吴云。解。释也。释阳明脉为病之义。
主肉 甲乙作肌肉。简按新校正云。脉。作肌。误。
惋 甲乙。作闷。释音。惋。乌贯切。简按集韵。惋。愠。宛。 同。音郁。心所郁积也。即与王注
符。若乌贯切。则为骇恨惊叹之义。志云。惊恐貌。高云。惊顾也。并乖经旨。
阳盛 甲乙。作邪盛。
骂詈 韵会。正斥曰骂。旁及曰詈。一切经音义云。詈。亦骂也。今解。恶言及之曰骂。诽谤咒诅曰詈。
不欲食不欲食故妄走 吴本。十字改为歌二字。简按问语乃然。当从吴。
马云。首言热病者皆伤寒之类。故即以热论名篇。
今夫热病 甲乙。外台。无今字。
伤寒之类也 张云。伤寒者。中阴寒杀厉之气也。寒盛于冬。中而即病者。是为伤寒。其不即病
者。至春则名为温病。至夏则名为暑病。然有四时不正之气。随感随发者。亦曰伤寒。寒邪束于肌表。则玄府
闭。阳气不散越。乃郁而为热。故凡系外感发热者。皆伤寒之类。马云。水热穴论。帝问。人伤于寒。而传为
热。何也。岐伯曰。夫寒盛则生热也。又此处王注。以伤寒论中。至夏变为热病之热病强解。甚非。盖未有伤
于寒而不成热者也。非但至夏之热病为然也。简按王引伤寒例文。暑病。作热病。五十八难云。伤寒有几。其
脉有变否。然。伤寒有五。有中风。有伤寒。有湿温。有热病。有温病。其所苦各不同。知是中风伤寒湿温热
病温病。古总称之伤寒。则王注不可废。
巨阳者诸阳之属也其脉连于风府故为诸阳主气也 巨。甲乙作太。下同。张云。太阳为六经之长。统
摄阳分。故诸阳皆其所属。太阳经脉。覆于巅背之表。故主诸阳之气分。志云。属。会也。谓太阳为诸阳之会。
滑本。此二十字。移于伤寒一日巨阳受之之下。徐本同。文义顺承。为胜。（资生经。风府下。引此节云。然
则风府者。固伤寒所自起也。北人皆以毛裹之。南人怯弱者。亦以帛护其项。俗谓三角。是也。凡怯弱者。须
护项后可也。）
伤寒一日巨阳受之 张云。按人身经络。三阳为表。三阴为里。三阳之序。则太阳为三阳。阳中之阳
也。阳明为二阳。居太阳之次。少阳为一阳。居阳明之次。此三阳为表也。三阴之序。则太阴为三阴。居少阳
之次。少阴为二阴。居太阴之次。厥阴为一阴。居少阴之次。是三阴为里也。其次序之数。则自内而外。故各
有一二三之先后者如此。又如邪之中人。必自外而内。如皮部论等篇曰。邪客于皮。则腠理开。开则邪入客于
络脉。络脉满则注于经脉。经脉满则入舍于腑脏。此所以邪必先于皮毛。经必始于太阳。而后三阴三阳。五脏
六腑皆受病。如下文之谓也。简按吴。此下。补以其脉经头项循腰脊九字。不可从。
头项痛腰脊强 张云。凡病伤寒者。多从太阳始。太阳之经云云。（与王注同）故其为病如此。仲景
曰。太阳之为病。脉浮头项强痛而恶寒。新校正云。甲乙。太素。作头项与腰皆强。简按今甲乙。作腰背强。
身热 张云。伤寒多发热。而独此云身热者。盖阳明主肌肉。身热尤甚也。邪热在胃则烦。故不得
卧。仲景曰。阳明之为病。胃家实也。
不得卧 调经论云。阳明者。胃脉也。其气下行。阳明逆不得从其道。故不得卧也。
少阳主胆 新校正。引全元起。太素。甲乙。并作主骨。简按病源。亦作主骨。只外台作胆。外台
引本篇文云。出第九卷中。考新校正。此篇。全本在第五卷。盖王氏改骨作胆。而宋人根据以改外台也。且灵经
脉篇云。胆主骨。如阳明。不云主胃。而云主肉。则理宜于少阳亦云主骨。盖太阳主皮肤。阳明主肉。少阳主
骨。从外而内。殆是半表半里之部分。故改胆作骨。于义为长。张云。邪在少阳者。三阳已尽。将入
太阴。故为半表半里之经。其经脉。出耳前后。下循胸胁。故为胁痛耳聋等证。仲景曰。伤寒。脉弦细。头痛
发热者。属少阳。少阳之病。口苦咽干目眩也。又曰。太阳病不解。转入少阳者。胁下硬满。干呕不能食。往
来寒热。盖邪在阴则寒。邪在阳则热。邪在表。则无呕满等证。邪在里。则胸满干呕不能食。故成无己曰。少
阳之邪。在半表半里之间。
未入于脏者 简按据新校正。全本。太素。脏。作腑。甲乙。伤寒例。亦作腑。只外台作脏。恐是
亦宋人所校改也。考下文未满三日者。可汗而已。其满三日者。可泄而已。此言邪在三阳之表者。可发汗。在
三阴之脏者。可下之。若推仲景之例。则当作腑。然本经治法表里只有汗下二法。故王改腑作脏。义甚明显。
而东垣李氏云。藏。非谓五脏之脏。乃是藏物之藏。（出此事难知）三阳王氏演而作热论脏字说。（出伤寒纲
目）并属强解。志云。藏者。里也。阴也。言三阳之经络。皆受三阳邪热之病。然在形身之外。而未入于里阴。
可发汗而解也。此解为胜。
四日太阴受之 张云。邪在三阳。失于汗解。则入三阴。自太阴始也。仲景曰。伤寒。脉浮而缓。
手足自温者。系在太阴。太阴之为病。腹满而吐。食不下。自利益甚。时腹自痛也。简按本经所论三阴病者。
即仲景所谓阳明胃家实证。故下文云。其满三日者。可泄而已。仲景所论三阴病者。乃阴寒之证。此本经所未
