素问曰。人之伤于寒也。则为病热。热虽甚不死。其两感于寒而
病者。必不免于死。
又曰。两感于寒者。病一日。则巨阳与少阴俱病。则头痛口干。
烦满而渴。二日。则阳明与太阴俱病。则腹满身热。不饮食。谵语。三
日。少阳与厥阴俱病。则耳聋囊缩而厥。水浆不入。不知人。六日死。
病源曰。水浆不入。不知人。则六日而死。其义甚明。
问曰。素问言不知人。六日死。又言三日其气乃尽。何也。雍曰。
两感之病。表里俱传。三日而六经竟。虽竟而气未绝。故经竟之后。
又三日。其气乃绝。其言三日者。谓三日而阳明之气方尽故也。言六
日者。通传经之日也。传经三日。气尽故言六日。何以明之。三日经
竟之时。五脏已伤。六腑不通。营卫不行。如是之后。又三日。气尽乃
死。帝以疑而问之。而岐伯告以阳明气血盛不知人。三日而后死也。
经既曰如是之后。则是传六经竟之后也。又曰不知人。三日。则是阳
明未绝之时也。经竟甚明。而或者谓其传六经而后死。夫能再传。则
不死矣。本以邪气传至少阳欲传太阴之间。而太阴已先与阳明同受
邪气。不能更受后来再传之邪。虽太阴复欲以邪传之三阳。而三阳
邪气亦皆满。亦不更尔容受。两邪相拒。六经皆满。俱不能流注传
泄。是以六腑不通。营卫不行。水浆不入。不知人。以待阳明之气尽
而后死矣。阳明。胃经也。胃为血气之海。朝夕灌注营卫六腑十二经
者。皆胃之气血也。诸经虽绝。独阳明气血未尽。故又三日而后死
也。六日死。三日死。只是两感一证。或者谓再传为六日死。邪气直
入阳明。为三日死。遂分两证。此说甚误。未通经意。又不当改经血
气盛为邪气盛。仍有血气随邪而尽之说。皆失也。反复读经。当自得
之。庞氏曰。两感之疾。素问无脉候。今详之。凡脉沉者。皆属阴也。
一日脉当沉而大。沉者。少阴也。大者。太阳也。二日脉当沉而长。三
日脉当沉而弦。乃以合表里之脉。沉长弦皆隐于沉大也。凡三阴无
合病。惟三阳有合病。今三阳与三阴合病。故其脉似沉紧而大。似沉
实而长。亦类革至之死脉也。
王仲弓监丞曰。本论言两感俱作。治有先后。发表攻里。本自不
同。近时张翊云。论有伤寒。医下之。利不止。身疼痛者。急当救里。
后身疼痛清便自调者。急当救表。今可根据仿而治。既云治有先后。则
宜先救里。内才温则可医。然救表亦不可缓也。朱氏曰。内尤为急
也。雍曰。救里药用四逆。救表药用桂枝汤。此法出于不得已。犹愈
于束手待毙矣。仲景曰。救里药用四逆。救表药用桂枝汤。更看临时
寒热多少参订之。幸有表里一轻者。则急治其重者也。然其治大宜
速。过三日。则水浆不入。虽有药不纳已。张亦未悟此也。
两感论曰。病患有不治之证。古人不复论方药者。立论固可如
此。医家亦可如此。而人有父兄母弟至亲。不幸遇疾如此。能坐视不
思拯援万死一生之术哉。孙真人论。精神困者。病久不瘥。欲死者。
但与药救之。十人中或瘥三四。以是言。则人虽有不治之病。其气未
绝之间。亦无不服药待尽之理。今观两感之证。以阴阳之经。邪气皆
满。不相来往传注。故为必死之候。乘其三日内邪气未满。营卫可通
之时。早为疗治。尚或不死。若六经邪气三日既满。则水浆不入。汤
药何缘可纳。势须于初觉之时急治之。然初感之日。谁能断然不疑。
知其为两感。拟议之间。已不及矣。是以必至于死也。雍谓汤药至
此。不如针灸。汤药虽可内攻。而内攻未必至。虽至而药病方有胜
负。针艾可以外泄。随其轻重。必有泄而出者。昔虢太子之死。扁鹊
治之。盖外泄之术也。方其厥气上行。绝阳破阴。有甚于两感不知人
之证。扁鹊以为阳脉下坠。阴脉上争。令气闭而不通。夫厥气。亦邪
