予谓一元真气即太阳。太阳进一步不同，又进一步不同，退一步不同，退两步又不同。移步换形，移步更名，其中许多旨归。外感内伤，皆本此一元有损耳。最可鄙者，今人云仲景之方，是为冬月伤寒立法，并非为内伤与杂证立法。试问内伤失血肺痿，有服甘草干姜汤而愈者否？呕吐泄泻，有服理中汤而愈者否？抑郁肝气不舒，两胁胀痛，有服小柴胡而愈者否？夜梦遗精，有服桂枝龙牡汤而愈者否？肾脏不温，水泛为痰，有服真武汤而愈者否？寒湿腰痛，有服麻黄附子细辛汤而愈者否？少气懒言，困倦嗜卧，咳嗽潮热，有服建中汤而愈者否？温病初起，有服麻杏石甘汤、鸡子黄连汤、四逆汤而愈者否？痢证，有服白头翁汤、桃花汤而愈者否？腹痛吐泻霍乱，有服理中汤、吴茱萸汤而愈者否？妇人经期、妊娠，有服桂枝汤而愈者否？痘证初起，有服桂枝汤、升麻葛根汤而愈者否？老人便艰涩，有服麻仁丸而愈者否？阳虚大便下血，有服四逆汤而愈者否？阴虚大便脓血，有服鸡子黄连汤而愈者否中？今人不体贴，只记时行几个通套方子，某病用某方，倍其味，某病用某方，减某味，如此而已。究其阴阳至理，全然莫晓，六经变化，罕有得知，愈趋愈下，不堪问矣。
附七绝一首：
伤寒二字立津梁，六气循环妙理藏，不是长沙留一线，而今焉有作医郎。
夫曰冬伤于寒者，伤于太阳寒水之气也。冬令乃阳气潜藏，正天一生水之际。少年无知，不能节欲。［眉批］节欲二字。不专指房劳，兼一切耗神耗气之事。耗散元精，元精即天一。元精一耗，冬不藏精也。不能化生真水，即不能克制燥金之气，故当春之际，
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温病立作。二月属卯、卯酉阳明，燥金主事。苟能封固严密，指冬能藏精者。元精即能化生真水，而燥金自不敢横行无忌，春即不病温矣。此刻辛温固本之药，未可遽施，当从二日传经之法治之，未为不可。虽然如此，又当细求，而清凉之品亦不可妄用。病人虽现大热口渴饮冷，谵语，又当于脉息，声音之有神无神，［眉批］无神非温，有神乃是。饮冷之多寡，大便之实与不实，小便之利与不利。有神者，可与麻杏石甘汤，无神者，可用回阳收纳之法治之，庶不致误人性命也。
辩 温 约 言
今人于春令偶感外邪，发热，身疼，口渴饮冷，汗出谵语，便闭，恶热等情。举世皆云温病，动用达原饮、三消饮、升解散、三黄石膏、大小承气、普济消毒散，种种方法。予思此等施治，皆是治客邪。［眉批］客邪二字，春为风客，夏为火客，夏为湿客，按六气候可。由太阳而趋至阳明，伏而不传，渐入阳明之里，以此等法治之，实属妥贴。切切不可言温，但言风邪伤了太阳，由太阳趋至阳明。风为阳邪，合阳明之燥热，化为一团热邪，热盛则伤阴，故现气实、脉实、身轻气粗，只宜清凉滋阴攻下等法。至于温病，乃冬不藏精，根本先坏，这点元气随木气发泄，病情近似外感，粗工不察，治以发散清凉，十个九死。予业斯道三十余年，今始认得病情形状，与用药治法，一并叙陈。病人初得病，便觉头昏，周身无力，发热而身不痛，口不渴，昏昏欲睡，舌上无苔，满口津液，而舌上青光隐隐；即或口渴，而却喜滚，即或饮冷，而竟一二口；即或谵语，而人安静闭目。即或欲行走如狂，其身轻飘无力；即或二便不利，倦卧，不言不语；即或汗出，而声
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低息短；即或面红，而口气温和；六脉洪大，究竟无力；即或目赤咽干，全不饮冷，大便不实，小便自利。即服清凉，即服攻下，即服升解，热总不退，神总不清，只宜回阳收纳，方能有济。
予经验多人，一见便知，重者非十余剂不效，轻者一二剂可了。惜乎世多畏姜、附，而信任不笃。独不思前贤云，甘温能除大热，即是为元气外越立法，即是为温病立法。今人不分阴阳病情相似处理会，一见发热，便云外感，便用升解。一见发热不退，便用清凉滋阴、攻下。一见二便不利，便去通利。把人治死尚不觉悟，亦由其学识之未到也。兹再将阴虚、阳虚病情录数十条，以与将来。
辩认邪盛热炽血伤病情
干 呕 不 止
病人二三日，发热不退，脉息、声音一切有神，干呕不止者，此热壅于阳明也。法宜解肌清热。
张 目 谵 语
病人四五日，发热恶热，烦躁不宁，张目不眠，时而妄言，脉健者，此热邪气盛，气主上升，故张目不眠，谵语频临，属邪热乘心，而神昏也。法宜清热。热清而正复，张目谵语自己。若瞑目谵诘，脉空无神，又当回阳，不可养阴。
口渴饮冷不止
病人六七日，发热不退，脉洪有力，饮冷不止者，此邪
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热太甚，伤及津液也。法宜灭火存阴为主。
大 汗 如 雨
病人或六七日，发热汗出如雨，脉大有力，口臭气粗，声音洪亮，口渴饮冷，此乃热蒸于内，胃火旺极也。法宜急清肌热。此有余之候，并非久病亡阳可比。
病人或七八日，发热不退，舌苔干黄，烦躁不宁，脉健身轻，肠胃已实。此胃火太甚，津液将枯，急宜滋阴攻下为主。
狂叫不避亲疏
病人或八九日，发热不退，气粗身轻，脉健，狂叫，目无亲疏，弃衣奔走。此邪火旺极，乱其神明，神无所主也。急宜清凉攻下，灭云邪火，不可迟延。
二 便 不 利
病人或七八日，发热恶热，烦躁不宁，口渴饮冷，脉健身轻，二便不利。此邪热伤阴，血液不能滋润沟渠，通体皆是一团邪火，急宜攻下，不可迟延。
鼻 如 煤 烟
病人或八九日，发热不退，烦躁饮冷，胸满不食，口臭气粗，忽现鼻如煤烟。此由邪火旺极，炎薰于上也。急宜坆下。
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肛 门 似 烙
病人或十余日，发热不退，脉健气粗，烦躁不宁，饮水不已，自觉肛门似烙。此邪热下攻于大肠，真阴有立亡之势［1］。急宜攻下，不可因循姑惜。
病人或八九日，发热恶热，烦渴饮冷，舌黄而芒刺满口，脉健身轻，小便涓滴痛者。此邪热下趋小肠，结于膀胱也。急宜清热利水。
食 入 即 吐
病人发热恶热，口臭气粗，脉健，食入即吐者。此是邪热伏于胃口，阻其下行之机，热主上升，此刻邪热为崇，升多降少，故食入即吐。急宜攻其邪火，邪火一灭，食自能下矣。
病人或八九日，身［2］热不退，气粗舌干，小便短赤，大便极黄而溏，或清水、血水，脉健有力，或脉细如丝，或四［3］肢厥逆［4］，人虽昏沉，其口气蒸手，舌根必红活，即舌黑起刺。此是邪热入里，伏于其内。急宜攻下清里，切不可妄用辛温。
病人或八九日，十余日，外邪未解，入于里分，身虽发
[1] 势原本作"热"，据文义改。
[2] 身原本作"鼻"，据文义改。
