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Taiyang disease, with a pulse that is floating, moving, and rapid. Floating indicates wind, rapid indicates heat, moving indicates pain, and rapid also indicates deficiency; headache and fever, with slight night sweats, yet conversely aversion to cold, indicate that the exterior syndrome has not yet resolved. The physician erroneously applies purgation, causing the moving and rapid pulse to change to a slow one, rejection pain within the diaphragm, emptiness in the stomach, disturbance of the pathogenic qi affecting the diaphragm, shortness of breath, irritability, mental restlessness (Ao Nao), internal sinking of Yang Qi, hardness below the heart, thus forming Jie Xiong (Chest Binding); Da Xian Xiong Tang (Great Decoction to Drain the Chest) is the primary treatment.

Commentary: Taiyang disease is at the exterior; attacking the interior without first resolving the exterior is indeed erroneous. Moreover, the obtained pulses are all floating, moving, and rapid; now, after erroneous purgation, the moving and rapid pulse becomes slow; it is also said that the stomach is empty and there is shortness of breath and irritability, indicating extreme deficiency. If one were to say that Yang Qi has sunk internally and hardness has occurred below the heart, can one swiftly apply purgation? Is the power of Xian Xiong Tang actually slower than Cheng Qi Tang? Purging once and then again, how can one not fear severe depletion? Furthermore, the Classics clearly state: In Jie Xiong syndrome, if the pulse is floating and large, do not purge; purging leads to death. It also states: If all symptoms of Jie Xiong are present and there is irritability, it is a death case. Now it says the pulse is floating and there is irritability; can Da Xian Xiong Tang truly be used? (Zhu Danxi)

Taiyang disease, after heavy sweating and subsequent purgation, resulting in no bowel movement for five or six days, dryness and thirst on the tongue, slight tidal fever in the late afternoon, hardness and fullness from the epigastrium down to the lower abdomen that cannot be touched, is treated with Da Xian Xiong Tang.

Commentary: Taiyang disease has already undergone heavy sweating, so the exterior is deficient. If purged subsequently, the interior is also deficient. No bowel movement for five or six days shows consumption of body fluids. Although there is hardness and pain, can one swiftly purge? If one argues that tidal fever in Shen and You hours belongs to Yangming and is an indication for Tiao Wei Cheng Qi Tang, yet it says "slight" tidal fever, leaving room for doubt; are there not other methods to achieve relief gradually? (Zhu Danxi)

For Jie Xiong syndrome, Zhang Zhongjing uses Da Xian Xiong Tang. I have observed that this is suitable only for original Shanghan (Cold Damage) disease, not caused by erroneous purgation, but where excess pathogen transmits to the interior, causing hardness and fullness below the heart, pain radiating to the lower abdomen that cannot be touched, or dry thirst, delirium, hard stool, and a solid pulse. For cases where Tai and Shao Yang exterior pathogens remain unresolved due to premature purgation, the exterior pathogen is still present; using Xian Xiong Tang again would be one error after another, which I dare not endorse. It is better to refer to the methods in the Pi Man (Fullness and Obstruction) section and apply them judiciously. (Zhang Jingyue)

Jueyin wind strike, with a pulse slightly floating, indicates impending recovery; if not floating, it indicates non-recovery.

If there is a pulse for impending recovery in Jueyin wind strike, there should be signs of non-recovery. Given that Jueyin is the wood organ, and during the time when wind-wood governs the qi, being struck by wind again implies that complications must be more severe than in other meridians; it is impossible that there are none, leaving regret over missing texts. ○ Zhang Zhongjing distinguishes the Six Meridians, each having pulse, syndrome, and treatment methods for wind strike and cold damage. During Wang Shuhe's time, the Taiyang chapter had many preserved and few lost; other meridians had few preserved and many lost; the Yangming chapter still has two items of wind strike pulse and syndrome, Shaoyang meridian has only one syndrome item without mentioning pulse; the Three Yin meridians only have the pulse for wind strike impending recovery, lacking wind strike pulse and syndrome entirely. To consider the Shanghan Lun as a complete work is too negligent. (Ke Yunbo)

Disease in the Yang aspect should be resolved by sweating; instead, cold water is sprayed or poured on the patient. The heat is constrained and cannot escape, becoming increasingly烦 (fán - vexed/restless), skin rises like millet grains, desire to drink water but no actual thirst; administer Wen Ge San (Clam Shell Powder).