言及。张引彼注此。殆不免乖谬。下少阴厥阴亦同。
络于肺 甲乙。病源。外台。无于字。
六日厥阴受之 简按方氏伤寒条辨云。一日二日三四五六日。犹言第一第二第三四五六之次第也。
大要譬如计程。如此立个前程的期式约模耳。非计日以限病之谓。张云。愚
按伤寒传变。止言足经。不言手经。其义本出此篇。如上文六节是也。奈何草窗刘氏不明其理。遂谬创伤寒传
足不传手之说。盖伤寒者。表邪也。欲求外证。但当察于周身。而周身上下脉络。惟足六经。则尽之矣。手经
无能遍也。且手经所至。足经无不至者。故但言足经。则其左右前后。阴阳诸证。无不可按而得。而手经亦在
其中。不必言矣。此本经所以止言足者。为周身之表证也。
烦满而囊缩 简按满。懑同。说文。懑。烦也。盖烦懑。乃烦闷也。（详见生气通天论喘满注。）缪
氏伤寒撮要云。妇人亦有囊缩可辨。但其乳头缩者。即是也。李氏入门云。在女子。则阴户急痛引小腹。吴。
囊缩下。补三阴经络者。皆受病已入于腑。可下而已十六字。此推三阳之例。则经文似脱此等十余字。然以三
阴称腑。尤为无谓。若改作脏字。仅通。
五脏不通则死矣 高云。则。犹即也。结上文三阴受病。非必四日太阴。五日少阴。六日厥阴。故内
之三阴。外之三阳。内之五脏。外之六腑。一日皆受其病。致荣卫不行。五脏不通。即死矣。较之两感于寒。
不免于死者。更甚也。
渴止不满 甲乙。伤寒例。并无不满二字。简按上文。不言腹满。此必衍文。
而嚏 口问篇云。阳气和则嚏。
大气皆去病日已矣 调经论云。泻实者。开其门而出。大气乃屈。五色篇云。大气入脏腑者。不病
而卒死。简按俱谓大邪之气。高云。其不两感于寒。属经脉之热病。皆以七日环复。病衰而愈。由此观之。则
上文所云。一日受二日受者。乃循次言之。非一定不移之期日也。会悟圣经。当勿以辞害志。
通其脏脉 张云。谓当随经分治也。志云。谓手足三阴
三阳之经脉。高云。脏脉。如上文太阴脾脏之脉。少阴肾脏之脉。厥阴肝脏之脉也。
可泄而已 张云。凡传经之邪。未满三日者。其邪在表。故可以汗。已满三日者。其邪传里。故可以
下。吴。此下补若其寒邪。传不以次。与夫专经不传。表里变易。则随证脉处治。吐下汗和。蚤暮异法。三十
二字。云。欲人通变云尔。简按王引伤寒论。义颇明显。若欲人通变。则有仲景伤寒论在焉。岂三十二字所包
括乎。不啻添足。殆亦 妄。薛氏原旨云。按伤寒一证。传变无穷。此不过言传经之常。而未及于变。自仲景
而后诸大家。俱有名言可法。学人所当尽读而精思之。然义多出于仲景。于仲景书。又当闭户深求者也。
遗 志云。伤寒论曰。大病瘥后劳复者。枳实栀子汤主之。若有宿食者。加大黄如博棋子五六枚。盖
因伤寒热甚之时而强食其食。故有宿食之所遗也。简按遗。是礼乐记。遗音遗味之遗。郑玄注。遗。犹余也。
盖与此同义。童氏活人指掌辨疑云。遗字注解多不同。活人书注。谓便不禁也。或云。遗。亡也。其人必利不
禁也。此皆非是。余谓遗者。如以物遗人之遗。即司马公所谓积德以遗后人之遗。是也。言当少愈之时。邪气
未尽去。胃气未尽复。肉食者。其后复病。多食者。其后遗病。将痊而不得痊矣。
强食之 甲乙。无之字。仲景云。病患脉已解。而日暮微烦者。以病新瘥。人强与谷。脾胃气尚弱。
不能消谷。故令微烦。损谷则愈。又曰。吐利发汗。脉平小烦者。以新瘥不胜谷气故也。
调其逆从 志云。脉浮者。以汗解之。脉沉者。以下解之。此之谓调其逆从也。高云。视其经脉之虚
实。调其阴阳之逆从。
食肉则复 马云。肉本性热而难化。所以热病复生。志云。肉。谓豕肉。豕乃水畜。其性寒冷。是以
多食则遗。简按当从马注。
谵言 甲乙。外台。作谵语。简按谵。又作 。并之廉切。音詹。考之字书。义少异。集韵。谵。多
言也。 。疾而寐语也。然医书则互用。刘奎说疫为二义。甚误。
不知人六日死 外台。作不知人则六日而死。滑云。六日。当作三日。下文可见。徐同。简按下文云。
如是之后。三日乃死。则作六日者。非字之误。谓至三日。则少阳与厥阴俱病云云。三阴三阳俱受病。水浆不
入。昏不知人。如是者三日。凡于六日之际当死也。
三日乃死 吴云。故不知人三日。六字为句。张云。如是之后。三日乃死。谓两感传遍之后。复三日
而死也。盖即六日之义。高云。乃死。非即死矣。简按朱氏活人书云。两感。仲景无治法。但云两感病俱作。
治有先后。伤寒下之后。复下利不止。身疼痛者。急当救里。宜四逆汤。复身体疼痛。清便自调者。急当救表。
宜桂枝汤。盖本经三阴证。并是仲景所谓胃家实。不宜以彼而例此。当考伤寒论。
病温 生气通天论曰。冬伤于寒。春必病温。金匮真言论曰。夫精者。身之本也。故冬藏于精者。春
不病温。仲景云。太阳病。发热而渴。不恶寒者。为温病。（详见金匮真言论。）
病暑 滑云。此病暑。与病 不同。病暑。即热病也。宜发汗。病 则不宜汗矣。张云。寒邪中人。
