某（二二） 客邪外侵。头胀。当用辛散。（寒邪客肺）
苏梗 杏仁 桔梗 桑皮 橘红 连翘
某 寒热。头痛脘闷。
淡豆豉 嫩苏梗 杏仁 桔梗 浓朴 枳壳
某（五二） 复受寒邪。背寒。头痛。鼻塞。（风寒伤卫） 桂枝汤加杏仁。
某（十九） 时邪外袭。卫痹发热。头痛。先散表邪。（寒邪兼湿）
淡豆豉 苏梗 杏仁 浓朴 木防己 茯苓皮
杨（四二） 太阳脉行。由背抵腰。外来风寒。先伤阳经。云雾自下及上。经气逆而病发。致呕痰涎头痛。
小溲数行病解。膀胱气通。斯逆者转顺矣。当通太阳之里。用五苓散。倘外感病发再议。（寒客太阳膀胱经气逆）
某（二八） 劳伤阳气。形寒身热。头疼脘闷。身痛。（劳倦阳虚感寒）
杏仁（三钱） 川桂枝（八分） 生姜（一钱） 浓朴（一钱） 广皮（一钱） 茯苓皮（三钱）
伤寒症。仲景立法于前。诸贤注释于后。先生虽天资颖敏。若拟其治法。恐亦不能出仲景
范围。其所以异于庸医者。在乎能辨症耳。不以冬温春温风温温热湿温伏暑内伤劳倦
瘟疫等症。误认为伤寒。其治温热暑湿诸症。专辨邪之在卫在营。或伤气分。或伤血分。更
专究三焦。故能述前人温邪忌汗。湿家忌汗。当用手经之方。不必用足经之药等明训。垂
示后人。此乃先生独擅见长之处也。若夫伤寒之书。自成无己注解以后。凡注疏者不啻
数百家。其尤着者。如嘉言三书。景岳书。伤寒三注四注等篇。近有柯韵伯来苏集。伤寒论
翼方翼。王晋三古方选注中所解一百十三方。诸家析疑辨义处。虽稍有异同。然皆或登
仲景之堂。或造仲景之室者。业医者。当日置案头。潜心参究。庶乎临症可无误矣。（华岫云）
伤寒一症。内经云。热病者。皆伤寒之类也。又曰。凡病伤寒而成温者。先夏至日者为病温。
后夏至日者为病暑。又曰。冬伤于寒。春必病温。其症有六经相传。并病合病。两感直中。难
经又言伤寒有五。有中风。有伤寒。有湿温。有热病。有温病。其所苦各不同。再加以六淫之
邪。有随时互相兼感而发之病。且其一切现症。则又皆有头痛发热。或有汗无汗。或恶风
恶寒。不食倦卧烦渴等。则又大略相同。故其症愈多。其理愈晦。毋怪乎医者临症时。不能
灼然分辨。即其所读之书。前人亦并无至当不易之论。将灵素难经之言。及一切外感之
症。逐一分晰辨明。使人有所遵循。故千百年来。欲求一鉴垣之士。察六淫之邪。毫不紊乱
者。竟未见其人。幸赖有仲景之书。以六经分症。治以汗吐下和寒温诸法。故古人云仲景
之法。不但治伤寒。苟能悉明其理。即治一切六气之病与诸杂症。皆可融会贯通。无所不
宜。此诚属高论。固深知仲景者也。然余谓六淫之邪。头绪甚繁。其理甚奥。即汇集河间东
垣丹溪。及前贤辈诸法而治之。犹虑未能兼括尽善。若沾沾焉。必欲但拘仲景之法而施
治。此乃见闻不广。胶柱鼓瑟。不知变通者矣。今观叶氏之书。伤寒之法。固属无多。然其辨
明冬温春温风温温热湿温之治。实超越前人。以此羽翼仲景。差可嘉惠后学。观者幸毋
忽诸。（华玉堂）
徐评 此即俗名著寒之症。偶尔受寒之小疾。不入经络之病也。何必牵引伤寒大症。发诸议
论。及细阅此编。竟无治伤寒一门。即此数方为伤寒之法。不禁失笑。夫医者之学问。全在明伤
寒之理。则万病皆通。故仲景之书只有二种。伤寒论治伤寒之法也。金匮治杂症之法也。而金
匮之方。则又半从伤寒论中来。则伤寒乃病中之第一症。而学医者之第一功夫也。今此编独
阙此一门。则平日所习何书。所治何病耶。此老数十年医道大行。岂无数千百大症经手。乃竟
只录此数方以了局。此非此老之过。乃编书之人胸中茫无定见耳。
某（二十二岁）：外感客邪侵袭。出现头胀症状。应当使用辛散药物。（寒邪客于肺脏）
苏梗、杏仁、桔梗、桑白皮、橘红、连翘。
某患者：出现寒热往来、头痛、胃脘部闷胀的症状。
淡豆豉、嫩苏梗、杏仁、桔梗、厚朴、枳壳。
某（五十二岁）：再次感受寒邪。出现背部发冷、头痛、鼻塞的症状。（风寒损伤卫气）
桂枝汤加杏仁。
某（十九岁）：时行邪气外袭。卫气痹阻导致发热、头痛。先疏散表邪。（寒邪兼夹湿邪）
淡豆豉、苏梗、杏仁、厚朴、木防己、茯苓皮。
杨先生（四十二岁）：太阳经脉循行，从背部抵至腰部。外来风寒之邪，首先损伤阳经。云雾之气自下而上弥漫，经气逆乱而发病，导致呕吐痰涎、头痛。
小便频数后病邪解除，膀胱气化功能通畅，那么逆乱之气便转为顺调了。此时应当通利太阳经的里证，使用五苓散。如果外感病复发再另行商议。（寒邪客于太阳膀胱经，导致经气逆乱）
