问经何十二。
曰。应十二辰数也。曰六而本之三阴三阳者。道生于三。一阴一阳之推也。是故。言六。则
十二在其中。言十二。则五脏六腑。四体百骸。周身内外所有。无一物不在其中矣。经在人身中。
一定而不移。无时而不然。病发于人身。舍经何言哉。昧者不察。但醉生梦死于伤寒传六经之一
语。六经岂独伤寒之一病为然哉。病病皆然也。又若小智。则亦知一不知二。舍手而言足。愎彼
而迷此。殊不知人身之阴阳。天地之阴阳也。阴阳之在天地。而于其升降往来进退消长之所以然
者。可容以一毫智故言哉。手经之阴阳。居人身之半。足经之阴阳。亦居人身之半。若谓传一半
不传一半。则是一身之中。当有病一半不病一半之人也。天下之病伤寒者。不为不多也。曾谓有
人如此乎。有则是矣。如曰无之。则是自眯其目。而谓人不见。见不明。不亦大谬乎。孔子曰。
道之不明也。我知之矣。智者过之。愚者不及也。愚者之不及。则亦已矣。道固自若也。大智
如舜。闻其好问而好察迩言。用其中于民矣。未闻何过也。故惟小智。一或过之。非穿则凿。
一凿与穿百邪蜂起。道何如哉。杂矣。乱矣。晦塞矣。厄矣。道本乎天。而曰厄矣。天将谓之何。
天下可言哉。后学君子。达而明之。上也。未至于达。不厌而勉焉。次也。勉而力不足。宁画。
可也。无若小智焉。不为斯道厄。道之幸也。天之庆也。天下之望。愚之日望也。
问素灵之言六经。起于中焦手太阴肺。阳明大肠。次足阳明胃。太阴脾。次手少阴心。太阳
小肠。次足太阳膀胱。少阴肾。次手厥阴心包。少阳三焦。次足少阳胆。厥阴肝。复从肝别贯膈。
上注肺。伤寒论之言六经。起于太阳。次阳明。次少阳。太阴。
少阴。厥阴。两不相同。何也。
曰。六经之在人身。犹六合之在天地。本无终始之可言。素灵之起于手太阴肺。一阴而一阳。
手而足。足而手。如此而终于厥阴肝。又复注肺者。盖以血气之在经道中。流行而循环。分拆不
开。无起止可言。借肺以言始。平人之常也。伤寒论之起于太阳。遍三阳而后历三阴者。盖以风
寒之中伤人。人是通身四面上下皆当之。其邪亦是如此而皆进。然其进也有渐。故次第人身外体
之躯壳为三重。第一薄外皮肤一重。太阳所主之部位也。第二肌肉一重。阳明之部位也。第三
躯壳里腑脏外匝空一重。少阳之部位也。如此一重一重逐渐而进。三阳主表之谓也。及其进里。
里面五内。亦第为三层。逐层亦是如此而渐上。三阴主里是也。盖经是各居其所的。其各该所辖
部属方位之处所。皆拱极而听命的。以邪之进也。不由经道而在部位方所上超直而径进。故但提
纲挈领。举六该十二以为言。病情事实。文本之权宜也。二说之所以不同者。各就事理以言其规
则耳。非谓必如此以为始终之定体也。后人不肯以身体察。只管在纸笔上拗气。譬如水底摸月。
形影不知。空自纷纷凿凿。千五百年来。举世若说梦。岂不大为可笑。大为可笑。
问太阳有纲有纪有目。余皆不然。何也。
曰。经为纲。变为目。六经皆然也。太阳一经。紧关有始病荣卫之道二。所以风寒单合而为
病三。三病之变证一百五十八。故分三病为三纪。以为各皆领其各该所有之众目。以统属于太阳。
邪过太阳而交余经。则荣卫皆不在论矣。以荣卫自后皆不在论。故皆即病于经。但仍皆举纲张目。
而省纪不须。
问经之为经。一也。太阳何独分三治。
曰。太阳一经。犹边疆也。风也。寒也。风寒俱有也。三病犹三寇。方其犯边之初。南北东
西。随其所犯。御之当各明辨其方法。譬如陆之车马。水之舟船。有所宜。有所不宜。是故。桂
枝麻黄。用之在各当其可。夫是之谓道也。余经犹服里。四夷入服。为寇则同。随在执之是已。
不在屑屑必以种类为别也。
问太阳篇中之言传。阳明少阳篇中又皆言转。夫传则传矣。而又曰转。转非回转之谓乎。
曰。非也。二字皆当音去声而读啭。传是驿传之传。转是轮转之转。传转无文。六书之转注
字。仲景之所以更互而迭用者。盖以明其合为一音义。欲人思而得之之意也。盖风寒遍历人身之
六经。正犹人行转路而过处所耳。后人不思。只单读传为平声如字。而置转于不理会。此义不明。
妄凿伤寒传六经之谬说。遂使杂乱纷然。蜂起而聚讼。卒致此书于阁置。孽由此作也。论语曰。学
而不思则罔。注曰。不求诸心。则昏而无得。呜呼。一人之昏。祸延天下。流毒至今。为学而至此。
可不令人长叹哉。
问传转皆读啭。此书之音义如此。然则七传。间脏传之传。与此音义异同何如。
曰。不同。七传间脏传是五脏自病。病自内出。盖五脏有相生相克之性能。故以夫妇之相克
而有七传。母子之相生而有间脏传。正得父子相代而相传之天然。故曰传。流传之谓也。风寒本
天之二气。于人病为外邪。故其渐次经历人身之六经。有如转路行过方所之委曲。传转之谓如此。
其义自别。何可以同言。
问素灵之起太阴而经以十二言。固是言平人之常。伤寒论之起太阳而经以六言。则是言病时
之变也。惟其常。故无议。以其变。故多口欤。
曰。伤寒论之书。本素问热论之旨也。热论略。伤寒论详。以略而言。譬如八卦起艮之连山。
起坤之归脏也。以详而言。譬如六十四卦起干之易也。孟子曰。前圣后圣。其揆一也。有能继之
者。则皇极经世可得拟而有也。世无尧夫。故口多耳。以多口言之。譬如猩猩与鹦鹉。嚣嚣谍谍。
安知其心不以为能出乎其类。而自谅哉。噫。可慨也已。
问荣卫。
曰。荣卫者。三病始分之二道也。二道明。三方对。则三病无余治。此仲景之所以圣也。二
