《少阴篇》曰∶少阴病，脉沉者，急温之，宜四逆汤。《太阳篇》曰∶病发热头疼，脉反沉，身体疼
痛，当救其里，宜四逆汤。夫急温、急救之在少阴、太阳者，有水火寒热之气化也。病在少阴，感君火之
甚者，急下之；病阴寒之剧者，急温之。寒伤太阳，欲如连枢，神气乃浮，脉反沉者，阳反内陷也，故
当救其里。二者止见脉沉，若待其厥冷脉绝，则不救
矣。故所谓急者，如人堕于水火之中，缓即焚溺矣。
一熏一莸，十年遗臭，故去邪莫如速也。曰∶汗多亡阳。如表邪盛者，汗之而解，以养阳也。曰∶
下多亡阴，如里邪实者，下之而解，以养阴也。多者，谓其太过也。太过不可，而况妄行乎！《灵枢
经》曰∶上焦开发，宣五谷味，熏肤充身泽毛，若雾露之溉，是谓气。盖气化而汗出溱溱也。又曰∶夺血
者无汗，是血气不足，邪不得从汗解也。《伤寒论》曰∶微则阳气不足，涩则无血。下之，则心下痞鞭，
是血气不足，又难从下解也。当知邪贼宜攻，而正气又当培养。夫邪正相持，则为寒热出入，邪负则愈，
正北则危。汗下之法，犹援兵也。善用兵者，寡可以敌众，弱足以胜强。若不审虚实，不识情势，而妄攻
之，反为贼害矣！
《辨脉篇》曰∶病有洒淅恶寒，而复发热者
何？答曰∶阴脉不足，阳往从之；阳脉不足，阴往乘之。曰∶何谓阳不足？答曰∶假令寸口脉微，名曰阳
不足。阴气上入阳中，则洒淅恶寒也。曰∶何谓阴不足？答曰∶尺脉弱，名曰阴不足。阳气下陷入阴中，
则发热也。阳脉浮、阴脉弱者，则血虚，血虚则筋急也。其脉沉者，荣气微也。其脉浮而汗出如流珠者，
卫气衰也。荣气微者，加烧针，则血流不行，更发热而躁烦也。夫脏脉为阴，腑脉为阳；血为阴，气为
阳；荣为阴，卫为阳；内为阴，外为阳。此所言阴阳者，非此之谓也，乃阴阳之气耳！阴阳之气者，先天
之水火也。在地为水，在天为寒；在地为火，在天为热。无形之气，曰阴曰阳；有形之征，曰水曰火。阴
阳气交，是为平人。乘于脉中，则为往来寒热矣。故始曰阴脉，曰阳脉，复曰寸口，曰尺脉，曰阴气，曰阳
气，曰阴中，曰阳中，谓阴阳之气相乘，入于脉中而见于寸尺也。盖以寸尺分阴阳，非脏脉为阴脉，腑脉
为阳脉也；又非谓内络于脏腑者为阴脉，外络于形身者为阳脉也。中脉中也，阴中、阳中者，谓身半以上
为阳，身半以下为阴，故曰上入下陷也。此阴阳之气，乘于脉中，而为寒为热，非脉中之血虚，故曰阳
脉浮、阴脉弱者，则为血虚也。血虚则筋急者，谓血行脉中，渗于脉外，肝脏所主，而血自有阴阳之分
也。（脉内为阴，脉外为阳。）荣气微者，其脉沉，卫气衰者，
其脉浮。谓阴阳相乘者，见寸口脉微，尺中脉弱，非荣卫之为阴阳，而脉之浮沉也。如烧针则血流不行者，
谓血随荣转，非随阴阳之气而往来也。更发热而躁烦者，谓荣气之生于阳明，而主于心、肾也。烧针之火
气伤阳明则发热，伤心、肾则躁烦。此言荣血生于后天水谷之精，阴阳本于先天水火之气，乃阴阳之气乘
于脉中，而为寒为热，非荣血之为寒热也。男玉师曰∶何以治之？曰∶金匮肾气丸为主方，配四物以养血。
《少阴篇》说：少阴病，脉象沉的，应当紧急温补，适宜用四逆汤。《太阳篇》说：病人发热头痛，脉象反而沉，身体疼痛，应当急救其里阳，适宜用四逆汤。所谓在少阴、太阳病中需要紧急温补或急救的，是因为涉及水火寒热的气化变化。病在少阴，感受君火邪气严重的，应当紧急攻下；感受阴寒邪气剧烈的，应当紧急温补。寒邪损伤太阳经，若欲如连枢（指太阳经气机枢纽）受阻，神气浮越，脉象反而沉的，是阳气反而内陷所致，所以应当急救其里。这两种情况只见到脉沉，如果等到四肢厥冷、脉搏断绝，那就无法救治了。所以所谓的“急”，就像人堕入水火之中，迟缓就会焚烧或淹死一样。
一熏香与一臭草混合，十年仍留臭味，所以祛除邪气莫过于迅速。有人说：发汗过多会亡失阳气。如果表邪盛实，通过发汗而解，是为了养护阳气。有人说：攻下过多会亡失阴液，如果里邪实结，通过攻下而解，是为了养护阴液。这里的“多”，是指太过分的意思。太过是不可以的，何况是胡乱使用呢！《灵枢经》说：上焦开发，宣发五谷的精微气味，熏蒸皮肤，充实身体，润泽毛发，像雾露灌溉一样，这叫做气。大概气化则汗出溱溱（形容汗出湿润的样子）。又说：夺血者无汗，这是血气不足，邪气不能从汗解。《伤寒论》说：脉微则是阳气不足，脉涩则是无血。如果误用攻下，会导致心下痞硬，这是因为血气不足，又难以从下法解除。应当知道邪气贼害宜于攻逐，但正气又当培养。邪气与正气相持不下，就会出现寒热往来出入，邪气败退则病愈，正气溃败则危殆。发汗和攻下的方法，如同援兵。善于用兵的人，少数可以抵挡多数，弱小足以战胜强大。如果不审察虚实，不了解情势，而胡乱攻击，反而会被贼邪所害！
