时一止复来曰结。主胸满烦躁）○若伤寒发厥至七八日。肤冷而躁。无时暂安者。为脏厥。此为难
治。○又问仲景少阴四逆汤。又有四逆散。何也。答曰。大抵少阴病不可便用热药。且如少阴病亦有
表热者。仲景谓之晚发热。用麻黄细辛之类以发汗。终不成少阴证。便不得发汗耶。今少阴病四肢
冷。亦有内热者。仲景用四逆散。（正七六）是也。四逆汤用附子干姜。而四逆散主四逆。而其人或咳或悸。或
小便不利。或腹中痛。或泄利下重。以上病皆热证耳。
（二十九）问吐长虫
此名蛔厥也。蛔厥者。脏寒蛔上入膈。其人吐蛔也。此是厥阴证。或病患有寒。复发其汗。胃中
冷。及因发汗后身热。重发其汗。胃中虚冷。故长虫逆上。先服理中丸（正七四）次用乌梅丸（正百六）。
（三十）问身体重少气。阴肿入里。腹内绞痛。热上冲胸。头重不欲举。眼中生花。妇人则里
急。腰胯连腹内痛。
此名阴阳易也。伤寒病新瘥。阴阳气未和。因合房室。则令人阴肿入腹绞痛。妇人则里急。腰胯
连腹内痛。名为阴阳易也。其男子病新瘥未平复。而妇人与之交接得病。名曰阳易其妇人病新瘥未平
复。男子与之交接得病。名曰阴易。所以呼为易者。阴阳相感动。其毒疫着于人。如换易然。其病状
身体重。热上冲胸。头重不能举。眼中生花。四肢拘急。小腹绞痛。手足拳。则皆死。其亦有不即死
者。病苦小腹里急。热上冲胸。头重不欲举。百节解离。经脉缓弱。血气虚。骨髓枯竭。便恍恍翕翕。
气力转小。着床而不能摇动。起止仰人。或引岁月方死。烧 散（正百十三） （音加）。鼠粪汤（杂二十六）、竹皮汤、
干
姜汤、青竹茹汤、当归白术汤（并杂二十七）、可选用之。
脉搏跳动中有一次停顿，随后又恢复跳动，这叫做“结脉”。（注：原文此处有断句错误，“主胸满烦躁”似为另一条目的开头或误植，但根据上下文及《类证活人书》体例，此处主要描述结脉特征。若强行翻译“主胸满烦躁”，意为：通常主治胸部胀满、心烦躁动之症。但在本段语境中，它紧接在定义之后，可能指代该脉象对应的病机或伴随症状，或者是一个独立的条目片段。鉴于要求不增添内容，我将按字面意思处理，但需注意其独立性。）
○如果伤寒病患者出现四肢厥冷持续七八天，皮肤冰冷且躁动不安，没有片刻安宁的时候，这称为“脏厥”。这种情况属于难治之症。
○又有人问张仲景的《伤寒论》中，少阴病有四逆汤，又有四逆散，这是为什么呢？回答说：大抵少阴病不能直接使用热性药物。比如少阴病也有表热的情况，张仲景称之为“晚发热”，使用麻黄、细辛之类的药物来发汗。难道说得了少阴证，就不能发汗了吗？现在的少阴病患者四肢发冷，其中也有体内有热的情况，张仲景使用四逆散。（正七六）就是这种情况。四逆汤使用附子、干姜，而四逆散也主治四肢厥逆，但患者可能有咳嗽、心悸、小便不利、腹痛或泄利下重等症状。以上这些病症都属于热证范畴。
（二十九）问吐长虫
这名叫“蛔厥”。所谓蛔厥，是因为内脏寒冷，蛔虫向上进入膈部，导致患者吐出蛔虫。这是厥阴病的证候。有的患者原本有寒邪，医生又误用发汗法，导致胃中寒冷；或者因为发汗后身体发热，再次误用发汗法，导致胃中虚冷，因此蛔虫逆乱上行。先服用理中丸（正七四），然后再服用乌梅丸（正百六）。
（三十）问身体沉重、气短、阴部肿胀并内陷、腹内绞痛、热气上冲胸部、头部沉重不想抬起、眼中生花、妇女则感觉小腹急迫、腰胯连接腹部疼痛。
这名叫“阴阳易”。伤寒病刚刚痊愈，阴阳之气尚未调和，如果此时进行房事，就会导致患者阴部肿胀、腹内绞痛。妇女则表现为小腹急迫、腰胯连接腹部疼痛，这叫作“阴阳易”。男子病刚愈尚未完全康复，女子与他发生性行为而染病，名叫“阳易”；女子病刚愈尚未完全康复，男子与她发生性行为而染病，名叫“阴易”。之所以称为“易”，是因为阴阳相互感应，疫毒附着于人身上，就像更换一样。其病症表现为身体沉重，热气上冲胸部，头部沉重无法抬起，眼中生花，四肢拘挛紧急，小腹绞痛，手足蜷缩成拳，这些情况都会导致死亡。但也有不立即死亡的，痛苦在于小腹里急，热气上冲胸部，头部沉重不想抬起，全身关节仿佛分离，经脉松弛无力，血气虚弱，骨髓枯竭，精神恍惚不定，气力逐渐减弱，卧床不能摇动，起身需要依靠他人搀扶，有的甚至拖延岁月才死。可以使用烧裈散（正百十三）（音加）、鼠粪汤（杂二十六）、竹皮汤、干姜汤、青竹茹汤、当归白术汤（均见杂病卷二十七），从中选择使用。
A pulse that stops intermittently and then resumes is called "Jie" (Knotted Pulse). [Note: The phrase "Zhu Xiong Man Fan Zao" (Mainly governing chest fullness and irritability) appears abruptly in the source text, likely a fragment or separate entry inserted here. Translated literally as it stands.]
