伤寒六经提纲病情
一日太阳以脉浮，头痛、项强、恶寒（八字为提纲）,恶寒（二字为病情）。
三日少阳以口苦、咽干、目眩（六字为提纲）、喜呕（二字为病情）。
四日太阴以腹满而吐，食不下，自利益甚，时腹自痛。若下之，必胸下结鞕（二十三字为提纲），食不下（三字为病情）。
五日少阴以脉微细，但欲寐（六字为提纲），但欲寐（三字为病情）。
六日厥阴以消渴，气上冲心，心中疼热，饥而不欲食，食则吐蚘，下之利不止（二十四字为提纲），不欲食（三字为病情）。
六经定法贯解
凡病邪初入，必由太阳。太阳为寒水之区，居坎宫子位，人身之气机，日日俱从子时发起。子为一阳，故曰太阳。太阳如天之日（日从东海而出，海为储水之区，水性主寒，故曰太阳寒水），无微不照，阳光自内而发外，一身上下四旁，莫不毕照焉。所以主皮肤，统营卫，为一身之纲领。然太阳底面，即是少阴肾经（相为表里也），若太阳病，过发汗，则伤少阴肾中之真阳，故有亡阳之虞。所以近来医家病家，畏桂麻二汤发汗，等于砒毒，毫不敢用，由其不知桂麻二汤，非发汗之剂，乃协和营卫之方也。营卫协和，则向之伏于皮毛肌肉间者，今皆随汗而尽越于外矣。邪出于外，则表气疏，里气畅，病所以立解矣。至若发汗而致亡阳者，岂真麻桂之为害哉？不知由其人内本先虚，复感寒邪，今得桂麻协和阴阳，鼓邪外出，大汗淋漓，而肾中一线之元阳，乘气机之鼓动，而与汗俱出，实气机势时之使然，非桂麻之必使人亡阳也。
观于气实之人发汗，毫不为害，从可识矣。然则仲景又岂不知内虚之人不可发汗乎？观于食粥、与不食粥，微发汗、更发汗，中病即止诸句，仲景已于内虚之人，早为筹画矣。真是步步规矩，处处苦心，惜乎知之者寡耳。六经当以一贯解之，章旨太多，恐学者易倦，仍将六经分解，参以附解，〔须〕知分解还是贯解，附解不在分贯之列，分贯是六经大旨，附解是补六经未发之大意。
附解：按六经以太阳为首，厥阴为终。经者常道也，先天之真阳，原寄于肾，肾与膀胱相表里（肾为里，膀胱为表），真阳之气机发动，必先行于太阳经，而后行于诸经，昼夜循环，周而复始。然太阳四面皆水，寒气布护，故曰"太阳之上，寒气主之"，真阳之气，此刻初生，阳气甚微，若太阳经病过发汗，则伤肾中之真阳（表阳被夺，里阳立消），故有亡阳之虞。须知太阳地界主寒，复感外寒之客气所犯，阻其真阳运行之机，故太阳之经症作。二日阳明，阳明地界主燥，客寒之气，自太阳而走入燥地，寒邪便化为燥邪，燥邪入阳明经，而阻其真阳运行之机，则阳明之经症作。馀仿此，学者务宜留心，六经各有表里，即有病经不病里处，详太阳〔经〕附解。
太阳经证解
按太阳一经，以寒为本（太阳之上，寒气主之，故也）。少阴为中气（肾与膀胱为表里），太阳为标（主外，是本经之标、本、中三气也）。太阳一经为病，有经病（本经自病），有伤风症（经症中之兼证），有伤寒症（经症中之兼症），有两感症（经症中之兼症），有腑症（太阳中之里症）。腑症之中，又有蓄尿症、蓄热症、蓄血症、癃闭症（腑症中恒有之病也）。不可不知也。经症者何？脉浮、头项强痛、恶寒，发热是也。（经病情形）兼自汗而恶风者，则为伤风症，是太阳之卫分为风邪所伤也，主以桂枝汤，协和营卫，驱风邪外出，浅一层立法也，服此方而若解则病愈（此刻节令之气寒，客风亦寒，故曰风寒。寒气即是风气，风气即是寒气。仲景以风寒冠旨（旨字应是首字、校正），一示厥阴循环之意，一示风轮主持大世界之意，风字宜活看）。经症而兼无汗者，则为伤寒症，是太阳之营分为寒邪所伤也，主以麻黄汤，大开腠里，俾营分之寒邪，尽从汗出，深一层立法也。服此方而若解，则病愈（此际若不知发汗，则病进从实；若过发汗，则症变从虚；若妄下，则症变从误）。经症而兼壮热烦躁脉浮紧者，则为两感症，是太阳之营卫，为风邪寒邪所伤也。
