（正解见中卷厥阴病中）
或问此条病。与前条同是胃中虚冷之证。何以不用四逆。余答云。胃中虚冷。饮水则哕。食谷欲呕。见证各异。
故不用四逆。投以吴茱萸汤为切当。盖呕为气逆。气逆者。必散之。吴茱萸辛苦。味重下泄。治呕为最。兼以生姜。
又治呕圣药。非若四逆中之干姜。守而不走也。武陵陈氏云。其所以致呕之故。因胃中虚。生寒。使温而不补。呕
终不愈。故用人参补中。合大枣以为和脾之剂焉。上条证。用上汤。愈者固多。间或有得汤反剧者。故成注云。另
以治上焦法治之也。
伤寒发汗已。身目为黄所以然者。以寒湿在里。不解故也。以为不可下也。于寒湿中求之。（此条伤寒。乃中
寒之证。若系伤寒。则发汗已。热气外越。何由发黄。今者发汗已。身目为黄。所以然者。以其人在里素有寒湿。
在表又中寒邪。发汗已。在表之寒邪虽去。在里之寒湿未除。故云不解也。且汗为阳液。乃中焦阳气所化。汗后中
气愈虚。寒湿愈滞。脾胃受寒湿所伤。而色见于外。此与湿热发黄不同。故云不可下。言不可以苦寒药下之也。于
寒湿中求之者。仲景正恐世医。与下文瘀热在里之证同治。而条辩尚论诸书。反以茵陈栀子柏皮等汤。补其治法。
大误之极。况仲景既云不可下。而茵陈蒿汤中。有大黄二两。谓非下乎。则知仲景当日。必另有治法。后人宜以意
会之而已。补亡论常器之云。宜五苓散。其议庶犹近之。○或问云。湿挟热。则郁 。故发黄。今挟寒。何以发黄。
余答云。寒湿发黄。譬之秋冬阴雨。草木不应黄者亦黄。此冷黄也。王海藏云阴黄。其证身冷。汗出。脉沉。乃太
阴经中湿。亦有身体发热者。身如熏黄。言如烟熏色黯也。终不如阳黄之明如橘子色。治法。小便利者。术附汤。
小便不利。大便反快者。五苓散。○愚按此条。当是太阴经错简。今入阳明。姑从仲景之旧云尔。）
上五条证（见原论中第五卷阳明病脉证并治法第八）
（琥）总按以上等证。皆自仲景太阳阳明病中集入者。太阳为寒水之经。故凡风寒湿邪外来。直中其经者有之。
中之既速。不及发热。故不头痛。不作烦热等证。或其人阳气本虚。虽病日久。亦不作郁热也。又阳明中寒。有胸
已前受寒气者。有因口食冷物而得者。因其人脾胃气弱。故不作郁热。为真阴证也。或问仲景少阳病中。何以无中
寒证。余答云。少阳本相火。相火不受寒。故无直中之证。其阳明病有中寒者。以阳明虽属燥金。金体本寒故也。
或又问云。诚如吾子之说则太阴湿土。厥阴风木。是风湿中本有寒气矣。至于少阴主君火。何以中寒之证反多。余
答云。君火之气。司天之位。乃子午也。午冲子水。焉得无寒。经云。少火之气壮。壮火之气衰。午为壮火火气衰。
寒能犯之。故夏至属午而一阴生。此之谓也。
（正确的解释见中卷厥阴病篇）
有人问：这一条的病证，与前一条同样是胃中虚冷的证候，为什么不用四逆汤？我回答说：胃中虚冷，喝水就会打嗝（哕），吃东西就想呕吐，表现出的症状各不相同。所以不用四逆汤，而投用吴茱萸汤更为恰当。因为呕吐是气机上逆，气机上逆的病症，必须用发散的方法治疗。吴茱萸味辛、苦，气味厚重，具有下行泄降的作用，治疗呕吐最为有效。再加上生姜，又是治疗呕吐的神圣药物。这不同于四逆汤中的干姜，干姜性质守而不走（固守中焦而不向外发散）。武陵陈氏说：导致呕吐的原因，是因为胃中虚寒，使用温补而不单纯滋补的药物，呕吐终究不能痊愈。所以用人参来补益中气，配合大枣，组成调和脾胃的方剂。上一条证候，用上方的汤药，治愈的人固然很多，但偶尔也有服用后病情反而加重的情况。所以成无己注释说：应当另外用治疗上焦病证的方法来治疗。
伤寒经过发汗治疗后，身体和眼睛发黄，之所以这样，是因为里有寒湿，未能解除的缘故。认为这种情况不可使用下法，应当在寒湿的病机中去寻求治疗方法。（这条所说的“伤寒”，实际上是中寒的证候。如果是普通的伤寒，发汗之后，热气向外发散，怎么会发黄呢？现在发汗后，身体和眼睛发黄，之所以这样，是因为患者体内素来有寒湿，体表又感受了寒邪。发汗后，体表的寒邪虽然去除了，但体内的寒湿并未清除，所以说“不解”。而且汗液属于阳液，是由中焦阳气化生而来的。发汗后，中气更加虚弱，寒湿更加停滞，脾胃受到寒湿的伤害，面色反映在体表。这与湿热发黄不同，所以说“不可下”，意思是不能用苦寒性质的药物进行攻下。“于寒湿中求之”的意思是，张仲景正是担心后世医生与下文“瘀热在里”的证候采用同样的治法，而《条辨》、《尚论》等书籍，反而用茵陈蒿汤、栀子柏皮汤等方剂来补充其治法，这是极大的错误。况且张仲景既然说了“不可下”，而茵陈蒿汤中含有二两大黄，难道不是下法吗？由此可知，张仲景当时必定另有治疗方法，后人应当用心领会罢了。《补亡论》常器之说：适宜用五苓散。这种议论比较接近原意。○有人问：湿气夹杂热邪，则郁结而发黄。现在夹杂寒邪，为什么会发黄？我回答说：寒湿发黄，好比秋冬季节的阴雨天气，草木本不该黄的也变黄了，这叫“冷黄”。王海藏说：阴黄，其证候表现为身冷、出汗、脉沉，这是太阴经中的湿邪。也有身体发热的，身体像熏黄一样，指颜色如烟熏般晦暗。终究不如阳黄那样明亮如橘子色。治疗方法：小便通利的，用术附汤；小便不利，大便反而通畅的，用五苓散。○我认为这一条，应该是太阴经的错简（竹简顺序错乱导致的条文位置错误），现在被归入阳明篇，姑且遵从张仲景的旧序而已。）