If not improved, administer Wu Ling San (Five-Ingredient Powder with Poria). If body heat and skin millet grains persist, and the patient desires to pull clothes to cover themselves, spraying or washing with water further constrains the heat preventing its exit; sweating should occur but does not, leading to vexation; if sweating occurs and abdominal pain follows, administer three liang of Shaoyao (Paeoniae Radix) according to the above method. ○ Taiyang disease on the second day, conversely restless, etc. (See Huitong) ○ After purgation, re-sweating, daytime irritability preventing sleep, nighttime quietness, no vomiting, no thirst, no exterior syndrome, pulse deep and faint, no significant body heat; Gan Jiang Fu Zi Tang (Ginger and Aconite Decoction) is the primary treatment. ○ Sweating, or purgation, disease remains unresolved, with irritability; Fu Ling Si Ni Tang (Poria and Four Reversal Decoction) is the primary treatment. ○ Cold damage, abdominal fullness and delirium, Cun Kou (radial) pulse floating and tight, this is Liver overacting on Spleen, named Zong (Vertical Overaction), puncture Qimen (LR14). ○ Cold damage fever, se se (shivering) aversion to cold, etc. ○ Patient with no exterior or interior syndrome, fever for seven to eight days, etc. (All see Cuojian) ○ Pulse floating and hollow (Kou); floating is Yang, hollow is Yin; floating and hollow interacting, Stomach Qi generates heat, its Yang is severed. ○ Yangming disease, conversely no sweat and clear urination, vomiting and coughing after two to three days, cold hands and feet, must suffer headache; if no coughing or vomiting, and hands and feet are not cold, the head does not hurt. ○ Yangming disease, only dizziness, no aversion to cold, thus able to eat and cough, the person's throat must hurt; if no coughing, the throat does not hurt. ○ Shaoyin disease, vomiting and diarrhea, cold hands and feet, irritability desiring death; Wu Zhu Yu Tang (Evodia Decoction) is the primary treatment. ○ Cold damage, pulse floating, spontaneous sweating, frequent urination, heart vexation, slight aversion to cold, leg cramping; conversely given Guizhi Tang (Cinnamon Twig Decoction) to attack the exterior, this is an error, resulting in cold limbs. Dry throat, irritability, vomiting and reflux; prepare Gan Cao Gan Jiang Tang (Licorice and Ginger Decoction) to restore Yang. If cold resolves and feet warm, prepare Shao Yao Gan Cao Tang (Peony and Licorice Decoction), legs will extend. If Stomach Qi is disharmonious and delirium occurs, give small amounts of Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct to the Interior Decoction). If heavily sweated and moxa needles added, Si Ni Tang (Four Reversal Decoction) is the primary treatment. ○ Question: Syndrome resembles Yangdan, etc. (See Wendan) ○ Cold damage six to seven days, after major purgation, Cun pulse deep and slow, cold hands and feet, etc. (See Fangkao) ○ Cold damage eight to nine days, after purgation, chest fullness, vexation and fright, difficult urination, delirium, heaviness throughout the body unable to turn; Chai Hu Jia Long Gu Mu Li Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction) is the primary treatment. ○ Pulse slightly rapid, strictly avoid moxibustion; because fire becomes pathogenic, causing vexation and rebellion, chasing deficiency and pursuing excess, blood scatters in vessels; although fire qi is weak, internal attack is powerful, scorching bones and injuring sinews, blood is hard to recover. ○ Pulse floating should be resolved by sweating; applying moxibustion leaves pathogen no outlet, flourishing due to fire, disease from waist down becomes heavy and numb, named Fire Rebellion. ○ Cold damage pulse floating, physician uses fire coercion, etc. (See Wendan) ○ Dampness patient purged, sweat on forehead, slight panting, clear urination, death; if diarrhea unceasing, also death. ○ Sunstroke in Taiyang, body heat and heavy pain, pulse faint and weak, this is also caused by summer injury to cold water, water circulating in the skin. ○ Pulse soft and weak, weakness reversed in Guan position, softness reversed in Dian position (Cun), faintness reversed above, choppy reversed below; faintness means insufficient Yang Qi, choppy means lack of blood, Yang Qi conversely faint, wind strike sweating, conversely vexation; choppy means lack of blood, reversal and cold, faint Yang sweating, vexation preventing sleep. ○ Pulse soft and weak, weakness reversed in Guan, softness reversed in Dian; wiry reversed above, faint reversed below; wiry is Yang movement, faint is Yin cold; upper excess lower deficiency, desire for warmth; faint and wiry is deficiency, do not sweat, sweating causes chills unable to recover. ○ Reversal with tight pulse, do not sweat, sweating causes voice disorder, hoarse throat, atrophied tongue, voice cannot emerge. ○ Coughing becomes severe, frequent spitting of saliva, throat must be dry, difficult urination, hunger and