生气通天雾露说，在神术六气加减后。
扁鹊云∶一呼四至，一吸四至，病欲甚，洪大烦满，沉细者腹中痛，滑者伤热，涩者
中雾露。
仲景云∶从霜衍降以后，至春分以前，凡有触冒霜露，体中寒邪而病者，皆谓之伤寒也。
海藏云∶霜露雾露，久雨清湿之气，山岚障气等，皆谓之清邪也。有单衣而感于外者，
有空
腹而感于内者，有单衣、空腹而内外俱感者，所禀轻重不一，在人本气虚实之所得耳！岂特
内寒饮冷误服凉药，而独得阴证哉？重而不可治者，以其虚人内已伏阴，外又感寒，内外俱
病，所以不可治也。
仲景紧脉，俱见许学士条下。
又云∶寸口脉阴阳俱紧者，法当清邪中于上焦，浊邪中于下焦。清邪中于上，名曰洁也
；浊
邪中于下，名曰浑也。阴中于邪，必内栗也，表气微虚，里气不守，故使邪中于阴也；阳中
于邪，必发热头痛，项强颈挛，腰痛胫酸，所谓中雾露之气。故曰清邪中上，浊邪中下。阴
气为栗，足膝逆冷，便溺妄出，表气微虚，里气微急，三焦相混，内外不通，上焦怫郁，脏
气相熏，口烂食龈也。中焦不治，胃气上冲，脾气不转，胃中为浊，荣卫不通，血凝不流。
若冲气前通者，小便赤大便赤黄，与热相搏，因热作使，游于经络，出入脏腑，热气所遏，则为痈
脓。若阴气前通者，阳气厥微，阴无所使，客气内入，嚏而出之，声 咽塞，寒厥相逐，为
热所拥，血自下，状如豚肝，阴阳俱厥，脾气孤弱，五液注下，下焦不阖，清便下重，令便
数难，脐腹湫痛，命将难痊。
扁鹊说：人一呼脉跳四次，一吸脉跳四次（即一息八至），病情将要加重；若脉象洪大且伴有烦闷胀满，是邪气盛的表现；若脉象沉细，则是腹中疼痛；若脉象滑利，是体内有热邪损伤；若脉象涩滞，则是感受了雾露之邪。
张仲景说：从霜降节气以后，到春分节气以前，凡是因触犯冒犯霜露，导致体内寒邪入侵而发病的，都称为伤寒。
海藏（王好古）说：霜露、久雨后的清湿之气、山间的岚障雾气等，都称为清邪。有的人因为衣着单薄而从外部受邪，有的人因为空腹而导致内部受邪，还有的人既衣着单薄又空腹，导致内外同时受邪。由于每个人禀赋的轻重不同，这取决于人体本气的虚实状态罢了！难道只有内寒、饮水过冷或误服凉药，才会单独导致阴证吗？那些严重到无法治疗的病例，是因为患者本身正气虚弱，体内已经潜伏阴寒，外部又感受了寒邪，内外俱病，所以难以治愈。
又说：寸口脉的阴部（尺）和阳部（寸）都呈现紧象，按照法则，应当是清邪侵袭上焦，浊邪侵袭下焦。清邪侵袭上部，称为“洁”；浊邪侵袭下部，称为“浑”。阴分受到邪气侵袭，必然会出现战栗，这是因为表气微弱虚损，里气不能固守，所以使邪气得以侵入阴分；阳分受到邪气侵袭，必然出现发热、头痛、项强、颈部拘挛、腰痛、小腿酸痛等症状，这就是所谓的中了雾露之气。所以说，清邪侵犯上部，浊邪侵犯下部。
阴气被邪气所伤而产生战栗，足膝逆冷，小便失禁或排泄异常，这是表气微弱虚损，里气轻微急迫，三焦之气混杂混乱，内外气机不通畅。上焦郁结不畅，脏腑之气相互熏蒸，导致口腔溃烂、牙龈受损。中焦失去治理功能，胃气上冲，脾气不运化，胃中形成浊气，营卫之气运行不通，血液凝滞不流动。如果冲气向前通畅，则小便赤红，大便赤黄，与热邪相搏结，借着热势，游走于经络，出入于脏腑，热气被遏制，就会形成痈脓。如果阴气向前通畅，阳气厥逆微弱，阴气无所依附驱使，客气内入，通过打喷嚏排出，声音嘶哑咽喉阻塞，寒厥与热邪相互追逐，被热邪壅拥，血液自行下行，状如猪肝，阴阳之气皆厥逆，脾气孤弱，五液注泄而下，下焦闭合功能失常，大小便排出不畅且有沉重感，导致排便次数多而困难，脐腹部隐痛，生命将难以痊愈。
The discourse on "Shengqi Tongtian and Fog/Dew" (Vital Energy Connecting with Heaven and the Influence of Fog and Dew) is located after the section on the addition and subtraction of the Six Qi in *Shenzhu San* (Divine Efficacy Powder).
