伤寒本症之外，有别症，有变症。别症者，其病与伤寒相类而实非伤寒是也。变症者，伤寒本不当有
此症，或因迁延时日；或因杂药误投，其病变态百出是也。其症不备，则必惊疑淆惑，而无所措手，故备
录之，庶不致临症 徨。
脏结、冷结、除中、伏气、晚发、痉、湿、风湿、湿温、温毒、 、阴毒、阳毒、温病、热病、两感、
风温、温疫、香港脚、多眠、狐惑、百合、脏厥见乌梅丸条。尸厥见刺法。
脏结
脏结如结胸状，饮食如故，时时下利，寸脉浮，关脉小细沉紧，名曰脏结。舌上白苔滑者，难治。
脏结，无阳证，其人反静、舌上苔滑者，不可攻也。
病胁下素有痞，连在脐旁，痛引少腹，入阴筋者，此名脏结，死。脏结与结胸，皆下后邪气乘虚
入里所致，热多与阳明相结，为结胸。寒多与阴相结，为脏结。故所现脉症，皆为阴象。舌上苔滑，则
上焦亦寒，全无阳象，故曰“难治”。曰“不可攻”，然犹有治法。至素有痞结，则中气已伤，连及脐旁少
腹，并入阴经，则上下俱病，阴极阳竭，不死何待。
冷结
病者手足厥冷，言我不结胸，小腹满，按之痛者，此冷结在膀胱关元也。
除中
伤寒脉迟，六、七日，而反与黄芩汤彻其热。脉迟为寒，今与黄芩汤，复除其热，腹中应冷，当不能
食，今反能食，此名除中，必死。
微则为咳，咳则吐涎。下之则咳止，而利因不休，利不休则胸中如虫啮，粥入则出；小便不利，
两胁拘急，喘急为难∶颈背相引，臂则不仁；极寒反汗出，身冷若冰，眼睛不慧，语言不休，而谷气多入，
此为除中。口虽欲言，舌不得前。
伤寒始发热六日，厥反九日而利。凡厥利者，当不能食，今反能食者，恐为除中，此病无治法。
伏气
伏气之病，以意候之。今月之内，欲有伏气，假令旧有伏气，当须脉之。若脉微弱者，当喉中痛，
似伤寒，非喉痹也。病患云∶实咽中痛。虽尔，今复欲下利。《活人书》云∶伏气之病，谓非时有暴寒中
人，伏于少阴经。始不竟病，旬月乃发，脉便微弱，法先咽痛，似伤寒非咽痹之病，次必下利。始用半夏
桂枝甘草汤主之，次四逆散主之。此病只二日便瘥，古方谓之“肾伤寒”也。
甘草、半夏、桂心等分，每服四钱匕，入生姜四片煎，放冷，少少含咽之。
晚发
脉阴阳俱紧，至于吐利，其脉独不解，紧去人安，
此为欲解，若脉迟至六、七日，不欲食，此为晚发，水停故也。为未解，食自可者，为欲解。《活人书》
云∶伤寒病，三月至夏为晚发。
痉
太阳病，发热无汗，反恶寒者，名曰刚 。《金匮》治刚 ，用葛根汤、大承气汤。汤俱见前。
太阳病，发热汗出，不恶寒者，名曰柔 。柔 用栝蒌桂枝汤。即桂枝汤加栝蒌根二两。
太阳病，发汗太多，因致 。
太阳病，发热脉沉而细者，名曰 。此言 脉。
病身热足寒。颈项强急，恶寒，时头热面赤，目脉赤，独头面摇，卒口噤，背反张者， 病也。此
言象。
湿
太阳病，关节疼痛而烦，脉沉而细者，此名湿痹之候，其人小便不利，大便反快，但当利其小便。
湿家之为病，一身尽疼，发热，身色如似熏黄。
湿家下之，额上汗出，微喘，小便利者死，若下利不止者，亦死。
湿家下之，其人但头汗出，背强，欲得被覆向火。若下之早则哕，胸满，小便不利。舌上如苔者，
以丹田有热，胸中有寒，渴欲得水而不能饮，则口燥烦也。
湿家病身上疼痛发热面黄而喘，头痛鼻塞而烦，其脉大，自能饮食，腹中和无病，病在头中寒湿，故
鼻塞。纳药鼻中则愈。
风湿
问曰∶风湿相搏，一身尽疼痛，法当汗出而解。值天阴雨不止，医云∶此可发汗，汗之病不愈者何
也？盖发其汗，汗大出者，但风气去，湿气在，是故不愈也。若治风湿者发其汗，但微微似欲汗出者，
风湿俱去也。此言治法。
病者一身尽疼，发热、日晡所剧者，此名风湿。此病伤于汗出当风，或久伤取冷所致也。
风湿脉浮，肢体痛重，不可转侧，额上微汗，不欲去被，或身微肿。
湿温
两胫逆冷，胸腹满，多汗，头目痛苦，妄言，其脉阳濡而弱，阴小而急，不可发汗，治在太阴。见《活人书》。
温毒
冬时触冒疹毒，至春始发，肌肉发斑，瘾疹如锦纹，或咳嗽心闷，但呕青汁。见《活人书》。
太阳中热者， 是也。其人汗出恶寒，身热而渴也。
太阳中 者，身热疼重，而脉微弱，此以夏月伤冷水，水行皮中所致也。
