脉来缓，时一止复来者，名曰结。脉来数，时一止复来者，名曰促。阳盛则促，阴盛则结。此皆病脉。脉按之
来缓，时一止复动者，名曰结。又脉来动而中止，更来小数，中有还者反动，名曰结阴也。
按∶脉按之来缓，时一止复动至名曰结阴也数语，文义不顺。且前论促结之脉已明，衍文也，当删之。
（《医宗金鉴》）
师曰∶病患脉微而涩者，此为医所病也。大发其汗，又数大下之，其人亡血，病当恶寒，后乃发热无休止时，
夏月盛热欲着复衣，冬月盛寒欲裸其身。所以然者，阳微则恶寒，阴弱则发热。此医发其汗，使阳气微，又
大下之，令阴气弱。五月之时，阳气在表，胃中虚冷，以阳气内微不能胜冷，故欲着复衣。十一月之时，阳
气在里，胃中烦热，以阴气内弱，不能胜热，故欲裸其身。又阴脉迟涩，故知血亡也。
按∶又脉冷迟涩，故知血亡也二句，与上文义不属。衍文也，当删之。（《医宗金鉴》）
寸口脉浮大，而医下之，此为大逆。浮则无血，大则为寒，寒气相搏，则为肠鸣。医乃不知，而反饮冷水，
令汗大出，水得寒气，冷必相搏，其人必KT 。
按∶令汗大出四字，当是衍文，宜删之。（《医宗金鉴》）
脉浮而数，浮为风，数为虚。风为热，虚为寒。风虚相搏，则洒淅恶寒也。
按∶数为虚之虚字，应是热字。风为热，虚为寒二句，应是衍文。风虚相搏之虚字，亦应是热字，当
改之、删之。（《医宗金鉴》）
脉阴阳俱紧，主于吐利，其脉独不解，紧去入安，此为欲解。若脉迟，至六七日不欲食，此为晚发，水停故也，
为未解，食自可者，为欲解。
按∶紧去入安之入字，当是人字。人安谓不吐利也，此为晚发、水停故也二句，与上下文义不属，应是
衍文，当改之、删之。（《医宗金鉴》）
寸口脉缓而迟，缓则阳气长，其色鲜，其颜光，其声商，毛发长；迟则阴气盛，骨髓生，血满肌肉紧，鲜
薄硬。阴阳相抱，营卫俱行，刚柔相得，名曰强也。
按∶鲜薄硬三字不成句，应是衍文，当删之。（《医宗金鉴》）
发汗后，水药不得入口为逆。若更发汗，必吐下不止。
按∶必吐、下不止之下字，衍文也，当删之。（《医宗金鉴》）
太阳病，脉浮而动数。浮则为风，数则为热，动则为痛，数则为虚。头痛发热，微盗汗出，而反恶寒者，表未
解也。医反下之，动数变迟，膈内拒痛，胃中空虚，客气动膈，短气烦躁，心中懊 ，阳气内陷，心下因硬，
则为结胸，大陷胸汤主之。若不结胸，但头汗出，余处无汗，剂颈而还，小便不利，身必发黄也。
按∶数则为虚句，衍文也，当删之。（《医宗金鉴》）
汗家重发汗，必恍惚心乱，小便已阴疼。与禹余粮丸。
按∶禹余粮丸为涩痢之药，与此证不合。与禹余粮丸五字，衍文也，当删之。（《医宗金鉴》）
发汗病不解，反恶寒者，虚故也。芍药甘草附子汤主之。
按∶发汗病不解之不字，衍文也。发汗病不解，则当恶寒，何谓反恶寒？病解恶寒，始可谓虚，当删之。（《医宗金鉴》）
太阳病，先发汗不解，而复下之，脉浮者不愈。浮为在外，而反下之，故令不愈。今脉浮，故知在外，当须
解外则愈，宜桂枝汤。
条中有冗句者删之。如桂枝证云∶先发汗不解，而复下之，脉浮者不愈，浮为在外，须解外则愈。何等
直捷。在外下更加而反下之，故令不愈，今脉浮，故知在外等句，要知此等繁音不是汉人之笔，如病常自汗出
条，亦从删例。（柯韵伯）
病常自汗出者，营气和，卫气不共营气和谐故尔。复发其汗，营卫和则愈，宜桂枝汤。
此段旧本多衍文，今删正。（吴遵程）
伤寒所致太阳病，痉、湿、 ，此三种宜应别论。
按∶伤寒所致四字，甚无所谓，当删之。（《医宗金鉴》）
太阳病，发热无汗，反恶寒者，名曰刚痉。
按∶反恶寒之反字，衍文也。刚痉证应恶寒，非反也。（《医宗金鉴》）
得病六七日，脉迟浮弱，恶风寒，手足温，医二三下之，不能食，而胁下满痛，面目及身黄，颈项强，小便
难者，与柴胡汤后必下重。本渴而饮水呕者，柴胡汤不中与也，食谷者哕。
按∶食谷者哕四字，衍文也。食谷呕者有之，从无食谷哕者之证，当删之。（《医宗金鉴》）
