冬伤于寒，即病者，名为伤寒；不即病者，至畚随阳气而发，变为温病。温病者，热病也，邪病太阳之标阳，故但发热而渴，不恶寒，所谓冬伤于寒，春变为温者是也，此言寒邪伏匿，而变为温病也。夫寒邪伏匿，寒出必解，若发汗已而身反灼热者，此非寒邪扶匿，乃风邪伏匿而名为风温也。风邢从内以出表，故脉阴阳俱浮，腠理开故自汗出。身重者。风伤通体之肌肉也。多眠者，风邪壅滞而神机不出也。邪搏于阴，致颃颡不通，故睡息必鼾，邪搏于阳，致生气不达，故语言难出，此风温危险之证，若被下，则水津内竭，姑则小便不利，继则津液不濡于上，而目直视矣，水道不约于下，而小便失溲矣。若被火攻，风火交炽，微则身必发黄，剧则火热伤神，故如惊痫病之手足时瘈疭也。此被火一逆，火熏为再逆，一逆尚引日，再逆促命期，由是而知风热之证，当滋养其血液，不宜汗下、火攻也。
温病风温，别详证脉，忌下、忌被火、忌火熏、忌逆治，明所忌，即知所宜矣。后贤叶，叶天士、吴鞠通、王孟英，对于温病特著专书，可以羽翼仲景，补充《伤寒》。
“病有发热恶寒者，发于阳也，无热恶寒者，发于阴也，发于阳者七日愈，发于阴者六日愈，以阳数七阴数六故也。”
此言太阳少阴之标阳标阴为病也，以寒邪而病太阳之标阳，故发热恶寒，而发于太阳也；以寒邪而病少阴之标阴，故无热恶寒，而发于少阴也。成氏曰“阳法火。阴法水，火成数七，水成数六，发于阳者七日愈，火数周也；发于阴者六日愈，水数周也。此下凡四节，皆论愈证。
发热就是阳，无热就是阴，不必凿分太阳、少阴，更不必凿分风邪、寒邪，至七日六日，亦只要知道发热恶寒病，七日当愈，无热恶寒病，六日当愈，如是而已足，若必深求，定成蛇足，试思人一呼，脉行三寸，一吸，脉行三寸，呼吸定息，脉行六寸，一日一夜，凡一万三千五百息，脉行五十度，周于身，六日为六周，七日为七周，每日一周，阴经阳经，无不遍焉，主张阴经短阳经长之说者，可以不攻自破，且少阴病二三日无里证，当微发汗。少阴病，始得之，及发热，主以麻黄附子细辛汤，可知少阴并不是绝对无发热证者。标阳标阴，高谈大可不必。
“太阳病头痛，至七日以上自愈者，以行其经尽故也，若欲作再经者，针足阳明，使经不传则愈。”
此论太阳为诸阳之首，六气运行，七日来复，球转之无端也，太阳病头痛者，所谓阳因而上病，气随太阳之在高也，七日以上自愈者，以六气已周而行其经尽，太阳之气来复于高表故也。若太阳为邪所搏，不能上出于高表，而欲作再经者，针足阳明，盖阳明主经脉，经脉流通，而使表邪不传则愈。高子曰“以行其经尽，言六气之环绕于外内也，使经不传，言使经无病邪之传也。”故传经者言邪，而纪日者论正，于此可见矣。
称得太阳病，头痛必兼项强恶寒，至七日以上自愈者，必项强恶寒皆罢，头痛亦已较轻，不问可知。阳明亦有头痛证，惟项不强身不恶寒耳。令太阳病七日自愈，未经医家诊治可知，病不服药，难保不留馀邪，防其再经欲作，刺阳明以泄病气，则邪不传矣。原文何等明白，太阳不为邪所搏不能上出于高标云云，试思太阳不为邪搏，何必称太阳病?三阳脉皆上于头，太阳何得独称高标？
“太阳病欲解时，人巳至未上。”
午乃太阳中天之时，巳未前后之气交也，夫天有六气，人有六气。人得天时之助。
则正气盛而邪病鲜矣。
“风家表解，而不了了者，十二日愈。”
风乃阳邪，六为阴数，表解而不了了者，里邪未尽也，故遇重阴则愈。《辨脉篇》曰“以阳得阴则解也。”
上条言愈之时，此条言愈之期。
“病人身大热，反欲得近衣者，热在皮肤，寒在骨髓也；身大寒，反不欲近衣者。寒在皮肤。热在骨髓也。”