主以大青龙汤，营卫两解，风寒并驱，又深一层立法也。服此方而若解，则病愈（两感症，又有一日太阳，而与少阳同病，亦名两感症。三阳症与三阴症同见，亦名两感，用药即当解表温经，再看表里重轻。以上兼症三法，系本经恒有之候，非传经之谓也。传经法详附解）。设若不解，不传经则必传腑（传经则现经症，传腑则现腑症）。腑症者何？口渴而小便不利是也。是邪由太阳之经，而转入太阳之腑也，主以五苓散，化太阳之气。气化一行，小便亦利，邪亦可从此而出，病亦可从此解矣（此处便是太阳首尾界限）。至于腑症之中，另有蓄尿一症（病形小腹满，便短赤不利，口渴），盖膀胱乃储水之区，今为寒气所束，太阳之气微，不足以胜其寒邪之气，气机于是乎不运矣，气机一刻不运，则所储之水，即不能出，势必上涌，而小腹作满，故名之曰蓄尿，主以五苓倍桂。桂本辛温，力能化太阳之寒气，气化一行，小便得出，病亦立解，此法中之法也。另有蓄热一症（病形小腹不满，口渴溺赤），由寒邪入腑，从太阳之标阳而化为热。热甚则必涸其所注之水，故小腹不满而便不利，故名之曰蓄热，主以五苓去桂，加滑石以清利其热。热邪一去，腑自立安，亦法中之法也。另有蓄血一症（病形小腹硬满），缘由寒邪入腑，阻其太阳之气机，而循行本经之血液，失其常度，不得归经，流入腑中，聚而不散，少腹硬满，故名之曰蓄血，主以五苓散中，加桃仁、红花、当归、万年霜之类，从小便以逐其瘀，即可移危为安，皆不易之法也。另有癃闭一症，与热结膀胱不同。热结者，尿常可出一二点，此则胀翻出窍，尿不得出，由三焦气机不运，水道壅塞太甚，法宜升提，俾壅者立开（此下陷从上治法也），尿即得出，病亦可解，此皆不易之法也（此太阳一经，经腑症形如是，至于传经，详附解）。
附解：太阳经，有经症初见，不传本经之腑，而传阳明、少阳，三阳经症同见者，名三阳并病，即以三阳之法治之，如桂枝汤加葛根、柴胡是也。有经症初见，传阳明而不传少阳者，名二阳为病，即以二阳之法治之，如桂枝加葛根汤是也。又有三阳经症同见，而见太阴之腹满自利，即于三阳表药中，合理中之法治之。有经症初见，转瞬而见少阴之身重欲寐者，肾与膀胱为表里，表病而及里也，当从少阴之法治之，如麻黄附子细辛汤是也。至于当汗而不汗，表里不通，壮热烦躁者，大青龙是也。经症误下遂利者，桂枝加葛根汤是也（误下邪陷于内，故加葛根以举之）。过汗而至汗不止者，桂枝加附子汤是也。下后而至脉促胸满者，桂枝去芍药汤是也。仲景之法，总在活法圆通，并无死法，方方皆有妙义，轻重大有经权，学者先将六经提纲病情熟记于心，方能见病知源。六经所主气机乃为本，客气所生乃为病，客气往往随主气而化为病，故一经一经病形不同，虽云伤寒二字冠首，因寒在子，故也。
【阐释】癃闭症只说法宜升提，未有处方，宜用补中益气汤治之。癃闭还有由于湿热下注，或瘀血内结，膀胱气化不利而致之实症；亦有因肾气亏损、膀胱气化无权，水液不能下注之虚症。实症小便量少、热赤、频急、而滴沥不畅，甚至尿闭不通，小腹胀满，或疼痛、口渴、便秘、苔黄腻、脉滑、数，宜清利湿热，宜猪苓汤或八正散加减治之。虚症小便滴沥不爽，排出无力，甚或不通，面白、腰冷、舌质淡、脉沉细，宜补肾温阳通窍，以济生肾气丸加减治之。
阳明经证解
按阳明一经，以燥为本（阳明之上，燥气主之，故也），太阴为中气（脾与胃为表里），阳明为标（主外，是本经之标、本、中三气也）。有经症，有里症、有腑症，不可不知也。（以下承接上太阳经）太阳之寒邪未尽，势必传于阳明，则治阳明，必兼治太阳，若全不见太阳之经症、腑症病情，独见阳明之经症、腑症，则专治阳明，方为合法。当知寒邪走入燥地，即从燥而化为燥邪，乃气机势时之使然也（寒邪化燥，乃本经病机主脑）。经症者何？前额连眼眶胀痛，鼻筑气而流清，发热不恶寒，此际寒邪初入阳明之经，寒气尚有一线未化尽，故还见筑气流清涕之寒形，渐渐发热不恶寒（不恶寒三字，便是寒邪俱化为热也）。邪在经尚可解肌，故用葛根汤以解肌，俾邪从肌肉而出（阳明主肌肉，故也），此本经浅一层立法也。