○ If a patient with Shanghan (Cold Damage) experiences Jue (extremity coldness) for seven to eight days, with cold skin and restlessness without any temporary relief, this is called "Zang Jue" (Visceral Coldness Reversal). This condition is difficult to treat.
○ Another question asks: Zhang Zhongjing's *Shanghan Lun* mentions Si Ni Tang (Four Counterflow Decoction) for Shaoyin disease, but also Si Ni San (Four Counterflow Powder). Why? The answer is: Generally, Shaoyin disease should not be treated immediately with hot-natured herbs. For instance, Shaoyin disease can also present with exterior heat, which Zhang Zhongjing calls "Wan Fa Re" (Late-onset Fever), treating it with sweating methods using herbs like Mahuang (Ephedrae Herba) and Xixin (Asari Radix et Rhizoma). Does obtaining a Shaoyin syndrome mean one cannot use sweating methods? Currently, some Shaoyin patients have cold extremities but internal heat; Zhang Zhongjing uses Si Ni San (Four Counterflow Powder) for such cases. Si Ni Tang uses Fuzi (Aconiti Lateralis Radix Praeparata) and Ganjiang (Zingiberis Rhizoma), while Si Ni San also treats Si Ni (Counterflow of Extremities), but the patient may experience cough, palpitations, difficulty urinating, abdominal pain, or dysentery with a sensation of heaviness in the anus. All the above conditions belong to Heat Syndromes.
(29) Question on Vomiting Long Roundworms
This is named "Hui Jue" (Roundworm Reversal). In Hui Jue, due to cold in the viscera, roundworms move upward into the diaphragm, causing the patient to vomit roundworms. This is a Jueyin Syndrome. If a patient originally had cold pathogens and was incorrectly induced to sweat, leading to cold in the stomach; or if after sweating, body heat persisted and sweating was induced again, leading to deficiency-cold in the stomach, the roundworms will rebel and move upward. First administer Lizhong Wan (Regulate the Middle Pill), followed by Wumei Wan (Mume Pill).
(30) Question on Heavy Body, Shortness of Breath, Genital Swelling extending inward, Abdominal Colic, Heat Rushing to the Chest, Heavy Head Unwilling to Lift, Visual Disturbances ("Seeing Flowers"), Women experiencing Lower Abdominal Urgency, and Pain connecting the Waist/Hips to the Abdomen.
This is named "Yin Yang Yi" (Yin-Yang Exchange). When a patient has just recovered from Shanghan, and the Yin and Qi are not yet harmonized, engaging in sexual intercourse causes genital swelling and abdominal colic. In women, it manifests as lower abdominal urgency and pain connecting the waist/hips to the abdomen, named "Yin Yang Yi". If a man who has just recovered and is not fully restored engages in intercourse with a woman, and she becomes ill, it is called "Yang Yi". If a woman who has just recovered and is not fully restored engages in intercourse with a man, and he becomes ill, it is called "Yin Yi". It is called "Exchange" because Yin and Yang mutually influence each other, and the epidemic toxin attaches to the person, similar to a replacement. The symptoms include heavy body, heat rushing to the chest, heavy head unable to be lifted, visual disturbances, spasticity of the four limbs, severe lower abdominal colic, and curling of hands and feet into fists; these conditions lead to death. However, some do not die immediately. They suffer from lower abdominal urgency, heat rushing to the chest, heavy head unwilling to lift, a sensation of joints separating, relaxed and weak meridians, deficiency of blood and Qi, depletion of bone marrow, mental confusion, decreasing strength, inability to move while lying in bed, requiring assistance to rise and walk. Some may drag on for months or years before dying. One may select from Shao Kun San (Burning Underwear Powder), Shu Fen Tang (Rat Dropping Decoction), Zhupi Tang (Phellodendron Bark Decoction), Ganjiang Tang (Dried Ginger Decoction), Qingzhuru Tang (Green Bamboo Slashing Decoction), Danggui Baizhu Tang (Angelica and Atractylodes Macrocephala Decoction), all found in the miscellaneous diseases sections, and choose to use them.