夫伤寒病之说，始自黄帝已开其端，主仲景方陈其条目，后世肤浅之学莫知其数。立言
者只
云∶病在表可发汗，病在里可下之，或云∶不可汗，或云∶不可下，即未尝有温中之说。仲景《伤寒
例》云∶尺寸俱沉细，太阴受病也；尺寸俱沉，少阴受病也；尺寸俱微缓，厥阴受病也。又辨
太阴证云∶太阴病，脉浮，可发汗，宜桂枝汤。又手足温，自利不渴，宜四逆汤。又腹满时
痛，桂枝加芍药汤。辨少阴证云∶少阴证，始得之，发热脉沉，麻黄细辛附子汤。又少阴病
二三日，麻黄附子甘草汤。又少阴病，身体疼痛，手足寒，骨节痛，脉沉，附子汤。又厥阴
病，吐利，手足逆冷，烦躁欲死，吴茱萸汤。又少阴病，脉沉，急温之，宜四逆汤。今举仲
景论中数条，最是治三阴病之良法。今世之用，尚有未尽证者。愚尝校自至和初岁，迄于今
三十余年，不以岁之太过不及为则，每至夏至以前，有病伤寒人十中七八，两手脉俱沉细数
，多是胸膈满闷，或呕逆，或气塞，或腹鸣，或腹痛，与仲景三阴病说，脉理同而证不同，
因兹不敢妄投仲景三阴药。才见脉沉及胸膈满，便投下药下之，往往不救。尝斟酌仲景理中
丸与服之，其病势轻者，即胸中便快，其病势重者，半日许满闷依然。或有病患脉沉细迟，
投仲景四逆汤温之，多药力太热，后必发烦躁。因较量此形证，今别立方以治之，得多对证
之药，不可不传焉。
上此一条，非四逆热而不当也，仲景当汉之末，韩氏当宋之隆，时世异也。病患但两手脉沉细数，或有力，
或无力，或关脉短及力小，胸膈塞闷，气短不能相接者
，便可随脉证投温中药以治之。此一法甚活。
病患两手脉沉迟，或缓或紧，皆是胃中寒也。若寸脉短及力小于关尺者，此阴盛阳虚也
。或胸膈塞闷，腹中胀满，身体拘急者，手足逆冷，急宜温之。
若立春以后至清明以前，宜温中汤主之；清明以后至芒种以前，宜橘皮汤主之；芒种以
后至立秋以前，宜七物理中丸主之。此皆随时也。
关于伤寒病的论述，始于黄帝开启了先河，张仲景的方书确立了其条目，后世那些肤浅的学问无法知晓其深奥。立论者只说：病在表可以用发汗法，病在里可以用泻下法，或者说不可发汗，或者说不可泻下，却从未有过温中法（温暖中焦脾胃）的说法。张仲景《伤寒例》中说：寸脉和尺脉都呈现沉细象，是太阴经受邪；寸脉和尺脉都呈现沉象，是少阴经受邪；寸脉和尺脉都呈现微缓象，是厥阴经受邪。又辨析太阴证时说：太阴病，脉浮，可以发汗，适宜用桂枝汤。又说手足温暖，自发性腹泻且不口渴，适宜用四逆汤。又说腹部胀满且有时疼痛，用桂枝加芍药汤。辨析少阴证时说：少阴病，刚发病时，发热且脉沉，用麻黄细辛附子汤。又说少阴病两三天，用麻黄附子甘草汤。又说少阴病，身体疼痛，手脚寒冷，骨节疼痛，脉沉，用附子汤。又说厥阴病，呕吐腹泻，手脚冰凉，烦躁欲死，用吴茱萸汤。又说少阴病，脉沉，应当紧急温补，适宜用四逆汤。现在列举张仲景论述中的这几条，是最为治疗三阴病（太阴、少阴、厥阴病）的好方法。但当今世人的应用，还有未尽善之处。我自从至和初年起到现在三十多年，不以年份气候的太过或不及为标准，每到夏至以前，患伤寒病的人十有七八，两手脉象都呈现沉细数，大多是胸膈部胀满闷塞，或者呕吐逆气，或者气机阻滞，或者肠鸣，或者腹痛，这与张仲景所说的三阴病的脉理相同而症状不同，因此我不敢随意投用张仲景治疗三阴病的药物。只要见到脉沉及胸膈满闷，就立即使用下药进行泻下，往往导致病人无法救治。我曾经斟酌使用张仲景的理中丸给病人服用，病情轻的，立刻感觉胸中畅快；病情重的，半天左右胀满闷塞依旧存在。有的病人脉象沉细迟，投用张仲景的四逆汤进行温补，大多因为药力太热，之后必然引发烦躁。通过比较这些形证，现在我另外制定方剂来治疗，得到了许多对症的药物，不能不传承下来。
以上这一条，并非四逆汤（回阳救逆之剂）温热不当，而是张仲景处于汉朝末年，韩祗和处于宋朝鼎盛时期，时代不同罢了。病人如果仅见两手脉象沉细数，或者有力，或者无力，或者关脉短小且力度弱，胸膈堵塞闷塞，气短不能接续的，就可以根据脉证随宜投用温中药（温暖中焦的药物）来治疗。这一种方法非常灵活。
病人两手脉象沉迟，或者缓或者紧，都是胃中有寒。如果寸脉短小且力度小于关脉和尺脉，这是阴盛阳虚。或者出现胸膈堵塞闷塞，腹部胀满，身体拘挛急迫，手脚冰凉，应当紧急予以温补。
如果在立春以后到清明以前，适宜用温中汤主治；清明以后到芒种以前，适宜用橘皮汤主治；芒种以后到立秋以前，适宜用七物理中丸主治。这都是顺应时节变化的。
Regarding the discourse on Shanghan (Cold Damage) disease, it began with the Yellow Emperor who opened the precedent, and Zhang Zhongjing's prescriptions established its categories. Superficial learning of later generations failed to grasp its depth. Those who formulated theories only stated: "If the pathogen is in the exterior, sweating may be induced; if in the interior, purgation may be applied," or alternatively, "sweating is contraindicated," or "purgation is contraindicated." There was never mention of warming the middle (warming the Middle Jiao/Spleen-Stomach). Zhang Zhongjing's *Shanghan Lun* states: "When both Cun (inch) and Chi (cubit) pulses are deep and fine, the Taiyin meridian is affected; when both Cun and Chi pulses are deep, the Shaoyin meridian is affected; when both Cun and Chi pulses are slightly slow and moderate, the Jueyin meridian is affected." Furthermore, regarding Taiyin syndrome: "In Taiyin disease, if the pulse is floating, sweating may be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate." It also states: "If the hands and feet are warm, with spontaneous diarrhea and no thirst, Sini Tang (Frigid Extremities Decoction) is appropriate." Regarding abdominal fullness with intermittent pain, Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction with Added Peony Root) is indicated. Regarding Shaoyin syndrome: "At the onset of Shaoyin disease, with fever and a deep pulse, Mahuang Xixin Fuzi Tang (Ephedra, Asarum, and Aconite Decoction) is used." Also, for Shaoyin disease persisting for two to three days, Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) is used. Additionally, for Shaoyin disease presenting with body pain, cold hands and