疫邪传里，胃热如沸，蛔动不安，下既不通，必反于上，蛔因呕出，此常事也。
但治其胃，蛔厥自愈。每见医家，妄引经论，以为脏寒，蛔上入膈，其人当吐蛔，又云∶“
胃中冷必吐蛔”之句。便用乌梅丸，或理中安蛔汤，方中乃细辛、附子、干姜、桂枝、川椒皆辛热
之品，投之如火上添油，殊不知疫证表里上下皆热，始终从无寒证者，不思现前事理，徒记
纸上文辞，以为根据经傍注，坦然用之无疑，因此误人甚众。
胃气逆则为呃逆，吴中称为冷呃，以冷为名，遂指为胃寒，不知寒热皆令呃逆，
且不以本证相参，专执俗语为寒，遂投丁、茱、姜、桂，误人不少，此与执辞害义者，尤为
不典。
治法各从其本证而消息之，如见白虎证则投白虎，见承气证则投承气，膈间痰闭，则宜导痰
，如果胃寒，丁香柿蒂散宜之，然不若四逆汤功效殊捷。要之，但治本证，呃自止，其他可
以类推矣。
时疫初起，邪气盘踞于中，表里阻隔，里气滞而为闷，表气滞而为头疼身痛。因
见头疼身痛，往往误认为伤寒表证，因用麻黄、桂枝、香苏、葛根、败毒、九味羌活之类，
此皆发散之剂，强求其汗，妄耗津液，经气先虚，邪气不损，依然发热。更有邪气传里，表
气不能通于内，必壅于外，每至午后潮热，热甚则头胀痛，热退即已，此岂表实者耶？以
上
似表，误为表证，妄投升散之剂，经气愈实，火气上升，头疼转甚，须下之，里气一通，经
气降而头疼立止。若果感冒头疼，无时不痛，为可辨也。且有别证相参。不可一途而取。若
汗若下后，脉静身凉，浑身肢节反加痛甚，一如被杖，一如坠伤，少动则痛若号呼，此经气
虚营卫行涩也。三、四日内，经气渐回，其痛渐止，虽不药必自愈，设妄引经论，以为风湿
相搏，一身尽痛，不可转侧，遂投疏风胜湿之剂，身痛反剧，似此误人甚众。
伤寒传胃，即便潮热谵语，下之无辞。今时疫初起，便作潮热，热甚亦能谵语，误认为里证
，妄用承气，是为诛伐无辜。不知伏邪附近于胃，邪未入腑，亦能潮热，午后热甚，亦能谵
语，不待胃实而后能也。假令常疟，热甚亦作谵语。瘅疟不恶寒，但作潮热，此岂胃实者耶
？以上似里，误投承气，里气先虚，及邪陷胃，转见胸腹胀满，烦渴益甚，病家见势危笃
，以致更医，医见下药病甚，乃指大黄为砒毒，或投泻心，或投柴胡枳桔，留邪在胃，变证
日增，神脱气尽而死。向则不应下而反下之，今则应下而反失下，盖因表里不明，用药前
后失序之误。
疫邪传入体内，胃中热势炽盛如沸水翻滚，导致蛔虫躁动不安。由于肠道不通，蛔虫必然向上逆行，随呕吐排出，这是常见的现象。
只要治疗胃部的热证，蛔厥自然痊愈。但我常看到医生们，胡乱引用经典理论，认为这是脏腑虚寒，蛔虫上行进入膈部，病人应当吐出蛔虫，又引用“胃中寒冷必定吐蛔”的说法。于是使用乌梅丸，或者理中安蛔汤，方剂中含有细辛、附子、干姜、桂枝、川椒等均为辛热性质的药物，投用这些药物如同火上浇油。他们不知道疫病证候在表、里、上、下都是热证，从头到尾从未有过寒证，却不思考眼前的实际情况，仅仅死记书本上的文字，以此作为依据，坦然地用药而毫无怀疑，因此误人甚多。
胃气上逆就会发生呃逆（打嗝），吴地称为冷呃，因为名字里有“冷”字，就将其指认为胃寒，却不知道寒证和热证都会导致呃逆，而且不参考病人的根本证候，专门固执于俗语认为是寒证，于是投用丁香、吴茱萸、干姜、桂枝等药物，误人不浅，这与拘泥于文辞而损害义理的人相比，尤为不合常理。
治疗方法应各自根据根本证候来斟酌处理，如见到白虎汤证则投用白虎汤，见到承气汤证则投用承气汤，若是膈间痰湿闭塞，则适宜导痰，如果确实是胃寒，丁香柿蒂散适宜，然而不如四逆汤功效显著快捷。总之，只要治疗根本证候，呃逆自然停止，其他情况可以类推。
时行疫病初起，邪气盘踞在中焦，表里阻隔，里气滞塞而感到闷胀，表气滞塞而导致头痛身痛。因为见到头痛身痛，往往误认为是伤寒的表证，因而使用麻黄、桂枝、香苏散、葛根、败毒散、九味羌活汤之类的药物，这些都是发散的药物，强行追求出汗，妄自耗伤津液，导致经气先虚，邪气未损，依然发热。更有甚者，邪气传入体内，表气不能通达于内，必然壅滞于外，每到午后出现潮热，热势严重时头部胀痛，热退后疼痛即止，这难道是表实证吗？以上这些看似表证，被误认为表证，妄用升散的药物，导致经气更加实滞，火气上升，头痛反而加重，必须使用下法，里气一通，经气下降，头痛立刻停止。如果是真正的感冒引起的头痛，是持续不断的疼痛，这是可以辨别清楚的。并且有其他证候相参照，不可只凭一种途径来判断。如果在发汗或攻下之后，脉象平静身体凉爽，浑身肢节反而疼痛加剧，就像被棍棒打过一样，又像遭受坠伤，稍微活动就痛得大声呼号，这是经气虚弱、营卫运行涩滞所致。在三、四天内，经气逐渐恢复，疼痛逐渐停止，即使不吃药也必然自愈，如果胡乱引用经典理论，认为是风湿相互搏结，全身疼痛，无法转动，于是投用疏风胜湿的药物，身体疼痛反而加剧，像这样误人的情况非常多。