服此方而邪若解，则病愈。设若不解，有传少阳之经，而不传本经之腑，有传本经之腑，而不传少阳之经者出矣（便是分途处）。若本经经症，合少阳之经症，名二阳合病，即以二阳之法治之，如葛根汤合柴胡汤是也。若本经经症，而传入本经之里，则现口燥心烦，汗出恶热，渴欲饮冷（这便是里症情形）。此刻全无一点寒形，尽是一团燥热之邪气，盘据胃中，兼之胃乃多气多血之府，邪热之气，又合胃中之气，二火交煽于中，则邪热炽矣。热甚则血亏，故口燥心烦，热蒸于外，故汗出，内热太甚，则乞救于外之水而欲为之扑灭，故大渴饮冷，仲景用白虎汤以救之，有不使邪热归腑之意，深一层立法也。服此方而若解，则病愈。设若白虎力轻，未能扑灭其邪热，邪即入腑，便见张目不眠，声音响亮，口臭气粗，身轻恶热，大便闭塞等情，此际邪已归腑。邪至腑中，热已过盛，热盛必将肠胃中之血液灼尽，即肠胃中所存宿谷糟粕中之津液，亦必灼尽。胃中枯槁，阴气不得上交，所以张目不眠，胃火旺极，故声音响亮，口臭气粗，身轻恶热，肠胃此际，无一毫血液运其糟粕，故大便闭塞，通身上下不啻一盆烈火。若不急为扑灭，顷刻将周身血液灼尽，脏腑有立坏之势也，主以大、小承气汤，苦寒陡进，推荡并行，火邪一灭，正气庶可复生。即有痞满实燥坚谵语狂走等情，皆缘热邪所致，俱当以此法为主，不可因循姑惜，酿成脱症之祸矣（阳旺极，而阴必立消）。
附解：病缘是伤寒为本，至于用大黄、芒硝、石膏之药，全不见伤寒面目，学者至此，每多茫然莫解，由其不知化机与六经所主耳。
万病不出阴阳两字，阳极化阴，阴极化阳，自然之理。阴阳分布六经，六经各有所主之气，寒主太阳，燥主阳明，火主少阳，湿主太阴，热主少阴，风主厥阴。须知寒邪至燥地，寒气即化为燥邪，一定不易之理也（譬如一团冷物，放于热物之中，顷刻冷物亦化为热物。一团热物而放于冷物之中，顷刻热物亦化为冷物。知此化机，便得伤寒一贯之旨，庶可识仲景步步立法之苦心也）。他经化机仿此。仲景以伤寒二字冠首者，寒居正冬子令，一阳初生，为一岁之首，一年分六气，六气配六经，一岁之气机，可以六日括之，六日之气机，又可以一日尽之，生生化化，循环不已，学者宜知。
少阳经证解
Outline of Pathogenesis in the Six Meridians of Cold Damage
Day 1: The outline for Taiyang (Greater Yang) disease is floating pulse, headache, stiffness of the neck and occiput, and aversion to cold (these eight characters serve as the outline); aversion to cold (these two characters describe the specific condition).
Day 2: The outline for Yangming (Yang Brightness) disease is "stomach house excess" (these three characters serve as the outline); aversion to heat (these two characters describe the specific condition).
Day 3: The outline for Shaoyang (Lesser Yang) disease is bitter taste in the mouth, dryness of the throat, and dizziness (these six characters serve as the outline); desire to vomit (these two characters describe the specific condition).
