71、治风伤汗□阳病，当着意于水。治中风病当着意于火。
72、寒热温凉自是四种，温与热异，凉与寒亦殊，不得以温药即名之为热药，以凉药取名之为寒药。
73、《千金方翼》为《伤寒论》原源。
74、《伤寒论注》以成氏为最先。《金匮注》以赵以德为最先。
75、世间□郁病最多，达、发、夺、泄者，皆治郁之法。
76目疾迎风下泪，责其有火，即心热则汗，肾热则溲之理，盖枫磷火于目，皮毛敛闭，郁其经阳，遂生里热，阳并于上，即五火独发之例也，安得不热蒸而泪流乎？即羞明怕日，拳毛倒睫，亦无不因于火。
77、鼠妇即《诗》所谓“〖虫伊〗□在室”，水湿所生虫也。
78、水湿之病，多见于太阴，脾水流湿也。火燥之病，多见于阳明，胃火就燥也。
79、太阴为三阴，故三阴疟者，太阴疟也。丹溪以发于子午卯酉日者为少阴，发于寅申巳亥日者为厥阴疟，发于辰戊丑未日者为太阴疟，恐有不然。
80、周慎斋曰：阳气足则阴气尽化为血，阳气不足，则阴气尽化为火。
81、自汗盗汗皆虚证也。阳虚则自汗，阴虚则盗汗。阳虚之汗必寒，阴虚之汗必热。然阳明实热之时，亦有自汗、盗汗者。
82、消渴病者，津液病也。上消以天花粉为神品；中消朽木煎汤，取腐可胜焦之义；下消饮缫丝汤代茶，并□半夏。
83、善忘属畜血证最多。
84、麻木两证，当分气血，气虚则麻，血虚则木。
85、癫痫两证当分水火，癫为阳病，火之病也；痫为阴病，水之病也，痰聚即是水病。痫属阴水为病也，水即是痰，痰盛有火。结于心胸之间，或因小劳，或因少睡，即猝然眩仆，有似中风，病发声或口作六畜声，将醒则吐涎沫。共有五痫，一以开痰解结为治，脉虚者可治，实则死。
86、病七日以上，行其经尽，欲再作经者，针足阳明，不预针太编辑，故病至三阴，从无再传太阳之理，但转属阳明耳。
87、白虎汤行阳明内蒸之热，非解阳明外见之热也，故但有表热不用石膏。
88、数脉有二，非热盛即虚极。迟脉亦有二，寒者固迟，而热极亦能迟，实非迟，乃伏而不动耳。
89、未汗恶寒者，邪盛而表实；已汗恶寒者，邪退而表虚。汗出之后，大邪都既散，不得更有恶寒者矣，汗后而更恶寒，非虚乎？
90、病之内陷，谓邪向内陷，不能从外解也，今则以内陷为虚矣。
91、正虚邪实，邪与正争，故发战汗出而解。正不虚，邪未实，邪不与正争，故不战，汗出而解。邪正俱衰，阴阳自和，故不战不汗出而解。
92、服桂枝汤，必当先烦，乃汗出而解。服柴胡汤必蒸蒸而振，却发热汗出而解。此烦此振，下□战汗也，战而汗出，其病必解，不可疑是加病。
93、阳明病奄然发狂，濈然汗出而解者，亦是战汗。
94、未经汗下而燥者，为阳盛致燥之阳明，必以撤热为急。已经汗下而燥者，为夺血致燥之阳明，则以滋燥为主，滋阴药之先后缓急，以此为准。
95、同一呕也，其发热恶寒而呕者，属太阳。寒热往来而呕主，属少阳。但发热不恶寒而呕者，属阳明。故凡呕当分三阳而治之。其无寒无热而呕者，则取诸中焦。
96、病之初传阳明，尚有营卫之分，过此则不论营卫矣。
97、古人谓阳气为阳，而于阳邪亦为阳；于阴气为阴，而于阴邪亦为阴。
98、头汗出，为阳郁于表，非阳虚相上也。
