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The *Shanghan Lun* (Treatise on Cold Damage) discusses cold damage diseases, while the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) discusses miscellaneous diseases; together they constitute the complete medical works of Zhang Zhongjing. The *Shanghan Lun* gained prominence because Cheng Wuji created the first commentary, followed by more than fifty other commentators, allowing it to be widely disseminated and elucidated throughout the realm. In contrast, the *Jingui Yaolue* is rarely discussed. Although there are commentaries by Zhao Liang, Xu Bin, and others, the original text is archaic and obscure. Due to its age, the book is fragmented and disordered, containing many doubts and missing passages. Later generations have inherited errors and allowed meanings to proliferate arbitrarily, leading readers to consider the content pedantic and remote, thus shelving it away. Now, I have reorganized the disordered sections, supplemented the missing parts, extensively consulted other books, and provided detailed annotations, so that these two works may coexist. It is hoped that future practitioners will not be misled by vulgar interpretations and will understand that Zhang Zhongjing was capable of treating not only cold damage but also miscellaneous diseases.

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Human beings inherit the constant principles of the Five Elements and grow through the influence of climatic factors (Wind). Although Wind can generate all things, it can also harm them, just as water can float a boat or capsize it. If the primordial qi (Yuan Zhen Qi) of the five zang organs flows smoothly, the person remains peaceful and harmonious. However, if attacked by pathogenic wind (Ke Qi), death often ensues. Among the thousands of diseases and hardships, none exceed three categories: First, pathogens enter the meridians and then the zang organs, constituting an internal cause due to internal deficiency. Second, pathogens affect the four limbs and nine orifices, causing blood and vessels to transmit disease and become obstructed, constituting an external invasion from the skin. Third, injuries caused by sexual excess, metal weapons, or insect and animal bites. By examining these three aspects, the origins of all diseases can be understood. If one carefully nurtures and guards against pathogens, preventing pathogenic wind from invading the meridians, even if pathogens initially invade the meridians before spreading to the zang organs, immediate medical treatment can resolve the issue. When the limbs feel heavy and stagnant, methods such as Dao Yin (qigong exercises), Tu Na (breathing regulation), acupuncture, and herbal massage should be employed to prevent the obstruction of the nine orifices. Furthermore, one must avoid legal troubles, animal disasters, and sexual depletion, regulate diet regarding temperature and the five flavors (Sour, Bitter, Sweet, Pungent, Salty), and ensure the physical form does not weaken, thereby preventing diseases from entering the Cou Li (skin texture and interstitial spaces). Cou refers to the places where the San Jiao (Triple Burner) connects and distributes primordial qi, and where blood and qi circulate. Li refers to the structural patterns of the skin and zang-fu organs.
[Commentary]
This chapter serves as the outline of the entire book. Previous editors mistakenly placed it later, disrupting the order. It is now placed at the beginning to summarize the main ideas.
[Annotation]
"Wu Chang" (Five Constants) refers to the Five Elements. The qi of the Five Elements includes Wind, Summer Heat, Dampness, Dryness, and Cold; their flavors include Sour, Bitter, Sweet, Pungent, and Salty. Humans inherit these to form their bodies, so the zang-fu organs constantly interact with these qi and flavors. Here, "Wind" is used to encompass the other climatic factors, similar to how "Ren" (Benevolence) encompasses the other virtues. Thus, it is said that humans grow through Wind. Although Wind generates all things, it can also harm them. The "Zheng Feng" (Correct Wind) comes from the direction appropriate to the season and nourishes all things. The "Xie Feng" (Pathogenic Wind) comes from the opposing direction and harms all things. Humans exist within the interaction of heaven and earth qi; their survival or harm is like water floating or capsizing a boat. The heavenly five qi become the true primordial qi of the five zang organs in humans. If this qi flows smoothly and generates each other in sequence, even pathogenic wind cannot harm, and the person remains healthy. If it does not flow smoothly, pathogenic wind enters through gaps, often causing death. The causes of death, though numbering in the thousands, generally fall into three categories: 1. Internal deficiency allows pathogens to enter meridians and zang organs (Internal Cause). 2. Internal strength prevents pathogens from affecting zang organs, resulting only in external symptoms like limb heaviness and vessel obstruction (External Invasion). 3. Sexual excess, trauma, or animal bites, which are neither caused by internal/external deficiency nor pathogenic invasion (Neither Internal Nor External Cause). By analyzing these three, the origins of all diseases are clarified. If one carefully nurtures the form and qi, preventing pathogenic wind from invading meridians, and seeks medical help early, recovery is possible. Early intervention with Dao Yin, Tu Na, acupuncture, and massage can resolve stagnation before orifice obstruction occurs. Avoiding legal issues, animal attacks, sexual depletion, and maintaining proper dietary balance ensures the form and qi remain strong, preventing diseases from entering the Cou Li. Cou is the space where blood and qi circulate and where the San Jiao distributes primordial qi. Li is the orderly structure of the skin and zang-fu organs.
[Commentary]
"Zheng Feng" (Correct Wind) comes from the eight directions according to the season and has a gentle, generating nature. "Xie Feng" (Pathogenic Wind) comes from the opposing direction and has a violent, clashing nature. For example, if the season requires East Wind but West Wind blows, "latter" refers to the time that has passed.
[Collected Annotations]
Zhao Liang stated: Humans exist in the qi interaction, inheriting Earth's rigidity and softness to form the five zang organs and hundred bones, and inheriting Heaven's yin and yang to form the qi of the six jing. Form and qi unite, Shen Ji (Spirit Mechanism) activates, driving Gu Qi (Grain Qi) in and out, aligning with heavenly degrees, rising and falling, responding to the four seasons, and governing the body. This is called Yuan Zhen (Primordial Truth). External infections are Ke Qi (Guest Qi). The *Ling Shu* states: Deficient evil cannot injure alone; it must find bodily deficiency to inhabit. Heavenly and human qi each have correct and incorrect states. Human qi correct resists evil; incorrect allows evil to exploit. Heavenly qi correct aids growth; incorrect causes harm. Human qi becomes incorrect due to emotional disturbance, improper diet, sexual excess, or trauma, all of which lead to disease. Heavenly qi becomes incorrect due to seasonal imbalance and irregular winds, harming all things.

