师曰：人脉皆无病，暴发重病，不省人事者，为厉鬼，治之以祝由，能言者可治，不言者死。
师曰：脉浮而洪，身汗如油，喘而不休，水浆不下，形体不仁，乍静乍乱，此为命绝也。又未知何脏先受其灾。若汗出发润，喘不休者，此为肺先绝也。阳反独留，形体如烟熏，直视摇头者，此为心绝也。唇吻反青，四肢掣习者，此为肝绝也。环口黧黑，油汗发黄者，此为脾绝也。溲便遗失，狂言，目反直视者，此为肾绝也。又未知何脏阴阳前绝。若阳气前绝，阴气后竭者，其人死身色必青；阴气前绝，阳气后竭者，其人死，身色必赤，腋下温，心下热也。
奇经八脉不系于十二经，别有自行道路。其为病总于阴阳，其治法属十二经。假令督脉为病，脊背强，隐隐痛，脉当微浮而急，按之涩，治属太阳。
阴跷为病，中于侧，气行于内，脉当浮缓，按之微急而弦，治属厥阴。
阴维与诸阴交，其为病在脉中，心中痛，手心热，脉当弦而涩，治属血分。
阳维维于阳，阴维维于阴，为气血之别，使不拘于一经也。
问曰：八脉内伤何以别之？师曰：督脉伤，柔柔不欲伸，不能久立，立则隐隐而胀；任脉伤，小便多，其色白浊；冲脉伤，时咳不休，有声无物，劳则；地喘；带脉伤，回身一周冷；阳跷伤，则身左不仁；阴跷伤，则身右不仁；阳维伤，则畏寒甚，皮常湿；阴维伤，则畏热甚，皮常枯。
问曰：八脉内伤其脉何似？师曰：督脉伤，尺脉大而涩；任脉伤，关脉大而涩；冲脉伤，寸脉短而涩；带脉伤，脉沉迟而结；阳跷伤，脉时大而弦；阴跷伤，脉时细时弦；阳维伤，脉时缓时弦；阴维伤，脉时紧时涩。问曰：其治奈何？师曰：督脉伤，当补髓；任脉伤，当补精；冲脉伤，当补气；带脉伤，当补肾；阳跷伤，则益胆；阴跷伤，则补肝；阴维伤，则调卫；阴维伤，则养荣。
问曰：其处方奈何？师曰：相体虚实，察病轻重，采取方法，权衡用之，则无失也。
问曰：六气主客何以别之？师曰：厥阴生少阴，少阴生少阳，少阳生太阴，太阴生阳明阳明生太阳，太阳复生厥阴，周而复始，久久不变，年复一年，此名主气；厥阴生少阴，少阴生太阴，太阴生少阳，少阳生阳明，阳明生太阳，复生厥阴，周而复始，此名客气。
问曰：其始终奈何？师曰：初气始于大寒，二气始于春分，三气始于小满，四气始于大暑，五气始于秋分，终气始于小雪，仍终于大寒，主客相同，其差各三十度也。
问曰：司天在泉奈何？师曰：此客气也。假如子午之年，少阴司天，阳明则为在泉，太阳为初气，厥阴为二气，司天为三气，太阴为四气，少阳为五气，在泉为终气；卯酉之年，阳明司天，少阴在泉，则初气太阴，二气少阳三气阳明四气太阳，五气厥阴，终气少阴；戌辰之年，太阳司天，太阴在泉；丑未之年，太阴司天，太阳在泉；寅申之年，少阳司天，厥阴在泉；巳亥之年，厥阴司天，少阳在泉；其余各气，以例推之。
问曰：其为病也何如？师曰：亦有主客之分也；假如厥阴司天，主胜，则胸胁痛，舌难以言；客胜，则耳鸣，掉眩，甚则咳逆。少阴司天，主胜，则心热，烦躁，胁痛支满；客胜，则鼽嚏，颈项强，肩背瞀热，头痛，少气，发热，耳聋，目暝，甚则跗肿，血溢，疮，喑，喘咳。太阴司天，主胜，则胸腹满，食已而瞀；客胜，则首、面、跗肿，呼吸气喘。少阳司天，主胜，则胸满，咳逆，仰息，甚则有血，手热；客胜，则丹疹外发，及为丹〖火票〗，疮疡，呕逆，喉痹，头痛，嗌踵，耳聋，血溢，内为瘛疭。阳明司天，主胜，则清复内余，咳，衄，嗌塞，心膈中热，咳不止而白血出者死，金居少阳之位，客不胜主也。太阳司天，主胜，则喉嗌中鸣；客胜，则胸中不利，出清涕，感寒则咳也。厥阴主在泉，主胜，则筋骨徭并，腰腹时痛；客胜，则关节不利，内为痉强，外为不便。少阴在泉，主胜，则厥气上行，心痛发热，膈中众痹皆作，发于〖月去〗胁，魄汗不藏，四逆而起；客胜，则腰痛，尻、股、膝、髀、〖月耑〗、〖月行〗、足病瞀热以酸，跗肿不能久立，溲便变。太阴在泉，主胜，则寒气逆满，食饮不下，甚则为疝；客胜，则足痿下肿，便溲不时，湿客下焦，发而濡泄，及为阴肿，隐曲之疾。少阳在泉，主胜，则热反上行，而客于心，心痛发热，格中而呕；客胜，则腰腹痛，而反恶寒，甚则下白溺白。阳明在泉，主胜，则腰重，腹痛，少腹生寒，下为鹜溏，寒厥于肠，上冲胸中，甚则喘满，不能久立；客胜，则清气动下，小腹坚满，而数便泄。太阳在泉，以水居水位，无所胜也。
问曰：其胜复何如？师曰：有胜必有复，无胜则无复也；厥阴之胜，则病耳鸣，头眩，愦愦欲吐，胃膈如寒，〖月去〗胁气并，化而为热，小便黄赤，胃脘当心而痛，上及两胁，肠鸣，飧泄，少腹痛，注下赤白，甚则呕吐，膈不通；其复也，则少腹坚满，里急暴痛，厥心痛，汗发，呕吐，饮食不入，入而复出，筋骨掉眩清厥，甚则入脾，食痹而吐。少阴之胜，则病心下热，善饥，脐下气动，气游三焦，呕吐，躁烦，腹满而痛，溏泄赤沃；其复也，则〖火奥〗热内作，烦躁，鼽嚏，少腹绞痛，嗌燥，气动于左上行于右，咳则皮肤痛，暴喑，心痛，郁冒不知人，洒淅恶寒振栗，谵妄，寒已而热，渴而欲饮，少气，骨痿，膈肠不便，外为浮肿，哕噫，痱疹，疮疡，痈疽，痤痔，甚则入肺，咳而鼻渊。太阴之胜，则火气内郁，疮疡于中，流散于外，病在〖月去〗胁甚则心痛热格，头痛，喉痹，项强，又或湿气内郁，寒迫下焦，少腹满，腰椎痛强，注泄，足下湿，头重，跗肿，足胫肿，饮发于中，跗肿于上；其复也，则体重，中满，食饮不化，阴气上厥，胸中不便，饮发于中，咳喘有声，头项痛重，掉瘛尤甚，呕而密默，唾吐清液，甚则入肾，窃泄无度。少阳之胜，则病热客于胃，心烦而痛，目赤呕酸，善饥，耳痛，溺赤，善惊谵妄，暴热消烁，少腹痛，下沃赤白；其复也，枯燥，烦热，惊瘛，咳，衄，心热，烦躁，便数，憎风，厥气上行，面如浮埃，目乃〖目闰〗瘛，火气内发，上为口糜，呕逆，血溢，血泄，发而为疟，恶寒鼓栗，寒极反热，嗌络焦槁，渴饮水浆，色变黄赤，少气肺痿，化而为水，传为跗肿，甚则入肺，咳而血泄。阳明之胜，则清发于中，左【月去】胁痛，溏泄，内为嗌塞，外发颓疝，胸中不便，嗌而咳；其复也，则病生【月去】胁，气归于左，善太息，甚则心痛痞满，腹胀而泄，呕苦，咳哕烦心，病在膈中，甚则入肝，惊骇筋挛。太阳之胜，则病痔疟，发寒，厥人胃，则内生心痛，阴中乃疡，隐曲不利，亘引阴股筋肉拘苛，血脉凝泣，络满血变，或为血泄，皮肤否肿，腹满时减，热反上行，头项囟顶脑户中痛，目如脱，寒入下焦，则传为濡泄；其复也，则心胃生寒，胸膈不利，心痛痞满，头痛，善悲，时发眩仆，食减，腰椎反痛，屈伸不便，少腹控睾引腰脊上冲心，唾出清水，及为哕噫，甚则入心，善忘，善悲，寒复内余，则腰尻痛，屈伸不利，股胫足膝中痛。此六气为病，须谨识之，而弗失也。
师曰：子知六气，不知五运，未尽其道，今为子言，假如太阳司天，而运当甲己，夫甲己土运也，太阳寒水也，土能克水，太阳不能正其位也；又如厥阴司天，而逢乙庚金运；少阴少阳司天，而逢丙辛水运；太阴司天，而逢丁壬木运；阳明司天，而逢戊癸火运，其例同也。
问曰：其治法奈何？师曰：风寒暑湿燥热各随其气，有假者反之，甚者从之，微者逆之，采取方法，慎毋乱也。
伤寒例第四
立春正月节斗指艮，雨水正月中斗指寅。
惊蛰二月节斗指甲，春分二月中斗指卯。
清明三月节斗指乙，谷雨三月中斗指辰。
立夏四月节斗指巽，小满四月中斗指巳。
