治疗上，太阳之渴用五苓散，阳明之渴用白虎汤，少阳之渴用小柴胡汤化裁，或柴胡桂枝干姜汤。三阴病中，太阴没有渴，即便有渴也不欲饮，所以，三阴病只有少阴和厥阴言渴。少阴病的渴已如前述，它是小便色白，一派阴寒之象。因此，少阴之渴也是容易区别的，特别很容易与三阳之渴区别。对付少阴的口渴，需要动用四逆汤一类的方剂。上述三阳的口渴，及少阴的口渴都各有千秋，易于鉴别，除外上述这些口渴，其他的就都属于厥阴的口渴。所以，厥阴渴的范围是非常广泛的。凡是上述四经之外的，一切不典型的口渴，皆属于厥阴渴的范畴。从这一点我们可以看到，厥阴之于渴，就像太阳之于脉一样。我们说一个人脉浮了，大致就可以断定他是太阳病，至少也是八九不离十。除极少数虚阳外越的病人也可以见到脉浮外，大部分的脉浮都与太阳相关。所以，我们根据一个脉浮，就可以下一个大致的判断，这个病与太阳有关。同样，我们根据一个口渴，如果这个口渴不具备上述四经的特殊表现，那就可以大致地判断这是一个与厥阴相关的疾病。因此，口渴，特别是渴而能饮，渴而能消者，对于厥阴病的诊断无疑就具有非常重要的意义。（4）厥阴治渴方上面我们讨论三阳的口渴，它都有专门的方剂对治，少阴和厥阴的口渴《伤寒论》中却没有提到对治的方剂。对于少阴而言，口渴并不是一个很主要的证，大可以随证治之即是。但是，对于厥阴病，就不能不立一个治渴的专方了。那么，这个治渴的专方是哪一个方呢？我想非厥阴的主方———乌梅丸莫属。最近治疗一例结肠癌术后的病人，患者男性，术后已近一年，大便仍不正常，每日腹泻五六次至七八次不等，初为烂便，后即纯水。除泻利以外，口渴很厉害，终日饮水不止，每日至少需饮两大暖瓶水。半年以来，叠进中医治疗，然效不甚显。观前医所用方，多是健脾燥湿一类，兼或有固肾收涩一类。像参苓白术散，香砂六君汤，补脾益肠丸一类皆在常用之列。用上述这些方药有没有错误呢？应该没有错误。慢性腹泻，又是肿瘤术后患者，不用苦寒抗癌一类已是高手了。不从脾去治，不从太阴去治，还能从哪儿下手呢？但是，若要学过《伤寒论》，学过六经辨证，我想就断然不会去从太阴下手。为什么呢？以“自利不渴者，属太阴也”，现在病人每日渴饮两瓶水，怎么可能病在太阴呢？所以，用上面的方剂当然就没有效果了。那么，对上述这样一个疾病该从何处入手呢？病人下利，然六经皆有下利。病人口渴，且饮水甚多，此即为消渴也。又下利，又消渴，这就非六经皆有，而是厥阴独具了。所以，毫无疑问地应该从厥阴来论治，应该投乌梅丸。于是为病人开具乌梅丸原方，不作一味增减，每诊开药三四剂，至第三次复诊，渴饮减一半，每日仅需喝一瓶水，水泻亦大大减轻。由上述这个病例，大家应该初步地感受到六经辨证是一个很方便的法门。只要我们将六经的提纲把握实在了，六经病的切入是很容易的。像这个病，你若是不用六经辨证的方法，很容易就切入到太阴里面，脾胃里面去了，而一旦你用六经的方法，那无论如何是不会把它摆到太阴脾胃里去思考的。因此，六经辨证不但具有上述的方便性，而且还有很大的可靠性。这样一个既方便又可靠的法门，为什么不去把握它呢？当然应该把握它！（5）对糖尿病的思考谈到消渴，大家会很自然地想到一个现代的病名，就是糖尿病。从文献记载来看，实际早在隋末的时候就已经把消渴病当作糖尿病了。那么，厥阴提纲条文中提到的这个消渴与隋唐以后的消渴病，亦即与现代的糖尿病有什么联系呢？记得上大学的时候，在讲到厥阴提纲证时，老师还会专门强调不要将厥阴的消渴当成现代的消渴（糖尿病），教材的释义也这样明文规定。厥阴病很主要的一个证是消渴，而现代糖尿病很主要的一个证也是消渴。虽然厥阴提纲证的消渴不一定就是糖尿病，但是，糖尿病与厥阴病会不会就没有关系呢？这个问题萦绕心头，久久难去。我们知道，糖尿病很直观的一个情况就是血糖升高，当血糖升高到一定时，超过了肾的糖阀值，这时就会连带出现尿糖。所以，古人对糖尿病的诊断就主要通过对尿糖的观察。尿糖怎么观察呢？那个时候又没有尿糖试纸，这就要靠蚂蚁帮忙。蚂蚁嗅觉很灵，尤其对于糖更是灵敏，一般的尿拉到地上是不招蚂蚁的，蚂蚁也怕这个臊味，可是糖尿病人的尿拉到地上，很快就会招来许多蚂蚁。古人就通过这个方法来诊断糖尿病。糖在身体的作用主要是为身体的组织器官提供能量，那么，现在血糖为什么会升高呢？现代的说法主要是胰岛素的不足，所以，过去治疗糖尿病的惟一方法，便是设法补充胰岛素，或是设法刺激胰岛细胞的分泌。但是，最新的研究表明，胰岛素的不足仅仅是一个方面，而更主要的原因是机体组织细胞对糖的利用发生障碍。所以，看起来好像是血糖很高，好像是糖多了。而真实的情况是什么呢？真实的情况却是机体组织细胞内处于缺糖的状态。正是因为机体组织内处于这样一种糖缺乏的状态，所以，你不足我就得补足你。怎么补足呢？当然就需要机体启动各式各样的方法，其中一个我们能够直接感受到的方法就是易饥，就是多食。糖尿病人的易饥多食其实就是由此而来。而在生化上的一个集中表现，便是血糖升高。因此，对于糖尿病我们应该有这样一个宏观的认识。它不是糖太多，而是糖不足。因而，糖尿病的关键问题是要没法解决糖的利用问题。扫除了糖利用过程中的障碍，糖尿病的诸多问题就会迎刃而解。以上我们从现代的角度对糖尿病作了一个大致剖析，那么，从中医的角度，尤其是从伤寒六经的角度，我们怎样去看待这个问题呢？糖尿病属于糖的代谢利用障碍，糖在中医它属于哪一类的东西呢？糖是甘味的东西，而甘味于五行属土，所以，很显然，糖应归到土这一类。因此，糖的代谢、利用障碍，从中医的角度来说，就应该是土系统的障碍。土系统怎么障碍呢？从上述直观的角度我们知道，糖尿病就是血中的糖太多了，糖太多当然也就是土太多，而血于中医、于自然它可以与什么类比呢？它可以与江河类比。故古人云：人之有血脉，如大地之有江河。所以，把血中的糖分过多的这样一个病理情况放到自然里，实际就是水中的土太多了，江河中的土太多了。过去，我们沿着长江往西走，江中的水是碧绿碧绿的，再加上两岸青山的依衬，真是青山绿水，美不胜收。可是现在我们再去长江看一看，原来的青山不在了，绿水也变得黄浊。绿水为什么会黄浊呢？水中的土太多了。土本来应该呆在它的本位上，不应该到河流里，可现在为什么会跑到河流里来呢？这个原因我们在太阴篇里已经讨论过，就是土的流失。由于树木砍伐，植被减少，所以，土就很难安住在本位上，几度风雨就把它带到河流里了。由此可见，水中的土太多，使河流变得浑浊，其根本的原因还是木少了，植被少了。看上去好像是土的问题，土不安分，跑到水里来滋事，使我们看不到从前的绿水，可是追溯它的根子，却是在木上面。我们遵循老子的“道法自然”，将上述糖尿病的过程放到自然里，就知道糖尿病虽然是土系统的毛病，可是它的病根却在木系统上，却在厥阴上。厥阴的提纲证为什么首言消渴呢？这里的消渴与后世的消渴病（糖尿病）是不是没有关系呢？这个问题就很清楚了。很显然，我们将糖尿病放到厥阴病里来思考，这便从根本上突破了原有的三消学说，使我们得以从真正的源头上来设立对治的方法。这便将糖尿病的论治，糖尿病的研究提升到了一个很高的自然境界。迄今为止，现代医学还是认为糖尿病是不可治愈性疾病，必须终身服药。而我们从厥阴的角度，能不能找到一个治愈的方法呢？对此我是满怀信心的。我们通过思考，利用中医的方法治愈了现代医学认为不能治愈的疾病，这个算不算现代化呢？这个不但是现代化，而且应该是超现代化。作为人类，我想他更希望中医以这样的方式来出奇制胜地为现代提供服务。用现代的仪器设备将中医武装起来，甚至武装到牙齿，不是没有用处，但，我们应该清楚地意识到这不是惟一的方法。我们应该更多地开动脑筋，用中医的思想来武装中医，只有这样，中医的路才可能走得长远。2.气上撞心，心中疼热这里我们首先要弄清一个问题，就是《伤寒论》中所讲的心究竟是指的什么？当然心的直接指义是五藏的心，但在《伤寒论》里，我们看到更多的并不是指五藏的心，而是讲的某个与体表相对应的部位。