伤寒传入胃部，立刻出现潮热和谵语，使用下法是没有异议的。如今时行疫病初起，就出现潮热，热势严重时也能谵语，被误认为是里证，妄用承气汤，这是诛伐无辜。不知道伏匿的邪气靠近胃部，邪气尚未进入腑脏，也能出现潮热，午后热势加重，也能谵语，不需要等到胃实之后才能发生。假使是普通的疟疾，热势严重时也会谵语。瘅疟不恶寒，只出现潮热，这难道是胃实证吗？以上这些看似里证，误用承气汤，导致里气先虚，等到邪气陷入胃部，转而出现胸腹胀满，烦渴更加严重，病家见病情危急，以致更换医生，医生见用了下药后病情加重，于是指责大黄是砒霜毒药，或者投用泻心汤，或者投用柴胡枳桔汤，留邪在胃，变证日益增加，神气脱失，元气耗尽而死。先前是不该下而反而下之，现在是应该下而反而失下，这都是因为表里不明，用药前后次序错误导致的失误。
When the epidemic pathogen transmits inward, the stomach heat is boiling like rolling water, causing the roundworms to move restlessly. Since the lower orifices are not unblocked, they must reverse and go upward; the roundworms are vomited out due to this, which is a common occurrence.
Simply treating the stomach will cause the roundworm jue (spasmodic abdominal pain with cold extremities) to heal spontaneously. I often see physicians blindly citing classical theories, believing it is visceral cold, where roundworms ascend into the diaphragm, stating that the patient should vomit roundworms, and also quoting the phrase: "Cold in the stomach inevitably leads to vomiting of roundworms." Consequently, they use Wumei Wan (Mume Pill) or Lizhong Anhe Tang (Regulate the Middle Decoction to Pacify Roundworms), which contain Xixin (Asarum Root), Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), Guizhi (Cinnamon Twig), and Chuanjiao (Sichuan Pepper), all acrid-hot substances. Administering these is like adding oil to fire. They fail to realize that in epidemic conditions, both exterior and interior, upper and lower aspects are hot, and there has never been a cold syndrome from beginning to end. Failing to consider the immediate reality, they merely memorize textual words, using them as basis for annotation and application, administering them calmly without doubt, thus misleading many people.