太阳中 者，发热恶寒，身重而疼痛；其脉弦细芤迟；小便已，洒洒然毛耸∶手足逆冷；小有劳，身
即热；口开，前板齿燥。若发汗，则恶寒甚；加温针则发热甚，数下之则淋甚。
阴毒
手足厥冷，背强，脐腹筑痛，咽痛，短气，呕吐、下利，身如被杖。或冷汗烦渴；或甲指面色青黑，烦
燥而渴，脉沉细欲绝，而一息七至。宜灸气海、丹田三、二百壮；或葱熨脐中。气海在脐下一寸五分；丹
田在脐下二寸。
阳毒
发躁狂走，妄言，面赤，咽痛，身斑斑若锦纹。或下利赤黄，脉洪实滑促；或舌卷焦黑，鼻中如烟煤，
宜用布渍冷水，搭于胸上，蒸热数换。《活人书》法。
温病
冬时受寒，藏于肌肤，至春而发。
热病
寒气至夏而发，俱与伤寒相似。
两感
太阳与少阴，阳明与太阴，少阳与厥阴。
风温
其人素伤于风，因复伤热，其脉尺寸俱浮。头疼身热，常自汗出，体重而喘，四肢不收，嘿嘿但欲眠，
发汗则谵语烦躁、状若惊痫。
温疫
一岁之中，男女老少之疾相似，其状不一。
香港脚
头疼身热，肢体痛，大便秘，呕逆，脚屈弱。
多眠
有风温症，有少阴症，有小柴胡症，有狐惑症。
狐惑
此症治法详《金匮》。
状如伤寒，或伤寒后变症，默默欲眠，目不能闭，不欲饮食，面目乍白、乍赤、乍黑，虫蚀其喉为
惑，其声嘎，蚀其肛为狐，其咽干。烂见五脏则死，当视其唇，上唇有疮，虫食其脏；下唇有疮，虫食其
肛。多因下利而得，湿 之病，亦相似。
百合
此症详《金匮》，治法亦备。
此亦伤寒变症，百脉一宗，悉致其病。百脉一宗，乃肺病也。故《金匮》用百合治之。其状欲食复不能
食，默默欲卧，复不能卧；欲行复不能行；饮食或有美时，或有恶闻食臭时；如寒无寒，如热无热，小便
赤，药入口即吐，如有神灵者。
刺法
古圣人治病之法，针灸为先，《灵》、《素》所论，皆为针灸而设。即治伤寒，亦皆用针刺。《热病篇》
所载是也。至仲景专以汤剂治伤寒，尤为变化神妙，然亦有汤剂所必不能愈，而必用刺者，仲景亦不能舍
此而为治。后人岂可不知！故另考明诸穴，以附于后。
尸厥
少阴脉不至，肾气微，少精血，奔气促迫，上入胸膈，宗气反聚，血结心下，阳气退下，热归阴股。
与阴相动，令身不仁，此为尸厥，当刺期门、巨阙，见《平脉法》。
期门二穴，在第二肋端，不容穴旁，各一寸五分，上直两乳。足太阴、厥阴、阴维之会。举臂取之，刺
入四分，灸五壮，肝募也。
巨阙一穴，在鸩尾下一寸，任脉气所发。刺入六分，留七呼，灸五壮。心募也。
伤寒，腹满谵语，寸口脉浮而紧，此肝乘脾也，名曰纵，刺期门。纵者，克其所胜，放纵不收也。
伤寒发热，啬啬恶寒，大渴欲饮水，其腹必满，自汗出，小便利，其病欲解，此肝乘肺也，名曰横，
刺期门。横者，犯其所不胜，横逆犯上也。刺期门，皆所以泄肝之盛气，期门穴见前。
太阳与少阳并病，头颈强痛，或眩冒，时如结胸，心下痞硬者，当刺大椎第一间、肺俞、肝俞。慎
不可发汗，发汗则谵语，脉弦，五、六日，谵语不止，当刺期门。
大椎一穴，在第一椎陷者中，三阳督脉之会。刺入五分，灸九壮。
肺俞二穴，在第三椎下两旁，各一寸五分，刺入三分，留七呼，灸三壮。
肝俞二穴，在第九椎下两旁，各一寸五分，刺三、四分，留六呼，灸三壮。
太阳、少阴并病，心下硬，颈项强而眩者，当刺大椎、肺俞、肝俞，慎勿下之。
阳明病，下血谵语者，此为热入血室。但头汗出者，刺期门。随其热而泻之， 然汗出者愈。此男子
热入血室之症。妇人亦有之，见小柴胡条下。
凡治温病，可刺五十九穴。
《内经》热俞五十九，头上五行，行五者，以越诸阳之热逆也。大杼、膺俞、缺盆、背俞。此八者，
以泻胸中之热也。气冲、三里、巨虚、上下廉，此八者，以泻胃中之热也。云门、 骨、委中、髓空，此
八者，以泻四肢之热也。五脏俞旁五，此十者，以泻五脏之热也。凡此五十九穴者，皆热之左右也。
在伤寒本证之外，还有别证和变证。所谓别证，是指那些病症表现与伤寒相似但实际上并非伤寒的疾病。所谓变证，是指伤寒原本不应当出现的症状，可能是因为病程迁延日久；也可能是因为误用了其他药物，导致病情变化多端。如果对这些症状不了解，就会感到惊慌疑惑、混淆困惑，从而不知如何下手治疗，因此将这些症状详细记录下来，以免在临诊时手足无措。