气也。阳脉阴脉者。即阳经阴经也。阳脉下坠。犹传之阳也。阴脉上
争。相搏而不能受也。气闭不通。以阴阳俱邪实。故不通。不通则水
浆不入矣。越人于是不施汤剂。而遽用针石。外取三阳五会。有间。
太子苏。是知汤不能达于外。而针尚可泄于外也。既苏而得为五分
之熨以逐余邪。邪去然后得服汤药。二旬而复故。倘使汤先。必不能
得入。何缘有复苏之理。今两感之邪。与尸厥之邪。其暴杀人一也。
诚能效越人先针后汤之术。取之三阳。使三阳气缓。然后灼三阴之
会以泄其邪。邪气未尽。方以汤攻。使无所逃。既尽。则以汤养之。虽
生死未可必。而其为治。有所据而不谬矣。故愚意欲先取昆仑委中。
乃去其血以泄太阳。次取三里以泄阳明。后取邱墟阳陵泉。以泄少
阳。三阳气既缓。急灸三阴交穴。以泄三阴之邪。此穴亦难取。或上
下左右少差即能中。一阴二阴不中。必三阴俱中。仍须审度。再分
灸之。上阴陵泉可泄太阴。太溪可泄少阴。大敦可泄厥阴。炷如麦
粒。缓缓灸之。徐泄其气。不必以多为贵也。虽其如此。亦不可以不
灸三阴交。先并泄之。然后分得阴阳。得阴阳缓。乃可服汤。泄不患
多。治不厌速。盖有三日之期。不可待也。所以不敢用熨者。必为火
邪。故惟用汤。二者。皆阴气闭不通之疾。大略相似。而其为寒热则
异也。以是思之。则三阴合病之中。脉有负者。亦宜灸刺以治之。且
如阳明少阳合病。其脉负者。少阳木气盛也。泻邱墟阳陵泉。则少阳
木气不得不平。补三里。则阳明之土。不得不旺。或不精补泻者。第
以刺为泻。灸为补。古人皆有是法。如是。则虽死亦有可生理。所谓
十中三四愈者。未必不如孙氏之言也。虽然。天下之事。固有大小同
异。而其理一也。昔洪水横流。泛滥于中国。禹决九州。然后人得平
土而居之。愚因诵此。而得通病有外泄之理。使早得而熟之。则越人
氏之学。何难至之。颜渊曰。舜何人也。予何人也。有为者亦若是。况
卢扁乎。惜余得之暮年。所用之小也。然亦不敢不告诸来者。故备言
之。
《素问》说：人受寒邪侵袭，就会发生发热性疾病。即使热势很严重，也不会死亡。如果是两感于寒而发病的，则必然不免于死亡。
又说：两感于寒的病，第一天，太阳经与少阴经同时发病，就会出现头痛、口干、心烦胀满且口渴的症状。第二天，阳明经与太阴经同时发病，就会出现腹部胀满、全身发热、不想饮食、胡言乱语（谵语）。第三天，少阳经与厥阴经同时发病，就会出现耳聋、阴囊收缩和四肢厥冷、水浆不能入口、神志昏迷不知人事。到了第六天死亡。
《病源》说：水浆不能入口，神志昏迷不知人事，那么第六天就会死亡。其中的道理非常明白。
有人问：《素问》说“不知人”是第六天死，又说“三天后其气才耗尽”，这是什么原因？郭雍回答说：两感病的病机是表里两经同时受邪并相互传变，经过三天六经的病变过程就结束了。虽然六经的病变过程结束了，但气血尚未完全断绝。所以在六经病变结束后的第三天，气血才真正耗尽。所谓“三天”，是指到第三天时阳明经的气血才完全耗尽；所谓“第六天”，是指总共经历了传经的六天时间。传经用了三天，气血耗尽，所以说第六天死。怎么证明这一点呢？在第三天六经病变结束时，五脏已经受损，六腑不通畅，营卫之气运行停滞。像这样之后，再过三天，气血耗尽才会死亡。黄帝因为疑惑而询问，岐伯告诉他，由于阳明经气血旺盛，所以病人出现不知人事的症状，要过三天后才死亡。经文既然说“像这样之后”，那就是指传遍六经之后的情况。又说“不知人”三天后死，那是阳明经气血尚未断绝的时候。