恶寒战栗非寒证，阳亢精微积热深，莫使毫厘谬千里，总须着意个中寻。恶寒之证，有
阳亢而见阴证者，此假寒真实热也。若真寒之证，其脉为迟，为微为弱，气虚欲脱，足冷厥
逆，自汗自利，此急宜温补之，真寒证也。若热极而恶寒者，脉必有力，宜用承气汤下之，
恶热因非热，元虚气自伤，莫教从实治，须用补虚方。恶热之证，有元气受伤，邪火独
盛而恶热者，所谓火与元气不两立也。温补真元，其火自退。盖此是阳虚火动，而非真热之
病也。真热之病，脉多洪大有力，身热谵语，大便燥结，口渴无汗。（钱本于此下有“得井
水探之不逆亟当重下无疑”十三字。张东扶曰∶大便燥结，口渴无汗，阳虚火动者亦有之，
当合上二句参看，方得真情实据耳。）若元气受伤而恶热，虽有便燥口渴外象，而脉大无力
，宜人参、麦冬、五味、山药、杞子、肉桂、细辛、生地、甘草、白芍、归身之类治之。
阴盛阳衰气薄，喜温恶冷通情，医能识破个中情，起死回生有应。经云∶气血者，喜温
暖而恶寒凉。盖温暖之味，得生长之性，多补。寒凉之味，行消杀之气，多泻也。且万物生
于土，土爰稼穑，稼穑作甘，甘则能补脾胃，为后天气血之原。治病而能用甘温以补土，则
效多。但行补之法，宜先轻后重，不及可加，太过则反剧矣。（详观近时气化渐衰薄。人身
一小天地也，自然相应。凡百病证，多宜温补，少宜凉散，阴盛阳衰之理，静验已久。本此
治疾，见效甚多，此实心得之妙也。钱本于此条内多此数行，而草庐本无之，盖亦慎斋平昔
之言，而门人所记录者，今附录于后。）
恶寒战栗并非一定是寒证，阳气亢盛、精微物质积滞化热深入体内时也会出现。切勿因毫厘之差而谬以千里，必须仔细探究其中的机理。恶寒的症状中，有因阳气亢盛而表现出阴寒症状的，这是假寒真热的证候。如果是真正的寒证，脉象表现为迟、微或弱，气虚欲脱，足部冰冷甚至四肢厥逆，自汗出且大便泄利，这种情况急需使用温补法治疗，属于真寒证。如果是热邪极盛而导致恶寒的，脉象必然有力，适宜使用承气汤攻下泄热。
恶热并不一定就是热证，元气虚弱导致气机自伤所致。不要按照实证来治疗，必须使用补益虚损的方剂。恶热的症状中，有因元气受损、邪火独盛而感到恶热的，这就是所谓的“火与元气不两立”。通过温补真元，邪火自然消退。因为这是阳虚导致火动，而不是真正的热病。真正的热病，脉象多洪大有力，身体发热、胡言乱语，大便干燥结秘，口渴无汗。（钱本在此处下有“得井水探之不逆亟当重下无疑”十三字。张东扶说：大便干燥结秘、口渴无汗，阳虚火动的情况也有出现，应当结合上面两句参看，才能得出真实可靠的依据。）如果是元气受伤而恶热，虽然有大便干燥、口渴等外在表现，但脉象大而无力，适宜用人参、麦冬、五味子、山药、枸杞子、肉桂、细辛、生地、甘草、白芍、当归身等药物进行治疗。
阴气盛而阳气衰，气血薄弱，喜欢温暖厌恶寒冷是人之常情。医生若能识破其中的机理，就能起死回生，疗效显著。经书云：气血，喜欢温暖而厌恶寒凉。大概温暖的药味，具有生长的特性，多能补益；寒凉的药味，具有消减杀伐的气性，多能泻实。况且万物生于土，土负责种植和收获，稼穑产生甘味，甘味能够补益脾胃，是后天气血生成的源头。治病如果能用甘温的药物来补益脾土，则疗效较多。但是施行补法时，宜先轻后重，力度不够可以加重，太过则会反而使病情加剧。（详细观察近来人体气化逐渐衰弱薄弱。人身即一小天地，与自然相应。各种病证，大多适宜温补，少适宜凉散，这是基于阴盛阳衰的道理，经过长期静验得出的结论。依据此理治病，见效很多，这确实是心得之妙。钱本在此条内多出这几行，而草庐本没有，大概是慎斋平素的话，由门人记录下来的，现附录在后面。）
Chills and tremors are not necessarily signs of a cold syndrome. When Yang qi is hyperactive and subtle nutrients accumulate with deep-seated heat, similar symptoms may occur. Do not let a slight error lead to a massive deviation; one must carefully investigate the underlying mechanism. Among cases of aversion to cold, some present with Yin-cold manifestations due to Yang hyperactivity; this is false cold with true heat. If it is a true cold syndrome, the pulse will be slow (Chi), minute (Wei), or weak (Ruo), accompanied by Qi deficiency approaching collapse, cold feet, cold extremities (Jue Ni), spontaneous sweating, and diarrhea. In such cases, urgent warming and tonification are required, indicating a true cold syndrome. If aversion to cold results from extreme heat, the pulse will certainly be forceful, and Chengqi Tang (Cinnamon Twig and Rhubarb Decoction) should be used for purgation.
