素问三十三篇曰。有温病者。汗出辄复热。而脉躁疾。不为汗
衰。狂言。不能食。岐伯曰。病名阴阳交。交者死也。人所以汗出者。
皆生于谷。谷生于精。今邪气交争于骨肉而得汗者。是邪却而精胜
也。精胜则当能食而不复热。复热者。邪气也。汗者。精气也。今汗出
而辄复发热者。是邪胜也。不能食者。精无俾也。汗而热留者。其寿
可立而倾也。
又曰。热论曰。汗出而脉尚躁盛者死。今脉不与汗相应。此不胜
其病也。其死明矣。狂言者。是失志。失志者。死。今见三死。不见一
生。虽愈。必死也。雍曰。汗出辄复热。一死。脉尚盛。二死。狂言失
志。三死也。
灵枢二十三篇曰。热病已得汗。而脉尚躁盛者。此阴脉之极也。
死。其得汗而脉静者。生。雍曰。此二证。脉经皆以为阴阳交。疑以得
汗者为交。不得汗者非交也。
又曰。热病已得汗。而脉尚躁。且复热。勿肤刺。喘甚者死。
脉经曰。热病。阴阳交者死。
又曰。热病。烦已而汗。脉当静。
又曰。太阳病。已得汗。脉反躁盛者。是阴阳交。死。复得汗。脉
静者。生。
又曰。热病阴阳交者。热烦心躁。太阴寸口脉两部尚躁盛。是阴
阳交。死。得汗脉静者。生。雍曰。以上二证。与前同。灵枢不言阴阳
交。此言阴阳交为异。脉经所载皆古书。此二证莫知所出也。
又曰。热病。阳进阴退。头独汗出者。死。阴进阳退。腰以下至足
汗出者。死。阴阳俱进。汗出已。热如故。亦死。阴阳俱退。汗出已。寒
不止。鼻口气冷。亦死。以上十证。并见脉经阴阳交部。
又曰。热病所谓并阴者。热病已汗。因得泄。是谓并阴。故治。
（一作活）
又曰。热病所谓并阳者。热病已得汗。脉尚躁盛。火热汗出。虽
不汗出。若衄（庞氏云和而衄）者。是谓并阳。故治。雍曰。并阴阳二
证。诸书无所见。亦类阴阳交。故脉经继之于其后。
阴阳交论曰。伤寒两感阴阳交二证。皆出于素问。仲景发明两
感。而不及阴阳交。王叔和载阴阳交。而不及两感。后世因仲景而明
两感之证。独阴阳交多所未解。予考阴阳交之证。大抵伤寒脉不为
汗解者。皆阴阳交也。何以不为汗解。曰。独阴独阳之病。一汗则解。
阴兼阳阳兼阴之病。一汗不能解。盖汗解其阴。阳脉不得退。汗解其
阳。阴脉不得退。此所以不为汗衰也。然则阴兼阳阳兼阴者。何病
也。余悉索之。则两感之证似之。一日太阳与少阴俱病。二日阳明与
太阴俱病。皆阴兼阳。阳兼阴也。阴阳相兼而病。故其病名曰交。是
以太阳汗解。而少阴未得解。阳明汗解。而太阴未得解者。岂非因其
相交而不为汗衰乎。观二证之言。初若不相同。合二证阴阳之理。则
无异也。故素问言两感。本非病名。至阴阳交。则曰病名阴阳交。盖
两感言其始感。阴阳交者。着其名也。故阴阳交之证。有曰复得汗。
脉静者生。是邪气再出而复生也。仲景亦曰。发表攻里。本自不同。
岂非再乎。故遇斯病者。当参二证而治之。然则仲景发明两感。而不
及阴阳交。叔和载阴阳交而不言两感。意岂异乎。更俟贤哲明之。
Chapter 33 of the *Suwen* (Plain Questions) states: There is a type of warm disease where, after sweating, fever returns immediately, the pulse is rapid and restless, and does not diminish due to sweating. The patient speaks deliriously and cannot eat. Qibo said: This disease is named "Yin-Yang Jiao" (Yin-Yang Intercalation/Conflict), and "Jiao" indicates a fatal outcome. The reason humans sweat is that sweat is generated from grain (food/nutrients), which in turn originates from essence (Jing). Now, when pathogenic factors contend with healthy qi in the muscles and bones, and sweating occurs, it signifies that the pathogen is retreating and the essence is prevailing. If the essence prevails, the patient should be able to eat and not have recurrent fever. Recurrent fever indicates the presence of pathogenic factors; sweat represents the loss of essence. Now, if sweating is followed immediately by fever, it means the pathogen is prevailing over the essence. Inability to eat means the essence has no support (cannot be replenished). If heat remains after sweating, life can be lost instantly.
It also states: The *Relun* (Discourse on Heat Diseases) says: If the pulse remains rapid and vigorous after sweating, death ensues. Currently, the pulse does not correspond with the sweating, indicating that the body cannot overcome the disease. Death is thus evident. Delirious speech indicates the loss of Zhi (Will/Shen); loss of Zhi leads to death. Seeing three signs of death and no sign of life, even if there is temporary improvement, death is inevitable. Guo Yong stated: Recurrent fever after sweating is the first sign of death; a still vigorous pulse is the second; delirious speech and loss of Zhi are the third.
