经义
黄帝问曰∶今夫热病者，皆伤寒之类也。或愈或死，其死皆以六、七日之间，其愈皆以十日以上者，何也？
岐伯对曰∶巨阳者，诸阳之属也，其脉连于风府，故为诸阳主气也。人之伤于寒也，则为病热，热虽盛不死；
其两感于寒而病者，必不免于死。帝曰∶愿闻其状。岐伯曰∶伤寒一日，巨阳受之，以其脉经头项循腰脊，故
头项痛，腰脊强。二日阳明受之，阳明主肉，其脉侠鼻络于目，故身热目疼而鼻干，不得卧也。三日少阳受之，
少阳主胆，其脉循胁络于耳，故胸胁痛而耳聋。三阳经络皆受病，未入于腑者，可汗而已。四日太阴受之，太
阴脉布胃中络于嗌，故腹满而嗌干。五日少阴受之，少阴脉贯肾络于肺，系舌本，故口燥舌干而渴。六日厥阴
受之，厥阴脉循阴器而络于肝，故烦满而囊缩。三阴经络皆受病，已入于腑者，可下而已。三阴三阳，五脏
六腑皆受病，营卫不行，五脏不通则死矣。其不两感于寒者，七日巨阳病衰，头痛少愈；八日阳明病衰，身热
少愈；九日少阳病衰，耳聋微闻；十日太阴病衰，腹减如故，则思饮食；十一日少阴病衰，渴止不满，舌干已
而嚏；十二日厥阴病衰，囊纵少腹微下，大气皆去，病日已矣。帝曰∶治之奈何？岐伯曰∶治之各通其脏脉，
病日衰已矣。其未满三日者，可汗而已；其满三日者，可泄而已。若其寒邪传不以次，与夫专经不传，表里变
易，则随证脉处治，吐、下、汗、和，早暮异法。帝曰∶热病已愈，时有所遗者何也？岐伯曰∶诸遗者，热甚
而强食之，故有所遗也。若此
者，皆病已衰而热有所藏，因其谷气相薄，两热相合，故有所遗也。帝曰∶治遗奈何？岐伯曰∶视其虚实，调
其逆从，可使必已矣。帝曰∶病热当何禁之？岐伯曰∶病热少愈，食肉则复，多食则遗，此其禁也。帝曰∶其
病两感于寒者，其脉应与其病形何如？岐伯曰∶两感于寒者，病一日则巨阳与少阴俱病，则头痛口干而烦满；
二日则阳明与太阴俱病，则腹满身热，不欲食，谵言；三日则少阳与厥阴俱病，则耳聋囊缩而厥，水浆不入，
不知人，六日死。（《素问》）
伤寒有汗出而愈，下之而死者；有汗出而死，下之而愈者，何也？然∶阳虚阴盛，汗出而愈，下之而死；
阳盛阴虚，汗出而死，下之而愈。（《难经》）
伤寒有三说
寒之伤人也有三∶雾露风雨，冬春霜雪，此天之寒气也；幽居旷室，砖地石阶，大江深泽，邃谷高山，此
地之寒气也；日食寒物，脏冰瓜果，此人之寒气也。（柯韵伯）
脉法
伤寒邪，无定体，或入阳经，则太阳为首；或入阴经，则少阴为先。其脉以浮紧而有力、无力，可知表之
虚实；沉紧而有力、无力，可知里之虚实；中而有力、无力，可知阴阳之吉凶。（张景岳）
浮、沉、迟、数，本不可以脏腑分，既有阴阳之可名，即以阳表、阴里、腑阳、脏阴定之，以为病所在耳。
试观脉之浮，为在表，应病亦为在外。然脉浮亦有里证，或表邪初陷，或里邪欲出，究竟不离于表，故主表，
其大纲也。沉为在里，应病亦为在里。然亦有表证，或阳病见阴而危，或阴出之阳而愈，究竟病根于里，故主
里，其大纲也。数阳主热，而数有浮、沉，浮数主表热，沉数主里热。有病在脏者，然其由必自腑，以阳脉营
其腑，故主腑也。迟阴主寒，而迟亦有浮、沉，浮迟应表寒，沉迟应里寒。有病在腑者，然其根必自脏，以阴
脉营其脏，故主脏也。（柯韵伯）
浮为在表，浮而有力为伤寒，浮而无力为伤风；沉为在里，沉而有力为传经里证，沉而无力为直中里证。
迟为寒，主病在脏；数为热，主病在腑。人迎大者为外感；气口大者为内伤。脉大为病进，为邪气盛；脉缓为
病退，为正气复。寸脉迟弱者，不可汗；尺脉细弱者，不可下。汗后脉如前状，表证仍在者，重汗之；下后脉
如前状，里证仍在者，重下之。发狂谵语，脉沉细者死；厥逆蜷卧，脉浮洪者生。发热，脉浮洪者生，脉沉细
者死。发汗后，脉平静者生，脉躁乱者死。（《伤寒五法》）
传经
太阳者，巨阳也，为诸阳之首。膀胱经病，若渴者，自入于本也，名曰传本。○太阳传阳明者，名曰循经
传。为发汗不彻，利小便，余邪不尽，透入于里也。○太阳传少阳者，名曰越经传。为初受病，脉浮无汗，当
用麻黄而不用之故也。○太阳传少阴者，名曰表里传。为得病急，当发汗而反下之，所以传也。○太阳传太阴者，
名曰误下传。为初受病；脉缓有汗，当用桂枝而反下之所致也。○太阳传厥阴者，为三阴不至于首，惟厥阴与督
脉上行，与太阳相接，名曰循经得度传。（《此事难知》）
伤寒传经，由表入里，邪气以渐传深。故一、二日始于太阳，二、三日传至阳明，三、四日少阳，四、五
日太阴，五、六日少阴，六、七日厥阴，此论其常耳。变则不可拘以日数，其传至厥阴，为传经尽，不复再传。
成氏曰∶六日厥阴为传经尽，七日不愈者谓之再传，再自太阳传，十二日再至厥阴，十三日当愈。不愈者，谓
之过经，言再过太阳经，谬矣。马仲化曰∶自太阳以至厥阴，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，诚千载断案。惜乎释七日病衰，义犹
未明，使后人不能绝无障蔽耳。然则邪气之入，果无自里而出于表者乎？无欲传之出，有欲愈之出也。《太阳
篇》曰∶欲自解者，必当先烦，乃有汗而解。何以
知之？脉浮故知汗出解也。此以脉浮为邪气还表，知是向安之兆，不待更用汤药，邪自外散。散则复何传焉？
须知里邪不出则已，出则欲愈，非复欲传也。或曰∶《论》云太阳病，头痛至七日以上自愈者，以行其经尽故
也。若欲再作经者，针足阳明，使经不传则愈。此非一日至六日，传遍三阳三阴经，至七日当愈，不愈则太阳
之邪再传阳明者欤？曰∶伤寒始于太阳，以次终于厥阴，为传经尽。诸经受病，凡七日自愈者，为行其经尽。
太阳病，至七日头痛自愈者，以行太阳经尽故也。邪气行来，始终只在太阳一经，而尽其七日，当愈之数也。
