问曰病有洒淅恶寒而复发热者何答曰阴脉不足阳往从之阳脉不足阴往乘之曰何以阳不足答曰假令寸口脉微名曰阳不
足阴气上入于阳中则洒洒恶寒也曰何以阴不足答曰假令尺脉弱名曰阴不足阳气下陷入阴中则发热也
洒淅恶寒而复发热者太阳之病也阴脉不足阳往从之则为发热阳脉不足阴往乘之则为恶寒假令寸口脉微名曰阳不足阴
气乘虚而上入于阳中则洒洒而恶寒也假令尺脉弱名曰阴不足阳气乘虚而下陷于阴中则发热也盖寸主卫尺主营营行脉中而
盛于下卫行脉外而盛于上一定之理也病则卫闭而不得外达乃内乘阴位而阳遂虚营扰不得内守乃外乘阳位而阴遂虚阴位虚
而阳乘之阳郁于内则发热阳位虚而阴乘之阴束于外则恶寒此营卫易位之故也
阳脉浮阴脉弱者则血虚血虚则筋急也其脉沉者营气微也其脉浮而汗出如流珠者卫气衰也营气微者加烧针则血流而不
行更发热而烦躁也
寸为阳尺为阴阳脉浮阴脉弱者则血虚血以养筋血虚则筋急阴脉曰弱不曰浮则脉沉可知其脉沉者营气之微也营微而阳
乘之此所以发热之原也而阳脉之浮亦非阳盛其脉浮而汗出如流珠者卫气之衰卫衰而阴乘之者所以恶寒之原也营气微者必
发热若加烧针以烁其血则血之流者必燥结而不行卫气阻郁遂乃更发热而益以烦躁是发热之故也阳虚于上则脉浮以其不根
于下也阴虚于下则脉沉以其不根于上也阴阳俱盛者寸不甚浮有关以降之尺不甚沉有关以升之故阴阳不盛于尺寸而盛于关
上以关者阴阳之中气升降浮沉之枢轴也
问：有的病人出现怕冷发抖（洒淅恶寒）而又发热的症状，这是什么原因？
答：这是阴脉不足，阳气前往依附它；阳脉不足，阴气前往侵犯它。
问：为什么说阳不足？
答：假如寸口脉微弱，这就叫阳不足。阴气乘虚上入于阳分之中，就会感到怕冷发抖。
问：为什么说阴不足？
答：假如尺脉虚弱，这就叫阴不足。阳气乘虚下陷入阴分之中，就会发热。
所谓怕冷发抖而又发热，是太阳病（Taiyang disease）。阴脉不足，阳气前往依附它，就表现为发热；阳脉不足，阴气前往侵犯它，就表现为怕冷。假如寸口脉微弱，这叫阳不足，阴气乘虚上入于阳分之中，就会怕冷发抖；假如尺脉虚弱，这叫阴不足，阳气乘虚下陷入阴分之中，就会发热。大概来说，寸部主卫气（Wei Qi, defensive qi），尺部主营气（Ying Qi, nutritive qi）。营气行于脉中，其气盛于下部；卫气行于脉外，其气盛于上部，这是一定的道理。生病时，卫气闭塞不能向外通达，反而内侵阴位，导致阳气遂虚；营气扰动不能向内固守，反而外侵阳位，导致阴气遂虚。阴位虚而阳气乘之，阳气郁结于内则发热；阳位虚而阴气乘之，阴气束缚于外则怕冷。这就是营卫之气位置互换的缘故。
阳脉浮，阴脉弱，说明血虚。血虚则筋脉拘急。脉象沉的，说明营气微弱。脉象浮且汗出如流珠状的，说明卫气衰弱。营气微弱的人，如果加用烧针疗法，会导致血液凝滞不行，更加发热并烦躁不安。
寸部属阳，尺部属阴。阳脉浮，阴脉弱，说明血虚。血用来滋养筋脉，血虚则筋脉拘急。阴脉说是“弱”而不是“浮”，那么脉沉就可以推知了。脉象沉，是因为营气微弱。营气微弱而阳气乘之，这就是发热的根源。而阳脉的浮也不是因为阳气亢盛，脉浮且汗出如流珠，是因为卫气衰弱。卫气衰弱而阴气乘之，这就是怕冷的根源。营气微弱必然发热，如果加用烧针来灼烧血液，那么流动的血液必然干燥凝结而不运行，卫气受阻郁结，于是更加发热并且增加烦躁，这就是发热的原因。阳气虚于上部则脉浮，因为它在下部没有根基；阴气虚于下部则脉沉，因为它在上部没有根基。阴阳都亢盛的时候，寸部不太浮，关部有脉以引导其下降；尺部不太沉，关部有脉以引导其上升。所以阴阳不盛于寸尺两部，而盛于关部。因为关部是阴阳中气的枢纽，是升降浮沉的轴心。
Question: Some patients present with chills (sajie ehan) accompanied by fever. What is the cause?
