寸口脉微。尺脉紧。其人虚损。多汗。知阴常在。绝不见阳也。
寸微为亡阳。尺紧为阴胜。阳微阴胜。故名虚损。又加之多汗。则愈损阳气。是阴
常在。而绝不见阳也。
寸口诸微亡阳。诸濡亡血。诸弱发热。诸紧为寒。诸乘寒者则为厥。郁冒不仁。以
胃无谷气。脾涩不通。口急不能言。战而栗也。
卫、阳也。微为卫气微。故云亡阳。荣、血也。濡为荣气弱。故云亡血。弱为阴
虚。虚则发热。紧为阴胜。故为寒。诸乘寒者。则阴阳俱虚。而为寒邪乘之也。寒乘气
虚。抑伏阳气。不得宣发。遂成逆也。郁冒。为昏冒不知人也。不仁。为强直而无觉也。
为尸厥焉。以胃无谷气致脾涩不通于上下。故使口急不能言。战者、寒在表也。栗者、
寒在里也。
问曰。濡弱何以反适十一头。师曰。五脏六腑相乘。故令十一。
濡弱者、气血也。往反有十一头。头者、五脏六腑共有十一也。
问曰。何以知乘腑。何以知乘脏。师曰。诸阳浮数为乘腑。诸阴迟涩为乘脏也。
腑、阳也。阳脉见者。为乘腑也。脏、阴也。阴脉见者。为乘脏也。
阴阳大论云。春气温和。夏气暑热。秋气清凉。冬气冷冽。此则四时正气之序也。
春夏为阳。春温夏热者。阳之动。始于温。盛于暑。故也。秋冬为阴。秋凉而冬
寒者。以阴之动。始于清。盛于寒。故也。
冬时严寒。万类深藏。君子固密。则不伤于寒。触冒之者。乃名伤寒耳。
冬三月。纯阴用事。阳乃伏藏。水冰地坼。寒气严凝。当是之时。善摄生者。出
处固密。去寒就温。则不伤于寒。其涉寒冷。触冒霜雪。为病者。谓之伤寒也。
其伤于四时之气。皆能为病。
春风、夏暑、秋湿、冬寒。谓之四时之气。
以伤寒为毒者。以其最成杀厉之气也。
热为阳。阳主生。寒为阴。阴主杀。阴寒为病。最为肃杀毒厉之气。
中而即病者。名曰伤寒。不即病者。寒毒藏于肌肤。至春变为温病。至夏变为暑病。
暑病者。热极重于温也。
内经曰。先夏至日为温病。后夏至日为暑病。温暑之病。本伤于寒而得之。故太医
均谓之伤寒也。
是以辛苦之人。春夏多温热病。皆由冬时触寒所致。非时行之气也。凡时行者。春
时应暖而复大寒。夏时应大热而反大凉。秋时应凉而反大热。冬时应寒而反大温。此非
其时而有其气。是以一岁之中。长幼之病多相似者。此则时行之气也。
四时气候不正为病。谓之时行之气。时气所行为病。非暴厉之气。感受必同。是
以一岁之中。长幼之病多相似也。
王宇泰云。以上辨伤寒时气之异。
夫欲候知四时正气为病。及时行疫气之法。皆当按斗历占之。
四时正气者。春风、夏暑、秋湿、冬寒、是也。时行者。时行之气是也。温者。冬时
感寒。至春发者是也。疫者。暴厉之气是也。占前斗建。审其时候之寒温。察其邪气之
轻重而治之。故下文曰。
九月霜降节后。宜渐寒。向冬大寒。至正月雨水节后宜解也。所以谓之雨水者。
以冰雪解而为雨水故也。至惊蛰二月节后。气渐和暖。向夏大热。至秋便凉。
冬寒、春温、夏热、秋凉、为四时之正气也。
从霜降以后。至春分以前。凡有触冒霜露。体中寒。即病者。谓之伤寒也。
九月、十月。寒气尚微。为病则轻。十一月、十二月。寒冽已严。为病则重。正月、
二月。寒渐将解。为病亦轻。此以冬时不调。适有伤寒之人。即为病也。此为四时正气。
中而即病者也。
其冬有非节之暖者。名曰冬温。冬温之毒。与伤寒大异。冬温复有先后。更相重沓。
亦有轻重。为治不同。证如后章。
此为时行之气。前云冬时应寒。而反大温者是也。
从立春节后。其中无暴大寒。又不冰雪。而有人壮热为病者。此属春时阳气发于冬
时。伏寒变为温病。
此为温病也。内经曰。冬伤于寒。春必病温。
从春分以后。至秋分节前。天有暴寒者。皆为时行寒疫也。三月、四月。或有暴寒。
其时阳气尚弱。为寒所折。病热犹轻。五月、六月。阳气已盛。为寒所折。病热则重。
七月、八月。阳气已衰。为寒所折。病热亦微。其病与温及暑病相似。但治有殊耳。
此为疫气也。是数者。以明前斗历之法。占其随时气候。发病寒热轻重不同耳。
王宇泰云。此辨时行与伤寒相似。治法不同。要在辨其病原。寒、热、温、三者之
异。则用药冷热之品味判然矣。
王履云。即病谓之伤寒。不即病谓之温暑。其原不殊。故一以伤寒为称。其类各别。
故施治不得以相混。今人以伤寒法治温暑。亦不过借用耳。非仲景立法之本意也。或用
辛凉解散。庶为得宜。苟不慎而轻用之。诚不免夫狂躁斑黄衄血
之变也。
王宇泰云。伤寒即发于天令寒冷之时。而寒邪在表。闭其腠理。故非辛甘温之剂。
不足以散之。此仲景桂枝麻黄等汤之所以必用也。温病、热病。后发于天令暄热之时。
怫热自内而达于外。郁其腠理。无寒在表。故非辛凉。或苦寒。或酸苦之剂。不足以解
之。
十五日得一气于四时之中。一时有六气。四六名为二十四气也。
节气十二。中气十二。共二十四。内经曰。五日谓之候。三候谓之气。六气谓之时。
四时谓之岁。
然气候亦有应至而不至。或有未应至而至者。或有至而太过者。皆成病气也。
疑漏或有至而不去。此一句。按金匮要略曰。有未至而至。有至而不至。有至而不
去。有至而太过。何故也。师曰。冬至之后。甲子夜半。少阳起。少阳之时。阳始生。
天得温和。以未得甲子。天因温和。此为未至而至也。以得甲子。而天未温和。此为
至而不至也。以得甲子。天大寒不解。此为至而不去也。以得甲子。而天温如盛夏五六
月时。此为至而太过也。内经曰。至而和则平。至而甚则病。至而反者
病。至而不至者病。未至而至者病。即是观之。脱漏明矣。
但天地动静。阴阳鼓击者。各正一气耳。
内经曰。阴阳者。天地之道。清阳为天。动而不息。浊阴为地。静而不移。天地阴
阳之气。鼓击而生。春夏秋冬。寒热温凉各正一气也。
是以彼春之暖。为夏之暑。彼秋之忿。为冬之怒。
春暖为夏暑。从生而至长也。秋忿为冬怒。从肃而至杀也。
是故冬至之后。一阳爻升一阴爻降也。夏至之后。一阳气下。一阴气上也。
十月六爻皆阴。坤卦为用。阴极阳来。阳生于子。冬至之后。一阳爻升。一阴爻降。
于卦为复。言阳气得复也。四月六爻皆阳。乾卦为用。阳极阴来。阴生于午。夏至之后。
一阳气下。一阴气上。于卦为 。言阴得遇阳也。内经曰。冬至四十五日阳气微上。阴
气微下。夏至四十五日阴气微上。阳气微下。
斯则冬夏二至。阴阳合也。春秋二分。阴阳离也。
阳生于子。阴生于午。是阴阳相接。故曰合。阳退于酉。阴退于卯。是阴阳相背。
故曰离。内经曰。气至之谓至。气分之谓分。至则气同。分则气异。
阴阳交易。人变病焉。
天地阴阳之气。既交错而不正。人所以变病。内经曰。阴阳相错。而变由生也。
此君子春夏养阳。秋冬养阴。顺天地之刚柔也。
内经曰。养生者。必顺于时。春夏养阳。以凉以寒。秋冬养阴。以温以热。所以然
者。从其根故也。
小人触冒必婴暴疹。须知毒烈之气。留在何经。而发何病。详而取之。
不能顺四时调养。触冒寒温者。必成暴病。医者当在意审详而治之。
是以春伤于风。夏必飧泄。夏伤于暑秋必病疟。秋伤于湿。冬必咳嗽。冬伤于寒。
