风寒二气。有阴阳之分。又相因为患。盖风中无寒。即是和风。一夹寒邪。中人而病。故得与伤寒相类。亦得
以伤寒名之。所以四时皆有风寒。而冬月为重也。伤寒中风。各有重轻。不在命名。而在见症。太阳篇。言中风脉
症者二。一日太阳中风。阳浮而阴弱。阳浮者热自发。阴弱者汗自出。啬啬恶寒淅淅恶风。翕翕发热。鼻鸣干呕者。
桂枝汤主之。一日太阳中风。脉浮紧。发热恶寒。身疼痛。不汗出而烦躁者。大青龙汤主之。以二症相较。阳浮见
寒之轻。浮紧见寒之重。汗出见寒之轻。不汗出见寒之重。啬啬淅淅。见风寒之轻。翕翕见发热之轻。发热恶寒。
见寒热之俱重。鼻鸣见风之轻。身疼见风之重。自汗干呕。见烦之轻。不汗烦躁。见烦之重也。言伤寒脉症者二。
一曰太阳病。或未发热。或已发热。必恶寒体痛呕逆。脉阴阳俱紧者。名曰伤寒。脉浮自汗出。小便数。心烦。微
恶寒。脚挛急。以二症相较。微恶寒。见必恶寒之重。体痛。觉脚挛急之轻。自汗出。小便数。心烦。见伤寒之轻。
或未发热。见发热之难。必先呕逆。见伤寒之重。脉浮。见寒之轻。阴阳俱紧。见寒之重。中风伤寒。各有轻重如
此。今人必以伤风为轻。中风为重。但知分风寒之中伤。而不辨风寒之轻重。于是有伤寒见风中风见寒之遁辞也。
夫风为阳邪。寒为阴邪。虽皆因于时气之寒。而各不失其阴阳之性。故伤寒轻者。全似中风。独脚挛急不是。盖腰
以上为阳。而风伤于上也。中风重。全似伤寒。而烦躁不是。盖寒邪呕而不烦。逆而不燥也。然阴阳互根。烦为阳
邪。烦极至躁。躁为阴邪。躁极致烦。故中风轻者烦轻。中风重者烦躁。伤寒重者躁烦。伤风重者微烦。微烦则恶
寒亦微。是微阳足以胜微寒。故脉浮不紧矣。如本论所云。凡欲自解者。必当先烦。乃有汗而解。以脉浮不紧。故
知汗出解也。若不待自解。而妄攻其表。所以亡阳。因阳微故耳。凡伤寒见烦。则寒气欲解。躁烦是阳为寒郁。而
邪转盛。故伤寒一日。若躁烦者为欲传。六七日躁烦者。为阳去入阴也。因病入所禀之阳气有不同。而受邪之部位
阴阳更不类。故阳有多少。热有微甚。如太阳为先天之巨阳。其热发于荣卫。故一身手足壮热。阳明乃太少两阳相
合之阳。其热发于肌肉。故蒸蒸发热。少阳为半表之阳。其热发于腠理。时开时合。故往来寒热。此三阳发热之差
别也。太阴为至阴。无热可发。因为胃行津液。以灌四旁。故得主四肢而发热于手足。所以太阴伤寒手足自温。太
阴中风四肢烦疼耳。少阴为封蛰之本。若少阴不藏。则坎阳无蔽。故有始受风寒。而脉沉发热者。或始无表热。八
九日来。热入膀胱。致一身手足尽热者。厥阴当两阴交尽。一阳之初生。其伤寒者。有从阴而先厥后热者。有从阳
而先热后厥者。或阳进而热多厥少。或阳退而热少厥多。或阴阳和而厥与热相应者。是三阴发热之差别也。太阳为
父。多阳盛之病。如初服桂枝而反烦解。半日许而后烦。下之而脉仍浮。气上撞。与不汗出而烦躁。服药微除而烦
瞑发衄者。皆阳气重故也。少阴为雌。多亡阳之病。如下利清谷。手足厥逆。脉微欲绝。恶寒蜷卧。吐利汗出。里
寒外热。不烦而躁。皆亡阳故也。又内经病形篇云。邪中于项。则下太阳。中于面。则下阳明。中于颊。则下少阳。
其中膺背两胁。亦中其经。故本篇太阳受邪。有中项。中背之别。中项则头项强痛。中背。则背强KT KT 也。阳明
有
中面中膺之别。中面则目痛鼻干。中膺则胸中胁下痞硬也。此岐伯中阳溜经之义。又云。邪中于阴。从臂 始。自经
及脏。藏气实而不能容。则邪还于府。故本篇论三阴。皆有自利症。是寒邪还府也。三阴皆有可下症。是热邪还府
也。此岐伯中阴溜府之义。六经之部位有高下。故受邪之日有远近。太阳为三阳居表。位最高。最易伤寒。故一日
受。阳明为二阳而居前。故二日受。少阳为一阳而居侧。故三日受。太阴为三阴。居阴位最高。故四日受。少阴为
二阴。居阴位之中。故五日受。厥阴为一阴。居三阴之尽。故六日受。此皆言见症之期。非六经以次相传之日也。
内经曰。气有高下。病有远近。适其至所。即此义也。按本论传字之义。各各不同。必牵强为传经之谬。伤寒一日。
太阳受之。脉若静者为不传。是指热传本经。不是传阳明之经络。阳明无所复传。始虽恶寒。二日自止。是止寒传
本经。不是传少阳之经络。阳明无所复传。始虽恶寒。二日自止。是止寒传本经。不是传少阳之经络。伤寒二三日。阳明少阳症不见者。为不传。皆指热传本经。不是二日传阳明。三日传少
阳之谓。太阳病至七日以上自愈者。以行其经尽故也。言七日当来复之辰。太阳一经之病当尽。非日传一经也。七
日复传太阳之谓。若复传则不当曰尽。若日传一经。则不当日行其经矣。若欲再作经。是太阳不罢。而并病阳明。
使经不传。是使阳明之经。不传太阳之热。非再传少阳之谓也。太阳与阳明少阳地面相近。故太阳之盛而不罢。使
