《伤寒论》论伤寒，《金匮要略》论杂病，乃仲景全书。《伤寒论》得成无己创注，续者
五十余家，故得昌明宇内∶《金匮要略》人罕言之，虽有赵良、徐彬等注释，但其文义古奥，系千载
残编错简，颇多疑义，阙文亦复不少，承讹袭谬，随文蔓衍，宜后人视为迂远，束诸高阁。今于其
失次者序之，残缺者补之，博采群书，详加注释，俾二书并行于世，庶后之业医者，不为俗说所误，
知仲景能治伤寒，未尝不能治杂证也。
夫人秉五常，因风气而生长。风气虽能生万物，亦能害万物，如水能浮舟，亦能覆舟。若五脏
元真通畅，人即安和。客气邪风，中人多死，千般 难，不越三条∶一者，经络受邪人脏腑，为内所
因也；二者，四肢九窍，血脉相传，壅塞不通，为外皮肤所中也；三者，房室金刃，虫兽所伤。以
此详之，病由都尽。若人能养慎，不令邪风干忤经络；适中经络，未流传腑脏，即医治之∶四肢才觉
重滞，即导引吐纳，针灸膏摩，勿令九窍闭塞；更能无犯王法，禽兽灾伤，房室勿令竭乏，服食节其
冷热、苦酸辛甘，不遣形体有衰，病则无由人其腠理。腠者，三焦通会元真之处，为血气所注。理者，是
皮肤脏腑之文理也。
【按】此篇乃一书之纲领，前人误编为次篇，先后失序，今冠于首，以统大意。
【注】五常者，五行也。五行之气──风、暑、湿、燥、寒也；五行之味──酸、苦、甘、
辛、咸也。夫人禀此而有其形，则脏腑日与气味相通。不曰五气，而曰风气者，该他气而言也。盖风
贯四气，犹仁贯四德，故曰∶因风气而生长也。然风气虽能生万物，亦能害万物者，盖主气正风，从其所
居之乡而来，主长养万物者也；客气邪风，从其冲后而来，主杀害万物者也。人在气交之中，其
生其害，犹水能浮舟亦能覆舟也。天之五气，人得之则为五脏真元之气，若通畅相生，虽有客气邪
风，勿之能害，人自安和；如不通畅，则客气邪风，乘隙而入，中人多死。然人致死之由，虽有千般
难，大要不外三因∶一者，中虚，经络受邪，即入脏腑，此为内所因也；二者，中实，虽感于邪，脏
腑不受，惟外病躯体，四肢九窍，血脉壅塞，此为外所中也；三者，房室金刃、虫兽所伤，非由中
外虚实，感召其邪，是为不内外因也，以此三者详之，千般 难，病由悉尽矣。若人能慎养
形气，不令客气邪风干忤经络，即适中经络，未传脏腑，遂医治之，自可愈也。四肢九窍，才觉
重滞，尚未闭塞，即导引、吐纳、针灸、按摩，亦可愈也。更能无犯王法，禽兽灾伤，房室勿令
竭乏，服食节其冷热，五味各得其宜，不使形气有衰，万病 难无由而入其腠理矣。腠者，一身空
隙，血气往来之处，三焦通会真元之道路也。理者，皮肤脏腑，内外井然，不乱之条理也。
【按】正风者，从八方应时而来，相生和缓之主气也；邪风者，从其冲后而来，相克冲烈之
客气也。如时当东风而来西风也，所谓后者，以已过之时言也。
【集注】赵良曰∶人在气交中，秉地之刚柔，以成五脏百骸之形；秉天之阴阳，以成
六经之气。形气合一，神机发用，驾行谷气，出入内外，同乎天度，升降浮沉，应夫四时，
主宰于身形之中，谓之元真。外感者，客气也。《灵枢》曰∶虚邪不能独伤，必因身形之
虚而后客之。盖天人之气，各有正、不正，人气正则不受邪，不正则邪乘之；天气正则助
其生长，不正则害之。人气不正者，由七情动中，服食不节，房欲过度，金刃虫兽，伤
其气血，尽足以受病也。天气不正者，由四时不和，八风不常，尽足以伤万物也。
问曰∶上工治未病，何也∶师曰∶夫治未病者，见肝之病，知肝传脾，当先实脾；四
季脾王不受邪，即勿补之。中工不晓相传，见肝之病，不解实脾，惟治肝也。夫肝之病，补
用酸，助用焦苦，益用甘味之药调之。酸入肝，焦苦入心，甘入脾，脾能伤肾，肾气微
弱，则水不行，水不行，则心火气盛，心火气盛，则伤肺，肺被伤，则金气不行，金气
不行，则肝气盛，肝气盛，则肝自愈，此治肝补脾之要妙也。肝虚则用此法，实则不在
用之。经曰∶虚虚实实，补不足，损有余。是其义也。余脏准此。
【注】此承上条受病三因，以明其治也。上工，良医也。中工，常医也。已病，已然
之病也。未病，未然之病也，假如现下肝病，此已然之病也；肝病将来传脾，此未然之病
也。良医知肝病传脾，见人病肝，先审天时衰旺，次审脾土虚实，时旺脾实则知不受肝
邪，不须补脾，直治已病之肝；若时衰脾虚，则知肝必传脾，先补未病之脾，兼治已病之
肝。彼常医不晓四时所胜，五脏相传之理，见肝之病，惟泻已病之肝，不知补未病之脾也。
上工不但知肝实必传脾虚之病，而且知肝虚不传脾虚反受肺邪之病。故治肝虚、脾虚之
病，则用酸入肝，以补已病之肝，用焦苦入心，以助不病之心，用甘入脾，以益不实之
脾。使火生土，使土制水，水弱则火旺，火旺则制金，金被制则木不受邪，而肝病自愈
矣。此亢则害，承乃制，制则生化，化生不病之理，隔二、隔三之治，故曰∶此治肝补
脾之要妙也。然肝虚则用此法，若肝实则不用此法也。中工不晓虚实，虚者泻之，是为
虚虚；实者补之，是为实实。非其义也。上工知其虚实，补其不足，损其有余。是其义
也。其余四脏，皆准此法。伤字，作制字看。
【集注】徐彬曰∶假如肝经之病，肝木胜脾土，知邪必传脾经，治宜实脾为先，此脾
未病而先实之，所谓治未病也。不忧本脏之虚，而忧相传不已，其病益深，故先以实脾
为急务也。
程林曰∶经云∶因其轻而扬之，因其重而减之，因其衰而彰之。所谓因者，乘其机
也。治未病者，谓治未病之脏腑，非治未病之人也。见肝之病，当先实脾，使土旺则能
胜水，水不行则火盛而制金，金不能干木，肝自愈矣。此治肝补脾，治未病之法也。
高世FS 曰∶实脾专为制水，使火盛金衰，肝不受制，则肝自愈，其理甚精微，故曰∶此
治肝补脾之要妙也。
问曰∶病患有气色见于面部，愿闻其说？师曰∶鼻头色青，腹中痛，苦冷者死（一云，腹
中冷，苦痛者死）；鼻头色微黑者，有水气；色黄者，胸上有寒；色白者，亡血也；设微赤非
