伤寒传经一日太阳二日阳明三日少阳四日太阴五日少阴六日厥阴日传一经亦与温病相同所谓发于阳者七日愈发于阴
者六日愈一定之数也六日经尽邪退正复汗出而解伤寒之常其与温病不同者温病邪感于经络而热生于脏腑伤寒中风原无里
邪不必定传脏腑阳旺而后传腑阴旺而后传脏(名曰传腑传脏实脏腑之自病也)此不同也太阳经所谓伤寒一日太阳受之脉
若静者为不传此不传三阴之脏也伤寒二三日阳明少阳证不见者为不传此不传阳明之腑也少阳篇所谓伤寒三日少阳脉小者
欲已也此不传阳明之腑也伤寒三日三阳为尽三阴当受邪其人反能食不呕此为三阴不受邪此不传三阴之脏也伤寒中风不传
脏腑则有之无不传经之理程氏以为伤寒不传经果不传经则仲景所谓发于阳者七日愈发于阴者六日愈太阳病头痛至七日以
上自愈者以行其经尽故也诸语不尽相刺缪乎人之里气无亏二三日内或经传阳明而汗解或经传少阳而汗解亦偶尔见之此不
过千百之十一未可以概寻常伤寒之家也
伤寒六经既尽自然汗解其六七日后经尽而不解者此非阳盛而入腑即阴盛而入脏也程氏以为伤寒无定经而其传其解亦
无定日或从太阳而阳明或从太阳而少阳不必挨经或数日方过阳明或数日仍在太阳不必刻期或从太阳而解或从阳明而解不
必遍周此皆入腑入脏之病而误以为经病故议论悖缪如此表邪汗解则已未经汗解则经热内郁日积日盛明日自当传于阳明后
日自当传于少阳六日六经必然之事以六经部次相挨经热不泄势必挨经而内传安有数日犹在太阳数日方过阳明之理又安有
或从太阳而阳明或从太阳而少阳之理更安有或从太阳而解或从阳明而解之理惟入腑入脏则传无定所解无定期邪盛则传正
复则解耳程氏较伤寒诸家稍有几微之明而误以里病为经病其于病传病解之际语语悖缪他如节 嘉言辈则梦魇之人耳
伤寒病的传经规律,第一天在太阳经,第二天在阳明经,第三天在少阳经,第四天在太阴经,第五天在少阴经,第六天在厥阴经。每天传递一经,这与温病(温热性质的疾病)的规律相同。所谓“发于阳”的病证,第七日痊愈;“发于阴”的病证,第六日痊愈。这是固定的定数。六天经络之气运行完毕,邪气衰退,正气恢复,通过出汗而病解,这是伤寒病的常理。
它与温病不同的地方在于:温病的邪气感受于经络,但热邪产生于脏腑;而伤寒中风原本没有里邪(体内之邪),不一定非要传入脏腑。只有阳气旺盛时才传入腑,阴气旺盛时才传入脏(名义上叫传入腑或脏,实际上是脏腑自身的病变)。这就是不同之处。
《太阳篇》说:“伤寒第一天,太阳经受邪,如果脉象平静,说明不传变。”这种不传变是指不传入三阴经的脏。
伤寒二三天,如果没有出现阳明经和少阳经的症状,说明不传变。这种不传变是指不传入阳明经的腑。
《少阳篇》说:“伤寒第三天,少阳脉象变小,是病欲愈的征兆。”这也是指不传入阳明经的腑。
伤寒第三天,三阳经的病程已经结束,三阴经应当受邪。如果病人反而能进食且不呕吐,这说明三阴经不受邪。这种不传变是指不传入三阴经的脏。
伤寒中风如果不传入脏腑,那是有可能的;但没有不传经的道理。程氏认为伤寒不传经,如果真的不传经,那么张仲景所说的“发于阳者七日愈,发于阴者六日愈”,以及“太阳病头痛持续七天以上自愈,是因为行经已尽”等话语,岂不是互相矛盾吗?
人的里气如果没有亏损,在二三日内,或者经过传变到阳明经后通过汗法解表,或者经过传变到少阳经后通过汗法解表,这也是偶尔见到的情况。但这不过是千百例中才有一例的情况,不可以用这种情况来概括普通的伤寒患者。
伤寒六经的病程既然结束,自然会通过出汗而病解。如果在六七日后,经络之气已尽但病仍未解,这不是因为阳气盛而传入腑,就是因为阴气盛而传入脏。
程氏认为伤寒没有固定的传经规律,其传变和解愈也没有固定的日子。有的从太阳经传到阳明经,有的从太阳经传到少阳经,不必按顺序挨着传;有的过几天才经过阳明经,有的过几天仍在太阳经;不必限定日期;有的从太阳经解表,有的从阳明经解表,不必遍传所有经络。这些都是将传入腑、脏的病误认为是传经的病,所以议论荒谬悖乱如此。
表邪通过汗法解除了也就罢了;如果没有通过汗法解除,那么经络中的热邪就会内郁,一天天积累,一天天增强。明天自然应当传入阳明经,后天自然应当传入少阳经。六天内六经依次传遍,这是必然的事情。因为六经的部位次序是相邻的,经络中的热邪不得宣泄,势必会按顺序向内传变。怎么会有几天还在太阳经、几天才经过阳明经的道理呢?又怎么会有有的从太阳经传到阳明经、有的从太阳经传到少阳经的道理呢?更怎么会有有的从太阳经解表、有的从阳明经解表的道理呢?
