赵嗣真曰∶仲景论两感为必死之证，而复以治有先后发表攻里之说继之者，盖不忍坐视而欲觊
其万一之可活也。《活人书》云宜先救里以四逆汤，后救表以桂枝汤。殊不知仲景云太阳与少阴俱
病，则头疼，为太阳邪盛于表；口干而渴，为少阴邪盛于里也。阳明与太阴俱病，则身热谵语，为
阳明邪盛于表；不欲食，腹满，为太阴邪盛于里也。少阳与厥阴俱病，则耳聋，为少阳邪盛于表；
囊缩，为厥阴邪盛于里也。三阳之头疼，身热，耳聋，救表也，不可汗乎？三阴之腹满，咽干口渴，
囊缩而厥，救里也，不可下乎？《活人书》引下利，身疼痛虚寒救里之例，而欲施于烦渴，腹满，
谵语，囊缩热实之证，然乎？否乎？盖仲景所谓发表者，葛根麻黄
汤是也。所谓救里者，调胃承气汤是也。《活人书》却谓救里则是四逆，救表则是桂枝。今以救为
攻，岂不相悖？若用四逆汤，是以火济火，而腹满，囊缩等证何由而除？脏腑何由而通？荣卫何由
而行？六日死者，可立而待也。吁，两感病故为不治之证矣，然用药之法，助正除邪之理，学人不
可素无一定之法于胸中也。
赵嗣真曰∶愚尝疑合病、并病之难明也久矣，因始释之。合病者，二阳经或三阳经同受病，病
之不传者也。并病者，一阳经先病，又过一经，病之传者也。且如太阳阳明并病一证，若并而未尽，
是传未过，尚有表证，仲景所谓太阳证不罢，面色赤，阳气怫郁在表，不得发越，烦躁短气是也，
犹当汗之，麻黄桂枝各半汤。若并之已尽，是为传过，仲景所谓太阳证罢，潮热，手足汗出，大便
硬而谵语者是也，法当下之，以承气汤。是知传则入腑，不传则不入腑。所以仲景论太阳阳明合病，
只出三证如前，于太阳阳明并病，则言其有传变如此也。又三阳互相合病，皆自下利，
仲景太阳阳明合病，则主于葛根汤；太阳少阳合病，主以黄芩汤；少阳阳明合病，主以承气汤。至
于太阳少阳并病，其证头项强痛，目眩，如结胸，心下痞硬，当刺大椎、肺俞、肝俞，不可汗下。
太阳阳明并病，已见上论。但三阳合病，仲景无背强恶寒语句。虽别有口燥渴，心烦，背微恶寒者，
乃属太阳证而非三阳合病也。三阳若与三阴合病，即是两感，所以三阴无合病例也。
赵嗣真说：张仲景在论述中将“两感”（太阳与少阴、阳明与太阴、少阳与厥阴同时受邪）视为必死的病证，却又接着论述治疗有先解表后攻里的说法，这是因为他不忍心看着病人死去，而希望侥幸有一线生机可以挽救。《活人书》说应当先用四逆汤救里，后用桂枝汤救表。殊不知张仲景说：太阳经与少阴经同时发病，则出现头痛，这是太阳经邪气盛于体表；口干且渴，这是少阴经邪气盛于体内。阳明经与太阴经同时发病，则出现身体发热、胡言乱语，这是阳明经邪气盛于体表；不想吃东西、腹部胀满，这是太阴经邪气盛于体内。少阳经与厥阴经同时发病，则出现耳聋，这是少阳经邪气盛于体表；阴囊收缩，这是厥阴经邪气盛于体内。三阳经病的头痛、身热、耳聋，是救表的方法，难道不可以发汗吗？三阴经病的腹满、咽干口渴、阴囊收缩和四肢厥冷，是救里的方法，难道不可以攻下吗？《活人书》引用了腹泻、身体疼痛等虚寒证需要救里的例子，却想将其应用于烦渴、腹满、谵语、阴囊收缩的热实证中，这样对吗？不对吧？大概张仲景所说的“发表”，指的是葛根麻黄汤。所说的“救里”，指的是调胃承气汤。《活人书》却说救里用四逆汤，救表用桂枝汤。现在把“救”当作“攻”，这岂不是相互矛盾？如果使用四逆汤，那就是以火助火，那么腹满、阴囊收缩等症状如何消除？脏腑如何通畅？营卫之气如何运行？第六天死亡的结局，是可以立刻等待到的。唉，两感病本来是不治之症，然而用药的方法，扶助正气、祛除邪气的道理，学习中医的人心中不可没有一定的法则。
赵嗣真说：我长久以来就怀疑合病、并病的概念难以阐明，因此开始解释它们。合病，是指两条阳经或三条阳经同时受邪发病，病情没有传变的情况。并病，是指一条阳经先发病，然后又传入另一条经，病情发生传变的情况。例如太阳经与阳明经并病这一证候，如果并病尚未完全传变，说明传变未过，还有表证，这就是张仲景所说的太阳证未罢，面色发红，阳气郁滞在体表，不能发散，出现烦躁、呼吸短促，这种情况仍然应当用发汗法，使用麻黄桂枝各半汤。如果并病已经完全传变，说明已经传过，这就是张仲景所说的太阳证已罢，出现潮热、手足出汗、大便干硬且胡言乱语，这种情况下依法应当用攻下法，使用承气汤。由此可知，传变则病邪入腑，不传变则病邪不入腑。所以张仲景论述太阳阳明合病时，只列出上述三种证候；而在论述太阳阳明并病时，则说明其有如此传变情况。另外，三阳经互相合病，都会出现腹泻，张仲景对于太阳阳明合病，主要用葛根汤；太阳少阳合病，主要用黄芩汤；少阳阳明合病，主要用承气汤。至于太阳少阳并病，其症状为头项强痛、头晕目眩，像结胸证一样，心下部痞塞坚硬，应当针刺大椎穴、肺俞穴、肝俞穴，不可用发汗或攻下法。太阳阳明并病，已在上面论述过。只是三阳合病，张仲景原文中没有“背强恶寒”的描述。虽然另有口燥渴、心烦、背部轻微恶寒的症状，但这属于太阳证，而不是三阳合病。三阳经若与三阴经合病，就是两感，所以三阴经没有合病的病例。
Zhao Sizhen stated: Zhang Zhongjing regarded "Liang Gan" (simultaneous involvement of Taiyang and Shaoyin, Yangming and Taiyin, or Shaoyang and Jueyin meridians) as a fatal condition in his treatises. However, he subsequently discussed treatment principles involving prioritizing the release of the exterior or the purgation of the interior. This was likely out of reluctance to passively watch patients die, hoping for a slim chance of survival. *The Book that Saves the World* (*Ren Shu*) suggests first rescuing the