《论》云∶发于阳者七日愈，以阳数七故也。若七日以上不愈，欲过太阳而作再经，当针足阳明，迎而夺之，
使不传阳明则愈。细玩行其经尽之句，不曰传经尽，则仲景之意昭然。成氏谬以行其经尽为传遍六经，乃有自
太阳再传之说耳。若果传遍六经，厥阴之邪再传太阳，太阳再传阳明，则于厥阴未传太阳之前，预针太阳矣，
何必待欲传阳明，而后针阳明哉？或曰∶《霍乱篇》有曰十三日愈，所以然者，经尽故也。此非伤寒六日传遍
三阳三阴，后六日再传经尽，十三日当愈者欤？《太阳篇》有曰∶伤寒十三日不解，过经谵语者，以有热也，
当以汤下之。此非十二日再传经尽，十三日不愈，谓之过经者欤？曰经尽者，如太阳行其经尽之谓也。由太阳
受病，于一日至七日，为行太阳经尽之例，推之则诸经皆可屈指而期矣。阳明受病于二日至八日自愈者，为行
阳明经尽；少阳受病于三日至九日自愈者，为行少阳经尽；即四、五日至三阴经上，次第至十二日自愈者，为
行厥阴经尽；十三日当大气皆去，精神爽慧之期也。故曰∶若过十三日以上，不问尺寸，陷者大危。其曰三十
日不解，过经谵语者，止以当解之期不解，乃过于经而入于里。谵语者，此为内实而结于里也，当以汤下之。
此泛言过经，不专指何经也。何尝有再传经尽，谓之过经之旨哉？（闵芝庆）
闵氏六经传尽不再传之说，实本于《内经》病邪递传，一脏
不两伤，两伤则死之理。谓传经，凡言日者，概不可以日数拘也。尤为破的。但亦有应申明者，《经》云一日
太阳受之，不过云太阳病始于此一日耳。在太阳数十日不罢，皆可谓之在太阳一日分内也，故有始终生死于太
阳者。此仲师设有过经不解专篇，乃为《伤寒论》不传经病言也。二日阳明受之者，亦以太阳传阳明之始为二
日。在太阳者暂，即日传阳明，固阳明之二日也；在太阳者久，七、八日始传阳明，亦为阳明之二日也。其余
各经递传，言三、四、五、六日，概如是矣。必言七日者，自太阳始受，病计至七日愈，藉日以明其递传之次
耳。如人自此起，行至某处，七日之程，其行之迟速，至之先后，则不可计。闵氏以为七阳数也，仍似执论。
余谓太阳病愈之日，即为七日，更觉明爽。是凡阳明受邪之日，皆为二日，不过计太阳始传于阳明之次耳。然
则在阳明为久为暂，得愈之日，皆为八日，亦不必谓七日合阳数也。诸经得愈之日，亦皆如此。似不合《经》
文，而深合于《经》旨也。何则？《经》文示天下万世以成宪，故不得不藉日以明其次第，使人知六经受病及
愈日之纪也。其实病邪迁变，倏忽无常，何可以日计乎？知计日以言经，却不计日以察病，斯可与言遵经治病
矣？及病邪已入厥阴，重言复传太阳，则合考《内经》、仲师之论，并无此说，可明其妄。盖人身内而脏腑，
外而经络，邪无自厥阴得入太阳之道路，如邪已透表，则升散矣，焉有自里透表，复自表入里者哉？试问∶古
今来，自厥阴复传太阳者，何人曾治此病乎？今人患伤寒，病在三阳经，生死决矣，直中阴经者有之，传至阴
经者已少，况六经传遍乎？以今人禀弱者多，世医操术不明者不少，不俟传遍已死矣，所以见治六经传遍之伤
寒病者，寥寥也。《伤寒论》虽如是分别六经，而病者未必尽分疆画界。初得之时，两经皆病者，三经皆病者，
甚多；此未尽而彼已传者，亦复不少；阳经未尽，亦有入于阴经者；又常见太、少两阴经俱病者；又常见三阴
经俱病者。所以仲师设《合病篇》以论病，《并
病篇》以论治也。合病、并病，虽独言三阳，乃举一隅也，岂不可推之三阴乎？若不能推，则虽有书充栋，亦
无用矣。（魏荔彤）
传足经不传手经
世医谓伤寒传足经，不传手经。陶节庵辨其非，谓人身气血，昼夜循环不息，岂有不传手经之理。谓其
伤足经不伤手经则可，若言传足经不传手经则非也。然思寒邪，何以只伤足经，不伤手经？其说犹有所未喻，
终夜思之，始得其意。夫足之三阳，由头至足，足之三阴，由足至腹，人身背、面、前、后、两傍，直至于足，
皆足六经主之。若手之三阳，不过始于手，终于头；手之三阴，不过始于腹，终于手。是手之六经所主，两手
而已，其及头与胸者，亦无多也。况人之伤寒，多从头、面、背、足得之，未闻另有手感寒邪者。此节庵所以
谓伤足不伤手也。（余傅山）
伤寒传变，止言足经，不言手经，其义本出《素问》，草窗刘氏不明其理，遂谬创伤寒传足不传手之说，
谓足经所属水、木、土，水寒则冰，木寒则凋，土寒则圻，是皆不胜其寒也。手经所属金与火，金得寒则愈坚，
火体极热，寒不能袭，所以伤寒只传足经，不传手经。巧言要誉，昧者称奇。夫人之金、火两脏，不过以五行
之气各有所属耳，岂即真金真火不能毁伤者耶？斯言一出，遂起人疑，致有谓足经在下，手经在上，寒本阴邪，
故传足也。有谓足之六经，皆东北方隅之气，手之六经，皆西南方隅之气，寒气中人，必在冬春，同气相求，
故先自水经以及木、土，而金、火则无犯也。有谓无奇经，则无伤寒，奇经惟附于足也。纷纷议论，其说皆谬。
夫人之血气，周身流注不息，岂传遇手经而邪有不入者哉？且寒之中人，必先皮毛，皮毛者肺之合也，故在外
则有寒栗、鼻塞等证，在内则有咳喘、短气等证，谓不传于肺乎？其入手少阴、厥阴也，则有舌苔拂郁，神昏
语乱等证，谓不传于心包络乎？其入手阳明也，则有泄泻、秘结等证，谓不传于大肠乎？其入手太阳也，则有
癃闭、不化等证，谓不传于小肠
乎？其入手少阳也，则有上下不通、痞、满、燥、实等证，谓不传于三焦乎？再观本节，三阴三阳，五脏六腑
皆受病，岂手经不在内乎？然本《经》之不言手者何也？盖伤寒者，表邪也。欲求外证，但察周身上下脉络，
惟足六经则尽之矣，手经无能遍也。且手经所至，足经无不至者，故但言足经，而手经在其中矣。此本《经》
所以止言足者，为察周身之表证也。义本易见，而疑辨至今，皆惑于刘氏之妄言耳。（张景岳）
前辈有伤足不伤手之说。夫心主营，肺主卫，风寒来伤营卫，即是手经矣。且大肠接胃，俱称阳明；小肠