道迷。三方惑。则虽三百九十七。一百一十三。犹以为未之足。其凿凿之所以嚣嚣与。未及六七
日而风寒有不救者。荣卫不明之罪也。
问传转。
曰。传转者。六经盈缩之玑衡也。六经明。则传转之机审。传转昏。则拘拘数日以论经。此
风寒之所以有治不治之分也。已过十三日而有不愈者。传转不明之罪也。
问两感。
曰。以虚者受病言之。风寒之病。表虚而病也。表虚则里实。故曰热虽甚不死。然则两感于
寒而病必不免于死者。盖以表里俱虚言也。惟其俱虚。故为不治。仲景亦付之不论。大羌活汤。
要亦不过存此活人之心云耳则可。乌在能奈何两感之万一于可必哉。然亦智者过之之一事。近世
以其自谓能治两感而不察。遂用之为通治风寒之套药。是又焉得不谓之愚者不及知之一 邪。
问医有内外。
内者何。曰。人是也。外者何。曰。天是也。知人而不知天。知内不知外也。知天而不知人。
知外而不知内也。知天知人。则知道矣。舍天人而言内外者。非道也。谬也。
问风寒必自太阳而中伤。而诸家乃有各经自中之说。其说何如。
曰。自中不在此中论。此书之论。论外入也。以论外入。故始太阳。太阳者。皮肤也。皮肤
之固护人身。犹城郭之卫护治所。经络脏腑者。譬如城中之百物耳。寇盗虽强。岂能不由城郭。
腾空犯内而伤人害物哉。无是理也。今以太阳揭中伤而言传。阳明更转以互音义。少阳言阳去入
阴。通章之大旨而玩味之。则风寒浸进之实义。昭然甚明。又何必乱凿叛经之剩说。然则各经无
自中邪。曰。非谓无也。人病不外则内。以内出言。何可谓无。中经中络。中腑中脏是也。此书
无此。此义不明。则自误矣。一有自误。则必误人。是故古之君子。为学必专务实。用其力于为
已。今人则不然。欲求无误。难矣哉。
问条目中太阳中风。阳明中风。少阳中风。三阴亦如此而历言。非各经自中之谓乎。
曰非也。盖谓中风矣。初起证见太阳。则谓之太阳中风。明日又明日。证转见阳明而少阳。
则又谓之阳明中风。少阳中风。三阴亦如此。伤寒亦如此。盖此书通篇大义。是自首贯串至尾。
一气说下来。脉络分明。无有间断。与诸家零零星星。一节一意。不相联属者不同。学人务要瞻
前顾后。彻首彻尾。反来复去。千遍熟读。沉潜深思。则义理自见。自然有得。洪范曰思。曰睿。
睿作圣。思是圣学工夫。为学不可不思。
问说者皆在中伤感冒上认病辨轻重。诸说孰优。
曰。中伤是素灵互用之二字。两感是热论推病之转语。冒是吴俗之常谈。认病当如尝酒。醇
美恶。只可在水米麴 中
理虚实。不当向 KT 漉上清滋味。
问先夏至为病温。后夏至为病暑。
曰。暑。必小暑令行而气至。小暑在夏至后一气。故谓夏至前犹是温。言春气未全除也。夏
至后始是暑。节令已行也。然自意为医以来。温变为瘟。暑为寒。寒遍四时。瘟满天下。夏之至
不至无复论矣。欲生民之命各不失其正。其可得乎。
问天有六气。风寒暑湿燥火。风寒暑湿。经皆揭病出条例以立论。而不揭燥火。燥火无病可
论乎。
曰。素问言春伤于风。夏伤于暑。秋伤于湿。冬伤于寒者。盖以四气之在四时。各有专令。
故皆专病也。燥火无专令。故不专病。而寄病于百病之中。犹土无正王。而寄王于四时辰戌丑未
之末。不揭者。无病无燥火也。条目中理会自见。
问虚者受病。卫中风也。而曰荣虚。何也。
曰风之中也。本荣实而卫虚也。风既中矣。则卫实而荣虚矣。虚以对实为言。卫家本虚。得
助则实。荣家本实。无助反虚。故医家之言虚实。凡虚皆正气虚。凡实皆邪气实。非别家泛言虚
实之可比也。经曰。邪气盛则实。精气夺则虚。又曰。入者为实。出者为虚。此之谓也。
问经之用方。皆言主之。后人则云专治。两意同否。
曰。不同。主之者。示人以枢纽之意也。专治则必人以胶柱矣。
问桂枝辛甘大热。经之用。其取发散为阳之义欤。
曰。中风发热汗出。卫不固而表疏。发散何取哉。然一则曰发汗。二则曰发汗。何也。曰。
经不云乎。桂枝本为解肌。又不云乎。
汗不出者不可与也。既曰本为解肌。又曰汗不出者不可与。则岂发汗之谓哉。桂枝有固卫之良能。
解肌乃中风之奥义。妙不可言也。然则发汗者。果为谁也。曰。热粥也。妙在此也。韩信以死地
与士卒。得效死之士卒而收背水之功。仲景以汗法与热粥。得逼汗之热粥而成桂枝之效。医道与
将道通也。非天下之至神。其孰能与于此。谓桂枝难用者。曾知此乎。噫。仲景远矣。可以与之
语夫此者谁哉。贾生有言。可为长太息者此也。
问桂枝本为解肌。而一则曰发汗宜桂枝汤。二则曰发汗宜桂枝汤。何也。
曰。风之为病。外邪也。故于其初也。法曰常发汗。然汗既自出也。卫行脉外。故曰本为解
肌。发汗以例言。发语之辞也。解肌以义言。核实之谓也。故曰解肌乃中风之奥义。妙不可言也。
学人能了悟桂枝发汗解肌之义例。则于入此书之道。已过第一关隘矣。不患不升堂入室也。谓桂
枝难用。与凡类集桂枝汤方于已之伤寒门。谓为有汗伤寒之治者。徒知桂枝发汗之例。何尝知其
解肌之义哉。
问KT KT 。
曰。几自说文以来。皆言鸟之短羽者。不能远飞。动则引颈KT KT 然。故仲景取以形容病患之
颈项俱病者。俯仰不能自如之貌。肖峰吴氏。六书总要。\r字\pt62a3.bmp\r文如此。注鸟飞远
影。盖有据也。然此以训释仲景书。故但从旧说。而于文之是非。注之得失。则皆不论。
问风土之异。东南偏暖。西北偏寒。故说者谓东南之人。不病风寒。偏病暑湿。西北之人。
