夜以阴为主阴气盛则目闭而安卧，若阴虚为阳所胜，则终夜烦扰而不眠也。心脏神，大汗后则阳
气虚，故不眠心主血，大下后则阴气弱，故不眠。热病邪热盛，神不清，故不眠。新瘥后、阴气未复，故不
眠。若汗出鼻干而不得眠者，又为邪入表也。
卫气者，昼则行阳，夜则行阴，行阳则寤，行阴则寐。今欲寐者，盖因阳气虚、阴气盛，故目瞑而多眠也，
乃邪传阴而不在阳也。然伤寒之多眠，虽属于少阴居多，而亦有不同。如太阳十余日，脉沈细，恶寒
蜷卧而欲寐者，此神气昏也。汗出身重，鼻干语□，目不了了而多眠者，此风温病也。唇黑有疮，咽干
声哑，默默而多眠者，此狐惑也。若汗下后，邪气已退，正气已复，身凉脉微，鼾息酣睡，此吉兆也。
澳□者，心中澳□，郁闷不舒之貌，比之烦闷尤甚者也。盖因表邪未解，而遽下之，阳气内陷于心胸
之间，郁而不发，心中恼乱不安，甚则为结胸也。若邪在心胸，宜吐。在胃府，宜下。已吐下后，邪气壅塞
而未尽，心中郁闷而不舒，又当随其虚实以治之。
拘急者，手足屈伸不便，如蜷卧恶风之貌，以四肢乃诸阳之本，因发汗亡阳，阳虚而有此症也。
舌者，心之官，应南方火，本红而泽。若伤寒邪热烁，则津液枯涸，是以心苗干槁，而舌生胎矣。若邪
热在表，则生白胎，邪热在里，则生胎刺，其或黄，或黑，或涩，或滑，或生芒刺，或生裂纹者，为热气之浅
深者也。故曰、胎白而滑，邪热渐深，胎黑而裂，邪热尤极，病则危笃矣。大抵鲜红湿润者吉，燥涩干裂
者凶。又有一种阴寒症，水极反来□火，亦现黑胎等症，其胎必湿冷而滑，不燥不涩，不渴不热，脉必
沈细，症必足冷，又当以四逆汤温之。夏月人病黑胎者，因时火与邪火内外炎烁，尚有可生，未可断
其死症。若冬月黑胎者，必死。此心传之妙也。
一切白胎之症，用生姜片薰蜜擦之。黄胎之症，用青布里指薰薄荷汤或冷水频擦之。至若胎黑而裂，乃水
刊于心火也。经曰、热病口干舌黑者，死。
夜间以阴气为主导，阴气旺盛时眼睛闭合而安稳睡眠。如果阴虚导致阳气偏胜，就会整夜烦躁扰攘而无法入睡。心藏神，大汗之后阳气虚弱，所以不能安睡；心主血，大泻之后阴气衰弱，所以不能安睡。热病中邪热炽盛，心神不清，所以不能安睡。大病初愈后，阴气尚未恢复，所以不能安睡。如果出汗且鼻干而不能安睡的，又是邪气侵入体表的表现。
卫气（运行于脉外、具有防御作用的气），白天行于阳分，夜晚行于阴分，行于阳分则清醒，行于阴分则睡眠。现在想睡觉的人，大概是因为阳气虚弱、阴气旺盛，所以眼睛闭合而多睡，这是邪气传入阴分而不在阳分所致。然而伤寒病中出现多眠的情况，虽然大多属于少阴病（肾经病变），但也有不同情况。例如太阳病（太阳经受邪所致的病证）十余日，脉象沉细，恶寒蜷缩而想睡觉的，这是神气昏昧。出汗后身体沉重，鼻干胡言乱语，眼神模糊不清而多睡的，这是风温病（感受风热之邪引起的急性外感热病）。嘴唇发黑且有疮疡，咽干声音嘶哑，沉默寡言而多睡的，这是狐惑病（一种以口腔、咽喉及前后二阴蚀烂为特征的疾病）。如果在发汗或攻下之后，邪气已退，正气已复，身体凉爽脉象微弱，打鼾酣睡，这是吉兆。
懊憹（心中烦闷不适的感觉），是心中懊憹郁闷不舒的样子，比一般的烦闷更为严重。这是因为表邪未解，就急于使用攻下法，导致阳气内陷于心胸之间，郁结而不能发散，心中恼乱不安，严重时就会形成结胸（邪热与痰水互结于胸膈脘腹的病证）。如果邪气在心胸部位，适宜用吐法；在胃腑，适宜用下法。已经经过吐法或下法治疗后，邪气壅塞而未清除干净，心中郁闷而不舒畅，又应当根据虚实的不同来治疗。
拘急，指手足屈伸不便，像蜷缩卧倒、厌恶风寒的样子，因为四肢是诸阳之本，因发汗过多导致亡阳，阳气虚弱而出现这种症状。
舌是心的官窍，对应南方的火，本色红润而有光泽。如果伤寒邪热灼烧，津液枯涸，那么作为心之苗窍的舌头就会干枯萎缩，从而生出舌苔。如果邪热在体表，就生白苔；邪热在体内，就生芒刺状的舌苔。或者呈现黄色、黑色，或者干燥涩滞，或者滑润，或者生芒刺，或者生裂纹的，反映了热气的深浅程度。所以说，舌苔白而滑润，说明邪热逐渐加深；舌苔黑而开裂，说明邪热极其严重，病情危重。大体上，舌色鲜红湿润的是吉兆，干燥涩滞干裂的是凶兆。还有一种阴寒证，水气极盛反来格拒虚火，也会出现黑苔等症状，但其舌苔必定湿冷而滑润，不干燥不涩滞，口不渴身不热，脉象必定沉细，症状必定足部寒冷，这时应当用四逆汤（回阳救逆的代表方剂）来温补。夏季人患黑苔病，是因为时令之火与邪火内外交蒸，还有生存的希望，不能断定其为死症。如果是冬季出现黑苔，必定死亡。这是心病传变的奥妙之处。
所有白苔的症状，用生姜片熏蒸蜂蜜擦拭。黄苔的症状，用青布蘸取薄荷汤或冷水频繁擦拭。至于舌苔黑而开裂，是水气克制心火的结果。经文说：热病口干舌黑的，预后不良（死）。
Night is dominated by Yin Qi. When Yin Qi is abundant, the eyes close and one sleeps peacefully. If Yin deficiency allows Yang to prevail, one will be restless throughout the night and unable to sleep. The Heart houses the Shen (Spirit). After profuse sweating, Yang Qi becomes deficient, leading to insomnia; the Heart governs Blood. After severe purging, Yin Qi becomes weak, also leading to insomnia. In febrile diseases, when pathogenic heat is exuberant, the Shen becomes unclear, causing insomnia. After a new recovery from illness, if Yin Qi has not yet restored, insomnia occurs. If sweating is accompanied by dryness of the nose and inability to sleep, it indicates that the pathogen has entered the exterior.
