传经必始太阳终厥阴者。太阳主气。厥阴主血也。邪气初伤。必在于气。渐深必及于血。血脉者。脏腑之道路
也。邪既入血。遂听其入腑入脏而不可御矣。治之必以行血活络。使血络松活。邪乃易消。养津强膜。使津膜相养。
正气乃固。否则血死气散水停筋弛。脏腑之腠理系络。渐见肿硬。无嘘 之气。以相循环。无伸缩之力以自兜裹。
而肩助引痛。不能转侧。一边不能眠。唇面青黑。 肿气喘。小涩大滑。脐筑湫痛。五液注下。诸败证见矣。故少
阴一经。虽多死证而偏属于寒。犹可温化。厥阴死证寒热夹杂不清。无从着手。由是言之。太阳病。只是表之气分。
病不必拘于膀胱小肠经也。厥阴病。只是里之血分病。不必拘于肝与心主经也。推之阳明太阴少阳少阴。莫不皆然。
故曰当在气化上讲求。勿在部位上拘泥。（上传经始太阳终厥阴解）
伤于寒毒为伤寒。伤于温毒为温病。与伤寒传化之温病。治法大异而小同。温毒起手须用凉散。接手即宜苦寒
以化之。咸寒以润之。甘寒以补之。而收功焉。甚有迭用苦寒。如吴又可所谓俟热邪复淤到胃。再三下之者。伤寒
转化之温。乃正气所化。是无根之邪。不宜重用驱逐。不但无须凉散。即苦寒亦不宜早用。更不宜迭用。故有下不
厌迟之说。王叔和伤寒例。剖析界限极明。后人反从而斥之。何也。至于瘟疫别是天地一种乖戾之气。或偏于湿。
或偏于燥。或偏于寒。不专属热也。初起。即在血分。血分。浊恶甚于温病末候。与温病为别派。如慎柔五书辨虚
损痨瘵之例相似。虚损无虫而瘵有虫。温热无虫而疫有虫。一常气。一奇气也。惟其奇也。故猪瘟不死鸡。鸡瘟不
死牛。其伤人也。或专杀贵逸。或专杀劳贱。或专杀强壮。或专杀幼稚。有不可以常理喻者。温病重症与瘟疫轻症。
往往相似。即 疹软脚大头粗颈。温病亦间有此症。大抵温病必由渐而成。气候专属于热。瘟疫一起即见。气候寒
热燥湿并有之。又有瘴毒溪毒。与瘟疫异源同派。疫有寒有热。多偏于燥。瘴亦有寒有热而多偏于湿。一发于天气。
一发于地气也。（上寒温疫瘴解）
辨脉篇。脉浮而大。医反下之。更饮冷水。其人即KT 。此节是仲景作论本旨。族人误死于伤寒者。误以治
温法治之也。寒水相搏。胃气愈促。能无呃乎。曾诊龚某。正与此合。二月。先忽大吐。喉伤碍食。以为火也。用
凉剂。遂发寒热。以为春温也。加重之。遂作呃。三日邀诊。脉来。弦长挺互。应指战栗。沉分。尺中尤甚。呃声
频仍。气从脐下直上撞心。曰。此下焦伏寒。乘时阳而上越。为凉药所抑而作呃耳。三日内当转关。否则再七日可
危。以生附子肉桂子细辛吴萸羌活独活胡芦巴破故纸。加泽泻牛膝导之。嘱令停温急服。三日复诊。其父喜迎于门
口。呃大减矣。小便鬯矣。筋骨痛减。能自起坐矣。及入诊。见面色枯黄。唇舌燥萎。脉来 长。无神摇摆尤甚。
惊曰。得毋改方乎。乃言小儿体弱。尊方力大。前日头煎。分三次服。每次皆呃止。熟睡两时。夜得微汗。昨日某
医来。以尊方一剂已足。改用平补。视之。则大剂参 归术。加姜汁胆汁也。我避中焦。急趋下焦。彼补中焦。升
提下焦。况术尤动气所忌。病患自室中大喊曰。自服彼方小便复闭。胸满气急难受也。此时若肯重服黑锡丹破阴丹。
或可希冀。勉照前方加竹茹知母与之。应期见鬼而逝。（上妄下变呃）
平脉之平读若骈。犹辨也。
关犹部也。寸关尺三部谓之三关。动脉见于关上无头尾者。谓形圆如豆。分见于各关之上。而不能通长有头尾
也。
微脉名。又不甚也。以句中有无而字别之。
若或也。发汗若下之。又此以曾经发汗若吐若下若亡血。
坐犹因也。但坐汗出不彻故也。如陌上编。归来怨新妇。但坐观罗敷。又无因而突然也。以手把刃。坐作疮
也。如鲍照芜城赋。孤蓬自振。惊沙坐飞。
反脉名。来微去大故名反。又金匮来近去远故曰反。
又不应也。脉浮而大。医反下之。又复也。少阴病。始得之。反发热。脉沉者谓既始得之。复有发热表证也。
太阳病。项背强KT KT 。反汗出恶风者。谓既项背KT KT 。复汗出恶风也。又却也。语助词。
其数先微。脉反但浮。谓其脉先微后数。却始终只在于浮也。又脉濡而弱。弱反在关。濡反在巅。（上字训正误）
The transmission of disease (Chuan Jing) must begin with the Taiyang channel and end with the Jueyin channel. This is because the Taiyang channel governs Qi, while the Jueyin channel governs Blood. When pathogenic factors initially injure the body, they inevitably affect the Qi level first; as the condition gradually deepens, it will inevitably involve the Blood level. Blood vessels are the pathways for Zang-Fu organs. Once pathogens enter the Blood level, they will be allowed to invade the Fu and Zang organs, at which point resistance becomes impossible. Treatment must employ methods to promote blood circulation and unblock collaterals, making the blood collaterals loose and smooth so that pathogens can be easily eliminated; simultaneously, nourish Body Fluids and strengthen sinews and membranes, allowing Body Fluids and membranes to mutually nourish each other, thereby consolidating Healthy Qi. Otherwise, blood stagnates and dies, Qi scatters, water dampness accumulates, and sinews relax. The pores and connecting networks of the Zang-Fu organs will gradually show swelling and hardness, lacking the "exhaling" Qi to maintain circulation, and lacking the power of contraction and expansion to self-enclose and protect. Consequently, the shoulders assist in breathing with pulling pain, the body cannot turn or shift position, sleep is only possible on one side, lips and face appear cyanotic and dark, edema and asthma occur, the pulse is choppy when small and slippery when large, the umbilical region feels