99、少阴用麻黄，证皆发热无汗《论》中不言无汗者，阴不得有汗，无庸言也。
100、六经之病，以证分之，于读书时先明何经作何证，则于临病时方可知何证为何经，在病者可□告人□是何经病也，故必先读书而后临证。
101、阳邪多结于上，阴邪多结于下，故上焦之结多热，下焦之结多冷。
102、营卫之流行，皆本肾中先天之气，故曰卫气，营气，皆以气言。
103、温病不恶寒，热从里生也；中暍汗出恶寒，以暑于表入也。温病之脉浮而实；中暍则浮而虚，以暑伤气也。温病传变无定；中暍则不传，不食则死。温病初起不过欲饮；中暍初起即大渴引饮。温与暑以此为辨。
104、中暍与伤寒相类，伤寒初起无汗不渴；中暍初起，渴而汗出。中热与温病相类，温病初起渴不恶寒；中暍初起恶寒而渴。
105、同一烦躁也，太阳烦躁用青龙，阳明烦躁用白虎，少阴烦躁用真武。
106、仲景法之者于存津液，夫人而知之矣，其所以存津液者，汗吐下和寒温之六法也，六法之中，尤以急下存阴为刻不可缓。贱用滋腻之药，以为可存津液者，适与六法相反，故有病无一治。
107、温病起于中焦，而或浮越于上焦，波及于下焦，一治其中，则上下皆安。若独见于上下焦者，便不是温病。
108、河间有云，古人以百病为杂病，惟伤寒名曰大病。河间论温者也，故无所谓大病，即是说温，即是说伤寒中之温病，故又曰内有阴寒者，止为杂病，终不能为汗病也。
109、疟兼他经则有之，未有不涉于少阳者，非独为少阳病也。
110、凡为医者，且先存见病用药之心，然后再论其见地之明昧，手法之高低，即使当时尚未极高明，他日亦必成良医。
111、谚云：“十个医十个法”，此言不然，以病者只有一个人也，自当只有一个法。
112、阴盛阳亦脱，不是阳虚而脱也。阳盛阴亦脱，不是阴虚而脱也。
113、姜枣至微者矣，而具扶正达邪之妙。
114、有病疟而一日轻一日重者，余谓轻日是重日，重日是轻日，必使两日并重，方得逐日逼轻，已而果然。
115、岐伯曰：“谨熟阴阳，毋与众谋。”何以阴阳两端，不可谋之于众。可见众人口中之阴阳，非即岐伯意中之阴阳矣，表里寒热虚实之旨皆然。
116、《内经》言“热未已寒病复归”句下有言：“寒未已热病复归之。”意在非独说一面也。
117、膀胱不利为癃，经曰：有癃者一日数十溲，此与滞下注之里急后重相似，皆为下焦之火郁也，故皆无止涩之理。
118、病有虚而不可攻者，补中自有攻意，善补阴即所以攻热，补阳即所以攻寒。若为实证，则不可以作此说。实与误补，虚而误攻，其误同，其祸亦同。
119、运气之学坏于马元素之徒，至以某年生人，以某日得病，当用某药为言，此丹溪之说也。其后再有程德斋作《伤寒钤法》以得病日之干支为主，自有此等人，而运气之说，于是乎不可通矣。
120、《宋史·仁宗本记》：“至和元年正月，碎通天犀和药以疗民疫。嘉8祜五年五月，京师民疫，选医给药以疗之。”此所谓疫，即《说文》皆病之疫，朝廷为之选医给药，必非一人独病温矣。
121、尝见一书有曰：余素不喜用热药。夫治寒以热，治热以寒，皆治法也。用寒用热岂有视乎医家之爱憎者!