有关心的所指，概括起来大体分三种情况，第一是直接言心，心之外没有附带其他的部位。如心悸，心烦，心乱等。这样一个心悸、心烦、心乱，我们往往很难给它一个确切的定位；第二是心下，心下讲得很多，比如心下痞，心下悸，心下急，心下支结，心下痛等。心下的部位比较明确，就是指腹以上剑突以下的这片区域；第三，是心中，如心中悸而烦，心中结痛，心中疼热等。心中指的是什么地方呢？这里有两种可能，其一，如《伤寒论辞典》所言，心中指心或心区，泛指胸部；其二，古人言心者，常非指心藏，而是指躯干的中央，这个中央就正好位于心窝（剑突下）这块地方。所以，心中实际是指心窝，亦即剑下。民间谓心痛，以及整个藏区言心痛，都是指这个部位的疼痛。因此，心中的第二层意义，实际是指胃脘的这个部位。厥阴提纲条文讲“气上撞心，心中疼热”，这里的“心”及“心中”就应该包括上述的两个方面。一个就是指的现在的心前区及胸骨后，这一片地方显然是手厥阴领地；另一个就是剑突下的这片区域，这片区域为中土所主。所以，气上撞心，心中疼热，一方面确实包括了现在的心脏疼痛，而另一方面则包括了胃脘及其周边邻近脏器的疼痛。前者属于现在的循环系统，后者属于现在的消化系统。前者之疼痛乃心包络痛也，系于手厥阴；后者的疼痛乃土系统之病变所致。土何以病呢？以木使之病，厥阴使之病也。故《金匮要略》曰“见肝之病，知肝传脾”也。因此，厥阴提纲的“气上撞心，心中疼热”，至少应该考虑到上述两个方面。气上撞心，撞之义有如《说文》云“捣也”，有如《广韵》云“击也”。捣与击所致之痛，颇似刺痛，压榨痛，绞痛一类。心中疼热，热之义已显，即疼痛而伴火烧、火辣的感觉。结合上述之定位，则刺痛、压榨痛及绞痛多为心绞痛一类，系循环系统疾病。而疼痛又兼热辣、烧灼之感，则多为胃脘痛一类，系消化系统疾病。当然，现在的胆系疾病亦多有绞痛之感，以其部位而言，亦接近心中，故亦应从厥阴来考虑。另者，厥阴病很重要的一个内容是讨论厥，整个厥阴篇计有52处言厥。厥者，手足逆冷是也。疼痛是很容易致厥的一个疾病，而心绞痛及胆系的绞痛尤其容易致厥。这是在讨论厥阴篇时，需要考虑的问题。3.饥而不欲食《伤寒论》中有不少的地方谈到饮食问题，如小柴胡汤四大证之一的“默默不欲饮食”，太阴病提纲条文的“腹满而吐，食不下”，以及这里所讲的“饥而不欲食”。虽然都是饮食有问题，但是，这里面还是有区别的。小柴胡汤的“默默不欲饮食”，就是我们平常讲的“茶饭不思”，这里重在不欲、不思，强调主观的方面。而厥阴病也是“不欲食”，在这个“不欲”上，它与小柴胡汤证是很类似的。但是，在不欲食的同时，他是很感觉饥饿的，又饥饿又不想吃，这就是厥阴区别于少阳的一个地方。太阴的饮食是强调食不下，为什么食不下呢？因为肚子很胀满，吃下去不舒服。所以，太阴病的食不下，是强调客观的食不下，强食之必不舒服，必生胀满。少阳、厥阴之不食，则是强调主观之食欲。太阴俱土性，少阳、厥阴俱木性，故知饮食一事，食不食主要在土（脾胃），欲不欲则主要在木（肝胆）也。因此，临床我们对饮食有问题的病人，就不能光停留在几味神曲、山楂、麦芽上，要仔细询问病人，要抓住它的根本。是光不想吃呢？还是吃下去不舒服？是整日不知饥饿，吃也可不吃也可呢？还是饥而不欲食？这些对于我们临床辨证都是很重要的因素。最近治疗一位学生，吃饭很困难，一丁点食欲也没有，吃一餐饭要一个多小时，但是肚子却很容易饿，这是什么呢？这就是典型的“饥而不欲食”，这就是典型的厥阴病。所以，给她开了三剂乌梅丸，三剂药以后，胃口大开，一顿饭很快就吃下去了。这是我们由“饥而不欲食”引出的一个问题。另外，在讨论六经的提纲条文时，还应注意一个问题，每一经的提纲条文内部既有较密切的联系，同时又有相对的独立性。以厥阴的提纲条文为例，并不是条文中的所有证都具备了，这才是厥阴病，这一点记得在太阳提纲的讨论中曾提起过，张仲景完全没有这个意思。只要条文中的一二个证具备了，厥阴病的诊断便可以成立。这是我们研究《伤寒论》很需要注意的一个问题，张仲景于厥阴提纲中首言消渴，可是后世的医家却不敢将这个消渴与消渴病联系起来。为什么呢？就因为条文中有“饥而不欲食”。
In treatment, thirst caused by Taiyang disease (disease syndrome resulting from pathogenic invasion of the Foot-Taiyang Bladder meridian) is treated with Wuling San; thirst caused by Yangming disease (disease syndrome resulting from pathogenic invasion of the Foot-Yangming Stomach meridian) is treated with Baihu Tang; thirst caused by Shaoyang disease (disease syndrome resulting from pathogenic invasion of the Foot-Shaoyang Gallbladder meridian) is treated with Xiaochaihu Tang with modifications, or Chaihu Guizhi Jiangtang Tang. Among the Three Yin diseases, Taidisease (disease syndrome resulting from pathogenic invasion of the Foot-Taiyin Spleen meridian) does not present with thirst; even if thirst occurs, there is no desire to drink. Therefore, among the Three Yin diseases, only Shao disease (disease syndrome resulting from pathogenic invasion of the Foot-Shaoyin Kidney meridian) and Jue disease (disease syndrome resulting from pathogenic invasion of the Foot-Jueyin Liver meridian and Hand-Jueyin Pericardium meridian) mention thirst. The thirst in Shao disease, as mentioned earlier, presents with clear white urine, manifesting a picture of Yin-cold. Thus, thirst in Shao disease is also easy to distinguish, particularly from the thirst of the Three Yang diseases. To address thirst in Shao disease, formulas such as Sini Tang are required. The thirsts of the aforementioned Three Yang diseases and Shao disease each have their own characteristics and are easy to differentiate. Excluding these types of thirst, others