此言太阳之根于少阴也。皮肤者，太阳表气之所主也；骨髓者，少阴里气之所主也。身大热而反欲近衣，太阳标阳外呈，而少阴之阴寒方盛于内，故反欲近衣也。大寒而反不欲近衣，太阳本寒外呈。而少阴之火热方盛于里。故反不欲近衣也。○此申明太阳主皮肤，少阴主骨髓，与发热无热而太阳少阴并呈乎外者之不同也。
此不过言假热真寒、假寒真热两种病证，与标本毫无关涉。曲说附会，俗显反晦矣，《伤寒论》一书，乃仲景探病所得随笔记录，据事直书之文，观自序“宗族素盛”
一节可信，乃注家偏欲刻意求深，难免牵强附会，如太阳病七日自愈，忘却“自”字。
只说一日太阳，二日阳明，三日少阳，六日六经行遍，七日再作太阳等语，此系据《内经》为释，谬误一也。发于阳，发于阴，忘却“有热无热”，以太阳、少阳为释，也有以胃阳脾阴为释，也有以风邪寒邪为释，纷纷扰扰，徒乱人意，谬误二也，故欲识《伤寒论》真面目，必如武进邹润庵而后可。
“太阳中风，阳浮而阴弱，阳浮者热自发，阴弱者汗自出，啬啬恶寒，浙淅恶风，翕翕发热，鼻鸣干呕者，桂枝汤主之。”
桂枝汤方桂枝三两去皮(桂枝止取稍尖嫩枝，内外如一，若有皮者去之，非去枝上之皮也，后仿此)芍药三两甘草二两炙生姜三两切大枣十二枚劈上五味哎咀，以水七升，微火者取三升，击滓，适寒温，服一升，服已须臾，饮热稀粥一升馀，以助药力，温覆令一时许，遍身（执/水）（执/水）微似有汗者益佳。不可令如水淋漓，病必不除。若一服汗出，病差，停后服，不必尽剂。若不汗，更服，依前法。又不汗，后服小促其间，半日许，令三服尽。若病重者，一日一夜服，周时观之。服一剂尽，病证犹在者，更作服，若汗不出，乃服至二三剂。禁生冷、粘滑、肉、面、五辛、酒酪、臭恶等物。
此论风邪搏于太阳通体之肌表，而为桂枝汤证也，盖风寒之邪，必先毫毛而入于肌腠。太阳中风，阳浮而阴弱者，太阳主表，故阳气外浮而发热，风伤肌腠，故阴气内弱而汗出，此风伤太阳之肌腠而然也。若风邪始搏于毫毛，而未入于肌腠之际，则有啬啬、浙浙、翕翕之象，啬啬者，皮毛慄慄之状，邪在皮毛，故啬音恶寒；淅淅者，洒淅不宁之貌，肌腠未开，故淅淅恶风；翕翕者，动起合聚之意，太阳邪正之气相持，故翕翕发热。夫风邪从表入肌，在皮毛则肺气不利而鼻鸣。入于肌腠，则三焦不和而干呕，桂枝汤主之。本论云：“桂枝本为解肌，盖三焦木火之气通会于肌腠，桂为百木之长，气温色赤，秉木火之性，主助肌中之气，以解肌表之邪；芍药气味苦平，花开赤白，放于二气之中，得少阴君火之气，主益神气，以助肌中之血，肌腠之气血调和，而邪自不能容矣；甘草生姜宣达胃中之气而辛甘发散；大枣色黄(当指枣肉色黄，而枣皮皆赤也，亦有黑者。]味甘，脾之果也，主助脾气之转输而为胃行其津液，汗乃水谷之津，故饮热稀粥以助药力，中焦之津液外布，即有留舍之邪，与汗共并而出矣，津液外泄则中气暴虚，故忌食生冷、肉、面、酒酪、臭恶等物，使勿伤脾胃之气。
《内经》为理论之书，《伤寒》为治病之书，所以读《伤寒》须要放出《伤寒》眼光，不可以读《内经》之眼光读《伤寒》。前辈于此一点，不肯注意。议论虽高。难免钻进牛角，《内经》最重针灸，故于标本中见，异常讲究。《伤寒》汤液治病，只消认证清楚，寒热、表里、虚实不便稍有含混，如是而已足，故余于《伤寒论》卑之，毋甚高论也。
新注《汤头歌诀》序《汤头歌诀》清代休宁汪訒庵氏所作，集方二百有六首，附方一百二十一首，分类二十有二，以其便于诵习也，初学者辄喜读之，顾其方不尽谆，而初学之士，见识有限，趋向稍岐，即成终身大害，余既著《医学南针》，指示学者以门径，而汪氏《汤头歌诀》，为当代流行最广之书，深惧其有误后学，爰取其歌为一一释方义，间有摭录前人旧作，务使读是书者，对于古方之组织，有深切之了解。而后因病取与，剪裁自易，否则执死方以治活病，几乎其不误己而误人也!
