言，故曰虚家亦然。应下之者，是脉滑而厥，内热闭郁，故曰厥深热亦深。若发汗，只能引火之升，不能逐
热外散，故令口伤。所谓下之，是下其热，非下其实。泄利下重者，四逆散；欲饮水升者数，白虎汤。此厥阴
之下药，所以下无形之邪也。若以承气汤下之，利不止矣。○诊厥阴脉，以阳为主；治厥阴病，以阴为主。故当
归四逆不去芍药，白头翁汤重用芩、连，乌梅丸用川连、黄柏，复脉汤用地黄、麦冬。所以然者，肝之相火，
本少阳之生气，而少阳实出于坎宫之真阴。○六经，惟厥阴最为难治。其本阴而标热，其体风木，其用相火。
以其具合晦朔之理，阴之初尽，即阳之初出，所以一阳为纪，一阴为独，则厥阴病热，是少阳之相火使然也。
火旺则水亏，故消渴；气有余便是火，故气上撞心，
心中疼热；木盛则克土，故饥不欲食，是为风化，饥则胃中空虚，蛔闻食臭则出，故吐蛔。此厥阴之火证，
非厥阴之伤寒也。《内经》曰∶必伏其所主，而先其所因。或收，或散，或逆，或从，随所利而行之。调其
中气，使之和平，是厥阴之治法也。（柯韵伯）
按∶厥阴篇中，次第不一，有纯阳无阴之证，有纯阴无阳之证，有阴阳差多差少之证，有阳进欲愈阴进
未愈之证，复有阴居八、九，阳居一、二之证。厥而发热，热深厥深，上攻而成喉痹，下攻而便脓血，此纯
阳无阴之证也。脉微细欲绝，厥冷灸之不温，恶寒，大汗，大利，躁不得卧，与夫冷结关元，此纯阴无阳之
证也。厥三日热亦三日，厥五日热亦五日，手足厥冷，而邪热在胸，火热在胃，此阴阳差多差少之证也。
渴欲饮水，饥欲得食，脉滑而数，手足自温，此阳进欲愈之证也。默默不欲食，寸脉虽浮数尺脉自涩，呕吐
涎沫，腹胀身疼，此阴进未愈之证也。下利清谷，里寒外热，呕而脉弱，小便复利，本自寒下，复误吐下，
脉沉微厥，面反戴阳，此阴居八、九，阳居一、二之证也。大率阳脉阳证，当取用三阳经治法；阴脉阴证，当
合用少阴经治法。厥阴病，见阳为易愈，见阴为难痊。其表里杂错不分，又必先温其里，后攻其表。设见咽
喉不利，咳唾脓血，则温法不可用，仍宜先解其表矣。○再按∶厥阴经，原无下法，首条即先示戒云∶下之利
不止矣。盖厥阴多至下利，下利中复有死证。《金匮》云∶五脏气绝于内，则下利不禁。此所以致戒不可下也。
中间虽有用小承气一法，因胃有燥屎，微攻其胃，非攻其肠也。虽有厥应下之一语，乃对发汗而言，谓厥阴内
解其热，不应外发其汗耳。岂可泥应下二字，遂犯厥阴之大戒耶？自晋迄今，伤寒失传，遇阳明二、三日内当
下之证，及少阴二、三日急下之证，总不能下，至厥阴六、七日不当下之时，反行下之。在热深厥深之阳证，
下之已迟，万一侥幸，不过为焦头烂额之客。在亡血脏虚之人，下之百无一生矣。（喻嘉言）
厥阴者，阴之尽也。厥字从HT 从欠，谓阴之尽，而不足乎阳
者也。又阴之尽，将上逆而接乎阳者也。《内经》谓一阴至绝处，却作朔晦是也。故热入厥阴者，得阳邪出表，
不至内扰乎阴则愈；寒入厥阴者，得阳气来复，得以入而救阴则愈。皆以外阳接乎内阴为顺。盖厥阴一证，经
虽属阴，总欲其气通于阳也。邪既入阴之尽，势必厥逆；内攻其里，势必下利。为喉痹，为脓血，皆阳胜之过
也；为除中，为戴阳，皆阴盛之极也。世之治厥阴者，若涉大海，茫无津涯，吾为两言以蔽之∶治厥者，曰辨
其寒厥、热厥而已矣；治利者，曰辨其寒利、热利而已矣。至于为呕为哕，亦莫不有寒热之辨也。（程扶生）
恶寒
恶寒者，风寒客于营卫，非寒热之寒，又非恶风也，故不待见风而后怯寒，虽身大热，亦不欲去衣被，甚
则向火增被不能遏其寒。所以然者，由阴气上入阳中，或阳微，或风虚相搏之所致也。恶寒属表，虽里证悉具，
当先解表，乃可攻里。《经》云∶发热恶寒发于阳，无热恶寒发于阴是也。恶寒虽属表，亦有虚实之分。若汗
出恶寒，为表虚；无汗恶寒，为表实。表虚可解肌，表实可发汗。太阳病在表，故恶寒；少阳半在表半在里，
亦微恶寒；阳明在里，本不恶寒，或恶寒者，与太阳合病也。三阴惟少阴有恶寒证，太阴、厥阴皆不恶寒。
（《证治准绳》）
有太阳病，重发其汗，不发热而恶寒；又有脉微人，不应发汗，误汗之亦恶寒；更有卫气不足，表气虚，
误汗之亦恶寒。以上乃过汗亡阳而恶寒也，治宜黄 建中汤、玉屏风散。另有阴证恶寒，治宜温经，又各不同。
（《伤寒大白》）
背恶寒有阴阳二证∶少阴中寒，阴寒气盛，不耗津液，故口中和；三阳合病，阳气陷入，津液为涸，
故舌干口燥。（余南村）
恶风
卫气者，所以温分肉，充皮肤，肥腠理，司开阖者也。风中于卫，则必恶风。恶风、恶寒俱为表证，但
恶风比恶寒为轻耳。
恶寒者，虽不当风，而时自怯寒；恶风者，居密室之中、帏 之内，则无所畏。恶寒则有阴阳之分，恶风惟属
阳耳。所以三阴无恶风之证。恶风虽在表，而治法不同。无汗恶风，为伤寒，当发汗；有汗恶风，为中风，当
解肌；里证虽具，而恶风未罢，当先解其外也。又有发汗过多，与夫风湿相搏，皆有恶风之证。盖发汗过多，
遂漏不止则亡阳，卫外不固，是以恶风也。风湿相搏，骨节疼烦，湿胜自汗，皮腠不固，是以恶风也。由是观
之，恶风属乎卫者可知矣。（黄仲理）
发热
太阳之发热，自表而入里之热；阳明之发热，自里而出表之热。太阳之汗出而热，汗自汗，热自热；阳明
之汗出而热，热揣之有似汗，汗揣之有似热。（魏荔彤）
发热无汗，表邪不得外泄者，宜解表；发热有汗，里邪不得内解者，宜清里。（《伤寒大白》）
发热者，热无休止也；寒热者，寒已而热，热已而寒，相继而发也；潮热者，时热时止，如潮汛不失其时
也；烦热者，发热而烦躁也。少阴、厥阴发热，谓之反发热。惟太阴无发热。（郑重光）
厥阴病，发热不死。发热亦死者，有三证∶一躁不得卧；一厥不止；一汗出不止。（张三锡）
恶寒发热
凡伤寒在表，必发热恶寒二者兼备。若但发热而不恶寒，此传入阳经之表证，非在里也；若但恶寒而不
发热，此直入阴经之里证，非在表也。夫阳经表邪，何为恶寒发热？阴经里邪，何为纯恶寒而不发热？缘阳经
邪初伤表，元气未虚，气为寒郁而不得舒，积而成热，故恶寒兼发热也。阴经邪中直入，元气已虚而不能作热，
故纯恶寒也。窃尝譬之，阳证犹炭之焰热，再以冷水沃之，则烟气冲起，阳证身热之象犹是也；阴证犹炭之未
热，本无热焰，虽以冷水沃之，亦无烟气冲起，阴证身冷之象犹是也。（余傅山）
发热恶寒似伤寒者，有五∶脉浮紧，发热恶寒者，是伤寒也；脉浮数，发热恶寒，或有病处者，是痈疖也；
脉浮按之反涩，发热恶寒呕吐者，是伤食也；脉浮滑，发热恶寒咳嗽者，是风痰也；脉浮弦，发热恶寒，或恶
饮食者，是作疟也。（方易庐）
头痛
问曰∶头痛何以是表证？答曰∶三阳经脉上至于头，惟太阳经脉最长，其痛居多，故一见头痛，即是表证
矣。又问曰∶三阴经无头痛，厥阴经何有头痛也？答曰∶三阴经脉至颈而还，惟厥阴与督脉会于巅顶，故有头
痛。然厥阴头痛，必呕吐涎沫，内无热证，属直中也，当温之。伤寒传至厥阴，头痛脉浮，为欲愈。（陈养晦）
伤寒以头痛分三阳，阳明之头痛在额，然阳明主里，头痛非其本证。《内经》曰∶伤寒一日，巨阳受之，
以其脉连风府，故头项痛；七日太阳病衰，头痛少愈。二日阳明受之，其脉侠鼻络于目，故身热目痛，鼻干不
得眠。是《内经》以头痛属太阳，不属阳明矣。仲景有阳明头痛二条∶一曰阳明病，反无汗而小便利，二、三
日呕而咳，手足厥者，必苦头痛；若不呕不咳，手足不厥者，头不痛。此头痛在二、三日，而不在得病之一日，
且因于呕咳，而不因于初感也。一曰伤寒，不大便六、七日，头痛身热者，与承气汤。此头痛反在太阳病衰时，
而因于不大便，即《内经》所谓 胀而头痛也。则阳明头痛，又与太阳迥别矣。（柯韵伯）
项强
发热恶风，项强者，属太阳。《论》曰∶太阳病，项背强KT KT ，反汗出恶风者，桂枝加葛根汤主之。又
曰∶太阳病，项背强KT KT ，无汗而恶风者，葛根汤主之。此皆发散之剂，而轻重有不同者。盖汗出恶风为表虚，
表虚者，可解肌；无汗恶风为表实，表实者，可发汗。是以治法不同也。（《证治准绳》）
身痛
身痛，六经俱有之证，有表，有里，有寒，有热，有风，有湿。如太阳伤寒，营血不和身痛者，宜发汗；
若汗后脉沉迟，身痛者，宜温之；中 身痛者，白虎汤解之；里寒外热身痛者，当先救里，而后攻表。寒在三
阴，则脉沉身痛；风在三阳，则肢节烦疼。太阳身痛，但拘急，中湿身痛，不可转侧；阴毒身痛，体如被杖。
以此为别。（《证治准绳》）
身重
身重，有风温、有风湿、有风寒、有火逆、有三阳合病、有易病，虽所得不一，然悉属三阳，非若身
疼兼有三阴里寒之证。（黄仲理）
面赤
伤寒面赤有数种∶如太阳病，面色缘缘正赤者，此阳气怫郁在表，汗出不彻故也，当发其汗。阳明病，合
面赤色者，不可攻之，谓表未解不可攻里也，宜解其肌。阳明内实，恶热不恶寒，或蒸蒸发热，或日晡潮热，
谵语，便秘，脉沉数有力而面赤者，此属内热，宜下之。如表里俱热，口燥，舌干饮水，脉数面赤，里未实者，
未可下，宜人参白虎汤清之。少阳病，邪在半表半里，脉弦数而面赤者，宜小柴胡汤和之。少阴病，下利清谷，
里寒外热，脉沉细而面赤者，宜四逆汤温之。此阴寒内盛，逼其浮火上行于面，非真热也，误投寒药即死。（《全生集》）
喘
未发汗，因风寒而喘者，是麻黄证；下后微喘者，是桂枝加浓朴杏仁证；喘而汗出者，是葛根黄连黄芩证；
