人被寒所伤者，谓之伤寒，夫寒居六气之一，岂可混称乎？尝考寒水之令，在乎小雪、大雪、冬至、小
寒之节，共主六十日有奇。盖小雪居于十月，乃六阴尽出之际，而寒气方盛之时；大雪、冬至居十一月，小寒
居十二月，正成发栗烈之候。斯时之气，人感触者，尽属伤寒之病。勿可以大寒至惊蛰之风木，春分至立夏
之君火，小满至小暑之相火，大暑至白露之湿土，秋分至立冬之燥金等等之时所患者，混同一称伤寒。然而亦
有可称者，不可不知。丰于前论中，有谓伤寒之寒字，为寒水之经之寒，非寒热之寒也。凡风、寒、暑、湿、
燥、火，无不由表而入，皆必先伤于寒水之经，六气之邪，佥可称为伤寒。但有不可称者，又不得不力辨其
非。尝闻专治伤寒家，有温病伤寒，热病伤寒，痧证伤寒，疮疡伤寒等名。不知温病、热病，皆属伏气，痧
因沙秽，疮因湿热，岂可混称为伤寒乎？尤有夹痰伤寒、夹食伤寒、夹气伤寒、夹血伤寒等名，揆厥由来，
痰、食、气、血，是为伤寒之兼证，又岂可混称为伤寒乎？仲景原文，从未见有此证，窃疑其为杜撰也。后
见吴中戈存橘先生《伤寒补天石》中，果有以上诸证之名，始知其有自也。虽然戈氏之书，医者不必宗之，其
所当宗者，如无己之《明理》，嘉言之《尚论》，韵伯之《来苏》，路玉之《大成》，诚为医家不可少之书，
后学所宜奉为圭臬也。至时俗混称伤寒之证，更为不通，见初起呕吐者，谓为龌龊伤寒；泄泻者，为漏底伤
寒；胁痛者，为刺胁伤寒；寒不甚寒，热不甚热，绵绵难愈者，为瘪疲伤寒，即徽俗谓之混沌伤寒，名
目极多，难以枚举。总之，小雪至小寒而重感者，为真伤寒。风、暑、燥、湿、火，先伤寒水之经者，亦可
称为伤寒。至温病、热病，痧症、疮疡，决不能混入伤寒。兼痰、食、气、血
者，是为伤寒之兼证。其余种种不通之名，皆不足论。医者须
按四时之六气，而分其孰为风、暑，孰为燥、湿，究不可笼统混为伤寒病也。
被寒气所伤害的，称为伤寒。寒是六气（风、寒、暑、湿、燥、火）之一，怎么能混同称呼呢？我曾经考证过，寒水主令的时间，是在小雪、大雪、冬至、小寒这几个节气，总共主导六十多天。大概小雪在十月，正是六阴之气全部显现的时候，也是寒气正盛的时刻；大雪和冬至在十一月，小寒在十二月，正是形成凛冽严寒气候的时候。这个时候感受到的邪气，人如果受到触动，都属于伤寒类的病证。不可以把大寒到惊蛰期间的风木之气，春分到立夏期间的君火之气，小满到小暑期间的相火之气，大暑到白露期间的湿土之气，秋分到立冬期间的燥金之气等等时节所患的疾病，混同为一种叫作伤寒的病。然而也有可以称为伤寒的情况，这是不能不知道的。我在前面的论述中说过，伤寒中的“寒”字，是指寒水经（足太阳膀胱经，五行属水）的寒，不是指寒热之寒（体温高低或冷热感觉）。凡是风、寒、暑、湿、燥、火这六种邪气，没有不由体表而入的，都必定先损伤寒水之经，所以六气的邪气，都可以称为伤寒。但是有不可称为伤寒的情况，又不得不极力辨析其错误。曾经听说专门治疗伤寒的医生，有温病伤寒、热病伤寒、痧证伤寒、疮疡伤寒等名称。不知道温病、热病，都属于伏气（潜伏体内的邪气），痧症是因为沙秽之气，疮疡是因为湿热，怎么能混称为伤寒呢？更有夹痰伤寒、夹食伤寒、夹气伤寒、夹血伤寒等名称，推究其来源，痰、食、气、血，是作为伤寒的兼证（伴随症状），又怎么能混称为伤寒呢？张仲景的原文中，从未见过这些证候，我私下怀疑它们是杜撰出来的。后来看到吴中戈存橘先生的《伤寒补天石》一书中，果然有以上各种证候的名称，才知道它们是有出处的。虽然戈氏的这本书，医者们不必尊崇它，其所应当尊崇的，如无己的《明理论》，嘉言的《尚论篇》，韵伯的《来苏集》，路玉的《大成书》，确实是医家不可缺少的书籍，后学者应当奉为准则。至于世俗混淆称呼伤寒的证候，更为不通，见到初起呕吐的，称之为龌龊伤寒；泄泻的，称之为漏底伤寒；胁痛的，称之为刺胁伤寒；寒不很寒，热不很热，缠绵难愈的，称之为瘪疲伤寒，也就是徽州习俗所说的混沌伤寒，名目极多，难以一一列举。总之，从小雪到小寒期间再次感受寒邪的，才是真伤寒。风、暑、燥、湿、火，先损伤寒水之经的，也可以称为伤寒。至于温病、热病、痧症、疮疡，绝对不能混入伤寒。兼有痰、食、气、血的，是作为伤寒的兼证。其余种种不通的名称，都不值得讨论。医者必须按照四季的六气，来分辨哪一个是风、暑，哪一个是燥、湿，终究不可以笼统地混同为伤寒病。
Those injured by cold are called *Shanghan* (Cold Damage). Cold is one of the Six Qi (Wind, Cold, Summer Heat, Dampness, Dryness, Fire); how can it be indiscriminately referred to as such? I have examined that the period when Cold Water dominates is during the solar terms of Minor Snow, Major Snow, Winter Solstice, and Minor Cold, totaling more than sixty days. Specifically, Minor Snow occurs in the tenth month, which is the time when all Yin energies emerge and Cold energy is at its peak; Major Snow and Winter Solstice occur in the eleventh month, and Minor Cold in the twelfth month, marking the season of biting cold. During this time, pathogens encountered by humans belong entirely to diseases of *Shanghan*. One must not confuse with *Shanghan* the diseases contracted during periods governed by Wind-Wood (from Great Cold to Awakening of Insects), Sovereign Fire (from Spring Equinox to Beginning of Summer), Ministerial Fire (from Grain Full to Minor Heat), Damp-Earth (from Great Heat to White Dew), and Dryness-Metal (from Autumn Equinox to Beginning of Winter), etc. However, there are cases that can indeed be termed *Shanghan*, a fact that must not be overlooked. In my