病有发热恶寒者，发于阳也，无热恶寒者，发于阴也。
无热，指初得病时，不是到底无热。发阴，指阳证之阴，非指直中于阴。阴阳指寒热，勿凿分营卫经络。
按本论云∶“太阳病，或未发热，或已发热。”已发热，即是发热恶寒；未发热，即是无热恶寒。斯时头项强
痛已见，第阳气闭郁，尚未宣发，其恶寒、体痛、呕逆、脉紧，纯是阴寒为病，故称发于阴，此太阳病发于阴
也。又《阳明篇》云∶“病得之一日，不发热而恶寒。”斯时寒邪凝敛，身热、恶热，全然未露，但不头项
强痛，是知阳明之病发于阴也。推此，则少阳往来寒热，但恶寒而脉弦细者，亦病发于阴；而三阴之反发热者，
便是发于阳矣。
发于阳者七日愈，发于阴者六日愈，以阳数七、阴数六故也。
寒热者，水火之本体；水火者，阴阳之征兆。七日合火之成数，六日合水之成数。至此则阴阳自和，故愈。
盖阴阳互为其根。阳中无阴，
谓之孤阳，阴中无阳，便是死阴。若是直中之阴，无一阳之生气，安得合六成之数而愈耶？《内经》曰∶“其死
多以六七日之间，其愈皆以十日以上。”使死期亦合阴阳之数，而愈期不合者，皆治者不如法耳。
问曰∶“凡病欲知何时得，何时愈？”答曰∶“假令夜半得病者，明日日中愈，日中得病者，夜半愈。何
以言之？日中得病夜半愈者，以阳得阴则解，夜半得病明日日中愈者，以阴得阳则解也。”
上文论日期，合阴阳之数而愈；此论愈时，于阴阳反盛时解。何也？阴盛极而阳生，阳盛极而阴生，阴阳
之相生，正阴阳之相得，即阴阳之自和也。然此指病在一二日愈者言耳。如六七日愈者，则六经各以主时解，
是又阳主昼而阴主夜矣。
问曰∶“脉有阴阳，何谓也？”答曰∶“凡脉浮、大、滑、动、数，此名阳也；脉沉、弱、涩、弦、微、
迟，此名阴也。”
脉有十种，阴阳两分，即具五法。浮、沉是脉体，大、弱是脉势，滑、涩是脉气，动、弦是脉形，迟、数
是脉息，总是病脉而非平脉也。脉有对看法，有正看法，有反看法，有平看法，有互看法，有彻底看法。如
有浮即有沉，有大即有弱，有滑即有涩，有数即有迟。合之于病。则浮为在表，沉为在里，大为有余，弱为不
足，滑为血多，涩为气少，动为搏阳，弦为搏阴，数为在府，迟为在藏，此对看法也。如浮、大、滑、动、数，
脉气之有余者，名阳，当知其中有阳胜阴病之机；沉、弱、涩、弦、迟，脉气之不足者，名阴，当知其中有阴胜
阳病之机，此正看法也。夫阴阳之在天地间也，有余而往，不足随之，不足而往，有余从之，知从知随，气可与
期。故其始为浮、为大、为滑、为动、为数，其继也反沉、反弱、反涩、反弦、反迟者，是阳消阴长之机，其病
为进；其始也为沉、为弱、为涩、为弦、为迟，其继也微浮、微大、微滑、微动、微数者，是阳进阴退之机，其
病为欲愈，此反看法也。浮为阳，如更兼大、动、滑、数之阳脉，是为纯阳，必阳盛阴虚之病矣；沉为阴，而更
兼弱、涩、弦、迟之阴脉，是为重阴，必阴盛阳虚之病矣，此为平看法。如浮而弱、浮而涩、浮而弦、浮而迟者，
此阳中有阴，其人阳虚，而阴气早伏于阳脉中也，将有
亡阳之变，当以扶阳为急务矣；如沉而大、沉而滑、沉而动、沉而数者，此阴中有阳，其人阴虚，而阳邪下陷