Day 4: The outline for Taiyin (Greater Yin) disease is abdominal fullness with vomiting, inability to eat, spontaneous diarrhea worsening over time, and occasional spontaneous abdominal pain. If purgatives are misused, it will inevitably lead to epigastric binding and hardness (these twenty-three characters serve as the outline); inability to eat (these three characters describe the specific condition).
Day 5: The outline for Shaoyin (Lesser Yin) disease is faint and fine pulse, and a constant desire to sleep (these six characters serve as the outline); constant desire to sleep (these three characters describe the specific condition).
Day 6: The outline for Jueyin (Terminal Yin) disease is excessive thirst, Qi rushing up to strike the heart, pain and burning sensation in the heart, hunger without desire to eat, vomiting roundworms after eating, and unceasing diarrhea if purgatives are misused (these twenty-four characters serve as the outline); lack of desire to eat (these three characters describe the specific condition).
Comprehensive Interpretation of the Fixed Methods of the Six Meridians
Whenever pathogenic factors first enter the body, they must do so via the Taiyang meridian. The Taiyang meridian belongs to the zone of Cold Water, located in the Kan Palace at the Zi position. The Qi mechanism of the human body originates daily from the Zi hour. Zi corresponds to the initial generation of one Yang, hence it is called Taiyang. Taiyang is like the sun in the sky (the sun rises from the East Sea; the sea is a reservoir of water, and the nature of water is cold, thus it is called Taiyang Cold Water). It illuminates everything without exception. Sunlight emanates from within to the exterior, illuminating the entire body, upper and lower, inside and out. Therefore, it governs the skin and controls Ying (Nutritive) and Wei (Defensive) Qi, serving as the general guideline for the whole body. However, the base of Taiyang is the Shaoyin Kidney meridian (they are interior-exteriorly related). If Taiyang disease is treated with excessive sweating, it damages the True Yang within the Shaoyin Kidney, thus posing a risk of Yang collapse. Consequently, physicians and patients nowadays fear the sweating effects of Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction), regarding them as toxic as arsenic, and dare not use them at all. This is because they do not understand that Guizhi Tang and Mahuang Tang are not merely diaphoretic agents, but formulas that harmonize Ying and Wei Qi. When Ying and Wei Qi are harmonized, pathogens previously latent between the skin and muscles are now expelled entirely through sweat. Once pathogens exit the exterior, the exterior Qi becomes loose, and the interior Qi flows smoothly, so the disease resolves immediately. As for those cases where sweating leads to Yang collapse, is it truly the harm caused by Mahuang Tang or Guizhi Tang? It is because the person was internally deficient beforehand and then contracted cold pathogens. Now, aided by Guizhi Tang and Mahuang Tang to harmonize Yin and Yang and drive pathogens outward, profuse sweating occurs. The single thread of Primordial Yang in the Kidney, riding on the momentum of the Qi mechanism, exits along with the sweat. This is actually due to the circumstances of the Qi mechanism, not because Guizhi Tang and Mahuang Tang inevitably cause Yang collapse.
Observing that individuals with robust Qi suffer no harm from sweating, this can be inferred. Then, did Zhang Zhongjing not know that individuals with internal deficiency should not undergo sweating therapy? Observing his instructions on drinking congee, not drinking congee, mild sweating, repeated sweating, and stopping treatment once the illness is addressed, Zhang Zhongjing had already made arrangements for individuals with internal deficiency. His methods are strictly regulated at every step, and he put great care into every detail, yet few people understand this. The Six Meridians should be understood as an integrated whole. There are too many chapter themes, which may tire learners, so I will still explain the Six Meridians separately, supplemented by additional explanations. [It is necessary] to know that separate explanation serves integration; additional explanations are not part of the separate/integrated classification. Separate explanation covers the main principles of the Six Meridians, while additional explanations supplement the major ideas not yet expounded in the Six Meridians.