下利瘥后，至其年月复发者，以病不尽故也。当下之，宜大承气汤。
此条世本有宜大承气汤五字，衍文也。详未尽之邪，可以留伏经年而发，必系寒邪，寒邪惟可备急丸温下，
不应大承气寒下也。设属热邪，必无经年久伏之理。（《伤寒缵论》）
此段成注亦就时令言法，正是叔和氏作《例》之本旨。病已周年，至期复发，仍用前药，愚不信为医圣
原文。（魏荔彤）
脉象来势迟缓，偶尔出现一次停顿后恢复跳动，称为结脉。脉象来势急促，偶尔出现一次停顿后恢复跳动，称为促脉。阳气偏盛则出现促脉，阴气偏盛则出现结脉。这些都属于病理性脉象。
（此处有一段文字：脉按之来缓，时一止复动者，名曰结。又脉来动而中止，更来小数，中有还者反动，名曰结阴也。）
按语：从“脉按之来缓”到“名曰结阴也”这几句话，文义不通顺。况且前文已经论述了促脉和结脉，含义已明，这段是衍文（多余的文字），应当删除。（出自《医宗金鉴》）
老师说：病人脉象微细而涩滞，这是医生治疗失误造成的。医生大发其汗，又多次峻下攻里，导致病人亡失血液，病情应当表现为恶寒，随后发热且无休止之时。夏季酷热时，病人反而想穿厚衣；冬季严寒时，病人反而想裸露身体。之所以这样，是因为阳气微弱则恶寒，阴血虚弱则发热。这是医生发汗使阳气微弱，又大下使其阴气虚弱。五月时节，阳气在体表，胃中虚冷，因为体内阳气微弱不能抵御寒冷，所以想穿厚衣。十一月时节，阳气在体内，胃中烦热，因为体内阴气虚弱不能抵御热邪，所以想裸露身体。另外，阴脉迟涩，所以知道是血亡失。
（此处有一段文字：又脉冷迟涩，故知血亡也二句。）
按语：“又脉冷迟涩，故知血亡也”这两句，与上文意义不连贯。这是衍文，应当删除。（出自《医宗金鉴》）
寸口脉浮大，医生却用攻下法，这是严重的错误。脉浮表示无血，脉大表示有寒，寒气相互搏结，则出现肠鸣。医生不知道这一点，反而让病人喝冷水，致使大汗淋漓，水气遇到寒气，冷气必然相互搏结，病人必定会出现呃逆（打嗝）。
按语：“令汗大出”这四个字，应该是衍文，适宜删除。（出自《医宗金鉴》）
脉象浮而数，浮脉主风，数脉主虚。风邪带来热，虚证带来寒。风邪与虚寒相搏结，则出现洒淅恶寒的症状。
按语：“数为虚”的“虚”字，应该是“热”字。“风为热，虚为寒”这两句，应该是衍文。“风虚相搏”的“虚”字，也应该是“热”字，应当修改、删除。（出自《医宗金鉴》）
脉象寸关尺三部都紧，主要症状是呕吐和下利。如果脉象独独不解，紧脉消失，人感到安适，这是病情将要解除的表现。如果脉象迟，到了六七天不想吃东西，这是迟发症，因为水饮停聚的缘故，属于病未解除。如果能正常进食，则是病情将要解除。
按语：“紧去入安”的“入”字，应该是“人”字。“人安谓不吐利也”、“此为晚发、水停故也”这两句，与上下文意义不连贯，应该是衍文，应当修改、删除。（出自《医宗金鉴》）
寸口脉缓而迟，缓脉表示阳气生长，面色鲜艳，容颜光亮，声音清亮如商音，毛发茂盛；迟脉表示阴气旺盛，骨髓充盈，血液满溢，肌肉坚实，色泽鲜明而质地薄硬。阴阳相互抱合，营气和卫气共同运行，刚柔相互协调，称为强壮。
按语：“鲜薄硬”这三个字不成句子，应该是衍文，应当删除。（出自《医宗金鉴》）
发汗之后，水药无法入口，这是逆证。如果再次发汗，必定会导致呕吐和下利不止。
按语：“必吐、下不止”的“下”字，是衍文，应当删除。（出自《医宗金鉴》）
太阳病，脉象浮而动数。浮脉则为风邪，数脉则为热邪，动脉则为疼痛，数脉则为虚。头痛发热，微微盗汗，反而恶寒的，说明表证未解。医生反而使用攻下法，动数之脉变为迟脉，膈内抗拒疼痛，胃中空虚，客气扰动膈膜，短气烦躁，心中懊恼，阳气内陷，心下因此变硬，这就形成了结胸证，用大陷胸汤主治。如果不形成结胸，只是头部出汗，身体其他部位无汗，汗水仅到颈部为止，小便不利，身体必定发黄。
按语：“数则为虚”这一句，是衍文，应当删除。（出自《医宗金鉴》）
