伤寒一二日至四五日而厥者，必发热。前热者，后必厥。厥深者热亦深，厥微者热亦微。厥应下之，而反发
汗者，必口伤烂赤。
其四五日来，恶寒无热可知。手足为诸阳之本，阴盛而阳不达，故厥冷也。伤寒三日，三阳为尽，四五日
而厥者，三阴受邪也。阴经受邪，无热可发。阴主藏，藏气实而不能入，则还之于府。必发热者，寒极而生热也。
先厥后热，为阳乘阴，阴邪未散，故必复发。此阴中有阳，乃阴阳相搏而为厥热，与阴厥亡阳者迥别也。欲知
其人阳气之多寡，即观其厥之微甚。厥之久者，郁热亦久，厥之轻者，郁热亦轻，故热与厥相应耳。若阳虚而不
能支，即成阴厥而无热矣。热发三阳，未入于府者，可汗；热在三阴，已入于府者，可下。阴不得有汗，而强发
之，此为逆也。阳邪不能外散而为汗，必上走空窍，口伤烂赤所由至矣。然此指热伤气而言。若动其血，或从口
鼻，或从目出，其害有不可言者。下之清之，谓对汗而言。是胃热而不是胃实，非三承气所宜。厥微者，当四
逆散，芍药、枳实以攻里，柴胡、甘草以和表也。厥深者，当白虎汤，参、甘、粳米以扶阳，石膏、知母以除
热也。
脉滑而厥者，里有热也，白虎汤主之。
上条明热厥之理，此条明热厥之脉，并热厥之方。脉弱以滑，是有胃气，缓而滑，名热中，与寒厥之脉微欲
绝者，大相径庭矣。当知有口燥舌干之证，与口伤烂赤者照应焉。
伤寒病，厥五日，热亦五日，设六日当复厥，不厥者自愈。厥终不过五日，故知自愈。
阴盛格阳，故先厥；阴极阳生，故后热。热与厥相应，是谓阴阳和平，故愈。厥终即不厥也，不过五日，即六
日不复厥之谓。愈指热言。
伤寒热少厥微，指头寒，默默不欲饮食，烦躁，数日小便利，色白者，此热除也。欲得食，其病为愈。若厥而呕，
胸胁逆满者，其后必便血。
身无大热，手足不冷，但指头寒，此热微厥亦微也。凡能食不呕，是三阴不受邪。若其人不呕，但默默不
欲饮食，此内寒亦微。烦躁是内热反盛。数日来，小便之难者已利，色赤者仍白，是阴阳自和，热除可知。不欲
食者，今欲得食，不厥可知矣。若其人外虽热少厥微，而呕不能食，内寒稍深矣；胸胁逆满，内热亦深矣。热
深厥深，不早治之，致热伤阴络，其后必便血也。此少阳半表半里症，微者小柴胡和之，深者大柴胡下之。
伤寒发热四日，厥反三日，复热四日，厥少热多，其病当愈。四日至七日热不除者，其后必便脓血。
伤寒以阳为主，热多当愈，热不除为太过，热深厥微，必伤阴络。医者当于阳盛时预滋其阴，以善其后也。
四日至七日，自发热起至厥止而言。热不除，指复热四日。复热四日句，语意在“其病当愈下”。
伤寒厥四日，热反三日，复厥五日，其病为进。寒多热少，阳气退，故为进也。
凡厥与热不相应，便谓之反。上文先热后厥，是阳为主；此先厥后热，是阴为主。热不及厥之一，厥反进
热之二。热微而厥反胜，此时不急扶其阳，阴盛以亡矣。
伤寒始发热六日厥反九日而利。凡厥利者，当不能食；今反能食者，恐为除中，食以索饼。不发热者，知胃
气尚在，必愈。恐暴热来出而复去也，后三日脉之，其热续在、脉和者，期之是日夜半愈。所以然者，本发热六
日，厥反九日，复发热三日，并前六日，亦为九日，与厥相应，故期之是日夜半愈。后三日脉之而脉数，其热不
罢者，此为热气有余，必发痈脓也。
病虽发于阳，而阴反胜之，厥利，此胃阳将乏竭矣。如胃阳未亡，腹中不冷，尚能化食，故食之自安。若除
中，则反见善食之状。如中空无阳，今俗云食禄将尽者是也。此为阳邪入阴，原是热厥热利，故能食而不为除中。其人
必有烦躁见于外，是厥深热亦深，故九日复能发热，复热则厥利自止可知。日热续在，则与暴出有别。续热三日来，其
脉自和可知。热当自止，正与厥相应，故愈。此愈指热言。夜半者，阳得阴则解也。若续热三日而脉数，可知热之不止，
是阳气有余，必有痈脓之患。便脓血，是阳邪下注于阴窍；发痈脓，是阳邪外溢于形身。俗所云伤寒留毒者是也。
发热而厥七日下利，为难治。
发于阳者，当七日愈。今厥不止而反下利，恐为除中，故难治。若躁烦而能食，尚为热厥利耳。便脓血发
痈脓者，是不足而往，有余从之也；发热而厥除中者，是有余而往，不足随之也。
伤寒先厥后发热而利者，必自止，见厥复利。
先厥利而后发热者，寒邪盛而阳气微，阳为阴抑故也。其始也，无热恶寒而复厥利，疑为无阳。其继也，发
热而厥利自止，是为晚发。此时阴阳自和则愈，若阴气胜则虚热外退，而真寒内生，厥利复作矣。厥与利相应
则愈，是阳消阴长之机。
伤寒先厥后发热而下利，必自止，而反汗出咽中痛者，其喉为痹。发热无汗而利，必自止，若不止，必便脓
血，便脓血者，其喉不痹。
此与上条同为先阴后阳。寒盛生热之证，而阳气虚实不同。上条阳不敌阴，故阳退而阴进。此热虽发汗厥后，
而阳能胜阴，故厥利自止而不复发。然阳气有余者，又有犯上陷下之不同，即可以发热时有汗无汗为区别。下利
不当有汗，有汗是阳反上升，故咽中痛而成喉痹，无汗是阳从中发，热与厥应，厥利止而寒热自解矣。若厥止而
热与利不止，是阳邪下陷，必便脓血，下而不上，故咽不痛而喉不痹。
上段似少阴之亡阳，下段似阳明之协热利。汗因于心，无汗则心气平，故火不上炎而咽不痛；利因于胃，利