通膀胱，俱称太阳。伤则俱伤，何分手足？如大便硬，是大肠病，岂专指胃？小便不利，亦小肠病，岂专指膀
胱？且汗为心液，如汗多亡阳，岂止坎中之阳，不干膻中之阳？不明仲景六经，故有传经之妄。（柯韵伯）
看目
凡治伤寒，先观两目。若见目赤，唇焦舌黑，脉洪数有力，大便实，大渴谵语者，属阳毒也，当下之。
【经文原义】
黄帝问道：如今所说的热病，都属于伤寒的范畴。有的痊愈，有的死亡，死亡的往往在发病后六、七天之间，痊愈的则多在十日以后，这是什么原因呢？
岐伯回答说：巨阳经（即太阳经），是诸阳经的统属，它的经脉连接风府穴，所以它是诸阳经的主气。人受了寒邪侵袭，就会发生热病，这种热病即使热度很高也不会致死；如果是两经同时感受寒邪而发病的，就一定难免于死亡。
黄帝说：我想听听它的具体症状表现。
岐伯说：伤寒第一天，巨阳经受邪，因为它的经脉经过头项部并沿着腰脊下行，所以出现头痛、项强、腰脊僵硬的症状。第二天阳明经受邪，阳明经主管肌肉，它的经脉夹行于鼻旁并联络眼部，所以出现身体发热、眼睛疼痛、鼻干、不能安卧的症状。第三天少阳经受邪，少阳经主胆，它的经脉循行于胁肋部并联络耳部，所以出现胸胁疼痛和耳聋的症状。此时三阳经的经络都受到了病邪侵害，但病邪尚未传入脏腑，可以通过发汗的方法治愈。第四天太阴经受邪，太阴经的经脉散布在胃中并联络咽喉，所以出现腹部胀满、咽喉干燥的症状。第五天少阴经受邪，少阴经的经脉贯穿肾脏并联络肺部，系连舌根，所以出现口燥、舌干、口渴的症状。第六天厥阴经受邪，厥阴经的经脉循行于生殖器部位并联络肝脏，所以出现心中烦闷、阴囊收缩的症状。此时三阴经的经络都受到了病邪侵害，且病邪已经传入脏腑，可以通过泻下的方法治愈。如果三阴三阳、五脏六腑全部受到病邪侵害，导致营卫之气运行停滞，五脏气机不通，人就会死亡。
那些没有两感于寒的患者，第七天巨阳经的病势衰退，头痛稍微减轻；第八天阳明经的病势衰退，身体发热稍微减轻；第九天少阳经的病势衰退，耳聋情况稍有好转，能微微听到声音；第十天太阴经的病势衰退，腹部胀满消退恢复如常，开始有食欲想吃东西；第十一天少阴经的病势衰退，口渴停止，腹部不再胀满，舌干缓解并开始打喷嚏；第十二天厥阴经的病势衰退，阴囊松弛，少腹部的拘急感轻微缓解，大邪之气都已散去，疾病日渐痊愈。
黄帝说：如何治疗呢？
岐伯说：治疗应当分别疏通各脏的经脉，病势就会日渐衰退痊愈。病程未满三天的，可以通过发汗治愈；病程已满三天的，可以通过泄下（或清热）治愈。如果寒邪传变不按照次序，或者只在一经而不传变，表里病情发生变化，就应当根据证候和脉象进行治疗，运用吐法、下法、汗法、和解法，早晚用药各有不同。
黄帝说：热病虽然已经痊愈，但时常还有余热遗留，这是什么原因呢？
岐伯说：凡是余热遗留的，都是因为热势正盛时勉强进食，所以导致余热遗留。像这种情况，都是病邪已经衰退但热邪有所潜藏，因为食物之气与残留的热邪相互搏结，两热相合，所以导致余热遗留。
黄帝说：如何治疗余热遗留呢？
岐伯说：观察病证的虚实，调理气机的逆乱或顺从，就可以使疾病必定痊愈。
黄帝说：患热病时应当禁忌什么？
岐伯说：患热病刚见好转时，吃肉会导致复发，多吃食物会导致余热遗留，这就是需要禁忌的。
黄帝说：对于两感于寒的患者，其脉象和病症表现是怎样的？
岐伯说：两感于寒的患者，第一天太阳与少阴两经同时发病，就会出现头痛、口干、烦闷；第二天阳明与太阴两经同时发病，就会出现腹部胀满、全身发热、不想吃东西、胡言乱语；第三天少阳与厥阴两经同时发病，就会出现耳聋、阴囊收缩、四肢厥冷、水浆不进、神志昏迷，到了第六天就会死亡。（出自《素问》）
伤寒有的出汗后痊愈，有的用泻下法后死亡；有的出汗后死亡，有的用泻下法后痊愈，这是什么原因呢？回答是：阳气虚弱阴气偏盛的，出汗后痊愈，用泻下法会导致死亡；阳气偏盛阴气虚弱的，出汗会导致死亡，用泻下法则会痊愈。（出自《难经》）
【关于伤寒的三种说法】
寒气伤人主要有三种来源：雾露、风雨、冬春霜雪，这是来自天空的寒气；幽居空旷的房屋、砖石地面台阶、大江深泽、深邃山谷高山，这是来自地面的寒气；日常食用寒凉食物、冷藏冰块瓜果，这是人为造成的寒气。（柯韵伯）
【脉法】
伤寒的邪气没有固定的形态，如果侵入阳经，则以太阳经为首要；如果侵入阴经，则以少阴经为先导。通过脉象浮紧有力或无力，可以判断表证的虚实；沉紧有力或无力，可以判断里证的虚实；脉象居中有力或无力，可以判断阴阳病情的吉凶。（张景岳）
浮、沉、迟、数这四种脉象，本来不能单纯用来区分脏腑，既然有了阴阳的名称，就用阳代表表、阴代表里、腑属阳、脏属阴来判定，以此确定病变所在的部位。试看脉象浮，表示病位在表，对应的病症也在外。然而脉浮也可能伴有里证，或者是表邪刚刚陷入里，或者是里邪想要透出体表，但归根结底不离于表，所以脉浮主要主表证，这是大纲。脉沉表示病位在里，对应的病症也在里。然而也有表证的情况，或者是阳病见到阴脉而危险，或者是阴病转出阳经而痊愈，但归根结底病根在于里，所以脉沉主要主里证，这是大纲。数脉属阳主热，但数脉有浮、沉之分，浮数主表热，沉数主里热。有病在脏的情况，但其根源必然来自腑，因为阳脉滋养腑，所以脉数主腑病。迟脉属阴主寒，但迟脉也有浮、沉之分，浮迟对应表寒，沉迟对应里寒。有病在腑的情况，但其根源必然来自脏，因为阴脉滋养脏，所以脉迟主脏病。（柯韵伯）
