仲景曰。伤寒初起。实时求治。凡作汤药。不避晨夜。医之稍迟。病即传变。必难为力
矣。凡作汗药。虽言一日三服。若病剧者。半日中可尽三服。一日一夜。当时时观之。如救焚拯
溺。不容少怠。
凡看伤寒。自顶至踵。最宜详察。一有不到。错误匪轻。仲景云。观今之医。各承家技
。始终顺旧。省疾问病。务在口给。相对斯须。便处汤剂。按寸不及尺。握手不及足。人迎趺阳
。三部不参。动数发息。不满五十。明堂阙庭。尽不见察。夫欲视死别生。实为难矣。嗟乎
。业已称医。人之司命。孟浪至此。乌乎可哉。
伤寒传经。自表入里。由浅渐深。故六经以次受之。六经传尽。无出而再传之理也。太
阳为三阳。最在于外。阳明为二阳。在太阳内。少阳为一阳。在阳明内。此三阳为表也。太阴为
三阴。在少阳内。少阴为二阴。在太阴内。厥阴为一阴。在少阴内。此三阴为里也。皆由内
以数至外。故一二三之次第如此。一二日始于太阳。二三日传于阳明。三四日少阳。四五日太阴
。五六日少阴。六七日厥阴。此论其常耳。若论其变。或间经。或越经。或始终一经。不可
以次第拘。不可以日数限也。大抵传至厥阴。为传经已尽。不复再传矣。乃成氏云。六日厥
阴为传经尽。七日当愈。七日不愈者。再自太阳。传至十二日。复至厥阴为传经尽。十三日
当愈。十三日不愈者。谓之过经。其说谬矣。善哉马仲化曰。自太阳以至厥阴。犹人从户外
。而升堂。而入室也。厥阴复出而传于太阳。奈有少阴太阴少阳阳明以隔之。岂有遽出而传
太阳之理乎。仲景太阳篇云。太阳病。头痛七日以上自愈者。以行其经尽故也。若欲作再经
者。针足阳明。使经不传则愈。此言始终只在太阳一经者也。故太阳篇曰。发于阳者七日愈
。阳数七故也。若七日不愈。欲再传阳明矣。当针足阳明。迎而夺之也。试玩行其经尽。不
曰传其经尽。则仲景之意。显然矣。成氏误认行其经尽为传遍六经。乃有自太阳再传之说耳
。或问曰。霍乱篇云。十三日愈者。经尽故也。此非六日传遍六经。后六日再传经尽。十三
日当愈者欤。仲景云。十三日不解。过经谵语者。当下之。此非十二日传尽。十三日不愈为
过经者欤。答曰。经尽者行其经尽之谓也。如太阳受病于一日。至七日为行。太阳经尽之例推
之。则诸经皆可屈指而期矣。阳明受病于二日。至八日自愈者。行阳明经尽也。少阳受病于
三日。至九日自愈者。行少阳经尽也。四五六日至三阴经。次第至十二日愈者行厥阴经尽也。十
三日大气皆去。精神爽慧之期。故曰。过十三日以上不间。尺寸陷者大危。何尝有再传经尽
。谓之过经之旨哉。详考仲景所谓过经。或言过太阳经成里症者。或泛言过经者。阳明篇曰
。汗出谵语燥屎在胃此为风也。过经乃可下之。谓燥屎在胃而谵语。风邪在表而汗出。须过
太阳经无表症。乃可下之。此言过太阳经成里症者也。果如成氏十三日再传经尽。谓之过经。
则燥屎在胃。必待十三日乃下乎。于此条则注曰。过太阳经无表症。乃可下之。则自相矛
盾矣。霍乱篇曰。下利后当便 （音硬）硬则能食者愈。今反不能食。到后经中颇能食。复过
一经能食。过之一日当愈。不愈者。不属阳明也。此泛言过经者也。何尝有再传经尽。谓之
过经之旨哉。蕴要祖成氏之说。其过经不解例曰。经言十三日不解。谓之过经。仲景实无此
语。误以成注为经矣。千古承讹后学聋瞽。故表而出之。
张仲景说：伤寒病初起时，应立即寻求治疗。凡是配制汤药，不分早晨或夜晚（随时进行）。医生如果稍微延误，病情就会发生传变，那时就难以施治了。凡是使用发汗的药物，虽然通常说一天服用三次，但如果病情严重，可以在半天内服完这三剂。在一日一夜之间，应当时时观察病情，就像救火和拯救溺水者一样，不容许丝毫懈怠。
凡是诊治伤寒，从头顶到脚底，最应该详细检查。一旦有遗漏，错误就不轻了。张仲景说：现在的医生，各自继承家传的技术，始终沿袭旧法。诊察疾病、询问病情，只务求口齿伶俐。相对片刻，便开出处方。切脉时，按寸口却不及尺部，握手部却不及足部；人迎穴和趺阳穴的脉象不加以参合比较；呼吸急促而脉搏跳动快，不满五十次就出现止歇；明堂（鼻准）、阙（两眉之间）、庭（前额）等面部色泽变化，完全不见察辨。想要区分生死，确实很难啊！唉！既然已经自称医生，就是人的命运主宰，如此草率马虎，怎么可以呢？
伤寒的传经，是从体表进入体内，由浅入深，所以六经依次受邪。六经传遍之后，没有再从头开始传变的道理。太阳是三阳，位置最在外层；阳明是二阳，在太阳之内；少阳是一阳，在阳明之内。这三阳属于表证。太阴是三阴，在少阳之内；少阴是二阴，在太阴之内；厥阴是一阴，在少阴之内。这三阴属于里证。都是由内向外数，所以一、二、三的次序是这样的。第一、二天始于太阳经，第二、三天传至阳明经，第三、四天传至少阳经，第四、五天传至太阴经，第五、六天传至少阴经，第六、七天传至厥阴经。这是论述其常规情况。如果论述其变化情况，或者跳过一经，或者越过一经，或者始终只在一经，不可以用固定的次第来拘泥，也不可以用天数来限制。大抵传到厥阴，就是传经已尽，不再继续传变了。然而成无己却说：第六天厥阴为传经已尽，第七天应当痊愈。如果第七天未愈，再从太阳经开始传，传到第十二天，再次到达厥阴为传经已尽，第十三天应当痊愈。如果第十三天未愈，称为“过经”。这种说法是错误的。马仲化说得好：从太阳到厥阴，就像人从门外走进厅堂，再进入内室一样。厥阴再出来传给太阳，中间隔着少阴、太阴、少阳、阳明，哪有突然出来传给太阳的道理呢？张仲景《太阳篇》说：太阳病，头痛七天以上自愈的，是因为行完了本经的病程。如果想要传入下一经，针刺足阳明经，使邪气不传则痊愈。这是说始终只在太阳一经的情况。所以《太阳篇》说：发于阳证的七天痊愈，因为阳数七的缘故。如果七天未愈，想要再传阳明经，应当针刺足阳明经，迎而夺之。仔细玩味“行其经尽”，不说“传其经尽”，那么张仲景的意思就很明显了。成无己错误地把“行其经尽”理解为传遍六经，才有了从太阳再传的说法。有人问：《霍乱篇》说：十三天痊愈的，是经尽的缘故。这不是指六天传遍六经，后六天再传经尽，第十三天痊愈吗？张仲景说：十三天不解，经过本经出现谵语的，应当攻下。这不是指十二天传尽，第十三天未愈称为过经吗？回答说：“经尽”是指行完本经的病程。如太阳经受病第一天，到第七天是行完太阳经尽的规律，以此类推，其他各经都可以屈指计算日期。阳明经受病第二天，到第八天自愈的，是行完阳明经尽。少阳经受病第三天，到第九天自愈的，是行完少阳经尽。第四、五、六天传到三阴经，依次到第十二天痊愈的，是行完厥阴经尽。第十三天气机全部去除，精神清爽的时候，所以说：过了十三日以上如果不间（好转），寸关尺三部脉陷下的，是大危之症。哪里有什么再传经尽称为过经的宗旨呢？详细考证张仲景所说的“过经”，有的说过太阳经转为里证，有的泛指过经。《阳明篇》说：汗出谵语，燥屎在胃，这是风邪。过经才可以攻下。是说燥屎在胃而谵语，风邪在表而汗出，必须过了太阳经没有表证，才可以攻下。这是说过太阳经转为里证。果真像成无己说的十三天再传经尽称为过经，那么燥屎在胃，一定要等到十三天才攻下吗？在这一条注释中说：过了太阳经没有表证，才可以攻下，这就自相矛盾了。《霍乱篇》说：下利后大便应当硬，如果能吃东西就痊愈。现在反而不能吃，到了后经中颇能食，再过一经能食，过了一天应当痊愈，若不愈，就不属于阳明经。这是泛指过经。哪里有什么再传经尽称为过经的宗旨呢？《伤寒括要》沿袭成无己的说法，其中“过经不解”的例子说：经文说十三天不解称为过经。张仲景实际上没有这句话，误把成无己的注解当作经典原文。千古以来承袭谬误，后学之人如同聋子瞎子，所以要把它揭示出来。