止则胃液藏，故火不下陷而无脓血。
伤寒发热，下利至甚，厥不止者死。
伤寒发热，下利厥逆，躁不得卧者死。
厥利不止，脏腑气绝矣；躁不得卧，精神不治矣。微阳不久留，故死。
伤寒病一二天到四五天出现手足逆冷的，必定伴有发热。先前发热的，后来必然出现手足逆冷。手足逆冷严重的，体内郁热也严重；手足逆冷轻微的，体内郁热也轻微。对于热厥应当用攻下法治疗，如果反而使用发汗法，必然导致口腔损伤、红肿溃烂。
到了四五天，恶寒而无发热是显而易见的。手足是诸阳经的根本，阴气盛而阳气不能通达，所以出现手足厥冷。伤寒三天，三阳经的病邪已尽，四五天出现手足逆冷，说明病邪传入三阴经。阴经受邪，本无热可发。阴主闭藏，若脏气充实而邪气不能内入，则邪气会返还于腑。必定会出现发热的情况，这是寒极生热的表现。先出现手足逆冷后出现发热，是阳气乘袭阴分，阴邪尚未消散，所以必然会再次复发。这属于阴中寓有阳气，是阴阳相互搏结而导致的手足逆冷与发热交替，与阴厥亡阳的情况截然不同。想要知道病人阳气的多少，只需观察其手足逆冷的程度轻重。手足逆冷持续时间长的，郁热也就深重；手足逆冷轻微的，郁热也轻微，所以发热与手足逆冷是相应的。如果阳气虚弱而不能支撑，就会形成阴厥而没有发热。热邪在三阳经，未进入腑的，可以用发汗法；热邪在三阴经，已经入腑的，可以用攻下法。阴证本不应出汗，如果强行发汗，这是逆治。阳邪不能从外发散为汗，必然向上走窜空窍，这就是导致口腔损伤、红肿溃烂的原因。然而这里指的是热邪伤及气分的情况。如果热邪动血，或者从口鼻出血，或者从眼睛出血，其危害是不可言说的。所谓“下之清之”，是相对于发汗而言的。这里是胃中有热而不是胃中有实邪，不适合使用三承气汤。手足逆冷轻微的，应当使用四逆散，用芍药、枳实来攻逐里邪，柴胡、甘草来调和表邪。手足逆冷严重的，应当使用白虎汤，用人参、甘草、粳米来扶助阳气，石膏、知母来清除热邪。
上一条条文阐明了热厥的原理，这一条阐明了热厥的脉象以及热厥的治疗方剂。脉弱而滑，说明还有胃气；脉缓而滑，称为热中，这与寒厥脉微欲绝的情况大相径庭了。应当知道会有口燥舌干的证候，这与前文提到的口腔损伤、红肿溃烂是相互照应的。
伤寒病，手足逆冷五天，发热也五天，假设第六天应当再次出现手足逆冷，如果没有出现，疾病就会自愈。因为手足逆冷终归不会超过五天，所以知道会自愈。
阴气盛而格拒阳气，所以先出现手足逆冷；阴气极盛而阳气初生，所以后出现发热。发热与手足逆冷相应，这叫作阴阳平和，所以痊愈。手足逆冷终结就是不再逆冷，不超过五天，也就是第六天不再出现手足逆冷的意思。“愈”字是指发热消退而言。
伤寒热象轻微、手足逆冷轻微，仅指尖发凉，神情沉默不想饮食，烦躁，过了几天小便通畅，颜色变白的，这是热邪已除。想要进食，疾病就会痊愈。如果出现手足逆冷并伴有呕吐，胸胁部气逆胀满的，其后必然会出现便血。
身体没有大热，手足不冷，只是指尖发凉，这是热邪轻微、手足逆冷也轻微的表现。凡是能够进食且不呕吐的，说明三阴经没有受邪。如果病人不呕吐，只是神情沉默不想饮食，这说明内寒也轻微。烦躁是内热反盛的表现。过了几天，原来小便困难的现在通畅了，颜色由赤红变为白色，这是阴阳自我调和，热邪已除，可以知道了。不想吃东西，现在想要吃东西，说明手足逆冷也会消失。如果这个人虽然外表热少厥微，但是呕吐不能进食，说明内寒稍微深重了；胸胁部气逆胀满，说明内热也深重了。热邪深重则手足逆冷深重，如果不早治疗，导致热邪损伤阴络，其后必然会出现便血。这是少阳半表半里的证候，轻微的用小柴胡汤和解，深重的用大柴胡汤攻下。
伤寒发热四天，手足逆冷反而三天，再次发热四天，手足逆冷时间短而发热时间长，疾病应当痊愈。从第四天到第七天热邪不退的，其后必然会出现脓血便。
伤寒以阳气为主，发热多应当痊愈，热邪不退是因为太过，热邪深重而手足逆冷轻微，必然损伤阴络。医生应当在阳气旺盛时预先滋养阴液，以妥善处理后事。
从第四天到第七天，是从开始发热起到手足逆冷停止来说的。热邪不退，指的是再次发热四天。“复热四天”这句话，语意重点在“其病当愈”之下。
伤寒手足逆冷四天，发热反而三天，再次手足逆冷五天，疾病在进展。寒多热少，阳气衰退，所以说是病情进展。
凡是手足逆冷与发热不相适应，就叫做“反”。上文是先发热后手足逆冷，是以阳气为主；这里是先手足逆冷后发热，是以阴气为主。发热时间不及手足逆冷的一半，手足逆冷反而超过了发热时间的两倍。热邪轻微而手足逆冷反而占优势，此时如果不紧急扶持阳气，阴气盛极就会导致阳气消亡。
伤寒开始发热六天，手足逆冷反而九天并且伴有下利。凡是手足逆冷伴下利的，应当不能进食；现在反而能进食的，恐怕是“除中”（胃气将绝的回光返照），给病人吃面条饼子测试。如果不感到突然发热，说明胃气还在，一定会痊愈。担心是暴热突然出现随即消失，三天后诊察脉象，如果热度持续存在、脉象和缓的，预测在当天半夜痊愈。之所以这样，是因为本来发热六天，手足逆冷反而九天，再次发热三天，加上前面的六天，也是九天，与手足逆冷的天数相应，所以预测在当天半夜痊愈。三天后诊察脉象如果脉数，热度不退的，这是热气有余，必然会发生痈脓。
