伤寒传足不传手,此谬言也。人之一身,无非血气,且风行水动,气行血流,昼夜循环而营运
不息,岂有不传手经哉!何所据也?冬月肾水用事,天气严寒,则
足少阴、太阳正司,受伤二经最多。其次是少阳、厥阴肝胆,继冬而施春令。盖风木起于大寒之节,
即正当十二月中,至春分方行温令,故风寒伤之。足阳明、太阴、脾胃中土,中土无定位,无成名,
寄旺于四时,寒热之气,皆能传也,其邪亦归于胃。其手之经,主于夏秋,故不伤也。若言伤足不
伤手,正理也。若言传足不传手,非理也。
夫六经传变所由,必须紧记诵,不释手可也。且如郑声者,手足郑重,冷而为虚也。谵语有虚
有实,虚则失血亡阳,实则内热便闭。脾约者,大便硬而小便利,水谷不化,脏寒也。久利不止,
曰肠癖。伤寒十三日不好,曰过经。吐长蛔,曰蛔厥。阴厥发躁,曰阴躁。手足冷者,为之厥。指
头微寒,情之纵。汗、吐、下、温不好,曰坏证。又若何为逆?逆而有四,或变为温疟,或变为风
湿,或变为温毒,
或变为温疫,此四者是也。发汗出不止,曰漏风,亦为亡阳。大下损血,为亡阳。阳证汗出不止,
曰亡阳。大衄取汗,发狂者,曰亡阳。大抵皆无汗,其有汗者,曰亡阳。三月至夏方发,为晚发。
冬感寒而春发者,曰温病。非时暴寒伏于少阴之经,咽痛下利,名曰肾伤寒。发汗后身灼热者,曰
风温,名中 。感四时不正之气,老幼相似者,为疫疠。病瘥后必发者,曰劳复。病瘥后多食而发
者,曰食复。病瘥后发热者,曰遗热。吐利交作,曰霍乱。鼻中出血,曰衄。逆咳者,曰嗽。干呕
者,曰哕。大便挟寒下利,曰肠垢。大便坚硬,曰硬。心振寒而动,曰悸。渴饮水而吐,曰水逆。
心中恼乱不安而闷者,曰 懊。皮肤不知痒痛者,曰不仁。振握而动,曰肉 筋惕。脐下有动气,
曰奔豚。上有吐者,曰涌之。下利者,曰泄之。手足挛搐者,曰螈 。四肢风病,曰末疾。厥而下
利,当不食,反能食者,曰除中。三阴无合病。三阳俱病者,曰合病。二阳先病,后一阳自病,曰
并病。凑泄之所,曰腠曰理。妇人之中二,曰理也。
“伤寒只传足经而不传手经”,这是错误的说法。人的全身,无非是血与气在运行,况且风气流动则水液随之而动,气行则血行,昼夜循环往复,营运不息,怎么会有不传入手经的呢?有什么依据这样说呢?
冬季肾水当令,天气严寒,此时足少阴、足太阳二经正主事,因此这两条经络最容易受邪受伤。其次是足少阳、足厥阴肝胆二经,它们继冬季之后施行春季的政令。因为风木之气起于大寒节气,正当十二月中,直到春分才施行温煦之令,所以风寒容易伤害这些经络。足阳明、足太阴脾胃属中土,中土没有固定的方位和名称,寄旺于四季之中,寒热之气都能传入,其邪气最终也归于胃。至于手经,主要主管夏秋季节,所以不容易受伤。如果说“伤足不伤手”,这是正理;如果说“传足不传手”,这就不是正理了。
六经传变的规律,必须牢记背诵,一刻也不能放下。比如郑声,是指手足郑重(沉重无力),因寒冷而导致虚证。谵语有虚有实,虚证是因为失血亡阳,实证是因为内热便秘。脾约证,是大便干硬而小便通畅,水谷不能消化,属于脏寒。久泻不止,称为肠癖。伤寒十三天不好,称为过经。呕吐出长蛔虫,称为蛔厥。阴厥发作时烦躁不安,称为阴躁。手足发冷的,称为厥。指尖微寒,是情志放纵所致。汗法、吐法、下法、温法治疗无效,称为坏证。
那么什么叫做逆证呢?逆证有四种:或者变为温疟,或者变为风湿,或者变为温毒,或者变为温疫,这四种就是。发汗后汗出不止,称为漏风,也是亡阳的表现。剧烈泻下损伤血液,导致亡阳。阳证发汗后汗出不止,称为亡阳。大量鼻出血后强行发汗,导致发狂的,称为亡阳。大抵上都是无汗的情况,如果有汗出的,也称为亡阳。三月到夏天才发病的,称为晚发。冬天感受寒邪而在春天发病的,称为温病。非时令的暴寒潜伏在少阴经,出现咽痛下利,名为肾伤寒。发汗后身体灼热的,称为风温,名为中风温。感受四时不正之气,老少症状相似的,称为疫疠。病愈后必然复发的,称为劳复。病愈后因多吃而复发的,称为食复。病愈后再次发热的,称为遗热。呕吐和下利同时发作,称为霍乱。鼻中出血,称为衄。咳嗽气逆的,称为嗽。干呕的,称为哕。大便夹杂寒邪而下利,称为肠垢。大便坚硬,称为硬。心中震颤寒冷且跳动不安,称为悸。口渴饮水却吐出,称为水逆。心中烦乱不安且闷塞的,称为懊憹。皮肤不知痒痛的,称为不仁。肌肉跳动抽搐,称为肉瞤筋惕。脐下有动气,称为奔豚。上有呕吐的,用涌吐法治疗。下利的,用泄下法治疗。手足挛急抽搐的,称为瘛疭。四肢的风病,称为末疾。厥证而下利,本应不能进食,反而能吃的,称为除中。三阴经没有合病的情况。三阳经同时发病的,称为合病。两阳经先发病,随后另一阳经自行发病的,称为并病。腠理之处,称为腠理。妇人中的二阴,称为理也。(注:原文此处可能有脱误或特定语境,直译为“妇人之中二,曰理也”)
"The statement that 'Shanghan (Cold Damage) transmits only through the Foot meridians and not the Hand meridians' is a fallacy. The human body consists entirely of blood and Qi. Since wind moves water, and Qi movement drives blood flow, circulating endlessly day and night, how could it be that the Hand meridians are spared! On what basis is this claim made?