[3] 四原本作"曰"，据文义改。
[4] 逆原本作"立"，据文义改。
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热，日晡更甚，饮冷不已，妄方言鬼神。此是热甚伤血，神昏无主。急宜养血滋阴。并非阴火上腾，元气外越可比。
呃 逆 不 止
病人或八九日，发热不退，口渴转增，饮水不辍，忽见呃逆连声。此由邪热隔中，阻其交通之气机也。法宜攻下。
鼻 血 如 注
病人发热烦燥，二便不利，口臭气粗，忽见鼻血如注，发热更甚者。此由邪火太甚，逼血妄行也。法宜清热攻下，苟血出而热退便通，又是解病佳兆。
斑 疹 频 发
病人发热不退，烦燥不宁，饮冷气粗，脉健声洪，烦渴饮冷，人时恍惚，干咳不已，吐涎胶粘。此乃火旺津枯，热逼于肺，宜润燥清金泻火为要。
喉 痛 厥 逆
病人或八九日，发热不退，或不身热，脉健身轻，品气极热，小便短赤，神气衰减，肌肤干粗，忽见喉痛厥逆。此邪入厥阴，热深厥深，上攻而为喉痹是也。急宜清润泻火养阴为主。
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脓血下行不止
病人或八九日，身热不退，或身不热，时而烦渴，时而厥逆，烦躁不宁。此厥阴邪热，下攻于肠也。法宜清火养阴为主。
皮 毛 干 粗
病人或七八日，发热不退，或身不热，必烦气衰，小便短而咽中干，忽见皮肤干粗，毛发枯槁。此邪火伤阴，血液失运，急宜泻火养阴为主。
筋 挛 拘 急
病人或七八日，或十余日，发热不退，或不身热，烦渴咽干，小便短赤，恶热喜冷，忽然四肢拘急不仁。此由邪火伤阴，血液不荣于筋，故见拘急。法宜滋阴泻火为主。
阴 囊 如 斗
病人或十余日，身热未退，或不身热，脉健身轻，心烦口渴，声音洪亮，忽见阴囊红肿，其大如斗，疼痛异常。此热邪下攻宗筋，宗筋之脉，贯于阴囊，急宜泻火养阴滋肝为主。
周 身 红 块
病人身热脉健，烦躁不宁，忽现周身红块，痛痒异常。此是邪热壅于肌肉也。宜解肌清热泻火为主。
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忽见身冷如水，形如死人。此是热极内伏，阳气不达于外，证似纯阴。此刻审治，不可粗心，当于气口中求之，二便处求之。予经验多人，口气虽微，极其蒸手，舌根红而不青，小便短赤，急宜攻下，不可因循姑惜，切切不可妄用姜、附。
头 面 肿 痛
以上数十条，略言其概，其中尚有许多火证情形。有当用甘寒养阴法者，有当用苦寒攻下存阴法者，有当用清凉滋阴法者，有当用利水育阴法者，有当用润躁救阴法者，有当用甘温回阳救阴法者。种种不一，全在临时变通。总之正气生人，邪气死人，用养阴等法，皆为阳证邪火立说，而非为阴气上腾之阴火立说。当知阳证邪火，其人脉息、声音一切有神。若阴气上腾之阴火，脉息，起居一切无神，阴象全具。此乃认证关健，不可不知。
辩认阴盛阳衰及阳脱病情
头 痛 如 劈
素禀阳虚之人，身无他苦，忽然头痛如劈，多见唇青爪甲青黑，或气上喘，或脉浮空，或劲如石。此阳竭于上，急宜回阳收纳，十中可救四五。
目 痛 如 裂
察非外感，非邪火上攻，或脉象与上条同，病情有一二
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耳 痒 欲 死
审无口若咽干，寒热往来，即非肝胆为病。此是肾气上腾，欲从耳脱也，必有阴象足征，急宜回阳收纳。
印 堂 如 镜
久病虚极之人，忽然印堂光明如镜，此是阳竭于上，旦夕死亡之征。若不思而救之，急宜大剂回阳收纳，光敛而饮食渐加，过七日而精神更健者，即有生机。否则未敢遽许。
唇 赤 如 朱
久病虚极之人，无邪火可征，忽见唇赤如朱。此真阳从唇而脱，旦夕死亡之征。急服回阳，十中可救二三。
两 颧 发 赤
久病与秉不足之人，两颧发赤。此真元竭于上也。急宜回阳收纳，误治则死。
鼻 涕 如 注
久病虚极之人，忽然鼻涕如注。此元气将脱，旦夕死亡之征。急宜回阳收纳，或救一二。
口 张 气 出
久病虚极之人，忽见口张气出。此元气将绝，旦夕死亡之征。法在不治，若欲救之，急宜回阳收纳，以尽人事。
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眼 胞 下 陷
久病之人，忽见眼胞下陷。此五藏元气竭于下也，旦夕即死。法在不治。若欲将之，急宜大剂回阳，十中或可救一二。
白 眼 轮 青
久病虚损之人，忽见白晴青而人无神。此真阳衰极，死亡之征。急宜回阳，十中可救五六。
目 肿 如 桃
久病与素秉不足之人，忽见目肿如桃，满身纯阴，并无一点邪火风热可险。此是元气从目脱出，急宜回阳收纳，可保无虞。
目 常 直 视
久病虚极之人，忽见目常直视。此真气将绝，不能运动，法在死例。若欲救之，急宜回阳，或可十中救一二。
目 光 如 华
久病与素秉不足之人，目前常见五彩光华。此五脏精气外越，阳气不藏，亦在死例。急宜回阳收纳，十中可救五六。
面 色 光 彩
久病虚损之人，忽见面色鲜艳，如无病之人，此是真阳已竭于上，旦夕死亡之客。若欲救之，急宜回阳，光敛而神稍健，过七日不变者，方有生机。否则不救。
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面 如 枯 骨
久病虚极之人，忽见面如枯骨。此真元已绝，精气全无，旦夕死亡之征，可预为办理后事，急服回阳，十中或可救得一二。
面赤沭如朱面赤如瘀，面白如纸，面黑如煤，面青如枯草。
久病虚极之人，并无邪火足征，忽见面赤如朱者。此真阳已竭于上也。法在不治，惟回阳一法，或可十中救一二。更有如瘀、如纸、如煤、如枯草之类，皆在死例，不可勉强施治。
齿 牙 血 出
素秉阳虚之人，并无邪火足征，阴象全具，忽见满口齿牙血出。此是肾中之阳虚，不能统摄血液，阴血个溢，只有扶阳收纳一法最妥。若以滋阴之六味地黄汤治之，是速其危也。
牙 肿 如 茄
