伤寒之病，非比杂科，乃大方脉之首务也。其间脉理精深，艮震无常，死生反掌，甚所难明。
苟或有称治伤寒者，未免羊质虎皮，然则名节虚隆，而实德则病矣。余早年盲学，昏昏如蝇触牖，
后得汉长沙张仲景先师治法，所得石函遗着，名曰《遗芳嘉秘》，玩而诵之，以开茅塞，手足舞蹈，
不自知也。数试数验，岂不珍重哉！第恐吾老，子亦犹前之昏学，临病无措，故将遗旨，应手得心
诀法，纂以成集，名曰《伤寒证脉药截江网》，存与朝夕备览，以看省己之愚。原夫伤寒之脉，浮、
大、动、数、滑为阳，沉、涩、弱、弦、微为阴。其弦、紧、浮、滑、沉、涩六者，为残
贼之脉，故诸脉作病。春弦，夏洪，秋毛，冬石，土缓，为四季之正脉。浮、沉、迟、数为客主。
左为人迎，右为气口。呼出心肺为阳，吸入肾肝为阴。一呼一吸为一息。寸口为阳，尺泽为阴，中为
关界。阳主气，阴主血；血为荣，气为卫；寒则伤荣，风则伤卫；理自然也。所谓伤寒之病，从浅
入深，先以皮肤肌肉，次入筋骨肠胃，专以浮、中、沉、迟、数辩其阴阳寒热及表里虚实而断之矣。
诸浮为在表，轻手于皮肤之上便得之，曰浮。略重指于皮肤之下，肌肉之上，阴阳各半得之，曰中，
证属半表半里。诸沉为在里，重手于肌肉之下，筋骨之间方得之，曰沉，属阴。诸迟为在脏，属寒。
诸数为在腑，属热。阴阳、寒热、虚实，用在有力无力中分。有力者，为阳，为热，为实。无力者，
为阴，为寒，为虚。杂病以弦为阳，伤寒以弦为阴。杂病以缓为弱，伤寒以缓为和。伤寒以大为病
进，以缓为邪退。缓为胃脉，有胃气曰生，无胃气曰死。伤寒病中有神脉，如脉中有力，即为有神。
神者，气血之先也。两手无脉，曰双伏，一手无脉，曰单伏，必有正汗也。寸口阳脉中，或见沉细
者，但无力者，为阳中伏阴。尺部阴脉中，或见沉数者，为阴中伏阳。寸口数大有力，为重阳；尺
部微而无力，为重阴。寸口细微如丝，为脱阳；尺部细微无力，为脱阴。寸脉浮而有力，主寒邪
表实，宜汗。浮而无力，主风邪表虚，宜实。尺脉沉而有力，主阳邪在里，为实，宜下；无力，主
阴邪在里，为虚，宜温。寸脉弱而无力，切忌发汗。尺脉弱而无力，切忌汗下。初按来疾去迟，名
曰内虚外实；去疾来迟，名曰内实外虚。尺寸俱同，名曰缓。缓者，和而生也。汗下后脉静者，生；
燥乱身热者，死，乃邪气胜也。温之后脉来歇止者，正气脱而不复生也。纯弦之脉，名曰负。负者，
死。按之解索，名曰阴阳离。离者，死。阴病见阳脉者生，阳病见阴脉者死。
伤寒这一疾病，不同于其他各科，它是内科（大方脉）的首要任务。其中的脉理精深奥妙，变化无常，生死往往在顷刻之间，非常难以阐明。
如果有人说自己擅长治疗伤寒，却难免是徒有虚名（羊质虎皮），那么名声虽然虚高，但实际的德行和医术却是有缺陷的。我早年盲目学习，糊涂得像苍蝇撞击窗户一样找不到出路，后来得到了汉代长沙太守张仲景先师的治法，获得了石函中遗留的著作，名叫《遗芳嘉秘》，我研读并背诵它，以此开启蒙昧，高兴得手舞足蹈，自己都不知道。多次尝试多次验证，难道不珍贵吗！只是担心我年老之后，子孙也像以前那样昏聩地学习，面对疾病束手无策，所以将遗留的宗旨、得心应手的诀法，编纂成集，名叫《伤寒证脉药截江网》，保存下来供早晚浏览，以审视反省自己的愚钝。
大凡伤寒的脉象，浮、大、动、数、滑属于阳脉；沉、涩、弱、弦、微属于阴脉。其中弦、紧、浮、滑、沉、涩这六种脉象，属于残贼之脉，所以各种脉象都会导致疾病。春季脉弦，夏季脉洪，秋季脉毛（浮），冬季脉石（沉），长夏脉缓，这是四季的正常脉象。浮、沉、迟、数是判断客主（病邪与正气）的依据。左手为人迎脉，右手为气口脉。呼出时关联心肺，属阳；吸入时关联肾肝，属阴。一呼一吸称为一息。寸口部位属阳，尺泽部位属阴，中间为关界。阳主气，阴主血；血为荣（营气），气为卫（卫气）；寒邪则伤荣，风邪则伤卫，这是自然的道理。
所谓伤寒的疾病，是从浅入深发展，先在皮肤肌肉，随后进入筋骨肠胃，专门通过浮、中、沉、迟、数来辨别阴阳、寒热以及表里虚实来进行诊断。
凡是浮脉表示病在表，轻手按在皮肤之上就能摸到，叫做浮。略重指按在皮肤之下、肌肉之上，阴阳各半的位置摸到，叫做中，证候属于半表半里。凡是沉脉表示病在里，重手按在肌肉之下、筋骨之间才能摸到，叫做沉，属于阴脉。凡是迟脉表示病在脏，属于寒证。凡是数脉表示病在腑，属于热证。阴阳、寒热、虚实的区分，要在脉象有力或无力中进行分辨。有力的，属于阳、热、实。无力的，属于阴、寒、虚。杂病中以弦脉为阳，伤寒中以弦脉为阴。杂病中以缓脉为弱，伤寒中以缓脉为平和。伤寒病中，脉大为病情进展，脉缓为邪气退去。缓脉是胃脉，有胃气表示生机，无胃气表示死亡。
