伤寒四五日，或十余日，无表症，无里症，俱用小柴胡汤，随症加减用之。
阳症者，即太阳、阳明、少阳也。初病发热头疼项强，以后唇焦口燥，烦渴喜冷，面色光彩，语言清亮，手
足温暖，爪甲红润，大便或闭或硬，小便或赤或□，脉来浮洪数大，此阶阳症之候也。其治或汗或和
或下可也。
阴症者，即直中太阴、少阴、厥阴之寒症也。初病无头疼，无身热，无口渴，就便恶寒或战栗，面如刀刮，
身体沈重，难以转侧，呕吐泻利，小便清白，蜷卧欲寐，手足厥冷，爪甲青面，面色惨黯而无光，脉来沈
涩而细小，此皆阴症之候也。其治或温或补可也。
阳毒者，阳气独盛，阴气暴绝所致也。或阳症？服温热之药，或吐下后变成阳毒。其人壮热发躁，或
狂走骂詈，妄见鬼神，或口吐脓血而发锦斑，或舌卷焦黑，鼻如□媒，或咽喉肿痛，下利黄赤，六脉洪
大而数。轻者阳毒升麻汤，重则青黛一物汤。
阴毒者，阴气独盛，阳气暴绝所致也。或虚症？服寒凉之药或吐泻后变成阴毒。其人脐腹搅痛，身
如被杖，或四肢厥冷，六脉沈细微弱。阴毒甘草汤主之。
发热者，怫怫然发于皮肤之间，熇熇然散而成热者是也。与潮热、寒热、烦躁之热不同。烦躁之热，热
在内者也。潮热之热，有时而热，不失其时。寒热之热，寒已而热，相继而发。至于发热，则无时而发也。
然有翕翕发热，蒸蒸发热之异。翕翕发热者，若合羽所覆，明其热在外也，故与桂枝汤汗以散之。蒸
蒸发热者，若熏蒸之蒸，明其热在内也，故与调胃承气汤下以除之。然发属表者，即风寒客于皮
肤，阳气怫郁所致也。发热属里者，即阳气下陷入阴中所致也，观其热所从来，而汗下之症明矣。若
热先自皮肤发者，知邪气在外者也。热先自里生而达于表者，知邪气在里者也。举斯二者，则邪之
在表在里又明矣。惟其在表在里俱有发热，故半表半里亦有发热，何者以表症未罢，邪气传里，里
未作实，是为半表半里。然同一发热也，或始自皮肤，而渐传为里热，或始自内热，而外达于肌表。故
邪气在表而发热者，表热而里不热也。邪气在里而发热者，里热甚而达于表也。其在半表半里而
发热者，则表里俱发热者也。难经云、发热恶寒者，发于阳也，无热恶寒者，发于阴也。然太阴厥阴，皆
不发热，维少阴病始得之，虽有发热之症亦脉沈下利手足冷为异尔，故与麻黄附子细辛汤汗以
散之。然有汗后发热者，或表邪未尽，或里症已具，或邪在半表半里之间。有下后发热者，或宿垢未
尽，或丸药？下。有劳复发热者，盖因新瘥后津液未复，血气尚弱，或语言以伤气，思虑以伤神，邪热
随至，原病复举，当调和营卫，清解邪热为佳也。有食复发热者，须涤邪扶正，消食丸为妙也。虽然，发
热、伤寒之常也，如有阴阳俱虚，及下利与新汗后，又皆恶其热也。岂可一概论耶。
伤寒病经过四五天，或者十几天，既没有表证，也没有里证，都使用小柴胡汤，根据具体症状进行加减后服用。
阳证，指的是太阳、阳明、少阳经的病证。初起时发热、头痛、项部僵硬，随后出现嘴唇焦裂、口干舌燥、心烦口渴且喜欢冷饮，面色红润有光泽，说话声音清晰洪亮，手脚温暖，指甲红润，大便或闭塞不通或干硬，小便或发红或短少（原文缺字，推测为“短”），脉象浮大、洪数、盛大，这是阳证的征候。治疗可以采用发汗、和解或攻下的方法。
阴证，指的是寒邪直接侵入太阴、少阴、厥阴经的寒证。初起时没有头痛，没有身体发热，没有口渴，反而怕冷或战栗，面色像刀刮过一样苍白，身体沉重，难以翻身转动，呕吐腹泻，小便颜色清亮或白色，蜷缩而卧想要睡觉，手脚冰凉，指甲发青，面色惨淡无光，脉象沉涩且细小，这些都是阴证的征候。治疗可以采用温法或补法。
阳毒，是由于阳气极度旺盛，阴气突然衰竭所致。或者是阳证误服了温热药物，或者在吐下之后转变为阳毒。患者高热烦躁，或者狂乱奔跑、骂人，看见虚幻的鬼神，或者口吐脓血并出现红色斑疹，或者舌头卷曲焦黑，鼻子颜色像烟煤一样黑，或者咽喉肿痛，腹泻排出黄赤色的粪便，六脉（寸关尺三部，左右手）洪大且数。轻症用阳毒升麻汤，重症用青黛一物汤。
阴毒，是由于阴气极度旺盛，阳气突然衰竭所致。或者是虚证误服了寒凉药物，或者在吐泻之后转变为阴毒。患者脐腹部绞痛，身体像被棍棒打过一样疼痛，或者四肢冰冷，六脉沉细微弱。主治方剂是阴毒甘草汤。
发热，是指热气郁结在皮肤之间，炽盛地散发出来的热。这与潮热、寒热、烦躁之热不同。烦躁之热，热邪在内。潮热之热，定时发热，不失其时。寒热之热，先恶寒后发热，相继发作。至于发热，则是随时都可能发作的。然而又有“翕翕发热”和“蒸蒸发热”的区别。“翕翕发热”，就像羽毛覆盖在身上那样温和发热，说明热邪在体表，所以用桂枝汤通过发汗来解散它。“蒸蒸发热”，就像熏蒸那样热气内涌，说明热邪在体内，所以用调胃承气汤通过攻下来清除它。然而，属于表证的发热，即风寒客居于皮肤，导致阳气郁结所致；属于里证的发热，即阳气下陷进入阴分所致。观察热邪的来源，发汗和攻下的适应症就明确了。如果热先从皮肤发出，可知邪气在体表。如果热先从体内产生而达于体表，可知邪气在体内。列举这两种情况，邪气在表还是在里就清楚了。正因为表和里都有发热，所以半表半里也有发热。