问曰。厥之寒热。何以别之。答曰。仲景言诸四逆厥者不可下。虚家亦然。又曰。厥阴
下之
。其语似涉两歧。然要认明病之来路。彼因四逆而厥。故不可下。此因发热而厥。故应下之
。此中消息。言下本自跃然。再推厥深热深之义。温热病一二日或五六日。沉昏谵妄。手足
厥逆。是热邪入膻之候。膻中属手厥阴是亦厥阴证也。仲景虽未明言。而厥深热深一语。已
包括无遗矣。谁谓温热之法。不可向仲景推寻哉。
仲景六经之法。一经有一经之证。先要分看。分看宜在有字句处精研。而或此经杂彼经
之症。
又要合看。合看全在无字句处善悟。而尤要在于辨似。有阳中之阴。有阴中之阳。有阳中之
阳。有阴中之阴。有阳证似阴。有阴证似阳。有阳证转阴。有阴证转阳。有阳证杂阴。有阴
证杂阳。有阴
阳错杂非细心体认。恶能窥其万一。今人辄畏仲景书难读。而从事于后世之方书。是犹涉海
问津。从仲景伤寒入手。始觉甚难。久之则其易焉者至矣从后世方书入手。始觉甚易。久之则
其难焉者至矣。总之凡病不外此六经。能解仲景六经辨证之法。可以识伤寒。即推此六经辨
证之法。可以识万病。伤寒既了然无遗。于杂证乎何有。此一以贯之之道也。故曰万病莫逃乎伤寒。
Q: How can one distinguish between cold-type and heat-type Jue (cold extremities)?
A: Zhang Zhongjing stated that for all cases of Si Ni (four limbs becoming cold) and Jue, purgation should not be used; this applies equally to patients with deficient constitutions. He also stated that if Jue Yin disease is treated with purgation... These two statements seem somewhat contradictory at first glance. However, the key lies in clearly identifying the origin of the disease. Those who develop Jue due to cold extremities caused by Yang deficiency should not undergo purgation. Conversely, those whose extremities become cold due to internal excess heat should indeed undergo purgation. The nuance here is self-evident from the context. Furthermore, considering the principle of "the deeper the Jue, the deeper the heat": in warm-heat diseases, if a patient presents with deep lethargy, delirium, manic behavior, and cold extremities on the first or second day, or even after five or six days, this indicates that heat pathogens have entered the Dan Zhong (Pericardium). Since the Pericardium belongs to the Hand Jue Yin meridian, this is also considered a Jue Yin syndrome. Although Zhang Zhongjing did not explicitly state this, the phrase "the deeper the Jue, the deeper the heat" encompasses it entirely. Who says that the methods for treating warm-heat diseases cannot be traced back to Zhang Zhongjing's theories?
The Six Meridians system of Zhang Zhongjing dictates that each meridian has its own specific syndromes. One must first analyze them separately; separate analysis requires careful study of the explicit textual descriptions. However, when symptoms of one meridian are mixed with another, they must be analyzed holistically; holistic analysis relies on keen insight into what is not explicitly written. Most importantly, one must differentiate between similar presentations. There are Yin within Yang, Yang within Yin, Yang within Yang, and Yin within Yin. There are Yang syndromes resembling Yin, Yin syndromes resembling Yang, Yang syndromes transforming into Yin, Yin syndromes transforming into Yang, Yang syndromes complicated by Yin, and Yin syndromes complicated by Yang. Without careful observation and understanding, how could one possibly grasp even a fraction of these complexities? Modern practitioners often fear that the *Shanghan Lun* is too difficult to read and instead turn to later medical formularies. This is like attempting to cross a sea without asking for the ferry crossing. Starting with Zhang Zhongjing’s *Shanghan Lun*, one may initially find it difficult, but over time, it becomes increasingly easy. Starting with later formularies, one may initially find it easy, but over time, it becomes increasingly difficult. In summary, all diseases fall within the scope of these Six Meridians. If one can understand Zhang Zhongjing’s method of Six Meridians differentiation, one can identify Shanghan (Cold Damage); extending this method of differentiation allows one to identify myriad other diseases. Once Shanghan is thoroughly understood without omission, what difficulty would there be in handling miscellaneous diseases? This is the principle of consistency running through everything. Therefore, it is said that all diseases do not escape the realm of Shanghan.