变法者。言与仲景之法不同。方论中各有权变也。娄全善着医学纲目。于伤寒一门独详。第中寒一证。亦溷杂
而莫辩。就其中。每条之下。以仲景居前。后贤续法附之。变法者。与续法之义本同。古今诸家有如朱奉议。庞安
时。崔文行。杨登父。王海藏云岐子。王朝奉。韩祗和。朱丹溪。戴元礼。吴仁斋辈。各有方论。然皆互相祖述。
辅翼仲景之书者也。愚因不揣固陋。纂集其说。合为一卷。仍以仲景目之云尔。
活人书问阴证。答曰。太阴少阴厥阴。皆属阴证也。太阴者。脾也。少阴者。肾也。厥阴者。肝也。何谓太阴证。
太阴脾之经。主胸膈 胀。甲乙经云。邪生于阳者。得之风雨寒暑。邪中于阴者。得之饮食居处。阴阳喜怒。又曰。贼
风虚邪者。阳受之。饮食不节。起居不时者。阴受之。阳受之。则入腑。阴受之。则入脏。入六腑。则身热不时卧。（一
本无卧字。）上为喘呼。入五脏。则 满闭塞。下为飧泄。久为肠 。何谓少阴证。少阴肾之经。主脉微细。心烦。但
欲寐。或自利而渴。又问经云。一二日。少阴病者。何也。答曰。谓国中病时。腠理寒。便入阴经。不经三阳也。盖寒
气入太阳经即发热而恶寒。入少阴经。只恶寒而不发热也。三阴中寒。微则理中汤。稍厥。或中寒下利。即干姜甘草汤。
大段重者。用四逆汤。无脉者。用通脉四逆汤也。何谓厥阴证。厥阴肝之经。主消渴。气上冲。心中疼热。饥不欲食。
食则吐蛔。下之。利不止也。若阴气独盛。阳气暴绝。则为阴毒。其证四肢逆冷。脐腹筑痛。身如被杖。脉沉疾。或吐
或利。当急灸脐下。服以辛热之药。令阳气复。而大汗解矣。古人云。辛甘发散为阳。谓桂枝甘草干姜附子之类。能复
其阳也。微用辛甘。甚则用辛热。若阴极发躁。阴证似阳。学人当以脉别之。
琥按上论云。邪中于阴者。得之饮食居处。阴阳喜怒。又云饮食不节。起居不时。阴受之。阴受之则入脏。入五脏。
则腹满闭塞。下为飧泄。久为肠 。可见太阴中寒。有饮食劳倦内伤一条。所以东垣起而云内伤极多。外伤间而有之。
补中益气等汤所由立也。至少阴中寒。谓国中病时。腠理寒。便入阴经。不经三阳。止恶寒而不发热者。全是外伤。然
亦由肾虚无火所致。至厥阴中寒。阴气独盛。阳气暴绝。四肢逆冷。脐腹筑痛。身如被杖。脉沉疾。或吐或利。此寒邪
乘虚深入于里。命在呼吸。最为危急之证。其用干姜甘草四逆通脉等汤。及灸脐下法。已见前二卷仲景论中。又理中汤。
本仲景治霍乱方也。谨采附后。
琥又按阴证不可发汗。上论云。服以辛热之药令阳气复而大汗解者。非以辛热之药大发其汗。乃病者阴阳气和。自
然得汗而解之意。
变法，是指与张仲景的治法不同。在方剂论述中，各有其权宜变通之处。娄全善撰写《医学纲目》，在伤寒这一门类中论述得尤为详尽。然而其中关于“中寒”这一证候，也混杂不清，难以辨别。因此，他在每条之下，将张仲景的原文置于前面，后人的续法附在后面。“变法”的意思，与“续法”的本义相同。古今各位医家，如朱奉议、庞安时、崔文行、杨登父、王海藏（号云岐子）、王朝奉、韩祗和、朱丹溪、戴元礼、吴仁斋等人，各自都有方论著作。然而他们的学说都是互相承袭，辅助阐释张仲景的书籍罢了。我因不揣冒昧，固守浅陋之见，将这些说法编纂收集，合为一卷，仍然以张仲景的名义来统摄它们，如此而已。
《活人书》问：什么是阴证？回答是：太阴病、少阴病、厥阴病，都属于阴证。太阴对应脾脏，少阴对应肾脏，厥阴对应肝脏。什么是太阴证？太阴脾经，主要主管胸膈部的胀满。《甲乙经》说：邪气产生于阳分，是由于风雨寒暑所致；邪气侵入阴分，是由于饮食起居不当以及情绪波动（阴阳喜怒）所致。又说：贼风虚邪等外邪，阳经受之；饮食不节制，起居无规律，阴经受之。阳经受邪，则邪气传入六腑；阴经受邪，则邪气传入五脏。邪入六腑，则身体发热，不时躺卧不安（另一版本没有“卧”字），向上表现为气喘呼叫；邪入五脏，则腹部胀满闭塞，向下表现为完谷不化的泄泻，日久则发展为肠澼（痢疾）。什么是少阴证？少阴肾经，主要主管脉象微细，心烦，只想睡觉，或者自发性腹泻且口渴。又问：经文说发病一两天就出现少阴病，这是为什么呢？回答是：指在气候寒冷之时患病，腠理受寒，邪气便直接侵入阴经，而不经过三阳经。寒气侵入太阳经，就会发热并恶寒；侵入少阴经，则只恶寒而不发热。三阴经中寒，轻症的用理中汤；稍微出现四肢厥冷，或者中寒导致下利的，就用干姜甘草汤；病情特别严重的，用四逆汤；没有脉搏的，用通脉四逆汤。什么是厥阴证？厥阴肝经，主要主管消渴，气往上冲，心中疼痛且有灼热感，饥饿但不想吃东西，吃东西则会吐出蛔虫，如果误用攻下法，会导致腹泻不止。如果阴气单独亢盛，阳气突然断绝，就会形成阴毒。其症状表现为四肢逆冷，脐腹剧烈疼痛，身体像被棍棒打过一样疼痛，脉象沉而急数，或者呕吐或者下利，应当紧急灸治脐下部位，服用辛热性质的药物，使阳气恢复，从而大汗出而病解。古人说：辛味和甘味的药物发散作用属于阳，指的是桂枝、甘草、干姜、附子这类药物，能够恢复人体的阳气。轻微的用辛甘药，严重的用辛热药。如果是阴极导致烦躁，即阴证表现出类似阳证的症状，学者应当通过脉象来辨别。
