太阳之为病。脉浮。头项强痛而恶寒。
此举中风伤寒之总脉总证而言。乃太阳三篇之大纲也。太阳者。膀胱寒水之经也。膀胱曷为称
寒水乎。夫肾者。天一之水也。上古天真论云。肾者主水。聚五脏六腑之精而藏之者也。盖以肾与膀胱。
一脏一腑。相为表里而为一合
也。既为寒水。曷为又称太阳乎。肾为坎水。一阳居于二阴之间。真阳藏于真阴之内。水中有火。谷入于胃。
其清气化而为营。行于脉中。谷入浊气。降于下焦。而肾中之真阳。蒸腾其气。行于脉外。直达皮肤而为
卫气。故膀胱虽为肾脏寒水之腑。而寒水之中。其所以蒸腾发越而为卫气者。则又肾中之真阳也。故卫气
之行。一日一夜。五十周于身。昼行于阳二十五周。夜行于阴二十五周。平旦阴气尽。阳气出于目。目张。则
气上于头。循项下太阳矣。故曰太阳。太阳者。盛阳也。阳不盛。不足以密腠理而卫风寒。故为六经之首。
为皮肤营卫之总统。灵枢营卫生会篇云。太阴主内。太阳主外。生气通天论云。阳者。卫外而为固也。
又曰。阳因而上。卫外者也。皆言太阳之统营卫而为最外之第一层也。脉浮者。脉有浮中沉三候。浮者。其
上候也。浮脉行于肉上而主表。以风寒初入皮毛营卫。邪气在太阳之表。故独盛于上候而脉浮也。足太阳
之脉。起于目内 。上额交巅。从巅络脑。还出别下项。连风府。循肩膊。内挟脊。抵腰中。挟督脉而行。风
寒客之。故头项强痛也。风寒在表则恶寒。皮部论云。邪之始入也。 然起毫毛。开腠理。玉机真藏论云。风
寒客于人。使人毫毛毕直。皮肤闭而为热。当是之时。可汗而发是也。言恶寒而不言恶风者。以恶寒者未必不恶风。
恶风者未尝不恶寒。举一即可该其义也。此条见症。为中风伤寒之所并有。故总举之为篇首。至太阳上编。则由此
脉证而申出中风诸证。以别风伤卫者如此。中篇亦由此脉证而申出伤寒诸证。以见寒伤营者如此。至下编则又
因此脉证。而申出风寒兼有之证。以辨风寒两伤营卫者又如此。然后各因其证而立法施治也。以后凡称太阳病
者。皆具此脉浮头项强痛而恶寒者。方是也。
太阳病。头痛至七日以上自愈者。以行其经尽故也。若欲再作经者。针足阳明。使经不传则愈。
头痛。太阳证也。七日以上。谓七日之内也。经者。经脉也。太阳之经。即所谓起于目锐 。上额交
巅络脑。下项连风府。挟脊抵腰。贯臀入 。过髀出外踝。至小趾之端者是也。行其经尽者。言邪入太阳
之表。游行于太阳经脉之中。经尽而邪气衰去。即内经热论所谓七日巨阳病衰。头痛少愈者是也。再作经
者。邪气再传一经也。谓太阳经尽。邪气未衰。欲再传足阳明。其势正未已也。当候其邪气已传。即针足
阳明之经穴以泄其邪。使经邪不传则愈矣。此经所谓迎而夺之。以泻其盛。离合真邪论又云。卒然逢之。
早遏其路之义也。然不于太阳刺之。而独针阳明者。何欤。盖胃为水谷之海。多气多血。素问热论云。
阳明者。十二经络之长。其血气盛。灵枢终始篇所谓阳明主胃。大富于谷气。故可日二取之。他经则或日
一取之。或二日一取之。盖取其可泻之经而刺之也。前注以为阳明中土万物所归。无所复传。非也。此乃
仲景论阳明入里之邪。胃实可下之证。故曰无所复传。然非所论于在经之邪也。若邪未入胃。则经经
可传。何独阳明。唯邪入阳明可刺之经而刺之。乃可遏其传路耳。观行其经尽。欲再作经。使经不传之三经字。