122、苦寒伐胃之说，为虚寒者言之也，若实热证，则非苦寒无以去病而保胃。
123、宋时有窦材者，自称第三扁鹊，谓仲景但\能治小病，狂诋〖讠其〗之。余谓此真能读仲景书者，可见人若能用仲景法，方可使病不大也。
124、石膏不可煅，煅则为石灰，性反热矣。
125、药之能起死回生者，惟石膏、大黄、附子、人参。有此四种之病，则一剂可以回春。此外皆不尽然。
126、七十二种风，不闻有七十二种治法；三十六中痛，亦不闻有三十六种治法。且曰一方可以通治，则何必有七十二、三十六之分乎？此不过言风病、痛病之多耳。
127、刮痧之法，亦妙法也。张景岳有《刮痧新探》。
128、六味地黄丸统治伤寒病，赵养葵《医贯》之说也，汪讱庵取以冠《医方》之首大误病人。
129、渴甚而呕者，必以饮水多之故。呕甚而渴者，必以津液伤之故。
130、病有初中末三传，而初中末三传之期，亦无一定，要不可以不分。
131、春夏温热，岂独用药之异于冬寒哉!尝见人家于温热亦用重茵复帐，甚至有以红毡罩窗者，实大忌也。
132、病以汗解，药到则自然得之，即冬月正伤寒亦然。乃有在夏之病，亦欲以温覆取汗，则大不然。
133、病自有宜于寒凉药者，但不可咨食生冷，惟梨汁、蔗汁、西瓜汁不在此例。
134、甘有淡义，不独以甜为甘也。《书》：“稼穑作甘”，《礼记》：“甘受和”，皆言淡，故石膏之甘，不同于麦、地。
135、《周礼》：“秋时有疟寒疾。”贾《疏》谓非火□金。
136、张刘李朱为金元四大家，张谓洁古，或曰子和，当以洁古为是。李士材乃以张为仲景，谬甚。
137、世俗所称伤风者，不发热，但有咳嗽清涕、鼻塞声重而已，非《伤寒论》之中风也，故不传变。
138、治咳须分新久，新咳宜泄，久咳宜敛。新咳误敛，则风寒不出，久咳更泄，则肺叶开张，皆足以成医怯。新久当以年计，不以月日计。
139、《伤寒论》口中和三字，最应着眼，口中和则不燥渴，燥渴则口中不和。一用附子，一用石膏，而以背皆微恶寒，辨之宜审。
140、恶风者不必皆恶寒，恶寒者未有不恶风。
141、阳明经热，但用膏知；阳明府热，始用硝黄，以燥屎之有无为辨。
142、《伤寒论》之往来寒热，，与疟相似，而实不同。凡疟当未作之前，已解之后，饮食行动即如平人，以此为辨。
143、问疾礼也，而最累病人，然总不可使与病人多语，甚者不可令至病榻四旁。
144、病加于小愈，故病后之谨慎，当十倍于病前，胃口初开，切忌多食，仲景所以有损谷则愈之训。
145、加病之与病去，外象相似，最宜分别，故衄后无再汗之理，余可以此类推。
146、仲景于热之自表而里者，曰翕翕发热与热之自里而表者，曰蒸蒸发热。翕翕、蒸蒸，即表热、里热之分。
147、病一至于阳明，无论风寒暑温，同归火化，故六因之病，不入阳明，皆无火象。
148、宋人书有以“敦阜之纪”、“敦阜之土”为厚阜者，避光宗名〖忄享〗之讳也，非改经文。
149、同一湿也，寒湿可用姜附，湿热可用黄连。
150、病之始为恶寒之甚者，即为发热之机，盖为人身自有之阳气为之也。
151、虚有各种之虚，补有各种之补。
152、虚寒之寒，不即是冷。虚热之热，不即是火。
153、风寒以解表为主，温热以清里为主，故伤寒成温，亦专清里，表谓太阳，里谓阳明，非泛言藏府之表里也。
154、学医自《伤寒论》入手者，始而难，继而易。自后世诸家入手者，始若甚易，继则大难矣。
155、六经之病要分看，又要合看，总以胸中先有六经之病，然后目中乃有六经之证。
156、昔人所谓破气药者，破气中之滞者也。昔人所谓票血药者，破血中之结者也。气血既有所滞，非破不可，岂有一用此药，即将人之气血而破之乎？
157、病在经宜汗，在府宜下，此定法也。乃有谓中府宜汗之，中藏宜下之者，并以脉浮恶风寒之明明为中经者为中府，大便秘结之明明中府者为中藏，于是乎经之与府，汗之与下，遂无定法，势必有里实已具而仍用汗，藏真失守而仍用下者矣!
158、世之好言补虚者，每云正气大旺，则外邪不能侵犯，此□未病者言之则可。若其人即既病也，则外邪已经侵犯矣，已有侵犯，则必先去其侵犯，正乃不伤，若仍执此说，则邪之不去，有日见其虚而已。
159、案者断也，必能断乃可云案。方者法也，必有法乃可云方。
160、《本草从新》于人参、生地下云：“治伤寒瘟疫。”何以伤寒之外只有瘟疫？人参下又云：“庸浅之辈，不察虚实，但见发热，动手便攻。”此种句不知何以教人!
