按《热病论》云∶“太阴脉布胃中，络于嗌，故腹满而嗌干。”此热伤太阴之标，自阳部注经之症，非太阴
本病也。仲景立本病为提纲，因太阴主内，故不及中风、四肢烦疼之表，又为阴中至阴，故不及热病嗌干之症。
太阴为开，又阴道虚，太阴主脾所生病，脾主湿，又主输。故提纲主腹满时痛而吐利，皆是里虚不固，湿胜外溢
之症也。脾虚则胃亦虚，食不下者，胃不主内也。要知胃家不实，便是太阴病。
脾胃同处腹中，故腹满为太阴阳明俱有之症。在阳明是热实为患，在太阴是寒湿为眚。阳明腹满不敢轻下者，
恐胃家不实，即转属太阴耳。世拘阳明传少阳之谬，反昧传太阴之义。
热病腹满，是热郁太阴之经，有嗌干可证，病在标也；寒湿腹满，是寒生至阴之脏，有自利可证，病在本也。
脾经有热，则阴精不上输于肺，故嗌干；脾脏有寒，则脾不为胃行其津液，故下利。夫阳明之当下，因本病；而
太阴之下症，反是标病。可以见阴阳异位之故，又以见阴从阳转之义也。
参中阴溜府之义，知热邪不遽入至阴，虽热在太阴之经，而实
仍在阳明之胃。可知下症只在阳明，太阴本无下法。
腹满亦两经之症∶不大便而满痛，或绕脐痛者，为实热，属阳明；下利而腹满时痛，为虚寒，属太阴。寒湿
是太阴本症，湿热又伤寒所致之变症也。其机关在小便；小便不利，则湿热外见而身黄；小便自利，非暴烦下利
而自愈，即大便硬而不便。所以然者，脾胃相连，此脾家实则腐秽自去，而成太阴之开。若胃家实则地道不通，
而转阳明之阖矣。故叔和知有三阳明，不知有太阴阳明症。
《序例》谓太阴受病，脉当沉细。不知沉细是太阴本病之脉，不是热病嗌干之脉。盖脉从病见，如太阴中风
则脉浮，不从脏之阴而从风之阳也。然浮为麻黄汤脉而用桂枝者，以太阴是里之表症，桂枝汤是里之表药。因脾
主肌肉，是宜解肌耳。太阴伤寒，脉浮而缓者，亦非太阴本病。盖浮为阳脉，缓为胃脉。太阴伤寒，脉不沉细，
而反浮缓，是阴中有阳，脉有胃气。所以手足自温，而显脾家之实，或发黄便硬，而转属阳明。此脉症在太阴阳
明之间，故曰“系在”。故若太阴自受寒邪，不应如是矣。
太阴脉浮为在表，当见四肢烦疼等症；沉为在里，当见腹满吐利等症。表有风热可发汗，宜桂枝汤；里有寒
邪当温之，宜四逆辈。太阳而脉沉者，因于寒，寒为阴邪，沉为阴脉也；太阴而脉浮者，因于风，风为阳邪，浮
为阳脉也。当知脉从病变，不拘于经，故阳经有阴脉，阴经有阳脉。世谓脉至三阴则俱沉，阴经不当发汗者，未
审此耳。
太阴中风，阳微阴涩而长者，为欲愈。要知涩与长不是并见，涩本病脉，涩而转长，病始愈耳。风脉本浮，
今浮已微，知风邪当去。涩则少气少血故中风，今长则气治，故愈。太阴中风，四肢烦疼，太阴伤寒，手足自温，
此指表热言也。热在四肢，则身体不热可知。盖太阴主内，表当无热。惟四肢为诸阳之本，脾为胃行津液以灌四
旁，故得主四肢，则四肢之温热，仍是阳明之阳也。且曰自温，便见有时不温，有时四逆矣。《内经》云∶“人
有四肢热，逢风而如炙如火者，是阴气虚而阳气盛。风者阳也，四肢亦阳也，两阳相搏，是火当内烁。”此即太
阴中风症。要知太阴中风，与三阳不同。太阴之阴，名曰关蛰，故阳邪不得深入。惟病在四关，久而不愈，脾液
不足以充肌肉，故肉烁。世人最多此症，其有手足心热者，亦中风之轻者耳。然太阴中风，因阴虚而阳凑之，外
风为内热所致，但当滋阴以和阳，不得驱风而增热
也。
手足自温句，暗对身不发热言，非言太阴伤寒必当手足温也。夫病在三阳尚有手足冷者，何况太阴？陶氏分
太阴手足温、少阴手足寒、厥阴手足冷，是大背“太阴手足烦疼，少阴一身尽热”之义矣。凡伤于寒知为病热，
寒为阴，太阴为至阴，两阴相合，无热可发，惟四末为阴阳之会，故当温耳。惟手足自温，中宫不遽受邪，故或
发身黄，或暴烦下利自止。即手足自温处，因以见脾家之实也。
发黄是阳明病，太阴身当发黄，非言太阴本有发黄症也。以手足温处。是阳明之阳盛。寒邪不得伤太阴之脏，
脏无寒而身有湿，故当发黄。若湿从溺泄，暴烦下利，仍是主输，故不失为太阴病。若烦而不利，即胃家之热实，
非太阴之湿热矣。此太阴伤寒，全藉阳明为之根，故有转属之症。此知伤寒以阳为主，不知太阴伤寒以阳明为主。
东垣以有声无声分呕吐，非也。呕吐皆有声有物，惟干呕是有声无物。呕以水胜，属上焦也；吐以物胜，属
中焦也。六经皆有呕吐，而呕属少阳，以喜呕故吐，属太阴而不属阳明，亦主输主内之分。
太阳以阴为根，而太阴以阳为本。太阳不敢妄汗，恐亡少阴之津也；太阴不敢轻下，恐伤阳明之气也。太阴
本无下症，因太阳妄下而阳邪下陷于太阴，因而有桂枝汤加芍药等法。太阴脉弱，知胃气易动，盒饭少加矣。此因