Additional Explanation: According to the Six Meridians, Taiyang is the beginning, and Jueyin is the end. "Jing" (Meridian/Classic) refers to the constant way. The Primordial Yang of the Pre-heaven resides originally in the Kidney. The Kidney and Bladder are interior-exteriorly related (Kidney is interior, Bladder is exterior). When the Qi mechanism of True Yang activates, it must first travel through the Taiyang meridian, and then through the other meridians, circulating day and night, completing cycles repeatedly. However, Taiyang is surrounded by water, with cold qi distributing and protecting it, hence it is said, "Above Taiyang, Cold Qi governs." The True Yang Qi is just born at this moment, and Yang Qi is very weak. If Taiyang meridian disease is treated with excessive sweating, it damages the True Yang in the Kidney (Exterior Yang is deprived, Interior Yang instantly vanishes), thus posing a risk of Yang collapse. One must realize that the Taiyang territory governs Cold. When external Cold pathogenic Qi invades, it obstructs the movement of True Yang, causing Taiyang meridian symptoms to arise. On the second day, Yangming. The Yangming territory governs Dryness. The invading Cold Qi moves from Taiyang into the Dryness territory; Cold pathogenic Qi transforms into Dryness pathogenic Qi. When Dryness pathogenic Qi enters the Yangming meridian and obstructs its True Yang movement, Yangming meridian symptoms arise. The rest follows this pattern. Learners must pay attention: each of the Six Meridians has interior and exterior aspects. Even if there are cases where the meridian is diseased but the interior is not, see the Additional Explanation for the Taiyang [meridian].
Explanation of Taiyang Meridian Syndromes
Regarding the Taiyang meridian, Cold is the root (Above Taiyang, Cold Qi governs, hence so). Shaoyin is the Middle Qi (Kidney and Bladder are interior-exteriorly related), and Taiyang is the Mark (governing the exterior; these are the Mark, Root, and Middle Qi of this meridian). When the Taiyang meridian is diseased, there are Meridian diseases (self-disease of the meridian), Wind-Strike syndromes (combined syndromes within meridian symptoms), Cold-Strike syndromes (combined syndromes within meridian symptoms), Two-Feelings syndromes (combined syndromes within meridian symptoms), and Fu-organ syndromes (interior syndromes within Taiyang). Among Fu-organ syndromes, there are also Urine Accumulation syndrome, Heat Accumulation syndrome, Blood Accumulation syndrome, and stranguria with retention (illnesses constantly present in Fu-organ syndromes). These must be known. What are Meridian symptoms? Floating pulse, stiffness and pain in the head and nape, aversion to cold, and fever are them. (The situation of meridian conditions). Combined with spontaneous sweating and aversion to wind, it is a Wind-Strike syndrome, meaning the Wei (Defensive) portion of Taiyang is injured by Wind pathogen. The primary treatment is Guizhi Tang (Cinnamon Twig Decoction) to harmonize Ying and Wei Qi and drive the Wind pathogen outward. This is a shallow-level prescription. If the disease resolves after taking this formula, the patient recovers (At this time, the seasonal Qi is cold, and the invading Wind is also cold, hence called Wind-Cold. Cold Qi is Wind Qi, and Wind Qi is Cold Qi. Zhang Zhongjing uses "Wind-Cold" as the heading (the character 'Zhi' should be the first character/correction), indicating the cycle of Jueyin and the role of the Wind Wheel in governing the world; the character 'Wind' should be viewed flexibly). If Meridian symptoms combine with absence of sweating, it is a Cold-Strike syndrome, meaning the Ying (Nutritive) portion of Taiyang is injured by Cold pathogen. The primary treatment is Mahuang Tang (Ephedra Decoction) to open the pores widely, allowing the Cold pathogen in the Ying portion to exit entirely through sweat. This is a deep-level prescription. If the disease resolves after taking this formula, the patient recovers (At this stage, if one does not know to induce sweating, the disease progresses to excess; if one sweats excessively, symptoms change to deficiency; if one wrongly uses purgatives, symptoms change due to error). If Meridian symptoms combine with high fever, irritability, and a tight floating pulse, it is a Two-Feelings syndrome, meaning the Ying and Wei Qi of Taiyang are injured by both Wind and Cold pathogens.