脏结、冷结、除中、伏气、晚发、痉病、湿病、风湿、湿温、温毒、暑病（注：原文此处缺字，据上下文补为暑）、阴毒、阳毒、温病、热病、两感证、风温、温疫、脚气、嗜睡、狐惑病、百合病。脏厥见乌梅丸条文。尸厥见刺法部分。
【脏结】
脏结的症状类似于结胸，但饮食如常，时常腹泻，寸脉浮，关脉小细沉紧，这叫做脏结。如果舌上苔白滑，属于难治之症。
脏结没有阳证表现，病人反而安静，舌苔滑润的，不可使用攻下法。
如果病人胁下素有痞块，牵连到脐旁，疼痛牵引至小腹并进入阴筋部位，这名叫脏结，预后不良，主死。脏结与结胸，都是误用下法后邪气乘虚入里所致。热邪多与阳明相结，形成结胸；寒邪多与阴经相结，形成脏结。所以所呈现的脉象和症状，都属于阴象。舌苔滑润，说明上焦也有寒，完全没有阳象，所以说“难治”。说“不可攻”，但仍有治疗方法。至于素有痞结，说明中气已经受损，连及脐旁小腹，并入阴经，则上下都患病，阴极阳竭，不死还等什么。
【冷结】
病人手足厥冷，说自己没有结胸，小腹胀满，按压时疼痛，这是冷结在膀胱关元穴部位。
【除中】
伤寒脉迟，过了六七天，却反而给予黄芩汤来清热。脉迟表示有寒，现在给黄芩汤，进一步清除其热，腹中应该寒冷，应当不能进食，但现在反而能进食，这叫做除中，必死无疑。
脉微则为咳嗽，咳嗽则吐出涎沫。如果用下法，咳嗽会停止，但腹泻不会停止，腹泻不止则胸中感觉像虫子咬一样难受，喝粥就会吐出来；小便不利，两胁拘急，喘急困难；颈背相互牵引，手臂麻木不仁；极寒反而出汗，身体冰冷如冰，眼睛昏花不明，言语不休，而谷气多入体内，这叫做除中。口虽然想说话，舌头却无法前伸。
伤寒开始发热六天，四肢厥冷反而九天并且伴有腹泻。凡是厥冷腹泻的病人，应当不能进食，现在反而能进食，恐怕是除中，此病无法治疗。
【伏气】
伏气病，需要用心推测判断。如果在当月之内，想要知道是否有伏气，假如旧有伏气，必须通过诊脉来判断。如果脉象微弱，应当喉咙痛，类似伤寒，但不是喉痹。病人说：确实是咽喉痛。即使如此，现在又想腹泻。《活人书》说：伏气病，是指非时节的暴寒伤人，潜伏在少阴经。起初并没有完全发病，经过一个月后才发作，脉象变得微弱，按照法则先出现咽痛，类似伤寒但不是咽痹病，随后必然腹泻。开始用半夏桂枝甘草汤主治，接着用四逆散主治。这种病只两天就能痊愈，古方称之为“肾伤寒”。
甘草、半夏、桂心等分，每次服用四钱匕，加入生姜四片煎煮，放凉后，少量含咽。
【晚发】
脉象阴阳俱紧，到了出现呕吐腹泻的时候，脉象唯独不解，紧脉消失且人安适，这是将要解除；如果脉迟到了六七天，不想吃东西，这叫晚发，是因为水饮停聚的缘故。如果脉象未解，想吃东西的，这是将要解除。《活人书》说：伤寒病，从三月到夏季发病的叫晚发。
【痉病】
太阳病，发热无汗，反而恶寒的，叫做刚痉。《金匮要略》治疗刚痉，用葛根汤、大承气汤。汤剂方见前面。
太阳病，发热汗出，不恶寒的，叫做柔痉。柔痉用栝蒌桂枝汤。即桂枝汤加栝蒚根二两。
太阳病，发汗太多，因而导致痉病。
太阳病，发热脉沉而细的，叫做痉病。这是在描述痉病的脉象。
病人身体发热足部寒冷。颈项强直紧急，恶寒，有时头部发热面红，眼脉络赤，只有头面部摇动，突然牙关紧闭，角弓反张的，这是痉病。这是在描述痉病的症状。
【湿病】
太阳病，关节疼痛而且烦躁，脉沉而细的，这叫做湿痹的候象，其人小便不利，大便反而通畅，只应当利小便。
患湿病的人，全身疼痛，发热，身体颜色像被烟熏过的黄色。
对湿病患者误用下法，额头出汗，轻微气喘，小便通利的会死，如果腹泻不止的，也会死。
对湿病患者误用下法，病人只是额头出汗，背部强直，想要盖被子靠近火源。如果下法用得过早则会呃逆，胸满，小便不利。舌上好像有苔，这是因为丹田有热，胸中有寒，口渴想喝水却不能喝，所以口燥烦闷。
湿病患者身上疼痛发热面黄而喘，头痛鼻塞而烦躁，脉象大，自己能饮食，腹部平和无病，病在头中寒湿，所以鼻塞。将药纳入鼻中即可痊愈。
【风湿】
问曰：风湿相搏，全身都疼痛，按理应当发汗而解。正值天下雨不停，医生说：这可以发汗，发了汗病却不愈，为什么呢？大概是因为发的汗太大，风气去了，湿气还在，所以不愈。如果治疗风湿病发汗，只要微微似欲出汗的样子，风湿就能一起去除。这是在讲述治疗方法。