为什么呢？因为表证未解，邪气传入里部，但里部尚未形成实证，这就是半表半里。同样是发热，有的开始于皮肤，逐渐传变为里热；有的开始于内部发热，向外达于肌表。所以邪气在表而发热者，是表热而里不热。邪气在里而发热者，是里热甚盛而达于体表。在半表半里而发热者，则是表和里都发热。《难经》说：发热伴恶寒的，发于阳经；无热伴恶寒的，发于阴经。然而太阴、厥阴都不发热，只有少阴病刚得病时，虽然有发热的症状，但以脉沉、腹泻、手脚冷为特征，所以用麻黄附子细辛汤通过发汗来解散它。然而，有发汗后发热的，可能是表邪未尽，或者里证已具备，或者邪气在半表半里之间。有攻下后发热的，可能是宿便未尽，或者因服用丸药攻下所致。有劳复发热的，大概是因为病愈不久津液未恢复，气血尚虚弱，或因言语过多伤气，思虑过多伤神，邪热随之而来，原发病复发，应当调和营卫，清解邪热为好。有食复发热的，必须涤除邪气扶助正气，消食导滞为妙。虽然发热是伤寒的常见症状，但如果阴阳俱虚，以及腹泻和新近发汗之后，又都厌恶发热。怎么能一概而论呢。
After four or five days, or even ten-plus days of contracting a cold injury (Shanghan), if there are neither exterior syndromes nor interior syndromes, Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be used universally, with modifications based on specific symptoms.
Yang syndromes refer to the Taiyang (Greater Yang), Yangming (Bright Yang), and Shaoyang (Lesser Yang) meridians. Initially, there is fever, headache, and stiffness in the neck. Later, lips become dry and cracked, mouth and throat feel parched, restlessness and thirst occur with a preference for cold drinks, the facial complexion is lustrous and bright, speech is clear and loud, hands and feet are warm, nail beds are ruddy, stool may be constipated or hard, urine may be red or scanty, and the pulse is floating, surging, rapid, and large. These are manifestations of Yang syndromes. Treatment may involve sweating (diaphoresis), harmonizing, or purging methods.
Yin syndromes refer to cold syndromes where pathogens directly invade the Taiyin (Great Yin), Shaoyin (Lesser Yin), and Jueyin (Terminal Yin) meridians. Initially, there is no headache, no body heat, and no thirst; instead, there is aversion to cold or shivering. The face appears pale as if scraped by a knife, the body feels heavy and difficult to turn, vomiting and diarrhea occur, urine is clear or white, the patient curls up wanting to sleep, hands and feet are cold, nails appear cyanotic, the facial complexion is dull and lifeless, and the pulse is deep, choppy, fine, and small. These are all manifestations of Yin syndromes. Treatment may involve warming or tonifying methods.
