Shao's Commentary: Plague belongs to Yang syndromes (Yang zheng). Surging, large, slippery, and rapid pulses are Yang pulses. The presence of a slack quality indicates that the Stomach Qi (Wei Qi) is preserved; therefore, it is treatable. A tight pulse indicates the absence of Stomach Qi; therefore, it is difficult to treat.
If the body has high fever, yet the pulse is deep (Chen), choppy (Se), fine (Xi), and small (Xiao), accompanied by cold feet, the condition is critical.
Shao's Commentary: High fever is a manifestation of Yang pathogenic factors. Deep, choppy, fine, and small pulses are Yin pulses. When a Yang disease presents with Yin pulses, the prognosis is critical. Cold feet indicate that the pathogen is excessive while Yang Qi is declining.
When plague progresses to the fourth or fifth day, presenting with fever, abdominal fullness, and vomiting, and the pulse is fine and wiry-strong (Xian Qiang), death is expected on the twelfth day.
Shao's Commentary: By the fourth or fifth day of plague, the pathogen has entered the interior. Abdominal fullness and vomiting indicate pathology in the Spleen and Stomach. Fever combined with a fine pulse represents a Yang syndrome presenting with Yin pulses. A wiry and strong pulse indicates excess pathogen and lack of Stomach Qi; hence, it leads to death.
When plague occurs on the second or third day, presenting with headache and abdominal fullness, and the pulse is straight and rapid (Zhi Ji), death is expected on the eighth day.
Shao's Commentary: Onset on the second or third day shows both exterior and interior symptoms. A pulse that is straight and rapid indicates that the pathogen is excessive while the healthy Qi is deficient; hence, it leads to death.
When plague reaches the eighth or ninth day, with no pain in the head or body, unchanged complexion, but unceasing diarrhea, hardness below the heart (epigastrium), and a large pulse, death is expected on the seventeenth day.
Shao's Commentary: By the eighth or ninth day, the pathogen has left the exterior and entered the interior. Unceasing diarrhea and hardness below the heart indicate the accumulation of deficiency pathogens. The pulse being unexpectedly large in a chronic illness indicates disease progression. With deficient healthy Qi and excessive pathogen, prolongation inevitably leads to death.
Another Commentary: This type of plague involves pestilential qi (Li Qi) from heaven’s movement entering through the mouth and nose. Wind-heat steams and fumes with damp-turbidity, and its qi circulates throughout the Triple Burner (San Jiao). In the Upper Burner, it manifests as Big Head Plague (Datou Wen) and Twisted Neck Plague (Nianjing Wen); in the Middle Burner, it manifests as Melon Rind Plague (Guanrang Wen), Yangmei Plague, and Lump Plague (Geda Wen); in the Lower Burner, it manifests as Intestine-Twisting Plague (Jiaochang Wen) and Soft Leg Plague (Ruanjiao Wen), among other conditions. Treatment should follow He Jian’s theory of the Triple Burner, distinguishing between Heart Ying (Nutritive Level) and Lung Wei (Defensive Level), using acrid-cool herbs from the Hand meridians to clear heat and detoxify. This is the correct treatment. One must not apply the exterior-interior boundaries of Cold Damage (Shanghan) nor use acrid-warm dispersing formulas from the Foot meridians. The listed formulas may be studied by learners according to their own understanding.