不病暑湿。偏病风寒。其说然否。
曰。难以此拘也。灵枢谓夫天之生风者。非以私百姓也。其行公平正直。犯者得之。避者得
无。殆非求人而人自犯之。然则
四气之所以为人病。在人之自犯不自犯何如耳。不在四气之偏不偏乃尔也。以犯而言。则东南之
人。何尝不病其东南之风寒。西北之人。岂可不病其西北之暑湿。何也。事有偶然。机有不测。
理不可以一途取也。今也必欲以偏言。则淮南子曰。匈奴出秽裘。干越生葛 。各生所急以备燥
湿。各因所处以御寒暑。并得其宜。物便其所。故兵家有言。朔陲积阴之野。食肉饮酪。其人理
密。故耐寒。百粤多阳之地。其人理疏。故耐暑。是其天性然也。如此则是地虽限人以偏。天则
全人以性。天地以生物为心。而谓以其气之所不能齐者适所以病患。岂天地之自然哉。亦过论矣。
且夫得气之先。莫如禽鸟。以燕雁同有无之乡言之。彼此虽偏。相差不甚相远可知也。乃若积冰
不雪。不青不毛之地。此固判然天地之殊方异域。偏之甚。无过于此矣。然而大禹圣人。定千八
百国。解衣入裸。无所不之。贤如诸葛。五月渡泸。深入不毛。牧羝大窖中。餐毡啮雪。十九年
而生还。诸如此者。虽履偏之甚。犹且不病。非有主不犯之明验乎。是故。君子立言。必以天下
问：为什么经络分为十二？
答：这是为了对应十二时辰的数量。之所以以六经为本，源于三阴三阳，因为“道”生于三，是一阴一阳推演的结果。因此，说六经，则十二经包含在其中；说十二经，则五脏六腑、四肢百骸，周身内外所有的事物，没有一样不在其中的。经络在人身中是固定而不移的，无时无刻不是如此。疾病发于人身，除了经络还能说什么呢？愚昧的人不加考察，只是沉醉于“伤寒传变六经”这一句话中。六经难道唯独伤寒这一种病才这样吗？所有的病都是这样的。如果像那些小聪明的人，只知道一端不知道另一端，只谈手经不谈足经，固执己见而迷惑于此，他们根本不知道人身中的阴阳就是天地间的阴阳。阴阳在天地之间，其升降往来、进退消长的原理，怎么能容许用丝毫的智巧去妄加揣测呢？手经的阴阳占据人身的一半，足经的阴阳也占据人身的一半。如果说病邪只传变一半经络而不传变另一半，那就是说身体之中有生病一半、不生病一半的人。天下患伤寒的人不少，难道真有这样的事吗？如果有，那就算了；如果说没有，那就是自己蒙住眼睛却以为别人看不见，见识不明，这不是很荒谬吗？孔子说：“道的不明亮，我是知道的。聪明人做得过头，愚蠢的人做不到。”愚蠢的人做不到也就罢了，道本来还是原来的样子。大智慧像舜那样，听说他喜欢提问并且善于审视浅近的话，把中庸之道施用于百姓，没听说过有什么过错。所以只有小聪明的人，一旦做得过头，不是穿凿附会就是生搬硬套。一旦穿凿，各种邪说就会蜂拥而起，道会变成什么样呢？杂乱啊，混乱啊，晦涩阻塞啊，困厄啊。道本乎天，却说它困厄，对天怎么说得过去？天下还有什么可说的呢？后学的君子们，通达并阐明它，是最好的；还没达到通达的程度，也不要厌烦而要努力，这是次等的；努力了但力量不足，宁可停止，也可以。不要像那些小聪明的人那样，让这道陷入困厄，这是道的幸运，也是天的福庆，更是天下的期望，是我日夜盼望的。
问：《素问》和《灵枢》论述六经，起于中焦的手太阴肺经，接着是阳明大肠经，然后是足阳明胃经、太阴脾经，接着是手少阴心经、太阳小肠经，然后是足太阳膀胱经、少阴肾经，接着是手厥阴心包经、少阳三焦经，然后是足少阳胆经、厥阴肝经，最后从肝别出贯穿膈肌，上注于肺。《伤寒论》论述六经，起于太阳经，接着是阳明经、少阳经、太阴经、少阴经、厥阴经。两者不相同，为什么呢？
答：六经在人身中，就像六合在天地中，本来就没有所谓始终可言。《素问》《灵枢》起于手太阴肺经，一阴一阳，手经足经交替，直到厥阴肝经，又回流注于肺，这是因为气血在经络中流行循环，分拆不开，没有起止可言，借肺经来说明起始，是平和之人的常态。《伤寒论》起于太阳经，遍历三阳之后经历三阴，这是因为风寒侵袭伤人，人是全身四面上下都承受邪气，邪气也是这样全部侵入的。然而它的侵入是有渐进过程的，所以依次将人身外体的躯壳分为三层：第一层薄薄的皮肤，是太阳经所主的部位；第二层肌肉，是阳明经的部位；第三层躯壳里脏腑外的空隙，是少阳经的部位。这样一层一层逐渐深入，三阳主表就是这样。等到邪气进入内部，里面的五脏也分为三层，逐层也是这样逐渐上升，三阴主里就是这样。经络各自居于其特定的位置，它们所辖的部属方位之处所，都像拱卫北极星一样听从命令。由于邪气的侵入，不沿着经络之道，而是在部位方所上超直而径直深入，所以只是提纲挈领，举六经来涵盖十二经作为论述。病情事实，是文本的一种权宜之计。这两种说法不同的原因，是各自就事理来说明规则罢了，并不是说必须这样作为固定的始终模式。后人不肯用身体去体察，只管在纸笔上争辩，譬如在水底摸月亮，不知形影，白白地纷纷凿凿争论一千五百年，举世之人如同做梦，岂不大为可笑，大为可笑。
问：太阳经有纲、纪、目，其他经却不是这样，为什么呢？
答：经络是纲，变证是目，六经都是这样的。太阳一经，紧密关联着起始病及营卫之道的两个方面，所以风寒单独结合成为三种病。这三种病的变证有一百五十八种，所以将三种病分为三纪，用来统领各自所属的所有众目，从而统属于太阳。邪气经过太阳而传入其余各经，那么营卫就不在讨论范围了。因为营卫自此后不再讨论，所以其他的病直接就在经络上发生，但仍然都是举纲张目，而省去了纪的划分，不需要了。
