夫经者，径也，行于皮之内，肉之中者也。腑者，器也，所以盛水谷者也。伤寒诸书，
以经为腑，以腑为经，混同立言，惑人滋甚，吾特设经腑论而详辨之。夫邪之在三阳也，有
太阳之经，有阳明之经，有少阳之经，凡三阳在经之邪，未入腑者，可汗而已。邪之在阴也
有太阴之经，有少阴之经，有厥阴之经。凡三阴之邪，已入腑者，可下而已。所谓入腑之
腑，指阳明胃腑而言也。三阳、三阴之邪，一入胃腑，则无复传矣。胃者、土也。万物归土
之义也。《伤寒论》云∶有太阳阳明，有正阳阳明，有少阳阳明。此阳明即胃腑，非阳明之
经也。假令邪在太阳，不传阳明经而径入胃腑者，名曰太阳阳明。邪在阳明经，不传少阳而
自入本腑者，名曰正阳阳明。邪在少阳经，不传三阴而径入胃腑者，名曰少阳阳明。凡三阳
之邪，已入胃腑，俱下之勿疑矣。
虽然，三阳入腑，人所共知，三阴入腑，鲜或能识。夫三阳之经，去腑尚远，三阴之经
与腑为近，然既曰经，则犹在径路之间，而未尝归并于一处也。《伤寒论》云∶太阴病，
脉浮者，可发汗，宜桂枝汤。少阴中风，脉阳微阴浮者，为欲愈。厥阴中风，脉微浮为欲愈
不浮为未愈。俱言邪在于经，故有还表向汗之时，若既入腑则无外出之路，惟有通其大便
令邪从内出也。此大、小承气，调胃承气所由设也。然则以白虎汤治腑病，何谓也？夫以
白虎治腑病者，乃三阳之邪，初入胃腑，表里皆热，邪未结聚，热势散漫，而无胃实不大便
之证，故用白虎汤内清胃腑，外透肌肤，令表里两解。若邪已结聚，如太阴之大实痛，少阴
之咽干口燥、下利青黄水、心下硬，厥阴之烦满囊缩，白虎不中与也，亦惟下之而已矣。此
无他，经腑既明，则施治不致差舛。
然则太阳之邪，自入本腑，何谓也？太阳之腑，膀胱是也。膀胱主盛溺，太阳病盛，则
遗邪于腑，而为口渴、溺赤之症。外显太阳病，而兼有此症者，名曰太阳传本。当用五苓散
以桂枝解外邪，以猪苓、泽泻等药，通其小便而愈也。
或问∶阳邪入阴，复有还表向汗之时，其信然乎？予曰∶古人之言，岂欺我哉！夫经、径
也，犹路径然。三阳之邪既有路以达三阴，三阴之邪，即有路以返三阳，此循环之至理，非
若邪入腑中，更无外出之路也。尝见病患体质素浓，有传经尽而自愈者，皆由汗解也。《伤
寒论》云∶其不再传经，不加异气者，七日太阳病衰，头痛稍愈。八日阳明病衰，身热稍歇
九日少阳病衰，耳聋微闻。十日太阴病衰，腹减思食。十一日少阴病衰，渴止，舌干已而
嚏也。十二日厥阴病衰，囊纵，小腹微下，大气皆去，病患精神爽慧也。由是观之，岂非经
尽而愈，还表向汗之明验乎？
或曰∶阴不得有汗，今太阴脉浮，用桂枝汤，然则三阴亦可汗解欤？桂枝汤，将为太阴
正药欤？余曰∶不然。读仲景书，举一隅当以三隅反，不可执一而论也。夫邪已入里而复发
其表，是增其热矣，故曰阴不得有汗。邪虽入里，而复返乎表，是邪外出矣，故曰还阳而向
汗。夫桂枝汤，太阳伤风药也，今太阴用桂枝者，实由太阳伤风，为医误下而传入太阴者也
太阴脉当沉，今反浮，是证在太阴，脉在太阳，则太阳之邪，未尽入于阴，太阴之邪，大
有还阳向汗之势，故用桂枝汤以彻散之，令其从太阳来者，仍自太阳出也。推而论之，若从
太阳伤寒来，得伤寒脉，则桂枝可易麻黄，仲景麻黄石膏汤之意可推也。若从阳明来，得阳
明脉，则桂枝可易葛根，仲景葛根黄连黄芩汤之意可推也。若从少阳来，得少阳脉，则桂枝
可易柴胡，是以大柴胡汤为少阳传入太阴之的方也。然必腹中实痛，乃为脾邪干胃，甫用大
黄下之。否则只于本方，加芍药以和之而已。《伤寒论》云∶本太阳证，为医误下，传入太
阴而腹痛者，桂枝汤加芍药，大实痛者，桂枝汤加大黄，亦此意也。太阴如此，少阴、厥阴
何独不然。仲景少阴篇内，以四逆散治阳厥，方用柴胡、黄芩、甘草、枳实者，人皆不得其
解，岂少阴亦用柴胡散之欤？诚以热邪传里，游行于少阴经络之间，尚未结聚成实，内陷于
胃腑之中，则用黄芩、甘草以清传经之热邪，用枳实以导胃中之宿滞，使邪气不得乘机而内
