太阳篇曰∶无热恶寒者,发于阴也。此言寒邪直中阴经之寒证也。始终则在一经非若热
证之
传经者也。人伤于寒者,自表而始,则皮肤受伤,阳气不能伸越,乃郁而成热,是为发于阳
之热证,表邪不解,则以次而传经。若夫非表始而直入于阴经,不由阳郁热而来,初起便手
足厥冷,或恶寒伴倦,成无热恶寒之证。始于阴经,是为发于阴之寒证,三阴所见,虽有吐
痢,语证稍异,如自利不渴属太阴,自痢而渴属少阴之类,皆起于无热恶寒,乃其常耳。惟
少阴有始得之反发热脉沉者,以罕有是证,故语其变而曰反也。然则发于阴经之寒证,岂可
与发于阳经之热证并论哉?热证属阳,寒证属阴,阴阳动静,造化自然。阴寒直入,只在一
经无传之理。何成氏昧于此,谓其从太阳始,亦以次而传变六经,且以再传三传推之,有是
理乎?《少阴篇》曰∶少阴病,脉微细,但欲寐者,阴主静也。乃注曰∶邪气传里深也。若
此之类,无始得便厥之文。盖误认为热证,无惑乎传里之说也。《厥阴篇》曰∶伤寒厥四日
,热反三日,复厥五日,其病为进,寒多热少,阳气退,故为凶也。夫先厥四日者,寒邪直
入厥阴阴胜也。热后三日,阳气欲复耳,非变为传经之热证也。复厥五日者,阴气胜阳,阳
不能复,故曰病进。乃注曰∶先厥四日,却热三日,七日传经尽当愈。若不愈而复厥者,再
作传经,盖再从太阳传里之谓也。阳经受病,必郁而成热,有先厥者乎?《灵枢》曰∶邪之
中人,或中于阴,或中于阳,何尝必自太阳始耶?盖因其或寒或热,不知始终。只是厥阴证
,亦无惑乎传经之失也。至若辨脉篇曰∶其脉沉而迟,不能食,身体重,大便反硬,名曰阴
结也,期十四日当剧。注曰∶沉迟阴结也,不能食,身体重,阴证也。阴病见阴脉则当下,
今大便硬者,为阴气结,阳不得而杂之,是名阴结。成氏知其寒证为纯阴矣,而复以传经至
再三释之。夫既为阴气结固,则结固于里者,能出而传之表乎?不可下编曰∶无阳阴强,大
便硬者,必清谷腹满,此即阴结之寒证也。成氏亦注曰∶阴强者寒多,阴结即里寒之证,其
有传经者哉。总由不知伤寒有直入三阴之寒证,又不知寒邪与热病大不相同,其意混谓中寒
则必传经。故虽知寒气胜而先厥者,概以自表而传论之。三阴注释,误者纷纷,立言垂训
之士,胡为若此,学人明于取舍,始得尚友之道矣。
The *Taiyang Chapter* states: "Those without fever but with aversion to cold originate from the Yin." This refers to Cold syndromes where Cold pathogenic factors directly invade the Yin meridians. Such conditions remain confined to a single meridian throughout, unlike Heat syndromes which undergo transmission (Chuan Jing) to other meridians. When humans are injured by Cold, it typically begins at the exterior, damaging the skin and muscles. Yang Qi fails to extend and transcend, leading to stagnation and transformation into Heat; this is termed "originating from Yang" (Fa Yu Yang), a Heat syndrome. If the exterior pathogen is not resolved, it transmits sequentially through the meridians. However, if the invasion does not begin at the exterior but directly enters the Yin meridians, and does not arise from Yang stagnation transforming into Heat, the initial presentation involves cold extremities or aversion to cold accompanied by fatigue, forming a syndrome of aversion to cold without fever. Starting in the Yin meridians, this is called "originating from Yin" (Fa Yu Yin), a Cold syndrome. Although the Three Yin syndromes (Taiyin, Shaoyin, Jueyin) present with vomiting and diarrhea, their specific manifestations vary slightly; for instance, spontaneous diarrhea without thirst belongs to Taiyin, while spontaneous diarrhea with thirst belongs to Shaoyin. All these originate from aversion to cold without fever, which is their normal course. Only in Shaoyin disease is there an exception where fever appears initially despite a deep pulse; because this presentation is rare, it is described as "counterfeit" (Fan) when discussing its variations. Given this, how can Cold syndromes originating from the Yin meridians be discussed on par with Heat syndromes originating from the Yang meridians? Heat syndromes belong to Yang, Cold syndromes belong to Yin; the movement and stillness of Yin and Yang follow the natural order of creation. When Yin-Cold invades directly, it remains confined to one meridian with no rationale for transmission. Why did Cheng Wuji fail to understand this, claiming that it starts from the Taiyang meridian and transmits sequentially through the Six Meridians, and deducing further transmissions? Is such reasoning valid?