汗后津液不足，饮水多而喘者，是五苓证。（柯韵伯）
无汗
伤寒无汗者九，不得汗者四，陶氏惟言寒邪一条，失之太简。《论》云∶太阳伤寒，无汗，发热恶寒，身
痛，脉浮紧，用麻黄汤；太阳中风，脉浮紧，无汗，烦躁，用大青龙汤；阳明病，头
痛，鼻干，脉浮，无汗而喘，用麻黄汤。此皆寒邪在表之无汗，当发表者也。又云∶阳明病无汗，身必发黄，
用茵陈栀豉汤；阳明病无汗，渴欲饮水无表证者，用白虎汤。此皆热邪在里之无汗，当清里者也。又云∶结胸
证，但头汗出，用大陷胸汤；但头汗出，身发黄者，用茵陈蒿汤；心中懊 ，但头汗出，用栀子豉汤。此皆水
饮内结之无汗也。又云∶脉浮而迟，迟为无阳，不能作汗，身必痒者，此阳虚表邪不能作汗外解，治用扶元发
汗者也。以上皆伤寒无汗之证也。他如呕恶胸闷，无汗脉滑，此痰结中焦，用二陈、导痰汤者；又有饱闷嗳气，
发热无汗，右关滑大，此食滞中焦，胃阳不布，用平胃、保和散者；又有发热恶寒，无汗脉不出，此表邪内伏，
用升阳散火汤者；又有发热无汗，寒凉抑遏，用温中升散者。总之，无汗之证，治用发散者居多。凡伤寒表证，
必须汗解，不论日数，须善为发汗。要知麻黄、桂枝，但发冬月之寒邪无汗，不可用于三时热令；羌活、干葛、
柴胡，能发在表无汗，不能发在里火闭无汗；滑石、石膏，能发在里火闭无汗，不能发在表无汗；淡豉、白蔻，
能散中焦抑遏无汗，不能发皮毛闭郁无汗；枳壳、木通，能发大小便不通无汗，不能发表邪无汗；桑皮、地骨、
桔梗，能发肺气壅遏无汗，不能发他经闭郁无汗。仲景发表加杏仁，妙在开肺之皮毛，亦发汗之良法也。（《伤寒大白》）
自汗
伤风，则恶风自汗；伤湿，则身重自汗；中暑，则脉虚自汗；中 ，则烦渴自汗；湿温，则妄言自汗；风
温，则鼾睡自汗；霍乱，则吐利自汗；柔痉，则搐搦自汗；阳明，则恶热潮热自汗；阴虚，则身倦自汗；亡阳，
则遂漏不止自汗。凡发热下利，汗不止者死；汗出如油，喘不休者死；汗冷肢厥，脉脱者死。（《全生集》）
战汗
战与栗异，战由乎外，栗由乎内。凡伤寒欲解，将汗之时，
若正气实，邪不能与之争，则但汗出而不作战。所谓不战，应知体不虚也。若其人本虚，邪与正争，微则为振，
甚则为战，正胜邪则战汗而解。故凡邪正之争于外者，则为战，战其愈者也；邪正之争于内者，则为栗，栗其
甚者也。《论》曰∶阴中于邪，必内栗也。夫战为正气将复，栗则邪气肆强，故伤寒六、七日，有但栗不战竟
成逆候者，此以正不胜邪而反为邪所胜，使非温补回阳，他焉能御？（张景岳）
战而汗解者，太阳也；不战有汗而解者，阳明也；不战无汗而解者，少阳也。（《此事难知》）
筋惕肉
（程杏轩按语）：所以说，体质虚弱的人也是如此。应当使用下法的，是脉象滑利而四肢厥冷，这是内热闭郁所致，所以说“厥深热亦深”。如果误用发汗法，只能引动火气上炎，不能驱散热邪外出，所以会导致口腔损伤。所谓“下之”，是泻其内热，而非攻下实邪。出现泄泻且肛门重坠感的，用四逆散；口渴想喝水且饮水后不久即感饥饿的，用白虎汤。这是治疗厥阴病的热证方法，目的是清除无形的邪热。如果用承气汤来攻下，就会导致腹泻不止。○诊察厥阴脉，以阳气为主；治疗厥阴病，以阴液为主。所以当归四逆汤不去掉芍药，白头翁汤重用黄芩、黄连，乌梅丸使用川连、黄柏，复脉汤使用地黄、麦冬。之所以这样，是因为肝中的相火，原本源于少阳的生气，而少阳实际上出于坎宫的真阴。○六经之中，唯独厥阴最难治疗。它的本气为阴而标气为热，其体为风木，其用为相火。因为它符合晦朔交替的道理，阴气将尽时，阳气初生，所以以一阳为纪，一阴为独盛，那么厥阴病的发热，就是少阳相火的作用。火旺则水亏，所以出现消渴；气有余便是火，所以气上冲撞心脏，心中疼痛灼热；木气过盛会克制土气，所以感到饥饿却不想进食，这属于风化。饥饿时胃中空虚，蛔虫闻到食物气味就会出来，所以呕吐蛔虫。这是厥阴的火证，而不是厥阴的伤寒证。《内经》说：“必须制服其主要病邪，并先探究其病因。或收敛，或发散，或逆治，或顺治，根据有利的方式进行治疗。调理中气，使其平和，这就是厥阴的治疗方法。”（柯韵伯）
按：厥阴篇中，病情次第不一，有纯阳无阴的证候，有纯阴无阳的证候，有阴阳偏多偏少的证候，有阳气进则欲愈、阴气进则未愈的证候，还有阴气占八、九分，阳气仅占一、二分的证候。四肢厥冷而发热，热越深则厥越甚，向上攻冲导致喉痹，向下攻冲导致便脓血，这是纯阳无阴的证候。脉象微细欲绝，四肢冰冷即使艾灸也不回暖，恶寒，大汗，严重腹泻，烦躁不得卧，以及冷结关元穴，这是纯阴无阳的证候。厥冷三天发热也三天，厥冷五天发热也五天，手足厥冷，但邪热在胸，火热在胃，这是阴阳偏多偏少的证候。口渴想喝水，饥饿想吃东西，脉象滑数，手足自然温暖，这是阳气进则欲愈的证候。沉默不想吃东西，寸脉虽浮数但尺脉自涩，呕吐涎沫，腹胀身疼，这是阴气进则未愈的证候。下利清谷，里寒外热，呕吐而脉弱，小便通利，本来就有寒性下利，又误用吐下法，脉沉微厥，面部反而泛红如戴阳，这是阴气占八、九分，阳气仅占一、二分的证候。大抵阳脉阳证，应当采用三阳经的治法；阴脉阴证，应当结合少阴经的治法。厥阴病，见到阳证容易痊愈，见到阴证难治。如果表里杂错不分，又必须先温补其里，然后攻解其表。假如出现咽喉不利，咳唾脓血，则温法不可用，仍应先解其表。○再按：厥阴经原本没有下法，首条就预先告诫说：“误下会导致腹泻不止。”大概厥阴病多导致下利，下利中又有死证。《金匮要略》说：“五脏之气在内衰竭，则下利不禁。”这就是告诫不可使用下法的原因。中间虽然有用小承气汤的方法，是因为胃中有燥屎，轻微攻伐胃气，并非攻伐肠道。虽然有“厥应下之”的说法，那是针对发汗而言，意思是厥阴病应在内部解除热邪，不应向外发汗。怎么能拘泥于“应下”二字，从而犯下厥阴的大忌呢？自从晋代至今，伤寒学失传，遇到阳明病二、三日应当下法的证候，以及少阴病二、三日急下法的证候，都不能及时使用下法，到了厥阴病六、七日不当下法的时候，反而行下法。对于热深厥深的阳证，下法已经太迟，万一侥幸成功，也不过是成为焦头烂额的过客。对于亡血脏虚之人，使用下法百无一活。（喻嘉言）
厥阴，是阴气的尽头。“厥”字从“HT”从“欠”，意思是阴气将尽，阳气不足。又是阴气将尽，将要上逆来接应阳气。《内经》所说的一阴至绝处，却作朔晦变化，就是这个意思。所以热邪侵入厥阴，得到阳气帮助出表，不向内扰乱阴气就能痊愈；寒邪侵入厥阴，得到阳气来复，得以入内救助阴气就能痊愈。都是以外部阳气接应内部阴气为顺。大概厥阴这一证候，经络虽属阴，总希望其气能通达于阳。邪气既然进入阴之尽，势必导致厥逆；向内攻伐其里，势必导致下利。导致喉痹、脓血的，都是阳胜的过错；导致除中、戴阳的，都是阴盛至极的表现。世间治疗厥阴病的人，就像涉海一样，茫茫无边无际，我用两句话概括它：治疗厥逆，只要辨别它是寒厥还是热厥罢了；治疗下利，只要辨别它是寒利还是热利罢了。至于呕吐、呃逆，也没有不是可以辨别寒热的。（程扶生）
恶寒：恶寒，是风寒客居于营卫之间，不是寒热之寒，也不是恶风，所以不一定要见风才害怕寒冷，即使身体很热，也不想脱去衣被，甚至靠近火源增加被子也不能遏制寒冷。之所以这样，是因为阴气上入阳中，或者是阳气微弱，或者是风邪与虚邪相搏所致。恶寒属于表证，即使具备所有里证，也应当先解表，然后才可攻里。《经》说：“发热恶寒发于阳，无热恶寒发于阴”就是这样。恶寒虽然属于表证，也有虚实之分。如果出汗而恶寒，是表虚；无汗而恶寒，是表实。表虚可以用解肌法，表实可以用发汗法。太阳病在表，所以恶寒；少阳病半在表半在里，也轻微恶寒；阳明病在里，本来不恶寒，如果有恶寒，是与太阳合病。三阴经中只有少阴有恶寒证，太阴、厥阴都不恶寒。（《证治准绳》）
有太阳病，再次大发其汗，不发热而恶寒；又有脉微弱的人，本不应发汗，误发其汗也恶寒；更有卫气不足，表气虚弱，误发其汗也恶寒。以上都是因为过汗亡阳而导致恶寒，治疗宜用黄芪建中汤、玉屏风散。另有阴证恶寒，治疗宜温经，又各不相同。（《伤寒大白》）
背恶寒有阴阳两种证候：少阴中寒，阴寒气盛，不耗伤津液，所以口中调和；三阳合病，阳气陷入，津液枯竭，所以舌干口燥。（余南村）
恶风：卫气，是用来温养肌肉，充实皮肤，肥厚腠理，主管开阖的。风邪中于卫分，则必然恶风。恶风、恶寒都属于表证，但恶风比恶风轻。恶寒者，即使不在风中，也时常自觉怕冷；恶风者，居住在密室之中、帷帐之内，则无所畏惧。恶寒则有阴阳之分，恶风只属于阳证。所以三阴经没有恶风的证候。恶风虽然在表，但治法不同。无汗恶风，是伤寒，应当发汗；有汗恶风，是中风，应当解肌；里证虽然具备，但恶风未罢，应当先解其外。又有发汗过多，以及风湿相搏，都有恶风的证候。大概发汗过多，导致汗漏不止则亡阳，卫外不固，所以恶风。风湿相搏，骨节疼痛烦扰，湿胜导致自汗，皮腠不固，所以恶风。由此看来，恶风属于卫分可知了。（黄仲理）
发热：太阳的发热，是从表入里的热；阳明的发热，是从里出表的热。太阳的汗出而热，汗是自汗，热是热；阳明的汗出而热，热摸起来像汗，汗摸起来像热。（魏荔彤）
发热无汗，表邪不得外泄的，宜解表；发热有汗，里邪不得内解的，宜清里。（《伤寒大白》）