问：经络作为经络，都是一样的。为什么唯独太阳经分为三种治法？
答：太阳一经，就像边疆。风、寒、风寒兼具，这三种病就像三个敌寇。当它们侵犯边疆之初，南北东西，随其所犯之处，防御时应当各自明确辨别方法。譬如陆地的车马，水中的舟船，有所适宜，有所不适宜。因此，桂枝汤和麻黄汤的使用，在于各自恰当合适。这就叫做道。其他经就像内地，四夷入侵成为寇贼是一样的，随处抓捕即可，不必琐碎地一定要按种类区别。
问：太阳篇中讲“传”，阳明、少阳篇中又说“转”。既然是传，又说转，转难道不是回转的意思吗？
答：不是。这两个字都应当读去声，音同“啭”。“传”是驿传的传，“转”是轮转的转。“传”、“转”没有文字上的区别，是六书中的转注字。仲景之所以更替使用，是为了表明它们合为一个音义，希望人们思考而领悟其中的意思。大概风寒遍历人身六经，正犹如人行走转过道路经过处所一样。后人不去思考，只单读“传”为平声如原字，而置“转”于不顾。这个意义不明白，妄加穿凿关于“伤寒传六经”的错误说法，于是导致杂乱纷然，邪说蜂起而聚讼，最终致使这本书被搁置不用，灾祸由此产生。《论语》说：“学而不思则罔。”注释说：“不求诸于心，则昏而无所得。”唉，一个人的昏聩，祸延天下，流毒至今，做学问到了这种地步，怎能不让人长叹呢？
问：既然“传”、“转”都读作“啭”，这本书的音义是这样，那么“七传”、“间脏传”中的“传”，与此音义异同如何？
答：不同。“七传”、“间脏传”是五脏自病，病从内出。因为五脏有相生相克的性能，所以以夫妇相克而有“七传”，以母子相生而有“间脏传”，正符合父子相代相传的天然道理，所以叫“传”，是流传的意思。风寒本是天上的二气，对人来说是外邪，所以它逐渐经历人身六经，有如转过道路经过处所的曲折，这叫“传转”。它们的意义自然不同，怎么可以混为一谈呢？
问：《素问》《灵枢》起于太阴而以十二经而言，固然是讲平和之人的常态；《伤寒论》起于太阳而以六经而言，则是讲发病时的变化。正因为是常态，所以没有争议；因为是变化，所以多口议论吗？
答：《伤寒论》这本书，本意是遵循《素问·热论》的宗旨。《热论》简略，《伤寒论》详尽。以简略而言，譬如八卦起于艮的《连山》，起于坤的《归藏》；以详尽而言，譬如六十四卦起于乾的《周易》。孟子说：“前圣后圣，其揆一也。”如果有能继承它的人，那么《皇极经世》就可以比拟而有了。世上没有邵尧夫这样的人，所以口舌多罢了。用多口舌来说，譬如猩猩与鹦鹉，喧闹喋喋，怎么知道它们的心不认为自己能超出同类，而自我估量呢？唉，真是令人感慨啊。
问：关于营卫。
答：营卫，是三种病开始区分的两个途径。两个途径明了，三方对策确立，那么三种病就没有剩余的治疗问题了。这就是仲景之所以神圣的原因。两个途径迷乱，三方困惑，那么即使有三百九十七种病证、一百一十三首方剂，还觉得不够。那种凿凿不休、喧嚣吵闹的原因就在这里。不到六七天风寒就有无法救治的，这是营卫不明的罪过。
问：关于传转。
答：传转，是六经盈缩的枢纽。六经明了，则传转的机理审慎；传转昏昧，则拘泥于日数来论断经络。这就是风寒之所以有治疗与不治疗之分的原因。过了十三天还有不痊愈的，这是传转不明的罪过。
问：关于两感（表里同病）。
答：从虚者受病来说，风寒的病，是表虚而病。表虚则里实，所以说热势虽然严重也不会死。然而两感于寒而病必定不免于死的，是因为表里俱虚的缘故。正因为俱虚，所以是不治之症。仲景也把它放在不讨论的范围。大羌活汤，也不过是保存一点救活人的心意罢了，哪里能在万一的可能中必然能救治两感呢？这也是聪明人做得过头的一件事。近代人自以为能治两感而不加考察，于是用它作为通治风寒的套药，这又怎么能不说是愚蠢的人做不到的事情呢？
问：医学有内科和外科之分。
答：内是什么？是人。外是什么？是天。知人而不知天，是知内不知外。知天而不知人，是知外不知内。知天知人，就知道道了。舍弃天人而言内外，不是道，是谬误。
问：风寒必定从太阳经开始中伤，而各家却有各经自中之说，这种说法怎么样？
答：自中不在此书的讨论范围内。此书论述的是外邪入侵。因为论述外邪入侵，所以始于太阳。太阳，指皮肤。皮肤的坚固保护人身，就像城郭保卫治所一样。经络脏腑，就像城中的各种物品。盗贼虽然强大，难道能不通过城郭，腾空犯内来伤害人和物品吗？没有这个道理。现在以太阳揭示中伤来讲传变，阳明再转用互音义，少阳讲阳去入阴，通章的大旨细细玩味，那么风寒浸透深入的真正含义，昭然若揭，非常明白。又何必搞乱穿凿背离经典的多余说法呢？那么各经没有自中邪气吗？我说：不是说没有。人患病不外乎由外入内，从内出来说，怎么能说没有呢？中经、中络、中腑、中脏就是。此书没有这些内容，这个意义不明白，就会自误。一有自误，就必误人。所以古代的君子，做学问一定专心务实，用力于修身。今人却不是这样，想要寻求无误，难啊！
问：条目中太阳中风、阳明中风、少阳中风，三阴也是如此历言，这不是各经自中的意思吗？
