问曰。伤寒三阳受病。传经何如。素问三十一篇曰。伤寒一日。
巨阳受之。故头项痛。腰脊强。二日。阳明受之。阳明主肉。其脉挟鼻
络于目。故身热目疼而鼻干。不得卧也。三日。少阳受之。少阳主胆。
其脉循胁。络于耳。故胸胁痛而耳聋。三阳经络皆受其病。未入于
脏。可汗而已。
问曰。三阴受病。传经如何。素问曰。四日。太阴受之。太阴脉布
胃中。络于嗌。故腹满而嗌干。五日。少阴受之。少阴脉贯肾络于肺。
系舌本。故口燥舌干而渴。六日。厥阴受之。厥阴脉循阴器而络于
肝。故烦满而囊缩。
问曰。三阴可下何如。仲景曰。三阴皆受病。已入于腑。可下而
已。
问曰。汗下系乎经。或系之日。何也。雍曰。日。犹经也。大抵受
病。皆有常变。其经与日不相应者。则变也。循常则易治。既变则难
通。然变当从证。常可从日。故素问又曰。若其未满三日者。可汗而
已。其满三日者。可泄而已。此言常道也。
问曰。经言其死皆以六七日之间。何也。雍曰。六七日传经皆
遍。阴阳俱受病已。故重者死也。素问曰。三阴三阳。五脏六腑皆受
病。营卫不行。五脏不通则死是也。故经又言。治之法各通其脏脉。
病日衰已。如是则五脏不通则死。通其脏脉。则病衰也。
问曰。经言其愈皆以十日以上者。何也。雍曰。此谓伤寒循常无
变者。故素问曰。其不两感于寒者。七日巨阳病衰。头痛少愈。八日
阳明病衰。身热少愈。九日少阳病衰。耳聋微闻。十日太阴病衰。腹
减如故。则思饮食。十一日少阴病衰。渴止不满。舌干。已而嚏。十二
日厥阴病衰。囊纵少腹微下。大气皆去。病日已矣。此所以愈者。皆
十日以上也。（仲景。十一日渴止下无不满。十二日大气皆去下有病
人精神爽慧也。）
问曰。十二日以上不愈者。何也。仲景曰。若过十三日以上。不
间。尺寸陷者。大危。若更感异气。变为他病者。当根据后坏病证而治
之。若脉阴阳俱盛。重感于寒。变成温疟。阳脉浮滑。阴脉濡弱者。更
遇于风。变为风湿。阳脉洪数。阴脉实大。更遇温热。变为温毒。为病
最重也。阳脉濡弱。阴脉弦紧。更遇温气。变为温疫。以此冬伤于寒。
发为温病。脉之变证。方治如说。（庞氏。温疫作湿温为当。）
问曰。伤寒一日。巨阳受之。（王氏曰。巨大也。）何他。素问曰。
巨阳者。诸阳之属也。（皆有所属）其脉连于风府。故为诸阳主气也。
又评热论曰。巨阳主气。故先受邪也。
问曰。两感于寒者何如。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。一日。太阳与少阴俱
病。则头痛口干而烦满。二日。阳明与太阴俱病。则腹满身热。不欲
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。
问曰。素问又言三日乃死。何也。雍曰。即前所谓六日死也。何
以言之。两感之病。阴阳表里两经俱传。至三日。则六经阴阳已传
尽。水浆不入口。不知人。是时五脏已尽伤。六腑已不通。营卫已不
仁。如是之后。三日乃死。帝疑之。故再举问。岐伯谓是时阳明之气
独未尽。故又三日而后死。是以其言曰。阳明者。十二经脉之长也。
其血气盛。故不知人。三日其气乃尽。故死矣。夫不知人者。则两感
阴阳俱传。三日之证也。阳明为诸经之长。其血气盛。所以滋养诸
经。其血气已散入诸经者。各随其经绝矣。其在阳明未散入诸经者。
又须三日而后乃尽。以是知六日者。三日传阴阳诸经。又三日阳明
之气方尽。是为六日。而世之读经者。以六日为阴阳再传经而死。若
阴阳尚能再传。则不死矣。其曰三日死者。又别为阳明气血随邪而
尽之说。与六日不相通。其误甚矣。
问曰。伤寒独传足阴阳六经。何也。孙真人云。人有五脏。心肺
二脏经络。所起在手十指。肝肾与脾三脏经络。所起在足十趾。夫风
毒之气。皆起于地。地之寒暑风湿。皆作蒸气。足常履之。所以中人
必中于足。雍曰。此孙真人感风毒之论。伤寒之感。亦无以异也。
问曰。伤寒三阳受病。传不传可见否。仲景曰。伤寒一日。太阳
受之。脉若静者为不传。颇欲吐。若躁烦。脉数急者。为传也。
又曰。伤寒二三日。阳明少阳证不见者。为不传也。
