感症。即所谓伤寒症也。古人以霜降以后。春分以前。直感寒邪者。名之为伤寒。（观此。
愈见春变为温。夏变为热之说之谬矣。）今统四时通行之症言之。谓之感症。大抵邪之所感。必
先皮毛。而后经络。由经络而入脏腑。（由络传经。由经入腑。须分看。）然按内经所指为脏。
及诸方书所称为腑。都言胃耳。（全书大旨。所重惟此。）盖六经经也。在肌肉之中。（东庄云。
肌肉不能传变。肌肉之中。皆经络也。经络皆谓之中。里则腑脏。表则皮毛。腑脏之气血。惟经
络传达。外邪之壅热。亦惟经络传变。故阳明少阳。皆从中治。中者经病。非胃与胆病也。经病
用和解。和解亦必由汗散。然非开发皮毛之法矣。盖邪初客表。经中阴津未伤。但启其窍。而汗
自通及热传中经。血液燔烁。窍虽启而汗为热隔。不能达外。庸工不知。尚用风热之药。以发其
表。益助热而耗阴。津原干涸。究竟不得汗而毙者多矣。仲景和解。只清解热邪。而津液自存。
阴汁既充。涌出肌表。而外邪自然涣散。此养汗以开玄府。与开玄府以出汗之迥乎不同也。）膀
胱胃胆脾肾肝。腑也脏也。在躯壳之里。玄府闭塞。本身之热。壅遏经络。以渐入里。而诸经之
井荣俞经原合。各有交接之处。由是自太阳而阳明。由阳明而少阳。而太阴少阴厥阴矣。此传经
之次第也。（东庄云。太阳经在最外一层。故邪入皮毛。即先伤之。皮毛不能传变。由太阳之络
传经。而后内入诸经也。邪客于皮毛。即玄府闭。人身脏腑之气。无刻不与外气通。故和畅。玄
府闭则内
气不能泄而生热。非风寒能变热也。此时但发其皮毛。玄府开而邪随汗散矣。麻黄桂枝。汗皮毛
之方。非解中之方也。表不解则热积而日甚。从本经反而之内。及各经井荣俞经原合交会之处。
则热交于他经。而各经病见矣。注中邪客于皮毛即元府闭九字。当移接和畅下。使人读之一气贯
通。尤觉醒亮。）顾当其传经也。井荣俞经原合之中。邪气郁勃。既不得从玄府透达。则必向里
而走空隙。而十二脏腑之中。惟胃为水谷之海。其上有口。其下有口。最虚而善受。故六经之邪。
皆能入之。邪入则胃实矣。胃实则津液干矣。津液干则死矣。（数语道尽感症致死根由。彼肆用
劫风燥液之剂。天人生命者。只坐不知此义耳。然阅此自应悔从前之误。而急思变计矣。胃为五
谷之海。六腑之大源。又主肌肉。而阳明行气于三阳。主乎津液。旨哉斯言。）经所云阳明中土。
无所复传是也。故伤寒书所称脏腑。皆专指胃而言。非兼指膀胱胆脾肾肝而言。或曰。伤寒有膀
胱胆脾肾肝气绝而死者何与。曰。此乃热邪从本经络逼入。如少阴经邪盛。直逼肾脏。因致水竭
是也。非传经之谓也。然如此者亦绝少。总之伤寒无膀胱传胃。胃传胆。胆传脾。脾传肾。肾传
肝之法也。此处学人宜深考。又伤寒之症。有阴阳表里之不同。人之感者。有虚实新久之各异。
而病之见也。有本症变症兼症之殊致。今将伤寒本症列于前。变症次之。兼症又次之。而一症之
中。又分攻补之两途。以便业是科者之观览焉。
感症，就是所谓的伤寒症。古人认为在霜降之后、春分之前，直接感受寒邪的，称为伤寒。（由此看来，春季变为温病、夏季变为热病的说法是错误的。）现在统而言之四季通行的病症，称为感症。大抵外邪侵袭人体，必定先侵犯皮毛，然后进入经络，再由经络传入脏腑。（由络脉传至经脉，由经脉传入腑脏，需要分别看待。）然而按照《内经》所指为“脏”，以及各方书所称为“腑”，都主要指胃而言。（全书的大旨，所重视的只有这一点。）盖六经属于经脉，位于肌肉之中。（东庄说：肌肉本身不能发生传变，肌肉之中都是经络。经络称为“中”，里则是腑脏，表则是皮毛。腑脏的气血，全靠经络传达；外邪的壅滞发热，也全靠经络传变。所以阳明、少阳的病，都从“中”来治。“中”指的是经病，不是胃病和胆病。经病用和解法，和解也必须通过发汗来疏散。但这已经不是开发皮毛的方法了。大概邪气初客于体表，经中的阴津尚未受伤，只要开启腠理毛孔，汗自然通畅；等到热邪传入中经，血液被煎熬灼伤，虽然开启了腠理，但汗被热邪阻隔，不能达于体表。庸医不知道这点，还使用风热性质的药物来发其表，反而助长热邪并耗伤阴液。津液原本已经干涸，最终因为无法出汗而死亡的很多。张仲景的和解法，只是清解热邪，从而保存津液。阴汁既然充足，就会涌出肌表，外邪自然涣散。这是通过滋养汗源来打开玄府（汗孔），与通过打开玄府来强行出汗有着天壤之别。）膀胱、胃、胆、脾、肾、肝，是腑和脏，位于躯壳之内。玄府闭塞，体内的热气壅遏在经络中，逐渐向内深入，而各条经脉的井、荥、俞、经、原、合穴，各有交接之处。因此疾病自太阳经传至阳明经，由阳明经传至少阳经，再传至太阴、少阴、厥阴经。这就是传经的次序。（东庄说：太阳经在最外层，所以邪气侵入皮毛，就先伤害它。皮毛不能传变，是由太阳的络脉传至经脉，然后才内入其他经脉。邪气客居在皮毛，导致玄府闭塞。人身脏腑之气，无时无刻不与外界之气相通，所以保持和畅。玄府闭塞则内部之气不能宣泄而生热，这不是风寒能变成热邪。此时只需发散皮毛之邪，玄府打开，邪气随汗而散。麻黄汤、桂枝汤是发汗解表的方剂，不是和解的方剂。表证不解则热邪积聚且日益加重，从本经反过来向内，到达各经井、荥、俞、经、原、合交会之处，则热邪交结于他经，于是各经病症出现。注文中“邪客于皮毛即元府闭”九个字，应当移到“和畅”二字下面，使人读起来一气贯通，尤其显得清醒明亮。）但是，当邪气传经时，在井、荥、俞、经、原、合穴中，邪气郁积勃发，既然不能从玄府透达出来，就必然向里走向空隙。而在十二脏腑之中，只有胃是水谷之海，它的上面有口（食管入口），下面有口（肛门出口），最虚弱且善于受纳。所以六经的邪气，都能进入胃中。邪气进入则胃实了，胃实则津液干了，津液干涸则人死了。（这几句话道尽了感症致死的根本原因。那些肆意使用劫夺风燥烈药物的医生，残害人的生命，只是因为不懂这个道理罢了。然而阅读到这里，自然应该后悔以前的错误，并急切地思考改变策略。胃是五谷之海，六腑的大源头，又主管肌肉，而阳明经在三阳经中运行气机，主司津液，这话真是精辟啊。）经文所说的“阳明中土，无所复传”就是这个意思。所以伤寒书中所称的脏腑，都专指胃而言，并非兼指膀胱、胆、脾、肾、肝。有人问：伤寒中有因膀胱、胆、脾、肾、肝气绝而死亡的，这怎么解释？回答说：这是热邪从本经络逼迫进入所致，比如少阴经邪气盛，直接逼迫肾脏，导致肾水枯竭，这就叫作“直中”或“逼入”，不叫作“传经”。然而像这样的情况也极少见。总之，伤寒没有膀胱传胃、胃传胆、胆传脾、脾传肾、肾传肝的规律。学习的人在这里应该深入考察。另外，伤寒的病症，有阴证、阳证、表证、里证的不同；人感受邪气，有虚证、实证、新病、久病的差异；而病症的表现，有本症、变症、兼症的区别。现在将伤寒的本症列在前面，变症次之，兼症再次之，而在每一种症状中，又分为攻法和补法两条途径，以便从事这一科医生的阅览参考。
Gan Zheng (Infection Syndrome), also known as Shang Han Zheng (Cold Damage Syndrome). The ancients referred to those who directly contracted cold pathogenic factors after the Frost's Descent solar term and before the Spring Equinox as having Shang Han. (This observation further reveals the fallacy of the theory that spring transforms into warm diseases and summer transforms into heat diseases.) Now, speaking generally of the conditions prevalent throughout the four seasons, we call them Gan Zheng. Generally, when a pathogen invades, it must first affect the skin