里急后重者，不可不用，又不可多用，故如是叮咛耳。
按《热病论》记载：“太阴经脉分布于胃中，联络于咽喉，所以会出现腹部胀满和咽喉干燥的症状。”这是热邪损伤了太阴经的标部，是从阳经传入本经的症状，并非太阴的本病。张仲景确立太阴本病作为提纲，因为太阴主司内脏功能，所以不涉及中风、四肢烦疼等表证；又因为太阴是“阴中之至阴”，所以也不涉及热病导致的咽喉干燥等症状。
太阴主“开”的功能，且属于虚性的阴道，太阴主要主管脾脏所生的疾病。脾主运化水湿，又主转输津液。因此，太阴病的提纲症状表现为腹部胀满、时而疼痛以及呕吐腹泻，这些都是里气虚弱不固、湿气偏盛向外溢出的表现。脾气虚弱则胃气也虚弱，食物无法下行，是因为胃失去了主受纳腐熟的功能。要知道，只要胃家没有实热结聚，就是太阴病。
脾胃同处腹腔之中，所以腹部胀满是太阴病和阳明病都可能出现症状。在阳明病中，这是由于热邪结实为患；在太阴病中，这是由于寒湿邪气为害。阳明病腹部胀满不敢轻易使用攻下法，是担心如果胃家不实（即非阳明腑实证），病情就会转属到太阴。世人拘泥于阳明传少阳的错误观点，反而忽略了传变至太阴的道理。
热病引起的腹满，是热邪郁结在太阴经脉，伴有咽喉干燥可以佐证，病位在标；寒湿引起的腹满，是寒邪生于至阴之脏，伴有自发性腹泻可以佐证，病位在本。脾经有热，则阴精不能向上输送给肺，所以咽喉干燥；脾脏有寒，则脾不能为胃传输津液，所以发生腹泻。阳明病应当用下法，是因为其为本病；而太阴病出现下利症状，反而是标病。这可以看出阴阳部位不同的缘故，也体现了阴病从阳转化的道理。
参考“中阴溜府”的理论，可知热邪不会立刻进入至阴之脏，即使热邪在太阴经脉，实际上仍在阳明的胃中。可知攻下的适应症只在阳明，太阴本病并没有攻下法。
腹部胀满也是两经共有的症状：不大便且胀满疼痛，或者绕脐疼痛的，属于实热，归属于阳明；腹泻且腹部胀满、时而疼痛的，属于虚寒，归属于太阴。寒湿是太阴的本症，湿热又是伤寒导致的变症。其关键机制在于小便：小便不利，则湿热外现导致身黄；小便自利，如果不是突然烦躁并腹泻后自愈，就是大便变硬而排便困难。之所以这样，是因为脾胃相连，这里脾家实（指脾运化功能恢复或正气充足）则腐败秽浊之物自然去除，从而形成太阴的“开”机。如果胃家实（指阳明腑实），则肠道不通，从而转属阳明的“阖”机。所以王叔和只知道有三个阳明病，却不知道有太阴与阳明的区别。
《序例》说太阴受病，脉象应当沉细。不知道沉细是太阴本病的脉象，不是热病咽喉干燥的脉象。一般来说脉象随病症变化，如太阴中风则脉浮，这是因为不从脏之阴而从风之阳所致。然而浮脉通常是麻黄汤证的脉象却使用桂枝汤，是因为太阴是里的表证，桂枝汤是治里的表药。因为脾主肌肉，适宜解肌发表。太阴伤寒，脉浮而缓的，也不是太阴本病。因为浮是阳脉，缓是胃脉。太阴伤寒，脉不沉细反而浮缓，说明阴中有阳，脉有胃气。所以手足自温，显示出脾家的实证，或者发黄、大便硬，从而转属阳明。这种脉症介于太阴和阳明之间，所以说“系在”。如果是太阴直接感受寒邪，不应该如此。
太阴脉浮表示病在表，应当见到四肢烦疼等症状；脉沉表示病在里，应当见到腹部胀满、呕吐腹泻等症状。表有风热可以发汗，宜用桂枝汤；里有寒邪应当温补，宜用四逆汤类方剂。太阳病脉沉，是因为寒邪，寒为阴邪，沉为阴脉；太阴病脉浮，是因为风邪，风为阳邪，浮为阳脉。应当知道脉象随病变而变化，不拘泥于经络，所以阳经可以有阴脉，阴经可以有阳脉。世人认为脉象到了三阴就都是沉脉，阴经不当发汗，是没有审察清楚这个道理。
太阴中风，脉象微涩而长，是快要痊愈的表现。要知道涩脉和长脉不是同时出现的，涩脉是本病的脉象，涩脉转为长脉，病才开始痊愈。风脉本来浮，现在浮象已微弱，知道风邪将要去除。涩脉代表气血不足所以中风，现在脉长代表气血调和，所以痊愈。太阴中风，四肢烦疼；太阴伤寒，手足自温，这是指表热而言。热在四肢，那么身体就不发热，这是显而易见的。因为太阴主内，体表应当无热。只有四肢是诸阳之本，脾为胃传输津液以灌溉四周，所以能主管四肢，那么四肢的温热，仍然是阳明的阳气。而且说“自温”，就表明有时不温，有时会出现四肢厥冷。《内经》说：“人有四肢发热，遇到风就像被烧烤一样，这是阴气虚而阳气盛。风是阳邪，四肢也是阳，两阳相搏，火就会在内灼烧。”这就是太阴中风症。要知道太阴中风，与三阳病不同。太阴之阴，名为关蛰（封闭潜藏），所以阳邪不得深入。只有病在四关，久而不愈，脾液不足以充实肌肉，所以肌肉消瘦。世人最多见这种病症，那些手心脚心发热的，也是中风较轻的情况。然而太阴中风，是因为阴虚而阳邪凑集，外风是由内热引起的，只应当滋阴以调和阳气，不得驱散风邪而增加热势。