芒种五月节斗指丙，夏至五月中斗指午。
小暑六月节斗指丁，大暑六月中斗指未。
立秋七月节斗指坤，处暑七月中斗指申。
白露八月节斗指庚，秋分八月中斗指酉。
寒露九月节斗指辛，霜降九月中斗指戌。
立冬十月节斗指乾，小雪十月中斗指亥。
大雪十一月节斗指壬，冬至十一月中斗指子。
小寒十二月节斗指癸，大寒十二月中斗指丑。
二十四节气，节有十二，中气有十二，五日为一候，气亦同，合有七十二候，决病生死，此须洞解也。
阴阳大论云：春气温和，夏气暑热，秋气清凉，冬气冰冽，此则四时正气之序也。冬时严寒，万类深藏，君子周密，则不伤于寒。触冒之者，则名伤寒耳。其伤于四时之气，皆能为病。以伤寒为病者，以其最盛杀厉之气也。中而即病者，名曰伤寒；不即病，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。是以辛苦之人，春夏多温热者，皆由冬时触寒所致，非时行之气也。凡时行者，春时应暖而反大寒；夏时应热而反大凉；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。夫欲候知四时正气为病，及时行疫气之法，皆当按斗历占之。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。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。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。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，发其冬时伏寒，变为温病。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。其病与温相似，但治有殊耳。十五日得一气，于四时之中，一时有六气，四六名为二十四气。然气候亦有应至仍不至，或有未应至而至者，或有至而太过者，皆成病气也。但天地动静，阴阳鼓击者，各正一气耳。是以彼春之暖，为夏之暑；彼秋之忿，为冬之怒。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。斯则冬夏二至，阴阳合也；春秋二分，阴阳离也。阴阳交易，人变病焉。此君子春夏养阳，秋冬养阴，顺天地之刚柔也。小人触冒，必婴暴疹。须知毒烈之气，留在何经，必发何病，详而取之。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。伤寒之病，逐日浅深，以施方治。今世人伤寒，或始不早治，或治不对病，或日数久淹，困乃告医。医人又不依次第而治之，则不中病。皆宜临时消息制方，无不效也。
又土地温凉，高下不同；物性刚柔，餐［注：桂本餐字为飧，似误］居亦异。是故黄帝兴四方之问，岐伯举四治之能，以训后贤，开其未悟。临病之工，宜须两审也。
凡伤于寒，传经则为病热，热虽甚，不死。若两感于寒而病者，多死。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。
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、汗出、目疼、鼻干、不得卧。
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。此三经受病，未入于腑者，皆可汗而已。
尺寸俱沉濡者，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。
尺寸俱沉细者，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。
尺寸俱弦微者，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。此三经受病，己入于腑者，皆可下而已。
麻黄汤方
麻黄三两（去节） 桂枝三两（去皮） 甘草一两（炙） 杏仁七十枚 （去皮尖）
右四味，以水九升，先煮麻黄减二升，去上沫，纳诸药，煮取二升半，去滓，温服八合，覆取微似汗，不须粥饮，余如桂枝法将息，桂枝汤见后卷。
传阳明，脉大而数，发热，汗出，口渴舌燥，宜白虎汤，不差与承气汤。
白虎汤方
老师说道：如果一个人的脉象看起来都没有疾病，却突然患上重病，导致昏迷不省人事，这是被厉鬼（指突发的邪气或精神异常）所侵扰，应当用祝由术（古代一种通过祝祷、心理暗示等疗法）来治疗。如果能说话，说明神志未完全丧失，可以治愈；如果不能说话，则预后不良，可能会死亡。
老师说道：如果脉象浮而洪大，身体出汗像油一样黏腻，气喘不停，水浆无法入口，身体麻木不仁，时而安静时而躁乱，这是生命即将终结的征象。但还不确定是哪一脏先受到灾害。如果出汗后头发湿润，气喘不止，这是肺脏先衰竭的表现。阳气反而独自留存，身体肤色如烟熏般晦暗，眼睛直视不动且摇头，这是心脏先衰竭的表现。嘴唇和嘴角发青，四肢抽搐颤动，这是肝脏先衰竭的表现。口周颜色黑黄，出油汗且汗液发黄，这是脾脏先衰竭的表现。大小便失禁，胡言乱语，眼睛上翻直视，这是肾脏先衰竭的表现。又不确定是阴气还是阳气先衰竭。如果是阳气先衰竭，阴气随后枯竭，人死后身体颜色必定发青；如果是阴气先衰竭，阳气随后枯竭，人死后身体颜色必定发红，腋下温暖，心窝处发热。
奇经八脉不与十二正经相连结，有自己独立的运行道路。它们致病总归于阴阳失调，治疗方法归属于十二经的调理。假如督脉发病，脊背僵硬疼痛，隐隐作痛，脉象应当微浮而急，重按感觉涩滞，治疗归属于太阳经。
任脉发病，体内结聚疼痛，形成疝气或瘕块，脉象应当沉而结滞，治疗归属于太阴经。
冲脉发病，气机上逆且腹部拘急，脉象应当浮虚而数，治疗归属于太阴经。
带脉发病，苦于腹痛，腰部冷痛，脉象应当沉而细，治疗归属于少阴经。
阳跷脉发病，病邪中于身体侧面，气行于体表，脉象应当弦急，重按感觉缓和，治疗归属于少阳经。
阴跷脉发病，病邪中于身体侧面，气行于体内，脉象应当浮缓，重按感觉微急且弦，治疗归属于厥阴经。
阳维脉与诸阳经交会，它的病变在脉外，表现为恶寒发热，脉象应当浮而虚，治疗归属于气分。
阴维脉与诸阴经交会，它的病变在脉中，表现为心中疼痛，手心发热，脉象应当弦而涩，治疗归属于血分。
阳维维系诸阳经，阴维维系诸阴经，这是气血的区别，使得病情不拘泥于某一经络。
奇经八脉的疾病，是由各经受邪气侵袭，日久传变而来，或者是劳损受伤所致，并非突然暴发。
问：八脉的内伤如何辨别？老师说：督脉受伤，身体柔韧但不想伸展，不能久站，站立时隐隐感到胀痛；任脉受伤，小便频多，颜色白浊；冲脉受伤，时常咳嗽不止，有声无痰，劳累则加重，地喘（形容喘息声低沉）；带脉受伤，周身一圈感到寒冷；阳跷脉受伤，则身体左侧麻木不仁；阴跷脉受伤，则身体右侧麻木不仁；阳维脉受伤，则极度畏寒，皮肤常湿；阴维脉受伤，则极度畏热，皮肤常干枯。