于阴脉中也，将有阴竭之患，当以存阴为深虑矣，此为互看法。如浮、大、滑、动、数之脉体虽不变，然始为有
力之强阳，终为无力之微阳，知阳将绝矣；沉、弱、涩、弦、迟之脉，虽喜变而为阳，如忽然暴见浮、大、滑、
动、数之状，是阴极似阳，知反照之不长，余烬之易灭也，是谓彻底看法。更有真阴真阳之看法，所谓阳者，胃
脘之阳也，脉有胃气，是知不死；所谓阴者，真藏之脉也，脉见真藏者死。然邪气之来也紧而疾，谷气之来也徐
而和，此又不得以迟数定阴阳矣。
寸口脉浮为在表，沉为在里，数为在府，迟为在藏。
寸口兼两手六部而言，不专指右寸也。上古以三部九候决死生，是遍求法；以人迎、寸口、趺阳辨吉凶，
是扼要法。自《难经》独取寸口，并人迎、趺阳不参矣。然气口成寸。为脉之大会，死生吉凶系焉，则内外脏腑
之诊，全赖浮沉、迟、数为大纲耳。浮、沉是审起伏，迟、数是察至数，浮、沉之间，迟、数寓焉。凡脉之不
浮、不沉而在中，不迟、不数而五至者谓之平脉。是有胃气，可以神求，不可以象求也。若一见浮、沉、迟、数
之象，斯为病脉矣。浮象在表，应病亦为在表，浮脉虽有里证，主表其大纲也；沉象在里，应病亦为在里，沉脉
虽或有表证，主里其大纲也。数为阳，阳主热，而数有浮、沉，浮数应表热，沉数应里热，虽数脉亦有病在藏者，
然六腑为阳，阳脉营其府，则主府其大纲也；迟为阴，阴主寒，而迟有浮、沉，浮迟应表寒，沉迟应里寒，虽
迟脉多有病在府者，然五脏为阴，而阴脉营其藏，则主藏其大纲也。脉状种种，总赅括于浮、沉、迟、数，然四
者之中，又以独浮、独沉、独迟、独数为准则，而独见何部，即以何部深求其表里脏腑之所在，病无遁情矣。
凡阴病见阳脉者生，阳病见阴脉者死。
起口用“凡字”。是开讲法，不是承接法。此与上文阴阳脉文同而义则异也。阳脉指胃气言，所谓二十五阳
者是也，五脏之阳和发见故生∶阴脉指真藏言，胃脘之阳不至于手太阴，五脏之真阴发见故死。要知上文沉、涩、
弱、弦、迟是病脉，不是死脉，其见于阳病最多。若真藏脉至，如肝脉中外急，心脉坚而搏，肺脉大而浮，肾脉
之如弹石，脾
脉之如喙距，反见有余之象，岂可以阳脉名之？若以胃脉为迟，真阴为数，能不误人耶？
寸脉下不至关为阳绝，尺脉上不至关为阴绝，此皆不治决死也。若计余命生死之期，期以月节克之也。
阴阳升降，以关为界。阳生于尺而动于寸，阴生于寸而动于尺，阴阳互根之义也。寸脉居上而治阳，尺脉生
下而治阴，上下分司之义也。寸脉不至关，则阳不生阴。是为孤阳，阳亦将绝矣；尺不至关，则阴不生阳，是
为孤阴，阴亦将绝矣。要知不至关，非脉竟不至，是将绝之兆，而非竟绝也，正示人以可续之机。此皆不治，
言皆因前此失治以至此，非言不可治也，正欲人急治之意，是先一着看法。夫上部有脉，下部无脉，尚有吐法；
上部无脉，下部有脉，尚为有根，即脉绝不至，尚有灸法。岂以不至关便为死脉哉？看“余命生死”句。则知
治之而有余命，不为月节所克者多耳，此又深一层看法。脉以应月，每月有节，节者月之关也。失时不治，则
寸脉不至关者，遇月建之属阴，必克阳而死；尺脉不至关者，遇月建之阳支，则克阴而死，此是决死期之法。若
治之得宜，则阴得阳而解，阳得阴而解，阴阳自和而愈矣。