答：不是。大概是说中了风邪，初起证候见于太阳，就叫太阳中风。明天又明天，证候转变见于阳明和少阳，就又叫阳明中风、少阳中风。三阴也是如此，伤寒也是如此。大概这本书通篇大义，是从头贯串到尾，一气呵成，脉络分明，没有间断，与各家零零星星、一节一意、不相联属的不同。学人务必瞻前顾后，彻首彻尾，反复阅读，千遍熟读，沉潜深思，那么义理自然显现，自然会有所得。《洪范》说：思，睿。睿作圣。思是圣学的工夫，做学问不可不思。
问：解说者都在中伤感冒上认病辨轻重，各种说法哪个优？
答：中伤是《素问》《灵枢》互用的两个字，两感是《热论》推演病机的转语，冒是吴地的俗语常谈。认病应当像尝酒，醇美或恶劣，只可在水米麴糵中理清虚实，不当向过滤后的清汁上去辨别滋味。
问：先夏至为病温，后夏至为病暑。
答：暑，必须小暑节气运行而气候到达。小暑在夏至后一个节气，所以说夏至前还是温，是说春气未完全消除。夏至后才是暑，节令已经运行了。然而自从意为医以来，温变成了瘟，暑变成了寒，寒遍布四季，瘟满天下，夏至到不到也不再讨论了。想让百姓的生命各自不失其正道，可能吗？
问：天有六气：风、寒、暑、湿、燥、火。风、寒、暑、湿，经络都揭示病症出条例来立论，而不揭示燥、火。燥火没有病可论吗？
答：《素问》说春伤于风，夏伤于暑，秋伤于湿，冬伤于寒，是因为四气在四季中各有专门的时令，所以都有专病。燥火没有专门的时令，所以没有专病，而是寄寓在百病之中，就像土没有正王，而寄王于辰、戌、丑、未这四个时辰的末尾。不揭示，是因为没有单独的燥火病。条目中理会自然可见。
问：虚者受病，卫中风，为什么说荣虚？
答：风的侵袭，本来是荣实而卫虚。风既已中伤，则卫实而荣虚了。虚是对实而言的。卫家本虚，得到帮助则实；荣家本实，没有帮助反而虚。所以医家所说的虚实，凡是虚都是正气虚，凡是实都是邪气实，不是别家泛言虚实可以比的。经文说：“邪气盛则实，精气夺则虚。”又说：“入者为实，出者为虚。”说的就是这个。
问：经络使用方剂，都说“主之”，后人则说“专治”，两种意思相同吗？
答：不同。“主之”是示人以枢纽的意思。“专治”则必然使人胶柱鼓瑟，不知变通。
问：桂枝辛甘大热，经文中使用它，是取其发散为阳的意义吗？
答：中风发热汗出，卫气不固而表疏，为什么要取发散呢？然而文中一则说发汗，二则说发汗，为什么呢？经文不是说了吗？桂枝本为解肌，又不是说了吗？汗不出者不可给予。既然说本为解肌，又说汗不出者不可给予，难道是发汗的意思吗？桂枝有巩固卫气的良能，解肌才是中风的奥义，妙不可言。那么发汗的，究竟是谁呢？是热粥。妙就在此。韩信把士卒置于死地，得到效死的士卒而收背水一战之功。仲景把汗法配合热粥，得到逼汗的热粥而成就桂枝的功效。医道与将道相通啊。如果不是天下最神妙的人，谁能做到这样呢？说桂枝难用的，曾知道这个吗？唉，仲景远矣，可以与他谈论这个的还有谁呢？贾谊有话说：“可为长太息者此也。”
问：桂枝本为解肌，而一则说发汗宜桂枝汤，二则说发汗宜桂枝汤，为什么呢？
答：风作为病，是外邪。所以在初起时，法度说常发汗。然而汗既然自己流出，卫行脉外，所以说本为解肌。发汗是以例言，是发语之辞。解肌是以义言，是核实的意思。所以说解肌才是中风的奥义，妙不可言。学人能领悟桂枝发汗解肌的义例，那么在进入本书的门径上，已过第一关隘了。不愁不能升堂入室。说桂枝难用，以及凡类集桂枝汤方于自己的伤寒门，谓为有汗伤寒的治疗者，只知道桂枝发汗的例，何曾知道解肌的义呢？
问：KT KT（项强）。
答：自从《说文》以来，都说鸟的短羽者，不能远飞，一动就引颈KT KT然。所以仲景取用来形容病患颈项俱病，俯仰不能自如的样子。肖峰吴氏的《六书总要》中字文如此，注解说鸟飞远影，大概是有根据的。然而这里是用以训释仲景的书，所以只从旧说，而对于文字的是非，注解的得失，都不讨论。
问：风土差异，东南偏暖，西北偏寒，所以解说者说东南的人，不病风寒，偏病暑湿；西北的人，不病暑湿，偏病风寒。这种说法对吗？
答：难以用这个来拘泥。《灵枢》说上天生成风，不是为了偏爱百姓，它运行公平正直，触犯的人得病，躲避的人不得病，大概不是求人来而人自犯之。那么四气之所以为人致病，在于人自犯不自犯如何，不在于四气偏不偏乃尔。以触犯而言，东南的人，何尝不是病其东南的风寒？西北的人，岂可不病其西北的暑湿？为什么呢？事有偶然，机有不测，理不可以一途取。现在一定要用偏说来解释，那么《淮南子》说：匈奴出秽裘，干越生葛，各生所急以备燥湿，各因所处以御寒暑，并得其宜，物便其所。所以兵家说：北方边陲积阴之野，食肉饮酪，其人腠理密，故耐寒；百粤多阳之地，其人腠理疏，故耐暑，是其天性使然。如果是这样，那么地虽限制人以偏，天则全人以性，天地以生物为心，而说以其气之所不能齐者适所以病患，难道是天地之自然吗？也是过论了。况且得气之先，莫过于禽鸟。以燕雁同有无之乡言之，彼此虽偏，相差不甚相远可知也。至于积冰不雪、不青不毛之地，这固然是判然天地之殊方异域，偏之甚，无过于此矣。然而大禹圣人，定千八百国，解衣入裸，无所不之；贤如诸葛，五月渡泸，深入不毛；牧羝大窖中，餐毡啮雪，十九年而生还。诸如此者，虽履偏之甚，犹且不病，非有主不犯之明验乎？是故，君子立言，必以天下……
Q: Why are the meridians divided into twelve?