转属阳明。阳已衰而不罢。使转系少阳。若阳陷则转系太阴。阳虚则转入少阴。阳逆则转入厥阴矣。阳明万物所归。
故六经皆得转属。而阳明无所复传。是知阳明无转属少阳之病。阳明太阴。俱属于胃。胃实则太阴转属阳明。胃虚
则阳明转属太阴矣。少阴与二阴地面相近。受太阴之寒。则吐利清谷。受厥阴之热。则咽痛便血也。厥阴为阴之
尽。亦如阳明之无复传。然阴出之阳。则热多厥少。阴极亡阳。则热少厥多。此即少阳往来寒热之变局。按本论云。
太阳病发热汗出恶风。脉缓者。为中风。又云。太阳中风。脉浮紧。不汗出而烦躁。又云。阳明中风。脉弦浮大不
得汗。合观之。不得以无汗谓非中风矣。本论云。太阳病。或未发热。或已发热。必恶寒。体痛。呕逆。脉阴阳俱
紧者。名曰伤寒。而未尝言无汗。又云。太阳病。头痛发热。身疼腰痛。骨节疼痛。恶风无汗而喘者。麻黄汤主之。
此不冠伤寒。又不言恶寒。又云伤寒脉浮。自汗出。微恶寒。合观之。又不得以有汗非伤寒矣。今人但据桂枝条之
中风自汗。而不究伤寒亦有自汗出者。强以麻黄症为无汗之伤寒。而不究中风最多无汗者。谓伤寒脉浮紧。中风脉
浮缓。而不知伤寒亦有浮缓。中风亦有浮紧者。知三阳脉浮。三阴脉沉。而不知三阴皆有浮脉。三阳亦有沉脉者。
总是据一条之说。不理会全书耳。当知麻黄汤。大青龙汤。治中风之重剂。桂枝汤。葛根汤。治中风之轻剂。伤寒
可通用之。非主治伤寒之剂也。世皆推桂枝汤。为中风主剂。而不敢以大青龙为中风之剂者。是惑于中风见寒。伤
寒见风之谬。不敢以麻黄汤。为中风之剂者。是泥于有汗为中风。无汗为伤寒之谬也。风为阳邪。因四时之气而变迁。
且一日亦具四时之气。而运更有郁复淫胜之不同。故有麻黄桂枝葛根青龙等法。当知四时俱有中风伤寒。不得拘春
伤于风。冬伤于寒之一说也。太阳经多中风方。麻黄附子细辛真武附子茱萸白通四逆通脉等汤是也。中风诸方可移
治伤寒。伤寒诸方不可治中风者。寒可温而风不可以热治也。风为阳邪。故中风者。在少阴每多阳症。寒为阴邪。
故伤寒者。虽在太阳每多阴症。太阳经多中风症。阳从阳也。少阴经多伤寒症。阴从阴也。夫风者善行而数变。故
脉症皆不可拘。自变者观之。其症或自汗鼻鸣。或无汗而喘。或不汗出而烦躁。或下利呕逆。或渴欲饮水。或往来
寒热。或口舌咽干。或短气腹满。鼻干嗜卧。或目赤耳聋。胸满而烦。或四肢烦疼。种种不同。其脉或浮缓。或浮
紧。或弦而浮大。或阳微阴涩。或阳微阴浮。亦种种不同。自不变也观之。惟浮是中风之主脉。恶风是中风之定
症。盖风脉变态不常。而浮为真体。风症变幻多端。而恶风其真情也。仲景广设诸方。以曲尽常变耳。夫寒之伤人
也有三。早晚雾露。四时风雨。冬春霜雪。此天之寒气也。幽居旷室。砖地土 。大江深泽。邃谷名山。地之寒气
也。好饮寒泉。喜食生冷。酷嗜瓜果。误服冷药。人之寒气也。此义最浅。伤寒诸书莫之或及。而以冬寒春温。时疫
之症掩之。何不求致病之因。而归时令之变耶。夫寒固为冬气。三时岂必无寒。第寒有轻重。伤亦有轻重。不拘定
于冬。温固为春气。而三时亦病温。且温随时而发者多。因冬月伤寒所致者少。不可谓必然之道也。即冬时病温。
亦因其人阴虚而发。岂冬时之暖气。即有毒以伤人乎。若时行疫气。正天地温热之毒。如凉风一起。疫即自散。岂
遇寒而反重耶。疫与寒。为风马牛不相及。何得以寒冠时行之疫。若为暴寒所折而病。即是三时之伤寒。勿得忘以
疫名之矣。谓三四月阳气尚弱。为寒折而病热轻。五六月阳气已盛。为寒折而病热重。七八月阳气已衰。为寒折而
病热微。此叔和之莫须有也。夫病寒病热。当审其人阴阳之盛衰。不得拘天时之寒热。天气之寒热以伤人。必因其
人阴阳之多少。元气之虚实为轻重。不全凭时令之阴阳为转移也。所以仲景立方。全以平脉辨症为急务。不拘于受
病之因。不拘于发病之时为施治。如夏月盛暑。而伤寒吐利。多有用姜附吴萸而始效。隆冬严寒而病温。多有用石
膏硝黄而热乃解者。谓麻黄桂枝二汤。只宜于冬月之正伤寒。三时不可轻用。其失岂不多乎。夫开口言伤寒。动手
反用寒凉克伐之剂。曷不于伤寒二字顾名思义耶。寒伤于表。法当温散。寒伤于里。法当温补。仲景治伤寒。只有
温散温补二法。其清火凉解吐下等法。正为温暑时疫而设。所以治热。非以治寒。治热淫于内。非治寒伤于表也。
今伤寒家皆曰。仲景治温治暑。必另方治法。今遗失而无征。伤寒只有汗吐下三法。将温补正法。置之不用。反曰
治伤寒无补法。于是人伤于天地之寒者轻。复伤于医师之法者重。死于寒食之内伤者少。死于寒药之内伤者多耳。
风寒两种邪气，有阴和阳的区别，又常常互为因果导致疾病。大概风中如果没有寒邪夹杂，就是温和之风；一旦夹带寒邪，侵袭人体致病，所以容易与伤寒混淆，也可以称之为伤寒。因此四季都有风寒之邪，而冬季最为严重。
