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陈逊斋说。伤寒六经者。阴、阳、寒、热、虚、实、表、里之代名词也。太阳、阳明、少阳、皆为阳病。太阴、
少阴、厥阴、皆为阴病。太阳、阳明、少阳、皆为热病。太阴、少阴、厥阴、皆为寒病。太阳、阳明、少阳、皆为
实病。太阴、少阴、厥阴、皆为虚病。阴阳寒热虚实之中。又有在表在里。与在半表半里之不同。太阳为表。少阴亦为表。
太阳之表为热为实。少阴之表为寒为虚。阳明为里。太阴亦为里。阳明之里。为热为实。太阴之里。为寒为虚。
少阳为半表半里。厥阴亦为半表半里。少阳之半表半里。为热为实。厥阴之半表半里。为寒为虚。
太阳少阴。皆为表。太阳之表。为发热恶寒。少阴之表。为无热恶寒。阳明太阴皆为里。阳明之里为胃实。太阴之里
为自利。少阳厥阴皆为半表半里。少阳之半表半里。为寒热往来。厥阴之半表半里。为厥热进退。太阳少阴皆为
表。太阳之表可汗。少阴之表不可汗。阳明太阴皆为里。阳明之里可下。太阴之里不可下。少阳厥阴皆为半表半
里。少阳之半表半里可清解。厥阴之半表半里。不可清解。
得病之初。身体之正气。起而反抗。发热恶寒。即正邪交争之表示也。头痛、项强、体痛。即正邪交争时所发生之充血作用也。此时因皮肤开合。汗腺通塞之故。又发生有汗为中风。无汗为伤寒之两大症候。伤寒为散温机能衰
弱。故以麻黄汤发其表。中风为散温机能亢进。故以桂枝汤解其肌。凡此伤寒中风。可由发汗解肌而愈者。皆称
为表病。又称为太阳病。
正气抵抗邪气。在太阳病期内。无法战胜。因而妨碍三焦水道之流行。由此而引起寒热往来、胸胁满呕、口苦咽
干各症。概称为少阳病。《内经》谓三焦为决渎之官。生理学则不称三焦。而称淋巴。其理由相同。三焦在脏腑之外。
皮肤之内。故谓之半表半里。小柴胡一方。为本病之主剂。
正邪交争愈久。水分愈加蒸散。内部粘膜。愈加干燥。及在太阳少阳期内。发汗利尿过多。则肠胃间之水津。乃愈
涸竭。由是发生烦渴谵语。不大便。但恶热不恶寒之阳明里实症。轻则用白虎汤。重则用承气汤。
若肠胃之抵抗力不足。失去消化水谷之能力。则为太阴病。水谷不化。则水分过剩。因而上吐下利。此与阳明病
正成反比。阳明热而太阴寒。阳明实而太阴虚也。理中汤温中去湿。故为太阴病之专剂。
若造温机能衰减。体温为之降低者。则为少阴病。中医谓为阳虚。因心脏衰弱。故少阴病之脉必微细也。因神经
不振。故少阴病之症但欲寐也。因体温不能分布。故少阴病之四肢必厥逆也。此与太阳病正成反比。太阳必发
热而恶寒。少阴必恶寒而不发热。四逆汤强心生温。实为少阴病之主剂。
若夫厥阴病者。实抵抗力消长进退之重要关头也。其病状为厥热互为来复。热多于厥。则抵抗力有恢
复之希望。故主病退。厥多于热。则抵抗力愈趋愈下。故主病进。若但厥无热。则抵抗力完全失败。病主不治。
此与少阳病正成反比。少阳之寒热往来。不过三焦不和。血管伸缩之作用。可以和解了事。厥阴之厥热来复。
则出生入死。关系重大。厥阴之主剂。亦不离四逆辈。盖非生温无以退厥也。
总观六经之变化。三阳病惟恐其热。三阴病惟恐其寒。三阳病惟恐其实。三阴病惟恐其虚。三阳病则抵
抗力均未衰弱。故三阳病无死症。三阴病则抵抗力均感不足。故三阴病多死症。一部伤寒论。盖如是而已。
【荣斋按】此篇为一九三五年陈逊斋先生在前中央国医馆附设训练班的演讲词。综合全文大意，所谓三阳，
它的病多属于进行性，而其人的脏器体功尚强壮，未曾发现衰弱状态的三种证状。所谓三阴，它的病多属退行
性，而其人的机体功能已非强壮，已表现出衰弱状态的三种证状。精简的说∶“就是三阳言实，三阴言虚。三
阳言表实、里实、半表半里实，三阴言气虚、血虚、气血两虚。”
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Chen Xunzhai said: The Six Meridians (Six Stages) of Shanghan are synonymous with the concepts of Yin, Yang, Cold, Heat, Deficiency, Excess, Exterior, and Interior. Taiyang disease (Disease of the Bladder and Heart Small Intestine), Yangming disease (Disease of the Stomach and Large Intestine), and Shaoyang disease (Disease of the Gallbladder and Sanjiao) all belong to Yang diseases; Taiyin disease (Disease of the Spleen and Lung), Shao Yin disease (Disease of the Kidney and Heart), and Jueyin disease (Disease of the Liver and Pericardium) all belong to Yin diseases. Taiyang, Yangming, and Shaoyang diseases all belong to Heat diseases; Taiyin, Shao Yin, and Jueyin diseases all belong to Cold diseases. Taiyang, Yangming, and Shaoyang diseases all belong to Excess syndromes; Taiyin, Shao Yin, and Jueyin diseases all belong to Deficiency syndromes. Within the categories of Yin, Yang, Cold, Heat, Deficiency, and Excess, there are further distinctions regarding whether the pathology is located at the Exterior (Biao), the Interior (Li), or the Half-Exterior Half-Interior (Ban Biao Ban Li).
