伤寒七八日，脉微肤冷，烦躁无时暂安者，此名藏厥。多难治，始当用四逆汤。
伤寒厥深，下利脉迟，当不能食，而反能食者，名曰除中。除中者，中气已绝，病不可治也。
不仁者，肌肤顽麻而不知痛痒寒热也。盖因发汗过多，亡其营血，不能周流经络，乃为寒邪辏袭，血
脉凝泣而不仁也。设或身汗如油，喘而不休，水浆不入，形体不仁，又为绝候也。
直视者，视物而目睛不转动者是也。伤寒至于直视，为邪气已极，候已逆，多难治也。设或目中不
了了者，又为可治之症也。二者形症相近，为工者宜熟思之。
内经曰、阳气者，精则养神，柔则养筋。发汗过多，津液枯少，阳气大虚，筋肉失养，故惕然而跳，目闰然而
动也。治宜温经养营之剂，故张氏特设真武汤以救之。
王冰曰、冲为血之至。言诸经之血，朝会于此。其脉起于肾下，并足阳明之经。若冲脉得热血必妄行故。
在男子则为下血谵语，以邪热传入，正场明府病也。在妇人则为寒热似疟，以邪热乃随经而入也。
故曰妇人则随经而入，男子由阳明而传。一说、伤寒中风，偶遇经水适来，邪随而入，或经水适断，血
热而结，或胸满胆语，或往来寒热，或如疟状，皆为热入血室也。皆不可汗下，无犯胃气及中上二焦，
并用小柴胡汤加归芍生地丹皮以治之。
伤寒病经过七八天，出现脉象微弱、皮肤发冷，且烦躁不安、没有片刻安宁的症状，这叫做藏厥。这种病症大多难以治疗，起初应当使用四逆汤。
伤寒导致四肢厥冷严重，伴有腹泻、脉象迟缓，按理说应该不能进食，但如果反而能够进食，这叫做除中。所谓除中，是指胃气已经断绝，病情无法治愈。
“不仁”是指肌肤麻木僵硬，不知道疼痛、瘙痒、寒冷或温暖的感觉。这是因为发汗过多，耗伤了营血，导致血液不能在经络中正常周流，于是寒邪聚集侵袭，血脉凝滞不畅，从而出现麻木不仁的症状。如果 additionally 出现汗水像油一样黏稠、喘息不止、水浆无法入口、身体麻木不仁，这又是死症（绝候）。
“直视”是指眼睛看着物体但眼球不转动。伤寒发展到直视的程度，说明邪气已经极盛，病势已逆，大多难以治疗。如果出现两眼昏花、视物不清的情况，反而是可以治疗的病症。这两种症状形态相近，医生应当仔细思考辨别。
《内经》说：阳气，精微时能滋养精神，柔和时能滋养筋脉。发汗过多，津液枯竭减少，阳气大虚，筋肉失去滋养，所以会出现心惊肉跳、眼睑颤动的症状。治疗适宜用温经养血的药剂，所以张氏特别设立真武汤来救治。
王冰说：冲脉是血液汇聚之处。意思是各条经脉的血液都朝会于此。冲脉起于肾下，与足阳明胃经并行。如果冲脉遇到热血，血液必定妄行。在男子身上表现为便血和胡言乱语，因为邪热传入，导致阳明腑病。在女子身上表现为忽冷忽热像疟疾一样，因为邪热随着经脉进入。所以说女子是邪热随经而入，男子是由阳明经传变。另一种说法认为，伤寒中风时，偶然遇到月经刚来，邪气随之进入，或者月经刚断，血热而凝结，或者胸满谵语，或者往来寒热，或者像疟疾状，这些都是热入血室的表现。这些情况都不可使用发汗或攻下的方法，不要损伤胃气及中上二焦，一律使用小柴胡汤加上当归、白芍、生地黄、牡丹皮来治疗。
After seven or eight days of cold damage, with a faint pulse and cold skin, accompanied by restlessness without any momentary relief, this is named Zang Jue (Visceral Cold Reversal). It is difficult to treat; initially, Sini Tang (Four Reversal Decoction) should be used.
In cold damage with severe limb reversal, diarrhea, and a slow pulse, the patient should theoretically be unable to eat; however, if they can eat instead, it is named Chuzhong (Elimination from the Middle). Chuzhong indicates that the Qi of the Middle Jiao has been exhausted, and the disease is incurable.
"Bu Ren" (Insensitivity) refers to the skin and muscles being numb and stiff, unaware of pain, itching, cold, or heat. This occurs because excessive sweating has depleted Ying Blood (Nutritive Blood), preventing it from circulating freely through the meridians. Consequently, Cold Evil gathers and attacks, causing blood vessels to stagnate and clot, leading to insensitivity. If additionally there is sweat like oil, unceasing panting, inability to take in fluids, and bodily insensitivity, these are signs of a critical prognosis (Jue Hou).
"Zhi Shi" (Fixed Gaze) refers to looking at objects while the eyeballs do not move. When cold damage progresses to fixed gaze, it indicates that the pathogenic factor is extremely intense and the condition has become adverse, making it difficult to treat. However, if the eyes appear dim or vision is unclear, it is a treatable symptom. Although the manifestations of these two conditions are similar, practitioners must ponder them carefully.
The Neijing states: "Yang Qi, when refined, nourishes the Spirit; when soft, it nourishes the sinews." Excessive sweating dries up body fluids and severely depletes Yang Qi, causing the sinews and muscles to lose nourishment. Thus, the patient experiences palpitations and twitching eyelids. The treatment should employ formulas that warm the meridians and nourish Ying Blood; therefore, Zhang Zhongjing specifically established Zhenwu Tang (True Warrior Decoction) to rescue this condition.
Wang Bing stated: "Chong Mai (Penetrating Vessel) is where blood converges," meaning blood from all meridians gathers here. The vessel originates below the kidney and runs parallel to the Foot-Yangming Stomach Meridian. If the Chong Mai encounters hot blood, the blood will flow recklessly. In men, this manifests as lower bleeding and delirious speech, as the pathogenic heat transmits inward, causing Yangming Fu-organ disease. In women, it manifests as alternating chills and fever resembling malaria, as the pathogenic heat enters along the meridians. Thus, it is said that in women, the pathogen enters via the meridians, whereas in men, it transmits via the Yangming channel. Another view holds that during cold damage or wind-stroke, if menstruation happens to begin, the pathogen enters with it; or if menstruation has just ceased, blood heat causes coagulation. Symptoms such as chest fullness and delirium, alternating chills and fever, or a malaria-like state are all classified as Re Ru Xue Shi (Heat Entering the Blood Chamber). These conditions should not be treated with sweating or purging methods, nor should the Stomach Qi and the Upper and Middle Jiao be violated. Instead, Xiaochaihu Tang (Minor Bupleurum Decoction) combined with Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Shengdihuang (Rehmanniae Radix), and Mudanpi (Moutan Cortex) should be used for treatment.