A: This is to correspond to the number of the twelve Earthly Branches (Shichen, 12 two-hour periods). The reason for taking six meridians as the basis, originating from the Three Yin and Three Yang (San Yin San Yang), is that "Dao" (the Way) arises from three, which is the deduction of one Yin and one Yang. Therefore, speaking of six meridians implies the twelve within; speaking of twelve meridians implies that all things within the five Zang organs, six Fu organs, four limbs, hundred bones, and inside and outside the body are included therein. The meridians in the human body are fixed and unchanging, existing at all times. Diseases arise in the human body; apart from the meridians, what else can be discussed? Ignorant people fail to examine this, merely intoxicated by the phrase "Shaoyang disease transmitting through the six meridians." Do the six meridians apply only to Shaoyang disease? All diseases are like this. Those with petty wisdom know one end but not the other, discussing hand meridians while ignoring foot meridians, being stubborn and confused. They do not realize that the Yin and Yang of the human body are the same as those of Heaven and Earth. Regarding Yin and Yang in Heaven and Earth, their principles of ascending, descending, coming, going, advancing, retreating, waxing, and waning cannot be subjected to the slightest intellectual speculation. The Yin and Yang of the hand meridians occupy half of the human body; the Yin and Yang of the foot meridians also occupy half. If one claims that transmission affects only half the meridians and not the other half, it would imply there are people whose bodies are half diseased and half healthy. There are many people suffering from Shaoyang disease in the world; does anyone really exist like this? If so, fine; if not, then covering one's own eyes and claiming others cannot see is a sign of unclear perception, which is greatly erroneous. Confucius said: "The Dao is not illuminated; I know why. The wise go too far, the foolish fall short." The foolish falling short is of no consequence; the Dao remains as it is. Even great wisdom like Shun's involved asking questions and examining simple words, applying the Mean to the people, without hearing of any fault. Only those with petty wisdom, when they go too far, resort to forced interpretations or rigid applications. Once such forced interpretation occurs, various heretical theories swarm forth. What becomes of the Dao? It becomes chaotic, disordered, obscure, and blocked. The Dao originates from Heaven, yet you say it is blocked; how can you justify this to Heaven? What is there left to say to the world? Scholars of later generations should understand and clarify this; this is the best. If not yet understanding, one should strive without weariness; this is secondary. If striving but lacking strength, it is acceptable to stop. Do not be like those with petty wisdom, causing the Dao to be blocked. This is the fortune of the Dao, the blessing of Heaven, and the hope of the world, which I day and night desire.
Q: The *Suwen* and *Lingshu* discuss the six meridians starting from the Hand Taiyin Lung Meridian at the middle jiao, followed by the Yangming Large Intestine Meridian, then the Foot Yangming Stomach Meridian, Taiyin Spleen Meridian, then Hand Shaoyin Heart Meridian, Taiyang Small Intestine Meridian, then Foot Taiyang Bladder Meridian, Shaoyin Kidney Meridian, then Hand Jueyin Pericardium Meridian, Shaoyang Sanjiao Meridian, then Foot Shaoyang Gallbladder Meridian, Jueyin Liver Meridian, finally branching from the liver, piercing the diaphragm, and flowing up to the lung. The *Shanghan Lun* discusses the six meridians starting from the Taiyang Meridian, followed by Yangming, Shaoyang, Taiyin, Shaoyin, and Jueyin. They are different. Why?
A: The six meridians in the human body are like the Six Directions (Liuhe) in Heaven and Earth; originally, there is no beginning or end to speak of. The *Suwen* and *Lingshu* start from the Hand Taiyin Lung Meridian, alternating Yin and Yang, hand and foot, until Jueyin Liver, then returning to the Lung. This is because Qi and Blood circulate continuously within the meridians, inseparable, with no clear start or finish. Using the Lung Meridian to indicate the beginning reflects the normal state of a healthy person. The *Shanghan Lun* starts from the Taiyang Meridian, traversing the Three Yang before moving to the Three Yin. This is because Wind and Cold invade the whole body, top to bottom, front to back, and the pathogen advances similarly. However, its advance is gradual. Thus, the outer shell of the body is divided into three layers: the first thin layer of skin, governed by Taiyang; the second layer of muscle, governed by Yangming; the third layer, the space between the outer shell and inner organs, governed by Shaoyang. Advancing layer by layer, the Three Yang govern the exterior. Upon entering the interior, the five internal organs are also divided into three layers, ascending gradually, which is how the Three Yin govern the interior. The meridians reside in their specific locations, and their respective jurisdictions obey like stars orbiting the North Star. Because pathogens advance directly through locations rather than following the meridian pathways, the text summarizes by listing the six meridians to encompass the twelve. This is a pragmatic approach to describing clinical facts. The difference between these two explanations lies in their respective focus on physiological rules versus pathological progression; neither prescribes a fixed beginning or end. Later scholars refuse to verify with their own bodies, arguing over texts instead, like trying to touch the moon's reflection in water. For 1,500 years, the world has debated in vain, acting like dreamers, which is truly laughable.
Q: The Taiyang Meridian has a "Gang" (Outline), "Ji" (Chronicle/Category), and "Mu" (Eye/Detail), but the others do not. Why?
A: The Meridian is the Gang, and the variations are the Mu; this applies to all six meridians. The Taiyang Meridian is closely linked to the initial onset involving Ying (Nutrient) and Wei (Defensive) mechanisms. Wind and Cold combine to form three types of illness. These three illnesses have 158 variation patterns. Thus, the three illnesses are divided into three Ji to lead their respective details, all subordinated to Taiyang. Once the pathogen passes Taiyang and enters other meridians, Ying and Wei are no longer the primary focus of discussion. Since Ying and Wei are no longer discussed subsequently, the diseases occur directly on the meridians. The structure still uses Gang and Mu, but the Ji classification is omitted as unnecessary.
Q: As meridians, they are uniform. Why is Taiyang uniquely divided into three treatments?