春必病温。此必然之道。可不审明之。
当春之时。风气大行。春伤于风。风气通于肝。肝以春适王。风虽入之。不能即发。
至夏肝衰。然后始动。风淫末疾。则当发于四肢。夏以阳气外盛。风不能外发。故攻内
而为飧泄。飧泄者。下利米谷不化而色黄。当秋之时。湿气大行。秋伤于湿。湿则干于
肺。肺以秋适王。湿虽入之。不能即发。至冬肺衰。然后湿始动也。雨淫腹疾。则当发
为下利。冬以阳气内固。湿气不能下行。故上逆而为咳嗽。当夏之
时。暑气大行。夏伤于暑。夏以阴为主内。暑虽入之。势未能动。及秋阴出而阳为内主。
然后暑动传阴而为 疟。 者、二日一发。疟者、一日一发。当冬之时。寒气大行。冬
伤于寒。冬以阳为主内寒虽入之。势未能动及春阳出而阴为内主。然后寒动传阳而为温
病。是感冒四时正气为病。必然之道。
伤寒之病。逐日浅深。以施方治。
内经曰。未满三日者。可汗而已。其满三日者。可泄而已。
今世人伤寒。或始不早治。或治不对病。或日数久淹。困乃告医。医人又不根据次第
而治之。则不中病。皆宜临时消息制方。无不效也。今搜采仲景旧论。录其证候。诊脉
声色。对病真方。有神验者。拟防世急也。
仲景之书。逮今千年。而显用于世者。王叔和之力也。
又土地温凉高下不同。物性刚柔餐居亦异。是黄帝兴四方之问。岐伯举四治之能。以
训后贤。开其未悟者。临病之工。宜须两审也。
东方地气温。南方地气热。西方地气凉。北方地气寒。西北方高。东南方下。是土
地温凉高下不同也。东方安居食鱼。西方陵居华食。南方湿处而嗜酸。北方野
处而食乳。是餐居之异也。东方治宜砭石。西方治宜毒药。南方治宜微针。北方治宜灸
。是四方医治不同也。医之治病。当审其土地所宜。
庞安时云。一州之内。有山居者。为居积阴之所。盛夏冰雪。其气寒。腠理闭。难
伤于邪。其人寿。其有病者。多中风中寒之疾也。有平泽居者。为居积阳之所。严冬生
草。其气温。腠理疏。易伤于邪。其人夭。其有病者。多中温中暑之疾也。
凡伤于寒。则为病热。热虽甚。不死。
内经曰。风寒客于人。使人毫毛毕直。皮肤闭而为热。是伤寒为病热也。针经曰。多
热者易已。多寒者难已。是热虽甚。不死。
若两感于寒而病者。必死。
表里俱病者。谓之两感。
尺寸俱浮者。太阳受病也。当一二日发。以其脉上连风府。故头项痛腰脊强。
太阳为三阳之长。其气浮于外。故尺寸俱浮。是邪气初入皮肤。外在表也。当一二日
发。风府。穴名也。项中央。太阳之脉。从巅入络脑。还出别下项。是以上连风府。其经循
肩膊内。侠脊。抵腰中。故病头项痛。腰脊强。
尺寸俱长者。阳明受病也。当二三日发。以其脉侠鼻。络于目。故身热、目疼、鼻
干。不得卧。
阳明血气俱多。尺寸俱长者。邪并阳明。而血气淖溢也。太阳受邪不已。传于阳
明。是当二三日发。其脉侠鼻者。阳明脉起于鼻。交颈中。络于目。阳明之脉。正上
。还出系目系。身热者。阳明主身之肌肉。针经曰。阳明气盛。则身以前皆热。目
疼鼻干者。经中客邪也。不得卧者。胃气逆。不得从其道也。内经曰。胃不和。则卧不
安。
尺寸俱弦者。少阳受病也。当三四日发。以其脉循胁。络于耳。故胸胁痛而耳聋。
内经曰。阳中之少阳。通于春气。春脉弦。尺寸俱弦者。知少阳受邪也。二三日。阳
明之邪不已。传于少阳。是当三四日发。胸胁痛而耳聋者。经壅而不利也。
此三经皆受病。未入于腑者。可汗而已。
三阳受邪。为病在表。法当汗解。然三阳亦有便入腑者。入腑则宜下。故云未入于
腑者。可汗而已。
尺寸俱沉细者。太阴受病也。当四五日发。以其脉布胃中。络于嗌。故腹满而嗌干。
阳极则阴受之。邪传三阳既遍。次乃传于阴经。在阳为表。在阴为里。邪在表则见
阳脉。邪在里则见阴脉。阳邪传阴。邪气内陷。故太阴受病。而脉尺寸俱沉细也。
自三阳传于太阴。是当四五日发也。邪入于阴。则渐成热。腹满而嗌干者。脾经壅而成
热也。
尺寸俱沉者。少阴受病也。当五六日发。以其脉贯肾。络于肺。系舌本。故口燥舌
干而渴。
少阴。肾水也。性趋下。少阴受病。脉尺寸俱沉也。四五日。太阴之邪不已。至五
六日。则传于少阴也。是少阴病当五六日发。人伤于寒。则为病热。谓始为寒而终成热
也。少阴为病。口燥舌干而渴。邪传入里。热气渐深也。
活人云。经云一二日少阴者。谓国中病时。便入少阴。不经三阳也。大抵伤寒发于
阳。则太阳也。发于阴。则少阴也。凡病一日至十二三日太阳证不能罢者。俱治太阳。
有初得病。便见少阴证者。宜攻少阴。亦不必先自巨阳。盖寒入太阳。即发热而恶寒。
入少阴。即恶寒而不热。
尺寸俱微缓者。厥阴受病也。当六七日发以其脉循阴器。络于肝。故烦满而囊缩。
缓者。风脉也。厥阴脉微缓者。邪传厥阴。热气已剧。近于风也。当六七日发。以
少阴邪传于厥阴。烦满而囊缩者。热气聚于内也。
王三阳云。厥阴风脉固当缓。但缓脉多是胃气和。脉有胃气。乃欲愈之候。病传厥
阴。亦甚危笃矣。岂有胃气乎。必缓中带弦直而无神气。方是病传厥阴之恶候也。若只
寸口脉微，尺脉紧，这是人体虚损的表现，多汗。说明阴气常存，而阳气完全衰竭。
寸脉微是亡阳，尺脉紧是阴胜。阳微阴胜，所以称为虚损。再加上多汗，更加损耗阳气，因此阴气常在，而阳气绝迹不见。
寸口脉象各种微脉都是亡阳，各种濡脉都是亡血，各种弱脉都是发热，各种紧脉都是寒邪。凡是受寒邪侵袭的，就会发生厥证，出现郁冒（昏蒙）和麻木不仁的症状。这是因为胃中无谷气，脾经涩滞不通，导致口唇拘急不能言语，身体战栗发抖。
卫气属于阳，脉微表示卫气微弱，所以说亡阳。营气属于血，脉濡表示营气虚弱，所以说亡血。脉弱表示阴虚，阴虚则发热。脉紧表示阴胜，所以为寒。凡是受寒邪乘袭的，就是阴阳俱虚，被寒邪所乘。寒邪乘人体气虚，抑制伏藏阳气，使其不得宣发，于是形成逆证。郁冒，是指昏蒙不知人。不仁，是指肢体强直而无知觉。这类似于尸厥。因为胃中无谷气，导致脾经涩滞，上下不通，所以使口唇拘急不能言语。战，是因为寒在表；栗，是因为寒在里。
问：濡脉和弱脉为什么反而对应十一头（指五脏六腑共十一部）？师答：五脏六腑相互传变，所以令其对应十一部。
濡弱代表气血，往来对应十一头。头，指五脏六腑共有十一部。
问：如何知道病邪传入腑？如何知道病邪传入脏？师答：诸阳脉浮数是病邪传入腑，诸阴脉迟涩是病邪传入脏。
腑属阳，见到阳脉，就是病邪传入腑。脏属阴，见到阴脉，就是病邪传入脏。
《阴阳大论》说：春气温和，夏气暑热，秋气清凉，冬气冷冽。这是四时正气的次序。
春夏属阳，春温夏热，是阳气发动的结果，始于温和，盛于暑热。秋冬属阴，秋凉冬寒，是阴气发动的结果，始于清肃，盛于寒冷。
冬季严寒，万物深藏，君子固守严密，就不会受寒邪伤害。如果触犯冒犯，才叫做伤寒。
冬季三个月，纯阴用事，阳气伏藏，水结冰，地开裂，寒气严酷凝结。在这个时候，善于养生的人，起居固密，远离寒冷，趋向温暖，就不会受寒邪伤害。那些涉足寒冷，触犯霜雪而生病的，叫做伤寒。
