这个事看起来像是突发的偶然事件，但实际上却有一个必然的渐进积累的过程。可为什么没有在这样一个渐进的过程中及早发现呢？由“辩之不早辩也”。而这里讲的“辩”很显然就是一个“谏议”的过程。在坤卦里讨论“臣杀其君，子杀其父”，在坤卦里讨论“辩之不早辩”。这一联系起来，实在就是《素问·刺法论》里讲“脾为谏议之官，知周出焉”的最好证明。一个国家，或者一个家庭，要避免上述事件的发生，那就必须保证这个“谏议”的职责随时发挥作用。而作为我们身体呢？这个“臣杀其君，子杀其父”，当然就是指的那些暴病、坏病、恶病。像现在讲的癌症、恶性肿瘤，这个病被突然发现，似乎是在一夜之间发生的。其实不然。正如坤卦所云：“非一朝一夕之故。其所由来者渐矣。”但为什么在这样一个“由来者渐”的过程中，机体没能识别，没能发现，没能及时予以处理，而等其殃成大祸呢？这就是因为“谏议之官”失去了作用的缘故。恶性肿瘤是机体细胞异常分化所致，为什么会形成这样一个疾病呢？现代医学把它归结为免疫的问题。人体的免疫系统有三大功能，其一是免疫防御功能；其二是免疫稳定功能；其三呢？就是免疫监视功能。如果免疫监视的功能能够正常发挥，就能及时识别出机体异常分化的细胞，并通过各种途径，启动各项功能来清除和调整这些异常细胞，从而杜绝肿瘤疾病的发生。这样一个“免疫监视”作用其实与“谏议之官”的作用非常相似。《刺法论》为我们作出了脾的特殊定位，而坤卦为这个特殊定位的意义作了很具体的描述，再结合现代的免疫科学，我想在肿瘤预防和治疗上应该大有文章可做。目前，肿瘤的发病率越来越高，而这些病人在接受各种治疗后，需要解决的一个最迫切的问题就是复发问题。怎么杜绝肿瘤的复发呢？在西医要求诸免疫，在免疫上下功夫。那么中医呢？我想作为“谏议之官”的脾就应该是一个重要的突破口。我们在新世纪里学习经典，在新世纪里研究《伤寒论》，会不会有一些新的收获呢？通过太阴篇的讨论，大家应该有所感受。前面谈到经典一个最显著的特点就是历久弥新，就是说经典的东西永远不会过时。你再新的研究，再尖端的课题，都可以在经典里找到落身处。就看你有没有悟性，就看你敢不敢承当。不敢承当，当然就失之交臂了。所以，传统与现代，诸位不要看绝对了。两者往往是相依而行。传统不离现代，现在是 21世纪，传统必须要适应现代、服务现代，乃至于最大限度地影响现代、引导现代。这一点搞传统的必须牢牢记住，这也是传统存在的根本意义所在。如果不弄清这个所在，还是抱着长袍马褂、之乎者也不放，那这个传统还有什么意义。同样，现代又何尝离开过传统，只因我们先入为主，把传统看得太低了，所以，不自明，不自知，得了便宜还卖乖。这亦是孔圣所云：“百姓日用而不知，故君子之道鲜矣。”三、太阴病时相讨论太阴病时相仍以太阴病的欲解时条文为依据，即275条：“太阴病，欲解时，从亥至丑上。”下面拟分几个方面来展开。1.亥至丑上亥子丑在日周期里，是亥子丑这三个时辰，也就是晚上9时至凌晨 3时这段时间。月周期里，每个时辰约占 2天半的时间。所以，亥子丑就位于晦日前后的 7 天半里。晦日前后的这段时间，是每个月周期里月相最缺甚或隐匿的时候。月相缺或隐反映了阳的收藏，这与太阴的性用相符。年周期里，亥子丑即亥月、子月、丑月，亦即农历的十月、十一月、十二月。上述三个月分别与十二消息卦里的坤、复、临相配。坤卦六爻皆阴，很多人看到这个卦都以为阴盛阳衰了，阳气没有了、消灭了。其实这是错会了坤卦。六爻皆阴不是阳气没有了，而是收藏起来了。正是这个藏才使阳气得到蓄养，得到恢复，才有后面的一阳生，二阳生。亥子丑除了上述的时间特性外，还有空间方位特性，这就是北方。前面我们谈到先后天的问题，先天卦里，北方居坤。先天为体，后天为用。所以，坤之体在北，坤之用在西南。坤体居北与坎同居，我们前面用水土合德来形容。而亥子丑为太阴病的欲解时却又为太阳病的欲剧时，这亦是值得思考的问题。2.欲解时要义我们现在看到的《伤寒论讲义》是经过节选的本子。而由王叔和所整理的《伤寒论》，在起手的太阳篇前，还有另外的四篇，即“辨脉法第一”、“平脉法第二”、“伤寒例第三”、“辨痉湿暍第四”。在“辨脉法第一”篇中有这样一段话：“五月之时，阳气在表，胃中虚冷，以阳气内微，不能胜冷，故欲著复衣；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。”这一段文字一半讲生理，一半讲病变。虽然它讲的是另外一个问题，但是对于我们理解太阴病欲解时却有很大的帮助。五月也就是夏至月，也就是午月，可是它能够涵括整个夏月，涵括巳午未。五月有什么特征呢？张仲景在这里讲道“阳气在表，胃中虚冷”，这个时候为什么阳气在表呢？因为整个春夏阳气都在蒸蒸日上，向上、向外，由于阳气是这样一个向表、向外的趋势，所以，在里的阳反而虚少，阳气虚少了当然就会冷，故曰“阳气在表，胃中虚冷”。而到了冬天，到了十一月，到了亥子丑的时候，情况正好相反。这个时候，阳气向里、向内，处于收藏的趋势。所以，这时在外的阳渐虚少，在里的阳渐多，阳多则热，故曰“阳气在里，胃中烦热”。民间流传这样一句话：“冬吃萝卜夏吃姜，不找医生开药方。”为什么呢？学中医的应该明白这个道理。萝卜是凉性的，姜是温性的。夏日天气炎热，为何反要吃姜？因为这个时候阳气在表，胃中虚冷，所以，要吃姜来温里暖胃。冬日寒冷，为何反要吃萝卜？因为冬日阳气在里，胃中烦热，所以，就用萝卜的凉性来平衡，以免积热的产生。冬月阳气趋里，所以，内里反热，如果你是太阴病，那么，正好可以借这个亥子丑的阳气入里，使藏寒得到温暖，使太阴病的里虚寒证得到转机。所以，太阴病要欲解于亥子丑。透过亥子丑，太阴病的内在涵义我们清楚了，太阴病的治疗规矩也就自然在把握之中。张仲景对六经病的描述是通过两方面：一方面是通过提纲条文，这方面往往有形可征，有案可查，也是大家注重的一方面；另一方面就是欲解时条文，从欲解时条文来揭示六经病，好似无形可征，无案可查，是以从古至今关注它的医家很少。其实，它是无形而无不形，无案而无不案。它的蕴义更深广、更透彻。经言：夫知道者，上知天文，下知地理，中知人事，乃可以长久。从上述两方面看，提纲条文是讲人事的条文，而欲解时条文则是讲天文、地理的。如果仅言提纲，显然已流于人事中医，那中医的这个道能够长久吗？3.欲剧时相欲剧时或者欲作时的概念我们前面已经提到过，它是与欲解时相对的。既然太阴病在这样一个时候容易好，在这样一个时候比较舒服，那就必然会有另一个不容易好，或者说比较恼火的时候。否则，光有好的时候，没有恼火的时候，那这个天地之道也就失却公允了。太阴病欲解时是亥子丑，因为这时的阳气在里，这对于太阴病的里虚寒而言，无疑是得道，得道多助，故曰欲解。那么，太阴病在什么时候欲剧呢？应该就是巳午未。