天道有遭世而兴，事有遇时而显，此古今之常理，出于自然者也。且谓儒书衰灭，以后邪
说蜂起，以淆乱六经之道，红紫乱朱，无以折衷。孝武皇帝，举用俊茂，罢黜百家之非，而六经
之道始明。自汉而降，注述繁错，医书尤甚。况医乃人之司命，所系尤重，殆非小智，所能及
也。
惟昔黄帝、岐伯，难疑答问，上穷天道，下极地理，中尽人性，垂法万世，以为生民之寿
域，是以名曰《素问》。于是守真刘先生恐斯文将坠于地，民罹横夭，于是天地、阴阳、刚柔、
消长之理，察人生风气、血脉、寒热之宜，逐一拟一篇，无不引《素问》，先标受病之本源，所
处方用药。注书有四焉，一者，明天地之造化，论运化之盛衰，目之曰《要旨论》一部，计三
万六千七百五十三字，一者，分君臣佐使，定奇偶之逆从，又作《宣明论》
一部，计八千九百零三字，一者，又注伤寒六经传受，《直格》一部，计一万七千零九字，又
取至真要大论一篇，病机气宜之说，着《玄机原病式》一帙，计二万余言。又，先生归世之后，
恐庸医不知枢要，于《宣明论》内，又集紧切药方六十道，分为六门，亦名《直格》。通计八
万余言，可谓勤矣。
守真曰∶自昔以来，惟仲景着述遗文，立伤寒九十七法，合一百一十三方，而后学人，莫
能宗之。谓如人病伤风，则用桂枝解肌，伤寒则用麻黄发汗。伤风反用麻黄，则致项强柔 ，伤
寒反用桂枝，则作惊狂发斑，或误用此二药，则必死矣。故仲景曰∶桂枝下咽，阳盛则毙，承气
入胃，阴盛则亡是也。守真为此虑，恐麻黄、桂枝之误，遂处双解散。无问伤风伤寒，内外诸
邪，皆能治疗，从下证错汗者，亦不为害。如此，革误人之弊，已不少矣。仲景处大承气汤、小
承气汤、调胃承气汤，亦各有所宜。热势大者，大承气主之，微，小承气主之，腹中有痛，大
便硬者，调胃承气主之。守真又恐承气有三，恐有过焉不及之患，遂处三一承气以总之。又虑
仲景所着之书，文深义奥，浅学难通，遂芟其根蔓，撮其根本，十去七八，将三百九十七法，
一百一十三方，制三十二药而总之，使人易于检阅。一见此书，对形见影，了无障碍，得之对证
用药，人可自疗，况医家者流，业此者乎。兼仲景除《伤寒》之外，亦无杂病之论，是已备于
仲景书也，故守真首论《伤寒》之差谬。
故一切内外所伤，俱有受汗之病，名曰热病，通谓之伤寒。今春温、夏热、秋凉、冬寒，是
随四时天气、所感轻重，及主疗消息不等，合而言之，则一也。冬伏寒邪，藏于肌肉之间，至
春变为温病，夏变为暑病，秋变为湿病，冬变为正伤寒。冬冒其气，而内生怫热，微而不病者
，以至将来阳热变动，或又感之，而成热病也，经曰冬伤于寒，春必病温，亦其义也。然其阴
证者，止为杂病，终不为汗病，由是伤寒汗病，直言热病，不言其寒也。三阴证者，邪热在脏
里，以脏为里为阴，当下者也。《素问》三篇∶刺热、评热论论、热论，论热不说其寒，非无
谓者也，热论之外，《素问》更无说伤寒之证。热论云∶热病者，皆伤寒之类也。又云∶人之
伤于寒也，则为病热。注云∶寒者，冬气也。冬时严寒，万类深藏固密，不伤于寒。触冒之者，
名曰伤寒。伤于四时之气皆能病，以伤寒为毒者，最为杀厉之气，中而即病，名曰伤寒，不即病
者，寒毒藏于肌肉之间，久而不去，变为热病，故曰热病者，伤寒之类也。
古圣训阴阳为表里，此一经大节目，惟仲景深得其旨趣。后朱肱编《活人书》，将阴阳二
字，释作寒热，此差之甚也，中间误HT 横夭，嗟之何及！《素问》言人之脏腑阴阳，脏者为阴
，腑者为阳，又四时阴阳，尽有经记，内外之应，皆表里，其信然乎。六合为十二经脉之合，太
阴阳明为一合，厥阴少阳为一合，少阴太阳为一合，手足之脉，是谓六合。表里者，诸阳脉皆
为表，诸阴脉皆为里。以此验之，是守真之言不诬矣。然恐俗人不悟，朱肱《活人书》之谬，
且略举伤寒六经传受一端而明之。肱书云∶伤寒中病时，腠理寒，便入阴经，脉不微细，不经三
阳也。三阴中寒，微则理中汤，稍厥或下利，即甘草干姜汤。若阴毒已深，病势困重，六脉附
骨，浮之则有，按之则无，于脐中用葱熨法。灸艾三五百壮以来，手足不温者，不可治也。守
真曰∶前三日，三阳病，在表，故当汗之，后三日，三阴病，在里，故当下之。六经传受，皆是
热证，非有阴寒之病也。《素问》云∶伤寒未满三日者，可汗而已，其满三日者，可泄而已
。由此言之，守真之说，正合《素问》，肱书失之远矣。又如身冷脉微，阳厥极深一证，肱书
云∶病患身冷，脉沉
细而疾，或时郑声，指甲面色青黑，阴毒已深。若服凉药，则渴转甚，躁转急，须急服辛热之
药。如得手足温，更服前热药助之。若阴气散，阳气来，即渐减热药而调之。守真曰∶伤寒下
后热不退，蓄热在内，阳厥极深，以至阳气怫郁，不能营运于身表四肢，以至遍身青冷。若急
下之，残阴暴绝，阳气俊竭而死，不下亦死。此际当以凉膈散或解毒养阴退阳。但欲蓄热渐散
，则心腹复暖，脉自渐生。至于脉复有力，方可三一承气汤下之。守真复虑热有两感之说，复
