汉张仲景先师通内经精义抉其奥旨着伤寒论脉证详明立法制方条分缕悉如太阳病发热恶
寒头
项痛腰脊强恶心拘急体痛骨节疼则知是太阳经表症标病也若加发热烦渴小便不利则知是太阳
腑病经传里症本病热结膀胱也若或有汗恶风不恶寒则知是伤风而非伤寒也其脉浮紧有力为伤
寒浮缓无力为伤风其要在脉静为不传脉躁盛为欲传也伤风脉当浮缓而反紧盛者其证热盛而烦
手足皆温则知是伤风而得伤寒脉躁盛为传也伤寒脉当浮紧而反浮缓者其证不烦少热四肢厥冷
则
知是伤寒元气虚而得伤风脉也若或身热恶寒头疼而脉反沉则知是太阳得少阴脉也若无头痛但
有身热恶寒而脉沉则知病还在少阴经也如阳明病身热微恶寒头额目痛鼻干不眠则是阳明经表
症标病也若皆身热烦渴欲饮汗出恶热则知是阳明传里证本病也若潮热自汗谵语发渴不恶寒反
恶热揭去衣被扬手掷足或发 黄狂乱大便燥实不通或手足乍温乍冷腹满
硬痛喘急则知是正阳明胃腑传里本实病也其脉微洪为标洪数为本沉数为实也如少阳病头
角痛
目眩胸胁痛耳聋寒热呕而口苦心下满闷则知是少阳经病也其脉乃弦数焉如太阴病身体壮热腹
痛咽干手足温或自利不渴则知是阳经热邪传太阴经标病也若加燥渴腹满身目黄小水赤大便燥
实不通则知是太阴经传本病也若初病起头不疼口不渴身不热怯寒手冷中脘腹满痛吐泻小便清
白或呕哕则知是太阴经直中本病也若初病起无热不渴止有胸膈 胀满面唇皆无光泽或呕胸急
痛手足冷自觉不舒快少情绪则知是太阴经饮食生冷伤于脾胃而为内伤寒也其脉沉缓为标沉实
为本沉细直中也其内伤寒亦沉细焉如少阴病引衣蜷卧而恶寒或舌干口燥谵语发渴大便不通则
知是阳经热邪传少阴标病若或身热面赤足冷脉沉则知是肾经自受夹阴伤寒标与本俱病也若加
烦躁欲坐卧泥水中虽欲饮而不受面赤脉沉足冷则知是阴极发躁本病也若身热面赤足冷烦躁欲
饮揭去衣被脉数大无力则知是虚阳伏阴标与本病也若初病起头不疼口不渴身不热就便怕寒厥
冷蜷卧或脐腹痛而吐泻或战栗面如刀刮则知是肾经直中本病也若无热恶寒面色青小腹绞痛足
冷脉沉蜷卧不渴或吐利甚则舌卷囊缩昏沉不省手足指甲皆青冷过肘膝心下胀满汤药不受则知
是肾经夹阴中寒本病也若身面赤足冷脉沉身疼痛下利清谷则知是阴利寒证俗呼漏底者也其脉
沉
实有力为阳经热邪传入少阴标病也脉沉细无力为直中寒证数大无力为虚阳伏阴其夹阴伤寒阴
极发躁脉皆沉也如厥阴病发热恶寒似疟状则知是阳经热邪传入厥阴经标病也若烦满囊缩消渴
舌卷谵妄大便不通手足乍温乍冷则是阳经热邪传入厥阴经本病也若初病起头不疼口不渴身不
热就便怕寒四肢厥冷或小腹至阴疼痛或吐泻体痛呕哕涎沫甚则手足指甲面唇皆青冷过肘膝舌
卷囊缩则知是厥阴经直中本病也其脉浮缓为标沉实有力为本微细无力或伏绝为直中也此六经
之脉证有标有本临症明辨学人宜尽心焉
The ancient master Zhang Zhongjing of the Han Dynasty mastered the profound principles of the *Neijing* (Inner Canon), dissected its esoteric meanings, and authored the *Shanghan Lun* (Treatise on Cold Pathogenic Diseases). His descriptions of pulse conditions and syndromes were detailed and clear; his established laws and formulated prescriptions were meticulously organized. For instance, in Taiyang disease (Disease of the Bladder and Small Intestine channels), if there is fever (Fever), aversion to cold (Aversion to Cold), pain in the head and nape, stiffness in the waist and spine, nausea with spasms, body aches, and bone and joint pain, it is known as a Taiyang channel exterior syndrome (Biao syndrome/Manifestation). If accompanied by fever, vexation and thirst, and difficult urination, it is known as a Taiyang fu-organ disease (Ben syndrome/Essence), where heat is bound in the bladder. If there is sweating, aversion to wind but not aversion to cold, it is known as Wind Strike (Wind Injury) rather than Cold Damage (Cold Injury). A pulse that is floating, tight, and forceful indicates Cold Damage; one that is floating, moderate, and weak indicates Wind Strike. The key lies in the pulse: a quiet pulse indicates no transmission, while a restless and vigorous pulse indicates impending transmission. The pulse for Wind Strike should be floating and moderate; if it is instead tight and vigorous, the syndrome involves excessive heat and vexation. If both hands and feet are warm, it is known as Wind Strike presenting with a Cold Damage pulse (restless pulse indicating transmission). The pulse for Cold Damage should be floating and tight; if it is instead floating and moderate, the syndrome involves no vexation, slight heat, and cold limbs, indicating that the primordial Qi is deficient and the pulse resembles that of Wind Strike. If the body is hot, there is aversion to cold and headache, yet the pulse is sunken, it is known as Taiyang receiving a Shaoyin pulse. If there is no headache, only body heat and aversion to cold with a sunken pulse, the disease remains in the Shaoyin channel.
