按消渴之证，虽由火热，然亦有属虚寒者。如《内经》所云∶心移寒于肺为肺消，饮一
溲二
，死不治之证是也。盖饮入于胃，游溢精气，上输于脾，脾气散精，上归于肺。其肺所受之
津液，俱赖心火以熏蒸之，故能上及耳。设心火既衰，则上下不交，阴阳失偶，津液何由熏
蒸上达哉？故肺燥则求救于水，究无火以熏蒸，则愈饮愈渴。上饮半升，下行十合，譬之釜
底有火，则釜中水沸，自然暖气升腾，其盖有汗。若火灭水寒，则气不上行，釜盖自无以润
，此理之必然也。今之医者，不达其故，谓内为热所伤，外为寒所膈，其亦不思之甚矣！其
心火者，君火也，虽不可以妄动，而亦不可消灭。今《内经》言移寒于肺，明是火衰之候，
与下文心移热于肺为膈消，火甚铄金之病，二证迥然各别，何得一概作热治之乎？若果然
，则能消水矣，何反饮一溲二乎？昔人以八味治渴，正为此证。倘不明阴阳虚实，概用寒凉
之剂，未免增其病耳，故辨及之。
方书多分头痛头风为二门，然一病也，但有新久去留之分耳。浅而近者，名头痛，卒然
，易于解散。深而远者，名头风，作止不常，愈后仍发，皆当验邪所从来，乃世俗不作风医
，即从寒治，安知《内经》有不一之邪乎？如云风从外入，振寒汗出头痛。新沐中风，则为
首风。大寒内至骨髓，髓以脑为主，脑逆故头痛。伤寒一日，巨阳受之，头项痛，少阳司天
，初之气，候乃大温，病气发于上，头痛。二之气，热郁于上，头痛，又火淫所胜。民病头
痛，湿淫所胜，头痛时眩。凡此皆六淫相侵，与清阳真气上薄而痛者也。有云头痛甚，则脑
尽痛，手足寒至节，死。头痛巅疾，下虚上实，心热甚，头痛面赤，肺热病。头痛汗出，肾
热病。头痛贞贞淡淡然，厥头痛。面若肿，起而烦心益悲泣，贞贞头痛。头半寒痛，膀胱足
太阳所主；头囟顶脑户中痛，胆足少阳所主。凡此皆脏腑经脉之气，逆乱于清道，壅遏经隧
而痛也。盖头象天，天府清阳之气，皆会于此，五脏清华之血，亦注于此，于是天气所发六
淫之邪，人气所变五贼之逆，皆能相害。或蔽覆其清明，或瘀塞其经络，因邪气相薄，郁而
成热，脉满则痛。若邪气稽留，脉满而气血乱，则痛甚，是实痛也。若寒湿所侵，真气虚弱
，虽不相薄成热，然邪客于脉外，则血泣脉寒，寒则缩卷筋急，外引小络而痛。得温则止，
是虚痛也。因风痛者，抽掣恶风，或无汗；因热痛者，烦心恶热，或有汗；因湿痛者，头痛
而遇天阴更甚；因痰痛者，头昏而愦愦欲痛；因寒痛者，结急而恶寒战栗；气虚而痛，遇劳
则甚，其脉大；血虚而痛，善生惊惕，其脉芤；伤食头痛，痞塞咽酸而恶食；伤酒头痛，恶
心眩晕而吐酒。更有偏头风者，在左属风与血虚，在右属痰与气热。雷头风者，或因风邪所
客，起块起核；或因痰火上逆，如蝉如雷。真头痛者，上引泥丸，死于旦夕。大头痛者，肿
大如斗，疫气时行。眉棱骨痛者，风寒痰热皆得干之。头风白屑者，木旺凌脾，金来报复。
头痒者，湿也痰也，二者皆能郁。头摇者，风也火也，二者皆能动。用是分别施治，无不得
矣。
按：消渴这一病证，虽然多由火热引起，但其中也有属于虚寒类型的。正如《内经》所说：“心将寒气转移至肺，称为肺消”，表现为喝一份水却排出两份尿，这是无法治愈的死证。大概饮水进入胃中，精气游溢出来，向上输送到脾；脾气散布精微物质，向上回归于肺。肺所接受的津液，都依赖心火的熏蒸作用，所以能上达耳部。如果心火衰弱，上下气机不能交通，阴阳失去平衡，津液又靠什么来熏蒸上达呢？因此肺燥就会向水求救，但最终没有火来熏蒸，导致越喝水越口渴。上半身喝下半升水，下行到下部变成十合（约两升），这就像锅底有火，锅中的水就会沸腾，自然产生暖气上升，锅盖会有水汽凝结。如果火灭了水变冷，气就不会上行，锅盖自然无法湿润，这是必然的道理。现在的医生，不明白其中的缘故，认为内部被热邪损伤，外部被寒邪阻隔，这也太不思考了！那心火，就是君火，虽然不可以妄动，但也不可以消灭。现在《内经》说寒气移于肺，明显是火衰的征候，与下文所说的“心将热邪移于肺，称为膈消”，即火盛灼伤肺金的病证，这两种证候截然不同，怎么能一概当作热证来治疗呢？如果真的那样，应该能消耗水分才对，为什么反而出现喝一份尿两份的情况呢？过去的人用八味丸治疗消渴，正是针对这种证候。如果不明白阴阳虚实，一概使用寒凉的药物，未免会增加病情罢了，所以对此加以辨析。
方书中大多将头痛和头风分为两个门类，但实际上是同一种病，只是有新久、去留的区别而已。病位浅且病程短的，称为头痛，突然发作，容易解散。病位深且病程长的，称为头风，发作停止没有规律，痊愈后仍会复发，都应当根据邪气来源进行辨证。然而世俗医生不是从风论治，就是从寒论治，哪里知道《内经》中有多种不同的邪气呢？比如文中说：“风从外侵入，恶寒汗出头痛。”刚洗完头受风，就称为首风。“大寒深入骨髓，髓以脑为主，脑气逆乱故头痛。”伤寒第一天，太阳经受邪，头项疼痛。少阳司天，初之气，气候大温，病气发于上部，头痛。二之气，热郁于上部，头痛，又是火淫胜复所致。百姓患病头痛，湿淫胜复，头痛时常眩晕。凡此种种，都是六淫邪气相侵，以及清阳真气上冲头部而致痛。有说法称：“头痛剧烈，则脑部尽痛，手足寒冷至关节，为死证。”头痛伴巅顶疾病，下虚上实，心热甚，头痛面赤，属肺热病。头痛汗出，属肾热病。头痛持续隐隐作痛，属厥头痛。面部像浮肿，起身心烦悲伤哭泣，持续头痛，属此类。头半侧寒冷疼痛，由膀胱足太阳经所主；头囟、头顶、脑户部位疼痛，由胆足少阳经所主。凡此种种，都是脏腑经脉之气，逆乱于清窍之道，壅遏经络隧道而致痛。大概头部象征天，天府清阳之气，都汇聚于此，五脏精华之血，也灌注于此，于是天气所发的六淫邪气，人气所变的五贼逆气，都能相互侵害。或遮蔽覆盖其清明，或瘀塞阻塞其经络，因邪气相互迫近，郁结而成热，脉道充盈则痛。如果邪气稽留，脉道充盈而气血紊乱，则疼痛剧烈，这是实痛。如果寒湿侵袭，真气虚弱，虽然不相迫近成热，但邪气客居脉外，则血液凝涩脉寒，寒则收缩卷曲筋脉拘急，向外牵引小络脉而痛。得温热则停止，这是虚痛。因风致痛的，抽搐恶风，或无汗；因热致痛的，心烦恶热，或有汗；因湿致痛的，头痛遇阴天更严重；因痰致痛的，头昏沉欲痛；因寒致痛的，拘急恶寒战栗；气虚而痛，劳累则加重，脉大；血虚而痛，易生惊悸，脉芤；伤食头痛，痞塞咽酸厌恶食物；伤酒头痛，恶心眩晕呕吐酒液。更有偏头风者，左侧属风与血虚，右侧属痰与气热。雷头风者，或因风邪客居，起块起核；或因痰火上逆，声音如蝉鸣如雷鸣。真头痛者，上引泥丸宫，旦夕之间死亡。大头痛者，肿大如斗，疫气流行时发生。眉棱骨痛者，风寒痰热皆可干犯。头风白屑者，木旺凌脾，金来报复。头痒者，是湿也是痰，二者皆能郁结。头摇者，是风也是火，二者皆能扰动。据此分别施治，没有不得当的。