以《素问》证之曰∶亢则害，承乃制。此则正谓阳厥极深，不能营运于四肢，以至身冷脉微也
。此略举一二端耳，余者自可触类。夫肱书，暴于当世，亦一代之名医，其误谬犹若是，况其余
碎杂不经之说，何可尽信！至论小儿，如阎孝忠曰∶凡小儿疮疹，当乳母慎口，不可令饥。及受
风冷，归肾变黑而难治。春夏病为顺，秋冬病为逆。冬月肾旺寒盛，多归肾变黑。若妄下之，
则内虚，多归于肾。此则直以疮疹为寒。守真云∶阎孝忠不详钱氏本方，斑疹黑陷，牛李膏、百
祥丸，寒药下之，多获痊，不救必死，为热岂不明哉！经云诸痛痒疮疡，皆属心火，及斑疹黑陷
，无不腹满喘急，小便赤涩不通，岂非热极使然耶！此阎孝忠所以失钱氏之意也。守真如此分别
，可谓医者之龟鉴也。学人当详其说，无妄谓伤寒有阴毒之证，便投姜附之药，使实实虚虚，损
不足，益有余，以此误人，不亦冤哉！每观乎城翟公《序》曰∶譬如宵行，冥冥迷路，不知其
往。遇明灯炬火，正路昭然，此医鉴之所作也。
然世俗恶寒好热，盖亦有说。守真云∶病势轻微，以热药强劫开发，误中而获效者有矣。
如中酒热毒，而复饮热酒以投之，令郁结得开，而气液宣通，此谓以热疗热，亦有痊者。世俗惑
于病轻而易痊，谓大疾亦然，殊不知不中则反为害也。热病以热药治之者，譬如骄主得佞臣纵恣
，祸及灭亡，更不觉佞臣之恶，惟其同好之可乐，使热势转甚，以至阳厥，身冷脉微，反阳为
阴，虽死不悟。至于诸热变证，十损八九，莫不皆然也。如下利不止，瘀热在里，若使火艾熨
烙，无不悦者也。此世俗好热恶寒，所以滋肱书之失也。
又，守真云∶病热势甚，根据法治之而不退者，或失寒凉，或因失下，或熨烙熏灸，使热极
而妄为阳厥。切不可用银粉、巴豆性热大毒丸药下之，反耗损阴气而衰竭津液，使热势转甚，而
懊、喘满、结胸、腹痛、下利不止、血溢、血泄，或为淋闭、惊狂谵妄，热证蜂起，不可胜举
。由此为瘕 坚积之疾，误人必多。然则世情亦不知医者之过，未尽究守真之奇效。
尝闻守真之言曰∶正治者，以寒治热，以热治寒。病证轻微，可如此治之，若病危重，则当
从反治之法。其反治者，亦名从治，盖药气从顺于病气也，是故以热治热，以寒治寒，是谓反治
。以热治热者，非谓病气热甚，而更以热性之药治之，本谓寒性之药，反佐而服之。盖谓病气热
甚，药气寒甚，拒其药寒，则寒攻不入，寒热交争，则其病转加也，故用寒药，反热佐而服之，
令药气与病气不相忤。其药本寒，热服下咽之后，热体既消，寒性乃发，由是病气随愈。余皆仿
此。然正治之法，犹君刑臣过，逆其臣性而刑之，故病热不甚，治之以寒，逆其病气，而病自愈
矣。反治之法，犹臣谏君非，顺其君性，而以悦之，其始则从，其终则逆，可以谏君去其邪而归
于正。王冰曰∶病微犹救人火，火得木而 ，得火而燔，得水而灭。病湿犹救龙火，火得湿而
，得水而燔，以人火不逐之，则其火自灭耳。此谓良医之法也。夫逆治从治，皆是违性之药，
病患岂有不恶者。是药病相争，其气所以得固也。然十救其十，不为医之功，以谓人之有命也。
如身冷脉微，终不省蓄热在内，设以凉膈、解毒之药调治，无有不恶。又如患形，不至有经年，
终不晓瘀热在里，设以承气。寒药下之，无有不畏，虽得痊愈，尚不免于畏恶。病势大，药力小
，而致死者，亦不知杯水救车薪之火为非，只指为凉药之过。此二者无他，存于世人是非不明，
而恶寒好热也。
天道有遭遇时代而兴盛，事物有遇到时机而显扬，这是古往今来的常理，出于自然。况且人们说儒家经典衰微灭绝后，各种邪说蜂拥而起，以此混淆六经的道理，如同红紫扰乱正色朱红，无法加以折中校正。孝武皇帝（汉武帝），选拔任用才俊之士，罢黜百家中不正确的学说，于是六经的道理才开始明晰。自从汉代以来，注释阐述繁杂错乱，医书尤其严重。何况医学是掌管人生命运的学问，所关系的重要程度尤为重大，大概不是小聪明所能达到的。
唯有从前的黄帝、岐伯，通过疑难问答的方式，上穷尽天道的奥秘，下极尽地理的变化，中尽人性的规律，留下法则流传万世，作为百姓长寿的领域，因此命名为《素问》。于是，守真刘先生担心这些文化典籍将坠落于地，百姓遭受横死夭折，于是探究天地、阴阳、刚柔、消长变化的道理，考察人生风气、血脉、寒热的适宜之处，逐一撰写了一篇篇文章，无不引用《素问》，先标明受病的本源，然后确定处方用药。他的注书共有四部：第一部，阐明天地的造化，论述运化盛衰的道理，名为《要旨论》一部，共计三万六千七百五十三字；第二部，区分君臣佐使，确定奇偶方剂的逆从关系，又作《宣明论》一部，共计八千九百零三字；第三部，又注解伤寒六经传受规律，《直格》一部，共计一万七千零九字；第四部，又选取《至真要大论》一篇，关于病机气宜的说法，著成《玄机原病式》一帙，共计二万余言。另外，先生去世之后，担心平庸的医生不知道关键要点，在《宣明论》内，又收集紧急切用的药方六十道，分为六门，也命名为《直格》。总计八万余言，可以说是勤勉了。