而成温病暑病者。其在时则以夏至前后言。在病则以热之微甚言。故凡温病暑病。皆伤寒也。简按温病暑病。
皆是热病。以时异其名耳。考灵论疾诊尺篇云。冬伤于寒。春生瘅热。张云。即温热之病。其义可概见也。为
热之微甚者。恐非。
与汗 简按与。予也。玉函经总例云。仲景曰。不须汗而强与汗之者。夺其津液。又须汗而不与汗之
者。使诸毛孔闭塞。
Wu Yun: "Jie" (Explain) means to interpret. This section aims to explain the pathology of the Yangming meridian.
(Text) Zhu Rou (Governs flesh/muscle). Jia Yi Jing (Classic of A-Bio Acupuncture and Moxibustion) reads "Ji Rou" (Muscle). Jian An: Xin Zheng Xiao (New Corrections) states that "Mai" (Pulse/Meridian) should be "Ji" (Flesh/Muscle), which is a textual error.
(Vernacular Translation): The meridian governs the muscles. In the *Jia Yi Jing*, it is written as "muscles." Note: According to the *Xin Zheng Xiao* corrections, the character "Mai" (Meridian) is an error for "Ji" (Flesh/Muscle).
(Text) Wan (Depression/Gloom). Jia Yi Jing reads "Men" (Oppression/Stuffy). Pronunciation explanation: "Wan" is pronounced "Wu Guan Qie." Jian An: *Ji Yun* (Collection of Rhymes) states that "Wan," "Yun" (Resentment), and "Wan" (Curve/Lie) are synonymous, pronounced "Yu" (Depressed), referring to the accumulation of qi in the heart. This aligns with Wang Bing's commentary. If read as "Wu Guan Qie," it implies shock, hatred, or astonishment. Zhang Zhicong says it refers to a look of fear and panic. Gao Shixi says it refers to startled looking around. Both interpretations deviate from the original intent of the classic.
(Vernacular Translation): The character "Wan" is written as "Men" in the *Jia Yi Jing*. Regarding pronunciation: "Wan" corresponds to the phonetic spelling "Wu Guan Qie." Note: According to the *Ji Yun*, "Wan," "Yun," and "Wan" share the same meaning and pronunciation "Yu," denoting mental depression or stagnation of qi. This matches Wang Bing's annotation. Reading it as "Wu Guan Qie" would imply meanings of shock, resentment, or amazement. Zhang Zhicong interprets it as a fearful expression, while Gao Shixi interprets it as startled glancing; both diverge from the classical meaning.