某（二十八岁）：劳倦损伤阳气，形体畏寒、身体发热、头痛、胃脘闷胀、身体疼痛。（劳倦导致阳虚，复感寒邪）
杏仁（三钱）、川桂枝（八分）、生姜（一钱）、厚朴（一钱）、广陈皮（一钱）、茯苓皮（三钱）。
伤寒病症，张仲景在前确立了治法，后世众多贤者进行注释。先生虽然天资聪颖敏锐，如果要模仿他的治法，恐怕也不能超出张仲景的范围。他之所以不同于庸医的地方，在于能够辨别病症。不将冬温、春温、风温、温热、湿温、伏暑、内伤、劳倦、瘟疫等病症，误认为是伤寒。他在治疗温热、暑湿等病症时，专门辨别邪气是在卫分还是在营分，或者是伤了气分还是血分，更专门研究三焦辨证。因此能阐述前人关于温邪忌用发汗、湿家忌用发汗，应当用手经方剂，不必用足经药物等明确训诫，垂示后人。这是先生独自擅长的长处。至于伤寒方面的书籍，自从成无己注解以后，凡是注疏的著作不止几百家。其中特别著名的，如喻嘉言的三部书，张景岳的书，《伤寒三注》《四注》等篇章，近期有柯韵伯的《来苏集》、《伤寒论翼》、《方翼》，王晋三的《古方选注》中所解析的一百一十三首方剂。各家辨析疑难、辨明义理之处，虽然稍有异同，但都是或登堂入室、或进入内室的境界。从事医疗工作的人，应当将这些书放在案头，潜心研究探讨，这样在临症时才可以没有失误。（华岫云评）
伤寒这一病症，《内经》说：热病，都属于伤寒的范畴。又说：凡是患伤寒而转化为温病的，在夏至日之前发病的叫温病，在夏至日之后发病的叫暑病。又说：冬季感受寒邪，春季必定发生温病。其病症有六经传变，并病、合病，两感、直中等情况。《难经》又言伤寒有五类：有中风的类型，有伤寒的类型，有湿温的类型，有热病的类型，有温病的类型。它们所痛苦的症状各不相同。再加上六淫邪气，有随着时间互相兼夹感受而发作的疾病。而且它们一切现症，大都有头痛发热，或有汗无汗，或恶风恶寒，不思饮食、倦怠卧床、烦躁口渴等，则大致相同。所以病症越多，道理越晦涩，难怪医生在临症时，不能清晰分辨。即使他们所读的书，前人也没有绝对正确不可更改的言论，将《灵枢》、《素问》、《难经》的话，以及一切外感病症，逐一分析辨明，使人有所遵循。所以千百年来，想求得一位像鉴垣之士那样，观察六淫邪气毫不混乱的人，竟然没见到。幸好有张仲景的书，以六经分症，用汗、吐、下、和、寒、温诸法治疗。所以古人说张仲景的法度，不仅是治疗伤寒，如果能完全明白其中的道理，即使是治疗一切六气致病与各种杂症，都可以融会贯通，无所不宜。这确实是高论，确实深知张仲景的人。然而我认为六淫邪气，头绪非常繁杂，道理非常深奥，即使汇集刘河间、李东垣、朱丹溪及前贤辈的各种方法来治疗，还担心不能兼顾完善。如果拘泥执着，一定要只拘守张仲景的方法来施治，这是见闻不广，胶柱鼓瑟，不知变通的人。现在看叶氏的书，伤寒的方法固然不多，但他辨明冬温、春温、风温、温热、湿温的治疗，实在超越前人。以此辅助张仲景，颇可嘉许惠及后学。读者希望不要忽视这些内容。（华玉堂评）
徐灵胎评语：这就是俗话说的“着寒”病症，偶尔受寒的小疾，不是侵入经络的病。何必牵扯到伤寒大病，发表议论。等到仔细翻阅这篇医案，竟然没有治疗伤寒的一个门类，仅凭这几首方子作为伤寒的方法，不禁让人失笑。医生的学问，全在于明白伤寒的道理，那么万病皆通。所以张仲景的书只有两种：《伤寒论》是治疗伤寒的方法，《金匮要略》是治疗杂症的方法。而《金匮》中的方子，又有一半是从《伤寒论》中来的。那么伤寒乃是病中的第一重症，也是学医者的第一功夫。现在这篇医案唯独缺少这一门类，那么平时学习的是什么书，治疗的是什么病呢？这位老先生几十年医术大行其道，难道没有经手过成千上百的大症吗？竟然只记录这几个方子来了事。这不是老先生的过错，而是编书之人胸中没有定见罢了。
Mr. (22 years old): External pathogenic factors invade. Head distension occurs. Acrid dispersing agents should be used. (Cold pathogen lodging in the Lung)
Perillae Caulis (Sugeng), Apricot Seed (Xingren), Platycodon Root (Jiegeng), Mulberry Bark (Sangpi), Tangerine Peel (Juhong), Forsythia Fruit (Lianqiao).
