（此系仲景原文）
（王安道云。仲景之书。叔和所增入者。辩脉平脉。与可汗可下等诸篇而已。其六经篇。非叔和所能赞辞也。缘注
太阳上编。仍遵仲景之旧云尔。）
太阳之为病脉浮。头项强痛而恶寒。（此言太阳之为病。是总下文中风伤寒而立论也。按黄仲理云。太阳之为病脉浮。
头项强痛而恶风寒。寒字上又增一风字。乃知恶寒二字。不但指伤寒而言。连中风之候。亦在其中。太阳之经主表。故
成注云。此是太阳表病。）
太阳病。发热。汗出。恶风。脉缓者。名为中风（太阳病。即上文云。脉浮。头项强痛是也。篇中凡言太阳病。皆
仿此。夫太阳表病。有营卫之分。成注云。风则伤卫。寒则伤营。风为阳邪。故病即发热。汗出恶风者。人受风邪所伤。
则皮腠疏。气不能卫固其外故也。方氏条辩云。风性柔和。故脉见缓。或云。脉缓。当作浮缓看。浮是太阳病脉。缓是
中风脉。下文云紧脉。亦当仿此。愚以上言中风。非东垣所云。中腑。中脏。中血脉之谓。盖中字与伤字同义。仲景论
中不直云伤风者。恐后学不察。以咳嗽鼻塞声重之伤风。混同立论。故以中字别之也。）
太阳病。或已发热或未发热。必恶寒体痛呕逆。脉阴阳俱紧者。名曰伤寒。（风伤卫之证。上文已言之矣。此特举寒
伤营之证而发明之。经云。人伤于寒。则为病热。仲景云。或未发热者。成注以寒为阴邪。不能即热。郁而方变热也。
伤寒恶寒。势所必至体痛者。寒伤营。营主血。血为寒气所凝。故作痛呕逆者。胃口亦受寒气所郁。而作呕也。脉经云。
寸口为阳。尺中为阴。伤寒之脉。尺与寸俱紧者。成注云。寒性劲急故也。愚按此条论。于未发热下。当增无汗二字。
然云恶寒体痛。则无汗之意。即在其中。又按体痛。尚论篇误注作体重。且云仲景恐人见恶寒体重呕逆。又未发热。误
认为直中阴经之证。故早揭此语于辩证之先。独不思仲景论太阳病。开口便云头项强痛。何至与阴经错误。喻氏之言。
何懵懂之至邪。）
伤寒一日。太阳受之。脉若静者。为不传。颇欲吐。若躁烦。脉数急者。为传也。（此言伤寒。乃兼上中风之证而言。
下言二三日。伤寒亦仿此。脉静者。谓浮紧者不甚紧。浮缓者不甚缓也。以外来风寒之邪。约略言之。则一日太阳。二
日阳明。三日少阳。成注云。阳明胃经受邪。则喜吐。颇欲吐者。言不但干呕作逆。直欲大吐。乃病进之兆也。躁烦者。
热郁之极。脉数者。一息五六至之谓。急疾也。言太阳病。欲传入阳明。不惟脉紧者。数而急疾。即缓脉。亦变而为数
且疾也。）
伤寒二三日。阳明少阳证不见者。为不传也。（条辩云上言不传。乃是太阳病向愈之候。此言不传。当兼太阳病不解
之候。成注亦云。知邪不传。止在太阳经中。此是不解之意。）
（附后例）太阳病发热而渴。不恶寒者。为温病。（此条是阳明病温。而亦列于太阳篇者。以初病起。即头项强痛故
也。然此条既系温病。不可与风寒同治。因另立治温法。在后第十三卷中。）
若发汗已。身灼热者。名曰风温。风温为病。脉阴阳俱浮。自汗出。身重。多眠睡。鼻息必鼾语言难出。若彼下者。
小便不利直视。失溲。若被火者。微发黄色。剧则如惊痫。时 。若火熏之。一逆尚引日。再逆促命期。（小便不利四
字。当在若被下者四字之上。否则既云不利。又曰失溲悖矣。此即上条温病。误发其汗。变作风温是为一逆。复误下。
或误火。是为再逆。程氏后条辩云。凡风温身重多眠。语言难出。小便不利。直视失溲。发黄惊痫 等。此皆温病中
之坏病。亦宜入治温论。正文与注。详见后第十三卷中。）
病有发热恶寒者。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。以阳数七。阴数六
故也。（凡病有身发热。而外作恶寒之状者。此风寒之邪。伤于阳经而发。乃伤寒病也。有身无热。而外作恶寒之状者。
此风寒之邪。直中阴经而发。为中寒病也。阳数奇。故愈。约以七日。七者。少阳之数也。阴数偶。故愈。约以六日。
六者。老阴之数也。成注以火成数七。水成数六。为解亦通。愚按条辩云。无热恶寒者。乃伤寒或未发热之时。尚论篇
云。寒邪初受。未郁成热。要之此言。终是太阳病。仲景云一二日发者。乌得云。病发于阴。若以寒伤营。营为阴作解。