问曰∶“脉欲知病愈未愈者，何以别之？”曰∶“寸口、关上、尺中三处，大小、浮沉、迟数同等，虽有
寒热不解者，此脉阴阳为和平，虽剧当愈。”
阴阳和平，不是阴阳自和，不过是纯阴纯阳无驳杂之谓耳。究竟是病脉，是未愈时寒热不解之脉。虽剧当
愈，非言不治自愈，正使人知此为阴阳偏胜之病脉，阳剧者当治阳，阴剧者当治阴，必调其阴阳，使其和平。失
此不治，反加剧矣。
伤寒一日，太阳受之。脉若静者为不传，颇欲吐，若躁烦。脉数急者，为传也。
太阳主表，故寒邪伤人，即太阳先受。太阳脉浮，若见太阳之浮。不兼伤寒之紧，即所谓静也。脉静证亦
静，无呕逆烦躁可知。今又有发热恶寒，头项强痛，不须七日衰，一日自止者，正此不传之谓也。若受寒之日，颇
有吐意，呕逆之机见矣。若见烦躁，阳气重可知矣。脉急
数，阴阳俱紧之互文。传者，即《内经》“人伤于寒，而传为热”之“传”，乃太阳之气，生热而传于表。即
发于阳者传七日之谓，非太阳与阳明、少阳经络相传之谓也。欲字、若字，是审其将然，脉之数急，是诊其已
然，此因脉定证之法也。
伤寒二三日，阳明、少阳证不见者，为不传也。
伤寒一日太阳，二日阳明，三日少阳者，是言见症之期，非传经之日也。岐伯曰∶“邪中于面，则下阳明；
中于项，则下太阳；中于颊，则下少阳。其中膺背两胁，亦中其经。”盖太阳经部位最高，故一日发；阳明经位
次之，故二日发，少阳经位又次之，故三日发。是气有高下，病有远近，适其至所为故也。夫三阳各受寒邪，
不必自太阳始。诸家言二阳必自太阳传来者，未审斯义耳。若伤寒二日，当阳明病，若不见阳明表证。是阳明
之热不传于表也。三日少阳当病，不见少阳表证，是少阳之热不传于表也。
伤寒三日，三阳为尽，三阴当受邪。其人反能食而不呕，此为三阴不受邪也。
受寒三日，不见三阳表症，是其人阳气冲和，不与寒争，寒邪亦不得入，故三阳尽不受邪也。若阴虚而不
能支，则三阴受邪气。岐伯曰∶“中于阴者，从臂 始。”故三阴各自受寒邪，不必阳经传授。所谓太阴四日、
少阴五日、厥阴六日者，亦以阴经之高下，为见症之期，非六经部位以次相传之日也。三阴受邪，病为在里。故
邪入太阴，则腹满而吐，食不下；邪入少阴，欲吐不吐；邪入厥阴，饥而不欲食，食即吐蛔。所以然者，邪自
阴经入藏，藏气实而不能容，则流于府。府者胃也，入胃则无所复传，故三阴受病。已入于府者，可下也。若胃
阳有余，则能食不呕，可预知三阴之不受邪矣，盖三阳皆看阳明之转旋。三阴之不受邪者，藉胃为之蔽其外也，
则胃不特为六经出路，而实为三阴外蔽矣。胃阳盛，则寒邪自解；胃阳虚，则寒邪深入阴经而为患；胃阳亡，
则水浆不入而死。要知三阴受邪，关系不在太阳而全在阳明。
伤寒六七日，无大热，其人躁烦者，此为阳去入阴故也。
上文论各经自受寒邪，此条是论阳邪自表入里症也。凡伤寒发
热至六七日，热退身凉为愈。此无大热则微热尚存，若内无烦躁，亦可云表解而不了了矣。伤寒一日即见烦躁，
是阳气外发之机；六七日乃阴阳自和之际，反见烦躁，是阳邪内陷之兆。阴者指里而言，非指三阴也。或入太
阳之本，而热结膀胱；或入阳明之本，而胃中干燥；或入少阳之本，而胁下硬满，或入太阴，而暴烦下利；或