In winter, Kidney Water is in command, and the weather is severely cold. At this time, the Foot Shaoyin and Foot Taiyang meridians are primarily active, so these two meridians suffer injury most frequently. Next are the Foot Shaoyang and Foot Jueyin (Liver and Gallbladder) meridians, which follow winter to implement the functions of spring. Wind Wood arises during the Great Cold solar term, specifically in the twelfth lunar month, and continues until the Spring Equinox when warm functions begin; thus, wind-cold injures these meridians. The Foot Yangming and Foot Taiyin (Spleen and Stomach) belong to Central Earth. Central Earth has no fixed position or name but thrives throughout the four seasons; both cold and heat pathogens can transmit through it, and the pathogen ultimately returns to the Stomach. The Hand meridians primarily govern summer and autumn, so they are less likely to be injured. Therefore, saying 'Foot meridians are injured but not Hand meridians' is correct reasoning; however, saying 'transmission occurs in Foot meridians but not Hand meridians' is incorrect reasoning.
The mechanisms of transmission and transformation among the Six Meridians must be memorized diligently, without letting go for a moment. For instance, 'Zhengsheng' (repetitive speech with heavy limbs) indicates deficiency caused by cold. 'Zhanyu' (delirious speech) can be either deficient or excess: deficiency results from loss of blood and collapse of Yang, while excess results from internal heat and constipation. 'Siyue' (Spleen constraint) presents with hard stool and free urination, where food and water are not digested, indicating cold in the Zang organs. Persistent diarrhea is called 'Changpi' (intestinal dysentery). If Shanghan persists for thirteen days without resolution, it is called 'Guojing' (passing beyond the meridian stage). Vomiting long roundworms is called 'Huijue' (ascaris jue). Irritability accompanying Yin Jue is called 'Yinzao' (Yin irritability). Cold hands and feet are termed 'Jue' (Jue syndrome). Slight coldness at the fingertips is attributed to indulgence of emotions. When sweating, vomiting, purging, and warming therapies fail, it is called 'Huai zheng' (ruined syndrome).
What constitutes a 'Ni' (adverse/rebellious) condition? There are four types of adverse transformations: it may transform into Wen Nue (warm malaria), Feng Shi (wind-dampness), Wendu (warm toxin), or Wenyi (warm epidemic); these four constitute the adverse conditions. Unceasing sweating after inducing diaphoresis is called 'Loufeng' (leaking wind) and also signifies collapse of Yang. Severe purging damaging blood leads to collapse of Yang. Unceasing sweating in Yang syndromes is called 'Wang Yang' (collapse of Yang). Inducing sweating after severe epistaxis leading to mania is called 'Wang Yang'. Generally, absence of sweat is typical; if sweat is present excessively, it is also termed 'Wang Yang'. Disease manifesting from March to summer is called 'Wanfa' (late onset). Cold contracted in winter but manifesting in spring is called 'Wenbing' (warm disease). Non-seasonal violent cold latent in the Shaoyin meridian, causing sore throat and diarrhea, is named 'Shen Shanghan' (Kidney Cold Damage). Heat burning the body after sweating is called 'Fengwen' (wind-warmth), also known as Zhong Fengwen. Contracting the irregular Qi of the four seasons, affecting both old and young similarly, is called 'Yili' (epidemic pestilence). Recurrence after recovery due to overexertion is called 'Laofu' (labor recurrence). Recurrence after recovery due to overeating is called 'Shifu' (food recurrence). Fever recurring after recovery is called 'Yire' (lingering heat). Simultaneous vomiting and diarrhea is called 'Huoluan' (cholera-like disorder). Epistaxis is called 'Nv'. Cough with rebellious Qi is called 'Sou'. Dry heaving is called 'Yue'. Diarrhea mixed with cold is called 'Changgou' (intestinal mucus). Hard stool is called 'Ying' (hardness). Palpitations with chills and trembling are called 'Ji'. Thirst with drinking followed by vomiting is called 'Shuini' (water rebellion). Mental restlessness and oppression are called 'Aonao' (regretful distress). Skin insensitivity to itch and pain is called 'Buren' (numbness). Muscle twitching and tendon tremors are called 'Rou Sun Jin Ti' (muscle twitching and tendon tremor). Pulsation below the navel is called 'Ben Tun' (rushing pig). Upper vomiting requires emetic therapy. Lower diarrhea requires purgative therapy. Spasms and convulsions of hands and feet are called 'Chi Zong' (spasm and clonic seizure). Wind diseases of the four limbs are called 'Moji' (extremity disease). Jue syndrome with diarrhea, where the patient unexpectedly can eat, is called 'Chuzhong' (elimination of the middle). There is no 'Hebing' (combined disease) in the Three Yin meridians. Simultaneous disease of the Three Yang meridians is called 'Hebing' (combined disease). When two Yang meridians are diseased first, and then another Yang meridian becomes diseased independently, it is called 'Bingbing' (consecutive disease). The spaces between skin and flesh are called 'Cou Li' (cou li/pores). In women, the lower orifices are referred to as 'Li ye' (the理 structure)."