邹注《伤寒论》仲景《伤寒论》注释者，自成无己以来，计有一百三十余家，诸家当命笔之始，无不自谓毕世穷研，独得其秘，尽斥前人之安，自诩见理之真，但是吾人今日视之，诸家之纷呶，正如公说公有理，婆说婆有理，各具一理，各备一说，吾人亦不过姑妄听之而已，诸家中能直抉仲景之奥者，只武进邹润庵先生一人，颇邹先生之《伤寒伦通解》四卷，《伤寒金匮方解》六卷，当世不少概见，大为遗憾。余服膺先生三十年来，拳拳如一日，自恨吾生也晚，未获亲炙先生门墙，因诸人之释伤寒，如宋儒之说理，标本中见，六气胜得，枢饥变化，满纸都是空谈，治病绝无用处。独先生之释伤寒，如汉儒之说经，全在脉证上注意，无一词半语空话，字字皆有来历，句句皆归实用，吾知悬诸国门，千金决不能易其一字，故特于《本经疏证》中，寻出一鳞一爪，集刊本林，颜曰《邹注伤寒论集》，吾知治伤寒学者，必与余有同好也。
“手足厥寒，脉细欲绝者，当归四逆汤主之，若其人内有久寒者，宜当归四逆汤加吴茱萸生姜汤主之。”
阴邪横及四肢，于理宜行姜附，乃仅用生姜、吴茱萸，生姜吴茱萸，岂能代干姜附子耶?原人身不外阴阳，邪气亦不外阴阳，病发于阴者，必客于腹中，腹中以肝为都会，肝者，体阴用阳，故虽因内有久寒，至手足厥逆。脉细欲绝，仍不能无消渴与心中疼热，吴茱萸降在上之热以就下，生姜散在下之寒而使之横达，不然热就上为咳吐脓血，寒就下为下利厥寒，岂四逆辈启生阳于肾中可比耶。
“食谷欲呕者，属阳明也，吴茱萸汤主之，得汤反剧者，属上焦也。”
“少阴病吐利，手足逆冷，烦躁欲死者，吴茱萸汤主之。”
“干呕吐涎沫，头痛者，吴茱萸汤主之。”
吴茱萸汤证，阳在上而阴在下，食谷欲呕，吐利干呕，吐涎沫，头痛，呕而胸满，则阳尽在中，不能安于中，且欲上出矣。手足厥逆，烦躁欲死，则仅能扰于中，不得达于外矣，所以致此者，非在下阴邪搏之而何?然据于中，则不越于上，泄于外，可知其阴自肝而不自肾矣。吴茱萸汤首吴茱萸，是导阳下达，然仅导阳下达，而不剿抚其阴，则阳虽下，阴仍得与之敌，是故参、枣所以抚定其阴，生姜则能使阴邪横散。不与阳为敌者也，然则生姜非治肝，乃散自肝上引之阴邪耳。
理中汤解理中汤所主，在《伤寒论》曰“既吐且利，寒多不欲饮水。”在《金匮要略》曰“胸痹心中痞闷，气结在胸，胸满胁下逆抢心。”一者由中而溃决四出，一者由上下而并凑于中，惟其中，无所守，是以外者能内，内者能外，内外可以易位，生死不可遂判乎。方中参、甘气味柔和，能羁内出外入之驶，不能制内出外入之令；白术刚乎参、甘，能制其出入矣，犹不能不令出入，惟干姜味辛气温，能令外不敢入，性守不走，能令内不也出。盖惟中虚，是以客气得入，惟中寒是以不能逐而使出，故理中补虚，即其制出之权，其驱寒即其制入之威，于是加以桂枝，则治内寒外热，内虚外实，心中痞鞭，利下不止，表里不解。桂枝人参汤证，杂以薯蓣及诸补散，则治虚劳诸不足，风气百疾。薯蓣丸证，间以半夏而去术、草，则治妊娠呕吐不止。干姜人参半夏丸证，增以旋覆花、代赭石、半夏、大枣而去术，则治心下痞鞭，噫气不除。旋复花代赭石汤证，莫非分理中之半，恃姜为却寒散满之长城，即对待以寒凉，如半夏泻心汤，生姜泻心汤，甘草泻心汤、黄连汤，干姜黄连黄芩人参汤，按而察之，犹有理中之参、草、干姜在其中，而恃干姜不浅矣。