病人全身疼痛，发热，傍晚加重，这叫做风湿。这种病是由于出汗当风，或久处寒凉环境所致。
风湿脉浮，肢体痛重，不能转侧，额头微汗，不想去掉被子，或者身体轻微浮肿。
【湿温】
两小腿逆冷，胸腹部胀满，多汗，头目痛苦，胡言乱语，其脉阳部濡弱，阴部小而急，不可发汗，治疗重点在太阴。见《活人书》。
【温毒】
冬季触犯疹毒，到春季才发作，肌肉发斑，瘾疹如锦纹，或者咳嗽胸闷，只呕吐青色汁液。见《活人书》。
【暑病】
太阳中热者，就是暑病。其人汗出恶寒，身体发热而口渴。
太阳中暑者，身体发热疼重，而脉微弱，这是因为夏天受了冷水，水行于皮中所致。
太阳中暑者，发热恶寒，身体重而疼痛；脉弦细芤迟；小便后，洒洒然毛发耸立；手足逆冷；稍微劳作，身体就发热；张口呼吸，门齿干燥。如果发汗，则恶寒更甚；加温针则发热更甚，多次用下法则淋证更重。
【阴毒】
手足厥冷，背部强直，脐腹剧烈疼痛，咽痛，短气，呕吐、腹泻，身体像被打过一样。或者冷汗烦躁口渴；或者指甲面色青黑，烦躁而渴，脉沉细欲绝，一息七至。适宜灸气海、丹田三二百壮；或者用葱熨脐中。气海在脐下一寸五分；丹田在脐下二寸。
【阳毒】
发躁狂走，胡言乱语，面赤，咽痛，身上斑点如锦纹。或者下利赤黄，脉洪实滑促；或者舌卷焦黑，鼻中如烟煤，适宜用布浸冷水，搭在胸上，蒸热数次更换。这是《活人书》的方法。
【风温】
其人素来伤于风，又复伤于热，其脉尺寸俱浮。头疼身热，经常自汗出，身体沉重而喘，四肢不收，沉默只想睡觉，发汗则谵语烦躁、状若惊痫。
【温疫】
一年之中，男女老少的疾病相似，症状不一。
【狐惑】
此症的治疗方法详见《金匮要略》。
症状像伤寒，或者是伤寒后的变证，沉默想睡，眼睛不能闭合，不想饮食，面目乍白、乍赤、乍黑，虫蚀咽喉为惑，声音嘶哑，蚀肛门为狐，咽喉干燥。腐烂见到五脏则死，应当看嘴唇，上唇有疮，虫食内脏；下唇有疮，虫食肛门。多因腹泻而得，湿病也与此相似。
【百合病】
此症详见《金匮要略》，治疗方法也很完备。
这也是伤寒的变证，百脉同源，全都致病。百脉同源，指的是肺病。所以《金匮要略》用百合治疗它。其症状是想吃又吃不下，沉默想躺下，又躺不下；想走又走不了；饮食有时觉得美味，有时厌恶食物气味；像冷又不冷，像热又不热，小便赤，药入口即吐，好像有神灵附体一样。
【刺法】
古代圣人治病的方法，针灸为先，《灵枢》、《素问》所论述的，都是为了针灸而设。即使是治疗伤寒，也都用针刺。《热病篇》所载的就是。到了张仲景专门用汤剂治疗伤寒，尤为变化神妙，然而也有汤剂一定不能治愈，而必须用针刺的情况，张仲景也不能舍弃这种方法而不采用。后人怎么可以不知道呢！所以另外考证明确各个穴位，附在后面。
【尸厥】
少阴脉不至，肾气微弱，精血不足，奔气急促迫近，向上进入胸膈，宗气反过来聚集，血液凝结在心下，阳气退下，热归阴股。与阴气相互作用，令身体麻木不仁，这叫尸厥，应当刺期门、巨阙，见《平脉法》。
期门二穴，在第二肋端，不容穴旁边，各一寸五分，上直两乳。是足太阴、厥阴、阴维的交会穴。举臂取穴，刺入四分，灸五壮，是肝的募穴。
巨阙一穴，在鸠尾下一寸，任脉气所发。刺入六分，留针七呼，灸五壮。是心的募穴。
伤寒，腹部胀满谵语，寸口脉浮而紧，这是肝乘脾，名叫纵，刺期门。纵者，克制其所胜，放纵不收。
伤寒发热，啬啬恶寒，大渴想喝水，腹部一定胀满，自汗出，小便通利，病将要解除，这是肝乘肺，名叫横，刺期门。横者，侵犯其所不胜，横逆犯上。刺期门，都是为了泄肝的盛气，期门穴见前文。
太阳与少阳并病，头颈强痛，或者眩晕冒昧，有时像结胸，心下痞硬的，应当刺大椎第一间、肺俞、肝俞。千万不要发汗，发汗则谵语，脉弦，五、六天，谵语不止，应当刺期门。
大椎一穴，在第一椎陷者中，是三阳督脉的交会穴。刺入五分，灸九壮。
肺俞二穴，在第三椎下两旁，各一寸五分，刺入三分，留七呼，灸三壮。
肝俞二穴，在第九椎下两旁，各一寸五分，刺三、四分，留六呼，灸三壮。
太阳、少阴并病，心下硬，颈项强而眩的，应当刺大椎、肺俞、肝俞，千万不要用下法。
