病有发热恶寒者，发于阳也；无热恶寒者，发于阴也。发于阳者，七日愈；发于阴者，六日愈。以阳
数七阴数六故也。
发热恶寒，脉浮属太阳。（方论甚众，并见发热门太阳病条。）
恶寒脉微而复利者，亡血也，四逆加人参汤主之。（王叔和原入霍乱门。）
四逆加人参汤
人参 干姜 甘草（各一两） 附子（一枝，去皮，煨）
上 咀，每服五钱，水煎温服，日三。
少阴病，恶寒身倦而利，若利止手足温者可治，利不止手足逆冷者不可治。（方论见下利。）少阴病，
恶寒身倦，时烦欲去衣被者，可治，四逆无脉，不烦而躁者，死。（方论见但欲寐。）恶寒手足逆冷，若
兼大汗拘急下利，四逆汤。（方论见下利。）若兼头汗，心下满，脉沉细，大便硬者，小柴胡汤。（方论见
厥。）若夏月中暑，脉虚而渴，背恶寒者，白虎加人参汤。（方论见中暑。）若口中和，但欲寐者，
灸之，宜附子汤。发汗后恶寒者，虚也。（论见发热。）发汗病不解，反恶寒者，虚故也，芍药甘草附
子汤主之。
芍药甘草附子汤方
芍药 白术（各二两） 甘草（三两） 桂枝（四两） 附子（一枚，炮，去皮）
上 咀，每服五钱，水煎温服。
太阳病下后，脉促胸满者，桂枝去芍药汤主之。
桂枝去芍药汤方
桂枝（去皮） 生姜（各两半，切） 甘草（一两，炙） 大枣（六枚）
上 咀，每服五钱，水煎，温服。
若微恶寒者，去芍药加附子汤主之。（《活人》云∶芍药味酸，脉促胸满，恐成结胸，故去芍药，单
用辛甘之味发散毒瓦斯也。）
桂枝去芍药加附子汤方
桂枝 生姜（各两半） 甘草（一两） 大枣（六枚） 附子（半个，去皮，炮）
上 咀，水煎温服，每服五钱。
伤寒汗下后，心下痞而恶寒者，表未解也，先用桂枝汤解表，用大黄黄连泻心汤攻痞。若痞而汗出恶寒者，
表已解也，附子泻心汤主之。（方论见痞。）
阳明病胃家实，若汗多发热恶寒者，表未解也，未可与承气汤。（方论见潮热。）
伤寒脉浮汗出，微恶寒，小便数，脚挛急者，忌服桂枝汤。（方论见厥。）
疾病中，出现发热并伴有恶寒症状的，属于阳证；没有发热而仅见恶寒的，属于阴证。发于阳证的，七天痊愈；发于阴证的，六天痊愈。这是因为阳数代表七、阴数代表六的缘故。
发热且恶寒，脉象浮，归属于太阳病（太阳经受邪所致的病证）。（相关的方剂论述很多，详见“发热门”中关于“太阳病”的条目。）
恶寒，脉象微弱并且又出现腹泻的，是亡血（阴血亏虚）的表现，应当用四逆加人参汤主治。（此条原文原收录在王叔和整理的霍乱门中。）
四逆加人参汤
人参 干姜 甘草（各一两） 附子（一枚，去皮，煨制）
以上药材切碎，每次服用五钱，加水煎煮后温服，每日三次。
少阴病（少阴经受邪所致的病证），恶寒且身体疲倦并有腹泻，如果腹泻停止且手足转温的，可以治疗；如果腹泻不止且手足逆冷的，不可治疗。（相关方剂论述见“下利”篇。）少阴病，恶寒且身体疲倦，时而心烦想要脱去衣被的，可以治疗；如果出现四肢厥冷无脉，不心烦但躁动的，预后不良，属死证。（相关方剂论述见“但欲寐”篇。）恶寒且手足逆冷，如果兼有大汗淋漓、筋脉拘急、腹泻的，用四逆汤主治。（相关方剂论述见“下利”篇。）如果兼有头部出汗、心下部胀满、脉象沉细、大便干硬的，用小柴胡汤主治。（相关方剂论述见“厥”篇。）如果是夏季中暑，脉象虚弱且口渴、背部恶寒的，用白虎加人参汤主治。（相关方剂论述见“中暑”篇。）如果口中平和（口不苦不燥），只是精神萎靡想睡觉的，应当施灸，适宜用附子汤。发汗治疗后出现恶寒的，是正气虚损所致。（相关论述见“发热”篇。）发汗后病邪未解，反而更加恶寒的，是因为虚损的缘故，用芍药甘草附子汤主治。
芍药甘草附子汤方
芍药 白术（各二两） 甘草（三两） 桂枝（四两） 附子（一枚，炮制，去皮）
以上药材切碎，每次服用五钱，加水煎煮后温服。
太阳病经过攻下治疗后，脉象急促且胸部胀满的，用桂枝去芍药汤主治。
桂枝去芍药汤方
