凡至七日,邪传阴分已足,如身微热,面有黄色,手足微温,精神清爽,此是阳气
欲复,阴气欲解,虽有卒然大热汗出,此邪气还表,即解之候也。如热而不已,昏沉烦
躁,此又是邪气胜正,阴极成热,乃必死之候。如七八日间,口噤不言,烦扰身热,或
战,此是阴阳争胜,如三部脉皆至,而目 黄者,此正气胜邪,其症即愈。即在一二日
间,病传太阳,阳明,候当头疼发热,睡卧不宁,其脉浮大。如反睡卧安宁,口不烦
渴,精神清爽、脉来沉迟而实,呼吸息数无乖,此外虽感冒,阴旺不受邪触,故不见于
脉,当三阳传足而愈,又不可作阳病见阴脉者论也。然阳病必至七日而愈,阴病必至六
日而愈者,以阳病法火,火数七,阴病法水,水数六耳。
鼻色青,主腹中痛。若冷者,死。鼻色微黑者,有水气。鼻色黄,主小便难。鼻色
白者,属气虚。鼻色赤者,属肺热。鼻色鲜明者,有留饮。鼻孔干燥者,必衄血。鼻色
燥如烟煤者,阳毒热极。鼻孔冷滑色黑者,阴毒冷极。鼻流浊涕者,属风热。鼻流清涕
者,是肺寒。鼻孔癖胀者,肺热有风。唇口焦红者,吉。唇口焦黑者,凶。唇口俱肿赤
者,是热极。唇口俱青黑者,是寒极。唇口舌断绞者,难治。唇口燥裂者,是脾热。唇
青舌卷者,死。唇吻色青者,死。环口黧黑者,死。口张气直出者,死。齿燥无津液
者,是阳明热极。前板齿燥兼脉虚者,是中暑。齿如热者,难治。耳黑枯燥者,是肾
惫。目赤唇焦舌黑者,属阳毒。目里黄色暗者,属湿毒。目黄兼小便利,大便黑,小腹
满痛者,属蓄血。目瞑者,将欲衄血。目白睛黄不渴,脉沉细者,属阴黄。两 黄者,
病欲愈。开目见人者,属阳。闭目不欲见人者,属阴。睛昏不识人,目反上视,睛小
瞪,目直视,目邪视,目睛正圆,戴眼反折,眼HT 陷下,此八者,皆死证。目睛微
定,临时稍转动者,属痰。目中不了了,睛
不和,不明白者。此因邪热结实在内,不了了者,谓见一半目,不见一半目是也。眼眶
黑者,亦主内有痰。舌肿者,雄治。舌出者,死。面观颊赤。在午后,此虚火上升,
不可作伤寒治。面赤脉数无力,此伏阴病,假热也。面赤脉沉细,此少阴病,外热内
寒,阴盛格阳,宜温。误用寒凉者,死。面赤脉弦数,此少阳病,宜小柴胡汤和解。面
部通赤,此阳明表症未解,宜解肌,不可攻里。面唇青,是阴寒极。面青兼舌卷囊缩,
亦是阴寒。面青兼小腹绞痛,是夹阴伤寒。面目身黄,兼小水短涩,是湿热。面目身
黄,小腹胀满硬痛,小便利,是蓄血伤寒。面白,为无神,或汗多是脱血所致,面白人
不宜大汗。若汗下吐后,神昏谵语者,坏病也。直视喘满下利者,死。脉沉肢冷者,
死。若黑气在鱼尾,相牵入太阳者,死。黑气自人中入口者,死。黑气入耳目鼻舌者,
死。面黑人在伤寒内涉虚,不宜参术大补,盖气多实故也。
When the seventh day arrives, the pathogenic factor has sufficiently transmitted to the Yin aspect. If there is slight body heat, a yellowish complexion, slightly warm hands and feet, and clear spirit, this indicates that Yang Qi is about to recover and Yin Qi is about to resolve. Even if sudden high fever and sweating occur, this is a sign that the pathogen returns to the exterior and is about to be resolved. If the fever persists with drowsiness and restlessness, this indicates that the pathogen overcomes the healthy Qi, Yin reaches its extreme transforming into heat, which is a fatal prognosis. If between the seventh and eighth days, there is lockjaw with inability to speak, restlessness, body heat, or shivering, this represents a struggle between Yin and Yang. If the pulses at the Cun, Guan, and Chi positions are all present and strong, and the eyes are yellow, this indicates that healthy Qi overcomes the pathogen, and the condition will heal.