以上五条证候（见原论中第五卷阳明病脉证并治法第八）
（琥按：总括以上这些证候，都是从张仲景的太阳病、阳明病中汇集进来的。太阳经是寒水之经，所以凡是风寒湿邪从外来，直接中伤该经的情况是有的。中邪迅速，来不及发热，所以不出现头痛、烦热等症状。或者其人阳气本来虚弱，即使患病日久，也不会产生郁热。另外，阳明中寒，有寒气侵袭胸部以前的，有因食用生冷食物而得的。因为其人脾胃之气虚弱，所以不产生郁热，属于真阴寒证。有人问：张仲景的少阳病篇中，为什么没有中寒证？我回答说：少阳本属相火，相火不受寒邪侵犯，所以没有直中的证候。其阳明病有中寒的，是因为阳明虽然属燥金，但金的本体本性是寒的。又有人问：确实像您所说的那样，那么太阴湿土、厥阴风木，本来就是风湿中带有寒气了。至于少阴主君火，为什么中寒的证候反而多？我回答说：君火之气，位于司天的方位，对应地支的子午。午冲克子水，怎么能没有寒气呢？经文说：少火之气壮盛，壮火之气衰弱。午时对应壮火，火气衰弱，寒气就能侵犯它。所以夏至日属于午，此时一阴始生，说的就是这个道理。）
(The correct explanation can be found in the Middle Volume, Jueyin Disease chapter.)
A question was asked: This condition is identical to the previous one in that both present as deficiency-cold of the Stomach. Why is Si Ni Tang (Four Counterflow Decoction) not used? I replied: In cases of deficiency-cold of the Stomach, drinking water may induce hiccups (yue), and eating food may provoke vomiting; the manifested symptoms differ. Therefore, Si Ni Tang is not used; instead, Wu Zhu Yu Tang (Evodia Decoction) is administered as it is more appropriate. Vomiting is caused by rebellious Qi. When Qi rebels, it must be dispersed. Wu Zhu Yu (Fructus Evodiae) is acrid and bitter, with a heavy flavor that directs downward and drains; it is most effective for treating vomiting. Combined with Sheng Jiang (Rhizoma Zingiberis Recens), which is also a sacred remedy for vomiting, this differs from Gan Jiang (Rhizoma Zingiberis) in Si Ni Tang, which remains stationary and does not circulate outward. Chen of Wuling stated: The reason for vomiting is deficiency-cold generated within the Stomach. Using warming agents without tonification will not ultimately cure the vomiting. Therefore, Ren Shen (Radix Ginseng) is used to tonify the Middle Jiao, combined with Da Zao (Fructus Jujubae), to form a formula that harmonizes the Spleen. For the preceding condition, using this decoction resulted in cures in many cases, but occasionally some patients worsened after taking it. Thus, Cheng Wuji noted: One should seek another method for treating Upper Jiao conditions.
