天地间死生消长之道，惟阴阳二气尽之，而人力挽回之权，亦惟阴阳二字尽之，至于伤寒一证
，则尤切于此，不可忽也。第伤寒之阴证阳证，其义有二，所谓二者，曰经有阴阳，证有阴阳也。
经有阴阳，则三阳为阳证，三阴为阴证。证有阴阳，则实热为阳证，虚寒为阴证。凡经之阴阳，则
有寒有热，故阳经亦有阴证，阴经亦有阳证。证之阴阳，则有假有真，故发热亦有阴证，厥逆亦有
阳证。此经自经，而证自证，乃伤寒中最要之纲领，不可混也。而今之医流，多不明此，故每致混
指阴阳，肆行克伐，杀人于反掌之间，而终身不悟，深为可慨。原其由然，非无所本，盖本于李子
建之《伤寒十劝》。《十劝》之中，惟八劝曰∶病已在里，不可发汗；九劝曰∶饮水不可过多；十
劝曰∶病后当忌饮食房劳；凡此三者，皆为得理，然亦人皆知之，无待其为劝矣。
此外七劝，则悉忌温补。
如一劝云∶伤寒头痛及身热，便是阳证，不可服热药。若此一说，乃悉以阳经之表病，认为内
热之阳证，治以寒凉，必杀人矣。观仲景治太阳经伤寒，头痛发热无汗者，用麻黄汤；头痛发热，
汗出恶风者，用桂枝汤；太阳病，发热头痛，脉反沉，身体疼痛者，当救其里，用四逆汤；阳明病
，脉浮，无汗而喘者，出汗则愈，宜麻黄汤。凡此之类，岂非皆用热药，以治阳经之疼痛发热乎？
且凡寒邪之感人，必先入三阳之表，所以为头疼发热等证，使于此时，能用温散，则浅而且易。故
岐伯曰∶发表不远热，是诚神圣传心之旨，惟仲景知之，故能用温散如此，是岂果阳经之病，便是
阳证耶？经证不明，而戒用温热，最妄之谈，此其一也。
又二劝曰∶伤寒必须直攻毒瓦斯，不可补益。若据此说，则凡是伤寒，尽皆实证，而必无虚证矣
，何岐伯曰∶邪之所凑，其气必虚。又曰∶寒则真气去，去则虚，虚则寒搏于皮肤之间。又观仲景
论伤寒之虚证虚脉，及不可汗吐下者，凡百十余条，此外如东垣、丹溪、陶节庵辈，所用补中益气
，回阳返本，温经益元等汤，则其宜否温补，概可知矣。矧今之人，凡以劳倦七情，色欲过度，及
天禀薄弱之流，十居七八。使以此辈一旦因虚感邪，若但知直攻毒瓦斯，而罔顾元阳，则寇未逐而主
先伤，鼠未投而器先破，顾可直攻无忌乎？凡受斯害，死者多矣，妄谈之甚，此其二也。
又三劝曰∶伤寒不思饮食，不可服温脾药。据此一说，则凡见伤寒不食者，皆是实热证，而何
以仲景有曰∶阳明病，不能食，攻其热必哕，所以然者，胃中虚冷故也。又曰∶病患脉数，数为热
，当消谷引饮，而反吐者，以其发汗，令阳气微，膈气虚，脉乃数也。数为客热，不能消谷，以胃
中虚冷故也。又曰∶食谷欲呕者。属阳明也，吴茱萸汤主之。若此之类，岂非皆寒证之宜温者耶？
但伤寒之热证固不能食，而寒证之不食者尤多，以中寒而不温脾，则元阳必脱而死矣。此妄谈之三
也。
又四劝曰∶伤寒腹痛，亦有热证，不可轻服温暖药。据所云亦有热证，则寒证居多矣，寒痛既
多，则何不曰不可轻服寒凉药，而特以温暖为禁者何也？独不见仲景之治腹痛，有用真武汤者，有
用通脉四逆汤者，有用
四逆散加附子者。有曰手足厥冷，小腹满，按之痛者，此冷结膀胱关元也。使以此证而亦忌温暖，
则寒在阴分，能无毙乎？此妄谈之四也。
再如五劝之伤寒自利，不可例服补药、暖药、止泻药，六劝之禁用艾火，七劝之手足厥冷，不
可例作阴证等说，总属禁热之谈，余亦不屑与之多辨，第拓取圣贤成法，明哲格言，再悉于此，用
救将来，是诚今日之急务也。因详考仲景《伤寒论》，见其所列三百九十七法，而脉证之虚寒者，
一百有余；一百一十三方，而用人参者二十，用桂附者五十有余。又东垣曰∶实火宜泻，虚火宜补
。又薛立斋曰∶大凡元气虚弱而发热者，皆内真寒而外假热也。凡若此者，岂皆余之杜撰耶？岂子
建诸人一无所见耶？若无所见，胡可妄言？若有所见，胡敢妄言？今观彼十劝之中，凡禁用温补者
，居其八九，而绝无一言戒及寒凉，果何意哉。因致未学认为圣经，遂悉以阴证作阳证，悉以虚证