问曰。三阴经传不传可见否。仲景曰。伤寒三日。三阳为尽。三
阴当受邪。其人反能食而不呕。此为三阴不受邪也。不受邪则不传
矣。
问曰。六经于脏腑何属也。雍曰。足太阳。膀胱经也。足阳明。胃
经也。足少阳。胆经也。此三腑者。皆为阳也。足太阴。脾之经也。足
少阴。肾之经也。足厥阴。肝之经也。此三脏。皆为阴也。阳为表。阴
为里。故足太阳与足少阴为表里。肾与膀胱也。足阳明与足太阴为
表里。脾与胃也。足少阳与足厥阴为表里。肝与胆也。
问曰。愿闻六经之所起。雍曰。本于灵枢之言。未可遽详也。朱
氏活人书可见。其略云。足太阳膀胱。起于目内 。上头。连于风府。
分为四道。下项。并正别脉上下六道。以行于背。与身为经。太阳之
经。为诸阳主气。或中寒邪。必发热而恶寒。缘头项腰脊。足太阳经
所过处。今头项痛。腰脊强。身体疼。其尺寸脉俱浮者。故知太阳经
受病。此其大略也。
问曰。阳明经何如。朱氏曰。足阳明胃之经。从鼻起。挟于鼻。络
于目。下咽。分为四道。并正别脉六道。上下行腹。纲维于身。盖诸阳
在表。阳明主肌肉。络于鼻。故病患身热。目疼。鼻干。不得卧。其脉
尺寸俱长者。故知阳明经受病。
问曰。少阳经何如。朱氏曰。足少阳胆之经。起目外 。（外当作
锐）络于耳。分为四道。下缺盆。循于胁。并正别脉六道上下。主经
营百节。流气三部。故病患胸胁痛而耳聋。或口苦咽干。或往来寒热
而呕。其脉尺寸俱弦者。知少阳经受病也。
问曰。太阴经何如。朱氏曰。足太阴脾之经。为三阴之首。其脉
布于脾胃。络于嗌喉。故病患腹满而嗌干。其脉尺寸俱沉细者。知太
阴经受病也。
问曰。少阴经何如。朱氏曰。足少阴肾之经。其脉起于足小趾之
下。斜趣足心。别行者入跟中。上至股内后廉。贯肾络膀胱。直行。从
肾上贯肝膈。入肺中。系舌本。伤寒热气入于脏。流入于少阴之经。
少阴主肾。肾恶燥。故渴而引饮。又经发汗吐下以后。脏腑空虚。津
液枯竭。肾有余热亦渴。故病患口燥舌干而渴。其脉尺寸俱沉者。少
阴受病也。
问曰。厥阴何如。朱氏曰。足厥阴肝之经。厥者尽也。灵枢经亥
为左足之厥阴。戌为右足之厥阴。两阴俱尽。故曰厥阴。夫阴尽为
晦。阴出为朔。厥阴者。以阴尽为义也。其脉循阴器而络于舌本。脉
弗营则筋急。筋急则引舌与卵。故唇青舌卷而囊缩。凡病患烦满而
囊缩。其脉尺寸俱微缓者。知厥阴经受病也。
问曰。六经之脉状何如。仲景曰。尺寸俱浮者。太阳受病也。尺
寸俱长者。阳明受病也。尺寸俱弦者。少阳受病也。尺寸俱沉细者。
太阴受病也。尺寸俱沉者。少阴受病也。尺寸俱微缓者。厥阴受病也。
问曰。阳明厥阴之义何也。素问七十四篇曰。阳明何谓也。岐伯
曰。两阳合明也。厥阴何谓也。岐伯曰。两阴交尽也。
问：伤寒病中，三阳经受邪，传变规律是怎样的？《素问·热论》第三十一篇说：伤寒第一天，太阳经（足太阳膀胱经）受邪，所以出现头痛、项强、腰脊僵硬。第二天，阳明经（足阳明胃经）受邪，阳明经主管肌肉，其经脉夹鼻而行，联络于目，所以出现身体发热、眼睛疼痛、鼻子干燥、不能安卧。第三天，少阳经（足少阳胆经）受邪，少阳经主管胆腑，其经脉沿胁肋行走，联络于耳，所以出现胸胁疼痛和耳聋。如果三阳经的经络都受到病邪侵袭，但病邪尚未传入五脏，可以通过发汗的方法治愈。
问：三阴经受邪，传变规律又是怎样的？《素问》说：第四天，太阴经（足太阴脾经）受邪，太阴经分布于胃中，联络于咽喉，所以出现腹部胀满、咽喉干燥。第五天，少阴经（足少阴肾经）受邪，少阴经贯穿肾脏，联络于肺，系连舌根，所以出现口燥、舌干而口渴。第六天，厥阴经（足厥阴肝经）受邪，厥阴经环绕生殖器并联络于肝脏，所以出现心中烦闷、阴囊收缩。
问：三阴经病变可以用下法治疗吗？张仲景说：三阴经都已受邪，且病邪已传入六腑，可以用泻下的方法治愈。
问：发汗或泻下疗法是依据经络还是依据发病天数呢？郭雍说：天数与经络是相应的。大抵来说，受病都有常理和变局。如果经络与天数不相符合，就是变局。遵循常理则容易治疗，既然发生变局则难以通晓。然而，变局应当根据症状来判断，常理可以依据天数推断。所以《素问》又说：如果病程未满三天，可以通过发汗治愈；如果病程已满三天，可以通过泻下治愈。这是指常规的治法。
