目窠上下肿者，主有水气之病，从面肿起者，名曰风水，阳水也。从足胫肿起者，名曰石水，阴水也。
若手肿至腕，足肿至踝，面肿至项，非水也，乃阳气虚结不还之死证也。
《经》曰∶夫五脏者，身之强也。头者，精明之府。头倾视深，精神将夺矣。背者，胸中之府，背曲肩
随，府将坏矣。腰者。肾之府，转摇不能，肾将惫矣。膝者，筋之府。屈伸不能，行则偻俯，筋将惫矣。骨者
，髓之府，不能久立，行则振掉，骨将惫矣。凡此形神将夺，筋骨虺颓之形状，皆主死候也。
一、假热者，水极似火也。凡病伤寒，或患杂证，有其素
禀虚寒，偶感邪气而然者。有过于劳倦而致者。有过于酒色而致者。有过于七情而致者。有原非火证，以误
服寒凉而致者。凡真热，本发热，而假热亦发热，其证则亦为面赤躁烦，亦为大便不通，小便赤涩，或为气促
、咽喉肿痛，或为发热脉见紧数等证∶ 者见之，便认为热，妄投寒凉，下咽必毙。不知身虽有热，而里
寒格阳，或虚阳不敛者，多有此证。但其内证则口虽干渴，必不喜冷，即喜冷者，饮亦不多，或大便不实，
或先硬后溏，或小水清频，或阴枯黄赤，或气短懒言，或色黯神倦，或起倒如狂，而禁之则止，自与登高骂
詈者不同，此虚狂也。或斑如蚊迹，而浅红细碎，自与紫赤热极者不同，此假斑也。凡假热之脉，必沉细迟弱
，或虽浮大紧数，而无力无神，此乃热在皮肤，寒在脏腑，所谓恶热非热，实阴证也。凡见此内颓内困
等证，而但知攻邪，则无有不死。急当以四逆之类，倍加附子，填补真阳，以引火归源。但使元气渐复，则
热必退藏，而病自愈。所谓火就燥者，即此义也。故凡见身热脉数，按之不鼓击者，此皆阴盛格阳，即非热
也。
二、假寒者，火极似水也。凡伤寒热甚，失于汗下，以致阳邪亢极，郁伏于内，则邪自阳经传入阴分，
故为身热发厥，神气昏沉，或时畏寒，状若阴证。凡真寒本畏寒，而假寒亦畏寒。此热深厥亦深，热极反兼寒
化也。大抵此证，必声壮气粗，形强有力，或唇焦舌黑。口渴饮冷，小便赤涩，大便秘结。或因多饮药水，
以致下利纯清水，而其中仍有燥粪，及失气极臭者。察其六脉，必皆沉滑有力，此阳证也。凡内实者，宜三
承气汤，择而用之。潮热者，以大柴胡汤，解而下之。内不实者。以白虎汤之类清之。若杂证之假寒者，亦
或为畏寒，或为战栗，此以热极于内，而寒侵于外，则寒热之气，两不相投，因而寒栗，此皆寒在皮肤，热在
骨髓，所谓恶寒非寒、明是热证。但察其
内证，则或为喜冷，或为便结，或小水之热涩，或口臭而躁烦。察其脉必滑实有力。凡见此证，即当以凉膈芩
连之属，助其阴而清其火，使内热既除，则外寒自伏，所谓水流湿者，亦此义也。故凡身寒厥冷，其脉滑数，
按之鼓击于指下者，此阳极似阴，即非寒也。
眼睑上下浮肿的，主病为水气病。从面部开始肿起的，名叫风水，属于阳水。从足胫部开始肿起的，名叫石水，属于阴水。
如果手部肿胀至手腕，足部肿胀至脚踝，面部肿胀至颈部，这不是水气病，而是阳气虚衰、郁结不散的死证。
《黄帝内经》说：五脏是身体强健的根本。头是精明之气汇聚的府库。如果头低垂、眼窝深陷，说明精神即将耗竭。背部是胸中脏腑的外应之府。如果背曲肩垂，说明胸中脏腑功能即将败坏。腰部是肾脏的外应之府。如果弯腰转身困难，说明肾脏功能即将衰竭。膝盖是筋脉汇聚的府库。如果屈伸不利，行走时弯腰驼背，说明筋脉功能即将衰竭。骨骼是骨髓汇聚的府库。如果不能久站，行走时身体颤抖摇晃，说明骨骼功能即将衰竭。凡是这种形神即将耗竭、筋骨颓废败坏的症状，都主死候。
一、假热证，是水极似火的表现。凡是患伤寒病，或患杂病，有的是因为素体禀赋虚寒，偶然感受邪气而导致的；有的是因为过度劳累而导致的；有的是因为过度饮酒色欲而导致的；有的是因为过度七情内伤而导致的；有的是原本不是火证，因为误服寒凉药物而导致的。凡是真热证，本来就会发热，而假热证也会发热，其症状也是面红烦躁，也是大便不通，小便赤涩，或者是气促、咽喉肿痛，或者是发热且脉象紧数等证候：医生见到这些，便认为是热证，妄用寒凉药物，药一下咽必然致死。不知道身体虽然有热，但内部是寒邪格拒阳气，或者是虚阳不能收敛，多有此类证候。但是其内在证候则是：口虽然干渴，一定不喜欢冷饮，即使喜欢冷饮，喝得也不多；或者大便不成形，或者先硬后稀；或者小便清长频数；或者阴部干枯黄赤；或者气短懒言；或者面色晦暗精神疲倦；或者起卧不安如发狂状，但制止后就停止，这与登高骂詈的人不同，这是虚狂。或者身上出现斑疹如蚊迹，颜色浅红细碎，这与紫赤色热极者不同，这是假斑。凡是假热证的脉象，一定是沉细迟弱，或者虽然浮大紧数，但无力无神，这是热在皮肤，寒在脏腑，所谓恶热并非真热，实际上是阴证。凡是见到这种内里颓败困顿等证候，如果只知道攻伐邪气，就没有不死的。应当急用四逆汤之类的方剂，加倍加入附子，填补真阳，以引火归源。只要使元气逐渐恢复，那么热邪必然退藏，疾病自然痊愈。所谓“火就燥”，就是这个道理。所以凡是见到身热脉数，但按压时不鼓击有力的，这都是阴盛格阳，即不是热证。