pounding and aching with mild persistent pain, the five fluids pour down, and various signs of collapse appear. Therefore, although the Shaoyin channel has many fatal syndromes, they mostly belong to Cold patterns, which can still be transformed using warming methods. In contrast, fatal syndromes of the Jueyin channel involve mixed Cold and Heat that are unclear, leaving no clear approach for treatment. From this perspective, Taiyang disease is merely a superficial Qi-level disorder and should not be confined to the Bladder and Small Intestine channels; Jueyin disease is merely a deep Blood-level disorder and should not be confined to the Liver and Pericardium channels. Extending this logic to Yangming, Taiyin, Shaoyang, and Shaoyin channels, none are exceptions. Thus, it is said that one should seek understanding in Qi transformation theory, rather than being rigidly attached to specific anatomical locations. (Above explains the transmission beginning with Taiyang and ending with Jueyin)
Contracting cold toxicity is termed Shanghan (Cold Damage); contracting warm toxicity is termed Wenbing (Warm Disease). These differ significantly but share minor similarities in treatment compared to Warm Diseases arising from the transformation of Shanghan. For Warm Toxicity, initial treatment must use cooling and dispersing methods; upon subsequent management, bitter-cold herbs should be used to resolve heat, salty-cold herbs to moisten, and sweet-cold herbs to tonify, thereby achieving recovery. There are cases where bitter-cold herbs are used repeatedly, as described by Wu Keyang: waiting for heat pathogens to re-stagnate in the Stomach before purging multiple times. However, Warm Diseases transformed from Shanghan are generated by Healthy Qi itself; they are rootless pathogens and should not be aggressively expelled. Not only is cooling and dispersing unnecessary, but bitter-cold herbs should also not be used early or repeatedly. Hence, there is the saying that purgation should not be delayed excessively. Wang Shuhe’s *Shanghan Li* clearly delineates these boundaries, yet later scholars criticized him. Why? As for Plague (Wenyi), it is a type of perverse Qi from Heaven and Earth, which may lean towards Dampness, Dryness, or Cold, and does not exclusively belong to Heat. Plague begins in the Blood level immediately; the turbidity and filth of the Blood level in plague are worse than the late stage of Warm Disease, placing it in a separate category. This is similar to how Shen Rou distinguished between Xu Sun (Deficiency Consumption) and Lao Zhai (Tuberculosis) in his *Five Books*. Xu Sun involves no parasites, whereas Lao Zhai involves parasites; Warm diseases involve no parasites, whereas Plagues do. One is ordinary Qi, the other is extraordinary Qi. Because it is extraordinary, Pig Plague does not kill chickens, and Chicken Plague does not kill cattle. When injuring humans, it may specifically target the wealthy and idle, the laboring and lowly, the strong, or the young and weak—phenomena that cannot be explained by ordinary reasoning. Severe cases of Warm Disease often resemble mild cases of Plague; symptoms such as rashes, soft