【纲】仲景曰。太阴病。脉浮者。可发汗。宜桂枝汤。
【目】朱肱曰。太阴症发汗后。根据前寒热者。须看脉如何。若浮数。或洪大。则表症犹在。再
表可也。如桂枝汤、桂枝二麻黄一汤之类。医人为见已汗。或已下。而发寒热。不敢再表。误矣。
盖脉浮为在表。表之必愈也。
李中梓曰。或表邪未尽。或邪传里。或邪气乘虚内客。故虽汗而病仍在也。
张从正曰。脉浮。病在表也。即已经发汗。或自汗。而脉仍浮。表犹有风热未尽。可再汗之。
王履曰。尝读仲景伤寒论。于太阴有曰。自利不渴者。属太阴。以其脏有寒故也。当温之。宜
四逆辈。于少阴有曰。少阴病。得之一二日。口中和。其背恶寒者。当灸之。少阴病。身体痛。手
足寒。骨节痛。脉沉者。附子汤主之。少阴病。下利。白通汤。少阴病。下利脉微者。与白通汤。
利不止。厥逆。无脉。干呕烦者。白通加猪胆汁汤。少阴病。下利清谷。里寒外热。手足厥逆。脉
微欲绝。身反不恶寒。其人面色赤。或腹痛。或干呕。或咽痛。或利止。脉不出者。通脉四逆汤。
少阴病。脉沉者。急温之。四逆汤。于厥阴有曰。手足厥寒。脉细欲绝者。当归四逆汤。大汗。若
大下利。而厥冷者。四逆汤。观仲景此论。则伤寒三阴。必有寒症。而宜用温热之剂也。及读刘守
真之书。有曰。伤寒邪热在表。腑病为阳。邪热在里。脏病为阴。俗妄谓有寒热阴阳异症。误人久
矣。寒病有矣。非汗病之谓也。寒病止为杂病。终莫能为汗病。且汗液之气。乃阳热之气。非阴寒
所能也。虽仲景有四逆汤症。是治表热里和。误以寒药下之太早。表热入里。下利不止。及或表热
里寒自利。急以四逆温药。利止里和。急解其表也。故仲景四逆汤症。复有承气下之者。由是伤寒
汗病。经直言热病。而不言寒也。经言三阴症者。邪热在脏在里。以脏与里为阴。当下热者也。素
问论伤寒热病有二篇。名曰热。竟无寒理。兼素问灵枢诸篇运气造化之理推之。则为热病。诚非寒
也。观守真此论。则伤寒无问在表在里。与夫三阳三阴。皆一于为热。而决无或寒者矣。成注亦只
随文略释。并不明言何由为热。何由为寒之故。彼盖止知伤寒皆是传经。故疑于六经所传。俱为热
症。而热无变寒之理。遂不敢别白耳。以寒为本脏之寒欤。安得当热邪传里入深之时。反独见寒而
不见热。且所用温热药。能不助传经之热邪乎。以寒为外邪之寒欤。则在三阳已成热矣。岂有传至
三阴。而反为寒哉。成氏能潜心于此。则必语其所以然矣。自仲景作伤寒论。靡不宗之。后人不能
决于似是而非之际。故或谓今世
无真伤寒。或谓今人皆病内伤。或谓论中诸温药。悉为传经热邪用者。以三阴经属阴故也。又或谓
论中凡有寒字。皆当作热字。其谬一至于此。殊不知三阳之病。其寒邪之在太阳也。寒郁其阳。阳
不畅而成热。阳虽人身之正气。既郁为邪。用麻黄发表以逐其寒。则腠理通而郁热泄。故汗而愈。
苟或不汗不解。其热不得外泄。则必里入。故传阳明。传少阳。而或入腑也。若夫三阴之病。则或
寒或热者何哉。盖寒邪之伤人也。或有在太阳经郁热。然后以次而传至阴经者。或有太阳不传阳明
少阳。便传三阴经者。或有寒邪不从三阳始。直伤阴经者。或有虽从太阳始。不及郁热。即入少阴。
而独见少阴症者。或有太阳始即入少阴。而太阳不能无伤者。或有直伤即入。而寒便变热。及始
寒而终热者。其郁热传经。与变热则为热症。其直伤阴经。及从太阳即入少阴则为寒症。其太阳不能
无伤。则少阴脉症而兼见太阳标病。其始为寒而终变热。则先见寒症而后见热症。此三阴之病。所
以或寒或热也。苟即三阴经诸篇细绎之。理斯出矣。夫其或传经。或直伤。或即入。或先寒后热者。
何也。邪气暴卒。本无定情。而传变不常故耳。故经曰。邪之中人也无有常。或中于阳。或中于
阴。彼守真非好为说以骇人。由其以温暑为伤寒。而仲景之方。每不与温暑对。故略乎温热之剂。
而例用寒凉。由其以伤寒一断为热而无寒。故谓四逆为寒药。误下表热里和之症。及为表热里寒自
利之症而立。又谓温里止利。急解其表。又谓寒病止为杂病。嗟乎。仲景伤寒论专为中而即病之伤
寒作。不兼为不即病之温暑作。故每有三阴之寒症。而温热之剂之所以用也。且如寒药误下而成里
寒者。固不为无矣。不因寒药误下而自为里寒者。其可谓之必无乎。殊不知阴经之每见寒症。本由
寒邪。不由阳经直伤于此。与夫虽由阳经始。不及郁热即入于此而致也。虽或有因寒药误下而致者。
盖亦甚少。仲景所以用诸温热之剂。何尝单为寒药误下而立。况表里俱寒之症。何尝每有急解其
表之文乎。夫里寒外热之症。乃是寒邪入客于内。迫阳于外。或者虚阳之气。自作外热之状耳。非
真热邪所为也。况仲景于里寒外热之症。但以温药治里。而不治外热。则知其所以为
治之意矣。兹果当急解其表。岂不于里和之后。明言之乎。夫内经所叙三阴病一于为热者。言其常
也。仲景所叙三阴病兼乎寒热。言其变也。重行而不悖耳。学人能知三阴固有寒邪所为之症。则仲
景创法之本意。可以了然矣。且仲景曰。病发热恶寒者。发于阳也。无热恶寒者。发于阴也。发于
阳者七日愈。发于阴者六日愈。夫谓之无热恶寒。则知非阳经之郁热矣。谓之发于阴。则知不从阳
经传至此矣。谓之六日愈。则知其不始太阳。而止自阴经发病之日而始数之矣。仲景又曰。伤寒一
二日至四五日而厥者。必发热。伤寒病厥五日。热亦五日。设六日当复厥。不厥者。自愈。伤寒厥
四日。热反三日。复厥五日。其病为进。夫得伤寒未为热即为厥者。岂亦由传经入深之热邪而致此
乎。今人多有始得病时。便见诸寒症。而并无或热者。此则直伤阴经。即入阴经者也。苟不能究仲
景之心。但执凡伤于寒即为病热之语以为治。其不夭人天年者几希矣。
【纲】张仲景说：太阴病，脉象浮的，可以用发汗法治疗，适宜用桂枝汤。
【目】朱肱说：太阴病症在发汗后，如果仍然像之前一样出现寒热交替的症状，必须观察脉象如何。如果脉象浮数，或者洪大，说明表证依然存在，可以再使用解表法，比如桂枝汤、桂枝二麻黄一汤之类的方剂。医生们因为看到已经发过汗，或者已经用过下法，而再次出现恶寒发热，就不敢再用解表法，这是错误的。大概脉浮表示病邪在表，解表治疗后必定痊愈。
李中梓说：或者是表邪没有完全清除，或者是邪气传入里部，或者是邪气趁着正气虚弱侵入体内，所以虽然发过汗，但疾病仍然存在。