凡是伤于四时之气，都能致病。
春风、夏暑、秋湿、冬寒，叫做四时之气。
认为伤寒是有毒的，是因为它最能形成杀厉之气。
热属阳，阳主生发；寒属阴，阴主杀伐。阴寒致病，是最为肃杀毒厉的气。
感受寒邪当即发病的，名叫伤寒。如果不当即发病，寒毒潜伏在肌肤，到春天变为温病，到夏天变为暑病。
暑病，比温病的热更重。
《内经》说：夏至日之前得的叫温病，夏至之后得的叫暑病。温病和暑病，原本都是因伤于寒而得之，所以太医都统称为伤寒。
因此，劳苦之人，在春夏季节多患温热病，都是由冬天时触冒寒邪所致，并非时行之气。凡是时行病，是春季应该暖和却突然大寒，夏季应该大热却反而大凉，秋季应该凉爽却反而大热，冬季应该寒冷却反而大温。这不是其时令而有其气候，所以一年之中，老少病人的症状大多相似，这就是时行之气。
四时气候不正导致疾病，叫做时行之气。时气流行导致的疾病，不是暴厉之气，但感受后病症必然相同，所以一年之中，老少病人的症状大多相似。
王宇泰说：以上辨别了伤寒与时气的不同。
想要诊察四时正气致病，以及时行疫气的方法，都应该通过观察斗柄指向和历法来占测。
四时正气，就是春风、夏暑、秋湿、冬寒。时行病，就是时行之气。温病，就是冬天感寒，到春天发作的。疫病，就是暴厉之气。推算前面的斗建，审察其时候的寒温，察辨其邪气的轻重而进行治疗。所以下文说：
九月霜降节后，应该逐渐变寒，到了冬天大寒，直到正月雨水节后应该解冻。之所以叫雨水，是因为冰雪融化成为雨水。到了惊蛰二月节后，气逐渐和暖，到了夏天大热，到了秋天就凉了。
冬寒、春温、夏热、秋凉，是四时的正气。
从霜降以后，到春分以前，凡是有触冒霜露，体内受寒立即发病的，叫做伤寒。
九月、十月，寒气还轻微，生病则轻。十一月、十二月，寒冽已经严酷，生病则重。正月、二月，寒渐将解，生病也轻。这是因为冬季气候不调，恰好有伤寒的人，就为此病。这是四时正气，感受寒邪当即发病的情况。
如果冬天有不合节令的温暖，叫做冬温。冬温的毒性，与伤寒大不相同。冬温又有先后之分，互相重叠，也有轻重之别，治疗方法不同，证候如后章所述。
这是时行之气，前文所说“冬季应该寒冷，却反而大温”的就是这种情况。
从立春节后，其中没有暴大的寒冷，也没有冰雪，如果有人壮热生病的，这属于春时阳气发于冬时，伏寒变为温病。
这是温病。《内经》说：冬伤于寒，春必病温。
从春分以后，到秋分节前，天有暴寒的，都是时行寒疫。三月、四月，或有暴寒，此时阳气尚弱，被寒邪折抑，病热较轻。五月、六月，阳气已盛，被寒邪折抑，病热则重。七月、八月，阳气已衰，被寒邪折抑，病热也微。其病与温病及暑病相似，但治疗有所不同。
这是疫气。这几条是用来说明前文斗历之法，占测其随季节变化的气候，发病的寒热轻重不同罢了。
王宇泰说：这里辨明了时行与伤寒相似，但治法不同。关键在于辨明病原，区分寒、热、温三者的差异，那么用药的冷热品味就判然不同了。
王履说：当即发病的叫伤寒，不即发病的叫温暑。它们的本源没有区别，所以都以伤寒称呼。但它们类别各自不同，所以施治不得混淆。现在的人用治伤寒的方法治温暑，也不过是借用而已，并非张仲景立法之本意。或许使用辛凉解散的方法，才比较适宜。如果不谨慎而轻率使用，确实不免出现狂躁、斑黄、鼻衄等变证。
王宇泰说：伤寒即在天气寒冷之时发作，而寒邪在表，闭塞腠理，所以非辛甘温的药剂，不足以发散它。这就是张仲景桂枝汤、麻黄汤等方剂必须使用的缘故。温病、热病，后来在天气暄热之时发作，郁热自内达于外，郁闭腠理，无寒在表，所以非辛凉，或苦寒，或酸苦的药剂，不足以解除它。
十五天得到一气于四时之中，一时有六气，四六相乘名为二十四气。
节气十二，中气十二，共二十四。《内经》说：五天叫一候，三候叫一气，六气叫一时，四时叫一岁。
然而气候也有应至而未至的，或有未应至而至的，或有至而太过的，都成为病气。
怀疑有遗漏，或有至而不去的。这一句，按《金匮要略》说：有未至而至，有至而不至，有至而不去，有至而太过。为什么呢？师答：冬至之后，甲子夜半，少阳起。少阳之时，阳气始生，天气变得温和。如果未到甲子天却温和，这叫未至而至。如果到了甲子天却不温和，这叫至而不至。如果到了甲子天，天气大寒不解，这叫至而不去。如果到了甲子天，天气温暖像盛夏五六月份，这叫至而太过。《内经》说：至而和则平，至而甚则病，至而反者病，至而不至者病，未至而至者病。由此观之，脱漏之处就很明显了。
只是天地动静，阴阳鼓击，各正一气罢了。
《内经》说：阴阳，是天地之道。清阳为天，动而不息；浊阴为地，静而不移。天地阴阳之气，鼓击而生，春夏秋冬，寒热温凉各正一气。
因此，那春天的暖，是夏天的暑；那秋天的忿，是冬天的怒。
春暖变成夏暑，是从生发到长养的过程。秋忿变成冬怒，是从肃杀到诛杀的过程。
所以冬至之后，一阳爻升，一阴爻降。夏至之后，一阳气下，一阴气上。
十月六爻皆阴，坤卦为用。阴极阳来，阳生于子。冬至之后，一阳爻升，一阴爻降，在卦象为复卦，意思是阳气得以恢复。四月六爻皆阳，乾卦为用。阳极阴来，阴生于午。夏至之后，一阳气下，一阴气上，在卦象为姤卦，意思是阴遇到阳。《内经》说：冬至四十五日阳气微上，阴气微下；夏至四十五日阴气微上，阳气微下。
这就是冬夏二至，阴阳合；春秋二分，阴阳离。
阳生于子，阴生于午，是阴阳相接，所以叫合。阳退于酉，阴退于卯，是阴阳相背，所以叫离。《内经》说：气至叫至，气分叫分。至则气同，分则气异。
阴阳交易，人就变病。
天地阴阳之气，既然交错而不正，人所以变病。《内经》说：阴阳相错，而变由生。
这就是君子春夏养阳，秋冬养阴，顺应天地的刚柔。
《内经》说：养生的人，必须顺于时节。春夏养阳，用凉用寒；秋冬养阴，用温用热。之所以这样，是顺着根本的缘故。
小人触犯冒犯，必定遭受暴疹。需要知道毒烈之气，留在哪条经络，而引发什么病，详细推求而取治。
不能顺应四时调养，触犯寒温的，必定成为暴病。医者应当在意审慎详查而治疗。
因此，春伤于风，夏必飧泄；夏伤于暑，秋必病疟；秋伤于湿，冬必咳嗽；冬伤于寒，春必病温。这是必然的道理，可不审明吗？
正当春时，风气大行。春伤于风，风气通于肝。肝在春天当旺。风虽侵入，不能立即发作。到夏天肝衰，然后才开始动。风淫末疾，则应当发于四肢。夏天阳气外盛，风不能外发，所以攻内而为飧泄。飧泄，是指下利米谷不化且色黄。正当秋时，湿气大行。秋伤于湿，湿干犯肺。肺在秋天当旺。湿虽侵入，不能立即发作。到冬天肺衰，然后湿才开始动。雨淫腹疾，则应当发为下利。冬天阳气内固，湿气不能下行，所以上逆而为咳嗽。正当夏时，暑气大行。夏伤于暑，夏天以阴为主在内。暑虽侵入，势未能动。等到秋天阴出而阳为内主，然后暑动传阴而为疟。瘅疟，是二日一发；疟，是一日一发。正当冬时，寒气大行。冬伤于寒，冬天以阳为主在内。寒虽侵入，势未能动。等到春天阳出而阴为内主，然后寒动传阳而为温病。这是感冒四时正气为病，是必然的道理。