and hair (mao pi), then enter the meridians (jing luo), and from there enter the zang-fu organs. (Transmission from collaterals to meridians, and from meridians to fu organs, requires distinct consideration.) However, according to the *Nei Jing* which refers to "zang" (solid organs), and various medical texts which refer to "fu" (hollow organs), they all primarily discuss the Stomach. (The main theme of this book focuses solely on this.) The Six Meridians are meridians located within the muscles. (Dong Zhuang stated: Muscles themselves do not undergo transmission; within the muscles are all meridians. Meridians are termed "Zhong" (middle/interior relative to exterior but interior to muscle surface), while inside are the zang-fu organs, and outside are the skin and hair. The qi and blood of the zang-fu organs are conveyed only through meridians; the stagnation and heat of external pathogens also transmit only through meridians. Therefore, Yangming and Shaoyang disorders are treated from the "Zhong". "Zhong" refers to meridian disease, not stomach or gallbladder disease. Meridian disease is treated with harmonizing methods, and harmonizing must necessarily involve sweating to disperse. However, this is no longer a method of opening the skin pores. When pathogens initially lodge in the exterior, the yin fluids in the meridians are not yet damaged; simply opening the pores allows sweat to flow naturally. But when heat transmits to the middle meridians, the blood is scorched and dried. Although the pores are opened, sweat is blocked by heat and cannot reach the exterior. Unskilled physicians, unaware of this, still use wind-heat promoting drugs to induce sweating at the exterior, which further assists heat and consumes yin. With the original fluids already dried up, many ultimately die because they cannot sweat. Zhang Zhongjing's harmonizing method merely clears and resolves heat pathogens, thereby preserving body fluids. Once the yin juices are replenished, they surge to the muscle surface, and external pathogens naturally dissipate. This is nourishing sweat to open the xuankou (pores), which is vastly different from opening the xuankou to force sweat out.) The Bladder, Stomach, Gallbladder, Spleen, Kidney, and Liver are fu and zang organs located inside the body shell. When the xuankou (pores) are closed, internal heat becomes stagnant in the meridians and gradually moves inward. The Jing-Ru-Shu-Jing-Yuan-He (Well, Spring, Stream, River, Source, Sea) acupoints of each meridian have their respective junctions. Thus, transmission proceeds from Taiyang to Yangming, from Yangming to Shaoyang, and then to Taiyin, Shaoyin, and Jueyin. This is the sequence of meridian transmission. (Dong Zhuang stated: The Taiyang meridian is in the outermost layer, so when pathogens enter the skin and hair, they injure it first. Skin and hair do not transmit; transmission occurs from the Taiyang collaterals to the meridians, and then internally to other meridians. When pathogens lodge in the skin and hair, the xuankou closes. The qi of human zang-fu organs is constantly communicating with external qi, maintaining harmony. If the xuankou closes, internal qi cannot vent, generating heat; this is not because wind-cold transforms into heat. At this time, one should only release the exterior via sweating; once the xuankou opens, pathogens scatter with sweat. Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) are formulas for inducing sweating at the exterior, not for harmonizing. If the exterior is not resolved, heat accumulates and intensifies daily. From the primary meridian, it reverses inward to the junctions of the Jing-Ru-Shu-Jing-Yuan-He points of various meridians, where heat intersects with other meridians, manifesting as diseases of those meridians. In the commentary, the nine characters "pathogens lodging in skin and hair immediately close the xuankou" should be moved below the word "harmony," making the reading flow continuously and appearing particularly lucid.) Nevertheless, during meridian transmission, within the Jing-Ru-Shu-Jing-Yuan-He points, pathogenic qi becomes stagnant and vigorous. Since it cannot penetrate outward through the xuankou, it must move inward toward void spaces. Among the twelve zang-fu organs, only the Stomach is the sea of water and grain, with an opening above (the mouth/esophagus) and an opening below (the anus), being the most deficient and receptive. Therefore, pathogens from the six meridians can all enter the Stomach. Once pathogens enter, the Stomach becomes full/excess. When the Stomach is excess, body fluids dry up. When body fluids dry up, death ensues. (These few sentences exhaustively explain the root cause of death in infection syndromes. Those who recklessly use astringent, wind-dispersing, and fluid-drying agents, destroying life, do so only because they do not understand this principle. Upon reading this, one should naturally regret past errors and urgently seek alternative strategies. The Stomach is the sea of five grains, the great source of the six fu organs, governs the muscles, and the Yangming meridian circulates qi among the three yang meridians, governing body fluids. This statement is profound.) As the classics state, "Yangming [Earth] receives no further transmission." Therefore, when Shang Han texts refer to zang-fu organs, they specifically refer to the Stomach, not including the Bladder, Gallbladder, Spleen, Kidney, or Liver. One might ask: What about deaths caused by the exhaustion of qi in the Bladder, Gallbladder, Spleen, Kidney, and Liver in Shang Han? I reply: These cases result from heat pathogens forcing entry from the primary meridian. For example, when Shaoyin meridian pathogenic qi is excessive, it directly forces into the Kidney, causing kidney water depletion. This is called "direct invasion" or "forcing entry," not "meridian transmission." However, such cases are extremely rare. In summary, there is no rule in Shang Han of transmission from Bladder to Stomach, Stomach to Gallbladder, Gallbladder to Spleen, Spleen to Kidney, or Kidney to Liver. Students should investigate this deeply here. Furthermore, Shang Han symptoms differ in Yin/Yang and Exterior/Interior; individuals contracting the disease vary in Deficiency/Excess and Acute/Chronic duration; and clinical manifestations differ between Primary Symptoms, Modified Symptoms, and Combined Symptoms. Now, the Primary Symptoms of Shang Han are listed first, followed by Modified Symptoms, and then Combined Symptoms. Within each symptom category, treatment is divided into Attacking (purging) and Tonifying (supplementing) approaches, to facilitate the study of practitioners in this field.