“手足自温”这句话，暗中对应手部不发热而言，并不是说太阴伤寒必定手足温。病在三阳还有手足冷的情况，何况太阴？陶氏区分太阴手足温、少阴手足寒、厥阴手足冷，是大大违背了“太阴手足烦疼，少阴一身尽热”的原义。凡是伤于寒邪，知道会化为热病，寒为阴，太阴为至阴，两阴相合，没有热可发，只有四肢末端是阴阳交会之处，所以应当温暖。只有手足自温，中焦脾胃才不至于迅速受邪，所以或者发黄，或者突然烦躁腹泻后自愈。就在手足自温这一点上，可以看出脾家的实证。
发黄是阳明病，太阴身当发黄，并不是说太阴本病有发黄的症状。因为手足温的地方，是阳明阳气旺盛。寒邪不能伤害太阴之脏，脏无寒而有湿，所以应当发黄。如果湿邪从小便排出，突然烦躁腹泻，仍然是主司转输的功能，所以不失为太阴病。如果烦躁但不腹泻，那就是胃家的热实证，不是太阴的湿热证。这是太阴伤寒，完全依赖阳明作为根本，所以有转属的症状。这说明伤寒以阳为主，不知道太阴伤寒以阳明为主。
李东垣用是否有声音来区分呕吐，是不对的。呕吐都是有声音且有物吐出，只有干呕是有声无物。呕是因为水饮胜，属于上焦；吐是因为食物胜，属于中焦。六经都有呕吐，但呕归属于少阳，因为喜欢呕所以吐，归属于太阴而不归属于阳明，这也是主输主内功能的区分。
太阳以阴为根，而太阴以阳为本。太阳不敢妄用发汗法，恐怕耗亡少阴的津液；太阴不敢轻用攻下法，恐怕损伤阳明的气机。太阴本无下症，是因为太阳误用攻下导致阳邪下陷于太阴，因而才有桂枝汤加芍药等方法。太阴脉弱，知道胃气容易动，饭盒应该少加（此处原文可能有误，结合语境应指药量不宜多）。这是因为如果有里急后重的症状，不可不用此法，但又不可多用，所以如此反复叮咛。
According to the *Re Bing Lun* (Treatise on Heat Diseases): "The Taiyin meridian distributes in the stomach and connects with the throat; therefore, abdominal fullness and dryness of the throat occur." This is a condition where heat damages the *biao* (branch/superficial aspect) of the Taiyin, representing symptoms transmitted from the Yang meridians into this meridian, not the *ben bing* (root disease) of Taiyin. Zhang Zhongjing established the root disease as the guiding principle. Since Taiyin governs the interior, it does not involve exterior symptoms such as wind-stroke or vexatious pain in the four limbs. Furthermore, because Taiyin is the "extreme Yin within Yin," it does not involve symptoms like dryness of the throat caused by heat diseases.
Taiyin governs the "opening" function and belongs to the deficient pathway of Yin. Taiyin primarily governs diseases generated by the Spleen. The Spleen governs dampness and also governs transportation and transformation. Therefore, the guiding symptoms of Taiyin disease include abdominal fullness, intermittent pain, vomiting, and