161、景岳、石顽皆以温疫置之杂证，而所论则皆温热，以其不知温热即是伤寒门中之病，故不于伤寒门中言之，而一作杂证，即不更用伤寒方，所以温热无一可活。
162、升发之药，有自下升上者，以其邪之下陷也；有自里升表者，以其邪之不达于表也。若一升而即脱者，率不用升法。
163、有小便不通而用升麻者，以为若酒注然，上窍开则下窍自通也。今有以此法言之于大便秘结者矣。
164、人之因虚而病者，谓之弱证。此外则以无病为虚，有病为实，故赵以德曰：邪在于气则气实，邪在于血则血实。
165、医者每曰邪在何经，病家闻一邪字则便以为祟也，乃弃医而就巫，有时即祟果凭之。
166、病之初入阳明者，尚有营卫之分，故有桂枝、麻黄两法，过此则不论营卫，而当不用桂麻矣。
167、葛根之有桂麻者，名葛根汤，葛根之有芩连者，名葛根黄连黄芩他刀，而前人于阳明用葛根芩连汤，或亦有但曰葛根者，明者知其谓有芩连之葛根汤也，昧者则仍视作有桂麻之葛根汤。又以初传阳明，亦或有宜用桂麻二汤时。于是而于阳明证，遂不能出卓见矣。是知二汤之葛根，亦若青龙、白虎之石膏，其当用白虎石膏时，安得用青龙之石膏耶!
168、孟□有《本事诗》，杨元善有《本事曲》，许学士因之成《本事方》，余亦欲效其体以纪事，而治验既多，难以悉载。
71. In treating wind injury causing sweating and yang deficiency, attention should be paid to water metabolism. In treating Wind-stroke (Zhongfeng, disease caused by external wind pathogen), attention should be paid to fire.
72. Cold, Heat, Warmth, and Coolness are four distinct natures. Warmth differs from Heat; Coolness differs from Cold. One cannot label a Warm herb as a Hot herb simply because it is warm, nor label a Cool herb as a Cold herb simply because it is cool.
73. *Qianjin Fang Yi* serves as the source study for *Shanghan Lun*.
74. The earliest commentary on *Shanghan Lun* is by Cheng Wuji. The earliest commentary on *Jingui Yaolue* is by Zhao Yide (Zhao Liangren).
75. Stagnation diseases are most common in the world. Da (unblocking), Fa (releasing), Duo (seizing/reducing), and Xie (draining) are all methods for treating stagnation.
76. Eye diseases with tearing upon exposure to wind are attributed to Fire. This follows the principle that Heart Heat causes sweating and Kidney Heat causes urinary abnormalities. Likely, Fire from Fenglin rises to the eyes, causing the skin and hair pores to contract and close, leading to stagnation of Yang Qi in the meridians and subsequent interior Heat. When Yang Qi converges upward, it exemplifies the independent flare-up of the Five Fires. How could it not result in steaming heat and flowing tears? Even photophobia and trichiasis are invariably caused by Fire.
77. *Shufu* (Crab Apple Woodlouse) is the insect referred to in the *Classic of Poetry* as "caterpillars in the room," an insect generated by water and dampness.
78. Water-Dampness diseases mostly appear in the Taiyin stage, as the Spleen governs water flow and dampness. Fire-Dryness diseases mostly appear in the Yangming stage, as Stomach Fire tends toward dryness.
79. Taiyin belongs to the Three Yin stages; thus, Three-Yin Malaria is Taiyin Malaria. Zhu Danxi believed that malaria occurring on Zi, Wu, Mao, You days is Shaoyin Malaria; on Yin, Shen, Si, Hai days is Jueyin Malaria; and on Chen, Xu, Chou, Wei days is Taiyin Malaria. This may not be correct.
80. Zhou Shenzhen said: When Yang Qi is sufficient, Yin Qi is entirely transformed into Blood; when Yang Qi is insufficient, Yin Qi is entirely transformed into Fire.
81. Spontaneous sweating and night sweats are both deficiency syndromes. Yang deficiency leads to spontaneous sweating; Yin deficiency leads to night sweats. Sweating due to Yang deficiency is necessarily cold; sweating due to Yin deficiency is necessarily hot. However, during Yangming Excess Heat, spontaneous and night sweats can also occur.
82. Xiao Ke (Wasting-Thirst) is a disease of body fluids. For Upper Xiao Ke, Tian Hua Fen (Trichosanthes Root) is a divine medicine; for Middle Xiao Ke, decoction of rotten wood is used, based on the meaning that rot can overcome scorching; for Lower Xiao Ke, silk-reeling soup is drunk instead of tea, combined with Ban Xia (Pinellia Tuber).
83. Amnesia (Shan Wang) mostly belongs to Blood Retention syndromes.
84. Numbness and Tingling must be distinguished by Qi and Blood. Qi deficiency causes Tingling (Ma); Blood deficiency causes Numbness (Mu).