interior with Sini Tang (Four Reversal Decoction), followed by rescuing the exterior with Guizhi Tang (Cinnamon Twig Decoction). Yet, it fails to realize that Zhang Zhongjing stated: when Taiyang and Shaoyin are diseased simultaneously, headache occurs due to excess pathogenic factors of Taiyang on the exterior; dry mouth and thirst occur due to excess pathogenic factors of Shaoyin in the interior. When Yangming and Taiyin are diseased simultaneously, fever and delirium occur due to excess pathogenic factors of Yangming on the exterior; anorexia and abdominal fullness occur due to excess pathogenic factors of Taiyin in the interior. When Shaoyang and Jueyin are diseased simultaneously, deafness occurs due to excess pathogenic factors of Shaoyang on the exterior; retraction of the scrotum occurs due to excess pathogenic factors of Jueyin in the interior. Headache, fever, and deafness in the Three Yang diseases are methods to rescue the exterior; can they not be treated with sweating? Abdominal fullness, dry throat and thirst, scrotal retraction, and cold limbs in the Three Yin diseases are methods to rescue the interior; can they not be treated with purgation? *The Book that Saves the World* cites examples of diarrhea and body pain requiring interior rescue for deficiency-cold patterns, yet attempts to apply this to heat-excess patterns characterized by irritability, thirst, abdominal fullness, delirium, and scrotal retraction. Is this correct? It is not. Generally speaking, what Zhang Zhongjing referred to as "releasing the exterior" is Gegen Mahuang Tang (Kudzu and Ephedra Decoction). What he referred to as "rescuing the interior" is Tiaowei Chengqi Tang (Regulating the Stomach and Guiding Out Decoction). *The Book that Saves the World*, however, claims that rescuing the interior uses Sini Tang and rescuing the exterior uses Guizhi Tang. To treat "rescue" as "purgation" is contradictory. If Sini Tang is used, it is adding fire to fire; how then will symptoms like abdominal fullness and scrotal retraction be eliminated? How will the zang-fu organs become unobstructed? How will Ying and Wei Qi circulate? Death on the sixth day would be imminent. Alas, Liang Gan disease is indeed incurable. Nevertheless, regarding the methods of medication and the principles of supporting healthy Qi and eliminating pathogenic factors, scholars must have definite principles in mind.