合，以作胃实不大便之证，更用柴胡疏通三阳之路，俾其从此来者，仍从此出，不必扰动中
宫，而病势已解，此仲景用药之微权，而其用心亦良苦矣。愚不自揣，每遇阳邪入阴，尚未
结实之证，仿古人三黄解毒之意，而加以石膏、柴胡、丹皮之属，往往获效。盖三黄以除三
阴之热邪，用石膏以守阳明之中路，加柴胡者，亦望其返之故道，而还阳向汗也。大抵伤寒治
法，急于解表而缓于攻里。非惟三阳之邪，务从表散，即三阴未结之邪，犹且徘徊观望，冀
其还阳而之表。必俟邪气结实，乃用承气汤攻下之。且戒曰∶欲行大承气，先与小承气，腹
中转矢气者，方与大承气汤，若不转矢气，慎未可再攻。兢兢然不苟下也有如此。仲景又云
∶病发于阳，而反下之，热入因作结胸；病发于阴而下之，因作痞。热入者，言入胃也。三
阴下早，虽不至成结胸，而已不免为痞气矣。噫嘻！经腑之间，乌可以不辨哉！
所谓“经”，就是路径的意思，是运行在皮肤之内、肌肉之中的通道。所谓“腑”，就是容器，是用来盛装水谷的器官。关于伤寒的各类书籍，往往将“经”与“腑”混淆，把经当作腑，把腑当作经，混在一起论述，极大地迷惑了人们。我特意撰写这篇《经腑论》来详细辨析这一问题。
邪气侵犯三阳经时，有太阳经、阳明经、少阳经之分。凡是三阳经的邪气，尚未传入腑的，可以通过发汗的方法治愈。邪气侵犯三阴经时，有太阴经、少阴经、厥阴经之分。凡是三阴经的邪气，已经传入腑的，可以通过泻下的方法治愈。这里所说的“入腑”之“腑”，特指阳明胃腑而言。无论是三阳还是三阴的邪气，一旦进入胃腑，就不再继续传变了。胃属土，符合万物归于土的义理。《伤寒论》说：“有太阳阳明，有正阳阳明，有少阳阳明。”这里的“阳明”指的是胃腑，而不是阳明经。假如邪气在太阳经，不经过阳明经而直接传入胃腑的，称为“太阳阳明”。邪气在阳明经，不传给少阳而自行传入本腑的，称为“正阳阳明”。邪气在少阳经，不传给三阴而直接传入胃腑的，称为“少阳阳明”。凡是三阳的邪气，已经进入胃腑的，都应当毫不犹豫地采用泻下法治疗。
虽然如此，三阳邪气入腑，是人们所共知的；但三阴邪气入腑，很少有人能识别。三阳经距离腑尚远，而三阴经与腑较为接近。然而既然称为“经”，就说明邪气仍在路径之中，并未归并聚集于一处。《伤寒论》说：“太阴病，脉浮的，可以发汗，适宜用桂枝汤。”“少阴中风，脉象寸微尺浮的，是即将痊愈的表现。”“厥阴中风，脉象微浮的是即将痊愈，不浮的是未愈。”这些都是说邪气还在经中，所以还有回归体表通过发汗排出的时机。如果邪气已经入腑，就没有外出的路径了，只有通过通大便让邪气从体内排出。这就是大承气汤、小承气汤、调胃承气汤设立的原因。那么，为什么用白虎汤治疗腑病呢？用白虎汤治疗腑病的情况，是三阳邪气初入胃腑，表里都有热，邪气尚未结聚，热势散漫，且没有胃实不大便的症状，所以使用白虎汤在内清泄胃腑之热，在外透达肌肤之热，使表里两解。如果邪气已经结聚，如太阴病的大实痛，少阴病的咽干口燥、下利青黄水、心下硬满，厥阴病的烦闷胀满、阴囊收缩，此时白虎汤就不适用了，也只能用泻下法罢了。这没有别的原因，只要经和腑辨明了，治疗就不会出现差错。
那么，太阳经的邪气，自行传入本腑，是怎么回事呢？太阳的腑是膀胱。膀胱主要盛装尿液，太阳病严重时，会将邪气遗留在腑中，从而出现口渴、小便赤涩等症状。外表显现太阳病的症状，同时兼有这些症状的，称为“太阳传本”。应当使用五苓散，以桂枝解除外部邪气，以猪苓、泽泻等药物通利小便，从而痊愈。
有人问：阳邪传入阴经，又有回归体表通过发汗排出的情况，真的吗？我说：古人的话，怎么会欺骗我们呢！所谓“经”，就是“径”（路径），就像道路一样。三阳的邪气既有路可以到达三阴，三阴的邪气就有路可以返回三阳，这是循环往复的道理，不像邪气进入腑中那样，再也没有外出的路径了。我曾见到患者体质本来强壮，有的传经完毕而自愈的，都是通过发汗解决的。《伤寒论》说：“如果不再次传经，不加杂气的，第七天太阳病衰退，头痛稍好；第八天阳明病衰退，身热稍歇；第九天少阳病衰退，耳聋稍微能听见声音；第十天太阴病衰退，腹部变软想吃东西；第十一天少阴病衰退，口渴停止，舌干好转并开始打喷嚏；第十二天厥阴病衰退，阴囊松弛，小腹轻微下坠，大气皆去，患者精神清爽。”由此看来，难道不是经尽而愈、回归体表通过发汗排出的明显证据吗？
