子谓伤寒有五。其辨证先从太阳病辨起。而病正有不必尽从太阳起者。且即从太阳起而亦有
传有不传。仲景以病静者为不传。若传胃者不复更传。即传经之中。亦不能泥定太阳之后。
必传阳明。有由太阳而径传少阳者。有由太阳而径传三阴者。有由太阳不传阳明而传太阳之
府者。且传府之中。有传气分者。有传血分者。又有病不起于太阳。由阳明而太阳者。由少
阳而太阳者。更有直中阴经者。有由阴而还返于阳者。有阴阳分传者。有阳证似阴者。有阴
证似阳者。种种变化。更仆难数。总不能以日数为拘。只宜在表里腑脏上探消息
。如一二日即见里证。断无发表之理。五六日仍见表证。断无攻里之理。里证急于表证者。
先治其里。后治其表。表证急于里证者。先治其表。后治其里。仲景论中朗若列眉。能解此
活变之法。则先汗后下之邪说。更不烦言而知其谬矣。
陶氏之学。盛行于世久矣。人谓仲景之学。得陶节庵而始彰。吾谓仲景之书。得陶节庵而遂
废。非苛论也。节庵毕生精神。致力于仲景伤寒论。非不费一番苦功。而卒为王叔和所掩。故
其论伤寒仍指为冬月正病。以桂枝麻黄二方。专为冬月正伤寒说法。此外论温论热。仍按节
气论病。此仍沿序例之说。而于伤寒开手辨证功夫。尚未透彻。至其六经分证。牵入内经热
病法。与仲景伤寒法。一并砌入。混同无别。其论脉尤为可议。仲景识病大法。全凭脉证互
参。方能谛实病因。论中辨脉平脉两篇。精微圆妙。非寤寐神游。焉能窥其奥 。且其脉法
之散见于六经篇中者。更当随证体认。节庵乃谓但凭浮中沉三部。及指下之有力无力。分别
表里阴阳寒热虚实。殊不知此仅持脉之大纲。恶足以尽病情之变。而其尤悖谬者。谓小柴胡
汤可以通治温疫时证。见热甚合解毒汤。不须论脉。此病定一七。或二三七。自然汗出身凉而
愈。信如此言。更不必辨其何经何证。并不必再辨浮中沉三部之脉。并不必辨其脉之有力无
力。但用一小柴胡汤。听其延久自愈。此说一开。病之轻者。延久始愈。病之重者。后救亦
无及矣。乃此书偏盛行于后世者。皆由今人无不避难而趋易。得如此简便之法。谁不乐从。
而节庵自序。乃云后之同志。但须熟玩此书。不必集闲方而观别论。是分明教人以不必复读
仲景书矣。试思仲景妙蕴。安能阐发得尽。纵日谆谆教人以宜学仲景。人犹畏难而思阻。今
如集中所辑方论。即果搜剔无遗。亦只拾糟粕而遗神髓。何如汲汲直追仲景渊源。语云。
取法乎上。仅得乎中。欲学伤寒。舍仲景其谁与归。
张仲景认为伤寒分为五种类型。其辨证应当先从太阳病（太阳经受邪所致的病证）开始辨析。然而，疾病确实有并非全部从太阳病起始的情况。况且，即使是从太阳病起始，也有传变和不传变之分。张仲景以病情安静作为不传变的判断标准。如果病邪传入胃腑，就不再继续传变。即使在传经的过程中，也不能拘泥于太阳病之后必定传阳明病（阳明经受邪所致的病证）。有的由太阳病直接传变至少阳病（少阳经受邪所致的病证），有的由太阳病直接传变至三阴经（太阴、少阴、厥阴经受邪所致的病证），有的由太阳病不传阳明而传变至太阳之腑（膀胱）。且在传变入腑的过程中，有传变至气分（功能层面）的，有传变至血分（物质层面）的。又有疾病并非起于太阳，而是由阳明病转归为太阳病的，由少阳病转归为太阳病的。更有直中阴经（寒邪直接侵犯三阴经）的情况，有由阴经返回转为阳经病的，有阴阳经同时传变的，有阳证表现出类似阴证症状的，有阴证表现出类似阳证症状的。种种变化，多得无法一一列举。总之不能以发病日数来拘泥限定，只应当在表里、腑脏上进行探求和把握。如发病一两天就出现里证（脏腑内部病变），绝对没有使用发汗解表法的道理；发病五六天仍然表现为表证，绝对没有使用攻下里实法的道理。里证比表证急迫的，先治疗里证，后治疗表证；表证比里证急迫的，先治疗表证，后治疗里证。张仲景的论述中清晰明了如眉目分明。能够理解这种灵活变化的法则，那么所谓“先汗后下”的错误说法，更不用多说就知道它是谬误了。
陶华（字节庵）的学说，在世间盛行已久。人们说张仲景的学问，得到陶节庵阐扬才显扬于世。我认为张仲景的著作，因为陶节庵反而被废弃了。这并不是苛刻的评论。陶节庵毕生的精力都致力于研究张仲景的《伤寒论》，并非没有花费一番苦功，但最终被王叔和（整理编次《伤寒杂病论》的医家）的观点所掩盖。因此，他论述伤寒仍然将其指为冬季感受正气的寒邪所致，用桂枝汤（调和营卫的方剂）和麻黄汤（发汗解表的方剂）两个方子，专门为了冬季感受正伤寒的说法进行解释。此外关于温病和热病的论述，仍然按照节气来论病。这仍然是沿袭《序例》中的说法，而在伤寒开篇辨证的功夫上，尚未透彻。至于他的六经分证（将疾病分为太阳、阳明、少阳、太阴、少阴、厥阴六个阶段），牵强地引入《内经》热病的方法，与张仲景的伤寒法混合在一起，混同而没有区别。他对于脉诊的论述尤其值得议论。张仲景识别疾病的大法，全凭脉象和证候互相参照，才能确切地知道病因。《伤寒论》中辨脉篇和平脉篇，精微圆妙，如果不是心神专注地深入探究，怎么能窥探其中的奥秘？况且他的脉法散见于六经篇中的，更应当随着证候去体察认识。陶节庵却认为只要凭借浮、中、沉三部脉，以及指下的有力无力，来分别表里、阴阳、寒热、虚实。殊不知这仅仅是持脉的大纲，怎么足以穷尽病情的变化？而他尤为悖谬的是，说小柴胡汤（和解少阳的方剂）可以通治温疫时行病症，见到热势严重配合解毒汤，不需要诊脉。这样的病定在一个七天周期，或者两三个七天周期，自然出汗身体凉爽而痊愈。相信这样的话，更不必辨别是何经何证，也不必再辨别浮中沉三部脉，也不必辨别脉的有力无力，只要用小柴胡汤，听任它拖延日久自愈。这种说法一旦开启，轻的病拖延久了才痊愈，重的病即使后来救治也来不及了。然而这本书偏偏在后世盛行，都是因为今人无不避难趋易，得到如此简便的方法，谁不愿意遵从？而陶节庵在自序中说，后来的同志，只需熟读此书，不必收集闲杂方剂而观看其他论述，这是明显教导人们不必再研读张仲景的书了。试思考张仲景的精妙蕴藏，怎么能被完全阐发出来？纵然每天谆谆教导人们应该学习张仲景，人们还畏惧困难而想要退缩。现在像书中集结的方论，即使果真搜罗剔抉没有遗漏，也只是拾取糟粕而遗忘了神髓。哪里比得上急切地直接追寻张仲景的渊源？俗话说：取法乎上，仅得乎中。想要学习伤寒，除了张仲景还有谁可归依呢？