张从正说：脉浮，说明病在表。即使已经发过汗，或者自发出汗，而脉象仍然浮，说明表部的风热尚未清除干净，可以再次发汗。
王履说：我曾经阅读张仲景的《伤寒论》，其中关于太阴病说道：“自发腹泻且不口渴的，属于太阴病，因为内脏有寒的缘故，应当温补，适宜用四逆汤类方剂。”关于少阴病说道：“少阴病，得病一两天，口中平和不燥，背部怕冷的，应当施灸；少阴病，身体疼痛，手脚寒冷，骨节疼痛，脉象沉的，用附子汤主治；少阴病，腹泻，用白通汤；少阴病，腹泻且脉象微弱的，给予白通汤；腹泻不止，四肢厥冷，无脉搏，干呕心烦的，用白通加猪胆汁汤；少阴病，腹泻排出未消化的食物，里有寒外有热，手脚厥冷，脉象微弱几乎摸不到，身体反而不怕冷，病人面色发红，或者腹痛，或者干呕，或者咽痛，或者腹泻停止但脉搏不出现的，用通脉四逆汤；少阴病，脉象沉的，紧急温补，用四逆汤。”关于厥阴病说道：“手脚厥冷，脉象细弱几乎摸不到的，用当归四逆汤；大汗出，或者严重腹泻，导致四肢冰冷的，用四逆汤。”看张仲景的这些论述，那么伤寒病的三阴经（太阴、少阴、厥阴），必然有寒证，而适宜使用温热的药剂。等到我读刘守真的书，其中有说道：“伤寒邪热在体表，腑病属于阳；邪热在体内，脏病属于阴。世俗荒谬地认为有寒热阴阳不同的病症，误导人很久了。寒病是有的，但不是指伤寒这类外感病。寒病只属于杂病，终究不能成为伤寒病。况且汗液之气，乃是阳热之气，不是阴寒所能产生的。虽然张仲景有四逆汤证，那是治疗表热里和，误用寒药过早攻下，导致表热入里，腹泻不止，以及或者表热里寒自发腹泻，紧急用四逆汤温热药物，腹泻停止里气调和，紧急解除表邪。所以张仲景的四逆汤证，又有用承气汤攻下的情况。由此看来，伤寒这类外感病，经典直言是热病，而不说是寒病。经典所说的三阴症，是指邪热在脏在里，因为脏与里属阴，应当攻下热邪。《素问》讨论伤寒热病有两篇，名为热，完全没有寒的理论。结合《素问》《灵枢》等篇章中运气造化的道理推导，这确实是热病，确实不是寒病。看刘守真这些论述，那么伤寒无论病在表在里，以及三阳三阴，全都统一为热，绝对没有寒的情况了。成无己的注解也只是顺着文意略微解释，并不明确说明为什么是热、为什么是寒的原因。他大概只知道伤寒都是传经病，所以对六经所传的病症都认为是热症，而热没有变成寒的道理，于是就不敢分辨清楚罢了。如果是本脏的寒吗？怎么能当热邪传入里部深入的时候，反而单独见到寒而不见热呢？而且所使用的温热药，难道不会助长传经的热邪吗？如果是外邪的寒吗？那么在三阳经就已经变成热了，哪有传到三阴经反而变成寒的呢？成无己如果能潜心研究于此，就一定能说出其中的原因了。自从张仲景撰写《伤寒论》，没有人不尊崇它。后人不能在似是而非的问题上做出决断，所以有人说现在世上没有真正的伤寒，或者说现在人都患内伤病，或者说《论》中的各种温药，全都是为了传经热邪使用的，因为三阴经属于阴的缘故。又有人说《论》中凡是带有‘寒’字的，都应该当作‘热’字，这种错误竟然到了这种地步。殊不知三阳的病，其寒邪在太阳经时，寒郁遏阳气，阳气不畅而变成热。阳气虽然是人身上的正气，既然被郁遏成为邪气，用麻黄发表以驱逐寒邪，那么腠理通畅而郁热发泄，所以发汗后痊愈。如果不发汗不解，热不得向外发泄，就一定向内传入，所以传给阳明、传给少阳，或者进入腑。至于三阴的病，为什么有的寒有的热呢？大概寒邪伤人，有的是在太阳经郁积化热，然后依次传到阴经；有的是太阳经不传给阳明、少阳，直接传给三阴经；有的是寒邪不从三阳经开始，直接伤害阴经；有的是虽然从太阳经开始，来不及郁积化热，就进入少阴，而单独出现少阴病症；有的是太阳经一开始就进入少阴，而太阳经不能完全不受损伤；有的是直接伤害随即进入，而寒便变成热，以及开始为寒最终变热的。那些郁积化热传经，以及变热就成为热症；那些直接伤害阴经，以及从太阳经直接进入少阴就成为寒症；那些太阳经不能完全不受损伤，则少阴的脉症而兼见太阳经标病；那些开始为寒最终变热，则先见寒症而后见热症。这就是三阴病之所以有的寒有的热的原因。如果在三阴经各篇中仔细推究，道理就在这里了。那些或传经、或直伤、或即入、或先寒后热的情况，为什么呢？邪气暴烈突然，本来没有固定的情状，而传变不常规律所致。所以经典说：邪气中人没有固定规律，有的中于阳，有的中于阴。那个刘守真并不是喜欢为了耸人听闻而故意说大话，而是因为他把温病、暑病当作伤寒，而张仲景的方剂，往往不与温病、暑病相对应，所以他忽略了温热药剂，而惯例使用寒凉药。因为他把伤寒一概断定为热而无寒，所以说四逆汤是寒药，误解了表热里和的病症，以及为表热里寒自发腹泻的病症而设立。又说温里止泻，紧急解表。又说寒病只属于杂病。唉！张仲景的《伤寒论》专门为中寒即发的伤寒所作，不兼为不即发的温病、暑病所作。所以常有涉及三阴的寒症，这也是使用温热药剂的原因。况且如用寒药误下而成里寒的情况，固然不能说没有。但不因寒药误下而自己成为里寒的情况，难道可以说一定没有吗？殊不知阴经经常见到寒症，本来是由寒邪引起，不是由阳经直接伤害于此，以及虽然由阳经开始，来不及郁积化热就进入于此所导致的。虽然或许有因寒药误下而致的，但也很少。张仲景所以使用各种温热药剂，何尝仅仅是为了寒药误下而设立的？况且表里俱寒的病症，何尝每每有紧急解表的文字呢？所谓里寒外热的病症，乃是寒邪侵入客居于内，逼迫阳气于外，或者是虚阳之气，自作外热的样子罢了，并非真正的热邪所为。况且张仲景对于里寒外热的病症，只用温药治疗里寒，而不治疗外热，就知道他治疗的意思了。这里果真应当紧急解表吗？难道不在里气调和之后，明确说明吗？《内经》所叙述的三阴病一律为热，说的是常理；张仲景所叙述的三阴病兼有寒热，说的是变理。两者并行而不违背。学医的人能知道三阴经固有寒邪所造成的病症，那么张仲景创立法则的本意，就可以明白了。况且张仲景说：生病发热恶寒的，发于阳经；不发热恶寒的，发于阴经。发于阳经的七天痊愈，发于阴经的六天痊愈。说‘无热恶寒’，就知道不是阳经的郁热了。说‘发于阴’，就知道不是从阳经传到这里来的。说‘六天痊愈’，就知道不是始于太阳经，而是只从阴经发病之日开始计算天数了。张仲景又说：伤寒一二天到四五天出现四肢厥冷的，一定会发热；伤寒病厥冷五天，发热也五天，假如第六天应当再次厥冷，如果不厥冷，就会自愈；伤寒厥冷四天，发热反而三天，再次厥冷五天，病情就是进展。得到伤寒还没有发热就出现厥冷的，难道也是由传经深入的邪热导致这样的吗？现在很多人有病刚开始时，就见到各种寒症，而并没有任何热症，这就是直接伤害阴经，随即进入阴经的情况。如果不能探究张仲景的心意，只是执着于凡是伤于寒就变成热病的言语来治疗，那不能夭折人的自然寿命的就太少了。