我认为，一元真气就是太阳。太阳病证随着邪气深入一步而有所不同，再深入一步又不同；随着正气退却一步而有所不同，再退却两步又不同。病情变化万千，名称也随之改变，其中蕴含着许多深奥的道理。外感病和内伤病，其根本原因都在于这一元真气的受损。最让人鄙视的是，现在的人说张仲景的方剂，是专门为冬季伤寒制定的，并不是为内伤和杂病制定的。试问：内伤导致的失血、肺痿（肺部虚损引起的咳嗽咯血等症），有服用甘草干姜汤而痊愈的吗？呕吐泄泻，有服用理中汤而痊愈的吗？抑郁导致肝气不舒，两胁胀痛，有服用小柴胡汤而痊愈的吗？夜间梦遗精滑，有服用桂枝加龙骨牡蛎汤而痊愈的吗？肾脏阳气不足不温，水液泛滥化为痰饮，有服用真武汤而痊愈的吗？寒湿腰痛，有服用麻黄附子细辛汤而痊愈的吗？少气懒言，困倦嗜卧，咳嗽潮热，有服用小建中汤而痊愈的吗？温病初起，有服用麻杏石甘汤、鸡子黄连汤、四逆汤而痊愈的吗？痢疾，有服用白头翁汤、桃花汤而痊愈的吗？腹痛吐泻霍乱，有服用理中汤、吴茱萸汤而痊愈的吗？妇女经期或妊娠期，有服用桂枝汤而痊愈的吗？痘疹初起，有服用桂枝汤、升麻葛根汤而痊愈的吗？老人大便干结难解，有服用麻仁丸而痊愈的吗？阳虚导致大便下血，有服用四逆汤而痊愈的吗？阴虚导致大便脓血，有服用鸡子黄连汤而痊愈的吗？现在的人不去仔细体会，只记住几个通用的套方，某病用某方，增加药味；某病用某方，减少药味，如此而已。究其阴阳至深的道理，全然不懂，六经的变化，很少有人知晓，医术越来越低劣，不堪入目了。
附七绝一首：
“伤寒”二字确立诊疗的津梁，六气循环中藏着妙理，若不是长沙太守（张仲景）留下这一线生机，如今哪里还有行医之人呢？
有人问：冬天感受寒邪，春天必定发生温病，这是什么缘故？
回答说：所谓冬天感受寒邪，是指感受了太阳寒水之气。冬季是阳气潜藏的时候，正是“天一生水”的关键时刻。少年人无知，不能节制欲望。［眉批］“节欲”二字，不仅仅指房事过度，还包括一切耗神耗气的事情。耗散了元精，元精即天一之精。元精一旦耗散，冬天就不能藏精。不能化生真水，就不能克制燥金之气，所以在春季来临时，温病就会立即发作。二月属卯月，卯酉对应阳明，燥金主事。如果能够封固严密，指冬天能藏住精气，元精就能化生真水，燥金自然不敢横行无忌，春天就不会得温病了。此刻使用辛温固本的药物，不可以急于施用，应当从第二天传经的法治之，也未尝不可。虽然如此，又应当细细探究，清凉的药物也不可以妄用。病人虽然出现大热、口渴想喝冷水、说胡话等症状，还应当观察脉象气息、声音是有神还是无神。［眉批］无神不是温病，有神才是。看喝冷水的多少，大便的实与不实，小便的通利与否。有神气的，可以给予麻杏石甘汤；无神气的，可以用回阳收纳的方法治疗，这样才不会误人性命。
辨析温病简要言论
现在的人在春季偶尔感受外邪，出现发热、身体疼痛、口渴想喝冷水、出汗、说胡话、便秘、怕热等情况。全社会都说是温病，动不动就用达原饮、三消饮、升解散、三黄石膏汤、大小承气汤、普济消毒散等各种方法。我思考这些治疗方法，都是治疗客邪。［眉批］“客邪”二字，春季是风邪客居，夏季是火邪客居，夏季是湿邪客居，按照六气气候来理解是可以的。由太阳经趋向到阳明经，伏留而不传变，渐渐进入阳明之里，用这些方法治疗，确实很妥当。切切不可说是温病，只说风邪伤了太阳经，由太阳经趋向到阳明经。风为阳邪，合并阳明之燥热，化为一团热邪，热盛则损伤阴液，所以表现为气实、脉实、身体轻爽、呼吸粗重，只宜用清凉滋阴攻下等方法。至于温病，是因为冬天没有藏住精气，根本先坏了，这点元气随着木气发泄出来，病情近似外感，粗心的医生不察觉，用发散清凉的方法治疗，十个有九个死亡。我从事这个行业三十多年，现在开始认清病情的形状，以及用药治法，一并陈述。病人刚得病，就觉得头昏，周身无力，发热但身体不痛，口不渴，昏昏欲睡，舌上没有苔，满口津液，而舌上隐隐透出青光；即使口渴，却喜欢喝热水；即使想喝冷水，也只喝一两口；即使说胡话，人却是安静闭目的；即使想行走如发狂，身体却是轻飘无力的；即使二便不利，倦怠卧床，不说话；即使出汗，声音却低沉气息短促；即使面红，口气却温和；六脉洪大，终究无力；即使眼睛红、咽喉干，完全不想喝冷水，大便不成形，小便自利。即使服用清凉药，服用攻下药，服用升解散，热总不退，神志总不清，只宜用回阳收纳的方法，才能有帮助。
我经验过很多人，一见就知道，重的非十余剂药不见效，轻的一两剂就可以好了。可惜世上多畏惧生姜、附子，而信任不坚定。独不思前贤说，甘温能除大热，这就是为元气外越立的法，也就是为温病立的法。现在的人不分阴阳，病情相似就处理会通，一见发热，就说外感，就用升解散。一见发热不退，就用清凉滋阴、攻下。一见二便不利，就去通利。把人治死了还不觉悟，也是由于学识没达到境界啊。兹再将阴虚、阳虚的病情记录数十条，留给将来的人参考。
辨析邪盛热炽血伤的病情
干呕不止
病人两三天，发热不退，脉象气息、声音一切有神，干呕不止的，这是热邪壅滞于阳明经。治法适宜解肌清热。
睁眼说胡话
病人四五日，发热怕热，烦躁不宁，睁眼不眠，时而胡乱说话，脉象健有力的，这是热邪气盛，气主上升，所以睁眼不眠，谵语频繁临近，属于邪热乘袭心脏，而神志昏迷。治法适宜清热。热清而正气恢复，睁眼说胡话自然停止。如果是闭眼说胡话，脉空虚无神，又应当回阳，不可以养阴。
口渴想喝冷水不止
病人六七日，发热不退，脉象洪大有力，想喝冷水不止的，这是邪热太甚，损伤了津液。治法应以灭火存阴为主。
大汗如雨
病人或者六七日，发热汗出如雨，脉象大有力，口臭气粗，声音洪亮，口渴想喝冷水，这是热气蒸腾于内，胃火旺极。治法应紧急清除肌表之热。这是有余的证候，并不是久病亡阳可以相比的。
病人或者七八日，发热不退，舌苔干黄，烦躁不宁，脉象健身轻，肠胃已经结实。这是胃火太甚，津液将枯，紧急应当以滋阴攻下为主。
狂叫不避亲疏
病人或者八九日，发热不退，气粗身轻，脉象健，狂叫，眼睛不看亲疏，脱衣奔走。这是邪火旺极，扰乱了神明，神无所主。紧急应当清凉攻下，灭掉邪火，不可迟延。
二便不利
病人或者七八日，发热怕热，烦躁不宁，口渴想喝冷水，脉象健身轻，二便不利。这是邪热伤阴，血液不能滋润沟渠，通体都是一团邪火，紧急应当攻下，不可迟延。
鼻子像煤烟
病人或者八九日，发热不退，烦躁想喝冷水，胸满不食，口臭气粗，忽然现出鼻子像煤烟一样黑。这是由邪火旺极，炎薰于上所致。紧急应当攻下。
肛门似烙铁烫
病人或者十余日，发热不退，脉象健气粗，烦躁不宁，喝水不停，自觉肛门似被烙铁烫。这是邪热下攻于大肠，真阴有立刻亡失的趋势［1］。紧急应当攻下，不可因循姑息。
小便点滴作痛
病人或者八九日，发热怕热，烦渴想喝冷水，舌黄而芒刺满口，脉象健身轻，小便点滴且痛的。这是邪热下趋小肠，结于膀胱。紧急应当清热利水。
病人发热怕热，口臭气粗，脉象健，吃进去就吐的。这是邪热伏在胃口，阻断了其下行的气机，热主上升，此刻邪热为害，升多降少，所以吃进去就吐。紧急应当攻其邪火，邪火一灭，食物自然能下咽。