“脐上筑者，肾气动也，去术加桂。”[指理中汤]夫肾气动亦不过作贲豚，气从少腹上冲心耳。贲豚水气也。土能制水，自术补土健睥，何不可使为中流之柱，横截于中，令水气不上冲心耶，是盖不然，夫土能防水。止能防其下泄，不能防其上涌。下泄者水之性。上涌者非水之性，必有激之使然者，除其激之之源，水自归壑矣。古之人有治堤者，随筑随溃，皆缘水从下上涌，则熔铁汁灌之，堤乃得成。以桂易术正此意耳。苓桂术甘汤，有心下逆满，气上冲心，脉沉紧，身振振摇。病未尝不涉肾，而不忌术，仅因发汗后脐下悸，用苓桂枣甘汤。旋即以枣易术，可见术之于肾确有所忌。矧霍乱为病，既吐且利，正系水土反乘，若更以所忌者横梗于中，令病与药相拒相争，不至溃败决裂不止矣。
霍乱，头痛发热，身疼痛，热多欲饮水者，五苓散主之；寒多不饮水者，理中汤主之。
理中丸人参甘草白术干姜各三两。上四味捣筛为末，蜜和为丸，如鸡子黄大，以沸汤数合，和一九，研碎。温服之，日三四服，夜二服。腹中未热，益至三四丸，然不及汤。作汤煮服法，四物依两数切，用水八升，煮取三升，去渣，温服一升，日三服。若脐上筑者，肾气动也，去术加桂四两。吐多者去术加生姜二两。下多者，还用采。悸者加茯苓二两。渴欲饮水者加术，足前成四两半。腹中痛者加人参，足前成四两半。寒者加干姜，足前成四两半。腹满者去术加附子一枚。服汤后，如食顷，饮热粥一升许，微自温，勿揭衣被。
五苓散、理中丸皆有白术，则白术执霍乱之两端，为必用之物矣，而去术还用术，更加术，纷纷无定，统而观之，其用术加术之意，总在使脾气散精，上归于肺，通调水道，下输膀胱而已。吐多者胃病，胃既作吐，则不能游溢精气，上输于脾，脾无所受精，于何输肺?下多者脾病，脾既下陷，不能循其上朝之职，若非有以扶之，则枢机于何转?于此见术能举脾之陷，不能定胃之逆也。渴者胃之虚，渴必多饮，饮多则纵使吐逆。亦能波及于脾，脾有所受而不能举，则下必更甚。腹满者脾实，脾实不能上输，即下泄，而不减其满，势必自下逆上，自腹及胸，吐更加甚，于此见未能治脾胃虚，不能治脾胃实也。为上为下，为实为虚，情势不同，而既吐且利则一，既吐且利，渴欲饮水，斯术为必需。
“伤寒，脉浮，自汗出。小便数，心烦微恶寒，脚挛急，反与桂枝汤攻其表。此误也，得之便厥。咽中干，烦躁，吐逆者，作甘草干姜汤与之，以复其阳。若厥愈，足温者，更作芍药甘草汤与之，其脚即伸。”
甘草干姜汤，芍药甘草汤，一和脾。一和肝。和脾者，安中宫阳气之怫乱；和肝者，通木脏阴气之凝结。虽系干姜、芍药之力，然此重彼轻，则不可见中央之病，中央药主之，干姜、芍药力虽大，然保泰定功。不能不归于甘草也，故两场之治，日便厥，咽中干，烦躁吐逆，两胫拘急，是阳明内结也，与甘草干姜汤。厥愈足温。重与芍药甘草汤，尔乃胫伸。夫阳结为厥，阴结为拘，干姜能破阳，芍药能破阴，破阴破阳，能愈拘愈厥，不能愈咽干，止烦躁，此保泰定功之所在矣。夫中者，上下之枢，《金匮要略》云“肺痿吐涎沫而不咳者，其人不渴，必遗尿，小便数，所以然者，上虚不能制下也，此为肺中冷。甘草干姜汤以温之，是由中以益上制下也，一变而为理中汤，治上吐下利，是由中以兼制上下矣。再变而为桂枝人参汤，治外热内寒，表里不解-是由中以兼制内外矣。又一变而为四逆汤，治下利清谷，是由中以制下矣。再变而为通脉四逆汤，治下利面赤。内寒外热，是由中及下，兼制内外矣。甘草干姜汤，制上中以及下，能扩充以至外。芍药甘草汤，则制中下以及外，能扩充以至内，如桂枝汤之治风，黄芩汤之治热，芍药甘草附子汤之治寒，莫不连类及者，亦可悟甘草居中安土之大凡矣。
批张隐庵《伤寒论集注》隐庵前辈致力伤寒二十年如一日，观其自序，经寒暑历岁月，废寝食绝交游，春花秋月之莫问，澄水佳山之弗临，致力之勤，无以复加，就惜其不脱宋明理学家习气，好为高论，之后读者，反觉高深莫测，余之批隐庵，非攻击隐庵也，实欲仲景之学，无微不显，无暗不明尔。
辨太阳病脉证篇第一“太阳之为病，脉浮，头项强痛而恶寒。”