Chapter 23 of the *Lingshu* (Spiritual Pivot) states: In heat diseases, if sweating has occurred but the pulse remains rapid and vigorous, this is the extreme depletion of Yin pulses, leading to death. If the pulse becomes calm after sweating, survival is indicated. Guo Yong stated: These two conditions are both classified as "Yin-Yang Jiao" in the *Maijing* (Pulse Classic). I suspect that sweating constitutes "Jiao," while non-sweating does not.
It further states: In heat diseases, if sweating has occurred but the pulse remains rapid, and fever recurs, do not needle the skin. If panting is severe, death ensues.
The *Maijing* states: In heat diseases, those classified as Yin-Yang Jiao die.
It also states: In heat diseases, if irritability ceases and sweating occurs, the pulse should become calm.
It further states: In Taiyang disease, if sweating has occurred but the pulse becomes rapidly vigorous instead, this is Yin-Yang Jiao, leading to death. If sweating occurs again and the pulse becomes calm, survival is indicated.
It also states: In heat diseases classified as Yin-Yang Jiao, there is intense heat, vexation, and restlessness. If both the Taiyin and Cun Kou (inch position at radial artery) pulses remain rapid and vigorous, this is Yin-Yang Jiao, leading to death. If the pulse becomes calm after sweating, survival is indicated. Guo Yong stated: These two conditions are identical to those mentioned earlier. The *Lingshu* does not mention "Yin-Yang Jiao," whereas this text does, marking a difference. The *Maijing* cites ancient texts, but the source of these two conditions is unknown.
It further states: What is referred to in heat diseases as "Bing Yin" (Merging with Yin) is when, after sweating in a heat disease, diarrhea subsequently occurs. This is called "Bing Yin," and treatment is possible (another version reads "Huó" - survival/life).
It also states: What is referred to as "Bing Yang" (Merging with Yang) in heat diseases is when, after sweating, the pulse remains rapid and vigorous, or fire-heat forces sweat out. Even if no sweat occurs, if nasal bleeding (bi-ni) happens (according to Pang Shi, harmonizing then causing nasal bleeding), this is called "Bing Yang," and treatment is possible. Guo Yong stated: The conditions of "Bing Yin" and "Bing Yang" are not found in other books but resemble "Yin-Yang Jiao," so the *Maijing* appended them afterwards.
The *Yin-Yang Jiao Lun* (Treatise on Yin-Yang Jiao) states: Both "Liang Gan" (Double Exposure) and "Yin-Yang Jiao" in cold damage originate from the *Suwen*. Zhang Zhongjing elucidated "Liang Gan" but did not address "Yin-Yang Jiao." Wang Shuhe recorded "Yin-Yang Jiao" but did not address "Liang Gan." Later generations understood "Liang Gan" through Zhang Zhongjing, but "Yin-Yang Jiao" remained largely misunderstood. I have examined the condition of "Yin-Yang Jiao" and generally concluded that in cold damage, if the pulse does not resolve with sweating, it belongs to "Yin-Yang Jiao." Why does it not resolve? The answer is: Diseases of pure Yin or pure Yang can be resolved with one sweating episode. However, diseases where Yin combines with Yang or Yang combines with Yin cannot be resolved with one sweating episode. Sweating resolves the Yin aspect, but the Yang pulse cannot recede; sweating resolves the Yang aspect, but the Yin pulse cannot recede. This is why it does not diminish with sweating. So, what are diseases where Yin combines with Yang and vice versa? Upon searching thoroughly, I find they resemble "Liang Gan." On the first day, Taiyang and Shaoyin are diseased simultaneously; on the second day, Yangming and Taiyin are diseased simultaneously. These are cases of Yin combining with Yang and Yang combining with Yin. Because Yin and Yang combine in the disease, it is named "Jiao" (Intercalation/Intersection). Therefore, Taiyang may resolve via sweating, but Shaoyin does not; Yangming may resolve via sweating, but Taiyin does not. Is this not because their intersection prevents resolution via sweating? Observing the descriptions of these two conditions, they initially seem different, but integrating them with Yin-Yang theory reveals no difference. Thus, the "Liang Gan" mentioned in the *Suwen* was originally not a disease name, whereas "Yin-Yang Jiao" is explicitly named as such. "Liang Gan" refers to the initial exposure, while "Yin-Yang Jiao" specifies the pathological state. Regarding "Yin-Yang Jiao," it is said that if sweating occurs again and the pulse becomes calm, the patient survives, indicating the pathogen is exiting again and life is restored. Zhang Zhongjing also said: "Releasing the exterior and purging the interior are fundamentally different." Does this not refer to a subsequent treatment? Therefore, when encountering this disease, one should consider both conditions for treatment. However, Zhang Zhongjing elucidated "Liang Gan" without mentioning "Yin-Yang Jiao," and Wang Shuhe recorded "Yin-Yang Jiao" without mentioning "Liang Gan." Could their intentions differ? I await clarification from worthy sages.