伤寒的病，逐日深浅，以此施用方治。
《内经》说：未满三日的，可发汗而愈。满三日的，可泻下而愈。
现在世人患伤寒，有的开始不早治，有的治不对病，有的日数久拖，困顿才告诉医生。医生又不根据次第而治，就不中病。都应当临时斟酌制方，没有不有效的。现在搜集采录张仲景旧论，记录其证候、诊脉声色，对病真方，有神效验的，打算防备世上的急难。
张仲景的书，到现在千年，而在世上显用的，是王叔和的力量。
又土地温凉高下不同，物性刚柔，饮食居住也不同。所以黄帝兴起四方之问，岐伯举出四治之能，以训导后贤，开启未悟者。临病之工，应当两审。
东方地气温，南方地气热，西方地气凉，北方地气寒。西北方高，东南方下，这是土地温凉高下不同。东方安居食鱼，西方陵居华食，南方湿处而嗜酸，北方野处而食乳，这是饮食居住的差异。东方治疗宜用砭石，西方治疗宜用毒药，南方治疗宜用微针，北方治疗宜用灸，这是四方医治不同。医生治病，应当审察土地所宜。
庞安时说：一州之内，有山居的人，居住在积阴之所。盛夏冰雪，其气寒，腠理闭，难伤于邪，其人长寿。如果有病的，多是中风中寒的疾病。有平泽居的人，居住在积阳之所。严冬生草，其气温，腠理疏，易伤于邪，其人短命。如果有病的，多是中温中暑的疾病。
凡是伤于寒，就为病热。热即使很严重，也不死。
《内经》说：风寒客于人，使人毫毛毕直，皮肤闭而为热，这是伤寒为病热。《针经》说：多热者易已，多寒者难已。所以热即使很严重，也不死。
如果两感于寒而病的，必死。
表里俱病，叫做两感。
尺寸脉俱浮的，是太阳受病，应当在一二日发作。因为其脉上连风府，所以头项痛腰脊强。
太阳为三阳之长，其气浮于外，所以尺寸俱浮。这是邪气初入皮肤，外在表。应当一二日发作。风府，是穴名。在项中央。太阳之脉，从巅入络脑，还出别下项，所以上连风府。其经循肩膊内，夹脊，抵腰中，所以病头项痛，腰脊强。
尺寸脉俱长的，是阳明受病，应当在二三日发作。因为其脉夹鼻，络于目，所以身热、目疼、鼻干，不得卧。
阳明血气俱多，尺寸俱长，是邪并阳明，而血气淖溢。太阳受邪不已，传于阳明，是当二三日发作。其脉夹鼻者，阳明脉起于鼻，交颈中，络于目。阳明之脉，正上额，还出系目系。身热者，阳明主身之肌肉。《针经》说：阳明气盛，则身以前皆热。目疼鼻干者，是经中客邪。不得卧者，是胃气逆，不得从其道。《内经》说：胃不和，则卧不安。
尺寸脉俱弦的，是少阳受病，应当在三四日发作。因为其脉循胁，络于耳，所以胸胁痛而耳聋。
《内经》说：阳中之少阳，通于春气。春脉弦。尺寸俱弦，知少阳受邪。二三日，阳明之邪不已，传于少阳，是当三四日发作。胸胁痛而耳聋者，是经壅而不利。
这三经都受病，未入于腑的，可发汗而愈。
三阳受邪，为病在表，法当汗解。然而三阳也有便入腑的，入腑则宜下。所以说未入于腑的，可发汗而愈。
尺寸脉俱沉细的，是太阴受病，应当在四五日发作。因为其脉布胃中，络于嗌，所以腹满而嗌干。
阳极则阴受之。邪传三阳既遍，次乃传于阴经。在阳为表，在阴为里。邪在表则见阳脉，邪在里则见阴脉。阳邪传阴，邪气内陷，所以太阴受病，而脉尺寸俱沉细。自三阳传于太阴，是当四五日发作。邪入于阴，则渐成热。腹满而嗌干者，是脾经壅而成热。
尺寸脉俱沉的，是少阴受病，应当在五六日发作。因为其脉贯肾，络于肺，系舌本，所以口燥舌干而渴。
少阴，是肾水。性趋下。少阴受病，脉尺寸俱沉。四五日，太阴之邪不已，至五六日，则传于少阴。是少阴病当五六日发作。人伤于寒，则为病热，谓始为寒而终成热。少阴为病，口燥舌干而渴，是邪传入里，热气渐深。
《活人书》说：经云一二日少阴者，谓国中病时，便入少阴，不经三阳。大抵伤寒发于阳，则太阳也；发于阴，则少阴也。凡病一日至十二三日太阳证不能罢者，俱治太阳。有初得病，便见少阴证者，宜攻少阴，亦不必先自巨阳。盖寒入太阳，即发热而恶寒；入少阴，即恶寒而不热。
尺寸脉俱微缓的，是厥阴受病，应当在六七日发作。因为其脉循阴器，络于肝，所以烦满而囊缩。
缓者，是风脉。厥阴脉微缓者，是邪传厥阴，热气已剧，近于风。当六七日发作，以少阴邪传于厥阴。烦满而囊缩者，是热气聚于内。
王三阳说：厥阴风脉固当缓，但缓脉多是胃气和。脉有胃气，乃是欲愈之候。病传厥阴，亦甚危笃矣，岂有胃气乎？必缓中带弦直而无神气，方是病传厥阴之恶候。若只
The pulse at the cun position is faint (Wei, indicating deficiency of Yang), and the pulse at the chi position is tight (Jin, indicating excess of Yin). The person suffers from deficiency and wasting (Xu Sun), with profuse sweating. This indicates that Yin is constantly present, while Yang is completely absent.
A faint pulse at the cun position signifies the loss of Yang (Wang Yang). A tight pulse at the chi position signifies an excess of Yin. With Yang being faint and Yin in excess, it is named deficiency and wasting. Furthermore, combined with profuse sweating, this further damages Yang Qi. Thus, Yin remains constant, and Yang is absolutely not seen.