牵强极矣。张氏缵论云。此条以有热无热证。阳病阴病之大端。乃阴阳寒热关头。学人所当体认。上论宜入前第二卷伤
寒例中）
太阳病。头痛。至七日以上。自愈者。以行其经尽故也。若欲作再经者。针足阳明。使经不传。则愈（欲作再经准
绳作欲再传经。犹言再传一经也。太阳者。巨阳也。内经云。七日巨阳病衰。头痛少愈。行其经尽者。谓寒邪之行。只
在太阳一经。至七日。则太阳之邪。不外泄。即内入。故曰尽也。凡诸经之邪。必至七日。为行经尽。而自愈之时。如
阳明病身热。二日受者。八日愈少阳病耳聋。三日受者。九日愈。皆七日以上也。欲作再经者。谓太阳病邪之初。郁热
不散。欲再传经。当是阳明受之。非若成注云。伤寒自一日至六日。传三阳三阴经尽。至七日。当愈不愈。则太阳之邪。
再传入阳明也。仲景立此条。是设一截病法云。太阳病愈。必至七日以上。太阳病传。止在二三日间医者。宜及此时。
针足阳明。迎而夺之。以泄其热。则病邪之气已衰。纵使有经而不至于传。则其病自愈。条辩云夺其传路而遏之。遏之
之意。犹未善解。针足阳明穴。详后第十四卷。刺热法中。愚按成氏此条注谬甚。尚论篇承其谬云。太阳之邪。传至厥
阴。六经尽矣。至七日当愈设不愈。则七日再传太阳。八日再传阳明。岂非谬中之谬邪。考马玄台内经注云。自太阳至
厥阴。犹人由户升堂入室。厥阴复出传于太阳。奈有少阴太阴少阳阳明以隔之。岂有遽出而传太阳之理。此斥再传之非。
实为千载定论。）
太阳病欲解时。从巳至未上。（太阳者。盛阳也。成注云。巳午未。太阳气王。故乘其时而病解。后条辩云。太阳病
欲解。必藉令未土。土者。阴阳之冲气也。缘病之发也。非虚发。必阴阳之乖气。有乘吾之经气者。病之解也。不徒解
必阴阳之冲气。有王吾之经气者。愚谓四时之气。如春温夏热秋燥冬寒。皆遇土令而后得解。六经之解。各以三时太阳
从巳至未。未。土也。阳明从申至戌。戌。土也。少阳从寅至辰。辰。亦土也。太阴从亥至丑。少阴从子至寅。厥阴从
丑至卯。三阴之解。亦以土也。此为至当不易之理。成注总解云。阳行速。阴行缓。阳生于昼。阴生于夜。三阳经解时。
从寅至戌。以阳道常饶也。三阴经解时。从亥至卯。以阴道常乏也。按此论亦有理。）
风家。表解而不了了者。十二日愈（成注云。中风家。发汗解后。未全快畅。此即是不了了。必俟十二日。六经行
尽之时。余邪悉去。不治自愈。）
病患身大热。反欲得近衣者。热在皮肤。寒在骨髓也。身大寒。反不欲近衣者。寒在皮肤。热在骨髓也。（身大热者。
足太阳病已。发热之时也。欲得近衣。是表恶风寒也。热在皮肤。是寒郁而肌表蒸热也。寒在骨髓。是风寒之气。束人
肌骨间也。凡人病外伤风寒。则遍身骨节入髓疼痛。而作恶寒之状。扪其皮肤。则大热烙手。此系太阳表证。故列入太
阳上编。身大寒者。谓病传三阴。邪已入腑。表无热也。不欲近衣。是内热发烦躁也。寒在皮肤。谓内热亢甚。肌表反
作冷也。热在骨髓。是为郁热在里。深入脏腑间也。凡人病外伤风寒。表之不散。传入于府。胃腑实热。久不得泄。扬
手掷足。大作烦躁之状。扪其肢体间。厥逆冰手。此非太阳病例。仲景举此对代而言之耳。愚以病患身热欲得近衣者。
仲景法。宜用麻黄汤以汗之。身寒不欲近衣者。宜用大柴胡汤。或三承气汤以下之。按成注以皮肤骨髓。有浅深内外表
里之分。后条辩不察其误。谓病患身大热。反欲得近衣者。是沉阴内锢。而虚阳外浮。皮肤表热是假。骨髓里寒是真。
悖谬极矣。身寒不欲近衣。注与上同义。兹不尽述。或云。此条非仲景论。系叔和所增入者。详其文义。与阳盛阴虚。
汗之则死云云。又桂枝下咽。阳盛则毙云云。同 此危疑之辞。以惊惑人耳。例宜从删。）
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（历举上十二条。但论太阳中风伤寒温病等脉证。此条特举治法而申言之也。中风脉缓。阳浮阴弱者。脉缓之义也。
诊脉之法。有浮中沉三候。浮取之为阳。沉取之为阴。阳以候卫。阴以候营。阳脉浮。则卫气虚。而皮腠空疏。风易透
之。风性本热。故不待闭郁而热自发也。阴脉弱。则营血虚而津液漏泄。热复蒸之。热气迫血。故不待覆盖而汗自出也。