发热，是指热无休止；寒热，是指寒止而热，热止而寒，相继发作；潮热，是指时热时止，如潮汛不失时机；烦热，是指发热而烦躁。少阴、厥阴发热，称为反发热。只有太阴没有发热。（郑重光）
厥阴病，发热不死。发热也会死的，有三种证候：一是烦躁不得卧；二是厥冷不止；三是汗出不止。（张三锡）
恶寒发热：凡是伤寒在表，必定发热恶寒二者兼备。如果只发热而不恶寒，这是传入阳经的表证，不是在里；如果只恶寒而不发热，这是直入阴经的里证，不是在表。阳经表邪，为何会恶寒发热？阴经里邪，为何会纯恶寒而不发热？因为阳经邪气初伤表，元气未虚，气被寒邪郁遏而不能舒展，积而成热，所以恶寒兼发热。阴经邪气直中，元气已虚而不能产生热，所以纯恶寒。我曾比喻，阳证就像炭火的火焰热，再用冷水浇它，则烟气冲起，阳证身热的景象依然如此；阴证就像炭火未热，本来没有热焰，即使以冷水浇它，也无烟气冲起，阴证身冷的景象依然如此。（余傅山）
发热恶寒类似伤寒的，有五种：脉浮紧，发热恶寒的，是伤寒；脉浮数，发热恶寒，或有局部病变的，是痈疖；脉浮按之反涩，发热恶寒呕吐的，是伤食；脉浮滑，发热恶寒咳嗽的，是风痰；脉浮弦，发热恶寒，或厌恶饮食的，是疟疾发作。（方易庐）
头痛：问：头痛为什么是表证？答：三阳经脉上行至头，只有太阳经脉最长，其痛居多，所以一见头痛，即是表证了。又问：三阴经无头痛，厥阴经为何有头痛？答：三阴经脉至颈部而还，只有厥阴与督脉会于巅顶，所以有头痛。然而厥阴头痛，必定呕吐涎沫，内无热证，属于直中，应当温治。伤寒传至厥阴，头痛脉浮，是欲愈之兆。（陈养晦）
伤寒以头痛区分三阳，阳明的头痛在额部，然而阳明主里，头痛非其本证。《内经》说：“伤寒一日，巨阳受之，以其脉连风府，故头项痛；七日太阳病衰，头痛少愈。”二日阳明受之，其脉夹鼻络于目，故身热目痛，鼻干不得眠。可见《内经》以头痛属太阳，不属阳明。仲景有阳明头痛两条：一条说阳明病，反无汗而小便利，二、三日呕而咳，手足厥者，必苦头痛；若不呕不咳，手足不厥者，头不痛。此头痛在二、三日，而不在得病之一日，且因于呕咳，而不因于初感。另一条说伤寒，不大便六、七日，头痛身热者，与承气汤。此头痛反在太阳病衰时，而因于不大便，即《内经》所谓腹胀而头痛。则阳明头痛，又与太阳迥然不同了。（柯韵伯）
项强：发热恶风，项强者，属太阳。《论》说：太阳病，项背强几几，反汗出恶风者，桂枝加葛根汤主之。又说：太阳病，项背强几几，无汗而恶风者，葛根汤主之。这都是发散之剂，而轻重有不同。大概汗出恶风为表虚，表虚者，可解肌；无汗恶风为表实，表实者，可发汗。所以治法不同。（《证治准绳》）
身痛：身痛，六经都有的证候，有表，有里，有寒，有热，有风，有湿。如太阳伤寒，营血不和身痛者，宜发汗；若汗后脉沉迟，身痛者，宜温之；中暑身痛者，白虎汤解之；里寒外热身痛者，当先救里，而后攻表。寒在三阴，则脉沉身痛；风在三阳，则肢节烦疼。太阳身痛，但拘急，中湿身痛，不可转侧；阴毒身痛，体如被杖。以此区别。（《证治准绳》）
身重：身重，有风温、有风湿、有风寒、有火逆、有三阳合病、有易病，虽然所得不一，但都属三阳，不像身疼兼有三阴里寒的证候。（黄仲理）
面赤：伤寒面赤有多种：如太阳病，面色缘缘正赤者，这是阳气怫郁在表，汗出不彻所致，应当发其汗。阳明病，合面赤色者，不可攻之，谓表未解不可攻里也，宜解其肌。阳明内实，恶热不恶寒，或蒸蒸发热，或日晡潮热，谵语，便秘，脉沉数有力而面赤者，此属内热，宜下之。如表里俱热，口燥，舌干饮水，脉数面赤，里未实者，未可下，宜人参白虎汤清之。少阳病，邪在半表半里，脉弦数而面赤者，宜小柴胡汤和之。少阴病，下利清谷，里寒外热，脉沉细而面赤者，宜四逆汤温之。此阴寒内盛，逼其浮火上行于面，非真热也，误投寒药即死。（《全生集》）
喘：未发汗，因风寒而喘者，是麻黄证；下后微喘者，是桂枝加厚朴杏子证；喘而汗出者，是葛根黄连黄芩证；汗后津液不足，饮水多而喘者，是五苓证。（柯韵伯）
无汗：伤寒无汗的情况有九种，不得汗的情况有四种种，陶氏只说寒邪一条，失之太简。《论》说：太阳伤寒，无汗，发热恶寒，身痛，脉浮紧，用麻黄汤；太阳中风，脉浮紧，无汗，烦躁，用大青龙汤；阳明病，头痛，鼻干，脉浮，无汗而喘，用麻黄汤。这些都是寒邪在表的无汗，应当发表。又说：阳明病无汗，身必发黄，用茵陈栀豉汤；阳明病无汗，渴欲饮水无表证者，用白虎汤。这些都是热邪在里的无汗，应当清里。又说：结胸证，但头汗出，用大陷胸汤；但头汗出，身发黄者，用茵陈蒿汤；心中懊憹，但头汗出，用栀子豉汤。这些都是水饮内结的无汗。又说：脉浮而迟，迟为无阳，不能作汗，身必痒者，此阳虚表邪不能作汗外解，治用扶元发汗。以上都是伤寒无汗的证候。其他如呕恶胸闷，无汗脉滑，这是痰结中焦，用二陈、导痰汤；又有饱闷嗳气，发热无汗，右关滑大，这是食滞中焦，胃阳不布，用平胃、保和散；又有发热恶寒，无汗脉不出，这是表邪内伏，用升阳散火汤；又有发热无汗，寒凉抑遏，用温中升散。总之，无汗之证，治用发散者居多。凡伤寒表证，必须汗解，不论日数，须善为发汗。要知道麻黄、桂枝，只发冬月之寒邪无汗，不可用于三时热令；羌活、干葛、柴胡，能发在表无汗，不能发在里火闭无汗；滑石、石膏，能发在里火闭无汗，不能发在表无汗；淡豉、白蔻，能散中焦抑遏无汗，不能发皮毛闭郁无汗；枳壳、木通，能发大小便不通无汗，不能发表邪无汗；桑皮、地骨、桔梗，能发肺气壅遏无汗，不能发他经闭郁无汗。仲景发表加杏仁，妙在开肺之皮毛，也是发汗的良法。（《伤寒大白》）
自汗：伤风，则恶风自汗；伤湿，则身重自汗；中暑，则脉虚自汗；中暑暍，则烦渴自汗；湿温，则妄言自汗；风温，则鼾睡自汗；霍乱，则吐利自汗；柔痉，则搐搦自汗；阳明，则恶热潮热自汗；阴虚，则身倦自汗；亡阳，则遂漏不止自汗。凡发热下利，汗不止者死；汗出如油，喘不休者死；汗冷肢厥，脉脱者死。（《全生集》）
战汗：战与栗不同，战由乎外，栗由乎内。凡伤寒欲解，将汗之时，若正气实，邪不能与之争，则但汗出而不作战。所谓不战，应知体不虚也。若其人本虚，邪与正争，微则为振，甚则为战，正胜邪则战汗而解。故凡邪正之争于外者，则为战，战其愈者也；邪正之争于内者，则为栗，栗其甚者也。《论》说：阴中于邪，必内栗也。夫战为正气将复，栗则邪气肆强，故伤寒六、七日，有但栗不战竟成逆候者，此以正不胜邪而反为邪所胜，使非温补回阳，他焉能御？（张景岳）
(Cheng Xingxuan's commentary): Therefore, it is also the case for those with deficient constitutions. When purgation should be used, it refers to a slippery pulse accompanied by cold extremities (Jue), indicating internal heat closure and stagnation; thus it is said, "The deeper the Jue, the deeper the heat." If sweating methods are mistakenly employed, they can only draw fire upward but cannot disperse heat outward, thereby causing oral injuries. The term "purging" here refers to draining internal heat, not attacking excess pathogens. For cases of diarrhea with a sensation of heaviness in the anus, Sini San (Four Counterflow Powder) is indicated; for cases of thirst with frequent desire to drink water, Baihu Tang (White Tiger Decoction) is indicated. These are the purgative methods for Jueyin disease, aimed at clearing formless pathogenic factors. If Chengqi Tang (Stomach-Regulating Decoction) were used for purgation, diarrhea would become uncontrollable. ○ In diagnosing Jueyin pulses, Yang Qi is prioritized; in treating Jueyin diseases, Yin fluids are prioritized. Hence, Danggui Sini Tang (Cinnamon Twig