雷真君曰，知生死而后可以为医。生中知死，死中知生，非易易也。何以知生中之死，如伤寒症，
七日不汗死是也。何以知死中有生，如中风、中恶、中毒是也。生中之死，而辨其不死；死中之生，而
辨其不生，医道其庶几乎。伤寒至七日犹无汗，人皆谓必死矣，而予独断其不死者，非因其无汗而可生
也。盖伤寒邪盛，禁汗之不得出，其人无烦躁之盛，肾水犹存，邪不能熬干之也，虽无汗，必有汗矣，
七日来复，岂虚言哉。此生中之死，而辨其不死之法也。中风不语，中恶不出声，中毒致闷乱，虽其人之
气犹存，似乎不死，然而，遗尿则肾绝矣，手撒则肝绝矣，水不下喉则脾胃绝矣。舌本强则心绝矣，声如
酣则肺绝矣。五脏无一生，无有不死者；倘有一脏之未绝，未死也。看何脏之绝，而救何脏之气，则死犹
不死矣。然而，五脏之中尤最急者，莫过心肾，心肾之药，莫过人参、附子二味，二味相合，则无经不
入。救心肾，而各脏亦无不救之矣。虽将死之人，必有痰涎之作祟，似祛痰化涎之药，亦不可轻度。然不
多用人参，而止用祛痰化涎之药，适足以死之也。即或偶尔生全，未几仍归于死。此死中之生，而辨其
不生之法也。
张公曰∶真奇绝之文。
雷真君曰∶病之有真有假也。大约寒热之症居多，《内经》已辨之无遗义矣。予再取而论之
者，以真假之病难知，而用药者不可徒执泛逆之治法也。予有治真寒假热之法，而不必尚夫汤剂也。如
人下部冰凉，上部大热，渴欲饮水，下喉即吐，此真寒反现假热之象以欺人。自当用八味汤，
大剂搅冷与饮。人或不敢用，或用之不多，或病患不肯服，当用吾法治之。以一人强有力者，擦其脚
心，如火之热，不热不已，以大热为度，后用吴茱萸一两为末，附子一钱，麝香一分，为细末，以少少
白面入之，打为糊，作膏二个，贴在脚心之中，少顷必睡熟，醒来下部身热，而上部之火自息矣，急以
八味汤与之，则病去如失。至于治真热假寒之法，则又不然。如人外身冰凉，内心火炽，发寒发热，战栗
不已，此内真热反现假寒之象。自当用三黄石膏汤加生姜，乘热饮之。医或信之不真，或病家不肯与
服，予法亟宜用之也。井水一桶，以水扑心胸，似觉心快，扑之至二三十次，则内热自止，而外
之战栗不觉顿失。急以元参、麦冬，白芍各二两，煎汤与之，任其恣饮，则病不至再甚矣。
张公曰∶何方法之奇至此，遵而行之，人无死法矣。
雷真君说：懂得判断生死，然后才可以成为医生。在生证中识别出死机，在死证中识别出生机，这并不是一件容易的事。如何从生证中识别出死机？例如伤寒病，到了第七天仍然没有出汗，就是死证。如何从死证中识别出生机？例如中风、中恶、中毒等病证就是例子。对于看似必死的生中之死，能辨别出其不死；对于看似有救的死中之生，能辨别出其无法挽救，那么医道也就差不多完备了。
伤寒病到了第七天仍然没有汗出，人们都认为是必死无疑，但我独自断定其不会死亡，并不是因为无汗就能存活。而是因为伤寒邪气盛极，禁止发汗导致汗液无法排出，但病人并没有严重的烦躁症状，说明肾水尚存，邪气不能将其熬干。虽然暂时无汗，但随后必然会有汗出，“七日来复”（人体正气七日一循环恢复）的道理，难道是空话吗？这就是在生中之死中辨别其不死的方法。
中风导致失语，中恶导致不出声，中毒导致烦闷混乱，虽然病人的气息尚存，看起来似乎不死，但如果出现遗尿，说明肾气已绝；手撒肢冷，说明肝气已绝；水浆不入喉，说明脾胃之气已绝；舌体僵硬，说明心气已绝；声音如鼾，说明肺气已绝。如果五脏都没有生机，就没有不死的；倘若有一脏之气未绝，就还有生的希望。观察是哪一脏先绝，就急救哪一脏的气，那么死证也可以转为不死。然而，在五脏之中，最紧急的莫过于心和肾。救治心肾的药物，莫过于人参和附子这两味药。两药合用，则无处不到。只要救了心肾，其他各脏也无不随之得救。即使是将死之人，也必然有痰涎作祟，像祛痰化涎这类药物，也不可轻易使用。如果不大量用人参，而只使用祛痰化涎的药物，反而足以导致死亡。即使偶尔侥幸保全性命，不久后仍会归于死亡。这就是在死中之生中辨别其无法挽救的方法。
张公说：真是奇妙绝伦的文章。
雷真君说：疾病中有真证也有假证。大致上寒热性质的病症居多，《黄帝内经》已经辨析得毫无遗漏了。我再拿出来论述它，是因为真假难辨的病证难以识别，而用药的人不可仅仅拘泥于常规的逆治法。我有治疗“真寒假热”的方法，不一定非要依赖汤剂。例如有人下部冰凉，上部大热，口渴想喝水，但水喝下去立刻吐出，这是真寒之证反现出假热之象来欺骗人。应当使用八味丸（即金匮肾气丸），大剂量煎煮后放凉让病人服用。如果有人不敢使用，或者用量不多，或者病人不肯服药，应当采用我的外治法。找一位力气大的人，用力擦拭病人的脚心，直到感觉如火般发热，不热不停，以大热为限度。然后用吴茱萸一两研成细末，加入附子一钱、麝香一分，也研成细末，加少量白面调和水打成药糊，做成两个药饼，贴在脚心中间。过了一会儿病人必定熟睡，醒来时下部身体变热，而上部的火气自然平息。此时急忙给病人服用八味丸，病就会像丢失了一样消失。