太阳为诸阳主气，有通体分部之不同。通体太阳如天，主周身皮肤、毫毛、肌表，一似天之环绕于地外；分部太阳如日，主头项、脊背、尾闾、血室，一似日之旋转于躔度，[躔，音chán，读蝉。躔度，谓日月星辰的运行。]此首明太阳主通体之毫毛，而复有循经之分部也。太阳之为病，脉浮，言太阳运行于周身之肤表，病通体之表阳’，故其脉应之而浮也。头项者，太阳经脉所循之分部也，病在表而涉于分部，故强痛也。恶寒者，恶本气之寒也。盖太阳之上，寒气主之，以寒为本，以热为标故也。《天元纪大论》：云“太阳之上，寒气主之，所谓本也。”《六微旨大论》云“本之下，中之见也，见之下，气之标也”。六气皆然。此下五节，言太阳受风寒之邪，而传阴转阳之义。
太阳病，有表证、经证两种，脉浮恶寒，表证也；头项强痛，羟证也。何必高谈天日，强为附会。再六经皆重见证，病在表，当然恶寒，热为寒遏，当然发热，与标本毫无关系，不必强为拉扯，徒乱人意。《内经》是《内经》，《伤寒》是《伤寒》。东拉西扯，大非读书之法。
“太阳病，发热汗出恶风，脉缓者，名为中风。”
此言风伤太阳通体之肌腠而为中风证也。夫风者，如冬令之寒风，寒为太阳之本气，风乃寒中所生之动气也。发热者，风伤太阳之标阳也；汗出者。风性鼓动，开发毛腠故也，汗出而毛腠虚，故恶风。风为阳邪，伤人阳气，两不相持，故脉缓也。此风祁开发太阳之毛窍而搏于通体肌腠，故名为中风。
此是中风病提纲，只要认清发热汗出恶风，脉缓，就是中风见证；头项强痛，脉浮，就是太阳见证，如是而已足。倘要说明其所以然。则风邪开发太阳之毛窃而搏于通体之肌腠。一句话已足，何必说上一大堆不相干的废话。
“太阳病，或已发热，或未发热，必恶寒体痛呕逆，脉阴阳俱紧者，名为伤寒。”
太阳病者，病太阳通体之表气也，或已发热者，感太阳之标阳而为热也，或束发热者，寒邪始袭于皮毛，未得太阳之热化也。太阳以寒为本，故无分已、未发热，而必恶寒也。通体之气，为阴邪所伤，故体痛凝敛于周身之毛窍，则里气不疏，故呕逆也。走阴阳、邪正相持，其脉则紧。今寒伤通体之表阳，故脉阴阳俱紧，而名为伤寒也。
太阳病者，头项强痛恶寒脉浮也，不论已发热，未发热，必有恶寒体痛呕逆脉阴阳俱紧，名叫伤寒，本文何等明白，就知道头项强痛。如有恶寒体痛呕逆脉紧者，是太阳伤寒病。标阳、本寒、热化等空话，说它则甚。
“伤寒一日，太阳受之，脉若静者，为不传，颇欲吐，若躁烦，脉数急者，为传也。”
此太阳受邪而即可传于少阴也，伤寒一日，太阳受之，言平人六气周流，环转不息，若以天之寒邪，伤人毛腠，则太阳正气受之，而即“一日起太阳矣。要知伤寒者言邪，而太阳者言正，脉若静者，太阳正气自和，故为不传。颇欲吐者，即少阴之欲吐不吐也；若躁烦者，感少阴阴寒之气则躁，感少阴君天之气则烦。脉数急者，诸数为热，诸急为寒，寒热相持，而脉不静，此太阳受邪而感少阴之气化者为传也。高子日“本论中凡云传者，言邪传于某经。则见某经之证，若纪日而云一日太阳，二日阳明等者，此论正气，非关邪也。
病在太阳，有太阳见证，病传他经，有他经见证，如渴之为阳明，呕之为少阳，欲吐躁烦之为少阴，消渴之为厥阴，腹满自利之为太阴，六经错综，路路可通，由病之自由出入，医者不过平脉辨证，知病在何经，用何方治之耳，何必高谈正气，假使正气果然自和，何致有病？
“伤寒二三日，阳明少阳证不见者，为不传也。”
此承上文，言伤寒一日太阳受之，传则或入于阳，或入于阴，若二三日而不见阳明、少阳之证者，病气只在太阳，为不传也。
阳明见证，口渴身热，不恶寒，但恶热。少阳见证，呕而发热，胁下满。仲景每言不呕不渴，可知渴是阳明要证，呕是少阳要证，注书而好为理论，忽略证据，何以开悟后人!