and Angelica Decoction) does not remove Shaoyao (Paeonia Root); Baitouweng Tang (Pulsatilla Decoction) heavily uses Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome); Wumei Wan (Mume Pill) uses Chuanlian (Coptis Rhizome) and Huangbai (Phellodendron Bark); Fumai Tang (Restore the Pulse Decoction) uses Dihuang (Rehmannia Root) and Maidong (Ophiopogon Tuber). The reason is that the Ministerial Fire (Xianghuo) in the Liver originates from the vital Qi of Shaoyang, which itself stems from the True Yin of the Kan Palace. ○ Among the Six Channels, Jueyin is the most difficult to treat. Its root is Yin and its branch is Heat; its substance is Wind-Wood, and its function is Ministerial Fire. Because it follows the principle of the waxing and waning moon, when Yin is exhausted, Yang begins to emerge; thus, one Yang serves as the record, and one Yin stands alone. Therefore, the fever in Jueyin disease is caused by the Ministerial Fire of Shaoyang. When Fire is excessive, Water is depleted, leading to Xiao Ke (Wasting and Thirsting); when Qi is excessive, it becomes Fire, leading to Qi rushing up to strike the Heart and causing pain and burning sensation in the chest; when Wood is excessive, it overacts on Earth, leading to hunger without desire to eat. This belongs to Wind transformation. When hungry, the Stomach is empty, and roundworms (Hui) emerge upon smelling food odor, leading to vomiting of worms. This is a Fire syndrome of Jueyin, not a Cold Damage syndrome of Jueyin. The *Neijing* states: "One must subdue what dominates and address the cause first. Whether by astringing, dispersing, counteracting, or following, act according to what is beneficial. Regulate the Middle Qi to achieve harmony." This is the treatment method for Jueyin. (Ke Yunbo)
Note: In the Jueyin chapter, the sequence of conditions varies. There are syndromes of pure Yang without Yin, pure Yin without Yang, syndromes where Yin and Yang are imbalanced in degree, syndromes where Yang advancement leads to recovery while Yin advancement leads to non-recovery, and syndromes where Yin occupies eight or nine parts and Yang only one or two. Cold extremities with fever, where deeper heat causes deeper cold extremities, attacking upwards causing throat obstruction (Hou Bi) or downwards causing pus and blood in stool, represents a syndrome of pure Yang without Yin. A faint, fine, almost imperceptible pulse, cold extremities unwarmed by moxibustion, aversion to cold, profuse sweating, severe diarrhea, restlessness unable to lie down, and cold accumulation at Guanyuan (CV4) represent a syndrome of pure Yin without Yang. Three days of cold extremities followed by three days of fever, or five days each, with cold extremities but pathogenic heat in the chest and stomach, represents a syndrome of Yin and Yang imbalance in degree. Thirst with desire to drink, hunger with desire to eat, a slippery and rapid pulse, and naturally warm extremities represent a syndrome where Yang advancement indicates impending recovery. Silence, lack of desire to eat, floating and rapid Cun pulse but stagnant Chi pulse, vomiting of saliva and foam, abdominal distension, and body pain represent a syndrome where Yin advancement indicates non-recovery. Diarrhea with undigested food, interior cold with exterior heat, vomiting with a weak pulse, free urination, pre-existing cold-type diarrhea exacerbated by mistaken emesis and purgation, deep and faint pulse with cold extremities, and facial flushing resembling Dai Yang (floating Yang) represent a syndrome where Yin occupies eight or nine parts and Yang only one or two. Generally, Yang pulses and Yang syndromes should adopt treatment methods of the Three Yang channels; Yin pulses and Yin syndromes should combine treatment