In Yangming disease, if there is body heat, slight aversion to cold, pain in the forehead and eyes, dry nose, and insomnia, this is a Yangming channel exterior syndrome (Biao syndrome). If all present with body heat, vexation and thirst with desire to drink, sweating, and aversion to heat, it is known as a Yangming transmission to the interior syndrome (Ben syndrome). If there is tidal fever, spontaneous sweating, delirium, thirst, aversion to heat without aversion to cold, removing clothes and blankets, throwing hands and legs about, or yellowing of the skin, mania, dry and solid stool that cannot pass, or hands and feet alternating between warm and cold, abdominal fullness and hard pain, panting and urgency, it is known as a proper Yangming stomach-fu organ transmission to the interior excess syndrome (Ben syndrome). The pulse is slightly洪 (Hong/Vigorous) for Biao, Hong and rapid for Ben, and sunken and rapid for Excess.
In Shaoyang disease, pain in the temporal region, vertigo, chest and hypochondriac pain, deafness, alternating chills and fever, vomiting, bitter taste in the mouth, and subcostal fullness indicate a Shaoyang channel disease. The pulse is wiry and rapid.
In Taiyin disease, high fever, abdominal pain, dry throat, warm hands and feet, or spontaneous diarrhea without thirst indicate that heat pathogen from the Yang channels has transmitted to the Taiyin channel (Biao syndrome). If accompanied by dry thirst, abdominal fullness, yellowing of the body and eyes, red urine, and dry solid stool that cannot pass, it is known as Taiyin channel transmission to the Ben syndrome. If at onset there is no headache, no thirst, no body heat, aversion to cold, cold hands and feet, fullness and pain in the epigastrium, vomiting and diarrhea, clear and copious urine, or belching and hiccups, it is known as direct involvement of the Taiyin channel Ben syndrome. If at onset there is no heat, no thirst, only chest and diaphragm distension, lack luster on face and lips, or vomiting, urgent chest pain, cold hands and feet, discomfort, and low mood, it is known as internal Cold Damage caused by dietary raw/cold food injuring the Spleen and Stomach in the Taiyin channel. The pulse is sunken and moderate for Biao, sunken and solid for Ben, and sunken and fine for direct involvement. This internal Cold Damage also presents with a sunken and fine pulse.
In Shaoyin disease, curling up in clothes with aversion to cold, or dry tongue and mouth, delirium, thirst, and constipation indicate that heat pathogen from the Yang channels has transmitted to the Shaoyin channel (Biao syndrome). If there is body heat, red face, cold feet, and sunken pulse, it is known as the Kidney channel suffering from Jia Yin Cold Damage (Cold Damage involving the Yin aspect), where both Biao and Ben are diseased. If accompanied by restlessness, desire to sit in mud, desire to drink but inability to accept fluids, red face, sunken pulse, and cold feet, it is known as Ben syndrome of extreme Yin generating false agitation. If there is body heat, red face, cold feet, restlessness, desire to drink, removing clothes, and a rapid, large, but weak pulse, it is known as Deficient Yang hidden within Yin, with both Biao and Ben diseased. If at onset there is no headache, no thirst, no body heat, immediate aversion to cold, cold limbs, curling up, or umbilical abdominal pain with vomiting and diarrhea, or shivering, face pale as if scraped by a knife, it is known as direct involvement of the Kidney channel Ben syndrome. If there is no heat, aversion to cold, greenish complexion, colicky lower abdominal pain, cold feet, sunken pulse, curling up, no thirst, or severe vomiting and diarrhea leading to curled tongue, retracted testicles, lethargy and unconsciousness, cyanosis and coldness of fingernails extending past elbows and knees, epigastric fullness, and inability to retain decoctions, it is known as Ben syndrome of Kidney channel Jia Yin Zhong Han (Internal Cold Damage involving Yin). If there is redness of body and face, cold feet, sunken pulse, body pain, and diarrhea with undigested food, it is known as Yin Diarrhea Cold Syndrome, commonly called "Lou Di" (Leaking Bottom). A sunken, solid, and forceful pulse indicates heat pathogen from Yang channels transmitting to Shaoyin (Biao syndrome); a sunken, fine, and weak pulse indicates direct invasion of Cold Syndrome; a rapid, large, and weak pulse indicates Deficient Yang hidden within Yin. Pulses for Jia Yin Cold Damage and extreme Yin generating false agitation are all sunken.
In Jueyin disease, fever and aversion to cold resembling malaria indicate that heat pathogen from Yang channels has transmitted to the Jueyin channel (Biao syndrome). If there is vexation and fullness, retracted testicles, Xiao Ke (Wasting-Thirst), curled tongue, delirium, constipation, and hands/feet alternating warm and cold, it is Yang channel heat pathogen transmitting to Jueyin channel Ben syndrome. If at onset there is no headache, no thirst, no body heat, immediate aversion to cold, cold limbs, or pain from lower abdomen to Yin area, or vomiting/diarrhea, body pain, vomiting saliva/phlegm, and in severe cases cyanosis and coldness of nails/face/lips past elbows/knees, curled tongue, retracted testicles, it is known as direct involvement of Jueyin channel Ben syndrome. The pulse is floating and moderate for Biao, sunken and solid/forceful for Ben, and fine/weak or hidden/extinct for direct involvement. These six channels' pulse and syndrome manifestations have Biao and Ben aspects; clinicians must distinguish them clearly, and students should study them diligently.