则在经在里。判然分明矣。
太阳病。欲解时。从巳至未上。
经云。邪之所凑。其气必虚。邪既入太阳之经。虽或气衰欲解。然经气已虚。无以自振。必待经气旺
时。方能决去其邪。夫太阳者。盛阳也。旺于巳午。巳为纯阳。乾卦主之。午虽一阴初生。然阳气
旺极之时也。生气通天论云。日中而阳气隆。日西而阳气已虚。故曰从巳至未上。
欲自解者。必当先烦。乃有汗而解。何以知之。脉浮故知汗出解也。
烦之为病不一。有表里阴阳虚实之不同。此则表邪怫郁。将解未解之时。不得发越而烦也。天地之气郁。
则阳蒸阴而为雨。人身之气郁。则阳蒸阴而为汗。阳气鼓动。阴液外泄。邪气随之而出矣。脉为气血之先。
邪气在表则浮。若郁蒸烦闷。则气欲外泄。故脉先浮。脉浮。是以知其必汗出而解也。
太阳病的主要特征是：脉象浮，头痛、项部僵硬疼痛且怕冷。
这是概括中风和伤寒的总脉象与总症状，是太阳上、中、下三篇的大纲。太阳经，是膀胱寒水之经。膀胱为什么称为寒水呢？肾，是天一之水。《上古天真论》说：“肾主水，汇聚五脏六腑的精气而储藏它。”这是因为肾与膀胱，一脏一腑，互为表里而构成一个配合体。既然属于寒水，为什么又被称为太阳呢？肾为坎水，一阳爻居于二阴爻之间，真阳藏于真阴之内，即水中含有火。食物进入胃中，其清轻部分化为营气，运行于脉管之中；食物的浊重部分下降至下焦，肾中的真阳蒸腾这股气，运行于脉管之外，直达皮肤成为卫气。所以膀胱虽然是肾脏寒水的腑，但在寒水之中，能够蒸腾发越成为卫气的，正是肾中的真阳。因此，卫气的运行，一天一夜在全身循环五十周，白天行于阳分二十五周，夜晚行于阴分二十五周。黎明时分阴气耗尽，阳气从眼睛发出，眼睛睁开，气上行至头部，沿着颈部下行至太阳经。所以称为太阳。太阳，就是盛阳。阳气不旺盛，就不足以致密腠理以抵御风寒，所以太阳经是六经之首，是皮肤营卫的统领。《灵枢·营卫生会篇》说：“太阴主内守，太阳主外御。”《生气通天论》说：“阳气具有护卫体表并使其坚固的作用。”又说：“阳气因向上而行，护卫体表。”这些都是说太阳统摄营卫，处于最外层的第一个层次。脉象浮，脉有浮、中、沉三种候法，浮是指上候。浮脉行于肌肉之上，主表证，因为风寒刚刚侵入皮毛营卫，邪气在太阳之表，所以独盛于上候而表现为脉浮。足太阳经脉，起于目内眦，上行额部交会于巅顶，从巅顶联络脑部，复出分别下行于项部，连接风府穴，沿肩膊内侧挟脊柱，抵达腰部，挟督脉而行。风寒侵袭人体，所以出现头项强痛。风寒在体表则怕冷。《皮部论》说：“邪气初入时，使毫毛竖立，腠理开泄。”《玉机真脏论》说：“风寒客居人体，使人毫毛全部竖起，皮肤闭塞而发热，在这个时候，可以用发汗的方法治疗。”这里只说恶寒而不说恶风，是因为恶寒的人未必不恶风，恶风的人未尝不恶寒，举出一种情况就可以涵盖其含义。这条条文列出的症状，是中风和伤寒共同具备的，所以总括起来作为篇首。到了太阳上编，则由此脉证引申出中风的各种症状，以此区分风伤卫的情况。中篇也由此脉证引申出伤寒的各种症状，以此显示寒伤营的情况。到下编，则又因此脉证，引申出风寒兼有的症状，以此辨别风寒两伤营卫的情况。然后根据不同的症状制定治法进行治疗。此后凡是称太阳病的，都必须具备脉浮、头项强痛、恶寒这些特征，才是正确的。