“太阳病，发热而渴，不恶寒者，为温病。若发汗已，身灼热者，名日风温。风温为病，脉阴阳俱浮，自汗出，身重，多眠睡，鼻息必鼾，语言难出，若被下者小便不利，直视失溲；若被火者，微发黄色，剧则如惊痫，时瘈疭，若火熏之，一逆尚引日，再逆促命期。”
Zou's annotated *Shanghan Lun* (Treatise on Cold Damage) is an annotation of Zhang Zhongjing's *Shanghan Lun*. Since Cheng Wuji in the Song Dynasty, there have been over 130 annotators. When these annotators began their work, none failed to claim that they had exhausted their lifelong efforts in research, uniquely grasping its secrets, completely dismissing previous scholars' views, and boasting of their true understanding. However, viewed from today's perspective, the disputes among various schools are like "the husband says he is right, the wife says she is right," each having its own logic and argument; we can only listen to them tentatively. Among these annotators, only Mr. Zou Run'an from Wujin could directly reveal the profound medical principles of Zhang Zhongjing. It is a great pity that Mr. Zou's *Tongjie of Shanghan Lun* (General Explanation of Treatise on Cold Damage), four volumes, and *Fangjie of Shanghan Jin Gui* (Explanation of Formulas in Treatise on Cold Damage and Essential Prescriptions of the Golden Cabinet), six volumes, are rarely seen in the world today, which is deeply regrettable. I have revered Mr. Zou for thirty years, remaining devoutly loyal as if it were one day. I only regret being born too late to personally study under his guidance. Because other people's annotations of *Shanghan Lun*, like Neo-Confucian scholars discussing principles, talk about *biao-ben zhong jian* (surface-root-middle manifestation), *liu qi sheng fu* (six Qi victory and defeat), and *shu ji bian hua* (pivot mechanism changes), filling pages with empty talk, which is absolutely useless for treating diseases. Only Mr. Zou's annotation of *Shanghan Lun*, like Han dynasty classicists interpreting classics, focuses entirely on pulse and syndrome differentiation, containing not a single word or half-sentence of empty talk. Every word has its origin, every sentence returns to practical application. I know that if these contents were hung at the city gates of the capital, a thousand gold pieces could not exchange even one character. Therefore, I specifically searched through *Ben Jing Shu Zheng* (Evidence-based Commentary on the Divine Farmer's Materia Medica), found some fragments, collected and published them in Lin, naming it *Zou Zhu Shanghan Lun Ji* (Collection of Zou's Annotations on Treatise on Cold Damage). I know that scholars studying cold damage will surely share my interest.
"For those with cold extremities and a fine pulse nearly imperceptible, Danggui Sini Tang (Cinnamon Twig Decoction with Angelica) should be administered. If the person has long-standing internal cold, Danggui Sini Tang plus Wuzhuyu and Shengjiang (Cinnamon Twig Decoction with Evodia and Fresh Ginger) should be administered."
When Yin pathogenic factors invade the limbs horizontally, logic dictates the use of Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite Root). Yet here, only Shengjiang (Fresh Ginger) and Wuzhuyu (Evodia Fruit) are used. Can Shengjiang and Wuzhuyu replace Ganjiang and Fuzi? Originally, the human body is nothing but Yin and Yang, and pathogenic factors are nothing but Yin and Yang. Diseases originating from Yin must reside in the abdomen. The Liver is the hub of the abdomen. The Liver's substance is Yin, while its function is Yang. Therefore, although long-standing internal cold causes cold extremities and a fine pulse nearly imperceptible, symptoms such as Xiao Ke (wasting-thirsting syndrome with excessive thirst) and Xin Zhong Teng Re (pain and heat sensation in the heart region) cannot be absent. Wuzhuyu descends the heat above to move it downward, while Shengjiang disperses the cold below to allow it to spread horizontally. Otherwise, heat moving upward would cause coughing and vomiting of pus and blood, while cold moving downward would lead to diarrhea and cold extremities. How could this be comparable to Si Ni Tang (Frigid Extremities Decoction) type formulas that stimulate the generation of Yang Qi in the Kidney?
"For those who feel the urge to vomit after eating food, this belongs to the Yangming stage, and Wuzhuyu Tang (Evodia Decoction) should be administered. If symptoms worsen after taking the decoction, it belongs to the Upper Jiao (Upper Burner)."
"For Shaoyin disease presenting with vomiting and diarrhea, cold extremities, and extreme irritability bordering on death, Wuzhuyu Tang (Evodia Decoction) should be administered."
"For dry retching, spitting of clear saliva and froth, and headache, Wuzhuyu Tang (Evodia Decoction) should be administered."
In Wuzhuyu Tang syndrome, Yang is located above and Yin below. The urge to vomit after eating, vomiting and diarrhea, dry retching, spitting froth, headache, and vomiting with chest fullness indicate that Yang Qi is entirely stagnated in the Middle Jiao, unable to remain stable there, and attempting to rush upward. Cold extremities and extreme irritability indicate that Yang Qi can only disturb the Middle Jiao and cannot reach the exterior. The reason for this is undoubtedly the battling of Yin pathogenic factors in the Lower Jiao. However, since the Yin evil occupies the Middle, it does not exceed to the Upper, nor does it leak to the Exterior. Thus, we can deduce that the Yin originates from the Liver, not the Kidney. Wuzhuyu Tang prioritizes Wuzhuyu to guide Yang downward. But merely guiding Yang downward without pacifying the Yin means that although Yang descends, Yin still contends with it. Therefore, Renshen (Ginseng Root) and Dazao (Jujube Fruit) are used to pacify the Yin, while Shengjiang (Fresh Ginger) allows the Yin pathogen to dissipate horizontally so as not to contend with Yang. Thus, Shengjiang does not treat the Liver itself, but rather disperses the Yin pathogen drawn up from the Liver.