Aversion to heat does not necessarily indicate a heat syndrome; it may arise from damage to Yuan Qi (Primordial Qi). Do not treat it as an excess condition; instead, use formulas that tonify deficiency. In cases of aversion to heat, some result from damaged Yuan Qi and rampant pathogenic fire, illustrating the principle that "fire and Yuan Qi cannot coexist." By warming and tonifying the True Yuan, the fire will naturally subside. This is due to Yang deficiency causing fire movement, rather than a true heat disease. True heat diseases typically present with a surging (Hong) and forceful pulse, high fever, delirium, dry and constipated stool, thirst, and absence of sweating. (The Qian edition adds thirteen characters here: "If probing with well water does not cause resistance, heavy purgation is undoubtedly indicated." Zhang Dongfu stated: Dry stool, thirst, and lack of sweat can also occur in Yang deficiency with fire movement; one must refer to the preceding two sentences to grasp the true evidence.) If aversion to heat stems from damaged Yuan Qi, despite external signs like dry stool and thirst, if the pulse is large but forceless, treatment should involve herbs such as Renshen (Ginseng Radix et Rhizoma), Maidong (Ophiopogonis Tuber), Wuweizi (Schisandrae Fructus), Shanyao (Dioscoreae Rhizoma), Gouqi Zi (Lycii Fructus), Rougui (Cinnamomi Cortex), Xixin (Asari Radix et Rhizoma), Shengdi Huang (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), and Dangguishen (Angelicae Sinensis Radix).
Yin abundance and Yang decline, with thin Qi, favor warmth and dislike cold, which is consistent with human nature. If physicians can discern the essence within, they can revive the dying and achieve effective results. The Classics state: Qi and Blood prefer warmth and dislike cold. Warm flavors possess the nature of growth and are mostly tonifying; cold flavors possess the nature of destruction and are mostly draining. Furthermore, all things are born from Earth; Earth governs sowing and reaping, producing sweetness, which tonifies the Spleen and Stomach, serving as the source of postnatal Qi and Blood. In treating diseases, using sweet-warm herbs to tonify Earth yields many successes. However, when applying tonification methods, one should start lightly and increase gradually; insufficient effect can be augmented, but excessive application may worsen the condition. (Observing closely, the vital energy of recent times has gradually declined. The human body is a microcosm, corresponding naturally to Heaven and Earth. Most diseases are suitable for warming and tonification rather than cooling and dispersing, based on the principle of Yin abundance and Yang decline, verified through long-term quiet observation. Treating illnesses according to this principle yields significant results; this is indeed a profound insight gained from personal experience. The Qian edition includes these additional lines, whereas the Caolu edition omits them, likely recording Master Shen Zhai's past words by his disciples, now appended here.)