Various faint pulses at the cun position indicate the loss of Yang. Various soggy pulses (Ru) indicate the loss of blood. Various weak pulses (Ruo) indicate fever. Various tight pulses indicate cold. Those who are attacked by cold will develop Jue syndrome (Cold Reversal), presenting with Yu Mao (dizziness and confusion) and Bu Ren (numbness or insensitivity to pain/touch). This is because there is no Grain Qi in the Stomach, and the Spleen is obstructed and unsmooth, leading to urgency in the mouth and inability to speak, along with trembling and shivering.
Wei Qi (Defensive Qi) belongs to Yang. A faint pulse indicates that Wei Qi is weak, hence "loss of Yang." Ying Qi (Nutritive Qi) belongs to Blood. A soggy pulse indicates that Ying Qi is weak, hence "loss of blood." A weak pulse indicates Yin deficiency; deficiency leads to fever. A tight pulse indicates Yin excess, hence Cold. Those attacked by cold have both Yin and Yang deficient, allowing Cold Pathogen to invade. Cold attacks when Qi is deficient, suppressing and hiding Yang Qi, preventing its dissemination, thereby forming a counterflow condition. Yu Mao refers to dizziness and confusion where one does not know people. Bu Ren refers to stiffness and lack of sensation. This resembles Shi Jue (Corpse-like Faintness). Because there is no Grain Qi in the Stomach, causing the Spleen to be obstructed and unsmooth above and below, it causes urgency in the mouth and inability to speak. Trembling (Zhan) is due to Cold in the Exterior; Shivering (Li) is due to Cold in the Interior.
Question: Why do soggy and weak pulses correspond to the "eleven heads"?
Master says: The Five Zang and Six Fu organs mutually influence each other, thus forming eleven.
Soggy and weak represent Qi and Blood, going back and forth corresponding to eleven heads. "Head" refers to the total of the Five Zang and Six Fu organs, which are eleven.
Question: How do we know if the pathogen has entered the Fu organs? How do we know if it has entered the Zang organs?
Master says: Floating and rapid pulses among Yang pulses indicate entry into the Fu organs. Slow and choppy pulses among Yin pulses indicate entry into the Zang organs.
Fu organs belong to Yang; seeing Yang pulses means entry into the Fu organs. Zang organs belong to Yin; seeing Yin pulses means entry into the Zang organs.
The *Treatise on Yin and Yang* states: Spring Qi is mild and harmonious; Summer Qi is hot and sultry; Autumn Qi is cool and clear; Winter Qi is cold and piercing. This is the order of the Correct Qi of the four seasons.
Spring and Summer belong to Yang. Spring warmth and Summer heat are the movement of Yang, beginning with mildness and flourishing with heat. Autumn and Winter belong to Yin. Autumn coolness and Winter cold are the movement of Yin, beginning with clarity and flourishing with cold.
During Winter, severe cold prevails, and all things hide deeply. The gentleman maintains solidity and secrecy, thus not injuring himself with cold. Those who touch and offend [the cold] are named as having Shang Han (Cold Damage).