作实证，但知凉泻之一长，尽忘虚寒之大害。夫生民元气足者其几，能堪此潜消暗剥之大盗乎？嗟
！嗟！，何物匪才，敢言十劝，既不能搜罗训典，明析阴阳，又不能揣摩实虚，原终要始，总弗求
阳德之亨，全不识冰霜之至。后学人多被所愚，致造终身之孽，无辜者阴受其戮，讵思冤魄可怜。
余言及此，能不转慈悲为愤怒，借笔削为箴规，独思深诋先辈，岂出本心，亦以目击多艰，难胜呜
咽，实亦有为而云然。盖以久感之余，复有所触，适一契姻，向以中年过劳，因患劳倦发热，余为
速救其本，已将复元，忽遭子建之徒，坚执十劝以相抗，昧者见其发热，反为左袒，不数剂而遂以
有生之徒，置之死地。因并往日见闻，倍加伤惨，诚可痛可恨也。子建、子建，吾知多冤之积于尔
者久矣，故悉此论，以解尔此后之冤孽，尔若有知，尚知感否。
天地间生与死、盛与衰的规律，完全由阴阳二气决定，而人力能够挽回局势的关键，也完全在于把握“阴阳”这两个字。至于伤寒这一类病证，尤其紧密地关联于此，不可轻视。然而，伤寒的阴证和阳证，其含义包含两个方面：所谓两个方面，是指经络有阴阳之分，证候也有阴阳之别。
经络有阴阳之分，那么三阳经（太阳、阳明、少阳）的病属于阳证，三阴经（太阴、少阴、厥阴）的病属于阴证。证候有阴阳之别，那么实热性质的属于阳证，虚寒性质的属于阴证。凡是涉及经络的阴阳，则既有寒证也有热证，所以阳经也可以出现阴证，阴经也可以出现阳证。涉及证候的阴阳，则有假象和真象之分，所以发热也可能属于阴证，四肢厥逆也可能属于阳证。这是经络自经络，证候自证候，乃是伤寒论中最关键的纲领，不可混淆。
然而现在的医生，大多不明白这个道理，因此常常错误地指认阴阳，肆意使用攻伐药物，在转瞬间就致人死亡，而他们终身都不醒悟，这真是令人深深感叹。探究其原因，并非没有根据，而是源于李子建的《伤寒十劝》。《十劝》中，只有第八劝说：“病邪已在体内深处，不可发汗”；第九劝说：“饮水不可过多”；第十劝说：“病后应当禁忌饮食不节和房事”。这三条都是合乎道理的，但这也是人人都知道的，不需要特别去劝告。
除此之外其余七条劝告，则完全是忌讳温补疗法。
比如第一劝说道：“伤寒出现头痛及身体发热，就是阳证，不可服用热性药物。”如果按照这种说法，那就是把三阳经的表证全部当作内热的阳证来治，用寒凉药物治疗，必然会杀人。看张仲景治疗太阳经伤寒，对于头痛、发热、无汗的患者，使用麻黄汤（Mahuang Tang, Ephedra Decoction）；对于头痛、发热、汗出、恶风的患者，使用桂枝汤（Guizhi Tang, Cinnamon Twig Decoction）；对于太阳病，发热、头痛，脉象反而沉，身体疼痛的患者，应当先救里，使用四逆汤（Sini Tang, Four Reversal Decoction）；对于阳明病，脉浮，无汗且喘的患者，发汗后即可痊愈，适宜用麻黄汤。凡此种种，难道不是都使用了热性药物来治疗阳经的疼痛和发热吗？
况且大凡寒邪伤人，必定先侵入三阳经的体表，从而引起头痛、发热等症状。如果在這個時候，能使用温散的方法，病情就会浅而易治。所以岐伯说：“发表解表不宜远离热药”，这确实是神圣传承的心法，只有张仲景深知此理，所以能如此使用温散之法。这难道真的是因为阳经的病就是阳证吗？经络证候不明，却禁止使用温热药物，这是最荒谬的言论，这是第一个错误。