legs, Big Head Plague, and swollen necks occasionally appear in Warm Disease. Generally, Warm Disease develops gradually, and its climatic nature belongs exclusively to Heat; Plague manifests immediately upon onset, and its climatic nature includes Cold, Heat, Dryness, and Dampness. Additionally, Zhang Du (Miasma Poison) and Xi Du (Stream Poison) share the same lineage as Plague but have different origins. Plague has Cold and Heat types, mostly leaning towards Dryness; Miasma also has Cold and Heat types, mostly leaning towards Dampness. Miasma arises from Heavenly Qi, while Plague arises from Earthly Qi. (Above explains the distinctions among Cold, Warm, Plague, and Miasma)
In the *Bian Mai Pian* (Chapter on Differentiating Pulses), it states: "If the pulse is floating and large, and the physician erroneously applies purgation, followed by giving cold water, the patient will immediately develop hiccups." This section represents the fundamental intent of Zhang Zhongjing’s treatise. A member of my clan died due to Shanghan because he was mistakenly treated with methods intended for Warm Disease. Cold water and cold pathogens clashed, further accelerating Stomach Qi; how could hiccups not occur? I once treated a patient named Gong, whose condition matched this exactly. In February, the patient suddenly vomited profusely, injuring the throat and hindering food intake. It was mistaken for Fire syndrome, and cooling formulas were administered. Subsequently, chills and fever developed, which were mistaken for Spring Warmth, leading to an increase in cooling medications, which resulted in hiccups. On the third day, I was invited to diagnose. The pulse was wiry, long, stiff, and intermixed, trembling under pressure, especially profound in the Chi position upon deep palpation. Hiccups were frequent, with Qi rushing straight up from below the navel to strike the heart. I stated: "This is latent Cold in the Lower Jiao, rising with seasonal Yang, suppressed by cooling medicines, causing hiccups. Within three days, there should be a turning point; otherwise, within another seven days, the condition will become critical." I prescribed Raw Aconite Root (Sheng Fuzi), Cinnamon Twig (Rougui), Asarum (Xixin), Evodia Fruit (Wuyu), Notopterygium Rhizome (Qianghuo), Angelica Pubescens Root (Duhuo), Pedalanthus Seed (Huluba), and Psoralea Fruit (PoguZhi), adding Alisma Rhizome (Zexie) and Achyranthes Root (Niuxi) to guide the action downward. I instructed stopping warm tonics and urgently taking this prescription. Three days later, upon follow-up, the patient's father welcomed me at the door, reporting that hiccups had greatly decreased, urination became smooth, bone and muscle pain reduced, and the patient could sit up independently. Upon entering to examine, the face appeared withered and yellow, lips and tongue dry and shriveled, the pulse was short and powerless, lacking spirit and showing severe wavering. I asked in surprise: "Has the prescription been changed?" He replied: "The child has a weak constitution, and your prescription is too potent. The first decoction from two days ago was divided into three doses; after each dose, hiccups