琥按：上述论述说，邪气侵入阴分，是由于饮食起居不当以及情绪波动；又说饮食不节制，起居无规律，阴经受之，阴经受之则邪气入脏，邪入五脏，则腹部胀满闭塞，向下表现为完谷不化的泄泻，日久则发展为肠澼。由此可见，太阴中寒，有饮食劳倦内伤这一条病因，所以李东垣起来主张内伤极多，外伤间或有之，补中益气汤等方剂由此创立。至于少阴中寒，说是气候寒冷时患病，腠理受寒，便直接侵入阴经，不经过三阳经，仅恶寒而不发热，这完全是外感寒邪。然而这也由肾虚无火所致。至于厥阴中寒，阴气独盛，阳气暴绝，四肢逆冷，脐腹剧烈疼痛，身体像被棍棒打过一样疼痛，脉象沉而急数，或者呕吐或者下利，这是寒邪乘虚深入体内，性命危在旦夕，是最为危急的证候。其使用干姜甘草汤、四逆汤、通脉四逆汤等方剂，以及灸脐下的方法，已经在前两卷张仲景的论述中见到。另外，理中汤，原本是张仲景治疗霍乱的方剂。谨此采集附在后面。
琥又按：阴证不可发汗。上述论述中说，服用辛热药物使阳气恢复而大汗出病解，并不是用辛热药物大发其汗，而是指病人阴阳之气调和，自然出汗而病解的意思。
Method of Variation refers to treatment methods that differ from those of Zhang Zhongjing. In the discussion of prescriptions, there are various adaptations and modifications. Lou Quanshan authored *Yixue Gangmu* (Outline of Medical Science), providing particularly detailed discussions on Shaoyang diseases. However, within this category, the syndrome of "Zhong Han" (Cold Strike) is mixed and indistinct, making it difficult to distinguish. Therefore, under each clause, he placed Zhang Zhongjing's original text first, followed by the supplementary methods of later generations. The meaning of "Method of Variation" is essentially the same as "Supplementary Methods." Various physicians throughout history, such as Zhu Fengyi, Pang Anshi, Cui Wenxing, Yang Dengfu, Wang Haizhang (courtesy name Yunqizi), Wang Chaofeng, Han Zhihe, Zhu Danxi, Dai Yuanli, Wu Renzhai, and others, each had their own prescription discussions. Yet, all of them mutually inherited from one another to assist and elucidate Zhang Zhongjing's works. Presuming my own limitations and lack of profound knowledge, I have compiled these theories into a single volume, still attributing them under the banner of Zhang Zhongjing, so to speak.