The *Shaoyin Chapter* states: "In Shaoyin disease, with a faint and thin pulse and only a desire to sleep, this is because Yin governs stillness." The commentary notes: "This indicates the pathogenic factor has transmitted deeply into the interior." In cases like this, there is no text describing initial cold extremities. Presumably, mistaking it for a Heat syndrome makes the theory of "transmission to the interior" unsurprising.
The *Jueyin Chapter* states: "In cold damage, cold extremities last four days, fever lasts three days, then cold extremities return for five days; the disease progresses because Cold is predominant and Heat is scarce, causing Yang Qi to retreat, thus indicating a ominous prognosis." The initial four days of cold extremities indicate Cold pathogenic factors directly invading Jueyin, with Yin excess. The subsequent three days of fever represent an attempt by Yang Qi to recover, not a transformation into a transmitting Heat syndrome. The return of cold extremities for five days signifies Yin overcoming Yang, preventing Yang recovery, hence stating the disease progresses. However, the commentary claims: "After four days of cold extremities and three days of fever, by the seventh day, the transmission cycle should complete and healing should occur. If not healed and cold extremities return, it constitutes another round of transmission, implying transmission again from Taiyang to the interior." When Yang meridians are affected, they must stagnate and transform into Heat; how could cold extremities appear first? The *Ling Shu* states: "Pathogenic factors attacking humans may strike Yin meridians or Yang meridians," questioning why it must necessarily start from Taiyang. Due to confusion between Cold and Heat and ignorance of the disease's beginning and end, even in Jueyin syndromes, errors regarding transmission are understandable.
Regarding the *Bian Mai Pian* (Chapter on Pulse Differentiation): "If the pulse is deep and slow, the patient cannot eat, feels heavy-bodied, and the stool is paradoxically hard, it is named Yin Knot (Yin Jie), expected to worsen on the fourteenth day." The commentary explains: "Deep and slow pulses indicate Yin Knot; inability to eat and heaviness indicate Yin syndromes. When Yin diseases present with Yin pulses, purgatives should be used. Now, hard stool indicates Yin Qi knotting, excluding Yang Qi interference, hence named Yin Knot." Cheng Wuji recognized this Cold syndrome as pure Yin, yet explained it via multiple rounds of transmission. If Yin Qi is firmly knotted internally, can this internal knotting transmit outward to the exterior? It is impossible. The *Bu Ke Xia Bian* states: "Without Yang, with strong Yin and hard stool, there must be undigested food in stools and abdominal fullness; this is the Cold syndrome of Yin Knot." Cheng Wuji also commented: "Strong Yin implies much Cold; Yin Knot is a Interior-Cold syndrome, where would transmission come from?" Ultimately, this stems from not knowing that cold damage includes Cold syndromes directly entering the Three Yin meridians, and failing to recognize that Cold pathogens differ significantly from Heat diseases. His intent conflates mid-Cold with inevitable transmission. Thus, even recognizing that excessive Cold causes initial cold extremities, he generally attributes it to transmission from the exterior. The commentaries on the Three Yin meridians are rife with errors. Why do those establishing doctrines act thus? Learners must discern what to accept and reject to achieve the way of befriending the ancients.