时者，死。其目正圆者痉，不治。又色青为痛，色黑为劳，色赤为风，色黄者便难，色
鲜明者有留饮。
【注】气色见于面部，而知病之死生者，以五气入鼻，藏于五脏，其精外荣于面也。色
者，青、赤、黄、白、黑也。气者，五色之光华也。气色相得者，有气有色，平人之色
也。即经云∶青如翠羽，赤如鸡冠，黄如蟹黄，白如豚膏，黑如乌羽者，生也。气色相
失者，色或浅深，气或显晦，病患之色也。即经云∶浮泽为外，沉浊为内，察其浮沉，以
知浅深，察其夭泽，以观成败，察其散搏，以知新故，视色上下，以知病处，色粗以明，沉
夭为甚，不明不泽，其病不甚也。有色无气者，色枯不泽，死人之色也。即经云∶青如
蓝叶，黄如黄土，赤如 血，白如枯骨，黑如炱者，死也。鼻者，明堂也。明堂光泽，则
无病矣。而曰见青色为腹中痛，鼻苦冷甚者死；黑色为水为劳，黄色为上寒下热，小便
难；面目鲜明，内有留饮；色白为亡血；色赤为热为风，若见于冬，为非其时者，死。目
直视，正圆不合，如鱼眼者，痉，不治。此气色主病之大略也，其详皆载《内经》。
师曰∶病患语声寂然，喜惊呼者，骨节间病；语声喑喑然不彻者，心膈间病；语声
啾啾然细而长者，头中病（一作痛）。
【按】头中病之“头”字，当是“腹”字。经中从无头中病之文，且文义不属，必是传
写之讹。
【注】病患语声寂然，谓寂然不语也；若恶人语是心病也。喜惊呼者，谓不恶人语，且
喜惊呼，是知其病不在心而在外也，故曰∶骨节间病也。病患语声喑喑然不彻者，谓声不
响亮而不了彻也，此有碍于息气，故知为心膈间病也。病患语声啾啾然细而长者，谓唧唧哝哝
小而悠长也，因不敢使气急促动中，故知腹中病也。
师曰∶息摇肩者，心中坚；息引胸中上气者，咳；息张口短气者，肺痿唾沫。
【注】息者，一呼一吸也。摇肩，谓抬肩也。心中坚，谓胸中壅满也。呼吸之息，动
形抬肩，胸中壅气上逆者，喘病也。呼吸引胸中之气上逆，喉中作痒梗气者，咳病也。呼
吸张口。不能续息，似喘而不抬肩者，短气病也。盖肺气壅满，邪有余之喘也，肺气不
续息，正不足之短气也。然不足之喘，亦有不续息者；有余之短气，亦有胸中壅满者，肺
气上逆者，必咳也。咳时唾痰，嗽也。若咳唾涎沫不已者，非咳病也，乃肺痿也。
师曰∶吸而微数，其病在中焦。实也，当下之即愈；虚者不治。在上焦者，其吸促；在
下焦者，其吸远。此皆难治。呼吸动摇振振者，不治。
【按】吸促之“促”字，当是“远”字；吸远之“远”字，当是“促”字，方合病义，
必传写之讹。
【注】此承上文，言喘分三焦，有可治、不可治之辨也。喘，肺病也，肺主气，司呼
吸，故以呼吸气促，谓之喘也，若呼吸气均促，是病在呼吸，阻升降之气也，故知喘在
中焦也。呼之气促，吸之气长，病在呼，呼出心与肺，故知喘在上焦也；呼之气长，吸
之气短，病在吸，吸入肾与肝，故知喘在下焦也。喘之实者，谓邪气盛，则实也，中实，
则必腹满便硬，当下之，可治也。喘之虚者，谓正气夺则虚也，中虚，则必腹软便滋，不
堪下，难治也。若喘而呼吸动摇，振振不能擎身者，则为形气不相保，勿论虚实不治也。
曰吸而微数，数即促也，促即短也，远即长也。吸不言呼，略辞也，犹言呼吸均短，呼
短吸长，吸短呼长也。
师曰∶寸口脉动者，因其王时而动，假令肝旺色青。四时各随其色。肝色青而反色
白，非其时色脉，皆当病。
【注】寸口者，统言左右三部脉也。脉动法乎四时，命乎五脏，然必因其旺时而动，则
为平脉也。假令肝旺于春，随其时，色当青，脉当弦，此不病之色脉也，若色反白，脉反
浮，此非其时，乃病之色脉也。四时准此。
【集注】尤怡曰∶旺时，当时至而气旺，乃脉乘之而动，其色亦应之。如肝旺于春，脉
弦而色青，此其常也。推之四时，无不皆然。若色当青而反白，为非其时而有是色，不特
肝病为然，即肺亦当病矣。
问曰∶有未至而至，有至而不至，有至而不去，有至而太过，何谓也？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；似得甲子，而天未温和，此为至而不至也；以得甲子，而天大寒不解，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。
【注】冬至之后，得甲子日夜半，少阳之气始生，天渐温和，气之常也。若未得甲子，
天即温和，此为未至而至也。气未应至而先至者，是来气有余也。已得甲子，阳气渐盛，
天未温和，此为至而不至也，气应至而不至者，是来气不足也。若天大寒不解，此为至
而不去也。气应去而不去者，是去气太过也。若天过温如盛夏时，此为至而太过也。气应
至而甚者，是至气太过也。太过者，其气淫，则薄其所不胜，乘其所胜也；不及者，其气
迫，则所胜妄行，所生者受病，所不胜薄之也。此《内经》所谓谨候其时，气可与期。余
皆仿此。
师曰∶病患脉，浮者在前，其病在表；浮者在后，其病在里。腰痛背强不能行，必短
气而极也。
【注】脉浮，虚风之候也。关前之寸脉浮者，病在表也；关后之尺脉浮者，病在里也。
虚风在表，故主腰痛背强不能行也；虚风在里，故主短气而极也。
问曰∶经云∶厥阳独行。何谓也？师曰∶此为有阳无阴，故称厥阳。
【注】阴阳偕行，顺也；阴阳独行，逆也。厥，逆也。逆阳独行，此为有阳无阴，故称
厥阳也。
【集注】李 曰∶厥阳即阳厥也。《内经》云∶阳气衰于下则为寒厥，阴气衰于下
则为热厥。此厥阳独行，有阳无阴之大概也。
高世FS 曰∶按此为有阳无阴，是为厥阳也。经曰∶阴气衰于下，则为热厥。帝曰∶热
厥何如而然也？岐伯曰∶阴气虚，则阳气入；阳气入，则胃不和；胃不和，则精气竭；精
气竭，则不营于四肢也。乃肾气日衰，阳气独胜，此所以为有阳无阴，而为厥阳独行也。
问曰∶寸脉沉大而滑，沉则为实，滑则为气。实气相搏，血气入脏即死，入腑即愈，
此为卒厥。何谓也？师曰∶唇口青，身冷，为入脏，即死；如身和，汗自出，为入腑，即
