小便赤色大便秘。其脉沉滑阳证是。四肢逆冷伏热深。阳证似阴当审谛。（小便赤。大便秘。脉沉滑。阳证也。阳极
生阴热极生寒。故令四肢逆冷。以其伏热深也。医见四肢逆冷便以为阴。则误也。当仔细审详。）轻者且宜供白虎。重者
须当用承气。重阳如阴理宜然。寒暑之变亦如是。
身冷脉沉紧且细。内虽烦躁不饮水。此名阴盛隔阳证。霹雳散用烦躁止。（脉沉紧而细。不欲饮水者。阴盛隔阳也。
当用附子霹雳散。）躁若止兮应得睡。寒已散兮阴自退。热气上行得汗痊。火焰丹砂宜用矣。
男子阴肿多绞刺。妇人腰痛并里急。伤寒瘥后便行房。男名阳易女阴易。热上冲胸头不举。眼中生花气翕翕。烧
（音加）鼠橘皮汤。选此用之医可必。（仲景云。伤寒阴阳易之为病。身体重。少气。小腹里急。或引阴中拘挛。热上
冲胸。头重不欲举。眼中生花。痂胞赤。膝胫拘急。烧 散主之。此病男子则阴肿。妇人则腰痛。千金外台云。有 鼠
汤。橘皮汤。亦可用。）
脉浮紧涩是伤寒。热少寒多不躁烦。（伤寒脉浮紧而涩。热少寒多。心不烦躁。）头痛无汗身拘急。微厥之时在指端。
腰脊疼痛色多惨。唯宜发汗与通关。（学人先须要辨。伤寒中风二证。伤寒脉浮紧而涩。中风脉浮而缓。伤寒者恶寒不恶
风。中风者恶风不恶寒。伤寒者无汗。中风者自汗。伤寒者面色惨凄。中风者其面色和悦也。）大青龙证及麻黄。热多寒
少亦其常。（伤寒大抵虽热少寒多。亦有热多寒少者。如麻黄证云。发热身痛。大青龙证云。脉浮紧。发热而恶寒。）热
多寒少不烦躁。亦宜汗解正相当。微弱无阳桂枝越。（仲景云。太阳病发热多寒少。脉微弱者。无阳也。不可发汗。用桂
枝二越婢一汤。）尺迟血少建中汤。（尺脉迟者。血少也。宜建中汤。仲景建中证云。伤寒阳脉涩。阴脉弦。法当腹中急
痛。与建中汤。迟弦虽不同。皆少血之脉也。）淋家衄家不可汗。小柴胡解自安康。（淋家。衄家。疮家。以至四动脉。
不可发汗者。王实皆用小柴胡汤。）
小便颜色红赤，大便秘结不通。脉象沉而滑数，这是阳证的表现。（小便红赤，大便干结，脉象沉滑，属于阳证。阳极则生阴象，热极则生寒象，因此导致四肢逆冷。这是因为体内伏热深重所致。医生如果见到四肢逆冷就误认为是阴证，那就错了。应当仔细审察详辨。）病情较轻者，适宜使用白虎汤；病情较重者，必须使用承气汤。重阳之证出现类似阴证的现象是理所当然的，就像寒暑交替变化一样也是这个道理。
身体寒冷，脉象沉紧且细。体内虽然烦躁但不想喝水。这叫做阴盛格阳证。应当使用霹雳散，服用后烦躁可止。（脉象沉紧而细，不想喝水，这是阴盛格阳。应当使用附子霹雳散。）如果烦躁停止，患者应该能够入睡。寒气散去，阴邪自然消退。热气上行，通过出汗痊愈。此时适宜使用火焰丹砂（朱砂）。
男子出现阴部肿胀并伴有剧烈绞痛，妇人腰痛并伴有腹部急迫感。伤寒病愈之后立即行房事，男子称为“阳易”，女子称为“阴易”。症状表现为热气上冲胸部，头部沉重抬不起来，眼中视物模糊如见花，气息微弱急促。应当使用烧裈散、橘皮汤等方剂，选用这些方剂治疗，医生可以确保疗效。（张仲景说：伤寒阴阳易这种病，身体沉重，气短，小腹部拘急疼痛，有时牵引阴中拘挛，热气上冲胸部，头部沉重不想抬起，眼中视物模糊，眼睑红肿，膝胫拘急痉挛。应当用烧裈散主治。这种病男子表现为阴肿，妇人表现为腰痛。《千金方》和《外台秘要》记载有烧裈散、鼠矢汤、橘皮汤，也可以使用。）
脉象浮紧而涩，这是伤寒。发热少而恶寒多，且不烦躁。（伤寒脉象浮紧而涩，发热少恶寒多，心中不烦躁。）头痛无汗，身体拘急僵硬。轻微的四肢厥冷出现在手指末端。腰脊疼痛，面色大多惨淡。只适宜采用发汗法和通关窍的方法。（学习中医的人必须先要辨别清楚，伤寒和中风两种证候。伤寒脉象浮紧而涩，中风脉象浮而缓。伤寒患者恶寒而不恶风，中风患者恶风而不恶寒。伤寒患者无汗，中风患者自汗。伤寒患者面色惨淡凄苦，中风患者面色和悦愉快。）如果是大青龙汤证或麻黄汤证，通常是热多寒少的情况。（伤寒大体上是热少寒多，也有热多寒少的情况。如麻黄汤证说：发热身痛。大青龙汤证说：脉浮紧，发热而恶寒。）如果热多寒少且不烦躁，也适宜用发汗法解表，这是正治之法。如果脉微弱而无阳证表现，则用桂枝二越婢一汤。（张仲景说：太阳病发热多而恶寒少，脉象微弱的，是无阳证。不可发汗，应使用桂枝二越婢一汤。）如果尺脉迟，说明血少，应用建中汤。（尺脉迟的，是血少。适宜用建中汤。张仲景在建中证中说：伤寒阳脉涩，阴脉弦，按照法则应当腹中急痛，给予建中汤。虽然迟脉和弦脉不同，但都属于少血的脉象。）患有淋病、鼻衄的患者不可发汗，用小柴胡汤和解，自然安康。（淋家、衄家、疮家，以及四动脉不可发汗的情况，王实都主张使用小柴胡汤。）
The urine is red, and the stool is dry and constipated. The pulse is deep and slippery, indicating a Yang syndrome. (Red urine, dry constipation, and a deep-slippery pulse belong to Yang syndrome. When Yang reaches its extreme, Yin phenomena arise; when heat reaches its extreme, cold phenomena arise, thus causing cold limbs. This is because the latent heat is deep-seated. If physicians see cold limbs and mistakenly diagnose it as a Yin syndrome, they are wrong. One must carefully examine and distinguish.) For mild cases, Baihu Tang (White Tiger Decoction) is appropriate; for severe cases, Chengqi Tang (Purgative Decoction) must be used. It is natural for an excessive Yang condition to present with symptoms resembling Yin, just as the alternation of cold and heat occurs in nature.
