论云。春气温和。夏气暑热。秋气清凉。冬气冷冽。此则四时正气之序也。
（春夏为阳。春温夏热者。阳之动。始于温。盛于暑故也。秋冬为阴。秋凉而冬寒者。
以阴
冬时严寒。万类深藏。君子固密。则不伤于寒。触冒之者。乃名伤寒耳。
（冬三月纯阴用事。阳乃伏藏。水冰地坼。寒气严凝。当是之时。善摄生者。出处固密。
去
其伤于四时之气。皆能为病。
（春风夏暑。秋湿冬寒。谓之四时之气。）
以伤寒为毒者。以其最成杀厉之气也。
（热为阳。阳主生。寒为阴。阴主杀。阴寒为病。最为肃杀毒厉之气。）
中而即病者。名曰伤寒。不即病者。寒毒藏于肌肤。至春变为温病。至夏变为暑病。暑
病者
（内经曰。先夏至日为温病。后夏至日为暑病。温暑之病。本伤于寒而得之。故太医均
谓之
是以辛苦之人。春夏多温热病。皆由冬时触寒所致。非时行之气也。凡时行者。春时应
暖而
其气。
（四时气候不正为病。谓之时行之气。时气所行为病。非暴厉之气。感受必同。是以一
岁之
夫欲候知四时正气为病。及时行疫气之法。皆当按斗历占之。
（四时正气者。春风夏暑。秋湿冬寒是也。时行者。时行之气是也。温者。冬时感寒。
至春
九月霜降节后。宜渐寒。向冬大寒。至正月雨水节后。宜解也。所以谓之雨水者。以冰
雪解
（冬寒春温。夏热秋凉。为四时之正气也。）
从霜降以后。至春分以前。凡有触冒霜露。体中寒即病者。谓之伤寒也。
（九月十月寒气尚微。为病则轻。十一月十二月寒冽已严。为病则重。正月二月寒渐将
解。
其冬有非节之暖者。名曰冬温。冬温之毒。与伤寒大异。冬温复有先后。更相重沓。亦
有轻
（此为时行之气。前云冬时应寒。而反大温者是也。）
从立春节后。其中无暴大寒。又不冰雪而有人壮热为病者。此属春时阳气。发于冬时伏
寒。
（此为温病也。内经曰。冬伤于寒。春必病温。）
从春分以后。至秋分节前。天有暴寒者。皆为时行寒疫也。三月四月或有暴寒。其时阳
气尚弱。为寒所折。病热犹轻。五月六月阳气已盛。为寒所折。病热则重。七月八月阳气已
衰。为寒所折。病热亦微。其病与温及暑病相似。但治有殊耳。
（此为疫气也。是数者。以明前斗历之法。占其随时气候。发病寒热轻重不同耳。）
十五日得一气。于四时之中。一时有六气。四六名为二十四气也。
（节气十二。中气十二。共二十四。内经曰。五日谓之候。三候谓之气。六气谓之时四。
时谓之岁。）
然气候亦有应至而不至。或有未应至而至者。或有至而太过者。皆成病气也。
（疑脱或有至而不去。此一句。金匮要略曰。有未至而至。有至而不至。有至而不去。
有至
以未得甲子。天因
子。天大寒不解。
内经曰。至而和则
脱漏明矣。）
但天地动静。阴阳鼓击者。各正一气耳。
（内经曰阴阳者。天地之道。清阳为天。动而不息。浊阴为地。静而不移。天地阴阳之
气。
是以彼春之暖。为夏之暑。彼秋之忿。为冬之怒。
（春暖为夏暑。从生而至长也。秋忿为冬怒。从肃而至杀也。）
是故冬至之后。一阳爻升。一阴爻降也。夏至之后。一阳气下。一阴气上也。
（十月六爻皆阴。坤卦为用。阴极阳来。阳生于子。冬至之后。一阳爻升。一阴爻降。
于卦
阳气
下。
斯则冬夏二至。阴阳合也。春秋二分。阴阳离也。
（阳生于子。阴生于午。是阴阳相接。故曰合。阳退于酉。阴退于卯。是阴阳相背。故
曰离
阴阳交易。人变病焉。
（天地阴阳之气。既交错而不正。人所以变病。内经曰。阴阳相错。而变由生也。）
此君子春夏养阳。秋冬养阴。顺天地之刚柔也。
（内经曰。养生者。必顺于时。春夏养阳。以凉以寒。秋冬养阴。以温以热。所以然者。
从
小人触冒。必婴暴疹。须知毒烈之气。留在何经。而发何病。详而取之。
（不能顺四时调养。触冒寒温者。必成暴病。医者当在意审详而治之。）
是以春伤于风。夏必飧泄。夏伤于暑。秋必病疟。秋伤于湿。冬必咳嗽。冬伤于寒。春
必病
（当春之时。风气大行。春伤于风。风气通于肝。肝以春适旺。风虽入之。不能即发。
至夏
飧泄
秋适旺。湿虽入之。不能即发。至冬肺衰。然后湿始动也。雨淫腹疾。则当发为下利。冬以