民国二十有五年四月五日，青浦陆士谔序于沪寓。
论黑热病治法新流行之黑热病，其所谓热，热从何来。其所谓黑，黑在何部，既不见黑在何部，又不知热从何来，何以名黑热病?新流行之病，吾真不知其命名之于意云何。
余以现今所谓黑热病之种种证象归纳之，不禁失笑日，此中国向来素有之“痞癥”也，黑热云乎哉?痞之为病，有虚有实，实者日癥，虚者日瘕，病之源不一，伤寒内陷成痞，热入成结胸，痞癥之一也；杂病久疟成疟母，痞癥之一也；五脏有积曰奔腾[贲豚]、曰肥气、曰伏梁、曰痞气、曰息贲，痞癥之一也；鳖癥、米癥、鱼癥、酒癥，痞癥之一也。同一痞癥，其成痞之因不一，治法即不能齐一，乃必欲预定一药，遍治诸痞，此种拟方待病之笨拙举动，尚自诩为特效药，吾中医真要笑煞。
吾中医非不有治痞之灵药，如鳖甲煎丸等万试万验，千投千效，所以不肯提出者，非特不屑与彼辈争一日之短长，亦郑重将事，不欲以一方一药，印定后人耳目也。
伏气论何谓伏气，气是何气?伏在何处?伏气之学说，《内经》与《伤寒论》虽有记载，却甚含混，后贤解释，分作九种学说，互相攻击，各不相干。
有言气之为物。即是寒邪中人不即为病，潜伏在少阴之经，到春阳发动，内应外合而为病，此一说也。
又有人驳言，人身气血周流，稍有阻滞，就要成疖成疮，少阴为肾之经，乃是性命之源，岂有性命之源，如此紧要所在，而病邪潜伏一冬之久，可以平安无事之理，此又一说也。
又有人言，人之一身十二经，十五络，奇经八脉，支络孙络，井营腧合各穴，幽微曲折，犹之一城一邑，万家灯火中，岂无一二莠民潜伏。当政治清明时，此一二莠民自不敢为非作歹，一至外寇逼境，则骚然起矣，此又一说也。
又有人言，冬令天气外寒内温，外愈寒内愈温，只要看井中的水就能够明白此理，到了春风解冻，外面的寒解，里面的温自然而然向外透发，里面透出的温，遇着外面袭入的温，两温相合而成病，这才是伏气的真理，他们主张寒邪久伏化热的，何尝认识伏气真面目，此又一说也。
这四派学说，除第二派非驳伏气，当然不算外，据我看来。其馀三派都是对的，都可以讲得通的。那第四派讲的是本气，第一派与第三派，讲的都是病气，本气人人都有，病气不是人人都有，所以有病有不病。不过第三派主张有了外感，才引动伏气。第一派主张天气一暖，伏邪自会发动，事实之证明，都是确实的，照我的眼光，吴鞠通、王盂英、章虚谷论的是指病气，叶子雨论的是指本气，两说不妨并存，不能偏袒某一说也。
伏气之为病-有犀角地黄汤证，有导赤散证，有黄芩汤证，有葱豉汤证，有白虎汤证，有小柴胡汤证，所伏有浅深之分，所发有气血之异，苟能见症治症，病无遁形矣。
风病之种类风之为病，种类最多，就《素问》所载，《病源》所述，《外台》《千金》所录，名目已极繁多，今姑择要摘录，以备学者探讨，一曰寒热。寒热亦风病之一也，风气藏于皮肤之间，内不得通，外不得泄，风者善行而数变，腠理开则洒然寒，腠理闭则热而闷。其寒也则衰其饮食，其热也则消其肌肉，所以使人帙僳而不能食，名曰寒热也。
寒热又须分出阳明经与太阳经风气与阳明经入到胃腑，循阳明脉而上至目内眦，要是肥人，肥人肌肉厚重，则风气不得外泄，就变为热中而目黄；要是瘦人，瘦人肌小肉薄，易于外泄而寒，就成为寒中而拉出，此风入阳明经之寒热也。
风气与太阳经俱入行诸脉腧，散于分肉之间，与卫气相干，其道不利，故使肌肉愤瞋而有疡，卫气有所凝而不行，故其肉有不仁也，此风入太阳经之寒热也。
一曰疠风。疠者有营气热腑，其气不清，故使鼻柱坏而色败，皮肤疡溃，风寒客于脉而不去，名曰疠风也。
一曰五脏之风。春伤于风者为肝风，夏伤于风者为心风，季夏伤于邪者为睥风，秋中于邪者为肺风，冬中于邪者为肾风，此五脏之风也。
一曰偏风。风邪中于五脏六腑之腧穴，亦为脏腑之风，各入其门户，所中则为偏风。
一曰风厥。汗出而身热者风也，汗出而烦满不解者厥也，病名日风厥。
一曰劳风。劳风法在肺下，其为病也，使人强上宴视，唾出若涕，恶风而振寒，此为劳风之病。
一曰痱。痱之为病，身无痛者，四肢不收，智乱不甚，其言微知可治，甚则不能言，不可治也。
一曰痹。风之为病，当半身不遂，或但臂不遂者，此为痹，脉微而数，中风使然。
以上所录，皆是风病之种类，至其病之因何而来，从何而治，当别著篇论之。
[Background Information]
Book: Shie Yihua (Medical Conversations of Shi E)
Chapter: Main Text (14/22)
Category: Medical Discourse
When cold pathogenic factors are contracted in winter and disease manifests immediately, it is called Shanghan (Cold Damage); if it does not manifest immediately, but erupts in spring along with the rising Yang Qi, it transforms into Wenbing (Warm Disease). Wenbing is a type of Rebing (Heat Disease), where the pathogen invades the Biao-Yang (Superficial Yang) of the Taiyang (Greater Yang) channel. Therefore, it presents only with fever and thirst, without aversion to cold. This refers to "winter cold contraction transforming into spring warmth," indicating that cold pathogens lie dormant within and subsequently transform into warm diseases. Since cold pathogens lie dormant, once the cold resolves, the disease should heal. However, if after inducing sweating the body becomes burning hot, this is not due to latent cold, but rather latent Wind pathogens, a condition named Fengwen (Wind-Heat). Wind pathogens emerge from the interior to the exterior; thus, the pulse is floating at all three positions (Cun, Guan, Chi), and spontaneous sweating occurs due to open Couli (pores and interstitial spaces). Heaviness of the body results from wind damaging the muscles throughout the body. Somnolence occurs because wind pathogens obstruct the Shenji (spiritual mechanism), preventing it from emerging externally. When pathogens contend with Yin levels, causing obstruction in the hangsang (nasopharynx), snoring inevitably occurs during sleep. When pathogens contend with Yang levels, preventing clear Qi from ascending, speech becomes difficult. These are dangerous signs of Fengwen. If mistakenly treated with purgation, internal fluids will be exhausted, leading to dysuria; subsequently, fluids fail to moisten the upper orifices, resulting in fixed staring eyes; and lower water pathways lose control, leading to urinary incontinence. If mistakenly treated with fire therapy (such as moxibustion or heat application), wind and fire will intensify each other. Mild cases result in jaundice; severe cases damage the Shen (Spirit) with fire-heat, causing convulsions of the hands and feet similar to epilepsy. One instance of fire therapy is a reversal error; using fire fumigation is a second reversal. One reversal may prolong the illness, while two reversals shorten life expectancy. From this, we know that for wind-heat conditions, nourishing blood is appropriate, while sweating, purging, and fire therapies are contraindicated.
Wenbing and Fengwen have their symptoms and pulses detailed elsewhere. They are contraindicated for purging, fire therapy, fire fumigation, and reverse treatments. Understanding these contraindications reveals the appropriate treatments. Later scholars Ye Tianshi, Wu Jutong, and Wang Mengying wrote specialized books on warm diseases, which can supplement Zhang Zhongjing's theories and enrich the *Shanghan Lun*.