问：医经中说病人多在六七天之间死亡，为什么呢？郭雍说：因为六七天时，传遍所有经络，阴阳二气都已受邪，所以病情严重的就会死亡。《素问》说：三阴三阳经，五脏六腑都受到病邪侵袭，营卫之气运行停滞，五脏不通畅就会死亡，说的就是这个道理。所以医经又说：治疗的方法是疏通各脏腑的经脉，疾病就会逐渐衰退。像这样，如果五脏不通畅就会死亡，如果能疏通脏腑经脉，疾病就会衰退。
问：医经中说病人痊愈多在十日以上，为什么呢？郭雍说：这是指伤寒遵循常理而没有发生变局的情况。所以《素问》说：那些没有同时感受寒邪（两感于寒）的病人，第七天太阳经病势衰退，头痛减轻；第八天阳明经病势衰退，身体发热减轻；第九天少阳经病势衰退，耳聋稍微能听到声音；第十天太阴经病势衰退，腹部胀满消退如常，开始想吃饭；第十一天少阴经病势衰退，口渴停止，腹部不再胀满，舌干缓解，随后打喷嚏；第十二天厥阴经病势衰退，阴囊松弛，小腹轻微舒缓，大气（正气）全部去除，疾病一天天好转。这就是为什么痊愈者都在十日以上的原因。（张仲景注：在“十一日渴止”之下没有“不满”二字；在“十二日大气皆去”之下有“病人精神爽慧”的描述。）
问：如果十二日以上还不痊愈，是怎么回事？张仲景说：如果过了十三日以上，病情没有间歇性好转，寸脉和尺脉都陷入沉伏不起的，情况非常危险。如果再感受其他异气，转变为其他疾病，应当根据后面坏病的证候来治疗。如果脉象阴阳俱盛，再次感受寒邪，变成温疟；如果阳脉浮滑，阴脉濡弱，再遇到风邪，变成风湿；如果阳脉洪数，阴脉实大，再遇到温热之邪，变成温毒，这是最重的病症；如果阳脉濡弱，阴脉弦紧，再遇到温气，变成温疫。这是因为冬天感受寒邪，发为温病。脉象变化的证候及方药治疗如上述所说。（庞安常说：温疫当作湿温来理解较为恰当。）
问：伤寒第一天，太阳经受邪。（王冰注：巨，意为巨大。）为何称为“巨阳”？《素问》说：巨阳，是诸阳经的统领。（所有阳经都归属于它）。其经脉连接于风府穴，所以成为诸阳经的主气。又《评热论》说：巨阳主司阳气，所以最先受邪。
问：什么是“两感于寒”？《素问》说：人感受寒邪，就会患热病，热势虽然严重也不会死。如果是两感于寒而患病的人，必定不免于死。第一天，太阳经与少阴经同时发病，就会出现头痛、口干、烦闷。第二天，阳明经与太阴经同时发病，就会出现腹部胀满、身体发热、不想吃东西、胡言乱语。第三天，少阳经与厥阴经同时发病，就会出现耳聋、阴囊收缩、四肢厥冷、水浆不进、神志昏迷。到了第六天死亡。
问：《素问》又说三日乃死，为什么呢？郭雍说：就是前面所说的第六天死亡。为什么这样说呢？两感于寒的病，阴阳表里两经同时传变，到第三天，六经阴阳已经传遍。此时水浆不入口，神志昏迷，这时五脏已经全部受伤，六腑已经不通畅，营卫之气已经失去知觉。在此之后，再过三天才死亡。黄帝对此有疑问，所以再次提问。岐伯回答说：这时阳明经的气还没有完全耗尽，所以又过三天后才死亡。因此经文说：阳明经是十二经脉之长，它的血气旺盛，所以即使神志昏迷，经过三天后它的气才会耗尽，人也就死了。所谓神志昏迷，是两感于寒、阴阳俱传的第三天的证候。阳明为诸经之长，血气旺盛，用来滋养诸经。那些已经散入诸经的血气，各自随着所属经脉的断绝而消散。那些还在阳明经未散入诸经的血气，又需要三天才能耗尽。由此可知，第六天死亡，是因为前三天传遍阴阳诸经，后三天阳明经的气才耗尽，合为六天。而世上读经的人，认为第六天是阴阳再传经而死，如果阴阳还能再传，就不会死了。那种说三日死的观点，又另立了阳明气血随邪气而尽的说法，这与六天死亡的理论不相贯通，错误很大。
问：为什么伤寒只传变足部的阴阳六经呢？孙思邈说：人有五脏，心肺二脏的经络起始于手十指，肝肾与脾三脏的经络起始于足十趾。风毒之气，都起于地面，地面的寒暑风湿，都化作蒸气，脚经常踩踏地面，所以中人必中于足部。郭雍说：这是孙真人关于感受风毒的论述，伤寒的感受，也没有与此不同的地方。