vexation in heart, attacks intermittently resembling malaria, cold without heat, deficiency with chills, coughing and sweating, curling up suffering fullness, abdomen again hard. ○ Pulse soft and weak, weakness reversed in Guan, softness reversed in Dian curling; faintness reversed above, choppy reversed below; faintness means insufficient Yang Qi, choppy means lack of blood, Yang Qi conversely faint, wind strike sweating, conversely vexation; choppy means lack of blood, reversal and cold; faint Yang cannot purge, purging causes epigastric pi-hardness. ○ Pulse soft and weak, weakness reversed in Guan, softness reversed in Dian; wiry reversed above, faint reversed below; wiry is Yang movement, faint is Yin cold; upper excess lower deficiency, desire for warmth; faint and wiry is deficiency, deficiency cannot purge. ○ Pulse soft and weak, weakness reversed in Guan, softness reversed in Dian; floating reversed above, rapid reversed below; floating is Yang deficiency, rapid is lack of blood; floating is deficiency, rapid is heat; floating is deficiency, spontaneous sweating and aversion to cold; rapid is pain, chills and shivering. Faint and weak in Guan, urgency below chest, panting and sweating unable to breathe, breathing pain in hypochondrium, chills interacting, shape like malaria, physician erroneously purges, thus making pulse rapid and feverish, running mad seeing ghosts, epigastric pi, dripping urination, severe lower abdominal hardness, hematuria. ○ Pulse soft and tight, soft means Wei Qi is weak, tight means Ying Cold in interior. Yang weak, Wei struck by wind, fever and aversion to cold. Ying tight, Stomach Qi cold, slight vomiting, internal heart vexation. Physician thinks there is great heat, releases muscle and sweats. Loss of Yang, deficiency vexation, epigastric bitter pi-hardness. Exterior and interior both exhausted, sudden rising causes dizziness. Guest heat in skin, discontented unable to sleep. Ignoring cold Stomach Qi, tight cold in Guanyuan. Skill useless. Drawing water to pour on body. Guest heat ceases with time, shivering and chills. Heavy blankets covering, sweating and head covered. Body trembling and shaking, urination slightly difficult. Cold qi triggered by water, clear undigested food allows no interval. Vomiting changes to evisceration, turning upside down unable to rest. Hands and feet slightly reversed, body cold and internal vexation. Late attempt to save from behind, how can it be追回 (retrieved)? ○ Pulse floating and large, floating is Qi excess, large is Blood deficiency; Blood deficiency is no Yin, solitary Yang descends alone to Yin parts, urine should be difficult and difficult to pass, uterus should be empty; now conversely clear urination and heavy sweating, law dictates Wei Qi should be weak; now conversely more solid, body fluids scatter four ways, Ying exhausted Blood finished, dry vexation unable to sleep, blood thin flesh wasting, becoming sudden fluid loss; physician again uses toxic drugs to attack Stomach, this is double deficiency. Guest Yang departure has a date, must defecate like mud and die. ○ Cold damage, Yin and Yang pulses both tight, aversion to cold and fever, then pulse wants to reverse. Reverse means pulse initially large, gradually small, then gradually large, this is its sign. Such cases have aversion to cold, severely fluttering sweat, throat pain. If heat is dominant, red eyes and many pulses, eyes dull; physician re-sweats, throat injured; if re-purged, both eyes close, cold dominant clear stool, heat dominant pus and blood in stool; if fumigated, body turns yellow; if ironed, throat dry. If urination clear, can be saved; if urination difficult, critical. ○ Cold damage fever, bubbling air from mouth, etc. (See Tuoyi) ○ Faintness causes cough, coughing spits saliva, purging stops cough but diarrhea continues unceasing; diarrhea unceasing, chest feels like insect biting, porridge enters and exits, difficult urination, bilateral hypochondriac tension, difficult breathing, neck and back pulling, arms numb, extreme cold, conversely sweating, body cold as ice, eyes dull, speech unceasing, grain qi enters much, this is Chu Zhong (Elimination of Central Qi). Mouth wants to speak, tongue cannot advance. ○ Rapid pulse, long-lasting rapid without stopping, stopping means pathogen binds, Zheng Qi cannot recover, Zheng Qi binds in Zang, thus pathogen floats and connects with skin and hair. Rapid pulse cannot be purged, purging causes vexation, diarrhea unceasing. ○ Cold damage fever, headache, slight sweat, sweating causes inability to recognize people; fumigation causes panting, inability to urinate, heart and abdominal fullness; purging causes shortness of breath, difficult urination, headache and stiff back; adding warm needle causes nosebleed. ○ Diarrhea with large pulse is deficiency, due to strong purgation. Suppose pulse floating and革 (Ge - drumskin), thus intestinal borborygmus, belongs to Dang Gui Si Ni Tang.