The indications for Lizhong Tang (Regulate the Middle Decoction) are described in *Shanghan Lun* as: "Vomiting and diarrhea accompanied by excess cold and no desire to drink water." In *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), it states: "Chest Bi (obstruction) with stifling sensation in the heart, Qi knotting in the chest, chest fullness, and rebellious Qi rushing from the hypochondrium to the heart." One scenario involves collapse from the Middle spreading outward; the other involves convergence from above and below into the Middle. Only when the Middle lacks stability can external pathogens enter internally and internal pathogens exit externally, allowing interior and exterior positions to swap, making life and death unpredictable. In the formula, Renshen (Ginseng Root) and Gancao (Licorice Root) have mild flavors and effects, capable of restraining the rapid influx and efflux, but unable to control the command of entry and exit. Baizhu (Atractylodes Macrocephala Rhizome) is more rigid than Renshen and Gancao, able to restrict entry and exit, yet still cannot completely prevent it. Only Ganjiang (Dried Ginger), with its pungent flavor and warm nature, prevents external pathogens from entering and ensures internal pathogens do not exit due to its steadfast nature. Essentially, because the Middle is deficient, external Qi invades; because the Middle is cold, expulsion fails. Thus, Lizhong Tang's tonification of deficiency is its power to restrict exit, and its dispelling of cold is its authority to restrict entry. Adding Guizhi (Cinnamon Twig) treats internal cold and external heat, internal deficiency and external excess, central stifling hardness, persistent diarrhea, and unresolved exterior-interior conditions (Guizhi Renshen Tang syndrome). Mixing in Shuyu (Chinese Yam Tuber) and various tonifying and dispersing herbs treats various deficiencies of consumptive fever and myriad wind diseases (Shuyu Wan syndrome). Intermittently adding Banxia (Pinellia Tuber) while removing Baizhu and Gancao treats persistent vomiting during pregnancy (Ganjiang Renshen Banxia Wan syndrome). Increasing Xuanfuhua (Inula Flower), Daizheshi (Hematite), Banxia, and Dazao while removing Baizhu treats central stifling hardness and persistent belching (Xuanfuhua Daizheshi Tang syndrome). All these divide half of Lizhong Tang, relying on Ganjiang as the Great Wall for dispelling cold and dissipating fullness. Even when countering with cold-cooling agents like Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium), Shengjiang Xiexin Tang (Fresh Ginger Decoction to Drain the Epigastrium), Gancao Xiexin Tang (Licorice Decoction to Drain the Epigastrium), Huanglian Tang (Coptis Decoction), and Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction), careful examination reveals the presence of Renshen, Gancao, and Ganjiang from Lizhong Tang, showing deep reliance on Ganjiang.
"Palpitations above the umbilicus indicate Kidney Qi movement; remove Baizhu and add Guizhi." [Referring to Lizhong Tang] Kidney Qi movement manifests merely as Ben Tun (Running Piglet), where Qi rushes from the lower abdomen to the heart. Ben Tun is Water Qi. Earth controls Water. Naturally, Baizhu tonifies Earth and strengthens the Spleen. Why not let it serve as a pillar in midstream, blocking horizontally to prevent Water Qi from rushing to the heart? This is incorrect. Earth can prevent water leakage but only stops downward leakage, not upward surging. Downward leakage is the nature of water; upward surging is not the nature of water but results from agitation. Remove the source of agitation, and water naturally returns to its channel. Ancient dyke builders faced repeated collapses because water surged upward from below. They poured molten iron to solidify the dam. Using Guizhi instead of Baizhu follows this principle. Linggui Zhugan Tang (Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction) presents with epigastric rebellious fullness, Qi rushing to the heart, deep-tight pulse, and body tremors. Although the disease may involve the Kidney, Baizhu is not contraindicated. Only after sweating causing palpitations below the umbilicus is Linggui Zao Gan Tang (Poria, Cinnamon Twig, Jujube, and Licorice Decoction) used, subsequently replacing Baizhu with Zao (Jujube). This shows Baizhu is indeed contraindicated for the Kidney. Moreover, Huoluan (Colic Disorder) involves both vomiting and diarrhea, representing abnormal interaction between Water and Earth. If one adds the contraindicated herb to block the middle, causing conflict between disease and medicine, collapse is inevitable.
Huoluan (Colic Disorder) with headache, fever, body pain, excess heat, and desire to drink water is treated with Wuling San (Five Ingredient Powder with Poria). Excess cold and no desire to drink water are treated with Lizhong Tang (Regulate the Middle Decoction).