belong to the category of thirst in Jue disease. Therefore, the scope of thirst in Jue disease is very broad. Any atypical thirst outside the aforementioned four meridians falls under the category of Jue disease thirst. From this perspective, we can see that Jue disease regarding thirst is analogous to Taiyang disease regarding pulse. When we say a person's pulse is floating (Fu Mai), it can be roughly determined that they have Taiyang disease, or at least it is highly likely. Except for a very small number of patients with floating pulse due to deflection of deficient Yang outward, most floating pulses are related to Taiyang disease. Therefore, based on a floating pulse, we can make a rough judgment that the disease is related to Taiyang disease. Similarly, based on thirst, if this thirst does not possess the specific manifestations of the aforementioned four meridians, we can roughly judge it as a disease related to Jue disease. Therefore, thirst, especially cases where one is thirsty yet able to drink and quench the thirst, undoubtedly holds significant importance for the diagnosis of Jue disease. (4) Formulas for Treating Thirst in Jue Disease Above, we discussed the thirst of the Three Yang diseases, which all have specialized formulas for treatment. However, *Shanghan Lun* does not mention specific formulas for treating thirst in Shao disease and Jue disease. For Shao disease, thirst is not a primary syndrome; it can generally be treated according to the specific presentation. However, for Jue disease, it is necessary to establish a specialized formula for treating thirst. So, which formula is this specialized formula? I believe none other than the main formula for Jue disease—Wumei Wan (Mume Pill). Recently, I treated a patient who had undergone surgery for colon cancer. The male patient was nearly a year post-surgery, but his bowel movements remained abnormal, with diarrhea occurring five to seven or eight times daily. Initially, the stool was loose, later becoming pure water. Apart from diarrhea, the thirst was severe, with continuous drinking throughout the day, requiring at least two large thermos bottles of water daily. Over the past six months, traditional Chinese medicine treatments were administered repeatedly, but the efficacy was not significant. Observing the formulas used by previous physicians, they mostly belonged to the categories of strengthening the Spleen and drying dampness, or consolidating the Kidney and astringing. Formulas such as Shenling Baizhu San, Xiangsha Liujun Tang, and Bupi Yichang Wan were commonly used. Were there errors in using these formulas? Probably not. For chronic diarrhea in a tumor post-operative patient, avoiding bitter-cold anti-cancer herbs already demonstrates high skill. If not treating from the Spleen or Taidisease, where else could one start? However, if one has studied *Shanghan Lun* and Six Meridian differentiation, I believe one would absolutely not start from Taidisease. Why? Based on "spontaneous diarrhea without thirst belongs to Taidisease," how could a patient drinking two bottles of water daily be suffering from Taidisease? Therefore, the aforementioned formulas naturally had no effect. So, where should one start for such a disease? The