桂枝（去皮） 生姜（各一两半，切片） 甘草（一两，炙烤） 大枣（六枚）
以上药材切碎，每次服用五钱，加水煎煮后温服。
如果有轻微恶寒症状的，用桂枝去芍药加附子汤主治。（《活人书》说：芍药味酸，脉象急促且胸部胀满时，恐怕会形成结胸证，所以去掉芍药，单用辛甘味的药物来发散毒邪之气。）
桂枝去芍药加附子汤方
桂枝 生姜（各一两半） 甘草（一两） 大枣（六枚） 附子（半个，去皮，炮制）
以上药材切碎，加水煎煮后温服，每次服用五钱。
伤寒经过发汗或攻下治疗后，心下部痞塞且恶寒的，说明表证尚未解除，应当先用桂枝汤解除表证，再用大黄黄连泻心汤攻逐痞结。如果痞塞且伴有汗出恶寒的，说明表证已解，用附子泻心汤主治。（相关方剂论述见“痞”篇。）
阳明病（阳明经受邪所致的病证）胃家实（胃肠实热积滞），如果汗多、发热且恶寒的，说明表证尚未解除，暂时不可以使用承气汤类方剂。（相关方剂论述见“潮热”篇。）
In diseases, those presenting with fever and aversion to cold belong to Yang syndromes; those without fever but only with aversion to cold belong to Yin syndromes. Those originating from Yang will recover in seven days; those originating from Yin will recover in six days. This is because the number for Yang is seven and the number for Yin is six.
Fever accompanied by aversion to cold and a floating pulse belongs to Taiyang disease (diseases of the Taiyang channel). (There are numerous discussions on formulas, see the entry for "Taiyang Disease" under the section "Fever".)
Aversion to cold, a faint pulse, and recurrent diarrhea indicate loss of blood (deficiency of Yin-blood), which should be treated with Sini Jia Renshen Tang (Four Reversal Decoction plus Ginseng). (This clause was originally included in the Huoluan [Cholera] section by Wang Shuhe.)
Sini Jia Renshen Tang (Four Reversal Decoction plus Ginseng)
Renshen (Ginseng Radix et Rhizoma) Ganjiang (Zingiberis Rhizoma) Gancao (Licorice Root) [each 1 liang] Fuzi (Aconiti Lateralis Radix Praeparata) [one piece, skin removed, roasted]
Crush the herbs. Take 5 qian per dose, decoct in water, and take warm. Three times daily.