[Outline] Zhang Zhongjing said: In Taiyin disease, if the pulse is floating, sweating therapy may be applied; Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
[Commentary] Zhu Gong said: After sweating therapy for a Taiyin syndrome, if chills and fever persist as before, one must examine the pulse. If the pulse is floating and rapid, or surging and large, it indicates that the exterior syndrome still exists, and exterior-releasing therapy can be used again, such as with Guizhi Tang (Cinnamon Twig Decoction) or Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction). Physicians, seeing that sweating or purging has already been performed, hesitate to use exterior-releasing therapy again when chills and fever recur; this is an error. Generally, a floating pulse indicates the pathogen is at the exterior; releasing the exterior will surely lead to recovery.
Li Zhongzi said: This occurs because either the exterior pathogen has not been fully cleared, or the pathogen has transmitted inward, or the pathogen invades internally taking advantage of deficiency. Thus, even after sweating, the disease remains.
Zhang Congzheng said: A floating pulse indicates the disease is at the exterior. Even if sweating has already occurred, or spontaneous sweating has happened, if the pulse remains floating, it means wind-heat at the exterior has not been fully resolved, and sweating can be performed again.
Wang Lü said: I once read Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage), which states regarding Taiyin disease: "Spontaneous diarrhea without thirst belongs to Taiyin, due to cold in the zang organs; it should be warmed, and Si Ni Tang (Frigid Extremities Decoction) type formulas are suitable." Regarding Shaoyin disease, it states: "In Shaoyin disease, within one or two days of onset, if the mouth feels neutral and there is aversion to cold on the back, moxibustion should be applied. In Shaoyin disease, with body pain, cold hands and feet, bone and joint pain, and a deep pulse, Fuzi Tang (Aconite Decoction) is the primary treatment. In Shaoyin disease with diarrhea, Baotong Tang (White Onion Decoction) is used. In Shaoyin disease with diarrhea and a faint pulse, administer Baotong Tang. If diarrhea does not