《辨脉篇》说：病人有洒淅（形容恶寒颤抖的样子）恶寒，而又发热的，是什么原因？回答说：阴脉不足，阳气就往那里依附；阳脉不足，阴气就往那里侵犯。问：什么叫阳不足？回答说：假如寸口脉微，名叫阳不足。阴气上入阳位，就会洒淅恶寒。问：什么叫阴不足？回答说：尺脉弱，名叫阴不足。阳气下陷入阴位，就会发热。阳脉浮、阴脉弱的，则是血虚，血虚则筋脉拘急。脉象沉的，是营气微弱。脉象浮且汗出如流珠的，是卫气衰败。营气微弱的，加用烧针，则血流不行，更加发热而躁烦。脏脉属阴，腑脉属阳；血属阴，气属阳；营属阴，卫属阳；内属阴，外表属阳。这里所说的阴阳，不是指这些，而是指阴阳之气罢了！阴阳之气，就是先天的水火。在地表现为水，在天表现为寒；在地表现为火，在天表现为热。无形的气，称为阴、阳；有形的征象，称为水、火。阴阳二气相交，就是健康的人。如果阴阳之气乘袭于脉中，就成为往来寒热。所以开始说阴脉、阳脉，接着说寸口、尺脉，再说阴气、阳气，阴中、阳中，是说阴阳之气相互乘袭，进入脉中而在寸口、尺部显现。大概是以寸、尺来分阴阳，并不是说脏脉为阴脉、腑脉为阳脉；也不是说内络于脏腑的为阴脉，外络于形身的为阳脉。中脉即脉中，阴中、阳中，是指身半以上为阳，身半以下为阴，所以说上入下陷。这种阴阳之气，乘袭于脉中，而为寒为热，并不是脉中之血虚，所以说阳脉浮、阴脉弱，则为血虚。血虚则筋急，是说血行于脉中，渗溢于脉外，由肝脏所主，而血自有阴阳之分。（脉内为阴，脉外为阳。）营气微弱，其脉沉；卫气衰败，其脉浮。所谓阴阳相乘，见于寸口脉微，尺中脉弱，并不是说营卫即为阴阳，而是指脉的浮沉。如烧针导致血流不行的，是说血随营气运转，并不随阴阳之气而往来。更加发热而躁烦的，是说营气生于阳明，而主宰于心、肾。烧针的火气伤害阳明则发热，伤害心、肾则躁烦。这里说荣血生于后天水谷之精，阴阳本于先天水火之气，乃是阴阳之气乘袭于脉中，而为寒为热，并不是荣血本身造成寒热。男玉师说：怎么治疗？回答说：以金匮肾气丸为主方，配合四物汤来养血。
The *Shaoyin Chapter* states: In Shaoyin disease, if the pulse is deep (Chen), urgent warming is required; Si Ni Tang (Four Reversal Decoction) is appropriate. The *Taiyang Chapter* states: When a patient presents with fever, headache, and a pulse that is surprisingly deep, accompanied by body pain, one should urgently rescue the interior Yang; Si Ni Tang (Four Reversal Decoction) is appropriate. The reason for urgent warming or urgent rescue in Shaoyin and Taiyang diseases lies in the qi transformation of water, fire, cold, and heat. When the disease is in Shaoyin and there is severe contraction of Ministerial Fire (Jun Huo), urgent purgation is indicated; when there is severe contraction of Yin-Cold, urgent warming is indicated. When Cold damages the Taiyang channel, if the pivot mechanism is obstructed and the Shen Qi floats outward, resulting in a surprisingly deep pulse, this indicates that Yang Qi has sunk inward; therefore, the interior must be urgently rescued. In these two cases, only a deep pulse is observed; if one waits until the limbs become cold and the pulse disappears, it will be beyond salvation. Thus, "urgent" means like a person falling into water or fire; delay leads to burning or drowning.