methods of the Shaoyin channel. In Jueyin disease, seeing Yang signs makes recovery easier, while seeing Yin signs makes it difficult. If exterior and interior are mixed and indistinct, one must first warm the interior before attacking the exterior. If symptoms include throat discomfort and coughing up pus and blood, warming methods are contraindicated, and exterior resolution should still be prioritized. ○ Further note: The Jueyin channel originally has no purgative method. The first clause warns: "Purgation will lead to uncontrollable diarrhea." Jueyin disease often leads to diarrhea, which may contain fatal conditions. The *Jinkui Yaolue* states: "When the Qi of the Five Zang organs fails internally, diarrhea becomes uncontrollable." This is why purgation is warned against. Although Xiaochengqi Tang (Minor Stomach-Regulating Decoction) is used in some instances, it is because there are dry feces in the Stomach, requiring mild attack on the Stomach, not the Intestines. The phrase "Jue should be purged" is contrasted with sweating; it means resolving heat internally in Jueyin, not inducing sweating externally. One should not rigidly adhere to "should be purged" and violate the major taboo of Jueyin. Since the Jin dynasty, Cold Damage knowledge has been lost. Cases requiring purgation in Yangming disease (2-3 days) and urgent purgation in Shaoyin disease (2-3 days) are often missed, while purgation is incorrectly applied in Jueyin disease (6-7 days) where it is contraindicated. For Yang syndromes with deep heat and deep cold extremities, purgation is already too late; even if successful by chance, the patient suffers severely. For patients with blood loss and organ deficiency, purgation is almost always fatal. (Yu Jiayan)
Jueyin represents the end of Yin. The character "Jue" consists of components implying the exhaustion of Yin and insufficiency of Yang. It also implies that as Yin exhausts, it rises to connect with Yang. As stated in the *Neijing*, when Yi Yin reaches its extreme, it transforms like the new moon after the dark moon. Thus, when heat enters Jueyin, if it receives Yang assistance to exit the exterior and does not disturb Yin internally, it heals; when cold enters Jueyin, if Yang Qi returns to assist and rescue Yin internally, it heals. Both scenarios rely on external Yang connecting with internal Yin as favorable. Although the Jueyin channel belongs to Yin, its Qi desires connection with Yang. Once pathogens enter the extreme of Yin, cold extremities (Jue Ni) inevitably occur; attacking the interior leads to diarrhea. Throat obstruction and pus/blood result from Yang excess; Chu Zhong (Eliminating Middle) and Dai Yang (Floating Yang) result from extreme Yin excess. Those treating Jueyin today feel like crossing a vast sea without shore. I summarize it in two words: Treating Jue involves distinguishing between Cold Jue and Heat Jue; treating diarrhea involves distinguishing between Cold Diarrhea and Heat Diarrhea. Vomiting and hiccups also require differentiation between Cold and Heat. (Cheng Fusheng)
Aversion to Cold (E Han): Aversion to cold refers to wind-cold invading Ying and Wei, distinct from general coldness or aversion to wind. It occurs even without exposure to wind; even with high fever, the patient does not wish to remove clothing/bedding, and may need fire and extra blankets to alleviate the chill. This happens because Yin Qi ascends into Yang, or due to deficient Yang or wind-deficiency interaction. Aversion to cold belongs to Exterior syndromes. Even if Interior symptoms are present, Exterior must be resolved first before attacking the Interior. The Classics state: "Fever with aversion to cold originates from Yang; absence of fever with aversion to cold originates