太阳病，头痛持续七天以上自愈的，是因为邪气在经脉中运行完毕的缘故。如果打算再次传变到另一经，针刺足阳明经，使邪气不传变就能痊愈。
头痛，是太阳证的典型表现。七日以上，是指七日以内。经，指经脉。太阳经，就是所谓起于目锐眦（此处原文有误，应为目内眦，但依文意理解），上行额部交会于巅顶，联络脑部，下行项部连接风府，挟脊抵腰，贯穿臀部入腘窝，过髀部出外踝，到达小趾末端的那条经脉。所谓“行其经尽”，是说邪气侵入太阳之表，游行于太阳经脉之中，当经脉行程结束时邪气衰退去除，正如《内经·热论》所说的“第七日巨阳病衰，头痛减轻”。所谓“再作经”，是指邪气再次传入下一经。即太阳经行程结束，邪气尚未衰退，想要再次传入足阳明经，其势头正盛。应当观察邪气已经传变，立即针刺足阳明经的经穴以泻除邪气，使经中之邪不传变就能痊愈。这就是经文所说的“迎而夺之”，以泻除盛实之邪。《离合真邪论》又说：“突然遇到邪气，要尽早阻断其去路”的意思。然而不在太阳经刺治，而唯独针刺阳明经，为什么呢？因为胃是水谷之海，多气多血。《素问·热论》说：“阳明经，是十二经络之长，其气血旺盛。”《灵枢·终始篇》所谓“阳明主胃，大量富含谷气”，所以可以每天两次取穴针刺，其他经脉则或每天一次，或两天一次。这是选取可以泻邪的经脉进行刺治。前人的注释认为阳明属中土，万物所归，不再传变，这是不对的。这乃是仲景论述阳明入里的邪气，胃实证可下的情况，所以说“无所复传”。但这并非讨论在经之邪。如果邪气未入胃，则是每一经都可以传变，为何唯独提到阳明？只有当邪气传入阳明，刺其经穴，才能遏制其传变的路径。看“行其经尽，欲再作经，使经不传”这三个“经”字，则在经和在里的区别，显然分明。
太阳病，想要解除的时间，是从巳时到未时这段时间。
经文说：“邪气聚集的地方，正气必然虚弱。”邪气既已侵入太阳经，虽然有时正气衰弱导致病情似乎要解，但因为经气已经虚弱，无法自我振奋，必须等到经气旺盛的时候，才能决然去除邪气。太阳经，是盛阳之经，在巳时、午时旺盛。巳时为纯阳，由乾卦主宰。午时虽然一阴初生，但也是阳气旺盛至极的时候。《生气通天论》说：“中午时阳气隆盛，傍晚时阳气已虚。”所以说是从巳时到未时。
想要自然痊愈的，必定先感到心烦，然后才有汗出而病解。怎么知道呢？因为脉浮，所以知道会通过出汗而解。
烦这种病症有多种情况，有表里、阴阳、虚实等不同。这里则是表邪郁结，将要解除 yet 尚未解除之时，不得发散而感到烦闷。天地之气郁结，则阳气蒸腾阴气而成雨；人身之气郁结，则阳气蒸腾阴液而成汗。阳气鼓动，阴液外泄，邪气随之而出。脉是气血的先导，邪气在体表则脉浮。如果郁蒸烦闷，则气欲向外宣泄，所以脉象先现浮象。脉浮，因此知道必定会汗出而解。
Taiyang disease is characterized by a floating pulse, headache, stiffness and pain in the neck and occiput, and aversion to cold.