二、假寒证，是火极似水的表现。凡是伤寒热势很盛，失于发汗或攻下治疗，导致阳邪亢盛至极，郁伏在内，那么邪气就会从阳经传入阴分，因此出现身热四肢厥冷，神气昏沉，或者有时畏寒，症状像阴证。凡是真寒证本来畏寒，而假寒证也畏寒。这是因为热邪越深，厥冷就越深，热极反而兼有寒化现象。大抵这类证候，一定声音壮实、气息粗重，形体强壮有力，或者嘴唇焦黑、舌苔黑，口渴想喝冷水，小便赤涩，大便秘结。或者因为多喝药水，导致腹泻全是清水，但其中仍有燥屎，以及放屁极其臭秽。诊察其六脉，一定都是沉滑有力，这是阳证。凡是体内实热的，宜选用三承气汤，酌情使用。有潮热症状的，用大柴胡汤，和解并攻下。体内不实的，用白虎汤之类清热。如果是杂病中的假寒证，也或者是畏寒，或者是战栗，这是因为热极于内，而寒侵于外，那么寒热之气互不相容，因而发生寒战栗动，这都是寒在皮肤，热在骨髓，所谓恶寒并非真寒，明明是热证。只要诊察其内在证候，那么或者是喜冷，或者是便秘，或者是小便热涩，或者是口臭而烦躁。诊察其脉象一定滑实有力。凡是见到这种证候，就应当用凉膈散、黄芩黄连之类的药物，资助阴液而清泻火邪，使内热既除，那么外寒自然潜伏，所谓“水流湿”，也是这个道理。所以凡是见到身寒厥冷，但脉象滑数，按压时指下有鼓击感的，这是阳极似阴，即不是寒证。
When the eyelids and the areas above and below them are swollen, it indicates a disease of water qi (Water Qi, pathogenic fluid retention). Swelling that starts from the face is called Fengshui (Wind Water, edema caused by wind attacking the exterior), which belongs to Yang Water. Swelling that starts from the lower legs and shins is called Shishui (Stone Water, severe edema with abdominal distension), which belongs to Yin Water.
If swelling extends to the wrists in the hands and to the ankles in the feet, and to the neck in the face, this is not due to water qi; rather, it is a critical condition indicating death caused by deficiency and stagnation of Yang Qi failing to return.
The *Classic* states: The Five Zang Organs are the strength of the body. The head is the mansion of Jingming (Clear Brightness, referring to mental clarity and spirit). If the head droops and the eyes are sunken, the Spirit (Shen) is about to be exhausted. The back is the mansion of the organs within the chest. If the back is curved and the shoulders sag, the mansion's function is about to deteriorate. The waist is the mansion of the Kidneys. If turning and shaking the waist is difficult, the Kidneys are about to become exhausted. The knees are the mansion of the Sinews (Jin). If flexion and extension are impossible, and walking involves stooping, the Sinews are about to become exhausted. The bones are the mansion of the Marrow. If one cannot stand for long, and trembles while walking, the Bones are about to become exhausted. All these conditions, where form and spirit are about to be depleted, and the appearance shows the decadence of sinews and bones, all indicate a fatal prognosis.