成注云。啬啬者。不足也。恶寒之貌。淅淅者。洒淅也。恶风之貌。盖人病外感之证。未有恶风而不兼恶寒。恶寒而不
兼恶风者不可拘拘于伤风但恶风也。翕翕者。言如合羽所覆。热发在表故也。鼻鸣者。肺开窍于鼻。又主皮毛。皮毛失
护。风热壅而气喘作声也。干呕者。诸阳受气于胸中。太阳之真气不能外布。故胸中逆塞而欲作呕也。与桂枝汤者。成
注云。和营卫而散风邪也。愚按成氏注太阳中风云。风并于卫。则卫实而营虚。又引经云太阳病发热汗出者。此为营弱
卫强。其言强实者。乃风邪之气入于卫中。既强且实也。如卫中之气果系强实。何由而外恶风寒邪。予故于阳脉浮下。
竟注作卫气虚也。营血果系虚弱矣。然此不过因其自汗出。汗为血液。故曰虚耳。如营中之血果虚。则仲景与桂枝汤后。
不当复云温覆。以出其汗矣。大抵外感之病以驱邪为主。风寒之邪入于营卫。营卫中真气总系虚弱。但一时为邪所入。
必先用发散药。攻去其邪待邪气去尽。方可以虚弱立论。成注所言不甚明畅。因多削去。以方喻程三家之注。及鄙意以
补之。）
（这是张仲景的原文）
（王安道说：张仲景的著作中，由王叔和增补的内容，只有《辨脉》、《平脉》以及可汗、可下等诸篇罢了。至于六经篇，不是王叔和所能插嘴评论的。因为这里注释太阳上编，仍然遵循张仲景的原貌。）
太阳病的主要特征是脉象浮，头痛且项部僵硬不适，并伴有恶寒。（这里所说的太阳病，是总括下文中的中风和伤寒而立的论断。按黄仲理的说法，太阳病的特征是脉浮，头痛且项强，恶风寒。“寒”字上面又增加了一个“风”字，由此可知“恶寒”二字，不仅指伤寒而言，连中风的证候也包含在其中。太阳经主司体表，所以成无己注解说：“这是太阳表的病证。”）
太阳病，出现发热、出汗、怕风、脉象缓的症状，称为中风（太阳病，即上文所说的脉浮、头项强痛。篇中凡是提到太阳病，都仿照这个意思。太阳表病，有营气和卫气的区分。成无己注解说：“风邪伤害卫气，寒邪伤害营气。”风属于阳邪，所以发病即发热。出汗、怕风，是因为人受到风邪侵袭，导致皮肤腠理疏松，气不能固护于外。方有执在《条辩》中说：“风性柔和，所以脉象表现为缓。也有人说，‘脉缓’应当看作‘浮缓’。浮是太阳病的脉象，缓是中风的脉象。下文提到的紧脉，也应当仿照此例理解。我认为上述所说的中风，并非李东垣所说的中腑、中脏、中血脉的意思。盖‘中’字与‘伤’字同义。张仲景论述时不直接称‘伤风’，是恐怕后学者不加考察，将咳嗽、鼻塞、声音沉重的普通伤风混为一谈进行论述，所以用‘中’字来区别它。）
太阳病，有的已经发热，有的尚未发热，但必定恶寒、身体疼痛、呕吐逆气，寸关尺三部脉象都紧的，称为伤寒。（风邪伤卫的证候，上文已经讲过了。这里特别列举寒邪伤营的证候加以阐明。经文说：“人受寒邪侵袭，就会生病发热。”张仲景说：“或者尚未发热。”成无己认为寒为阴邪，不能立即发热，郁结之后才变为热。伤寒必见恶寒，这是必然的趋势。身体疼痛，是因为寒邪伤了营气，营主血，血液被寒气凝滞，所以作痛。呕吐逆气，是因为胃口也受到寒气郁阻，从而产生呕吐。《脉经》说：寸口属阳，尺中属阴。伤寒的脉象，尺部和寸部都紧。成无己注解说：“这是因为寒性劲急的缘故。”我按语认为，这一条论述，在“未发热”之下，应当增加“无汗”二字。然而既然说了恶寒、体痛，那么无汗的意思就包含在其中了。另外按，《尚论篇》误将“体痛”注为“体重”，并且说张仲景恐怕人们见到恶寒、体重、呕逆，又加上未发热，误认为是直中阴经的病证，所以在辨证之前特意提出这句话。却不想张仲景论述太阳病，开口便说头项强痛，怎么会与阴经的错误混淆？喻嘉言的话，为何如此糊涂？）
伤寒第一天，太阳经受邪，如果脉象平静（没有数急之象），说明病邪没有传变。如果出现频频想吐，或者烦躁不安，脉象数而急促的，说明病邪已经传变。（这里说的伤寒，是兼带上文的中风证候而言的。下文说的二三日，伤寒也仿照此例。脉静，是指浮紧的脉不那么紧，浮缓的脉不那么缓。以外来的风寒邪气大致来说，一日太阳，二日阳明，三日少阳。成无己注解说：阳明胃经受邪，则喜欢呕吐。“颇欲吐”，是说不仅仅是干呕逆气，而是真的想要大吐，这是病情进展的征兆。躁烦，是热郁积到极点；脉数，是一息跳动五六次的样子，即急疾。意思是太阳病，想要传入阳明，不仅是紧脉变得数而急疾，即使是缓脉，也会变成数而且疾。）