病虽然发于阳经，但阴气反而胜过阳气，出现手足逆冷和下利，这是胃阳将要枯竭了。如果胃阳未亡，腹中不冷，还能消化食物，所以吃了食物安然无恙。如果是“除中”，则会反常地表现出善于进食的样子。就像中空无阳，也就是俗话说的食禄将尽一样。这是因为阳邪入阴，原本是热厥热利，所以能进食而不属于“除中”。这个人一定在外表有烦躁的表现，这是热邪深重则手足逆冷也深重，所以第九天又出现发热，再次发热则手足逆冷和下利自然停止是可以知道的。如果热度持续存在，那就与暴热不同。持续发热三天，脉象自然会和缓。热邪应当自行停止，正好与手足逆冷的天数相应，所以痊愈。“愈”字是指发热而言。半夜时分，阳气得到阴气的帮助就能解除病邪。如果持续发热三天而脉数，可知热邪不止，这是阳气有余，必然会有痈脓的祸患。便脓血，是阳邪下注于阴窍；发痈脓，是阳邪外溢于形体身躯。也就是俗话所说的伤寒留毒。
发于阳经的病，应当七天痊愈。现在手足逆冷不止反而下利，恐怕是“除中”，所以难治。如果躁动烦乱但能进食，还算是热厥下利罢了。便脓血或发痈脓的，是正气不足而邪气随之而来；发热而手足逆冷且出现“除中”的，是邪气有余而正气随之衰败。
伤寒先出现手足逆冷后出现发热并且伴有下利的，下利必定自行停止，如果再出现手足逆冷，下利会再次发作。
先手足逆冷下利而后发热的，是寒邪盛而阳气微弱，阳气被阴气抑制的缘故。起初，没有发热、恶寒并且手足逆冷下利，让人怀疑是没有阳气。随后，发热而手足逆冷下利自行停止，这是迟发的阳气。此时如果阴阳自我调和就会痊愈，如果阴气胜则虚热外退，而真寒内生，手足逆冷和下利会再次发作。手足逆冷与下利相应则痊愈，这是阳气消减、阴气增长的机理。
伤寒先出现手足逆冷后出现发热并且伴有下利的，下利必定自行停止，但如果反而出现出汗、咽喉疼痛的，喉部会闭塞不通（喉痹）。发热无汗并且伴有下利的，下利必定自行停止，如果不停止，必然出现便脓血，出现便脓血的，喉部就不会闭塞不通。
这一段与上一条相同，都是先阴后阳。寒盛生热的证候，但阳气的虚实不同。上一条是阳不敌阴，所以阳气退却而阴气进逼。这一段虽然发热在手足逆冷之后，但阳气能战胜阴气，所以手足逆冷和下利自行停止而不复发。然而阳气有余的人，又有犯上（向上）和陷下（向下）的不同，这就可以通过发热时有汗无汗来区别。下利不应当有汗，有汗说明阳气反而上升，所以咽喉疼痛而成喉痹；无汗说明阳气从中焦发出，热与手足逆冷相应，手足逆冷和下利停止而寒热自然解除。如果手足逆冷停止而热与下利不止，是阳邪下陷，必然出现便脓血，热邪下行而不向上，所以咽喉不痛而喉部不闭塞。
上一段类似少阴病的亡阳证，下一段类似阳明病的协热利。汗由心所主，无汗则心气平静，所以火气不上炎而咽喉不痛；下利因于胃，下利停止则胃液收藏，所以火气不下陷而无脓血。
In the course of a cold damage disease, if cold extremities appear from the first or second day to the fourth or fifth day, fever must be present. If there was fever previously, cold extremities will inevitably follow later. The deeper the cold extremities, the deeper the internal heat; the milder the cold extremities, the milder the internal heat. Cold extremities due to heat should be treated with purgation; if sweating is used in error, it will inevitably lead to oral lesions and redness.
By the fourth or fifth day, chills without fever are evident. The hands and feet are the root of all yang meridians; when yin is excessive and yang cannot reach them, cold extremities occur. After three days of cold damage, the pathogenic factors in the three yang meridians are exhausted; if cold extremities appear on the fourth or fifth day, the pathogen has entered the three yin meridians. When the yin