巳午未的阳气在表，阳在表则里易虚冷，这对于太阴病而言，无疑是失道，失道寡助，故曰欲剧。巳午未阳气趋表，里易虚冷，故易生藏寒，易生太阴病。这是从理上去分析。现在我们回到事上来，夏天的天气很热，阳气蒸腾向外，这个时候由于天热，人们纷纷吃生饮冷，什么东西都来冰的。本来就胃中虚冷，偏偏还要大进生冷，这不就雪上加霜了。所以，这是最容易得太阴病的时候。大家不要以为冬天才容易得太阴病，其实恰恰相反，夏天才是最容易得太阴病的时候。因此，夏天用理中汤的机会很多。只是现在有太多的人不明这个事理，不但患者不明，医者亦不明。光知道夏有暑热，却不知夏亦有寒凉。夏日是天热而地寒，天地的区别大家要搞清楚。特别是我们学太阴篇更应弄清这层关系。太阴分手足太阴，手太阴肺就是言天，足太阴脾则是言地。所以，夏日这个天热地寒的格局其实也就是肺热脾寒的格局。如果我们只知道热，只知道叶天士的“温邪上受，首先犯肺”，只知道用寒凉，这还不够，充其量我们只是知道了天的一面。夏日用寒凉，很有名的是刘河间《宣明论方》的益元散，也叫六一散，太白散。什么叫太白呢？看《西游记》就知道有一个太白金星，所以，太白实际上是指金、指肺。因此，太白散实际上是针对夏日里天的这一面，肺的这一面。还有地的这一面呢？也就是太阴脾的这一面呢？如果这一面照顾不好，那就很容易影响太阴，太阴的门一开，三阴的门也就随之打开了。因此，大家应该很好地把握天地的格局，除了知道益元散、太白散之外，还应该知道理中汤也很好用。从时间上看，巳午未三时是太阴病的欲剧时，而前面我们反复强调过时空（方）的同一性、统一性。因此，我们研究欲解或者欲剧时都应该结合空间方位。从空间方位看，巳午未就是南方，所以，南方也就应该成为太阴病的欲剧方。这说明南方人得太阴病的机会就要多一些。进一步而言，南方人的脾胃就要比北方人的相对为弱。大家思考一下，是不是这么回事呢？我们拿南人与北人一比，你就清楚了。北人的个头普遍较南人大，四肢较南人粗壮，为什么呢？就因为北人土气强，南人土气弱。土气弱，四肢肌肉不发达，当然就个头小了。所以，大家对这样一个南北的差异要弄清楚，要知道南方人有一个比北方人容易患太阴病的基础。作为南方人，作为南方的医生，就更应该意识到温养的重要，保护脾胃的重要。不要一天到晚只知道凉茶、凉茶。上面的讨论实际上是通过《辨脉法》的一段文字展开的，在《辨脉法》中还有另一段十分精彩的对话：“问曰：凡病欲知何时得？何时愈？答曰：假令夜半得病，明日日中愈；日中得病，夜半愈。何以言之？日中得病，夜半愈者，以阳得阴则解也。夜半得病，明日日中愈者，以阴得阳则解也。”夜半是什么时候？是子时，推广开来就是亥子丑。日中呢？日中是午时，推广开来就是巳午未。日中得病而夜半愈，这正好符合于太阴病欲解于亥子丑，欲剧（作）于巳午未的格局。将这样一个格局延伸开来，六经病的得时与愈时就能很容易地确定出来。由此亦见，《辨脉法》等篇的内容与六经各篇关系密切，轻忽不得。现在研究《伤寒论》的往往不重视这几篇，有的甚至根本不知道有这几篇，这样来看《伤寒论》也就很难看得透彻。巳午未是太阴病的欲剧时或得时，这个巳午未可能是一天的巳午未三时，可能是一月的望月前后，也可能是一年的农历四五六月。但，这都是相对固定的时。在这些时里，阳气蒸腾向外、向上，所以，在里的阳气相对虚少，容易胃中虚冷。根据巳午未时空里阳气的这样一种趋势，我们就应该联想到在这个相对固定的巳午未外，还有一个不固定的、灵活的“巳午未”。也就是凡是机体处在阳气蒸腾在外，胃中虚冷的这样一个状态，都应该为巳午未，都应该视为太阴病的欲剧时或得时。比如我们剧烈运动了，烦劳了，这个时候的阳气就在外，胃中就容易虚冷，就是容易患太阴病的时候。因此，这个时候我们要特别小心，不要马上打开冰箱喝冷饮。实在想喝，就喝一些温水热饮，这样反而解渴。非要喝冰，只有等静下来，阳气慢慢转头向内的时候，才可以喝一点。这是太阴病的欲剧时。4.太阴治方要义太阴的治方可以用太阴篇 277 条的一句话来概括，就是“当温之，宜服四逆辈”。温者，温什么呢？就是温藏，就是温里。这样一个治方显然就与太阴病的欲解时相亥子丑的意义相符。（1）四逆义太阴病属里虚寒，用理中汤本来是大家非常熟悉的，可是在太阴篇里，张仲景给出的是四逆辈。这说明四逆汤这一类的方子与太阴有着密切的关系。太阴的主方为什么叫“四逆”？四逆与太阴有什么关系？首先我们看四，四的涵义是什么呢？四主要指的是四肢。而四肢禀气于胃，脾又主四肢，所以，四与脾胃的关系是最密切的。接下来我们看逆，逆的一个比较公认的说法是逆冷，合四就是四肢的逆冷。什么叫作逆冷呢？逆它有另外一层涵义，这个涵义正好与顺相对。顺是指由上而下，由近而远，由中央而四傍。逆则刚好反过来，就是由下而上，由远而近。所以，逆冷就是指这个冷是从四肢的远端开始，从肢末开始，逐渐向上发展，甚至延肘过膝。而为什么会产生逆冷呢？当然是火没有了，阳气虚衰了。《伤寒论》将疾病分阴阳两类，阳类即太阳、阳明、少阳，阴类即太阴、少阴、厥阴。病至于阴，阳气开始不足了，这个不足主要是内里的阳气不足，内里的阳不足，这就导致里虚寒。所以，三阴病一个基本的共同特征就是里虚寒。而三阴病的这个里虚寒是由太阴开始的。太阴虚寒了，阳气不足了，它首先表现在哪里呢？就表现在它所主的、所禀气的这个四肢。出现四肢不温，出现四逆。
这件事看起来像是突发的偶然事件，但实际上却有一个必然的渐进积累的过程。可为什么没有在这样一个渐进的过程中及早发现呢？这就是因为“辩之不早辩也”（未能尽早辨别/谏议）。而这里讲的“辩”很显然就是一个“谏议”（臣子向君主进言规劝）的过程。在坤卦里讨论“臣杀其君，子杀其父”，在坤卦里讨论“辩之不早辩”。这一联系起来，实在就是《素问·刺法论》里讲“脾为谏议之官，知周出焉”（脾脏作为谏议之官，智慧周全由此产生）的最好证明。一个国家，或者一个家庭，要避免上述事件的发生，那就必须保证这个“谏议”的职责随时发挥作用。而作为我们身体呢？这个“臣杀其君，子杀其父”，当然就是指的那些暴病、坏病、恶病（指病情急剧恶化或难以治愈的重症）。像现在讲的癌症、恶性肿瘤，这个病被突然发现，似乎是在一夜之间发生的。其实不然。正如坤卦所云：“非一朝一夕之故。其所由来者渐矣。”（这不是一个早晨或一个晚上造成的，它的形成是逐渐积累的。）但为什么在这样一个“由来者渐”的过程中，机体没能识别，没能发现，没能及时予以处理，而等其殃成大祸呢？这就是因为“谏议之官”失去了作用的缘故。恶性肿瘤是机体细胞异常分化所致，为什么会形成这样一个疾病呢？现代医学把它归结为免疫的问题。人体的免疫系统有三大功能，其一是免疫防御功能；其二是免疫稳定功能；其三呢？就是免疫监视功能。如果免疫监视的功能能够正常发挥，就能及时识别出机体异常分化的细胞，并通过各种途径，启动各项功能来清除和调整这些异常细胞，从而杜绝肿瘤疾病的发生。