伤寒和中风，各有轻重之分，这不在于名称，而在于临床表现。《太阳篇》中论述中风脉症的有两处：第一处说太阳中风，脉象阳浮而阴弱。阳浮代表热自发，阴弱代表汗自出，伴有怕冷、怕风的感觉，发热轻微，鼻鸣，干呕的，用桂枝汤主治。第二处说太阳中风，脉象浮紧，发热恶寒，身体疼痛，无汗且烦躁的，用大青龙汤主治。将这两个症状比较来看：脉象阳浮显示寒邪较轻，脉象浮紧显示寒邪较重；有汗显示寒邪较轻，无汗显示寒邪较重；啬啬（畏缩寒冷貌）、淅淅（洒洒恶风貌）显示风寒较轻，翕翕（温热貌）显示发热较轻；发热恶寒同时出现显示寒热都重；鼻鸣显示风邪较轻，身体疼痛显示风邪较重；自汗、干呕显示烦扰较轻，无汗、烦躁显示烦扰较重。
论述伤寒脉症的也有两处：一处说太阳病，或者还没发热，或者已经发热，必定恶寒，身体疼痛，呕吐逆气，脉象阴阳俱紧的，名叫伤寒。另一处说脉象浮，自汗出，小便频数，心烦，微恶寒，脚部拘挛急迫的。将这两个症状比较来看：微恶寒，说明“必恶寒”的情况更重；身体疼痛，相比脚部拘挛急迫显得轻；自汗出、小便数、心烦，显示伤寒较轻；或者未发热，显示发热困难（病情深重）；必须先呕吐逆气，显示伤寒较重；脉浮显示寒邪较轻，阴阳俱紧显示寒邪较重。中风和伤寒的轻重情况如此。现在的人一定认为伤风是轻证，中风是重证，只知道区分风寒是被风伤还是被寒伤，却不辨别风寒本身的轻重，于是就有了“伤寒见风症、中风见寒症”这种推脱责任的借口。
风是阳邪，寒是阴邪，虽然都因时令寒气引起，但各自不失其阴阳的属性。所以伤寒轻者，完全像中风，只有脚部拘挛急迫这一点不像。因为腰以上属阳，风邪伤害上部。中风重者，完全像伤寒，只有烦躁这一点不像。因为寒邪致呕而不烦，致逆而不燥。然而阴阳互根，烦属于阳邪，烦极至躁，躁属于阴邪，躁极致烦。所以中风轻者烦轻，中风重者烦躁；伤寒重者躁烦，伤风重者微烦。微烦则恶寒也微，这是微弱的阳气足以战胜微弱的寒邪，所以脉象浮而不紧。如《本论》所说，凡是想要自愈的，必定先出现烦，然后才有汗出而解，因为脉象浮而不紧，所以知道是汗出而解。如果不等待自愈，而妄自攻伐其表，就会导致亡阳，这是因为阳气微弱的原因。凡是伤寒出现烦，说明寒气将要解除；躁烦则是阳气被寒邪郁遏，而邪气转盛。所以伤寒第一天，如果出现躁烦，是欲传变；六七天出现躁烦，是阳气离去进入阴经。因为病人禀受的阳气不同，受邪的部位阴阳也不相同，所以阳气有多寡，热势有微甚。
太阳为先天巨阳，其热发于营卫，所以一身手足壮热。阳明乃太少两阳相合之阳，其热发于肌肉，所以蒸蒸发热。少阳为半表之阳，其热发于腠理，时开时合，所以往来寒热。这是三阳发热的区别。太阴为至阴，无热可发，因为胃行津液以灌溉四旁，所以主管四肢而在手足发热，因此太阴伤寒手足自温，太阴中风四肢烦疼。少阴为封蛰之本，如果少阴不藏，则坎阳无蔽，所以有的开始受风寒，脉沉发热；有的开始无表热，八九天后来，热入膀胱，致一身手足尽热。厥阴当两阴交尽，一阳初生，其伤寒者，有从阴而先厥后热的，有从阳而先热后厥的，或者阳进而热多厥少，或阳退而热少厥多，或阴阳调和而厥与热相应。这是三阴发热的区别。
太阳为父，多阳盛之病，如初服桂枝汤反而烦解，半天左右后又烦，下之后脉仍浮，气上撞心，以及无汗而烦躁，服药后症状稍减但出现烦闷、昏睡、鼻衄的，都是阳气重的缘故。少阴为雌，多亡阳之病，如下利清谷，手足厥逆，脉微欲绝，恶寒蜷卧，吐利汗出，里寒外热，不烦而躁，都是亡阳的缘故。
又《内经·病形篇》说，邪气中于项部，则下入太阳；中于面部，则下入阳明；中于颊部，则下入少阳。其中于胸膺、背部、两胁的，也中及其经络。所以本篇太阳受邪，有中项、中背的区别。中项则头项强痛，中背则背强僵硬。阳明有中面、中膺的区别，中面则目痛鼻干，中膺则胸中胁下痞硬。这是岐伯所说的“中阳溜经”的道理。又说，邪气中于阴，从臂开始，由经及脏。脏气实而不能容纳，则邪还归于腑。所以本篇论三阴，都有自利的症状，这是寒邪还府。三阴都有可下的症状，这是热邪还府。这是岐伯所说的“中阴溜府”的道理。
六经的部位有高下之分，所以受邪的日子有远近。太阳为三阳居表，位置最高，最容易受寒，所以第一天受邪。阳明为二阳而居前，所以第二天受邪。少阳为一阳而居侧，所以第三天受邪。太阴为三阴，居阴位最高，所以第四天受邪。少阴为二阴，居阴位之中，所以第五天受邪。厥阴为一阴，居三阴之尽，所以第六天受邪。这都是指出现症状的时期，不是六经依次相传的日子。《内经》说，气有高下，病有远近，适其至所，就是这个意思。