守真先生说：“自古以来，只有张仲景的著作遗文，确立了伤寒九十七法，合计一百一十三方，而后来的学习者，没有人能尊奉它。比如有人患伤风病，就用桂枝汤解肌，患伤寒就用麻黄汤发汗。如果伤风反而用麻黄汤，就会导致项背强直、肢体柔缓；如果伤寒反而用桂枝汤，就会导致惊狂、发斑疹。或者误用了这两种药，就必定死亡。所以张仲景说：‘桂枝汤下咽，若阳气盛则毙命，承气汤入胃，若阴气盛则亡’就是这个意思。守真为此忧虑，担心麻黄、桂枝被误用，于是创制了双解散。无论伤风还是伤寒，内外各种邪气，都能治疗，即使是误用发汗法导致的坏证，也不会造成危害。像这样，革除误人的弊端，已经不少了。张仲景创制大承气汤、小承气汤、调胃承气汤，也各有适宜的病症。热势大的，由大承气汤主治；热势轻微，由小承气汤主治；腹中有痛感，大便硬的，由调胃承气汤主治。守真又担心承气汤有三种，恐怕有过用或不及的隐患，于是创制三一承气汤来统括它们。又考虑到张仲景所著的书籍，文辞深奥义理玄妙，浅学之人难以通晓，于是删去其枝蔓，提取其根本，去掉十分之七八，将三百九十七法、一百一十三方，制成三十二种药物来统括，使人容易查阅。一见此书，就像对形见影，毫无障碍，得到它对症用药，人可以自我疗治，何况是医生这一类人呢。加上张仲景除了《伤寒论》之外，也没有关于杂病的论述，这已经完备于张仲景的书中了，所以守真首先论述《伤寒论》中的差谬。
所以一切内外所伤，都有受汗之病，名叫热病，通称为伤寒。如今春温、夏热、秋凉、冬寒，是随着四季天气、感受邪气的轻重，以及主治调理的消息不等，合起来说，则是一回事。冬天潜伏的寒邪，藏在肌肉之间，到春天变为温病，夏天变为暑病，秋天变为湿病，冬天变为正伤寒。冬天冒犯寒气，而内生郁热，轻微而不发病的，以至于将来阳热变动，或者又感受外邪，而成热病。经文说：‘冬天伤于寒，春天必病温’，也是这个意义。然而那些阴证，只是杂病，终究不是汗病（指因汗法不当或寒邪束表引起的病），因此伤寒汗病，直言热病，不说其寒。三阴证，邪热在脏腑内部，以脏为里为阴，应当用下法。《素问》三篇：刺热篇、评热论篇、热论篇，论述热不说寒，并非没有意义的，热论篇之外，《素问》更没有论述伤寒的证候。热论篇说：‘热病者，都是伤寒的一类。’又说：‘人受寒邪侵袭，就变成热病。’注解说：‘寒，是冬天的气候。’冬天时严寒，万物深藏固密，不伤于寒。触犯冒犯的，名叫伤寒。伤于四时的气都能致病，以伤寒为毒，是最为杀厉之气，中邪即发病，名叫伤寒，不立即发病的，寒毒藏在肌肉之间，久而不去，变为热病，所以说热病者，是伤寒的一类。
古代圣人训示阴阳为表里，这是这一经的大节目，只有张仲景深得其中的旨趣。后来朱肱编撰《活人书》，将阴阳二字，解释作寒热，这差得很远啊，中间误写“横夭”，叹息有什么用！《素问》说人的脏腑阴阳，脏者为阴，腑者为阳，又四时阴阳，都有经络记载，内外的对应，都是表里，确实如此吗？六合是十二经脉的合会，太阴阳明为一合，厥阴少阳为一合，少阴太阳为一合，手足的脉，叫做六合。表里者，诸阳脉都为表，诸阴脉都为里。以此验证，是守真的话没有虚假。然而担心世俗人不醒悟，朱肱《活人书》的错误，且略举伤寒六经传受一端来阐明它。朱肱的书说：“伤寒中病时，腠理寒，便进入阴经，脉不微细，不经三阳。”三阴中寒，轻微的用理中汤，稍微厥冷或下利的，就用甘草干姜汤。如果阴毒已深，病势困重，六脉附骨，浮取则有，按之则无，在脐中用葱熨法。灸艾三五百壮以来，手足不温暖的，不可治。守真说：“前三日，三阳病，在表，所以应当发汗，后三日，三阴病，在里，所以应当攻下。六经传受，都是热证，没有阴寒的病。”《素问》说：“伤寒未满三日的，可以发汗治愈，满三日的，可以泄下治愈。”由此说来，守真的说法，正符合《素问》，朱肱的书失之远矣。又如身冷脉微，阳厥极深一证，朱肱的书说：“病患身冷，脉沉细而疾，有时郑声，指甲面色青黑，阴毒已深。如果服凉药，则口渴转甚，烦躁转急，须急服辛热的药。如果得手足温暖，再服前面的热药助之。如果阴气散，阳气来，就逐渐减少热药来调理。”守真说：“伤寒下后热不退，蓄热在内，阳厥极深，以至阳气怫郁，不能营运于身体表面四肢，以至遍身青冷。如果急下之，残阴暴绝，阳气衰竭而死，不下也会死。此时应当用凉膈散或解毒养阴退阳。只要欲蓄热渐散，则心腹复暖，脉自然渐生。至于脉复有力，方可用三一承气汤下之。”守真又顾虑热有两感之说，又以《素问》证验曰：“亢则害，承乃制。”这正是谓阳厥极深，不能营运于四肢，以至身冷脉微。这只是略举一二端罢了，其余自然可以触类旁通。朱肱的书，暴行于当世，也是一代的名医，其误谬尚且如此，何况其余琐碎杂乱不经之说，怎么可以全信！至于论小儿，如阎孝忠说：“凡是小儿疮疹，应当乳母慎口，不可令其饥饿。以及受风冷，归肾变黑而难治。春夏病为顺，秋冬病为逆。冬月肾旺寒盛，多归肾变黑。如果妄用下法，则内虚，多归于肾。这则是直接把疮疹当作寒证。”守真说：“阎孝忠不详察钱氏的本方，斑疹黑陷，用牛李膏、百祥丸，寒药下之，多获痊愈，不救必死，为热难道不明显吗！经文说诸痛痒疮疡，皆属心火，以及斑疹黑陷，无不腹满喘急，小便赤涩不通，难道不是热极使然吗！这就是阎孝忠所以违背钱氏的意思。守真如此分别，可说是医生的镜子。学习者应当详细研究它的说法，不要胡乱说伤寒有阴毒之证，就投用姜附之药，使实实虚虚，损不足，益有余，以此误人，不也很冤屈吗！每次观看城翟公《序》说：‘譬如夜行，冥冥迷路，不知其去向。遇到明灯炬火，正路昭然，这就是医鉴的所作所为。’”