(Text) Yang Sheng (Yang Excess). Jia Yi Jing reads "Xie Sheng" (Pathogenic Excess).
(Vernacular Translation): Yang excess. The *Jia Yi Jing* version reads "pathogenic excess."
(Text) Ma Li (Cursing/Scolding). *Yun Hui* (Rhyme Compilation) states: Directly rebuking is called "Ma"; implicating others is called "Li." *Yi Qie Jing Yin Yi* (Sound and Meaning of All Sutras) states: "Li" also means scolding. Current interpretation: Using abusive language is "Ma"; slander and cursing is "Li."
(Vernacular Translation): "Ma Li" (Cursing and Scolding). The *Yun Hui* distinguishes them: direct verbal abuse is "Ma," while indirect slander or cursing is "Li." The *Yi Qie Jing Yin Yi* notes that "Li" is synonymous with scolding. Modern interpretation defines "Ma" as using foul language and "Li" as slandering or casting spells/curses.
(Text) Bu Yu Shi (No desire to eat), Bu Yu Shi Gu Wang Zou (Due to no desire to eat, one wanders aimlessly). Wu Ben (Wu Kun's edition) changes the character "Shi" (Ten) to "Ge" (Sing). Jian An: The interrogative context supports this; one should follow Wu Ben.
(Vernacular Translation): Lack of appetite leads to aimless wandering. Wu Kun's edition alters the character "ten" to "sing." Note: The grammatical structure of the question supports Wu Kun's reading; therefore, his version should be adopted.
Ma Yun: The chapter begins by stating that heat diseases belong to the category of Shanghan (Cold Damage), hence it is named "Re Lun" (Treatise on Heat).
(Vernacular Translation): Ma Shi explains that since the chapter opens by categorizing heat diseases under Shanghan, it is titled "Treatise on Heat."
(Text) Jin Fu Re Bing (Now, regarding heat disease). Jia Yi Jing and Wai Tai Mi Yao (Essential Prescriptions of the Imperial Library) omit the character "Jin" (Now).
(Vernacular Translation): Concerning current heat diseases. The characters "Jin" (Now) are absent in the *Jia Yi Jing* and *Wai Tai Mi Yao*.
(Text) Shanghan Zhi Lei Ye (They are of the Shanghan category). Zhang Yun: Shanghan refers to contracting the severe yin-cold pathogenic qi. Cold is prevalent in winter; contracting it and falling ill immediately is Shanghan. If not ill immediately, it becomes Wenbing (Warm Disease) in spring and Shubing (Summerheat Disease) in summer. However, pathogenic qi from any season that causes immediate illness is also called Shanghan. When cold pathogen binds the muscle surface, the Xu Fu (pores/sweat glands) close, yang qi cannot disperse, and thus stagnates into heat. Therefore, all external contraction fevers belong to the Shanghan category. Ma Yun: In the *Shui Re Xue Lun* (Treatise on Water and Heat Acupoints), the Yellow Emperor asks: Why does cold injury transmit into heat? Qibo answers: Severe cold generates heat. Furthermore, Wang Bing’s commentary here forcibly interprets this using the concept from the *Shanghan Lun* that cold transforms into heat disease in summer, which is inappropriate. Generally, cold injury does not fail to transform into heat. This applies not only to summer heat diseases. Jian An: Wang Bing cites the *Shanghan Li* (Example of Cold Damage), writing "Shubing" as "Re Bing." The *Nan Jing* (Classic of Difficult Issues) Chapter 58 asks: How many types of Shanghan are there? Does the pulse change? It answers: There are five types of Shanghan: Fengzhong (Wind Strike), Shanghan, Shiwen (Damp-Warmth), Re Bing, and Wenbing. Their symptoms differ. Thus, Fengzhong, Shanghan, Shiwen, Re Bing, and Wenbing were collectively termed Shanghan in antiquity. Therefore, Wang Bing’s commentary cannot be discarded.
(Vernacular Translation): They fall under the category of Shanghan. Zhang Jingyue states: Shanghan involves contracting severe yin-cold pathogens. Winter is the season of extreme cold; immediate illness upon exposure is Shanghan. Delayed onset manifests as Warm Disease in spring and Summerheat Disease in summer. Additionally, pathogens from irregular seasonal conditions causing immediate illness are also classified as Shanghan. Cold binding the exterior closes the pores, trapping yang qi which stagnates and transforms into heat. Thus, all exogenous febrile diseases are categorized under Shanghan. Ma Shi references the *Shui Re Xue Lun*: The Yellow Emperor asks why cold transforms into heat; Qibo replies that extreme cold generates heat. Wang Bing’s interpretation here, linking it to summer heat transformation in the *Shanghan Lun*, is forced. Fundamentally, cold injuries invariably transform into heat. This principle extends beyond just summer heat diseases. Note: Wang Bing’s citation of the *Shanghan Li* equates Summerheat Disease with Heat Disease. The *Nan Jing* classifies five types of Shanghan: Wind Strike, Cold Damage, Damp-Warmth, Heat Disease, and Warm Disease. Historically, these were collectively referred to as Shanghan. Thus, Wang Bing’s commentary retains validity.