按《本论》中“传”字的含义，各不相同，必须牵强附会地认为是传经，这是谬误。伤寒第一天，太阳受之，脉若静者为不传，是指热传本经，不是传阳明之经络。阳明无所复传，开始虽恶寒，第二天自然停止，是止寒传本经，不是传少阳之经络。伤寒二三日，阳明少阳症不见的，为不传，皆指热传本经，不是第二天传阳明，第三天传少阳。太阳病至七日以上自愈的，是因为行其经尽的缘故。言七日当来复之辰，太阳一经之病应当结束，不是日传一经。七日后复传太阳的说法不对，如果复传就不应当说“尽”。如果日传一经，就不应当说“行其经矣”。如果想再作经，是太阳不罢，而并病阳明，使经不传，是使阳明之经不传太阳之热，不是再传少阳。太阳与阳明、少阳地面相近，所以太阳之盛而不罢，使转属阳明；阳已衰而不罢，使转系少阳。若阳陷则转系太阴，阳虚则转入少阴，阳逆则转入厥阴。阳明万物所归，所以六经皆得转属，而阳明无所复传，是知阳明无转属少阳之病。阳明、太阴俱属于胃，胃实则太阴转属阳明，胃虚则阳明转属太阴。少阴与二阴地面相近，受太阴之寒，则吐利清谷；受厥阴之热，则咽痛便血。厥阴为阴之尽，亦如阳明之无复传。然阴出之阳，则热多厥少；阴极亡阳，则热少厥多。此即少阳往来寒热之变局。
按《本论》说，太阳病发热汗出恶风，脉缓者，为中风。又说，太阳中风，脉浮紧，不汗出而烦躁。又说，阳明中风，脉弦浮大不得汗。合观之，不能因为没有汗就说不属于中风。《本论》说，太阳病，或未发热，或已发热，必恶寒，体痛，呕逆，脉阴阳俱紧者，名曰伤寒，而未尝言无汗。又说，太阳病，头痛发热，身疼腰痛，骨节疼痛，恶风无汗而喘者，麻黄汤主之。此不冠伤寒，又不言恶寒。又说伤寒脉浮，自汗出，微恶寒。合观之，又不能因为有汗就说不是伤寒。现在的人只根据桂枝条的中风自汗，而不探究伤寒也有自汗出的情况，强行把麻黄症定为无汗之伤寒，而不探究中风最多无汗的情况，谓伤寒脉浮紧，中风脉浮缓，而不知伤寒亦有浮缓，中风亦有浮紧者。知三阳脉浮，三阴脉沉，而不知三阴皆有浮脉，三阳亦有沉脉者，总是依据一条之说，不理会全书罢了。应当知道麻黄汤、大青龙汤，是治疗中风的重剂，桂枝汤、葛根汤，是治疗中风的轻剂，伤寒可通用之，并非主治伤寒的方剂。世人都推崇桂枝汤为中风主剂，而不敢以大青龙汤为中风之剂的，是惑于“中风见寒、伤寒见风”的谬误；不敢以麻黄汤为中风之剂的，是泥于“有汗为中风、无汗为伤寒”的谬误。
风为阳邪，因四时之气而变迁，且一日亦具四时之气，而运更有郁复淫胜的不同，故有麻黄、桂枝、葛根、青龙等法。应当知道四时俱有中风伤寒，不得拘泥于“春伤于风，冬伤于寒”这一说法。太阳经多中风方，如麻黄附子细辛汤、真武汤、附子茱萸汤、白通汤、四逆汤、通脉汤等。中风诸方可移治伤寒，伤寒诸方不可治中风者，因为寒可温而风不可以热治。风为阳邪，故中风者在少阴每多阳症；寒为阴邪，故伤寒者在太阳每多阴症。太阳经多中风症，阳从阳也；少阴经多伤寒症，阴从阴也。
夫风善行而数变，所以脉症皆不可拘。从自变的症状看，其症或自汗鼻鸣，或无汗而喘，或不汗出而烦躁，或下利呕逆，或渴欲饮水，或往来寒热，或口舌咽干，或短气腹满，鼻干嗜卧，或目赤耳聋，胸满而烦，或四肢烦疼，种种不同。其脉或浮缓，或浮紧，或弦而浮大，或阳微阴涩，或阳微阴浮，亦种种不同。从不变的症状看，惟浮是中风之主脉，恶风是中风的定症。盖风脉变态不常，而浮为真体；风症变幻多端，而恶风是其真情。仲景广设诸方，以曲尽常变耳。
夫寒之伤人有三：早晚雾露，四时风雨，冬春霜雪，此天之寒气也；幽居旷室，砖地土湿，大江深泽，邃谷名山，地之寒气也；好饮寒泉，喜食生冷，酷嗜瓜果，误服冷药，人之寒气也。此义最浅，伤寒诸书莫之或及，而以冬寒春温、时疫之症掩之，何不求致病之因，而归时令之变耶？夫寒固为冬气，三时岂必无寒？第寒有轻重，伤亦有轻重，不拘定于冬。温固为春气，而三时亦病温，且温随时而发者多，因冬月伤寒所致者少，不可谓必然之道也。即冬时病温，亦因其人阴虚而发，岂冬时之暖气即有毒以伤人乎？若时行疫气，正天地温热之毒，如凉风一起，疫即自散，岂遇寒而反重耶？疫与寒，为风马牛不相及，何得以寒冠时行之疫？若为暴寒所折而病，即是三时之伤寒，勿得忘以疫名之矣。
谓三四月阳气尚弱，为寒折而病热轻；五六月阳气已盛，为寒折而病热重；七八月阳气已衰，为寒折而病热微，此叔和之莫须有也。夫病寒病热，当审其人阴阳之盛衰，不得拘天时之寒热。天气之寒热以伤人，必因其人阴阳之多少，元气之虚实为轻重，不全凭时令之阴阳为转移也。所以仲景立方，全以平脉辨症为急务，不拘于受病之因，不拘于发病之时为施治。如夏月盛暑，而伤寒吐利，多有用姜、附、吴萸而始效；隆冬严寒而病温，多有用石膏、硝、黄而热乃解者。谓麻黄、桂枝二汤，只宜于冬月之正伤寒，三时不可轻用，其失岂不多乎？夫开口言伤寒，动手反用寒凉克伐之剂，曷不于伤寒二字顾名思义耶？寒伤于表，法当温散；寒伤于里，法当温补。仲景治伤寒，只有温散、温补二法，其清火、凉解、吐下等法，正为温暑时疫而设，所以治热，非以治寒，治热淫于内，非治寒伤于表也。今伤寒家皆曰，仲景治温治暑，必另方治法，今遗失而无征。伤寒只有汗、吐、下三法，将温补正法置之不用，反曰治伤寒无补法，于是人伤于天地之寒者轻，复伤于医师之法者重，死于寒食之内伤者少，死于寒药之内伤者多耳。