问：伤寒三阳经受邪，能否看出是否传变？张仲景说：伤寒第一天，太阳经受邪，如果脉象平静，说明不传变；如果频频想吐，或者烦躁不安，脉象数而急，说明传变了。又说：伤寒二三天，如果没有出现阳明经和少阳经的证候，说明不传变。
问：三阴经是否传变能否看出？张仲景说：伤寒三天，三阳经的病邪已尽，三阴经应当受邪。如果病人反而能进食且不呕吐，这说明三阴经不受邪。不受邪就不传变了。
问：六经分别属于哪些脏腑？郭雍说：足太阳经是膀胱经，足阳明经是胃经，足少阳经是胆经。这三腑都属于阳。足太阴经是脾经，足少阴经是肾经，足厥阴经是肝经。这三脏都属于阴。阳主表，阴主里。所以足太阳与足少阴互为表里，即膀胱与肾；足阳明与足太阴互为表里，即脾与胃；足少阳与足厥阴互为表里，即肝与胆。
问：我想了解六经的起源。郭雍说：本源于《灵枢》的论述，这里不便详尽阐述。可以参考朱氏的《活人书》，其中大致说：足太阳膀胱经，起于目内眦，上行头部，连接于风府，分为四道，下行颈部，并与正别脉上下六道，行于背部，作为身体的经脉。太阳经为诸阳主气，如果中寒邪，必然发热恶寒。因为头项腰脊是足太阳经所经过的地方，现在出现头项痛、腰脊强、身体疼，且寸关尺脉都浮，所以知道是太阳经受病。这只是大概情况。
问：阳明经怎么样？朱氏说：足阳明胃经，从鼻起，夹鼻而行，络于目，下咽，分为四道，并与正别脉六道，上下行于腹部，纲维全身。因为诸阳在表，阳明主肌肉，络于鼻，所以病人身体发热、眼睛疼痛、鼻子干燥、不能安卧。如果寸关尺脉都长，就知道是阳明经受病。
问：少阳经怎么样？朱氏说：足少阳胆经，起于目外眦（外当为锐），络于耳，分为四道，下行缺盆，沿胁肋行走，并与正别脉六道上下，主持经营百节，流注气于三部。所以病人胸胁疼痛、耳聋，或者口苦咽干，或者往来寒热而呕吐。如果寸关尺脉都弦，就知道是少阳经受病。
问：太阴经怎么样？朱氏说：足太阴脾经，是三阴之首，其脉分布于脾胃，络于咽喉。所以病人腹部胀满、咽喉干燥。如果寸关尺脉都沉细，就知道是太阴经受病。
问：少阴经怎么样？朱氏说：足少阴肾经，其脉起于足小趾之下，斜向足心，别行的进入脚跟中，上行至大腿内侧后缘，贯穿肾脏，联络膀胱。直行的，从肾上贯肝膈，入肺中，系连舌根。伤寒热气入于脏，流入少阴经。少阴主肾，肾厌恶燥，所以口渴想喝水。另外，经过发汗、催吐、泻下之后，脏腑空虚，津液枯竭，肾有余热也会口渴。所以病人口燥、舌干而渴。如果寸关尺脉都沉，就是少阴经受病。
问：厥阴经怎么样？朱氏说：足厥阴肝经，“厥”意为尽。《灵枢经》说亥时为左足厥阴，戌时为右足厥阴，两阴俱尽，所以叫厥阴。阴尽为晦，阴出为朔。厥阴，是以阴尽为含义。其脉循行生殖器并络于舌根。脉气不营养则筋脉拘急，筋脉拘急则牵引舌和睾丸，所以嘴唇青紫、舌头卷缩、阴囊收缩。凡是病人烦闷、阴囊收缩，如果寸关尺脉都微缓，就知道是厥阴经受病。
问：六经的脉象如何？张仲景说：寸关尺脉都浮，是太阳经受病；寸关尺脉都长，是阳明经受病；寸关尺脉都弦，是少阳经受病；寸关尺脉都沉细，是太阴经受病；寸关尺脉都沉，是少阴经受病；寸关尺脉都微缓，是厥阴经受病。
问：阳明和厥阴的含义是什么？《素问·阴阳类论》第七十四篇说：什么叫阳明？岐伯说：两阳合明。什么叫厥阴？岐伯说：两阴交尽。
Q: In the context of cold damage (Shanghan), when the three Yang meridians are affected, what is the pattern of transmission? The *Suwen* (Plain Questions), Chapter 31, states: On the first day of cold damage, the Taiyang meridian (Foot-Taiyang Bladder Meridian) is affected, resulting in headache, stiffness of the neck and occiput, and rigidity of the lower back and