第二劝说道：“伤寒必须直接攻杀毒邪，不可补益。”如果依据这个说法，那么所有的伤寒都是实证，必然没有虚证了。为什么岐伯说：“邪气聚集的地方，正气必定虚弱。”又说：“寒气侵袭则真气离去，离去则导致虚弱，虚弱则寒气搏结于皮肤之间。”再看张仲景论述伤寒的虚证和虚脉，以及不可使用汗、吐、下法的条文，有一百多条。此外如李东垣、朱丹溪、陶节庵等人，所使用的补中益气汤（Buzhong Yiqi Tang, Tonify the Middle and Augment Qi Decoction）、回阳返本汤、温经益元汤等，他们是否适宜使用温补疗法，大概就可以知道了。更何况现在的人，凡是因劳倦、七情内伤、色欲过度以及先天禀赋薄弱的人，占十分之七八。假如这些人一旦因为体虚感受外邪，如果只知道直接攻杀毒邪，而不顾护元阳，那么敌人还未驱逐，主人先受损伤，老鼠还没投进去，容器先破裂了，怎么可以肆无忌惮地直接攻伐呢？凡是遭受这种害处的，死者很多，妄谈之甚，这是第二个错误。
第三劝说道：“伤寒不想吃东西，不可服用温脾药物。”依据这一说法，那么凡是见到伤寒不吃饭的，都是实热证。为什么张仲景说：“阳明病，不能进食，如果攻其热必会呃逆，之所以这样，是因为胃中虚冷。”又说：“病人脉数，数脉主热，应当消谷善饥并想喝水，反而呕吐的，是因为发汗导致阳气微弱，膈气虚弱，脉才表现为数。数是客热，不能消化食物，是因为胃中虚冷。”又说：“进食后想要呕吐的，属于阳明病，用吴茱萸汤（Wuzhuyu Tang, Evodia Fruit Decoction）主治。”像这类情况，难道不是都属于寒证宜用温法吗？只是伤寒的热证固然会导致不能进食，而寒证导致不进食的情况更多。如果中焦受寒却不温补脾脏，那么元阳必定脱失而死。这是妄谈的第三个错误。
第四劝说道：“伤寒腹痛，也有热证，不可轻易服用温暖药物。”据它所说也有热证，那么寒证就占多数了。既然寒痛居多，为什么不说不可以轻易服用寒凉药物，而特别禁止温暖药物呢？难道没看见张仲景治疗腹痛时，有用真武汤（Zhenwu Tang, True Warrior Decoction）的，有用通脉四逆汤（Tongmai Sini Tang, Pulse-Rescuing Four Reversal Decoction）的，有用四逆散加附子（Sini San plus Fuzi, Four Reversal Powder plus Aconite Root）的。还有说：“手足厥冷，小腹胀满，按压疼痛的，这是冷结膀胱关元穴。”如果对这个证候也忌讳温暖，那么寒邪在阴分，能不致死吗？这是妄谈的第四个错误。
再如第五劝说道：伤寒自利（自发腹泻），不可一概服用补药、暖药、止泻药；第六劝说道：禁用艾火灸疗；第七劝说道：手足厥冷，不可一概当作阴证等说法，总归属于禁止热疗的言论，我也不屑于与它们多作辩驳。我只是撷取圣贤的成法和明哲的格言，再次详细陈述于此，用来救治将来之人，这确实是当今的急务。于是详细考证张仲景的《伤寒论》，见其所列三百九十七条法则，其中脉证属虚寒的有一百多条；一百一十三首方剂中，用人参的有二十首，用桂枝、附子的有五十多首。又李东垣说：“实火适宜泻法，虚火适宜补法。”又薛立斋说：“大凡元气虚弱而发热的，都是内真寒而外假热。”像这样的情况，难道都是我杜撰的吗？难道是李子建等人一无所见吗？如果无所见，怎么能妄言？如果有所见，怎么敢妄言？如今看那《十劝》之中，凡是禁用温补的，占了八九成，而绝无一言告诫关于寒凉的坏处，究竟是何用意呢？
因此导致未学者将其视为圣经，于是把所有阴证都当作阳证，把所有虚证都当作实证，只知道凉泻的一方面之长，完全忘记了虚寒的巨大危害。百姓中元气充足的人有多少呢？能承受这种暗中侵蚀的大盗吗？唉！唉！什么无名之辈，敢发表《十劝》，既不能搜罗经典训诫，明晰辨析阴阳，又不能揣摩虚实，探究始终，根本不追求阳德的亨通，完全不知道冰霜将至的危险。后学人多被其愚弄，导致造下终身的罪孽，无辜者暗中受到杀戮，岂能想到冤魂可怜。我谈到这些，怎能不将慈悲转为愤怒，借笔削作为规劝？独自思考深斥先辈，难道出于本心？也是因为我目睹太多艰难，难以抑制呜咽，实在是有所为而这样说。
