阴阳之证二相交，生死相兼事可昭，微热微寒微赤肿，半昏半爽半平高，脉来虽
数多无力，饮食虽餐便不调；肿而不溃因脾弱，溃而不敛为脓饶，大便多溏小便数，
上身有汗下体焦，五善虽兼有，七恶未全逃；口渴喜茶肠腹痛，面浮厌饮足心高，心
烦不稳睡，神乱怕音焦，投方应命方为妙，阴转为阳渐可调，逢之任是神仙手，半死
余生定莫逃。（《正宗》）
澄曰∶痈疽之候，纯阳固多，纯阴原少，惟半阳半阴之证最多，全在医者留心，
不可忽略。盖阴阳兼半之证，若从辛温之剂内服外敷，则阴气潜消，转为阳证；若
从清凉外敷，或用冷蜜蛋清调药涂敷，内投苦寒败毒之剂，则阳气冰伏，变为纯阴
之证，吉凶反掌，医家病家均宜警省。
经曰∶诸痛痒疮疡，皆属心火。但亦有初起色紫赤而肿痛，脉沉细数而恶寒喜
暖，非真寒也，乃火极似水，阳极生阴，亢则害，承乃制之理。或平时富贵，享用浓
味，服金石等药致之，故阳极似阴，始热终寒之变，宜顺其时而内服疏托泻心等剂
治之，则愈矣。
澄曰∶假寒者，火极似水也。凡疮疡
初起，热甚失于汗解，以致阳邪亢极，郁伏于内，则邪自阳经传入阴分，故为身热
发厥，神气昏沉，或者畏寒，状若阴证；凡真寒本畏寒；而假寒亦畏寒，此热深厥亦
深，热极反兼寒化也。大抵此证，必声壮气粗，形强有力；或唇焦舌黑，口渴饮冷，
小便赤涩，大便秘结，或因多饮药水，以致下利纯清水，而其中仍有燥粪及失气极
臭者，察其六脉，必皆沉滑有力，此阳证也。若杂证也，假寒者，亦或为畏寒，或
为战栗，此以热极于内，而寒侵于外，则寒热之气，两不相投，因而寒栗，此皆寒
在皮肤，热在骨髓，所谓恶寒非寒，则是热证。但察其内证，则或为喜冷，或为便
结，或小水之热涩，或口臭而躁烦，察其脉必滑实有力，凡见此证，即当以凉隔、芩
连之属，助其阴而清其火，使内热既除，则外寒自伏，所谓水流湿者，亦此义也。故
凡身寒厥冷，其脉滑数，按之鼓击于指下者，此阳极似阴，即非寒也。
阴阳两种证候相互交织，生死吉凶并存，情况清晰可见：表现为轻微的发热、轻微的恶寒、轻微的赤色肿胀；神志半昏迷半清醒，疮面半平坦半高起；脉象虽然快速但大多无力，饮食虽然进食但大便不调；肿胀但不溃破是因为脾气虚弱，溃破后却不收敛是因为脓液过多；大便多稀溏，小便频数；上身有汗而下肢干枯焦躁；五善证虽兼有表现，七恶证也未完全逃脱；口渴喜欢喝茶，腹部肠鸣疼痛，面部浮肿厌恶饮水，足心部位高突；心中烦乱不安难以入睡，神志错乱害怕声音且焦躁。投用方药若能对症见效才算巧妙，若能使阴证转为阳证则逐渐可以调治。遇到这种病情，即使是神仙之手，也难以保证不陷入半死半生的境地。（引自《外科正宗》）
顾世澄说：痈疽的证候，纯阳证固然较多，纯阴证原本较少，只有半阳半阴的证候最多，全在于医生留心诊治，不可忽略。凡是阴阳兼半的证候，如果从辛温的药物内服外敷，那么阴气就会潜消，转化为阳证；如果从清凉药物外敷，或用冷蜜、蛋清调和药物涂敷，内服苦寒败毒的药物，那么阳气就会被冰伏，变为纯阴证，吉凶变化只在顷刻之间，医生和病人都应当警惕反省。
经典记载：所有的痛、痒、疮疡，都属于心火。但也有的初起时颜色紫赤而肿痛，脉象沉细数而恶寒喜暖，这并不是真正的寒证，而是火极似水，阳极生阴，亢盛则有害，承制才能平衡的道理。或者因为平时富贵，享用浓味厚腻的食物，服用金石类药物所致，所以出现阳极似阴，开始热后来寒的变化，适宜顺应其时机，内服疏托泻心等方剂治疗，就能痊愈。
顾世澄说：假寒证，就是火极似水。凡是疮疡初起，热势很盛却失于发汗解表，导致阳邪亢盛到了极点，郁伏在体内，那么邪气自然从阳经传入阴分，所以出现身体发热、四肢厥冷，神气昏沉，或者畏寒，症状像阴证；凡是真寒证本来畏寒；而假寒证也畏寒，这是热深厥亦深，热极反而兼有寒化的表现。大抵这种证候，必定声音壮实、气息粗重，形体强壮有力；或者嘴唇焦黑，口渴想喝冷水，小便赤涩，大便秘结，或者因为多喝药水，导致下利全是清水，但其中仍有燥屎以及放屁极其臭秽的情况，观察其六脉，必定都沉滑有力，这是阳证。如果是杂病中的假寒证，也会表现为畏寒或战栗，这是因为热极于内，而寒侵于外，那么寒热之气，互不相容，因而寒战栗动，这都是寒在皮肤，热在骨髓，所说的恶寒并非真寒，则是热证。只要观察其内部证候，那么或者是喜欢冷饮，或者是便秘，或者是小便热涩，或者是口臭且烦躁，观察其脉象必定滑实有力，凡见到这种证候，就应当使用凉膈散、黄芩黄连之类的药物，资助阴气而清除火邪，使内热既除，那么外寒自然潜伏，所谓“水流湿”的道理，也是这个意思。所以凡是身体寒冷厥冷，脉象滑数，按压时鼓击于指下的，这是阳极似阴，即不是寒证。
The two patterns of Yin and Yang intersect, with life and death intertwined, a matter that can be clearly discerned: slight fever, slight aversion to cold, slight redness and swelling; half-comatose yet half-alert, the lesion is half-flat yet half-elevated; the pulse comes rapid but mostly forceless; although food is consumed, bowel movements are irregular; swelling without ulceration is due to Spleen deficiency, while ulceration without healing is due to excessive pus; stools are often loose, urination frequent; sweat on the upper body with dryness and scorching sensation in the lower limbs; although some of the Five Good prognostic signs are present, none of the Seven Evil prognostic signs have been entirely escaped; thirst with a desire for tea, abdominal pain and intestinal rumbling, facial edema with aversion to drinking, elevation of the soles of the feet; mental restlessness and inability to sleep, mental confusion with fear of noise and agitation. Prescribing formulas that respond effectively is considered skillful; if Yin transforms into Yang, gradual regulation becomes possible. Encountering such conditions, even with the hands of an immortal, one cannot guarantee escape from a state of half-death and half-life. (From *Zhengzong*)