previous discussions, I stated that the character "Han" (Cold) in *Shanghan* refers to the Cold of the Cold Water Meridian (Foot Taiyang Bladder Meridian, associated with Water element), not the Cold of heat-cold sensation. All six pathogenic factors—Wind, Cold, Summer Heat, Dampness, Dryness, and Fire—enter from the exterior and inevitably first injure the Cold Water Meridian; thus, pathogens of all six Qi can be termed *Shanghan*. Nevertheless, there are conditions that cannot be termed *Shanghan*, and their errors must be vigorously refuted. I have heard that specialists in treating *Shanghan* use names such as Warm Disease *Shanghan*, Hot Disease *Shanghan*, Sha Syndrome *Shanghan*, and Carbuncle *Shanghan*. It is unknown that Warm Diseases and Hot Diseases both belong to Hidden Pathogens (latent pathogens), Sha Syndrome arises from sandy filth, and Carbuncles arise from Damp-Heat; how can they be indiscriminately called *Shanghan*? Furthermore, there are names like Phlegm-complicated *Shanghan*, Food-complicated *Shanghan*, Qi-complicated *Shanghan*, and Blood-complicated *Shanghan*. Tracing their origins, Phlegm, Food, Qi, and Blood serve as accompanying syndromes (complications) of *Shanghan*; how can they be indiscriminately called *Shanghan*? Zhang Zhongjing’s original texts never mention these syndromes; I privately suspect them to be fabrications. Later, seeing Mr. Ge Cunju of Wuzhong in his book *Shanghan Butianshi* (Supplementary Stone for Heaven in Shanghan), I found indeed the aforementioned syndrome names, realizing they had sources. Although practitioners need not follow Ge’s book, what they should follow includes Wu Ji’s *Mingli Lun*, Jiayan’s *Shanglun Pian*, Yunbo’s *Laosu Ji*, and Luyu’s *Dacheng Shu*. These are indispensable books for physicians, which students should regard as standards. As for the vulgar indiscriminate naming of *Shanghan* syndromes, it is even more illogical: vomiting at onset is called Wocho *Shanghan*; diarrhea is called Loudi *Shanghan*; hypochondriac pain is called Ci Xie *Shanghan*; mild chills and fever that persistently linger are called Bipi *Shanghan*, also known in Huizhou custom as Hundun *Shanghan* (Chaotic *Shanghan*). The names are numerous and hard to enumerate. In summary, those who contract cold again from Minor Snow to Minor Cold are true *Shanghan*. Those affected by Wind, Summer Heat, Dryness, Dampness, or Fire, which first injure the Cold Water Meridian, may also be called *Shanghan*. However, Warm Diseases, Hot Diseases, Sha Syndromes, and Carbuncles absolutely cannot be mixed into *Shanghan*. Cases complicated by Phlegm, Food, Qi, or Blood are merely accompanying syndromes of *Shanghan*. The rest of these illogical names are unworthy of discussion. Physicians must analyze the Six Qi of the four seasons to distinguish which are Wind/Summer Heat and which are Dryness/Dampness; ultimately, one must not loosely and indiscriminately classify everything as *Shanghan* disease.