入少阴，而口燥舌干；或入厥阴，而心中疼热，皆入阴之谓。
太阳病，头痛至七日以上自愈者，以行其经尽故也。若欲再作经者，针足阳明，使经不传则愈。
旧说伤寒日传一经，六日至厥阴，七日再传太阳，八日再传阳明，谓之再经。自此说行，而仲景之堂无门
可入矣。夫仲景未尝有日传一经之说，亦未有传至三阴而尚头痛者。曰头痛者，是未离太阳可知；曰行，则与
传不同；曰其经，是指本经而非他经矣。发于阳者七日愈，是七日乃太阳一经行尽之期，不是六经传变之日。
岐伯曰“七日太阳病衰，头痛少愈，”有明证也。故不曰传足阳明，而曰欲再作经，是太阳过经不解，复病阳
明而为并病也。针足阳明之交，截其传路，使邪气不得再入阳明之经，则太阳之余邪亦散，非归并阳明，使
不犯少阳之谓也。
本论传经之说，惟见于此。盖阳明经起于鼻 旁纳太阳之脉，故有传经之义。目疼、鼻干，是其症也。若
脚挛急，便非太阳传经矣。阳明经出大指端内侧，太阳经出小指端外侧，经络不相连接。十二经脉，足传手，
手传足，阳传阴，阴传阳，与伤寒之六经先阳后阴，先太后少之次第迥别。不知太阳传六经，阳明传少阳之说
何据乎？细审仲景转属、转系、并病、合病诸条，传经之妄，不辨自明矣。
风家表解而不了了者，十二日愈。
不了了者，余邪未除也。七日表解后，复过一候，而五脏元气始充，故十二日精神慧爽而愈。此虽举风家，
伤寒概之矣。如太阳七日病衰，头痛少愈，曰衰曰少，皆表解而不了了之谓也。六经部位有高下，故发病有迟
早之不同。如阳明二日发，八日衰，厥阴至六日发，十二日衰，则六经皆自七日解，而十二日愈。夫若误治，
又不在此例。
仲景分别六经，各经俱有中风伤寒脉症治法。叔和时太阳篇存
者多，而失者少，他经存者少，而失者多。阳明篇尚有中风脉症二条。少阳经只症一条而不及脉。三阴俱有中
风欲愈脉，俱无中风脉症。以《伤寒论》为全书，不亦疏乎？
上论伤寒诊病大略。
疾病有发热且恶寒的，是发于阳经；没有发热而只恶寒的，是发于阴经。
“无热”，是指刚得病的时候，并不是指到最后都没有热。“发阴”，是指阳证中表现为阴的一面，并非指寒邪直接侵入阴经。这里的阴阳指的是寒热表现，不要机械地分割为营卫或经络。
按《伤寒论》原文说：“太阳病（太阳经受邪所致的病证），有的尚未发热，有的已经发热。”已经发热，就是发热恶寒；尚未发热，就是无热恶寒。在这个时候，头项强痛的症状已经出现，只是阳气闭郁，还没有宣发出来，此时的恶寒、身体疼痛、呕吐气逆、脉象紧，纯粹是阴寒性质的病，所以称为发于阴，这是太阳病发于阴的情况。又《阳明篇》说：“患病第一天，不发热而恶寒。”这个时候寒邪凝敛，身热、恶热的症状完全没显露出来，只是不像太阳病那样头项强痛，由此可知这是阳明病发于阴。推究这一点，那么少阳病的往来寒热，如果只有恶寒且脉象弦细的，也是病发于阴；而三阴病（太阴、少阴、厥阴病）反而发热的，就是发于阳了。
发于阳的七天痊愈，发于阴的六天痊愈，这是因为阳数七、阴数六的缘故。
寒和热，是水与火的本体；水和火，是阴阳的征兆。七天符合火之成数，六天符合水之成数。到了这个时候，阴阳自然调和，所以痊愈。