病人或者八九日，身体［2］发热不退，气粗舌干，小便短赤，大便极黄而溏，或者是清水、血水，脉象健有力，或者脉细如丝，或者四肢厥逆［4］，人虽然昏沉，但其口气蒸手，舌根必红活，即使舌黑起刺。这是邪热入里，伏于体内。紧急应当攻下清里，切不可妄用辛温。
下午发热想喝冷水胡说鬼神
病人或者八九日，十余日，外邪未解，进入里分，身体虽然发热，下午更严重，想喝冷水不停，胡说鬼神之事。这是热甚伤血，神昏无主。紧急应当养血滋阴。并不是阴火上腾，元气外越可以相比的。
呃逆不止
病人或者八九日，发热不退，口渴转增，饮水不停，忽然见呃逆连声。这是由邪热隔阻中焦，阻断了交通的气机。治法适宜攻下。
病人发热烦躁，二便不利，口臭气粗，忽然见鼻血如注，发热更严重的。这是由邪火太甚，逼迫血液妄行。治法适宜清热攻下，如果血出而热退便通，又是解除疾病的好兆头。
斑疹频发
病人发热不退，烦躁不宁，想喝冷气粗，脉象健声音洪亮，烦渴想喝冷水，人时常恍惚，干咳不停，吐涎胶粘。这是火旺津枯，热逼迫于肺，宜润燥清金泻火为要。
喉痛厥逆
病人或者八九日，发热不退，或者不身热，脉象健身轻，气息极热，小便短赤，神气衰减，肌肤干粗，忽然见喉痛厥逆。这是邪入厥阴经，热深厥深，上攻而为喉痹。紧急应当清润泻火养阴为主。
脓血下行不止
病人或者八九日，身热不退，或者身不热，时而烦渴，时而厥逆，烦躁不宁。这是厥阴邪热，下攻于肠。治法适宜清火养阴为主。
病人或者七八日，发热不退，或者身不热，必然烦躁气衰，小便短而咽中干，忽然见皮肤干粗，毛发枯槁。这是邪火伤阴，血液失去运化，紧急应当泻火养阴为主。
病人或者七八日，或者十余日，发热不退，或者不身热，烦渴咽干，小便短赤，恶热喜冷，忽然四肢拘急不仁。这是由邪火伤阴，血液不能荣养于筋，所以见到拘急。治法适宜滋阴泻火为主。
阴囊如斗
病人或者十余日，身热未退，或者不身热，脉象健身轻，心烦口渴，声音洪亮，忽然见阴囊红肿，其大如斗，疼痛异常。这是热邪下攻宗筋，宗筋的经脉，贯穿于阴囊，紧急应当泻火养阴滋肝为主。
病人身热脉健，烦躁不宁，忽然现出周身红块，痛痒异常。这是邪热壅滞于肌肉。宜解肌清热泻火为主。
病人八九日，初发热口渴想喝冷水，二便不利，烦躁说胡话，忽然见身冷如水，形如死人。这是热极内伏，阳气不达于外，证候似纯阴。此刻审察治疗，不可粗心，应当在气口中求之，二便处求之。我经验过很多人，口气虽微，极其蒸手，舌根红而不青，小便短赤，紧急应当攻下，不可因循姑息，切切不可妄用姜、附。
病人二三日，头面肿痛，这是邪热壅滞于三阳经。紧急应当散清热为主。
以上数十条，略言其概，其中还有许多火证的状况。有当用甘寒养阴法的，有当用苦寒攻下存阴法的，有当用清凉滋阴法的，有当用利水育阴法的，有当用润燥救阴法的，有当用甘温回阳救阴法的。种种不一，全在临时变通。总之正气使人存活，邪气使人死亡，用养阴等方法，都是为阳证邪火立说，而不是为阴气上腾的阴火立说。应当知道阳证邪火，其人的脉象气息、声音一切有神。若阴气上腾的阴火，脉象气息、起居一切无神，阴象全具。这是认证的关键，不可不知道。
辨析阴盛阳衰及阳脱的病情
头痛如劈
素来禀赋阳虚的人，身体没有其他痛苦，忽然头痛如劈，多见嘴唇青、爪甲青黑，或者气上喘，或者脉浮空，或者脉劲如石。这是阳气竭于上，紧急应当回阳收纳，十人中可救四五。
目痛如裂
察知不是外感，不是邪火上攻，或者脉象与上条相同，病情有一二同的，紧急应当回阳。如果滋阴解散则会死。
耳痒欲死
审察没有口苦咽干，寒热往来，就不是肝胆为病。这是肾气上腾，欲从耳部脱出，必有阴象足以证明，紧急应当回阳收纳。
印堂如镜
久病虚极的人，忽然印堂光明如镜，这是阳气竭于上，旦夕死亡的征兆。如果不思而救之，紧急应当大剂回阳收纳，光敛而饮食渐加，过七日而精神更健的，就有生机。否则不敢轻易许诺。
久病虚极的人，没有邪火可征，忽然见唇赤如朱。这是真阳从唇而脱，旦夕死亡的征兆。紧急服用回阳药，十人中可救二三。
久病与禀赋不足的人，两颧发赤。这是真元竭于上。紧急应当回阳收纳，误治则死。
久病虚极的人，忽然鼻涕如注。这是元气将脱，旦夕死亡的征兆。紧急应当回阳收纳，或许能救一二。
久病虚极的人，忽见口张气出。这是元气将绝，旦夕死亡的征兆。治法在不治，若想救之，紧急应当回阳收纳，以尽人事。
眼睑下陷
久病的人，忽见眼睑下陷。这是五脏元气竭于下，旦夕即死。治法在不治。若想救之，紧急应当大剂回阳，十人中或许可救一二。
久病虚损的人，忽见白睛青而人无神。这是真阳衰极，死亡的征兆。紧急应当回阳，十人中可救五六。
目肿如桃
久病与素禀不足的人，忽见目肿如桃，满身纯阴，并无一点邪火风热可险。这是元气从目脱出，紧急应当回阳收纳，可保无虞。
目常直视
久病虚极的人，忽见目常直视。这是真气将绝，不能运动，治法在死例。若想救之，紧急应当回阳，或许十人中救一二。
久病与素禀不足的人，目前常见五彩光华。这是五脏精气外越，阳气不藏，也在死例。紧急应当回阳收纳，十人中可救五六。
面色光彩
久病虚损的人，忽见面色鲜艳，如无病之人，这是真阳已竭于上，旦夕死亡的客证。若想救之，紧急应当回阳，光敛而神稍健，过七日不变的，方有生机。否则不救。
久病虚极的人，忽见面如枯骨。这是真元已绝，精气全无，旦夕死亡的征兆，可预为办理后事，紧急服用回阳药，十人中或许可救得一二。
面赤如朱，面赤如瘀，面白如纸，面黑如煤，面青如枯草。
久病虚极的人，并无邪火足征，忽见面赤如朱者。这是真阳已竭于上。治法在不治，唯有回阳一法，或许十中救一二。更有如瘀、如纸、如煤、如枯草之类，都在死例，不可勉强施治。
素禀阳虚的人，并无邪火足征，阴象全具，忽见满口齿牙血出。这是肾中之阳虚，不能统摄血液，阴血溢，只有扶阳收纳一法最妥。如果用滋阴的六味地黄汤治疗，是加速其危险。
牙肿如茄