问：八脉内伤的脉象是什么样的？老师说：督脉受伤，尺脉大而涩；任脉受伤，关脉大而涩；冲脉受伤，寸脉短而涩；带脉受伤，脉象沉迟而结滞；阳跷脉受伤，脉象时而大时而弦；阴跷脉受伤，脉象时而细时而弦；阳维脉受伤，脉象时而缓时而弦；阴维脉受伤，脉象时而紧时而涩。问：如何治疗？老师说：督脉受伤，应当补髓；任脉受伤，应当补精；冲脉受伤，应当补气；带脉受伤，应当补肾；阳跷脉受伤，则益胆；阴跷脉受伤，则补肝；阳维脉受伤，则调卫气；阴维脉受伤，则养营血。（注：原文此处“阴维伤，则调卫”重复出现一次“阴维伤”，根据上下文及中医理论，前一个应为阳维，后一个为阴维，译文依原文逻辑修正为对应关系，即阳维调卫，阴维养荣）。
问：处方如何制定？老师说：根据体质的虚实，观察病情的轻重，采取相应的方法，权衡利弊使用，就不会有失误了。
问：六气的主气和客气如何区分？老师说：厥阴生少阴，少阴生少阳，少阳生太阴，太阴生阳明，阳明生太阳，太阳复生厥阴，循环往复，长久不变，年复一年，这叫做主气；厥阴生少阴，少阴生太阴，太阴生少阳，少阳生阳明，阳明生太阳，复生厥阴，循环往复，这叫做客气。
问：它们的起止时间如何？老师说：初气始于大寒节气，二气始于春分，三气始于小满，四气始于大暑，五气始于秋分，终气始于小雪，仍然终于大寒，主气和客气的起止相同，每气相差三十度（约十五天）。
问：司天和在泉是什么情况？老师说：这是客气。假如子午之年，少阴司天，阳明则在泉，太阳为初气，厥阴为二气，司天为三气，太阴为四气，少阳为五气，在泉为终气；卯酉之年，阳明司天，少阴在泉，则初气太阴，二气少阳，三气阳明，四气太阳，五气厥阴，终气少阴；戌辰之年，太阳司天，太阴在泉；丑未之年，太阴司天，太阳在泉；寅申之年，少阳司天，厥阴在泉；巳亥之年，厥阴司天，少阳在泉；其余各年的气运，以此类推。
问：它们致病的情况如何？老师说：也有主气和客气的区别。假如厥阴司天，主气胜，则胸胁痛，舌强难以言语；客气胜，则耳鸣，头晕目眩，严重则咳嗽气逆。少阴司天，主气胜，则心中发热，烦躁，胁痛支撑胀满；客气胜，则鼻塞喷嚏，颈项强直，肩背部闷热，头痛，气短，发热，耳聋，眼睛昏花，严重则足背浮肿，出血，疮疡，失音，气喘咳嗽。太阴司天，主气胜，则胸腹胀满，进食后头昏眼花；客气胜，则头部、面部、足背浮肿，呼吸气喘。少阳司天，主气胜，则胸满，咳嗽气逆，仰面呼吸，严重则有血，手部发热；客气胜，则丹疹外发，以及丹熛（一种急性皮肤病），疮疡，呕吐气逆，喉痹，头痛，咽喉肿痛，耳聋，出血，内部发生抽搐。阳明司天，主气胜，则寒气复返体内，咳嗽，鼻衄，咽喉阻塞，心膈部发热，咳嗽不止且咳出白血的会死亡，因为金居少阳之位，客气不胜主气。太阳司天，主气胜，则咽喉中有鸣响；客气胜，则胸中不利，流出清涕，感受寒邪则咳嗽。厥阴在泉，主气胜，则筋骨拘挛，腰腹时时疼痛；客气胜，则关节不利，内部发生痉挛强直，外部行动不便。少阴在泉，主气胜，则厥气上行，心痛发热，膈部的各种痹痛皆发作，发于胁肋，魄汗（大汗）不能收敛，四肢厥逆而起；客气胜，则腰痛，臀部、大腿、膝盖、髀部、小腿肚、小腿、足部发生闷热酸痛，足背浮肿不能久立，大小便异常。太阴在泉，主气胜，则寒气逆满，饮食不下，严重则形成疝气；客气胜，则足痿下肿，大小便不时，湿气客居下焦，发作则为濡泄，以及阴部肿胀，隐私部位的疾病。少阳在泉，主气胜，则热气反向上行，侵犯心脏，心痛发热，格拒而呕吐；客气胜，则腰腹痛，反而恶寒，严重则下利白冻，小便白浊。阳明在泉，主气胜，则腰部沉重，腹痛，小腹生寒，下部为鹜溏（稀便如鸭粪），寒气厥逆于肠，上冲胸中，严重则喘满，不能久立；客气胜，则清气动于下，小腹坚硬胀满，频繁便泄。太阳在泉，以水居水位，无所克制。
问：它们的胜复情况如何？老师说：有胜必有复，无胜则无复。厥阴之胜，则病耳鸣，头眩，心中烦闷欲吐，胃膈部如寒，胁肋部气机并聚，化而为热，小便黄赤，胃脘当心而痛，上及两胁，肠鸣，完谷不化的泄泻，少腹痛，痢下赤白，严重则呕吐，膈部不通；其复气到来时，则少腹坚硬胀满，里急暴痛，厥心痛，出汗，呕吐，饮食不入，入而复出，筋骨抖动眩晕清冷厥逆，严重则传入脾脏，食痹而吐。少阴之胜，则病心下热，容易饥饿，脐下气动，气游走在三焦，呕吐，躁烦，腹满而痛，溏泄赤沃（红色粘液）；其复气到来时，则火热内作，烦躁，鼻塞喷嚏，少腹绞痛，咽喉干燥，气机动于左向上行于右，咳嗽则皮肤痛，突发失音，心痛，郁冒不知人事，洒淅恶寒振栗，谵妄，寒退后发热，口渴想喝水，气短，骨痿，膈肠不便，外部浮肿，呃逆嗳气，痱疹，疮疡，痈疽，痤疮痔疮，严重则传入肺脏，咳嗽且鼻渊（流脓涕）。太阴之胜，则火气内郁，疮疡生于内部，流散于外部，病在胁肋，严重则心痛热格，头痛，喉痹，项强，或者湿气内郁，寒气逼迫下焦，少腹满，腰椎痛强，泄泻，足下湿，头重，足背浮肿，小腿浮肿，饮邪发于中，浮肿于上；其复气到来时，则身体沉重，中焦胀满，饮食不化，阴气上逆，胸中不便，饮邪发于中，咳嗽气喘有声，头项痛重，抽搐尤其严重，呕吐且沉默寡言，唾吐清液，严重则传入肾脏，滑泄无度。少阳之胜，则病热客于胃，心烦而痛，目赤呕酸，容易饥饿，耳痛，尿赤，容易惊吓谵妄，暴热消烁，少腹痛，下利赤白；其复气到来时，则枯燥，烦热，惊悸抽搐，咳嗽，鼻衄，心热，烦躁，小便频数，憎风，厥气上行，面色如浮埃，眼睛抽搐，火气内发，上部为口糜，呕吐气逆，出血，血泄，发作成为疟疾，恶寒鼓栗，寒极反热，咽喉脉络焦枯，口渴饮水浆，颜色变黄赤，气短肺痿，化为水饮，传变为浮肿，严重则传入肺脏，咳嗽且血泄。阳明之胜，则清气发于中，左侧胁痛，溏泄，内部为咽喉阻塞，外部发为颓疝，胸中不便，咽痛而咳；其复气到来时，则病生胁肋，气归于左，喜欢叹气，严重则心痛痞满，腹胀而泄，呕吐苦水，咳嗽呃逆烦心，病在膈中，严重则传入肝脏，惊骇筋挛。太阳之胜，则病痔疟，发寒，厥气入胃，则内生心痛，阴部生溃疡，隐私部位不利，牵引阴股筋肉拘挛苛刻，血脉凝涩，络脉满盛血变，或者为血泄，皮肤闭塞浮肿，腹满时减，热气反上行，头项囟顶脑户中痛，眼睛像要脱出，寒气入下焦，则传变为濡泄；其复气到来时，则心胃生寒，胸膈不利，心痛痞满，头痛，喜欢悲伤，时常发作眩晕仆倒，食欲减退，腰椎反痛，屈伸不便，少腹牵引睾丸引腰脊上冲心，唾出清水，以及呃逆嗳气，严重则传入心脏，健忘，喜欢悲伤，寒复气内余，则腰尻痛，屈伸不利，大腿小腿足膝中痛。这六气致病，必须仔细识别，不可失误。
老师说：你懂六气，不懂五运，没有穷尽其中的道理，现在为你解说。假如太阳司天，而运当甲己年，甲己年是土运，太阳是寒水，土能克水，太阳不能正其位；又如厥阴司天，而逢乙庚年金运；少阴少阳司天，而逢丙辛年水运；太阴司天，而逢丁壬年木运；阳明司天，而逢戊癸年火运，其他例子同理。
问：治疗方法如何？老师说：风寒暑湿燥热各自随其气性，有假象则反之，严重的顺从其性，轻微的逆其性，采取方法，务必谨慎不乱。
伤寒例第四
立春正月节斗指艮位，雨水正月中斗指寅位。
惊蛰二月节斗指甲位，春分二月中斗指卯位。
清明三月节斗指乙位，谷雨三月中斗指辰位。
立夏四月节斗指巽位，小满四月中斗指巳位。
芒种五月节斗指丙位，夏至五月中斗指午位。