In the three months of Winter, Pure Yin is in charge, and Yang is hidden and stored. Water freezes, and the earth cracks. The Cold Qi is strict and condensed. At this time, those skilled in preserving life maintain solid and secret conduct, leaving cold for warmth, thus not injuring themselves with cold. Those who wade through cold and snow, touching frost and snow and becoming ill, are called having Shang Han.
Injury by the Qi of the four seasons can all cause disease.
Spring Wind, Summer Heat, Autumn Dampness, and Winter Cold are called the Qi of the four seasons.
Shang Han is considered toxic because it most forms a killing and fierce Qi.
Heat belongs to Yang, and Yang governs generation. Cold belongs to Yin, and Yin governs destruction. Illness caused by Yin-Cold is the most肃杀 (solemn/destructive) and fierce Qi.
If illness occurs immediately upon injury, it is named Shang Han. If it does not occur immediately, the Cold Toxin hides in the skin and muscles. By Spring, it transforms into Wen Bing (Warm Disease); by Summer, it transforms into Shu Bing (Summerheat Disease).
Shu Bing is more severe in heat than Wen Bing.
The *Nei Jing* (Inner Canon) states: Diseases occurring before the Summer Solstice are called Wen Bing; those occurring after are called Shu Bing. Wen and Shu diseases originally result from injury by Cold, so the Imperial Physicians uniformly call them Shang Han.
Therefore, hardworking people often suffer from Warm-Heat diseases in Spring and Summer, all caused by touching Cold during Winter. This is not the Qi of the Time (Shi Xing Zhi Qi). Whenever there is Time Qi, Spring should be warm but becomes severely cold; Summer should be hot but becomes severely cool; Autumn should be cool but becomes severely hot; Winter should be cold but becomes severely warm. This is having the Qi out of season. Therefore, throughout the year, the illnesses of young and old are mostly similar. This is the Qi of the Time.
Illness caused by abnormal climate of the four seasons is called the Qi of the Time. When Time Qi circulates to cause disease, it is not a violent/fierce Qi, but the infection is uniform, so throughout the year, the illnesses of young and old are mostly similar.
Wang Yutai said: The above distinguishes between Shang Han and Time Qi.
To observe and understand diseases caused by the Correct Qi of the four seasons and the methods for Time Epidemic Qi, one must consult the Dipper and Calendar.
The Correct Qi of the four seasons refers to Spring Wind, Summer Heat, Autumn Dampness, and Winter Cold. Time Qi refers to the Qi of the Time. Wen refers to feeling Cold in Winter and manifesting in Spring. Yi (Epidemic) refers to violent and fierce Qi. One calculates the previous Dipper direction, examines the cold/warmth of the time, observes the severity of the pathogen, and treats accordingly. Hence the following text states:
After the Frost Descent solar term in September, it should gradually become cold. In deep Winter, it is very cold. After the Rain Water solar term in January, it should thaw. It is called Rain Water because ice and snow melt into rain water. After the Awakening of Insects solar term in February, the air gradually becomes warm. Approaching Summer, it becomes very hot. By Autumn, it cools down.
Winter Cold, Spring Warmth, Summer Heat, and Autumn Coolness are the Correct Qi of the four seasons.
From Frost Descent until before Spring Equinox, anyone who touches frost and dew, feels Cold in the body, and immediately falls ill, is called having Shang Han.
In September and October, Cold Qi is still slight; illness is mild. In November and December, Cold is severe; illness is heavy. In January and February, Cold gradually resolves; illness is also mild. This is due to irregularity in Winter, encountering Shang Han, thus falling ill. This is the Correct Qi of the four seasons, where illness occurs immediately upon injury.
If there is unseasonable warmth in Winter, it is named Dong Wen (Winter Warmth). The toxicity of Dong Wen is greatly different from Shang Han. Dong Wen has sequence and overlap, with varying severity and different treatments, as detailed in subsequent chapters.
This is the Qi of the Time, referring to what was previously stated: "Winter should be cold but becomes severely warm."
After the Beginning of Spring solar term, if there is no sudden severe cold, nor ice and snow, yet someone suffers from high fever, this belongs to Spring Yang Qi emerging from Winter, where latent Cold transforms into Wen Bing.
This is Wen Bing. The *Nei Jing* states: Injury by Cold in Winter leads to Wen disease in Spring.
From after Spring Equinox until before Autumn Equinox, if there is sudden cold in the sky, it is all Time Cold Yi (Epidemic). In March and April, there may be sudden cold; at this time, Yang Qi is still weak, bent by Cold, so the heat of illness is light. In May and June, Yang Qi is abundant, bent by Cold, so the heat of illness is heavy. In July and August, Yang Qi is declining, bent by Cold, so the heat of illness is slight. The illness is similar to Wen and Shu diseases, but treatment differs.
This is Yi Qi (Epidemic Qi). These points clarify the method of the previous Dipper Calendar, estimating the climate according to the time, showing that the onset of illness varies in cold/heat and severity.
Wang Yutai said: This distinguishes that Time Qi and Shang Han are similar but have different treatments. The key is to distinguish the pathogen source, differentiating Cold, Heat, and Warmth, so that the temperature and flavor of medicines are clearly determined.
Wang Lü said: Immediate illness is called Shang Han; delayed illness is called Wen/Shu. Their origin is not different, so they are all called Shang Han. Their categories are distinct, so treatment must not be mixed. Modern people using Shang Han methods to treat Wen/Shu are merely borrowing; it is not the original intent of Zhang Zhongjing's legislation. Perhaps using Acrid-Cool dispersing methods would be appropriate. If one is not cautious and uses them lightly, one cannot avoid changes such as mania, jaundice, and epistaxis.
Wang Yutai said: Shang Han occurs during cold weather, with Cold Pathogen in the Exterior, closing the Cou Li (pores/skin texture). Therefore, only Acrid-Sweet-Warm agents are sufficient to disperse it. This is why Zhang Zhongjing's Guizhi Tang and Mahuang Tang must use these. Wen Bing and Re Bing occur later during warm/hot weather. Oppressive Heat reaches from the Interior to the Exterior, stagnating the Cou Li, with no Cold in the Exterior. Therefore, only Acrid-Cool, or Bitter-Cold, or Sour-Bitter agents are sufficient to resolve it.
Every fifteen days yields one Qi in the four seasons. Each season has six Qis. Four times six are named Twenty-Four Qis.
There are twelve Solar Terms (Jie Qi) and twelve Middle Qis (Zhong Qi), totaling twenty-four. The *Nei Jing* states: Five days constitute one Hou (Observation). Three Hous constitute one Qi. Six Qis constitute one Season (Shi). Four Seasons constitute a Year.
However, climate may have cases where it should arrive but does not, or arrives before it should, or arrives excessively. All these become pathogenic Qi.