六经传变的过程已经很明白了，但有些人认为传完六经后才死。如果能再传一遍，就不会死了。原本邪气传到少阳经，正要传给太阴经时，太阴经已经先与阳明经一同受了邪气，不能再接受后来再传来的邪气。虽然太阴经也想把邪气传给三阳经，但三阳经的邪气也已经充满，也不能再容纳。两种邪气相互抗拒，六经都充满了邪气，都不能流通注泄。因此六腑不通畅，营卫之气不行，水浆不能入口，神志昏迷不知人事，只能等待阳明经的气血耗尽而死。阳明经就是胃经。胃是血气的海洋，早晚灌注营卫和六腑十二经脉的，都是胃的气血。各条经脉的气血虽然都断绝了，唯独阳明经的气血还没有耗尽，所以要过三天后才死亡。说是第六天死，或是第三天死，只是两感这一种证候。有些人认为是再传导致第六天死，邪气直入阳明导致第三天死，于是分为两种证候，这种说法非常错误，没有通晓经文的意旨，而且不应该把经文中的“血气盛”改为“邪气盛”，还有“血气随着邪气一起耗尽”的说法，都是失当的。反复研读经文，自然会有所领悟。庞氏说：两感的疾病，《素问》中没有记载脉象。现在详细分析它，凡是脉沉的，都属于阴证。第一天脉应当沉而大。沉，代表少阴经；大，代表太阳经。第二天脉应当沉而长。第三天脉应当沉而弦。这是用来符合表里两经的脉象。沉、长、弦这三种脉象都隐含在沉大的脉象之中。凡是三阴经没有合病的情况，只有三阳经有合病。现在三阳经与三阴经合病，所以脉象好像沉紧而大，好像沉实而长，也类似革脉或至阴的死脉。
王仲弓监丞说：本论讲两感证同时发作，治疗有先后顺序。解表攻里，本来就有不同。近来张翊说，经文中有伤寒，医生用下法治疗后，腹泻不止，身体疼痛的，应当紧急救治里证。后来身体疼痛消失，大小便正常的，应当紧急救治表证。现在可以根据这个仿效来治疗。既然说治疗有先后顺序，那就应该先救里证。内里温暖了才可以医治。然而救表证也不可迟缓。朱氏说：救里证尤为紧急。郭雍说：救里证用药用四逆汤，救表证用药用桂枝汤。这种方法出于不得已，但也比束手待毙要好。张仲景说：救里证用药用四逆汤，救表证用药用桂枝汤。还要根据当时寒热的多少进行参详订正。如果有表里证都较轻的，就紧急治疗较重的那个。然而治疗一定要迅速。过了三天，水浆就不能入口了，虽然有药也无法纳入了。张翊也没有领悟这一点。
《两感论》说：患有无法治愈的证候，古人不再讨论方药，立论固然可以这样。医家也可以这样。但是人有父亲、兄长、母亲、弟弟等至亲，不幸遇到这样的疾病，怎么能坐着观看而不思考挽救万死一生机会的方法呢？孙思邈真人论述说，精神困倦的病人，患病很久不好转，想要死亡的，只要给药救治，十个人中或许能治好三四个。由此而言，人即使有无法治愈的病，在气血尚未断绝之间，也没有不服药等待结局的道理。现在观察两感证的病机，阴阳经脉的邪气都充满了，不相往来传注，所以是必死的征候。趁着三天内邪气尚未充满，营卫之气还可以通畅的时候，尽早进行治疗，或许不会死。如果六经邪气在三天内已经充满，那么水浆就不能入口，汤药从哪里可以纳入？形势上必须在刚察觉的时候紧急治疗。然而在初感之日，谁能果断地不怀疑，知道它是两感证呢？在犹豫商议之间，就已经来不及了。所以必然导致死亡。郭雍认为，到了这种地步，汤药不如针灸。汤药虽然可以内服攻治，但内服未必能到达病所；即使到达了，药物与病邪之间也有胜负之分。针艾可以从外部泄出邪气，根据病情的轻重，一定有被泄出的邪气。从前虢太子之死，扁鹊治疗他，大概就是用外部泄邪的方法。当他的厥气上行，绝阳破阴，比两感证中不知人事的症状还要严重。