阳
暑
疟
及
伤寒之病。逐日浅深。以施方治。
（内经曰。未满三日者。可汗而已。其满三日者。可泄而已。）
今世人伤寒。或始不早治。或治不对病。或日数久淹。困乃告医。医人又不根据次第而治
之。
真方
（仲景之书逮今千年。而显用于世者。王叔和之力也。）
又土地温凉高下不同。物性刚柔。餐居亦异。是以黄帝兴四方之问。岐伯举四治之能。
以训
（东方地气温。南方地气热。西方地气凉。北方地气寒。西北方高。东南方下。是土地
温凉
居之
也。
凡伤于寒。则为病热。热虽甚不死。
（内经曰。风寒客于人。使人毫毛毕直。皮肤闭而为热。是伤寒为病热也。针经曰。多
热者
若两感于寒而病者。必死。
（表里俱病者。谓之两感。）
尺寸俱浮者。太阳受病也。当一二日发。以其脉上连风府。故头项痛。腰脊强。
（太阳为三阳之长。其气浮于外。故尺寸俱浮。是邪气初入皮肤。外在表也。当一二日
发。
肩膊
尺寸俱长者。阳明受病也。当二三日发。以其脉挟鼻络于目。故身热目疼鼻干。不能卧。
（阳明血气俱多。尺寸俱长者。邪并阳明。而血气淖溢也。太阳受邪不已。传于阳明。
是当二三日发。其脉挟鼻者。阳明脉起于鼻。交 中。络于目。阳明之脉正上 还出系目
系。
也。
尺寸俱弦者。少阳受病也。当三四日发。以其脉循胁。络于耳。故胸胁痛而耳聋。
（内经曰。阳中之少阳。通于春气。春脉弦。尺寸俱弦者。知少阳受邪也。二三日阳明
之邪
此三经皆受病。未入于腑者。可汗而已。
（三阳受邪。为病在表。法当汗解。然三阳亦有便入腑者。入腑则宜下。故云未人于腑
者。
尺寸俱沉细者。太阴受病也。当四五日发。以其脉布胃中。络于嗌。故腹满而嗌干。
（阳极则阴受之。邪传三阳既遍。次乃传于阴经。在阳为在表。在阴为在里。邪在表。
则见
三阳传于太阴。是当四五日发也。邪入于阴。则渐成热。腹满而嗌干者。脾经壅而成热也。）
尺寸俱沉者。少阴受病也。当五六日发。以其脉贯肾。络于肺。系舌本。故口燥舌干而
渴。
（少阴。肾水也。性趋下。少阴受病。脉尺寸俱沉也。四五日太阴之邪不已。至五六日。
则
为
尺寸俱微缓者。厥阴受病也。当六七日发。以其脉循阴器。络于肝。故烦满而囊缩。
（缓者。风脉也。厥阴脉微缓者。邪传厥阴。热气已剧。近于风也。当六七日发。以少
阴邪
此三经。皆受病已入于腑。可下而已。
（三阴受邪。为病在里。于法当下。然三阴亦有在经者。在经则宜汗。故云已入于腑者。
可
若两感于寒者。一日太阳受之。即与少阴俱病。则头痛口干。烦满而渴。二日阳明受之。
即
厥
则死矣。
（阴阳俱病，表里俱伤者。为两感。以其阴阳两感。病则两证俱见。至于传经。则亦阴
阳两
而少阴
太阴又
内经曰。五
十二经脉之长也。其血气盛。故云不知人。三日其气乃尽。故死矣。谓三日六经俱病。营卫
以此冬伤于寒。发为温病。脉之变证。
方治
（此前热未已。又感温气者也。温热相合。变为温疫。）
凡人有疾。不时即治。隐忍冀瘥。以成痼疾。
（凡觉不佳。急须求治。苟延时日。则邪气入深。难可复治。千金曰。凡有少苦。似不
如平
小儿女子。益以滋甚。
（小儿气血未全。女子血室多病。凡所受邪。易于滋蔓。）
时气不和。盒饭早言。寻其邪由。及在腠理。以时治之。罕有不愈者。
（腠理者。津液腠泄之所。纹理缝会之中也。金匮要略曰。腠者。是三焦通会元真之处。
为
之
委
患人忍之。数日乃说。邪气入脏。则难可制。此为家有患。备虑之要。
（邪在皮肤。则外属阳而易治。邪传入里。则内属阴而难治。内经曰。善治者。治皮毛。
其
皮
凡作汤药。不可避晨夜。觉病须臾。即宜便治。不等早晚。则易愈矣。
（千金曰。凡始觉不佳。即须治疗。迄至于病。汤食兢进。折其毒势。自然而瘥。）
若或瘥迟。病即传变。虽欲除治。必难为力。
（传。有常也。变。无常也。传为循经而传。如太阳传阳明是也。变为不常之变。如阳
证变
服药不如方法。纵意违师。不须治之。
（内经曰。拘于鬼神者。不可与言至德。恶于针石者。不可与言至巧。病不许治者。病
必不
凡伤寒之病。多从风寒得之。