脉浮表示病在表，浮而有力是伤寒，浮而无力是伤风；脉沉表示病在里，沉而有力是传经入里的证候，沉而无力是直中里的证候。迟脉主寒，病多在脏；数脉主热，病多在腑。人迎脉（颈动脉）盛大的是外感病；气口脉（桡动脉）盛大的是内伤病。脉大表示病势进展，邪气旺盛；脉缓表示病势退却，正气恢复。寸脉迟弱，不可发汗；尺脉细弱，不可泻下。发汗后脉象如前，表证仍在的，再次发汗；泻下后脉象如前，里证仍在的，再次泻下。发狂胡言乱语，脉象沉细的预后不良（死）；四肢厥冷蜷缩卧床，脉象浮洪的预后良好（生）。发热，脉象浮洪的预后良好（生），脉象沉细的预后不良（死）。发汗后，脉象平静的预后良好（生），脉象躁乱的预后不良（死）。（出自《伤寒五法》）
【传经】
太阳经就是巨阳经，是诸阳经之首。膀胱经发病，如果出现口渴，说明病邪自传入本经，名叫“传本”。○太阳经传给阳明经，名叫“循经传”。是因为发汗不彻底，又利小便，残余邪气不尽，透入体内所致。○太阳经传给少阳经，名叫“越经传”。是因为初受病时，脉浮无汗，应当用麻黄汤而没有使用的原因。○太阳经传给少阴经，名叫“表里传”。是因为得病急迫，应当发汗反而用了泻下法，所以导致传变。○太阳经传给太阴经，名叫“误下传”。是因为初受病时，脉缓有汗，应当用桂枝汤反而用了泻下法所导致的。○太阳经传给厥阴经，是因为三阴经不从头部起始，只有厥阴经与督脉上行，与太阳经相接，名叫“循经得度传”。（出自《此事难知》）
伤寒传经，是由表入里，邪气逐渐深入。所以一、二日开始于太阳经，二、三日传至阳明经，三、四日传至少阳经，四、五日传至太阴经，五、六日传至少阴经，六、七日传至厥阴经，这是论述一般规律。变化则不能拘泥于日数。病邪传到厥阴，称为传经结束，不再继续传变。
成无己说：第六天厥阴经为传经结束，第七天如果不愈，叫做再传，重新从太阳经开始传，十二天再次传到厥阴，十三天应当痊愈。如果不愈，叫做过经，意思是再过太阳经，这是错误的。
马仲化说：从太阳经到厥阴经，就像人从门口进入厅堂再到内室一样。厥阴经如果再传出传给太阳经，中间隔着少阴、太阴、少阳、阳明经，怎么会有突然传出传给太阳经的道理呢？这是驳斥“再传”说法的错误，确实是千古定论。可惜他对“七日病衰”的解释，意义仍然不明确，使得后人不能完全消除疑惑。那么邪气进入体内，果真没有从里出到表的情况吗？不是邪气想要传出去，而是想要痊愈而透出的。《太阳篇》说：想要自行解除的，必定先出现烦躁，然后才有汗出而解。为什么知道是这样？因为脉浮，所以知道是汗出而解。这是以脉浮作为邪气回归体表的标志，知道这是趋向安康的征兆，不需要再用汤药，邪气自然向外消散。消散了还谈何传变呢？须知体内的邪气如果不出来就算了，一旦出来就是想要痊愈，而不是为了再传变。
有人问：《伤寒论》说太阳病，头痛持续七天以上自愈的，是因为行完了该经的病程。如果想要再次传经发作的，针刺足阳明经，使经脉不传变就能痊愈。这不是指一到六天传遍三阳三阴经，到第七天应当痊愈，如果不愈则是太阳经的邪气再传阳明经吗？
回答是：伤寒始于太阳经，依次终于厥阴经，这叫传经结束。各经受病，凡是七天自愈的，是因为行完了该经的病程。太阳病，到第七天头痛自愈，是因为行完了太阳经的病程。邪气运行，始终只在太阳一经，而耗尽了七天的病程，这是应当痊愈的数目。《伤寒论》说：发于阳经的七天痊愈，是因为阳数的缘故。如果七天以上不愈，想要超过太阳经而进行再经传变，应当针刺足阳明经，迎而夺之，使不传阳明经就能痊愈。仔细玩味“行其经尽”这句话，不说“传经尽”，那么张仲景的意思就很明显了。成无己错误地把“行其经尽”理解为传遍六经，于是有了从太阳经再传的说法。如果真的传遍了六经，厥阴经的邪气再传太阳经，太阳经再传阳明经，那么在厥阴经未传太阳经之前，就应该预先针刺太阳经了，何必等到想要传阳明经时，才去针刺阳明经呢？
有人问：《霍乱篇》中有说十三天痊愈，之所以这样，是因为经气已尽的缘故。这不是指伤寒六天传遍三阳三阴经，后六天再传经气已尽，十三天应当痊愈吗？《太阳篇》中有说：伤寒十三天不解，过了经气期限出现谵语的，是因为有热，应当用汤药泻下。这不是指十二天再传经气已尽，十三天不愈，叫做过经吗？
回答是：所谓经气已尽，就像太阳经行完其经气的意思一样。由太阳经受病，从第一天到第七天，是行完太阳经气的例子，推及其他各经都可以屈指计算预期时间。阳明经受病从第二天到第八天自愈，是行完阳明经气；少阳经受病从第三天到第九天自愈，是行完少阳经气；即使是第四、五天传到三阴经，依次到第十二天自愈，是行完厥阴经气；第十三天应当是大邪之气全部去除，精神清爽的时候。所以说：如果超过十三天以上，不问寸关尺哪部脉，陷伏的都是大危之症。所谓三十天不解，过了经气期限出现谵语的，只是指应当在解期而未解，于是超过了经气界限而入于里。谵语，这是因为内实而结聚在里，应当用汤药泻下。这是泛泛地说过了经气期限，不专门指哪一经。哪里有什么再传经气已尽叫做过经的宗旨呢？（闵芝庆）
闵氏关于六经传尽不再传变的说法，实际上基于《内经》病邪递次传变、一脏不两伤的理法，两伤则死。他说传经，凡是提到日数的，一概不可以日数拘泥。这尤为精辟。但也有一些应当申明的地方，《内经》说一日太阳受之，不过是说太阳病开始于这一天罢了。如果在太阳经几十天不罢休，都可以称之为在太阳经的第一天范围内，所以有始终在太阳经生死的情况。这是张仲景设有“过经不解”专篇，是为了《伤寒论》中不传经的病而言的。说二日阳明受之，也是以从太阳传阳明开始算作二日。在太阳经时间短的，当天就传阳明，固然是阳明病的第二天；在太阳经时间长的，七八天才传阳明，也算作阳明病的第二天。其余各经递次传变，说三、四、五、六日，一概如此。一定要说七日，是从太阳经开始受病，计算病程到七天痊愈，借日数来说明递传的次序而已。就像人从这里出发，走到某处，需要七天的路程，行走的快慢、到达的先后，是无法计算的。闵氏认为七是阳数，仍然显得拘泥。我认为太阳病痊愈的那天，就是第七天，这样觉得更明白清爽。