小暑六月节斗指丁位，大暑六月中斗指未位。
立秋七月节斗指坤位，处暑七月中斗指申位。
白露八月节斗指庚位，秋分八月中斗指酉位。
寒露九月节斗指辛位，霜降九月中斗指戌位。
立冬十月节斗指乾位，小雪十月中斗指亥位。
大雪十一月节斗指壬位，冬至十一月中斗指子位。
小寒十二月节斗指癸位，大寒十二月中斗指丑位。
二十四节气，节有十二个，中气有十二个，五天为一候，气也是同样的规律，合起来有七十二候，判断疾病生死，这需要深刻理解。
《阴阳大论》说：春气温和，夏气暑热，秋气清凉，冬气冰冽，这是四时正气的顺序。冬天严寒，万物深藏，君子周密防护，则不伤于寒。触犯冒犯的，就叫做伤寒。受四时之气侵害，都能致病。以伤寒为病的，是因为它是最盛杀厉的气。中气即发病的，名叫伤寒；不立即发病，寒毒藏在肌肤，到春天变为温病，到夏天变为暑病。暑病，热极重于温病。所以辛苦劳作的人，春夏多温热病，都是由冬天触寒所致，不是时行之气。凡是时行者，春天应该暖而反大寒；夏天应该热而反大凉；秋天应该凉而反大热；冬天应该寒而反大温。这不是其时而有其气，所以一年之中，老少生病多相似，这就是时行之气。想要推测四时正气为病，及时行疫气的方法，都应当按斗历占卜。九月霜降节后，宜渐寒，向冬大寒，至正月雨水节后宜解也。所以叫雨水，是因为冰雪融化而为雨水。至惊蛰二月节后，气渐和暖，向夏大热，至秋便凉。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。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。这是因为冬天不调，适有伤寒之人即为病。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。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，发其冬时伏寒，变为温病。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。其病与温相似，但治有殊耳。十五日得一气，于四时之中，一时有六气，四六名为二十四气。然气候亦有应至仍不至，或有未应至而至者，或有至而太过者，皆成病气也。但天地动静，阴阳鼓击者，各正一气耳。是以彼春之暖，为夏之暑；彼秋之忿，为冬之怒。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。斯则冬夏二至，阴阳合也；春秋二分，阴阳离也。阴阳交易，人变病焉。此君子春夏养阳，秋冬养阴，顺天地之刚柔也。小人触冒，必婴暴疹。须知毒烈之气，留在何经，必发何病，详而取之。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。伤寒之病，逐日浅深，以施方治。今世人伤寒，或始不早治，或治不对病，或日数久淹，困乃告医。医人又不依次第而治之，则不中病。皆宜临时消息制方，无不效也。
又土地温凉，高下不同；物性刚柔，餐［注：桂本餐字为飧，似误］居亦异。是故黄帝兴四方之问，岐伯举四治之能，以训后贤，开其未悟。临病之工，宜须两审也。
凡伤于寒，传经则为病热，热虽甚，不死。若两感于寒而病者，多死。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。
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、汗出、目疼、鼻干、不得卧。
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。此三经受病，未入于腑者，皆可汗而已。
尺寸俱沉濡者，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。
尺寸俱沉细者，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。
尺寸俱弦微者，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。此三经受病，己入于腑者，皆可下而已。
麻黄汤方
麻黄三两（去节） 桂枝三两（去皮） 甘草一两（炙） 杏仁七十枚 （去皮尖）
右四味，以水九升，先煮麻黄减二升，去上沫，纳诸药，煮取二升半，去滓，温服八合，覆取微似汗，不须粥饮，余如桂枝法将息，桂枝汤见后卷。
传阳明，脉大而数，发热，汗出，口渴舌燥，宜白虎汤，不差与承气汤。
白虎汤方
The Master said: If a person's pulse appears normal without signs of disease, yet suddenly suffers from a severe illness resulting in unconsciousness, this is caused by "Li Gui" (malevolent spirits/abnormal pathogens). It should be treated with Zhuyou therapy (an ancient method involving incantations and psychological suggestion). If the patient can speak, they are treatable; if they cannot speak, death is likely.
The Master said: If the pulse is floating and surging, sweat oozes like oil, panting is incessant, fluids cannot be taken in, the body is numb and unresponsive, and there is alternating calmness and restlessness, this indicates the exhaustion of life force. However, it is unknown which organ has first suffered disaster. If sweating wets the hair and panting continues, this indicates the exhaustion of the Lung first. If Yang Qi remains alone while the body appears dark as if smoked, with fixed staring eyes and head shaking, this indicates the exhaustion of the Heart first. If the lips and mouth turn blue-green