仲景论曰∶日数虽多,但有表证,而脉浮者,犹可发汗;日数虽少,若有里证,而脉沉实者,即须下之。是日
数之不可拘也如此。孙思邈曰∶服承气得利,谨勿中补。热气得补复成,此所以言实热也。王叔和有曰∶虚
热不可攻,热去则寒起,此所以言虚热也。二人之言,殊途同归。是虚实之不可辨也如此。又况寒、温、热,
同实而不同名。暑、湿、风,异种而有兼病。异气之相承,他邪之并作,表证中之有不可汗,里证中之有不
可下。三阴可温,而攻积证者不同。表里俱见,与半表半里无表里有异,伤寒、伤风,脉证互
见。中暑、热病,疑似难明。阳明本多汗,而有反无汗之形;少阴本无汗,而有反自汗之证。或阴极发躁,
阳极发厥,阴证似阳,阳证似阴,差之毫厘,谬以千里。又有痰证,食积、虚烦,香港脚,证
似伤寒,不可以伤寒之法拘之。自非心领意会。达变知机,体认之精,发用之当,则纵横泛应,几何而不
Zhang Zhongjing stated: Although the number of days since onset is long, if there are still exterior symptoms (biao zheng) and the pulse is floating (mai fu), sweating therapy (fa han) may still be employed; although the number of days is short, if interior symptoms (li zheng) are present and the pulse is deep and excess (mai chen shi), purgative therapy (xia zhi) is required. Thus, the number of days cannot be rigidly adhered to. Sun Simiao said: After taking Chengqi Tang (Chengqi Decoction, a formula for purging heat and unblocking bowels) results in smooth bowel movement, do not administer tonification midway. If heat is supplemented, it will reconstitute as excess heat; this refers to excess heat (shi re). Wang Shuhe said: Deficient heat (xu re) must not be treated with attacking/purgative methods; if the heat is removed by such means, cold (han) will arise; this refers to deficient heat. The statements of these two individuals differ in approach but converge in conclusion. Thus, the distinction between deficiency and excess is complex. Furthermore, cold (han), warm (wen), and heat (re) pathogens share the same nature but have different names. Summerheat (shu), dampness (shi), and wind (feng) are distinct pathogens yet often cause combined diseases. Different pathogens may succeed one another, and other pathogenic factors may arise simultaneously. There are cases where exterior syndromes preclude sweating therapy, and interior syndromes preclude purgative therapy. The Three Yin syndromes (San Yin) can be treated with warming methods, but treating accumulation syndromes differs. Exterior and interior signs appearing together are distinct from Half-Exterior Half-Interior syndromes (Ban Biao Ban Li) which lack clear exterior-interior differentiation. Pulse and symptom presentations in Cold Damage (Shang Han) and Wind Strike (Shang Feng) interweave. Heat Stroke (Zhong Shu) and Heat Disease (Re Bing) are difficult to distinguish due to their similarity. Yangming disease (Yang Ming Bing) typically presents with profuse sweating, yet may paradoxically present without sweat; Shaoyin disease (Shao Yin Bing) typically presents without sweat, yet may paradoxically present with spontaneous sweating. Extreme Yin conditions may manifest as restlessness (Ji Yin Fa Zao), and extreme Yang conditions may manifest as cold limbs (Ji Yang Fa Jue). Yin syndromes may resemble Yang syndromes, and Yang syndromes may resemble Yin syndromes. A slight error leads to a massive deviation. Additionally, Phlegm disorders (Tan Zheng), Food Stagnation (Shi Ji), Deficiency Vexation (Xu Fan), and Hongjiao (Hongjiao, a disease characterized by lower limb swelling and weakness due to dampness) resemble Cold Damage but cannot be confined to the treatment principles of Cold Damage. Unless one comprehends through mind and intuition, understands change and opportunity, possesses precise recognition, and applies treatments appropriately, how could one handle diverse situations without error?