扁鹊认为是阳脉下坠，阴脉上争，导致气机闭塞而不通畅。所谓的厥气，也是邪气。阳脉阴脉，就是阳经阴经。阳脉下坠，犹如其邪气传入阳经；阴脉上争，相互搏结而不能承受。气机闭塞不通，是因为阴阳二经都是邪气实证，所以不通。不通就会导致水浆不能入口。越人（扁鹊）在这种情况下不施用汤剂，而是立即使用针石。从外部选取三阳五会穴，过了一会儿，太子苏醒。由此可知，汤药不能达于外部，而针刺还可以从外部泄邪。太子苏醒后，得以用五分厚的熨法来驱逐残余的邪气，邪气去除后才能服用汤药，二十天后恢复健康。假如先用汤药，必定不能进入体内，哪里会有复苏的道理呢？现在的两感邪气，与尸厥的邪气，突然杀人的程度是一样的。如果能效法越人先针刺后汤药的技术，取三阳经的穴位，使三阳经的气机缓和，然后灼灸三阴经的交会穴以泄除邪气。邪气未尽，再用汤药攻治，使其无处可逃。邪气尽后，再用汤药调养。虽然生死还不能一定，但治疗方法有所依据而不谬误。所以我个人的想法是想先取昆仑穴、委中穴，然后放血以泄除太阳经的邪气；其次取足三里穴以泄除阳明经的邪气；随后取邱墟穴、阳陵泉穴，以泄除少阳经的邪气。三阳经的气机既已缓和，紧急灸三阴交穴，以泄除三阴经的邪气。这个穴位也很难取准，如果上下左右稍有偏差就不能中穴。一阴经、二阴经如果不中，必须三阴经都中才行。仍然需要审慎度量，再分别施灸。上部的阴陵泉穴可以泄除太阴经的邪气，太溪穴可以泄除少阴经的邪气，大敦穴可以泄除厥阴经的邪气。艾炷像麦粒那么大，缓缓施灸，慢慢泄除邪气，不必以数量多为贵。虽然如此，也不可以不灸三阴交穴。先一起泄除，然后分别调理阴阳。得到阴阳气机的缓和，才可以服用汤药。泄邪不怕多，治疗不嫌快。因为只有三天的期限，不可以等待。所以不敢用熨法，一定是怕产生火邪，所以只用汤药。这两种病，都是阴气闭塞不通的疾病，大体相似，但寒热的表现不同。由此思考，在三阴合病中，脉象有负（虚弱/不利）的情况，也适宜用灸刺来治疗。比如阳明经和少阳经合病，脉象有负的，是少阳木气旺盛。泻邱墟、阳陵泉穴，少阳木气不得不平和；补足三里穴，阳明土气不得不旺盛。如果不精通补泻手法，仅仅以针刺为泻，艾灸为补，古人都有这种方法。像这样，即使是死症也有生机。所谓十人中治好三四例，未必不如孙思邈所说的话。虽然如此，天下的事情，固有大小同异，但其道理是一致的。从前洪水横流，泛滥于中国，大禹疏导九州，然后人们才能居住在平坦的土地上。我因此诵读此事，而悟通了疾病有外部泄邪的道理。如果早点得到并熟习它，那么越人的学问，有什么难以达到的呢？颜渊说：舜是什么样的人？我是什么样的人？有所作为的人也会像他一样。何况是卢医（扁鹊）那样的神医呢？可惜我晚年才得到这个理论，应用的范围很小。然而也不敢不告诉后来者。所以详尽地陈述出来。
The *Suwen* (Basic Questions) states: When humans are injured by cold pathogens, they develop febrile diseases. Even if the heat is severe, it will not result in death. However, for those who contract "Lianggan" (simultaneous contraction of exterior and interior meridians) from cold, death is inevitable.