and the limbs twitch and tremble, this indicates the exhaustion of the Liver first. If the area around the mouth is blackish-yellow, with oily yellow sweat, this indicates the exhaustion of the Spleen first. If there is incontinence of urine and feces, delirious speech, and upward-fixed staring eyes, this indicates the exhaustion of the Kidney first. Furthermore, it is unknown whether Yin or Yang Qi exhausts first. If Yang Qi exhausts first and Yin follows, the corpse will be blue; if Yin Qi exhausts first and Yang follows, the corpse will be red, with warmth in the axillae and heat in the epigastrium.
The Eight Extraordinary Vessels do not connect to the Twelve Regular Meridians but have their own independent pathways. Their diseases generally relate to Yin and Yang imbalances, and their treatment belongs to the regulation of the Twelve Regular Meridians. For example, if the Du Mai (Governing Vessel) is diseased, causing stiffness and hidden pain in the spine, the pulse should be slightly floating and rapid, feeling choppy upon pressure; treatment belongs to the Taiyang (Greater Yang) channel.
If the Ren Mai (Conception Vessel) is diseased, causing internal knotted pain, hernias, or masses, the pulse should be deep and knotted; treatment belongs to the Taiyin (Greater Yin) channel.
If the Chong Mai (Penetrating Vessel) is diseased, causing rebellious Qi and abdominal urgency, the pulse should be floating, deficient, and rapid; treatment belongs to the Taiyin channel.
If the Dai Mai (Girdle Vessel) is diseased, causing painful abdomen and cold pain in the waist, the pulse should be deep and fine; treatment belongs to the Shaoyin (Lesser Yin) channel.
If the Yang Qiao Mai (Yang Heel Vessel) is diseased, affecting the lateral side with Qi moving outward, the pulse should be wiry and rapid, feeling relaxed upon pressure; treatment belongs to the Shaoyang (Lesser Yang) channel.
If the Yin Qiao Mai (Yin Heel Vessel) is diseased, affecting the lateral side with Qi moving inward, the pulse should be floating and relaxed, feeling slightly rapid and wiry upon pressure; treatment belongs to the Jueyin (Terminal Yin) channel.
The Yang Wei Mai (Yang Linking Vessel) meets with all Yang vessels; its disease is outside the vessels, manifesting as aversion to cold and fever, with a floating and deficient pulse; treatment belongs to the Qi aspect.
The Yin Wei Mai (Yin Linking Vessel) intersects with all Yin vessels; its disease is inside the vessels, manifesting as heart pain and hot palms, with a wiry and choppy pulse; treatment belongs to the Blood aspect.
The Yang Wei Mai links the Yang, and the Yin Wei Mai links the Yin; these represent the distinction between Qi and Blood, preventing confinement to a single meridian.
Diseases of the Eight Extraordinary Vessels arise from pathogenic invasion of various meridians, transmitting over time, or due to劳伤 (labor injury/exhaustion), rather than sudden onset.