（凡中风与伤寒为病。自古通谓之伤寒。千金曰。夫伤寒病者。起自风寒。入于腠理。
与精
始表中风寒。入里则不消矣。
（始自皮肤。入于经络。传于脏腑是也。）
未有温覆而当不消散者。
（风寒初客于皮肤。便投汤药。温暖发散而当者。则无不消散之邪。）
不在证治。拟欲攻之。犹当先解表。乃可下之。
（先解表而后下之。则无复传之邪也。）
若表已解而内不消。非大满犹生寒热。则病不除。
（表证虽罢。里不至大坚满者。亦未可下之。是邪未收敛成实。下之则里虚。而邪复不
除。
若表已解而内不消。大满大实。坚有燥屎。自可除下之。虽四五日。不能为祸也。
（外无表证。里有坚满。为下证悉具。外台云。表和里病。下之则愈。下证既具。则不
必拘
若不宜下而便攻之。内虚热入。协热遂利。烦躁诸变。不可胜数。轻者困笃。重者必死
矣。
（下之不当。病轻者。证犹变易而难治。又矧重者乎。）
夫阳盛阴虚。汗之则死。下之则愈。阳虚阴盛。汗之则愈。下之则死。
（表为阳。里为阴。阴虚者。阳必凑之。阳盛之邪。乘其里虚而入于腑者。为阳盛阴虚
也。
反汗
于营
恶
此为
夫如是。则神丹安可以误发。甘遂何可以妄攻。虚盛之治。相背千里。吉凶之机。应若
影响
（神丹者。发汗之药也。甘遂者。下药也。若汗下当则吉。汗下不当则凶。其应如影随
形。
况桂枝下咽。阳盛则毙。承气入胃。阴盛以亡。
（桂枝汤者。发汗药也。承气汤者。下药也。金匮玉函曰。不当汗而强与汗之者。令人
夺其
死生之要在乎须臾。视身之尽。不暇计日。
（投汤不当。则灾祸立见。岂暇计其日数哉。）
此阴阳虚实之交错。其候至微。发汗吐下之相反。其祸至速。而医术浅狭。懵然不知病
源。
痛欤
而饮
动作
。惟明者居然能获其本。近取诸身。夫何远之有哉。
（两感病俱作。欲成不治之疾。医者大宜消息。审其先后。次第而治之。若妄意攻治。
以求
凡发汗。温服汤药。其方虽言日三服。若病剧不解。当促其间。可半日中尽三服。
若与病相
复作本汤服
（发汗药。须温暖服者。易为发散也。日三服者。药势续也。病势稍重。当促急服之。
以折
生。阳
剂。更
汤不能
凡得时气病。至五六日而渴欲饮水。饮不能多。不当与也。何者。以腹中热尚少。不能
消之
也。言
为自愈
（热在上焦则为消渴。言热消津液。而上焦干燥。则生渴也。大热则能消水。热少不能
消之
与之
不
凡得病反能饮水。此为欲愈之病。其不晓病者。但闻病饮水自愈。小渴者。乃强与饮之。
因
（小渴者。为腹中热少。若强与水。水饮不消。复为诸饮病也。）
凡得病厥。脉动数。服汤药更迟。脉浮大减小。初躁后静。此皆愈证也。
（动数之脉。邪在阳也。汤入而变迟者。阳邪愈也。浮大之脉。邪在表也。而复减小者。
表
凡治温病。可刺五十九穴。
（五十九穴者。以泻诸经之温热。针经曰。热病取之诸阳五十九穴。刺以泻其热。而出
其汗
八
口下
经曰
八者
委
九
又身之穴三百六十有五。其三十穴。灸之有害。七十九穴。刺之为灾。并中髓也。
（穴有三百六十五。以应一岁。其灸刺之禁。皆肉薄骨解之处。血脉虚少之分。针灸并
中髓
脉四损。三日死。平人四息。病患脉一至。名曰四损。脉五损。一日死。平人五息。病
人脉
（四脏气绝者。脉四损。五脏气绝者。脉五损。五脏六腑俱绝者。脉六损。）
脉盛身寒。得之伤寒。脉虚身热。得之伤暑。
（内经曰。脉者。血之腑也。脉实血实。脉虚血虚。寒则伤血。邪并于血。则血盛而气
虚。
脉阴阳俱盛。大汗出。不解者死。
The ancients stated: The Qi of spring is mild and harmonious; the Qi of summer is hot and sultry; the Qi of autumn is cool and clear; the Qi of winter is cold and biting. This is the order of the correct Qi of the four seasons.