stop, accompanied by cold extremities, absence of pulse, dry heaving, and irritability, use Baotong Jia Zhuchidan Tang (Baotong Decoction with Pig Bile). In Shaoyin disease with diarrhea of undigested food, interior cold with exterior heat, cold extremities, and a pulse so faint it seems absent, yet the body feels no aversion to cold and the face appears red, or with abdominal pain, dry heaving, sore throat, or cessation of diarrhea with unpalpable pulse, Tongmai Si Ni Tang (Pulse-Returning Si Ni Decoction) is indicated. In Shaoyin disease with a deep pulse, urgent warming is required using Si Ni Tang (Frigid Extremities Decoction)." Regarding Jueyin disease, it states: "With cold extremities and a fine, nearly absent pulse, Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities) is used. After profuse sweating or severe diarrhea leading to cold extremities, Si Ni Tang (Frigid Extremities Decoction) is used." Observing these discussions by Zhang Zhongjing, it is clear that the Three Yin stages (Taiyin, Shaoyin, Jueyin) of Shanghan certainly involve cold syndromes and are suitable for warm-hot agents. However, upon reading Liu Shouzhen's works, he stated: "When Shanghan pathogenic heat is at the exterior, fu organ diseases are Yang; when pathogenic heat is at the interior, zang organ diseases are Yin. The vulgar misconception that there are distinct cold and hot yin-yang syndromes has misled people for a long time. Cold diseases exist, but they do not refer to Shanghan. Cold diseases belong only to miscellaneous diseases and cannot constitute Shanghan. Moreover, the qi of sweat is yang-heat qi, not something yin-cold can produce. Although Zhang Zhongjing mentions Si Ni Tang syndromes, these treat cases where exterior heat and interior harmony were mistakenly purged too early with cold medicines, causing exterior heat to enter the interior and resulting in persistent diarrhea, or cases of spontaneous diarrhea due to exterior heat and interior cold. Urgent use of warm medicines like Si Ni Tang stops diarrhea and harmonizes the interior, followed by urgent release of the exterior. Therefore, some Zhang Zhongjing Si Ni Tang syndromes are later treated with Chengqi Tang (Gardenia and Rhubarb Decoction) purgatives. From this, it follows that Shanghan is explicitly described in classics as a heat disease, not a cold one. The 'Three Yin syndromes' mentioned in classics refer to pathogenic heat residing in the zang and interior; since zang and interior are Yin, purging heat