spine. On the second day, the Yangming meridian (Foot-Yangming Stomach Meridian) is affected. Since Yangming governs the flesh, and its channels run alongside the nose and connect to the eyes, symptoms include fever, eye pain, dryness of the nose, and inability to lie down comfortably. On the third day, the Shaoyang meridian (Foot-Shaoyang Gallbladder Meridian) is affected. As Shaoyang governs the Gallbladder, and its channels follow the hypochondrium and connect to the ears, symptoms include pain in the chest and hypochondrium, and deafness. If the channels of the three Yang meridians are all affected by the pathogen, but the disease has not yet entered the Zang organs, it can be cured by inducing sweating (Diaphoresis).
Q: When the three Yin meridians are affected, what is the pattern of transmission? The *Suwen* states: On the fourth day, the Taiyin meridian (Foot-Taiyin Spleen Meridian) is affected. Its channels distribute in the stomach and connect to the throat, causing abdominal fullness and dryness of the throat. On the fifth day, the Shaoyin meridian (Foot-Shaoyin Kidney Meridian) is affected. Its channels pass through the kidney, connect to the lungs, and attach to the root of the tongue, causing dry mouth, dry tongue, and thirst. On the sixth day, the Jueyin meridian (Foot-Jueyin Liver Meridian) is affected. Its channels encircle the genitalia and connect to the liver, causing mental restlessness, fullness, and retraction of the scrotum.
Q: Can the Shaoyin stage be treated with purgation? Zhang Zhongjing states: When the three Yin meridians are all affected and the pathogen has entered the Fu organs, it can be cured by purgation (Purgative Therapy).