diarrhea. These are all manifestations of deficiency and insecurity in the interior, and excessive dampness overflowing outward. When the Spleen is deficient, the Stomach is also deficient; inability to ingest food indicates that the Stomach has lost its function of receiving and rotting/ripening. It must be understood that if the Stomach house is not excess (solid), it is Taiyin disease.
The Spleen and Stomach reside together in the abdomen; thus, abdominal fullness is a symptom shared by both Taiyin and Yangming diseases. In Yangming disease, this is caused by heat and excess; in Taiyin disease, it is caused by cold and dampness. One dare not lightly use purgation for abdominal fullness in Yangming disease, fearing that if the Stomach house is not solid (i.e., not a Yangming Fu-organ excess pattern), the condition will transform into Taiyin disease. The world adheres to the erroneous view that Yangming transmits to Shaoyang, thereby ignoring the meaning of transmission to Taiyin.
Abdominal fullness in heat diseases results from heat stagnating in the Taiyin meridian, evidenced by dryness of the throat, indicating the disease is at the *biao* (branch). Abdominal fullness due to cold-dampness results from cold generating in the Zhiyin (Extreme Yin) organ, evidenced by spontaneous diarrhea, indicating the disease is at the *ben* (root). If there is heat in the Spleen meridian, Yin essence cannot ascend to the Lungs, causing dryness of the throat. If there is cold in the Spleen organ, the Spleen fails to transport fluids for the Stomach, causing diarrhea. Purging is indicated in Yangming disease because it addresses the root disease; conversely, diarrhea in Taiyin disease represents a branch manifestation. This reveals the reason for the different positions of Yin and Yang, and illustrates the principle of Yin transforming from Yang.