It further states: In cases of Lianggan contracted from cold, on the first day, the Taiyang (Greater Yang) and Shaoyin (Lesser Yin) meridians are affected simultaneously, resulting in headache, dry mouth, vexation, fullness, and thirst. On the second day, the Yangming (Bright Yang) and Taiyin (Greater Yin) meridians are affected simultaneously, resulting in abdominal fullness, generalized fever, anorexia, and delirious speech. On the third day, the Shaoyang (Lesser Yang) and Jueyin (Terminal Yin) meridians are affected simultaneously, resulting in deafness, retraction of the scrotum, and cold extremities; the patient cannot take fluids or food and loses consciousness. Death occurs on the sixth day.
The *Bingyuan* (Source of Diseases) states: If the patient cannot take fluids or food and has lost consciousness, death will occur on the sixth day. The rationale is very clear.
A question arises: The *Suwen* states that loss of consciousness leads to death on the sixth day, yet it also says that "the qi exhausts after three days." What is the reason? Guo Yong replies: In Lianggan disease, the exterior and interior meridians transmit the pathogen simultaneously. After three days, the transmission through the six meridians is completed. Although the transmission process is complete, the vital qi has not yet completely exhausted. Therefore, three days after the completion of the meridian transmission, the qi finally exhausts. When it says "three days," it refers to the exhaustion of the Qi of the Yangming meridian at that time. When it says "six days," it refers to the total duration of the meridian transmission. The transmission takes three days, and the qi exhausts, hence the mention of the sixth day. How is this clarified? At the time when the six meridians' transmission completes on the third day, the five zang organs are already damaged, the six fu organs are obstructed, and the Ying (Nutritive) and Wei (Defensive) qi cease to circulate. After such a state persists for another three days, the qi exhausts and death ensues. The Yellow Emperor asked out of doubt, and Qibo answered that because the Qi and Blood of the Yangming meridian are abundant, the patient experiences loss of consciousness, and death occurs three days later. Since the text says "after such a state," it implies after the transmission through the six meridians is complete. It also says "loss of consciousness for three days," which indicates the period before the Yangming qi is completely exhausted. The process of meridian transmission is clear. However, some believe that death occurs after the transmission through the six meridians. If there were a second transmission, death would not occur. Originally, the pathogen transmits to the Shaoyang meridian and intends to transmit to the Taiyin meridian, but the Taiyin meridian has already received the pathogen simultaneously with the Yangming meridian and cannot accept subsequent transmitted pathogens. Although the Taiyin meridian might attempt to transmit the pathogen back to the Three Yang meridians, the pathogens in the Three Yang meridians are already full and cannot accommodate more. The two pathogens resist each other, filling all six meridians, preventing flow and discharge. Thus, the six fu organs are obstructed, the Ying and Wei qi do not circulate, fluids and food cannot be taken, and consciousness is lost, waiting only for the Qi of the Yangming meridian to exhaust before death. The Yangming meridian is the Stomach meridian. The Stomach is the sea of Qi and Blood; the Qi and Blood that nourish the Ying, Wei, six fu organs, and twelve meridians morning and evening are all derived from the Stomach. Although the Qi and Blood of all other meridians may be exhausted, the Qi and Blood of the Yangming meridian remain unexhausted, hence death occurs three days later. Whether stated as death on the sixth day or the third day, it refers to the single syndrome of Lianggan. Some argue that a second transmission causes death on the sixth day, while direct entry into Yangming causes death on the third day, thus dividing it into two syndromes. This view is erroneous, fails to understand the classic's intent, incorrectly changes "abundant Qi and Blood" to "abundant pathogen," and posits that "Qi and Blood exhaust along with the pathogen," all of which are mistakes. Repeatedly reading the classic will lead to natural understanding.