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Question: What does it mean when superior doctors treat disease before it arises?
Master said: To treat disease before it arises, when seeing liver disease, one must know that the liver transmits pathology to the spleen and should first strengthen the spleen. If the spleen is prosperous in any season and resistant to evil, supplementation is unnecessary. Inferior doctors do not understand transmission; seeing liver disease, they fail to strengthen the spleen and only treat the liver. For liver disease, sour herbs are used for tonification, scorched bitter herbs for assistance, and sweet herbs for regulation. Sour enters the liver, scorched bitter enters the heart, and sweet enters the spleen. The spleen can control the kidney. If kidney qi is weak, water metabolism fails. If water metabolism fails, heart fire becomes excessive. Excessive heart fire damages the lung. If the lung is damaged, metal qi fails. If metal qi fails, liver qi becomes excessive. Excessive liver qi leads to the self-healing of liver disease. This is the subtlety of treating liver disease by strengthening the spleen. This method applies to liver deficiency but not liver excess. The classic states: Do not make deficiency more deficient or excess more excessive; tonify insufficiency, reduce excess. This is the principle. The same applies to other zang organs.
[Annotation]
This follows the previous section on the three causes of disease to explain treatment. Superior doctors are excellent physicians; inferior doctors are ordinary physicians. "Already diseased" refers to existing disease; "not yet diseased" refers to potential disease. For example, current liver disease is existing disease; future transmission to the spleen is potential disease. Excellent doctors know liver disease transmits to the spleen. Upon seeing liver disease, they assess seasonal prosperity and spleen deficiency/prosperity. If the season is prosperous and the spleen strong, they know it resists liver evil and treat the existing liver disease directly. If the season is declining and the spleen weak, they know liver will transmit to the spleen, so they first tonify the potential spleen disease while treating the existing liver disease. Ordinary doctors do not understand seasonal dominance and zang transmission. Seeing liver disease, they only purge the existing liver disease, ignoring the need to tonify the potential spleen disease. Superior doctors also understand that liver deficiency does not transmit, but spleen deficiency may receive lung evil. Therefore, for liver and spleen deficiency, they use sour to tonify the existing liver, scorched bitter to assist the non-diseased heart, and sweet to benefit the weak spleen. This promotes Fire generating Earth, and Earth controlling Water. Weak Water makes Fire strong; strong Fire controls Metal. Controlled Metal does not attack Wood, so liver disease heals. This follows the principle of "Excess brings disaster, succession brings control; control generates transformation." It is a treatment across two or three levels, hence the term "subtlety." This method applies to liver deficiency, not liver excess. Inferior doctors confuse deficiency and excess, purging deficiency (making it weaker) and tonifying excess (making it stronger), which is incorrect. Superior doctors identify deficiency and excess, tonifying insufficiency and reducing excess. The character "Shang" (harm/injure) here should be read as "Zhi" (control/restrict).
[Collected Annotations]
Xu Bin said: If there is liver meridian disease, liver wood overacts on spleen earth. Knowing evil will transmit to the spleen, treatment should prioritize strengthening the spleen. This strengthens the spleen before it is diseased, known as treating disease before it arises. One worries not about the root organ's deficiency but about endless transmission deepening the disease, making spleen strengthening urgent.
Cheng Lin said: The classic states: "Lighten what is light, reduce what is heavy, clarify what is declining." "Following" means seizing the opportunity. Treating disease before it arises means treating the undiseased zang-fu, not the undiseased person. Seeing liver disease, one must first strengthen the spleen. Strong earth controls water; failing water makes fire strong and controls metal. Metal cannot attack wood, so liver disease heals. This is the method of treating liver disease by strengthening the spleen to prevent illness.
Gao Shishi said: Strengthening the spleen specifically controls water, making fire strong and metal weak. If the liver is not controlled, it heals itself. The principle is subtle, hence called the "subtlety" of treating liver disease by strengthening the spleen.