愈。
【按】“寸脉沉大而滑，沉则为实，滑则为气，实气相搏”之十八字，文理不顺，衍
文也。血气入脏之“血”字，当是“厥”字，始与卒厥相合，必传写之讹也。
《伤寒论》论述伤寒，《金匮要略》论述杂病，这两部著作构成了张仲景的完整医学体系。《伤寒论》因为得到了成无己的首创性注释，随后又有五十多位医家续作注解，因此得以在天下广泛传播和阐明；而《金匮要略》却很少有人提及，虽然已有赵良、徐彬等人的注释，但其文字义理古奥深涩，且由于历经千年流传，竹简错乱脱漏，存在许多疑问之处，缺失的文字也不少，后人沿袭错误，谬误随文蔓延，导致后来的学者认为其迂阔遥远，将其束之高阁。如今我对其中次序混乱的地方进行整理，对残缺的部分进行补全，广泛搜集各类书籍，详细加以注释，使这两部书能并行于世，希望后世从事医疗工作的人，不被世俗的说法所误导，知道张仲景不仅能治疗伤寒，也同样能够治疗杂病。
人秉承五行之常道，依靠自然界的风气而生长发育。风气虽然能够滋生万物，也能危害万物，就像水能浮起船只，也能倾覆船只一样。如果五脏的真元之气通畅无阻，人就能平安调和。外界的客气邪风，一旦侵入人体，往往会导致死亡，千种万种的疾病，不出三条原因：第一，经络受邪气侵袭进而传入脏腑，这是由内部虚弱所致的原因（内因）；第二，四肢和九窍之间，血脉相互传变，壅塞不通，这是由外部皮肤所受的伤害（外因）；第三，房事过度、金属利器伤害、虫兽咬伤等。根据这三点来详细分析，疾病的来源就完全清楚了。如果人能谨慎调养，不让邪风侵犯经络；即使邪气刚刚侵入经络，尚未流传到脏腑，就立即进行治疗；四肢刚觉得沉重滞涩，就采用导引、吐纳、针灸、膏摩等方法，不要让九窍闭塞；此外，不触犯法律，避免禽兽灾祸伤害，房事不要使其枯竭匮乏，饮食调节冷热及酸苦辛甘五味，不让形体身体衰弱，那么病邪就无法侵入腠理。腠，是三焦通会真元之气的处所，是血气灌注的地方。理，是皮肤和脏腑的纹理结构。
【按语】这一篇是全书的纲领，前人错误地将其编排在第二篇，导致先后次序颠倒，现在把它放在卷首，以统领全文大意。
【注释】五常，指的是五行。五行的气候——风、暑、湿、燥、寒；五行的味道——酸、苦、甘、辛、咸。人禀受这些而形成形体，那么脏腑就每日与气味相通。不说“五气”而说“风气”，是因为风气包含其他四种气而言。大概风气贯通四时之气，就像仁德贯通四德一样，所以说：“依靠风气而生长。”然而风气虽然能生养万物，也能危害万物，这是因为主气正风，从其所居的方向而来，主要作用是长养万物；客气邪风，从对冲的后方而来，主要作用是杀害万物。人处于天地气交之中，其生存与受害，就像水能浮舟也能覆舟一样。天上的五气，人得到它就成了五脏的真元之气，如果能通畅相生，即使有客气邪风，也不能伤害人，人自然平安调和；如果不通畅，那么客气邪风就会乘虚而入，侵入人体多导致死亡。然而人致死的缘由，虽然有千般难疾，大都不外乎三种病因：第一，中气虚弱，经络受邪，随即进入脏腑，这称为内所因；第二，中气充实，虽然感受了邪气，但脏腑不受影响，只有体表躯体生病，四肢九窍血脉壅塞，这称为外所中；第三，房事、金刃、虫兽所伤，不是由内外虚实感召邪气，这称为不内外因。用这三者来详细分析，千般难疾，疾病的来源就全部穷尽了。如果人能谨慎调养形气，不让客气邪风侵犯经络，即使邪气刚中于经络，未传至脏腑，随即医治，自然可以痊愈。四肢九窍，刚觉得重滞，尚未闭塞，采用导引、吐纳、针灸、按摩，也可以痊愈。此外，不触犯王法，避免禽兽灾伤，房事不要使其枯竭，饮食调节冷热，五味各得其宜，不让形气衰弱，各种疾病就无法侵入腠理。腠，是一身的空隙，血气往来的地方，是三焦通会真元的道路。理，是皮肤脏腑，内外井然有序，不乱条理。
【按语】正风，是从八方顺应时节而来的，具有相生和缓特点的主气；邪风，是从对冲后方而来的，具有相克冲烈特点的客气。比如时令应当吹东风却吹西风，所谓的“后”，是指已经过去的时辰而言。
【集注】赵良说：人处于气交之中，秉承地的刚柔，形成五脏百骸的形体；秉承天的阴阳，形成六经的气。形与气合一，神机发动运用，驾驭运行谷气，出入内外，与天道度数相同，升降浮沉，顺应四时，主宰于身形之中，称之为元真。外感的是客气。《灵枢》说：虚邪不能单独伤人，必须因为身形虚弱而后才客居入侵。大概天人之气，各有正常和不正常，人气正常则不受邪，不正常则邪气乘虚而入；天气正常则助其生长，不正常则伤害它。人气不正常，是由于七情扰动内心，饮食不节制，房欲过度，金刃虫兽伤害气血，这些都足以导致生病。天气不正常，是由于四时不和，八风无常，这些都足以伤害万物。
问：上工（高明的医生）治未病，是什么意思？老师说：治疗未病，看到肝脏有病，知道肝病会传变给脾脏，应当先充实脾脏；如果四季中脾土当令旺盛而不受邪，就不必补脾。中等水平的医生不懂这种传变规律，看到肝脏有病，不懂得充实脾脏，只治疗肝脏。对于肝病，补益用酸味药，辅助用焦苦味药，增益用甘味药来调理。酸入肝，焦苦入心，甘入脾，脾能制约肾，肾气微弱，则水气不行，水气不行，则心火气盛，心火气盛，则损伤肺，肺被损伤，则金气不行，金气不行，则肝气盛，肝气盛，则肝病自愈，这就是治疗肝病补益脾脏的要妙之处。肝虚证适用这种方法，肝实证不适用此法。经文说：不要使虚证更虚，实证更实，要补不足，损有余。就是这个道理。其余脏腑也以此为准。