至于治疗“真热假寒”的方法，则又不一样。例如有人外表身体冰凉，内心火热炽盛，出现发冷发热、战栗不止的症状，这是内里真热反现出假寒之象。应当使用三黄石膏汤加入生姜，趁热饮用。如果医生对此怀疑不信，或者家属不肯让病人服用，我的方法就非常适宜使用了。取一桶井水，用水泼洒病人的心胸部位，病人会觉得心里爽快，泼洒二三十次之后，内热自然停止，而外部的战栗也会不知不觉顿时消失。急忙用玄参、麦冬、白芍各二两，煎汤给病人服用，任凭病人随意饮用，病情就不会再加重了。
张公说：什么方法竟然奇妙到这种地步，遵循并实行这些方法，人就再也没有必死的局面了。
Lei Zhenjun said, "To know life and death is the prerequisite for becoming a physician. Distinguishing death within life, and life within death, is not an easy task. How to identify death within life? For instance, in Taiyang disease (disease of the Taiyang channel), if there is no sweating after seven days, it indicates a fatal prognosis. How to identify life within death? Conditions such as Zhongfeng (Wind Stroke), Zhong'e (Sudden Evil Invasion), and poisoning are examples. If one can distinguish non-fatal outcomes from seemingly fatal 'death within life,' and recognize hopeless cases from seemingly salvageable 'life within death,' then one's medical art is nearly complete."
Regarding Taiyang disease where no sweating occurs by the seventh day, people generally consider it fatal. However, I alone assert that it will not be fatal. This is not because the absence of sweating implies survival. Rather, although the pathogenic factor is exuberant and sweating is contraindicated or inhibited, preventing sweat discharge, the patient does not exhibit severe restlessness. This indicates that Kidney Water (Kidney Yin/fluids) is still preserved, and the pathogen cannot boil it dry. Although there is currently no sweat, sweat will inevitably follow. The principle of 'recovery every seven days' (the cyclical restoration of healthy Qi) is not an empty statement. This is the method for distinguishing non-fatal outcomes from 'death within life.'