85. Dian and Xian (Epilepsy types) must be distinguished by Water and Fire. Dian is a Yang disease, a disease of Fire; Xian is a Yin disease, a disease of Water. Phlegm accumulation is a Water disease. Xian is caused by Yin Water; Water is Phlegm, and excessive Phlegm involves Fire. It knots between the heart and chest. Due to slight exertion or lack of sleep, one may suddenly faint and fall, resembling Stroke. Sounds may be emitted, or the mouth may make sounds like six domestic animals. Upon waking, saliva foam is vomited. There are five types of Xian. Treatment focuses on resolving Phlegm and untying knots. If the pulse is deficient, it is treatable; if excess, it is fatal.
86. After seven days, the meridian cycle completes. If it is about to restart transmission, needle the Foot-Yangming meridian, but do not prematurely needle the Taiyin. Thus, when pathogens reach the Three Yin, there is no logic for them to transmit back to Taiyang; they merely transfer to Yangming.
87. Baihu Tang clears the internal steaming Heat of Yangming, not the external manifest Heat. Therefore, Gypsum (Shi Gao) is not used if there is only exterior Heat.
88. A Rapid Pulse has two meanings: either Excess Heat or extreme Deficiency. A Slow Pulse also has two meanings: Cold naturally causes slowness, but extreme Heat can also cause slowness. In the latter case, it is not truly slow, but rather deep and immobile.
89. Aversion to cold before sweating indicates Excess Pathogen and Exterior Excess. Aversion to cold after sweating indicates Retreat of Pathogen and Exterior Deficiency. After profuse sweating, major pathogens should have dispersed; aversion to cold should not persist. If aversion to cold worsens after sweating, is this not Deficiency?
90. Interior sinking of disease refers to pathogens sinking inward and failing to resolve from the exterior. Now, however, interior sinking is regarded as Deficiency.
91. When Zheng (Upright Qi) is weak and Xie (Pathogen) is strong, they contend, resulting in chills followed by sweating and resolution. When Zheng is not weak and Xie is not strong, they do not contend, so there are no chills; resolution occurs via sweating alone. When both Zheng and Xie are depleted, Yin and Yang harmonize spontaneously, so there are no chills or sweating, yet resolution occurs.
92. After taking Guizhi Tang, one must first feel vexation, then sweat out and resolve. After taking Chaihu Tang, one must feel steaming heat and tremors, then feverish sweating and resolution. This vexation and trembling are precursors to Zhan Han (Chill-Sweat). Resolution occurs after trembling and sweating; do not doubt this as worsening disease.
93. Yangming disease with sudden mania and continuous sweating leading to resolution is also Zhan Han (Chill-Sweat).
94. Dryness without prior sweating or purging indicates Yangming Dryness caused by Yang Excess; clearing Heat is urgent. Dryness after prior sweating or purging indicates Yangming Dryness caused by Blood depletion; moistening Dryness is primary. The sequence and urgency of Yin-nourishing herbs are determined by this.
95. Vomiting accompanied by fever and aversion to cold belongs to Taiyang. Vomiting with alternating chills and fever belongs to Shaoyang. Vomiting with fever but no aversion to cold belongs to Yangming. Thus, vomiting should be treated by distinguishing the Three Yang meridians. Vomiting without cold or heat symptoms should be treated from the Middle Jiao.
96. When disease initially transmits to Yangming, there is still a distinction between Ying and Wei. Beyond this point, Ying and Wei distinctions no longer apply.
97. Ancients called Yang Qi "Yang" and Yang Pathogens "Yang"; they called Yin Qi "Yin" and Yin Pathogens "Yin."
98. Head sweating indicates Yang stagnation at the exterior, not Yang Deficiency floating upward.
99. Shaoyin conditions using Mahuang present with fever and no sweating. *Shanghan Lun* does not explicitly state "no sweating" because Yin conditions inherently do not sweat; this needs no elaboration.
100. Diseases of the Six Meridians are distinguished by symptoms. One must first understand which meridian presents which symptoms while studying, so that clinically one knows which symptom belongs to which meridian, allowing patients to report accurately. Thus, one must study before practicing.
101. Yang pathogens tend to knot in the upper part; Yin pathogens tend to knot in the lower part. Thus, upper Jiao knots are mostly Heat, and lower Jiao knots are mostly Cold.
