夫头疼发热，恶寒，或一手无脉，两手全无者，庸俗以为阳证得阴脉，便呼为死证不治。殊不
知此因寒邪不得发越，便为阴伏，故脉伏必有邪汗也，当攻之。又有伤寒病至六七日以来，别无刑
克证候，或昏沉冒昧，不知人事，六脉俱静，或至无脉，此欲正汗也，勿攻之。此二者，便如久旱
将雨，六合阴晦，雨后庶物皆苏，换阳之吉兆。正所谓欲雨则天郁热，晴霁天乃反凉，理可见也。
当攻者，发汗，冬用麻黄汤，三时用羌活冲和汤。勿攻者，止汗，五味子汤。各有治法，当谨记之。
言证不言病者，深有理哉！夫证之一字，有明证、见证、对证之义存。且如妇证奸而赃证盗，
刃证杀而病对证，不得辞而无逃其情矣。人之心、肝、脾、肺、肾，
藏而不见，若夫耳、目、口、鼻、舌，则露而共见者也。五脏受病，人焉知之？盖有诸中，必形诸外。
肝病则目不能视，心病舌不能言，脾病口不知味，肺病则鼻不闻香臭，肾病则耳不听声，以此言之，
其证最亲切矣。其太阳经受病，证出头疼身热，恶寒。一或伤之，本经之证见矣。将此首经论之，余
经不言可知，吾故曰伤寒言证不言病耳。
传足不传手者，此庸俗之谬论也，岂有是哉！人之充满一身，无非血气所养，昼夜循环，营运
不息，岂有只行足而不行手乎？况风寒之中人，先入荣卫，吾故明其所由。盖伤寒者，乃冬时感寒
即病之名。冬乃坎水用事，其气严凝凛冽，水冰地冻，在时则足太阳少阴正司其令，触冒之者，则二
经受病。其次则足少阳厥阴继冬而施春令，而亦受伤者，盖风木之令起于大寒节，正当十二月，至
春分后
方行温令，故风寒亦能伤之。足阳明太阴，中土也，与冬时无预而亦受伤者，土无定位，无成名，
无专气，寄旺于四时，终始于万物，则四时寒热温凉之气皆能伤之也。况表邪传里，必归于胃而为
燥屎，用承气汤下之，胃气和矣。手之六经，主于夏秋，故不伤也。足之六经，盖受伤之方分境界
也。若言伤足不伤手则可，以为传足不传手则不可也。设或不传，气逆作喘，何经而来？如谓不然，
仲景设有桂枝、麻黄，乃肺经药也，岂虚言哉？
头痛、发热、恶寒，或者一只手没有脉搏，两只手都没有脉搏的，庸俗之人认为是阳证得了阴脉，便称之为死证而不治。殊不知这是因为寒邪不能发散，从而形成阴伏，所以脉伏必然会有邪汗排出，应当采用攻法治疗。又有伤寒病到了六七天以来，没有其他克贼相乘的症状表现，或者神志昏沉迷糊，不省人事，六脉都安静微弱，或者甚至摸不到脉搏，这是将要出正汗的征兆，不要采用攻法。这两种情况，就像久旱即将下雨，天地昏暗，雨后万物复苏，是阳气转换的吉祥征兆。正所谓要下雨时天空闷热郁结，雨后天晴反而凉爽，道理由此可见。应当攻法的，用发汗法，冬天用麻黄汤，春三季用羌活冲和汤。不应当攻法的，用止汗法，五味子汤。各有治疗方法，应当牢记。
只谈症状不谈病名，其中有很深的道理啊！“证”这个字，有明证、见证、对证的含义存在。就像妇人通奸而有赃物为证，盗窃而有赃物为证，杀人而有凶器为证，治病要对证，不能推辞而无法逃避真情实况。人的心、肝、脾、肺、肾，脏腑深藏体内看不见，至于耳、目、口、鼻、舌，则是显露在外共同可见的。五脏受到疾病侵袭，人怎么知道呢？大概内部有病变，必然表现在外部。肝病则眼睛不能视物，心病舌头不能言语，脾病嘴巴不知道味道，肺病则鼻子闻不到香臭，肾病则耳朵听不见声音，从这些方面来说，症状是最切近真实的。太阳经受病，症状表现为头痛身热，恶寒。一旦受邪，本经的症状就出现了。将这一首经论述清楚，其余各经不言自明，所以我所以说伤寒只谈症状不谈病名罢了。
说只传足经不传手经，这是庸俗之人的谬论，哪有这种道理呢！人全身充满的地方，无非是血气所滋养，昼夜循环，营运不息，难道只有足经运行而不行手经吗？况且风寒邪气中人，先侵入荣卫，我因此阐明其缘由。所谓伤寒，是冬季感受寒邪随即发病的名称。冬季是坎水当令，气候严酷凝滞凛冽，水结冰地冻裂，在时令上足太阳经和足少阴经正当其令，触犯冒犯的人，这两条经脉就会受病。其次是足少阳经和足厥阴经继冬季之后施行春季的时令，而也受伤的，因为风木的时令起于大寒节气，正当十二月，到春分后才施行温令，所以风寒也能伤害它们。足阳明经和足太阴经，属于中土，与冬季没有直接关系却也受伤，是因为土没有固定的位置，没有专成的名称，没有专属的气，寄旺于四季，始终贯穿万物，那么四季寒热温凉的气都能伤害它。况且表邪传入里，必定归于胃而形成燥屎，用承气汤泻下，胃气调和了。手之六经，主宰于夏秋季节，所以不受伤。足之六经，大概是受伤的部位分野境界。如果说伤足不伤手还可以，如果说传足不传手就不可以了。假设如果不传，气逆作喘，是从哪条经脉来的呢？如果认为不是这样，张仲景设有桂枝汤、麻黄汤，乃是肺经的药物，难道是虚言吗？
Headache, fever, aversion to cold, or the absence of pulse in one hand, or in both hands: vulgar practitioners consider this as a Yang syndrome presenting with a Yin pulse, and thus declare it a fatal condition untreatable. They fail to realize that this is due to pathogenic cold failing to be dispersed, thereby forming a "Yin entrapment" (Yin Fu). Therefore, a hidden pulse must be accompanied by the expulsion of pathogenic sweat, and an attacking method should be employed. Furthermore, in cases of Shanghan (Cold Damage) progressing to the sixth or seventh day, without other signs of mutual overacting or restraining, but with mental confusion, stupor, and loss of consciousness, where all six pulses are quiet or even imperceptible, this indicates the impending emergence of physiological sweat (Zheng Han). In such cases, do not employ attacking methods. These two scenarios are like the sky darkening before rain after a long drought; after the rain, all things revive, which is an auspicious sign of Yang transformation. Just as the weather becomes stiflingly hot when rain is imminent, and turns cool after the sky clears, the principle is evident here. For those requiring attack, use diaphoresis (sweating method): Ma Huang Tang (Ephedra Decoction) in winter, and Qiang Huo Chong He Tang (Notopterygium Harmonizing Decoction) in spring. For those not requiring attack, use antiperspirants: Wu Wei Zi Tang (Schisandra Decoction). Each has its specific treatment; these must be remembered carefully.