Patient: Chills and fever, headache, epigastric stuffiness.
Fermented Soybean (Douchi), Tender Perilla Stem (Sugeng), Apricot Seed (Xingren), Platycodon Root (Jiegeng), Magnolia Bark (Houpo), Bitter Orange (Zhike).
Mr. (52 years old): Re-exposed to cold pathogen. Coldness in the back, headache, nasal congestion. (Wind-cold damaging the Defensive Qi)
Guizhi Decoction (Cinnamon Twig Decoction) with added Apricot Seed (Xingren).
Patient (19 years old): Seasonal pathogens attack externally. Defensive obstruction causes fever, headache. First, disperse the exterior pathogens. (Cold pathogen combined with Dampness)
Fermented Soybean (Douchi), Perilla Stem (Sugeng), Apricot Seed (Xingren), Magnolia Bark (Houpo), Stephania Root (Mufangji), Poria Skin (Fulingpi).
Mr. Yang (42 years old): The Taiyang meridian runs from the back to the waist. External wind-cold first damages the Yang meridians. Cloud-like turbidity rises from below to above, meridian Qi rebels causing disease, resulting in vomiting of phlegm-saliva and headache.
After frequent urination, the disease resolves, Bladder Qi flows smoothly, and the rebellious Qi turns smooth. At this point, one should unblock the interior of the Taiyang, using Wuling San (Five-Ingredient Powder with Poria). If the external contraction recurs, it will be discussed again. (Cold lodging in the Taiyang Bladder Meridian, causing Qi rebellion)
Mr. (28 years old): Labor injury damages Yang Qi, body feels cold yet feverish, headache, epigastric stuffiness, body pain. (Labor fatigue leading to Yang deficiency and cold invasion)
Apricot Seed (San qian), Cinnamon Twig (Chen Guizhi - Ba fen), Fresh Ginger (Shengjiang - Yi qian), Magnolia Bark (Houpo - Yi qian), Broad-leaved Tangerine Peel (Guangpi - Yi qian), Poria Skin (Fulingpi - San qian).