Referring to the concept of "Zhong Yin Liu Fu" (Intermediate Yin flowing into the Fu organs), it is known that heat pathogens do not immediately enter the Zhiyin organs. Even if heat is in the Taiyin meridian, it essentially remains in the Yangming Stomach. Thus, purging indications exist only in Yangming; Taiyin root disease has no purging method.
Abdominal fullness is also a symptom of two meridians: Constipation accompanied by fullness and pain, or periumbilical pain, indicates excess heat and belongs to Yangming. Diarrhea accompanied by abdominal fullness and intermittent pain indicates deficiency-cold and belongs to Taiyin. Cold-dampness is the root symptom of Taiyin, while damp-heat is a transformed symptom caused by cold damage. The key mechanism lies in urination: if urination is difficult, damp-heat manifests externally causing jaundice; if urination is normal, either the patient will spontaneously recover after sudden irritability and diarrhea, or the stool will become hard and difficult to pass. This is because the Spleen and Stomach are connected. Here, when the Spleen house is solid (functionally robust), foul waste is naturally expelled, forming the "opening" mechanism of Taiyin. If the Stomach house is solid (Yangming excess), the intestinal pathway is blocked, transforming into the "closing" mechanism of Yangming. Therefore, Wang Shuhe knew of three Yangming patterns but did not understand the distinction between Taiyin and Yangming symptoms.
The *Xu Li* states that when Taiyin is affected, the pulse should be deep and fine. However, deep and fine pulses are characteristic of Taiyin root disease, not the pulse for heat disease with dry throat. Generally, the pulse follows the disease manifestation; for example, in Taiyin wind-stroke, the pulse floats, following the Yang nature of wind rather than the Yin nature of the organ. Although a floating pulse is typically associated with Mahuang Tang, Guizhi Tang is used here because Taiyin represents an interior-exterior syndrome, and Guizhi Tang is a medicine for treating interior-exterior conditions. Since the Spleen governs muscles, releasing the muscle layer is appropriate. In Taiyin cold damage, a floating and moderate pulse is not the Taiyin root pulse. Floating is a Yang pulse, and moderate is the Stomach pulse. A Taiyin cold damage pulse that is not deep and fine but instead floating and moderate indicates Yang within Yin and the presence of Stomach Qi in the pulse. Consequently, the hands and feet remain warm, revealing a solid state in the Spleen house, or leading to jaundice and hard stools, transforming into Yangming. These pulse and symptom patterns lie between Taiyin and Yangming, hence described as "connected to." If Taiyin directly contracted cold pathogens, this would not occur.
A floating pulse in Taiyin indicates the disease is in the exterior, manifesting as vexatious pain in the four limbs; a deep pulse indicates the disease is in the interior, manifesting as abdominal fullness, vomiting, and diarrhea. Exterior wind-heat can be treated with sweating, preferably using Guizhi Tang; interior cold should be warmed, preferably using Sizni Tang or similar formulas. In Taiyang disease, a deep pulse is due to cold, which is a Yin pathogen, and deep is a Yin pulse. In Taiyin disease, a floating pulse is due to wind, which is a Yang pathogen, and floating is a Yang pulse. One must understand that the pulse changes with the disease and is not confined to the meridians; thus, Yang meridians can have Yin pulses, and Yin meridians can have Yang pulses. The common belief that pulses at the Three Yin levels are always deep, and that Yin meridians should not be treated with sweating methods, stems from a failure to examine this principle carefully.