大概是因为久感之余，又有所触动，恰好有一位姻亲，向来因为中年过度劳累，患上了劳倦发热，我为他迅速救本，已经快要复原，忽然遭到李子建门徒的坚持，执守《十劝》与我对抗。无知者看到其发热，反而偏袒对方，不到几剂药，就将一个有生命的人置于死地。因此结合往日的见闻，加倍感到伤心惨痛，真是可痛可恨啊。李子建，李子建，我知道你积累的冤屈已久，所以写下这篇论述，以解开你此后的冤孽，如果你若有知觉，还知道感激吗？
The principles of life and death, growth and decline in the world are entirely determined by Yin and Yang Qi (Vital Energy), and the power of human effort to reverse these trends also lies entirely in understanding "Yin" and "Yang". This is particularly true for Shanghan (Cold Damage) diseases, which are closely linked to this principle and must not be neglected. However, the concepts of Yin syndrome and Yang syndrome in Shanghan have two meanings. These two aspects refer to: meridians having Yin and Yang distinctions, and syndromes having Yin and Yang distinctions.
If meridians have Yin and Yang distinctions, then the Three Yang meridians (Taiyang, Yangming, Shaoyang) constitute Yang syndromes, and the Three Yin meridians (Taiyin, Shaoyin, Jueyin) constitute Yin syndromes. If syndromes have Yin and Yang distinctions, then Excess-Heat constitutes a Yang syndrome, while Deficiency-Cold constitutes a Yin syndrome. Regarding the Yin-Yang of meridians, there are both Cold and Heat patterns; thus, Yang meridians can present with Yin syndromes, and Yin meridians can present with Yang syndromes. Regarding the Yin-Yang of syndromes, there are both false and true manifestations; thus, fever can belong to a Yin syndrome, and cold extremities (Jue Ni) can belong to a Yang syndrome. This distinction between meridian pathology and syndrome manifestation is the most crucial guideline in Shanghan studies and must not be confused.