然而世俗厌恶寒证喜好热证，大概也有说法。守真说：“病势轻微，用热药强行劫夺开发，误中而获得效果的有了。比如中酒热毒，而又饮热酒以投之，令郁结得开，而气液宣通，这叫以热疗热，也有痊愈的。世俗迷惑于病轻而易痊，谓大病也是这样，殊不知不中则反为害。热病用热药治疗的，譬如骄横的君主得到奸臣纵容恣意，祸及灭亡，更不觉知奸臣的恶，只因其同好之乐，使热势转甚，以至阳厥，身冷脉微，反阳为阴，虽死不悟。至于诸热变证，十损八九，莫不皆然。如下利不止，瘀热在里，如果用火艾熨烙，没有不高兴的。这是世俗好热恶寒，所以滋长了朱肱书的错误。”
又，守真说：“病热势很盛，根据法治之而不退的，或者失于寒凉，或因失于攻下，或熨烙熏灸，使热极而妄为阳厥。切不可用银粉、巴豆性热大毒丸药下之，反耗损阴气而衰竭津液，使热势转甚，而懊憹、喘满、结胸、腹痛、下利不止、血溢、血泄，或为淋闭、惊狂谵妄，热证蜂起，不可胜举。由此成为瘕坚积之疾，误人必多。然而世情也不知道医者的过错，未尽究守真的奇效。”
曾经听守真先生说：“正治者，以寒治热，以热治寒。病证轻微，可以这样治，若病危重，则应当从反治之法。其反治者，也叫从治，盖药气顺从于病气，是以用热治热，以寒治寒，这叫反治。以热治热者，不是说病气热甚，而更用热性的药治之，本谓寒性的药，反佐而服之。盖谓病气热甚，药气寒甚，拒其药寒，则寒攻不入，寒热交争，则其病转加也，故用寒药，反用热佐而服之，令药气与病气不相忤。其药本寒，热服下咽之后，热体既消，寒性乃发，由是病气随愈。其余都仿照此例。然而正治之法，犹如君主惩罚臣子的过错，逆其臣性而刑之，所以病热不甚，治之以寒，逆其病气，而病自愈矣。反治之法，犹如臣子劝谏君主的非，顺其君性，而以悦之，其始则从，其终则逆，可以谏君去其邪而归于正。王冰说：‘病微犹救人火，火得木而燃，得火而燔，得水而灭。病湿犹救龙火，火得湿而燃，得水而燔，以人火不逐之，则其火自灭耳。’这叫良医之法。夫逆治从治，皆是违性之药，病患岂有不厌恶的。是药病相争，其气所以得固也。然而十救其十，不为医之功，以为人之有命也。如身冷脉微，终不省悟蓄热在内，设以凉膈、解毒之药调治，没有不厌恶的。又如患形，不至有经年，终不晓瘀热在里，设以承气寒药下之，没有不畏惧的，虽得痊愈，尚不免于畏恶。病势大，药力小而致死的，也不知道杯水救车薪之火为非，只指为凉药的过错。这两者无他，存于世人是非不明，而恶寒好热也。”
The Way of Heaven flourishes when it encounters the era, and affairs become prominent when they meet the timing; this is a constant principle from ancient to modern times, originating from nature. Furthermore, it is said that after the decline and extinction of Confucian classics, various heterodox theories arose like bees, confusing the Dao of the Six Channels (Liu Jing), just as red and purple confuse the orthodox color vermilion, making it impossible to reach a compromise. Emperor Xiaowu (Emperor Wu of Han) selected and employed talented individuals, dismissed the errors of the hundred schools of thought, and thus the Dao of the Six Channels began to be clarified. Since the Han Dynasty, annotations and expositions have been complex and confused, especially in medical books. Moreover, medicine governs human life and death, and its significance is particularly heavy; it is likely beyond the reach of petty wisdom.