Wind and cold are two types of pathogenic factors, distinguished by Yin and Yang, and often cause disease in conjunction. Generally, wind without cold is gentle wind; once mixed with cold, it invades the human body causing illness, thus easily confused with Shanghan (Cold Damage) and can also be named as such. Therefore, wind-cold exists in all four seasons, but is most severe in winter.
Shanghan and Fengzhong (Wind Strike) each have degrees of severity, which lies not in their names but in clinical manifestations. In the *Taiyang Chapter*, there are two descriptions of pulse and symptoms for Fengzhong: The first states that Taiyang Fengzhong presents with a floating-yin and weak-yang pulse (Yang floating indicates spontaneous heat, Yin weakness indicates spontaneous sweating), accompanied by aversion to cold, aversion to wind, mild fever, nasal congestion, and dry retching; this is treated with Guizhi Tang (Cinnamon Twig Decoction). The second states that Taiyang Fengzhong presents with a floating-tight pulse, fever, aversion to cold, body pain, absence of sweat, and irritability; this is treated with Da Qinglong Tang (Major Green Dragon Decoction). Comparing these two presentations: A floating-yang pulse indicates lighter cold, while a floating-tight pulse indicates heavier cold; presence of sweat indicates lighter cold, absence of sweat indicates heavier cold; "Sese" (shivering/cold sensation) and "Xixi" (chilly feeling) indicate lighter wind-cold, while "Xixi" (warmth) indicates lighter fever; simultaneous fever and aversion to cold indicate both heavy cold and heat; nasal congestion indicates lighter wind, while body pain indicates heavier wind; spontaneous sweating and dry retching indicate lighter irritability, while absence of sweat and irritability indicate heavier irritability.