from Yin." Although belonging to Exterior, aversion to cold has Deficiency and Excess types. Sweating with aversion to cold indicates Exterior Deficiency; no sweating with aversion to cold indicates Exterior Excess. Exterior Deficiency is treated with muscle-relieving methods; Exterior Excess with sweating methods. Taiyang disease at the Exterior causes aversion to cold; Shaoyang, being half-exterior/half-interior, causes slight aversion to cold; Yangming, being Interior, normally has no aversion to cold, unless combined with Taiyang. Among the Three Yin channels, only Shaoyin presents with aversion to cold; Taidao and Jueyin do not. (*Zhengzhi Zhunsheng*)
Taiyang disease treated with excessive sweating may result in aversion to cold without fever. Patients with faint pulses should not sweat; mistaken sweating causes aversion to cold. Those with insufficient Wei Qi and deficient Exterior Qi also develop aversion to cold after mistaken sweating. These are all cases of Yang collapse due to excessive sweating, treated with Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) and Yupingfeng San (Jade Windscreen Powder). Other cases of Yin syndrome aversion to cold require warming the channels, differing in treatment. (*Shanghan Dabai*)
Back aversion to cold has Yin and Yang types: Shaoyin cold invasion with excessive Yin cold Qi does not consume fluids, so the mouth feels normal; Three-Yang combined disease with sunken Yang Qi and depleted fluids causes dry tongue and mouth. (Yu Nancun)
Aversion to Wind (E Feng): Wei Qi warms muscles, fills skin, thickens pores, and controls opening/closing. Wind invading Wei causes aversion to wind. Both aversion to wind and cold are Exterior syndromes, but aversion to wind is milder. Aversion to cold occurs spontaneously even without wind; aversion to wind only occurs when exposed to drafts, even in enclosed rooms. Aversion to cold has Yin/Yang distinction; aversion to wind belongs only to Yang. Thus, Three Yin channels have no aversion to wind. Although both are Exterior, treatments differ: No sweating with aversion to wind indicates Cold Damage, requiring sweating; sweating with aversion to wind indicates Wind Strike, requiring muscle-relieving. If Interior symptoms exist but aversion to wind persists, resolve the Exterior first. Excessive sweating or Wind-Damp interaction also cause aversion to wind. Excessive sweating leads to leakage and Yang collapse, weakening defense; Wind-Damp causes joint pain, dampness-induced sweating, and porous pores. Thus, aversion to wind belongs to Wei. (Huang Zhongli)
Fever: Taiyang fever is heat entering from Exterior to Interior; Yangming fever is heat emerging from Interior to Exterior. In Taiyang, sweating and fever are independent; in Yangming, heat feels like sweat, and sweat feels like heat. (Wei Litong)
Fever with no sweating, where Exterior pathogens cannot vent, requires Exterior resolution; fever with sweating, where Interior pathogens cannot resolve, requires Interior clearing. (*Shanghan Dabai*)
Fever implies continuous heat; Chills and Fever imply alternating chills and heat; Tide-like Fever implies periodic heat; Irritable Fever implies fever with restlessness. Fever in Shaoyin and Jueyin is called "Counter-flow Fever." Only Taidao lacks fever. (Zheng Zhongguang)
In Jueyin disease, fever is not fatal. However, fever can be fatal in three cases: restlessness unable to lie down, persistent cold extremities, or unceasing sweating. (Zhang Sanxi)