102. The circulation of Ying and Wei originates from the Pre-Heaven Qi in the Kidneys. Hence, Wei Qi and Ying Qi are both described as "Qi."
103. Wen Bing (Warm Disease) has no aversion to cold; Heat arises from within. Zhong Ye (Summerheat) involves sweating and aversion to cold because Summerheat enters from the exterior. Wen Bing pulse is Floating and Excess; Zhong Ye pulse is Floating and Deficient because Summerheat damages Qi. Wen Bing transmission is variable; Zhong Ye does not transmit; death occurs if food intake ceases. Wen Bing onset involves thirst; Zhong Ye onset involves intense thirst. This distinguishes Warmth from Summerheat.
104. Zhong Ye resembles Shang Han; Shang Han onset has no sweating or thirst; Zhong Ye onset has thirst and sweating. Zhong Re (Heatstroke) resembles Wen Bing; Wen Bing onset has thirst but no aversion to cold; Zhong Ye onset has aversion to cold and thirst.
105. For Fanzao (Vexation and Restlessness): Taiyang uses Qinglong Tang; Yangming uses Baihu Tang; Shaoyin uses Zhenwu Tang.
106. Zhang Zhongjing’s method preserves Body Fluids. Everyone knows this. The means to preserve fluids are the Six Methods: Sweating, Vomit-inducing, Purging, Harmonizing, Cooling, and Warming. Among these, Ji Xia Cun Yin (Urgent Purging to Preserve Yin) is critical. Indiscriminate use of cloying/nourishing herbs contradicts these six methods, rendering treatment ineffective.
107. Wen Bing originates in the Middle Jiao, may float to the Upper Jiao, or affect the Lower Jiao. Treating the Middle Jiao stabilizes the whole. If it appears only in the Upper or Lower Jiao, it is not Wen Bing.
108. He Jian stated that ancients called Hundred Diseases "Miscellaneous Diseases" and only Shang Han "Major Disease." He Jian discussed Warm Diseases, hence no "Major Disease." Discussing Warm Disease is discussing Shang Han's Warm Disease. Thus, those with interior Yin-Cold are only Miscellaneous Diseases and cannot become Sweat-diseases (Shang Han requiring diaphoresis).
109. Malaria involving other meridians exists, but none do not involve Shaoyang. It is not exclusively a Shaoyang disease.
110. Physicians must first have the mindset of prescribing based on observed disease, then discuss their insight and skill. Even if not highly skilled initially, they will become good physicians later.
111. The proverb "Ten doctors, ten methods" is incorrect. Since there is only one patient, there should be only one method.
112. Extreme Yin causes Yang collapse; this is not simple Yang Deficiency collapse. Extreme Yang causes Yin collapse; this is not simple Yin Deficiency collapse.
113. Ginger and Jujube are mild but possess the wonder of supporting Righteous Qi and expelling Pathogens.
114. For malaria alternating severity daily, I believe the light day continues the heavy day, and the heavy day continues the light day. Making them equal forces gradual improvement. This proved true.
115. Qibo said: "Meticulously master Yin and Yang; do not consult the masses." Why cannot Yin and Yang be consulted with others? The Yin and Yang in popular discourse differ from Qibo’s understanding. The same applies to Exterior/Interior, Cold/Heat, Deficiency/Excess.
116. *Neijing* states "If Heat has not ceased, Cold disease returns," and adds "If Cold has not ceased, Heat disease returns." The intent is not to describe only one side.
117. Bladder dysfunction causing Long (difficulty urinating) is described as frequent urination dozens of times a day. This resembles Li Ji (Dysentery) tenesmus. Both are due to Lower Jiao Fire Stagnation; thus, neither should be treated with astringents.
118. Some Deficient diseases cannot be attacked; tonification contains attacking intent. Good Yin tonification attacks Heat; Yang tonification attacks Cold. This does not apply to Excess syndromes. Mistaken tonification of Excess and mistaken attack of Deficiency yield similar errors and disasters.
119. Yunqi (Five Movements and Six Qi) theory was corrupted by Ma Yuansu’s disciples, who claimed specific birth years/days dictate specific treatments. This is Zhu Danxi’s view. Later, Cheng Dezhai’s *Shanghan Qianfa* focused on birth day stems/branches. With such people, Yunqi theory became unintelligible.
120. *History of Song* records Emperor Renzong ordering rhino horn medicines for epidemics in 1054 and 1060. This "epidemic" refers to widespread disease (*Shuowen*). Government intervention implies it was not just one person with Warm Disease.