I consider that the One Yuan True Qi (Yi Yuan Zhen Qi) is the Taiyang (Greater Yang). As Taiyang progresses further, it differs; progressing even further, it differs again. As it retreats one step, it differs; retreating two steps, it differs yet again. The form changes with every step, and the name changes with every step, containing many profound principles. Both external contraction diseases (Wai Gan) and internal injury diseases (Nei Shang) are fundamentally due to the damage of this One Yuan True Qi. What is most despicable is that people today claim that Zhang Zhongjing's formulas were established solely for winter cold damage (Shang Han), and not for internal injuries or miscellaneous diseases. Let me ask: Have cases of internal injury leading to blood loss or lung atrophy (Fei Wei) been cured by Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction)? Have vomiting and diarrhea been cured by Lizhong Tang (Regulate the Middle Decoction)? Have depression and liver qi stagnation causing distending pain in both hypochondria been cured by Xiaochaihu Tang (Minor Bupleurum Decoction)? Have nocturnal emission and spermatorrhea been cured by Guizhi Jia Longgu Muli Tang (Cinnamon Twig Decoction plus Dragon Bone and Oyster Shell)? Have kidney yang deficiency failing to warm, leading to water flooding and transforming into phlegm, been cured by Zhenwu Tang (True Warrior Decoction)? Have cold-dampness lower back pain been cured by Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction)? Have shortness of breath, reluctance to speak, fatigue, drowsiness, cough, and tidal fever been cured by Xiaojianzhong Tang (Minor Construct the Middle Decoction)? Have early-stage warm diseases (Wen Bing) been cured by Maxing Shigan Tang (Ephedra, Apricot Seed, Gypsum, and Licorice Decoction), Ji Zi Huanglian Tang (Chicken Egg and Coptis Decoction), or Sini Tang (Recover the Extremities Decoction)? Have dysentery cases been cured by Baitouweng Tang (Pulsatilla Decoction) or Taohua Tang (Peach Kernel Decoction)? Have abdominal pain, vomiting, diarrhea, and cholera been cured by Lizhong Tang or Wuzhuyu Tang (Evodia Decoction)? Have women during menstruation or pregnancy been cured by Guizhi Tang (Cinnamon Twig Decoction)? Have early-stage smallpox/rash cases been cured by Guizhi Tang or Shengma Gegen Tang (Cimicifuga and Pueraria Decoction)? Have elderly patients with difficult, dry bowel movements been cured by Maren Wan (Semen Cannabis Pill)? Have yang deficiency leading to bloody stools been cured by Sini Tang? Have yin deficiency leading to purulent and bloody stools been cured by Ji Zi Huanglian Tang? People today do not carefully contemplate; they merely memorize a few generic formulas, applying Formula A to Disease A by increasing ingredients, or Formula B to Disease B by decreasing ingredients, and nothing more. They completely fail to understand the profound principles of yin and yang, and rarely comprehend the changes of the Six Channels (Liu Jing). Their skills deteriorate progressively, becoming utterly unacceptable.