凡是阳明经受邪的日子，都算作第二天，不过是计算从太阳开始传给阳明的次序罢了。然而在阳明经时间长还是短，痊愈的日子都算作第八天，也不必说是因为七合阳数。其他各经痊愈的日子，也都如此。这似乎不符合《内经》原文，但深深契合《内经》的宗旨。为什么呢？《内经》向天下万世展示成法，所以不得不借日数来说明次第，使人知道六经受病及痊愈日期的纪限。其实病邪迁延变化，瞬息无常，怎么能用日数来计算呢？知道用日数来谈论经络，却不拘泥于日数来考察病情，这才可以与谈论遵循经典治病的人说话了。等到病邪已经进入厥阴经，又说重新传回太阳经，这时综合考证《内经》和张仲景的论述，并没有这种说法，可以明确它是荒谬的。大概人体内部是脏腑，外部是经络，邪气没有从厥阴经进入太阳经的道路，如果邪气已经透出体表，就会升散，哪有从里透出体表，又重新从表入里的道理呢？试问：古往今来，从厥阴经重新传回太阳经的，有谁曾经治疗过这种病呢？现在人患伤寒，病在三阳经，生死已决，有直中阴经的，传到阴经的已经很少，何况传遍六经呢？因为现代人禀赋虚弱的很多，世间医生医术不明朗的也不少，不等传遍就已经死了，所以见到治疗六经传遍的伤寒病的，寥寥无几。《伤寒论》虽然这样分别六经，但病人未必完全分疆画界。初得病时，两经同病的，三经同病的，很多；此经未好彼经已传的，也不在少数；阳经未好，也有进入阴经的；又常见太阴、少阴两阴经同病的；又常见三阴经同病的。所以张仲景设立《合病篇》来讨论病证，《并病篇》来讨论治疗。合病、并病，虽然只说三阳经，是举一例而言，难道不可以推及三阴经吗？如果不能推演，那么虽然有书堆满屋子，也没有用处。（魏荔彤）
【传足经不传手经】
世间的医生认为伤寒只传足经，不传手经。陶节庵驳斥这种观点是错误的，他说人身气血，昼夜循环不息，哪有只传足经不传手经的道理。说它损伤足经不损伤手经还可以，如果说传足经不传手经就是错误的。然而思考寒气，为什么只伤足经，不伤手经？这个说法还有不明白的地方，整夜思考，才明白其中的意思。足部的三条阳经，从头到足；足部的三条阴经，从足到腹。人体的背、面、前、后、两旁，一直至于足，都由足六经主管。至于手部的三条阳经，不过始于手，终于头；手部的三条阴经，不过始于腹，终于手。手部六经所主管的，仅仅是两手而已，涉及头部和胸部的也不多。况且人患伤寒，多从头部、面部、背部、足部感受，没听说过另外有手部感受寒邪的。这就是陶节庵所以说伤足不伤手的原因。（余傅山）
伤寒传变，只说足经，不说手经，这个含义原本出自《素问》，草窗刘氏不明白这个道理，于是错误地创伤寒传足不传手的说法，说足经所属的水、木、土，水冷则结冰，木寒则凋零，土寒则龟裂，这些都是不胜受寒的。手经所属的金与火，金遇到寒则更加坚固，火体极热，寒邪不能侵袭，所以伤寒只传足经，不传手经。这是巧妙的言辞博取名誉，愚昧的人称奇。人的金、火两脏，不过是五行之气各自有所归属罢了，难道是真正的金和火不能被毁伤吗？这种话一出，就引起人们的怀疑，导致有人说足经在下，手经在上，寒本是阴邪，所以传足经。有人说足之六经，都是东北方隅的气，手之六经，都是西南方隅的气，寒气中人，一定在冬春季节，同气相求，所以先从水经以及木、土，而金、火则不被侵犯。有人说没有奇经就没有伤寒，奇经只附属于足经。议论纷纷，这些说法都是错误的。人的血气，周身流注不息，哪有传遇手经而邪气就不进入的呢？而且寒邪中人，必先侵犯皮毛，皮毛是肺的合应，所以在外则有恶寒战栗、鼻塞等症状，在内则有咳嗽气喘、短气等症状，能说是不传肺吗？它进入手少阴、厥阴经，则有舌苔郁滞、神昏语乱等症状，能说是不传心包络吗？它进入手阳明经，则有泄泻、便秘等症状，能说是不传大肠吗？它进入手太阳经，则有尿闭、不化等症状，能说是不传小肠吗？它进入手少阳经，则有上下不通、痞、满、燥、实等症状，能说是不传三焦吗？再看本节，三阴三阳，五脏六腑都受到病邪侵害，难道手经不在其中吗？然而《内经》为什么不说手经呢？大概伤寒是表邪。想要寻求外证，只要观察周身上下的脉络，只有足六经才能涵盖全面，手经无法遍及。而且手经到达的地方，足经没有不到的，所以只说足经，而手经就在其中了。这原本是《内经》只说足经的原因，是为了观察周身的外证。含义本来容易看见，而疑惑辩驳至今，都是被刘氏的妄言所迷惑。（张景岳）
前辈有伤足不伤手的说法。心主营，肺主卫，风寒来伤营卫，就是手经了。而且大肠接胃，都称为阳明；小肠通膀胱，都称为太阳。受伤则一起受伤，何必分手足？比如大便硬，是大肠病，难道专指胃吗？小便不利，也是小肠病，难道专指膀胱吗？而且汗是心液，如果汗多亡阳，难道只是坎中之阳受损，不干膻中之阳吗？不明白张仲景的六经理论，所以有传经的谬误。（柯韵伯）
【看目】
凡是治疗伤寒，先观察两眼。如果见到眼睛红赤，嘴唇焦黑，舌头发黑，脉象洪数有力，大便结实，极度口渴、胡言乱语的，属于阳毒证，应当用泻下法治疗。
[Original Script Meaning]
The Yellow Emperor asked: "Now, the so-called heat diseases all belong to the category of cold damage (Shanghan). Some recover, while some die. Those who die usually do so within six or seven days after onset, whereas those who recover usually do so after ten days. What is the reason for this?"