meridians are affected, there is no heat to manifest initially. Yin governs storage; if the zang organ qi is solid and the pathogen cannot enter, it returns to the fu organs. Fever must eventually appear, which is heat generated from extreme cold. First cold extremities followed by fever indicates yang invading yin; since the yin pathogen has not dissipated, recurrence is inevitable. This represents yang within yin, where yin and yang contend causing alternating cold extremities and fever, which is distinctly different from cold extremities with collapse of yang. To know the abundance or deficiency of a person's yang qi, one observes the severity of the cold extremities. Prolonged cold extremities indicate prolonged stagnant heat; mild cold extremities indicate mild stagnant heat, hence fever and cold extremities correspond. If yang is deficient and cannot sustain itself, it becomes true cold extremities without fever. Heat in the three yang meridians that has not entered the fu organs can be treated with sweating; heat in the three yin meridians that has entered the fu organs can be treated with purgation. Yin patterns should not sweat; forcing sweating is a contraindication. Yang pathogens cannot disperse externally as sweat but must ascend to the orifices, leading to oral lesions and redness. However, this refers to heat damaging qi. If blood is disturbed, bleeding may occur from the mouth, nose, or eyes, with consequences beyond description. "Purgation and clearing" here contrasts with sweating. This is stomach heat rather than stomach excess, so the three Chengqi Decoctions are not suitable. For mild cold extremities, Sini San (Four Counterflow Powder) should be used: Shaoyao (Paeoniae Radix), Zhishi (Aurantii Fructus) to attack the interior; Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma) to harmonize the exterior. For deep cold extremities, Baihu Tang (White Tiger Decoction) should be used: Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Jingmi (Oryzae Semen) to support yang; Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma) to remove heat.