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Question: Patients show facial complexion and color changes. May I ask for your explanation?
Master said: A blue color on the tip of the nose indicates abdominal pain. If accompanied by severe cold intolerance, it is fatal (another version says: cold abdomen with severe pain is fatal). A slightly black color on the nose tip indicates fluid retention. A yellow color indicates cold in the chest. A white color indicates blood loss. If slightly red and appearing out of season, it is fatal. Eyes fixed straight open indicate Jing disease (spasm), which is incurable. Additionally, blue indicates pain, black indicates exhaustion/labor, red indicates wind, yellow indicates difficult defecation, and bright/shiny color indicates retained fluid retention (Liú Yǐn).
[Annotation]
Facial complexion reveals life and death prognosis because five qi enter the nose and store in the five zang organs, with their essence shining outward on the face. "Se" (Color) refers to blue, red, yellow, white, and black. "Qi" (Aura/Luster) refers to the radiance of these colors. Harmonious Qi and Se indicate health (Ping Ren), described in the classic as: Blue like kingfisher feathers, red like chicken combs, yellow like crab roe, white like pig fat, black like crow feathers—these are signs of life. Disharmonious Qi and Se, with varying depth or clarity, indicate patient colors. Described as: Floating/clear indicates exterior, sinking/turbid indicates interior. Observing floating/sinking determines depth; observing dull/shiny determines outcome; observing scattered/clumped determines new/old; observing upper/lower determines location. Rough/bright colors indicate mild disease; sinking/dull colors indicate severe disease; unclear/dull colors indicate moderate disease. Color without Qi (dull/withered) indicates death, described as: Blue like indigo leaves, yellow like soil, red like clotted blood, white like dry bones, black like soot—these are signs of death. The nose is the Ming Tang (Bright Hall). Glossy Ming Tang indicates no disease. Blue on the nose indicates abdominal pain; severe cold indicates fatality. Black indicates fluid or labor. Yellow indicates upper cold/lower heat and difficult urination. Bright eyes indicate internal retained fluid. White indicates blood loss. Red indicates heat/wind. If red appears in winter (out of season), it is fatal. Fixed, round-open eyes like fish eyes indicate Jing disease, which is incurable. This is a general overview of complexion diagnosis; details are in the *Nei Jing*.

