初病无热，便四肢厥冷，或胸腹中满，或呕吐，腹满痛，下利，脉细无力，此自阴经受寒，即
真阴证，非从阳经传来，便宜温之，不宜少缓。经云∶发热恶寒者，发于阳也。无热恶寒者，发于
阴也。治宜四逆汤。
凡腹满腹痛，皆是阴证，只有微甚不同，治难一概。腹痛不大便，桂枝芍药汤。
腹痛甚，桂枝大黄汤。若自利腹痛，小便清白，盒饭温，理中、四逆，看微甚用。轻者五积散，重
者四逆汤。
无脉者，通脉四逆汤，使阴退而阳复也。
阴毒病手足指甲皆青，脉沉细而急者，四逆汤；无脉者，通脉四逆汤、阴毒甘草汤，脐中葱熨，
气海、关元着艾，可灸二三百壮，仍用温和补气之药通其内外，以复阳气。若俱不效，死证也。
凡伤寒，阴证难看。凡看伤寒，惟阴证最难识。自然阴证，人皆可晓，及至反常则不能矣。如
身不发热，手足厥冷，好静沉默，不渴，泄利腹痛，脉沉细，人共知为阴证矣。至于发热面赤，烦
躁不安，揭去衣被，饮冷脉大，人皆不识，认作阳证，误投寒药，死者多矣。必须凭脉下药，至为
切当。不问浮沉大小，但指下无力，按至筋骨全无力者，必有伏阴，不可与凉剂，急与五积散一服，
通解表里之寒，随手而愈。但更有沉寒之甚，须用姜、附以退之，秘之勿泄。脉虽洪大，按之无力
者，
重按全无，便是阴证。
凡治伤寒，尺脉弱而无力者，切忌汗下，宜小柴胡汤和解之。阳毒伤寒，服药不效，斑烂皮肤，
手足皮俱脱，身如涂朱，眼珠如火，燥渴欲死，脉洪大而有力，昏不知人，宜三黄石膏汤主之。
凡看伤寒，须问病患有何疼痛处，所苦所欲，饮食大便，并服过何药。问有吐蛔者，虽有大热，
忌下凉药，犯之必死。盖胃中有寒，则蛔上入膈，大凶之兆，急用炮干姜理中汤加乌梅二个煎服。
蛔安，却以小柴胡汤退热。盖蛔性闻酸则静，见苦则安故也。
凡看伤寒，有口沃白沫，或唾多流冷涎，俱是有寒，吴茱萸汤、理中、真武汤之类，看轻重用，
切忌凉药。杂病亦然。或用甘温药补元气，四君子汤加附子一片。血虚，用仲景八味丸。
发病初期没有发热，随即出现四肢厥冷，或者胸腹部胀满，或者呕吐，腹部胀满疼痛，腹泻，脉象细弱无力，这是阴经受寒所致，即真阴证，并非从阳经传变而来，应当立即温补，不宜稍有延误。《内经》说：发热且恶寒的，是发于阳经；无发热而恶寒的，是发于阴经。治疗适宜用四逆汤（Sini Decoction）。
凡是腹部胀满、腹痛，都属于阴证，只是程度有轻微和严重之分，治疗难以一概而论。腹痛伴大便秘结不通的，用桂枝芍药汤（Guizhi Shaoyao Decoction）。腹痛剧烈的，用桂枝大黄汤（Guizhi Dahuang Decoction）。如果是自发性腹泻伴腹痛，小便清亮色白，应当温中，根据病情轻重选用理中汤（Lizhong Decoction）或四逆汤。轻症用五积散（Wuji San），重症用四逆汤。
没有脉搏的，用通脉四逆汤（Tongmai Sini Decoction），以使阴邪退去而阳气恢复。
阴毒病（Yindu Disease）表现为手足指甲皆呈青色，脉象沉细而急促的，用四逆汤；若无脉搏的，用通脉四逆汤、阴毒甘草汤（Yindu Gancao Decoction），并在神阙穴（Qihai, CV8）用葱白熨敷，在气海穴（Qihai, CV6）、关元穴（Guanyuan, CV4）施以艾灸，可灸二三百壮，同时仍需用温和补气之药以通达内外，恢复阳气。如果以上方法均无效，则为死证。
凡是伤寒病，阴证最难辨认。凡是诊治伤寒，唯有阴证最难识别。自然的典型阴证，人人都能知晓，但到了表现反常时，就无法辨识了。例如身体不发热，手足厥冷，喜静默不语，口不渴，泄泻腹痛，脉象沉细，人们都知道这是阴证。至于出现发热、面赤、烦躁不安、掀开衣被、想喝冷水、脉象洪大的情况，人们往往不能识别，误认为是阳证，错误地投予寒凉药物，导致死亡的人很多。必须依据脉象来用药，才最为恰当。不论脉象浮沉大小，只要指下感觉无力，重按至筋骨处全然无力的，必定有伏匿之阴寒，不可给予凉剂，应立即服用一剂五积散，以通解表里之寒，随手即可痊愈。但是还有沉寒极重的情况，必须使用干姜、附子来驱除，此法需保密勿泄。脉象虽然洪大，但重按无力的，若重按完全无感，便是阴证。