Question: How to distinguish internal injuries of the eight vessels? The Master said: Injury to the Du Mai causes reluctance to extend the body and inability to stand for long periods, with dull distending pain when standing; injury to the Ren Mai causes frequent urination with turbid white color; injury to the Chong Mai causes incessant coughing with sound but no phlegm, worsening with exertion; injury to the Dai Mai causes coldness around the entire torso; injury to the Yang Qiao Mai causes numbness on the left side of the body; injury to the Yin Qiao Mai causes numbness on the right side; injury to the Yang Wei Mai causes severe aversion to cold and damp skin; injury to the Yin Wei Mai causes severe aversion to heat and dry skin.
Question: What do the pulses look like for internal injuries of the eight vessels? The Master said: Injury to the Du Mai shows a large and choppy Chi (Cun-Kuan-Chi) pulse at the radial artery's distal position; injury to the Ren Mai shows a large and choppy Guan pulse at the middle position; injury to the Chong Mai shows a short and choppy Cun pulse at the proximal position; injury to the Dai Mai shows a deep, slow, and knotted pulse; injury to the Yang Qiao Mai shows a pulse that is sometimes large and wiry; injury to the Yin Qiao Mai shows a pulse that is sometimes fine and wiry; injury to the Yang Wei Mai shows a pulse that is sometimes relaxed and wiry; injury to the Yin Wei Mai shows a pulse that is sometimes tight and choppy. Question: How to treat them? The Master said: Injury to the Du Mai requires tonifying Marrow; injury to the Ren Mai requires tonifying Essence; injury to the Chong Mai requires tonifying Qi; injury to the Dai Mai requires tonifying the Kidney; injury to the Yang Qiao Mai benefits the Gallbladder; injury to the Yin Qiao Mai tonifies the Liver; injury to the Yang Wei Mai regulates Defensive Qi (Wei Qi); injury to the Yin Wei Mai nourishes Nutritive Qi (Ying Qi).
Question: How to prescribe formulas? The Master said: Assess the constitution's deficiency or excess, observe the severity of the disease, adopt appropriate methods, and weigh them carefully to avoid error.
Treatise on Cold Damage and Miscellaneous Diseases, Volume 3
Chapter 3: Principal and Guest Six Qi
Question: How to distinguish the Principal and Guest Six Qi? The Master said: Jueyin generates Shaoyin, Shaoyin generates Shaoyang, Shaoyang generates Taiyin, Taiyin generates Yangming, Yangming generates Taiyang, and Taiyang regenerates Jueyin, cycling endlessly without change year after year; this is called Principal Qi. Jueyin generates Shaoyin, Shaoyin generates Taiyin, Taiyin generates Shaoyang, Shaoyang generates Yangming, Yangming generates Taiyang, and Taiyang regenerates Jueyin, cycling endlessly; this is called Guest Qi.
Question: What are their start and end points? The Master said: The First Qi starts at Great Cold, the Second at Spring Equinox, the Third at Grain Full, the Fourth at Great Heat, the Fifth at Autumn Equinox, and the Final Qi starts at Light Snow, ending again at Great Cold. Principal and Guest Qi share the same timing, differing by thirty degrees (approx. 15 days) each.
Question: What are Si Tian (Ruling Heaven) and Zai Quan (Ruling Earth)? The Master said: These refer to Guest Qi. For example, in Zi-Wu years, Shaoyin rules Heaven, Yangming rules Earth, Taiyang is First Qi, Jueyin is Second Qi, Si Tian is Third Qi, Taiyin is Fourth Qi, Shaoyang is Fifth Qi, and Zai Quan is Final Qi. In Mao-You years, Yangming rules Heaven, Shaoyin rules Earth; First Qi is Taiyin, Second is Shaoyang, Third is Yangming, Fourth is Taiyang, Fifth is Jueyin, Final is Shaoyin. In Xu-Chen years, Taiyang rules Heaven, Taiyin rules Earth. In Chou-Wei years, Taiyin rules Heaven, Taiyang rules Earth. In Yin-Shen years, Shaoyang rules Heaven, Jueyin rules Earth. In Si-Hai years, Jueyin rules Heaven, Shaoyang rules Earth. Other years follow this pattern.
Question: How do they cause disease? The Master said: There is a distinction between Principal and Guest. If Jueyin rules Heaven and Principal Qi prevails, there is chest/hypochondriac pain and tongue stiffness; if Guest Qi prevails, there is tinnitus, dizziness, and severe coughing/rebellious Qi. If Shaoyin rules Heaven and Principal Qi prevails, there is heart heat, irritability, hypochondriac pain/distension; if Guest Qi prevails, there is nasal congestion/sneezing, neck stiffness, shoulder/back heat, headache, shortness of breath, fever, deafness, blurred vision, severe foot edema, bleeding, sores, aphonia, and panting/coughing. If Taiyin rules Heaven and Principal Qi prevails, there is chest/abdominal fullness and postprandial dizziness; if Guest Qi prevails, there is head/facial/foot edema and respiratory panting. If Shaoyang rules Heaven and Principal Qi prevails, there is chest fullness, coughing/rebellious Qi, orthopnea, severe bleeding, and hand heat; if Guest Qi prevails, there is erysipema eruption, Dan Biao (acute skin inflammation), sores, vomiting/rebellious Qi, throat obstruction, headache, sore throat, deafness, bleeding, and internal convulsions. If Yangming rules Heaven and Principal Qi prevails, there is internal cold recurrence, coughing, epistaxis, throat obstruction, epigastric heat; persistent coughing with white blood expulsion leads to death because Metal resides in Shaoyang's position, and Guest Qi does not overcome Principal Qi. If Taiyang rules Heaven and Principal Qi prevails, there is hoarseness; if Guest Qi prevails, there is chest discomfort, clear nasal discharge, and cough upon cold exposure. If Jueyin rules Earth and Principal Qi prevails, there is tendon/bone spasm and periodic waist/abdominal pain; if Guest Qi prevails, there is joint stiffness, internal spasms, and external immobility. If Shaoyin rules Earth and Principal Qi prevails, there is rebellious Qi ascending, heart pain/heat, widespread Bi syndrome in the diaphragm radiating to hypochondria, uncontrolled sweating, and limb coldness; if Guest Qi prevails, there is lower back pain, buttock/thigh/knee/hip/calf/foot heat/soreness, foot edema, inability to stand long, and urinary/stool abnormalities. If Taiyin rules Earth and Principal Qi prevails, there is cold Qi rebellion/fullness, inability to eat/drink, severe hernia; if Guest Qi prevails, there is foot flaccidity/lower edema, irregular urination/stool, dampness invading Lower Jiao causing diarrhea,阴肿 (genital swelling), and private ailments. If Shaoyang rules Earth and Principal Qi prevails, there is heat rising to invade the Heart, causing heart pain/heat and vomiting; if Guest Qi prevails, there is waist/abdominal pain, aversion to cold, severe white diarrhea/urine. If Yangming rules Earth and Principal Qi prevails, there is heavy waist, abdominal pain, lower abdominal cold, loose stools, cold reversal in intestines rushing to chest, severe panting/fullness, inability to stand long; if Guest Qi prevails, there is clear Qi moving downward, lower abdominal hardness, frequent diarrhea. If Taiyang rules Earth, Water occupies its position, so there is no overcoming.
