伤寒结胸者，今人不分曾下与未下，便呼为结胸，便与枳桔汤，反成真结胸者有之。殊不知乃
因下早而成，未经下者，非结胸也，乃表邪传至胸中，未入于腑者，
虽满闷，尚为在表，正属少阳部分，只消小柴胡加枳、桔以治其闷。如未效，则以本方对小陷胸汤，
一服豁然，其妙如神。秘之，莫与俗人言之耳。若因下早而成者，方可用陷胸汤，分浅深从缓而治
之，不宜太峻，此乃清道至高之分，若过下之，则伤元气也。太阳证，发热恶寒，头疼无汗，此寒
伤荣血，当服麻黄汤发散。医者不达而误下之，荣血重伤而成痞满。太阳证，头疼恶寒，发热自汗，
此风伤卫气，当服桂枝汤散邪实表。医者不达而误下之，卫气重伤而成结胸。盖言荣卫，阴阳也。
若言寒热阴阳证者，则误之甚矣。治法又录于后条。
夫病身不热，头不疼，初起怕寒，四肢厥冷，腹痛呕吐，泄泻，蜷卧，沉默不渴，脉来沉迟无
力，人皆共知为阴证必矣。至于发热面赤，烦躁，揭去衣被，脉大，人皆不识，认作阳证，误投寒
药，死者多矣。殊不知阴证不分热与不热，须凭脉下药，至为切当。不问脉之浮沉大小，但指下无
力，重按全无，便是伏阴，不可与凉药，服之必死，急与五积散一服，通解表里之寒，随手而愈。
若内有沉寒，必须姜、
附以温之，切忌发泄。脉虽洪大，按之无力，重按全无者，阴脉也。若将伏阴之证而误作热证，用
凉药治之，则渴愈盛而燥愈急，岂得生乎？此取脉不取证也。
伤寒结胸证，如今的人不分是否曾经使用过泻下法，就称之为结胸，并立即给予枳桔汤治疗，反而导致变成真正的结胸证的，这种情况是有的。殊不知结胸证是因为过早使用泻下法而形成的，未曾使用泻下法的，不是结胸证，而是表邪传至胸中，尚未进入腑脏的，虽然感到满闷，但仍属于在表，正属于少阳病部分，只需用小柴胡汤加枳实、桔梗来治疗其满闷。如果无效，则用本方（小柴胡汤）合用小陷胸汤，服用一剂后豁然开朗，其疗效神妙。此法应秘而不宣，不要告诉世俗之人。如果是因过早使用泻下法而形成的结胸，才可以使用陷胸汤，根据病位的深浅从缓治疗，不宜过于峻猛，这是清道至高之分，如果过度泻下，就会损伤元气。太阳病证，发热恶寒，头痛无汗，这是寒邪伤及营血，应当服用麻黄汤发散。医生不懂医理而误用泻下法，导致营血重伤而形成痞满证。太阳病证，头痛恶寒，发热自汗，这是风邪伤及卫气，应当服用桂枝汤散邪实表。医生不懂医理而误用泻下法，导致卫气重伤而形成结胸证。所谓营卫，就是阴阳。如果说寒热阴阳证的话，那就错得很厉害了。治法又记录在后条中。
至于疾病身体不热，头不疼，初起怕冷，四肢厥冷，腹痛呕吐，泄泻，蜷缩而卧，沉默不渴，脉象沉迟无力，人们都知道这是阴证无疑。至于发热面赤，烦躁，掀开衣被，脉大，人们都不认识，误认为是阳证，错误地投用寒凉药，死亡的很多。殊不知阴证不分是否有热，必须凭脉象用药，最为恰当。不问脉象的浮沉大小，只要指下无力，重按完全无力的，就是伏阴证，不可给予凉药，服用必死，急用五积散一服，通解表里之寒，随手而愈。如果内有沉寒，必须用干姜、附子来温补，切忌发泄。脉象虽然洪大，但按之无力，重按完全无力的，是阴脉。如果将伏阴证误作热证，用凉药治疗，那么口渴会更盛而燥热更急，怎么能生存呢？这是取脉象而不取症状的意思。
In cases of *Jie Xiong* (Chest Binding) due to Cold Damage, people nowadays do not distinguish whether purgatives have been used or not, and immediately call it *Jie Xiong*, administering Zhiju Tang (Bitter Orange and Fructus Trichosanthis Decoction), which sometimes results in a true *Jie Xiong*. They fail to realize that *Jie Xiong* is caused by premature purgation; if no purgative has been used, it is not *Jie Xiong*, but rather pathogenic factors from the exterior transmitted to the chest, not yet entering the fu organs. Although there is fullness and oppression, it remains at the exterior level and belongs to the Shaoyang pattern. It can be treated with Xiaochaihu Tang (Minor Bupleurum Decoction) added with Zhishi (Immature Bitter Orange) and Jiegeng (Platycodon Root) to relieve the oppression. If ineffective, combine this formula with Xiaoxianxiong Tang (Minor Intra-thoracic Knot Decoction); one dose brings immediate relief, miraculous as if by divine power. This method should be kept secret and not told to ordinary people. Only when *Jie Xiong* is formed due to premature purgation can Xiantong Tang (Knot-Loosening Decoctions) be used, treating it gradually according to depth, avoiding overly harsh methods, for this is the