(Summer and spring belong to Yang. Spring warmth and summer heat occur because Yang moves, starting with mildness and reaching fullness in heat. Autumn and winter belong to Yin. Autumn coolness and winter coldness occur because Yin dominates.)
During the severe cold of winter, all things hide deeply. A gentleman (one who cultivates virtue) maintains solidity and closeness (protects the exterior), thus not being injured by cold. Those who are exposed to it are said to have contracted Shanghan (Cold Damage).
(The three months of winter are purely Yin acting. Yang is hidden and stored. Water freezes and earth cracks; the cold Qi is strict and condensed. At this time, those good at preserving life maintain solidity and closeness in their movements and rest.)
Injury by the Qi of the four seasons can all cause disease.
(Spring wind, summer heat, autumn dampness, and winter cold are called the Qi of the four seasons.)
Shanghan is considered toxic because it forms the most killing and fierce Qi.
(Heat belongs to Yang, and Yang governs generation. Cold belongs to Yin, and Yin governs destruction. Illness caused by Yin-cold is the most肃杀 (severe/killing) and toxic Qi.)
Those who contract cold and immediately fall ill are named Shanghan (Cold Damage). Those who do not immediately fall ill harbor the cold toxin in the skin and muscles; when spring arrives, it transforms into Wenbing (Warm Disease); when summer arrives, it transforms into Shubing (Summerheat Disease).
Patients with Shubing...
(The *Neijing* states: Diseases occurring before the Summer Solstice are called Wenbing (Warm Disease); those after are called Shubing (Summerheat Disease). Both Wenbing and Shubing originate from injury by cold, hence the Imperial Physicians generally call them...)
Therefore, hardworking people often suffer from warm-heat diseases in spring and summer, all caused by touching cold during winter, not by the Shixing Zhiqi (Seasonal Epidemic Qi). Whenever there is Shixing Qi (Epidemic Qi), spring should be warm but...
its climate is abnormal.
(When the climate of the four seasons is incorrect and causes disease, it is called Shixing Zhiqi (Seasonal Epidemic Qi). Diseases caused by the movement of seasonal Qi are not violent toxic Qi, but upon contraction, symptoms are identical, so within one year...)
To observe and understand diseases caused by the correct Qi of the four seasons, as well as Shixing epidemic Qi, one must consult the Dipper Calendar (astronomical/seasonal calendar) for divination.
(The correct Qi of the four seasons refers to spring wind, summer heat, autumn dampness, and winter cold. Shixing refers to Shixing Zhiqi. Wen refers to contracting cold in winter...) until spring...)
After the Frost Descent solar term in the ninth month, the weather should gradually become cold, reaching extreme cold towards winter. After the Rain Water solar term in the first month, ice and snow should melt. It is called "Rain Water" because ice and snow dissolve...
(Winter cold and spring warmth, summer heat and autumn coolness are the correct Qi of the four seasons.)
From after Frost Descent until before Spring Equinox, anyone who is exposed to frost and dew and falls ill immediately due to internal cold is termed to have Shanghan (Cold Damage).
(In the ninth and tenth months, cold Qi is still slight, so illness is mild. In the eleventh and twelfth months, cold is severe, so illness is heavy. In the first and second months, cold gradually resolves...)
If there is unseasonable warmth in winter, it is called Dongwen (Winter Warmth). The toxicity of Dongwen is vastly different from Shanghan. Dongwen has early and late stages, overlapping conditions, and varying severity...
(This belongs to Shixing Zhiqi (Seasonal Epidemic Qi). As mentioned earlier, winter should be cold but is unusually warm.)