Qibo replied: "The Juyang meridian (i.e., the Taiyang meridian) is the master of all Yang meridians. Its vessels connect to the Fengfu point (GV16), thus it governs the Qi of all Yang meridians. When a person is invaded by cold pathogen, a heat disease occurs. Even if the heat is severe, it will not be fatal; however, if two meridians are simultaneously affected by cold (Lianggan), death is inevitable."
The Yellow Emperor said: "I wish to hear about its specific manifestations."
Qibo said: "On the first day of cold damage, the Juyang meridian is affected. Since its vessels pass through the head and neck and follow the spine, symptoms include headache, stiff neck, and stiffness in the lower back and spine. On the second day, the Yangming meridian is affected. The Yangming meridian governs the flesh, and its vessels run alongside the nose and connect to the eyes, resulting in fever, eye pain, dry nose, and inability to sleep. On the third day, the Shaoyang meridian is affected. The Shaoyang meridian governs the Gallbladder, and its vessels circulate along the hypochondrium and connect to the ears, causing chest and hypochondriac pain and deafness. At this stage, the meridians of the Three Yang are all diseased, but the pathogen has not yet entered the Fu organs; it can be cured by inducing sweating. On the fourth day, the Taiyin meridian is affected. Its vessels spread in the stomach and connect to the throat, leading to abdominal fullness and dry throat. On the fifth day, the Shaoyin meridian is affected. Its vessels penetrate the Kidney, connect to the Lung, and attach to the root of the tongue, causing dry mouth, dry tongue, and thirst. On the sixth day, the Jueyin meridian is affected. Its vessels circulate around the genitalia and connect to the Liver, resulting in irritability, fullness, and retraction of the scrotum. At this stage, the meridians of the Three Yin are all diseased, and the pathogen has entered the Zang organs; it can be cured by purging. If the Three Yin and Three Yang, as well as the Five Zang and Six Fu organs, are all affected, causing the circulation of Ying and Wei Qi to cease and the obstruction of the Five Zang Qi, death will ensue.
For those who did not suffer from simultaneous involvement of two meridians (Lianggan), on the seventh day, the pathology of the Juyang meridian declines, and the headache slightly improves; on the eighth day, the pathology of the Yangming meridian declines, and body heat slightly subsides; on the ninth day, the pathology of the Shaoyang meridian declines, and deafness slightly improves with faint hearing; on the tenth day, the pathology of the Taiyin meridian declines, abdominal distension resolves, appetite returns; on the eleventh day, the pathology of the Shaoyin meridian declines, thirst ceases, abdominal fullness resolves, dry tongue recovers, and sneezing occurs; on the twelfth day, the pathology of the Jueyin meridian declines, the scrotum relaxes, mild lower abdominal tension subsides, the major pathogenic factor dissipates, and the disease gradually heals.
The Yellow Emperor asked: "How should it be treated?"
Qibo replied: "Treatment should focus on unblocking the meridians of each respective organ, and the pathological condition will decline day by day. If the duration is less than three days, sweating can cure it; if it exceeds three days, purging (or clearing heat) can cure it. If the cold pathogen transmits irregularly, or remains confined to one meridian without transmission, and exterior-interior conditions change, treatment must be tailored to the syndrome and pulse using emesis, purgation, sweating, or harmonizing methods, varying by time of day.
The Yellow Emperor asked: "When a heat disease has healed, why does residual heat sometimes persist?"
Qibo replied: "Residual heat persists because food was consumed forcibly while the heat was still intense. In such cases, although the pathogen has declined, heat remains latent. The Qi of the food clashes with the residual heat, and the two heats combine, causing residual heat to linger.
The Yellow Emperor asked: "How should residual heat be treated?"
Qibo replied: "Assess the deficiency or excess, regulate the reversal or smooth flow of Qi, and the disease will surely heal.
The Yellow Emperor asked: "What should be forbidden during a heat disease?"
Qibo replied: "When a heat disease is slightly better, eating meat causes relapse, and overeating causes lingering heat. These are the prohibitions.
The Yellow Emperor asked: "What are the pulse and symptom manifestations for simultaneous involvement of two meridians (Lianggan) by cold?"
Qibo replied: "In Lianggan, on the first day, both Taiyang and Shaoyin are affected, causing headache, dry mouth, and irritability/fullness; on the second day, both Yangming and Taiyin are affected, causing abdominal fullness, fever, anorexia, and delirious speech; on the third day, both Shaoyang and Jueyin are affected, causing deafness, scrotal retraction, cold limbs, inability to swallow fluids, and unconsciousness. Death occurs on the sixth day." (From *Suwen*)
In cold damage, some recover after sweating but die after purging; some die after sweating but recover after purging. Why? The answer is: In cases of Yang deficiency and Yin excess, sweating leads to recovery, while purging leads to death; in cases of Yang excess and Yin deficiency, sweating leads to death, while purging leads to recovery." (From *Nanjing*)
[Three Perspectives on Cold Damage]
Cold pathogen harms humans in three ways: Fog, dew, wind, rain, winter frost, and spring snow constitute the cold of Heaven; secluded rooms, brick floors, stone steps, large rivers, deep marshes, deep valleys, and high mountains constitute the cold of Earth; consuming cold foods, ice, and raw fruits constitutes the cold created by human behavior. (Ke Yunbo)
[Pulse Diagnosis]
The pathogen of cold damage has no fixed form. If it enters Yang meridians, Taiyang is primary; if it enters Yin meridians, Shaoyin is primary. A floating and tight pulse, whether forceful or weak, indicates the deficiency or excess of the Exterior; a sinking and tight pulse, whether forceful or weak, indicates the deficiency or excess of the Interior; a moderate pulse, whether forceful or weak, indicates the auspicious or inauspicious nature of Yin and Yang. (Zhang Jingyue)
Floating, sinking, slow, and rapid pulses cannot originally be divided by Zang-Fu organs. However, since they have Yin-Yang designations, we use Yang for Exterior, Yin for Interior, Fu for Yang, and Zang for Yin to determine the location of the disease. Observe that a floating pulse indicates the Exterior, and the corresponding disease is also external. Yet, a floating pulse may also present Interior signs, either because Exterior pathogen has just sunk inward or because Interior pathogen is attempting to emerge. Ultimately, it does not leave the Exterior, so floating primarily indicates Exterior syndromes—this is the general principle. A sinking pulse indicates the Interior, and the corresponding disease is also internal. However, there may also be Exterior signs, either because a Yang disease shows a Yin pulse (dangerous) or because a Yin disease emerges to Yang (healing). Ultimately, the root lies in the Interior, so sinking primarily indicates Interior syndromes—this is the general principle. Rapid pulse belongs to Yang and indicates Heat. Rapid pulses can be floating or sinking; floating-rapid indicates Exterior Heat, while sinking-rapid indicates Interior Heat. Diseases in the Zang exist, but their origin must come from the Fu, because Yang pulses nourish the Fu, so rapid pulse primarily indicates Fu diseases. Slow pulse belongs to Yin and indicates Cold. Slow pulses can be floating or sinking; floating-slow corresponds to Exterior Cold, while sinking-slow corresponds to Interior Cold. Diseases in the Fu exist, but their root must come from the Zang, because Yin pulses nourish the Zang, so slow pulse primarily indicates Zang diseases. (Ke Yunbo)