However, many physicians today fail to understand this, often misidentifying Yin and Yang, and recklessly employing purgative or attacking methods, killing patients in an instant without ever realizing their error, which is deeply lamentable. The origin of this error lies in Li Zijian's "Ten Admonitions on Shanghan". Among the "Ten Admonitions", only the Eighth states: "If the pathogen has entered the interior, do not induce sweating"; the Ninth states: "Do not drink excessive water"; and the Tenth states: "After illness, one must avoid improper diet and sexual activity". These three points are reasonable, yet they are common knowledge requiring no special admonition.
The remaining seven admonitions, however, strictly prohibit warm and tonifying therapies.
For instance, the First Admonition claims: "Shanghan presenting with headache and body heat indicates a Yang syndrome; hot-natured medicines must not be taken." If this view were adopted, all exterior conditions of the Yang meridians would be treated as interior Heat syndromes using cold-natured medicines, inevitably leading to death. Consider Zhang Zhongjing's treatment of Taiyang Shanghan: for patients with headache, fever, and no sweat, he used Mahuang Tang (Ephedra Decoction); for those with headache, fever, sweating, and aversion to wind, he used Guizhi Tang (Cinnamon Twig Decoction); for Taiyang disease presenting with fever, headache, a surprisingly deep pulse, and body pain, he prioritized rescuing the interior using Sini Tang (Four Reversal Decoction); for Yangming disease with a floating pulse, no sweat, and wheezing, he recommended inducing sweat to cure it, suitable for Mahuang Tang. Do these not demonstrate the use of warm/hot medicines to treat pain and fever in Yang meridians?
Furthermore, when Cold pathogens invade the body, they first enter the exterior of the Three Yang meridians, causing symptoms like headache and fever. At this stage, using warm-dispersing methods makes the condition superficial and easy to treat. As Qibo stated: "To release the exterior, one should not avoid hot medicines." This is indeed a sacred transmission of wisdom, known well by Zhang Zhongjing, who employed warm dispersal so effectively. Does this not prove that diseases of Yang meridians are not necessarily Yang syndromes? To forbid the use of warm medicines due to unclear meridian-syndrome relationships is the most absurd theory; this is the first error.
The Second Admonition states: "Shanghan requires direct attack on toxic pathogens; tonification must not be used." Following this logic, all Shanghan cases would be considered Excess syndromes, leaving no room for Deficiency syndromes. Yet Qibo said: "Where pathogenic factors gather, Qi is necessarily deficient." He also said: "When Cold invades, True Qi departs; its departure leads to deficiency, and deficiency allows Cold to contend within the skin." Furthermore, Zhang Zhongjing discusses numerous Deficiency syndromes and pulses in Shanghan, along with over a hundred clauses advising against sweating, vomiting, or purging methods. Additionally, the formulas used by Li Dongyuan, Zhu Danxi, and Tao Jian'an—such as Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction), Huiyang Fanben Tang, and Wenjing Yiyuan Tang—clearly indicate the appropriateness of warm and tonifying treatments. Moreover, people suffering from fatigue, emotional stress, excessive sexual activity, or congenital weakness account for seven or eight out of ten. If such individuals contract pathogens due to deficiency, and one only knows how to directly attack toxins while ignoring Yuan Yang (Original Yang), the host will be damaged before the enemy is expelled, and the vessel broken before the mouse is thrown. How can one recklessly attack without caution? Many have died from this harm; this reckless talk is the second error.
The Third Admonition states: "In Shanghan, if there is no appetite, warm spleen medicines must not be taken." According to this, any Shanghan patient lacking appetite must have an Excess-Heat syndrome. Why did Zhang Zhongjing state: "In Yangming disease, inability to eat means that attacking the heat will cause hiccups; this is because the stomach is deficient and cold"? He also said: "If a patient has a rapid pulse, indicating Heat, one expects efficient digestion and thirst, but if vomiting occurs instead, it is because sweating depleted Yang Qi, causing emptiness in the Diaphragm Qi, resulting in a rapid pulse. This rapid pulse represents 'guest heat' and cannot digest food, again due to a deficient and cold stomach." He further stated: "Those who feel like vomiting after eating belong to Yangming disease, treated primarily with Wuzhuyu Tang (Evodia Fruit Decoction)." Are these not examples of Cold syndromes requiring warm treatment? While Heat syndromes in Shanghan certainly cause loss of appetite, Cold syndromes causing loss of appetite are even more common. If middle-jiao Cold is not warmed by tonifying the spleen, Yuan Yang will surely collapse, leading to death. This is the third error of reckless talk.