After the Beginning of Spring solar term, if there is no sudden severe cold or ice/snow, yet someone suffers from high fever, this belongs to spring Yang Qi activating and releasing latent winter cold...
(This is Wenbing (Warm Disease). The *Neijing* states: Injury by cold in winter leads to Wenbing in spring.)
From after Spring Equinox until before Autumn Equinox, sudden cold weather constitutes Shixing Hanyi (Seasonal Cold Epidemic). In March and April, sudden cold may occur; Yang Qi is still weak, restrained by cold, so fever is light. In May and June, Yang Qi is abundant, restrained by cold, so fever is heavy. In July and August, Yang Qi is declining, restrained by cold, so fever is also slight. These illnesses resemble Wenbing and Shubing, but treatment differs.
(This is epidemic Qi. These points clarify the method of using the Dipper Calendar to observe seasonal climate, determining that the onset and severity of cold/heat vary.)
Every fifteen days yields one Qi (solar term). Within each season, there are six Qis. Four times six makes twenty-four Qis (Solar Terms).
(Twelve Jieqi (Solar Terms) and twelve Zhongqi (Mid-season Qis) total twenty-four. The *Neijing* states: Five days constitute one Hou (pentad); three Hous constitute one Qi; six Qis constitute one Shi (season); four Shis constitute a year.)
However, climate may arrive when expected or fail to arrive; it may arrive early or excessively. All these become pathogenic Qi.
(It is suspected that the phrase "or arrives but does not depart" is missing. The *Jinkui Yaolue* states: There is arriving before expected, arriving late, arriving but not departing, and arriving excessively...)
Due to lacking the correct Jiazi calendar calculation, heaven's... Zi. Heaven remains extremely cold without resolving.
The *Neijing* states: Arriving and harmonious then... The omission is clear.)
It is merely that heaven and earth move and rest, and Yin-Yang drum and strike, each rectifying its own Qi.
(The *Neijing* states: Yin and Yang are the Way of heaven and earth. Clear Yang is heaven, moving ceaselessly; turbid Yin is earth, resting immovably. The Qi of heaven and earth Yin-Yang...)
Thus, the warmth of spring becomes the heat of summer; the anger (severity) of autumn becomes the rage (extreme cold) of winter.
(Spring warmth turning to summer heat is from growth to flourishing. Autumn severity turning to winter rage is from肃杀 (desiccation) to destruction.)
Therefore, after Winter Solstice, one Yang Yao rises, and one Yin Yao descends. After Summer Solstice, one Yang Qi descends, and one Yin Qi ascends.
(The tenth month has six Yin Yaos, Kun Hexagram acts. Yin reaches extremity, Yang returns; Yang is born at Zi. After Winter Solstice, one Yang Yao rises, one Yin Yao descends. In the hexagram... Yang Qi... descends.)
This is why Winter and Summer Solstices represent Yin-Yang union, while Spring and Autumn Equinoxes represent Yin-Yang separation.
(Yang is born at Zi, Yin at Wu; this is Yin-Yang connecting, hence "union". Yang retreats at You, Yin at Mao; this is Yin-Yang opposing, hence "separation".)
Yin-Yang exchange and intermingle, causing humans to change and become ill.
(The Qi of heaven and earth Yin-Yang, having crossed and become irregular, causes humans to change and fall ill. The *Neijing* states: When Yin and Yang cross, changes arise.)
Thus, gentlemen nourish Yang in spring and summer, and nourish Yin in autumn and winter, following the hardness and softness of heaven and earth.
(The *Neijing* states: Those who preserve life must follow the times. Nourish Yang in spring and summer with coolness and cold; nourish Yin in autumn and winter with warmth and heat. The reason is...)
Commoners who are exposed and careless will surely suffer from sudden rashes. One must know which meridian the toxic and fierce Qi stays in, and what disease it triggers, examining carefully and treating accordingly.
(Those who cannot adjust to the four seasons and are exposed to cold and warmth will surely form sudden diseases. Physicians must pay attention to careful examination and treatment.)
Thus, injury by wind in spring leads to Sundxie (undigested food diarrhea) in summer; injury by summerheat in summer leads to Nuemalaria in autumn; injury by dampness in autumn leads to cough in winter; injury by cold in winter... leads to... in spring.
(During spring, wind Qi prevails. Spring injury by wind: Wind Qi connects to the Liver. The Liver is prosperous in spring. Although wind enters, it does not manifest immediately. By summer... Sundxie... Autumn is prosperous; although dampness enters, it does not manifest immediately. By winter, Lung Qi declines, then dampness moves. Excessive rain/dampness causes abdominal disease, leading to dysentery. Winter with Yang... Summerheat... Malaria... And...)