In Taiyin wind-stroke, if the pulse is slightly wiry-choppy (*se*) yet long, recovery is imminent. Note that *se* and long pulses do not appear simultaneously; *se* is the pulse of the existing disease, and the transition from *se* to long indicates healing. The wind pulse is originally floating; now that the floating quality has diminished, it is known that the wind pathogen is departing. *Se* indicates qi and blood deficiency causing wind-stroke; a long pulse indicates harmonious qi, hence recovery. Taiyin wind-stroke presents with vexatious pain in the four limbs; Taiyin cold damage presents with warm hands and feet. This refers to exterior heat. If heat is in the four limbs, it is evident that the body is not hot. Since Taiyin governs the interior, the exterior should lack heat. Only the four limbs are the root of all Yang meridians; the Spleen transports fluids for the Stomach to irrigate the four sides, thus governing the limbs. Therefore, warmth in the limbs still reflects Yangming Yang. Moreover, saying "self-warm" implies that sometimes they are not warm, and sometimes cold limbs (*si ni*) occur. The *Neijing* states: "When a person has hot limbs and feels as if roasted upon exposure to wind, it is due to deficient Yin and abundant Yang. Wind is Yang, and the limbs are Yang; the collision of two Yangs causes fire to scorch internally." This is the Taiyin wind-stroke syndrome. It must be understood that Taiyin wind-stroke differs from the Three Yang diseases. The Yin of Taiyin is called "Guan Zhe" (closed and stored), so Yang pathogens cannot penetrate deeply. Only if the disease persists in the four gates without resolving, and Spleen fluids are insufficient to nourish the muscles, will the muscles emaciate. Many people suffer from this condition; those with heat in the palms and soles are experiencing a mild form of wind-stroke. However, Taiyin wind-stroke arises from Yin deficiency allowing Yang pathogens to gather. External wind is caused by internal heat; thus, one should nourish Yin to harmonize Yang, not dispel wind which would increase heat.
The phrase "hands and feet self-warm" implicitly contrasts with "body not feverish," and does not mean that Taiyin cold damage always presents with warm hands and feet. Even in Three Yang diseases, there are cases of cold hands and feet, let alone Taiyin. Tao's differentiation of Taiyin having warm hands/feet, Shaoyin having cold hands/feet, and Jueyin having cold hands/feet greatly contradicts the meaning of "Taiyin vexatious pain in limbs, Shaoyin whole-body heat." All injuries from cold pathogens eventually manifest as heat diseases. Cold is Yin, and Taiyin is Extreme Yin; the combination of two Yins leaves no heat to emit. Only the extremities are the meeting point of Yin and Yang, so they should be warm. Because the hands and feet are self-warm, the central palace (Spleen/Stomach) is not immediately invaded by pathogens; thus, either jaundice develops, or sudden irritability and diarrhea cease spontaneously. It is precisely at the point of self-warm hands and feet that the solidity of the Spleen house is revealed.
Jaundice is a Yangming disease. Saying "Taiyin body should develop jaundice" does not mean jaundice is a root symptom of Taiyin. The area of warm hands and feet indicates abundant Yangming Yang. Cold pathogens cannot injure the Taiyin organ; since the organ lacks cold but the body has dampness, jaundice should develop. If dampness drains through urine, causing sudden irritability and diarrhea, the transportation function remains intact, so it remains a Taiyin disease. If there is irritability but no diarrhea, it is Stomach excess heat, not Taiyin damp-heat. Taiyin cold damage relies entirely on Yangming as its root, hence there are transforming symptoms. This shows that Shanghan relies on Yang as the master, and Taiyin cold damage relies on Yangming as the master.
Li Dongyuan's distinction of vomiting based on the presence or absence of sound is incorrect. Vomiting involves both sound and material expulsion; only dry heaving (*gan ou*) involves sound without material. "Ou" (retching/vomiting fluid) is dominated by water/phlegm and belongs to the Upper Jiao; "Tu" (vomiting food) is dominated by solids and belongs to the Middle Jiao. All Six Meridians can present with vomiting, but "Ou" belongs to Shaoyang because of frequent retching; "Tu" belongs to Taiyin and not Yangming, reflecting the distinction between governing transportation and governing the interior.
Taiyang takes Yin as its root, while Taiyin takes Yang as its foundation. Taiyang dares not sweat recklessly, fearing the loss of Shaoyin fluids; Taiyin dares not purge lightly, fearing injury to Yangming Qi. Taiyin root disease has no purging indication; however, if Taiyang was incorrectly purged, causing Yang pathogens to sink into Taiyin, methods like Guizhi Tang plus Shaoyao are employed. If the Taiyin pulse is weak, it indicates the Stomach Qi is easily disturbed, and the dosage should be small. This caution is given because while certain conditions like tenesmus may require this approach, it must not be overused.