The Fourth Admonition states: "Abdominal pain in Shanghan can also be a Heat syndrome; warm medicines must not be lightly administered." By claiming there are also Heat syndromes, it implies Cold syndromes are predominant. Since Cold pain is more common, why not advise against lightly administering cold medicines, but specifically prohibit warm ones? Did one not see Zhang Zhongjing treating abdominal pain with Zhenwu Tang (True Warrior Decoction), Tongmai Sini Tang (Pulse-Rescuing Four Reversal Decoction), or Sini San (Four Reversal Powder) added with Fuzi (Aconite Root)? He also noted: "Cold extremities, fullness in the lower abdomen, and tenderness upon pressure indicate Cold binding at the Bladder and Guanyuan acupoint." If one forbids warmth for such conditions, how can Cold in the Yin divisions fail to cause death? This is the fourth error of reckless talk.
Regarding the Fifth Admonition (self-directed diarrhea in Shanghan should not generally be treated with tonics, warming agents, or antidiarrheals), the Sixth (prohibition of moxibustion), and the Seventh (cold extremities should not generally be classified as Yin syndromes), these all fall under prohibitions of heat therapies. I disdain to debate them extensively. Instead, I will extract the established laws of sages and wise maxims, restate them here to aid future generations, as this is an urgent task today. Upon detailed examination of Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage), among the 397 methods listed, over 100 involve deficiency-cold pulses and syndromes; among the 113 prescriptions, 20 contain Renshen (Ginseng), and over 50 contain Guizhi (Cinnamon Twig) or Fuzi (Aconite Root). Li Dongyuan stated: "Excess Fire is suited to draining, Deficient Fire is suited to tonifying." Xue Lizhai stated: "Generally, fever arising from weak Yuan Qi is actually internal True Cold with external False Heat." Are such statements my fabrication? Or did Li Zijian and others see nothing? If they saw nothing, how could they speak rashly? If they saw something, how dare they speak rashly? In the "Ten Admonitions," prohibitions on warm and tonifying therapies comprise eight or nine parts, with absolutely no warning against cold and cooling therapies. What is the intent behind this?
Consequently, inexperienced practitioners regard these admonitions as sacred scriptures, mistaking all Yin syndromes for Yang, and all Deficiency syndromes for Excess. They know only the benefits of cooling and purging, completely forgetting the great harm of deficiency-cold. How many people possess sufficient Yuan Qi to withstand this silent thief that consumes them? Alas! Alas! Who is this insignificant talent daring to propose the "Ten Admonitions"? Unable to search classics for instruction or clearly distinguish Yin and Yang, nor able to discern deficiency and excess or trace origins to ends, they neither seek the prosperity of Yang Virtue nor recognize the arrival of frost. Many students have been deceived by this, creating lifelong karmic debts, while innocent people suffer hidden slaughter. Can one not pity the aggrieved souls? When I speak of this, how can compassion not turn to anger, using writing as admonition? Is my harsh criticism of predecessors born of malice? No, it stems from witnessing too much hardship, unable to suppress sorrow, and speaking out of necessity.
Recently, triggered by past experiences, a relative of mine, who had overworked himself in middle age, suffered from fatigue-induced fever. I urgently rescued his root constitution, and he was nearly recovered. Suddenly, disciples of Li Zijian insisted on opposing me, adhering rigidly to the "Ten Admonitions." Ignorant observers, seeing his fever, sided with them. Within just a few doses, a living person was put to death. Combining this with past observations, I feel doubly heartbroken and hateful. Li Zijian, Li Zijian, I know your accumulated grievances have long existed. Thus, I write this treatise to resolve your future karmic debts. If you have consciousness, would you not feel gratitude?