Q: Are the methods of sweating or purgation determined by the meridian involved or by the number of days since onset? Guo Yong states: The number of days corresponds to the meridians. Generally, disease acquisition follows both regular patterns and variations. If the meridian involved does not correspond to the day count, it represents a variation. Following the regular pattern makes treatment easier; dealing with variations makes understanding more difficult. However, variations should be judged based on symptoms, while regular patterns can be inferred from the day count. Therefore, the *Suwen* further states: If the duration is less than three days, sweating may be used; if it is three days or more, purgation may be used. This refers to the standard approach.
Q: Why do medical classics state that death often occurs between the sixth and seventh days? Guo Yong states: By the sixth or seventh day, the transmission has covered all meridians, and both Yin and Yang qi are affected. Thus, severe cases result in death. The *Suwen* states: When the three Yin and three Yang meridians, along with the five Zang and six Fu organs, are all affected, and the Ying (Nutritive) and Wei (Defensive) qi cease to circulate, death occurs due to the blockage of the five Zang organs. This is exactly what is meant. Therefore, the classics also state: The method of treatment is to unblock the channels of each organ. Once unblocked, the disease will decline. Conversely, if the five Zang organs remain blocked, death ensues; if their channels are unblocked, the disease declines.
Q: Why do medical classics state that recovery usually takes ten days or more? Guo Yong states: This refers to cases where cold damage follows the regular pattern without variation. The *Suwen* states: For those not suffering from simultaneous contraction of cold (Lianggan Yu Han), on the seventh day, the Taiyang disease begins to recede, and the headache slightly improves. On the eighth day, the Yangming disease recedes, and body heat slightly subsides. On the ninth day, the Shaoyang disease recedes, and hearing slightly returns. On the tenth day, the Taiyin disease recedes, abdominal fullness subsides to normal, and appetite returns. On the eleventh day, the Shaoyin disease recedes, thirst stops, abdominal distension ceases, tongue dryness resolves, followed by sneezing. On the twelfth day, the Jueyin disease recedes, the scrotum relaxes, lower abdominal tension slightly eases, and the vital qi is completely expelled, leading to daily improvement. This is why recovery typically occurs after ten days. (Zhang Zhongjing notes: Below "thirst stops on the eleventh day," there is no mention of "no abdominal distension"; below "vital qi is expelled on the twelfth day," there is a description of "the patient's spirit being clear and bright.")
Q: What if the patient does not recover after twelve days? Zhang Zhongjing states: If more than thirteen days have passed without intermittent relief, and both the Cun (Inch) and Chi (Cubit) pulses are sunken and imperceptible, the condition is critical. If the patient contracts another pathogen, transforming into a different disease, treatment should follow the protocols for complicated diseases (Huaibing). If the pulse shows excess in both Yin and Yang positions, and the patient contracts cold again, it transforms into Warm Malaria (Wen Nue); if the Yang pulse is floating and slippery, and the Yin pulse is soggy and weak, and wind is encountered again, it transforms into Wind-Dampness; if the Yang pulse is surging and rapid, and the Yin pulse is solid and large, and warm-heat is encountered again, it transforms into Warm-Toxicity, which is the most severe condition; if the Yang pulse is soggy and weak, and the Yin pulse is string-tight and fast, and warm qi is encountered again, it transforms into Warm Epidemic (Wen Yi). This arises because winter cold damage manifests as Warm Disease later. The pulse changes, syndromes, and formulas are as described above. (Pang Anchang suggests that Wen Yi should be understood as Damp-Warmth.)
Q: On the first day of cold damage, the Taiyang meridian is affected. (Wang Bing notes: Ju means great/large.) Why is it called "Ju Yang"? The *Suwen* states: Ju Yang is the leader of all Yang meridians (all Yang meridians belong to it). Its channels connect to the Fengfu point (GV16), making it the master of Qi for all Yang meridians. The *Ping Re Lun* also states: Ju Yang governs Qi, so it is the first to be attacked by pathogens.
Q: What is "simultaneous contraction of cold" (Lianggan Yu Han)? The *Suwen* states: When humans contract cold, they develop febrile disease. Even if the fever is severe, death does not necessarily follow. However, those who suffer from simultaneous contraction of cold will inevitably die. On the first day, Taiyang and Shaoyin are both affected, causing headache, dry mouth, and mental restlessness/fullness. On the second day, Yangming and Taiyin are both affected, causing abdominal fullness, body heat, anorexia, and delirious speech. On the third day, Shaoyang and Jueyin are both affected, causing deafness, scrotal retraction, and cold limbs, inability to take food or fluids, and unconsciousness. Death occurs on the sixth day.