Suspected omission: Or arrives and does not depart. According to the *Jin Gui Yao Lue*: There is "arriving before it should," "arriving but not arriving [as expected]," "arriving but not departing," and "arriving excessively." Why? The Master said: After Winter Solstice, at midnight of the Jia Zi day, Shao Yang rises. During Shao Yang time, Yang begins to generate, and the sky becomes mild. If the sky is mild before obtaining Jia Zi, this is "arriving before it should." If the sky is not mild after obtaining Jia Zi, this is "arriving but not arriving." If the sky is severely cold after obtaining Jia Zi and does not resolve, this is "arriving but not departing." If the sky is warm like mid-Summer (May/June) after obtaining Jia Zi, this is "arriving excessively." The *Nei Jing* states: Arriving and harmonious is peace; arriving and excessive is disease; arriving and contrary is disease; arriving but not arriving is disease; arriving before it should is disease. From this observation, the omissions are clear.
It is simply that Heaven and Earth move and rest, and Yin and Yang drum and strike, each correcting one Qi.
The *Nei Jing* states: Yin and Yang are the Way of Heaven and Earth. Clear Yang is Heaven, moving without ceasing. Turbid Yin is Earth, resting without shifting. The Yin and Yang Qi of Heaven and Earth drum and strike to generate. Spring, Summer, Autumn, Winter, Cold, Heat, Warmth, Coolness each correct one Qi.
Therefore, the warmth of that Spring becomes the heat of that Summer. The anger of that Autumn becomes the fury of that Winter.
Spring warmth to Summer heat is from generation to growth. Autumn anger to Winter fury is from肃杀 (solemn/destruction) to killing.
Thus, after Winter Solstice, one Yang line rises, and one Yin line descends. After Summer Solstice, one Yang Qi goes down, and one Yin Qi goes up.
In the tenth month, all six lines are Yin; Kun Hexagram is in use. Yin reaches extremity, Yang comes. Yang generates at Zi (Winter Solstice). After Winter Solstice, one Yang line rises, one Yin line descends. In hexagrams, this is Fu (Return), meaning Yang Qi returns. In the fourth month, all six lines are Yang; Qian Hexagram is in use. Yang reaches extremity, Yin comes. Yin generates at Wu (Summer Solstice). After Summer Solstice, one Yang Qi goes down, one Yin Qi goes up. In hexagrams, this is Gou (Meeting), meaning Yin meets Yang. The *Nei Jing* states: Forty-five days after Winter Solstice, Yang Qi slightly ascends, Yin Qi slightly descends. Forty-five days after Summer Solstice, Yin Qi slightly ascends, Yang Qi slightly descends.
Thus, Winter and Summer Solstices are Yin and Yang combining. Spring and Autumn Equinoxes are Yin and Yang separating.
Yang generates at Zi, Yin generates at Wu; this is Yin and Yang connecting, hence called "combining." Yang retreats at You, Yin retreats at Mao; this is Yin and Yang turning away, hence called "separating." The *Nei Jing* states: Qi arriving is called "Zhi" (至). Qi dividing is called "Fen" (分). Zhi means Qi is same; Fen means Qi is different.
Yin and Yang exchange, and humans change into disease.
Since the Yin and Yang Qi of Heaven and Earth are interlaced and incorrect, humans therefore change into disease. The *Nei Jing* states: When Yin and Yang cross, changes arise.
This is why gentlemen nourish Yang in Spring and Summer, and nourish Yin in Autumn and Winter, following the hardness and softness of Heaven and Earth.
The *Nei Jing* states: Those who preserve life must follow the times. Nourish Yang in Spring and Summer with coolness and coldness; nourish Yin in Autumn and Winter with warmth and heat. The reason is to follow the root.
Petty people who touch and offend will surely suffer from violent rashes. One must know which meridian the toxic and fierce Qi remains in, and what disease it develops, examining carefully to treat.
Those who cannot follow the four seasons' regulation and touch cold/warmth will surely form violent diseases. Physicians must pay attention to examine carefully and treat.
Therefore, injury by Wind in Spring leads to Hun Dun Diarrhea (insufficiently digested food in stool) in Summer; injury by Summerheat in Summer leads to Malaria in Autumn; injury by Dampness in Autumn leads to Cough in Winter; injury by Cold in Winter leads to Wen Disease in Spring. This is the inevitable way; how can it not be examined clearly?
When Spring is in full swing, Wind Qi is prevalent. Spring injury by Wind: Wind Qi connects to the Liver. The Liver is prosperous in Spring. Although Wind enters, it does not immediately manifest. By Summer, the Liver declines, then it moves. Wind causing terminal diseases manifests in the four limbs. In Summer, Yang Qi is externally abundant; Wind cannot emit externally, so it attacks internally causing Hun Dun Diarrhea. Hun Dun Diarrhea is diarrhea with undigested grain and yellow color.
When Autumn is in full swing, Dampness Qi is prevalent. Autumn injury by Dampness: Dampness affects the Lung. The Lung is prosperous in Autumn. Although Dampness enters, it does not immediately manifest. By Winter, the Lung declines, then Dampness moves. Rain causing abdominal diseases manifests as lower diarrhea. In Winter, Yang Qi is internally solid; Dampness cannot descend, so it rebels upward causing cough.
When Summer is in full swing, Summerheat Qi is prevalent. Summer injury by Summerheat: Summer is primarily Yin internally. Although Summerheat enters, its momentum cannot move. When Autumn comes, Yin emerges and Yang is internally master, then Summerheat moves and transmits to Yin causing Chan Malaria (Hot Malaria). Chan is two-day interval; Malaria is one-day interval.
When Winter is in full swing, Cold Qi is prevalent. Winter injury by Cold: Winter is primarily Yang internally. Although Cold enters, its momentum cannot move. When Spring comes, Yang emerges and Yin is internally master, then Cold moves and transmits to Yang causing Wen Disease. This is contracting the Correct Qi of the four seasons to cause disease, an inevitable way.
Shang Han disease progresses daily in depth, applying prescriptions accordingly.
The *Nei Jing* states: If less than three days, it can be resolved by sweating. If three days or more, it can be resolved by purging.
Nowadays, people with Shang Han either do not treat early, or treat incorrectly, or delay many days until exhausted before telling the doctor. Doctors do not treat according to sequence, thus failing to hit the disease. One must temporarily adjust and formulate prescriptions, achieving efficacy without fail. Now, collecting Zhang Zhongjing's old theories, recording his symptoms, pulse diagnosis, voice/color, and true prescriptions for diseases with miraculous effects, intending to prepare for worldly emergencies.
Zhang Zhongjing's book, reaching a thousand years today, became prominent in the world due to Wang Shuhe's efforts.
Furthermore, land temperature/cold and elevation/lowliness differ. Material nature hardness/softness and diet/residence also differ. Thus, Huangdi raised questions of the four directions, and Qibo presented abilities of four treatments, to instruct later sages and open those not yet awakened. Practitioners facing illness must examine both.