is required. Two chapters in *Suwen* discussing Shanghan heat diseases are named 'Heat,' containing no theory of cold. Deduced from the principles of luck and transformation in *Suwen* and *Lingshu*, these are indeed heat diseases, certainly not cold. Based on Liu Shouzhen's argument, Shanghan, whether at the exterior or interior, and regardless of the Three Yang or Three Yin stages, is uniformly heat, absolutely without cold. Cheng Wuji's annotations merely explain the text slightly without clarifying why it is heat or cold. He likely believed Shanghan always transmits through meridians, thus assuming all Six Meridian transmissions result in heat syndromes, believing heat cannot transform into cold, and therefore dared not distinguish otherwise. If it were inherent cold of the zang, how could one see only cold and not heat when heat pathogens transmit deeply into the interior? Would the warm-hot medicines used not aid the transmitting heat pathogen? If it were external cold pathogen, it would have already become heat in the Three Yang stages; how could it turn cold upon reaching the Three Yin? If Cheng had studied this deeply, he would have explained the rationale. Since Zhang Zhongjing wrote *Shanghan Lun*, everyone reveres it. Later generations, unable to decide between plausible and implausible interpretations, claim either that true Shanghan no longer exists in the world, or that modern people suffer from internal injury, or that all warm medicines in the Treatise are used for transmitting heat pathogens because the Three Yin meridians belong to Yin. Others claim every instance of the character 'cold' in the Treatise should be read as 'heat'; such errors have reached absurdity. They fail to realize that in Three Yang diseases, when cold pathogen is in the Taiyang meridian, cold stifles yang qi, causing stagnation and transformation into heat. Although yang qi is the righteous qi of the body, once stifled into pathogen, using Mahuang (Ephedra) to release the exterior expels cold, opening the pores and venting stifled heat, leading to recovery via sweating. If sweating fails to resolve it, heat cannot escape outward and must enter inward, transmitting to Yangming or Shaoyang, or entering the fu organs. As for Three Yin diseases, why are some cold and some hot? Generally, when cold pathogen injures the person, sometimes it stifles heat in Taiyang before transmitting sequentially to the Yin meridians; sometimes Taiyang does not transmit to Yangming or Shaoyang but