Zhang Zhongjing's Shanghan Lun, every chapter is worthy of emulation. But completed in the late Han, transmission has many errors, misplaced bamboo slips are also numerous, such as in the treatise, diarrhea and vomiting treated with Shi Zao Tang (Ten Date Pill) harsh purgative; severe Yang nosebleed treated with Mahuang Tang (Ephedra Decoction) to sweat; sweating resolves disease, conversely aversion to cold, one extra "not" in "disease resolves"; epigastric pi, pressing soft, one missing "not" above "soft". Various schools following classics to annotate, forced to interpret arbitrarily, causing this rare book of millennia to not be trusted in the world, truly pitiable. Now correcting errors, listed one by one, small characters above side are original text; below side are corrected text; centered are original existing. Or moved up, or moved down, or moved from elsewhere, and supplemented where original lacks. Circle above character means deleted. Especially whole sections erroneous, thirty-five items, syndrome does not match pulse, medicine does not match disease, although formula exists, world has no such disease, even if disease exists, although medicine used, inheriting errors and falsehoods, no practical help. Yet among them there are still sentences worth采 (collecting), so each chapter does not move Classic text, forcibly adds annotation, re-copies original text attached to end of volume, to record doubts. (Yizong Jinjian)

The "Ke Bu Ke" (Can and Cannot) chapters, claimed as Sage of Medicine's original text, have several suspicious points: Original text is concise and meaning complete, here words are many but meaning incomplete, one; deliberately rhyming sentences, resembling five-character poetry, Six Meridians treatises have no such style, two; reasons for can/cannot cite original texts from Six Meridians, some say already seen in certain chapters of Shanghan Lun, inconsistent, three; often use "fan" (conversely/reverse) character, but no reverse meaning, such as saying pulse soft and weak, weakness conversely in Guan, softness conversely in Dian, could softness suit Guan and weakness suit Dian? Dian two characters, also Sage's words, pulse never seen, four; various can-purge inside, generally use Da Cheng Qi, Sage's words on purging mostly do not give formulas, presumably from Da Chai Hu, Tiao Wei, Da, Xiao San Cheng Qi, Xian Xiong, Xie Xin, Di Dang etc. methods, all say purging, now can/cannot purge, only say purge stool, already feel meaning incomplete, moreover purging stool is not covered by just Da Cheng Qi, not detailed, why need special treatise, five; regarding various annotations, roughly fabricated into text, explanation slightly coherent, if attacked, cannot withstand contradiction, how can one raise the dead to ask? six; Formula notes extract six long paragraphs, thinking categories unclear, not establishing notes, in my view, these four characters "categories unclear" can cover the whole meaning of four chapters, seven; Can vomit, can sweat, can purge major rules set seasonal times, still old wisdom of making examples, even more rigid, eight. (Wei Litong)

Wang Shuhe's additions are Bian Mai (Differentiating Pulses), Ping Mai (Leveling Pulses), and Ke Han (Can Sweat), Ke Xia (Can Purge) etc. chapters. His Six Meridians etc. chapters must not be praised by Wang Shuhe. But in Jueyin meridian, diarrhea, vomiting, hiccups various items, are indeed Wang Shuhe attaching them because of Jue Ni (Reversal Cold), and thus those without Jue Ni but similar kind, also attached. (Su Hui Ji)

Six Evils first emphasize Cold Damage, Suwen although started its beginning, did not exhaust its meaning, Later Han Zhang Zhongjing wrote Shanghan Lun, elucidated its depths, detailed its treatment methods, truly a treasure raft in medical forest. Only its book language is ancient and profound, and transmitted for long time, already many scattered and lost, and Wang Shuhe's compilation, Lin Yi's proofreading, Cheng Wuji's annotation, again many deviations, causing learners' path hard to glimpse, reading confused, relying on later heroes, each possessing great vision, one by one verifying. Pity that precious things scattered, unable to list in one area, difficult to browse casually. Not daring presumption, carefully trace various schools' annotations,凡是 (all) in Lun having inverted order, misplaced slips, transmission errors, omissions, interpolations, character errors, annotation falsehoods, formula deviations, pointed out by former sages, supplemented, moved, deleted, changed, verified and examined, and Huitong, Wendan, Queyi, carefully recorded several items, divided into eleven chapters, compiled into one volume, readers may hopefully see clearly at a glance. ○ Someone asks: Traditionally Suwen not from Xuanyuan and Qibo, but written by Warring States people, falsely attributing name, and Shanghan Lun theory deeper than Suwen, yet errors more, why? I say: Ask thoroughly! Formerly heard old doctor Fang Xingyan say: Shanghan Lun not Zhang Zhongjing's own book, but Yi Yin's words, and elaborated upon. So this book more ancient and profound than Suwen, truly not Han literature, and preface and main text tone different, originating from two hands known. According to Yi Yin original writing You Tangye, Zhang Zhongjing preface already has diligent seeking ancient teachings, extensively collecting formulas words, also examine Huangfu Mi say: Zhang Zhongjing expanded Yi Yin Tangye into dozens of volumes, used much effective. From this view, Fang's words, must have basis, tentatively record, to question wise men. Student Cheng Wenyu knows.