Chills and Fever: Exterior Cold Damage always presents with both. Fever without chills indicates transmission to Yang channels (Exterior); chills without fever indicates direct entry into Yin channels (Interior). Yang channel pathogens cause chills and fever because initial injury leaves Yuan Qi intact, leading to stagnation and heat generation. Yin channel pathogens cause pure chills because Yuan Qi is deficient and cannot generate heat. Analogy: Yang syndrome is like hot charcoal; adding water creates steam (heat). Yin syndrome is like cool charcoal; adding water creates no steam (cold). (Yu Fushan)
Five conditions mimic Cold Damage with fever/chills: Floating-tight pulse with fever/chills is Cold Damage; floating-rapid pulse with local lesions is abscess/furuncle; floating pulse,涩 (choppy) on pressure, with vomiting is Food Retention; floating-slippery pulse with cough is Wind-Phlegm; floating-wiry pulse with dietary intolerance is Malaria onset. (Fang Yilu)
Headache: Why is headache an Exterior sign? The Three Yang channels ascend to the head; Taiyang is longest and most common, so headache usually indicates Exterior syndrome. Why does Jueyin have headache? Three Yin channels stop at the neck; only Jueyin meets Du Mai at the vertex. Jueyin headache is accompanied by saliva vomiting, no internal heat, indicating direct invasion, treated with warming. Headache with floating pulse in transmitted Jueyin indicates recovery. (Chen Yanghui)
Yangming headache is in the forehead, but Yangming governs Interior, so headache is not its primary sign. *Neijing* states Taiyang receives pathogen first, causing head/neck pain. Yangming receives it second, causing eye pain/nasal dryness. Thus, headache belongs to Taiyang, not Yangming. Zhang Zhongjing describes two Yangming headaches: 1. Dry stool, small urine, vomiting/cough, cold extremities causing headache (secondary to vomiting/cough, not initial infection). 2. Constipation for 6-7 days with headache/fever, treated with Chengqi Tang (headache due to constipation, similar to *Neijing*'s abdominal distension causing headache). Thus, Yangming headache differs from Taiyang. (Ke Yunbo)
Stiff Neck: Fever, aversion to wind, stiff neck belong to Taiyang. "Taiyang disease, stiff neck/back, with sweating and aversion to wind" is treated with Guizhi Jia Ge Gen Tang (Cinnamon Twig plus Kudzu Decoction). "No sweating and aversion to wind" is treated with Ge Gen Tang (Kudzu Decoction). Both are dispersing agents but differ in strength. Sweating/aversion to wind is Exterior Deficiency (muscle-relieving); no sweating/aversion to wind is Exterior Excess (sweating). Treatments differ accordingly. (*Zhengzhi Zhunsheng*)
Body Pain: Present in all Six Channels, varying by Exterior/Interior, Cold/Heat, Wind/Damp. Taiyang Cold Damage with disharmonious Ying/Blood requires sweating; post-sweating sinking/slow pulse with pain requires warming; Summerheat pain is cleared by Baihu Tang; Interior Cold/Exterior Heat pain requires warming Interior first. Cold in Three Yin causes sinking pulse/body pain; Wind in Three Yang causes joint pain. Taiyang pain is spasmodic; Dampness pain prevents turning; Yin Toxicity pain feels like being beaten. (*Zhengzhi Zhunsheng*)
Heaviness: Caused by Wind-Warmth, Wind-Damp, Wind-Cold, Fire Reversal, Three-Yang combination, or easy illness. All belong to Three Yang, unlike body ache with Three Yin Interior Cold. (Huang Zhongli)
Red Face: Several types: Taiyang full-face redness is Yang Qi stagnation in Exterior, needs sweating. Yangming full-face redness with unresolved Exterior cannot be purged; use muscle-relieving. Yangming Interior Excess with heat, delirium, constipation, strong pulse, and red face requires purgation. Exterior/Interior Heat with dry mouth/thirst, strong pulse, but un-solid Interior requires Ren Shen Baihu Tang (Ginseng White Tiger Decoction). Shaoyang half-exterior/half-interior with wiry-rapid pulse and red face requires Xiao Chai Hu Tang (Minor Bupleurum Decoction). Shaoyin diarrhea with undigested food, Interior Cold/Exterior Heat, faint-thin pulse, and red face requires Sini Tang (Four Counterflow Decoction) to warm; this is floating fire driven up by Yin Cold, not true Heat—cold herbs are fatal. (*Quansheng Ji*)