伤寒二三天，没有出现阳明病和少阳病的证候的，说明病邪没有传变。（《条辩》说：上文说的不传，是太阳病向愈的征候；这里说的不传，应当兼有太阳病未解的征候。成无己也认为：知道邪气不传，只停留在太阳经中，这就是不解的意思。）
（附在后面作为凡例）太阳病，发热且口渴，不怕冷的，称为温病。（这一条是阳明病的温病，但也列在太阳篇中，是因为刚发病起，就有头项强痛的原因。然而这一条既然是温病，就不能与风寒同治，因此另外设立治疗温病的方法，在后第十三卷中。）
如果发汗以后，身体灼热的，称为风温。风温这种病，脉象阴阳两部都浮，自汗出，身体沉重，嗜睡，鼻息一定打鼾，说话困难。如果误用攻下法，会导致小便不利、两眼直视、大小便失禁。如果误用火疗，轻微的发黄色，严重的像惊痫一样，时时抽搐。如果用火熏烤，一次误治还会拖延病程，再次误治就会危及生命。（“小便不利”四字，应当在“若被下者”四字之上，否则既然说了小便不利，又说失禁，就矛盾了。这就是上一条温病，误发其汗，变作风温，这是一次误治；再误用下法，或误用火疗，就是第二次误治。程氏《后条辩》说：凡是风温身重多眠，语言难出，小便不利，直视失禁，发黄惊痫等，这些都是温病中的坏病，也应当列入治疗温病的论述中。正文与注解，详见后第十三卷中。）
疾病有发热恶寒的，是发于阳经；没有发热只有恶寒的，是发于阴经。发于阳经的，七天痊愈；发于阴经的，六天痊愈。因为阳数是七，阴数是六的缘故。（凡是疾病有身体发热，而外部表现出恶寒状态的，这是风寒邪气伤于阳经而发作，属于伤寒病。有身体不发热，而外部表现出恶寒状态的，这是风寒邪气直中阴经而发作，属于中寒病。阳数是奇数，所以约以七日痊愈。七，是少阳之数。阴数是偶数，所以约以六日痊愈。六，是老阴之数。成无己用火成数七、水成数六来解释，也通顺。我按语认为，《条辩》说：无热恶寒，是伤寒或者尚未发热的时候。《尚论篇》说：寒邪初受，尚未郁结成热。总之这说的是太阳病。张仲景说一二日发作的，怎么能说是病发于阴呢？如果把寒伤营，营为阴来解释，太牵强了。张璐《缵论》说：这一条以有热无热的证候，作为阳病阴病的大端，是阴阳寒热的关键，学人应当体会认识。上论宜放入前第二卷伤寒例中。）
太阳病，头痛，到了七天以上，自愈的，是因为邪气在经脉中行尽的缘故。如果想要传到下一经的，针刺足阳明经穴，使病邪不传变，就能痊愈（“欲作再经”在《准绳》中作“欲再传经”，犹言再传一经。太阳者，巨阳也。《内经》说：七日巨阳病衰，头痛稍减。行其经尽，是说寒邪的行进，只在太阳一经，到了七天，太阳的邪气如果不向外发散，就会向内传入，所以叫“尽”。凡各经的邪气，必须到七天，才是行经尽而自愈的时候。如阳明病身热，二天受邪的，八天痊愈；少阳病耳聋，三天受邪的，九天痊愈，都是七天以上。所谓“欲作再经”，是说太阳病邪之初，郁热不散，想要再传经，应当是阳明经受邪。不像成无己注解说：伤寒从一日到六日，传遍三阳三阴经尽，到了七天，应当痊愈却不愈，则太阳的邪气，再传入阳明。张仲景立这一条，是设定一种截断病势的方法：太阳病痊愈，必至七天以上；太阳病传变，止在二三日间。医者，应当趁此时机，针刺足阳明经，迎而夺之，以泄其热，这样病邪之气已衰，即使有经传变也不会发生，病就能自愈。《条辩》说：夺取它的传变路径而遏制它。遏制它的意思，还没有很好地理解。针刺足阳明穴，详见后第十四卷刺热法中。我按语认为：成无己对这一条的注解谬误很大。《尚论篇》承袭其谬误说：太阳的邪气，传至厥阴，六经尽矣，到了七天应当痊愈，设若不愈，则七日再传太阳，八日再传阳明，这岂不是谬中之谬吗？考证马玄台《内经注》说：自太阳至厥阴，犹如人由户升堂入室，厥阴复出传于太阳，奈何有少阴、太阴、少阳、阳明阻隔，岂有突然出来传于太阳的道理。这斥责再传的非议，实在是千古定论。）
