服柴胡汤已。渴者属阳明也。
注见少阳阳明篇
伤寒三日。少阳脉小者。欲已也。
热论云。三日少阳受之。则伤寒三日。乃邪传少阳之时也。若邪在少阳。脉必弦数而不小。三日而少阳脉小。
为少阳不受邪矣。即使已传少阳而得此脉。亦必邪气轻微。故为将解而欲已也。
少阳病。欲解时。从寅至辰上。
少阳者。发生草木之初阳也。自一阳来复于子。阳气萌于黄泉。木气即含生于少阴之中。至丑而为二阳。至寅而三
阳为泰。阳气将出。至卯则其气上升于空际而为风。阳气附于草木。木得阳气而生长。在人则阳气藏于两肾之中。
所谓命门先天相火也。其阳气流行于上中下者曰三焦。其成形而生长条达者曰胆。其气旺于寅卯。至此而经
气充盈。正可胜邪。故为病之欲解时也。至辰土而其气已化。阳气大旺。将成太阳。则阳不为少矣。故曰自寅至辰上。
伤寒三日。三阳为尽。三阴当受邪。其人反能食不呕。此为三阴不受邪也。
此所以验阳邪不传阴经之法也。素问热论云。一日巨阳受之。故头项痛。腰脊强。二日阳明受之。阳明主肉。
其脉挟鼻络于目。故身热目疼而鼻干不得卧也。三日少阳受之。少阳主胆。其脉循胁络于耳。故胸胁痛而耳聋。三阳经
络
皆受病。而未入于脏者。故可汗而已也。四日太阴受之。太阴脉布胃中络于嗌。故腹满而嗌干。五日少阴受之。
少阴脉贯肾络于肺。系舌本。故口燥舌干而渴。六日厥阴受之。厥阴脉循阴器而络于肝。故烦满而囊缩。三阴三阳五脏
六腑皆受病。以此推之。则伤寒三日。自太阳而之少阳。三阳为尽矣。四日当传太阴。而三阴当受邪矣。若已传太阴
其脉布胃络嗌。腹满嗌干。自不能食矣。即太阴篇首所谓腹满而吐。食不下。时腹自满之证也。若其人反能食不呕。
是邪气未入太阴。故为三阴不受邪。其邪即从阳经解矣。
伤寒六七日无大热。其人躁烦者。此为阳去入阴故也。
此言邪自三阳传入三阴之验也。伤寒六七日。邪持三阳已久。而身无大热。似乎阳经之邪已解。当无躁烦之证矣。
盖躁者。阴邪也。烦者。阳邪也。邪在阳分则烦。邪入阴经则躁。其人躁烦者。知其为阳邪传入阴经之故也。阳去入阴。
非但指少阳之邪传入阴经也。即太阳阳明之邪。虽不由少阳。亦可传入。前人所谓越经传者是也。所以仲景不独
言少阳而总言之曰阳去入阴也。以少阳为三阳尽处。与三阴为邻。故以此二条附入少阳篇后。以为邪气传阴与
不传阴之辨也。
After taking Chaihu Tang (Bupleurum Decoction), if thirst occurs, it belongs to Yangming disease.
(Note: See the chapter on Shaoyang-Yangming.)
In cold damage occurring after three days, if the Shaoyao pulse is small, the disease is about to resolve.
The *Re Lun* (Treatise on Heat) states: "On the third day, the Shaoyang channel receives the pathogen." Therefore, three days after the onset of cold damage is when the pathogen transmits to the Shaoyang. If the pathogen is in the Shaoyang, the pulse must be wiry and rapid, not small. If on the third day the Shaoyang pulse becomes small, it indicates that the Shaoyang has not received the pathogen. Even if the pathogen has transmitted to the Shaoyang and this pulse appears, it must indicate a slight pathogenic factor; thus, it signifies that the disease is about to resolve and heal.
Shaoyang disease tends to resolve from Yin hour to Chen hour.