(Text) Ju Yang Zhe Zhu Yang Zhi Shu Ye, Qi Mai Lian Yu Feng Fu, Gu Wei Zhu Yang Zhu Qi Ye (The Greater Yang is the leader of all yang meridians; its vessels connect to the Fengfu point, thus it governs the qi of all yang). Ju. Jia Yi Jing reads "Tai" (Great), same below. Zhang Yun: Taiyang is the head of the six meridians, commanding the yang divisions, so all yang meridians belong to it. The Taiyang meridian covers the vertex and back exterior, thus governing the qi of all yang. Zhi Yun: "Shu" means convergence, implying Taiyang is the convergence of all yang. Hua Shou’s edition moves these twenty characters to below "Shanghan Day One: Taiyang Receives It," aligning better with the text flow. (*Zisheng Jing* quotes this section under Fengfu: Thus, Fengfu is indeed where Shanghan originates. Northerners wrap their heads in fur; southerners with weak constitutions use cloth to protect the neck, known as the triangular scarf. Weak individuals must protect the neck.)
(Vernacular Translation): The Foot-Taiyang Bladder Meridian is the chief of all yang meridians; its pathway connects to the Fengfu acupoint, making it the master of yang qi. "Ju" is written as "Tai" in the *Jia Yi Jing*. Zhang Jingyue explains: Taiyang leads the six meridians and controls the yang aspect, so all yang meridians are subordinate to it. Its pathway covers the head and back, governing yang qi. Zhang Zhicong notes "Shu" means meeting, signifying Taiyang as the hub of yang. Hua Shou rearranges this passage for better logical flow. Note: The *Zisheng Jing* cites this under the Fengfu acupoint, emphasizing its role as the entry point for cold pathogens and the importance of protecting the neck in vulnerable populations.
(Text) Shanghan Yi Ri Ju Yang Shou Zhi (On the first day of Shanghan, Taiyang receives the pathogen). Zhang Yun: Examining the meridians, three yang are exterior, three yin are interior. Order of three yang: Taiyang is the third yang (yang within yang); Yangming is the second yang, following Taiyang; Shaoyang is the first yang, following Yangming. These three yang are exterior. Order of three yin: Taiyin is the third yin, following Shaoyang; Shaoyin is the second yin, following Taiyin; Jueyin is the first yin, following Shaoyin. These three yin are interior. The numbering proceeds from inside out. Similarly, pathogens enter from outside in: skin -> collaterals -> main vessels -> zang-fu. Hence, pathology starts at Taiyang. Jian An: Wu Kun adds "because its vessel passes through the head, neck, and along the spine" (nine characters); this addition is inadvisable.
(Vernacular Translation): On the first day of Cold Damage, the Taiyang meridian is affected. Zhang Jingyue outlines the sequence: Taiyang (3rd Yang), Yangming (2nd Yang), Shaoyang (1st Yang) constitute the exterior; Taiyin (3rd Yin), Shaoyin (2nd Yin), Jueyin (1st Yin) constitute the interior. Pathogens invade from exterior to interior, starting with the skin and Taiyang meridian before affecting deeper organs. Note: Wu Kun’s interpolation regarding the meridian pathway is considered unnecessary by the annotator.
(Text) Tou Xiang Tong, Yao Ji Qiang (Head and nape pain, stiffness of waist and spine). Zhang Yun: Shanghan usually begins with Taiyang... (Same as Wang Bing). Thus, symptoms present this way. Zhongjing says: Taiyang disease features floating pulse, stiff/painful head and nape, and aversion to cold. Xin Zheng Xiao: Jia Yi Jing and Tai Su read "Head, nape, and waist are all stiff." Jian An: Current Jia Yi Jing reads "Waist and back stiff."
(Vernacular Translation): Headache, nuchal rigidity, and stiffness of the lower back and spine. Zhang Jingyue notes that Shanghan typically initiates in the Taiyang channel. Zhang Zhongjing describes Taiyang syndrome as presenting with a floating pulse, stiffness and pain in the head and neck, and aversion to cold. Textual variants exist, with some editions specifying stiffness in the waist and back.
(Text) Shen Re (Body heat). Zhang Yun: Shanghan often involves fever, but specifically mentioning "body heat" here is because Yangming governs the muscles, making body heat particularly intense. Pathogenic heat in the stomach causes irritability, leading to inability to sleep. Zhongjing says: Yangming disease is characterized by "Stomach House Excess" (Fu organ excess).