directly to the Three Yin; sometimes the cold pathogen does not start from the Three Yang but directly injures the Yin meridians; sometimes starting from Taiyang, it enters Shaoyin before stifling heat, presenting solely as Shaoyin syndrome; sometimes entering Shaoyin immediately from Taiyang, while Taiyang is not entirely uninjured; sometimes direct injury leads immediately to transformation from cold to heat, or starting as cold and ending as heat. Stifled heat transmitting through meridians and transforming heat results in heat syndromes; direct injury to Yin meridians and immediate entry from Taiyang to Shaoyin result in cold syndromes. When Taiyang is not entirely uninjured, Shaoyin pulse and symptoms appear alongside Taiyang marker symptoms. Starting as cold and finally transforming to heat presents first with cold symptoms then heat symptoms. This is why Three Yin diseases present as either cold or hot. Careful examination of the chapters on the Three Yin meridians reveals this logic. Why do some transmit, some suffer direct injury, some enter immediately, and some go from cold to heat? Because pathogenic qi is violent and sudden, lacking fixed patterns, and its transmission is irregular. Hence, the classic says: Pathogens injuring humans have no constancy; some strike Yang, some strike Yin. Liu Shouzhen did not speak wildly to shock people; rather, he conflated Warm diseases and Summerheat diseases with Shanghan. Since Zhang Zhongjing's formulas often do not correspond to Warm/Summerheat treatments, he overlooked warm agents and routinely used cold-cool ones. By categorizing Shanghan strictly as heat without cold, he labeled Si Ni Tang as a cold medicine, misunderstanding syndromes of exterior heat with interior harmony, and those of exterior heat with interior cold causing spontaneous diarrhea. He claimed warming the interior stops diarrhea and urgently releases the exterior, and that cold diseases are merely miscellaneous diseases. Alas! Zhang Zhongjing's *Shanghan Lun* was specifically composed for Shanghan contracted immediately upon exposure to cold, not for non-immediate Warm or Summerheat diseases. Thus, cold syndromes of the Three Yin occur, necessitating the use of warm agents. Although cold medicines mistakenly purging into interior cold is possible, can we say interior cold arising spontaneously without such mistake is impossible? It is unknown that cold syndromes frequently seen in Yin meridins originate from cold pathogens, not from direct injury