121. A book stated: "I dislike using Hot herbs." Treating Cold with Heat and Heat with Cold are therapeutic principles. Using Cold or Hot herbs should not depend on physician preference.
122. "Bitter-Cold damages Stomach" applies to Deficient-Cold. For Excess Heat, Bitter-Cold is necessary to remove disease and protect the Stomach.
123. Song dynasty doctor Dou Cai called himself the Third Bian Que and slandered Zhang Zhongjing as only capable of treating minor illnesses. I consider him a true reader of Zhang’s works; using Zhang’s methods prevents severe illness.
124. Shi Gao (Gypsum) must not be calcined. Calcined gypsum becomes lime and becomes Hot in nature.
125. Only Shi Gao, Da Huang (Rhubarb), Fu Zi (Aconite), and Ren Shen (Ginseng) can revive the dying. With indications for these four, one dose restores life. Others are less effective.
126. There are seventy-two types of Wind, but no seventy-two treatments. Thirty-six types of Pain, but no thirty-six treatments. One formula treats all; why distinguish numbers? This merely indicates the variety of Wind and Pain diseases.
127. Gua Sha (Scraping) is a wonderful method. Zhang Jingyue wrote *Gua Sha Xin Tan*.
128. Liuwei Dihuang Wan treating all Shang Han diseases is Zhao Yangkui’s view in *Yi Guan*. Wang Ren’an placing it first in *Yifang* greatly misleads patients.
129. Severe thirst with vomiting is due to excessive water intake. Severe vomiting with thirst is due to fluid damage.
130. Diseases have Early, Middle, and Late transmission stages. Timing varies, but distinction is essential.
131. Spring/Summer warmth requires different medication than Winter cold. Yet, some use thick quilts and red wool window covers in warm weather—this is a major taboo.
132. Disease resolves via sweating; medicine induces this naturally, even in Winter Shang Han. Applying warming covers to induce sweating in Summer diseases is wrong.
133. Some diseases suit Cold-Cool herbs, but raw/cold food should be avoided. Pear juice, sugarcane juice, and watermelon juice are exceptions.
134. Gan (Sweet) includes Dan (Bland). *Book of Documents*: "Crops produce Sweetness." *Book of Rites*: "Sweetness accepts harmony." These refer to Blandness. Thus, Shi Gao’s Sweetness differs from Wheat and Rehmannia.
135. *Zhou Li*: "Autumn brings Malaria and Cold diseases." Jia Gongyan’s commentary says this is not Metal overcoming Fire.
136. Zhang, Liu, Li, and Zhu are the Four Masters of Jin/Yuan. Zhang refers to Jiegu (Zhang Yuansu), sometimes Zihé (Zhang Congzheng); Jiegu is correct. Li Shicai mistakenly identified Zhang as Zhang Zhongjing, a grave error.
137. Secular "Wind Injury" (Shang Feng) has no fever, only cough, clear nasal discharge, and nasal congestion. It is not *Shanghan Lun*’s Zhong Feng (Wind Strike) and does not transmit.
138. Cough treatment distinguishes new vs. old. New cough: disperse. Old cough: astringe. Mistaken astringency traps Wind-Cold; mistaken dispersion opens Lung lobes. Both cause medical harm. Distinguish by years, not months/days.
139. "Kou He Zhong" (Mouth feels neutral) in *Shanghan Lun* is crucial. Neutral mouth means no dryness/thirst; dry mouth means imbalance. Fuzi (Aconite) vs. Shi Gao (Gypsum) is distinguished by slight aversion to cold on the back; discern carefully.
140. Aversion to Wind does not always imply Aversion to Cold. Aversion to Cold always implies Aversion to Wind.
141. Yangming Meridian Heat: use Shi Gao and Zhi Mu. Yangming Fu Heat: use Xiao and Huang. Distinguish by presence of dry stool.
142. *Shanghan Lun*’s alternating chills/fever resembles Malaria but differs. Malaria patients act normal between episodes; this distinguishes them.
143. Visiting the sick is polite but burdensome. Do not let visitors talk much to patients; avoid bedside visits for severe cases.
144. Condition worsens after slight recovery. Post-illness caution must be tenfold greater. Appetite returning requires strict dietary control. Zhang Zhongjing advised reducing food intake for recovery.