有人说：阴经不应该有汗证，现在太阴脉浮，用桂枝汤，那么三阴也可以发汗解表吗？桂枝汤将成为太阴的主药吗？我说：不是这样的。读仲景的书，举一反三，不能拘泥于一点而论断。邪气已经入里却再发其表，这是增加热邪，所以说“阴不得有汗”。邪气虽然入里，但又返回到体表，这是邪气向外排出，所以说“还阳向汗”。桂枝汤是治疗太阳伤风的药物，现在太阴病用桂枝，实际上是因为太阳伤风，被医生误用下法而传入太阴。太阴的脉象应当沉，现在反而浮，这是证候在太阴，脉象在太阳，说明太阳的邪气没有完全传入阴分，太阴的邪气大有回归阳气、趋向发汗的趋势，所以用桂枝汤来疏散它，让它从太阳来的，仍然从太阳出去。推而言之，如果是从太阳伤寒传来，得到伤寒脉象，那么桂枝可以换成麻黄，可以推知仲景麻黄石膏汤的意思。如果是从阳明传来，得到阳明脉象，那么桂枝可以换成葛根，可以推知仲景葛根黄连黄芩汤的意思。如果是从少阳传来，得到少阳脉象，那么桂枝可以换成柴胡，因此大柴胡汤是少阳传入太阴的确切方剂。但是必须腹中实痛，才是脾邪干扰胃，才刚刚使用大黄泻下。否则只在本方中加入芍药来调和即可。《伤寒论》说：“原本太阳证，被医生误下，传入太阴而出现腹痛的，用桂枝汤加芍药；大实痛的，用桂枝汤加大黄。”也是这个意思。太阴是这样，少阴、厥阴难道唯独不是这样吗？仲景在少阴篇中，用四逆散治疗阳厥，方子用柴胡、黄芩、甘草、枳实，人们都不理解，难道少阴也用柴胡散吗？实在是因为热邪传入里部，游行在少阴经络之间，尚未结聚成实，内陷于胃腑之中，就用黄芩、甘草来清泄传入经的热邪，用枳实来导引胃中的宿滞，使邪气不得趁机内合，造成胃实不大便的症状，再用柴胡疏通三阳的路径，让它们从此处来的，仍然从此处出去，不必扰动中宫（脾胃），病势就已经解除，这是仲景用药的精妙权变，他的用心也是良苦的。我不自量力，每当遇到阳邪入阴、尚未结实的证候，模仿古人三黄解毒的意思，加上石膏、柴胡、丹皮之类，往往获得疗效。大概三黄用来清除三阴的热邪，用石膏来守住阳明的中路，加柴胡，也是希望它返回故道，回归阳气趋向发汗。大抵伤寒的治疗方法，急于解表而缓于攻里。不仅仅是三阳的邪气务必从表消散，即使是三阴未结的邪气，也徘徊观望，希望它回归阳气而趋向体表。一定要等到邪气结实，才用承气汤攻下。并且告诫说：“想要用大承气汤，先用小承气汤，如果腹中有转矢气（放屁）的现象，才给大承气汤；如果不转矢气，千万不要再攻下。”谨慎不苟且下如此严重。仲景又说：“病发于阳，反而用下法，热邪内入因而形成结胸；病发于阴而下早，因而形成痞证。”“热入者”，说的是邪气进入胃腑。三阴过早攻下，虽然不至于形成结胸，但也难免成为痞气了。唉！经和腑之间，怎么能不辨别清楚呢！
The term "Jing" (Meridian/Channel) refers to a path, which runs within the skin and among the muscles. The term "Fu" (Hollow Organ) refers to a vessel, used to contain food and fluids. Various books on Shanghan (Cold Damage) often confuse Jing with Fu, treating meridians as hollow organs and vice versa, mixing them in their discussions, which greatly confuses people. I have specifically composed this "Treatise on Meridians and Hollow Organs" to clarify this distinction in detail.