Taiyang disease is an Exterior syndrome, and Shao Yin disease is also an Exterior syndrome. However, the Exterior syndrome of Taiyang presents as Heat and Excess, whereas the Exterior syndrome of Shao Yin presents as Cold and Deficiency. Yangming disease is an Interior syndrome, and Taiyin disease is also an Interior syndrome. The Interior syndrome of Yangming presents as Heat and Excess, whereas the Interior syndrome of Taiyin presents as Cold and Deficiency. Shaoyang disease is a Half-Exterior Half-Interior syndrome, and Jueyin disease is also a Half-Exterior Half-Interior syndrome. The Half-Exterior Half-Interior syndrome of Shaoyang presents as Heat and Excess, whereas the Half-Exterior Half-Interior syndrome of Jueyin presents as Cold and Deficiency.
Both Taiyang and Shao Yin diseases involve the Exterior. The Exterior syndrome of Taiyang manifests as Fever and Aversion to Cold, while the Exterior syndrome of Shao Yin manifests as Aversion to Cold without Fever. Both Yangming and Taiyin diseases involve the Interior. The Interior syndrome of Yangming manifests as "Stomach Excess" (constipation/fecal impaction), while the Interior syndrome of Taiyin manifests as spontaneous diarrhea. Both Shaoyang and Jueyin diseases involve the Half-Exterior Half-Interior. The Half-Exterior Half-Interior syndrome of Shaoyang manifests as Alternating Chills and Fever, while that of Jueyin manifests as alternating cold limbs and fever.
Regarding treatment for the Exterior: Taiyang Exterior can be treated with Sudorific therapy (sweating method), but Shao Yin Exterior cannot. Regarding the Interior: Yangming Interior can be treated with Purgative therapy (draining method), but Taiyin Interior cannot. Regarding the Half-Exterior Half-Interior: Shaoyang Half-Exterior Half-Interior can be treated by Clearing Heat and Harmonizing, but Jueyin Half-Exterior Half-Interior cannot.
At the onset of illness, the body's Zheng Qi (Healthy Qi) rises to resist Xie Qi (Pathogenic Factors). Fever and aversion to cold represent the struggle between healthy and pathogenic factors. Headache, stiffness of the neck, and body pain are congestive reactions occurring during this struggle. Due to the opening and closing of the skin pores and the patency or blockage of sweat glands, two major symptom patterns arise: "having sweat indicates Wind-stroke," and "no sweat indicates Cold damage." Cold damage results from a decline in thermoregulatory function, so Ephedra Decoction (Mahuang Tang) is used to induce sweating and release the exterior. Wind-stroke results from hyperactive thermoregulatory function, so Cinnamon Twig Decoction (Guizhi Tang) is used to release the muscle layer. All such cases of Cold damage and Wind-stroke that recover through sweating or releasing the muscle layer are called Exterior diseases, also known as Taiyang disease.