One fragrant herb mixed with one stinking herb leaves a bad smell for ten years; therefore, expelling pathogenic factors is best done swiftly. It is said: Excessive sweating causes loss of Yang Qi. If exterior pathogens are abundant, resolving them through sweating preserves Yang Qi. It is also said: Excessive purgation causes loss of Yin fluids; if interior pathogens are excess, resolving them through purgation preserves Yin fluids. Here, "excessive" refers to going too far. Going too far is inadvisable, let alone reckless administration! The *Ling Shu Jing* (Spiritual Pivot) states: The Upper Jiao opens and develops, disseminating the flavors of grains and foods, steaming the skin, filling the body, and moistening the hair, like mist and dew irrigating; this is called Qi. Generally, when Qi transforms, sweat flows profusely. It also states: Those who have lost blood do not sweat; this indicates insufficiency of Blood and Qi, so pathogens cannot be resolved through sweating. The *Shang Han Lun* (Treatise on Cold Damage) states: A faint pulse indicates insufficient Yang Qi; a choppy pulse indicates lack of Blood. If purgation is mistakenly used, epigastric fullness and hardness result, indicating that due to insufficiency of Blood and Qi, resolution via purgation is difficult. One must understand that while pathogenic evils should be attacked, Righteous Qi must also be nourished. When Pathogen and Righteous Qi contend, alternating chills and fever occur; if the Pathogen retreats, recovery ensues; if Righteous Qi collapses, danger arises. Sweating and purging methods are like reinforcements. A skilled commander can defeat many with few and the weak with the strong. If one does not examine deficiency and excess, nor understand the situation, but attacks recklessly, one will instead be harmed by the enemy!