A: The Taiyang Meridian is like a border region. Wind, Cold, and combined Wind-Cold are like three types of invaders. When they initially breach the border, regardless of direction, defense methods must be distinguished clearly. Like land vehicles and water boats, some are suitable, others not. Therefore, Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) are used according to appropriateness. This is called Dao. Other meridians are like the interior; invaders are invaders regardless of origin, and capture is capture, without needing trivial distinctions by type.
Q: The Taiyang chapter speaks of "Zhuan" (Transmission), while Yangming and Shaoyang chapters speak of "Zhuan" (Rotation/Turning). If it is transmission, why also rotation? Does Zhuan mean turning back?
A: No. Both characters should be pronounced with the departing tone, sounding like "Zhuan" (twisting/turning). "Zhuan" (Transmission) refers to relay stations; "Zhuan" (Rotation) refers to wheel rotation. They are phonetic loan characters (Zhuanzhu) in the Six Scripts. Zhang Zhongjing used them interchangeably to indicate they share one sound and meaning, expecting readers to ponder and understand. Wind and Cold traversing the six meridians is like a person walking along a winding road. Later scholars failed to reflect, reading only "Zhuan" (Transmission) as level tone and ignoring "Zhuan" (Rotation). This misunderstanding led to erroneous theories about "Shaoyang disease transmitting through six meridians," causing chaos and debate, resulting in the book being neglected. The harm stems from here. The *Analects* states: "Learning without thought leads to confusion." Commentary says: "Seeking not in the heart leads to darkness and lack of gain." Alas, one person's confusion brings disaster to the world, poisoning it to this day. Is it not worthy of a long sigh?
Q: If "Zhuan" and "Zhuan" are both read as "Zhuan," what about the "Zhuan" in "Seven-Step Transmission" (Qi Zhuan) and "Inter-visceral Transmission" (Jian Zang Chuan)? Are the pronunciation and meaning the same?
A: Different. Seven-Step and Inter-visceral transmissions refer to diseases originating within the five Zang organs, arising from within. The five Zang have generating and controlling relationships. Seven-Step Transmission follows the controlling cycle (like husband-wife conflict), while Inter-visceral Transmission follows the generating cycle (like mother-child generation), resembling natural generational succession. Hence it is called "Chuan" (Flow/Spread). Wind and Cold are external pathogens from Heaven, progressing through the six meridians like traveling a winding road, hence "Zhuan Zhuan." Their meanings are distinct and cannot be conflated.
Q: The *Suwen* and *Lingshu* start from Taiyin and discuss twelve meridians, describing the normal state of a healthy person. The *Shanghan Lun* starts from Taiyang and discusses six meridians, describing pathological changes. Because it is normal, there is no dispute; because it is change, there is much debate?
A: The *Shanghan Lun* follows the principle of the *Suwen*'s "Treatise on Heat Diseases" (Re Lun). The *Re Lun* is brief; the *Shanghan Lun* is detailed. Briefly, it is like the *Lianshan* (starting from Gen) or *Guicang* (starting from Kun); detailed, it is like the *Zhouyi* (starting from Qian). Mencius said: "Former sages and latter sages share the same measure." One who inherits it could model the *Huangji Jingshi*. Since the world lacks someone like Shao Yaofu, there is much talk. Like parrots mimicking speech, how do we know they don't think they surpass their kind? Alas, how lamentable.
Q: Regarding Ying and Wei.
A: Ying and Wei are the two pathways distinguishing the three initial illnesses. Clarifying these two pathways establishes the three countermeasures, leaving no remaining treatment issues. This is why Zhang Zhongjing is sage-like. If these pathways are confused, even 397 symptoms and 113 formulas are insufficient. The noise arises from this lack of clarity. Cases where Wind-Cold is untreatable within six or seven days are due to ignorance of Ying and Wei.
Q: Regarding Transmission and Rotation.
A: Transmission and Rotation are the pivot of the six meridians' fullness and emptiness. Understanding the six meridians clarifies the mechanism of transmission; confusing transmission leads to rigidly counting days to judge meridians. This distinguishes treatable from untreatable Wind-Cold cases. Cases lingering beyond thirteen days are due to unclear understanding of transmission.
Q: Regarding Lianggan (Simultaneous Exterior and Interior Involvement).
A: Speaking of deficiency patients receiving disease, Wind-Cold causes exterior deficiency. Exterior deficiency implies interior excess, so severe heat does not necessarily lead to death. However, Lianggan involves simultaneous exterior and interior deficiency, leading inevitably to death. Because it is dual deficiency, it is considered untreatable. Zhang Zhongjing excludes it from discussion. Da Qianghuo Tang exists merely to preserve the intent of saving lives, but cannot guarantee success in all Lianggan cases. This is an example of the wise going too far. Modern practitioners, claiming to cure Lianggan without proper examination, use it as a generic formula for all Wind-Cold, which is the folly of the ignorant.
Q: Medicine has Internal and External branches.
A: Internal is Human; External is Heaven. Knowing Human but not Heaven is knowing Internal but not External. Knowing Heaven but not Human is knowing External but not Internal. Knowing both Heaven and Human constitutes knowing Dao. Discussing Internal and External apart from Heaven and Human is not Dao; it is error.
Q: Wind-Cold always attacks via Taiyang, yet some schools propose each meridian can be attacked directly. What is your view?
A: Direct attack is not discussed in this book. This book discusses external invasion. Hence it begins with Taiyang. Taiyang refers to the skin. Skin protects the body like city walls protect a capital. Meridians and organs are like items within the city. Can thieves bypass walls and fly inward to cause harm? Impossible. By analyzing Taiyang as the entry point, Yangming as rotation, and Shaoyang as transition from Yang to Yin, the gradual deepening of Wind-Cold is clear. Why resort to chaotic, heterodox theories? Do meridians never receive direct attack? I say: Not that they don't. Disease comes from outside or inside. From the perspective of internal emergence, it exists (e.g., attacking meridians, collaterals, Fu, or Zang). This book omits this; failing to understand this leads to self-deception. Self-deception leads to deceiving others. Ancient scholars focused on practical cultivation. Modern scholars seek errorlessness but fail. How difficult!
Q: Entries list Taiyang Wind Strike, Yangming Wind Strike, etc. Isn't this direct attack on each meridian?