Q: The *Suwen* also mentions death on the third day. Why? Guo Yong states: This refers to the death on the sixth day mentioned earlier. Why? In simultaneous contraction of cold, both Yin and Yang, exterior and interior meridians transmit simultaneously. By the third day, the transmission through the six meridians of Yin and Yang is complete. At this time, the patient cannot take food or fluids and is unconscious. The five Zang organs are fully damaged, the six Fu organs are blocked, and Ying and Wei qi have lost sensation. After this state persists for three more days, death occurs. The Emperor had doubts, hence the repeated inquiry. Qibo replied: At this time, the Qi of the Yangming meridian has not yet completely exhausted, so death occurs three days later. Thus, the text says: Yangming is the head of the twelve meridians, possessing abundant blood and Qi. Therefore, even when unconscious, it takes three days for its Qi to exhaust, leading to death. Unconsciousness is a sign of simultaneous contraction of cold and transmission of Yin and Yang on the third day. Yangming, as the head of the meridians, has abundant blood and Qi to nourish the other meridians. The blood and Qi that have already dispersed into the other meridians dissipate as their respective meridians fail. The blood and Qi remaining in Yangming require another three days to exhaust. Thus, we know that on the sixth day, the first three days cover the transmission through Yin and Yang meridians, and the next three days exhaust Yangming Qi, totaling six days. Scholars who read the classics mistakenly believe that death on the sixth day is due to a second round of transmission through Yin and Yang; if Yin and Yang could still transmit, death would not occur. The theory of death on the third day posits that Yangming blood and Qi exhaust due to the pathogen, which contradicts the six-day theory and is significantly erroneous.
Q: Why does cold damage transmit only through the Foot Yin and Yang six meridians? Sun Simiao states: Humans have five Zang organs. The channels of the Heart and Lung originate in the ten fingers of the hands. The channels of the Liver, Kidney, and Spleen originate in the ten toes of the feet. Pathogenic wind-toxin originates from the earth. The cold, heat, wind, and dampness of the earth transform into vapors. The feet constantly tread upon the ground, so when people are afflicted, it is always through the feet. Guo Yong states: This is Sun Simiao’s theory regarding wind-toxin. The mechanism of contracting cold damage is no different.
Q: In cold damage affecting the three Yang meridians, can transmission be observed? Zhang Zhongjing states: On the first day of cold damage, the Taiyang meridian is affected. If the pulse is calm, it indicates no transmission. If the patient frequently desires to vomit, or is restless and irritable, and the pulse is rapid and urgent, it indicates transmission. He also states: On the second or third day of cold damage, if Yangming and Shaoyang syndromes do not appear, it indicates no transmission.
Q: Can transmission in the three Yin meridians be observed? Zhang Zhongjing states: On the third day of cold damage, the pathogen in the three Yang meridians is exhausted, and the three Yin meridians should be affected. If the patient can eat and does not vomit, it indicates that the three Yin meridians are not affected by the pathogen. If not affected, there is no transmission.
Q: Which Zang and Fu organs do the six meridians belong to? Guo Yong states: The Foot-Taiyang meridian belongs to the Bladder; the Foot-Yangming meridian belongs to the Stomach; the Foot-Shaoyang meridian belongs to the Gallbladder. These three Fu organs are Yang. The Foot-Taiyin meridian belongs to the Spleen; the Foot-Shaoyin meridian belongs to the Kidney; the Foot-Jueyin meridian belongs to the Liver. These three Zang organs are Yin. Yang represents the Exterior, and Yin represents the Interior. Therefore, Foot-Taiyang and Foot-Shaoyin are exterior-interior pairs (Bladder and Kidney); Foot-Yangming and Foot-Taiyin are exterior-interior pairs (Stomach and Spleen); Foot-Shaoyang and Foot-Jueyin are exterior-interior pairs (Liver and Gallbladder).
