病患脉微来又涩。误汗误下皆为失。（脉微则气虚。脉涩则血少。二者不可汗下。既下而又汗。荣卫皆虚。故发热也。）
既汗亡阳斯恶寒。又下阴微还热极。（阴虚者阳必凑之。既下则阴虚。故阳入阴分。所以内外皆热。素问云。阳虚则外热。
阴虚则内热。故热极也。）最忌阴阳皆已虚。热又不止病斯亟。更有劳复并食复。失于调治并将息。（既下之后。必须身
凉。今下之而复热者。不特汗下之误。亦有劳复食复二证。劳复。谓病后用力。食复。谓饮食过度。失于调治之所致。）
新瘥血气尚虚羸。劳复生热无气力。（劳复。则无力而少气。）脾胃尚弱食过多。食复发热还憎食。（食复。则发热呕吐。
憎闻食臭矣。）小柴枳实栀子汤。数者用之宜审的。
恶寒发热在阳经。无热恶寒病发阴。（仲景云。发热而恶寒者。病发于阳也。无热而恶寒者。病发于阴也。）阳宜发
汗麻黄辈。阴宜温药理中宁。（发于阳。宜桂枝麻黄青龙辈。发于阴。宜四逆理中也。）啬啬恶寒桂枝证。（仲景云。啬啬
恶寒。翕翕发热。桂枝汤证。）汗后恶寒虚不任。（汗后恶寒。虚也。）脉微恶寒不可下。尚宜发汗莫令深。（脉微。不可
下。虽发汗。亦微发汗可也。）亦有头汗恶寒者。柴胡加桂值千金。（头有汗而恶寒者。仲景用小柴胡加桂汤。）汗已恶寒
心下痞。附子增加入泻心。（仲景云，心下痞，而复恶寒。汗出者。附子泻心汤主之。方第十八。）
患者脉象微弱且往来艰涩。误用发汗或攻下法都是失误。（脉微说明气虚，脉涩说明血少。这两种情况都不可使用发汗和攻下法。如果已经攻下后又发汗，导致营卫之气皆虚，所以出现发热。）
既然发汗导致亡阳就会恶寒，再次攻下导致阴液亏损则热势极盛。（阴虚则阳气必凑集于内。既然经过攻下，则阴液亏虚，所以阳气陷入阴分，因此内外都感到热。《素问》说：阳虚则体表发热，阴虚则体内发热，所以热势极盛。）最忌讳的是阴阳两虚，如果热势不止，病情就会危急。还有劳复（因劳累复发）和食复（因饮食不当复发），若失于调理治疗和休养护理。（攻下之后，身体应当凉爽。现在攻下后反而发热，不仅是汗下法的错误，也有劳复和食复两种证候。劳复，是指病后用力劳作；食复，是指饮食过度，这是失于调理治疗所致。）
刚痊愈时气血依然虚弱羸弱，劳复产生热邪且没有力气。（劳复，则表现为无力且气短。）脾胃尚且虚弱，吃得过多，食复导致发热且厌恶进食。（食复，则表现为发热呕吐，厌恶闻到食物的气味。）小柴胡枳实栀子汤，对于这几种情况使用应当审慎确切。
恶寒发热出现在阳经，无热而恶寒的病发于阴经。（张仲景说：发热而恶寒的，是病发于阳。无热而恶寒的，是病发于阴。）阳经病适宜发汗，用麻黄类方剂；阴经病适宜温里理中，用理中汤等。（发于阳，适宜用桂枝、麻黄、青龙汤类；发于阴，适宜用四逆汤、理中汤。）啬啬然畏寒是桂枝汤证。（张仲景说：啬啬然畏寒，翕翕然发热，是桂枝汤证。）发汗后恶寒属于虚证，不能耐受。（发汗后恶寒，是正气虚损。）脉微恶寒不可攻下，仍宜轻微发汗，不要发汗过深。（脉微，不可攻下。即使发汗，也只需微微发汗即可。）也有头出汗而恶寒的情况，用小柴胡加桂枝汤价值千金。（头部有汗而恶寒的，张仲景用小柴胡加桂枝汤。）发汗后恶寒且心下痞满，附子泻心汤增加附子使用。（张仲景说：心下痞满，又兼恶寒、汗出的，用附子泻心汤主治。见方第十八。）
The patient's pulse is faint and choppy. Erroneous use of sweating or purging methods constitutes a mistake. (A faint pulse indicates Qi deficiency, while a choppy pulse indicates Blood deficiency. Neither sweating nor purging should be employed in these cases. If purging is followed by sweating, both Ying [Nutritive] and Wei [Defensive] Qi become deficient, resulting in fever.)