In the past, the Yellow Emperor and Qibo answered questions on difficult issues, exploring the Way of Heaven above, the geography below, and human nature in the middle, leaving laws for ten thousand generations as a realm of longevity for the people, hence named *Suwen* (Basic Questions). Thus, Mr. Liu Shouzhen (Liu Wansu), fearing that these cultural texts would fall to the ground and that people would suffer premature death, investigated the principles of heaven and earth, yin and yang, rigidity and softness, waxing and waning, examined the suitability of wind qi, blood vessels, cold, and heat in human life, and wrote essays one by one, all citing *Suwen*, first marking the root source of disease, then prescribing formulas and medicines. His annotated works consist of four: First, clarifying the creation of heaven and earth, discussing the prosperity and decline of transformation, titled *Yaozhi Lun* (Treatise on Key Principles), one volume, totaling 36,753 characters. Second, distinguishing Sovereign, Minister, Assistant, and Courier roles, determining the reversal and compliance of odd and even formulas, also composing *Xuanming Lun* (Treatise on Manifestation), one volume, totaling 8,903 characters. Third, annotating the transmission of the Six Channels of Cold Damage, *Zhige* (Direct Grid), one volume, totaling 17,009 characters. Fourth, selecting the essay "Zhi Zhen Yao Da Lun" (Essential Requirements of the Most True), discussing pathogenesis and qi suitability, writing *Xuanji Yuanbing Shi* (Original Formulas of Mysterious Mechanisms), one fascicle, totaling over 20,000 words. Additionally, after Mr. Liu's passing, fearing that mediocre doctors did not know the key points, he collected sixty urgent and effective prescriptions within *Xuanming Lun*, divided into six categories, also named *Zhige*. In total, over 80,000 words, which can be called diligent.