伤寒病中有“神脉”，如脉中有力，就是有神。神，是气血的先导。两手都摸不到脉，叫做双伏；一只手摸不到脉，叫做单伏，必然会有正常的汗出。在寸口阳脉中，如果出现沉细且无力的脉象，这是阳中伏阴。在尺部阴脉中，如果出现沉数脉象，这是阴中伏阳。寸口脉数大有力，称为重阳；尺部脉微弱无力，称为重阴。寸口脉细微如丝，称为脱阳；尺部脉细微无力，称为脱阴。
寸脉浮而有力，主寒邪在表且实证，适宜发汗。浮而无力，主风邪在表且虚证，适宜补益固表（实）。尺脉沉而有力，主阳邪在里且实证，适宜攻下；无力，主阴邪在里且虚证，适宜温补。寸脉弱而无力，切忌发汗。尺脉弱而无力，切忌发汗和攻下。初按时感觉脉搏去得快来得慢，叫做内虚外实；去得慢来得快，叫做内实外虚。尺寸两部脉象相同，叫做缓。缓脉，是和缓而有生机的表现。发汗或攻下后脉象平静的，预后良好；身体燥乱发热的，预后不良，这是邪气胜过的表现。温补之后脉象出现歇止的，是正气脱失而不能复生的表现。纯弦的脉象，叫做负。负的脉象，主死。按之像解开的绳索一样散乱无序，叫做阴阳离决。离决的脉象，主死。阴病见到阳脉者生，阳病见到阴脉者死。
The disease of Shanghan (Cold Damage) is not comparable to other medical specialties; it is the primary concern of internal medicine (Da Fang Mai). The principles of pulse diagnosis are profound and intricate, unpredictable like the changes of Heaven and Earth, with life and death hanging in the balance, making it extremely difficult to elucidate.
If someone claims to treat Shanghan, they may merely be a sheep with tiger skin—appearing formidable but lacking substance. Thus, their reputation might be inflated, but their actual virtue and skill are flawed. In my early years, I studied blindly, confused as if a fly were bumping against a windowpane. Later, I obtained the treatment methods from my predecessor, Zhang Zhongjing, the Chancellor of Changsha during the Han Dynasty. I acquired his遗著 (legacy writings) preserved in a stone casket, titled *Yi Fang Jia Mi* (Precious Secrets Fragrant in Retrospect). I studied and recited them to clear my mental obscurity, dancing with joy without realizing it. Having tested them repeatedly with success, how could they not be cherished? However, fearing that in my old age, my descendants would still study foolishly and be at a loss when facing illness, I compiled the legacy instructions and effective techniques into a collection named *Shanghan Zheng Mai Yao Jie Jiang Wang* (The Intercepting River Net for Shanghan Symptoms, Pulses, and Medicines), to be kept for daily review, allowing me to examine and reflect upon my own ignorance.