【注释】这是承接上一条关于受病的三种原因，来说明治疗方法。上工，指良医；中工，指普通医生。已病，指已经发生的病；未病，指尚未发生的病。假如现在患有肝病，这是已经发生的病；肝病将来传变给脾，这是尚未发生的病。良医知道肝病会传脾，见到病人患肝病，先审察天时旺衰，再审察脾土虚实，如果天时旺、脾土实则知道不会受肝邪，不需要补脾，直接治疗已病的肝；如果天时衰、脾土虚，则知道肝必传脾，先补未病的脾，兼治已病的肝。那些普通医生不懂四时胜复、五脏相传的道理，见到肝病，只泻已病的肝，不知道补未病的脾。上工不仅知道肝实必传脾虚的病，而且知道肝虚不传脾虚反而受肺邪的病。所以治疗肝虚、脾虚的病，就用酸味入肝，以补已病的肝；用焦苦味入心，以助未病的心；用甘味入脾，以益未实的脾。使火生土，使土制水，水弱则火旺，火旺则制金，金被制则木不受邪，而肝病自愈。这是“亢则害，承乃制，制则生化，化生不病”的道理，属于隔二、隔三的治法，所以说：这是治疗肝病补脾的要妙。然而肝虚才用此法，若肝实则不用此法。中工不懂虚实，虚证用泻法，这叫虚虚（使虚者更虚）；实证用补法，这叫实实（使实者更实）。这不符合医理。上工知道虚实，补其不足，损其有余。这才是正确的道理。其余四脏，都依据此法。“伤”字，当作“制”字看。
【集注】徐彬说：假如是肝经的病，肝木克制脾土，知道邪气必定传变到脾经，治疗应当以充实脾脏为先，这是脾脏未病而先充实它，所说的治未病。不担忧本脏的虚损，而担忧传变不已，病情日益加深，所以先以充实脾脏为急务。
程林说：经文说：因其轻而扬之，因其重而减之，因其衰而彰之。所谓“因”，是趁着病机。治未病，是说治疗未病的脏腑，不是治疗未病的人。看到肝病，应当先实脾，使土旺则能胜水，水不行则火盛而制金，金不能干扰木，肝病自愈。这是治疗肝病补脾，治未病的方法。
高世栻说：实脾专门为了制约水，使火盛金衰，肝不受制约，则肝病自愈，其道理非常精微，所以说：这是治疗肝病补脾的要妙。
问：病患的面部气色显现出来，想听听其中的说法？老师说：鼻头颜色发青，腹中痛，怕冷严重的会死（另一种说法是：腹中冷，疼痛严重的会死）；鼻头颜色微黑的，有水气；颜色黄的，胸上有寒；颜色白的，失血；如果微红且不在相应季节出现的，会死。眼睛直视不动、瞳孔正圆的，是痉病，无法治疗。另外，青色主痛，黑色主劳损，赤色主风，黄色主大便困难，颜色鲜明润泽的有留饮。
【注释】面部显现气色从而知道疾病生死的原因，是因为五气通过鼻子进入，藏于五脏，其精华外荣于面部。色，指青、赤、黄、白、黑五种颜色。气，指五色中的光泽。气色相得的，既有颜色又有光泽，是健康人的面色。即经文所说：青如翠羽，赤如鸡冠，黄如蟹黄，白如豚脂，黑如乌羽，这是有生机的表现。气色相失的，颜色或浅或深，光泽或显或晦，是病人的面色。即经文所说：浮泽表示病在外，沉浊表示病在内，观察其浮沉，以知道病位的深浅，观察其枯润，以观察预后成败，观察其散聚，以知道是新病还是久病，观察颜色的上下分布，以知道病处，颜色粗糙明亮，沉夭则病重，不明不泽则病不重。有色无气的，颜色枯槁无光泽，是死人的面色。即经文所说：青如蓝叶，黄如黄土，赤如衃血，白如枯骨，黑如炱尘，这是死色的表现。鼻，是明堂。明堂光泽，就没有病了。但这里说见青色为腹中痛，鼻头苦冷严重的死；黑色为水气或劳损，黄色为上寒下热、小便难；面目鲜明，内有留饮；白色为失血；赤色为热或风，如果出现在冬天，是非其时之色，会死。眼睛直视，正圆不合，像鱼眼一样的，是痉病，无法治疗。这是气色主病的大略，详细内容都记载在《内经》中。
老师说：病患说话声音寂静无声，喜欢突然惊呼的，是骨节间的病；说话声音暗哑不清彻的，是心膈间的病；说话声音唧唧哝哝细而长的，是头中病（一作腹痛）。
【按语】头中病的“头”字，应当是“腹”字。经文中从来没有“头中病”的说法，而且文义不通，必然是传抄的错误。
【注释】病患说话声音寂静，指寂静不语；如果厌恶别人说话，那是心病。喜欢惊呼，指不厌恶别人说话，且喜欢惊呼，由此知道病不在心而在体外，所以说：是骨节间的病。病患说话声音暗哑不清彻，指声音不响亮且不透彻，这阻碍了气息，所以知道是心膈间的病。病患说话声音唧唧哝哝细而长，指小声嘟囔且悠长，因为不敢让气息急促扰动内脏，所以知道是腹中的病。
老师说：呼吸时耸肩抬肩的，是胸中坚满；呼吸牵引胸中气上逆的，是咳嗽；呼吸张口短气的，是肺痿唾沫。
【注释】息，指一呼一吸。摇肩，指抬肩。心中坚，指胸中壅满。呼吸时动形抬肩，胸中壅气上逆的，是喘病。呼吸引胸中之气上逆，喉中作痒梗气的，是咳病。呼吸张口，不能接续气息，似喘但不抬肩的，是短气病。大概是肺气壅满，邪气有余的喘；肺气不能接续气息，正气不足的短气。然而正气不足的喘，也有不能接续气息的；邪气有余的短气，也有胸中壅满的，肺气上逆的，必然咳嗽。咳嗽时吐痰，叫嗽。如果咳嗽吐涎沫不止，不是普通的咳病，而是肺痿。
老师说：吸气轻微急促的，病在中焦。如果是实证，用攻下法即可痊愈；如果是虚证，则无法治疗。病在上焦的，吸气短促；病在下焦的，吸气深长。这些都是难治的。呼吸时全身动摇振颤的，无法治疗。
【按语】吸促的“促”字，应当是“远”字；吸远的“远”字，应当是“促”字，才符合病义，必然是传抄的错误。
【注释】这是承接上文，说明喘分为三焦，有可治和不可治的区别。喘，是肺病，肺主气，司呼吸，所以以呼吸气促，称为喘。如果呼吸气均促，是病在呼吸本身，阻碍了升降之气，所以知道喘在中焦。呼气气促，吸气气长，病在呼气，呼出关联心和肺，所以知道喘在上焦；呼气气长，吸气气短，病在吸气，吸入关联肾和肝，所以知道喘在下焦。喘的实证，指邪气盛则为实，中焦实，则必然腹满便硬，用攻下法，可治。喘的虚证，指正气夺则为虚，中焦虚，则必然腹软便溏，不耐攻下，难治。如果喘而呼吸动摇，振颤不能支撑身体，则是形气不相保，无论虚实都无法治疗。说吸气轻微急促，数就是促，促就是短，远就是长。只说吸气不说呼气，是省略的说法，犹言呼吸均短，呼短吸长，吸短呼长。
老师说：寸口脉跳动，是因为随着当令时节而动的，假如肝旺时面色青。四季各自随其对应的颜色。肝色青而反见白色，非其时而见其色脉，都应当生病。
