恶风与恶寒异。恶寒者。不待风而自寒。虽置之密室之中。帏帐之内。甚至覆被向火。
而犹不
能禁其寒也。恶风者。风至斯恶。一居密室之中。帏帐之内。而即坦然自若矣。故恶寒者未
有不恶风。而恶风者不必皆恶寒。恶风属表者。风邪客于卫也。经云。太阳病。发热汗出。
恶风脉缓者。名曰中风。又云。太阳中风。啬啬恶寒。淅淅恶风。翕翕发热。鼻鸣干呕者。桂
枝
汤主之。此有风者必恶风也。而寒邪亦有恶风。以有汗无汗为辨。经云。太阳病。头痛发热
。身疼腰痛。骨节疼痛。恶风无汗而喘者。麻黄汤主之。此太阳病初起风寒异治不易之定法
。其有太阳病循经下入。其势未趋入阳明。而犹恋于太阳之表。致头痛已瘥。恶风仍在者。
如经云。太阳病。项背强KT KT 。无汗恶风者。葛根汤主之。又云。太阳病。项
背强KT KT 反汗
出恶风者。桂枝加葛根汤主之。则仍以有汗无汗为辨也。亦有太阳病其势径趋入少阳。而恶
风证仍未罢者。经云。伤寒四五日身热恶风。头项强。胁下满。手足温而渴者。小柴胡汤主
之。是其里证已具。而恶风为表未解。故以半表半里治之也。盖恶寒有属于阳者。有属于阴
者。恶风则主表而专属于阳。此皆治表之大略也。
其有发汗太过。致漏不止而恶风者。经云。太阳病发汗。遂漏不止。其人恶风。小便难
。四
肢微急。难以屈伸者。桂枝加附子汤主之。盖汗出既多。即召亡阳之变。故于桂枝汤中加附
子以扶阳固卫。同一恶风。而前宜和卫以解肌。此宜固卫以实表。其治法又各不同矣。
更有里热炽甚。而外反恶风者。经云。伤寒若吐若下后。七八日不解。热结在里。表里
俱热
。时时恶风。大渴。舌上干燥而烦。欲饮水数升者。白虎加人参汤主之。盖必直撤其热。则
表
里俱和。而恶风自止。又非解表所能愈也。又有风湿相搏而外恶风者。经云。风湿相搏。骨
节烦疼。掣痛。近之则痛剧。汗出短气。小便不利。恶风不欲去衣。或身微肿者。甘草附子
汤主之。其所谓湿。盖寒湿。非湿热也。寒湿之内郁者。自里而搏乎表。风邪之外入者。自
表而搏乎里。其相搏在骨节之间。则阳气被遏。遂恶风不欲去衣。必以甘草附子汤宣达阳气
。则风与湿俱去。痛止而恶风自罢矣。
恶风与恶寒是不同的。所谓恶寒，是不依赖风吹就感到寒冷，即使将其置于密室之中、帷帐之内，甚至盖上被子靠近火源，仍然无法抑制这种寒冷感。而恶风，则是只有当风吹到时才感到厌恶，一旦处于密室之中、帷帐之内，便立刻安然自若了。因此，有恶寒症状的人没有不伴有恶风的，但有恶风症状的人不一定都伴有恶寒。
属于表证的恶风，是风邪客居在卫分。《伤寒论》中说：“太阳病，发热汗出，恶风脉缓者，名曰中风。”又说：“太阳中风，啬啬恶寒，淅淅恶风，翕翕发热，鼻鸣干呕者，桂枝汤主之。”这是说有风邪必然会有恶风的表现。然而寒邪也有导致恶风的情况，可以通过有汗或无汗来辨别。《伤寒论》说：“太阳病，头痛发热，身疼腰痛，骨节疼痛，恶风无汗而喘者，麻黄汤主之。”这是太阳病初起时，风寒异治的不可更改的定法。
如果有太阳病循经传入，其势尚未趋向阳明，但仍留恋于太阳之表，导致头痛已经缓解，但恶风仍在的情况。如经文所说：“太阳病，项背强几几，无汗恶风者，葛根汤主之。”又说：“太阳病，项背强几几，反汗出恶风者，桂枝加葛根汤主之。”这仍然是以有汗和无汗作为辨别的依据。
也有太阳病其势直接趋向传入少阳，而恶风证仍未消除的情况。经文说：“伤寒四五日，身热恶风，头项强，胁下满，手足温而渴者，小柴胡汤主之。”这说明里证已经具备，而恶风表明表证未解，所以采用半表半里的方法治疗。
大概恶寒有属于阳证的，也有属于阴证的；而恶风则主要属于表证，专门归属于阳证。这些都是治疗表证的大略原则。
如果有发汗太过，导致汗漏不止而恶风的情况。经文说：“太阳病发汗，遂漏不止，其人恶风，小便难，四肢微急，难以屈伸者，桂枝加附子汤主之。”因为汗出过多，就会招致亡阳的变化，所以在桂枝汤中加入附子以扶助阳气、巩固卫气。同样是恶风，前一种情况适宜调和卫气以解肌，这种情况适宜固护卫气以实表，治疗方法又各不相同了。
更有里热炽盛，而体表反而恶风的情况。经文说：“伤寒若吐若下后，七八日不解，热结在里，表里俱热，时时恶风，大渴，舌上干燥而烦，欲饮水数升者，白虎加人参汤主之。”因为只有直接清除内热，才能使表里调和，恶风自然停止，这就不是单纯解表所能治愈的了。
还有风湿相搏而导致体表恶风的情况。经文说：“风湿相搏，骨节烦疼，掣痛，近之则痛剧，汗出短气，小便不利，恶风不欲去衣，或身微肿者，甘草附子汤主之。”这里所说的湿，指的是寒湿，而非湿热。寒湿在内郁结，从体内向外搏击于体表；风邪从外侵入，从体表向内搏击于体内。它们相互搏击在骨节之间，导致阳气被遏制，于是恶风不想脱去衣服。必须用甘草附子汤宣达阳气，这样风邪与湿邪都能去除，疼痛停止，恶风自然也就消除了。
Wind aversion differs from cold aversion. Cold aversion refers to feeling cold without the need for wind; even if placed in a sealed room, within curtains, or even covered with quilts near a fire, one still cannot suppress the sensation of cold. Wind aversion, on the other hand, occurs only when wind blows; once situated in a sealed room or within curtains, one feels completely at ease and composed. Therefore, those with cold aversion invariably have wind aversion, but those with wind aversion do not necessarily have cold aversion.