Regarding Shaoyin syndrome (Typhoid), Zhang Zhongjing established laws previously, and various sages annotated afterwards. Although Mr. possesses natural intelligence and acuity, if he were to imitate his treatment methods, it is feared he could not go beyond Zhang Zhongjing's scope. What distinguishes him from mediocre physicians lies in his ability to differentiate syndromes. He does not mistake winter-warmth, spring-warmth, wind-warmth, heat-warmth, damp-warmth, latent summerheat, internal injury, labor fatigue, or pestilence for Shaoyin syndrome. In treating warmth, summerheat, and dampness syndromes, he specifically differentiates whether the pathogen is in the Wei (Defensive) level or Ying (Nutritive) level, or whether it has injured the Qi level or Blood level, and further investigates the Triple Burner (Sanjiao). Thus, he expounds on the clear instructions of predecessors that warm pathogens contraindicate sweating, and patients with dampness contraindicate sweating; hand-meridian formulas should be used, without needing foot-meridian herbs, etc., to instruct future generations. This is where Mr. excels uniquely. As for books on Shaoyin syndrome, since Cheng Wuji's annotations, there have been hundreds of commentaries. Notable ones include Yu Jiayan's three books, Zhang Jingyue's works, chapters like "Shaoyin Three Annotations" and "Four Annotations", recently Ke Yunbo's *Laosu Ji*, *Shaoyin Lun Yi*, *Fang Yi*, and Wang Jinsan's *Gufang Xuanzhu* which analyzes 113 ancient formulas. Although various schools differ slightly in resolving doubts and clarifying meanings, all are either entering the hall or reaching the inner chambers of Zhang Zhongjing's knowledge. Practitioners should keep these books at hand and study them diligently, so as to avoid errors in clinical practice. (Comment by Hua Xiuyun)
Regarding Shaoyin syndrome, the *Neijing* states: Heat diseases are all of the category of Shaoyin. It also says: For those who contract Shaoyin and develop into warmth diseases, those occurring before the Summer Solstice are called Warmth diseases, and those after the Summer Solstice are called Summerheat diseases. It also says: Injury to cold in winter leads to Warmth disease in spring. Syndromes involve transmission through the Six Meridians, concurrent diseases, combined diseases, simultaneous infection, or direct entry. The *Nanjing* further states that Shaoyin includes five types: Wind-stroke, Cold damage, Damp-warmth, Heat disease, and Warmth disease. Their suffering symptoms differ. Additionally, with the six climatic pathogens, diseases may occur due to mutual combination and infection over time. Moreover, their presenting symptoms generally share headaches and fever, with or without sweat, aversion to wind or cold, anorexia, lethargy, lying down, irritability, and thirst, making them roughly similar. Thus, the more syndromes exist, the more obscure the principles become, no wonder physicians cannot clearly differentiate when treating patients. Even in the books they read, predecessors lacked absolute, unchangeable theories to analyze and clarify the words of *Lingshu*, *Suwen*, *Nanjing*, and all external contraction diseases, providing guidance for people. Therefore, for thousands of years, seeking a scholar like Jian Yuan who can observe the six climatic pathogens without confusion has been rare. Fortunately, we have Zhang Zhongjing's book, which differentiates syndromes via the Six Meridians and treats them with sweating, vomiting, purging, harmonizing, cooling, and warming methods. Hence, ancients said Zhang Zhongjing's methods treat not only Shaoyin but, if one fully understands the principles, can integrate and apply to all diseases caused by the six qi and miscellaneous disorders, being suitable everywhere. This is indeed a high theory, showing deep understanding of Zhang Zhongjing. However, I believe the six climatic pathogens are complex in detail and profound in principle. Even combining methods from Liu Hejian, Li Dongyuan, Zhu Danxi, and other sages, one might still worry about not achieving perfection. To cling rigidly to only Zhang Zhongjing's methods for treatment is to be narrow-minded, stuck in conventions, and unable to adapt. Now, observing Mr. Ye's book, although methods for Shaoyin are few, his differentiation of treatments for winter-warmth, spring-warmth, wind-warmth, heat-warmth, and damp-warmth truly surpasses predecessors. Using this to support Zhang Zhongjing is commendable and beneficial to learners. Readers should not ignore this. (Comment by Hua Yutang)
Comment by Xu Lingtai: This is what common people call "catching cold," a minor illness from occasional cold exposure, not a disease invading the meridians. Why drag in major Shaoyin discussions and express opinions? Upon carefully reading this compilation, there is not even a section on treating Shaoyin. Relying on these few prescriptions as Shaoyin methods makes one laugh. A physician's learning lies entirely in understanding the principles of Shaoyin, then all diseases become clear. Thus, Zhang Zhongjing's books are only two: *Shaoyin Lun* for treating Shaoyin methods, and *Jingui Yaolue* for treating miscellaneous diseases. And half of the formulas in *Jingui* come from *Shaoyin Lun*. Therefore, Shaoyin is the primary disease among diseases and the first skill for learning physicians. Now, this compilation lacks this section entirely. What books did he usually study, and what diseases did he treat? This old man practiced medicine successfully for decades; surely he handled thousands of major cases. Yet he records only these few formulas to finish. This is not the old man's fault, but the compiler's lack of definite views.