Zhang Zhongjing stated: When Shaoyang (Taiyang) disease first begins, treatment should be sought immediately. The preparation of herbal decoctions should not be restricted to morning or night. If a physician delays even slightly, the disease will transmit and change, making it difficult to treat. For herbal medicines that induce sweating, although it is generally said to take three doses per day, if the condition is severe, all three doses may be taken within half a day. Throughout the day and night, one must observe the patient constantly, as if rescuing from fire or drowning, allowing no slackness.
When diagnosing Shaoyang (Taiyang) disease, one must examine carefully from the crown of the head to the soles of the feet. Any omission can lead to serious errors. Zhang Zhongjing said: "Current physicians merely inherit family techniques and adhere rigidly to old methods. In examining illnesses and asking about symptoms, they rely solely on eloquence. After a brief conversation, they prescribe decoctions immediately. They palpate the Cun (inch) position but neglect the Chi (cubit) position; they hold the hand but neglect the foot; they do not compare the Renying (Stomach Meridian pulse at neck) and Duyang (Spleen Meridian pulse at foot) pulses with the three positions (Cun, Guan, Chi); their respiration is rapid and pulse frequent, failing to reach fifty beats without interruption; they fail to observe the color changes in the Mingtang (nose), Que (glabella), and Ting (forehead). To distinguish between life and death under such conditions is truly difficult. Alas! Having claimed to be physicians, who are the masters of people's lives, how can one be so reckless?"
The transmission of Shaoyang (Taiyang) disease moves from the exterior to the interior, progressing from shallow to deep. Thus, the Six Channels (Liu Jing) are affected in sequence. Once the Six Channels have been fully transmitted, there is no mechanism for transmitting again from the beginning. Taiyang is the Yang of Three, located most externally; Yangming is the Yang of Two, inside Taiyang; Shaoyang is the Yang of One, inside Yangming. These three Yang channels constitute the Exterior. Taiyin is the Yin of Three, inside Shaoyang; Shaoyin is the Yin of Two, inside Taiyin; Jueyin is the Yin of One, inside Shaoyin. These three Yin channels constitute the Interior. The