Zhang Zhongjing stated that Shanghan (Cold Damage) comprises five types. Its differentiation should begin with the differentiation of Taiyang disease (diseases caused by pathogenic factors affecting the Taiyang channel). However, there are indeed cases where the disease does not necessarily originate from Taiyang. Furthermore, even if it originates from Taiyang, there are instances of transmission and non-transmission. Zhang Zhongjing regarded a quiet disease state as non-transmission. If the pathogen transmits to the Stomach, it ceases further transmission. Even within the process of channel transmission, one cannot rigidly adhere to the notion that Yangming disease (diseases caused by pathogenic factors affecting the Yangming channel) must follow Taiyang. There are cases transmitting directly from Taiyang to Shaoyang disease (diseases caused by pathogenic factors affecting the Shaoyang channel), or from Taiyang directly to the Three Yin channels (Taiyin, Shaoyin, Jueyin). There are cases transmitting from Taiyang without involving Yangming but instead to the Fu organ of Taiyang (the Bladder). Moreover, within Fu organ transmission, some transmit to the Qi level (functional aspect), while others transmit to the Blood level (material aspect). There are also cases not originating in Taiyang but transitioning from Yangming to Taiyang, or from Shaoyang to Taiyang. Additionally, there are cases of direct invasion into the Yin channels (cold pathogens directly invading the Three Yin channels), recovery from Yin channels returning to Yang channels, simultaneous transmission of Yin and Yang channels, Yang patterns resembling Yin patterns, and Yin patterns resembling Yang patterns. These variations are too numerous to count. One cannot be constrained by the number of days; rather, one should seek clues based on exterior-interior and Fu-Zang relationships. For instance, if interior patterns (internal organ pathology) appear within one or two days, there is absolutely no rationale for using diaphoretic methods (sweating therapy); if exterior patterns persist after five or six days, there is absolutely no rationale for using purgative methods (draining downward therapy). When interior patterns are more urgent than exterior ones, treat the interior first, then the exterior; when exterior patterns are more urgent than interior ones, treat the exterior first, then the interior. Zhang Zhongjing’s discussions are clear as day. Understanding this method of flexible variation renders the erroneous doctrine of "diaphoresis followed by purgation" obviously false without further explanation.