太阳病想要解除的时间，是从巳时到未时这段时间。（太阳者，盛阳也。成无己注解说：巳午未，太阳气旺，所以乘其时而病解。后世《条辩》说：太阳病欲解，必须借助于未土。土者，阴阳之冲气也。因为病的发作，不是虚发，必有阴阳的乖气，乘我们经气之时。病的解除，不只是解，必须有阴阳的冲气，旺于我们的经气之时。我认为四时之气，如春温夏热秋燥冬寒，都遇到土令而后得解。六经的解，各以三时：太阳从巳至未，未，土也；阳明从申至戌，戌，土也；少阳从寅至辰，辰，亦土也；太阴从亥至丑；少阴从子至寅；厥阴从丑至卯。三阴的解，也以土为主。这是最恰当不易的道理。成无己总解说：阳行速，阴行缓，阳生于昼，阴生于夜。三阳经解时，从寅至戌，以阳道常饶也。三阴经解时，从亥至卯，以阴道常乏也。按此论也有道理。）
患风病的人，表证已解，但身体仍感觉不清爽舒适的，十二天痊愈（成无己注解说：中风家，发汗解后，未全快畅，这就是不了了。必须等到十二天，六经行尽之时，余邪全部去除，不治自愈。）
病人身体大热，反而想要靠近穿衣物的，是热在皮肤，寒在骨髓。身体大寒，反而不想要靠近穿衣物的，是寒在皮肤，热在骨髓。（身体大热，是足太阳病已，发热的时候。想要靠近衣物，是表恶风寒。热在皮肤，是寒郁而肌表蒸热。寒在骨髓，是风寒之气，束于人肌骨之间。凡人病外伤风寒，则遍身骨节入髓疼痛，而作恶寒状。扪其皮肤，则大热烙手。这是太阳表证，所以列入太阳上编。身体大寒，是说病传三阴，邪已入腑，表无热。不欲近衣，是内热发烦躁。寒在皮肤，谓内热亢甚，肌表反作冷。热在骨髓，是为郁热在里，深入脏腑间。凡人病外伤风寒，表之不散，传入于府，胃腑实热，久不得泄，扬手掷足，大作烦躁状。扪其肢体间，厥逆冰手。这不是太阳病例，张仲景举此对代而言之耳。我认为病人身热欲得近衣者，按张仲景的法度，宜用麻黄汤以汗之；身寒不欲近衣者，宜用大柴胡汤，或三承气汤以下之。按成无己注以皮肤骨髓，有浅深内外表里之分。后世《条辩》没察觉其中的错误，说病人身大热，反欲得近衣者，是沉阴内锢，而虚阳外浮，皮肤表热是假，骨髓里寒是真，悖谬极了。身寒不欲近衣，注与上同义，兹不尽述。有人说：这一条不是张仲景的论述，是王叔和增补的。详其文义，与“阳盛阴虚，汗之则死”云云，又“桂枝下咽，阳盛则毙”云云，同属此类危疑之辞，用来惊惑人耳。例宜从删。）
太阳中风，脉阳浮而阴弱。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（历举上十二条，只论太阳中风、伤寒、温病等脉证，这一条特别列举治法而申言之。中风脉缓，阳浮阴弱，是脉缓的含义。诊脉之法，有浮中沉三候。浮取之为阳，沉取之为阴。阳以候卫，阴以候营。阳脉浮，则卫气虚，而皮腠空疏，风易透之。风性本热，故不待闭郁而热自发。阴脉弱，则营血虚而津液漏泄，热复蒸之，热气迫血，故不待覆盖而汗自出。成无己注解说：啬啬，是不足的样子，恶寒之貌。淅淅，是洒淅的样子，恶风之貌。大概人病外感之证，未有恶风而不兼恶寒，恶寒而不兼恶风的。不可拘泥于伤风但恶风。翕翕，是说如合羽所覆，热发在表。鼻鸣，肺开窍于鼻，又主皮毛，皮毛失护，风热壅而气喘作声。干呕，诸阳受气于胸中，太阳之真气不能外布，故胸中逆塞而欲作呕。给予桂枝汤，成无己注解说：和营卫而散风邪。我按语认为：成氏注太阳中风说：风并于卫，则卫实而营虚。又引经云：太阳病发热汗出者，此为营弱卫强。其言强实者，乃风邪之气入于卫中，既强且实。如卫中之气果系强实，何由而外恶风寒？所以我于阳脉浮下，竟注作卫气虚。营血果系虚弱，然这不过是因其自汗出，汗为血液，故曰虚耳。如营中之血果虚，则张仲景与桂枝汤后，不当复云温覆以出其汗。大抵外感之病以驱邪为主，风寒之邪入于营卫，营卫中真气总系虚弱，但一时为邪所入，必先用发散药，攻去其邪，待邪气去尽，方可以虚弱立论。成注所言不甚明畅，因多削去，以方喻程三家之注，及鄙意以补之。）
(This is the original text of Zhang Zhongjing.)