(Vernacular Translation): Generalized body heat. Zhang Jingyue explains that while fever is common in Shanghan, the specific mention of "body heat" highlights Yangming’s association with the muscles, resulting in prominent heat. Stomach heat causes restlessness and insomnia. Zhongjing defines Yangming disease as an excess condition of the fu organs.
(Text) Bu De Wo (Inability to lie down/rest). *Tiao Jing Lun* says: Yangming is the stomach meridian; its qi descends. If Yangming qi rebels and fails to descend, one cannot lie down.
(Vernacular Translation): Insomnia or inability to assume a supine position. The *Tiao Jing Lun* attributes this to rebellious Yangming qi failing to descend normally.
(Text) Shao Yang Zhu Dan (Shaoyang governs the Gallbladder). Xin Zheng Xiao cites Quan Yuanqi, Tai Su, and Jia Yi Jing reading "Zhu Gu" (Governs Bone). Jian An: *Bing Yuan* also reads "Governs Bone"; only *Wai Tai Mi Yao* reads "Gallbladder." *Wai Tai Mi Yao* cites this from Volume 9. New Corrections note the full text is in Volume 5. Likely Wang Bing changed "Bone" to "Gallbladder," and Song editors followed suit. *Ling Shu* states "Gallbladder governs bone." Just as Yangming is said to govern flesh rather than stomach, Shaoyang should govern bone. Exterior to Interior: Skin (Taiyang) -> Flesh (Yangming) -> Bone (Shaoyang). This fits the Half-Exterior/Half-Interior classification. Changing "Gallbladder" to "Bone" makes more sense. Zhang Yun: Shaoyang is Half-Exterior/Half-Interior. Pathology includes hypochondriac pain and deafness. Zhongjing: Shaoyang disease features sour taste, dry throat, vertigo, alternating chills and fever. Cheng Wuji: Shaoyang pathogen resides between exterior and interior.
(Vernacular Translation): Shaoyang governs the Gallbladder. However, earlier texts like *Tai Su* read "Governs Bone." The annotator argues that "Bone" is likely the original term, consistent with the *Ling Shu* and the progression from Skin (Taiyang) to Flesh (Yangming) to Bone (Shaoyang). This structural view supports Shaoyang as the Half-Exterior/Half-Interior stage. Symptoms include hypochondriac fullness, deafness, bitter taste, dry throat, and vertigo.
(Text) Wei Ru Yu Zang Zhe (Not yet entered the Zang organs). Jian An: Based on Xin Zheng Xiao, Full Text and Tai Su read "Fu" (Fu organs). Jia Yi Jing and Shanghan Li also read "Fu." Only Wai Tai Mi Yao reads "Zang." Likely a Song dynasty correction. Context: "Less than 3 days, sweat; more than 3 days, purge." Exterior (Yang/Fu) treated by sweating; Interior (Yin/Zang) treated by purging. If following Zhongjing, it should be "Fu." But Wang Bing changed it to "Zang" to fit the simple Sweat/Purge dichotomy. Li Dongyuan argues "Zang" means storage, not the five zang organs. Zhang Zhicong argues "Zang" means interior/yin. He states yang meridians are affected by yang heat but remain in the exterior/form, treatable by sweating. This interpretation is superior.
(Vernacular Translation): The pathogen has not yet entered the Zang organs. Textual evidence suggests the original word was "Fu" (organs). Wang Bing likely changed it to "Zang" (organs) to emphasize the distinction between exterior (treatable by sweating) and interior (treatable by purging). Zhang Zhicong interprets "Zang" broadly as the interior/yin aspect, arguing that while yang meridians are affected, the pathogen remains superficial enough to be resolved via sweating.
(Text) Si Ri Tai Yin Shou Zhi (On the fourth day, Taiyin receives it). Zhang Yun: If exterior pathogen is not resolved by sweating, it enters the interior, starting with Taiyin. Zhongjing: Taiyin disease features abdominal fullness, vomiting, poor appetite, diarrhea, and abdominal pain. Jian An: The Nei Jing’s discussion of Three Yin diseases corresponds to Zhongjing’s Yangming excess (purgeable). Zhongjing’s Three Yin diseases are cold-deficiency patterns, not discussed here. Zhang’s comparison is flawed. Same for Shaoyin and Jueyin.
(Vernacular Translation): On the fourth day, the Taiyin meridian is affected. Zhang Jingyue links this to the transmission from exterior to interior. Zhongjing describes Taiyin syndrome with digestive symptoms. The annotator notes a discrepancy: the *Nei Jing* focuses on excess heat patterns (similar to Yangming), whereas Zhongjing’s Taiyin syndrome is typically a cold-deficiency pattern.
(Text) Luo Yu Fei (Connects to the Lung). Jia Yi Jing, Bing Yuan, Wai Tai Mi Yao omit "Yu".
(Vernacular Translation): The meridian connects to the Lung. Some editions omit the preposition "to."
