宝丰弋唐臣时始冠，平日饮食嗜冷，久遂成阴证，脉迟七八至一止，二三日后脉仅三至。余
亟进温热之剂数服，四五日不解，遂续夜半一服，昼三夜一，脉颇生。一夕误阙其药，明旦
证遂增剧，复连进前药七日兼夜，脉生大汗而解。人问其故，余曰∶人与天地同一气耳。阳
病昼剧而夜宁，阴病夜剧而昼宁，各从其类而化也。今病阴极至夜尤甚，故令夜半服药。何
以然？所以却类化之阴而接子后所生之阳，则阴易退而阳易生矣。此一条具见前章。
潞州义井街北浴堂秦二母病太阴证，三日不解，后呕逆恶心，而脉不浮。文之与半硫丸二三
服不止，复与黄 建中等药，脉中得之极紧，无表里，胸中大热，发渴引饮，众皆疑为阳证
，欲饮之水。余与文之争不与，又一日与姜附等药，紧脉反细沉，阳犹未生。以桂、附、姜
、乌之类，酒丸，每百丸接之，二日中凡十余服，渴止脉尚沉细，以其病患身热燥烦不宁，
欲作汗，不禁其热，去其衣被盖覆，体之真阳营运未全，而又见风寒，汗不能出，神愦不醒
，家人衣之装束甚浓，以待其毙，但能咽物，又以前丸接之，阳脉方出，而作大汗。盖其人
久好三生茶，积寒之所致也。愈后元秘大小始得通利，翌日再下瘀血一盆如豚肝。然文之疑
不能判，余教以用胃风汤加桂附，三服血止。其寒甚如此，亦世之所未尝见也，治宜详之。
大抵前后证变之不同，以脉别之，最为有准，不必求诸外证也。
宝丰县弋唐臣，当时刚行过冠礼（成年），平时饮食喜好生冷，久而久之便形成了阴证。其脉象迟缓，每呼吸七八次才出现一次停顿，到了第二三天，脉搏仅每分钟三至。我急忙给予温热性质的药剂服用了几次，四五天后病情未解，于是改为在半夜服药，白天服三次，夜间服一次，脉象逐渐恢复生机。有一晚误漏了服药，第二天清晨症状便加剧，随后连续七天昼夜兼服之前的药物，最终通过大汗而痊愈。有人问其中的缘故，我说：人与天地同受一气所化。阳病通常在白天加重而夜间安宁，阴病则在夜间加重而白天安宁，这是各自顺应同类属性而变化的结果。如今此病阴气极盛，到夜晚尤为严重，所以让他在半夜服药。为什么呢？这是为了驱散与同类相化的阴邪，接续子时之后所生发的阳气，这样阴气容易消退，阳气容易生发。这一条的原理在前面章节中已有详细阐述。
潞州义井街北浴堂秦二的母亲患太阴证，三天未愈，后来出现呕吐、逆气、恶心的症状，且脉象不浮。我与文之给她服用半硫丸两三次，症状不止；又给予黄耆建中等药，脉象变得极其紧束，无表里之分，胸中感到大热，口渴想喝水，众人都怀疑是阳证，想要让她喝水。我与文之争论，不赞同她的做法。又过了一天，给予干姜、附子等药物，紧脉反而变得细沉，阳气仍未生发。用桂枝、附子、干姜、乌头之类的药物制成酒丸，每次一百丸接连服用，两天内共服用了十几次，口渴停止但脉象仍沉细。因为病人身体发热、燥热烦闷不安，想要出汗，但不禁受热的干扰，去掉衣物被褥的覆盖，然而患者体内真阳运行尚未完全恢复，又受到风寒侵袭，导致汗不能出，神志昏沉不醒。家人给她穿上厚重的衣服，等待她死亡，但她还能吞咽食物，我又以前面的药丸接连服用，直到阳脉显现，才发出大汗。大概是因为这个人长期喜欢喝三生茶，导致寒气积聚所致。痊愈后，元气秘结的大小便才得以通利，第二天又排出一盆像猪肝一样的瘀血。然而文之对此疑虑重重，无法判断，我教他用胃风汤加入桂枝、附子，服用三剂后出血停止。寒邪如此严重，也是世间未曾见过的案例，治疗应当仔细斟酌。大抵前后病症变化不同，以脉象来辨别，最为准确，不必单纯依赖外在症状。
Yi Tangchen of Baofeng County, who had just undergone the capping ceremony (coming of age), usually preferred cold food and drink in his daily diet. Over time, this developed into a Yin syndrome (a syndrome characterized by deficiency-cold). His pulse was slow and intermittent, occurring once after seven or eight beats, and later reduced to only three beats per cycle. I urgently administered several doses of warming and hot agents. After four or five days without resolution, I continued with one dose at midnight, three doses during the day and one at night, which gradually revived the pulse. One night, the medication was accidentally omitted; the next morning, the symptoms worsened significantly. Subsequently, I consecutively administered the previous medicine for seven days, both day and night. The patient recovered through profuse sweating. When asked about the reason, I said: "Humans share the same Qi as Heaven and Earth. Yang syndromes typically worsen during the day and improve at night, while Yin syndromes worsen at night and improve during the day; each transforms according to its own category. Now, the disease is at its Yin extreme and worsens particularly at night, hence the medication is given at midnight. Why? This is to repel the Yin that transforms according to its kind and to connect with the Yang born after the Zi hour (11 PM - 1 AM), so that Yin easily retreats and Yang easily generates." This principle is fully detailed in the previous chapter.
The mother of Qin Er from the bathhouse on the north side of Yijing Street in Luzhou suffered from Taiyin syndrome (a syndrome involving the Spleen and Stomach characterized by internal cold) for three days without relief. Later, she experienced vomiting, regurgitation, and nausea, but her pulse was not floating. Wen Zhi and I administered Banliu Wan (Half-Sulfur Pill) two or three times, but it did not stop the symptoms. We then administered Huangqi Jianzhong Decoction (Astragalus and Middle-Jianzhong Decoction). The pulse became extremely tight, lacking distinct exterior or interior signs, with intense heat in the chest and thirst prompting drinking. Everyone suspected a Yang syndrome and wanted to give her water. I argued with Wen Zhi against this. A day later, we administered drugs such as Shengjiang (Fresh Ginger) and Fuzi (Prepared Aconite Root). The tight pulse instead became fine and deep, and Yang had not yet generated. We used Jiuwan (Wine Pills) made from Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), Shengjiang (Fresh Ginger), and Wutou (Monkshood Root), taking 100 pills at a time. In two days, more than ten doses were taken. Thirst stopped, but the pulse remained fine and deep. Because the patient's body was hot, dry, restless, and anxious to sweat, but could not tolerate heat interference, her clothes and covers were removed. However, her true Yang qi circulation was incomplete, and upon exposure to wind and cold, sweat could not emerge. Her spirit was confused and unconscious. Her family dressed her heavily, waiting for her death. Since she could still swallow, I continued administering the previous pills. Only when the Yang pulse appeared did she break out in profuse sweating. This was likely due to her long-term preference for Sansheng Tea (Three-Life Tea), causing accumulated cold. After recovery, her blocked urination and defecation finally became smooth. The next day, she passed a basin full of dark blood resembling pig liver. However, Wen Zhi remained doubtful and unable to judge. I taught him to use Weifeng Tang (Stomach-Wind Decoction) added with Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root). After three doses, the bleeding stopped. Such severe cold is unprecedented in the world; treatment requires careful deliberation. Generally, differences in symptom changes before and after are best distinguished by the pulse, which is most accurate, without relying solely on external symptoms.