In *Huo Ren Shu* (Book for Saving People), a question is asked: What is Yin Syndrome? The answer is: Taiyin Disease, Shaoyin Disease, and Jueyin Disease all belong to Yin Syndromes. Taiyin corresponds to the Spleen; Shaoyin corresponds to the Kidney; Jueyin corresponds to the Liver. What is Taiyin Syndrome? The Taiyin Spleen Meridian primarily governs distension in the chest and diaphragm. *Jia Yi Jing* states: Pathogenic factors arising from the Yang aspect result from wind, rain, cold, and heat; pathogenic factors invading the Yin aspect result from improper diet and living habits, as well as emotional fluctuations (Joy, Anger, etc.). It further states: Treacherous winds and empty evils are received by the Yang meridians; irregular diet and untimely rest are received by the Yin meridians. When received by the Yang meridians, the pathogen enters the Fu organs; when received by the Yin meridians, it enters the Zang organs. Entering the Six Fu organs leads to fever and inability to lie still continuously (some versions omit the character "lie"). Upward, it manifests as panting and calling out; entering the Five Zang organs leads to abdominal fullness and obstruction, downward manifesting as undigested food diarrhea (Sun Xie). If prolonged, it develops into Chang Pi (dysentery/intestinal inflammation). What is Shaoyin Syndrome? The Shaoyin Kidney Meridian primarily governs a faint and thin pulse, mental restlessness (Fan Xin), and a desire only to sleep (Dan Yu Mei). There may also be spontaneous diarrhea accompanied by thirst. Another question asks: Why does the classic state that Shaoyin disease appears within one or two days? The answer is: This refers to contracting illness during cold weather, where the interstices (Cou Li) are chilled, causing the pathogen to enter the Yin meridians directly without passing through the Three Yang meridians. Cold qi entering the Taiyang Meridian causes fever and aversion to cold; entering the Shaoyin Meridian causes only aversion to cold without fever. For Cold Strike in the Three Yin meridians: if mild, use Lizhong Tang (Regulate the Middle Decoction); if slightly presenting with cold extremities or cold strike leading to diarrhea, use Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction); if severe, use Sini Tang (Counterflow Decoction); if there is no pulse, use Tongmai Sini Tang (Pulse-Resuscitating Counterflow Decoction). What is Jueyin Syndrome? The Jueyin Liver Meridian primarily governs Xiao Ke (Wasting and Thirsting), Qi rushing upward, pain and burning sensation in the heart, hunger without desire to eat, vomiting of roundworms after eating, and uncontrollable diarrhea if purgatives are misused. If Yin Qi alone becomes excessive and Yang Qi suddenly perishes, it forms Yin Du (Yin Toxin). Symptoms include cold extremities, severe stabbing pain in the umbilical and abdominal regions, body pain as if beaten by a stick, deep and rapid pulse, or vomiting and diarrhea. One should urgently moxa below the navel and administer acrid-hot medicines to restore Yang Qi, leading to resolution through profuse sweating. Ancients stated: Acrid and Sweet substances disperse and belong to Yang, referring to herbs like Guizhi (Cinnamon Twig), Gancao (Licorice), Ganjiang (Dried Ginger), and Fuzi (Aconite Root), which can restore Yang Qi. Mild cases use Acrid-Sweet herbs; severe cases use Acrid-Hot herbs. If Yin reaches its extreme causing agitation, or if Yin Syndrome mimics Yang Syndrome, practitioners must differentiate via pulse diagnosis.
Hu notes: The above discourse states that pathogenic factors invading the Yin aspect result from improper diet and living habits, as well as emotional fluctuations. It also states that irregular diet and untimely rest are received by the Yin meridians; receiving by the Yin meridians means entering the Zang organs. Entering the Five Zang organs leads to abdominal fullness and obstruction, downward manifesting as undigested food diarrhea, and if prolonged, into Chang Pi. Thus, it is evident that Taiyin Zhong Han includes the etiology of internal injury due to diet and overwork. Hence, Li Dongyuan arose to claim that internal injuries are very common, while external injuries occur occasionally, leading to the establishment of formulas such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Regarding Shaoyin Zhong Han, it is said that during cold weather, chilled interstices cause direct entry into Yin meridians without passing through the Three Yang, presenting only with aversion to cold and no fever. This is entirely an external contraction. However, it is also caused by Kidney Deficiency lacking Fire. As for Jueyin Zhong Han, with Yin Qi dominating and Yang Qi suddenly perishing, presenting with cold extremities, severe abdominal pain, body pain as if beaten, deep rapid pulse, or vomiting/diarrhea, this indicates cold pathogens penetrating deeply into the interior due to deficiency. Life hangs in the balance, representing a critical emergency. The use of Ganjiang Gancao Tang, Sini Tang, Tongmai Sini Tang, and moxibustion below the navel has already been seen in the previous two volumes of Zhang Zhongjing's discourses. Additionally, Lizhong Tang was originally Zhang Zhongjing's formula for treating Huoluan (Cholera-like disorder). I respectfully collect and append it here.
Hu further notes: Yin Syndromes should not be treated with sweating methods. The above discourse mentions that administering acrid-hot medicines restores Yang Qi, leading to resolution through natural sweating. This does not mean using acrid-hot medicines to induce massive sweating, but rather that the patient's Yin and Yang Qi harmonize, resulting in natural sweating and recovery.