Floating indicates Exterior; floating and forceful indicates Cold Damage (Shanghan), while floating and weak indicates Wind Strike (Shangfeng). Sinking indicates Interior; sinking and forceful indicates transmitted Interior syndrome, while sinking and weak indicates direct invasion of the Interior. Slow indicates Cold, primarily involving Zang; Rapid indicates Heat, primarily involving Fu. A prominent Renying pulse (carotid) indicates External contraction; a prominent Qikou pulse (radial) indicates Internal injury. A large pulse indicates disease progression and excess pathogen; a relaxed pulse indicates disease regression and recovery of healthy Qi. If the Cun pulse is slow and weak, sweating is contraindicated; if the Chi pulse is fine and weak, purging is contraindicated. After sweating, if the pulse remains unchanged and Exterior signs persist, repeat sweating; after purging, if the pulse remains unchanged and Interior signs persist, repeat purging. Manic delirium with a sinking-fine pulse indicates death; cold limbs with curled posture and a floating-hong pulse indicates survival. Fever with a floating-hong pulse indicates survival; fever with a sinking-fine pulse indicates death. After sweating, a calm pulse indicates survival; a chaotic pulse indicates death. (From *Shanghan Wufa*)
[Transmission of Meridians]
Taiyang is Juyang, the head of all Yang meridians. If Bladder meridian disease presents with thirst, it means the pathogen has entered its home meridian, named "Transmitting to the Root." ○ Transmission from Taiyang to Yangming is named "Meridian-to-Meridian Transmission." This occurs due to incomplete sweating, diuresis, and residual pathogen penetrating inward. ○ Transmission from Taiyang to Shaoyang is named "Cross-Meridian Transmission." This happens when the initial illness presents with floating pulse and no sweat, requiring Mahuang Decoction which was not used. ○ Transmission from Taiyang to Shaoyin is named "Exterior-Interior Transmission." This results from acute onset where sweating was indicated but purging was mistakenly used. ○ Transmission from Taiyang to Taiyin is named "Mistaken Purge Transmission." This results from initial illness presenting with relaxed pulse and sweat, requiring Guizhi Decoction which was mistakenly replaced by purging. ○ Transmission from Taiyang to Jueyin occurs because the Three Yin meridians do not start at the head; only Jueyin ascends with the Du vessel to connect with Taiyang, named "Meridian-to-Meridian Degree Transmission." (From *Cishi Nan Zhi*)
Cold damage transmission proceeds from Exterior to Interior, with pathogen gradually deepening. Thus, days 1-2 begin at Taiyang, days 2-3 transmit to Yangming, days 3-4 to Shaoyang, days 4-5 to Taiyin, days 5-6 to Shaoyin, and days 6-7 to Jueyin. This describes the normal course. Variations cannot be rigidly bound by days. Transmission to Jueyin marks the end of meridian transmission, with no further transmission.
Cheng Wuji stated: Day 6 Jueyin marks the end of transmission. If not healed by day 7, it is called "Re-transmission," restarting from Taiyang, reaching Jueyin again on day 12, and healing on day 13. If not healed, it is called "Passing the Meridian," implying passing Taiyang again, which is erroneous.
Ma Zhonghua stated: From Taiyang to Jueyin is like entering a house from the gate to the hall to the inner room. For Jueyin to transmit back to Taiyang, it would have to pass Shaoyin, Taiyin, Shaoyang, and Yangming. How could it suddenly transmit to Taiyang? This refutes the error of "re-transmission" and is a definitive judgment for millennia. Unfortunately, his explanation of "day 7 pathology decline" remains unclear, leaving later generations confused. So, is there really no case of pathogen exiting from Interior to Exterior? It is not that the pathogen wants to transmit out, but that it wants to heal and emerge. The *Taiyang Chapter* states: "To resolve spontaneously, one must first feel irritable, then sweat and resolve." How do we know? Because the pulse is floating, we know it resolves via sweat. Floating pulse indicates pathogen returning to Exterior, signaling approaching health. No further decoction is needed; the pathogen disperses outward. Once dispersed, how can it transmit? Know that Interior pathogen, if it does not exit, stays; if it exits, it seeks healing, not transmission.
Some ask: The *Treatise* says Taiyang disease headache heals after seven days because the meridian cycle is complete. If it is to restart the cycle, needle Foot Yangming to prevent transmission and ensure healing. Does this mean days 1-6 transmit through Three Yang and Three Yin, healing on day 7, and if not, Taiyang pathogen transmits to Yangming?
Answer: Cold damage starts at Taiyang and ends at Jueyin, completing the transmission cycle. All meridians healing after seven days do so because they completed their meridian cycle. Taiyang headache healing on day 7 is because the Taiyang meridian cycle is complete. The pathogen moves solely within Taiyang, exhausting the seven-day healing period. The *Treatise* says "Yang diseases heal in seven days" due to the number seven belonging to Yang. If not healed after seven days, intending to pass Taiyang for another cycle, one should needle Foot Yangming to intercept and prevent transmission. Carefully studying "completing its meridian cycle," noting it does not say "transmitting through all meridians," Zhang Zhongjing's intent is clear. Cheng Wuji erroneously interpreted "completing its meridian cycle" as transmitting through all six meridians, creating the theory of re-transmission from Taiyang. If it truly transmitted through all six meridians, Jueyin pathogen transmitting to Taiyang, then Taiyang to Yangming, one should needle Taiyang before Jueyin transmits to it, rather than waiting until Yangming transmission is anticipated to needle Yangming.
Some ask: The *Huo Luan Chapter* mentions healing on day 13 because the meridian cycle is complete. Does this mean six days transmit through Three Yang and Three Yin, followed by six more days completing the cycle, healing on day 13? The *Taiyang Chapter* mentions: "Cold damage unresolved for thirteen days, passing the meridian period with delirium, indicates heat, requiring purging." Does this mean twelve days complete the cycle, and day 13 non-healing is "passing the meridian"?