Shouzhen said: "Since ancient times, only Zhang Zhongjing's writings established ninety-seven methods for Cold Damage, combined with 113 formulas, yet later learners could not take them as their model. For example, if a person suffers from Wind Injury (Shang Feng), Guizhi Tang (Cinnamon Twig Decoction) is used to resolve the muscle layer; if suffering from Cold Damage (Shang Han), Mahuang Tang (Ephedra Decoction) is used to induce sweating. If Wind Injury is wrongly treated with Mahuang Tang, it will cause neck stiffness and flaccidity; if Cold Damage is wrongly treated with Guizhi Tang, it will cause panic, mania, and macules. Or if these two medicines are misused, death is certain. Therefore, Zhang Zhongjing said: 'When Guizhi Tang enters the throat, if Yang is excessive, death ensues; when Chengqi Tang enters the stomach, if Yin is excessive, death ensues.' This is what Shouzhen worried about, fearing the misuse of Mahuang and Guizhi, so he prescribed Shuangjie San (Double Release Powder). Regardless of Wind Injury or Cold Damage, internal and external pathogens can all be treated; even those harmed by incorrect sweating methods will not suffer harm. In this way, correcting the弊 (弊端 - drawbacks) of misleading people is already considerable. Zhang Zhongjing prescribed Dachengqi Tang (Major Order the Qi Decoction), Xiaochengqi Tang (Minor Order the Qi Decoction), and Tiaoweichengqi Tang (Regulate the Stomach Order the Qi Decoction), each having its appropriate indications. For severe heat, Dachengqi Tang governs; for mild heat, Xiaochengqi Tang governs; for abdominal pain and hard stool, Tiaoweichengqi Tang governs. Shouzhen again feared that there were three types of Chengqi formulas, worrying about the risk of over-treatment or under-treatment, so he created Sanyi Chengqi Tang (Three-One Order the Qi Decoction) to summarize them. He also considered that Zhang Zhongjing's books were profound and obscure, difficult for shallow learners to understand, so he pruned the branches and vines, extracted the roots, removed seven or eight tenths, and summarized the 397 methods and 113 formulas into 32 medicines, making them easy to consult. Seeing this book is like seeing the shadow of the form, without obstacles; obtaining it allows one to treat oneself according to symptoms, let alone doctors. Furthermore, besides *Shanghan Lun* (Treatise on Cold Damage), Zhang Zhongjing had no discussions on miscellaneous diseases, which was already complete in his books; therefore, Shouzhen first discussed the errors in *Shanghan Lun*.
Thus, all internal and external injuries have diseases caused by sweat exposure, named Re Bing (Heat Disease), collectively called Shanghan (Cold Damage). Now, Spring Warmth, Summer Heat, Autumn Coolness, Winter Cold, follow the weather of the four seasons, the severity of infection, and the varying degrees of treatment; speaking together, they are one. Winter latent cold evil hides between the muscles; by spring it becomes Wen Bing (Warm Disease), by summer Shu Bing (Summerheat Disease), by autumn Shi Bing (Dampness Disease), and by winter Zheng Shanghan (True Cold Damage). Exposing oneself to cold qi in winter causes internal fu re (stagnant heat); if mild and not causing illness, until future yang-heat changes, or if infected again, it becomes Re Bing. The classic says: 'Winter injury by cold leads to Warm Disease in Spring,' which is also its meaning. However, those Yin syndromes are merely miscellaneous diseases, ultimately not Sweat Diseases (Han Bing - diseases related to sweating/cold constraint), thus Shanghan Sweat Diseases speak directly of Heat Disease, not mentioning Cold. Three Yin syndromes involve pathogenic heat in the interior of the zang organs; since zang are interior and yin, purgation should be used. *Suwen* has three chapters: Cila Re (Acupuncture for Heat), Ping Re Lun (Evaluation of Heat Treatise), and Re Lun (Heat Treatise), discussing heat without mentioning cold, which is not meaningless. Outside of Re Lun, *Suwen* has no other discussion of Shanghan syndromes. Re Lun states: 'Heat diseases are all of the category of Cold Damage.' It also says: 'When humans are injured by cold, they become diseased with heat.' The annotation says: 'Cold is the qi of winter.' During winter's severe cold, all things hide deeply and securely, not injured by cold. Those who touch and offend it are named Shanghan. Being injured by the qi of the four seasons can all cause disease; considering Shanghan as toxic, it is the most lethal qi. If one contracts it and falls ill immediately, it is named Shanghan; if not ill immediately, the cold toxin hides in the muscles, lingering for a long time, transforming into Heat Disease, hence saying Heat Disease is of the category of Cold Damage.
