伤寒传足不传手经者,俗医之谬论也,岂有是哉!人禀天地之气以生,请以天地间可证者言之。
盈天地至大而营运者,莫如元气与水。且以有形论之,则江河湖海,溪涧沟浍,以为行水潴水之道
焉。人之充满一身,无非血气,亦有十二经脉,大小络脉,血海,以为行血停血之隧道。风行水动,
气行血流,皆自然之理也。夫人之气,自平旦会于膻中,朝行手太阴肺经,以次分布诸经,行尽周
天三百六十五度,在人则行三百六十五骨节,明日寅时复会于手太阴也。血亦随气流布营运不息,
荣卫一身腠理,司开阖,维持纲纪,以为一身动静,云为之主。所以一脉愆和
则百脉皆病,理固然而不得不然也。彼云传足不传手者,何所据乎?请备言其所由。盖伤寒者,乃
冬时感寒即病之名也。冬乃坎水用事,其气严寒凛冽,水冰地冻,在时则足太阳少阴正司其令,触
冒之者,则二经受病。其次则足少阳厥阴继冬而司春令,而亦受伤,何也?盖风木之令起于大寒节,
正当十二月中,至春分后方行温令,故风寒亦能伤之。足阳明太阴,中土也,与冬时无预而亦伤之,
何也?紫阳朱子曰∶土无定位,无成名,无专气,寄旺于四季,能终始万物,则四时寒热温凉之气
皆能伤之也。况表邪传里,必归于脾胃而成燥粪,用承气汤以除去之,胃气和矣。手之六经,主于
夏秋,故不伤之。足之六经,盖受伤之分境界也。若言伤足不伤手则可,以为传足不传手则不可也。
况风寒之中人,先入荣卫,昼夜循环,无所不至,岂间断于手经哉!经云∶两感于寒者,六日死。
若三阴三阳,五脏六腑皆受病,荣卫不行,脏腑不通,则死矣,岂虚言哉!尝观《此事难知》曰∶
伤寒至五六日间,渐变神昏不语,或睡中独语一二句,目赤唇焦,舌干不饮水,稀粥与之则咽,不
与则不思,六脉沉数而不洪,心下不痞,腹中不满,大小便如常,或传之十日以来,
形如醉人,此热传手少阴心经也。然未知自何经而来。答曰∶本太阳伤风,风为阳邪,阳邪伤卫,
阴血自燥,热蓄膀胱,壬病逆于丙,丙丁兄妹,由是传心,心火自上而逼肺,所以神昏也,栀子黄
芩黄连汤。若在丙者,导赤散。在丁者,泻心汤。若脉浮沉俱有力者,是丙丁中俱有热也,可导赤、
泻心各半服之宜矣。此膀胱传丙,足传手经也。又谓之腑传脏也,下又传上也,表传里也。壬传丁
者,乃坎传离也,名曰经传。气逆而喘者,非肺经乎?如谓不然,何仲景桂枝、麻黄二汤乃心肺药
也,请试思之。
所谓“伤寒只传足经而不传手经”的说法,是庸医的错误理论,怎么会有这种道理呢!人禀受天地之气而生存,请让我用天地间可以验证的事物来阐述。
充盈天地之间且运行不息的,没有比元气和水更宏大的了。如果从有形的物体来看,江河湖海、溪涧沟渠,都是水流汇聚和通行的通道。人体充满全身的都是血气,也有十二经脉、大小络脉、血海,作为血液运行和停聚的隧道。风动则水动,气行则血流,这都是自然的道理。人的气,在清晨汇聚于膻中穴,白天依次流注于手太阴肺经,然后依次分布到各条经脉,运行完周天三百六十五度,对应人体则是经过三百六十五个骨节,第二天寅时再次汇聚于手太阴肺经。血也随着气流动布散,营运不停,滋养护卫全身的腠理(皮肤肌肉的纹理及间隙),主管开阖,维持纲纪,成为身体动静的主宰。所以一旦某一条经脉失调,百条经脉都会生病,这是理所当然且不得不然的规律。那些说“只传足经不传手经”的人,有什么依据呢?请详细说说他们的由来。
大概来说,“伤寒”是指冬季感受寒邪随即发病的病名。冬季是坎水当令,气候严寒凛冽,水结冰地冻,在时令上正是足太阳膀胱经和足少阴肾经主事的时候,触犯冒犯这些寒气的人,这两条经脉就会受病。其次是足少阳胆经和足厥阴肝经,它们继冬季之后掌管春季的时令,也会受到损伤,为什么呢?因为风木之气始于大寒节气,正当农历十二月,直到春分后才施行温煦的时令,所以风寒也能伤害它们。足阳明胃经和足太阴脾经属于中土,虽然与冬季没有直接关联但也可能受伤,为什么呢?紫阳朱熹先生说:“土没有固定的位置,没有特定的名称,没有专一的气,寄旺于四季,能够终结并开启万物,所以四时寒热温凉之气都能伤害它。”况且表邪传入里部,必定归于脾胃形成燥屎,使用承气汤来清除它,胃气就能调和。手经六条经脉主要主管夏秋季节,所以不受冬季寒邪伤害。足经六条经脉,大概是受伤的主要部位境界。如果说伤足不伤手还可以,但说是只传足经不传手经就不对了。况且风寒中人,先侵入营卫,昼夜循环,无所不至,难道会在手经中断绝吗!《内经》说:“两感于寒者,六日死。”如果三阴三阳、五脏六腑都受病,营卫不通,脏腑闭塞,就会死亡,这难道是空话吗!