patient has diarrhea, yet all Six Meridians can present with diarrhea. The patient has thirst and drinks copiously, which constitutes Xiao Ke (wasting-thirst syndrome). Having both diarrhea and wasting-thirst is unique to Jue disease, not common to all Six Meridians. Therefore, undoubtedly, treatment should proceed from Jue disease, administering Wumei Wan. Consequently, I prescribed the original formula of Wumei Wan without any modifications, opening three to four doses per consultation. By the third follow-up visit, the thirst and drinking reduced by half, requiring only one bottle of water daily, and watery diarrhea was significantly alleviated. From this case, everyone should initially feel that Six Meridian differentiation is a very convenient method. As long as we firmly grasp the outline syndromes of the Six Meridians, entering into the diagnosis of Six Meridian diseases is quite easy. For this disease, if one does not use Six Meridian differentiation, it is easy to fall into thinking about Taidisease or the Spleen and Stomach; however, once Six Meridian methods are applied, one will never consider placing it within Taidisease or the Spleen and Stomach. Therefore, Six Meridian differentiation not only possesses the aforementioned convenience but also great reliability. Why not grasp such a convenient and reliable method? Of course, it should be grasped! (5) Reflections on Diabetes When discussing Xiao Ke, people naturally think of a modern disease name: diabetes mellitus. According to literature records, actually since the end of the Sui Dynasty, Xiao Ke disease has been regarded as diabetes mellitus. So, what is the connection between the Xiao Ke mentioned in the outline clause of Jue disease and the Xiao Ke disease after the Sui and Tang dynasties, i.e., modern diabetes mellitus? I remember that when studying the outline syndrome of Jue disease in university, teachers specifically emphasized not to equate the Xiao Ke of Jue disease with modern Xiao Ke (diabetes mellitus), and textbook interpretations explicitly stated this. A major syndrome of Jue disease is Xiao Ke, and a major syndrome of modern diabetes mellitus is also Xiao Ke. Although the Xiao Ke in the outline syndrome of Jue disease may not necessarily be diabetes mellitus, could there be no relationship between diabetes mellitus and Jue disease? This question lingered in my mind for a long time. We know that a direct manifestation of diabetes mellitus is elevated blood sugar. When blood sugar rises to a certain level, exceeding the renal glucose threshold, glycosuria appears concomitantly. Therefore, ancient diagnoses of diabetes mellitus mainly relied on observing glycosuria. How was glycosuria observed? At that time, there were no urine test strips, so ants were relied upon. Ants have a keen sense of smell, especially sensitive to sugar. Ordinary urine spilled on the ground does not attract ants, as ants fear the ammonia odor; however, urine from diabetic patients spilled on the ground quickly attracts many ants. The ancients used this method to diagnose diabetes mellitus. The main role of sugar in the body is to provide energy for tissues and organs. So, why does blood sugar rise now? The modern explanation is mainly insulin