热入血室为阴虚，则夜不宁而病剧。汗下过多为亡阳，阳虚则昼不安。
【和解】妇人伤寒发热，昼则明了，暮则谵语，为热入血室，以阴虚而热邪乘虚
而入，故暮谵昼了，小柴胡加牡丹皮汤。
【温】下之后复发汗，昼则烦躁不得眠，夜而安静，不呕不渴，无表里证，脉沉微，
身无大热者，干姜附子汤。为下而复汗以亡阳，故昼烦而夜静。
伤寒时证，汗后和平，身凉安静，却因饮酒复剧，发热烦闷，干呕呻吟错语，不得
卧，黄连解毒汤。
伤寒瘥后十数日，或半月二十日，终不惺惺，常昏沉如失精神，言语错谬，似鬼祟，似
风非风，或无寒热，或潮热有寒热如疟，皆缘发汗未尽，余毒在心包络所致，知母麻黄汤。
出汗不均，为汗不流、是汗出盖覆不周，则汗出不均，致腰背手足搐搦，或冷或热，牛蒡
根散。
水气，大病瘥后从腰以下有水气者，牡蛎泽泻散。
伤寒病中又感寒暑燥湿风热异气，而成坏证。或经汗吐下温针仍不解，小柴胡汤证罢
亦成坏证。况病已过
经，热留脏腑，证候多变，久而不瘥，阴阳舛乱，无复纪纲，大率以表证多者，知母麻
黄汤。若诸药不效者，用鳖甲散。若柴胡证在，则不为逆。
谓不柔和，则痛痒寒热屈伸灸刺皆不自知，皮肤不荣谓之不仁。经曰∶虚邪乘寒，则
为郁冒不仁。盖其血气虚少，不能周流于身，是为邪气所伏，故肌体顽麻不知痛痒，又因
少阴肾气微，精血少，气逆心下，阳气退，热归阴，与阴相动，令身不仁，此为尸厥。其
乘寒之厥，郁冒不仁，即此尸厥可知矣。若脉浮而洪，身汗如油，喘而不仁，水浆不入，
即体不仁，此为命绝。
【温】《直指方》用甘草干姜汤、桂枝芍药加干姜各半汤。
【灸】中极穴。（一名玉泉。）
【针】昔越人入虢，太子病尸厥，以郁冒不仁为可治，刺之而得痊。
热邪侵入血室导致阴虚，因此夜间症状加重而病情剧烈。发汗和攻下过度导致亡阳，阳气虚弱则白天心神不安。
【和解法】妇女患伤寒发热，白天神志清醒，傍晚出现胡言乱语，这是热邪侵入血室的表现。因为阴虚而热邪乘虚而入，所以傍晚谵妄、白天清醒，使用小柴胡汤加牡丹皮汤。
【温法】经过攻下之后又再次发汗，白天烦躁不能入睡，夜晚却安静，没有呕吐也没有口渴，没有表证或里证的典型表现，脉象沉微，身体没有大热，使用干姜附子汤。这是因为先攻下再发汗导致亡阳，所以白天烦躁而夜晚安静。
伤寒的时令病症，发汗后虽然平和，身体凉爽安静，但因为饮酒导致病情再次加重，出现发热烦闷、干呕、呻吟、言语错乱、无法躺卧的症状，使用黄连解毒汤。
伤寒病愈后十几天，或者半个月到二十天，始终精神不振，常常昏沉如同失魂落魄，言语错误谬误，像被鬼祟附体，又像中风而非中风，或者没有寒热症状，或者有潮热且伴有类似疟疾的寒热往来，这都是因为发汗不彻底，余毒在心包络所致，使用知母麻黄汤。出汗不均匀，是因为汗液不流通，或者是覆盖被子不周全，导致出汗不均，进而引起腰背手足抽搐，或冷或热，使用牛蒡根散。水气病，大病初愈后腰部以下有水气停留的，使用牡蛎泽泻散。
在伤寒病期间又感受了寒暑燥湿风热等异气，从而形成坏证。或者经过发汗、催吐、攻下、温针等治疗仍然不解，小柴胡汤证消失后也形成了坏证。况且病邪已经传入经络，热邪留滞在脏腑，证候变化多端，久治不愈，阴阳紊乱，失去纲纪，大体上以表证为主者，使用知母麻黄汤。如果各种药物都无效，使用鳖甲散。如果小柴胡汤证仍然存在，则不属于逆证。
所谓“不仁”，是指感觉迟钝，疼痛、瘙痒、寒冷、发热、屈伸等活动都无法感知，皮肤缺乏荣润称为不仁。经书说：虚邪侵袭寒气，会导致郁冒和不仁。大概是因为气血虚弱稀少，不能在全身周流运行，被邪气潜伏，所以肌肤顽麻不知痛痒。又因为少阴肾气微弱，精血不足，气逆于心下，阳气衰退，热归于阴，与阴相互激荡，导致身体不仁，这称为尸厥。那种因侵袭寒气导致的厥逆、郁冒不仁，也就是这种尸厥，可以由此推知。如果脉象浮而洪大，身体出汗如油，喘息且不仁，饮食水浆无法进入，即身体完全失去知觉，这称为命绝。
【温法】《直指方》使用甘草干姜汤、桂枝芍药加干姜各半汤。
【灸法】中极穴。（又名玉泉。）
Heat entering the blood chamber causes Yin deficiency, resulting in restlessness at night and exacerbation of the disease. Excessive sweating and purgation lead to Yang collapse; Yang deficiency results in daytime unrest.