我曾经阅读《此事难知》记载:伤寒到了五六天间,逐渐变为神志昏迷不说话,或者睡梦中独自说一两句话,眼睛红赤嘴唇焦枯,舌头干燥但不想喝水,给稀粥喝就能咽下,不给就不想吃,六脉沉数但不洪大,心下不痞满,腹中不胀满,大小便正常,或者传到十天左右,形态像喝醉的人,这是热邪传入手少阴心经的表现。然而不知道是从哪条经脉传来的。回答说:原本是太阳中风,风为阳邪,阳邪伤害卫气,阴血自然干燥,热邪蓄积在膀胱,壬水之病逆乱影响丙火,丙丁如同兄妹,由此传变至心,心火从上向下逼迫肺,所以出现神志昏迷,可用栀子黄芩黄连汤治疗。如果病在丙(小肠/心包相关之火),用导赤散。如果病在丁(心/肺相关之火),用泻心汤。如果脉象浮取沉取都有力,说明丙丁之中都有热邪,可以导赤散和泻心汤各半服用为宜。这是膀胱传丙,即足经传手经。又称之为腑传脏,下传上,表传里。壬传丁,就是坎传离,名叫经传。气逆而喘息的,不是肺经的问题吗?如果认为不是这样,为什么张仲景的桂枝汤、麻黄汤乃是心肺的药呢?请仔细思考一下。
The theory that "Shanghan (Cold Damage) transmits only through the Foot meridians and not the Hand meridians" is a fallacy of mediocre physicians; how could such a thing exist! Humans are born by inheriting the Qi of Heaven and Earth. Let me illustrate this using phenomena observable in the world.
Nothing is more vast and operational within Heaven and Earth than Yuan Qi (Primal Qi) and Water. Speaking from the perspective of有形 (tangible forms), rivers, lakes, seas, streams, and ditches serve as channels for water flow and accumulation. Similarly, the human body is filled with Blood and Qi, possessing twelve primary meridians, large and small collaterals, and the Sea of Blood, which act as tunnels for blood circulation and storage. When wind moves, water moves; when Qi circulates, Blood flows. This is the natural principle. Human Qi converges at Danzhong (CV17, Chest Center) at dawn, then sequentially enters the Lung Meridian of Hand-Taiyin, distributing to other meridians in turn. It completes a cycle of 365 degrees (corresponding to the 365 acupoints or bone joints in the body), and reconverges at the Lung Meridian of Hand-Taiyin at Yin hour (3-5 AM) the next day. Blood also circulates continuously following Qi, nourishing and protecting the Couli (interstices of skin and muscles), managing opening and closing, maintaining order, and serving as the master of bodily movement and stillness. Therefore, if one meridian becomes disharmonious, all meridians become diseased; this is logical and inevitable. On what basis do those who claim "transmission occurs only in Foot meridians and not Hand meridians" speak? Let us examine their reasoning in detail.