feet, joint pain, and a deep pulse, Fuzi Tang (Aconite Decoction) is used. For Jueyin disease presenting with vomiting and diarrhea, cold extremities, and severe restlessness desiring death, Wuzhuyu Tang (Evodia Fruit Decoction) is used. Furthermore, for Shaoyin disease with a deep pulse, urgent warming is required, and Sini Tang (Frigid Extremities Decoction) is appropriate. These excerpts from Zhang Zhongjing's treatise represent excellent methods for treating the Three Yin diseases (Taiyin, Shaoyin, and Jueyin). However, contemporary clinical application remains incomplete. I have observed patients from the early Zhihe era up to the present thirty-plus years. Regardless of whether the annual climate is excessive or deficient, before the Summer Solstice, seven or eight out of ten patients suffering from Shanghan exhibit deep, fine, and rapid pulses in both hands. They predominantly suffer from chest and diaphragm fullness and oppression, or vomiting and regurgitation, or qi stagnation, or borborygmus, or abdominal pain. Although the pulse principles align with Zhang Zhongjing’s description of Three Yin diseases, the symptoms differ. Therefore, I dare not recklessly administer Zhang Zhongjing’s formulas for Three Yin diseases. When encountering a deep pulse accompanied by chest and diaphragm fullness, practitioners often immediately apply purgatives, which frequently leads to fatal outcomes. I once carefully administered Lizhong Wan (Regulate the Middle Pill) based on Zhang Zhongjing’s formula. For mild cases, patients felt immediate relief in the chest; for severe cases, the fullness and oppression persisted after half a day. In some cases where patients presented with deep, fine, and slow pulses, administering Sini Tang (Frigid Extremities Decoction) for warming proved too hot due to its potent medicinal force, subsequently causing irritability and restlessness. By comparing these manifestations and symptoms, I have formulated new prescriptions for treatment, obtaining many effective remedies that must be transmitted.
The preceding passage does not imply that Sini Tang (Frigid Extremities Decoction) is improperly warm; rather, Zhang Zhongjing lived at the end of the Han Dynasty, while Han Zhihe lived during the height of the Song Dynasty; the eras differed. If a patient presents with deep, fine, and rapid pulses in both hands—whether forceful or weak—or a short Guan (bar) pulse with weak strength, accompanied by chest and diaphragm blockage and oppression, and shortness of breath unable to connect, one should flexibly administer warming-the-middle herbs according to the pulse and symptoms. This method is highly adaptable.
If a patient’s hands and feet pulses are deep and slow, or moderate or tight, this indicates Cold in the Stomach. If the Cun (inch) pulse is short and weaker than the Guan (bar) and Chi (cubit) pulses, this signifies Excess of Yin and Deficiency of Yang. If accompanied by chest and diaphragm blockage and oppression, abdominal distension, bodily stiffness and urgency, and cold extremities, urgent warming is indicated.
From after Lichun (Start of Spring) until before Qingming (Clear and Bright), Wenzhong Tang (Warm the Middle Decoction) is appropriate. From after Qingming until before Mangzhong (Grain in Ear), Chupi Tang (Tangerine Peel Decoction) is appropriate. From after Mangzhong until before Liqiu (Start of Autumn), Qiwu Lizhong Wan (Seven-Ingredient Regulate the Middle Pill) is appropriate. These adjustments follow the seasonal changes.