When pathogens invade the Three Yang channels, there are the Taiyang channel, Yangming channel, and Shaoyang channel. For pathogens in the Three Yang channels that have not yet entered the Fu organs, treatment by sweating (diaphoresis) is sufficient. When pathogens invade the Three Yin channels, there are the Taiyin channel, Shaoyin channel, and Jueyin channel. For pathogens in the Three Yin channels that have already entered the Fu organs, treatment by purgation is sufficient. The "Fu organ" referred to here as the destination of entry specifically denotes the Stomach (Yangming Fu). Once pathogens from either the Three Yang or Three Yin channels enter the Stomach, they cease further transmission. The Stomach belongs to Earth, symbolizing the principle that all things return to the earth. The *Shanghan Lun* states: "There is Taiyang-Yangming, Zhengyang-Yangming, and Shaoyang-Yangming." Here, "Yangming" refers to the Stomach Fu organ, not the Yangming channel. If pathogens are in the Taiyang channel but bypass the Yangming channel to directly enter the Stomach Fu, it is called "Taiyang-Yangming." If pathogens are in the Yangming channel and do not transmit to Shaoyang but enter its own Fu organ spontaneously, it is called "Zhengyang-Yangming." If pathogens are in the Shaoyang channel and do not transmit to the Three Yin but directly enter the Stomach Fu, it is called "Shaoyang-Yangming." In all cases where Three Yang pathogens have entered the Stomach Fu, purgation should be employed without hesitation.