"Diseases presenting with fever and aversion to cold originate in Yang channels; those without fever but with aversion to cold originate in Yin channels. Those originating in Yang heal in seven days; those originating in Yin heal in six days, due to the numerical attributes of Yang being seven and Yin being six."
This discusses diseases of the Biao-Yang and Biao-Yin of the Taiyang and Shaoyin channels. Cold pathogens invading the Biao-Yang of Taiyang cause fever and aversion to cold, originating in Taiyang. Cold pathogens invading the Biao-Yin of Shaoyin cause absence of fever with aversion to cold, originating in Shaoyin. Cheng Wuji stated: "Yang corresponds to Fire, Yin corresponds to Water. The completion number of Fire is seven, and of Water is six. Healing in seven days for Yang-originating diseases represents one cycle of Fire numbers; healing in six days for Yin-originating diseases represents one cycle of Water numbers." The following four sections discuss signs of recovery.
Fever indicates Yang; absence of fever indicates Yin. There is no need to rigidly distinguish between Taiyang and Shaoyin, nor between Wind and Cold pathogens. Regarding the seven-day and six-day periods, one only needs to know that diseases with fever and aversion to cold heal in seven days, and those without fever with aversion to cold heal in six days. That suffices. Insisting on deep speculation leads to superfluous complexity. Consider: with each breath, the pulse moves three cun; with each inhalation, three cun; per complete respiration cycle, six cun. In a day and night, there are 13,500 cycles, and the pulse circulates fifty times around the body. Six days constitute six cycles, seven days constitute seven cycles, completing one cycle daily through both Yin and Yang channels. This disproves theories claiming Yin channels are short and Yang channels are long. Moreover, Shaoyin disease presenting without interior signs after two to three days requires mild sweating. Early-stage Shaoyin disease with fever is treated with Mahuang Fuzi Xixin Tang, proving that Shaoyin disease is not absolutely devoid of fever. Discussions on Biao-Yang and Biao-Yin are unnecessary.
"Taiyang disease with headache heals spontaneously after seven days because the pathogen has exhausted its course in the channels. If it is about to transmit to the next channel, acupuncture of the Foot-Yangming channel prevents transmission and ensures healing."
This discusses Taiyang as the head of all Yang channels. The movement of the Six Qi repeats every seven days, circulating endlessly. Headache in Taiyang disease arises because "Yang rises upward," with Qi following Taiyang's high position. Spontaneous healing after seven days occurs because the Six Qi have completed their cycle, exhausting the pathogen's course, and Taiyang Qi recovers at the superficial high level. If Taiyang is contended by pathogens and cannot ascend to the superficial high level, intending to transmit to the next channel, acupuncture of the Foot-Yangming channel is indicated. Yangming governs the meridians; ensuring meridian flow prevents superficial pathogen transmission. Gao Gongfu stated: "'Exhausting its course' refers to the Six Qi circling internally and externally; 'preventing transmission' means preventing pathological transmission within the meridians." Thus, transmission refers to pathogens, while recording days refers to Zhengqi (Upright Qi).
Confirmed Taiyang disease involves headache accompanied by neck stiffness and aversion to cold. Spontaneous healing after seven days implies resolution of neck stiffness, aversion to cold, and reduced headache severity. Yangming disease also features headache, but without neck stiffness or aversion to cold. Here, Taiyang disease heals in seven days without medical intervention. Without medication, residual pathogens may remain, risking further transmission. Acupuncture of Yangming drains pathogenic Qi, preventing transmission. The original text is clear. Claims like "Taiyang not contended by pathogens cannot ascend to the high level" are flawed. If Taiyang were not contended, why call it Taiyang disease? All three Yang channels ascend to the head; why single out Taiyang as "high"?
"Taiyang disease resolves between Si hour (9-11 AM) and Wei hour (1-3 PM)."
Wu hour (11 AM-1 PM) is when the Sun is at its zenith. Si and Wei hours represent the intersection of Qi. Heaven has Six Qi, and humans have Six Qi. Assisted by heavenly timing, Zhengqi becomes robust, and pathogens diminish.
"For patients with Wind disease, after exterior signs resolve but discomfort persists, healing occurs in twelve days."