Shaoyang represents the initial yang energy of sprouting grasses and trees. From Zi hour, one yang returns; yang qi germinates underground, and wood qi contains life within Shaoyin. By Chou hour, it becomes two yangs; by Yin hour, three yangs open up (Tai), and yang qi is about to emerge. By Mao hour, its qi rises into the sky and transforms into wind. Yang qi attaches to plants; wood grows upon receiving yang qi. In the human body, yang qi is stored in the two kidneys, known as the Mingmen (Gate of Life) primordial ministerial fire. Its yang qi circulating through the upper, middle, and lower jiao is called Sanjiao (Triple Burner); its formed structure that grows and spreads freely is called Gallbladder. The qi of the gallbladder is vigorous during Yin and Mao hours. At this time, the meridian qi is full, and righteous qi can overcome the pathogen; hence, this is the time when the disease tends to resolve. By Chen hour (earth element), the qi has transformed, yang qi is very vigorous, and it is about to become Taiyang; at this point, yang is no longer "shaoyang" (less). Hence, it is said from Yin to Chen hour.
Three days after cold damage, the three yang channels should be exhausted, and the three yin channels should receive the pathogen. If the person can eat and does not vomit, this indicates that the three yin channels have not received the pathogen.
This is the method to verify that yang pathogens do not transmit to the yin meridians. The *Suwen Re Lun* states: "On the first day, Juyang (Taiyang) receives it, causing headache, stiff neck, and back stiffness. On the second day, Yangming receives it. Yangming governs flesh; its vessels run along the nose and connect to the eyes, causing fever, eye pain, dry nose, and inability to lie down. On the third day, Shaoyang receives it. Shaoyang governs the gallbladder; its vessels follow the flanks and connect to the ears, causing hypochondriac pain and deafness. When the meridians of the three yang channels are diseased but have not entered the zang organs, they can be cured by sweating. On the fourth day, Taiyin receives it. Taiyin vessels distribute in the stomach and connect to the throat, causing abdominal fullness and dry throat. On the fifth day, Shaoyin receives it. Shaoyin vessels penetrate the kidney and connect to the lung, attaching to the root of the tongue, causing dry mouth, dry tongue, and thirst. On the sixth day, Jueyin receives it. Jueyin vessels follow the genitalia and connect to the liver, causing irritability, fullness, and retraction of the scrotum. When the three yin and three yang, five zang and six fu organs are all diseased..." Based on this deduction, three days after cold damage, moving from Taiyang to Shaoyang means the three yang channels are exhausted. On the fourth day, it should transmit to Taiyin, and the three yin channels should receive the pathogen. If it has already transmitted to Taiyin, with vessels distributing in the stomach and connecting to the throat, there will be abdominal fullness and dry throat, making eating impossible. This corresponds to the syndrome mentioned at the beginning of the Taiyin chapter: "abdominal fullness with vomiting, inability to eat, and frequent spontaneous abdominal fullness." If the person can instead eat and does not vomit, it means the pathogen has not entered Taiyin; thus, the three yin channels have not received the pathogen. The pathogen will resolve from the yang channels.
Six or seven days after cold damage, without significant high fever, but with restlessness and vexation, this is because yang [pathogen] has gone and entered yin.
This describes the verification of pathogen transmission from the three yang channels to the three yin channels. Six or seven days after cold damage, the pathogen has remained in the three yang channels for a long time, and there is no significant high fever, suggesting the yang channel pathogen has resolved, and symptoms of restlessness and vexation should be absent. Generally, restlessness (zao) is associated with yin pathogens, while vexation (fan) is associated with yang pathogens. When the pathogen is in the yang portion, it causes vexation; when it enters the yin channels, it causes restlessness. The presence of both restlessness and vexation indicates that yang pathogen has transmitted to the yin channels. "Yang going and entering yin" does not only refer to Shaoyang pathogen transmitting to the yin channels. Even Taiyang or Yangming pathogens, although not passing through Shaoyang, can also transmit. This is what predecessors referred to as "transmission across channels" (Yuejing Zhuan). Therefore, Zhang Zhongjing did not just mention Shaoyang but generally stated "yang going and entering yin." Since Shaoyang is the end of the three yang channels and is adjacent to the three yin channels, these two clauses are appended after the Shaoyang chapter to distinguish whether the pathogen transmits to the yin channels or not.