阳明病，下血谵语的，这是热入血室。只有头部出汗的，刺期门。随着热势而泻之，濈然汗出的就痊愈了。这是男子热入血室的症候。妇人也有这种情况，见小柴胡条下。
凡是治疗温病，可刺五十九穴。
《内经》热俞五十九穴，头上五行，每行五个，用来发散诸阳的热逆。大杼、膺俞、缺盆、背俞。这八个穴，用来泻胸中之热。气冲、三里、巨虚上下廉，这八个穴，用来泻胃中之热。云门、髀骨、委中、髓空，这八个穴，用来泻四肢之热。五脏俞旁五，这十个穴，用来泻五脏之热。凡这五十九穴，都是热的左右旁开穴位。
Beyond the primary syndromes of Shanghan (Cold Damage), there are distinct syndromes (Bie Zheng) and transformed syndromes (Bian Zheng). Distinct syndromes refer to conditions that resemble Shanghan but are not actually Shanghan. Transformed syndromes refer to symptoms that should not originally appear in Shanghan, either due to the disease lingering for a long time or due to the misadministration of miscellaneous medicines, resulting in a hundred variations of pathological changes. If these symptoms are not well understood, one will feel alarmed, doubtful, and confused, knowing not how to proceed with treatment. Therefore, they are recorded in detail to prevent hesitation when facing clinical cases.
Zang Jie (Visceral Knotting), Leng Jie (Cold Knotting), Chu Zhong (Elimination of the Middle), Fu Qi (Latent Pathogen), Wan Fa (Late Onset), Jing Bing (Spasm Disease), Shi Bing (Dampness Disease), Feng Shi (Wind-Dampness), Shi Wen (Damp-Warmth), Wen Du (Warm-Toxin), Shu Bing (Summerheat Disease), Yin Du (Yin Toxin), Yang Du (Yang Toxin), Wen Bing (Warm Disease), Re Bing (Heat Disease), Liang Gan (Double Exposure), Feng Wen (Wind-Warmth), Wen Yi (Warm Pestilence), Hong Jiao Jiao Qi (Hongjiao/Grain-Induced Foot Weakness), Duo Mian (Excessive Sleepiness), Hu Huo (Fox-Huo Disease), Bai He Bing (Lily Disease). Zang Jue (Visceral Cold Extremity) is found under the Wumei Wan (Mume Pill) section. Shi Jue (Corpse Syncope) is found under the Acupuncture Methods section.