Gu Shicheng states: Among the manifestations of carbuncles and ulcers, pure Yang patterns are indeed common, while pure Yin patterns are originally rare. The pattern of half-Yang and half-Yin is the most prevalent. It entirely depends on the physician's attentiveness; it must not be neglected. For patterns where Yin and Yang are mixed, if warm-acrid agents are used internally and externally, the Yin Qi will gradually dissipate, transforming into a Yang pattern. If cooling agents are applied externally, or medicines are mixed with cold honey and egg white for topical application, and bitter-cold detoxifying agents are administered internally, the Yang Qi will be frozen and stagnant, transforming into a pure Yin pattern. Fortune and misfortune can reverse in an instant; both physicians and patients should remain vigilant.
The Classics state: All pain, itching, sores, and ulcers belong to Heart Fire. However, there are cases where the initial presentation features purple-red coloration with swelling and pain, a deep, fine, and rapid pulse, aversion to cold, and preference for warmth. This is not true Cold; rather, it is extreme Heat resembling Water, extreme Yang generating Yin, following the principle that hyperactivity causes harm, and control brings balance. This may result from a lifestyle of luxury, consumption of rich and greasy foods, or ingestion of mineral drugs. Thus, extreme Yang resembles Yin, leading to variations starting with heat and ending with cold. It is appropriate to follow the timing and treat internally with formulas such as those that vent and support, or clear Heart Fire, which will lead to recovery.
Gu Shicheng states: False Cold is essentially extreme Heat resembling Water. In the initial stage of sores and ulcers, if intense Heat is not resolved through sweating, the Yang pathogen becomes hyperactive to the extreme and stagnates within. Consequently, the pathogen transmits from the Yang meridians to the Yin aspects, resulting in body heat, cold extremities, lethargy, or aversion to cold, mimicking a Yin pattern. True Cold inherently involves aversion to cold; False Cold also involves aversion to cold. This is because "the deeper the heat, the deeper the cold extremities"; extreme Heat manifests with apparent Cold transformation. Generally, this pattern presents with a strong voice and coarse breathing, a robust physique, scorched lips and black tongue, thirst with a desire for cold drinks, dark and scanty urine, and constipation. Or, due to excessive intake of medicinal decoctions, it may cause diarrhea of clear water only, yet still retain dry feces and extremely foul-smelling flatulence. Examination of the six pulses will reveal them all to be deep, slippery, and forceful, indicating a Yang pattern. In miscellaneous diseases, false Cold may also manifest as aversion to cold or shivering. This occurs because extreme Heat is internal while Cold invades externally; the Cold and Heat energies do not harmonize, leading to chills. This indicates Cold in the skin and Hair follicles, and Heat in the bone marrow. The so-called aversion to cold is not true Cold, but a Heat pattern. By observing the internal signs—such as preference for cold, constipation, hot and difficult urination, bad breath, and irritability—and noting that the pulse is slippery, full, and forceful, one should immediately use formulas like Liang Ge San (Cool the Diaphragm Decoction) or herbs like Huangqin (Scutellariae Radix) and Lianhua (Coptidis Rhizoma) to nourish Yin and clear Fire. Once internal Heat is eliminated, external Cold will naturally subside. This aligns with the principle that "water flows to dampness." Therefore, whenever the body feels cold with cold extremities, yet the pulse is slippery and rapid, beating forcefully against the fingers upon palpation, this is extreme Yang resembling Yin, and is not a Cold pattern.