这样一个“免疫监视”作用其实与“谏议之官”的作用非常相似。《刺法论》为我们作出了脾的特殊定位，而坤卦为这个特殊定位的意义作了很具体的描述，再结合现代的免疫科学，我想在肿瘤预防和治疗上应该大有文章可做。目前，肿瘤的发病率越来越高，而这些病人在接受各种治疗后，需要解决的一个最迫切的问题就是复发问题。怎么杜绝肿瘤的复发呢？在西医要求诸免疫，在免疫上下功夫。那么中医呢？我想作为“谏议之官”的脾就应该是一个重要的突破口。我们在新世纪里学习经典，在新世纪里研究《伤寒论》，会不会有一些新的收获呢？通过太阴篇的讨论，大家应该有所感受。前面谈到经典一个最显著的特点就是历久弥新，就是说经典的东西永远不会过时。你再新的研究，再尖端的课题，都可以在经典里找到落身处。就看你有没有悟性，就看你敢不敢承当。不敢承当，当然就失之交臂了。所以，传统与现代，诸位不要看绝对了。两者往往是相依而行。传统不离现代，现在是 21世纪，传统必须要适应现代、服务现代，乃至于最大限度地影响现代、引导现代。这一点搞传统的必须牢牢记住，这也是传统存在的根本意义所在。如果不弄清这个所在，还是抱着长袍马褂、之乎者也也不放，那这个传统还有什么意义。同样，现代又何尝离开过传统，只因我们先入为主，把传统看得太低了，所以，不自明，不自知，得了便宜还卖乖。这亦是孔圣所云：“百姓日用而不知，故君子之道鲜矣。”
三、太阴病时相讨论
太阴病时相仍以太阴病的欲解时条文为依据，即275条：“太阴病，欲解时，从亥至丑上。”下面拟分几个方面来展开。
1.亥至丑上
亥子丑在日周期里，是亥子丑这三个时辰，也就是晚上9时至凌晨 3时这段时间。月周期里，每个时辰约占 2天半的时间。所以，亥子丑就位于晦日前后的 7 天半里。晦日前后的这段时间，是每个月周期里月相最缺甚或隐匿的时候。月相缺或隐反映了阳的收藏，这与太阴的性用相符。年周期里，亥子丑即亥月、子月、丑月，亦即农历的十月、十一月、十二月。上述三个月分别与十二消息卦里的坤、复、临相配。坤卦六爻皆阴，很多人看到这个卦都以为阴盛阳衰了，阳气没有了、消灭了。其实这是错会了坤卦。六爻皆阴不是阳气没有了，而是收藏起来了。正是这个藏才使阳气得到蓄养，得到恢复，才有后面的一阳生，二阳生。亥子丑除了上述的时间特性外，还有空间方位特性，这就是北方。前面我们谈到先后天的问题，先天卦里，北方居坤。先天为体，后天为用。所以，坤之体在北，坤之用在西南。坤体居北与坎同居，我们前面用水土合德来形容。而亥子丑为太阴病的欲解时却又为太阳病的欲剧时，这亦是值得思考的问题。
2.欲解时要义
我们现在看到的《伤寒论讲义》是经过节选的本子。而由王叔和所整理的《伤寒论》，在起手的太阳篇前，还有另外的四篇，即“辨脉法第一”、“平脉法第二”、“伤寒例第三”、“辨痉湿暍第四”。在“辨脉法第一”篇中有这样一段话：“五月之时，阳气在表，胃中虚冷，以阳气内微，不能胜冷，故欲著复衣；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。”这一段文字一半讲生理，一半讲病变。虽然它讲的是另外一个问题，但是对于我们理解太阴病欲解时却有很大的帮助。五月也就是夏至月，也就是午月，可是它能够涵括整个夏月，涵括巳午未。五月有什么特征呢？张仲景在这里讲道“阳气在表，胃中虚冷”，这个时候为什么阳气在表呢？因为整个春夏阳气都在蒸蒸日上，向上、向外，由于阳气是这样一个向表、向外的趋势，所以，在里的阳反而虚少，阳气虚少了当然就会冷，故曰“阳气在表，胃中虚冷”。而到了冬天，到了十一月，到了亥子丑的时候，情况正好相反。这个时候，阳气向里、向内，处于收藏的趋势。所以，这时在外的阳渐虚少，在里的阳渐多，阳多则热，故曰“阳气在里，胃中烦热”。民间流传这样一句话：“冬吃萝卜夏吃姜，不找医生开药方。”为什么呢？学中医的应该明白这个道理。萝卜是凉性的，姜是温性的。夏日天气炎热，为何反要吃姜？因为这个时候阳气在表，胃中虚冷，所以，要吃姜来温里暖胃。冬日寒冷，为何反要吃萝卜？因为冬日阳气在里，胃中烦热，所以，就用萝卜的凉性来平衡，以免积热的产生。冬月阳气趋里，所以，内里反热，如果你是太阴病，那么，正好可以借这个亥子丑的阳气入里，使藏寒得到温暖，使太阴病的里虚寒证得到转机。所以，太阴病要欲解于亥子丑。透过亥子丑，太阴病的内在涵义我们清楚了，太阴病的治疗规矩也就自然在把握之中。张仲景对六经病的描述是通过两方面：一方面是通过提纲条文，这方面往往有形可征，有案可查，也是大家注重的一方面；另一方面就是欲解时条文，从欲解时条文来揭示六经病，好似无形可征，无案可查，是以从古至今关注它的医家很少。其实，它是无形而无不形，无案而无不案。它的蕴义更深广、更透彻。经言：夫知道者，上知天文，下知地理，中知人事，乃可以长久。从上述两方面看，提纲条文是讲人事的条文，而欲解时条文则是讲天文、地理的。如果仅言提纲，显然已流于人事中医，那中医的这个道能够长久吗？
3.欲剧时相
欲剧时或者欲作时的概念我们前面已经提到过，它是与欲解时相对的。既然太阴病在这样一个时候容易好，在这样一个时候比较舒服，那就必然会有另一个不容易好，或者说比较恼火的时候。否则，光有好的时候，没有恼火的时候，那这个天地之道也就失却公允了。太阴病欲解时是亥子丑，因为这时的阳气在里，这对于太阴病的里虚寒而言，无疑是得道，得道多助，故曰欲解。那么，太阴病在什么时候欲剧呢？应该就是巳午未。巳午未的阳气在表，阳在表则里易虚冷，这对于太阴病而言，无疑是失道，失道寡助，故曰欲剧。巳午未阳气趋表，里易虚冷，故易生藏寒，易生太阴病。这是从理上去分析。现在我们回到事上来，夏天的天气很热，阳气蒸腾向外，这个时候由于天热，人们纷纷吃生饮冷，什么东西都来冰的。本来就胃中虚冷，偏偏还要大进生冷，这不就雪上加霜了。所以，这是最容易得太阴病的时候。大家不要以为冬天才容易得太阴病，其实恰恰相反，夏天才是最容易得太阴病的时候。因此，夏天用理中汤的机会很多。只是现在有太多的人不明这个事理，不但患者不明，医者亦不明。光知道夏有暑热，却不知夏亦有寒凉。夏日是天热而地寒，天地的区别大家要搞清楚。特别是我们学太阴篇更应弄清这层关系。太阴分手足太阴，手太阴肺就是言天，足太阴脾则是言地。所以，夏日这个天热地寒的格局其实也就是肺热脾寒的格局。如果我们只知道热，只知道叶天士的“温邪上受，首先犯肺”，只知道用寒凉，这还不够，充其量我们只是知道了天的一面。夏日用寒凉，很有名的是刘河间《宣明论方》的益元散，也叫六一散，太白散。什么叫太白呢？看《西游记》就知道有一个太白金星，所以，太白实际上是指金、指肺。因此，太白散实际上是针对夏日里天的这一面，肺的这一面。