After sweating therapy for Shang Han (Cold Damage), the body and eyes turn yellow. The reason for this is that cold-dampness resides in the interior and has not resolved. It is considered inadvisable to use purgation; rather, one should seek treatment within the context of cold-dampness. (The "Shang Han" mentioned here refers to a Zhong Han [direct attack by cold] syndrome. If it were typical Shang Han, after sweating, the pathogenic heat would escape outward, so how could jaundice occur? Now, after sweating, the body and eyes turn yellow. The reason is that the patient inherently possesses cold-dampness in the interior and has additionally contracted cold pathogens on the exterior. After sweating, the exterior cold pathogens are expelled, but the interior cold-dampness remains unremoved, hence it is said "not resolved." Moreover, sweat is a Yang fluid, transformed from the Yang Qi of the Middle Jiao. After sweating, the Middle Qi becomes more deficient, and cold-dampness becomes more stagnant. The Spleen and Stomach are injured by cold-dampness, causing discoloration to appear externally. This differs from jaundice caused by damp-heat; therefore, it is said "do not purge," meaning bitter-cold purgative drugs should not be used. "Seek treatment within cold-dampness" implies that Zhang Zhongjing feared later physicians might treat this similarly to the "stagnant heat in the interior" condition described later. Books such as *Tiao Bian* and *Shang Lun* erroneously supplemented treatments with formulas like Yin Chen Hao Tang (Artemisia Capillaris Decoction) and Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Bark Decoction), which is a grave error. Furthermore, since Zhang Zhongjing explicitly stated "do not purge," yet Yin Chen Hao Tang contains two liang of Da Huang (Radix et Rhizoma Rhei), is this not a purgative method? Thus, we know Zhang Zhongjing must have had another treatment method in mind, which later generations should interpret through careful consideration. Chang Qizhi in *Bu Wang Lun* suggested Wu Ling San (Five-Ingredient Powder with Poria); his discussion is relatively close to the original intent. ○ A question was asked: Dampness combined with heat causes stagnation and thus jaundice. Now, if combined with cold, why does jaundice occur? I replied: Cold-damp jaundice is like the rainy season in autumn and winter; plants that should not turn yellow also do, known as "cold jaundice." Wang Haicang stated: Yin Jaundice presents with cold limbs, sweating, and a deep pulse, resulting from dampness in the Taiyin Meridian. There are also cases with fever, where the body appears like smoked yellow, meaning the color is dark and dull like smoke. This is distinctly different from Yang Jaundice, which is bright orange-yellow. Treatment: If urination is free, use Shu Fu Tang (Aconite and Atractylodes Decoction). If urination is difficult but stool is loose, use Wu Ling San. ○ I observe that this clause likely belongs to the Taiyin Meridian due to bamboo slip misordering, but it is currently placed in the Yangming chapter; I shall temporarily follow Zhang Zhongjing's original arrangement.)
The above five conditions (see Original Treatise, Volume 5, Yangming Disease Pulse, Syndrome, and Treatment Methods, Chapter 8).
(Hu summarizes: All the above conditions are derived from Zhang Zhongjing's Taiyang and Yangming diseases. The Taiyang Meridian is the meridian of Cold Water. Therefore, when Wind-Cold-Damp pathogens invade from outside, they may directly strike the meridian. If the invasion is rapid, there is insufficient time for fever to develop, so symptoms such as headache or irritability/heat do not appear. Or, if the person's Yang Qi is originally deficient, even if the disease persists for a long time, it will not generate constrained heat. Additionally, Yangming Zhong Han (Cold Attack on Yangming) can result from cold air invading the chest area or from consuming cold foods. Because the person's Spleen and Stomach Qi is weak, constrained heat is not generated, resulting in a true Yin-cold syndrome. A question was asked: Why are there no Zhong Han conditions in Zhang Zhongjing's Shaoyang disease chapter? I replied: Shaoyang originates from Minister Fire. Minister Fire does not accept cold pathogens; therefore, there are no direct attack conditions. However, Yangming disease can involve cold because, although Yangming belongs to Dry Metal, the nature of metal is inherently cold. Another question was asked: If your statement is true, then Taiyin Wet Earth and Jueyin Wind Wood inherently contain cold within wind and dampness. As for Shaoyin governing Lord Fire, why are there relatively more Zhong Han conditions? I replied: The Qi of Lord Fire occupies the position of Heaven's Governance, corresponding to the Earthly Branches Zi and Wu. Wu clashes with Zi Water; how can there be no cold? The Classic states: The Qi of Lesser Fire is vigorous; the Qi of Greater Fire declines. Wu corresponds to Greater Fire, where fire energy declines, allowing cold to invade. Hence, at the Summer Solstice, which belongs to Wu, one Yin begins to arise. This is what is meant.)