有豪子病伤寒。脉浮而长。喘而胸满。身热头疼。腰脊强。鼻干。不得眠。予曰。太阳阳明
合病证。仲景法中有三证。下利者葛根汤。不下利呕逆者加半夏。喘而胸满者麻黄汤也。治以麻
黄汤。得汗而解。
论曰。或问传入之次第。自太阳阳明少阳太阴少阴厥阴何哉。说者谓阳主生。故足太阳水。
传足阳明土。土传足少阳木。为微邪。阴主杀。故太阴土传少阴水。水传足厥阴木。为贼邪。少
阴水传厥阴木。安得为贼也。故予以为不然。素问阴阳离合论云。太阳根起于至阴。结于命门。
名曰阴中之阳。阳明根起于厉兑。名曰阴中之阳。少阳根起于窍阴。名曰阴中之少阳。太阴根起于隐白。名曰阴中之阴。
少阴根起于涌泉。名曰阴中之少阴。厥阴根起于大敦。名曰阴之绝阴。大抵伤寒始因中之气得之于阴。是以
止传足经者。是阴中之阳。阳中之阴。亦自然之次第也。故此篇因黄帝问三阴三阳之离合。岐伯
自圣人南面而立前曰广明而推之。且以太阳为开。阳明为阖。少阳为枢。太阴为开。厥阴为阖。
少阴为枢。六经不得相失。则其序有授矣。不特此也。以六气在天而考之。厥阴为初之气。少阴
为二之气。太阴为三之气。少阳为四之气。阳明为五之气。太阳为六之气。此顺也。逆而言之。
则太阳而后阳明。阳明而后少阳。少阳而后太阴。太阴而后少阴。少阴而后厥阴。伤寒为病。在
气则逆而非顺。自太阳而终厥阴也。
A wealthy gentleman suffered from Shanghan (Cold Damage). His pulse was floating and long, accompanied by wheezing and chest fullness, fever, headache, stiffness of the waist and spine, dry nose, and insomnia. I said, “This is a Taiyang-Yangming combined disease syndrome. In Zhang Zhongjing’s methods, there are three presentations: if accompanied by diarrhea, Gegen Tang (Pueraria Decoction) is used; if without diarrhea but with vomiting and regurgitation, Banxia (Pinellia Rhizome) is added to the formula; if with wheezing and chest fullness, Mahuang Tang (Ephedra Decoction) is used.” Therefore, Mahuang Tang (Ephedra Decoction) was administered, and the patient recovered after sweating.
The discussion states: Someone asked about the sequence of transmission, why it proceeds from Taiyang to Yangming, Shaoyang, Taiyin, Shaoyin, and Jueyin? Explainers claim that Yang governs generation, so the Foot-Taiyang Bladder Water channel transmits to the Foot-Yangming Stomach Earth channel, and Earth transmits to the Foot-Shaoyang Gallbladder Wood channel, which is termed “Wei Xie” (Minor Pathogen). Yin governs destruction, so the Foot-Taiyin Spleen Earth channel transmits to the Foot-Shaoyin Kidney Water channel, and Water transmits to the Foot-Jueyin Liver Wood channel, which is termed “Ze Xie” (Ruthless Pathogen). However, when Shaoyin Water transmits to Jueyin Wood, how can it be considered a Ruthless Pathogen? Thus, I believe this view is incorrect. The *Suwen* (Plain Questions), Chapter on the Separation and Union of Yin and Yang, states: The Taiyang channel originates at Zhiyin (BL-66) and terminates at Mingmen, named “Yang within Yin.” The Yangming channel originates at Lidui (ST-45), named “Yang within Yin.” The Shaoyang channel originates at Qiaoyin (GB-44), named “Lesser Yang within Yin.” The Taiyin channel originates at Yinbai (SP-1), named “Yin within Yin.” The Shaoyin channel originates at Yongquan (KI-1), named “Lesser Yin within Yin.” The Jueyin channel originates at Dazhun (LR-1), named “Extreme Yin within Yin.” Generally, Shanghan initially arises because the Middle Qi is affected by pathogens entering from the Yin aspect; thus, transmission occurs only through the Foot channels. This is due to the relationships of “Yang within Yin” and “Yin within Yang,” which constitute the natural sequence of transmission. Therefore, this chapter cites the Yellow Emperor’s inquiry into the separation and union of the Three Yin and Three Yang channels. Qibo, standing before the Sage facing South, deduces from the concept of “Guangming” (Broad Brightness). Furthermore, Taiyang is designated as the Opening, Yangming as the Closing, Shaoyang as the Pivot, Taiyin as the Opening, Jueyin as the Closing, and Shaoyin as the Pivot. If the functions of the Six Channels do not fail each other, their order is established. Moreover, examining the Six Qi in Heaven, Jueyin is the First Qi, Shaoyin is the Second Qi, Taiyin is the Third Qi, Shaoyang is the Fourth Qi, Yangming is the Fifth Qi, and Taiyang is the Sixth Qi. This is the順 (Shun/Smooth/Normal) sequence. Conversely, Taiyang transmits to Yangming, Yangming to Shaoyang, Shaoyang to Taiyin, Taiyin to Shaoyin, and Shaoyin to Jueyin. Shanghan pathology, in terms of Qi dynamics, is Ni (Ni/Opposite/Abnormal) rather than Shun, proceeding from Taiyang ultimately to Jueyin.