还有地的这一面呢？也就是太阴脾的这一面呢？如果这一面照顾不好，那就很容易影响太阴，太阴的门一开，三阴的门也就随之打开了。因此，大家应该很好地把握天地的格局，除了知道益元散、太白散之外，还应该知道理中汤也很好用。从时间上看，巳午未三时是太阴病的欲剧时，而前面我们反复强调过时空（方）的同一性、统一性。因此，我们研究欲解或者欲剧时都应该结合空间方位。从空间方位看，巳午未就是南方，所以，南方也就应该成为太阴病的欲剧方。这说明南方人得太阴病的机会就要多一些。进一步而言，南方人的脾胃就要比北方人的相对为弱。大家思考一下，是不是这么回事呢？我们拿南人与北人一比，你就清楚了。北人的个头普遍较南人大，四肢较南人粗壮，为什么呢？就因为北人土气强，南人土气弱。土气弱，四肢肌肉不发达，当然就个头小了。所以，大家对这样一个南北的差异要弄清楚，要知道南方人有一个比北方人容易患太阴病的基础。作为南方人，作为南方的医生，就更应该意识到温养的重要，保护脾胃的重要。不要一天到晚只知道凉茶、凉茶。上面的讨论实际上是通过《辨脉法》的一段文字展开的，在《辨脉法》中还有另一段十分精彩的对话：“问曰：凡病欲知何时得？何时愈？答曰：假令夜半得病，明日日中愈；日中得病，夜半愈。何以言之？日中得病，夜半愈者，以阳得阴则解也。夜半得病，明日日中愈者，以阴得阳则解也。”夜半是什么时候？是子时，推广开来就是亥子丑。日中呢？日中是午时，推广开来就是巳午未。日中得病而夜半愈，这正好符合于太阴病欲解于亥子丑，欲剧（作）于巳午未的格局。将这样一个格局延伸开来，六经病的得时与愈时就能很容易地确定出来。由此亦见，《辨脉法》等篇的内容与六经各篇关系密切，轻忽不得。现在研究《伤寒论》的往往不重视这几篇，有的甚至根本不知道有这几篇，这样来看《伤寒论》也就很难看得透彻。巳午未是太阴病的欲剧时或得时，这个巳午未可能是一天的巳午未三时，可能是一月的望月前后，也可能是一年的农历四五六月。但，这都是相对固定的时。在这些时里，阳气蒸腾向外、向上，所以，在里的阳气相对虚少，容易胃中虚冷。根据巳午未时空里阳气的这样一种趋势，我们就应该联想到在这个相对固定的巳午未外，还有一个不固定的、灵活的“巳午未”。也就是凡是机体处在阳气蒸腾在外，胃中虚冷的这样一个状态，都应该为巳午未，都应该视为太阴病的欲剧时或得时。比如我们剧烈运动了，烦劳了，这个时候的阳气就在外，胃中就容易虚冷，就是容易患太阴病的时候。因此，这个时候我们要特别小心，不要马上打开冰箱喝冷饮。实在想喝，就喝一些温水热饮，这样反而解渴。非要喝冰，只有等静下来，阳气慢慢转头向内的时候，才可以喝一点。这是太阴病的欲剧时。
4.太阴治方要义
太阴的治方可以用太阴篇 277 条的一句话来概括，就是“当温之，宜服四逆辈”。温者，温什么呢？就是温藏，就是温里。这样一个治方显然就与太阴病的欲解时相亥子丑的意义相符。
（1）四逆义
太阴病属里虚寒，用理中汤本来是大家非常熟悉的，可是在太阴篇里，张仲景给出的是四逆辈。这说明四逆汤这一类的方子与太阴有着密切的关系。太阴的主方为什么叫“四逆”？四逆与太阴有什么关系？首先我们看四，四的涵义是什么呢？四主要指的是四肢。而四肢禀气于胃，脾又主四肢，所以，四与脾胃的关系是最密切的。接下来我们看逆，逆的一个比较公认的说法是逆冷，合四就是四肢的逆冷。什么叫作逆冷呢？逆它有另外一层涵义，这个涵义正好与顺相对。顺是指由上而下，由近而远，由中央而四傍。逆则刚好反过来，就是由下而上，由远而近。所以，逆冷就是指这个冷是从四肢的远端开始，从肢末开始，逐渐向上发展，甚至延肘过膝。而为什么会产生逆冷呢？当然是火没有了，阳气虚衰了。《伤寒论》将疾病分阴阳两类，阳类即太阳、阳明、少阳，阴类即太阴、少阴、厥阴。病至于阴，阳气开始不足了，这个不足主要是内里的阳气不足，内里的阳不足，这就导致里虚寒。所以，三阴病一个基本的共同特征就是里虚寒。而三阴病的这个里虚寒是由太阴开始的。太阴虚寒了，阳气不足了，它首先表现在哪里呢？就表现在它所主的、所禀气的这个四肢。出现四肢不温，出现四逆。
This matter appears to be a sudden, accidental event, but in reality, it involves an inevitable process of gradual accumulation. Why was it not detected early during such a gradual process? This is due to "failure to discern/admonish early" (Bian zhi bu zao bian ye). The "discernment/admonition" (Bian) mentioned here clearly refers to the process of "admonishing" (Jianyi), where ministers advise rulers. In the Kun Hexagram (Earth), discussions occur regarding "ministers killing their ruler, sons killing their father," and also regarding "failure to admonish early." Linking these together serves as the best proof for the statement in *Suwen: Cifa Lun* (Treatise on Needing Methods): "The Spleen is the official of admonition; wisdom and comprehensiveness arise from it." To avoid the occurrence of the aforementioned events in a country or a family, one must ensure that this duty of "admonition" functions at all times. What about our body? The phrase "ministers killing their ruler, sons killing their father" naturally refers to acute illnesses, deteriorating conditions, and malignant