According to: The syndrome of Xiao Ke (Wasting and Thirsting, characterized by excessive thirst, hunger, and urination), although often caused by Fire-Heat, also includes cases belonging to Deficiency-Cold. As stated in the *Nei Jing* (Classic of Internal Medicine): "When Heart transfers Cold to the Lung, it is called Lung Xiao," manifesting as drinking one portion but urinating two portions, a fatal and incurable syndrome. Generally, when water enters the Stomach, its essence floats and overflows, moving upward to be transported by the Spleen; the Spleen disperses the refined essences, sending them upward back to the Lung. The fluids received by the Lung rely on the steaming action of Heart Fire to reach upwards, even to the ears. If Heart Fire declines, the upper and lower do not interact, Yin and Yang lose their balance, and how can fluids be steamed and ascend? Thus, Lung Dryness seeks relief from water, but without Fire to steam, the more one drinks, the thirstier one becomes. Half a sheng (approx. 0.5L) drunk at the top descends as ten he (approx. 2L) at the bottom. This is like having fire under a pot: if there is fire, the water boils, natural warm qi rises, and the lid becomes moist with condensation. If the fire goes out and the water becomes cold, the qi does not ascend, and the lid naturally remains dry; this is an inevitable principle. Current physicians, failing to understand this cause, claim that the interior is injured by Heat and the exterior is obstructed by Cold, which shows a profound lack of reflection! That Heart Fire is the Sovereign Fire (Jun Huo); while it should not be recklessly disturbed, it must not be extinguished. The *Nei Jing*'s mention of transferring Cold to the Lung clearly indicates a sign of Fire decline, which is distinctly different from the subsequent text stating "Heart transfers Heat to the Lung, causing Ge Xiao" (Diaphragm Wasting-Thirst), a disease where excessive Fire scorches Metal (Lung). These two syndromes are completely distinct; how can they all be treated uniformly as Heat patterns? If they were truly Heat patterns, the water would be consumed; why instead result in drinking one part and urinating two parts? In ancient times, Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) was used to treat thirst precisely for this type of syndrome. If one fails to understand Yin-Yang and Deficiency-Excess, and uniformly employs Cold-Cooling agents, it will inevitably aggravate the illness. Hence, this distinction is made.