Lizhong Wan (Regulate the Middle Pill) consists of Renshen (Ginseng Root), Gancao (Licorice Root), Baizhu (Atractylodes Macrocephala Rhizome), and Ganjiang (Dried Ginger), each three liang. The above four ingredients are crushed, sifted into powder, mixed with honey to form pills the size of chicken egg yolks. Dissolve one pill in several he of boiling water, grind finely, and take warm. Take three to four times daily, twice at night. If the abdomen does not feel warm, increase to three or four pills, though decoction is superior. For decoction preparation: cut the four ingredients according to weight, add eight sheng of water, boil to obtain three sheng, strain, and take one sheng warm, three times daily. If palpitations above the umbilicus indicate Kidney Qi movement, remove Baizhu and add four liang of Guizhi (Cinnamon Twig). For excessive vomiting, remove Baizhu and add two liang of Shengjiang (Fresh Ginger). For excessive diarrhea, retain Baizhu. For palpitations, add two liang of Fuling (Poria). For thirst and desire to drink, increase Baizhu to total four and a half liang. For abdominal pain, increase Renshen to total four and a half liang. For cold conditions, increase Ganjiang to total four and a half liang. For abdominal fullness, remove Baizhu and add one Fuzi (Prepared Aconite Root). After taking the medicine, approximately after a meal duration, drink about one sheng of hot porridge to induce slight warmth. Do not remove clothing or blankets.
Both Wuling San (Five Ingredient Powder with Poria) and Lizhong Wan (Regulate the Middle Pill) contain Baizhu (Atractylodes Macrocephala Rhizome), making it essential for managing both extremes of Huoluan (Colic Disorder). However, the frequent removal and addition of Baizhu seem inconsistent. Overall, the intent behind using or adding Baizhu is always to enable the Spleen Qi to scatter essence, send it upward to the Lung, regulate water passages, and transport it downward to the Bladder. Excessive vomiting indicates Stomach disease; if the Stomach vomits, it cannot circulate essence and Qi upward to the Spleen. With no essence received, how can the Spleen transmit to the Lung? Excessive diarrhea indicates Spleen disease; if the Spleen sinks, it cannot perform its ascending duty. Without support, how can the pivot turn? Here we see Baizhu can lift Spleen sinking but cannot stabilize Stomach rebellion. Thirst indicates Stomach deficiency; thirst leads to excessive drinking, which, even if causing vomiting, affects the Spleen. If the Spleen receives but cannot lift, diarrhea worsens. Abdominal fullness indicates Spleen excess; if the Spleen is excess and cannot transmit upward, even with diarrhea, fullness remains, inevitably reversing upward from abdomen to chest, worsening vomiting. Here we see Baizhu cannot treat Spleen/Stomach deficiency nor Spleen/Stomach excess. Although situations differ—upper vs. lower, excess vs. deficiency—the combination of vomiting and diarrhea is constant. When vomiting and diarrhea occur with thirst and desire to drink, Baizhu becomes necessary.
"In cold damage, with floating pulse, spontaneous sweating, frequent urination, mental restlessness, slight aversion to cold, and cramped legs, administering Guizhi Tang (Cinnamon Twig Decoction) to attack the exterior is an error. This leads to cold extremities, dry throat, irritability, and vomiting/reversal. Prepare Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) to restore Yang. If cold extremities resolve and feet become warm, prepare Shaoyao Gancao Tang (Peony and Licorice Decoction) to extend the legs."
Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) and Shaoyao Gancao Tang (Peony and Licorice Decoction) harmonize the Spleen and Liver respectively. Harmonizing the Spleen stabilizes the chaotic Yang Qi in the Central Palace; harmonizing the Liver unblocks the condensed Yin Qi of the Wood Organ. Although relying on the power of Ganjiang (Dried Ginger) and Shaoyao (White Peony Root), their weights differ. One cannot assume that diseases of the Center are solely treated by Center herbs. While Ganjiang and Shaoyao are potent, achieving stability and success ultimately relies on Gancao (Licorice Root). Thus, in treating these two formulas: cold extremities, dry throat, irritability, vomiting/reversal, and calf cramps indicate Yangming internal knotting. Administer Gancao Ganjiang Tang. Once extremities warm, administer Shaoyao Gancao Tang again to extend the calves. Yang knotting causes cold extremities; Yin knotting causes cramping. Ganjiang breaks Yang knotting; Shaoyao breaks Yin knotting. Breaking Yin and Yang cures cramping and cold extremities but does not cure dry throat or stop irritability. This is where stability and success lie. The Middle is the pivot of upper and lower. *Jin Gui Yao Lue* states: "In Lung萎 (Flaccidity) with salivary foam expectoration but no cough, if the patient is not thirsty, they will inevitably have enuresis and frequent urination. This is because upper deficiency fails to control the lower. This is cold in the Lung. Warm it with Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction). This benefits the Upper via the Middle to control the Lower." Transforming into Lizhong Tang (Regulate the Middle Decoction) treats upper vomiting and lower diarrhea, controlling both upper and lower via the Middle. Transforming further into Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) treats external heat and internal cold with unresolved exterior-interior conditions, controlling interior and exterior via the Middle. Transforming into Si Ni Tang (Frigid Extremities Decoction) treats diarrhea with undigested food, controlling the Lower via the Middle. Transforming into Tongmai Si Ni Tang (Pulse-Returning Frigid Extremities Decoction) treats diarrhea with red face, internal cold and external heat, controlling interior and exterior from Middle to Lower. Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) controls Upper and Middle extending to Lower, expanding outward. Shaoyao Gancao Tang (Peony and Licorice Decoction) controls Middle and Lower extending to Exterior, expanding inward. Like Guizhi Tang (Cinnamon Twig Decoction) treating Wind, Huangqin Tang (Scutellaria Decoction) treating Heat, and Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction) treating Cold, all relate analogously. One can thus comprehend the general principle of Gancao (Licorice Root) anchoring the Earth in the Center.