diseases. Take cancer and malignant tumors discussed today: when discovered suddenly, they seem to have occurred overnight. However, this is not the case. As stated in the Kun Hexagram: "It is not the cause of a single morning or evening; its origin has been gradual." But why, during this gradual process of origin, did the organism fail to recognize, detect, and timely address the issue, waiting until disaster struck? This is because the "official of admonition" lost its function. Malignant tumors result from abnormal differentiation of bodily cells. Why does such a disease form? Modern medicine attributes it to immune issues. The human immune system has three major functions: first, immune defense; second, immune homeostasis; third, immune surveillance. If the function of immune surveillance operates normally, it can timely identify abnormally differentiated cells in the body and activate various pathways to clear and regulate these abnormal cells, thereby preventing the occurrence of tumor diseases. This role of "immune surveillance" is very similar to the function of the "official of admonition." *Cifa Lun* provides a special positioning for the Spleen, while the Kun Hexagram offers a concrete description of the significance of this special positioning. Combined with modern immunological science, I believe there is much room for exploration in the prevention and treatment of tumors. Currently, the incidence rate of tumors is increasing, and for patients undergoing various treatments, the most urgent problem to solve is recurrence. How to prevent tumor recurrence? Western medicine relies on immunity and works hard on it. What about Traditional Chinese Medicine (TCM)? I think the Spleen, as the "official of admonition," should be an important breakthrough point. Will we gain new insights by studying classics and researching the *Shanghan Lun* (Treatise on Cold Damage) in the new century? Through the discussion of the Taiyin Chapter, everyone should have some feelings. Previously, it was mentioned that the most significant characteristic of classics is that they remain relevant over time, meaning classic knowledge never becomes outdated. No matter how new your research or how cutting-edge the topic, you can always find a place for it within the classics. It depends on whether you have insight and dare to take responsibility. If you dare not take responsibility, you will inevitably miss the opportunity. Therefore, do not view tradition and modernity as absolute opposites. They often accompany each other. Tradition does not separate from modernity. We are now in the 21st century; tradition must adapt to and serve modernity, and even influence and guide modernity to the greatest extent. Those engaged in tradition must firmly remember this, as it is the fundamental