The *Bian Mai Pian* (Chapter on Pulse Differentiation) states: Why does a patient experience shivering chills followed by fever? The answer is: When Yin pulses are deficient, Yang Qi moves to join them; when Yang pulses are deficient, Yin Qi invades them. Question: What is meant by Yang deficiency? Answer: For example, if the Cun Kou (radial artery at the wrist) pulse is faint, it is named Yang deficiency. When Yin Qi ascends into the Yang region, shivering chills occur. Question: What is meant by Yin deficiency? Answer: If the Chi pulse (distal radial pulse) is weak, it is named Yin deficiency. When Yang Qi sinks downward into the Yin region, fever occurs. If the Yang pulse is floating and the Yin pulse is weak, this indicates Blood deficiency; Blood deficiency leads to tendon tension. A deep pulse indicates slight Ying Qi (Nutritive Qi). A floating pulse with sweat droplets flowing like pearls indicates decline of Wei Qi (Defensive Qi). If Ying Qi is slight and moxibustion with heated needles (Shao Zhen) is applied, blood flow stagnates, leading to increased fever and restlessness. Zang pulses belong to Yin, Fu pulses belong to Yang; Blood belongs to Yin, Qi belongs to Yang; Ying belongs to Yin, Wei belongs to Yang; Interior belongs to Yin, Exterior belongs to Yang. The Yin and Yang mentioned here do not refer to these distinctions, but rather to the Qi of Yin and Yang! The Qi of Yin and Yang is the primordial Water and Fire. On earth, it manifests as Water; in heaven, as Cold; on earth, as Fire; in heaven, as Heat. Formless Qi is called Yin and Yang;有形 manifestations are called Water and Fire. When Yin and Yang Qi interact, the person is healthy. If this Qi invades the vessels, it results in alternating chills and fever. Thus, initially mentioning Yin and Yang pulses, then Cun Kou and Chi pulses, then Yin and Yang Qi, and Yin/Yang regions, refers to the mutual invasion of Yin and Yang Qi entering the vessels and manifesting at the Cun and Chi positions. Essentially, Cun and Chi are used to distinguish Yin and Yang, not implying that Zang pulses are Yin and Fu pulses are Yang; nor does it mean that vessels connecting internally to Zang-Fu are Yin and those connecting externally to the body are Yang. "Middle of the vessel" refers to within the vessel itself; "Yin middle" and "Yang middle" refer to the upper half of the body as Yang and the lower half as Yin, hence "ascending" and "sinking." This Yin-Yang Qi invading the vessels causes chills and heat, not due to Blood deficiency in the vessels; thus, floating Yang pulse and weak Yin pulse indicate Blood deficiency. Blood deficiency causing tendon tension means Blood circulates within vessels and seeps outside; it is governed by the Liver, and Blood itself has Yin and Yang aspects. (Inside the vessel is Yin, outside is Yang.) Slight Ying Qi results in a deep pulse; declining Wei Qi results in a floating pulse. The term "mutual invasion of Yin and Yang," seen as faint Cun Kou pulse and weak Chi pulse, does not equate Ying and Wei with Yin and Yang, but refers to the floating and deep nature of the pulse. Regarding heated needles causing stagnant blood flow, it means Blood follows the circulation of Ying Qi, not moving back and forth with Yin-Yang Qi. Increased fever and restlessness mean Ying Qi originates from the Yang Ming stage and is governed by the Heart and Kidney. The fire energy of heated needles damaging Yang Ming causes fever; damaging Heart and Kidney causes restlessness. This text states that Ying Blood is generated from postnatal essence of water and grains, while Yin and Yang are rooted in pre-natal Water and Fire Qi. It is the Yin-Yang Qi invading the vessels that causes chills and heat, not Ying Blood itself causing chills and heat. Master Nan Yu asked: How should this be treated? The answer is: Use Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet) as the primary formula, combined with Si Wu Tang (Four Substance Decoction) to nourish Blood.