Answer: This occurs when the Yin pulse is deficient and Yang Qi moves to follow it; or when the Yang pulse is deficient and Yin Qi moves to invade it.
Question: Why do you say Yang is deficient?
Answer: If the Cun position (Cunkou pulse) is faint (wei), this is called Yang deficiency. When Yin Qi enters the Yang region due to deficiency, chills occur.
Question: Why do you say Yin is deficient?
Answer: If the Chi position pulse is weak (ruo), this is called Yin deficiency. When Yang Qi sinks into the Yin region due to deficiency, fever occurs.
Chills accompanied by fever constitute a Taiyang disease (Taiyang bing). When the Yin pulse is deficient and Yang Qi follows it, fever results; when the Yang pulse is deficient and Yin Qi invades it, chills result. If the Cun position pulse is faint, it indicates Yang deficiency, and Yin Qi invading the Yang region causes chills. If the Chi position pulse is weak, it indicates Yin deficiency, and Yang Qi sinking into the Yin region causes fever. Generally, the Cun position governs Wei Qi (Defensive Qi), and the Chi position governs Ying Qi (Nutritive Qi). Ying Qi circulates within the vessels and is abundant in the lower part; Wei Qi circulates outside the vessels and is abundant in the upper part. This is a fixed principle. In disease, Wei Qi becomes closed and cannot reach the exterior, instead invading the Yin position, causing Yang to become deficient. Ying Qi becomes disturbed and cannot guard inwardly, instead invading the Yang position, causing Yin to become deficient. When the Yin position is deficient and Yang invades it, Yang stagnates internally leading to fever; when the Yang position is deficient and Yin invades it, Yin binds externally leading to chills. This is the reason for the reversal of Ying and Wei Qi positions.
If the Yang pulse is floating (fu) and the Yin pulse is weak (ruo), there is Blood deficiency. Blood deficiency leads to tendon tension. A sinking (chen) pulse indicates deficient Ying Qi. A floating pulse with sweating like flowing pearls indicates deficient Wei Qi. In cases of deficient Ying Qi, if moxibustion needles (shao zhen) are applied, blood flow will stagnate, resulting in increased fever and irritability.
The Cun position belongs to Yang, and the Chi position belongs to Yin. If the Yang pulse is floating and the Yin pulse is weak, there is Blood deficiency. Blood nourishes the tendons; thus, Blood deficiency causes tendon tension. The Yin pulse is described as "weak" rather than "floating," implying the pulse is sinking. A sinking pulse indicates deficient Ying Qi. When Ying Qi is deficient and Yang Qi invades, this is the origin of fever. The floating nature of the Yang pulse does not indicate Yang excess; rather, a floating pulse with profuse sweating indicates deficient Wei Qi. When Wei Qi is deficient and Yin Qi invades, this is the origin of chills. Deficient Ying Qi inevitably leads to fever. If burning needles are used to cauterize the blood, the flowing blood will dry and coagulate, stopping circulation. Wei Qi becomes obstructed and stagnant, causing further fever and increased irritability. This is the cause of fever. Yang deficiency in the upper part leads to a floating pulse because it lacks root in the lower part. Yin deficiency in the lower part leads to a sinking pulse because it lacks root in the upper part. When both Yin and Yang are excessive, the Cun position is not excessively floating, and the Guan position (Guan pulse) has a pulse to guide descent; the Chi position is not excessively sinking, and the Guan position has a pulse to guide ascent. Therefore, Yin and Yang are not excessive at the Cun and Chi positions but are excessive at the Guan position. The Guan position is the pivot of the middle Qi of Yin and Yang, serving as the axis for ascending, descending, floating, and sinking.