Although it is common knowledge that Three Yang pathogens enter the Fu organs, few can recognize when Three Yin pathogens enter the Fu organs. The Three Yang channels are relatively distant from the Fu organs, whereas the Three Yin channels are closer to them. However, since they are termed "channels," the pathogens remain within the pathways and have not yet coalesced into a specific location. The *Shanghan Lun* states: "In Taiyin disease, if the pulse is floating, sweating may be induced, preferably using Guizhi Tang (Cinnamon Twig Decoction)." "In Shaoyin wind-strike, if the radial pulse is faint and the cun pulse is floating, recovery is imminent." "In Jueyin wind-strike, a faintly floating pulse indicates impending recovery; a non-floating pulse indicates no recovery." These statements indicate that pathogens remain in the channels, allowing for a return to the exterior via sweating. Once pathogens enter the Fu organs, there is no path for external exit; only through promoting bowel movements can pathogens be expelled internally. This explains the establishment of Dachengqi Tang (Major Order the Qi Decoction), Xiaochengqi Tang (Minor Order the Qi Decoction), and Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction). Then, why is Baihu Tang (White Tiger Decoction) used to treat Fu organ diseases? Baihu Tang is used for Fu organ conditions when Three Yang pathogens have just entered the Stomach Fu, causing heat in both the interior and exterior, but the pathogens have not yet condensed, the heat is diffuse, and there are no symptoms of stomach excess with constipation. Thus, Baihu Tang clears heat from the Stomach Fu internally while venting heat through the skin externally, resolving both layers. If pathogens have condensed, such as in severe abdominal pain in Taiyin disease, dry throat and mouth with yellow-green diarrhea and epigastric hardness in Shaoyin disease, or irritability, fullness, and retraction of the scrotum in Jueyin disease, Baihu Tang is contraindicated, and purgation alone is required. There is no other reason; once the distinction between channels and Fu organs is clear, treatment will not err.
What then of Taiyang pathogens entering their own Fu organ? The Fu organ of Taiyang is the Bladder. The Bladder primarily stores urine. In severe Taiyang disease, pathogens may linger in the Fu organ, resulting in thirst and dark urine. When exterior Taiyang symptoms are accompanied by these signs, it is called "Taiyang transmitting to its root." Wuling San (Five-Ingredient Powder with Poria) should be used, employing Guizhi (Cinnamon Twig) to resolve exterior pathogens, and Zhuling (Polyporus), Zexie (Alisma), etc., to promote urination, leading to recovery.
One might ask: Is it true that Yang pathogens entering Yin channels can still return to the surface for sweating? I reply: Would ancient sages deceive us? "Jing" means "path," like a road. Just as there is a path for Three Yang pathogens to reach the Three Yin, there is a path for Three Yin pathogens to return to the Three Yang. This is the principle of cyclical circulation, unlike pathogens entering Fu organs, which have no exit route. I have observed patients with strong constitutions who recovered after the completion of channel transmission, all resolved through sweating. The *Shanghan Lun* states: "If there is no further channel transmission and no mixed pathogens, on the seventh day, Taiyang disease declines, and headache improves slightly. On the eighth day, Yangming disease declines, and body heat subsides slightly. On the ninth day, Shaoyang disease declines, and deafness improves slightly. On the tenth day, Taiyin disease declines, the abdomen softens, and appetite returns. On the eleventh day, Shaoyin disease declines, thirst stops, dry tongue resolves, and sneezing occurs. On the twelfth day, Jueyin disease declines, the scrotum relaxes, the lower abdomen feels slightly heavy, the vital qi departs, and the patient's spirit becomes refreshed." Does this not constitute clear evidence that completion of channel transmission leads to recovery via return to the surface and sweating?