Ancient sages instructed that Yin and Yang are Exterior and Interior; this is a major program of this channel, only Zhang Zhongjing deeply grasped its purport. Later, Zhu Gong compiled *Huo Ren Shu* (Book for Saving People), interpreting the two characters Yin and Yang as Cold and Heat; this is a great error! *Suwen* speaks of the Yin and Yang of human zang-fu: zang are Yin, fu are Yang. Also, the Yin and Yang of the four seasons are all recorded in scriptures; internal and external correspondences are all Exterior and Interior, is this true? The Six Combinations (Liu He) are the unions of the Twelve Meridians: Taiyin and Yangming are one combination, Jueyin and Shaoyang are one combination, Shaoyin and Taiyang are one combination; hand and foot meridians are called the Six Combinations. Exterior and Interior: all Yang meridians are Exterior, all Yin meridians are Interior. Verifying this, Shouzhen's words are not false. However, fearing that common people do not realize the error in Zhu Gong's *Huo Ren Shu*, I briefly cite one aspect of the Six Channels' transmission in Shanghan to clarify it. Gong's book says: 'When Shanghan strikes the disease, the pores are cold, entering the Yin channels; the pulse is not fine and subtle, bypassing the Three Yang.' For Cold in the Three Yin, if mild, Lizhong Tang (Regulate the Middle Decoction) is used; if slightly cold or with diarrhea, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) is used. If Yin Poison is deep, the disease is critical, the six pulses adhere to the bone, floating reveals them, pressing makes them vanish; use the Scallion Ironing Method at the navel. After moxibustion of three to five hundred moxa cones, if hands and feet are not warm, it is incurable. Shouzhen said: 'For the first three days, Three Yang diseases are in the Exterior, so they should be sweated out; for the last three days, Three Yin diseases are in the Interior, so they should be purged. The transmission of the Six Channels are all Heat syndromes, not Cold diseases.' *Suwen* says: 'If Shanghan is less than three days, it can be cured by sweating; if more than three days, it can be cured by purging.' From this, Shouzhen's theory conforms to *Suwen*, while Gong's book is far off. Again, regarding the syndrome of cold body and faint pulse, extreme Yang Jue (Reversal): Gong's book says: 'Patient has cold body, pulse is deep, fine, and rapid, sometimes Zhengsheng (slurred speech), nails and face are cyan and black, Yin Poison is deep. If taking cooling medicines, thirst becomes worse, restlessness increases, must urgently take acrid-hot medicines. If hands and feet become warm, continue taking previous hot medicines to assist. If Yin qi scatters and Yang qi returns, gradually reduce hot medicines to regulate.' Shouzhen said: 'After purging Shanghan, heat does not recede, accumulated heat is inside, Yang Jue is extreme, until Yang qi is constrained and cannot circulate to the body surface and limbs, causing whole-body cyan and cold. If urgently purged, residual Yin abruptly perishes, Yang qi exhausts and death occurs; if not purged, also death. At this moment, use Liangge San (Cool Diaphragm Powder) or Jiedu Yangyin Taiyang (Detoxify and Nourish Yin to Retreat Yang). Only if accumulated heat gradually scatters, will heart and abdomen become warm again, and pulse naturally regenerate. When pulse becomes strong, only then can Sanyi Chengqi Tang be used to purge.' Shouzhen again worried about the theory of Two Simultaneous Infections (Lianggan) in Heat, verifying with *Suwen*: 'Excess causes harm, succession brings control.' This precisely refers to extreme Yang Jue, unable to circulate to limbs, causing cold body and faint pulse. This briefly cites one or two ends; the rest can be understood by analogy. Gong's book was popular in the contemporary world, and he was a famous doctor of the generation, yet his errors were so great; how much more so for other trivial, chaotic, and unorthodox sayings, which cannot be fully believed! Regarding children, Yan Xiaozhong said: 'For all childhood eruptions, the nursing mother must guard her diet, not letting the child go hungry. And upon contracting wind-cold, it returns to the Kidney, turning black and becoming difficult to treat. Spring and Summer diseases are favorable; Autumn and Winter diseases are unfavorable. In Winter, Kidney is prosperous and Cold is strong, mostly returning to Kidney to turn black. If wrongly purged, interior becomes deficient, mostly returning to Kidney. This directly treats eruptions as Cold.' Shouzhen said: 'Yan Xiaozhong did not detail Qian's original formulas. For black sinking macules and rashes, using Niuli Gao (Ox Plum Paste) and Baixiang Wan (Hundred Fragrance Pill), purging with cold medicines, often results in recovery; without rescue, death is certain. Is it not clear that this is Heat! The classic says: 'All pain, itching, ulcers, and sores belong to Heart Fire.' And for black sinking macules and rashes, there is invariably abdominal fullness, wheezing, urgency, and red, scanty, obstructed urination; is this not caused by extreme Heat! This is why Yan Xiaozhong lost Qian's intent. Shouzhen's distinction such as this can be called the mirror of physicians. Learners should study its arguments carefully, do not rashly claim that Shanghan has Yin Poison syndromes and immediately administer Jiang Fu (Ginger and Aconite) medicines, making excess more excess and deficiency more deficient, damaging the insufficient and benefiting the surplus, thereby misleading people, is this not unjust! Every time I read Cheng Dizhong's Preface: 'Like traveling at night, lost in darkness, not knowing where to go. Meeting bright lamps and torches, the correct path is clear; this is the purpose of writing Medical Mirror.'