【注释】寸口，统称左右三部脉。脉动遵循四时规律，取决于五脏，但必须随着旺时而动，才是平脉。假如肝旺于春季，随其时节，色应当青，脉应当弦，这是不病的色脉，如果色反白，脉反浮，这是非其时，乃是病的色脉。四季都以此类推。
【集注】尤怡说：旺时，指当时令到来而气旺，脉随之而动，其色也应之。如肝旺于春，脉弦而色青，这是常态。推及四季，无不如此。如果色当青而反白，是非其时而有此色，不仅是肝病如此，肺也会生病。
问：有未到之时而至，有到时而未至，有到时而未去，有到时而太过，这是什么意思？老师说：冬至之后，甲子日夜半，少阳之气始生。少阳之时，阳气开始生长，天气变得温和。如果在未得甲子日之前，天气就温和，这叫未至而至；如果得了甲子日，但天气未温和，这叫至而不至；如果得了甲子日，但天气大寒不解，这叫至而不去；如果得了甲子日，但天气温暖如同盛夏五六月时，这叫至而太过。
【注释】冬至之后，得甲子日夜半，少阳之气始生，天气渐温和，这是气的常态。如果未得甲子日，天即温和，这叫未至而至。气未应至而先至，是来气有余。已得甲子日，阳气渐盛，天未温和，这叫至而不至。气应至而不至，是来气不足。如果天大寒不解，这叫至而不去。气应去而不去，是去气太过。如果天过温如盛夏时，这叫至而太过。气应至而甚者，是至气太过。太过者，其气淫溢，则侵凌其所不胜，乘袭其所胜；不及者，其气迫近，则所胜妄行，所生者受病，所不胜侵凌它。这是《内经》所说的谨慎等候其时，气可与期。其余都仿照此理。
老师说：病患的脉，浮脉在前（寸部），病在表；浮脉在后（尺部），病在里。腰痛背强不能行走，必然短气且极度疲乏。
【注释】脉浮，是虚风的征候。关前的寸脉浮，病在表；关后的尺脉浮，病在里。虚风在表，所以主腰痛背强不能行；虚风在里，所以主短气且极度疲乏。
问：经文说：厥阳独行。是什么意思？老师说：这是有阳无阴，所以称为厥阳。
【注释】阴阳偕行，顺；阴阳独行，逆。厥，逆也。逆阳独行，这是有阳无阴，所以称为厥阳。
【集注】李 说：厥阳即阳厥。《内经》说：阳气衰于下则为寒厥，阴气衰于下则为热厥。此厥阳独行，是有阳无阴的大概情况。
高世栻说：按此为有阳无阴，是为厥阳。经文说：阴气衰于下，则为热厥。帝问：热厥是如何形成的？岐伯说：阴气虚，则阳气入；阳气入，则胃不和；胃不和，则精气竭；精气竭，则不营于四肢。于是肾气日衰，阳气独胜，这就是所谓的有阳无阴，而为厥阳独行。
问：寸脉沉大而滑，沉则为实，滑则为气。实与气相搏，血气入脏即死，入腑即愈，这称为卒厥。是什么意思？老师说：唇口青紫，身冷，是入脏，即死；如果身体温和，汗自出，是入腑，即愈。
【按语】“寸脉沉大而滑，沉则为实，滑则为气，实气相搏”这十八个字，文理不顺，是衍文。血气入脏的“血”字，应当是“厥”字，才与卒厥相合，必然是传抄的错误。
Shanghan Lun (Treatise on Cold Damage) discusses cold damage, while Jingui Yaolue (Essential Prescriptions of the Golden Cabinet) discusses miscellaneous diseases; together they constitute Zhang Zhongjing's complete medical system. Shanghan Lun gained prominence because Cheng Wuji provided the first commentary, followed by more than fifty other physicians who added annotations, allowing it to be widely disseminated and clarified throughout the realm. In contrast, Jingui Yaolue is rarely discussed. Although commentators such as Zhao Liang and Xu Bin have annotated it, its text is archaic and obscure. Due to centuries of transmission, bamboo slips were misplaced and fragments lost, resulting in many doubts and missing passages. Errors were copied and propagated, leading later scholars to regard it as remote and impractical, relegating it to obscurity. Today, I have reorganized the disordered sections, supplemented the残缺 (incomplete/missing parts), extensively collected various books, and provided detailed annotations, so that these two works may coexist. It is hoped that future practitioners will not be misled by vulgar theories, but will understand that Zhang Zhongjing was capable of treating not only cold damage but also miscellaneous diseases.