numbering proceeds from inside out, hence the order of One, Two, Three. On days 1-2, transmission begins at Taiyang; on days 2-3, it transmits to Yangming; on days 3-4, to Shaoyang; on days 4-5, to Taiyin; on days 5-6, to Shaoyin; on days 6-7, to Jueyin. This describes the normal pattern. Regarding variations, transmission may skip a channel, jump over a channel, or remain confined to a single channel; it cannot be constrained by fixed sequences or limited by specific days. Generally, once transmission reaches Jueyin, the process is complete, and no further transmission occurs. However, Cheng Wuji claimed: "On the sixth day, Jueyin marks the end of transmission; healing should occur on the seventh day. If not healed by the seventh day, transmission restarts from Taiyang, reaching Jueyin again on the twelfth day, marking the end of transmission, with healing expected on the thirteenth day. If not healed by the thirteenth day, it is called 'Guo Jing' (Passing the Channel)." This theory is erroneous. Ma Zhonghua rightly said: "Transmission from Taiyang to Jueyin is like a person entering from outside, moving into the hall, and then into the inner room. For Jueyin to transmit back to Taiyang, it would have to pass through Shaoyin, Taiyin, Shaoyang, and Yangming. How could it suddenly transmit directly to Taiyang?" In the Taiyang Chapter, Zhang Zhongjing states: "In Taiyang disease, if headache persists for seven days or more and heals spontaneously, it is because the pathogen has exhausted its course within that channel. If one wishes to prevent transmission to the next stage, needle the Foot-Yangming channel to stop transmission and achieve cure." This indicates confinement to a single channel. Thus, the Taiyang Chapter states: "Diseases originating in Yang heal in seven days because seven is the number of Yang." If not healed by the seventh day, intending to transmit to Yangming, one should needle the Foot-Yangming channel to intercept and drain the pathogen. Carefully pondering the phrase "Xing Qi Jing Jin" (completing the course within the channel) rather than "Chuan Qi Jing Jin" (transmitting through the channel), Zhang Zhongjing's intent is clear. Cheng Wuji mistakenly interpreted "completing the course within the channel" as "transmitting through all six channels," leading to his theory of re-transmission from Taiyang. Someone asked: "In the Huoluan (Vomiting and Diarrhea) Chapter, it says healing on the thirteenth day is due to the exhaustion of the channel. Does this not mean transmission through all six channels in six days, followed by another cycle of six days, totaling thirteen days? Zhang Zhongjing also said: 'If unresolved after thirteen days, and delirium occurs after passing the