丁未岁。一妇患伤寒。寒热。夜则谵语。目中见鬼。狂躁不宁。其夫访予询其治法。予曰。
若经水适来适断。恐是热入血室也。越日亟告曰。已作结胸之状矣。予为诊之曰。若相委信。急
行小柴胡汤等必愈。前医不识涵养至此。遂成结胸证。药不可及也。无已。则有一法。刺期门穴。或庶几愈。如教而得
愈。
论曰。或问热入血室。何为而成结胸。予曰。邪入经络。与正气相搏。上下流行。或遇经水
适来适断。邪气乘虚而入血室。血与邪迫。上入肝经。肝既受邪。则谵语如见鬼。肝病则见鬼。
目昏则见鬼。复入膻中。则血结于胸也。何以言之。盖妇人平居。经水常养于目。血常养肝也。
方未孕。则下行之以为月水。既妊娠。则中蓄之以养胎。及已产。则上壅。得金化之以为乳。今
邪逐之并归肝经。聚于膻中。壅于乳下。非刺期门以泻。不可也。期门者肝之膜原。使其未聚于
乳。则小柴胡尚可行之。既聚于乳。小柴胡不可用也。譬如凶盗行于闾里。为巡逻所迫。寡妇处
女适启其门。突入其室。妇女为盗所迫。直入隐奥。以避之。盗蹑其踪。必不肯出。乃启孔道以
行诱焉。庶几其可去也。血结于胸。而刺期门。何以异此。
一达官乘舟悉归。四月风雨。饮食不时。得疾如伤寒状。头重自汗。身体悉疼。医作中风湿
证治投以术附姜附等汤。汗不止。单服附子。及灸脐下。亦不止。予往视之。曰六阳俱绝。不可
治也。（其汗必如珠。验之果然。半时卒。）
论曰。难经云六阳气俱绝者。阴与阳相离。阴阳相离。则腠理开。绝汗乃出。汗出如珠。转
而不流。夕占旦死。旦占夕死。此之谓也。盖病者之汗。有阳盛阴虚。阴盛阳虚。阳盛者如骨蒸
热病之汗。则流溢如润。阳绝者如此证。则凝聚而止。假如甑 之蒸物。出汗而散者。阳盛之类
也。假如置冰于金银瓦器中。汗出而凝聚不流。阳绝之证也。
丁未年。一位妇女患伤寒。出现寒热往来，夜间说胡话，眼中看见鬼怪，狂躁不安。她的丈夫来找我咨询治疗方法。我说：
如果月经正好来潮或刚结束，恐怕是热邪陷入血室（指胞宫及肝经相关部位）。过了一天，她丈夫急忙告知说：已经出现结胸（邪气与痰水互结于胸膈）的症状了。我为她诊脉后说：如果信任我，赶快服用小柴胡汤等方剂，必定痊愈。之前的医生不懂得养护正气导致病情至此，最终形成了结胸证，药物已经无法治愈了。如果没有办法，则有一个方法，针刺期门穴，或许能痊愈。按照我的建议治疗后果然痊愈。
论述说：有人问热入血室为什么会形成结胸。我说：邪气侵入经络，与正气相互搏结，上下流行。如果遇到月经正好来潮或刚结束，邪气乘虚进入血室。血液与邪气相迫，向上进入肝经。肝脏受到邪气侵犯，就会出现说胡话如见鬼怪的症状。肝病会导致看见鬼怪，眼睛昏花也会导致看见鬼怪。邪气再深入膻中，就会使血液凝结在胸部。为什么这样说呢？因为妇女平时，月经常滋养眼部，血液常滋养肝脏。在未怀孕时，下行成为月经；既已怀孕，则蓄积在中部以滋养胎儿；分娩后，则上壅，经过金的转化成为乳汁。现在邪气追逐它们并归并于肝经，聚集在膻中，壅塞在乳下。如果不针刺期门穴以泻除邪气，是不行的。期门穴是肝的膜原（肝脏的边缘组织），如果邪气尚未聚集在乳房部位，那么小柴胡汤还可以使用。既然已经聚集在乳房，小柴胡汤就不能使用了。这就像凶恶的强盗在街巷中游荡，被巡逻的人逼迫，寡妇和处女恰好打开门，强盗突然闯入室内。妇女被强盗逼迫，直接进入隐蔽之处躲避。强贼跟踪踪迹，一定不肯出来。于是打开通道进行引诱，或许可以将其去除。血液凝结在胸部而针刺期门穴，与此有什么不同呢？
一位达官贵人乘船回家。四月间风雨交加，饮食不规律，得了像伤寒一样的病。头重，自汗，全身疼痛。医生当作中风湿证治疗，投用白术、附子、干姜、附子等汤药。汗出不止，单独服用附子，以及灸脐下穴位，汗也不止。我去探望他，说：六阳俱绝（六种阳气全部衰竭），不可治了。（他的汗一定像珠子一样，验证之后果然如此，半个时辰后去世。）
论述说：《难经》说六阳气俱绝的情况，是阴与阳分离。阴阳分离，则腠理（皮肤纹理及毛孔）开放，绝汗（临终前的冷汗）流出。汗出像珠子一样，转动但不流动，晚上占测早上死，早上占测晚上死。说的就是这种情况。病人的汗，有阳盛阴虚，阴盛阳虚。阳盛的像骨蒸热病的汗，则流溢滋润。阳绝的像这个病症，则凝聚而停止。假如蒸笼蒸食物，出汗而散开的，是阳盛之类的情况。假如把冰放在金银瓦器中，出汗而凝聚不流动的，是阳绝的病症。
In the Dingwei year, a woman suffered from Shanghan (Cold Damage). She presented with alternating chills and fever, delirium at night, visual hallucinations of ghosts, and restlessness with mania. Her husband visited me to inquire about treatment methods. I said:
If her menstruation had just started or recently ceased, it is likely that heat has entered the Blood Chamber (a concept referring to the uterus and related liver meridian pathways). The next day, her husband urgently reported that symptoms of Jie Xiong (Chest Binding, where pathogenic factors bind with phlegm and fluid in the chest) had developed. Upon palpating her pulse, I said: If you trust me, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) and similar formulas immediately, and she will surely recover. The previous physicians failed to nurture the healthy Qi, leading to this state, resulting in a Jie Xiong syndrome for which medicinal herbs are no longer effective. If there is no other way, there is one method: puncture the Qimen acupoint, which might lead to recovery. Following my advice, she recovered.