[Zang Jie]
Zang Jie presents similarly to Jie Xiong (Chest Binding), but digestion remains normal, with frequent diarrhea. The Cun (Inch) pulse is floating, while the Guan (Bar) pulse is small, fine, deep, and tight; this is named Zang Jie. If the tongue has white, slippery coating, it is difficult to treat.
In Zang Jie, there are no Yang syndrome manifestations; the patient appears calm, and with a slippery tongue coating, purgative methods must not be used.
If the patient has had a mass (Pi) under the ribs since childhood, extending to the side of the navel, with pain radiating to the lower abdomen and into the genital tendons, this is named Zang Jie, which is fatal. Both Zang Jie and Jie Xiong result from pathogenic factors entering the interior due to deficiency after improper purgation. Heat pathogens often bind with Yangming, forming Jie Xiong; cold pathogens often bind with Yin meridians, forming Zang Jie. Thus, the presenting pulses and symptoms all exhibit Yin characteristics. A slippery tongue coating indicates cold in the Upper Jiao (Upper Burner) with no Yang signs, hence "difficult to treat." Saying "do not purge" implies there are still treatment methods. However, if there is a pre-existing mass, the Middle Qi (Middle Energy) is already damaged. Involvement of the navel, lower abdomen, and entry into Yin meridians means both upper and lower parts are diseased, leading to extreme Yin and exhaustion of Yang; death is inevitable.
[Leng Jie]
The patient experiences cold extremities, states they do not have Jie Xiong, has fullness in the lower abdomen, and pain upon pressure. This is Cold Knotting located at the Bladder Guan Yuan point.
[Chu Zhong]
In Shanghan, the pulse is slow. After six or seven days, administering Huang Qin Tang (Scutellaria Decoction) to clear heat is erroneous. A slow pulse indicates cold. Giving Huang Qin Tang further clears heat, causing internal cold and an inability to eat. If the patient suddenly can eat, this is named Chu Zhong (Elimination of the Middle), which is fatal.
A faint pulse leads to coughing and expectoration of saliva. Purging stops the cough but causes persistent diarrhea. Persistent diarrhea feels like insects biting in the chest; drinking porridge causes vomiting. Urination is difficult, hypochondriac tension is severe, and breathing is labored. Neck and back are drawn together, arms are numb. Extreme cold with sweating, body cold as ice, dull eyes, incessant speech, yet food intake is high—this is Chu Zhong. Although the mouth wants to speak, the tongue cannot move forward.
Shanghan begins with fever for six days, followed by nine days of cold extremities and diarrhea. Patients with cold extremities and diarrhea should not be able to eat. Sudden ability to eat suggests Chu Zhong; this condition has no cure.
[Fu Qi]
Fu Qi (Latent Pathogen) disease requires careful observation. Within the current month, if latent pathogen is suspected, and if there is a history of latent pathogen, pulse diagnosis is necessary. If the pulse is weak and faint, throat pain should occur, resembling Shanghan but not Hou Bi (Throat Bi). The patient claims true throat pain. Even so, diarrhea may follow. *Huren Shu* states: Fu Qi disease refers to sudden cold striking at an inappropriate season, lying dormant in the Shaoyin Meridian. It does not manifest fully initially, appearing only after a month with a weak pulse. According to method, it first presents as throat pain, resembling Shanghan but not throat Bi, followed inevitably by diarrhea. Initially, Banxia Guizhi Gancao Tang (Pinellia, Cinnamon Twig, and Licorice Decoction) is used, followed by Sini San (Recover the Initial Powder). This disease resolves in two days; ancient texts call it "Kidney Shanghan."
Equal parts Gancao (Licorice), Banxia (Pinellia), and Guixin (Cinnamon Heart). Take four qian bi per dose, decoct with four slices of Shengjiang (Fresh Ginger), cool, and swallow slowly in small amounts.
[Wan Fa]
When both Yin and Yang pulses are tight, progressing to vomiting and diarrhea, if the pulse alone does not resolve, but the tightness disappears and the person feels comfortable, this indicates impending resolution. If the pulse becomes slow after six or seven days, accompanied by loss of appetite, this is called Wan Fa (Late Onset), caused by water retention. If the pulse remains unresolved but appetite returns, it indicates impending resolution. *Huren Shu* states: Shanghan disease occurring from March to summer is called Wan Fa.
[Jing Bing]
In Taiyang (Greater Yang) disease, fever without sweat and aversion to cold is named Gang Jing (Rigid Spasm). *Jinkui Yaolue* treats Gang Jing with Gegen Tang (Kudzu Decoction) and Dachengqi Tang (Major Order the Qi Decoction). Formulas are seen previously.
In Taiyang disease, fever with sweat and no aversion to cold is named Rou Jing (Soft Spasm). Rou Jing is treated with Gualou Guizhi Tang (Trichosanthes Root and Cinnamon Twig Decoction), which is Guizhi Tang plus Gualougen (Trichosanthes Root) two liang.
