太阳伤寒。必头痛项强。太阳中风。兼湿成痉。亦项强。
金鉴云。项强。太阳病。项背强。太阳阳明病也。脉浮无汗。从伤寒传来。宜葛根汤。有
汗。从中风传来。宜桂枝加葛根汤。若脉沉而项背强。邪已入胸。宜栝蒌桂枝汤。
风寒客于太阳而身痛。但拘急耳。中湿。则身痛不能转侧。阴毒身痛。则体势沉重。
宛如被杖。以此别之。太阳身痛。解表自除。风湿身痛。宜桂枝加附子汤。阴症身痛。四逆、真
武辈温之。（参准绳）金鉴云。身痛未汗属表实。宜麻黄汤。汗后身痛属表虚。宜桂枝新加汤。若身
痛尺脉迟。是血少营气不足。虽未经汗。不可发汗。宜建中汤。加归 。以补营血也。风湿身痛。
令人一身尽痛。不能转侧。筋脉牵引。烦疼不宁。宜桂枝附子汤。少阴身痛。则脉沉。四肢逆冷。
宜附子汤。厥阴身痛。厥逆汗出不止。下利清谷。宜四逆汤。
邵评∶身痛有表实、表虚、营虚、血少、风湿各因。若少阴厥阴二经中寒。亦有身痛。临症均须细辨。
北方地浓天寒。人之禀气亦浓。风寒所感。只在本经留连。故多太阳正病。若大江以南。地势卑。
天气暖。人禀薄。一感外邪。即从太阳而入阳明少阳。或从太阳而入
太阴少阴。总属太阳兼症。不得以太阳正病治之。
太阳阳明。太阳少阳。太阳兼肺。太阳太阴。太阳少阴。
太阳伤寒证，必然出现头痛和项部僵硬。太阳中风证，若兼夹湿邪导致痉病，也会出现项部僵硬。
《医宗金鉴》说：项部僵硬，属于太阳病；项背部僵硬，属于太阳阳明合病。如果脉象浮而无汗，是从伤寒传变而来，适宜用葛根汤。如果有汗，是从中风传变而来，适宜用桂枝加葛根汤。如果脉象沉而项背部僵硬，说明邪气已经传入胸中，适宜用栝蒌桂枝汤。
风寒之邪侵袭太阳经而导致身体疼痛，只是拘急不适而已。如果感受湿邪，则身体疼痛且不能转动侧身。阴毒证的身体疼痛，则身体姿态沉重，宛如被棍棒打过一样。根据这些特点来加以辨别。太阳经的身痛，通过解表治疗自然消除；风湿引起的身痛，适宜用桂枝加附子汤。阴症（少阴寒化证）的身痛，用四逆汤、真武汤这类方剂温补。（参考《医学准绳六要》）《医宗金鉴》说：身体疼痛且未发汗的属于表实证，适宜用麻黄汤；发汗后身体疼痛的属于表虚证，适宜用桂枝新加汤。如果身体疼痛且尺部脉象迟，这是血少营气不足的表现，即使没有经过发汗，也不可以发汗，适宜用建中汤，加入当归，以补益营血。风湿引起的身痛，使人全身都疼痛，不能转侧，筋脉牵引，烦扰疼痛不安，适宜用桂枝附子汤。少阴病的身痛，则脉象沉，四肢逆冷，适宜用附子汤。厥阴病的身痛，伴有四肢厥逆、出汗不止、下利清谷，适宜用四逆汤。
邵评注：身痛有表实、表虚、营虚、血少、风湿等各种病因。如果少阴、厥阴两经中寒，也会有身痛，临证时都必须仔细辨别。
北方地势高厚，天气寒冷，人的禀赋之气也浓厚。感受风寒，只在本经停留，所以多是太阳正病。如果大江以南，地势低洼，天气温暖，人的禀赋薄弱，一旦感受外邪，就会从太阳传入阳明、少阳，或者从太阳传入太阴、少阴。这总属于太阳兼症，不能用治疗太阳正病的方法来处理。
太阳阳明合病，太阳少阳合病，太阳兼肺病，太阳太阴合病，太阳少阴合病。
Taiyang cold damage (Taiyang Cold Damage) inevitably presents with headache and stiffness of the neck. Taiyang wind strike (Taiyang Wind Strike), when complicated by dampness leading to spasm, also presents with stiffness of the neck.