This statement summarizes the general pulse and symptoms of wind-stroke (Zhongfeng) and cold-injury (Shanghan), serving as the overarching principle for the Upper, Middle, and Lower chapters of Taiyang. Taiyang corresponds to the Bladder meridian, which is associated with Cold Water. Why is the Bladder referred to as Cold Water? The Kidney is the Water of Heavenly One. As stated in the *Suwen: Shanggu Tianzhen Lun* (Treatise on the Natural Vitality of Antiquity): "The Kidney governs water, gathering the essence of the five zang and six fu organs to store it." This is because the Kidney and Bladder are a zang-fu pair, interior-exteriorly related and forming a unified system. Since it belongs to Cold Water, why is it also called Taiyang? The Kidney is Kan Water, with one Yang line situated between two Yin lines; True Yang is hidden within True Yin, meaning Fire exists within Water. When food enters the stomach, its clear and subtle part transforms into Ying Qi (Nutritive Qi), circulating within the vessels. The turbid part descends to the Lower Jiao, where the True Yang of the Kidney steams and ascends this Qi, circulating outside the vessels and reaching the skin to become Wei Qi (Defensive Qi). Thus, although the Bladder is the Fu organ of the Kidney's Cold Water, what steams and ascends within this Cold Water to become Wei Qi is precisely the True Yang of the Kidney. Therefore, the circulation of Wei Qi completes fifty cycles around the body in one day and night, twenty-five cycles during the day in the Yang aspects and twenty-five cycles at night in the Yin aspects. At dawn, when Yin Qi is exhausted, Yang Qi emerges from the eyes. When the eyes open, Qi ascends to the head, travels down the neck, and enters the Taiyang meridian. Hence, it is called Taiyang. Taiyang means Abundant Yang. If Yang Qi is not abundant, it cannot sufficiently consolidate the Couli (pores and interstices) to defend against Wind and Cold. Therefore, Taiyang is the head of the Six Meridians and the commander of the skin's Ying and Wei Qi. The *Lingshu: Yingwei Shenghui Pian* states: "Taiyin governs the interior, Taiyang governs the exterior." The *Suwen: Shengqi Tongtian Lun* states: "Yang protects the exterior and ensures solidity." It further says: "Yang moves upward and protects the exterior." All these statements indicate that Taiyang governs Ying and Wei Qi and constitutes the outermost first layer. A floating pulse refers to the three levels of palpation: Floating, Middle, and Deep. Floating refers to the superficial level. The Floating pulse is felt above the muscle and indicates an Exterior syndrome. Because Wind and Cold have just invaded the skin, hair, Ying, and Wei, and the pathogenic factor is at the Exterior of Taiyang, it manifests predominantly at the superficial level, resulting in a Floating pulse. The Foot-Taiyang meridian originates at the inner canthus, ascends to the forehead, intersects at the vertex, connects with the brain, re-emerges to descend separately along the nape, connects with the Fengfu point (GV16), runs along the shoulder blades, and runs alongside the spine internally to reach the waist, traveling alongside the Du meridian. When Wind and Cold invade, headache and stiffness/pain in the neck and occiput occur. When Wind and Cold remain at the Exterior, there is aversion to cold. The *Pibu Lun* states: "When pathogenic factors first enter, they cause the body hair to stand erect and the Couli to open." The *Yuji Zhenzang Lun* states: "When Wind and Cold invade a person, all body hairs stand erect, the skin closes, and heat results. At this time, sweating therapy should be employed." The text mentions only aversion to cold and not aversion to wind because those who experience aversion to cold likely also experience aversion to wind, and those with aversion to wind invariably experience aversion to cold; mentioning one implies the other. The symptoms listed in this clause are common to both wind-stroke and cold-injury, so they are summarized together at the beginning of the chapter. In the Upper Chapter of Taiyang, various symptoms of wind-stroke are derived from these general pulse and symptoms to distinguish Wind injuring Wei Qi. In the Middle Chapter, various symptoms of cold-injury are derived to show Cold injuring Ying Qi. In the Lower Chapter, symptoms of combined Wind and Cold are derived to differentiate cases where both Wind and Cold injure Ying and Wei Qi. Subsequently, treatment methods are established based on specific symptoms. Thereafter, any condition referred to as Taiyang disease must possess the characteristics of a floating pulse, headache, stiffness/pain in the neck and occiput, and aversion to cold to be correctly diagnosed.
In Taiyang disease, if headache persists for seven days or more and resolves spontaneously, it is because the pathogenic factor has completed its course through the meridian. If the pathogen intends to transmit to another meridian, needling the Foot-Yangming meridian can prevent transmission and lead to recovery.