Critique of Zhang Yinan's *Shanghan Lun Jizhu* (Collected Notes on Treatise on Cold Damage): Senior Yinan dedicated twenty years to studying cold damage, day and night. Reading his preface, he endured seasons, passed time, neglected sleep and food, severed social ties, ignored spring flowers and autumn moons, and avoided clear waters and beautiful mountains. His diligence was unparalleled. Unfortunately, he did not shed the habits of Song-Ming Neo-Confucian scholars, preferring high-minded theories, making readers find them unfathomable. My critique of Yinan is not an attack, but rather a desire for Zhang Zhongjing's learning to be fully revealed and illuminated.
Differentiating Taiyang Disease Pulse and Syndrome Chapter One: "Taiyang disease is characterized by a floating pulse, stiffness and pain in the head and neck, and aversion to cold."
Taiyang governs the Qi of all Yang meridians, differing between the whole-body aspect and segmental aspects. The whole-body Taiyang is like Heaven, governing the skin, hair, and muscle surface of the entire body, similar to Heaven surrounding the Earth. The segmental Taiyang is like the Sun, governing the head, neck, back, sacrum, and Blood Chamber, similar to the Sun rotating along its orbit. This opening statement clarifies that Taiyang governs the hair of the whole body, followed by meridian-specific segments. Taiyang disease features a floating pulse because Taiyang circulates on the body's surface; disease affecting the whole-body exterior Yang results in a floating pulse. The head and neck are the segments governed by the Taiyang meridian. Disease in the exterior involving segments causes stiffness and pain. Aversion to cold is aversion to the Cold Qi of the fundamental energy. Above Taiyang, Cold Qi governs, taking Cold as the root and Heat as the branch. *Tianyuan Ji Da Lun* states: "Above Taiyang, Cold Qi governs, which is called the Root." *Liuzhi Da Lun* states: "Below the Root is the Manifestation of the Middle; below the Manifestation is the Branch of Qi." This applies to all Six Qi. The following five sections discuss the meaning of Taiyang receiving Wind-Cold pathogens and transmitting from Yin to Yang.
Taiyang disease has two types: Exterior Syndrome and Channel Syndrome. Floating pulse and aversion to cold are Exterior Syndromes; stiffness and pain in the head and neck are Channel Syndromes. Why engage in lofty discussions of Heaven and Sun, forcing interpretations? Furthermore, all Six Meridians emphasize clinical manifestations. Disease in the exterior naturally causes aversion to cold; heat suppressed by cold naturally causes fever. This has nothing to do with Root/Branch theory. Do not force connections, confusing the reader. *Nei Jing* (Inner Canon) is *Nei Jing*; *Shanghan Lun* (Treatise on Cold Damage) is *Shanghan Lun*. Dragging unrelated concepts together is not the correct way to study.
"Taiyang disease, with fever, sweating, aversion to wind, and a slow pulse is named Wind Strike (Zhong Feng)."
This describes Wind damaging the muscle pores of the whole-body Taiyang, resulting in Wind Strike syndrome. Wind is like winter cold wind; Cold is the fundamental Qi of Taiyang, while Wind is the dynamic Qi generated within Cold. Fever results from Wind damaging the superficial Yang of Taiyang. Sweating occurs because Wind's nature is stirring and opens the hair follicles. With open follicles, the exterior is deficient, hence aversion to wind. Wind is a Yang pathogen damaging Yang Qi; the two do not contend strongly, resulting in a slow pulse. This Wind pathogen opens Taiyang hair follicles and battles the whole-body muscle pores, hence named Wind Strike.
This is the outline for Wind Strike syndrome. Recognizing fever, sweating, aversion to wind, and slow pulse identifies Wind Strike manifestations; recognizing stiffness/pain in head/neck and floating pulse identifies Taiyang manifestations. That is sufficient. To explain the rationale: Wind pathogen opens Taiyang hair follicles and battles whole-body muscle pores. One sentence suffices. Why add irrelevant nonsense?