deficiency. Thus, the only method for treating diabetes mellitus in the past was to supplement insulin or stimulate the secretion of pancreatic islet cells. However, latest research indicates that insulin deficiency is only one aspect; the more main reason is that the utilization of sugar by tissue cells in the body encounters obstacles. So, although it appears that blood sugar is very high and there is too much sugar, what is the true situation? The true situation is that tissue cells within the body are in a state of sugar deficiency. Precisely because the body tissues are in such a state of sugar deficiency, compensation is needed. How to compensate? Naturally, the body must activate various methods, one of which we can directly perceive is increased hunger and excessive eating. The increased hunger and excessive eating in diabetic patients stem from this. A concentrated biochemical manifestation is elevated blood sugar. Therefore, we should have such a macroscopic understanding of diabetes mellitus. It is not that there is too much sugar, but rather that there is a lack of sugar utilization. Hence, the key issue in diabetes mellitus is the inability to resolve the problem of sugar utilization. Once the obstacles in the process of sugar utilization are removed, many problems of diabetes mellitus will be solved easily. Above, we made a rough analysis of diabetes mellitus from a modern perspective. So, from the perspective of Traditional Chinese Medicine (TCM), especially from the angle of Shanghan Six Meridians, how should we view this issue? Diabetes mellitus belongs to disorders of sugar metabolism and utilization. What category does sugar belong to in TCM? Sugar is sweet in flavor, and sweet flavor corresponds to Earth in the Five Elements. Therefore, obviously, sugar should be classified under Earth. Thus, disorders of sugar metabolism and utilization, from a TCM perspective, should be considered as disorders of the Earth system. How does the Earth system become disordered? From the aforementioned intuitive perspective, we know that diabetes mellitus means too much sugar in the blood; too much sugar implies too much Earth. In TCM and nature, what can blood be analogized to? It can be analogized to rivers and streams. Hence, the ancients said: "Human blood vessels are like rivers and streams on earth." Therefore, placing the pathological condition of excessive sugar in the blood into nature is actually equivalent to too much Earth in water, or too much silt in rivers. In the past, traveling west along the Yangtze River, the water was emerald green, complemented by green mountains on both banks, creating a beautiful scene of green mountains and clear waters. But now, looking at the Yangtze again, the original green mountains are gone, and the clear waters have turned yellow and turbid. Why have the clear waters turned turbid? Because there is too much silt in the water. Earth should originally stay in its proper position and not enter rivers, so why has it entered rivers now? We have discussed this reason in the Taidisease chapter: it is the loss of soil. Due to deforestation and reduced vegetation, soil finds it difficult to remain in its proper position; after a few storms, it is carried into the