However, the secular world dislikes Cold and likes Heat; there is probably a reason for this. Shouzhen said: 'For mild diseases, using hot medicines to forcibly force open development, mistakenly hitting and gaining effect has occurred. For example, suffering from Wine Heat Toxicity, and drinking hot wine to treat it, allowing stagnation to open and qi-fluids to circulate freely; this is called treating Heat with Heat, and there are recoveries. Secular people are confused by mild diseases easily recovering, thinking severe diseases are the same; little do they know that missing the mark causes harm. Treating Heat Disease with hot medicines is like a proud ruler receiving a flattering minister's indulgence; disaster leads to destruction, unaware of the minister's evil, only enjoying their shared pleasures, causing Heat to intensify, leading to Yang Jue, cold body and faint pulse, reversing Yang to Yin, dying without realizing it. As for various Heat transformation syndromes, nine out of ten are damaged, none different. For example, unremitting diarrhea, stagnant heat in the interior, if using fire moxas and ironing, none would not be pleased. This is why the secular world likes Heat and dislikes Cold, thus nourishing the errors of Gong's book.'
Furthermore, Shouzhen said: 'When Heat disease is severe, following standard treatment but not receding, either due to lack of cooling, or failure to purge, or ironing, smoking, and moxibustion, causing extreme Heat and delirious Yang Jue. One must absolutely not use Yinfen (Calomel) and Badou (Croton Seed) hot and highly toxic pill medicines to purge, which instead deplete Yin qi and exhaust fluids, causing Heat to intensify, leading to Ao Nao (restlessness), wheezing and fullness, Jie Xiong (Chest Binding), abdominal pain, unremitting diarrhea, bleeding, hematochezia, or strangury and retention, panic, mania, and delirium; Heat syndromes arise like bees, too numerous to list. Thus becoming masses and firm accumulations, misleading people is frequent. Yet worldly sentiments do not know the physician's fault, failing to fully investigate Shouzhen's miraculous effects.'
I once heard Shouzhen say: 'Orthodox Treatment (Zheng Zhi) uses Cold to treat Heat, and Heat to treat Cold. For mild diseases, this can be done; for critical diseases, one must follow Counter-Treatment (Fan Zhi). Its Counter-Treatment is also called Following Treatment (Cong Zhi), because the medicinal qi follows the pathogenic qi. Thus, using Heat to treat Heat, and Cold to treat Cold, is called Counter-Treatment. Using Heat to treat Heat does not mean the pathogenic Heat is severe and more hot-natured medicines are used; rather, it means cold-natured medicines are taken with hot adjuvants. Because pathogenic Heat is severe, and medicinal Cold is severe, rejecting the medicinal Cold, the Cold attack cannot enter; Cold and Heat contend, and the disease worsens. Therefore, using cold medicines, one adds hot adjuvants to take them, ensuring medicinal qi and pathogenic qi do not conflict. The medicine is originally cold; after taking it hot, once the heat constitution is eliminated, the cold nature emerges, and thus the pathogenic qi heals accordingly. The rest follow this pattern. However, the method of Orthodox Treatment is like a sovereign punishing a minister's fault, going against the minister's nature to punish him; thus, if Heat is not severe, treating with Cold goes against the pathogenic qi, and the disease heals itself. The method of Counter-Treatment is like a minister remonstrating with a sovereign's error, following the sovereign's nature to please him; initially it complies, finally it opposes, able to admonish the sovereign to remove evil and return to orthodoxy. Wang Bing said: 'Treating minor disease is like saving a fire; fire gets wood and burns, gets fire and blazes, gets water and extinguishes. Treating dampness is like saving Dragon Fire; fire gets dampness and burns, gets water and blazes. Human fire, if not driven away, extinguishes itself.' This is called the method of good physicians. Both Opposing Treatment (Ni Zhi) and Following Treatment (Cong Zhi) are medicines contrary to nature; how could patients not dislike them? It is the struggle between medicine and disease that solidifies the qi. However, saving ten out of ten is not the physician's merit, attributing it to fate. Like cold body and faint pulse, never realizing accumulated heat is inside; if using Liangge or Jiedu medicines to regulate, none would not dislike it. Again, regarding chronic conditions lasting years, never understanding stagnant heat in the interior; if using Chengqi cold medicines to purge, none would not fear it. Even if recovered, one cannot avoid fear and aversion. Deaths caused by severe disease and weak medicine power are also unaware that saving a cartload of burning wood with a cup of water is wrong, only blaming the cooling medicine. These two cases have no other reason; it is that worldly people lack clarity on right and wrong, disliking Cold and liking Heat.'