Pang Shi states: The *Suwen* does not record pulse diagnoses for Lianggan. Analyzing it now, any sinking pulse belongs to the Yin category. On the first day, the pulse should be sinking and large. Sinking represents Shaoyin; large represents Taiyang. On the second day, the pulse should be sinking and long. On the third day, the pulse should be sinking and wiry. These correspond to the exterior-interior pulse relationships. Sinking, long, and wiry pulses are all implicit within the sinking-large pulse. Generally, there are no combined diseases among the Three Yin meridians, only among the Three Yang meridians. Now, since the Three Yang and Three Yin meridians are involved in a combined disease, the pulse resembles sinking-tight and large, or sinking-solid and long, similar to the Ge (Leather) pulse or the Zhi (Arrival) pulse, which are signs of death.
Wang Zhonggong, Supervisor, states: The original treatise discusses Lianggan occurring simultaneously, with treatment having a sequence. Releasing the exterior and purging the interior are fundamentally different. Recently, Zhang Yi cited a case where a patient with Cold Damage was treated with purgatives, resulting in persistent diarrhea and body pain. In such cases, one should urgently rescue the interior. Later, when body pain ceases and bowel movements normalize, one should urgently rescue the exterior. One can follow this model for treatment. Since treatment has a sequence, rescuing the interior should come first. Only when the interior is warm can treatment proceed. However, rescuing the exterior should not be delayed. Zhu Shi states: Rescuing the interior is particularly urgent. Guo Yong states: For rescuing the interior, use Sini Tang (Four Reversal Decoction); for rescuing the exterior, use Guizhi Tang (Cinnamon Twig Decoction). This method is a last resort, but better than waiting passively for death. Zhang Zhongjing states: Use Sini Tang for rescuing the interior and Guizhi Tang for rescuing the exterior. Adjust based on the degree of cold and heat at the time. If both exterior and interior symptoms are mild, urgently treat the more severe one. However, treatment must be swift. After three days, the patient cannot take fluids; even if medicine is available, it cannot be retained. Zhang Yi did not grasp this point.