Headache is a symptom of Taiyang syndrome. "Seven days or more" refers to within the seventh day. "Meridian" refers to the channels of qi and blood. The Taiyang meridian is described as originating at the inner canthus, ascending to the forehead, intersecting at the vertex, connecting with the brain, descending the nape to connect with Fengfu, running alongside the spine to the waist, passing through the buttocks into the popliteal fossa, crossing the thigh, exiting at the lateral malleolus, and ending at the tip of the little toe. "Completing its course through the meridian" means that after the pathogen invades the Exterior of Taiyang and circulates within the Taiyang meridian, when the meridian's pathway is exhausted, the pathogenic factor declines and dissipates. This corresponds to the statement in the *Neijing: Re Lun*: "On the seventh day, the Juyang (Taiyang) disease declines, and the headache lessens." "Re-acting as a meridian" refers to the pathogen transmitting to the next meridian. That is, when the Taiyang meridian's cycle ends, if the pathogen has not declined but intends to transmit to the Foot-Yangming meridian, its momentum is still strong. One should observe if the pathogen has transmitted and immediately needle the acupoints of the Foot-Yangming meridian to drain the pathogen, preventing transmission and ensuring recovery. This aligns with the classic principle of "meeting and seizing" (Yinger DuoZhi) to drain excess. The *Lihé Zhenxie Lun* also states: "When encountering the pathogen suddenly, block its path early." However, why needle only Yangming and not Taiyang? Because the Stomach is the Sea of Water and Grain, rich in Qi and Blood. The *Suwen: Re Lun* states: "Yangming is the leader of the twelve meridians, and its blood and Qi are abundant." The *Lingshu: Zhongshi Pian* states: "Yangming governs the Stomach and is rich in Gu Qi (Grain Qi)," allowing for twice-daily needling, whereas other meridians may require once-daily or every-two-days needling. This selects meridians suitable for draining. Previous commentaries claiming that Yangming, belonging to Central Earth, is the destination of all things and does not transmit further is incorrect. Zhang Zhongjing was discussing pathogens entering the Interior with Stomach Excess syndromes treatable by purgation, hence saying "no further transmission." This does not apply to pathogens remaining in the Meridians. If the pathogen has not entered the Stomach, transmission can occur through any meridian. Only by needling the Yangming meridian when the pathogen transmits there can the transmission route be blocked. The use of the word "meridian" three times in "completing its course through the meridian, intending to re-act as a meridian, preventing transmission through the meridian" clearly distinguishes between Exterior (Meridian) and Interior conditions.
Taiyang disease tends to resolve between the hours of Si (09:00–11:00) and Wei (13:00–15:00).
The classics state: "Where pathogenic factors gather, Qi must be deficient." Although the pathogen has entered the Taiyang meridian and the condition might seem ready to resolve due to declining Qi, the meridian Qi is already deficient and unable to self-revitalize. Recovery requires waiting for the time when meridian Qi is prosperous. Taiyang is the meridian of Abundant Yang, which peaks during Si and Wu hours. Si hour represents Pure Yang, governed by the Qian trigram. Although Wu hour marks the initial generation of Yin, it is also the time when Yang Qi reaches its peak abundance. The *Shengqi Tongtian Lun* states: "At midday, Yang Qi is robust; in the evening, Yang Qi is deficient." Therefore, resolution occurs from Si to Wei hours.
Spontaneous resolution typically begins with vexation (Fan), followed by sweating and recovery. How do we know this? Because the pulse is Floating, we know recovery will come through sweating.
Vexation can arise from various causes, differing in Exterior/Interior, Yin/Yang, and Deficiency/Excess. In this case, it is due to Exterior pathogenic stagnation during the transition from unresolved to resolving stages, where the pathogen cannot be freely dispersed, causing vexation. Just as stagnant atmospheric Qi leads to Yang steaming Yin to form rain, stagnant human Qi leads to Yang steaming Yin fluids to form sweat. Yang Qi mobilizes, Yin fluids exude externally, and the pathogen exits with them. The pulse reflects the movement of Qi and Blood prior to their manifestation. When the pathogen is at the Exterior, the pulse floats. If there is stagnation and vexation, Qi desires to escape outward, causing the pulse to float first. Given the Floating pulse, we deduce that recovery will occur through sweating.