When the pulse is slippery and there are cold extremities, there is heat in the interior; Baihu Tang (White Tiger Decoction) is the primary treatment.
The previous clause explained the principle of heat-induced cold extremities; this clause explains the pulse of heat-induced cold extremities and the corresponding formula. A weak yet slippery pulse indicates the presence of Stomach Qi; a slow and slippery pulse is called "Heat in the Middle," which is vastly different from the faint, nearly imperceptible pulse of cold-induced cold extremities. One should recognize symptoms such as dry mouth and tongue, which correspond to the oral lesions and redness mentioned earlier.
In cold damage disease, if cold extremities last five days and fever lasts five days, assuming the sixth day should bring recurrent cold extremities, if they do not recur, the disease will heal spontaneously. Since cold extremities do not exceed five days, spontaneous healing is expected.
Yin excess repelling yang causes initial cold extremities; yin reaching its extreme allows yang to generate, causing subsequent fever. Correspondence between fever and cold extremities signifies yin-yang harmony, hence healing. "End of cold extremities" means cessation of cold extremities; not exceeding five days means no recurrence on the sixth day. "Healing" refers to the resolution of fever.
If cold damage presents with slight heat and mild cold extremities (only fingertips cold), silent desire not to eat, and irritability, after several days if urination becomes smooth and urine color turns white, this indicates heat elimination. Desire to eat signals recovery. If cold extremities accompany vomiting and fullness/oppression in the chest and hypochondrium, hematochezia will likely follow later.
No significant body heat, hands and feet not cold, only fingertips cold—this indicates slight heat and mild cold extremities. Those who can eat and do not vomit have not been affected by the three yin meridians. If a patient does not vomit but is silent and lacks appetite, internal cold is also slight. Irritability indicates internal heat is relatively strong. After several days, if difficulty urinating resolves and color changes from red to white, yin-yang self-harmonization and heat elimination are confirmed. Lack of appetite turning into desire to eat confirms the cessation of cold extremities. If externally slight heat and mild cold extremities are accompanied by vomiting and inability to eat, internal cold is slightly deeper; chest/hypochondriac oppression indicates deeper internal heat. Deep heat causes deep cold extremities; failure to treat early leads to heat damaging yin collaterals and subsequent hematochezia. This is a Shaoyang half-exterior half-interior syndrome: mild cases are harmonized with Xiaochaihu Tang (Minor Bupleurum Decoction); severe cases are purged with Dachaihu Tang (Major Bupleurum Decoction).
Cold damage with four days of fever followed by three days of cold extremities, then four more days of fever: fewer cold extremities and more fever suggests the disease should heal. If heat persists from the fourth to the seventh day, pus and blood in stool will likely follow later.
Cold damage prioritizes yang; more fever implies healing. Persistent heat indicates excess; deep heat with mild cold extremities damages yin collaterals. Physicians should nourish yin proactively during yang excess to manage outcomes.
Days four to seven refer to the period from onset of fever to cessation of cold extremities. "Heat not eliminated" refers to the second four-day fever period. The phrase "four more days of fever" emphasizes "the disease should heal."
Cold damage with four days of cold extremities, three days of fever, then five more days of cold extremities: the disease is progressing. More cold and less fever indicates yang decline, hence progression.
Any mismatch between cold extremities and fever is termed "counter." The previous case (fever then cold extremities) prioritizes yang; this case (cold extremities then fever) prioritizes yin. Fever duration is less than half that of cold extremities, while cold extremities exceed twice the fever duration. With mild heat but dominant cold extremities, failing to urgently support yang leads to yin excess and yang collapse.