Attached is a seven-character quatrain:
"Shang Han" establishes the bridge for diagnosis and treatment, hiding the wondrous principles of the six qi cycle.
If Changsha [Zhang Zhongjing] had not left this ray of hope,
How could there be medical practitioners today?
A question is asked: "Winter injury from cold leads to spring warm disease." What is the reason for this?
The answer is: "Winter injury from cold" refers to injury from the Taiyang Cold Water qi. Winter is when yang qi hides and stores, which is precisely the time of "Heaven generates One Water" (Tian Yi Sheng Shui). Young people, lacking wisdom, cannot restrain their desires. [Marginal Note: "Restraining desire" does not refer exclusively to sexual excess, but includes all matters that consume spirit and qi.] When Yuan Jing (Primordial Essence) is dissipated, it means Tian Yi is lost. Once Yuan Jing is dissipated, the essence is not stored in winter. If true water cannot be generated, the Dry Metal qi cannot be restrained. Therefore, when spring arrives, warm disease immediately arises. The second month belongs to Mao; Mao and You correspond to Yangming, where Dry Metal governs. If one can seal and store tightly—meaning storing essence in winter—Yuan Jing can generate true water, and Dry Metal will dare not act recklessly. Thus, one will not contract warm disease in spring. At this moment, using acrid-warm root-fortifying medicines should not be done hastily; treating according to the method of transmission on the second day is acceptable. Although so, one must seek details carefully, and cooling substances should not be used recklessly. Although the patient presents with high fever, thirst for cold drinks, and delirium, one must examine whether the pulse and voice have Shen (Spirit/Essence). [Marginal Note: Lack of Shen is not warm disease; presence of Shen is.] Observe the quantity of cold drink intake, whether stool is solid or not, and whether urination is free or obstructed. If there is Shen, Maxing Shigan Tang may be given; if there is no Shen, methods of returning yang and gathering/collecting may be used, thus avoiding fatal errors.
Brief Remarks on Differentiating Warm Diseases
Today, when people occasionally contract external pathogens in spring, presenting with fever, body ache, thirst for cold drinks, sweating, delirium, constipation, and aversion to heat, the whole world calls it "Warm Disease." They readily employ Dachuan Yin (Reach the Origin Decoction), Sanxiao Yin (Three Eliminations Decoction), Shengjie San (Ascend and Release Powder), Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction), Da/Xiao Chengqi Tang (Major/Minor Order the Qi Decoctions), Puji Xiaodu San (Universal Benefit Detoxification Powder), and various other methods. I ponder that these treatments are all for treating Guest Pathogens (Ke Xie). [Marginal Note: "Guest Pathogen" means wind guest in spring, fire guest in summer, dampness guest in summer, consistent with the six qi climate theory.] From Taiyang moving to Yangming, lying dormant without transmitting, gradually entering the interior of Yangming, using these methods is indeed appropriate. One must absolutely not call it "Warm Disease," but rather say wind pathogen injured Taiyang, moving from Taiyang to Yangming. Wind is a yang pathogen; combining with Yangming's dry-heat, it transforms into a mass of heat pathogen. Heat excess injures yin, presenting as excess qi, excess pulse, light body, and coarse breathing. Only cooling, yin-nourishing, and purging methods are suitable. However, "Warm Disease" occurs because winter essence was not stored, damaging the root first. This bit of yuan qi vents out with wood qi. The condition resembles external contraction, but careless physicians fail to notice, treating with dispersing and cooling methods; nine out of ten die. I have practiced this profession for over thirty years and now begin to recognize the shape of the condition and the corresponding medication methods, stating them all here. When a patient first contracts the disease, they feel dizzy, lack strength throughout the body, have fever but no body pain, no thirst, feel drowsy, have no tongue coating, full mouth saliva, yet faint green light under the tongue; or if thirsty, prefer hot drinks; or if wanting cold drinks, only take one or two sips; or if delirious, the person is quiet with eyes closed; or if wanting to walk like a madman, the body is light and weak; or if bowels/bladder obstructed, lying tiredly, silent; or if sweating, the voice is low and breath short; or if face red, the breath is mild; the six pulses are surging but ultimately powerless; or if eyes red and throat dry, completely refusing cold drinks, loose stools, free urination. Even if taking cooling, purging, or ascending-releasing medicines, the heat never subsides, and the spirit never clears. Only returning yang and gathering methods can help.
I have experienced many such cases and know them at a glance. Severe cases require more than ten doses to show effect; mild cases resolve in one or two doses. It is a pity that the world fears Ginger and Aconite and lacks firm trust. Do they not recall the ancients saying, "Sweet-warm can remove great heat"? This was established for yuan qi venting outward, and thus for Warm Disease. Today's people do not distinguish yin and yang; when conditions appear similar, they treat indiscriminately. Seeing fever, they say "external contraction" and use Ascending-Release. Seeing fever persist, they use cooling-yin-nourishing and purging. Seeing bowel/bladder obstruction, they use draining methods. They kill patients without realizing it, due to insufficient knowledge. Here, I record dozens of yin-deficiency and yang-deficiency conditions for future reference.
Differentiating Conditions of Excess Evil, Blazing Heat, and Blood Injury
Unremitting Dry Retching
On the 2nd or 3rd day, fever persists, pulse and voice all show Shen, with unremitting dry retching. This is heat congestion in Yangming. The method should be releasing the muscle layer and clearing heat.