Humans inherit the constant principles of the Five Elements (Wu Xing, Wood, Fire, Earth, Metal, Water) and grow through the influence of wind and Qi. Wind and Qi can generate all things, yet they can also harm them, just as water can float a boat or capsize it. If the Yuan Zhen Qi (Primal True Qi) of the five Zang organs flows smoothly, the person remains peaceful and harmonious. External Ke Qi (Guest Qi) and Xie Feng (Evil Wind), if they penetrate the body, often lead to death. The myriad diseases do not exceed three categories: First, pathogenic factors invade the meridians and enter the Zang organs, constituting an internal cause (Nei Yin); Second, the four limbs and nine orifices experience transmission via blood vessels, leading to obstruction and blockage, constituting an external cause (Wai Zhong) from skin exposure; Third, injuries from sexual excess, metal weapons, or insects and beasts. Analyzing these three aspects exhausts the origins of disease. If one carefully nourishes and guards against pathogenic factors, preventing evil wind from invading the meridians, even if pathogens initially affect the meridians before spreading to the Zang organs, immediate treatment can resolve it. When the limbs feel heavy and stagnant, methods such as Dao Yin (guiding and pulling exercises), Tu Na (breathing regulation), acupuncture, and topical massage should be employed to prevent the closure of the nine orifices. Furthermore, one should avoid legal troubles, animal attacks, and sexual depletion, and regulate diet regarding temperature and the five flavors (Sour, Bitter, Sweet, Pungent, Salty), ensuring the physical form does not weaken, so that pathogens cannot enter the Cou Li (interstitial spaces). Cou refers to the places where San Jiao (Triple Burner) connects and Yuan Zhen Qi meets, where blood and Qi are infused. Li refers to the texture and structure of the skin and Zang organs.
[Note] This chapter serves as the outline of the entire book. Previous editors mistakenly placed it as the second chapter, disrupting the order. It is now placed at the beginning to govern the main ideas.
[Annotation] "Wu Chang" (Five Constants) refers to the Five Elements. The Qi of the Five Elements includes Wind, Summer Heat, Dampness, Dryness, and Cold; their flavors are Sour, Bitter, Sweet, Pungent, and Salty. Humans receive these to form their bodies, so the Zang organs interact with these flavors and Qi daily. It says "Wind Qi" rather than "Five Qi" because Wind encompasses the other four. Wind permeates the four seasons like Ren (Benevolence) permeates the four virtues, hence "growing through Wind Qi." However, since Wind Qi can both generate and harm, this is because the Main Qi Zheng Feng (Upright Wind) comes from its proper direction and nurtures all things, whereas Ke Qi Xie Feng (Guest Evil Wind) comes from the opposing direction and harms all things. Humans exist within the intersection of Heaven and Earth Qi; their survival or harm is like water floating or capsizing a boat. The Heavenly Five Qi become the Zang organs' Yuan Zhen Qi in humans. If they flow smoothly and generate each other, even Guest Evil Wind cannot harm, and the person remains harmonious. If not smooth, Guest Evil Wind enters through gaps, often causing death. The causes of death, though numerous, fall into three main categories: First, deficiency in the center allows meridian pathogens to enter the Zang organs, called Nei Suo Yin (Internal Cause); Second, strength in the center prevents organ involvement despite pathogen exposure, affecting only the exterior, limbs, and orifices with vessel obstruction, called Wai Suo Zhong (External Strike); Third, injuries from sex, weapons, or animals, which are neither internal nor external causes induced by deficiency/excess, called Bu Nei Wai Yin (Neither Internal Nor External Cause). Analyzing these three covers all disease origins. If one carefully nourishes shape and Qi, preventing Guest Evil Wind from invading meridians, even if pathogens strike the meridians before reaching the Zang organs, timely treatment ensures recovery. When limbs feel heavy but orifices are not closed, Dao Yin, Tu Na, acupuncture, and massage can cure. Avoiding legal issues, animal attacks, and sexual depletion, and regulating diet so the five flavors are appropriate and shape/Qi do not weaken, prevents all diseases from entering the Cou Li. Cou is the void space of the body, the pathway for blood and Qi, and the channel for San Jiao to connect Yuan Zhen. Li is the orderly arrangement of skin and organs.
[Note] Zheng Feng (Upright Wind) comes from the eight directions according to season, possessing generating and gentle characteristics. Xie Feng (Evil Wind) comes from the opposing direction, possessing overcoming and fierce characteristics. For example, if East Wind should blow but West Wind blows, "after" refers to the passed time.
[Collected Annotations] Zhao Liang said: Humans exist in the Qi intersection, inheriting Earth's rigidity and softness to form the five Zang organs and hundred bones; inheriting Heaven's Yin and Yang to form the Qi of the six Jing (Channels). When shape and Qi unite, Shen Ji (Spirit Mechanism) activates, driving Gu Qi (Grain Qi) in and out, aligning with heavenly degrees, rising and falling, responding to four seasons, governing the body, called Yuan Zhen. External infections are Ke Qi. Ling Shu states: False Evil cannot injure alone; it must find bodily deficiency to inhabit. Heaven and Human Qi each have upright and non-upright states. Upright human Qi repels evil; non-upright allows evil to invade. Upright Heaven Qi aids growth; non-upright harms. Non-upright human Qi results from seven emotions disturbing the interior, irregular diet, sexual excess, or injury from weapons/animals, all sufficient to cause disease. Non-upright Heaven Qi results from irregular four seasons and abnormal eight winds, sufficient to harm all things.
Question: What does "Superior physicians treat disease before it arises" mean? Teacher said: Treating disease before it arises means seeing liver disease, knowing it transmits to the spleen, and thus first strengthening the spleen. If the spleen is prosperous in the four seasons and resists evil, do not tonify. Average physicians do not understand transmission; seeing liver disease, they fail to strengthen the spleen and only treat the liver. For liver disease, tonification uses sour herbs, assistance uses scorched bitter herbs, and benefit uses sweet herbs to regulate. Sour enters the liver, scorched bitter enters the heart, sweet enters the spleen. The spleen can control the kidney. If kidney Qi is weak, water does not move. If water does not move, heart fire becomes prosperous. If heart fire is prosperous, it damages the lung. If the lung is damaged, metal Qi does not move. If metal Qi does not move, liver Qi becomes prosperous. If liver Qi is prosperous, liver disease heals. This is the subtlety of treating the liver by tonifying the spleen. This method applies to liver deficiency, not liver excess. The classic says: Do not make deficiency more deficient or excess more excessive; tonify insufficiency, reduce excess. This is the principle. Other organs follow this rule.
