阳证阴脉，身冷如冰，为体厥。
施幼声，卖卜颇行，年四旬，禀赋肥甚，六月患时疫，口燥舌干，苔刺如锋，不时太息，咽
喉肿痛，心腹胀满，按之痛甚，渴思冰水，日晡益甚，小便赤涩，得涓滴则痛甚，此下证悉
备，但通身肌表如冰，指甲青黑，六脉如丝，寻之则有，稍按则无，医者不究里证热极，但
引《陶氏全生集》，以为阳证。但手足厥逆若冷过乎肘膝，便是阴证，今已通身冰冷，比之冷
过肘膝
如无，比之无力更甚，宜其为阴证二也；阴证而得阴脉之至，有何说焉？以内诸阳证竟置不问，遂投附子理中汤
。未服，延予至，以脉相参，表里正较，此阳证之最者，下证悉具，但嫌下之晚耳。盖因内
热之极，气道壅闭，乃至脉微欲绝，此脉厥也。阳郁则四肢厥逆，若素禀肥盛，尤易壅闭，
今
亢阳已极，以至通身冰冷，此体厥也。六脉如无者，群龙无首之象，证亦危矣。急投大承气汤，嘱其缓缓下之，脉至厥
回，便得生矣
。其妻闻一曰阴证，一曰阳证，天地悬隔，疑而不服。更请一医，指言阴毒，须灸丹田，其
兄叠延三医续至，皆言阴证，妻乃惶惑。病者自言∶何不卜之神明。遂卜得从阴则吉，从阳则凶，更惑于医之议阴证者
居多，乃进附子汤，下之如火，烦躁顿加。乃叹曰∶吾已矣，药之所误也。言未已，更加之，不超时乃卒。嗟乎！向以
卜谋生，终以卜致死，欺人还自误，可为医巫之戒。
施幼声，以卖卜为业，颇为流行，四十岁左右，体质非常肥胖。六月患时疫，口燥舌干，舌苔如刺状尖锐，不时长叹，咽喉肿痛，心腹胀满，按压时疼痛剧烈，渴望喝冰水，傍晚时分症状加重，小便赤红涩痛，仅得点滴尿液则疼痛加剧，这些里实热证的指征都已具备，只是全身肌肤表面像冰一样冷，指甲青黑，六脉细如丝线，轻取可及，稍加重按则感觉不到。医生不探究体内热极的里证，只引用《陶氏全生集》，认为是阳证。但手足厥逆如果冷过肘膝，便是阴证，如今已全身冰冷，比冷过肘膝更甚；若无脉象，比无力更严重，理应判定为阴证二：阴证出现阴脉，有什么可说的呢？于是将体内的诸阳证完全置之不问，遂投用附子理中汤（Aconite and Poria Decoction）。患者尚未服药，延请我诊治，通过脉象相互参详，表里正面对照，这是阳证中最严重的类型，下法（泻下）的指征全部具备，只是遗憾使用泻法太晚罢了。因为内部热邪至极，气机通道壅塞闭阻，以至于脉微细欲绝，这称为“脉厥”。阳气郁结则四肢厥逆，如果素来体质肥盛，更容易发生壅闭，如今亢盛的阳热已达极点，导致全身冰冷，这称为“体厥”。六脉几乎摸不到的现象，是群龙无首的征兆，病情也已危重。急忙投用大承气汤（Major Order to the Yang Decoction），嘱咐其缓缓泻下，待脉象恢复、厥逆消退，便可得救。
他的妻子听说一种说法是阴证，一种是阳证，两者天壤之别，怀疑而不肯服药。又请了一位医生，指出是阴毒证，必须灸丹田穴（Shenque, CV8 / Dantian area）。其兄接连延请三位医生相继到来，都说是阴证，妻子于是惶恐疑惑。病人自己说：“为什么不向神明占卜呢？”于是占卜得到结果：顺从阴证则吉，顺从阳证则凶。加之多数医生建议阴证，于是服用了附子汤（Aconite Decoction），服药后如火烧般难受，烦躁顿时加重。于是叹息道：“我完了，是被药物误害了。”话还没说完，病情更加恶化，不超过一天就去世了。唉！先前靠占卜谋生，最终因占卜致死，欺骗别人反而误导了自己，可作为医者和巫者的警戒。
Yang syndrome presenting with Yin pulse, and body cold as ice, is termed "Ti Jue" (Body Coldness due to Yang Depression).
Shi Yousheng, a fortune teller whose practice was quite popular, was about forty years old. He had a very obese constitution. In the sixth month, he contracted a pestilential disease (Shi Yi). He suffered from dry mouth and tongue, prickly coating on the tongue like sharp needles, frequent sighing, swelling and pain in the throat, distension and fullness in the heart and abdomen with severe pain upon palpation, intense craving for ice water, worsening symptoms in the late afternoon (Bing hour), red and scanty urine where even a few drops caused severe pain. All indications for interior excess syndromes requiring purgation were present; however, his entire skin surface was cold as ice, fingernails were cyanotic and black, and the pulses of all six positions were thread-thin: detectable with light pressure but vanishing with slight pressure. The physician failed to investigate the extreme heat in the interior, instead citing *Tao Shi Quan Sheng Ji* (Complete Collection for Life Preservation by Tao) and diagnosing it as a Yang syndrome. However, if cold extremities extend beyond the elbows and knees, it indicates a Yin syndrome. Now, with the whole body icy cold, it is more severe than cold extending beyond elbows and knees; and the absence of pulse is more severe than a weak pulse. Thus, it should be considered a Yin syndrome for two reasons: a Yin syndrome presenting with a Yin pulse leaves no room for argument. Ignoring all interior Yang syndromes, they administered Fuzi Lizhong Tang (Aconite and Poria Decoction). Before the medicine could be taken, I was invited. By correlating the pulse and comparing exterior and interior signs, I determined this was the most severe type of Yang syndrome, with all indications for purgation present, only regretting that the purgative method was delayed. Because internal heat reached its extreme, blocking the Qi mechanism, the pulse became faint and nearly imperceptible; this is termed "Mai Jue" (Pulse Coldness due to Qi Stagnation). When Yang Qi is depressed, extremities become cold. In those with a naturally obese constitution, stagnation is even more likely. Here, hyperactive Yang heat had reached its peak, causing the whole body to become icy cold; this is termed "Ti Jue". The phenomenon of the six pulses being almost undetectable resembles "a group of dragons without a head," indicating a critical condition. Urgently, Da Chengqi Tang (Major Order to the Yang Decoction) was administered, with instructions to purge slowly. Once the pulse returned and coldness receded, life would be saved.
His wife heard one diagnosis as Yin syndrome and another as Yang syndrome, which were worlds apart. Suspicious, she refused to take the medicine. Another doctor was consulted, who identified it as Yin Toxin (Yin Du) and prescribed moxibustion at the Dantian region. Her brother subsequently invited three more doctors, all of whom diagnosed it as a Yin syndrome, leaving the wife confused and panicked. The patient himself said, "Why not consult the divine through divination?" The divination result indicated auspiciousness if following the Yin diagnosis and misfortune if following the Yang diagnosis. Furthermore, since the majority of physicians advised the Yin syndrome diagnosis, they administered Fuzi Tang (Aconite Decoction). The effect was like fire burning inside, and irritability increased abruptly. He sighed, saying, "It is over for me; I have been harmed by the medicine." Before he finished speaking, his condition worsened further, and he died within less than a day. Alas! He once made a living through divination, but ultimately died because of it. Deceiving others led to self-deception; this serves as a warning for both physicians and shamans.