Wind is a Yang pathogen; six is a Yin number. Resolution of exterior signs with persistent discomfort indicates incomplete interior pathogens. Thus, healing occurs on a heavy Yin day (twelve days). The *Bian Mai Pian* states: "Yang resolving with Yin assistance leads to cure."
The previous section discussed the time of resolution; this section discusses the duration of recovery.
"If a patient has high body heat but desires clothing, the heat is in the skin, and cold is in the marrow. If a patient has low body temperature but rejects clothing, the cold is in the skin, and heat is in the marrow."
This illustrates the root relationship between Taiyang and Shaoyin. Skin is governed by Taiyang exterior Qi; marrow is governed by Shaoyin interior Qi. High heat with desire for clothing indicates Taiyang Biao-Yang manifesting externally while Shaoyin Yin-cold盛 (abounds) internally. Low temperature with rejection of clothing indicates Taiyang Ben-Han (Original Cold) manifesting externally while Shaoyin Fire-heat abounds internally. This clarifies that Taiyang governs skin and Shaoyin governs marrow, differing from cases where fever or lack thereof manifests simultaneously in Taiyang and Shaoyin.
This merely describes false heat with true cold, and false cold with true heat, unrelated to Ben-Biao (Root-Branch) theory. Forced interpretations obscure simple truths. The *Shanghan Lun* is Zhang Zhongjing's record of clinical observations, written straightforwardly based on facts, as confirmed by his preface mentioning his clan's prosperity. Annotators seeking depth often resort to forced associations. For example, ignoring the word "spontaneously" in "Taiyang disease heals spontaneously in seven days," and instead citing "Day 1 Taiyang, Day 2 Yangming..." based on the *Neijing* is Error 1. Interpreting "originating in Yang/Yin" by ignoring "fever/no fever" and assigning them to Taiyang/Shaoyang, Stomach Yang/Spleen Yin, or Wind/Cold pathogens creates confusion, constituting Error 2. To understand the true face of the *Shanghan Lun*, one must follow the approach of Zou Run'an from Wujin.
"Taiyang Wind Strike: Pulse is floating externally and weak internally. Floating externally indicates spontaneous fever; weak internally indicates spontaneous sweating. With chills (*Sese*), shivering aversion to wind (*Xixi*), mild fever (*Xixi*), nasal congestion, and dry retching, Guizhi Tang is indicated."
Guizhi Tang Formula: Guizhi (Cinnamon Twig) 3 liang, peeled; Shaoyao (Peony Root) 3 liang; Gancao (Licorice Root) 2 liang, roasted; Shengjiang (Fresh Ginger) 3 liang, sliced; Dazao (Jujube) 12 pieces, crushed. Decoct five ingredients in 7 sheng of water with gentle heat until 3 sheng remain. Strain. Drink warm, one sheng. Shortly after drinking, consume over one sheng of hot thin rice porridge to assist medicinal power. Cover with blankets for about an hour until slight perspiration is achieved throughout the body. Do not allow profuse sweating like bathing, or the disease will not be resolved. If sweating occurs after one dose and the disease improves, stop subsequent doses; do not finish the entire decoction. If no sweating, administer again according to previous methods. If still no sweating, shorten the interval between doses, administering three doses within half a day. For severe cases, administer over day and night, observing for one shichen (two hours). If symptoms persist after one full dose, prepare another. If no sweating, continue up to two or three doses. Avoid raw/cold, sticky/slippery, meat, wheat products, Five Pungent Spices, dairy/wine, and foul-smelling foods.