凡是治疗伤寒，尺脉弱而无力的，切忌使用发汗和攻下法，适宜用小柴胡汤（Xiaochaihu Decoction）和解少阳。阳毒伤寒（Yangdu Shanghan），服药无效，皮肤斑烂，手足皮肤全部脱落，身体像涂了朱砂一样红，眼珠如火般红赤，燥热口渴欲死，脉象洪大而有力，昏迷不知人事，适宜用三黄石膏汤（Sanhuang Shigao Decoction）主治。
凡是诊治伤寒，必须询问患者有何疼痛之处，痛苦与欲望所在，饮食及大便情况，以及服用过什么药物。询问到有吐蛔虫者，即使有大热症状，也忌用寒凉攻下药，触犯必死。这是因为胃中有寒，蛔虫上入膈部，是大凶之兆，急用炮干姜理中汤加两个乌梅煎服。待蛔虫安定后，再用小柴胡汤退热。因为蛔虫的特性是闻酸则静，见苦则安。
凡是诊治伤寒，有口中流白色泡沫，或多唾冷涎的，都是有寒证，吴茱萸汤（Wuzhuyu Decoction）、理中汤、真武汤（Zhenwu Decoction）等，根据病情轻重选用，切忌使用凉药。杂病也是如此。或者用甘温药物补益元气，用四君子汤（Sijunzi Decoction）加一片附子。血虚者，用张仲景的八味丸（Bawei Wan）。
At the onset of the disease, there is no fever, followed immediately by cold extremities (Jieling), or fullness in the chest and abdomen, vomiting, abdominal fullness and pain, diarrhea, and a fine and weak pulse. This is caused by cold invading the Yin meridians, constituting a True Yin Syndrome (Zhen Yin Zheng), not transmitted from the Yang meridians. It should be treated with warming methods immediately, without delay. The Classics state: "Fever with aversion to cold indicates onset in the Yang; absence of fever with aversion to cold indicates onset in the Yin." The appropriate treatment is Sini Decoction (Sini Tang).
Abdominal fullness and pain are all indicative of Yin Syndromes, differing only in severity, so treatment cannot be generalized. For abdominal pain accompanied by constipation, use Guizhi Shaoyao Decoction (Guizhi Shaoyao Tang). For severe abdominal pain, use Guizhi Dahuang Decoction (Guizhi Dahuang Tang). If there is spontaneous diarrhea with abdominal pain and clear, colorless urine, warming is indicated; choose between Lizhong Decoction (Lizhong Tang) or Sini Decoction based on severity. For mild cases, use Wuji Powder (Wuji San); for severe cases, use Sini Decoction.
