病有发热恶寒者。发于阳也。无热恶寒者。发于阴也。发于阳者七日愈。发于阴者六日愈。
以阳数七。阴数六故也。
此条特举阳经阴经受邪之异。而辨其病状。及其愈期。发于阳者。病在阳之经也。以寒加阳。
阳气被郁。故发热而恶寒。发于阴者。病在阴之经也。以阴加阴。无阳可郁。故无热而但恶寒耳。
夫阳受邪者。必阳气充而邪乃解。阴受病者。必阴气盛而病始退。七日为阳气来复之日。六日为阴
气盛满之候。故其病当愈耳。然六日七日。亦是概言阴阳病愈之法。大都如此。学人勿泥可也。
太阳病头痛。至七日以上自愈者。以行其经尽故也。若欲作再经者。针足阳明。使经不传则愈
。太阳病头痛。所谓病发于阳也。法当七日愈。云以上者。该常与变而言之也。行其经尽者。邪行
诸经。尽而当解也。设不解。则将从太阳而复入阳明。所谓作再经也。故针足阳明。以引邪外出。邪出则经
不传而愈矣。盖伤寒之邪。有在经在腑在脏之异。行其经尽者。邪行诸经而未入脏腑之谓。而经
脉阴阳相贯。如环无端。是以行阴极而复行阳者有之。若入厥阴之脏。则病深热极而死耳。其或
幸而不死者。则从脏出腑而愈。未闻有作经再传者也。此条诸注释俱误。盖于经腑脏未审耳。
再按内经云、伤寒一日。巨阳受之云云。又云、七日太阳病衰。头痛少愈云云。盖伤寒之邪
。有离太阳。而入阳明者。有遍传诸经而犹未离太阳者。此太阳病头痛。至七日以上自愈。正与内
经之旨相合。盖六日邪遍六经。至七日而太阳先受者。当先解耳。则是所谓行其经尽者。不但未
入腑脏。亦并未离太阳。所以当有头痛。所谓作再经者。七日不愈。而欲至十四日也。针足阳明者
。以其经多气多血。可以任受针石。且离太阳未远。尤易逐邪外出耳。
太阳病欲解时。从巳至未止。
太阳经为诸阳之长。巳午未时为阳中之阳。太阳病解。必从巳至未。所谓阳受病者。必阳气
充而邪乃解也。与发于阳者七日愈同意。
风家表解。而不了了者。十二日愈。
风家表解。邪退而正安矣。而犹不能霍然无患者。邪去未尽故也。十二日。经气已周。余邪
毕达。故必自愈。欲自解者。必当先烦。乃有汗而解。何以知之。脉浮。故知汗出解也。
邪气欲解之候。必先见之于证与脉。若其人自烦而脉浮者。知其邪必将从汗而解。盖自烦为邪正
相争之候。而脉浮为邪气外达之征也。设脉不浮而沉。则虽烦岂能作汗。即汗亦岂得解哉。伤寒一
日。太阳受之。脉若静者。为不传。颇欲吐。若躁烦。脉数急者。为传也。
伤寒二三日。阳明少阳证不见者。为不传也。
寒气外入。先中皮肤太阳之经。居三阳之表。故受邪为最先。而邪有微甚。证有缓急。体有强
弱。病有传与不传之异。邪微者。不能挠乎正。其脉多静。邪甚者。得与正相争。其脉则数急。其
人则躁烦而颇欲吐。
盖寒邪稍深。即变而成热。胃气恶邪。则逆而欲吐也。然邪既传经。则必递见他经之证。伤寒
二三日。阳明少阳受病之时。而不见有身热、恶热、口苦、咽干、目眩等证。则邪气止在太阳。而
不更传阳明少阳可知。仲景示人以推测病情之法如此。
Diseases manifesting with fever and aversion to cold originate in the Yang [channels]. Those without fever but with aversion to cold originate in the Yin [channels]. Those originating in the Yang recover in seven days; those originating in the Yin recover in six days. This is because the completed number of Yang is seven, and that of Yin is six.
This clause specifically highlights the differences between pathogenic invasion of the Yang and Yin channels, distinguishing their clinical manifestations and recovery periods. "Originating in the Yang" means the disease is located in the Yang channels. When cold invades the Yang, the Yang Qi (vital energy) becomes constrained, resulting in fever accompanied by aversion to cold. "Originating in the Yin" means the disease is located in the Yin channels. Since Yin pathogen affects Yin channels, there is no Yang Qi to be constrained, thus presenting as absence of fever with only aversion to cold.
When Yang channels are invaded by pathogen, recovery requires sufficient Yang Qi to resolve the pathogen. When Yin channels are affected by disease, recovery requires abundant Yin Qi for the illness to recede. The seventh day marks the return of Yang Qi, and the sixth day represents the peak of Yin Qi; hence, recovery should occur at these times. However, six and seven days are generalizations regarding the recovery patterns of Yin and Yang diseases. Generally, this applies, so students should not adhere rigidly to these numbers.