大概阴阳互为根本。阳中没有阴，叫做孤阳；阴中没有阳，便是死阴。如果是寒邪直中的阴证，没有一点阳气的生气，怎么能符合六成之数而痊愈呢？《内经》说：“死亡多发生在六七天之间，痊愈都在十天以上。”如果死期也符合阴阳之数，而痊愈期不符合，都是治疗不得法罢了。
问曰：“凡是生病，想知道什么时候得的，什么时候好？”回答说：“假设半夜得病，第二天中午痊愈；中午得病，半夜痊愈。为什么这样说？中午得病半夜痊愈，是因为阳得到阴则解；半夜得病第二天中午痊愈，是因为阴得到阳则解。”
上文论述日期，是结合阴阳之数而愈；这里论述痊愈的时间，是在阴阳反盛的时候解除。为什么呢？阴盛极则阳生，阳盛极则阴生，阴阳的相生，正是阴阳的相得，也就是阴阳的自和。然而这指的是病在一两天内痊愈的情况。如果是六七天痊愈的，则是六经各自在其主时解除，这又是阳主昼、阴主夜了。
问曰：“脉象有阴阳之分，是什么意思？”回答说：“凡是脉象浮、大、滑、动、数，这叫阳脉；脉象沉、弱、涩、弦、微、迟，这叫阴脉。”
脉象有十种，分为阴阳两类，就具备了五种法则。浮、沉是脉体，大、弱是脉势，滑、涩是脉气，动、弦是脉形，迟、数是脉息，这些都是病脉而不是平脉（正常脉象）。脉象有对看的方法，有正看的方法，有反看的方法，有平看的方法，有互看的方法，有彻底看的方法。比如有浮就有沉，有大就有弱，有滑就有涩，有数就有迟。结合病症来看，则浮表示在表，沉表示在里，大表示有余，弱表示不足，滑表示血多，涩表示气少，动表示搏动于阳，弦表示搏动于阴，数表示在腑，迟表示在脏，这是对看法。比如浮、大、滑、动、数，是脉气有余的，名叫阳，应当知道其中有阳胜阴病的机会；沉、弱、涩、弦、迟，是脉气不足的，名叫阴，应当知道其中有阴胜阳病的机会，这是正看法。夫阴阳在天地间，有余而去，不足随之；不足而去，有余从之。知道随从跟随的道理，就可以预测气的变化。所以起初是浮、大、滑、动、数，后来反而变成沉、弱、涩、弦、迟的，这是阳消阴长的机转，病情在进展；起初是沉、弱、涩、弦、迟，后来微微变成浮、大、滑、动、数的，这是阳进阴退的机转，病情将要痊愈，这是反看法。浮为阳，如果再兼见大、动、滑、数的阳脉，这是纯阳，必定是阳盛阴虚的病；沉为阴，如果再兼见弱、涩、弦、迟的阴脉，这是重阴，必定是阴盛阳虚的病，这是平看法。比如浮而弱、浮而涩、浮而弦、浮而迟的，这是阳中有阴，其人阳虚，而阴气早已潜伏在阳脉中，将有亡阳的变化，应当以扶阳为紧急事务；比如沉而大、沉而滑、沉而动、沉而数的，这是阴中有阳，其人阴虚，而阳邪下陷于阴脉中，将有阴竭的祸患，应当以存阴为深虑，这是互看法。比如浮、大、滑、动、数的脉体虽然不变，但开始是有力的强阳，最终是无力的微阳，知道阳气将绝了；沉、弱、涩、弦、迟的脉，虽然喜欢变为阳脉，如果忽然暴现出浮、大、滑、动、数的状态，这是阴极似阳，知道反光不会长久，余烬容易熄灭，这叫彻底看法。更有真阴真阳的看法，所谓阳，是指胃脘之阳，脉有胃气，就知道不死；所谓阴，是指真藏之脉，脉见真藏者死。然而邪气来势紧而急，谷气来势缓而柔和，这又不能单纯用迟数来定阴阳了。