Wide-eyed Delirium
On the 4th or 5th day, fever and aversion to heat, restlessness, wide-eyed insomnia, occasional wild speech, with strong pulse. This is excess heat pathogen qi; qi tends to rise, hence wide-eyed insomnia and frequent delirium. This belongs to evil heat assaulting the heart, causing spirit confusion. The method should be clearing heat. Once heat clears and righteous qi recovers, wide-eyed delirium stops naturally. If eyes are closed while delirious, and pulse is empty/lacking Shen, one must return yang; nourishing yin is contraindicated.
Unremitting Thirst for Cold Drinks
On the 6th or 7th day, fever persists, pulse is surging and forceful, with unremitting thirst for cold drinks. This is extreme evil heat injuring fluids. The method should focus on extinguishing fire and preserving yin.
Profuse Sweating Like Rain
On the 6th or 7th day, fever with sweating like rain, large forceful pulse, bad breath, coarse breathing, loud voice, thirst for cold drinks. This is heat steaming internally, stomach fire blazing. The method should urgently clear muscle-layer heat. This is an excess syndrome, not comparable to prolonged illness losing yang.
Dry Yellow Tongue Coating with Restlessness
On the 7th or 8th day, fever persists, dry yellow tongue coating, restlessness, strong pulse, light body, intestines/stomach already solid. This is excessive stomach fire, fluids about to dry up. Urgently prioritize nourishing yin and purging.
Mad Shouting Ignoring Kinship
On the 8th or 9th day, fever persists, coarse breathing, light body, strong pulse, mad shouting, ignoring kinship, discarding clothes and running. This is extreme evil fire disturbing the spirit, leaving it without master. Urgently apply cooling and purging to extinguish the evil fire; do not delay.
Obstruction of Bowels and Urine
On the 7th or 8th day, fever and aversion to heat, restlessness, thirst for cold drinks, strong pulse, light body, obstruction of bowels and urine. This is evil heat injuring yin, blood unable to moisten the channels, the whole body a mass of evil fire. Urgently purge; do not delay.
Nose Like Coal Smoke
On the 8th or 9th day, fever persists, restlessness, thirst for cold drinks, chest fullness, anorexia, bad breath, coarse breathing, suddenly nose appears black like coal smoke. This is due to extreme evil fire flaming upward. Urgently purge.
Anus Feeling Like Scalding
On the 10th+ day, fever persists, strong pulse, coarse breathing, restlessness, incessant drinking, feeling anus is scalded. This is evil heat attacking the Large Intestine downward, with true yin facing imminent destruction [1]. Urgently purge; do not procrastinate or show mercy.
Dribbling Painful Urination
On the 8th or 9th day, fever and aversion to heat, irritability/thirst for cold drinks, yellow tongue with prickles covering the mouth, strong pulse, light body, dribbling painful urination. This is evil heat trending downward to the Small Intestine, knotting in the Bladder. Urgently clear heat and promote urination.
Vomiting Immediately After Eating
Fever and aversion to heat, bad breath, coarse breathing, strong pulse, vomiting immediately after eating. This is evil heat lurking in the stomach opening, blocking its descending mechanism. Heat tends to rise; currently evil heat dominates, rising more than descending, hence vomiting after eating. Urgently attack the evil fire; once extinguished, food will descend naturally.
Coma and Unconsciousness
On the 8th or 9th day, body [2] fever persists, coarse breathing, dry tongue, short dark urine, very yellow loose stool, or clear/bloody water, pulse strong or fine as a thread, or four [3] limbs cold [4]. Though comatose, breath feels hot to touch, tongue root is red and lively, even if tongue is black with prickles. This is evil heat entering the interior, lurking inside. Urgently purge and clear the interior; absolutely do not recklessly use acrid-warm herbs.
Afternoon Fever, Thirst for Cold, Delirium About Gods/Spirits
On the 8th or 9th day, or 10+ days, external pathogen unresolved, entering the interior. Body has fever, worse in the afternoon, incessant thirst for cold drinks, delirium about gods/spirits. This is severe heat injuring blood, spirit confused and masterless. Urgently nourish blood and yin. This is not comparable to yin fire soaring or yuan qi venting outward.
Unremitting Hiccups
On the 8th or 9th day, fever persists, thirst increases, drinking continues, suddenly hiccups occur continuously. This is due to evil heat blocking the middle, obstructing the communication of qi mechanism. The method should be purging.
Nosebleed Like a Spout
Fever, irritability, obstruction of bowels/urine, bad breath, coarse breathing, suddenly nosebleed like a spout, fever worsening. This is due to extreme evil fire forcing blood to move recklessly. The method should clear heat and purge. If bleeding stops heat and bowel movement resumes, it is a good omen of recovery.
Frequent Eruption of Macules/Rashes
Fever persists, irritability, thirst for cold, coarse breathing, strong pulse, loud voice, irritability/thirst for cold, occasional trance, dry cough, sticky saliva. This is fire excess/fluid depletion, heat pressing on the lungs. Prioritize moistening dryness, clearing metal, and purging fire.
Throat Pain and Cold Extremities
On the 8th or 9th day, fever persists, or no body heat, strong pulse, light body, extremely hot breath, short dark urine, declining spirit, dry/coarse skin, suddenly throat pain and cold extremities. This is evil entering Jueyin, deep heat causing deep cold, attacking upward causing throat bi. Urgently prioritize clearing/moistening, purging fire, and nourishing yin.
Unremitting Downward Flow of Pus and Blood
On the 8th or 9th day, body fever persists, or no body heat, intermittent irritability/thirst, intermittent cold extremities, restlessness. This is Jueyin evil heat attacking the intestines downward. The method should prioritize clearing fire and nourishing yin.
Dry/Coarse Skin and Hair
On the 7th or 8th day, fever persists, or no body heat, necessarily irritability/energy decline, short urine, dry throat, suddenly dry/coarse skin, withered hair. This is evil fire injuring yin, blood losing circulation. Urgently prioritize purging fire and nourishing yin.
Tendon Cramping and Contraction
On the 7th or 8th day, or 10+ days, fever persists, or no body heat, irritability/thirst/dry throat, short dark urine, aversion to heat/preference for cold, suddenly limbs contract and become insensible. This is due to evil fire injuring yin, blood failing to nourish tendons, hence contraction. The method should prioritize nourishing yin and purging fire.
Scrotum Like a Bucket
On the 10+ day, body heat unresolved, or no body heat, strong pulse, light body, heart vexation/thirst, loud voice, suddenly scrotum red/swollen, large as a bucket, extremely painful. This is heat pathogen attacking the Zongjin (Girdle Vessels); the Zongjin meridians pass through the scrotum. Urgently prioritize purging fire, nourishing yin, and nourishing liver.