If Zheng Qi fails to overcome Xie Qi during the Taiyang stage, it obstructs the flow of the Sanjiao water passages. This leads to symptoms collectively termed Shaoyang disease, including alternating chills and fever, fullness in the chest and hypochondrium, vomiting, bitter taste in the mouth, and dry throat. The *Neijing* refers to the Sanjiao as the "Official of Dredging." Modern physiology does not use the term Sanjiao but refers to the lymphatic system, for similar reasons. Located outside the Zang-Fu organs but inside the skin, the Sanjiao is thus termed Half-Exterior Half-Interior. Minor Bupleurum Decoction (Xiaochaihu Tang) is the principal formula for this disease.
The longer the struggle between Zheng Qi and Xie Qi persists, the more moisture evaporates, and the drier the internal mucous membranes become. If excessive sweating and diuresis occur during the Taiyang or Shaoyang stages, the fluids in the intestines and stomach become increasingly depleted. This leads to the Yangming Interior Excess syndrome characterized by irritability, thirst, delirium, constipation, and a preference for heat with aversion to cold. Mild cases are treated with White Tiger Decoction (Baitao Tang), and severe cases with Gastrointestinal Replenishment Decoctions (Chengqi Tang).
If the resistance of the intestines and stomach is insufficient, losing the ability to digest food and drink, it becomes Taiyin disease. Undigested food and drink lead to fluid excess, resulting in vomiting and diarrhea. This is the exact opposite of Yangming disease: Yangming is Hot, Taiyin is Cold; Yangming is Excess, Taiyin is Deficient. Regulate the Middle Decoction (Lizhong Tang) warms the middle and dispels dampness, making it the specific formula for Taiyin disease.
If the thermogenic function declines and body temperature drops, it becomes Shao Yin disease. In Traditional Chinese Medicine, this is called Yang Deficiency. Because the heart is weak, the pulse in Shao Yin disease must be fine and faint. Because neural activity is depressed, the symptom in Shao Yin disease is listlessness (desire to sleep). Because body temperature cannot distribute to the extremities, the limbs in Shao Yin disease must be cold (cold extremities). This is the exact opposite of Taiyang disease: Taiyang always features fever and aversion to cold, while Shao Yin always features aversion to cold without fever. Four Reversal Decoction (Sini Tang) strengthens the heart and restores Yang, serving as the principal formula for Shao Yin disease.
As for Jueyin disease, it represents a critical juncture of waxing and waning in resistance. The symptoms involve alternating cold limbs and fever. If fever exceeds cold limbs, there is hope for the recovery of resistance, indicating the disease is retreating. If cold limbs exceed fever, resistance declines further, indicating the disease is advancing. If there is only cold limbs without fever, resistance has completely failed, and the disease is difficult to cure. This contrasts with Shaoyang disease: the alternating chills and fever in Shaoyang result merely from disharmony of the Sanjiao and vascular constriction/dilation, which can be resolved by harmonizing. However, the alternating cold limbs and fever in Jueyin involves life and death, carrying significant weight. The principal formulas for Jueyin disease also revolve around the Sini Tang category, because warmth must be generated to resolve cold limbs.
In summary of the changes in the Six Meridians: For the Three Yang diseases, one fears Heat; for the Three Yin diseases, one fears Cold. For the Three Yang diseases, one fears Excess; for the Three Yin diseases, one fears Deficiency. In the Three Yang diseases, resistance has not yet weakened, so there are no fatal cases. In the Three Yin diseases, resistance is insufficient, so many cases are fatal. The entire *Treatise on Cold Damage* can be summarized as such.
[Note by Rongzhai] This passage is based on a lecture delivered by Mr. Chen Xunzhai in 1935 at the training class affiliated with the former Central National Medical Association. Synthesizing the main idea of the text: The so-called "Three Yang" diseases are mostly progressive, and the patient's organ functions remain robust, showing no signs of the three states of weakness. The so-called "Three Yin" diseases are mostly degenerative, and the patient's bodily functions are no longer robust, manifesting the three states of weakness. Concisely put: "Three Yang speaks of Excess, Three Yin speaks of Deficiency. Three Yang refers to Exterior Excess, Interior Excess, and Half-Exterior Half-Interior Excess; Three Yin refers to Qi Deficiency, Blood Deficiency, and combined Qi and Blood Deficiency."