表外实，下内实，忌∶
世治外实，多用表剂。表则外虚，风寒得入，而病加剧。世治内实，多用下剂，下则内
虚，肠胃气促，而肢不畅。华先生治府吏倪寻头痛身热，则下之，以其外实也。治李延头痛
身热，则汗之，以其内实也。盖得外实忌表，内实忌下之秘也。又按内实则湿火上冲，犹地
气之郁，正待四散也；外实则积垢中留，犹山间之水，正待下行也。其患头痛身热同，而治
法异者，虽得之仙秘，实本天地之道也。余屡试之，果屡见效。（孙思邈注）
汗，愈；不汗，死。
县吏尹世，苦四肢烦，口中干。不欲闻人声，小便不利。华先生曰∶“试作热食，得汗
即愈，不汗后三日死。”即作热食，而汗不出。华先生曰∶“脏气已绝于内，当啼泣而绝。”
已而果然。先生盖有所本而云然也。按肢烦口干，不欲闻声，热症也。医者遇此症，决不敢
曰热食，多主用凉剂。然一用凉剂，使起搐搦，却无啼泣之状，缘先生进热食，故有啼泣状
耳。余昔遇此症，常用热表剂，见汗涔涔而愈，益信先生言之不诬。窃怪世之治此症者，不
能决其愈不愈，死不死。观于先生之治法，可以知所从事矣。（孙思邈注）
宜辛散，忌凉遏。
世传华先生治牙痛∶一撮花椒水一盅，细辛白芷与防风。浓煎漱齿三更后，不怕牙痛
风火虫。实则先生之医术，虽本乎仙人，其用药则由己。如宜辛散，忌凉遏，即治百般牙痛
之秘诀也。故知治病不必拘定汤药，盖汤药可伪造，可以假托，且当视其病之重轻，人之虚
实，时之寒燠，而增减之。故有病同药同，而效与不效异。医者于此，宜知所酌夺矣。（孙
思邈注）
体表邪气盛实，体内邪气也盛实，治疗禁忌：
世人治疗表证邪气盛实，多用发汗解表的方剂。发汗会导致体表正气虚弱，风寒之邪趁机侵入，从而使病情加重。世人治疗里证邪气盛实，多用泻下攻里的方剂，泻下会导致体内正气虚弱，肠胃之气急促不畅，从而导致四肢活动不利。华佗先生治疗府吏倪寻的头痛身热，采用泻下法，是因为他属于外实（表邪盛）；治疗李延的头痛身热，采用发汗法，是因为他属于内实（里邪盛）。这大概是掌握了“外实忌用解表、内实忌用泻下”的秘诀。又按：内实则湿火向上冲逆，如同地气郁结，正等待向四周发散；外实则积滞污垢停留于中焦，如同山间积水，正等待向下排泄。他们的病症都是头痛身热相同，但治疗方法不同，虽然这是得自仙人的秘传，但实际上是符合天地自然规律的。我多次尝试验证，果然屡次见效。（孙思邈注）
通过发汗来治愈；如果不发汗，则死亡。
县吏尹世，苦于四肢烦扰不适，口中干燥。不想听到人声，小便不通利。华佗先生说：“试着吃热的食物，若能出汗即刻痊愈，若不出汗，三天后必死。”于是做了热食给他吃，但汗没有出来。华佗先生说：“内脏之气已在内部断绝，应当会哭泣着死去。”不久果然如此。先生这话大概是有依据才这样说的。按：四肢烦扰、口干、不想听声音，属于热症。医生遇到这种病症，决不敢说用热食，大多主张使用寒凉方剂。然而一旦使用寒凉方剂，会使患者出现抽搐痉挛，却没有哭泣的情状，正因为先生进用热食，所以才有哭泣的情状。我以前遇到这种病症，常用辛温解表的方剂，见到汗水淋漓而出而痊愈，更加相信先生的话没有虚假。私下奇怪世上治疗这种病症的人，不能断定其能否痊愈或死亡。观察先生的治疗方法，就可以知道该如何施治了。（孙思邈注）
适宜使用辛味药物发散，忌用寒凉药物遏制。
世间流传华佗先生治疗牙痛的方法：一撮花椒配水一盅，加入细辛、白芷和防风。浓煎后在半夜之后漱口，就不怕牙痛由风、火、虫引起。实际上先生的医术，虽然本源于仙人，但他用药则由自己决定。比如适宜辛散，忌用凉遏，这就是治疗各种牙痛的秘诀。因此知道治病不必拘泥于固定的汤药，因为汤药可以伪造，可以假托，而且应当根据病情的轻重、人体的虚实、气候的寒暖来进行增减调整。所以有病症相同、药物相同，但疗效却不同的情况。医生对此，应该懂得斟酌权衡。（孙思邈注）
Exterior excess and interior excess, contraindications:
In times of peace (stable conditions), when treating exterior excess, physicians often use diaphoretic agents. Diaphoresis leads to deficiency at the exterior, allowing wind-cold pathogens to enter, thereby exacerbating the disease. When treating interior excess, physicians often use purgative agents. Purging leads to deficiency within, causing urgency and obstruction in the qi of the intestines and stomach, resulting in poor mobility of the limbs. Master Hua treated Ni Xun, a government clerk, for headache and fever by purging him, because his condition was characterized by exterior excess. He treated Li Yan, also with headache and fever, by inducing sweating, because his condition was characterized by interior excess. This reflects the secret principle that "exterior excess contraindicates diaphoresis, while interior excess contraindicates purging." Furthermore, interior excess involves damp-heat and fire rushing upward, akin to stagnant earth qi awaiting dispersion; exterior excess involves accumulated filth remaining in the middle jiao, akin to water in the mountains awaiting downward flow. Although their symptoms of headache and fever are identical, their treatments differ. While this may be derived from immortal secrets, it is fundamentally based on the Dao of Heaven and Earth. I have tested this repeatedly, and indeed, it has yielded frequent success. (Annotation by Sun Simiao)
