齐大哥十一月间。因感寒邪。头项强。身体痛。自用灵砂丹四五粒并服以酒引下。遂大汗出。
汗后身轻。至夜。前病复来。以前药复汗。其病不愈。复以通圣散发汗。病添身体沉重足 冷而恶寒
。是日方命医。医者不究前治。又以五积散汗之。翌日。身重如石。不能反侧。足 如冰。冷及
腰背。头汗如贯珠。出而不流。心胸躁热。烦乱不安。喜饮冷。西瓜、梨柿冰水之物。常置左右。
病至于此。命予治之。诊得六脉如蛛丝。微微欲绝。予以死决之。主家曰。得汗多矣。焉能为害。
予曰。夫寒邪中人者。阳气不足之所致也。而感之有轻重。汗之者岂可失其宜哉。仲景曰。阴盛阳
虚。汗之则愈。汗者、助阳退阴之意也。且寒邪不能自出。必待阳气泄。乃能出也。今以时月论之
。大法夏月宜汗。此大法焉。然并以太过为戒。况冬三月闭藏之时。无扰乎阳。无泄皮肤。使气
亟夺。为养藏之道也。逆之则少阴不藏。此冬气之应也。凡有触冒。宜微汗之。以平为期。邪退乃
已。急当衣暖衣。居密室。服实表补卫气之剂。虽有寒邪。弗能为害。此从权之治也。今非时而大
发其汗。乃谓之逆。故仲景有云。一逆尚引日。再逆促命期。今本伤而汗。汗而复伤。伤而复汗。汗
出数回。使气亟夺。卫气无守。阳泄于外。阴乘于内。故经云。独阳不生。独阴不长。不死何待。
虽卢扁亦不能治之活也。是日。至夜将半。项强身体不仁。手足搐急。爪甲青而死矣。金匮要略云
。不当汗而妄汗之。令人夺其津液枯槁而死。今当汗之。一过亦中绝其命。况不当汗而强汗之者乎。
齐大哥在十一月期间，因为感受了寒邪，出现头项僵硬、身体疼痛的症状。他自行服用灵砂丹四五粒，并用酒送服，结果导致大汗淋漓。
出汗之后身体感觉轻松，但到了夜晚，之前的病症又复发。他又用同样的药物再次发汗，病情并未痊愈。随后他又服用通圣散来发汗，结果病情加重，出现了身体沉重、足部寒冷且恶寒的症状。
直到这一天，家人才请医生诊治。医生没有探究之前的治疗经过，又使用五积散让他发汗。第二天，他身体沉重得像石头一样，无法翻身侧卧，双脚像冰一样冷，寒意一直蔓延到腰背部。头部出汗如串联的珠子，流出但不流淌。心胸烦躁发热，心烦意乱不得安宁，喜欢喝冷饮，西瓜、梨、柿子以及冰水等凉性食物常放在身边。
病情发展到这种地步，家人请求我诊治。我诊察发现六脉细弱如蛛丝，微弱得几乎要断绝。我判断他为死证。家属说：“已经出了很多汗了，怎么能造成危害呢？”我说：“寒邪侵入人体，是因为阳气不足所致。感邪有轻重之分，发汗治疗岂能失去适宜的程度？张仲景说：‘阴盛阳虚，汗之则愈’（此处原文似有误，通常指阳虚忌汗或特定语境，依原文直译），发汗是助阳退阴的意思。而且寒邪不能自行排出，必须等待阳气宣泄，才能随汗而出。
从时令来看，一般原则是夏季适宜发汗，这是大法则。然而并以此为戒不可太过。况且冬季三个月是闭藏的季节，不应扰动阳气，不应使皮肤开泄，导致气机频繁耗夺，这才是养藏之道。违背这一点，少阴肾气就不能闭藏，这与冬气的相应规律相悖。凡是外感邪气，应当轻微发汗，以平和为度，邪气退去就停止。此时应当穿暖和的衣服，居住在密闭的室内，服用固表补益卫气的药剂。即使有寒邪，也不能造成伤害，这是权宜的治疗之法。现在不在适当的时机却大发其汗，这就叫做逆治。所以张仲景说：‘一次误治还能拖延时日，两次误治就会加速死亡。’如今本是伤寒却发汗，发汗后又受邪，受邪后又发汗，多次出汗，导致气机频繁耗夺，卫气失去守御，阳气外泄，阴寒内乘。所以经书说：‘独阳不生，独阴不长’，不死还等什么？即使是卢医和扁鹊再生，也无法救活他。
当天夜里将近半夜，他项强、身体麻木不仁，手足抽搐拘急，指甲发青而死。《金匮要略》说：‘不当汗而妄汗之，令人夺其津液枯槁而死。’如今正当发汗的时候，稍微过头也会中断性命，何况是不当发汗却强行发汗的呢。”
During the eleventh month, Elder Qi contracted a cold pathogen, resulting in stiffness of the head and neck and body pain. He self-administered four or five pills of Lingsha Dan (Cinnabar Pill), taken with wine as a vehicle, which led to profuse sweating.