寸口脉浮表示病在表，沉表示病在里，数表示病在腑，迟表示病在脏。
寸口兼指两手六部而言，不专指右寸。上古时期用三部九候决断生死，这是遍求法；用人迎、寸口、趺阳辨别吉凶，这是扼要法。自从《难经》独取寸口，就不参用人迎、趺阳了。然而气口成为寸脉，是脉的大会，生死吉凶都系于此，那么内外脏腑的诊断，全赖浮、沉、迟、数为大纲。浮、沉是审察起伏，迟、数是察看出至数，在浮、沉之间，寓含着迟、数。凡是脉象不浮、不沉而在中间，不迟、不数而五至的叫做平脉。这是有胃气，可以用神意去寻求，不可以用形象去追求。如果一见浮、沉、迟、数的形象，这就是病脉了。浮象在表，对应病症也在表，浮脉虽然有里证，但主表是其大纲；沉象在里，对应病症也在里，沉脉虽然或有表证，但主里是其大纲。数为阳，阳主热，而数脉有浮、沉之分，浮数应表热，沉数应里热，虽然数脉也有病在脏的，然六腑为阳，阳脉营运于其腑，则主腑是其大纲；迟为阴，阴主寒，而迟脉有浮、沉之分，浮迟应表寒，沉迟应里寒，虽然迟脉多有病在腑的，然五脏为阴，而阴脉营运于其脏，则主脏是其大纲。脉状种种，总括于浮、沉、迟、数之中，然而这四者之中，又以独浮、独沉、独迟、独数为准则，独见于哪一部，就以哪一部深入探求表里脏腑所在，病情就没有隐藏的了。
凡是阴病见到阳脉的预后良好，阳病见到阴脉的预后不良。
起句用“凡”字，是开讲法，不是承接法。这与上文的阴阳脉文同义则异。阳脉指胃气而言，所谓二十五阳就是这种，五脏之阳和谐发散故生；阴脉指真藏脉而言，胃脘之阳不至手太阴，五脏之真阴发散故死。要知道上文说的沉、涩、弱、弦、迟是病脉，不是死脉，它们见于阳病最多。如果真藏脉出现，如肝脉中外急，心脉坚而搏，肺脉大而浮，肾脉像弹石，脾脉像鸟嘴，反而呈现有余的现象，怎么可以叫阳脉呢？如果把胃脉定为迟，真阴定为数，能不误人吗？
寸脉下不到关部为阳绝，尺脉上不到关部为阴绝，这都是不治必死的决断。如果要计算剩余寿命和死亡的期限，是以月令节气相克来推算的。
阴阳升降，以关部为界。阳生于尺部而作用于寸部，阴生于寸部而作用于尺部，这是阴阳互根的意义。寸脉居上而治阳，尺脉生在下而治阴，这是上下分司的意义。寸脉不到关部，则阳不生阴，这叫孤阳，阳也将绝了；尺脉不到关部，则阴不生阳，这叫孤阴，阴也将绝了。要知道不到关部，不是脉竟完全不至，是将绝的征兆，而非竟然绝灭，正是指示给人可续接的生机。这里说不治，是说都因为此前失治才到这一步，不是说不可治，正是想要人急忙治疗的意思，这是先一步的看法。上部有脉，下部无脉，还有吐法可用；上部无脉，下部有脉，尚且有根，即使脉绝不至，还有灸法可用。怎么能因为不到关部就认为是死脉呢？看“余命生死”这句话，就知道治疗后还有余命的，不被月节所克的很多，这又是更深一层的看法。脉象对应月份，每月有节气，节气就是月的关隘。失时不治，那么寸脉不到关部的，遇到月建属阴的时候，必克阳而死；尺脉不到关部的，遇到月建属阳支的时候，则克阴而死，这是决断死期的方法。如果治疗得当，则阴得到阳则解，阳得到阴则解，阴阳自和而痊愈了。