平素多汗的人，如果再重发其汗，必定会出现心神恍惚、心烦意乱，小便结束后阴茎疼痛。给予禹余粮丸治疗。
按语：禹余粮丸是治疗滑脱痢疾的药物，与此证候不合。“与禹余粮丸”这五个字，是衍文，应当删除。（出自《医宗金鉴》）
发汗后病未解除，反而恶寒的，这是虚证。用芍药甘草附子汤主治。
按语：“发汗病不解”的“不”字，是衍文。如果发汗后病未解除，应当恶寒，怎么能说“反”恶寒呢？只有病解之后仍恶寒，才能称之为虚，应当删除“不”字。（出自《医宗金鉴》）
太阳病，先发汗未解，又用攻下法，脉象仍然浮的，病不会愈。浮脉表示病邪在外，反而用攻下法，所以导致病不愈。现在脉象浮，所以知道病邪仍在表，应当通过解表法治愈，宜用桂枝汤。
条文中如果有冗长的句子就删除它。例如桂枝证条文说：“先发汗不解，而复下之，脉浮者不愈，浮为在外，须解外则愈。”何等直接快捷。如果在“在外”之下加上“而反下之，故令不愈，今脉浮，故知在外”等句，要知道这些繁复的声音不是汉代人的笔法。如“病常自汗出”那条，也遵循此例进行删除。（柯韵伯评注）
病人经常自汗出的，是营气调和，但卫气不与营气和谐所致。再次发其汗，营卫调和则痊愈，宜用桂枝汤。
这段旧版本中多有衍文，现在已删除并校正。（吴遵程评注）
伤寒所导致的太阳病，以及痉病、湿病、暍病，这三种病症应当分别论述。
按语：“伤寒所致”这四个字，没有什么意义，应当删除。（出自《医宗金鉴》）
按语：“反恶寒”的“反”字，是衍文。刚痉证应当恶寒，并非“反”常。（出自《医宗金鉴》）
得病六七天，脉象迟浮弱，恶风寒，手足温暖，医生进行了两三次攻下，导致不能进食，胁下胀满疼痛，面目及全身发黄，颈项强直，小便困难，如果给予柴胡汤，之后必定出现肛门下坠感。本来口渴，喝水却呕吐的，柴胡汤不可服用，进食谷物则会呃逆。
按语：“食谷者哕”这四个字，是衍文。有进食呕吐的情况，从无进食呃逆的证候，应当删除。（出自《医宗金鉴》）
下利病愈后，到了原来的年月复发，是因为病邪未尽的缘故。应当用攻下法，宜用大承气汤。
这条世传版本中有“宜大承气汤”五个字，是衍文。详细分析未尽的病邪，可以留伏经年而发作，必定是寒邪，寒邪只可用备急丸温下，不应使用大承气汤寒下。如果属于热邪，必定没有经年久伏的道理。（出自《伤寒缵论》）
这段成无己的注解也是就时令而言治法，这正是王叔和氏作《例》的本旨。病已满一年，到期复发，仍用前药，我不相信这是医圣张仲景的原文。（魏荔彤评注）
The pulse comes slowly, occasionally pausing before resuming beating, is named Jie (Knotted) pulse. The pulse comes rapidly, occasionally pausing before resuming beating, is named Cu (Rapidly Knotted) pulse. Yang excess leads to Cu pulse, Yin excess leads to Jie pulse. These are all pathological pulses.
(Text in question: "When pressed, the pulse comes slowly, occasionally pausing before resuming movement, it is named Jie. Also, when the pulse moves and stops midway, then returns with a slightly smaller rate, and there is a return movement reversing back, it is named Jie Yin.")