Red Patches All Over Body
Body heat, strong pulse, restlessness, suddenly red patches all over body, extremely painful/itchy. This is evil heat congested in muscles. Prioritize releasing muscle layer, clearing heat, and purging fire.
Body Cold as Ice, Form Like a Dead Person
On the 8th or 9th day, initially fever/thirst/cold drinks, obstruction of bowels/urine, restlessness/delirium, suddenly body cold as water, form like a dead person. This is extreme heat lurking internally, yang qi unable to reach the exterior, syndrome resembling pure yin. Examining and treating now requires care; seek clues in the breath and bowels/urine. I have experienced many cases: though breath is faint, it is extremely hot to touch, tongue root is red not cyan, urine is short/dark. Urgently purge; do not procrastinate. Absolutely do not recklessly use Ginger/Aconite.
Head/Face Swelling and Pain
On the 2nd or 3rd day, head/face swelling/pain. This is evil heat congested in the Three Yang channels. Urgently prioritize scattering/clearing heat.
The above dozens of items briefly outline the general situation; there are many other fire syndromes. Some require sweet-cold yin-nourishing methods, some bitter-cold purging-to-preserve-yin methods, some cooling-yin-nourishing methods, some diuretic-yin-nourishing methods, some moistening-dryness-saving-yin methods, some sweet-warm returning-yang-saving-yin methods. Various and numerous, relying entirely on temporary adaptation. In short, Righteous Qi sustains life, Evil Qi causes death. Using yin-nourishing methods etc. is stated for Yang Syndrome Evil Fire, not for Yin Qi soaring Yin Fire. Know that Yang Syndrome Evil Fire presents with Shen in pulse, breath, and voice. If Yin Qi soaring Yin Fire, pulse, breath, and daily activities all lack Shen, with full yin signs. This is the key to differentiation, which must not be ignored.
Differentiating Conditions of Yin Excess/Yang Deficiency and Yang Collapse
Splitting Headache
Those with inherent yang deficiency, having no other suffering, suddenly experience splitting headache. Often lips/clavicles are cyan/black, or gasping asthma, or floating/empty pulse, or hard as stone. This is yang exhaustion at the upper part. Urgently return yang and gather; 4-5 out of 10 may be saved.
Cracking Eye Pain
Examined as not external contraction, not evil fire attacking upward, or pulse same as above, condition similar in 1-2 aspects. Urgently return yang. If nourishing yin and releasing, death ensues.
Ear Itching to Death
Examined as no bitter taste/dry throat, alternating chills/fever, thus not Liver/Gallbladder disease. This is Kidney qi soaring, attempting to escape via ears. Must have sufficient yin signs. Urgently return yang and gather.
Forehead Bright as Mirror
In prolonged illness with extreme deficiency, suddenly forehead bright as mirror. This is yang exhaustion at the upper part, sign of imminent death. If not thoughtfully rescued, urgently use large dose to return yang and gather. If brightness收敛s and diet gradually increases, spirit strengthens after 7 days, there is vitality. Otherwise, do not promise.
Lips Red as Vermilion
In prolonged illness with extreme deficiency, no evil fire signs, suddenly lips red as vermilion. This is true yang escaping via lips, sign of imminent death. Urgently take returning yang medicine; 2-3 out of 10 may be saved.
Red Cheekbones
Prolonged illness or inherent insufficiency, red cheekbones. This is true yuan exhausted at the upper part. Urgently return yang and gather; mis-treatment leads to death.
Runny Nose
In prolonged illness with extreme deficiency, suddenly runny nose. This is yuan qi about to collapse, sign of imminent death. Urgently return yang and gather; perhaps 1-2 saved.
Mouth Open, Air Escaping
In prolonged illness with extreme deficiency, suddenly mouth open with air escaping. This is yuan qi about to cease, sign of imminent death. Treatment is considered untreatable; if wishing to save, urgently return yang and gather to do one's utmost.
Sunken Eye Bags
In prolonged illness, suddenly sunken eye bags. This is five zang yuan qi exhausted at the lower part, imminent death. Treatment is untreatable. If wishing to save, urgently use large dose returning yang; perhaps 1-2 out of 10 saved.
Blue White of Eye Wheel
In prolonged illness with deficiency, suddenly blue white of eye with no spirit in person. This is true yang extremely depleted, sign of death. Urgently return yang; 5-6 out of 10 may be saved.
Eyes Swollen Like Peaches
Prolonged illness or inherent insufficiency, suddenly eyes swollen like peaches, whole body pure yin, no trace of evil fire/wind-heat danger. This is yuan qi escaping from eyes. Urgently return yang and gather; safety can be ensured.
Constant Staring Eyes
In prolonged illness with extreme deficiency, suddenly constant staring eyes. This is true qi about to cease, unable to move, treated as death case. If wishing to save, urgently return yang; perhaps 1-2 out of 10 saved.
Brilliant Light in Eyes
Prolonged illness or inherent insufficiency, constantly seeing five-color brilliance before eyes. This is five zang essence/qi venting outward, yang qi not storing, also a death case. Urgently return yang and gather; 5-6 out of 10 may be saved.
Radiant Complexion
In prolonged illness with deficiency, suddenly radiant complexion, like a healthy person. This is true yang exhausted at the upper part, sign of imminent death. If wishing to save, urgently return yang. If brightness收敛s and spirit slightly strengthens, unchanged after 7 days, then there is vitality. Otherwise, untreatable.
Face Like Withered Bone
In prolonged illness with extreme deficiency, suddenly face like withered bone. This is true yuan ceased, essence/qi completely gone, sign of imminent death. Prepare funeral arrangements; urgently take returning yang; perhaps 1-2 out of 10 saved.
Face Red as Vermilion, Face Red Like Bruise, Face White as Paper, Face Black Like Coal, Face Cyan Like Withered Grass.
In prolonged illness with extreme deficiency, no evil fire signs, suddenly face red as vermilion. This is true yang exhausted at the upper part. Treatment is untreatable; only returning yang method might save 1-2 out of 10. Others like bruise, paper, coal, withered grass are all death cases; do not force treatment.
Tooth/Gum Bleeding
Those with inherent yang deficiency, no evil fire signs, full yin signs, suddenly gums/tooth bleeding. This is kidney yang deficiency, unable to control blood, yin blood overflowing. Only supporting yang and gathering is best. Treating with yin-nourishing Liuwei Dihuang Tang accelerates danger.
Gum Swollen Like Eggplant