Generally speaking, the pulses of Shanghan: Fu (Floating), Da (Large), Dong (Surging), Shu (Rapid), and Hua (Slippery) belong to Yang; Chen (Deep), Se (Choppy), Ruo (Weak), Xian (Wiry), and Wei (Fine) belong to Yin. Among these, Xian (Wiry), Jin (Tight), Fu (Floating), Hua (Slippery), Chen (Deep), and Se (Choppy) are considered "destructive and harmful" pulses, causing various diseases. In Spring, the pulse is Wiry; in Summer, Surging; in Autumn, Floating (Mao); in Winter, Deep (Shi); and in the late summer/earth phase, Slow (Huan). These are the normal pulses of the four seasons. Fu, Chen, Chi (Slow), and Shu (Rapid) distinguish between pathogenic factors and healthy qi. The left wrist represents Ying (Human Welcome), and the right wrist represents Qi Kou (Qi Mouth). Exhalation relates to the Heart and Lung (Yang); inhalation relates to the Kidney and Liver (Yin). One exhalation and one inhalation constitute one breath (Xi). Cun Kou (Inch Port) is Yang, Chi Ze (Cubit Marsh) is Yin, and Guan (Pass) is the boundary between them. Yang governs Qi; Yin governs Blood. Blood is Ying (Nutritive Qi); Qi is Wei (Defensive Qi). Cold injures Ying; Wind injures Wei. This is the natural order.
The disease of Shanghan progresses from shallow to deep, initially affecting the skin and muscles, then entering the sinews, bones, intestines, and stomach. Diagnosis relies on distinguishing Yin/Yang, Cold/Heat, Exterior/Interior, and Deficiency/Excess through Fu, Zhong (Moderate), Chen, Chi, and Shu pulses.
All Fu (Floating) pulses indicate the disease is in the Exterior; felt lightly on the skin surface, it is called Fu. Felt slightly heavier below the skin but above the muscle, where Yin and Yang are equal, it is called Zhong, indicating a Half-Exterior/Half-Interior syndrome. All Chen (Deep) pulses indicate the disease is in the Interior; felt heavily below the muscle and between the sinews and bone, it is called Chen, belonging to Yin. All Chi (Slow) pulses indicate the disease is in the Zang (Organ), belonging to Cold. All Shu (Rapid) pulses indicate the disease is in the Fu (Organ), belonging to Heat. The distinctions of Yin/Yang, Cold/Heat, and Deficiency/Excess are determined by whether the pulse is Forceful or Feeble. Forceful indicates Yang, Heat, and Excess. Feeble indicates Yin, Cold, and Deficiency. In miscellaneous diseases, Wiry is Yang; in Shanghan, Wiry is Yin. In miscellaneous diseases, Slow is Weak; in Shanghan, Slow is Harmonious. In Shanghan, Large indicates disease progression; Slow indicates pathogenic retreat. Slow is the pulse of the Stomach; having Stomach Qi implies life, lacking it implies death.
In Shanghan, a "Spirit Pulse" exists; if the pulse has force, it possesses Spirit. Spirit is the precursor of Qi and Blood. If no pulse is felt in both hands, it is called Double Hidden (Shuang Fu); if no pulse is felt in one hand, it is called Single Hidden (Dan Fu). In both cases, normal sweating will occur. In the Cun Kou (Yang pulse position), if a Deep-Fine pulse is seen and is feeble, it is Yang concealing Yin. In the Chi position (Yin pulse position), if a Deep-Rapid pulse is seen, it is Yin concealing Yang. Cun Kou Rapid-Large and Forceful indicates Heavy Yang; Chi Fine-Weak and Feeble indicates Heavy Yin. Cun Kou Fine-as-silk indicates Collapse of Yang; Chi Fine-Weak and Feeble indicates Collapse of Yin.
Cun Floating and Forceful indicates Cold Pathogen in the Exterior with Excess, suitable for Sweating (Diaphoresis). Floating and Feeble indicates Wind Pathogen in the Exterior with Deficiency, suitable for Consolidating (Tonifying). Chi Deep and Forceful indicates Yang Pathogen in the Interior with Excess, suitable for Purging (Downward Drainage); Feeble indicates Yin Pathogen in the Interior with Deficiency, suitable for Warming. Cun Weak and Feeble strictly forbids Sweating. Chi Weak and Feeble strictly forbids Sweating and Purging. Upon initial palpation, if the pulse departs quickly and arrives slowly, it is called Internal Deficiency and External Excess; if it departs slowly and arrives quickly, it is called Internal Excess and External Deficiency. If Cun and Chi are identical, it is called Slow (Huan). Slow implies harmony and vitality. After Sweating or Purging, if the pulse becomes quiet, there is life; if the body is restless and hot, there is death, due to the dominance of pathogenic qi. After Warming, if the pulse shows intermittent pauses, it indicates the collapse of Healthy Qi with no recovery. A purely Wiry pulse is called Negative (Fu); Negative implies death. A pulse felt like unraveling silk is called Separation of Yin and Yang; Separation implies death. Yin diseases manifesting Yang pulses indicate life; Yang diseases manifesting Yin pulses indicate death.