To discuss symptoms rather than disease names holds profound rationale! The character "Zheng" (Syndrome/Pattern) implies clear evidence, observed evidence, and targeted evidence. Just as adultery is proven by illicit objects, theft by stolen goods, and murder by weapons, treating disease requires targeting the syndrome; one cannot evade the true nature of the condition. The Zang organs—Heart, Liver, Spleen, Lungs, and Kidneys—are concealed within and invisible. However, the ears, eyes, mouth, nose, and tongue are exposed and visible to all. How can one know if the five Zang organs are diseased? Generally, internal pathology manifests externally. Liver disease causes visual impairment; Heart disease causes speech difficulties; Spleen disease causes loss of taste; Lung disease causes anosmia (loss of smell); Kidney disease causes hearing loss. From this perspective, symptoms are the most intimate and reliable indicators. When the Taiyang Channel (Taiyang Jing) is affected, symptoms include headache, body heat, and aversion to cold. Once invaded, the manifestations of the primary channel appear. By discussing this first channel, the others become self-evident without explicit mention. Hence, I say that Shanghan discusses syndromes rather than disease entities.
The notion that diseases transmit only through the Foot channels and not the Hand channels is a fallacy of the vulgar, lacking any basis! The human body is filled with blood and Qi nourishing it, circulating day and night without cease. How could it be that only the Foot channels operate while the Hand channels do not? Moreover, when Wind-Cold invades the human body, it first enters the Ying (Nutritive) and Wei (Defensive) levels. I clarify this origin. "Shanghan" refers specifically to illness occurring immediately after contracting cold in winter. Winter is governed by Kan Water, characterized by severe, freezing cold where water freezes and ground cracks. At this time, the Foot Taiyang and Foot Shaoyin channels are in command. Those exposed to these conditions suffer disease in these two channels. Subsequently, the Foot Shaoyang and Foot Jueyin channels follow winter into spring, also becoming injured. This is because the Wind-Wood command begins at the Da Han (Great Cold) solar term, in the twelfth lunar month, and only shifts to warm commands after the Spring Equinox; thus, Wind-Cold can injure them. The Foot Yangming and Foot Taiyin channels belong to Central Earth. Although unrelated to winter directly, they still suffer injury because Earth has no fixed position, no exclusive name, and no dedicated Qi; it thrives during the four seasons, beginning and ending all things. Therefore, the cold, heat, warmth, and coolness of all four seasons can injure it. Furthermore, when exterior pathogens transmit inward, they inevitably accumulate in the Stomach to form dry feces, treated by purgation with Cheng Qi Tang (Order the Qi Decoction), restoring Stomach harmony. The Hand Six Channels govern Summer and Autumn, hence they are not injured. The Foot Six Channels represent the territorial domains where injury occurs. It may be acceptable to say that the Foot is injured while the Hand is spared, but claiming transmission occurs only in the Foot and not the Hand is incorrect. If transmission did not occur, and Qi rebellion caused wheezing, from which channel would it arise? If one argues otherwise, Zhang Zhongjing prescribed Gui Zhi Tang (Cinnamon Twig Decoction) and Ma Huang Tang, which are medicines for the Lung Channel. Would he speak in vain?