channel, purgation is indicated.' Is this not referring to transmission completing on the twelfth day, with non-healing on the thirteenth being 'Guo Jing'?" The answer is: "Jing Jin" refers to completing the course within the specific channel. For example, if Taiyang is affected on day one, day seven represents the completion of the Taiyang channel's course. By analogy, other channels can be calculated similarly. If Yangming is affected on day two, healing on day eight indicates completion of the Yangming channel's course. If Shaoyang is affected on day three, healing on day nine indicates completion of the Shaoyang channel's course. Transmission to the Three Yin channels on days four, five, and six, healing by day twelve, indicates completion of the Jueyin channel's course. By day thirteen, the pathogenic qi is expelled, and mental clarity returns. Hence it is said: 'If beyond thirteen days there is no improvement, and the Cun, Guan, and Chi pulses are sunken, the condition is critical.' Where is there any principle of 're-transmission completing the channel' called 'Guo Jing'? Detailed examination of Zhang Zhongjing's use of 'Guo Jing' shows it either means 'passing Taiyang to form Interior syndrome' or is used generally. In the Yangming Chapter: 'Sweating and delirium with dry stool in the stomach indicate Wind. Purgation is only permissible after Guo Jing.' This means that when dry stool causes delirium and Wind pathogen causes sweating, one must wait until Taiyang exterior symptoms resolve before purging. This refers to passing Taiyang to form Interior syndrome. If Cheng Wuji's theory were correct—that 'Guo Jing' means re-transmission completing on the thirteenth day—then dry stool in the stomach would require waiting until the thirteenth day for purgation. Yet the commentary on this clause states: 'Purgation is allowed only after Taiyang exterior symptoms resolve,' which is self-contradictory. In the Huoluan Chapter: 'After diarrhea, stool should become hard; if the patient can eat, they will heal. If they cannot eat now, but later can eat slightly, and after passing another channel can eat, they should heal one day after passing that channel. If not, it does not belong to Yangming.' This is a general reference to 'Guo Jing.' There is no principle here of 're-transmission completing the channel' called 'Guo Jing'. *Shanghan Kuoyao* follows Cheng Wuji's theory, citing an example of 'Unresolved Guo Jing': 'The classic says unresolved after thirteen days is called Guo Jing.' Zhang Zhongjing actually never wrote this; he mistakenly treated Cheng's commentary as canonical text. For millennia, errors have been inherited, leaving later scholars deaf and blind. Therefore, I reveal this truth."