Someone asks: Yin channels should not have sweating syndromes. Now, Taiyin presents with a floating pulse, treated with Guizhi Tang. Can Three Yin channels also be resolved by sweating? Will Guizhi Tang become the primary medicine for Taiyin? I say: Not so. One must infer the whole from part when reading Zhang Zhongjing’s works and not argue rigidly. If pathogens have entered the interior but one again induces sweating at the exterior, it increases heat; hence, "Yin should not have sweating." However, if pathogens have entered the interior but return to the exterior, it signifies pathogens moving outward; hence, "returning to Yang towards sweating." Guizhi Tang is a formula for Taiyang wind-strike. Its use in Taiyin is actually because Taiyang wind-strike was mistakenly treated with purgation by a physician, causing transmission to Taiyin. The Taiyin pulse should be deep; the current floating pulse indicates the syndrome is in Taiyin but the pulse reflects Taiyang. This shows Taiyang pathogens have not fully entered the Yin, and Taiyin pathogens have a strong tendency to return to Yang and move towards sweating. Therefore, Guizhi Tang is used to disperse them, allowing what came from Taiyang to exit via Taiyang. By extension, if transmitted from Taiyang cold-injury presenting with a cold-injury pulse, Guizhi could be replaced by Mahuang (Ephedra), inferring the intent of Zhang Zhongjing’s Mahuang Shigao Tang. If from Yangming presenting with a Yangming pulse, Guizhi could be replaced by Gegen (Kudzu Root), inferring the intent of Gegen Huanglian Huangqin Tang. If from Shaoyang presenting with a Shaoyang pulse, Guizhi could be replaced by Chaihu (Bupleurum), making Daxiehu Tang (Major Bupleurum Decoction) the precise formula for Shaoyang transmitting to Taiyin. However, this requires solid abdominal pain, indicating Spleen pathogens interfering with the Stomach, warranting the use of Dahuang (Rhubarb) for purgation. Otherwise, only adding Shaoyao (Peony) to the base formula for harmonization is needed. The *Shanghan Lun* states: "For original Taiyang syndrome mistakenly purged, transmitting to Taiyin with abdominal pain, use Guizhi Tang plus Shaoyao; for severe solid pain, use Guizhi Tang plus Dahuang." This is the same principle. Taiyin is thus; how could Shaoyin and Jueyin be different? In the Shaoyin chapter, Zhang Zhongjing uses Sini San (Frigid Extremities Powder) for Yang cold-extremities, containing Chaihu, Huangqin (Scutellaria), Gancao (Licorice), and Zhishi (Immature Bitter Orange). People do not understand this; does Shaoyin also use Bupleurum dispersion? It is because heat pathogens have transmitted to the interior, wandering between Shaoyin channels and collaterals, not yet condensed into solidity, and sinking into the Stomach Fu. Huangqin and Ganqing clear the transmitted heat, Zhishi guides out old stagnation in the Stomach, preventing pathogens from combining internally to cause stomach excess and constipation. Chaihu unblocks the Three Yang pathways, allowing pathogens to exit as they entered, without disturbing the Middle Jiao (Spleen/Stomach), resolving the disease. This is the subtle flexibility of Zhang Zhongjing’s medication and his painstaking care. Presuming upon my limited ability, whenever I encounter Yang pathogens entering Yin without condensation, I imitate the ancient intent of Sanhuang Jiedu Tang (Three Yellows Detoxification Decoction) by adding Shigao (Gypsum), Chaihu, and Danpi (Moutan Cortex), often achieving efficacy. Sanhuang removes heat from the Three Yin; Shigao guards the central path of Yangming; Chaihu is added hoping to return the pathogens to their original path, returning to Yang towards sweating. Generally, Shanghan treatment prioritizes resolving the exterior over attacking the interior. Not only are Three Yang pathogens dispersed from the surface, but even Three Yin pathogens that have not condensed hesitate, hoping to return to Yang and the surface. Only when pathogens condense is Chengqi Tang used for purgation. He also warns: "To use Dachengqi Tang, first give Xiaochengqi Tang. If intestinal gas passes, then give Dachengqi Tang; if not, do not purge again." Such caution against indiscriminate purgation is profound. Zhang Zhongjing also said: "Disease arising from Yang, if wrongly purged, heat enters forming Jie Xiong (Chest Binding); disease arising from Yin, if wrongly purged, forms Pi (Glomus)." "Heat entering" refers to entering the Stomach. Premature purgation in the Three Yin, while not forming Jie Xiong, inevitably results in Pi. Alas! How can the distinction between channels and Fu organs be left unclarified!