(Text) Liu Ri Jue Yin Shou Zhi (On the sixth day, Jueyin receives it). Jian An: Fang Youzhi argues days represent sequence, not fixed duration. Zhang Yun: Shanghan transmission discusses only Foot meridians. Hand meridians are omitted because Foot meridians cover the whole body. Liu Wansu’s theory of "Foot only" is criticized by Zhang as incomplete, but Zhang admits the text focuses on Foot meridians to describe systemic exterior signs.
(Vernacular Translation): On the sixth day, the Jueyin meridian is affected. Fang Youzhi interprets the days as a sequential order rather than a strict timeline. Zhang Jingyue explains that the text focuses on the Foot meridians as they encompass the systemic circulation, rendering explicit mention of Hand meridians redundant for describing exterior syndromes.
(Text) Fan Man Er Nang Suo (Irritability, fullness, and retraction of the scrotum). Jian An: "Man" equals "Men" (oppression). Miao Xizhong notes women may have nipple retraction instead. Li Chan notes women may have vaginal pain pulling to the lower abdomen. Wu Kun adds "Three Yin meridians affected, entered Fu, can purge." Annotator rejects "Fu" for Three Yin, prefers "Zang."
(Vernacular Translation): Mental agitation, chest/abdominal fullness, and retraction of the genitalia. The annotator clarifies that "fullness" implies oppression. Clinical manifestations in females may differ (e.g., nipple retraction or pelvic pain). Wu Kun’s addition suggesting purification therapy for Three Yin is rejected as anatomically inconsistent; "Zang" is preferred over "Fu."
(Text) Wu Zang Bu Tong Ze Si Yi (If the Five Zang do not communicate, death ensues). Gao Yun: "Ze" means "then/immediately." Summarizes Three Yin disease. Not necessarily Day 4-6. All Yin/Yang, Zang/Fu can be affected simultaneously, stopping Ying-Wei circulation, leading to death. Worse than "Liang Gan" (Double Exposure).
(Vernacular Translation): Blockage of the Five Zang organs leads to death. Gao Shixi interprets this as a critical summary where multiple systems fail simultaneously, halting vital circulation (Ying and Wei), resulting in mortality more severe than standard double-exposure cases.
(Text) Ke Zhi Bu Man (Thirst stops, no fullness). Jia Yi Jing and Shanghan Li omit "Bu Man". Jian An: Previous text didn't mention abdominal fullness; "Bu Man" is likely a scribal error.
(Vernacular Translation): Thirst ceases, and abdominal distension resolves. The phrase "no fullness" appears to be a textual corruption, as abdominal fullness was not previously mentioned.
(Text) Er Ti (And sneezing). *Kou Wen* says: Harmonious yang qi causes sneezing.
(Vernacular Translation): Sneezing occurs when yang qi becomes harmonious and unobstructed.
(Text) Da Qi Jie Qu, Bing Ri Yi Yi (The great pathogen departs, the disease days end). *Tiao Jing Lun*: Purging excess opens the door, defeating the great pathogen. *Se Wu Pian*: Great pathogen entering Zang-Fu causes sudden death without prior illness. Gao Yun: Non-Liang Gan heat diseases resolve in 7-day cycles. Days 1-6 are sequential, not fixed deadlines. Do not let words obscure the meaning.
(Vernacular Translation): Once the major pathogen is expelled, the disease resolves. The seven-day cycle indicates a pattern of decline rather than a rigid deadline. Interpretation should focus on the underlying principles rather than literal day counts.
(Text) Tong Qi Zang Mai (Unblock the Zang pulses). Zhang Yun: Treat according to the specific meridian. Zhi Yun: Hand and Foot Yin/Yang meridians. Gao Yun: Refers to pulses of Spleen, Kidney, Liver.
(Vernacular Translation): Unblock the pulses of the Zang organs. This implies treating the specific meridians involved, such as those of the Spleen, Kidney, and Liver.
(Text) Ke Xie Er Yi (Can be resolved by purging). Zhang Yun: <3 days, exterior, sweat; >3 days, interior, purge. Wu Kun adds 32 characters about flexible treatment (vomiting, purging, sweating, harmonizing) based on pulse/symptoms. Jian An: Wang Bing’s reference to *Shanghan Lun* is clear. Adding Wu Kun’s text is superfluous. Xue Yue: Transmission is infinite; this text describes normal transmission. Study Zhongjing’s works deeply.
(Vernacular Translation): Purging is indicated. Zhang Jingyue distinguishes treatment based on duration (<3 days exterior/sweat, >3 days interior/purge). Wu Kun’s addition emphasizes clinical flexibility. The annotator criticizes this addition as redundant, urging reliance on Zhongjing’s comprehensive framework.
(Text) Yi (Leftover/Remnant). Zhi Yun: Cites *Shanghan Lun* regarding recurrence after illness due to forced eating (remnant food). Jian An: "Yi" means remainder (from *Li Ji*). Tong Hanchun: "Yi" means leaving behind pathology. When recovering, if qi is weak, eating meat causes recurrence; overeating leaves residual disease.