(Wang Andao said: In Zhang Zhongjing's works, the parts added by Wang Shuhe are only the chapters on "Differentiating Pulse", "Leveling Pulse", and those discussing methods for sweating (Han) or purging (Xia). As for the Six Meridians chapters, they were not within Wang Shuhe's competence to comment upon. Since this commentary on the Upper Section of Taiyang Disease still follows Zhang Zhongjing's original form...)
The defining characteristics of Taiyang disease (Disease of the Taiyang Meridian) include a floating pulse (Pulse that feels superficial), headache with stiffness in the neck and occiput, and aversion to cold. (This statement regarding Taiyang disease establishes a general principle covering both Wind Strike (Zhong Feng) and Cold Damage (Shang Han) discussed below. According to Huang Zhongli, the phrase "aversion to wind and cold" indicates that "aversion to cold" encompasses not only Cold Damage but also the manifestations of Wind Strike. The Taiyang meridian governs the exterior; thus, Cheng Wuji noted: "This is an exterior disease of the Taiyang.")
In Taiyang disease, if there is fever, spontaneous sweating, aversion to wind, and a moderate (Huan) pulse, it is named Wind Strike (Zhong Feng). (Taiyang disease refers to the condition mentioned above: floating pulse, headache, and neck stiffness. Whenever "Taiyang disease" is mentioned in this chapter, it implies this context. Exterior diseases of the Taiyang have distinctions between Ying (Nutritive) and Wei (Defensive) levels. Cheng Wuji noted: "Wind injures the Wei, Cold injures the Ying." Wind is a Yang pathogen, so fever appears immediately upon onset. Spontaneous sweating and aversion to wind occur because wind pathogen invasion causes the skin and pores to loosen, preventing Qi from securing the exterior. Fang Youzhi, in his *Tiao Bian*, stated: "Wind nature is gentle, hence the pulse appears moderate." Some suggest reading "moderate pulse" as "floating-moderate". Floating is the pulse of Taiyang disease, while moderate is the pulse of Wind Strike. The "tight pulse" mentioned later should be interpreted similarly. I hold that the "Wind Strike" described here does not refer to Li Dongyuan's concepts of striking the Fu organs, Zang organs, or blood vessels. The character "Zhong" (Strike/Hit) shares the same meaning as "Shang" (Injure). Zhang Zhongjing did not directly use "Shang Feng" (Injured by Wind) to prevent later students from conflating common cold symptoms like coughing, nasal congestion, and hoarseness with this specific syndrome. Thus, he used "Zhong" to distinguish it.)
In Taiyang disease, whether fever has already appeared or not, there will inevitably be aversion to cold, body pain, vomiting or regurgitation, and a tight pulse (Jin) at all positions (Yin and Yang). This is named Cold Damage (Shang Han). (The syndrome of Wind injuring Wei was discussed above. Here, the syndrome of Cold injuring Ying is specifically highlighted for elucidation. The classic states: "When humans are injured by Cold, they develop febrile diseases." Zhang Zhongjing says: "Or perhaps no fever yet." Cheng Wuji explained that Cold is a Yin pathogen and cannot cause immediate heat; rather, heat arises after stagnation. Aversion to cold is inevitable in Cold Damage. Body pain occurs because Cold injures Ying, which governs Blood; Blood congeals due to Cold, causing pain. Vomiting and regurgitation occur because the Stomach Qi is also constrained by Cold stagnation. The *Mai Jing* states: Cunkou (radial artery at wrist) represents Yang, and Chizhong (distal radial artery) represents Yin. In Cold Damage, both Cun and Chi pulses are tight. Cheng Wuji noted: "This is due to the vigorous and urgent nature of Cold." My commentary suggests that the phrase "no fever yet" should ideally include "absence of sweating". However, since aversion to cold and body pain are present, the absence of sweating is implied. Additionally, the *Shang Lun Pian* erroneously annotated "body pain" as "heavy body", claiming Zhang Zhongjing wanted to prevent misdiagnosis of direct transmission to Yin meridians. This ignores that Zhang Zhongjing explicitly defines Taiyang disease with head and neck stiffness, making such confusion unlikely. Yu Jia Yan's remarks are overly confused.)
On the first day of Cold Damage, the Taiyang meridian is affected. If the pulse remains calm (stable), the disease has not transmitted. If there is frequent urge to vomit, restlessness, irritability, and a rapid (Shu) and urgent pulse, the disease has transmitted. (Here, "Cold Damage" includes aspects of Wind Strike. The mention of "second or third day" applies similarly. A "calm pulse" means the floating-tight pulse is not excessively tight, or the floating-moderate pulse is not excessively moderate. Generally, external Wind-Cold pathogens follow a sequence: Day 1 Taiyang, Day 2 Yangming, Day 3 Shaoyang. Cheng Wuji noted: When the Yangming Stomach meridian is affected, vomiting is favored. "Frequent urge to vomit" implies severe vomiting, signaling disease progression. Restlessness and irritability indicate extreme heat stagnation. A "rapid pulse" beats five to six times per breath, indicating urgency. This means if Taiyang disease transmits to Yangming, even a moderate pulse will become rapid and urgent.)