Question: What about Sheng Fu (Overcoming and Repaying)? The Master said: Where there is Overcoming, there is Repaying; where there is no Overcoming, there is no Repaying. Jueyin Overcoming causes tinnitus, dizziness, mental confusion/vomiting, stomach/diaphragm cold sensation, hypochondriac Qi stagnation transforming into heat, yellow-red urine, epigastric pain radiating to hypochondria, borborygmus, incomplete digestion diarrhea, lower abdominal pain, dysentery, severe vomiting, and diaphragmatic blockage. Its Repaying causes lower abdominal hardness/fullness, internal urgency/sudden pain, Jueyin heart pain, sweating, vomiting, inability to keep food down, tendon/joint tremors/dizziness/cold reversal, severe spleen invasion leading to food stagnation/vomiting. Shaoyin Overcoming causes subcostal heat, hunger, umbilical Qi movement, Qi wandering San Jiao, vomiting, irritability, abdominal fullness/pain, loose red discharge. Its Repaying causes internal fire/heat, irritability, nasal congestion/sneezing, lower abdominal colic, throat dryness, Qi moving left-up/right, cough with skin pain, sudden aphonia, heart pain, depression/unconsciousness, chills/shivering, delirium, followed by fever/thirst, shortness of breath, bone flaccidity, diaphragmatic/intestinal constipation, external edema, hiccups/belching, macules/rashes, sores/carbuncles, acne/hemorrhoids, severe lung invasion causing cough and nasal sinusitis. Taiyin Overcoming causes internal fire depression, internal sores spreading externally, hypochondriac pain, severe heart pain/heat obstruction, headache, throat obstruction, neck stiffness, or internal dampness depression, cold forcing Lower Jiao, lower abdominal fullness, lumbar stiffness, diarrhea, wet feet, heavy head, foot edema, calf swelling, internal fluid retention, upper edema. Its Repaying causes heavy body, middle jiao fullness, undigested food, Yin Qi reversing upward, chest discomfort, internal fluid retention, cough/wheezing, head/neck pain/heaviness, severe convulsions, vomiting with silence, clear saliva, severe kidney invasion causing profuse diarrhea. Shaoyang Overcoming causes heat invading Stomach, heart vexation/pain, red eyes, sour vomiting, hunger, ear pain, red urine, fright/delirium, sudden heat consumption, lower abdominal pain, red-white discharge. Its Repaying causes dryness, vexing heat, fright/convulsions, cough, epistaxis, heart heat, irritability, frequent urination, wind aversion, Qi ascending, dusty complexion, eye twitching, internal fire erupting as mouth ulcers, vomiting/rebellious Qi, bleeding, malaria, chills/shivering, extreme cold turning to heat, scorched throat veins, thirst for fluids, yellow-red discoloration, shortness of breath, lung萎 (withering), transformation into water, edema, severe lung invasion causing cough and blood discharge. Yangming Overcoming causes clear Qi erupting internally, left hypochondriac pain, loose stools, internal throat obstruction, external hernia, chest discomfort, throat pain/cough. Its Repaying causes hypochondriac disease, Qi gathering left, frequent sighing, severe heart pain/fullness, abdominal distension/diarrhea, bitter vomiting, cough/hiccups/vexation, diaphragmatic disease, severe liver invasion causing fright/tendon spasms. Taiyang Overcoming causes hemorrhoidal malaria, chills, Qi entering Stomach causing internal heart pain, genital ulcers, private dysfunction,牵引 (pulling) of thigh muscles/spasms, blood vessel coagulation, collateral fullness/blood changes, blood discharge, skin closure/edema, fluctuating abdominal fullness, heat rising, head/occipital pain, eyeball protrusion, cold entering Lower Jiao causing diarrhea. Its Repaying causes heart/stomach cold, diaphragmatic discomfort, heart pain/fullness, headache, sadness, vertigo/fainting, reduced appetite, lumbar pain, stiffness, lower abdominal pain pulling testicles/waist/spine to heart, clear saliva, hiccups/belching, severe heart invasion causing amnesia/sadness, internal cold surplus causing sacral pain, stiffness, thigh/calf/knee pain. These six Qi diseases must be carefully recognized.
The Master said: You know Six Qi but not Five Movements (Wu Yun), thus not fully understanding the Dao. Now I explain: If Taiyang rules Heaven and the movement is Jia-Ji, Jia-Ji is Earth Movement, Taiyang is Cold Water; Earth overcomes Water, so Taiyang cannot maintain its proper position. Similarly, if Jueyin rules Heaven and encounters Yi-Geng Metal Movement; Shaoyin/Shaoyang rule Heaven encountering Bing-Xin Water Movement; Taiyin rule Heaven encountering Ding-Ren Wood Movement; Yangming rule Heaven encountering Wu-Gui Fire Movement. The principle is the same.
Question: How to treat? The Master said: Wind, Cold, Summer-Heat, Dampness, Dryness, and Heat each follow their Qi nature. If there is a false appearance, reverse it; if severe, follow it; if mild, oppose it. Adopt methods cautiously without disorder.
Example of Cold Damage, Chapter 4
Method for Determining Disease via Four Seasons, Eight Festivals, Twenty-Four Solar Terms, and Seventy-Two Pentads:
Start of Spring (Lichun), First Month Festival: Dipper points Gen. Rain Water (Yushui), First Month Middle: Dipper points Yin.
Awakening of Insects (Jingzhe), Second Month Festival: Dipper points Jia. Spring Equinox (Chunfen), Second Month Middle: Dipper points Mao.
Clear and Bright (Qingming), Third Month Festival: Dipper points Yi. Grain Rain (Guyu), Third Month Middle: Dipper points Chen.
Start of Summer (Lixia), Fourth Month Festival: Dipper points Xun. Grain Full (Xiaoman), Fourth Month Middle: Dipper points Si.
Grain in Ear (Mangzhong), Fifth Month Festival: Dipper points Bing. Summer Solstice (Xiazhi), Fifth Month Middle: Dipper points Wu.
Minor Heat (Xiaoshu), Sixth Month Festival: Dipper points Ding. Major Heat (Dashu), Sixth Month Middle: Dipper points Wei.
Start of Autumn (Liqiu), Seventh Month Festival: Dipper points Kun. Limit of Heat (Chushu), Seventh Month Middle: Dipper points Shen.
White Dew (Bailu), Eighth Month Festival: Dipper points Geng. Autumn Equinox (Qiufen), Eighth Month Middle: Dipper points You.
