阴阳俱紧鼻出涕。舌上苔滑勿妄治。蜷卧恶寒多呕痰。腹内痛者须成利。（仲景云。脉阴阳俱紧。口中气出。唇口干
燥。蜷卧足冷。鼻中涕出。舌上苔滑。勿妄治也。至七八日以来。其人微发热。手足温者。此为欲解。或到七八日以上。
反大热者。此为难治。设使恶寒者。必欲呕也。腹内痛者。必欲利也。）阳明湿痹并脏结。色白苔滑多在舌。（二证见下
文。）脏结无阳不可攻。（仲景云。脏结者无阳证。不往来寒热。其人反静。舌上滑苔者。不可攻。）湿痹丹田应有热。（仲
景云。湿痹之候。舌上有苔者。以丹田有热。胸中有寒。湿痹中湿也。）阳明懊 胁下坚。栀子柴胡不徒设。（阳明有二
证。仲景云。阳明。心中懊 舌上苔者。栀子汤主之。又云。阳明病。胁下坚满。不大便而呕。舌上苔者。可与柴胡汤。
上焦得通。津液得下。胃气因和。身 然汗出则解。）
伤寒表实里还虚。热气乘虚肠里居。下利脓血赤黄汁。或如鱼脑状难拘。（病源。伤寒病。苦表实里虚。热气乘虚入
于肠胃。则下赤黄汁。若湿毒瓦斯盛。则腹痛壮热。下脓血如鱼脑或如烂肉汁。）太阳下之脉浮滑。定知便血色殷（于闲切。）
如。（仲景云。太阳下之。其脉浮而滑者。必下血。）阳明下血而谵语。热入血室病难除。（仲景云。阳明病下血而谵语者。
必为热入血室。头汗出者。当刺期门。随其实而泻之。 然汗出则愈。）少阴脓血桃花证。不尔刺之邪可祛。（仲景云。
少阴下利。便脓血者。桃花汤主之。又云。少阴病下利。便脓血者可刺。）下利脉浮尺中涩。或者发厥热如初。二证皆圊
脓血利。悉见长沙仲景书。（仲景云。一证伤寒发热四日厥。反三四日复热。四日厥少热多。其病当愈。四日至六日热不
除。必清脓血。又一证云。下利脉又浮数。尺中自涩。其人必圊脓血。）
阴阳脉象俱紧，伴有鼻涕流出。舌苔滑腻时不可盲目治疗。身体蜷缩卧倒、恶寒且多呕吐痰涎者，若腹部疼痛，则必然导致腹泻。（张仲景说：脉象寸关尺三部俱紧，口中呼气，嘴唇干燥，身体蜷缩卧倒，足部发冷，鼻中流涕，舌上苔滑，此时不可妄加治疗。到了七八日以后，如果病人轻微发热，手足温暖，这是病情将要解除的征兆。或者到了七八日以上，反而出现大热症状，这属于难治之症。假如病人恶寒，必定想要呕吐；腹部疼痛，必定想要腹泻。）阳明湿痹与脏结证，舌苔色白且滑腻多见于舌面。（这两个证候见下文。）脏结证没有阳证表现，不可使用攻下法。（张仲景说：脏结证没有阳证，不出现往来寒热，病人反而安静，舌上滑苔，不可攻下。）湿痹证丹田部位应当有热。（张仲景说：湿痹的征候，舌上有苔，是因为丹田有热，胸中有寒，这是湿痹中湿的表现。）阳明病懊憹伴胁下坚硬，栀子汤和柴胡汤并非虚设。（阳明病有两个证候，张仲景说：阳明病，心中懊憹且舌上有苔，用栀子汤主治。又说：阳明病，胁下坚硬胀满，不大便且呕吐，舌上有苔，可给予柴胡汤。上焦通畅，津液下行，胃气调和，周身微微汗出则病愈。）
伤寒表实而里虚，热气乘虚侵入肠道。腹泻排出脓血及赤黄色汁液，或状如鱼脑般难以拘束形态。（《病源》记载：伤寒病，苦于表实里虚，热气乘虚进入肠胃，则排泄赤黄汁液。若湿毒之气旺盛，则腹痛壮热，排泄脓血状如鱼脑或如烂肉汁。）太阳病误下后脉象浮滑，必定知道大便血色深红如鸡肝。（张仲景说：太阳病误用下法，脉象浮而滑的，必然出现便血。）阳明病下血并伴有谵语，是热入血室之病，难以消除。（张仲景说：阳明病下血且谵语的，必定是热入血室，头部出汗的，应当针刺期门穴，随其实邪而泻之，周身濈然汗出则痊愈。）少阴病脓血便属桃花汤证，若不采用药物治疗，针刺亦可祛除邪气。（张仲景说：少阴病下利，便脓血的，用桃花汤主治。又说：少阴病下利，便脓血的，可以针刺。）下利脉浮且尺中涩，或者出现四肢厥冷发热如初的情况。这两种证候都涉及排泄脓血性腹泻，均见于长沙太守张仲景的医书中。（张仲景说：一证伤寒发热四日厥逆，反三四日后又发热，四日厥少热多，病应当痊愈。若第四日至第六日热不退，必然排泄脓血。又一证说：下利脉又浮数，尺中自涩，此人必然排泄脓血。）
Yin and Yang pulses are both tight, accompanied by nasal discharge. When the tongue coating is slippery, do not treat rashly. Curling up in bed, aversion to cold, and frequent vomiting of phlegm indicate that abdominal pain will inevitably lead to diarrhea. (Zhang Zhongjing stated: When the Yin and Yang pulses are all tight, breath exits the mouth, lips and mouth are dry, the body curls up with cold feet, nasal discharge occurs, and the tongue has a slippery coating, do not treat rashly. After seven or eight days, if the person has slight fever and warm hands and feet, this indicates the disease is about to resolve. Or, after seven or eight days, if there is sudden high fever, this is difficult to treat. If the person has aversion to cold, they will likely vomit; if there is abdominal pain, they will likely have diarrhea.) Yangming damp-bi and Zang-Jie syndromes present with white, slippery tongue coatings mostly on the tongue. (These two syndromes are described below.) Zang-Jie lacks Yang manifestations and cannot be treated with purgation. (Zhang Zhongjing stated: In Zang-Jie, there are no Yang signs, no alternating chills and fever, the person appears quiet, and with a slippery tongue coating, purgation is