There are also two descriptions of pulse and symptoms for Shanghan: One states that Taiyang disease may present without fever or with fever, must include aversion to cold, body pain, vomiting/reversal of Qi, and a pulse that is tight at both Yin and Yang positions; this is named Shanghan. Another describes a floating pulse, spontaneous sweating, frequent urination, mental restlessness, slight aversion to cold, and cramping in the feet. Comparing these: Slight aversion to cold implies that "must aversion to cold" is heavier; body pain is lighter compared to foot cramping; spontaneous sweating, frequent urination, and mental restlessness indicate lighter Shanghan; absence of initial fever indicates difficulty in generating heat (deeper condition); necessity of vomiting/reversal indicates heavier Shanghan; a floating pulse indicates lighter cold, while tightness at both Yin and Yang positions indicates heavier cold. Thus, the severity of Fengzhong and Shanghan varies as described.
Currently, people assume that Shangfeng (Wind Injury) is mild and Fengzhong is severe, knowing only to distinguish between wind-injury and cold-injury, but failing to differentiate the intrinsic severity of wind and cold. This leads to excuses like "Shanghan presenting with wind symptoms" or "Fengzhong presenting with cold symptoms." Wind is a Yang pathogen, and cold is a Yin pathogen. Although both arise from seasonal cold, they retain their respective Yin-Yang natures. Therefore, mild Shanghan resembles Fengzhong completely, except for foot cramping, because the upper body is Yang and wind injures the upper part. Severe Fengzhong resembles Shanghan completely, except for irritability, because cold causes vomiting without irritability and reversal without dryness. However, Yin and Yang are interdependent. Irritability (Fan) is a Yang pathogen; extreme irritability leads to restlessness (Zao), which is a Yin pathogen. Extreme restlessness leads back to irritability. Thus, mild Fengzhong has mild irritability, severe Fengzhong has irritability and restlessness; severe Shanghan has restlessness and irritability, and severe Shangfeng has slight irritability. Slight irritability implies slight aversion to cold, meaning weak Yang can overcome weak cold, resulting in a floating but not tight pulse. As stated in the *Ben Lun* (Original Treatise), when self-resolution occurs, one must first experience irritability, followed by sweating and resolution, because the pulse is floating and not tight. If one does not wait for self-resolution but wrongly attacks the exterior, Yang collapse (Wang Yang) occurs due to weak Yang. When Shanghan presents with irritability, it indicates cold is resolving; restlessness and irritability indicate Yang is constrained by cold and pathogens are flourishing. Thus, on the first day of Shanghan, restlessness and irritability suggest transmission; on the sixth or seventh day, it suggests Yang leaving and entering Yin channels. Because individuals differ in innate Yang Qi and the location of pathogen invasion differs in Yin-Yang nature, Yang Qi varies in quantity, and heat varies in intensity.
Taiyang is the Great Yang of congenital origin; its heat arises from Ying and Wei, causing robust heat in the whole body and limbs. Yangming is the combination of Shaoyang and Taiyang Yang; its heat arises in the muscles, causing steaming heat. Shaoyang is the Half-Exterior Yang; its heat arises in the interstices, opening and closing intermittently, causing alternating chills and fever. These are the differences in heat among the Three Yang channels.
Taiyin is the Ultimate Yin, having no heat to emit; since the Stomach distributes fluids to nourish the four extremities, it governs the limbs and generates heat in the hands and feet. Therefore, in Taiyin Shanghan, the hands and feet remain warm; in Taiyin Fengzhong, the limbs are painful and uncomfortable. Shaoyin is the root of storage; if Shaoyin fails to store, Kan Yang (Kidney Yang) lacks protection. Thus, some initially suffer wind-cold with a deep pulse and fever; others initially have no exterior heat, but after eight or nine days, heat enters the Bladder, causing heat throughout the body and limbs. Jueyin represents the end of Yin and the beginning of Yang. In Jueyin Shanghan, some progress from Yin experiencing cold extremities first then fever, while others progress from Yang experiencing fever first then cold extremities. Some have more heat and fewer cold extremities as Yang advances, or less heat and more cold extremities as Yang retreats, or harmonious Yin-Yang where cold extremities and fever correspond. These are the differences in heat among the Three Yin channels.
Taiyang is the Father, prone to Yang-excess diseases. For example, after taking Guizhi Tang, relief is followed by irritability; half a day later, irritability returns; after purgation, the pulse remains floating, and there is a sensation of Qi rushing upward; or there is absence of sweat with irritability; or after medication, symptoms slightly subside but are followed by drowsiness and epistaxis. All these are due to heavy Yang Qi. Shaoyin is the Female, prone to Yang-collapse diseases, such as diarrhea with undigested food, cold extremities, faint pulse nearly imperceptible, aversion to cold with curling up, vomiting/diarrhea with sweating, interior cold with exterior heat, and restlessness without irritability. All these are due to Yang collapse.