Answer: "Completing the meridian cycle" refers to Taiyang completing its cycle. Taiyang disease from day 1 to day 7 completes the Taiyang cycle. By analogy, other meridians can be calculated. Yangming disease healing from day 2 to day 8 completes the Yangming cycle; Shaoyang disease healing from day 3 to day 9 completes the Shaoyang cycle; even if transmission reaches Three Yin from days 4-5, healing by day 12 completes the Jueyin cycle. Day 13 is when major pathogen dissipates and spirit refreshes. Thus, if exceeding thirteen days, regardless of pulse position, sinking indicates great danger. "Thirty days unresolved, passing meridian period with delirium" simply means failing to resolve at the expected time, allowing pathogen to enter Interior. Delirium indicates interior excess binding, requiring purging. This broadly refers to "passing the meridian period," not specifying a particular meridian. There is no concept of "re-completing transmission cycle" called "passing the meridian." (Min Ziqing)
Min's theory that transmission through six meridians does not re-transmit is based on *Neijing* principles of sequential transmission and one Zang not being injured twice (double injury leads to death). He argues that mentioning days in transmission should not be rigidly bound by numbers. This is particularly incisive. However, clarification is needed. *Classic* says "Day 1 Taiyang receives it," merely indicating Taiyang disease begins on that day. If Taiyang disease lasts dozens of days, it can still be considered within the "first day" scope of Taiyang. Thus, some live or die entirely within Taiyang. Zhang Zhongjing's chapter on "Unresolved Passing the Meridian" addresses non-transmitting cold damage. "Day 2 Yangming receives it" counts from the start of transmission from Taiyang to Yangming. If staying in Taiyang briefly and transmitting same day, it is Yangming Day 2; if staying in Taiyang for 7-8 days before transmitting, it is also Yangming Day 2. Other meridians follow this logic. The mention of "seven days" uses days to illustrate sequence, like calculating travel time. Speed varies, but distance is fixed. Min's view that seven is a Yang number is somewhat rigid. I believe the day Taiyang disease heals is simply Day 7, which is clearer. Any day Yangming is affected counts as Day 2, merely counting the sequence from Taiyang transmission. Whether long or short stay in Yangming, healing occurs on Day 8, not necessarily because seven combines with Yang numbers. Other meridians follow suit. This seems inconsistent with *Classic* text but deeply aligns with its intent. The *Classic* uses days to establish rules for learning, showing the timeline of six meridians. In reality, pathogen changes are sudden and unpredictable; how can they be counted by days? Knowing to discuss meridians by days but examine disease without rigid day-counting allows one to discuss treating according to classics. Regarding re-transmission from Jueyin to Taiyang, consulting *Neijing* and Zhang Zhongjing reveals no such theory, proving it false. There is no pathway for pathogen to enter Taiyang from Jueyin internally. If pathogen emerges to Exterior, it disperses upward; how can it go from Interior to Exterior and then back to Interior? Ask: Who in history has treated Jueyin re-transmitting to Taiyang? Modern patients with cold damage in Three Yang often face critical outcomes; direct invasion of Yin meridians exists, transmission to Yin is rare, let alone completing all six meridians. Due to weak constitutions today and many incompetent physicians, patients die before transmission completes, making cases of full six-meridian transmission rare. Although *Shanghan Lun* distinguishes six meridians, patients do not strictly adhere to boundaries. Early stages often involve two or three meridians simultaneously; one meridian resolving while another transmits is common; Yang meridians may enter Yin; Taiyin and Shaoyin may coexist; Three Yin may coexist. Hence, Zhang Zhongjing established *He Bing* (Combined Disease) and *Bing Bing* (Concurrent Disease) chapters. While *He Bing* and *Bing Bing* mention Three Yang, they are examples; can they not be extended to Three Yin? Without such deduction, books are useless. (Wei Litong)
[Transmission to Foot Meridians Only, Not Hand Meridians]
Physicians claim cold damage transmits only to Foot meridians, not Hand meridians. Tao Jie'an refuted this, stating Qi and Blood circulate endlessly; how could Hand meridians be spared? Saying Foot meridians are injured but not Hand meridians is acceptable; saying transmission only affects Foot meridians is wrong. But why does cold only injure Foot meridians? After deep thought, the meaning becomes clear. Foot Three Yang descend from head to foot; Foot Three Yin ascend from foot to abdomen. The back, front, sides, and feet are governed by Foot Six Meridians. Hand Three Yang start at hand and end at head; Hand Three Yin start at abdomen and end at hand. Hand Six Meridians govern only hands, with little involvement of head or chest. Moreover, cold damage usually enters via head, face, back, or feet; hand-specific cold invasion is unheard of. This explains Tao's statement that Foot is injured, not Hand. (Yu Fushan)
Cold damage transmission mentions only Foot meridians, omitting Hand meridians. This originates from *Suwen*. Caochuang Liu misunderstood, falsely claiming cold damage only transmits to Foot meridians because Foot meridians belong to Water, Wood, Earth (which succumb to cold), while Hand meridians belong to Metal and Fire (which resist cold). This clever rhetoric misled the ignorant. Human Metal and Fire organs are merely elemental associations, not literal metal and fire immune to damage. This caused confusion: some claimed Foot meridians are lower (Yin) and thus receive Yin cold; others cited directional Qi (Northeast vs Southwest); others linked odd vessels only to Foot meridians. All these theories are false. Qi and Blood flow continuously; why would pathogen stop at Hand meridians? Cold invades skin/hair first (Lung association), causing chills, nasal congestion (Exterior) and cough, asthma (Interior). Is Lung not involved? Entering Hand Shaoyin/Jueyin causes tongue coating issues, coma, delirium. Is Pericardium not involved? Entering Hand Yangming causes diarrhea/constipation. Is Large Intestine not involved? Entering Hand Taiyang causes urinary retention. Is Small Intestine not involved? Entering Hand Shaoyang causes blockage, fullness, dryness. *Suwen* states all Zang-Fu are affected; are Hand meridians excluded? Why does *Classic* omit them? Cold damage is Exterior pathogen. To observe Exterior signs, one examines whole-body vessels, covered by Foot Six Meridians; Hand meridians cannot cover the whole body. Where Hand meridians reach, Foot meridians also reach. Thus, mentioning Foot meridians includes Hand meridians. This explains why *Classic* mentions only Foot meridians: to observe Exterior signs. The meaning is simple, yet confusion persists due to Liu's errors. (Zhang Jingyue)
Predecessors claimed Foot is injured, not Hand. Heart governs Ying, Lung governs Wei. Wind-Cold injuring Ying-Wei involves Hand meridians. Large Intestine connects to Stomach (both Yangming); Small Intestine connects to Bladder (both Taiyang). Injury affects both; why distinguish? Hard stool is Large Intestine disease, not just Stomach; difficult urination is Small Intestine disease, not just Bladder. Sweat is Heart fluid; excessive sweating depletes Yang, affecting both Kan (Kidney) and Danzhong (Pericardium). Ignorance of Zhang Zhongjing's Six Meridians leads to transmission errors. (Ke Yunbo)
[Observing the Eyes]
When treating cold damage, first observe the eyes. Red eyes, cracked lips, black tongue, surging-rapid-forceful pulse, solid stool, extreme thirst, and delirium indicate Yang Toxicity. Purging is required.