*Yizong Jinjian* states: Stiffness of the neck belongs to Taiyang disease; stiffness of the neck and back belongs to Taiyang-Yangming combined disease. If the pulse is floating without sweat, it is transmitted from cold damage, and Gegen Tang (Kudzu Decoction) is indicated. If there is sweat, it is transmitted from wind strike, and Guizhi Jia Gegen Tang (Cinnamon Twig plus Kudzu Root Decoction) is indicated. If the pulse is deep with stiffness of the neck and back, the pathogen has entered the chest, and Gualou Guizhi Tang (Trichosanthes Root and Cinnamon Twig Decoction) is indicated.
Wind-cold invading the Taiyang meridian causes body pain, merely characterized by stiffness and tension. If dampness is contracted, body pain occurs with inability to turn or shift the body. Yin poison (Yin Du) body pain presents with a heavy bodily posture, as if beaten by a club. These features are used to differentiate them. Body pain due to Taiyang is resolved naturally through releasing the exterior. Body pain due to wind-dampness is treated with Guizhi Jia Fuzi Tang (Cinnamon Twig plus Aconite Root Decoction). Body pain due to Yin syndrome (Shaoyin Cold Transformation Syndrome) is warmed with Sini Tang (Frigid Extremities Decoction) and Zhenwu Tang (True Warrior Decoction). (*Refer to Yixue Zhunsheng*) *Yizong Jinjian* states: Body pain without sweating belongs to excess in the exterior, and Mahuang Tang (Ephedra Decoction) is indicated. Body pain after sweating belongs to deficiency in the exterior, and Guizhi Xinjia Tang (Cinnamon Twig New Additions Decoction) is indicated. If body pain is accompanied by a slow pulse at the cun position, this indicates blood deficiency and insufficient Ying-nutrient Qi. Even if sweating has not occurred, diaphoresis should not be induced; instead, Jianzhong Tang (Middle-Building Decoction) with Danggui (Angelica Sinensis) added is indicated to tonify Ying-blood. Body pain due to wind-dampness causes pain throughout the entire body, inability to turn or shift, pulling sensations in the sinews and vessels, irritability, restlessness, and severe pain, for which Guizhi Fuzi Tang (Cinnamon Twig and Aconite Root Decoction) is indicated. Body pain due to Shaoyin disease presents with a deep pulse and cold extremities, indicating Fuzi Tang (Aconite Root Decoction). Body pain due to Jueyin disease presents with cold extremities, continuous sweating, and diarrhea with undigested food, indicating Sini Tang (Frigid Extremities Decoction).
Shao’s Commentary: Body pain arises from various causes including exterior excess, exterior deficiency, Ying-nutrient deficiency, blood deficiency, and wind-dampness. When Cold invades the Shaoyin and Jueyin meridians, body pain may also occur; careful differentiation is required during clinical practice.
In the North, the earth is thick and the weather cold, so people’s innate constitution is robust. Contracting wind-cold usually remains within its own meridian, thus presenting mostly as primary Taiyang disease. In contrast, south of the Great River, the terrain is low and the weather warm, and people’s constitutions are thin. Upon contracting external pathogens, the disease quickly transmits from Taiyang to Yangming and Shaoyang, or from Taiyang to Taiyin and Shaoyin. These all belong to Taiyang combined syndromes and cannot be treated as primary Taiyang disease.
Taiyang-Yangming combined disease, Taiyang-Shaoyang combined disease, Taiyang complicated with Lung disease, Taiyang-Taiyin combined disease, Taiyang-Shaoyin combined disease.