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Master said: If a patient speaks silently but suddenly cries out in fear, the disease is in the joints. If speech is hoarse and unclear, the disease is in the heart and diaphragm. If speech is murmuring, thin, and long, the disease is in the abdomen (one version says head).
[Commentary]
The character "Head" (Tou) in "Head disease" should likely be "Abdomen" (Fu). There is no mention of "head disease" in the classics, and the context does not fit, suggesting a copying error.
[Annotation]
Silent speech indicates muteness; aversion to speaking suggests heart disease. Sudden crying out without aversion to speaking indicates the disease is external, specifically in the joints. Hoarse and unclear speech indicates obstruction of breath, suggesting disease in the heart and diaphragm. Murmuring, thin, and long speech indicates reluctance to breathe deeply to avoid disturbing the interior, suggesting abdominal disease.

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Master said: Breathing with shoulder movement indicates chest fullness/stiffness. Breathing drawing qi upward from the chest indicates cough. Breathing with open mouth and shortness of breath indicates Fei Wei (Lung萎/Flaccidity) with saliva/phlegm.
[Annotation]
Xi refers to inhalation and exhalation. Yao Jian (shaking shoulders) refers to lifting shoulders. Xin Zhong Jian (stiffness in the heart/chest) refers to chest fullness. Shoulder-lifting during breathing with chest qi rebellion indicates Asthma (Chuan). Chest qi rebellion with throat itching/gagging indicates Cough. Open-mouth breathing with inability to continue breath, resembling asthma but without shoulder lifting, indicates Shortness of Breath (Duan Qi). Lung qi fullness with excess evil is Asthma; lung qi insufficiency is Shortness of Breath. Insufficient asthma may also lack continuous breath; excess shortness of breath may have chest fullness. Lung qi rebellion always involves cough. Coughing with phlegm is Sou; coughing with frothy saliva continuously is Fei Wei (Lung Flaccidity), not simple cough.

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Master said: Slightly rapid inhalation indicates disease in the Middle Jiao, which is Excess. Purging will cure it. Deficiency cases are incurable. In the Upper Jiao, inhalation is hurried/short. In the Lower Jiao, inhalation is distant/long. All are difficult to treat. Trembling during breathing is incurable.
[Commentary]
The character "Cù" (hurried) for inhalation should be "Yuǎn" (distant); "Yuǎn" should be "Cù". This correction fits the pathology, indicating a copying error.
[Annotation]
This continues the discussion on asthma divided by the Three Jiao, distinguishing treatable from untreatable cases. Asthma is a lung disease; the lung governs qi and respiration. Equal shortness in inhalation and exhalation indicates respiratory obstruction, placing disease in the Middle Jiao. Hurried exhalation and long inhalation place disease in the Upper Jiao (Heart/Lung). Long exhalation and short inhalation place disease in the Lower Jiao (Kidney/Liver). Excess asthma implies abundant evil, middle fullness, abdominal distension, and hard stool; purging is effective. Deficiency asthma implies depleted righteous qi, middle emptiness, soft abdomen, and loose stool; purging is contraindicated and difficult to treat. Trembling during breathing indicates form and qi are unsupported, making it incurable regardless of excess or deficiency. "Slight rapidity" means hurried/short; "distant" means long. Omitting exhalation is a rhetorical ellipsis, implying various combinations of short/long inhalation/exhalation.