Cold Dew (Hanlu), Ninth Month Festival: Dipper points Xin. Frost Descent (Shuangjiang), Ninth Month Middle: Dipper points Xu.
Start of Winter (Lidong), Tenth Month Festival: Dipper points Qian. Light Snow (Xiaoxue), Tenth Month Middle: Dipper points Hai.
Heavy Snow (Daxue), Eleventh Month Festival: Dipper points Ren. Winter Solstice (Dongzhi), Eleventh Month Middle: Dipper points Zi.
Minor Cold (Xiaohan), Twelfth Month Festival: Dipper points Gui. Major Cold (Dahan), Twelfth Month Middle: Dipper points Chou.
There are twelve Solar Terms and twelve Middle Qi, five days per Pentad, totaling seventy-two Pentads. Determining disease and death requires profound understanding.
The "Great Treatise on Yin and Yang" states: Spring Qi is mild, Summer Qi is hot, Autumn Qi is cool, Winter Qi is icy; this is the order of Four Seasons' Correct Qi. In winter, severe cold hides all things; if gentlemen are careful, they are not injured by cold. Those who violate this are called suffering from Shanghan (Cold Damage). Invasion by Four Seasons' Qi causes disease. Shanghan is named so because it is the most lethal Qi. Immediate illness upon invasion is called Shanghan; delayed illness occurs when Cold Toxicity hides in skin/muscles, becoming Wenbing (Warm Disease) in Spring, and Shubing (Summer Heat Disease) in Summer. Shubing is more severe than Wenbing. Thus, hardworking people often get warm diseases in Spring/Summer due to winter cold exposure, not seasonal epidemic Qi. Seasonal epidemic Qi occurs when Spring is abnormally cold, Summer abnormally cool, Autumn abnormally hot, Winter abnormally warm. This mismatch causes similar illnesses among all ages. To predict Four Seasons Correct Qi diseases and seasonal epidemics, one must consult the Dipper calendar. After Frost Descent in September, it gradually cools to severe cold in Winter; by Rain Water in January, it thaws. Hence "Rain Water." After Awakening of Insects in February, Qi warms toward Summer heat, cooling in Autumn. From Frost Descent to Spring Equinox, cold exposure causing immediate illness is Shanghan. Sept/Oct cold is mild; Nov/Dec cold is severe; Jan/Feb cold is light. This is due to improper Winter conditions. Abnormal Winter warmth is Dongwen (Winter Warmth), distinct from Shanghan, with varying severity and treatments. After Start of Spring, if no severe cold/ice occurs but high fever appears, it is Spring Yang Qi releasing Winter latent cold, becoming Warm Disease. After Spring Equinox to Autumn Equinox, sudden cold is seasonal Cold Epidemic. March/April cold affects weak Yang, causing mild heat; May/June cold affects strong Yang, causing severe heat; July/August cold affects declining Yang, causing mild heat. Treatment differs from Warm Disease. Each Qi lasts 15 days; four seasons have six Qi each, totaling twenty-four Qi. Climate may arrive early, late, or excessively, all becoming pathogenic. Heaven and Earth move, Yin and Yang interact, establishing each Qi. Spring warmth becomes Summer heat; Autumn intensity becomes Winter cold. After Winter Solstice, one Yang line rises, one Yin falls. After Summer Solstice, one Yang falls, one Yin rises. Solstices represent Yin-Yang union; Equinoxes represent separation. Yin-Yang exchange causes human disease. Gentlemen nourish Yang in Spring/Summer, Yin in Autumn/Winter, following Heaven-Earth softness/hardness. Villains violating this suffer acute rashes. One must know which meridian retains toxic Qi and which disease arises. Thus, Spring wind injury causes Summer diarrhea; Summer summer-heat injury causes Autumn malaria; Autumn dampness injury causes Winter cough; Winter cold injury causes Spring Warm Disease. This is inevitable. Shanghan treatment depends on daily progression. Modern patients delay treatment, receive incorrect treatment, or seek help only when exhausted. Physicians failing to treat sequentially miss the disease. Formulas must be adjusted timely for efficacy.
Land temperature varies by altitude; material nature varies by region; diet and residence differ. Thus, Yellow Emperor asked about four directions, Qibo explained four treatments, instructing future sages. Physicians must examine both.
All cold damage transmitting meridians causes heat disease; even severe heat is not fatal. If two meridians are affected by cold simultaneously (Liang Gan), death is common. Floating pulse at Cun/Kuan positions indicates Taiyang disease, appearing day 1-2. Pulse connects to Fengfu, causing head/neck pain and stiff spine.
Long pulse indicates Yangming disease, appearing day 2-3. Pulse connects nose/eyes, causing body heat, sweating, eye pain, dry nose, insomnia.
Wiry pulse indicates Shaoyang disease, appearing day 3-4. Pulse follows hypochondrium/ears, causing chest/hypochondriac pain and deafness. These three meridian diseases, not entering Fu organs, can be treated with sweating.
Deep-soft pulse indicates Taiyin disease, appearing day 4-5. Pulse spreads to Stomach/connects throat, causing abdominal fullness and dry throat.
Deep-fine pulse indicates Shaoyin disease, appearing day 5-6. Pulse passes Kidney/connects Lung/ties tongue root, causing dry mouth/throat and thirst.
Wiry-micro pulse indicates Jueyin disease, appearing day 6-7. Pulse follows genitals/connects Liver, causing vexation/fullness and scrotal retraction. These three meridian diseases, having entered Fu organs, can be treated with purgation.
Shanghan transmitting to Taiyang: Floating-rapid pulse, fever, no sweat, irritability; use Mahuang Tang.
Mahuang Tang Formula:
Ephedrae Herba (Mahuang) 3 liang (remove joints)
Cinnamomi Ramulus (Guizhi) 3 liang (remove bark)
Glycyrrhizae Radix et Rhizoma (Gancao) 1 liang (roasted)
Prunus Armeniaca Semen (Xingren) 70 seeds (remove skin/apex)
These four ingredients: Boil in 9 sheng water, first boil Ephedra until reduced by 2 sheng, remove foam, add other herbs, boil to 2.5 sheng, strain, warm drink 8 he. Cover for slight sweating. No porridge drink needed. Rest as with Guizhi Tang (see later volume).
Transmitting to Yangming: Large-rapid pulse, fever, sweating, dry mouth/thirst; use Baihu Tang. If ineffective, use Chengqi Tang.
Baihu Tang Formula:
Anemarrhenae Rhizoma (Zhimu) 6 liang
Gypsum Fibrosum (Shigao) 1 jin
Glycyrrhizae Radix et Rhizoma (Gancao) 2 liang (roasted)
Oryza Sativa (Jingmi) 6 he