Sweating leads to recovery; lack of sweating leads to death.
Yin Shi, a county clerk, suffered from vexation in the four limbs and dryness in the mouth. He did not wish to hear human voices, and urination was difficult. Master Hua said, "Try eating hot food. If sweat appears, he will recover immediately; if no sweat appears, he will die within three days." Hot food was prepared, but no sweat emerged. Master Hua said, "The qi of the zang organs has already severed internally; he will likely weep before passing away." Soon after, this proved true. The Master's statement was presumably based on established principles. Analysis: Vexation in the limbs, dry mouth, and aversion to sound are signs of heat syndrome. Physicians encountering this syndrome would dare not prescribe hot food, typically preferring cooling formulas. However, if cooling formulas are used, they may induce convulsions without the symptom of weeping. It is precisely because the Master prescribed hot food that the symptom of weeping appeared. In my past encounters with this syndrome, I have frequently used diaphoretic formulas with acrid-warm properties, observing profuse sweating leading to recovery, which further confirms that the Master's words were not false. I privately marvel that contemporary physicians treating this syndrome cannot determine whether the patient will recover or die. Observing the Master's treatment method reveals how one should proceed. (Annotation by Sun Simiao)
Acrid dispersal is suitable; cold suppression is contraindicated.
It is passed down that Master Hua treated toothache as follows: One handful of Sichuan pepper boiled in one cup of water, added with Asarum (Xixin), Angelica dahurica (Baizhi), and Saposhnikovia divaricata (Fangfeng). Decoct strongly and rinse the teeth after midnight; fear not toothache caused by wind, fire, or worms. In reality, although the Master's medical skills originated from immortals, his prescription of herbs was self-determined. For instance, favoring acrid dispersal and avoiding cold suppression constitutes the secret recipe for treating all kinds of toothaches. Thus, one knows that treating disease need not be confined to fixed decoctions, as decoctions can be forged or falsely attributed. Moreover, adjustments must be made according to the severity of the disease, the deficiency or excess of the person, and the cold or warmth of the season. Therefore, cases may present with identical diseases and identical prescriptions, yet yield different efficacies. Physicians should exercise discretion in such matters. (Annotation by Sun Simiao)