Wind aversion belonging to the exterior syndrome is caused by wind pathogen lodging in the Wei (Defensive) level. The Classic states: "Taiyang disease, with fever, sweating, wind aversion, and a slow pulse, is named Wind Strike." It further states: "In Taiyang Wind Strike, with shivering cold aversion, chilly wind aversion, mild fever, nasal congestion, and dry retching, Guizhi Tang (Cinnamon Twig Decoction) governs it." This indicates that where there is wind pathogen, there must be wind aversion. However, cold pathogen can also cause wind aversion, which can be distinguished by the presence or absence of sweating. The Classic states: "Taiyang disease, with headache, fever, body ache, lower back pain, joint pain, wind aversion, no sweating, and wheezing, is governed by Mahuang Tang (Ephedra Decoction)." This is an unchangeable principle for differentiating treatment between wind and cold pathogens at the initial stage of Taiyang disease.
If Taiyang disease follows the meridian transmission but has not yet progressed to Yangming, while still lingering in the Taiyang exterior, causing the headache to have subsided but wind aversion remaining, consider the following: As stated in the Classic, "Taiyang disease, with stiffness and discomfort in the nape and back, no sweating, and wind aversion, is governed by Gegen Tang (Kudzu Root Decoction)." It also states: "Taiyang disease, with stiffness and discomfort in the nape and back, accompanied by sweating and wind aversion, is governed by Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Kudzu Root)." In these cases, the distinction remains based on the presence or absence of sweating.
There are also instances where Taiyang disease progresses directly towards Shaoyang, yet the symptom of wind aversion persists. The Classic states: "After four or five days of Shanghan (Cold Damage), with body heat, wind aversion, stiffness in the head and neck, fullness below the costal region, warm hands and feet, and thirst, Xiaochaihu Tang (Minor Bupleurum Decoction) governs it." This indicates that interior symptoms are already present, while wind aversion signifies that the exterior syndrome has not resolved; thus, it is treated as a half-exterior, half-interior condition.
Generally, cold aversion may belong to Yang syndromes or Yin syndromes, whereas wind aversion primarily belongs to the exterior and is specifically categorized under Yang. These are the general principles for treating exterior syndromes.
If excessive sweating therapy leads to persistent leakage of sweat and subsequent wind aversion, the Classic states: "In Taiyang disease, after inducing sweating, if sweating continues uncontrollably, the patient experiences wind aversion, difficulty urinating, slight stiffness in the four limbs making flexion and extension difficult, Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Root) governs it." Since excessive sweating can lead to the collapse of Yang Qi, Aconite Root is added to Guizhi Tang to support Yang and secure the Defensive level. Although both cases involve wind aversion, the former requires harmonizing the Defensive level to release the muscle layer, while this case requires securing the Defensive level to consolidate the exterior; thus, the therapeutic methods differ.
Furthermore, there are cases where intense interior heat causes apparent wind aversion on the exterior. The Classic states: "After purging or vomiting in Shanghan, if unresolved after seven or eight days, with heat binding in the interior, simultaneous heat in the exterior and interior, intermittent wind aversion, severe thirst, dry tongue with irritability, and a desire to drink several liters of water, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng Root) governs it." Only by directly eliminating the interior heat can the exterior and interior harmonize, and the wind aversion will cease naturally; this cannot be cured by exterior-releasing methods alone.
Finally, there are cases of wind-aversion due to the binding of Wind and Dampness. The Classic states: "When Wind and Dampness bind together, causing vexing pain in the bone joints, pulling pain that worsens upon touch, sweating, shortness of breath, difficulty urinating, wind aversion with reluctance to remove clothing, or slight edema, Gancao Fuzi Tang (Licorice and Aconite Decoction) governs it." The "Dampness" mentioned here refers to Cold-Dampness, not Damp-Heat. Cold-Dampness stagnates internally and attacks the exterior from within, while Wind pathogen invades externally and attacks the interior from without. Their binding occurs between the bone joints, obstructing Yang Qi, leading to wind aversion and reluctance to remove clothing. One must use Gancao Fuzi Tang to disseminate and promote Yang Qi; once Wind and Dampness are expelled, the pain stops, and wind aversion naturally resolves.