This discusses Wind pathogens contending with the Taiyang exterior musculature, forming the Guizhi Tang syndrome. Wind-Cold pathogens enter via hair follicles into Couli. In Taiyang Wind Strike, external floating pulse indicates Yang Qi floating outward causing fever; internal weak pulse indicates Yin Qi weakening internally causing sweating due to Wind damaging Couli. Early stage, before pathogens reach Couli, presents with *Sese* (chills/shivering), *Xixi* (shivering unease), and *Xixi* (mild fever). *Sese* reflects furrowed skin and chills due to pathogens in furrows. *Xixi* reflects unease due to closed Couli. *Xixi* fever reflects contention between pathogen and Zhengqi. Wind entering from exterior to muscle causes Lung Qi obstruction (nasal congestion) if in furrows, or Sanjiao disharmony (dry retching) if in Couli. Guizhi Tang treats this. The text states: "Guizhi primarily resolves the musculature." Sanjiao Wood-Fire Qi converges in Couli. Guizhi, leader of woods, is warm and red, embodying Wood-Fire nature, assisting Qi in musculature to release exterior pathogens. Shaoyao is bitter and neutral, blooming red and white, balancing Qi, receiving Shaoyin Sovereign Fire Qi, benefiting Spirit and assisting Blood in musculature. Harmonized Qi and Blood in Couli exclude pathogens. Gancao and Shengjiang promote Stomach Qi and disperse via pungent-sweet properties. Dazao (yellow flesh, red/black skin), sweet and Spleen-associated, assists Spleen transport and Stomach fluid distribution. Sweat derives from Grain Fluids; hot porridge aids medicine. Exterior distribution of Middle Jiao fluids expels lingering pathogens with sweat. Fluid loss causes sudden Middle Qi deficiency; hence avoid damaging Spleen-Stomach Qi with prohibited foods.
The *Neijing* is a theoretical text; the *Shanghan Lun* is a clinical treatment text. Reading the *Shanghan Lun* requires a clinical perspective, not a theoretical one. Predecessors failed to note this, leading to pedantic arguments despite high discourse. The *Neijing* emphasizes acupuncture and intricate Ben-Biao theories. The *Shanghan Lun* uses herbal decoctions; accurate differentiation of Cold/Heat, Exterior/Interior, Deficiency/Excess suffices. My view on the *Shanghan Lun* is modest: do not overcomplicate it.
Preface to New Annotation of *Tangtou Gejue*: *Tangtou Gejue* by Wang Ren'an (Qing Dynasty, Xiuning) collects 206 formulas, 121 supplementary formulas, in 22 categories for easy memorization. Beginners love it, but its formulas are imperfect. Novices with limited insight may develop harmful biases. Having written *Yixue Nanzhen* to guide students, I fear the widespread *Tangtou Gejue* misleads learners. I annotated the verses to explain formula composition deeply, borrowing from predecessors where necessary. This enables understanding of ancient formulas for flexible application. Otherwise, applying static formulas to dynamic diseases harms both self and others.
April 5, Republic Year 25 (1936). Lu Shie'e, Preface at Shanghai Residence.
On Treatment of Kala-azar: The newly prevalent Kala-azar—where does the "heat" come from? Where is the "blackness"? Ignorance of origin justifies the name poorly. What is the intent behind naming this new disease?
Summarizing symptoms of modern Kala-azar, I laugh: this is simply the traditional Chinese "Pi Zheng" (Abdominal Masses). Pi diseases are Deficient or Excess. Excess is "Zheng"; Deficient is "Jia". Etiologies vary: Shanghan sinking inward forms Pi; Heat entering forms Jie Xiong (Chest Binding)—both types of Pi/Zheng. Chronic malaria forms Nu Mu (Malaria Mother)—a type of Pi/Zheng. Five Zang accumulations (Ben Tun, Fei Qi, Fu Liang, Pi Qi, Xi Ben)—types of Pi/Zheng. Bi Zheng, Mi Zheng, Yu Zheng, Jiu Zheng—also types of Pi/Zheng. Same Pi/Zheng, different causes require different treatments. Prescribing one drug for all Pi is clumsy yet touted as a specific remedy. We TCM practitioners find this absurd.
TCM possesses effective Pi remedies, such as Biejia Jian Wan, universally effective. We withhold them not out of disdain for debate, but out of caution, refusing to limit future generations to a single formula.
On Fuqi (Latent Qi): What is Fuqi? What Qi? Where does it lie? The concept appears vaguely in *Neijing* and *Shanghan Lun*. Later scholars proposed nine conflicting theories.
Theory 1: Cold pathogens enter but don't immediately cause disease, lying dormant in Shaoyin channel. Spring Yang activation triggers internal-external interaction, causing disease.
Critique 2: Blood and Qi circulate continuously; minor stagnation causes sores/abscesses. Shaoyin is Kidney channel, source of life. How can pathogens lie dormant there for a winter without harm?
Theory 3: The body's channels (Twelve Meridians, Eight Extraordinary Vessels, etc.) are complex like a city. Hidden "rogues" (pathogens) exist. Under normal governance (health), they remain inactive. External invasion triggers rebellion.