In Taiyang disease (Taiyang Disease), headache may resolve spontaneously after seven days or more because the pathogen has exhausted its course within the channels. If the pathogen is about to transmit to the next channel ("Zuo Zai Jing"), needling the Foot-Yangming channel can prevent transmission and lead to recovery. Taiyang headache is described as disease originating in the Yang. According to standard principles, it should resolve in seven days. The phrase "seven days or more" accounts for both typical and variable courses. "Xing Qi Jing Jin" implies the pathogen traverses the channels and resolves upon completion. If unresolved, the pathogen may re-enter from Taiyang into Yangming, termed "Zuo Zai Jing." Therefore, needling the Foot-Yangming channel guides the pathogen outward. Once expelled, transmission ceases, and recovery ensues. Generally, Shaoyin pathogens vary in location: channels, Fu organs, or Zang organs. "Xing Qi Jing Jin" refers to pathogen movement within channels without entering Zang or Fu organs. Channels connect Yin and Yang cyclically like a ring without end; thus, pathogen progression may reach extreme Yin and then revert to Yang. If entering Jueyin Zang, the condition becomes severe with extreme heat, leading to death. Survivors may recover as pathogen moves from Zang to Fu. Transmission to subsequent channels after this stage is unheard of. Previous commentaries on this clause are erroneous due to misunderstanding the relationships among channels, Fu, and Zang organs.
Referencing the *Neijing*: "On the first day of Cold Damage, Juyang (Giant Sun/Taiyang) receives the pathogen..." and "On the seventh day, Taiyang disease declines, and headache lessens..." Pathogens may leave Taiyang to enter Yangming, or circulate through all channels while remaining associated with Taiyang. Spontaneous resolution of Taiyang headache after seven days aligns with the *Neijing*. By the sixth day, pathogen spreads through the Six Channels; by the seventh day, since Taiyang was initially affected, it should resolve first. Thus, "Xing Qi Jing Jin" implies not only non-entry into Zang/Fu but also retention within Taiyang, explaining persistent headache. "Zuo Zai Jing" refers to failure to resolve by day seven, potentially extending to day fourteen. Needling Foot-Yangming is effective because this channel is rich in Qi and Blood, tolerates needling well, and is close to Taiyang, facilitating pathogen expulsion.
The optimal time for Taiyang disease resolution is from Si hour to Wei hour.
Taiyang is the head of all Yang channels. Si, Wu, and Wei hours represent Yang within Yang. Resolution occurs during these hours, consistent with the principle that Yang channel diseases require robust Yang Qi to expel pathogens, paralleling the concept that "originating in Yang resolves in seven days."
For patients with Wind disorders, if exterior symptoms resolve but the patient remains uncomfortable ("Bu Liao Liao"), recovery typically occurs after twelve days.
Although exterior pathogens have retreated and Zheng Qi (Upright Qi) is stable, residual discomfort persists due to incomplete pathogen elimination. Twelve days allow one full cycle of Jing Qi (Channel Qi); once residual pathogens are fully cleared, spontaneous recovery occurs. Spontaneous resolution often begins with restlessness ("Fan"), followed by sweating and cure. How do we know? A floating pulse indicates impending resolution via sweat.
Signs of impending pathogen resolution appear in symptoms and pulses. Restlessness combined with a floating pulse suggests resolution through sweating. Restlessness indicates struggle between pathogen and Zheng Qi; floating pulse indicates pathogen moving outward. If the pulse is deep rather than floating, sweating cannot occur even with restlessness, and cure is unlikely.
On the first day of Cold Damage, when Taiyang is affected, a quiet pulse indicates no transmission. Symptoms such as nausea, irritability, and rapid/urgent pulses indicate transmission.
By the second or third day of Cold Damage, absence of Yangming and Shaoyang symptoms indicates no transmission.
External Cold first invades the skin-level Taiyang channel, the outermost of the Three Yang channels, making it the primary site of initial infection. Pathogen severity varies, as do symptom urgency and constitutional strength, determining whether transmission occurs. Mild pathogens do not disturb Zheng Qi, resulting in quiet pulses. Severe pathogens contend with Zheng Qi, causing rapid/urgent pulses, irritability, and nausea.
Cold transforming into heat causes Stomach Qi to rebel against the pathogen, inducing nausea. If transmission occurs, symptoms of other channels emerge. On days two or three, when Yangming and Shaoyang are susceptible, absence of symptoms like fever, aversion to heat, bitter taste, dry throat, and dizziness confirms the pathogen remains in Taiyang and has not transmitted to Yangming or Shaoyang. Zhang Zhongjing demonstrates this method for predicting disease progression.