For diseases like Shanghan, prescriptions are applied according to the daily depth of the pathogen.
(The *Neijing* states: If less than three days, sweating can cure it. If three days or more, purgation can cure it.)
Nowadays, people with Shanghan either do not treat it early enough, or treat incorrectly, or delay until exhausted before seeking a doctor. Doctors then fail to treat according to sequence... True prescriptions...
(Zhang Zhongjing's book, now a thousand years old, became prominent in the world due to Wang Shuhe's efforts.)
Furthermore, land varies in temperature, altitude, and geography; material natures differ in rigidity and flexibility; diet and residence also vary. Thus, the Yellow Emperor asked about the four directions, and Qibo presented four methods of treatment to instruct...
(Eastern land is warm, southern land is hot, western land is cool, northern land is cold. Northwest is high, southeast is low. This is land temperature... Residence... also.)
Any injury by cold results in heat disease. Even if heat is severe, death does not ensue.
(The *Neijing* states: Wind-cold lodging in man causes all hair to stand erect, skin pores close, resulting in heat. This is Shanghan manifesting as heat. The *Zhenjing* states: Those with much heat...)
If both Exterior and Interior are injured by cold (Lianggan Yu Han), death is certain.
(Exterior and Interior simultaneously diseased is called Lianggan.)
Pulse floating at both Cun and Chi positions indicates Taiyang channel involvement, manifesting on day 1 or 2. Because its channel connects to Fengfu, headache, neck stiffness, and back pain occur.
(Taiyang is the head of the Three Yangs; its Qi floats outward, hence Cun and Chi pulses are floating. This is evil qi just entering the skin, external and superficial. Manifests on day 1 or 2... Shoulders...)
Pulse long at both Cun and Chi positions indicates Yangming channel involvement, manifesting on day 2 or 3. Because its channel runs alongside the nose and connects to the eyes, body heat, eye pain, nasal dryness, and inability to lie down occur.
(Yangming has abundant blood and Qi. Long pulses at Cun and Chi indicate evil merging into Yangming, causing blood and Qi to overflow. Taiyang evil not resolved transmits to Yangming, manifesting on day 2 or 3. Its channel beside the nose: Yangming channel starts at the nose, crosses..., connects to the eyes. Yangming channel goes up... returns out to connect to the eye system... also.)
Pulse wiry at both Cun and Chi positions indicates Shaoyang channel involvement, manifesting on day 3 or 4. Because its channel follows the hypochondrium and connects to the ears, chest/hypochondriac pain and deafness occur.
(The *Neijing* states: Shaoyang among Yang connects to Spring Qi. Spring pulse is wiry. Wiry pulses at Cun and Chi indicate Shaoyang evil. Day 2-3 Yangming evil...)
These three channels are diseased but have not entered the Fu organs; they can be cured by sweating.
(Three Yang evil, disease is in the Exterior, method requires sweating. However, Three Yang can also enter Fu organs; if entered, purgation is needed. Hence, "not entered Fu organs"...))
Pulse deep and fine at both Cun and Chi positions indicates Taiyin channel involvement, manifesting on day 4 or 5. Because its channel spreads in the stomach and connects to the throat, abdominal fullness and dry throat occur.
(Yang extremum leads to Yin receiving. After evil transmits through Three Yang, it next transmits to Yin channels. In Yang is Exterior, in Yin is Interior. Evil in Exterior shows... Three Yang transmitting to Taiyin manifests on day 4 or 5. Evil entering Yin gradually generates heat. Abdominal fullness and dry throat indicate Spleen channel congestion generating heat.)
Pulse deep at both Cun and Chi positions indicates Shaoyin channel involvement, manifesting on day 5 or 6. Because its channel penetrates the Kidney, connects to the Lung, and ties to the root of the tongue, dry mouth/tongue and thirst occur.
(Shaoyin is Kidney Water. Nature tends downward. Shaoyin evil, pulses at Cun and Chi are deep. Day 4-5 Taiyin evil not resolved, by day 5-6... then... becomes...)
Pulse slightly and moderately slow at both Cun and Chi positions indicates Jueyin channel involvement, manifesting on day 6 or 7. Because its channel follows the genitalia and connects to the Liver, irritability, fullness, and testicular retraction occur.
(Slow is Wind pulse. Slightly slow Jueyin pulse indicates evil transmitting to Jueyin, heat intense, approaching Wind. Manifests on day 6 or 7, because Shaoyin evil...)