Q: I wish to hear about the origins of the six meridians. Guo Yong states: They originate from the *Lingshu*, but detailed explanation is beyond the scope here. One may refer to Zhu’s *Huoren Shu*. It briefly states: The Foot-Taiyang Bladder meridian originates at the inner canthus of the eye, ascends to the head, connects to the Fengfu point (GV16), divides into four pathways, descends the neck, and runs along the back with the main and branch channels (six paths total), serving as the meridians of the body. The Taiyang meridian is the master of Qi for all Yang meridians. If attacked by cold pathogens, it must cause fever and aversion to cold. Since the head, neck, waist, and spine are areas traversed by the Foot-Taiyang meridian, symptoms such as headache, neck/back stiffness, and body ache, accompanied by floating pulses at Cun, Guan, and Chi positions, indicate Taiyang meridian involvement. This is a general overview.
Q: How about the Yangming meridian? Zhu states: The Foot-Yangming Stomach meridian originates at the nose, runs alongside the nose, connects to the eyes, descends through the pharynx, divides into four pathways, and runs up and down the abdomen with the main and branch channels (six paths total), providing structural support to the body. Since all Yang meridians are in the exterior, and Yangming governs the muscles and connects to the nose, patients exhibit fever, eye pain, nasal dryness, and insomnia. If the pulses at Cun, Guan, and Chi are long, it indicates Yangming meridian involvement.
Q: How about the Shaoyang meridian? Zhu states: The Foot-Shaoyang Gallbladder meridian originates at the outer canthus of the eye, connects to the ears, divides into four pathways, descends to the clavicular fossa (Quepen), follows the hypochondrium, and runs up and down with the main and branch channels (six paths total), governing the joints and circulating Qi through the three sectors. Patients present with chest/hypochondriac pain and deafness, or bitter taste, dry throat, alternating chills and fever, and vomiting. If the pulses at Cun, Guan, and Chi are wiry, it indicates Shaoyang meridian involvement.
Q: How about the Taiyin meridian? Zhu states: The Foot-Taiyin Spleen meridian is the head of the three Yin meridians. Its channels distribute in the spleen and stomach and connect to the throat. Patients present with abdominal fullness and dry throat. If the pulses at Cun, Guan, and Chi are deep and fine, it indicates Taiyin meridian involvement.
Q: How about the Shaoyin meridian? Zhu states: The Foot-Shaoyin Kidney meridian originates below the little toe, slants toward the center of the foot, with a branch entering the heel, ascending to the posterior medial aspect of the thigh, passing through the kidney, and connecting to the bladder. The straight branch ascends from the kidney through the liver and diaphragm, enters the lungs, and attaches to the root of the tongue. Heat pathogens enter the Zang organs and flow into the Shaoyin meridian. Shaoyin governs the Kidney, which dislikes dryness, leading to thirst and desire to drink. Additionally, after sweating, vomiting, or purging, the Zang-Fu organs are empty, and body fluids are depleted; residual heat in the Kidney also causes thirst. Thus, patients present with dry mouth, dry tongue, and thirst. If the pulses at Cun, Guan, and Chi are deep, it indicates Shaoyin meridian involvement.
Q: How about the Jueyin meridian? Zhu states: The Foot-Jueyin Liver meridian. "Jue" means exhaustion. The *Lingshu* states that Hai hour corresponds to the left Foot-Jueyin, and Xu hour to the right Foot-Jueyin. With both Yin energies exhausted, it is called Jueyin. Exhaustion of Yin is associated with the dark moon (Hui), emergence of Yin with the new moon (Shuo). Jueyin signifies the exhaustion of Yin. Its channels encircle the genitalia and connect to the root of the tongue. If the channels do not nourish, tendons become tight, pulling the tongue and testicles, resulting in cyanotic lips, curled tongue, and scrotal retraction. When patients present with mental restlessness/fullness and scrotal retraction, and the pulses at Cun, Guan, and Chi are faint and slow, it indicates Jueyin meridian involvement.
Q: What are the pulse characteristics of the six meridians? Zhang Zhongjing states: Floating pulses at Cun, Guan, and Chi indicate Taiyang involvement; Long pulses indicate Yangming involvement; Wiry pulses indicate Shaoyang involvement; Deep and Fine pulses indicate Taiyin involvement; Deep pulses indicate Shaoyin involvement; Faint and Slow pulses indicate Jueyin involvement.
Q: What is the meaning of Yangming and Jueyin? The *Suwen*, Chapter 74, asks: What is meant by Yangming? Qibo answers: The combination of two Yangs. What is meant by Jueyin? Qibo answers: The intersection and exhaustion of two Yins.