meaning of tradition's existence. If this is not understood, and one still clings to traditional robes and archaic language, what meaning does this tradition hold? Similarly, how has modernity ever separated from tradition? It is only because we have preconceived notions, viewing tradition too lowly, that we are unaware of ourselves, enjoying benefits yet acting ungrateful. This is also what Confucius said: "The common people use it daily without knowing it, thus the way of the gentleman is rare."
III. Discussion on the Time Phase of Taiyin Disease
The time phase of Taiyin disease is still based on the clause regarding the time when Taiyin disease tends to resolve, specifically Clause 275: "Taiyin disease tends to resolve from Hai to Chou hours." Below, we will expand on this from several aspects.
1. Hai, Zi, and Chou Hours
In the daily cycle, Hai, Zi, and Chou refer to these three two-hour periods, i.e., from 9 PM to 3 AM. In the lunar monthly cycle, each hour accounts for approximately 2.5 days. Thus, Hai, Zi, and Chou are located within the 7.5 days surrounding the dark moon (the last day of the lunar month). This period around the dark moon is when the moon phase is most deficient or even hidden in each monthly cycle. The deficiency or hiding of the moon phase reflects the storage of Yang Qi, which aligns with the nature and function of Taiyin. In the annual cycle, Hai, Zi, and Chou correspond to the Hai Month, Zi Month, and Chou Month, i.e., the tenth, eleventh, and twelfth months of the lunar calendar. These three months correspond respectively to the Kun, Fu, and Lin hexagrams in the Twelve Message Hexagrams. The Kun Hexagram consists of six Yin lines. Many people seeing this hexagram assume that Yin is flourishing and Yang is declining, that Yang Qi is gone or destroyed. Actually, this is a misunderstanding of the Kun Hexagram. Six Yin lines do not mean Yang Qi is gone; rather, it is stored. It is precisely this storage that allows Yang Qi to be nourished and restored, leading to the subsequent emergence of one Yang line, then two Yang lines. Besides the temporal characteristics mentioned above, Hai, Zi, and Chou also possess spatial directional characteristics, which is the North. Previously, we discussed the concepts of Pre-Heaven and Post-Heaven. In the Pre-Heaven Bagua, the North belongs to Kun. Pre-Heaven is the substance, Post-Heaven is the function. Therefore, the substance of Kun is in the North, and its function is in the Southwest. The substance of Kun residing in the North coexists with Kan (Water); we previously described this as the harmony of Water and Earth. However, Hai, Zi, and Chou being the resolution time for Taiyin disease is simultaneously the aggravation time for Taiyang disease, which is also a problem worth pondering.