If within one or two days of onset, the disease transmits to the Taiyang (Greater Yang) and Yangming (Yang Brightness) meridians, headache and fever should occur, along with restless sleep and a floating, large pulse. If instead the patient sleeps peacefully, has no thirst or irritability in the mouth, maintains a clear spirit, and presents with a deep, slow, and solid pulse without irregular breathing, although the exterior appears affected by cold, it is because Yin Qi is prosperous and resists the pathogen, so the exterior signs do not manifest in the pulse. This condition should resolve after the Three Yang diseases transmit through the Foot meridians, and it should not be discussed as "Yang disease presenting with Yin pulse." However, Yang diseases must heal by the seventh day, and Yin diseases by the sixth day, because Yang diseases follow the number of Fire (seven), and Yin diseases follow the number of Water (six).
A blue nose indicates abdominal pain. If caused by cold, it is fatal. A slightly black nose indicates water retention. A yellow nose indicates difficult urination. A white nose belongs to Qi deficiency. A red nose belongs to Lung Heat. A bright and lustrous nose indicates retained fluids (Liuyin). Dry nostrils indicate epistaxis. A dry nose resembling soot indicates extreme heat from Yang Toxin. Cold, slippery, and black nostrils indicate extreme cold from Yin Toxin. Thick nasal discharge belongs to Wind-Heat. Clear nasal discharge indicates Lung Cold. Distended nostrils indicate Lung Heat with Wind. Scorched red lips and mouth are auspicious. Scorched black lips and mouth are ominous. Swollen and red lips and mouth indicate extreme heat. Blue-black lips and mouth indicate extreme cold. Broken and twisted lips, mouth, and tongue are difficult to treat. Dry and cracked lips and mouth indicate Spleen Heat. Blue lips with curled tongue are fatal. Blue lips and mouth corners are fatal. Black around the mouth is fatal. Mouth open with straight outflow of breath is fatal. Dry teeth without saliva indicate extreme Yangming Heat. Dry front incisors with a deficient pulse indicate Summerheat. Teeth feeling hot are difficult to treat. Black and dry ears indicate Kidney exhaustion. Red eyes, scorched lips, and black tongue belong to Yang Toxin. Dark yellow inside the eyes belongs to Damp-Toxin. Yellow eyes with free urination, black stool, and lower abdominal fullness/pain belong to Blood Stasis. Closed eyes indicate impending epistaxis. Yellow sclera with no thirst and a deep, fine pulse belongs to Yin Jaundice. Yellow eyes indicate the disease is about to heal. Opening eyes to see people belongs to Yang. Closing eyes and unwillingness to see people belongs to Yin. Dim eyes unable to recognize people, eyes rolling upward, small staring pupils, fixed gaze, strabismus, round fixed eyeballs, eyes deviated upward with opisthotonos, and sunken eye sockets—these eight conditions are all fatal. Eyes slightly fixed but occasionally moving belong to Phlegm. Unclear vision and disordered eyes, unable to see clearly, result from pathogenic heat knotting internally. "Unclear" means seeing half and not seeing half. Black eye orbits also indicate internal Phlegm. Swollen tongue is treated with Xionghuang (Realgar). Tongue protruding and unable to retract is fatal. Red cheeks observed in the afternoon indicate rising Deficient Fire and should not be treated as Shanghan. Red face with rapid but weak pulse indicates Fu Yin Disease (Hidden Yin Disease), a false heat syndrome. Red face with deep and fine pulse indicates Shaoyin Disease, external heat and internal cold, with Yin excess repelling Yang; warming methods are appropriate. Misuse of cold/cooling herbs leads to death. Red face with wiry and rapid pulse indicates Shaoyang Disease; Xiaochaihu Tang is indicated for harmonizing. General redness of the face indicates unresolved Yangming exterior syndrome; muscle-releasing methods are indicated, not purgation. Blue face and lips indicate extreme Yin Cold. Blue face with curled tongue and retracted testicles also indicates Yin Cold. Blue face with severe lower abdominal colic indicates Jia Yin Shanghan (Cold Damage involving Yin). Yellow face, eyes, and body with scanty, obstructed urination indicate Damp-Heat. Yellow face, eyes, and body with lower abdominal fullness, hardness, pain, and free urination indicate Blood Stasis Shanghan. White face indicates lack of Spirit or blood loss due to excessive sweating; persons with white faces should not sweat excessively. Confusion and delirium after sweating, purging, or vomiting constitute Huai Bing (Ruined Disease). Fixed gaze, wheezing, fullness, and diarrhea are fatal. Deep pulse with cold limbs is fatal. Black qi in the corner of the eye extending to the Taiyang region is fatal. Black qi entering the mouth from the Renzhong point is fatal. Black qi entering the eyes, ears, nose, or tongue is fatal. In patients with a black face suffering from Shanghan involving deficiency, large tonics like Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala) should not be used, as Qi is often Excess.