Generally speaking, "Shanghan" refers to illness occurring immediately after contracting cold during winter. Winter is governed by Kan Water, characterized by severe cold where water freezes and earth hardens. In terms of seasonal correspondence, the Foot-Taiyang Bladder Meridian and Foot-Shaoyin Kidney Meridian are in command. Those exposed to these cold pathogens will suffer disease in these two meridians. Next, the Foot-Shaoyang Gallbladder Meridian and Foot-Jueyin Liver Meridian succeed winter in governing spring, and they too can be injured. Why? Because the Wind-Wood influence begins at the Da Han (Great Cold) solar term, which falls in the twelfth lunar month, and does not transition to warm influences until after the Spring Equinox. Thus, wind-cold can also injure them. The Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian belong to Central Earth. Although seemingly unrelated to winter, they can also be injured. Why? Zhu Xi (Ziyang) stated: "Earth has no fixed position, no specific name, and no exclusive Qi; it thrives寄旺 (is parasitically prosperous) in the four seasons, capable of concluding and initiating all things. Therefore, the cold, heat, warmth, and coolness of all four seasons can injure it." Moreover, when exterior pathogens transmit inward, they must return to the Spleen and Stomach to form dry feces, which are cleared using Chengqi Tang (Gut-Clearing Decoction), thereby harmonizing Stomach Qi. The six Hand meridians primarily govern summer and autumn, so they are not injured by winter cold. The six Foot meridians represent the primary domains of injury. It is acceptable to say that the Feet are injured while the Hands are not, but unacceptable to claim that transmission occurs only in Foot meridians and not Hand meridians. Furthermore, when wind-cold invades humans, it first enters Ying (Nutritive) and Wei (Defensive) Qi, circulating day and night without exception. How could it stop at the Hand meridians? The Classics state: "Those suffering from Lianggan (Simultaneous Invasion of Exterior and Interior) due to cold die within six days." If the Three Yin and Three Yang, Five Zang and Six Fu organs are all diseased, and Ying-Wei circulation and Zang-Fu communication cease, death ensues. Is this merely empty talk?
I once read in *Ci Shi Nan Zhi* (Difficulties of This Matter): "During the fifth or sixth day of Shanghan, the patient gradually develops confusion and muteness, or speaks alone for one or two sentences while sleeping. The eyes are red, lips are scorched, the tongue is dry, yet there is no desire to drink. Given thin porridge, they swallow; without it, they have no appetite. The six pulses are deep and rapid but not surging. There is no epigastric fullness or abdominal distension, and urination and defecation are normal. Or, upon reaching the tenth day, the patient appears intoxicated. This indicates Heat transmitting into the Heart Meridian of Hand-Shaoyin. However, it is unknown which meridian it originated from." The answer given was: "Originally, this was Taiyang Wind Strike. Wind is a Yang pathogen. Yang pathogens injure Wei Qi, causing Yin Blood to naturally dry out. Heat accumulates in the Bladder. Ren (Kan/Water) pathology rebels against Bing (Yang Fire). Since Bing and Ding (Heart/Lung Fire) are like siblings, the pathogen transmits to the Heart. Heart Fire presses down on the Lung from above, causing confusion. Treat with Zhizi Huangqin Huanglian Tang (Gardenia, Scutellaria, and Coptis Decoction). If the pathology is in Bing, use Daochi San (Guide Out Red Powder). If in Ding, use Xiexin Tang (Drain the Epigastrium Decoction). If both floating and deep pulses are forceful, it indicates heat in both Bing and Ding; taking half doses of Daochi San and Xiexin Tang together would be appropriate. This represents Bladder transmitting to Bing, i.e., Foot meridian transmitting to Hand meridian. It is also called Fu organ transmitting to Zang organ, lower transmitting to upper, and exterior transmitting to interior. Ren transmitting to Ding is Kan transmitting to Li, named Jing Chuan (Meridian Transmission). Gas rebellion causing wheezing—does this not involve the Lung Meridian? If you argue otherwise, why are Zhang Zhongjing's Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) medicines for the Heart and Lung? Please ponder this."