The *Treatise on Lianggan* states: There are syndromes considered incurable, so ancients did not discuss formulas for them. While theoretical discussion may proceed this way, physicians might adopt this attitude. However, when one's close relatives suffer from such diseases, how can one sit idly without seeking methods to save them from near-death situations? Sun Simiao stated that for patients with depleted spirit and prolonged illness nearing death, administering medicine might cure three or four out of ten. Thus, even for incurable diseases, while vital qi remains, there is no reason not to administer medicine until the end. Observing the Lianggan syndrome, the pathogens fill both Yin and Yang meridians, preventing mutual transmission, making it a fatal prognosis. If treated early, while within three days the pathogens have not fully filled the meridians and Ying-Wei circulation is still possible, survival might be achieved. However, if after three days the pathogens in all six meridians are full, the patient cannot take fluids, and how could decoctions enter? Urgent treatment is necessary at the initial stage. Yet, at the onset, who can definitively diagnose Lianggan without hesitation? By the time of deliberation, it is too late, leading inevitably to death. Guo Yong believes that at this stage, acupuncture and moxibustion are superior to herbal decoctions. Decoctions may not reach the target effectively, and even if they do, the outcome depends on the struggle between medicine and pathogen. Acupuncture and moxa can expel pathogens externally according to severity. In the case of the Crown Prince of Guo, Bian Que used external expulsion techniques. His condition involved upward-rushing Jue Qi (Rebellious Qi), severing Yang and breaking Yin, worse than the unconsciousness in Lianggan. Bian Que diagnosed descending Yang pulses and ascending Yin pulses, causing Qi blockage. Jue Qi is also a pathogen. Yang and Yin pulses refer to Yang and Yin meridians. Descending Yang pulses imply pathogen transmission to Yang meridians; ascending Yin pulses indicate conflict and inability to bear it. Qi blockage results from excess pathogens in both Yin and Yang meridians, leading to inability to take fluids. Bian Que did not use decoctions but immediately applied needles. He selected the San Yang Wu Hui (Three Yang Five Meetings) acupoint externally. After a while, the prince revived. This shows that decoctions cannot reach externally, whereas needles can expel externally. After revival, he used hot compresses (five fen thickness) to drive out residual pathogens. Once pathogens were cleared, decoctions were administered, and health returned in twenty days. Had decoctions been used first, they could not have entered, and revival would have been impossible. The sudden lethality of Lianggan pathogens is similar to that of Shijue (Corpse-like Coma) pathogens. If one could emulate Bian Que’s technique of needle first, then decoction, selecting points from the Three Yang meridians to缓 (slow/relax) their Qi, then burning intersection points of the Three Yin meridians to expel pathogens, and using decoctions only after pathogens are exhausted to nourish the body, although survival is not guaranteed, the treatment would be grounded and correct. My suggestion is to first select Kunlun (BL60) and Weizhong (BL40), bleed to expel Taiyang pathogens. Next, select Zusanli (ST36) to expel Yangming pathogens. Then, select Qiuxu (GB40) and Yanglingquan (GB34) to expel Shaoyang pathogens. Once the Three Yang Qi is relaxed, urgently moxa Sanyinjiao (SP6) to expel Three Yin pathogens. This point is difficult to locate accurately; slight deviation misses the point. All Three Yin meridians must be correctly targeted. Careful measurement is required. Subsequently, moxa Yinlingquan (SP9) above to expel Taiyin pathogens, Taixi (KI3) to expel Shaoyin pathogens, and Dazhuan (LR1) to expel Jueyin pathogens. Use wheat-grain-sized moxa cones, moxa slowly to gradually expel Qi; quantity is not as important as quality. Regardless, Sanyinjiao (SP6) must be moxa first to jointly expel, then balance Yin and Yang. Only when Yin-Yang Qi is relaxed can decoctions be taken. Expelling pathogens does not fear excess; treatment does not fear speed, as there is only a three-day window. I dare not use hot compresses due to the risk of Fire Pathogens, so I rely solely on decoctions. Both conditions involve blocked Yin Qi, sharing similarities but differing in cold/heat presentation. Considering this, in combined diseases of the Three Yin meridians with deficient pulses, moxa and acupuncture are also suitable. For example, in Yangming-Shaoyang combined disease with a deficient pulse, Shaoyang Wood Qi is excessive. Reducing Qiuxu and Yanglingquan calms Shaoyang Wood; tonifying Zusanli strengthens Yangming Earth. For those unfamiliar with tonification/reduction, using needle for reduction and moxa for tonification is an ancient method. Thus, even in fatal cases, there is hope for recovery, aligning with Sun Simiao’s statistic of 30-40% survival. Although matters vary in size and nature, the principle is one. Just as Yu the Great drained the floods to allow habitation, I realized that diseases can be treated via external expulsion. Had I mastered this earlier, Bian Que’s art would have been accessible. Yan Yuan said, "What kind of person was Shun? What kind of person am I? Those who act will be like him." How much more so for masters like Lu and Bian? I regret learning this in my twilight years, limiting its application, but I dare not withhold it from future generations. Hence, I state it fully.