The commentary states: Someone asked why Heat entering the Blood Chamber results in Jie Xiong. I said: Pathogenic factors enter the meridians and contend with Healthy Qi, circulating up and down. If this occurs when menstruation is just starting or has ceased, pathogenic factors enter the Blood Chamber due to deficiency. Blood and pathogenic factors press against each other and ascend into the Liver Meridian. Once the Liver is affected by pathogens, delirium resembling seeing ghosts occurs. Liver pathology causes seeing ghosts; blurred vision also causes seeing ghosts. If the pathogen enters further into the Danzhong (Conception Vessel area between the nipples), blood binds in the chest. Why is this so? Because in women, menstruation normally nourishes the eyes, and blood nourishes the Liver. Before pregnancy, it descends to become menstrual blood; during pregnancy, it is retained centrally to nourish the fetus; after childbirth, it ascends and transforms via Metal energy into milk. Now, pathogens chase these fluids and converge into the Liver Meridian, gathering at Danzhong and obstructing below the breasts. Without puncturing Qimen to drain the pathogen, it cannot be resolved. Qimen is the membrane origin of the Liver. If the pathogen has not yet gathered at the breast, Xiao Chai Hu Tang can still be used. Since it has gathered at the breast, Xiao Chai Hu Tang is contraindicated. This is like vicious bandits roaming the streets, forced by patrols, while widows or unmarried women happen to open their doors, allowing the bandits to burst into the room. The women, pressured by the bandits, retreat into hidden places to hide. The bandits follow their tracks and refuse to leave. Thus, an opening is created to lure them out, perhaps allowing their removal. Puncturing Qimen for blood binding in the chest is no different from this scenario.
An official was returning by boat. In April, amidst wind and rain, with irregular diet, he fell ill with symptoms resembling Shanghan. He experienced heavy head, spontaneous sweating, and generalized body pain. Physicians treated him as Wind-Dampness striking the middle, administering decoctions containing Atractylodis Rhizoma (Baizhu), Aconiti Lateralis Radix Praeparata (Fuzi), Zingiberis Rhizoma (Jiang), etc. Sweating did not cease. He took Fuzi alone and received moxibustion below the navel, but sweating continued. I examined him and said: All Six Yangs are exhausted (failure of all six Yang qi systems); it is untreatable. (His sweat would indeed be like pearls, which proved true; he died half an hour later.)
The commentary states: The Nan Jing states that when the Six Yang qi are simultaneously exhausted, Yin and Yang separate. When Yin and Yang separate, the Cou Li (pores and interstitial spaces) open, and Jue Han (terminal sweat) emerges. The sweat appears like pearls, rolling but not flowing. Death is predicted for morning if observed in the evening, and for evening if observed in the morning. This is what is meant. Patient's sweat varies: there is Excess Yang with Deficient Yin, and Excess Yin with Deficient Yang. In Excess Yang cases, such as bone-steaming fever, sweat flows freely and moistens. In Deficient Yang cases like this syndrome, sweat coagulates and stops. Imagine steaming food in a steamer; sweat evaporates and disperses, representing Excess Yang. Imagine placing ice in gold, silver, or earthenware vessels; sweat condenses and does not flow, representing Deficient Yang.