2. Key Principles of Resolution Time
The *Shanghan Lun Lecture Notes* we see now are abridged versions. The *Shanghan Lun* compiled by Wang Shuhe contains four additional chapters before the opening Taiyang Chapter: "Chapter 1: Differentiating Pulse Methods," "Chapter 2: Assessing Pulse Methods," "Chapter 3: Examples of Cold Damage," and "Chapter 4: Differentiating Spasm, Dampness, and Heatstroke." In "Chapter 1: Differentiating Pulse Methods," there is a passage: "During the fifth month, Yang Qi is on the exterior, and the stomach center is empty and cold. Because internal Yang is weak and cannot overcome cold, one desires to wear extra clothes. During the eleventh month, Yang Qi is inside, and the stomach center is vexed and hot. Because internal Yin is weak and cannot overcome heat, one desires to strip naked." This text discusses half physiology and half pathology. Although it addresses another issue, it greatly helps us understand the resolution time of Taiyin disease. The fifth month is the Summer Solstice month, the Wu month, but it encompasses the entire summer month, including Si, Wu, and Wei months. What is the characteristic of the fifth month? Zhang Zhongjing states here: "Yang Qi is on the exterior, and the stomach center is empty and cold." Why is Yang Qi on the exterior at this time? Because throughout spring and summer, Yang Qi rises vigorously, moving upward and outward. Due to this trend of Yang Qi moving toward the exterior and outward, the Yang inside becomes relatively deficient. When Yang is deficient, it becomes cold; hence, "Yang Qi is on the exterior, and the stomach center is empty and cold." Conversely, when winter arrives, in the eleventh month, during Hai, Zi, and Chou hours, the situation is exactly opposite. At this time, Yang Qi moves inward and inside, entering a state of storage. Therefore, the Yang on the outside gradually becomes deficient, while the Yang inside gradually increases. More Yang generates heat; hence, "Yang Qi is inside, and the stomach center is vexed and hot." There is a folk saying: "Eat radish in winter and ginger in summer, and you won't need a doctor to prescribe medicine." Why? Those studying TCM should understand this principle. Radish is cooling in nature, and ginger is warming. Why eat ginger in the hot summer? Because at this time, Yang Qi is on the exterior, and the stomach center is empty and cold, so one needs ginger to warm the interior and the stomach. Why eat radish in the cold winter? Because in winter, Yang Qi is inside, causing vexation and heat in the stomach center, so one uses the cooling nature of radish to balance it and prevent the accumulation of heat. In the winter month, Yang Qi trends inward, so the interior becomes relatively hot. If you suffer from Taiyin disease, you can precisely borrow the Yang Qi entering the interior during Hai, Zi, and Chou hours to warm the stored cold and bring a turning point to the interior deficiency-cold syndrome of Taiyin disease. Therefore, Taiyin disease tends to resolve during Hai, Zi, and Chou. Through Hai, Zi, and Chou, we clarify the internal meaning of Taiyin disease, and the rules for treating Taiyin disease naturally come into grasp. Zhang Zhongjing describes the Six Meridian diseases through two aspects: one is through the outline clauses, which often have tangible signs and records, and is the aspect everyone focuses on; the other is through the resolution time clauses, which reveal Six Meridian diseases seemingly without tangible signs or records, leading few physicians from ancient times to the present to pay attention to them. In fact, it is formless yet containing all forms, record-less yet containing all records. Its implications are deeper and more thorough. The Classics state: "One who knows the Way understands astronomy above, geography below, and human affairs in the middle, and thus can endure long." From the above two aspects, the outline clauses discuss human affairs, while the resolution time clauses discuss astronomy and geography. If one only speaks of outlines, it obviously degenerates into mere human-affairs TCM; can the Dao of TCM then endure long?
3. Aggravation Time Phase
The concept of aggravation time (Yu Ju Shi) or onset time (Yu Zuo Shi) was mentioned earlier; it is relative to the resolution time. Since Taiyin disease tends to improve and feel comfortable at such times, there must inevitably be another time when it is difficult to improve or feels more distressing. Otherwise, if there were only good times and no distressing times, the Way of Heaven and Earth would lose fairness. The resolution time for Taiyin disease is Hai, Zi, and Chou, because at this time Yang Qi is inside. For the interior deficiency-cold of Taiyin disease, this is undoubtedly gaining the Way (De Dao); he who gains the Way has many helpers, hence "tends to resolve." So, when does Taiyin disease tend to aggravate? It should be Si, Wu, and Wei. At Si, Wu, and Wei, Yang Qi is on the exterior. When Yang is on the exterior, the interior easily becomes empty and cold. For Taiyin disease, this is undoubtedly losing the Way (Shi Dao); he who loses the Way has few helpers, hence "tends to aggravate." At Si, Wu, and Wei, Yang Qi trends outward, making the interior prone to deficiency and cold, thus easily generating stored cold and Taiyin disease. This is an analysis from the perspective of principles. Now let us return to practical matters. The weather in summer is very hot, and Yang Qi steams outward. Due to the heat, people consume raw food and cold drinks, preferring ice. The stomach center is already empty and cold, yet one consumes large amounts of raw and cold items, adding frost to snow. Thus, this is the time when one is most likely to contract Taiyin disease. Do not think that winter is when Taiyin disease is easily contracted; actually, it is the opposite. Summer is when Taiyin disease is most easily contracted. Therefore, there are many opportunities to use Lizhong Tang (Regulate the Middle Decoction) in summer. However, too many people today do not understand this principle; neither do patients nor physicians. They only know that summer has summer heat, but do not know that summer also has coldness. In summer, the heaven is hot while the earth is cold; one must clarify the distinction between heaven and earth. Especially those studying the Taiyin Chapter should understand this relationship well. Taiyin is divided into Hand Taiyin and Foot Taiyin. Hand Taiyin Lung refers to Heaven, while Foot Taiyin Spleen refers to Earth. Therefore, the pattern of hot heaven and cold earth in summer is essentially the pattern of Lung Heat and Spleen Cold. If we only know heat, only know Ye Tianshi's "Warm pathogens enter from above and first attack the Lung," and only know using cold-cooling methods, this is insufficient. At best, we only know the aspect of Heaven. Using cold-cooling methods in summer, a famous example is Yi Yuan San (Benefit Origin Powder) from Liu Hejian's *Xuanming Lun Fang*, also known as Liu Yi San (Six-to-One Powder) or Tai Bai San (Great White Powder). What does Tai Bai mean? Watching *Journey to the