If, on the second or third day of Cold Damage, there are no signs of Yangming or Shaoyang diseases, the pathogen has not transmitted. (*Tiao Bian* states: The previous mention of "no transmission" referred to recovery from Taiyang disease; here, "no transmission" implies the Taiyang disease itself has not resolved. Cheng Wuji agreed: Knowing the pathogen does not transmit means it remains confined to the Taiyang meridian, indicating unresolved disease.)
(Attached as a General Principle) In Taiyang disease, if there is fever, thirst, and no aversion to cold, it is named Warm Disease (Wen Bing). (This clause describes Yangming Warm Disease but is listed in the Taiyang chapter because early symptoms include head and neck stiffness. However, since this is Warm Disease, it must not be treated identically to Wind-Cold. Therefore, separate treatment methods for Warm Disease are established in Volume 13.)
If, after inducing sweating, the body becomes burning hot, it is named Wind-Warm (Feng Wen). In Wind-Warm disease, the pulse is floating at both Yin and Yang positions, there is spontaneous sweating, heaviness of the body, excessive sleepiness, snoring nasal breathing, and difficulty speaking. If mistakenly treated with purgatives, it leads to difficult urination, fixed gaze, and incontinence. If mistakenly treated with fire therapy, mild cases result in yellowing of the skin, while severe cases resemble convulsive epilepsy with spasms. If subjected to fire fumigation, one error may prolong the illness, but a second error will hasten death. ("Difficult urination" should precede "if mistakenly treated with purgatives"; otherwise, stating both difficult urination and incontinence is contradictory. This scenario arises when Warm Disease is mistakenly sweated, transforming into Wind-Warm (first error), followed by mistaken purgation or fire therapy (second error). Cheng Shi's *Hou Tiao Bian* notes that symptoms like body heaviness, somnolence, dysarthria, urinary retention, fixed gaze, jaundice, and epilepsy are complications (Huai Bing) of Warm Disease and should be included in Warm Disease treatments. See Volume 13 for details.)
Diseases manifesting with fever and aversion to cold originate in Yang. Diseases manifesting with aversion to cold but no fever originate in Yin. Those originating in Yang heal in seven days; those originating in Yin heal in six days, based on the numerical attributes of Yang (7) and Yin (6). (Febrile diseases with external aversion to cold indicate Wind-Cold injuring Yang meridians, classified as Shang Han. Non-febrile diseases with external aversion to cold indicate Wind-Cold directly invading Yin meridians, classified as Zhong Han. Yang numbers are odd, healing around day 7 (Shaoyang number). Yin numbers are even, healing around day 6 (Lao Yin number). Cheng Wuji explained using Fire forming number 7 and Water forming number 6, which is also valid. My commentary references *Tiao Bian*: "Aversion to cold without fever" occurs during the initial phase of Shang Han before heat develops. *Shang Lun Pian* states: Initial Cold invasion has not yet stagnated into heat. Ultimately, this describes Taiyang disease. Zhang Zhongjing mentions onset on days 1-2; how can this be called "originating in Yin"? Interpreting "Cold injuring Ying" as "Ying is Yin" is extremely forced. Zhang Lu's *Zuan Lun* emphasizes recognizing this distinction between Yang and Yin diseases as crucial for students. This discussion belongs in the General Principles of Shang Han in Volume 2.)
In Taiyang disease, if headache persists beyond seven days and resolves spontaneously, it is because the pathogen has exhausted its course in the meridian. If the disease is about to transmit to the next meridian, acupuncture points on the Foot-Yangming meridian should be needled to prevent transmission, leading to recovery. ("About to transmit to the next meridian" means transmitting to one more meridian. Taiyang is also called Ju Yang. The *Nei Jing* states: On the seventh day, Ju Yang disease declines, and headache lessens. "Exhausting the meridian course" means the Cold pathogen stays within the Taiyang meridian for seven days; if not expelled outward, it enters inward, hence "exhausted". All meridians typically resolve after seven days. E.g., Yangming body heat acquired on day 2 resolves on day 8; Shaoyang deafness acquired on day 3 resolves on day 9. "About to transmit" implies lingering heat in Taiyang wishes to transmit to Yangming. Unlike Cheng Wuji's view that transmission completes through all Six Meridians by day 7, Zhang Zhongjing sets a method to intercept transmission: If Taiyang disease transmits, it usually happens within 2-3 days. The physician should needle Foot-Yangming points to intercept and drain heat, weakening the pathogen and preventing transmission. *Tiao Bian* suggests blocking the transmission route. My commentary criticizes Cheng Wuji's note as erroneous. *Shang Lun Pian* inherits this error, suggesting transmission goes to Jueyin then back to Taiyang, which is absurd. Ma Xuantai's commentary on the *Nei Jing* correctly argues that transmission from Jueyin back to Taiyang is impossible due to intervening meridians. This refutation of re-transmission is a definitive theory.)