"Taiyang disease, whether fever has already appeared or not, must include aversion to cold, body pain, vomiting/reversal, and a tight pulse on both Yin and Yang positions. This is named Cold Damage (Shang Han)."
Taiyang disease affects the exterior Qi of the whole-body Taiyang. "Already fever" means feeling the superficial Yang of Taiyang as heat. "Not yet fever" means Cold pathogen initially attacks hair/skin, not yet transforming into Taiyang heat. Taiyang takes Cold as its root, so regardless of existing or non-existing fever, aversion to cold is mandatory. The whole-body Qi is damaged by Yin pathogens, causing body pain. Constriction of hair follicles throughout the body prevents interior Qi from diffusing, causing vomiting/reversal. Contention between Yin/Yang and Pathogen/Righteous Qi results in a tight pulse. Now, Cold damages the exterior Yang of the whole body, resulting in a tight pulse on both Yin and Yang positions, hence named Cold Damage.
Taiyang disease is characterized by stiffness/pain in head/neck, aversion to cold, and floating pulse. Regardless of existing or non-existing fever, there must be aversion to cold, body pain, vomiting/reversal, and tight pulse on both Yin and Yang positions, named Cold Damage. The text is clear. Recognizing stiffness/pain in head/neck: if accompanied by aversion to cold, body pain, vomiting/reversal, and tight pulse, it is Taiyang Cold Damage. Empty talk about Superficial Yang, Fundamental Cold, and Heat Transformation is unnecessary.
"On the first day of cold damage, Taiyang receives the pathogen. If the pulse is quiet, transmission has not occurred. If there is strong urge to vomit, or irritability/restlessness, and the pulse is rapid and urgent, transmission has occurred."
This indicates Taiyang receiving the pathogen can immediately transmit to Shaoyin. On the first day of cold damage, Taiyang receives it. Ordinary people's Six Qi circulate endlessly. If Heavenly Cold damages hair/skin, Taiyang Righteous Qi receives it, marking "Day One begins Taiyang." Understand that "Cold Damage" refers to the Pathogen, while "Taiyang" refers to Righteous Qi. If the pulse is quiet, Taiyang Righteous Qi is self-harmonized, so no transmission. Strong urge to vomit corresponds to Shaoyin's urge to vomit but inability to do so. Irritability/restlessness: sensing Shaoyin Yin Cold Qi causes agitation (Zao); sensing Shaoyin Ministerial Fire Qi causes restlessness (Fan). Rapid and urgent pulses indicate Heat (rapid) and Cold (urgent). Cold and Heat contend, and the pulse is not quiet. This is Taiyang receiving the pathogen and sensing Shaoyin Qi transformation, constituting transmission. Gao Zi said: "Whenever 'transmission' is mentioned in this treatise, it means the Pathogen transmits to a certain meridian, showing that meridian's syndromes. When days are recorded as Day One Taiyang, Day Two Yangming, etc., this discusses Righteous Qi, not the Pathogen."
Disease in Taiyang shows Taiyang manifestations; disease transmitting to other meridians shows other meridian manifestations. Thirst indicates Yangming; vomiting indicates Shaoyang; urge to vomit/agitation indicates Shaoyin; wasting-thirst indicates Jueyin; abdominal fullness and spontaneous diarrhea indicate Taiyin. The Six Meridians interweave, paths are open, and disease enters/exits freely. Physicians merely calm the pulse and differentiate syndromes to know which meridian is affected and prescribe appropriate formulas. Why discuss Righteous Qi loftily? If Righteous Qi were truly self-harmonized, how could disease arise?
"On the second or third day of cold damage, if Yangming and Shaoyang syndromes are not seen, transmission has not occurred."
Continuing from above, on Day One Taiyang receives the pathogen. Transmission enters either Yang or Yin. If on Days Two or Three, Yangming and Shaoyang syndromes are absent, the pathogenic Qi remains only in Taiyang, indicating no transmission.
Yangming manifestations: thirst, body heat, no aversion to cold, only aversion to heat. Shaoyang manifestations: vomiting with fever, fullness in the hypochondrium. Zhang Zhongjing often mentions "no vomiting, no thirst." Thus, thirst is a key Yangming symptom, and vomiting is a key Shaoyang symptom. Annotators who prefer theory over evidence fail to enlighten future generations!
"Taiyang disease, with fever and thirst, and no aversion to cold is Warm Disease (Wen Bing). If after sweating, the body becomes burning hot, it is named Wind-Warmth (Feng Wen). Wind-Warmth disease features floating pulses on both Yin and Yang, spontaneous sweating, heavy body, excessive sleepiness, snoring breath, and difficulty speaking. If purgatives are incorrectly applied, there is urinary difficulty, staring gaze, and incontinence. If fire therapy is incorrectly applied, slight jaundice develops; severely, it resembles convulsive epilepsy with periodic spasms, resembling smoke-stained fire. One error prolongs the illness; a second error hastens death."