Theory 4: Winter has external cold and internal warmth. Well water demonstrates this: external cold preserves internal warmth. Spring thaw releases internal warmth. Internal warmth meets external warmth, combining to cause disease. Proponents of "cold transforming to heat" miss the true nature of Fuqi.
Of these, excluding Theory 2 (which refutes Fuqi), I find 1, 3, and 4 valid. Theory 4 discusses Ben Qi (Constitutional Qi); Theories 1 and 3 discuss Bing Qi (Pathogenic Qi). Everyone has Ben Qi; not everyone has Bing Qi, explaining varying susceptibility. Theory 3 posits exterior contraction triggers latent Qi; Theory 1 posits warming weather triggers latent pathogens. Both are factually supported. Wu Jutong, Wang Mengying, and Zhang Xugu discuss Pathogenic Qi; Ye Ziyu discusses Constitutional Qi. Both views coexist; neither should be favored exclusively.
Fuqi manifestations include Sigao Dihuang Tang syndrome, Daochi San syndrome, Huangqin Tang syndrome, Congchi Tang syndrome, Baihu Tang syndrome, and Xiaochaihu Tang syndrome. Depth of latency and Qi/Blood involvement vary. Treating visible symptoms reveals the disease clearly.
Types of Wind Diseases: Wind diseases are numerous. *Suwen*, *Bingyuan*, *Waitai*, and *Qianjin* list many names. Selected excerpts for study:
1. Hanre (Chills and Fever): Wind hides in skin, blocked internally and externally. Wind moves quickly; open Couli causes chills; closed Couli causes heat/stuffiness. Chills reduce appetite; heat consumes muscles, causing tremors and anorexia. Named Hanre.
Hanre differs by channel. Wind entering Yangming goes to Stomach, ascends to inner canthus. In obese persons (thick muscle), wind traps, causing Heat-Zhong (Internal Heat) and yellow eyes. In thin persons (thin muscle), wind escapes easily, causing Cold-Zhong (Internal Cold) and diarrhea. This is Yangming Wind Hanre.
Wind entering Taiyang travels through meridians, disperses in muscle intervals, conflicts with Wei Qi. Obstruction causes swelling/ulcers. Coagulated Wei Qi causes numbness. This is Taiyang Wind Hanre.
2. Lifeng (Leprosy): Ying Qi heat putrefies, turbidity causes nasal collapse and skin decay. Wind-Cold lingers in vessels. Named Lifeng.
3. Wuzang Zhi Feng (Wind of Five Zang): Spring Wind damages Liver (Liver Wind); Summer Wind damages Heart (Heart Wind); Late Summer Wind damages Spleen (Spleen Wind); Autumn Wind damages Lung (Lung Wind); Winter Wind damages Kidney (Kidney Wind).
4. Pian Feng (Hemiplegic Wind): Wind strikes Zang-Fu acupoints, entering respective portals, causing hemiplegia.
5. Naofeng (Brain Wind): Wind ascends via Fengfu point to Brain.
6. Mufeng (Eye Wind): Wind enters head connections, affecting eyes.
7. Loufeng (Leaking Wind): Alcohol consumption with wind exposure causes sweating.
8. Neifeng (Internal Wind): Sexual activity with sweating and wind exposure.
9. Shoufeng (Head Wind): Wind exposure after washing hair.
10. Changfeng (Intestinal Wind): Chronic wind enters middle, causing diarrhea.
11. Xiefeng (Escaping Wind): Wind stays in Couli.
12. Fengjue (Wind-Jue): Sweating with fever is Wind; sweating with irritability/fullness is Jue. Combined: Fengjue.
13. Laofeng (Labor Wind): Located below Lungs. Causes stiff neck, staring, thick sputum, aversion to wind/chills.
14. Jiufeng (Alcohol Wind): Body heat, flaccidity, profuse sweating, aversion to wind, shortness of breath.
15. Piangu (Hemiplegia): Asymmetric sweating leads to hemiplegia.
16. Fei (Flaccidity Syndrome): No pain, limb paralysis, mild mental confusion. Speech possible: treatable. Speech impossible: untreatable.
17. Bi (Obstruction Syndrome): Wind causes hemiplegia or arm paralysis. Pulse micro-rapid indicates Wind Stroke.
These are types of Wind diseases. Etiology and treatment are discussed separately.