The primary treatment is Da Qing Long Tang (Major Blue Green Dragon Decoction) to resolve both Ying and Wei, driving out both Wind and Cold. This is another deep-level prescription. If the disease resolves after taking this formula, the patient recovers (Two-Feelings syndrome also includes cases where Taiyang disease occurs on the first day and simultaneously involves Shaoyang, also named Two-Feelings syndrome. When Three-Yang syndromes and Three-Yin syndromes appear together, it is also named Two-Feelings syndrome; medication should resolve the exterior and warm the meridians, considering the severity of exterior vs. interior. The above three methods for combined syndromes refer to constant presentations of this meridian, not transmission of disease. Transmission methods are detailed in the Additional Explanation). Suppose the disease does not resolve; if it does not transmit via meridians, it must transmit to the Fu organs (Transmission via meridians presents meridian symptoms; transmission to Fu organs presents Fu organ symptoms). What are Fu organ symptoms? Thirst and difficulty urinating are them. This means pathogens have transferred from the Taiyang meridian to the Taiyang Fu organ. The primary treatment is Wu Ling San (Five-Ingredient Powder with Poria) to transform Taiyang Qi. Once Qi transformation occurs, urination becomes smooth, pathogens can exit thereby, and the disease can resolve (This point marks the boundary between the beginning and end of Taiyang). Regarding Fu organ syndromes, there is additionally Urine Accumulation syndrome (symptoms: fullness in the lower abdomen, short and red scanty urine, thirst). The Bladder is a reservoir of water. Now constrained by Cold Qi, Taiyang Qi is weak and insufficient to overcome the Cold pathogen Qi, so the Qi mechanism ceases to operate. For even a moment that the Qi mechanism does not operate, the stored water cannot exit, inevitably surging upward, causing fullness in the lower abdomen, hence named Urine Accumulation. The primary treatment is Wu Ling San with increased Gui Zhi (Cinnamon Twig). Gui Zhi is naturally acrid and warm, capable of transforming Cold Qi in Taiyang. Once Qi transformation occurs, urine exits, and the disease resolves immediately. This is a method within a method. There is additionally Heat Accumulation syndrome (symptoms: no fullness in the lower abdomen, thirst, red urine). Cold pathogen enters the Fu organ and transforms into Heat from the Mark Yang of Taiyang. Severe heat depletes the water it pours upon, hence no fullness in the lower abdomen but difficult urination, named Heat Accumulation. The primary treatment is Wu Ling San without Gui Zhi, adding Hua Shi (Talcum) to clear and drain the heat. Once Heat pathogen is gone, the Fu organ stabilizes immediately; this is also a method within a method. There is additionally Blood Accumulation syndrome (symptoms: hardness and fullness in the lower abdomen). The cause is Cold pathogen entering the Fu organ, obstructing the Taiyang Qi mechanism, causing blood circulating in this meridian to lose its normal course, fail to return to the vessels, flow into the Fu organ, accumulate and not disperse, resulting in hardness and fullness in the lower abdomen, named Blood Accumulation. The primary treatment adds Tao Ren (Peach Kernel), Hong Hua (Safflower), Dang Gui (Angelica Sinensis), and Wan Nian Shuang (Frost of Ten Thousand Years/Moss) to Wu Ling San to purge stasis through urination, turning danger into safety. These are unchangeable methods. There is additionally Stranguria with Retention (Liong Bi), which differs from Heat Binding in the Bladder. In Heat Binding, urine may trickle out a drop or two; here, swelling forces the orifice open, yet urine cannot exit. This is due to non-operation of the Sanjiao Qi mechanism and severe obstruction of the water passages. The method should involve lifting and raising, allowing the obstruction to open immediately (This is treating sinking from above). Once urine exits, the disease resolves. These are all unchangeable methods (This describes the meridian and Fu organ manifestations of the Taiyang meridian; regarding transmission, see the Additional Explanation).