145. Worsening vs. Recovery look similar. After nosebleed, sweating is contraindicated. Apply this logic elsewhere.
146. Zhang Zhongjing calls Heat moving from Exterior to Interior "Xi Xi Fa Re" (Fluttering Fever) and Heat moving from Interior to Exterior "Zheng Zheng Fa Re" (Steaming Fever). These terms distinguish Exterior vs. Interior Heat.
147. Once disease reaches Yangming, regardless of origin (Wind, Cold, Summerheat, Warmth), it transforms into Fire. Thus, Six Causes not entering Yangming show no Fire signs.
148. Song texts interpreting "Dun Fu" as thick mounds did so to avoid Emperor Guangzong’s name taboo (Zhao Dun), not to alter scripture.
149. Same Dampness: Cold-Damp uses Ginger/Aconite; Heat-Damp uses Coptis.
150. Severe initial aversion to cold is the mechanism for fever, driven by innate Yang Qi.
151. Deficiency has various types; Tonification has various methods.
152. Deficient-Cold is not equivalent to Cold sensation. Deficient-Heat is not equivalent to Fire.
153. Wind-Cold prioritizes Exterior release; Warmth prioritizes Interior clearing. Thus, Shang Han transforming into Warmth focuses on Interior clearing. "Exterior" here means Taiyang; "Interior" means Yangming, not general Zang-Fu relations.
154. Studying *Shanghan Lun* starts hard, becomes easy. Studying later schools starts easy, becomes hard.
155. Six Meridian diseases require separate and combined analysis. One must conceptualize the Six Meridian diseases internally to recognize their clinical manifestations.
156. "Qi-Breaking" herbs break Qi stagnation. "Blood-Breaking" herbs break Blood clots. Since Qi/Blood stagnation requires breaking, these herbs do not destroy healthy Qi/Blood.
157. Disease in Meridians: Sweat. Disease in Fu Organs: Purge. This is fixed. Claiming Fu organs need sweating or Zang organs need purging confuses Meridian/Fu distinctions. This leads to erroneous sweating in Interior Excess or purging in Zang Deficiency.
158. "Strong Righteous Qi repels Pathogens" applies to prevention. For existing disease, Pathogens have already invaded. Must expel Pathogens first to protect Righteous Qi. Persisting in tonification without expelling leads to increasing Deficiency.
159. An (Case Record) implies judgment. Fang (Prescription) implies Method. Judgment and Method are essential.
160. *Bencao Congxin* lists Ginseng for Shang Han and Plague. Why only these two? It also criticizes mediocre doctors for attacking Fever without assessing Deficiency/Excess. Such advice is confusing.
161. Zhang Jingyue and Shi Wan classified Warm Epidemics as Miscellaneous Diseases, discussing Warmth. They failed to recognize Warmth as part of Shang Han. Classifying it as Miscellaneous led to abandoning Shang Han formulas, resulting in high mortality.
162. Ascending herbs work by lifting Sunken Pathogens or bringing Interior Pathogens to the Exterior. If ascending causes Collapse, do not use ascending methods.
163. Sheng Ma (Cimicifuga) is used for urinary retention, opening Upper Orifices to open Lower Orifices. This method is now applied to constipation.
164. Disease due to Deficiency is Weak Syndrome. Otherwise, No Disease = Deficiency; Disease = Excess. Zhao Yide said: Pathogen in Qi makes Qi Excess; Pathogen in Blood makes Blood Excess.
165. Doctors say "Pathogen in which Meridian." Patients hear "Pathogen" and think "Evil Spirit," abandoning doctors for shamans. Sometimes spirits do attach.
166. Initial Yangming transmission retains Ying/Wei distinction, allowing Guizhi/Mahuang methods. Beyond this, Ying/Wei distinctions cease, and Guizhi/Mahuang are contraindicated.
167. Gegen Tang contains Guizhi/Mahuang. Gegen Huangqin Huanglian Tang contains Qin/Lian. Antiquity sometimes said "Gegen" for the latter. Experts knew it meant Qin/Lian Gegen Tang; novices confused it with Guizhi/Mahuang Gegen Tang. Early Yangming transmission might allow Guizhi/Mahuang. This confusion prevents clear Yangming diagnosis. Gegen in these two formulas is like Shi Gao in Qinglong vs. Baihu. When Baihu Shi Gao is indicated, Qinglong Shi Gao is wrong.
168. Meng Yuanlao wrote *Baoshi Shi*, Yang Yuanshan wrote *Baoshi Qu*, Xu Xueshi wrote *Baoshi Fang*. I wish to emulate this format, but numerous cases make complete recording difficult.