1. False Heat is when Water extreme resembles Fire. In cases of Shanghan (Cold Damage) or miscellaneous diseases, some arise because the patient has a constitution of inherent deficiency-cold and accidentally contracts pathogenic factors; some arise from excessive fatigue; some from excessive alcohol and sexual indulgence; some from excessive emotional stress; and some are originally not Heat patterns but result from the mistaken administration of cold-cooling herbs. True Heat patterns naturally involve fever, and False Heat patterns also involve fever. Their symptoms include red face, restlessness, and irritability; constipation; dark and scanty urine; shortness of breath; sore and swollen throat; or fever with a tight and rapid pulse. Physicians seeing these may mistakenly diagnose Heat and recklessly administer cold-cooling herbs, leading to death upon ingestion. They fail to realize that although there is heat on the surface, there is internal Cold repelling Yang, or deficient Yang failing to consolidate, which often presents such symptoms. However, the internal signs reveal that although the mouth is dry and thirsty, there is no desire for cold drinks; even if desired, intake is small. There may be loose stools, or hard stools followed by loose ones, or clear and frequent urination, or dryness and yellow-red discoloration of the genitals, or shortness of breath and reluctance to speak, or dull complexion and spiritual fatigue. Restlessness resembling madness may occur, but stops when restrained, differing from those who climb high and curse, which is false mania. Rashes may appear like mosquito bites, light red and fine, differing from the purple-red rashes of extreme heat, which are false rashes. The pulse in False Heat must be deep, fine, slow, and weak; or although floating, large, tight, and rapid, it lacks force and spirit. This means heat is in the skin and Cold is in the Zang-Fu organs. It is said that "aversion to heat is not true heat," but actually a Yin pattern. When encountering such internal decadence and distress, if one only knows how to attack pathogens, death is inevitable. One should urgently use formulas similar to Sini Tang (Recover the Extremity Decoction), doubling the dosage of Fuzi (Aconite Lateral Root), to tonify True Yang and guide fire back to its source. Once Yuan Qi (Original Qi) gradually recovers, the heat will retreat and store itself, and the illness will heal spontaneously. This illustrates the principle that "fire moves towards dryness." Therefore, whenever body heat and rapid pulse are present, but pressing reveals no pounding force against the fingers, this is Yin excess repelling Yang, meaning it is not Heat.
2. False Cold is when Fire extreme resembles Water. In cases of severe Shanghan heat, failure to induce sweating or purge leads to Yang pathogens becoming extremely hyperactive and stagnant internally. Thus, pathogens transmit from Yang meridians to Yin divisions, resulting in body heat with cold extremities, lethargy, or occasional aversion to cold, mimicking a Yin pattern. True Cold inherently involves aversion to cold, and False Cold also involves aversion to cold. This is because the deeper the heat, the deeper the cold limbs; extreme heat manifests with cold transformation. Generally, this pattern features strong voice and coarse breathing, robust physical strength, or scorched lips and black tongue, thirst with desire for cold drinks, dark and scanty urine, and constipation. Or, due to drinking too much medicinal water, it causes diarrhea of pure clear water, yet dry feces remain inside, accompanied by extremely foul-smelling flatulence. Examining the six pulses reveals they are all deep, slippery, and forceful, indicating a Yang pattern. For internal excess, choose among San Chengqi Tangs (Three Attendant Qi Decoctions) as appropriate. For tidal fever, use Da Chaihu Tang (Major Bupleurum Decoction) to harmonize and purge. For internal non-excess, clear with Baizhu Tang (White Tiger Decoction) or similar. In miscellaneous diseases, False Cold may also manifest as aversion to cold or shivering. This occurs because heat is extreme internally while Cold invades externally; the conflicting cold and heat energies do not merge, causing chills. This indicates Cold in the skin and Heat in the marrow. It is said that "aversion to cold is not true cold," clearly a Heat pattern. Examining internal signs reveals either preference for cold, constipation, hot and obstructive urination, bad breath with irritability. The pulse must be slippery, full, and forceful. Upon seeing this pattern, one should use Lian Ge Qing Re Tang (Cool the Diaphragm Clear Heat Decoction) or Huangqin Huanglian Tang (Scutellaria and Coptis Decoction) to nourish Yin and clear Fire. Once internal heat is removed, external cold naturally subsides. This illustrates the principle that "water flows to dampness." Therefore, whenever body cold and cold extremities are present, but the pulse is slippery and rapid, and pounding against the fingers upon pressure, this is Yang extreme resembling Yin, meaning it is not Cold.