The body is cold, and the pulse is deep, tight, and thin. Although there is restlessness inside, there is no desire to drink water. This is called Yin Excess Repelling Yang Syndrome. Pili San (Thunderbolt Powder) should be used, which will stop the restlessness. (A deep, tight, and thin pulse with no desire to drink indicates Yin Excess Repelling Yang. Fuzi Pili San (Aconite Thunderbolt Powder) should be administered.) If the restlessness ceases, the patient should be able to sleep. As the cold dissipates, the Yin pathogen naturally recedes. As the hot qi ascends, recovery comes through sweating. At this time, Huoyan Dansha (Flame Cinnabar) is suitable for use.
Men may experience swelling of the genitals accompanied by severe cramping pain, while women suffer from lower back pain and abdominal urgency. Having sexual intercourse immediately after recovering from Shanghan (Cold Damage) is termed "Yang Yi" (Yang Transformation) in men and "Yin Yi" (Yin Transformation) in women. Symptoms include hot qi rushing up to the chest, heaviness of the head making it difficult to lift, visual disturbances such as seeing spots, and shortness of breath. Shao Kun San (Burnt Undergarment Powder) or Jupi Tang (Tangerine Peel Decoction) should be selected; using these formulas ensures therapeutic efficacy. (Zhang Zhongjing stated: In the disease of Yin-Yang Yi, the body feels heavy, there is shortness of breath, and the lower abdomen feels urgent and painful, sometimes drawing into spasms in the genital region. Hot qi rushes up to the chest, the head feels heavy and does not wish to be lifted, eyes see spots, eyelids are red, and knees and shins are stiff and cramped. Shao Kun San should be used. In this disease, men present with penile swelling, and women with lower back pain. Qianjin Fang and Waitai Miyao record that Shao Kun San, Shushi Tang (Rat Dropping Decoction), and Jupi Tang can also be used.)
A floating, tight, and choppy pulse indicates Shanghan. There is less heat and more cold, without restlessness. (Shanghan presents with a floating, tight, and choppy pulse, less heat and more cold, and no mental restlessness.) Headache, absence of sweat, and bodily stiffness occur. Slight cold extremities appear at the fingertips. Lower back and spine pain are present, and the complexion is often pale and gloomy. Only sweating methods and opening the orifices are suitable. (Students must first distinguish between Shanghan and Fengzhong syndromes. Shanghan presents with a floating, tight, and choppy pulse, whereas Fengzhong presents with a floating and moderate pulse. Shanghan patients fear cold but not wind, while Fengzhong patients fear wind but not cold. Shanghan patients have no sweat, while Fengzhong patients have spontaneous sweating. Shanghan patients have a pale and grim complexion, while Fengzhong patients have a harmonious and pleasant complexion.) If it is Daqinglong Tang (Major Blue Green Dragon Decoction) syndrome or Mahuang Tang (Ephedra Decoction) syndrome, it is usually characterized by more heat and less cold. (Generally, Shanghan has less heat and more cold, but there are cases of more heat and less cold. For example, Mahuang Tang syndrome states: fever and body pain. Daqinglong Tang syndrome states: floating-tight pulse, fever, and aversion to cold.) If there is more heat and less cold without restlessness, sweating to resolve the exterior is the correct treatment. If the pulse is weak and lacks Yang signs, Guizhi Er Yuebiyi Tang (Cinnamon Twig Twice Yuebiyi Decoction) should be used. (Zhang Zhongjing stated: In Taiyang disease with more fever and less aversion to cold, if the pulse is weak, it indicates a lack of Yang. Sweating is contraindicated; instead, Guizhi Er Yuebiyi Tang should be used.) If the Chi pulse is slow, it indicates blood deficiency, and Jianzhong Tang (Establish the Middle Decoction) should be used. (A slow Chi pulse indicates blood deficiency. Jianzhong Tang is appropriate. Zhang Zhongjing stated in his Jianzhong syndrome text: In Shanghan, if the Yang pulse is choppy and the Yin pulse is string-taut, abdominal urgency and pain are expected according to the law; Jianzhong Tang should be given. Although slow and string-taut pulses differ, both are pulses indicative of blood deficiency.) Patients with Lin syndrome (dysuria) or Xue (epistaxis) cannot undergo sweating therapy; Xiaochaihu Tang (Minor Bupleurum Decoction) should be used for harmonization, leading to natural health. (For patients with Lin syndrome, epistaxis, sores, or those with four types of pulse conditions where sweating is contraindicated, Wang Shi advocated the use of Xiaochaihu Tang.)