Furthermore, the *Neijing·Bingxing Chapter* states: Pathogens striking the neck enter Taiyang; striking the face enter Yangming; striking the cheeks enter Shaoyang. Those striking the chest, back, and flanks enter their respective meridians. Hence, in this chapter, Taiyang pathogen invasion distinguishes between neck and back strikes. Neck strike causes stiffness and pain in the head and neck; back strike causes stiffness in the back. Yangming distinguishes between face and chest strikes. Face strike causes eye pain and dry nose; chest strike causes fullness and hardness in the chest and hypochondrium. This follows Qibo’s principle of "Yang strikes flow into meridians." It also states: Pathogens striking Yin start from the arm, moving from meridians to Zang organs. If Zang Qi is solid and cannot contain the pathogen, it returns to the Fu organs. Hence, in the discussion of the Three Yin channels, spontaneous diarrhea appears, indicating cold returning to Fu organs. The Three Yin channels also present conditions suitable for purgation, indicating heat returning to Fu organs. This follows Qibo’s principle of "Yin strikes flow into Fu organs."
The locations of the Six Channels vary in height, so the timing of pathogen invasion varies. Taiyang, being the outermost of the Three Yang and highest in position, is most susceptible to cold, hence affected on Day 1. Yangming, being the Second Yang and anterior, is affected on Day 2. Shaoyang, being the First Yang and lateral, is affected on Day 3. Taiyin, being the Third Yin and highest among Yin, is affected on Day 4. Shaoyin, being the Second Yin and central among Yin, is affected on Day 5. Jueyin, being the First Yin and at the end of the Three Yin, is affected on Day 6. These refer to the timing of symptom appearance, not the sequential transmission of the Six Channels. The *Neijing* states: Qi has high and low positions, diseases have near and far origins; reaching the target site follows this principle.
In the *Ben Lun*, the term "transmission" (Chuan) has various meanings. Forcing it into a theory of meridian transmission is erroneous. On Day 1 of Shanghan, Taiyang is affected; if the pulse is quiet, it is not transmitting. This refers to heat staying within the affected channel, not transmitting to Yangming meridians. Yangming has nothing further to transmit; initial aversion to cold stops spontaneously on Day 2, meaning cold transmission to the current channel ceases, not transmission to Shaoyang. If on Days 2-3 of Shanghan, Yangming and Shaoyang symptoms do not appear, it is not transmitting. This all refers to heat staying within the current channel, not Day 2 to Yangming and Day 3 to Shaoyang. Taiyang disease healing after seven days is because the channel cycle is complete ("walking through its course"). Seven days marks the time of recovery; the Taiyang channel disease should end, not daily transmission to a new channel. Saying it transmits back to Taiyang after seven days is incorrect, as "end" implies completion. If it were daily transmission, it would not be called "walking through its course." If it were to restart a cycle, Taiyang would not cease, leading to concurrent disease with Yangming, preventing transmission. This prevents Yangming from receiving Taiyang heat, not transmitting to Shaoyang. Since Taiyang is close to Yangming and Shaoyang, persistent Taiyang excess may transfer to Yangming; declining Yang may attach to Shaoyang. If Yang sinks, it attaches to Taiyin; if Yang deficiency, it enters Shaoyin; if Yang rebels, it enters Jueyin. Yangming is the destination of all things, so all Six Channels can transfer to it, but Yangming has nothing further to transmit. Thus, Yangming does not transmit to Shaoyang. Yangming and Taiyin both belong to the Stomach; if Stomach is excess, Taiyin transfers to Yangming; if Stomach is deficient, Yangming transfers to Taiyin. Shaoyin is close to the other Yin channels; receiving Taiyin cold causes vomiting and diarrhea with undigested food; receiving Jueyin heat causes sore throat and bloody stool. Jueyin is the end of Yin, similar to Yangming having nothing further to transmit. However, if Yin emerges to Yang, there is more heat and fewer cold extremities; if Yin extreme leads to Yang collapse, there is less heat and more cold extremities. This is a variation of Shaoyang's alternating chills and fever.
According to the *Ben Lun*: Taiyang disease with fever, sweating, aversion to wind, and a slow pulse is Fengzhong. Also, Taiyang Fengzhong with a floating-tight pulse, absence of sweat, and irritability. Also, Yangming Fengzhong with a string-like, floating, large pulse and inability to sweat. Observing these together, one cannot say absence of sweat excludes Fengzhong. The *Ben Lun* states: Taiyang disease, whether without fever or with fever, must have aversion to cold, body pain, vomiting/reversal, and a pulse tight at both Yin and Yang positions, named Shanghan, without mentioning absence of sweat. Also, Taiyang disease with headache, fever, body/low back/joint pain, aversion to wind, absence of sweat, and wheezing is treated with Mahuang Tang (Ephedra Decoction). This does not prefix "Shanghan" nor mention aversion to cold. Also, Shanghan with a floating pulse, spontaneous sweating, and slight aversion to cold. Observing these together, one cannot say presence of sweat excludes Shanghan. People today only rely on Guizhi Tang treating Fengzhong with spontaneous sweating, ignoring that Shanghan can also have spontaneous sweating. They force Mahuang syndrome to be defined as Shanghan without sweat, ignoring that Fengzhong often lacks sweat. They claim Shanghan has a floating-tight pulse and Fengzhong has a floating-slow pulse, ignoring that Shanghan can have floating-slow pulses and Fengzhong can have floating-tight pulses. They know Three Yang pulses are floating and Three Yin pulses are sunken, ignoring that Three Yin can have floating pulses and Three Yang can have sunken pulses. This is relying on isolated statements and ignoring the whole book. One should know that Mahuang Tang and Da Qinglong Tang are heavy formulas for treating severe Fengzhong, while Guizhi Tang and Gegen Tang are light formulas for mild Fengzhong; Shanghan can use them generally, but they are not exclusive to Shanghan. The world promotes Guizhi Tang as the main formula for Fengzhong and dares not use Da Qinglong Tang for Fengzhong due to confusion over "Fengzhong showing cold signs, Shanghan showing wind signs." They dare not use Mahuang Tang for Fengzhong due to the fallacy that "sweating is Fengzhong, non-sweating is Shanghan."