Additional Explanation: In the Taiyang meridian, when Meridian symptoms appear initially, instead of transmitting to the meridian's own Fu organ, they may transmit to Yangming and Shaoyang. When symptoms of the Three Yang meridians appear together, it is named Three-Yang Concurrent Disease, treated with methods for the Three Yangs, such as Guizhi Tang added with Ge Gen (Kudzu Root) and Chai Hu (Bupleurum). When Meridian symptoms appear initially and transmit to Yangming but not Shaoyang, it is named Two-Yang Disease, treated with methods for the Two Yangs, such as Guizhi Jia Ge Gen Tang (Guizhi Decoction plus Kudzu Root). When symptoms of the Three Yang meridians appear together, accompanied by Taiyin abdominal fullness and spontaneous diarrhea, one should combine the exterior-resolving drugs of the Three Yangs with methods of Lizhong Tang (Regulate the Middle Decoction). When Meridian symptoms appear initially and suddenly show Shaoyin heaviness of the body and desire to sleep, since Kidney and Bladder are interior-exteriorly related, exterior disease affecting the interior should be treated according to Shaoyin methods, such as Ma Huang Fu Zi Xi Xin Tang (Ephedra, Aconite, and Asarum Decoction). When sweating is indicated but not performed, leading to blockage between interior and exterior, high fever, and irritability, Da Qing Long Tang (Major Blue Green Dragon Decoction) is used. When Meridian symptoms are wrongly purged leading to diarrhea, Guizhi Jia Ge Gen Tang (Guizhi Decoction plus Kudzu Root) is used (Wrong purging causes pathogens to sink inward, hence Ge Gen is added to lift them). When excessive sweating leads to unceasing sweat, Guizhi Jia Fu Zi Tang (Guizhi Decoction plus Aconite) is used. After purging, leading to rapid pulse and chest fullness, Guizhi Qu Shao Yao Tang (Guizhi Decoction minus Peony) is used. Zhang Zhongjing's methods always emphasize flexible and comprehensive application, having no rigid rules; every formula contains profound meaning, with light and heavy applications following flexibility and principle. Learners should first memorize the outlines and conditions of the Six Meridians thoroughly to understand the source of diseases. The Qi mechanism governed by the Six Meridians is the Root; pathogenic Qi generated is the Disease. Pathogenic Qi often transforms into disease following the Host Qi. Hence, the manifestation of disease differs from meridian to meridian. Although "Cold Damage" heads the title, it is because Cold resides in Zi (Winter), hence so.
[Interpretation]: Stranguria with Retention (Liong Bi) only states that the method should involve lifting and raising, without providing a prescription. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. Stranguria with Retention can also result from Damp-Heat pouring downward, or intra-abdominal Blood Stasis causing impaired Bladder Qi transformation, leading to Excess syndromes; or it can result from Kidney Qi deficiency and powerless Bladder Qi transformation, preventing fluid descent, leading to Deficiency syndromes. Excess syndromes feature scanty urine, hot and red color, frequent and urgent need, poor dribbling, even complete urinary retention, lower abdominal distension or pain, thirst, constipation, yellow greasy coating, and slippery or rapid pulse. Clearing and draining Damp-Heat is suitable, using Zhu Ling Tang (Polyporus Decoction) or Ba Zheng San (Eight-Herb Powder for Rectification) with modifications. Deficiency syndromes feature dribbling discomfort, weak expulsion force, even non-excretion, pale complexion, cold waist, pale tongue body, and deep fine pulse. Tonifying Kidney and warming Yang to unblock orifices is suitable, using Ji Sheng Shen Qi Wan (Shen Qi Pill for Saving Life) with modifications.
Explanation of Yangming Meridian Syndromes
Regarding the Yangming meridian, Dryness is the root (Above Yangming, Dryness Qi governs, hence so). Taiyin is the Middle Qi (Spleen and Stomach are interior-exteriorly related), and Yangming is the Mark (governing the exterior; these are the Mark, Root, and Middle Qi of this meridian). There are Meridian syndromes, Interior syndromes, and Fu-organ syndromes; these must be known. (Following the previous Taiyang meridian): If Cold pathogen of Taiyang is not fully resolved, it will inevitably transmit to Yangming. Then, treating Yangming must concurrently treat Taiyang. If there are absolutely no signs of Taiyang meridian or Fu organ conditions, but only Yangming meridian or Fu organ conditions appear, then treating Yangming exclusively is the correct method. One must know that when Cold pathogen enters the Dryness territory, it transforms into Dryness pathogen according to Dryness. This is due to the momentum and timing of the Qi mechanism (Transformation of Cold into Dryness is the core pathogenesis of this meridian). What are Meridian symptoms? Distending pain connecting the forehead and eye sockets, nasal congestion with clear discharge, fever without aversion to cold. At this time, Cold pathogen has just entered the Yangming meridian; a trace of Cold Qi remains untransformed, hence clear nasal discharge and congestion (Cold signs) are still seen. Gradually, fever appears without aversion to cold (The phrase "without aversion to cold" indicates that Cold pathogen has completely transformed into Heat). Since pathogens are in the meridian, muscle-releasing is still possible, hence Ge Gen Tang (Pueraria Decoction) is used to release the muscles, allowing pathogens to exit from the muscles (Yangming governs the muscles, hence so). This is a shallow-level prescription for this meridian.