Taiyang disease, with excessive sweating, leads to Jing Bing.
Taiyang disease, with fever and a deep, fine pulse, is named Jing Bing. This describes the pulse of Jing Bing.
The patient has body heat and cold feet. Stiffness and tension in the neck and back, aversion to cold, occasional head heat and facial redness, red eye vessels, only the head and face tremble, sudden lockjaw, and opisthotonos (backward arching of the back)—this is Jing Bing. This describes the symptoms of Jing Bing.
[Shi Bing]
In Taiyang disease, joint pain with irritability and a deep, fine pulse is named Shi Bi (Dampness Bi). The patient has difficulty urinating, but loose stools; treatment should focus on promoting urination.
Patients with Shi Bing suffer from whole-body pain, fever, and a yellowish body color resembling smoke-staining.
Purging patients with Shi Bing results in sweating on the forehead, slight wheezing, and free urination, which is fatal. If diarrhea persists, it is also fatal.
Purging patients with Shi Bing results in sweating only on the head, back stiffness, and a desire to cover up near fire. Early purging causes hiccups, chest fullness, and difficulty urinating. Tongue coating resembling moss indicates heat in the Dantian (Lower Elixir Field) and cold in the Chest, thirst wanting water but unable to drink, leading to dry mouth and irritability.
Shi Bing patients with body pain, fever, yellow face, wheezing, headache, nasal congestion, and irritability, with a large pulse, who can eat normally and have a peaceful abdomen, have cold-dampness in the head causing nasal congestion. Inserting medicine into the nose cures it.
[Feng Shi]
Question: Wind-Dampness binding causes whole-body pain, theoretically resolved by sweating. Why does illness persist despite rain and prescribed sweating? Sweating heavily expels wind but leaves dampness, hence no cure. Treating Wind-Dampness requires mild sweating; only then are both wind and dampness expelled. This explains the treatment method.
Whole-body pain, fever worsening in the late afternoon, is named Feng Shi. This disease results from sweating exposed to wind or prolonged exposure to cold.
Feng Shi presents with floating pulse, heavy limb pain, inability to turn, slight forehead sweating, reluctance to remove blankets, or slight body swelling.
[Shi Wen]
Reverse coldness in both calves, chest and abdominal fullness, profuse sweating, head and eye pain, delirium. Pulse is superficial and weak (Yang) and small and rapid (Yin). Do not induce sweating; treatment focuses on Taiyin (Lesser Yin). See *Huren Shu*.
[Wen Du]
Contracting rash-toxin in winter, manifesting in spring. Muscle rashes, urticaria like brocade patterns, or cough and chest oppression, vomiting green fluid. See *Huren Shu*.
[Shu Bing]
Taiyang Zhong Re (Summerheat in Taiyang) is Shu Bing. The patient sweats, fears cold, has body heat, and thirst.
Taiyang Zhong Shu (Summerheat in Taiyang) presents with body heat and heavy pain, with a weak pulse. This is caused by consuming cold water in summer, where water circulates in the skin.
Taiyang Zhong Shu presents with fever, aversion to cold, heavy body and pain; pulse is string-taut, fine, hollow, and slow. After urination, chills and hair standing on end; cold extremities; slight exertion causes body heat; open mouth, dry front teeth. Inducing sweating worsens aversion to cold; warming needles worsen fever; repeated purging worsens strangury.
[Yin Du]
Cold extremities, back stiffness, severe abdominal pain, sore throat, shortness of breath, vomiting, diarrhea, body feeling like beaten. Or cold sweat, irritability, thirst; or blue-black nails and face, irritability, thirst, deep-fine pulse nearly imperceptible, seven beats per breath. Moxibustion on Qihai (Sea of Qi) and Dantian (300-200 moxa cones); or warm ginger application on the navel. Qihai is 1.5 cun below the navel; Dantian is 2 cun below the navel.
[Yang Du]
Restlessness, manic running, delirium, red face, sore throat, spotted body like brocade. Or bloody-yellow diarrhea, surging-full-slippery-rapid pulse; or curled black scorched tongue, nose smelling like burnt coal. Apply cloth soaked in cold water to the chest, replacing when warm. Method from *Huren Shu*.
[Wen Bing]
Cold contracted in winter, stored in skin and muscles, manifesting in spring.
[Re Bing]
Cold qi manifesting in summer, similar to Shanghan.
[Liang Gan]
Taiyang with Shaoyin, Yangming with Taiyin, Shaoyang with Jueyin.
[Feng Wen]
Constitutionally injured by wind, re-injured by heat. Pulses at Cun and Chi are both floating. Headache, body heat, spontaneous sweating, heavy body, wheezing, limbs flaccid, silent desire to sleep. Inducing sweating causes delirium, irritability, resembling convulsions.
[Wen Yi]
In one year, diseases among men, women, old, and young are similar, though symptoms vary.