West*, you know there is a Star Lord Tai Bai Jinxing. Thus, Tai Bai actually refers to Metal and the Lung. Therefore, Tai Bai San actually targets the aspect of Heaven in summer, the aspect of the Lung. What about the aspect of Earth? That is, the aspect of the Taiyin Spleen? If this aspect is not taken care of, it easily affects Taiyin. Once the door of Taiyin opens, the doors of the Three Yin open accordingly. Therefore, everyone should well grasp the pattern of Heaven and Earth. Besides knowing Yi Yuan San and Tai Bai San, one should also know that Lizhong Tang is very useful. From a temporal perspective, the three hours of Si, Wu, and Wei are the aggravation times for Taiyin disease. As emphasized repeatedly before, space-time (and direction) share identity and unity. Therefore, when studying resolution or aggravation times, we should combine them with spatial directions. From a spatial direction perspective, Si, Wu, and Wei correspond to the South. Thus, the South should also become the aggravation direction for Taiyin disease. This indicates that Southerners have a higher chance of contracting Taiyin disease. Furthermore, the spleen and stomach of Southerners are relatively weaker than those of Northerners. Think about it, is this true? Comparing Southerners and Northerners makes it clear. Northerners are generally taller and have sturdier limbs than Southerners. Why? Because Northerners have strong Earth Qi, while Southerners have weak Earth Qi. Weak Earth Qi leads to underdeveloped limb muscles, resulting in smaller stature. Therefore, everyone should understand this North-South difference and know that Southerners have a foundation that makes them more prone to Taiyin disease than Northerners. As Southerners, or doctors in the South, one should be more aware of the importance of warming and nourishing, and protecting the spleen and stomach. Do not just talk about cooling herbal teas all day long. The above discussion was actually展开 (unfolded) through a passage in *Differentiating Pulse Methods*. In *Differentiating Pulse Methods*, there is another wonderful dialogue: "Question: How to know when a disease began and when it will heal? Answer: Suppose one falls ill at midnight and heals at noon the next day; if one falls ill at noon, one heals at midnight. Why say this? Healing at midnight after falling ill at noon occurs because Yang obtains Yin to resolve. Healing at noon after falling ill at midnight occurs because Yin obtains Yang to resolve." When is midnight? It is Zi hour, extended to include Hai, Zi, and Chou. When is noon? Noon is Wu hour, extended to include Si, Wu, and Wei. Falling ill at noon and healing at midnight perfectly fits the pattern of Taiyin disease resolving at Hai, Zi, and Chou, and aggravating/onsetting at Si, Wu, and Wei. Extending this pattern, the onset and healing times for Six Meridian diseases can be easily determined. This shows that the content of chapters like *Differentiating Pulse Methods* is closely related to the chapters of the Six Meridians and must not be neglected. Researchers of *Shanghan Lun* often do not value these chapters, some not even knowing they exist. Viewing *Shanghan Lun* this way makes it difficult to see thoroughly. Si, Wu, and Wei are the aggravation or onset times for Taiyin disease. This Si, Wu, and Wei may refer to the three hours of a day, the period around the full moon of a month, or the fourth, fifth, and sixth lunar months of a year. But these are relatively fixed times. In these times, Yang Qi steams outward and upward, so the Yang Qi inside is relatively deficient, making the stomach center prone to empty cold. Based on this trend of Yang Qi in the Si, Wu, and Wei space-time, we should associate with an unfixed, flexible "Si, Wu, and Wei" outside these relatively fixed times. That is, whenever the organism is in a state where Yang Qi steams outward and the stomach center is empty and cold, it should be considered Si, Wu, and Wei, and viewed as the aggravation or onset time for Taiyin disease. For example, after strenuous exercise or mental fatigue, Yang Qi is on the outside, the stomach center easily becomes empty and cold, and it is a time when Taiyin disease is easily contracted. Therefore, one must be particularly careful at this time and not immediately open the refrigerator to drink cold beverages. If one really wants to drink, drink some warm water or hot drinks, which quench thirst better. Only if one insists on drinking ice should one wait until quiet, when Yang Qi slowly turns inward, before drinking a little. This is the aggravation time for Taiyin disease.
4. Key Principles of Treatment Formulas for Taiyin
The treatment formulas for Taiyin can be summarized by a sentence from Clause 277 of the Taiyin Chapter: "One should warm it;适宜服用四逆辈 (suitable to take Si Ni category decoctions)." What does "warm" mean? It means warming the interior organs (Zang) and warming the interior. Such a treatment formula obviously aligns with the significance of the resolution time phase Hai, Zi, and Chou for Taiyin disease.
(1) Meaning of Si Ni
Taiyin disease belongs to interior deficiency-cold. Using Lizhong Tang is something everyone is very familiar with, but in the Taiyin Chapter, Zhang Zhongjing gives the Si Ni category. This shows that decoctions like Si Ni Tang have a close relationship with Taiyin. Why is the main formula for Taiyin called "Si Ni"? What is the relationship between Si Ni and Taiyin? First, let us look at "Si" (Four). What is the meaning of Four? Four mainly refers to the four limbs. The four limbs receive Qi from the Stomach, and the Spleen governs the four limbs. Therefore, the relationship between Four and the Spleen/Stomach is the closest. Next, let us look at "Ni" (Reverse). A widely accepted explanation for Ni is reverse coldness. Combined with Si, it means reverse coldness of the four limbs. What is reverse coldness? "Ni" has another layer of meaning, which is exactly opposite to "Shun" (Smooth/Following). Shun refers to moving from top to bottom, near to far, center to periphery. Ni reverses this, moving from bottom to top, far to near. Therefore, reverse coldness means the cold starts from the distal ends of the four limbs, from the extremities, and gradually develops upward, even extending past the elbows and knees. Why does reverse coldness occur? Naturally, because the fire is gone, and Yang Qi is deficient and衰竭 (exhausted). *Shanghan Lun* divides diseases into Yin and Yang categories. Yang categories are Taiyang, Yangming, Shaoyang; Yin categories are Taiyin, Shaoyin, Jueyin. When disease reaches Yin, Yang Qi begins to be insufficient. This insufficiency is mainly internal Yang deficiency. Internal Yang deficiency leads to interior deficiency-cold. Therefore, a basic common feature of the Three Yin diseases is interior deficiency-cold. And this interior deficiency-cold of the Three Yin diseases starts from Taiyin. When Taiyin becomes deficient and cold, and Yang Qi is insufficient, where does it first manifest? It manifests in the four limbs, which it governs and receives Qi from. One presents with cold limbs, presenting with Si Ni.