Wheezing/Asthma: Pre-sweating wind-cold wheezing is Mahuang Zheng; post-purgation mild wheezing is Guizhi Jia Houpo Xingren Tang; wheezing with sweating is Gegen Huanglian Huangqin Tang; post-sweating fluid deficiency with drinking/wheezing is Wuling San. (Ke Yunbo)
No Sweating: Nine types of Cold Damage no-sweating, four types of inability to sweat. Taoshi only mentions cold pathogens, which is too simple. Taiyang Cold Damage (no sweat, fever, chills, body pain, floating-tight pulse) uses Mahuang Tang. Taiyang Wind Strike (floating-tight, no sweat, irritability) uses Da Qing Long Tang. Yangming headache, nasal dryness, floating pulse, no sweat, wheezing uses Mahuang Tang. These are Exterior Cold, requiring release. Yangming no sweat with jaundice uses Yinchen Zhichi Tang. Yangming no sweat with thirst/no Exterior signs uses Baihu Tang. These are Interior Heat, requiring clearing. Jie Xiong (Chest Binding) with head-only sweat uses Da Xian Xiong Tang. Jaundice with head-only sweat uses Yinchen Hao Tang. Restlessness with head-only sweat uses Zhizi Chi Tang. These are Internal Fluid retention. Floating-slow pulse with itching indicates Yang deficiency preventing sweating, treated with supporting Yuan Qi and sweating. Other causes: Phlegm binding Middle Jiao (slippery pulse) uses Er Chen/Daotan Tang; Food stagnation (slippery-large Right Guan pulse) uses Pingwei/Baohe San; Interior-hidden Exterior pathogens use Shengyang Sanhuo Tang; Cold suppression uses warming/dispersing. Generally, dispersing is key. Exterior Cold Damage must be sweated out. Mahuang/Guizhi work for Winter Cold; Qianghuo/Gegen/Chaihu for Exterior no-sweat; Huashi/Shigao for Interior Fire block; Danshi/Bako for Middle Jiao suppression; Zhike/Mutong for Bowel/Bladder block; Sangpi/Digu/Jiegeng for Lung Qi block. Zhongjing adds Xingren to open Lung pores, aiding sweating. (*Shanghan Dabai*)
Spontaneous Sweating: Wind Strike causes aversion-to-wind spontaneous sweating; Dampness causes heaviness spontaneous sweating; Summerheat causes weak-pulse spontaneous sweating; Summerstroke causes irritability/thirst spontaneous sweating; Damp-Warmth causes delirium spontaneous sweating; Wind-Warmth causes snoring spontaneous sweating; Cholera causes vomiting/diarrhea spontaneous sweating; Soft Spasm causes convulsion spontaneous sweating; Yangming causes aversion-to-heat tide-like spontaneous sweating; Yin Deficiency causes fatigue spontaneous sweating; Yang Collapse causes leaking spontaneous sweating. Fatal signs: Fever/diarrhea with unceasing sweat; oil-like sweat with unceasing panting; cold sweat with cold extremities and absent pulse. (*Quansheng Ji*)
Shivering and Sweating: Shivering (Zhan) is external; trembling (Li) is internal. When Cold Damage resolves, if Zheng Qi is strong, sweat occurs without shivering (indicating no deficiency). If the person is deficient, Zheng and Xie struggle; mild struggle causes tremors, severe causes shivering. Victory of Zheng leads to shivering-sweating resolution. External struggle is Shivering (recovery); internal struggle is Trembling (worsening). *Lun* states: "Yin struck by pathogen causes internal trembling." Shivering indicates recovering Zheng; Trembling indicates rampant Xie. In 6-7 days, trembling without shivering leads to adverse outcomes due to Zheng failing against Xie, requiring warming/tonifying Yang. (Zhang Jingyue)
Shivering with sweating resolves Taiyang; no shivering with sweating resolves Yangming; no shivering without sweating resolves Shaoyang. (*Cishi Nan Zhi*)