Cold damage starting with six days of fever, nine days of cold extremities with diarrhea: typically, cold extremities with diarrhea preclude eating. If the patient can eat, suspect "Chu Zhong" (extinction of middle jiao qi). Feed them Suobing (noodle cakes). No sudden fever indicates remaining Stomach Qi and probable recovery. Fear of sudden transient heat followed by disappearance warrants pulse check after three days. If heat persists and pulse is harmonious, recovery is predicted at midnight. Reason: originally six days fever, nine days cold extremities, plus three more days fever equals nine days total, matching the cold extremity duration, thus predicting recovery at midnight. If pulse is rapid and heat persists after three days, heat excess will cause carbuncles and suppuration.
Though originating in yang, yin prevails with cold extremities and diarrhea, indicating impending exhaustion of Stomach Yang. If Stomach Yang remains, abdomen is warm, food digests normally, and eating is tolerated. In "Chu Zhong," excessive appetite appears paradoxically, akin to "running out of livelihood." Here, yang pathogen enters yin; it is heat-induced cold extremities and diarrhea, so eating does not constitute "Chu Zhong." External irritability indicates deep heat and deep cold extremities; recurrence of fever on day nine stops cold extremities and diarrhea. Persistent heat differs from sudden heat. Three days of persistent heat yields a harmonious pulse. Heat should cease naturally, corresponding to cold extremities, signaling healing. "Healing" refers to fever resolution. Midnight represents yang resolving through yin. If heat persists three days with rapid pulse, heat continues, indicating yang excess and risk of carbuncles. Pus/blood in stool indicates yang pathogen sinking to yin orifices; carbuncles indicate yang pathogen overflowing to the body. This is what laypeople call "lingering toxin from cold damage."
Fever with cold extremities for seven days and diarrhea is difficult to treat.
Yang-originating diseases should heal in seven days. Persistent cold extremities with diarrhea suggest "Chu Zhong," making it difficult to treat. If irritability coexists with ability to eat, it remains heat-induced cold extremities with diarrhea. Pus/blood in stool or carbuncles indicate deficiency allowing excess to follow; fever with cold extremities and "Chu Zhong" indicates excess preceding deficiency.
Cold damage with initial cold extremities and diarrhea, followed by fever: diarrhea stops spontaneously; recurrence of cold extremities brings back diarrhea.
Initial cold extremities/diarrhea followed by fever indicates cold pathogen excess and weak yang, suppressed by yin. Initially, no fever, chills, cold extremities, and diarrhea suggest absence of yang. Subsequently, fever with cessation of cold extremities/diarrhea indicates delayed yang emergence. Self-harmonization of yin-yang leads to healing; if yin wins, false heat retreats, true cold generates internally, and cold extremities/diarrhea recur. Correspondence of cold extremities and diarrhea cessation indicates yang decline and yin growth dynamics.
Cold damage with initial cold extremities and diarrhea, followed by fever: diarrhea stops spontaneously. If sweating and sore throat occur instead, Bi syndrome of the throat develops. Fever without sweat and diarrhea: diarrhea stops spontaneously. If it persists, pus/blood in stool occurs; if pus/blood occurs, throat Bi does not develop.
This parallels the previous section (yin then yang). Both are cold-excess generating heat, but differ in yang deficiency/excess. Previous case: yang fails against yin, so yang retreats and yin advances. Current case: though fever follows cold extremities, yang overcomes yin, so cold extremities/diarrhea stop and do not recur. However, excess yang manifests differently upward or downward, distinguishable by presence/absence of sweat during fever. Diarrhea should not have sweat; sweat indicates yang ascending, causing sore throat and throat Bi. No sweat indicates yang emerging from center, heat corresponds to cold extremities, stopping cold extremities/diarrhea and resolving cold/heat. If cold extremities stop but heat/diarrhea persist, yang pathogen sinks, causing pus/blood in stool; descending without ascending means no sore throat or throat Bi.
Upper section resembles Shaoyin collapse of yang; lower section resembles Yangming協熱利 (collateral heat diarrhea). Sweat originates from Heart; no sweat means Heart Qi is calm, fire does not flare up, throat is pain-free. Diarrhea relates to Stomach; cessation of diarrhea conserves Stomach fluids, fire does not sink, no pus/blood.
Cold damage with fever, severe diarrhea, and unceasing cold extremities: death.
Cold damage with fever, diarrhea, cold extremities, and restlessness preventing lying down: death.
Unceasing cold extremities and diarrhea indicate exhaustion of zang-fu qi; restlessness preventing lying down indicates loss of spirit. Weak yang cannot remain long, hence death.