[Harmonizing Method] When a woman suffers from Shanghan (Cold Damage) with fever, she is lucid during the day but experiences delirium at dusk. This indicates heat entering the blood chamber. Due to Yin deficiency, pathogenic heat takes advantage of the deficiency to enter, causing delirium at dusk and lucidity during the day. Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Mu Dan Pi Tang (Moutan Cortex) is used.
[Warming Method] After purgation followed by sweating, the patient experiences irritability and insomnia during the day but remains quiet at night. There is no vomiting or thirst, no exterior or interior syndromes are evident, the pulse is deep and faint, and there is no significant heat on the body. Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Root Decoction) is prescribed. This occurs because purgation followed by sweating leads to Yang collapse, causing daytime irritability and nighttime quietness.
In seasonal Shanghan syndromes, after sweating, the condition becomes peaceful, the body cools down, and the patient is calm. However, if drinking alcohol causes the condition to worsen again, presenting with fever, vexation, stuffiness, dry heaving, groaning, confused speech, and inability to lie down, Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) is used.
More than ten days or half to twenty days after recovery from Shanghan, if the patient never fully regains alertness, often feeling drowsy as if losing their spirit, with erroneous speech, resembling possession by spirits or wind-stroke but not quite, or having no chills/fever or having tidal fever with chills/fever like malaria, this is due to incomplete sweating leaving residual toxins in the Pericardium Collateral. Zhi Mu Ma Huang Tang (Anemarrhena and Ephedra Decoction) is used. Uneven sweating, caused by lack of sweat flow or improper covering during sweating, leads to uneven perspiration, resulting in spasms of the waist, back, hands, and feet, alternating between cold and heat. Niu Bang Gen San (Arctium Root Powder) is used. For Water Qi (Fluid Retention), when fluid accumulation occurs below the waist after a major illness has healed, Lv Zhe Ze Xie San (Oyster Shell, Scutellaria, and Alisma Powder) is used.
During Shanghan, contracting other pathogenic factors such as cold, heat, dryness, dampness, wind, or heat can result in complex, deteriorated syndromes (Huai Zheng). Even if treated with sweating, emesis, purgation, or moxibustion without resolution, or if the Xiao Chai Hu Tang syndrome resolves yet the condition persists, it becomes a Huai Zheng. Moreover, if the disease has passed through the meridians, heat remains in the Zang-Fu organs, symptoms vary greatly, and chronic non-resolution leads to chaotic Yin and Yang without order, generally treating cases with predominant exterior symptoms using Zhi Mu Ma Huang Tang. If various medicines fail, Die Jia San (Turtle Shell Powder) is used. If the Xiao Chai Hu Tang syndrome persists, it is not considered a counterflow (Ni) condition.
"Bu Ren" (Insensibility) refers to a state where pain, itching, cold, heat, flexion, and extension are not perceived, and the skin lacks nourishment. The Classics state: "When deficient pathogens encounter cold, it leads to Yu Mao (depression and vertigo) and Bu Ren." Generally, this is because Qi and Blood are deficient and insufficient to circulate throughout the body, allowing pathogenic factors to hide. Thus, the muscles and body become numb and insensitive to pain and itch. Additionally, due to weak Kidney Qi of the Shao Yin channel and scant Essence and Blood, Qi rebels upwards to the epigastrium, Yang Qi retreats, Heat returns to Yin, and interacts with Yin, causing bodily insensibility. This is called Shi Jue (Corpse Trance). The Jue (cold extremities/reversal) caused by encountering cold, leading to Yu Mao and Bu Ren, is essentially this Shi Jue. If the pulse is floating and surging, sweat is like oil, there is panting and insensibility, and fluids cannot be ingested, indicating total bodily insensibility, this signifies the end of life (Ming Jue).
[Warming Method] *Zhizhi Fang* uses Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) and Gui Zhi Shao Yao Jia Gan Jiang Ge Ban Tang (Cinnamon Twig and Peony Decoction with Half Dose of Dried Ginger).
[Moxibustion Point] Zhong Ji (CV3) (Also known as Yu Quan/Jade Spring).
[Acupuncture Method] In ancient times, Bian Que (Yue Ren) entered the State of Guo when the Crown Prince suffered from Shi Jue. Diagnosing Yu Mao and Bu Ren as treatable, he cured him through acupuncture.