by Yang meridians, nor from entering quickly from Yang meridians before heat stifling occurs. Even if caused by mistaken cold purgation, it is rare. Did Zhang Zhongjing create various warm agents solely for mistaken cold purgation? Furthermore, in cases of simultaneous exterior and interior cold, where is the text urging urgent exterior release? The syndrome of interior cold with exterior heat is caused by cold pathogen invading internally, forcing yang qi outward, or false yang qi manifesting as exterior heat; it is not true heat pathogen. Moreover, Zhang Zhongjing treats interior cold with warm medicines without addressing exterior heat in such cases, revealing his therapeutic intent. If urgent exterior release were truly indicated, would he not state it clearly after the interior harmonizes? *Neijing* describes Three Yin diseases as uniformly heat, stating the norm; Zhang Zhongjing describes them as mixed cold and heat, stating the variation. Both proceed without contradiction. If students understand that Three Yin meridians inherently have cold syndromes caused by cold pathogens, the original intent of Zhang Zhongjing's methods becomes clear. Zhang Zhongjing also said: Diseases presenting with fever and aversion to cold arise from Yang; those without fever but with aversion to cold arise from Yin. Those arising from Yang heal in seven days; those arising from Yin heal in six days. 'No fever, aversion to cold' indicates it is not stifled heat of Yang meridians. 'Arising from Yin' indicates it did not transmit from Yang meridians. 'Healing in six days' indicates it did not start from Taiyang but began counting from the day of Yin meridian onset. Zhang Zhongjing further said: In Shanghan, if cold extremities appear from day one to four or five, fever will inevitably follow. If cold extremities last five days, fever lasts five days; if on the sixth day cold extremities return but do not, the disease heals itself. If cold extremities last four days, fever lasts three days, then cold extremities return for five days, the disease progresses. Can Shanghan presenting with cold extremities before fever be caused by heat pathogens transmitting deeply? Many people today present with various cold symptoms from the onset, with no heat; this is direct injury to Yin meridians and immediate entry into Yin. If one cannot fathom Zhang Zhongjing's intent and rigidly adheres to the saying that all cold injuries become heat diseases for treatment, few would avoid premature death.