Zhao Sizhen stated: I have long suspected that the concepts of He Bing (Combined Disease) and Bing Bing (Consecutive Disease) are difficult to clarify, so I began to explain them. He Bing refers to two or three Yang meridians being affected by pathogens simultaneously, without transmission of the disease. Bing Bing refers to one Yang meridian being diseased first, and then the disease transmitting to another meridian, indicating transmission. For example, in the case of Taiyang-Yangming Bing Bing, if the combination is incomplete, it means transmission has not fully occurred, and exterior signs remain. This corresponds to what Zhang Zhongjing described as "Taiyang signs not yet resolved," with a red face, Yang Qi constrained at the exterior, inability to disperse, irritability, and shortness of breath. In such cases, sweating therapy should still be employed, using Mahuang Guizhi Banjian Tang (Half-Dose Decoction of Ephedra and Cinnamon Twig). If the combination is complete, it means transmission has occurred. This corresponds to what Zhang Zhongjing described as "Taiyang signs resolved," with tidal fever, sweating on hands and feet, hard stool, and delirium. In such cases, purgation therapy should be applied according to the method, using Chengqi Tang (Guiding Out Decoction). Thus, we know that transmission leads to entry into the Fu organs, while no transmission means no entry into the Fu organs. Therefore, when discussing Taiyang-Yangming He Bing, Zhang Zhongjing only lists the aforementioned three syndromes; whereas for Taiyang-Yangming Bing Bing, he describes its transmission characteristics. Furthermore, when the Three Yang meridians combine, diarrhea typically occurs. For Taiyang-Yangming He Bing, Gegen Tang (Kudzu Decoction) is primarily used; for Taiyang-Shaoyang He Bing, Huangqin Tang (Scutellaria Decoction) is primarily used; for Shaoyang-Yangming He Bing, Chengqi Tang is primarily used. Regarding Taiyang-Shaoyang Bing Bing, symptoms include stiffness and pain in the head and neck, dizziness, resembling Jie Xiong (Chest Binding) syndrome, with hardness and stuffiness below the heart. Acupuncture at Dazhui (GV14), Feishu (BL13), and Ganshu (BL18) should be performed; sweating and purgation are contraindicated. Taiyang-Yangming Bing Bing has been discussed above. However, in San Yang He Bing, Zhang Zhongjing does not mention "stiffness in the back and aversion to cold." Although there are other descriptions involving dry mouth and thirst, irritability, and slight aversion to cold in the back, these belong to Taiyang syndrome rather than San Yang He Bing. If the Three Yang meridians combine with the Three Yin meridians, it becomes Liang Gan; therefore, there are no cases of He Bing involving the Three Yin meridians alone.