rivers. Thus, the excessive silt in water causing turbidity in rivers fundamentally stems from a lack of Wood, i.e., reduced vegetation. It appears to be an Earth problem, with Earth being unruly and causing trouble in the water, preventing us from seeing the former clear waters, but tracing back to the root, it lies in Wood. Following Laozi's "The Dao follows Nature," placing the process of diabetes mellitus into nature reveals that although diabetes mellitus is a disorder of the Earth system, its root cause lies in the Wood system, specifically in Jue disease. Why does the outline syndrome of Jue disease first mention Xiao Ke? Is there really no relationship between this Xiao Ke and the Xiao Ke disease (diabetes mellitus) of later generations? This question becomes very clear. Obviously, thinking about diabetes mellitus within the framework of Jue disease fundamentally breaks through the original "Three Xiao" theory, allowing us to establish therapeutic methods from the true source. This elevates the discussion and research of diabetes mellitus to a high natural realm. To date, modern medicine still considers diabetes mellitus an incurable disease requiring lifelong medication. Can we find a curative method from the perspective of Jue disease? I am full of confidence in this. By thinking and utilizing TCM methods to cure diseases that modern medicine deems incurable, does this count as modernization? This is not only modernization but should be considered super-modernization. As humans, I believe they hope more that TCM serves modernity by achieving victory through unconventional means. Armoring TCM with modern instruments and equipment, even to the teeth, is not useless, but we should clearly realize this is not the only method. We should exert more mental effort to arm TCM with TCM thought; only in this way can the path of TCM be taken far. 2. Qi rushing up to strike the Heart, pain and heat in the center of the chest Here, we must first clarify a problem: what exactly does "Heart" refer to in *Shanghan Lun*? Of course, the direct meaning of Heart is the Zang-organ Heart. However, in *Shanghan Lun*, what we see more often is not referring to the Zang-organ Heart, but rather a specific area corresponding to the body surface. Regarding the reference of "Heart," it can be broadly categorized into three situations. First, directly mentioning Heart, without attaching other areas to it. Such as Xin Ji (palpitations), Xin Fan (restlessness of the heart), Xin Luan (mental confusion). For such palpitations, restlessness, and mental confusion, it is often difficult to give them a precise localization. Second, "Xia Xin" (below the heart). This is mentioned frequently, such as Xin Xia Pi (fullness below the heart), Xin Xia Ji (palpitations below the heart), Xin Xia Ji (urgency below the heart), Xin Xia Zhi Jie (binding below the heart), Xin Xia Tong (pain below the heart), etc. The location of "Xia Xin" is relatively clear, referring to the area above the abdomen and below the xiphoid process. Third, "Xin Zhong" (in the center of the chest/heart). Such as Xin Zhong Ji Er Fan (palpitations and restlessness in the center of the chest), Xin Zhong Jie Tong (binding pain in the center of the chest), Xin Zhong Teng