stopped, and he slept soundly for two hours, sweating slightly at night. Yesterday, another doctor came, stating that one dose of your prescription was sufficient, and switched to a mild tonic. Looking at that prescription, it contained large doses of Ginseng (Renshen), Astragalus (Huangqi), Angelica Sinensis (Danggui), and Atractylodes Macrocephala (Baizhu), added with Ginger Juice and Bear Bile. You avoided the Middle Jiao and targeted the Lower Jiao; he tonified the Middle Jiao, inadvertently lifting Qi from the Lower Jiao. Moreover, Atractylodes is contraindicated for moving Qi. The patient shouted from the bedroom: 'Since taking that doctor's prescription, urination has ceased again, and I suffer from chest fullness and urgent difficulty breathing.' At this moment, if he were willing to take Black Tin Pill (Heixi Dan) or Yin-Breaking Pill (Poyin Dan) again, there might be hope. Reluctantly, I added Bamboo Shavings (Zhuru) and Anemarrhena Rhizome (Zhimu) to the original formula. He passed away as predicted, seeing ghosts." (Above analyzes hiccups caused by erroneous purgation and variable syndromes)
"Ping" (Level/Normal) in Ping Mai is pronounced like "Pian," meaning to differentiate.
"Guan" (Carpel/Gate) is akin to "Bu" (Section). The three positions Cun, Guan, and Chi are called the Three Guans. The Dong Mai (Surging Pulse) appears at the Guan position without head or tail; its shape is round like a bean, appearing separately above each Guan, but unable to extend longitudinally with distinct heads and tails.
"Wei" (Fine/Micro) is a pulse name, meaning not prominent. The character distinction depends on the presence or absence of "bu" (not) in the sentence.
"Ruo" (If/Like) indicates possibility. As in "sweating or purging," here referring to having previously sweated, vomited, purged, or lost blood.
"Zuo" (Sit) means "because." As in "only because sweat discharge was incomplete." Also seen in *Mo Shang Sang*: "Returning home, the new wife complains, only because she watched Luofu." And "without cause, suddenly occurring," such as "handling blades with hands, sitting [causing] wounds." Also in Bao Zhao’s *Wucheng Fu*: "Lonely tumbleweed shakes itself, startled sand flies by chance."
"Fan" (Reverse/Opposite) is a pulse name; coming weak and going strong is thus called Fan. Also, in *Jingui Yaolue*, coming close and going far is called Fan.
"Fan" also means "not" or "yet." As in "pulse floating and large, physician erroneously purges." It also means "again" or "instead." As in "Shaoyin disease, just acquired, yet has fever, pulse sinking," meaning since just acquiring the disease, there is instead fever and exterior signs. "Taiyang disease, stiff neck and back, yet has sweating and aversion to wind," meaning since stiff neck and back, there is instead sweating and aversion to wind.
"Fan" also serves as a particle meaning "however." As in "its rate was previously fine, pulse however only floats," meaning the pulse was previously fine then rapid, but ultimately remains only floating. "Also, pulse is soft and weak, weakness however is at Guan, softness however is at Dian." (Above corrects errors in character definitions)