Annotation: From "When pressed, the pulse comes slowly" to "it is named Jie Yin," the meaning is not coherent. Moreover, the discussion of Cu and Jie pulses has already been clarified previously; this is an interpolated text (extraneous text) and should be deleted. (From *Yi Zong Jin Jian*)
The Master said: If the patient's pulse is faint and choppy, this is due to medical error. The physician induced heavy sweating, followed by multiple severe purgations, causing the person to lose blood. The condition should manifest as aversion to cold, followed by fever without cessation. In the height of summer heat, the patient desires to wear thick clothes; in the depth of winter cold, the patient desires to expose their body. The reason for this is that slight Yang causes aversion to cold, and weak Yin causes fever. This occurred because the physician's sweating depleted Yang Qi, and severe purgation weakened Yin Qi. In the fifth month, Yang Qi is on the exterior, but the Stomach is empty and cold; because internal Yang is slight and cannot overcome the cold, the patient desires thick clothes. In the eleventh month, Yang Qi is within, and the Stomach is vexed and hot; because internal Yin is weak and cannot overcome the heat, the patient desires to expose their body. Furthermore, the Yin pulse is slow and choppy, thus knowing that blood has been lost.
(Text in question: "Also, if the pulse is cold, slow, and choppy, one knows blood has been lost." - two sentences.)
Annotation: These two sentences do not connect logically with the preceding text. They are interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
If the Cun Kou (inch position) pulse is floating and large, yet the physician uses purgation, this is a major reversal/error. Floating indicates lack of blood; large indicates cold. When cold qi combats, bowel sounds occur. The physician, unaware of this, instead gives cold water, causing profuse sweating. Water encountering cold qi results in cold combat, and the person will certainly experience hiccups (eructation).
Annotation: The four characters "causing profuse sweating" are likely interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
A pulse that is floating and rapid: floating indicates Wind, rapid indicates deficiency. Wind brings heat, deficiency brings cold. When Wind and deficiency-combat, the person experiences shivering aversion to cold.
Annotation: The character "deficiency" in "rapid indicates deficiency" should be "heat." The sentences "Wind brings heat, deficiency brings cold" are likely interpolated text. The character "deficiency" in "Wind and deficiency-combat" should also be "heat"; these should be corrected and deleted. (From *Yi Zong Jin Jian*)
When the pulse is tight at both Yin and Yang positions, it primarily indicates vomiting and diarrhea. If the pulse alone does not resolve, and the tightness disappears while the person feels at ease, this indicates the disease is about to resolve. If the pulse is slow, and after six or seven days the person has no desire to eat, this is a late onset caused by water retention, indicating the disease has not resolved. If the person can eat normally, it indicates the disease is about to resolve.
Annotation: The character "enter" in "tightness disappears, enter peace" should be "person." "Person at ease means no vomiting or diarrhea" and "this is due to late onset and water retention" do not fit the context; they are likely interpolated text and should be corrected and deleted. (From *Yi Zong Jin Jian*)
The Cun Kou pulse is slow and delayed. Slow indicates Yang Qi growing; the complexion is fresh, the face radiant, the voice resonant (like Shang), and hair grows long. Delayed indicates Yin Qi abundant; marrow generates, blood fills, muscles are firm, fresh, thin, and hard. Yin and Yang embrace each other, Ying (Nutritive) and Wei (Defensive) Qi move together, Gang (Hard) and Rou (Soft) harmonize; this is called strength.
Annotation: The three characters "fresh, thin, hard" do not form a complete sentence; they are likely interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
After inducing sweating, if water and medicine cannot be kept down, it is a adverse reaction. If sweating is induced again, vomiting and diarrhea will certainly ceaselessly continue.
Annotation: The character "down" in "certainly vomiting, down ceaselessly continue" is interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
In Taiyang disease, the pulse is floating and moving-rapid. Floating indicates Wind, rapid indicates Heat, moving indicates Pain, rapid indicates Deficiency. Headache, fever, slight nocturnal sweating, yet contrary aversion to cold, indicates the exterior is not resolved. The physician contrary to protocol uses purgation; the moving-rapid pulse changes to slow. Rejection pain in the diaphragm interior occurs; the Stomach is empty and void; external hostile Qi disturbs the diaphragm; shortness of breath and irritability occur; the heart feels restless. Yang Qi sinks inward, the epigastrium becomes hard, forming Jie Xiong (Chest Binding); Da Xian Xiong Tang (Major Decoction to Drain the Chest) governs it. If Jie Xiong does not form, but only the head sweats, with no sweat elsewhere, stopping at the neck, and urination is difficult, the body will certainly become jaundiced.
Annotation: The sentence "rapid indicates Deficiency" is interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
For those who habitually sweat, heavy induction of sweating will certainly cause mental confusion and restlessness, and pain in the genitalia after urination. Provide Yu Yu Liang Wan (Halloysite Pill).