The time when Taiyang disease tends to resolve is from Si hour (9-11 AM) to Wei hour (1-3 PM). (Taiyang represents abundant Yang. Cheng Wuji noted: During Si, Wu, and Wei hours, Taiyang Qi is prosperous, facilitating resolution. Later commentators suggest Taiyang resolution relies on Wei Earth, representing the harmonizing Qi of Yin and Yang. Disease arises from disharmony exploiting meridian Qi; resolution requires harmonizing Qi to support meridian Qi. I propose that seasonal Qi (Spring Warmth, Summer Heat, Autumn Dryness, Winter Cold) resolves via Earth influence. Similarly, Six Meridian resolutions align with Earth phases: Taiyang (Si-Wei, Wei is Earth), Yangming (Shen-Xu, Xu is Earth), Shaoyang (Yin-Chen, Chen is Earth). Taiyin (Hai-Chou), Shaoyin (Zi-Yin), Jueyin (Chou-Mao) also relate to Earth. Cheng Wuji summarized: Yang moves fast, Yin moves slow; Yang generates in day, Yin in night. Three Yang meridians resolve from Yin to Xu (abundance of Yang); Three Yin meridians resolve from Hai to Mao (scarcity of Yin). This logic holds merit.)
Patients with Wind disorders, after the exterior syndrome resolves, may still feel unwell or uncomfortable. They will recover in twelve days. (Cheng Wuji noted: After sweating resolves Wind Strike, if full comfort is not achieved, it is termed "not fully well". Recovery takes twelve days, allowing the Six Meridians to complete their cycles and residual pathogens to dissipate spontaneously.)
If a patient has high body heat but desires to wrap themselves in clothing, the heat is superficial (Skin), and the cold is deep (Bone Marrow). If a patient has low body temperature but desires to remove clothing, the cold is superficial, and the heat is deep. (High heat with desire for clothing indicates Taiyang exterior aversion to wind/cold. "Heat in Skin" refers to heat steaming the surface due to Cold stagnation. "Cold in Bone Marrow" refers to Wind-Cold binding the muscles and bones. External Wind-Cold causes bone/joint pain and aversion to cold, yet skin feels hot to touch. This is a Taiyang exterior syndrome. Low temperature without desire for clothing indicates transmission to Three Yin meridians, with interior heat causing restlessness. "Cold in Skin" reflects intense interior heat causing peripheral cooling. "Heat in Bone Marrow" signifies deep interior heat in Zang-Fu. This contrasts with Taiyang cases where exterior heat fails to disperse, entering Fu organs causing excess heat, restlessness, and cold extremities. Zhang Zhongjing uses this contrast for illustration. I suggest: For heat with desire for clothing, Ma Huang Tang (Ephedra Decoction) is appropriate to induce sweating. For cold without desire for clothing, Da Chai Hu Tang (Major Bupleurum Decoction) or the Three Cheng Qi Decoctions are appropriate to purge. Cheng Wuji distinguished Skin/Bone Marrow by depth/exterior-interior. Later commentators wrongly interpreted "heat with desire for clothing" as false heat floating externally due to internal Yin cold. This is highly erroneous. Some argue this clause is Wang Shuhe's addition, citing similar alarming language elsewhere. It should arguably be omitted.)
In Taiyang Wind Strike, the pulse is floating at Yang position and weak at Yin position. Floating Yang indicates spontaneous heat generation. Weak Yin indicates spontaneous sweating. With symptoms of shivering aversion to cold, chilly aversion to wind, feather-like warmth (fever), nasal congestion (sniffing sounds), and dry retching, Gui Zhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Previous clauses discussed pulses/symptoms; this clause specifies treatment. Wind Strike pulse is moderate; floating Yang/weak Yin explains this moderation. Pulse diagnosis involves Floating, Middle, and Deep positions. Floating represents Yang/Wei, Deep represents Yin/Ying. Floating Yang pulse indicates deficient Wei Qi and loose pores, allowing Wind entry. Wind is inherently hot, causing spontaneous heat without stagnation. Weak Yin pulse indicates deficient Ying Blood and leaking fluids; heat steams these fluids, causing spontaneous sweating. Cheng Wuji defined "Se Se" as insufficient/shivering (aversion to cold) and "Xi Xi" as chilly/dripping (aversion to wind). One cannot separate aversion to wind from aversion to cold. "Xi Xi" heat resembles warmth under feathers, indicating exterior heat. Nasal congestion occurs because Lung opens to nose and governs skin/hair; Wind-Heat congestion causes asthmatic breathing. Dry retching occurs because Yang Qi gathers in the chest; Taiyang True Qi fails to distribute outward, causing chest blockage and nausea. Gui Zhi Tang harmonizes Ying and Wei and disperses Wind. Cheng Wuji claimed Wind merging with Wei makes Wei Excess and Ying Deficient, citing "Yang Weak, Wei Strong". However, if Wei were truly Excess/Strong, why would there be aversion to wind/cold? I annotate "Floating Yang" as Wei Qi Deficiency. While Ying Blood is deficient (indicated by sweating), attributing pure deficiency ignores the need for warming coverings to assist sweating post-medication. Exterior diseases prioritize expelling pathogens. Initially, Ying and Wei Qi are weakened by pathogen invasion. Dispersing herbs must be used first to remove pathogens before addressing deficiency. Cheng's notes were unclear; I have revised them incorporating views from Fang, Yu, and Cheng, along with my own insights.)