contraindicated.) In damp-bi, heat should be present in the Dantian. (Zhang Zhongjing stated: The manifestation of damp-bi includes a tongue coating, caused by heat in the Dantian and cold in the chest, which characterizes dampness obstructing the interior.) Yangming restlessness with hardness under the hypochondrium: Zhizi Tang and Chaihu Tang are not set in vain. (There are two Yangming syndromes. Zhang Zhongjing stated: In Yangming, with mental restlessness and a tongue coating, Zhizi Tang is the primary treatment. Also: In Yangming disease, with hardness and fullness under the hypochondrium, constipation, vomiting, and a tongue coating, Chaihu Tang may be given. Once the Upper Jiao is unblocked and fluids descend, Stomach Qi harmonizes, and mild sweating resolves the condition.)
Taiyang exterior excess with interior deficiency allows heat qi to invade the intestines vacuously. Diarrhea presents with pus, blood, and yellow-red fluid, or resembling fish brains, defying fixed forms. (The *Bing Yuan* states: In Taiyang disease, suffering from exterior excess and interior deficiency, heat qi invades the stomach and intestines vacuously, resulting in the discharge of yellow-red fluid. If damp-toxic qi is vigorous, there is abdominal pain and high fever, discharging pus and blood resembling fish brains or rotten meat juice.) Following incorrect purgation in Taiyang, a floating and slippery pulse indicates bright red blood in the stool. (Zhang Zhongjing stated: After incorrect purgation in Taiyang, if the pulse is floating and slippery, blood in the stool is certain.) Yangming bleeding with delirium indicates Heat Entering the Blood Chamber, a difficult condition to eradicate. (Zhang Zhongjing stated: In Yangming disease, bleeding with delirium indicates Heat Entering the Blood Chamber. With head sweating, puncture Qimen (LR14) to drain the excess; generalized sweating leads to recovery.) Shaoyin pus and blood stool belongs to Taohua Tang syndrome; otherwise, acupuncture can dispel the pathogen. (Zhang Zhongjing stated: In Shaoyin disease with diarrhea and pus/blood in stool, Taohua Tang is the primary treatment. Also: In Shaoyin disease with diarrhea and pus/blood in stool, acupuncture may be used.) Diarrhea with a floating pulse and a choppy Chi position, or recurrent cold limbs and fever, involve these two syndromes of purging pus and blood, all recorded in Changsha Zhang Zhongjing's medical texts. (Zhang Zhongjing stated: One case involves Taiyang fever for four days followed by cold limbs, then returning to fever for three to four days; four days of less cold and more heat suggests recovery. If heat persists from day four to six, pus and blood in stool will occur. Another case states: Diarrhea with a floating and rapid pulse, where the Chi position is naturally choppy, indicates the person will purge pus and blood.)