If pathogens resolve after taking this formula, the disease heals. Suppose it does not resolve; pathogens may transmit to the Shaoyang meridian without transmitting to the home Fu organ, or transmit to the home Fu organ without transmitting to the Shaoyang meridian (this is where the paths diverge). If the home Meridian syndrome combines with Shaoyang Meridian syndrome, it is named Two-Yang Combined Disease, treated with methods for the Two Yangs, such as Ge Gen Tang combined with Chai Hu Tang (Bupleurum Decoction). If the home Meridian syndrome transmits to the home Interior, it presents with dry mouth, mental restlessness, sweating, aversion to heat, and desire to drink cold fluids (this is the situation of Interior syndromes). At this moment, there is not a trace of Cold signs; it is entirely a mass of Dryness-Heat pathogenic Qi settling in the Stomach. Furthermore, the Stomach is a mansion abundant in Qi and Blood. The pathogenic Heat Qi combines with the Stomach Qi; the two Fires stir mutually within, causing pathogenic Heat to become blazing. Severe heat depletes Blood, hence dry mouth and mental restlessness; heat steams outward, hence sweating; extreme internal heat seeks rescue from external water to extinguish it, hence intense thirst and desire to drink cold fluids. Zhang Zhongjing uses Bai Hu Tang (White Tiger Decoction) to rescue this, intending to prevent pathogenic Heat from entering the Fu organs. This is a deep-level prescription. If the disease resolves after taking this formula, the patient recovers. Suppose Bai Hu Tang is too weak to extinguish the pathogenic Heat, the pathogen enters the Fu organ. Symptoms include staring eyes, insomnia, loud voice, bad breath, coarse breathing, lightness of body, aversion to heat, and fecal impaction. At this time, the pathogen has returned to the Fu organ. In the Fu organ, Heat is excessive. Extreme heat will scorch away the Blood in the intestines and stomach, and even the fluids in the retained food residue and chaff in the intestines and stomach will be scorched away. The Stomach becomes withered, and Yin Qi cannot ascend to communicate. Hence, staring eyes and insomnia. Stomach Fire is extremely旺盛 (prosperous), hence loud voice, bad breath, coarse breathing, lightness of body, and aversion to heat. The intestines and stomach currently have no Blood to move the residue, hence fecal impaction. The entire body is like a basin of fierce fire. If not urgently extinguished, the Blood of the whole body will be scorched away in an instant, and the Zang-Fu organs face imminent destruction. The primary treatment is Da Cheng Qi Tang (Major Order the Qi Decoction) or Xiao Cheng Qi Tang (Minor Order the Qi Decoction). Bitter-cold herbs are administered abruptly to push and wash away simultaneously. Once Fire pathogen is extinguished, Righteous Qi may recover. Conditions such as palpitations, fullness, excess, dryness, hardness, delirium, and manic walking are all caused by Heat pathogen and should primarily be treated with this method. Do not delay or hesitate, lest you precipitate the disaster of Collapse syndrome (When Yang is extremely prosperous, Yin must instantly vanish).
Additional Explanation: The disease originates from Cold Damage as the root. However, using herbs like Da Huang (Rhubarb), Mang Xiao (Mirabilite), and Shi Gao (Gypsum) shows no appearance of Cold Damage. Learners at this point are often bewildered and confused, because they do not understand the Transformation Mechanism and what each of the Six Meridians governs.
All diseases stem from the two characters Yin and Yang. Extreme Yang transforms into Yin, and extreme Yin transforms into Yang; this is the natural law. Yin and Yang are distributed among the Six Meridians, and each meridian governs a specific Qi: Cold governs Taiyang, Dryness governs Yangming, Fire governs Shaoyang, Dampness governs Taiyin, Heat governs Shaoyin, and Wind governs Jueyin. One must know that when Cold pathogen reaches the Dryness territory, Cold Qi transforms into Dryness Qi; this is an immutable principle (For example, place a cold object among hot objects, and the cold object instantly becomes hot. Place a hot object among cold objects, and the hot object instantly becomes cold. Understanding this Transformation Mechanism allows one to grasp the consistent principle of Cold Damage and appreciate Zhang Zhongjing's painstaking legislation at every step). The Transformation Mechanism of other meridians follows this pattern. Zhang Zhongjing uses "Cold Damage" as the heading because Cold resides in the Zi period of mid-winter, where one Yang is initially born, marking the beginning of the year. One year is divided into Six Qi, and the Six Qi correspond to the Six Meridians. The Qi mechanism of one year can be summarized in six days; the Qi mechanism of six days can be encompassed in one day. Generation and transformation continue in endless cycles. Learners should understand this.
Explanation of Shaoyang Meridian Syndromes