Reversal of stomach qi results in hiccup (e'ni). In Wu region, it is called "cold hiccup"; because of the name "cold," it is identified as stomach cold. However, one does not know that both cold and heat syndromes can cause hiccups. Furthermore, by not referring to the primary syndrome but exclusively adhering to colloquialisms as indicating cold, they administer Dingxiang (Caryophylli Flos), Zhuyu (Evodia Fruit), Jiang (Ginger), and Guizhi (Cinnamon Twig), misleading many people. This is even more inappropriate than those who harm the meaning by sticking to literal words.
Treatment methods should be determined according to the primary syndrome. For example, if Baizhu Tang (White Tiger Decoction) syndrome is seen, administer Baizhu Tang; if Chengqi Tang (Purgative Decoction) syndrome is seen, administer Chengqi Tang. If phlegm obstruction exists in the diaphragm, expectorating phlegm is appropriate. If it is truly stomach cold, Dingxiang Shidi San (Clove and Persimmon Calyx Powder) is suitable, yet it is not as effective as Sini Tang (Frigid Extremities Decoction). In summary, simply treating the primary syndrome will stop the hiccups; other cases can be inferred analogously.
At the onset of seasonal epidemics, the pathogen lodges in the middle jiao, blocking the connection between exterior and interior. Stagnation of interior qi causes oppression, while stagnation of exterior qi causes headache and body pain. Seeing headache and body pain, physicians often mistakenly identify it as an exterior syndrome of Shanghan (Cold Damage), and thus use Mahuang (Ephedra Herb), Guizhi (Cinnamon Twig), Xiangsu San (Aromatic Su Decoction), Gegen (Kudzu Root), Baidu San (Rescue the Damaged Powder), or Jiuwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction). These are all dispersing agents that forcibly seek sweating, recklessly consuming body fluids. The channel qi becomes deficient first, the pathogen remains undamaged, and fever persists. Moreover, when the pathogen transmits inward, the exterior qi cannot communicate with the interior and must congest externally. This often results in tidal fever in the afternoon; when the heat is severe, the head swells and aches, and the pain ceases when the heat subsides. Is this truly an exterior excess syndrome? The above cases resemble exterior syndromes but are mistaken for such, leading to the reckless use of ascending and dispersing agents. This makes the channel qi more stagnant, fire qi rises, and the headache worsens. Purging is required; once the interior qi is unblocked and the channel qi descends, the headache stops immediately. If it were indeed a common cold causing headache, the pain would be constant at all times, which allows for differentiation. Additionally, other symptoms provide reference; one cannot rely on a single approach. After sweating or purging, if the pulse is calm and the body is cool, but limb joints suddenly become more painful, feeling as if beaten with sticks or suffering from bruising, with slight movement causing cries of pain, this indicates deficiency of channel qi and sluggish circulation of Ying and Wei (Nutritive and Defensive Qi). Within three to four days, as channel qi gradually returns, the pain subsides; even without medication, it will heal spontaneously. If one recklessly cites classics, attributing it to wind-dampness clashing, causing whole-body pain and inability to turn, and administers wind-dispelling and dampness-resolving agents, the body pain worsens. Such errors mislead many.
When Shanghan transmits to the stomach, tidal fever and delirious speech appear immediately, and purging is unquestionably indicated. However, in current seasonal epidemics, tidal fever appears at the onset, and severe heat can also cause delirium. Mistaking this for an interior syndrome and recklessly using Chengqi Tang constitutes punishing the innocent. One fails to realize that latent pathogens near the stomach, before entering the fu organs, can also cause tidal fever, with worsening heat in the afternoon and delirium, without needing gastric excess to occur. Suppose ordinary malaria; severe heat can also cause delirium. Danmalaria (Hot Malaria) presents without aversion to cold, only with tidal fever; is this gastric excess? The above cases resemble interior syndromes, but mistaking them for such and using Chengqi Tang causes prior deficiency of interior qi. When the pathogen then sinks into the stomach, chest and abdominal distension appear, and thirst and irritability increase severely. Seeing the critical condition, patients change doctors. Physicians, seeing the condition worsen after purgatives, blame Dahuang (Rhubarb Root) as arsenic poison, or administer Xiexin Tang (Drain the Epigastrium Decoction) or Chaihu Zhijie Tang (Bupleurum and Aurantium Decoction), leaving the pathogen in the stomach. Variations increase daily until spirit dissipates and qi exhausts, leading to death. Previously, purging was used when it shouldn't have been; now, purging is missed when it should have been used. This error stems from unclear differentiation of exterior and interior, and disorderly sequence of medication.