Bian Que stated: If a patient's pulse beats four times during one exhalation and four times during one inhalation (eight beats per respiration), the disease is about to worsen. A surging and large pulse accompanied by vexation and fullness indicates excess pathogenic factors; a deep and fine pulse indicates abdominal pain; a slippery pulse indicates injury from heat pathogens; and a choppy pulse indicates contraction of fog and dew pathogens.
Zhang Zhongjing stated: From the solar term of Frost Descent until before the Spring Equinox, any illness caused by exposure to frost and dew, resulting in cold pathogens invading the body, is termed *Shanghan* (Cold Damage).
Haizang (Wang Haogu) stated: Frost, dew, clear and damp qi from prolonged rain, mountain mists, and barrier vapors are all termed *Qingxie* (Clear Pathogens). Some contract pathogens externally due to thin clothing, some internally due to an empty stomach, and some both internally and externally due to thin clothing and an empty stomach simultaneously. The severity varies according to individual constitution, depending solely on the deficiency or excess of the person's original qi (*Benqi*). Does not only internal cold, drinking cold liquids, or mistakenly taking cooling medicines lead exclusively to *Yinzheng* (Yin Syndromes)? Cases that are severe and incurable occur because the deficient person already has latent Yin cold inside, and additionally contracts cold from outside. With both internal and external pathology, they become incurable.
The tight pulse mentioned by Zhang Zhongjing can be found under the entries of Xu Xueshi (Xu Shuwei).
He further stated: When both the Yin (Chi position) and Yang (Cun position) pulses at the Cun Kou (Radial Artery) are tight, according to the principle, this indicates that Qingxie (Clear Pathogens) have attacked the Upper Jiao, and Zhuoxie (Turbid Pathogens) have attacked the Lower Jiao. Qingxie attacking the upper part is called "Jie" (Pure); Zhuoxie attacking the lower part is called "Hun" (Turbid). When the Yin aspect is attacked by pathogens, chills must occur internally. This is because the exterior Qi is slightly deficient and the interior Qi fails to maintain its post, allowing pathogens to enter the Yin. When the Yang aspect is attacked by pathogens, it necessarily results in fever, headache, stiffness of the neck and occiput, spasms of the neck, lower back pain, and soreness of the shins. This is what is meant by contracting the qi of fog and dew. Thus, it is said that Qingxie attacks the upper, and Zhuoxie attacks the lower.
When Yin Qi is affected by chills, there is cold reversal in the feet and knees, and abnormal urination or defecation. This reflects slight deficiency of exterior Qi and slight urgency of interior Qi, causing the Three Jiao to mix chaotically, with no communication between interior and exterior. The Upper Jiao becomes stagnant and depressed, and Zang-Fu Qi薰 (fumes/interacts) with each other, leading to oral ulcers and damaged gums. If the Middle Jiao loses its governance, Stomach Qi rebels upward, Spleen Qi fails to transform, turbidity forms in the Stomach, Ying and Wei (Nutritive and Defensive) Qi do not flow smoothly, and blood coagulates and stagnates. If Chong Qi flows forward smoothly, urine will be red, stool red-yellow, clashing with heat pathogens. Relying on heat as a vehicle, it wanders through meridians and collaterals, entering and exiting the Zang-Fu organs. Where heat is obstructed, carbuncles and pus form. If Yin Qi flows forward smoothly, Yang Qi becomes厥逆 (rebellious/cold extremities) and weak, leaving Yin without direction. Exogenous pathogens enter internally, expelled via sneezing, but accompanied by hoarseness and throat obstruction. Cold厥 and heat chase each other; oppressed by heat, blood flows downward, resembling pig liver. Both Yin and Yang Qi are 厥逆, Spleen Qi is isolated and weak, the Five Fluids pour downwards, the Lower Jiao fails to close, leading to a sensation of heaviness in defecation, frequent difficult bowel movements, and shallow pain in the umbilical and abdominal regions. Life will be difficult to save.