Shaoyin disease (diseases of the Shaoyin channel) presents with aversion to cold, fatigue, and diarrhea. If the diarrhea stops and the hands and feet become warm, it is treatable; if the diarrhea continues and the hands and feet become cold, it is untreatable. (See formula discussions under "Diarrhea".) In Shaoyin disease, with aversion to cold, fatigue, occasional irritability, and a desire to remove clothing or blankets, it is treatable; however, if there is cold extremities without a pulse, no irritability but restlessness, it is fatal. (See formula discussions under "Desire to Sleep".) Aversion to cold with cold extremities, if accompanied by profuse sweating, muscle cramps, and diarrhea, should be treated with Sini Tang (Four Reversal Decoction). (See formula discussions under "Diarrhea".) If accompanied by sweating on the head, fullness in the epigastrium, a deep and fine pulse, and hard stool, Xiao Chaihu Tang (Minor Bupleurum Decoction) should be used. (See formula discussions under "Jue/Cold Extremities".) If suffering from heatstroke in summer, with a weak pulse, thirst, and aversion to cold on the back, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) should be used. (See formula discussions under "Heatstroke".) If the mouth feels normal (not bitter or dry) and there is only drowsiness, moxibustion should be applied, and Fuzi Tang (Aconite Decoction) is suitable. After sweating therapy, if aversion to cold occurs, it indicates deficiency. (See discussion under "Fever".) After sweating therapy, if the disease does not resolve but aversion to cold worsens, it is due to deficiency, and Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) should be used.
Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) Formula
Shaoyao (Paeoniae Radix Alba) Baizhu (Atractylodis Macrocephalae Rhizoma) [each 2 liang] Gancao (Licorice Root) [3 liang] Guizhi (Cinnamomi Ramulus) [4 liang] Fuzi (Aconiti Lateralis Radix Praeparata) [one piece, processed, skin removed]
Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.
After purgation in Taiyang disease, if the pulse is rapid and there is chest fullness, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony) should be used.
Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony) Formula
Guizhi (Cinnamomi Ramulus) [skin removed] Shengjiang (Zingiberis Rhizoma Recens) [each 1.5 liang, sliced] Gancao (Licorice Root) [1 liang, honey-fried] Dazao (Ziziphi Jujubae Fructus) [six pieces]
Crush the herbs. Take 5 qian per dose, decoct in water, and take warm.
If there is slight aversion to cold, Guizhi Qu Shaoyao Jia Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Aconite) should be used. (The *Ren Jian Lu* states: Peony has a sour taste. With a rapid pulse and chest fullness, there is fear of forming Jie Xiong [Chest Binding], so Peony is removed, using only acrid and sweet flavors to disperse pathogenic qi.)
Guizhi Qu Shaoyao Jia Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Aconite) Formula
Guizhi (Cinnamomi Ramulus) Shengjiang (Zingiberis Rhizoma Recens) [each 1.5 liang] Gancao (Licorice Root) [1 liang] Dazao (Ziziphi Jujubae Fructus) [six pieces] Fuzi (Aconiti Lateralis Radix Praeparata) [half a piece, skin removed, processed]
Crush the herbs, decoct in water, and take warm. Take 5 qian per dose.
After sweating or purgation in Shanghan (Cold Damage), if there is epigastric stuffiness and aversion to cold, the exterior syndrome has not yet resolved. First use Guizhi Tang (Cinnamon Twig Decoction) to release the exterior, then use Dahuang Huanglian Xiexin Tang (Rhubarb, Coptis, and Scutellaria Heart-Draining Decoction) to attack the stuffiness. If there is stuffiness accompanied by sweating and aversion to cold, the exterior has resolved, and Fuzi Xiexin Tang (Aconite Heart-Draining Decoction) should be used. (See formula discussions under "Pi/Stuffiness".)
Yangming disease (diseases of the Yangming channel) involves Wei Jia Shi (Excess in the Stomach and Intestines). If there is excessive sweating, fever, and aversion to cold, the exterior has not yet resolved, and Chengqi Tang formulas should not be administered yet. (See formula discussions under "Tidal Fever".)
In Shanghan, if the pulse is floating, there is sweating, slight aversion to cold, frequent urination, and leg cramps, Guizhi Tang (Cinnamon Twig Decoction) is contraindicated. (See formula discussions under "Jue/Cold Extremities".)