These three channels are diseased and have entered the Fu organs; they can be cured by purgation.
(Three Yin evil, disease is in the Interior, method requires purgation. However, Three Yin can also be in the Channels; if in Channel, sweating is needed. Hence, "entered Fu organs"... can...)
If Lianggan Yu Han (Double Injury by Cold): Day 1 Taiyang receives evil, simultaneously with Shaoyin, causing headache, dry mouth, irritability, fullness, and thirst. Day 2 Yangming receives evil, simultaneously... Jue... then death occurs.
(Yin and Yang both diseased, Exterior and Interior both injured is Lianggan. Because Yin and Yang double injured, both syndromes appear. Regarding transmission, Yin and Yang double... and Shaoyin... Taiyin again... *Neijing* states: Five... Head of the Twelve Main Channels. Blood and Qi are abundant, hence unconsciousness. After three days, Qi exhausts, hence death. Refers to three days, Six Channels all diseased, Ying and Wei...)
This is because winter injury by cold develops into Wenbing, with pulse changes and syndromes... Prescription treatment...
(Prior heat unresolved, newly contracting warm Qi. Warm and heat combine, transforming into Wenyi (Warm Epidemic).)
Whenever a person has disease, if not treated promptly, enduring hoping for recovery leads to chronic stubborn disease.
(Whenever feeling unwell, seek treatment urgently. Delaying allows evil to penetrate deep, making recovery difficult. *Qianjin Fang* states: Any slight discomfort, better than flat...)
Children and women suffer even more severely.
(Children's blood and Qi are incomplete; women's Blood Chamber often has disease. Any evil contracted easily spreads.)
When seasonal Qi is discordant, speak early. Trace the source of evil while it is in the Couli (skin and pores), and treat timely; rarely is it incurable.
(Couli are places where fluid excretes, between texture seams. *Jinkui Yaolue* states: Cou is where Sanjiao meets Yuanzhen. For... Of... Wei...)
Patients endure suffering, speaking only after days. Evil entering Zang organs becomes hard to control. This is the key precaution for household illness.
(Evil in skin is External/Yang, easy to treat; evil entering interior is Internal/Yin, hard to treat. *Neijing* states: Good physicians treat the skin/hair. Its... Skin...)
When preparing decoctions, do not avoid morning or night. Upon sensing disease, treat immediately, regardless of time, for easier recovery.
(*Qianjin Fang* states: Upon initial discomfort, treat immediately. Until illness, administer decoctions/food competitively, break toxic force, naturally recover.)
If recovery is delayed, disease transmits. Though wishing to remove it, effort will be futile.
(Transmission has regularity; Change has irregularity. Transmission follows channels, e.g., Taiyang to Yangming. Change is irregular, e.g., Yang syndrome changing...)
Medication not following method, willfully disobeying the master, need not be treated.
(*Neijing* states: Those bound by ghosts/spirits cannot be spoken to regarding supreme virtue. Those hating needles/stones cannot be spoken to regarding supreme skill. Patients refusing treatment, disease surely will not...)
All Shanghan diseases mostly originate from wind-cold.
(Wind stroke and Shanghan are generically called Shanghan since ancient times. *Qianjin Fang* states: Shanghan disease starts from wind-cold, entering Couli, combining with essence... Initially Exterior/Interior wind-cold, entering interior does not dissipate.)
(Starting from skin, entering meridians, transmitting to Zang-Fu.)
There is none covered with warmth that does not dissipate.
(Wind-cold initially lodging in skin, immediately administering decoction, warming and dispersing appropriately, results in no undissipated evil.)
Not in syndrome treatment scope, intending to attack, one must first resolve the Exterior, then can purge.
(Resolving Exterior first then purging leaves no residual transmitting evil.)
If Exterior resolved but Interior not dissipated, unless large fullness, cold and heat persist, disease remains.
(Exterior signs gone, Interior not largely solid/full, cannot purge yet. Evil not consolidated into excess, purging causes Interior deficiency, evil remains.)
If Exterior resolved but Interior not dissipated, with large fullness and excess, hard dry stool present, purgation can naturally remove it. Even after 4-5 days, it causes no harm.
(No Exterior signs, Interior large fullness, purgation indications complete. *Waitai Miyao* says: Exterior harmonious, Interior diseased, purging cures. Purgation indications complete, no need to adhere...)
If purgation is inappropriate yet used, Interior deficiency allows heat entry,協熱 (colluding heat) causes diarrhea,烦躁 (restlessness) and other changes are countless. Light cases worsen, heavy cases die.