Medical texts mostly divide Headache and Tou Feng (Chronic Head Wind/Headache) into two categories, yet it is one disease, differing only in newness vs. chronicity and retention vs. departure. Superficial and recent cases are named Headache, occurring suddenly and easily dispersed. Deep and distant cases are named Tou Feng, with irregular onset and cessation, recurring after remission; all should be differentiated based on the origin of the pathogen. However, lay physicians either treat from the perspective of Wind or Cold, ignoring that the *Nei Jing* describes various diverse pathogens. For instance, it states: "Wind entering from outside causes aversion to cold, sweating, and headache." Catching wind immediately after washing hair results in Shou Feng (First Wind). Severe Cold reaching the bone marrow, where the Brain is the master, causes Brain Qi rebellion, leading to headache. In the first day of Shang Han (Cold Damage), the Taiyang (Greater Yang) channel receives the pathogen, causing pain in the head and neck. When Shaoyang (Lesser Yang) governs the year, during the first climate phase, the weather is significantly warm; pathogenic qi emerges from above, causing headache. During the second climate phase, Heat stagnates above, causing headache, again due to excessive Fire influence. People suffer from headaches; due to excessive Dampness influence, headaches occur with occasional dizziness. All these are invasions by the Six Excesses (Six Evils) and upward thrusting of Clear Yang True Qi causing pain. It is said: "Severe headache leads to complete brain pain, cold hands and feet extending to the joints, indicating death." Headache associated with crown disorders, with deficiency below and excess above, severe Heart Heat, headache with red face, belongs to Lung Heat Disease. Headache with sweating belongs to Kidney Heat Disease. Persistent, dull headache belongs to Jue Headache. Face appearing swollen, irritability upon rising, sadness, weeping, and persistent headache belong to this category. Half-head cold pain is governed by the Bladder Foot-Taiyang channel; pain in the fontanelle, vertex, and Naohu (GV16) is governed by the Gallbladder Foot-Shaoyang channel. All these result from the rebellious disorder of Zang-Fu and meridian Qi in the clear orifices, blocking the meridians and collaterals, causing pain. The head symbolizes Heaven; the Clear Yang Qi of the Heavenly Mansion converges here, and the purest blood of the Five Zang organs also pours here. Thus, the Six Excesses emitted by Heaven and the Five Robbers' rebellion generated by human Qi can harm each other. They may obscure clarity or block meridians. Due to pathogenic confrontation, stagnation generates Heat; full pulses cause pain. If pathogens linger, pulses are full, and Qi-Blood is chaotic, pain is severe; this is Excess Pain. If invaded by Cold-Dampness, True Qi is weak; although no confrontation generates Heat, pathogens lodging outside the vessels cause Blood stasis and vessel cold. Cold causes contraction and curling of sinews, tension, and external pulling of small collaterals, causing pain. Relief with warmth indicates Deficiency Pain. Pain caused by Wind involves twitching, aversion to wind, or absence of sweat; pain caused by Heat involves irritability, aversion to heat, or presence of sweat; pain caused by Dampness worsens on cloudy days; pain caused by Phlegm involves heavy-headedness and drowsiness; pain caused by Cold involves stiffness, aversion to cold, and shivering. Qi-deficiency pain worsens with labor and presents with a large pulse; Blood-deficiency pain involves frequent palpitations/fright and a hollow pulse. Food-injury headache involves epigastric fullness, sour regurgitation, and food aversion; Alcohol-injury headache involves nausea, vertigo, and vomiting of alcohol. There is also Biateral Head Wind: left-sided belongs to Wind and Blood Deficiency; right-sided belongs to Phlegm and Qi-Heat. Lei Tou Feng (Thunder Head Wind) may be due to lodged Wind Pathogens forming lumps/nodules, or due to Phlegm-Fire rebelling upward, sounding like cicadas or thunder. Zhen Tou Tong (True Headache) pulls up to Ni Wan Palace (the brain/dantian area) and leads to death within a day or night. Da Tou Tong (Great Headache) swells as large as a dou (bushel measure), occurring during epidemic seasons. Meilinggu (Eyebrow Ridge Bone) pain can be affected by Wind-Cold, Phlegm, or Heat. White scales in Tou Feng indicate Wood overacting on Spleen, with Metal retaliating. Itchiness indicates Dampness or Phlegm, both capable of stagnation. Trembling indicates Wind or Fire, both capable of movement. Differentiating and treating accordingly yields appropriate results.