Eastern land is warm; Southern land is hot; Western land is cool; Northern land is cold. Northwest is high; Southeast is low. This is difference in land temperature/cold and elevation/lowliness. Eastern people live peacefully eating fish; Western people live on hills eating fine foods; Southern people live in damp places craving sour; Northern people live in wild places eating milk. This is difference in diet/residence. Eastern treatment suits Bi Shi (Stone Needles); Western treatment suits Du Yao (Poisonous Drugs); Southern treatment suits Wei Zhen (Fine Needles); Northern treatment suits Jiu (Moxibustion). This is difference in four-direction treatments. Treating disease, physicians must examine land suitability.
Pang Anshi said: Within one province, mountain dwellers live in accumulated Yin places. Midsummer has ice and snow; their Qi is cold, Cou Li closed, hard to injure by pathogens, long-lived. If ill, mostly Feng Zhong (Wind Stroke) or Han Zhong (Cold Stroke). Plain/marsh dwellers live in accumulated Yang places. Severe winter grows grass; their Qi is warm, Cou Li loose, easy to injure by pathogens, short-lived. If ill, mostly Wen Zhong (Warm Stroke) or Shu Zhong (Summerheat Stroke).
All injuries by Cold result in Heat disease. Even if Heat is severe, death does not occur.
The *Nei Jing* states: Wind and Cold guests enter humans, making hair stand erect, skin close, generating heat. This is Shang Han causing Heat disease. The *Zhen Jing* (Needle Canon) states: Many Heat cases heal easily; many Cold cases heal with difficulty. Thus, even if Heat is severe, death does not occur.
If suffering from Liang Gan (Double Feeling) by Cold, death is certain.
Exterior and Interior both diseased is called Liang Gan.
Cun and Chi pulses both floating indicate Tai Yang receiving disease, manifesting on day 1 or 2. Its pulse connects to Feng Fu, causing headache, stiff neck, and strong waist/spine.
Tai Yang is the head of Three Yang; its Qi floats outward, so Cun and Chi are both floating. This is pathogen just entering skin, exterior in table. Manifests day 1 or 2. Feng Fu is an acupoint name, in the center of the neck. Tai Yang pulse enters brain from vertex, emerges separately down the neck, thus connecting to Feng Fu. Its channel runs inside shoulders/arms, flanks spine, reaches middle of waist, thus causing headache/stiff neck and strong waist/spine.
Cun and Chi pulses both long indicate Yang Ming receiving disease, manifesting on day 2 or 3. Its pulse flanks nose and connects to eyes, causing body heat, eye pain, dry nose, and inability to sleep.
Yang Ming has abundant Blood and Qi. Cun and Chi long indicate pathogen merging with Yang Ming, causing Blood and Qi to overflow. Tai Yang pathogen not resolving transmits to Yang Ming, manifesting day 2 or 3. Pulse flanking nose: Yang Ming pulse starts at nose, crosses bridge of nose, connects to eyes. Yang Ming pulse goes up forehead, returns to connect to eye system. Body heat: Yang Ming governs muscles of body. *Zhen Jing* states: Yang Ming Qi abundant, front of body all hot. Eye pain/dry nose: Pathogen in channel. Inability to sleep: Stomach Qi rebels, not following its path. *Nei Jing* states: Stomach disharmony leads to restless sleep.
Cun and Chi pulses both wiry (Xian) indicate Shao Yang receiving disease, manifesting on day 3 or 4. Its pulse follows hypochondrium and connects to ears, causing chest/hypochondriac pain and deafness.
*Nei Jing* states: Shao Yang among Yang connects to Spring Qi. Spring pulse is wiry. Cun and Chi wiry indicates Shao Yang receiving pathogen. Day 2-3, Yang Ming pathogen not resolving transmits to Shao Yang, manifesting day 3-4. Chest/hypochondriac pain/deafness: Channel obstruction and lack of flow.
These three channels all receive disease. Not yet entered Fu organs, can be resolved by sweating.
Three Yang receiving pathogen, disease is in Exterior, method should be sweating resolution. However, Three Yang can also enter Fu organs; entering Fu requires purging. Hence "not yet entered Fu organs, can be resolved by sweating."
Cun and Chi pulses both deep and fine indicate Tai Yin receiving disease, manifesting on day 4 or 5. Its pulse spreads in Stomach and connects to throat, causing abdominal fullness and dry throat.
Yang extremity then Yin receives. Pathogen transmitted through Three Yang fully, then transmits to Yin channels. In Yang is Exterior, in Yin is Interior. Pathogen in Exterior shows Yang pulses; pathogen in Interior shows Yin pulses. Yang pathogen transmitting to Yin, pathogen sinks inward, thus Tai Yin receives disease, and pulses Cun/Chi are deep and fine. Transmitting from Three Yang to Tai Yin, manifesting day 4 or 5. Pathogen entering Yin gradually becomes Heat. Abdominal fullness/dry throat: Spleen channel obstruction generating Heat.
Cun and Chi pulses both deep indicate Shao Yin receiving disease, manifesting on day 5 or 6. Its pulse pierces Kidney, connects to Lung, ties to root of tongue, causing dry mouth/tongue and thirst.
Shao Yin is Kidney Water. Nature tends downward. Shao Yin receiving disease, pulses Cun/Chi are deep. Day 4-5, Tai Yin pathogen not resolving, by day 5-6 transmits to Shao Yin. Shao Yin disease manifests day 5-6. Human injured by Cold becomes Heat disease, meaning starting as Cold ending as Heat. Shao Yin disease, dry mouth/tongue/thirst, pathogen transmitted to Interior, Heat Qi gradually deepens.
*Huo Ren Shu* (Book Reviving People) states: Scripture says "day 1-2 Shao Yin" means entering Shao Yin immediately upon illness, bypassing Three Yang. Generally, Shang Han originating in Yang is Tai Yang; originating in Yin is Shao Yin. Any illness from day 1 to 12-13 where Tai Yang syndrome does not cease, all treat Tai Yang. Some initially see Shao Yin syndrome, should attack Shao Yin, not necessarily starting from Ju Yang (Tai Yang). Cold entering Tai Yang immediately causes fever and aversion to cold; entering Shao Yin immediately causes aversion to cold without fever.
Cun and Chi pulses both faint and slow indicate Jue Yin receiving disease, manifesting on day 6 or 7. Its pulse follows genitalia and connects to Liver, causing irritability/fullness and retraction of scrotum.
Slow is Wind pulse. Jue Yin pulse faint/slow indicates pathogen transmitting to Jue Yin, Heat Qi already severe, approaching Wind. Manifests day 6-7, as Shao Yin pathogen transmits to Jue Yin. Irritability/fullness/scrotal retraction: Heat Qi gathering internally.
Wang Sanyang said: Jue Yin Wind pulse should indeed be slow, but slow pulse mostly indicates Stomach Qi harmony. Pulse with Stomach Qi is sign of recovery. Disease transmitting to Jue Yin is very critical; how could there be Stomach Qi? Must be slow with stringy/straight quality lacking Shen Qi (Spirit), only then is it bad omen of transmitting to Jue Yin. If only...