After sweating, he felt physically light; however, by nightfall, his previous symptoms recurred. He took the same medication again to induce sweating, but the illness did not resolve. Subsequently, he took Tongsheng San (Tongsheng Powder) to induce sweating, which worsened his condition, adding symptoms of heavy body, cold feet, and aversion to cold.
It was only on that day that the family summoned a physician. The physician failed to investigate the prior treatments and administered Wuji San (Wuji Powder) to induce sweating. By the next day, his body was as heavy as stone, unable to turn over or change position. His feet were like ice, with coldness extending up to the waist and back. Sweat on the head flowed like beads strung together, emerging but not flowing freely. He experienced restlessness and heat in the chest and heart, mental agitation, and discomfort, desiring cold drinks. Foods such as watermelon, pear, persimmon, and iced water were kept constantly by his side.
When the condition reached this stage, he requested my treatment. I palpated the six pulses, finding them thin as spider silk, faint and nearly imperceptible. I pronounced it a fatal case. The head of the household said, "He has sweated profusely; how can this be harmful?" I replied, "The invasion of cold pathogens is caused by insufficiency of Yang Qi. The severity of contraction varies; how can sweating therapy be applied without proper appropriateness? Zhang Zhongjing stated: 'In cases of Yin excess and Yang deficiency, sweating may cure' [Note: Interpreting original text literally]. Sweating is intended to assist Yang and retreat Yin. Moreover, cold pathogens cannot exit spontaneously; they must wait for the venting of Yang Qi to be expelled through sweat.
Considering the season, the general principle is that sweating is suitable in summer; this is a general rule. However, one must beware of excess. Furthermore, the three months of winter are a time of storage and concealment; one should not disturb Yang, nor allow the skin pores to open, causing frequent depletion of Qi. This is the way of nourishing storage. Violating this leads to the failure of Shaoyin (Kidney) to store, contradicting the correspondence of Winter Qi. In cases of external invasion, slight sweating should be induced, aiming for balance, stopping when the pathogen recedes. One should urgently wear warm clothes, reside in a sealed room, and take formulas that consolidate the exterior and tonify Wei Qi (Defensive Qi). Even if cold pathogens are present, they will cause no harm; this is a flexible treatment approach. Now, inducing massive sweating out of season is called 'counter-flow' (Ni). Thus, Zhang Zhongjing said: 'One error may prolong life for a day; two errors accelerate the end of life.' Here, originally suffering from injury (cold), he was made to sweat; after sweating, he was injured again; after being injured, he was made to sweat again. Multiple episodes of sweating caused frequent depletion of Qi, loss of defensive function of Wei Qi, leakage of Yang on the exterior, and invasion of Yin on the interior. Hence, the Classics state: 'Solitary Yang does not generate; solitary Yin does not grow.' Why would he not die? Even if Lu Yuan (Bian Que) were alive, he could not save him.
That night, near midnight, he developed stiffness of the neck, insensibility of the body, spasms and cramping of the hands and feet, and cyanosis of the nail beds, after which he died. The *Jin Gui Yao Lue* states: 'Sweating improperly when not indicated causes depletion of fluids and death by withering.' Even when sweating is indicated, going too far can sever life; how much more so when sweating is forced inappropriately?"