The teachings of Tao Hua (styled Jie'an) have been prevalent in the world for a long time. People claim that Zhang Zhongjing's scholarship became prominent only through Tao Jie'an. I argue that Zhang Zhongjing's works were subsequently neglected due to Tao Jie'an. This is not a harsh critique. Tao Jie'an devoted his lifelong energy to studying Zhang Zhongjing's *Treatise on Cold Damage*, expending considerable effort, yet ultimately his views were overshadowed by Wang Shuhe (the physician who compiled and edited the *Treatise on Cold Damage and Miscellaneous Diseases*). Consequently, his discussion of Shanghan still identifies it as the "correct cold" contracted in winter, using Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) specifically to explain winter correct cold damage. Regarding warm diseases and heat diseases, he still analyzed illnesses according to solar terms. This merely follows the precepts of the *Preface*, showing that his foundational功夫 (effort/skill) in differentiating Shanghan at the outset was not thorough. His classification of Six Channel differentiation forcibly incorporated the *Neijing* (Inner Canon) method for hot diseases, mixing it indistinguishably with Zhang Zhongjing's Shanghan methodology. His discussion on pulse diagnosis is particularly debatable. Zhang Zhongjing's primary method for identifying diseases relies entirely on the mutual reference of pulse and symptoms to ascertain the etiology accurately. The chapters on Differentiating Pulses and Calming Pulses in his work are subtle and profound; how could one penetrate their mysteries without deep spiritual contemplation? Furthermore, his pulse methods scattered throughout the Six Channel chapters must be understood in conjunction with specific symptoms. Tao Jie'an, however, claimed that one need only rely on the Floating, Middle, and Sinking positions of the three pulses, and whether they are forceful or feeble under the fingers, to differentiate exterior-interior, Yin-Yang, cold-heat, and deficiency-excess. Little did he know that this is merely the general outline of pulse taking, insufficient to exhaust the variations of pathological conditions. Most absurdly, he asserted that Xiaochaihu Tang (Minor Bupleurum Decoction) could universally treat epidemic warm diseases and seasonal disorders, adding Jiedu Tang (Detoxification Decoction) for severe heat, without needing to examine the pulse. Such diseases would naturally resolve with sweating and cooling after one seven-day cycle, or two or three cycles. If one believes this, there is no need to differentiate which channel or pattern is involved, nor to examine the three pulse positions or their forcefulness. One simply uses Xiaochui Tang and waits for spontaneous recovery after a prolonged period. Once this theory is established, mild cases may take longer to recover, and severe cases may become incurable even with later treatment. Yet this book became popular in later generations precisely because people avoid difficulty and seek ease; who would not gladly follow such a simple method? In his preface, Tao Jie'an stated that future colleagues need only study this book carefully and need not collect miscellaneous prescriptions or read other treatises, clearly teaching people not to re-read Zhang Zhongjing's works. Consider how could Zhang Zhongjing's profound insights be fully elucidated? Even if one diligently teaches others to learn from Zhang Zhongjing, people still fear difficulty and hesitate. Now, the collected prescriptions and theories in this book, even if thoroughly exhaustive, merely pick up dregs while discarding the essence. Is it not better to eagerly pursue the source of Zhang Zhongjing? As the saying goes: "Aim high, and you may reach the middle." To learn Shanghan, apart from Zhang Zhongjing, whom else can one turn to?