Re (pain and heat in the center of the chest), etc. Where does "Xin Zhong" refer to? There are two possibilities here. One, as stated in the *Dictionary of Shanghan Lun*, "Xin Zhong" refers to the Heart or heart region, generally referring to the chest. Two, when ancients spoke of "Heart," it often did not refer to the Heart Zang, but rather to the center of the trunk, which is exactly located at the epigastrium (below the xiphoid process). Therefore, "Xin Zhong" actually refers to the epigastrium, i.e., below the xiphoid. Folk terms for heartache, and the entire Tibetan region's term for heartache, all refer to pain in this area. Therefore, the second layer of meaning of "Xin Zhong" actually refers to the Wei Wan (epigastric region). The outline clause of Jue disease states "Qi rushes up to strike the Heart, pain and heat in Xin Zhong." The "Heart" and "Xin Zhong" here should include the aforementioned two aspects. One refers to the current precordial area and retrosternal space; this area is clearly the territory of the Hand-Jueyin Pericardium meridian. The other is the area below the xiphoid process, which is governed by Central Earth. Therefore, "Qi rushing up to strike the Heart, pain and heat in Xin Zhong" includes, on one hand, current cardiac pain, and on the other hand, pain in the epigastrium and surrounding adjacent organs. The former belongs to the current circulatory system, and the latter belongs to the current digestive system. The pain of the former is Pericardium meridian pain, associated with the Hand-Jueyin Pericardium meridian; the pain of the latter is caused by lesions of the Earth system. Why does the Earth system become diseased? It is diseased due to Wood, specifically due to Jue disease. Hence, *Jingui Yaolue* states: "When you see Liver disease, know that it transmits to the Spleen." Therefore, the "Qi rushing up to strike the Heart, pain and heat in Xin Zhong" in the outline of Jue disease should at least consider the aforementioned two aspects. "Qi rushing up to strike the Heart": the meaning of "strike" is like "beating" as stated in *Shuowen Jiezi*, or "hitting" as stated in *Guangyun*. Pain caused by beating and hitting is somewhat similar to stabbing pain, crushing pain, or colicky pain. "Pain and heat in Xin Zhong": the meaning of "heat" is evident, i.e., pain accompanied by a burning, fiery sensation. Combining the aforementioned localizations, stabbing, crushing, and colicky pains are mostly angina pectoris, belonging to circulatory system diseases. Pain accompanied by hot, spicy, and burning sensations is mostly epigastric pain, belonging to digestive system diseases. Of course, current biliary system diseases also often present with colicky pain; considering its location, it is also close to "Xin Zhong," so it should also be considered from the perspective of Jue disease. Additionally, an important content of Jue disease is the discussion of Jue (cold extremities). The entire Jue disease chapter mentions Jue 52 times. Jue refers to cold extremities. Pain is a disease that easily leads to Jue, and angina pectoris and biliary colic especially easily lead to Jue. This is a point to consider when discussing the Jue disease chapter. 