Annotation: Yu Yu Liang Wan is a drug for astringing dysentery, which does not match this syndrome. The five characters "Provide Yu Yu Liang Wan" are interpolated text and should be deleted. (From *Yi Zong Jin Jian*)
After inducing sweating, if the disease is not resolved and aversion to cold appears contrarily, it is due to deficiency. Shao Yao Gan Cao Fu Zi Tang (Peony, Licorice, and Aconite Decoction) governs it.
Annotation: The character "not" in "inducing sweating, disease not resolved" is interpolated text. If the disease is not resolved after sweating, aversion to cold should be expected; how can it be described as "contrary"? Only if the disease resolves but aversion to cold remains can it be called deficiency. The character "not" should be deleted. (From *Yi Zong Jin Jian*)
In Taiyang disease, if initial sweating fails to resolve the condition, and purgation is subsequently applied, a floating pulse indicates non-resolution. Floating indicates the pathogen is outside; applying purgation contrary to this causes non-resolution. Now that the pulse is floating, we know the pathogen is outside; one must resolve the exterior to achieve cure; Gui Zhi Tang (Cinnamon Twig Decoction) is appropriate.
Remove redundant sentences from the clauses. For example, regarding the Gui Zhi syndrome: "Initial sweating failed to resolve, and purgation was subsequently applied; a floating pulse indicates non-resolution. Floating indicates the pathogen is outside; one must resolve the exterior to achieve cure." How direct and concise. Adding "and contrary purgation was applied, thus causing non-resolution; now the pulse is floating, thus knowing the pathogen is outside" etc., makes it clear that such verbose phrasing is not the style of Han dynasty authors. As with the clause "the disease often presents with spontaneous sweating," follow this example for deletion. (Commentary by Ke Yunbo)
When the disease frequently presents with spontaneous sweating, the Ying Qi is harmonious, but the Wei Qi does not harmonize with the Ying Qi. Induce sweating again; once Ying and Wei Qi are harmonized, the disease cures; Gui Zhi Tang (Cinnamon Twig Decoction) is appropriate.
This section contains many interpolated texts in old editions; they have now been deleted and corrected. (Commentary by Wu Zun Cheng)
Taiyang diseases resulting from Shang Han (Cold Damage), along with Jing (Spasm), Shi (Dampness), and Yue (Heat Stroke), these three types should be discussed separately.
Annotation: The four characters "resulting from Shang Han" are meaningless and should be deleted. (From *Yi Zong Jin Jian*)
In Taiyang disease, fever without sweating, yet contrary aversion to cold, is named Gang Jing (Stiff Spasm).
Annotation: The character "contrary" in "contrary aversion to cold" is interpolated text. Gang Jing syndrome should present with aversion to cold; it is not "contrary." (From *Yi Zong Jin Jian*)
After contracting the disease for six or seven days, the pulse is slow, floating, and weak; there is aversion to wind and cold, and the hands and feet are warm. The physician performs purgation two or three times, leading to inability to eat, fullness and pain under the costal region, yellowing of the face and body, stiffness of the neck, and difficulty urinating. If Chai Hu Tang (Bupleurum Decoction) is given, heaviness in the rectum will follow. If the person is thirsty but vomiting occurs upon drinking water, Chai Hu Tang is contraindicated; eating grain will cause hiccups.
Annotation: The four characters "eating grain causes hiccups" are interpolated text. There are cases of vomiting after eating, but never hiccups specifically triggered by eating grain as a distinct syndrome. These should be deleted. (From *Yi Zong Jin Jian*)
After diarrhea has healed, if it recurs at the same time of year, it is because the pathogenic factor was not fully eliminated. It should be treated with purgation; Da Cheng Qi Tang (Major Order the Qi Decoction) is appropriate.
The five characters "Da Cheng Qi Tang is appropriate" in this clause are interpolated text in worldly editions. Detailed analysis shows that residual pathogens can lie dormant for years and recur; this must be Cold Pathogen. Cold Pathogens can only be treated with Bei Ji Wan (Emergency Preparedness Pill) for warming purgation, not with Da Cheng Qi Tang for cold purgation. If it were a Heat Pathogen, it would be impossible for it to lie dormant for years. (From *Shang Han Zuan Lun*)
Cheng Wuji's commentary on this section discusses methods based on seasonal timing, which aligns with Wang Shuhe's original intent in compiling the *Li* (Examples). The disease has lasted a full year and recurs at the appointed time; using the previous medication again—I do not believe this is the original text of the Medical Sage (Zhang Zhongjing). (Commentary by Wei Litong)