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Master said: Cun Kou pulse movements follow the seasonal prosperity. For example, when the Liver is prosperous, the color is green. Each season follows its corresponding color. If the Liver is green but the color is white, or the pulse/color is out of season, disease is present.
[Annotation]
Cun Kou collectively refers to the pulses of both hands. Pulse movement follows the four seasons and commands the five zang organs. Movement during the prosperous season is a normal pulse. If the Liver is prosperous in Spring, the color should be green and the pulse wiry (Xian). This is normal. If the color is white and the pulse floating, it is out of season and indicates disease. The same logic applies to other seasons.
[Collected Annotations]
You Yi said: Wang Shi (Prosperous Time) is when the qi arrives and becomes dominant, moving the pulse and reflecting in the color. E.g., Liver prosperous in Spring, wiry pulse and green color is normal. This applies to all seasons. If color should be green but is white, it is out of season. Not only is the Liver diseased, but the Lung is also likely diseased.

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Question: There is "arrival before time," "non-arrival at time," "departure after time," and "excess arrival." What do these mean?
Master said: After Winter Solstice, at midnight on the Jia Zi day, Shaoyang Qi begins to rise. At this time, Yang begins to generate, and the weather becomes warm. If the weather is warm before Jia Zi day, this is "arrival before time" (Wei Zhi Er Zhi). If the weather is not warm after Jia Zi day, this is "non-arrival at time" (Zhi Er Bu Zhi). If the weather remains severely cold after Jia Zi day, this is "departure after time" (Zhi Er Bu Qu). If the weather is as hot as midsummer (5th/6th lunar months) after Jia Zi day, this is "excess arrival" (Zhi Er Tai Guo).
[Annotation]
After Winter Solstice, at midnight on Jia Zi day, Shaoyang Qi generates, and weather warms gradually—this is the norm. Warmth before Jia Zi is "arrival before time," indicating excessive incoming qi. Lack of warmth after Jia Zi is "non-arrival," indicating insufficient incoming qi. Persistent cold after Jia Zi is "departure after time," indicating excessive outgoing qi. Extreme heat after Jia Zi is "excess arrival," indicating excessive incoming qi. Excess qi invades the unconquered and overacts on the conquered. Insufficient qi forces the conquered to act recklessly, harms the generated, and is invaded by the unconquered. This aligns with the *Nei Jing*: "Carefully observe the time, and the qi can be anticipated."

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Master said: If the Fu pulse (Cun) is floating, the disease is in the Exterior. If the Chi pulse (Scarf) is floating, the disease is in the Interior, accompanied by lower back pain, stiffness, inability to walk, shortness of breath, and extreme fatigue.
[Annotation]
Floating pulse indicates deficient wind. Floating at Cun (Front) indicates Exterior disease. Floating at Chi (Back) indicates Interior disease. Deficient wind in the Exterior causes back/neck stiffness and immobility. Deficient wind in the Interior causes shortness of breath and extreme fatigue.

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Question: The classic mentions "Jue Yang traveling alone." What does this mean?
Master said: This is Yang without Yin, hence called Jue Yang.
[Annotation]
Yin and Yang traveling together is smooth/harmonious; traveling alone is reversed/pathological. Jue means reversed. Reversed Yang traveling alone is Yang without Yin, hence Jue Yang.
[Collected Annotations]
Li [Name] said: Jue Yang is Yang Jue. The *Nei Jing* states: Yang deficiency below causes Cold Jue; Yin deficiency below causes Hot Jue. Jue Yang traveling alone represents the state of Yang without Yin.
Gao Shishi said: This is Yang without Yin, i.e., Jue Yang. The classic states: Yin deficiency below causes Hot Jue. Emperor asked: How does Hot Jue occur? Qibo answered: Yin deficiency allows Yang to enter; Yang entering causes Stomach disharmony; Stomach disharmony depletes Essence Qi; depleted Essence Qi fails to nourish limbs. Kidney Qi declines daily, Yang dominates alone. This is why it is Yang without Yin and Jue Yang traveling alone.

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Question: The Cun pulse is deep, large, and slippery. Deep indicates Excess; Slippery indicates Qi. When Excess and Qi contend, if Blood and Qi enter the Zang, death ensues; if they enter the Fu, recovery occurs. What is this sudden collapse (Cu Jue)?
Master said: Blue lips and cold body indicate entry into the Zang, leading to death. If the body is warm and sweating occurs spontaneously, it indicates entry into the Fu,