[Hong Jiao Jiao Qi]
Headache, body heat, limb pain, constipation, vomiting, weak and flexed feet.
[Duo Mian]
Includes Feng Wen syndrome, Shaoyin syndrome, Xiaochaihu Tang syndrome, and Hu Huo syndrome.
[Hu Huo]
Treatment detailed in *Jinkui Yaolue*.
Resembles Shanghan or transformed Shanghan. Silent desire to sleep, eyes cannot close, loss of appetite, face alternating white, red, and black. Worms eroding throat cause "Huo," hoarse voice; eroding anus cause "Hu," dry throat. Rottenness reaching five zang organs is fatal. Examine lips: ulcers on upper lip indicate worm erosion of zang organs; ulcers on lower lip indicate worm erosion of anus. Often acquired after diarrhea; Shi Bing (Dampness Disease) is similar.
[Bai He Bing]
Detailed in *Jinkui Yaolue*, with complete treatments.
This is a transformed Shanghan syndrome. All meridians share one source, leading to disease. One source refers to Lung disease. Hence *Jinkui Yaolue* uses Baihe (Lily Bulb) to treat it. Symptoms: desire to eat but cannot, silent desire to lie down but cannot, desire to walk but cannot. Food sometimes tastes good, sometimes smells repulsive. Feels cold but not cold, feels hot but not hot. Red urine. Medicine vomited immediately upon entry, as if possessed by spirits.
[Acupuncture Methods]
Ancient sages prioritized acupuncture and moxibustion. *Ling Shu* and *Su Wen* discuss these methods. Even treating Shanghan, needle insertion was used. Zhang Zhongjing specialized in herbal decoctions, which is miraculous, but some cases require acupuncture where decoctions fail. Later generations must know this. Thus, specific acupoints are documented here.
[Shi Jue]
Shaoyin pulse fails to arrive. Kidney Qi is weak, essence and blood deficient. Rushing Qi presses upward into chest and diaphragm. Zong Qi (Gathering Qi) aggregates. Blood knots below the heart. Yang Qi retreats downward. Heat enters Yin thighs. Interaction with Yin causes insensibility. This is Shi Jue. Needle Qimen and Juque. See *Ping Mai Fa*.
Qimen (two points): At the end of the second rib, 1.5 cun lateral to Burong. Directly above both breasts. Meeting of Foot-Taiyin, Foot-Jueyin, and Yin Wei meridians. Raise arm to locate. Needle 4 cun, moxa 5 cones. Liver Mu point.
Juque (one point): 1 cun below Jiwei. Release of Ren Mai Qi. Needle 6 cun, retain 7 breaths, moxa 5 cones. Heart Mu point.
Shanghan with abdominal fullness and delirium, Cun-Chi pulse floating and tight: Liver overacting on Spleen, named Zong (Vertical). Needle Qimen. Zong means overcoming the conquered, unrestrained.
Shanghan with fever, shivering aversion to cold, intense thirst for water, abdominal fullness, spontaneous sweating, free urination: illness resolving. Liver overacting on Lung, named Heng (Horizontal). Needle Qimen. Heng means violating the unconquerable, rebelling upward. Needling Qimen drains excess Liver Qi.
Taiyang and Shaoyang combined disease: stiff neck and pain, dizziness, intermittent chest binding, epigastric hardness. Needle Dazhui (first interspace), Feishu, Ganshu. Do not induce sweating; sweating causes delirium, string-taut pulse. If delirium persists after 5-6 days, needle Qimen.
Dazhui (one point): Depression of first thoracic vertebra. Meeting of Three Yang and Du Mai. Needle 5 cun, moxa 9 cones.
Feishu (two points): 1.5 cun lateral to spinous process of third thoracic vertebra. Needle 3 cun, retain 7 breaths, moxa 3 cones.
Ganshu (two points): 1.5 cun lateral to spinous process of ninth thoracic vertebra. Needle 3-4 cun, retain 6 breaths, moxa 3 cones.
Taiyang and Shaoyin combined disease: epigastric hardness, stiff neck, dizziness. Needle Dazhui, Feishu, Ganshu. Do not purge.
Yangming disease with bloody stool and delirium: Heat entering Blood Chamber. Only head sweating: needle Qimen. Drain heat according to its location. Profuse sweating indicates recovery. This is male Heat entering Blood Chamber. Females also have this; see Xiaochaihu Tang section.
For all Warm Disease treatments, 59 acupoints may be needled.
*Neijing* lists 59 Heat acupoints. Five rows of five on the head disperse rebellious Yang heat. Dazhu, Yingshu, Quepen, Beishu (8 points) drain chest heat. Qichong, Zusanli, Shangjixu, Xiajixu (8 points) drain stomach heat. Yunmen, Bitong, Weizhong, Suikong (8 points) drain limb heat. Five points beside each Zang Shu (10 points) drain Zang heat. These 59 points surround heat pathways.