If sweating leads to Yang collapse, aversion to cold ensues; if subsequent purging causes Yin depletion, heat becomes extreme. (When Yin is deficient, Yang inevitably congregates within. Since purging depletes Yin, Yang enters the Yin aspect, causing heat internally and externally. As stated in Su Wen: "Yang deficiency results in external heat; Yin deficiency results in internal heat," hence the extreme heat.) The most contraindicated scenario is when both Yin and Yang are already deficient; if the heat persists, the condition becomes critical. Additionally, there are relapse due to exertion [Lao Fu] and relapse due to diet [Shi Fu]; neglecting proper regulation, treatment, and nursing exacerbates the issue. (After purging, the body should cool down. If fever recurs after purging, it is not only due to erroneous sweating or purging but also involves Lao Fu and Shi Fu. Lao Fu refers to physical exertion after illness; Shi Fu refers to overeating, caused by failure in proper care and regulation.)
Upon recent recovery, Qi and Blood remain weak and emaciated; relapse due to exertion generates heat and lethargy. (Relapse due to exertion manifests as weakness and shortness of breath.) If the Spleen and Stomach are still weak and food intake is excessive, relapse due to diet causes fever and anorexia. (Relapse due to diet manifests as fever, vomiting, and aversion to the smell of food.) Xiao Chai Hu Zhi Shi Zhi Zi Tang (Minor Bupleurum, Immature Bitter Orange, and Gardenia Decoction) should be used with careful deliberation for these conditions.
Aversion to cold accompanied by fever occurs in the Yang meridians; absence of fever with aversion to cold indicates onset in the Yin meridians. (Zhang Zhongjing stated: "Fever with aversion to cold indicates onset in Yang; absence of fever with aversion to cold indicates onset in Yin.") Yang-onset diseases are suitable for sweating therapy using Ephedra-based formulas; Yin-onset diseases are suitable for warming and regulating Middle Jiao therapies like Lizhong Tang. (Onset in Yang is suitable for Guizhi Tang, Mahuang Tang, or Qinglong Tang variants; onset in Yin is suitable for Sini Tang or Lizhong Tang.) "Se se" [shivering] aversion to cold is a Guizhi Tang syndrome. (Zhang Zhongjing stated: "Shivering aversion to cold and mild fever constitute a Guizhi Tang syndrome.") Aversion to cold after sweating indicates deficiency and intolerance. (Aversion to cold post-sweating signifies Qi/Yang deficiency.) A faint pulse with aversion to cold contraindicates purging; slight sweating may still be appropriate, avoiding deep sweating. (A faint pulse contraindicates purging. Even if sweating is indicated, it should be mild.) There are also cases of head sweating with aversion to cold, where Chai Hu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction) is invaluable. (Head sweating with aversion to cold is treated by Zhang Zhongjing using Chai Hu Jia Guizhi Tang.) After sweating, if aversion to cold persists with epigastric fullness [Xin Xia Pi], Fuzi Xie Xin Tang (Aconite Draining the Epigastrium Decoction) adds Fuzi. (Zhang Zhongjing stated: "Epigastric fullness accompanied by aversion to cold and sweating is treated with Fuzi Xie Xin Tang." See Formula 18.)