Wei Qi (Defensive Qi) travels through the Yang meridians during the day and the Yin meridians at night. Traveling through Yang leads to wakefulness; traveling through Yin leads to sleep. Now, those who desire sleep are likely suffering from deficient Yang Qi and abundant Yin Qi, causing their eyes to close and sleep excessively. This indicates that the pathogen has transmitted to the Yin and is no longer in the Yang. However, although excessive sleepiness in Shanghan (Cold Damage) mostly belongs to Shaoyin disease (disease of the Kidney meridian), there are differences. For example, after more than ten days of Taiyang disease (disease of the Bladder and Heart meridians characterized by exterior syndrome), if the pulse is deep and fine, with aversion to cold, curling up, and desire to sleep, this is due to the dimness of Shen Qi. If sweating is accompanied by heaviness of the body, dry nose, delirious speech, blurred vision, and excessive sleepiness, this is Fengwen disease (Wind-Warmth disease). If the lips are black with sores, the throat is dry, the voice is hoarse, and one is taciturn with excessive sleepiness, this is Huhuo disease (a disease characterized by erosion of the mouth, throat, and genitalia). If, after sweating or purging, the pathogenic qi has retreated, the healthy qi has recovered, the body is cool, the pulse is faint, and one snores soundly, this is an auspicious sign.
Aonao (restlessness and discomfort in the chest/epigastrium) refers to a state of inner restlessness and depression, more severe than ordinary irritability. This occurs because the exterior pathogen has not been resolved, but purgatives were hastily used, causing Yang Qi to sink inward into the chest and epigastrium, where it stagnates and fails to disperse. This causes mental disturbance and unease, which may progress to Jie Xiong (Chest Binding, a condition where pathogenic heat and phlegm-fluid bind in the chest/abdomen). If the pathogen is in the chest and epigastrium, vomiting therapy is appropriate; if in the Stomach fu organ, purging is appropriate. After vomiting or purging, if pathogenic qi remains obstructed and uneliminated, causing inner depression and discomfort, treatment should follow the principles of deficiency or excess.
Ju Ji (muscle contraction and tension) refers to difficulty in flexing and extending the hands and feet, resembling a curled-up posture with aversion to wind. Since the four limbs are the root of all Yang meridians, this symptom arises from Yang loss due to excessive sweating, resulting in Yang deficiency.
The tongue is the orifice of the Heart and corresponds to the Fire element of the South; its normal color is red and lustrous. If Shanghan pathogenic heat scorches the body, depleting fluids, the tongue (the sprout of the Heart) becomes dry and shriveled, leading to the formation of tongue coating. If pathogenic heat is in the exterior, white coating forms; if in the interior, prickly coating forms. Whether yellow, black, rough, slippery, prickly, or cracked, these features reflect the depth of heat. Thus, it is said: white and slippery coating indicates gradually deepening pathogenic heat; black and cracked coating indicates extreme pathogenic heat, signaling critical illness. Generally, fresh red and moist tongue is auspicious; dry, rough, and cracked tongue is ominous. There is also a type of Yin-cold syndrome where extreme Water counteracts deficient Fire, presenting with black coating etc., but the coating must be wet, cold, and slippery, not dry or rough, with no thirst or heat sensation, a deep and fine pulse, and cold feet. In such cases, Sini Tang (Decoction for Reversing Collapse) should be used to warm. In summer, patients with black coating suffer from seasonal fire and pathogenic fire burning internally and externally; survival is possible, and death cannot be declared. In winter, black coating indicates certain death. This is the subtle transmission of Heart disease.
For all white coating syndromes, use ginger slices steamed with honey to wipe the tongue. For yellow coating syndromes, use green cloth dipped in mint decoction or cold water to frequently wipe. As for black and cracked coating, it represents Water overcoming Heart Fire. The Classics state: "In febrile diseases, dry mouth and black tongue indicate death."