(Vernacular Translation): Residual pathogen or dietary retention. The term "Yi" denotes remnants. Tong Hanchun explains that improper diet during recovery can leave residual pathogens or cause relapse.
(Text) Qiang Shi Zhi (Forcefully eating). Jia Yi Jing omits "Zhi". Zhongjing: Post-illness mild vexation at dusk is due to forcing food on a weak spleen/stomach. Reduce intake to heal. Also, post-vomit/purge mild vexation is due to inability to handle grain qi.
(Vernacular Translation): Forcing food intake. Zhongjing advises that post-illness discomfort arises from overwhelming a weakened digestive system; reducing food intake promotes recovery.
(Text) Tiao Qi Ni Cong (Regulate rebellion and compliance). Zhi Yun: Floating pulse -> sweat; Deep pulse -> purge. This is regulating rebellion/compliance. Gao Yun: Observe deficiency/excess, regulate yin/yin rebellion.
(Vernacular Translation): Regulate the flow of qi, addressing both rebellious (ascending/excess) and compliant (descending/deficient) states through appropriate therapies like sweating or purging.
(Text) Shi Rou Ze Fu (Eating meat causes recurrence). Ma Yun: Meat is hot and hard to digest, causing heat disease recurrence. Zhi Yun: Pork is cold/water-associated, causing residual disease if overeaten. Jian An: Follow Ma Yun.
(Vernacular Translation): Consuming meat may trigger relapse. Ma Shi attributes this to meat’s heating nature and difficulty in digestion.
(Text) Zhan Yan (Delirious speech). Jia Yi Jing/Wai Tai Mi Yao read "Zhan Yu". Jian An: "Zhan" means talking much; "Zhan" (variant) means sleeping talk. Medical texts use them interchangeably. Liu Kui’s distinction is erroneous.
(Vernacular Translation): Delirious speech. The terms are used interchangeably in medical literature to describe incoherent speech associated with high fever or altered consciousness.
(Text) Bu Zhi Ren, Liu Ri Si (Unconscious, dies on the 6th day). Wai Tai Mi Yao: "Unconscious, then dies on the 6th day." Hua Shou: "Six" should be "Three." Jian An: Text says "After this, three days then dies." So "Six" is not a typo. It means Day 3 (Shaoyang/Jueyin involvement) + 3 days = Day 6 total death.
(Vernacular Translation): Loss of consciousness leading to death on the sixth day. The timeline accounts for the initial three days of transmission plus three additional days of critical decline.
(Text) San Ri Nai Si (Three days later, then dies). Wu Yun: "Bu Zhi Ren San Ri" is one sentence. Zhang Yun: After transmission completes, three more days pass before death. Equivalent to six days. Gao Yun: "Nai Si" means eventually dies, not instantly. Zhu Gong: Zhongjing lacks treatment for Liang Gan. Prioritize interior/exterior. Nei Jing’s Three Yin resembles Zhongjing’s Yangming Excess. Consult *Shanghan Lun*.
(Vernacular Translation): Death occurs three days after the onset of unconsciousness. This confirms the six-day total timeline. Treatment strategies for such critical stages require careful differentiation, as referenced in the *Shanghan Lun*.
(Text) Bing Wen (Contracting Warm Disease). *Sheng Qi Tong Tian Lun*: Winter cold injury leads to Spring Warm Disease. *Jin Gui Zhen Yan Lun*: Essence is root; storing essence in winter prevents Spring Warm Disease. Zhongjing: Taiyang disease with fever, thirst, no aversion to cold is Warm Disease.
(Vernacular Translation): Contracting Warm Disease. Etiology links winter cold injury to spring warmth. Preservation of essence in winter is preventive. Clinically, Warm Disease presents with fever, thirst, and absence of aversion to cold.
(Text) Bing Shu (Contracting Summerheat). Hua Shou: "Bing Shu" differs from "Bing Dan." "Bing Shu" is Heat Disease, treatable by sweating. "Bing Dan" is not. Zhang Yun: Timing (around Summer Solstice) and severity define Shu vs. Wen. Both are Shanghan. Jian An: Wen and Shu are Heat Diseases, named by season. *Ling Shu*: Winter cold -> Spring Dan Heat. Zhang: Means Warm-Heat disease. Severity distinction is doubtful.
(Vernacular Translation): Contracting Summerheat Disease. Distinctions are made based on seasonal timing and symptom severity. Both Warm and Summerheat diseases are subtypes of heat pathology originating from cold injury.
(Text) Yu Han (Give sweating). Jian An: "Yu" means give/administer. *Yu Han Jing*: Zhongjing warns against forced sweating (depletes fluids) or withheld sweating (closes pores).
(Vernacular Translation): Administering sweating therapy. Caution is advised against inappropriate use, which can either deplete fluids or trap pathogens.