(Inappropriate purging: light cases change and become hard to treat. How much more so heavy cases?)
Yang Excess and Yin Deficiency: Sweating causes death, purging cures. Yang Deficiency and Yin Excess: Sweating cures, purging causes death.
(Exterior is Yang, Interior is Yin. Yin Deficiency, Yang invades. Yang Excess evil, taking advantage of Interior deficiency entering Fu organs, is Yang Excess Yin Deficiency. Reverse sweating... To Ying... Dislike... This is...)
Thus, how can Shendan (Divine Pill) be mistakenly induced to sweat? How can Gansui (Kudzu Root/Euphorbia) be recklessly attacked? Treatment of Deficiency/Excess differs by a thousand miles; auspicious/ominous mechanisms respond like shadow and echo.
(Shendan is a sweating herb. Gansui is a purgative. If sweating/purging appropriate, auspicious; inappropriate, ominous. Response like shadow/form... Moreover, Guizhi swallowed, Yang Excess leads to death. Chengqi entering stomach, Yin Excess leads to demise.)
(Guizhi Tang is a sweating drug. Chengqi Tang is a purgative. *Jinkui Yuhan* says: Forcing sweat when inappropriate deprives...)
Life and death depend on moments; observing the body's end, no time to count days.
(Inappropriate decoction administration brings disaster immediately; who has time to count days?)
This is the interweaving of Yin-Yang Deficiency/Excess, subtle signs. Opposite effects of sweating/vomiting/purging bring rapid disaster. Shallow medical skills, ignorant of disease origin, painful!
And drink... Movement... Only the wise can grasp the root. Taking examples from oneself, what is far?
(Double injury disease acting together, becoming incurable. Physicians must carefully consider, examine priority, treat sequentially. Reckless attack seeking... All sweating, take decoction warm. Formula says three doses daily; if disease severe/unresolved, accelerate interval, finish three doses in half a day. If matching disease... Repeat original decoction... (Sweating drugs must be taken warm for easier dispersion. Three doses daily ensures continuous drug effect. Severe disease requires urgent dosing to break... Life, Yang... Dose, more... Decoction cannot...))
Whenever contracting Seasonal Qi disease, by day 5-6, thirsty for water but drinking little, do not give. Why? Because abdominal heat is scant, unable to... Also. Says... Spontaneous recovery...
(Heat in Upper Jiao causes Xiaoke (Wasting-Thirst). Heat consumes fluids, Upper Jiao dry, causing thirst. Great heat consumes water; little heat cannot... Consume it... Give it... No...)
Whenever sick and able to drink water, this is a sign of impending recovery. Ignorant people, hearing "disease recovers by drinking," force-feed small thirst. Because...
(Small thirst means scant abdominal heat. Forcing water, undigested water becomes various fluid-retention diseases.)
Whenever contracting Jue disease, pulse active and rapid; after taking medicine, pulse slower; pulse floating/large decreasing; initially restless then quiet; these are all recovery signs.
(Active/rapid pulse, evil in Yang. Medicine enters, pulse slows, Yang evil cured. Floating/large pulse, evil in Exterior. Decreasing, Exterior...)
When treating Wenbing, one may puncture 59 acupoints.
(59 Acupoints drain heat/heat from all channels. *Zhenjing* says: Heat disease takes 59 points from Yang channels. Puncture to drain heat, induce sweat... Eight... Mouth below... Classic says... Eight... Wei... Nine...)
Also, the body has 365 acupoints. Thirty are harmful to moxa; seventy-nine are disastrous to needle. Both pierce Marrow.
(365 points correspond to a year. Moxa/needle prohibitions are at thin flesh/bone junctions, deficient blood/vessel areas. Moxa/needle both piercing marrow...)
Pulse Si Sun (Four Damages), death in three days. Normal person four breaths, patient pulse one beat, named Si Sun. Pulse Wu Sun (Five Damages), death in one day. Normal person five breaths, patient... Pulse...
(Four Zang Qi exhaustion, Pulse Si Sun. Five Zang Qi exhaustion, Pulse Wu Sun. Six Fu-Zang exhaustion, Pulse Liu Sun.)
Pulse vigorous, body cold, contracted from Shanghan. Pulse deficient, body hot, contracted from Shangshu (Summerheat Injury).
(*Neijing* states: Pulse is the mansion of blood. Pulse solid, blood solid; pulse deficient, blood deficient. Cold injures blood, evil merges with blood, blood surplus, Qi...)
Pulse Yin and Yang both vigorous, profuse sweating, unresolved, death.