脉浮而数，能食，不大便者，名曰阳结，十七日当剧；脉沉而迟，不能食，身体重，大
便反
硬，名曰阴结，十四日当剧。盖天人之气，十五日一更，更则结者当解，设不解，其病则剧
。云十七日者，阳结能食，故过期；十四日者，阴结不能食，故不及期也。成氏过结再传之
说，失之泥矣。
伤寒，腹满，谵语，寸口脉浮而紧，此肝乘脾也，名曰纵，刺期门；伤寒，发热，啬啬
恶寒
，大渴欲饮水，其腹必满，自汗出，小便利，此肝乘肺也，名曰横，刺期门。按腹满、谵语
，其脉当实沉，而反浮紧，此非里实，乃肝邪乘脾，气窒而实也；发热，恶寒，病为在表，
其证本不当渴，而反大渴，此非内热，乃肝邪乘肺，气郁而燥也。以里无热，不能消水，故
腹满，而汗出便利，则肺气已行，故愈。二者俱泻肝邪则愈，设不知而攻其实热，则误矣。
此病机之变，不可不审也。
邪气入，正气抑，则病；正气复，邪气退，则汗出而愈矣。然邪犹未强而未即服，正犹
微而未即胜，此所以战也。
邪气外与正争，则为战；内与正争，则为栗。栗者，心内鼓栗。经曰∶阴中于邪，必内
栗也
。若战，则但肢体战摇而已。战者，正气胜，则有得汗而解者；栗者，内气虚，不能御邪，
遂成厥脱也。
脉象浮而数，患者能进食，但大便不通，这称为阳结，到了第十七天病情可能会加重；脉象沉而迟，患者不能进食，身体沉重，大便反而干硬，这称为阴结，到了第十四天病情可能会加重。大概因为天地人的气机，每十五天更替一次，气机更替时，郁结之气应当解除，如果未能解除，疾病就会加剧。说第十七天病情加重，是因为阳结患者能进食，正气尚存，所以超过了十五天的周期；说第十四天病情加重，是因为阴结患者不能进食，正气虚弱，所以不到十五天就出现剧变。成无己关于“结邪再传”的说法，过于拘泥而不准确。
伤寒病，腹部胀满，胡言乱语，寸口脉象浮而紧，这是肝木乘克脾土，称为“纵”，针刺期门穴治疗；伤寒病，发热，怕冷，极度口渴想喝水，腹部必然胀满，自汗出，小便通畅，这是肝木乘克肺金，称为“横”，针刺期门穴治疗。按腹部胀满、胡言乱语来看，脉象应当是实沉脉，却反而出现浮紧脉，这说明不是里实热证，而是肝邪乘袭脾脏，导致气机窒塞而显得实证；发热、恶寒，病位在表，本不应口渴，却反而极度口渴，这说明不是内热，而是肝邪乘袭肺脏，导致气机郁滞而化燥。因为里没有热邪，不能消化水液，所以腹部胀满；而汗出和小便通利，说明肺气已经宣发运行，所以病愈。这两种情况只要泻除肝邪就能痊愈，如果不知道这一点而攻伐其实热，那就是误治了。这种病机的变化，不可不仔细审察。
邪气侵入，正气被抑制，就会生病；正气恢复，邪气退却，就会出汗而痊愈。然而邪气尚未强盛到立刻致病，正气也还微弱到不能立刻战胜邪气，这就是发生战栗的原因。
邪气向外与正气相争，就表现为战（肢体颤抖）；向内与正气相争，就表现为栗（内心恐惧战栗）。栗，是指心中惊恐战栗。《内经》说：“阴分受到邪气侵袭，必定内心战栗。”如果是战，只是肢体颤抖摇晃而已。战的情况，是正气胜邪，往往会有汗出而病解；栗的情况，是体内正气虚弱，不能抵御邪气，最终会导致四肢厥冷甚至虚脱。
The pulse is floating and rapid, the patient can eat, but there is no bowel movement; this is called Yang Jie (Yang Knotting), and the condition will likely worsen on the seventeenth day. The pulse is deep and slow, the patient cannot eat, the body feels heavy, and the stool is conversely hard; this is called Yin Jie (Yin Knotting), and the condition will likely worsen on the fourteenth day. Generally, the Qi of Heaven and Humanity changes every fifteen days; upon change, the knotting should resolve. If it does not resolve, the disease will become severe. The mention of the seventeenth day refers to Yang Jie where the patient can eat, thus exceeding the period; the mention of the fourteenth day refers to Yin Jie where the patient cannot eat, thus falling short of the period. Cheng Wuji’s theory regarding the "secondary transmission of knotting" is overly rigid and inaccurate.
In Shanghan (Cold Damage), with abdominal fullness and delirium, if the Cun Kou (Cun position at the radial artery) pulse is floating and tight, this is Liver Wood overacting on Spleen Earth, named Zong (Vertical/Longitudinal), treated by needling Qimen (LR14). In Shanghan, with fever, shivering aversion to cold, extreme thirst desiring water, inevitable abdominal fullness, spontaneous sweating, and free urination, this is Liver Wood overacting on Lung Metal, named Heng (Horizontal/Lateral), treated by needling Qimen (LR14). Regarding abdominal fullness and delirium, the pulse should be solid and deep, yet it is floating and tight; this indicates not interior excess-heat, but Liver Pathogen invading the Spleen, causing Qi obstruction resulting in an apparent excess syndrome. Regarding fever and aversion to cold, the pathology is in the exterior, where thirst is not typical, yet extreme thirst occurs; this indicates not internal heat, but Liver Pathogen invading the Lungs, causing Qi stagnation leading to dryness. Since there is no heat in the interior to consume fluids, abdominal fullness results; however, sweating and free urination indicate that Lung Qi has already circulated, hence recovery. Both conditions resolve by draining the Liver Pathogen; failing to recognize this and attacking apparent excess-heat would be a mistake. Such variations in pathogenesis must be carefully examined.
When Pathogenic Qi enters and Righteous Qi is suppressed, disease occurs; when Righteous Qi recovers and Pathogenic Qi retreats, sweating occurs and health is restored. However, if Pathogenic Qi is not yet strong enough to immediately cause illness, and Righteous Qi is still weak and unable to immediately overcome the Pathogen, this is why trembling and shivering occur.
When Pathogenic Qi contends outwardly with Righteous Qi, it manifests as Zhan (Trembling/Shivering); when it contends inwardly with Righteous Qi, it manifests as Li (Shuddering/Fearful Trembling). Li refers to inner heart palpitations and fearfulness. The Classics state: "If Yin is invaded by Pathogens, there must be inner shuddering." If it is Zhan, only the limbs tremble and shake. In cases of Zhan, Righteous Qi prevails, often leading to resolution through sweating. In cases of Li, interior Qi is deficient and unable to resist the Pathogen, eventually leading to Jue (Cold Extremities) and Tuo (Collapse).