A: No. It means contracting Wind. If initial symptoms appear in Taiyang, it is called Taiyang Wind Strike. If symptoms shift to Yangming or Shaoyang later, it is called Yangming or Shaoyang Wind Strike. This applies to the Three Yin and Cold Damage alike. The book's main theme runs continuously from start to finish, with clear connections, unlike fragmented theories of other schools. Students must read thoroughly, repeatedly, and reflect deeply to grasp the logic naturally. The *Hongfan* states: Thought leads to Wisdom; Wisdom leads to Sagehood. Thinking is essential for learning.
Q: Commentators identify severity based on contraction of Wind-Cold. Which theory is superior?
A: "Zhong Shang" (Mid-injury) is a term from *Suwen/Lingshu*; "Liangan" is from *Re Lun*; "Mao" is a local colloquialism. Identifying disease is like tasting wine: discerning quality requires analyzing the base ingredients (Water, Rice, Yeast), not just the filtered liquor.
Q: Before Summer Solstice is Warm Disease; after is Summer Heat Disease.
A: Summer Heat requires the arrival of the Xiao Shu (Minor Heat) solar term, which follows the Summer Solstice. Thus, pre-solstice is Warm (Spring Qi not fully gone); post-solstice is Summer Heat (Solar term active). Since becoming a physician, Warm has become Plague, and Summer Heat has become Cold. Cold pervades all seasons; Plague fills the world. Whether Summer Solstice arrives or not is ignored. How can people's lives remain true to nature under these conditions?
Q: Heaven has Six Qi: Wind, Cold, Summer Heat, Dampness, Dryness, Fire. Wind, Cold, Summer Heat, and Dampness have specific entries, but Dryness and Fire do not. Is there no disease of Dryness and Fire?
A: *Suwen* states Spring Wind, Summer Heat, Autumn Dampness, Winter Cold because these four Qi have specific seasonal commands and thus specific diseases. Dryness and Fire lack specific commands, so they do not have specific diseases but manifest within various diseases, like Earth lacking a specific ruler but ruling during the last months of each season. Not listing them means there is no isolated Dryness/Fire disease. Details can be found in the entries.
Q: Deficient persons receive disease via Wei Wind Strike, yet it is said Ying is deficient. Why?
A: Wind invasion initially involves Ying Excess and Wei Deficiency. After invasion, Wei becomes Excess and Ying becomes Deficient. Deficiency is relative to Excess. Wei is originally deficient; aided, it becomes Excess. Ying is originally Excess; unaided, it becomes Deficient. Medical "Deficiency" refers to Zheng Qi (Upright Qi) deficiency; "Excess" refers to Xie Qi (Pathogenic Qi) excess, differing from general usage. Scripture says: "Excess of Pathogenic Qi is Excess; Depletion of Essence is Deficiency." Also: "Entering is Excess; Exiting is Deficiency." This is the meaning.
Q: Formulas in the text say "Zhu Zhi" (Mainly Governs), but later authors say "Zhuan Zhi" (Specially Treats). Are they the same?
A: No. "Zhu Zhi" indicates a pivot/key strategy. "Zhuan Zhi" implies rigid application, like glued tuning pegs.
Q: Guizhi Tang is Pungent, Sweet, and Greatly Hot. Is it used for its Yang-dispersing property?
A: Wind Strike with fever and sweating indicates Wei insecurity and exterior looseness; why disperse? Yet the text mentions "inducing sweat" twice. Why? Scripture says: "Guizhi is primarily for resolving the muscle layer." And: "Do not give if there is no sweat." If it resolves the muscle layer and is contraindicated without sweat, is it for inducing sweat? Guizhi consolidates Wei; resolving the muscle layer is the profound meaning of treating Wind Strike. Who induces the sweat? Hot Porridge. This is the妙 (wonder). Han Xin placed soldiers in death ground to win; Zhongjing pairs Guizhi with hot porridge to induce sweat and achieve efficacy. Medicine and Strategy are connected. Only the most divine can achieve this. Those who find Guizhi difficult to use, did you know this? Alas, Zhongjing is distant; who can discuss this with him? Jia Yi said: "This is worth a long sigh."
Q: Guizhi resolves the muscle layer, yet it says "Induce Sweat, Guizhi Tang is appropriate." Why?
A: Wind is an external pathogen; initially, the method is to induce sweat. However, since sweat occurs spontaneously and Wei moves outside the vessels, it is primarily for resolving the muscle layer. "Induce Sweat" is a procedural statement; "Resolve Muscle Layer" is the substantive meaning. Resolving the muscle layer is the profound meaning. Understanding this allows one to pass the first gate. Those who claim Guizhi is hard to use, or classify it solely as a treatment for Sweating Shaoyang Disease, only know the procedure, not the meaning.
Q: Regarding "Xiang Qiang" (Stiff Neck).
A: Since *Shuowen*, it has been described as birds with short wings stretching their necks to fly. Zhongjing uses it to describe patients with stiff necks unable to nod or look up freely. Xiao Feng Wu's *Liushu Zongyao* illustrates this. I follow the old explanation here, disregarding textual debates.
Q: Climate differs: Southeast is warm, Northwest is cold. Some say Southerners don't get Wind-Cold but get Summer Heat/Dampness; Northerners don't get Summer Heat/Dampness but get Wind-Cold. Is this correct?
A: One cannot be bound by this. *Lingshu* states Heaven's wind is fair; those who encounter it get sick, those who avoid it do not. It is not that Heaven seeks people, but people encounter it. Disease depends on whether one encounters the Qi, not on regional bias. Southerners can get Wind-Cold; Northerners can get Summer Heat/Dampness. Events are accidental; principles vary. *Huainanzi* notes: Nomads wear fur for dry/cold; Yue people use hemp for heat/humidity. Each adapts to their environment. Soldiers say: Northern people eat meat/drink milk, have dense pores, resist cold; Southern people have loose pores, resist heat. This is nature. Though geography limits, Heaven completes human nature. Heaven's heart is to generate life; saying unequal Qi causes disease contradicts nature. It is an overstatement. Birds adapt best. Even in extreme places like ice fields or barren lands, sages like Yu, Zhuge Liang, and Su Wu survived without illness. This proves one can avoid disease. Thus, a gentleman's words must consider the whole world...