In cases of absent pulse, use Tongmai Sini Decoction (Tongmai Sini Tang) to drive away Yin pathogenic factors and restore Yang Qi.
For Yindu Disease (Yindu Bing), characterized by cyanosis of the fingernails and toenails, with a deep, fine, and rapid pulse, use Sini Decoction. If the pulse is absent, use Tongmai Sini Decoction and Yindu Gancao Decoction (Yindu Gancao Tang). Apply moxibustion at Qihai (CV6) and Guanyuan (CV4), approximately 200-300 moxa cones, and warm the Shenque point (CV8) with scallion compresses. Simultaneously, administer mild Qi-tonifying herbs to unblock the interior and exterior and restore Yang Qi. If these measures fail, it is a death case.
Among all types of Cold Damage (Shanghan), Yin Syndromes are the most difficult to identify. While typical Yin Syndromes are easily recognized, atypical presentations are often missed. For instance, when a patient presents with no fever, cold extremities, a preference for quietness and silence, no thirst, diarrhea with abdominal pain, and a deep, fine pulse, everyone recognizes this as a Yin Syndrome. However, when symptoms include fever, flushed face, restlessness, removing clothing and blankets, desire for cold drinks, and a large pulse, people often fail to recognize them, misdiagnosing them as Yang Syndromes and erroneously administering cold-natured medicines, leading to many deaths. One must prescribe medication based on the pulse for utmost accuracy. Regardless of whether the pulse is floating, deep, large, or small, if it feels weak under the fingers and completely devoid of strength when pressed deeply to the bone, there is hidden Yin Cold. Cold-natured formulas must not be given. Immediately administer one dose of Wuji Powder to resolve exterior and interior cold, resulting in quick recovery. However, in cases of extreme Deep Cold (Chen Han), Ginger (Ganjiang) and Aconite (Fuzi) must be used to dispel it; this method should be kept secret. Even if the pulse appears large and forceful superficially, if it lacks strength upon heavy pressure, or feels completely empty upon deep pressing, it is a Yin Syndrome.
When treating Cold Damage, if the Chi position pulse is weak and powerless, sweating and purging methods are strictly contraindicated. Instead, use Xiaochaihu Decoction (Xiaochaihu Tang) to harmonize. For Yangdu Cold Damage (Yangdu Shanghan), where medication is ineffective, presenting with skin ulceration, shedding of skin on hands and feet, body red as cinnabar, eyes red as fire, extreme dryness and thirst, a large and forceful pulse, and unconsciousness, treat primarily with Sanhuang Shigao Decoction (Sanhuang Shigao Tang).
When diagnosing Cold Damage, one must ask about the location of pain, the patient's suffering and desires, diet, bowel movements, and any previous medications taken. If the patient vomits roundworms (Hui), even in the presence of high heat, cold-purgative drugs are contraindicated; violating this rule leads to death. This is because stomach cold causes roundworms to migrate upward into the diaphragm, indicating a dire prognosis. Immediately administer Lizhong Decoction with fried dried ginger (Pao Ganjiang) and two smoked plums (Wumei). Once the roundworms settle, use Xiaochaihu Decoction to reduce fever. This is because roundworms become quiet upon tasting sour flavors and calm upon encountering bitter ones.
In Cold Damage diagnosis, the presence of white froth in the mouth or excessive flow of cold saliva indicates Cold. Use Wuzhuyu Decoction (Wuzhuyu Tang), Lizhong Decoction, or Zhenwu Decoction (Zhenwu Tang) according to severity. Cold-natured medicines are strictly contraindicated. The same applies to miscellaneous diseases. Alternatively, use sweet-warm herbs to tonify Yuan Qi, such as Sijunzi Decoction (Sijunzi Tang) with one slice of Aconite. For Blood Deficiency, use Zhang Zhongjing's Bawei Pill (Bawei Wan).