表症者，发热恶寒，头疼身痛，而脉浮者是也。然恶寒者，表症也，恶寒为表之虚，此属太阳，宜汗之。若
热多寒少，脉来微弱，或尺脉迟者，不可汗。？血下血者，不可汗也。坏病者，不可汗也。经水适来者，不
可汗也。风温者，不可汗也。湿温者，不可汗也。虚烦者，不可汗也。动气者，不可汗也。又有三阴病，不可
发汗，发汗则动经血。若太阴症脉浮者，宜微汗之。少阴症发热脉沈者，又宜麻黄附子细辛汤汗之。
里症者，不恶寒，反恶热，潮热谵语，腹胀满，大便硬，脉沈而滑者是也。然恶热者，里症也，恶热为里之
实，此属阳明，宜下之。若脉浮者，不可下也。虚细者，不可下也。呕吐者，不可下也。不转矢气者，不可下
也。小便清者，不可下也。三阴，大约可温而不可下，然有积症，又当下也。如太阴腹满时痛，少阴口燥
咽干，或腹满不大便，或下利清水，心下痛，此积症也。
病人脉浮而大，即是表症当汗之。其人发热烦渴，小便志□，却当下。此是表里症俱见也，五苓散主
之。
伤寒不大便六七日，头痛有热，即是里症，当下之。其人小便清者，知不在里、仍在表也，当发汗。此是
两症俱见，未可下，宜桂枝汤。
病人心下满，不欲食，大便硬，即是里症，当下之。其人头汗出，微恶寒，手足冷，却当汗。此是两症俱见，
仲景所谓半表半里，小柴胡汤主之。
表症，表现为发热、恶寒（怕冷）、头痛、身体疼痛，且脉象浮取即得。其中，恶寒属于表症，恶寒意味着表虚，病位在太阳经，适宜采用发汗法治疗。如果热多寒少，脉象微弱，或者尺部脉象迟缓的，不可使用发汗法。若患者有下血症状的，不可发汗。坏病（误治后病情复杂化）的，不可发汗。月经适逢来潮的，不可发汗。风温病的，不可发汗。湿温病的，不可发汗。虚烦证的，不可发汗。动气证（脐周悸动不安）的，不可发汗。又有三阴病（太阴、少阴、厥阴病），不可发汗，若强行发汗则会扰动经络之血。如果是太阴病出现脉浮的，适宜微发其汗。少阴病出现发热、脉沉的，又适宜用麻黄附子细辛汤发汗。
里症，表现为不恶寒，反而恶热，潮热（定时发热或热势增高），谵语（神志不清，胡言乱语），腹部胀满，大便干硬，脉象沉取而滑利的，即是里症。其中，恶热属于里症，恶热意味着里实，病位在阳明经，适宜采用攻下法治疗。如果脉象浮的，不可攻下。脉象虚细的，不可攻下。呕吐的，不可攻下。不转矢气（不放屁）的，不可攻下。小便清长的，不可攻下。三阴病，大体上适宜温补而不适宜攻下，但是如果有积滞病症的，又应当攻下。例如太阴病腹部胀满、时而疼痛，少阴病口燥咽干，或者腹部胀满不大便，或者下利清水、心下疼痛，这些都属于积滞病症。
病人脉象浮而大，即是表症，应当发汗。其人发热、烦躁、口渴，小便不利（此处原文“志”疑为“不利”或相关描述，结合语境及五苓散主治，推断为小便不利），却应当攻下。这是表症和里症同时出现的情况，以五苓散为主方治疗。
伤寒病六七日不大便，头痛且有发热，即是里症，应当攻下。其人小便清长的，可知病不在里、仍在表，应当发汗。这是表里两症俱见，暂不可攻下，适宜用桂枝汤。
病人心下部胀满，不想吃东西，大便干硬，即是里症，应当攻下。其人头部出汗，轻微恶寒，手脚冰冷，却应当发汗。这是表里两症俱见，正如张仲景所说的半表半里证，以小柴胡汤为主方治疗。
Exterior syndromes are characterized by fever, aversion to cold (Ehan), headache, body aches, and a floating pulse. Among these, aversion to cold indicates an exterior syndrome; it signifies deficiency at the exterior level and belongs to the Taiyang channel, for which diaphoresis (sweating method) is appropriate. However, if heat predominates over cold, or if the pulse is weak and thready, or if the Chi position pulse is slow, diaphoresis is contraindicated. If there is bleeding from the lower orifice, diaphoresis is contraindicated. In cases of Huai Bing (complicated disease due to mis-treatment), diaphoresis is contraindicated. When menstruation has just begun, diaphoresis is contraindicated. In Feng Wen (wind-warmth disease), diaphoresis is contraindicated. In Shi Wen (damp-warmth disease), diaphoresis is contraindicated. In Xu Fan (deficiency irritability), diaphoresis is contraindicated. In Dong Qi syndrome (palpitations/throbbing at the umbilicus), diaphoresis is contraindicated. Furthermore, in Three Yin diseases (Taiyin, Shaoyin, Jueyin diseases), diaphoresis is contraindicated; forcing sweat will disturb the blood in the meridians. If Taiyin syndrome presents with a floating pulse, mild diaphoresis is appropriate. If Shaoyin syndrome presents with fever and a deep pulse, Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asarum Decoction) should be used for diaphoresis.
Interior syndromes are characterized by absence of aversion to cold, but presence of aversion to heat, tidal fever (Cha Re), delirium (Zhanyu), abdominal fullness and distension, hard dry stools, and a deep, slippery pulse. Among these, aversion to heat indicates an interior syndrome; it signifies excess at the interior level and belongs to the Yangming channel, for which purgation (downward-draining method) is appropriate. However, if the pulse is floating, purgation is contraindicated. If the pulse is deficient and thready, purgation is contraindicated. If there is vomiting, purgation is contraindicated. If there is no passage of flatus (Zhuan Shi Qi), purgation is contraindicated. If the urine is clear and copious, purgation is contraindicated. Generally, Three Yin diseases are suitable for warming methods rather than purgation; however, if there are accumulation syndromes (Ji Zheng), purgation is indicated. For example, in Taiyin syndrome with abdominal fullness and intermittent pain, or in Shaoyin syndrome with dry mouth and throat, or with abdominal fullness and constipation, or with diarrhea of clear water and pain in the epigastrium, these constitute accumulation syndromes requiring purgation.
If a patient's pulse is floating and large, it indicates an exterior syndrome that requires diaphoresis. If the patient has fever, irritability, thirst, and urinary difficulty (Zhi [likely typo for Bu Li], interpreted as difficulty in urination), yet purgation is required, this represents simultaneous exterior and interior syndromes, treated primarily with Wuling San (Five-Ingredient Poria Powder).
In Shang Han (cold damage) disease, if there has been no bowel movement for six or seven days, accompanied by headache and fever, it indicates an interior syndrome requiring purgation. However, if the urine is clear, it indicates the pathogen is not in the interior but remains in the exterior, requiring diaphoresis. This represents simultaneous exterior and interior symptoms where purgation is premature; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
If a patient has fullness in the epigastrium, loss of appetite, and hard stools, it indicates an interior syndrome requiring purgation. However, if the patient has sweating only on the head, slight aversion to cold, and cold hands and feet, diaphoresis is required. This represents simultaneous exterior and interior symptoms, which Zhang Zhongjing refers to as Half-Exterior Half-Interior syndrome, treated primarily with Xiaochaihu Tang (Minor Bupleurum Decoction).