[Annotation] This follows the previous section on the three causes of disease to explain treatment. Superior physician (Shang Gong) refers to excellent doctors; average physician (Zhong Gong) refers to ordinary doctors. Yi Bing (Already Diseased) is the manifested disease; Wei Bing (Not Yet Diseased) is the potential disease. If current liver disease exists, this is Yi Bing; liver disease transmitting to the spleen later is Wei Bing. Excellent doctors know liver disease transmits to the spleen. Seeing liver disease, they first assess seasonal prosperity/decline and spleen earth deficiency/excess. If season is prosperous and spleen is solid, they know it won't accept liver evil and need not tonify the spleen, directly treating the existing liver disease. If season is declining and spleen is deficient, they know liver will transmit to spleen, first tonifying the un-diseased spleen while treating the diseased liver. Ordinary doctors do not understand seasonal dominance and five-organ transmission. Seeing liver disease, they only purge the diseased liver, failing to tonify the un-diseased spleen. Superior doctors also know that liver deficiency does not transmit to spleen deficiency but instead accepts lung evil. Thus, for liver and spleen deficiency, use sour to enter the liver and tonify the diseased liver; use scorched bitter to enter the heart and assist the undiseased heart; use sweet to enter the spleen and benefit the deficient spleen. This makes fire generate earth, and earth control water. Weak water leads to strong fire; strong fire controls metal. Controlled metal does not attack wood, so liver disease heals. This is the principle of "Hyperactivity brings disaster, succession brings control; control generates transformation, transformation prevents disease," known as treating across two or three organs. Hence, "this is the subtlety of treating liver by tonifying spleen." However, this applies only to liver deficiency, not excess. Average doctors do not understand deficiency/excess; purging deficiency is "making deficiency deficient"; tonifying excess is "making excess excessive." This is incorrect. Superior doctors know deficiency/excess, tonify insufficiency, reduce excess. This is correct. The other four organs follow this method. The character "Shang" (harm) should be read as "Zhi" (control).
[Collected Annotations] Xu Bin said: Suppose there is liver meridian disease; liver wood overcomes spleen earth, knowing evil will transmit to the spleen meridian. Treatment should prioritize strengthening the spleen. This is strengthening the spleen before it is diseased, called treating disease before it arises. Not worrying about the primary organ's deficiency but fearing endless transmission leading to deeper illness, strengthening the spleen is urgent.
Cheng Lin said: The classic says: Disperse what is light, reduce what is heavy, clarify what is declining. "Following" means seizing the opportunity. Treating disease before it arises means treating the undiseased organ, not the undiseased person. Seeing liver disease, first strengthen the spleen. If earth is prosperous, it controls water; if water doesn't move, fire becomes strong and controls metal. Metal cannot interfere with wood, so liver disease heals. This is the method of treating liver by tonifying spleen, i.e., treating disease before it arises.
Gao Shishi said: Strengthening the spleen specifically controls water, making fire strong and metal weak. If liver is not controlled, it heals. The logic is subtle, hence "this is the subtlety of treating liver by tonifying spleen."
Question: Patients show facial complexion changes. What is the explanation? Teacher said: If the nose tip is blue/green, there is abdominal pain; those suffering from cold die (or: abdominal cold, suffering pain die). If the nose tip is slightly black, there is fluid retention. If yellow, there is cold above. If white, there is blood loss. If slightly red and not in season, death ensues. Eyes fixed straight and round indicate Spasm Disease (Jing Bing), which is untreatable. Also, blue indicates pain, black indicates劳损 (consumption/overwork), red indicates wind, yellow indicates difficult defecation, and bright/clear color indicates retained fluid.
[Annotation] Facial complexion reveals disease prognosis because five Qi enter the nose and store in the five Zang organs, their essence flourishing externally on the face. Color refers to green, red, yellow, white, black. Qi refers to the luster of the five colors. Harmonious color and Qi, having both color and luster, belong to healthy people. As the classic says: Green like kingfisher feathers, red like chicken combs, yellow like crab roe, white like pig fat, black like crow feathers—these indicate life. Disharmonious color and Qi, varying depth or luster, belong to patients. As the classic says: Floating and moist indicate exterior; deep and turbid indicate interior. Observe floating/deep to know depth; observe dull/moist to judge outcome; observe scattered/clumped to know new/old; observe upper/lower distribution to locate disease. Rough and bright, or deep and dull, indicate severe disease; unclear and unmotivated indicate mild disease. Color without Qi, dry and lusterless, is the color of the dead. As the classic says: Green like indigo leaves, yellow like loess soil, red like clotted blood, white like dry bone, black like soot—these are death colors. The nose is the Ming Tang (Bright Hall). A luminous Ming Tang indicates no disease. But here, green indicates abdominal pain, severe nasal cold indicates death; black indicates fluid/consumption, yellow indicates upper cold/lower heat/difficult urination; bright face indicates retained fluid; white indicates blood loss; red indicates heat/wind. If appearing in winter, it is out of season and fatal. Fixed, round eyes like fish eyes indicate Spasm Disease, untreatable. This is the general rule of complexion diagnosing; details are in Neijing.
Teacher said: If a patient speaks silently but likes sudden shouts, the disease is in the joints. If speech is hoarse and unclear, the disease is in the chest/diaphragm. If speech is murmuring, thin, and long, the disease is in the head (one version says abdomen).
[Note] "Silent speech" means silence. If hating speech, it is heart disease. Liking sudden shouts means not hating speech and preferring to shout, indicating the disease is external, hence "disease in joints." Hoarse and unclear speech obstructs breath, indicating "disease in chest/diaphragm." Murmuring, thin, and long speech implies fear of rapid breathing disturbing the interior, indicating "disease in abdomen."
Teacher said: Breathing with shoulder movement indicates chest fullness/stiffness. Breathing drawing Qi upward from the chest indicates cough. Breathing with open mouth and shortness of breath indicates Lung萎 (Lung Flaccidity) with saliva/phlegm.
[Annotation] Xi (Breath) is one inhalation and exhalation. Yao Jian (Shaking shoulders) means raising shoulders. Xin Zhong Jian (Stiffness in heart/chest) means chest fullness. Breathing moving the body to raise shoulders with chest Qi rebellion is Asthma (Chuan Bing). Breathing drawing chest Qi up with throat itching/blockage is Cough (Ke Bing). Breathing with open mouth, unable to continue breath, resembling asthma but without shoulder raising, is Shortness of Breath (Duan Qi Bing). Lung Qi fullness with excess evil is Asthma; Lung Qi inability to continue breath is deficiency-type Shortness of Breath. Deficiency asthma may lack continuous breath; excess shortness of breath may have chest fullness. Lung Qi rebellion always involves cough. Coughing with phlegm is Sou. Continuous coughing with saliva indicates Lung Flaccidity, not simple cough.