Yang toxicity (Yang Du) results from excessive Yang qi and sudden exhaustion of Yin qi. It may arise from a Yang syndrome mistakenly treated with warm-hot herbs, or transforming into Yang toxicity after emesis or purgation. The patient suffers from high fever and agitation, may run around wildly cursing, see hallucinations of ghosts, vomit pus and blood accompanied by red rashes, have a curled and scorched-black tongue, a nose resembling soot, swollen and painful throat, yellow-red diarrhea, and six pulses (radial arteries at both wrists) that are surging, large, and rapid. For mild cases, Yang Du Sheng Ma Tang (Yang Toxicity Corydalis Decoction) is used; for severe cases, Qing Dai Yi Wu Tang (Indigo Naturalis Single Herb Decoction) is used.
Yin toxicity (Yin Du) results from excessive Yin qi and sudden exhaustion of Yang qi. It may arise from a deficiency syndrome mistakenly treated with cold-cool herbs, or transforming into Yin toxicity after emesis or diarrhea. The patient experiences twisting pain in the umbilical and abdominal region, body pain as if beaten with a stick, cold limbs, and six pulses that are deep, minute, and weak. Yin Du Gan Cao Tang (Yin Toxicity Licorice Decoction) is the primary treatment.
"Fa Re" (Fever/Heat emission) refers to heat accumulating between the skin and becoming hot through intense dispersion. This differs from tidal fever (Chao Re), alternating chills and fever (Han Re), and heat from restlessness (Fan Zao). Heat from restlessness originates internally. Tidal fever occurs at specific times without fail. Alternating chills and fever involves chills followed sequentially by fever. In contrast, "Fa Re" can occur at any time. However, there are distinctions between "Xi Xi Fa Re" (gentle fever like feathers covering) and "Zheng Zheng Fa Re" (steaming fever). "Xi Xi Fa Re" resembles warmth under feathers, indicating heat is external; thus, Gui Zhi Tang (Cinnamon Twig Decoction) is used to disperse it via sweating. "Zheng Zheng Fa Re" resembles steaming, indicating heat is internal; thus, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) is used to remove it via purging. Exterior-type "Fa Re" is caused by wind-cold lodging in the skin and stagnating Yang qi. Interior-type "Fa Re" is caused by Yang qi sinking into the Yin. Observing the origin of the heat clarifies whether sweating or purging is indicated. If heat starts from the skin, the pathogen is external. If heat arises internally and reaches the surface, the pathogen is internal. These two examples clarify the location of the pathogen. Since both exterior and interior present with fever, the half-exterior half-interior stage also presents with fever. Why? Because the exterior syndrome has not resolved, the pathogen has transmitted inward, but the interior has not yet formed an excess condition; this is the half-exterior half-interior state. Although the symptom is fever, some begin at the skin and gradually transform into interior heat, while others start as internal heat reaching the muscle layer. Thus, when the pathogen is in the exterior causing fever, it is exterior heat without interior heat. When the pathogen is in the interior causing fever, it is intense interior heat reaching the exterior. When in the half-exterior half-interior, both exterior and interior are heated. The *Nan Jing* states: Fever with aversion to cold indicates onset in Yang channels; absence of fever with aversion to cold indicates onset in Yin channels. However, Taiyin and Jueyin do not typically feature fever. Only in early Shaoyin disease, although fever may occur, it is distinguished by a deep pulse, diarrhea, and cold limbs; therefore, Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction) is used to disperse via sweating. Furthermore, fever after sweating may indicate residual exterior pathogen, established interior syndrome, or pathogen in the half-exterior half-interior. Fever after purging may indicate incomplete removal of accumulated feces or effects from pill-based purgatives. Fever due to relapse from overexertion (Lao Fu) generally occurs because fluids are not yet restored and Qi/Blood are weak after recovery; excessive speech damages Qi, excessive thinking damages Shen (Spirit), allowing residual heat to return and the original illness to recur. Harmonizing Ying and Wei (Nutritive and Defensive systems) and clearing residual heat is appropriate. Fever due to dietary relapse (Shi Fu) requires eliminating pathogens, supporting healthy Qi, and resolving food stagnation. Although fever is common in cold injuries, in cases of simultaneous deficiency of Yin and Yang, or following diarrhea and recent sweating, fever is often dreaded. How can one apply a uniform principle?