Wind is a Yang pathogen, changing with seasons and even within a single day, with varying stagnation and excess. Hence methods like Mahuang, Guizhi, Gegen, and Qinglong exist. One must know that Fengzhong and Shanghan occur in all seasons, not just "Spring wind injury, Winter cold injury." Taiyang channel has many Fengzhong formulas, such as Mahuang Fuzi Xixin Tang, Zhenwu Tang, Fuzi Lizhong Tang, Baitong Tang, Sini Tang, Tongmai Tang, etc. Fengzhong formulas can be adapted for Shanghan, but Shanghan formulas cannot treat Fengzhong, because cold can be warmed, but wind cannot be treated with heat. Wind is Yang, so Fengzhong in Shaoyin often presents Yang syndromes; Cold is Yin, so Shanghan in Taiyang often presents Yin syndromes. Taiyang channel has many Fengzhong syndromes because Yang follows Yang; Shaoyin channel has many Shanghan syndromes because Yin follows Yin.
Wind moves quickly and changes frequently, so pulse and symptoms cannot be rigidly fixed. From variable symptoms: spontaneous sweating/nasal congestion, or no sweat/wheezing, or no sweat/irritability, or diarrhea/vomiting, or thirst/water craving, or alternating chills/fever, or dry mouth/tongue/throat, or shortness of breath/abdominal fullness, dry nose/drowsiness, red eyes/deafness, chest fullness/irritability, or limb pain/uncomfortableness—various forms exist. Pulses may be floating-slow, floating-tight, string-like-floating-large, Yang-micro/Yin-choppy, or Yang-micro/Yang-floating—various forms exist. From invariant aspects: Floating is the main pulse of Fengzhong; aversion to wind is the definitive symptom of Fengzhong. Wind pulses change unpredictably, but floating is the true form; wind symptoms vary greatly, but aversion to wind is the true emotion. Zhang Zhongjing designed numerous formulas to cover constant and variable patterns.
Cold injuring humans comes from three sources: Morning/evening fog/dew, seasonal wind/rain, winter/spring frost/snow—this is Heaven's cold air. Living in dark/empty rooms, brick/earth floors, large rivers/deep marshes, deep valleys/famous mountains—this is Earth's cold air. Drinking cold spring water, eating raw/cold food, loving melons/fruits, mistakenly taking cold medicines—this is Human cold air. This principle is shallow, yet few Shanghan books address it, covering it instead with "Winter cold, Spring warmth, Epidemic diseases." Why not seek the cause of disease and attribute it to seasonal changes? Cold is indeed Winter Qi, but do the other seasons lack cold? Cold has severity, and injury has severity, not limited to Winter. Warmth is indeed Spring Qi, but other seasons also see warmth diseases. Warmth often arises with the season, rarely caused by Winter Shanghan; it is not an absolute rule. Even if warmth occurs in Winter, it is due to individual Yin deficiency, not because Winter warmth is toxic. If epidemic Qi is the toxicity of Heaven/Earth warmth, it disperses with cool wind; why would it worsen with cold? Epidemics and cold are unrelated; why label epidemic Qi with cold? If illness results from sudden cold, it is simply Shanghan in other seasons, not an epidemic.
Suhé claimed: In March/April, Yang Qi is weak, so cold injury results in mild heat; in May/June, Yang Qi is strong, so cold injury results in heavy heat; in July/August, Yang Qi declines, so cold injury results in slight heat. This is Suhé's fabrication. When suffering from cold or heat, one must assess the individual's Yin-Yang balance, not rigidly follow seasonal climate. Climate injures based on individual Yin-Yang quantity and Yuan Qi (Primordial Qi) deficiency/excess, not solely on seasonal Yin-Yang. Therefore, Zhang Zhongjing's prescriptions focus primarily on balancing pulse and differentiating symptoms, not on the cause of infection or timing of onset. For example, in midsummer heat, Shanghan with vomiting/diarrhea often responds to Ginger, Aconite, and Evodia. In deep winter cold, warmth disease often resolves with Gypsum, Mirabilite, and Rhubarb. Claiming Mahuang and Guizhi decoctions are only for Winter Shanghan and should not be used lightly in other seasons is a great error. Speaking of Shanghan but using cold/cooling attacking agents contradicts the name. Cold injuring the exterior requires warming dispersion; cold injuring the interior requires warming tonification. Zhang Zhongjing's treatment of Shanghan uses only warming dispersion and warming tonification. Clearing fire, cooling, purging, and vomiting methods are designed for Warmth, Summerheat, and Epidemics to treat Heat, not Cold. Treating internal Heat excess is not treating exterior Cold injury. Today's Shanghan practitioners claim Zhang Zhongjing had separate methods for Warmth/Summerheat, now lost. They claim Shanghan has only Sweating, Vomiting, and Purging methods, ignoring Warming Tonification, and falsely stating Shanghan has no tonification method. Thus, people injured by Heaven/Earth cold suffer lightly, but suffer heavily from physicians' errors. Few die from internal cold-food injury; many die from internal cold-medicine injury.