highest part of the clear pathways; excessive purgation will damage Yuan Qi (Primal Qi). In Taiyang disease patterns, with fever, aversion to cold, headache, and anhidrosis, this indicates Cold damaging Ying Blood (Nutritive Blood), and Mahuang Tang (Ephedra Decoction) should be taken to disperse. Doctors who do not understand may mistakenly use purgatives, severely injuring Ying Blood and resulting in Pi Man (Fullness Syndrome). In Taiyang disease patterns, with headache, aversion to cold, fever, and spontaneous sweating, this indicates Wind damaging Wei Qi (Defensive Qi), and Guizhi Tang (Cinnamon Twig Decoction) should be taken to dispel pathogens and secure the exterior. Doctors who do not understand may mistakenly use purgatives, severely injuring Wei Qi and resulting in *Jie Xiong*. Ying and Wei correspond to Yin and Yang. Confusing these with Cold/Heat or Yin/Yang patterns leads to grave errors. Treatment methods are recorded in subsequent sections.
Regarding diseases where the body is not hot, the head does not hurt, initially there is aversion to cold, cold limbs, abdominal pain, vomiting, diarrhea, curling up while lying, silence, no thirst, and a deep, slow, and weak pulse, everyone knows this must be a Yin Pattern. However, regarding fever, red face, restlessness, removing clothes and blankets, and a large pulse, people often fail to recognize them, mistaking them for Yang Patterns, erroneously administering Cold-Cooling Medicines, leading to many deaths. One must not know that for Yin Patterns, regardless of heat or no heat, medication must be based on the pulse, which is most appropriate. Regardless of whether the pulse is floating, sunken, large, or small, if it feels weak under the fingers and completely vanishes upon heavy pressure, it is Fu Yin (Hidden Yin), and cooling medicines must not be given, as administration will lead to death. Immediately administer Wuji San (Five Accumulations Powder) to resolve exterior and interior cold simultaneously, resulting in quick recovery. If there is deep-seated cold within, Shengjiang (Dried Ginger) and Fuzi (Prepared Aconite Root) must be used to warm, and absolutely avoid dispersing/sweating methods. Even if the pulse is surging and large, if it is weak upon pressing and completely vanishes upon heavy pressure, it is a Yin Pulse. Mistaking Fu Yin patterns for Heat patterns and treating them with cooling medicines will cause thirst to increase and dryness to intensify, making survival impossible. This emphasizes relying on pulse diagnosis rather than symptoms alone.