Teacher said: Slight rapidity in inhalation indicates disease in the Middle Jiao. If excess, purging cures it; if deficiency, it is untreatable. In Upper Jiao, inhalation is hurried (Cu); in Lower Jiao, inhalation is distant/long (Yuan). All are difficult to treat. Trembling during respiration is untreatable.
[Note] This continues discussing asthma divided by Three Jiaos, distinguishing treatable from untreatable. Asthma is a lung disease; lungs govern Qi and respiration. Rapid respiration is asthma. Equal rapidity in inhale/exhale suggests disease in respiration itself, blocking ascending/descending Qi, indicating Middle Jiao asthma. Hurried exhale, long inhale relates to exhaling (Heart/Lung), indicating Upper Jiao asthma. Long exhale, short inhale relates to inhaling (Kidney/Liver), indicating Lower Jiao asthma. Excess asthma means excess evil; middle excess causes abdominal fullness/hard stool, purging is curable. Deficiency asthma means depleted righteous Qi; middle deficiency causes soft abdomen/loose stool, purging is intolerable, difficult to treat. Trembling during respiration indicates shape and Qi cannot support each other; untreatable regardless of excess/deficiency. "Slight rapidity" means Cu (hurried) equals Duan (short); Yuan (distant) equals Chang (long). Mentioning only inhalation is elliptical, implying equal shortness, long exhale/short inhale, or short exhale/long inhale.
Teacher said: Cun Kou pulse movement follows the prosperous season. For example, when Liver is prosperous, color is green. Each season follows its corresponding color. If Liver color is green but turns white, or pulse/color appears out of season, disease is present.
[Annotation] Cun Kou generally refers to the three positions on both wrists. Pulse movement follows four seasons and depends on five Zang organs. Movement during the prosperous season is a normal pulse. If Liver is prosperous in Spring, color should be green, pulse should be Xian (Wiry). This is non-disease color/pulse. If color turns white, pulse turns Fu (Floating), this is out-of-season, indicating disease. Four seasons follow this rule.
[Collected Annotations] You Yi said: Prosperous season means Qi is abundant when the time arrives, pulse moves accordingly, and color responds. E.g., Liver prosperous in Spring, pulse wiry, color green, is normal. This applies to all seasons. If color should be green but is white, it is out-of-season color. Not only Liver disease, but Lung would also be diseased.
Question: There is "arriving before time," "not arriving at time," "arriving but not leaving," and "arriving but excessive." What does this mean? Teacher said: After Winter Solstice, at midnight on the Jia Zi day, Shao Yang Qi begins. During Shao Yang time, Yang begins to grow, and weather becomes warm. If weather is warm before Jia Zi day, this is "arriving before time." If Jia Zi day has passed but weather is not warm, this is "not arriving at time." If Jia Zi day has passed but severe cold persists, this is "arriving but not leaving." If Jia Zi day arrives but weather is as hot as midsummer, this is "arriving but excessive."
[Annotation] After Winter Solstice, at midnight on Jia Zi day, Shao Yang Qi begins, weather warms gradually—this is normal. Warmth before Jia Zi is "arriving before time." Qi arrives early, indicating excess incoming Qi. After Jia Zi, Yang grows, but weather isn't warm—"not arriving at time." Qi should arrive but doesn't, indicating insufficient incoming Qi. Severe cold persisting after Jia Zi is "arriving but not leaving." Qi should leave but doesn't, indicating excessive outgoing Qi. Overly warm weather is "arriving but excessive." Qi arriving excessively indicates excessive incoming Qi. Excess means Qi floods, attacking the element it cannot overcome and riding over the element it overcomes. Insufficiency means Qi presses, causing the overcome element to act wildly, harming the generated element, and being attacked by the non-overcome element. This matches Neijing: "Carefully await the time, Qi can be expected." Others follow this.
Teacher said: Patient's pulse: Fu (Floating) at the front (Cun position) indicates Exterior disease; Fu at the back (Chi position) indicates Interior disease. Lower back pain, back stiffness, inability to walk, accompanied by shortness of breath and extreme fatigue.
[Annotation] Fu pulse is a sign of Empty Wind. Fu at Cun (front of Guan) indicates Exterior disease. Fu at Chi (back of Guan) indicates Interior disease. Empty Wind in Exterior causes lower back pain, back stiffness, inability to walk. Empty Wind in Interior causes shortness of breath and extreme fatigue.
Question: Classic says: Jue Yang travels alone. What does this mean? Teacher said: This is Yang without Yin, hence called Jue Yang.
[Annotation] Yin and Yang traveling together is Smooth (Shun); traveling alone is Rebellious (Ni). Jue means Rebellious. Rebellious Yang traveling alone is Yang without Yin, hence Jue Yang.
[Collected Annotations] Li said: Jue Yang is Yang Jue. Neijing says: Yang deficiency below causes Cold Jue; Yin deficiency below causes Hot Jue. Jue Yang traveling alone represents Yang without Yin.
Gao Shishi said: This is Yang without Yin, called Jue Yang. Classic says: Yin deficiency below causes Hot Jue. Emperor asked: How does Hot Jue occur? Qibo said: Yin deficiency allows Yang to enter; Yang entering causes Stomach disharmony; Stomach disharmony depletes Essence Qi; depleted Essence Qi fails to nourish limbs. Kidney Qi declines daily, Yang dominates alone. This is Yang without Yin, hence Jue Yang traveling alone.
Question: Cun pulse is Chen (Deep) Da (Large) and Hua (Slippery). Chen indicates Excess (Shi), Hua indicates Qi. Excess and Qi contend. Blood and Qi entering Zang causes death; entering Fu causes recovery. This is Cu Jue (Sudden Syncope). What does this mean? Teacher said: Blue lips/mouth, cold body indicates entering Zang, leading to death. Warm body, spontaneous sweating indicates entering Fu, leading to recovery.
[Note] The eighteen characters "Cun pulse Deep Large Slippery, Deep is Excess, Slippery is Qi, Excess and Qi contend" are grammatically awkward and likely interpolations. The character "Xue" (Blood) in "Blood and Qi entering Zang" should be "Jue" (Syncope) to match Cu Jue, likely a copying error.