3. Hunger but no desire to eat *Shanghan Lun* discusses dietary issues in many places, such as "silently having no desire to eat or drink," which is one of the four major syndromes of Xiaochaihu Tang; "abdominal fullness with vomiting and inability to eat," which is the outline clause of Taidisease; and here, "hunger but no desire to eat." Although all involve dietary problems, there are distinctions. "Silently having no desire to eat or drink" in Xiaochaihu Tang is what we usually call "having no appetite for tea or rice"; here, the emphasis is on "no desire" and "no thought," highlighting the subjective aspect. Jue disease also presents with "no desire to eat," and in this "no desire," it is very similar to Xiaochaihu Tang syndrome. However, while having no desire to eat, the patient feels very hungry. Being hungry yet not wanting to eat is where Jue disease differs from Shaoyang disease. The dietary issue in Taidisease emphasizes "inability to eat." Why unable to eat? Because the abdomen is very full, and eating causes discomfort. Therefore, the "inability to eat" in Taidisease emphasizes objective inability to eat; forcing food will inevitably cause discomfort and bloating. The non-eating in Shaoyang disease and Jue disease emphasizes subjective appetite. Taidisease shares the nature of Earth, while Shaoyang disease and Jue disease share the nature of Wood. Thus, we know that regarding eating, whether one eats depends mainly on Earth (Spleen and Stomach), while whether one desires to eat depends mainly on Wood (Liver and Gallbladder). Therefore, clinically, for patients with dietary problems, we cannot merely rely on a few herbs like Shenqu, Shanzha, and Maiya. We must carefully inquire about the patient and grasp the root cause. Is it simply not wanting to eat? Or is it discomfort after eating? Is it knowing no hunger all day, indifferent to eating or not? Or is it hunger but no desire to eat? These are important factors for clinical differentiation. Recently, I treated a student who had difficulty eating, with absolutely no appetite, taking over an hour to finish a meal, yet her stomach got hungry easily. What is this? This is typical "hunger but no desire to eat," which is typical Jue disease. Therefore, I prescribed three doses of Wumei Wan. After three doses, her appetite opened up greatly, and she finished a meal very quickly. This is an issue derived from "hunger but no desire to eat." Additionally, when discussing the outline clauses of the Six Meridians, another point should be noted: internally, the outline clause of each meridian has close connections, yet also relative independence. Taking the outline clause of Jue disease as an example, it is not required that all syndromes in the clause be present for a diagnosis of Jue disease. This was mentioned in the discussion of the Taiyang outline; Zhang Zhongjing certainly did not mean this. As long as one or two syndromes in the clause are present, the diagnosis of Jue disease can be established. This is a point requiring careful attention in our study of *Shanghan Lun*. Zhang Zhongjing first mentions Xiao Ke in the outline of Jue disease, yet later physicians dared not connect this Xiao Ke with Xiao Ke disease. Why? Because the clause contains "hunger but no desire to eat."