只有传入腑、脏,传变就没有固定的处所,解愈就没有固定的日期。邪气盛则传变,正气恢复则解愈。程氏比较其他研究伤寒的医家稍微有一点明白的地方,但是错误地把里病当作经病,他在关于病传变和病解愈的问题上,每一句话都荒谬悖乱。其他人如节庵、嘉言等人,简直就是像做噩梦的人一样糊涂。
The general principles of the transmission of meridians in Cold Damage (Shanghan) disease: On the first day, it is in the Taiyang meridian; on the second day, in the Yangming meridian; on the third day, in the Shaoyang meridian; on the fourth day, in the Taiyin meridian; on the fifth day, in the Shaoyin meridian; and on the sixth day, in the Jueyin meridian. It transmits one meridian per day, which is the same as the pattern in Warm Disease (Wenbing). It is said that diseases "originating from Yang" heal on the seventh day, and those "originating from Yin" heal on the sixth day. This is a fixed number. After six days, the circulation through the meridians is complete, the pathogenic factor recedes, the healthy qi recovers, and the disease resolves through sweating. This is the normal course of Cold Damage disease.
The difference between it and Warm Disease lies in the following: In Warm Disease, the pathogenic factor affects the meridians, but the heat generates within the Zang-Fu organs. In contrast, Cold Damage and Wind Strike originally have no interior pathogenic factors and do not necessarily transmit to the Zang-Fu organs. Transmission to the Fu organs occurs only when Yang qi is vigorous, and transmission to the Zang organs occurs only when Yin qi is vigorous (nominally called transmission to Fu or Zang, but actually it is a self-disease of the Zang-Fu organs). This is the point of difference.
In the *Taiyang Chapter*, it states: "On the first day of Cold Damage, the Taiyang meridian is affected. If the pulse remains tranquil, it indicates no transmission." This non-transmission refers to the non-transmission to the Zang organs of the Three Yin meridians.
If, on the second or third day of Cold Damage, there are no signs of the Yangming or Shaoyang meridians, it indicates no transmission. This non-transmission refers to the non-transmission to the Fu organs of the Yangming meridian.
In the *Shaoyang Chapter*, it states: "On the third day of Cold Damage, if the Shaoyang pulse is small, the disease is about to resolve." This also refers to the non-transmission to the Fu organs of the Yangming meridian.
On the third day of Cold Damage, the course of the Three Yang meridians is completed, and the Three Yin meridians should be affected. If the patient can eat and does not vomit, it indicates that the Three Yin meridians are not affected by the pathogen. This non-transmission refers to the non-transmission to the Zang organs of the Three Yin meridians.
It is possible for Cold Damage or Wind Strike not to transmit to the Zang-Fu organs, but there is no principle of not transmitting through the meridians. Cheng believed that Cold Damage does not transmit through the meridians. If it truly did not transmit, then Zhang Zhongjing's statements such as "those originating from Yang heal in seven days, those originating from Yin heal in six days," and "Headache in Taiyang disease persists for more than seven days and heals spontaneously because the meridian cycle has been exhausted" would contradict each other.
If the interior qi of a person is not deficient, within two or three days, the disease might resolve through sweating after transmitting to the Yangming meridian, or resolve through sweating after transmitting to the Shaoyang meridian. However, this is seen only occasionally. This accounts for only one in a thousand cases and cannot be used to generalize ordinary cases of Cold Damage.
After the Six Meridians of Cold Damage have completed their course, they naturally resolve through sweating. If, after six or seven days, the meridian course is complete but the disease does not resolve, this is either due to excess Yang transmitting to the Fu organs or excess Yin transmitting to the Zang organs.
Cheng believed that Cold Damage has no fixed meridian of transmission, and its transmission and resolution have no fixed days. Some may transmit from Taiyang to Yangming, or from Taiyang to Shaoyang, without needing to follow the sequential order; some may take several days to pass through Yangming, or remain in Taiyang for several days, without adhering to specific timelines; some may resolve from Taiyang, others from Yangming, without needing to circulate through all meridians. These are all illnesses that have transmitted to the Fu and Zang organs but were mistakenly considered as meridian transmissions, leading to such absurd and contradictory discussions.
If the exterior pathogen resolves through sweating, so be it. If it does not resolve through sweating, the heat within the meridians will stagnate internally, accumulating day by day and growing stronger. The next day, it will naturally transmit to the Yangming meridian, and the day after, to the Shaoyang meridian. The sequential transmission through the Six Meridians within six days is an inevitable event. Since the Six Meridians are arranged in adjacent order, if the meridian heat is not vented, it will inevitably transmit inward in sequence. How could there be a principle of remaining in the Taiyang meridian for several days or passing through Yangming only after several days? How could there be a principle of transmitting from Taiyang to Yangming or from Taiyang to Shaoyang arbitrarily? Furthermore, how could there be a principle of resolving from Taiyang or from Yangming arbitrarily?
Only when transmitting to the Fu and Zang organs is there no fixed location for transmission and no fixed period for resolution. When the pathogenic factor is strong, transmission occurs; when the healthy qi recovers, resolution occurs. Compared to other scholars studying Cold Damage, Cheng had slightly more insight, but he mistakenly treated interior diseases as meridian diseases. His statements regarding the transmission and resolution of diseases are entirely contradictory and erroneous. Others, such as Jie [An] and Jiayan, are like people suffering from nightmares.