In Zhongfeng (Wind Stroke) causing aphasia, Zhong'e (Sudden Evil Invasion) causing silence, or poisoning causing mental confusion, although vital Qi remains, suggesting they are not immediately fatal, certain signs indicate organ failure: enuresis indicates Kidney failure; flaccid paralysis of the hands indicates Liver failure; inability to swallow fluids indicates Spleen and Stomach failure; stiffness of the tongue base indicates Heart failure; and snoring-like sounds indicate Lung failure. If all five Zang organs fail, death is inevitable. However, if even one Zang organ has not failed, there is still hope. By identifying which Zang organ fails first and urgently rescuing its Qi, a fatal condition can be turned into a non-fatal one. Among the five Zang organs, the most critical are the Heart and Kidney. The best herbs to rescue the Heart and Kidney are Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata). When combined, these two herbs penetrate all channels. Rescuing the Heart and Kidney ensures the rescue of other organs. Even in near-death situations, phlegm and saliva often cause complications. Medications for resolving phlegm should not be used lightly. If Ren Shen (Ginseng Radix et Rhizoma) is not used in large doses, but only phlegm-resolving agents are employed, it may hasten death. Even if the patient occasionally survives temporarily, they will soon return to death. This is the method for distinguishing hopeless cases from 'life within death.'
Master Zhang said: "This is truly extraordinary writing."
Lei Zhenjun said: "Diseases present with both true and false manifestations. Cold and heat patterns are predominant, and the *Neijing* (Inner Canon) has already analyzed them exhaustively. I discuss them again because true and false diseases are difficult to discern, and physicians must not rigidly adhere to general counter-treatment methods. I have methods for treating 'True Cold with False Heat' that do not necessarily rely on decoctions. For example, if a person has cold lower limbs and intense upper body heat, feels thirsty and desires water, but vomits immediately upon swallowing, this is True Cold presenting as False Heat to deceive observers. One should use Bawei Wan (Eight-Ingredient Pill with Rehmannia Root) in a large dose, cooled before administration. If patients or others dare not use it, use insufficient dosage, or refuse to take it, my external treatment method should be applied. Have a strong person rub the soles of the feet vigorously until they feel hot like fire, continuing until a high degree of heat is achieved. Then, mix 1 liang of Wuzhuyu (Evodiae Fructus) powder, 1 qian of Fuzi (Aconiti Lateralis Radix Praeparata), and 1 fen of Shexiang (Musk) into fine powder. Add a small amount of wheat flour paste to form two medicated plasters. Apply them to the center of the soles. After a short while, the patient will fall into a deep sleep. Upon waking, the lower body will become warm, and the upper body heat will naturally subside. Immediately administer Bawei Wan (Eight-Ingredient Pill with Rehmannia Root), and the illness will vanish as if lost.
As for treating 'True Heat with False Cold,' the approach differs. For example, if a person has cold extremities externally but intense internal heat, experiencing chills, fever, and uncontrollable tremors, this is True Heat internally presenting as False Cold externally. One should use Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) with added fresh ginger, administered warm. If the physician doubts its efficacy or the family refuses administration, my method is highly suitable. Take a bucket of well water and splash it onto the chest and heart region. The patient will feel relief. After splashing 20 to 30 times, the internal heat will cease, and external tremors will suddenly disappear. Immediately prepare a decoction of Xuanshen (Scrophulariae Radix), Maidong (Ophiopogonis Radix), and Baishao (Paeoniae Radix Alba), each in 2 liang quantities. Allow the patient to drink freely, and the condition will not worsen further.
Master Zhang said: "How can methods be so miraculous? Following these practices, there will be no unavoidable deaths."