问曰：“脉象想知病愈未愈，如何区别？”回答说：“寸口、关上、尺中三处，大小、浮沉、迟数同等，虽然有寒热不解的，此脉阴阳为和平，虽然严重也会痊愈。”
阴阳和平，不是阴阳自和，不过是纯阴纯阳无驳杂的意思罢了。终究还是病脉，是未愈时寒热不解的脉。虽然严重也会痊愈，不是说不治自愈，正是让人知道这是阴阳偏胜的病脉，阳剧者当治阳，阴剧者当治阴，必须调其阴阳，使其和平。失去这个时机不治，反而加剧了。
伤寒第一天，太阳经受邪。脉象若静稳的是不传变，很想要吐，或者躁烦，脉数急的，是传变了。
太阳主表，所以寒邪伤人，即太阳先受邪。太阳脉浮，如果见到太阳之浮脉，不兼伤寒之紧脉，就是所谓的静。脉静证亦静，可知无呕逆烦躁。现在又有发热恶寒，头项强痛，不须七天衰退，一天自止的，正是这不传变的说法。如果受寒的那天，很有吐意，呕逆之机已现。如果见烦躁，可知阳气重了。脉急数，是阴阳俱紧的互文。传，即《内经》“人伤于寒，而传为热”的“传”，乃太阳之气，生热而传于表。即发于阳者传七天的说法，不是太阳与阳明、少阳经络相传的说法。欲字、若字，是审察其将然，脉之数急，是诊察其已然，这是因脉定证的方法。
伤寒二三天，不见阳明、少阳证的，是不传变。
伤寒第一天太阳，第二天阳明，第三天少阳，是说见症的时期，不是传经的日子。岐伯说：“邪中于面，则下阳明；中于项，则下太阳；中于颊，则下少阳。其中膺背两胁，亦中其经。”大概太阳经部位最高，所以第一天发；阳明经位次之，所以第二天发，少阳经位又次之，所以第三天发。这是气有高下，病有远近，适其至所为的缘故。夫三阳各受寒邪，不必自太阳始。诸家说二阳必自太阳传来，是不明此义。如果伤寒第二天，当阳明病，如果不见阳明表证，是阳明之热不传于表。第三天少阳当病，不见少阳表证，是少阳之热不传于表。
伤寒三天，三阳为尽，三阴当受邪。其人反而能食而不呕，这是三阴不受邪。
受寒三天，不见三阳表症，是其人阳气冲和，不与寒争，寒邪亦不得入，故三阳尽不受邪。如果阴虚而不能支撑，则三阴受邪气。岐伯说：“中于阴者，从臂始。”故三阴各自受寒邪，不必阳经传授。所谓太阴第四日、少阴第五日、厥阴第六日，也是以阴经的高下，为见症的时期，不是六经部位依次相传的日子。三阴受邪，病为在里。故邪入太阴，则腹满而吐，食不下；邪入少阴，欲吐不吐；邪入厥阴，饥而不欲食，食即吐蛔。之所以这样，是因为邪自阴经入脏，脏气实而不能容，则流于腑。腑者胃也，入胃则无所复传，故三阴受病。已入于腑者，可下也。如果胃阳有余，则能食不呕，可预知三阴之不受邪矣，盖三阳皆看阳明之转旋。三阴之不受邪者，藉胃为之蔽其外也，则胃不特为六经出路，而实为三阴外蔽矣。胃阳盛，则寒邪自解；胃阳虚，则寒邪深入阴经而为患；胃阳亡，则水浆不入而死。要知道三阴受邪，关系不在太阳而全在阳明。
上文论各经自受寒邪，此条是论阳邪自表入里的症候。凡伤寒发热至六七天，热退身凉为愈。这里无大热则微热尚存，如果内无烦躁，也可以说是表解而不了了（精神不爽快）。伤寒第一天就见烦躁，是阳气外发的机转；六七天乃阴阳自和之际，反见烦躁，是阳邪内陷的征兆。阴者指里而言，非指三阴。或入太阳之本，而热结膀胱；或入阳明之本，而胃中干燥；或入少阳之本，而胁下硬满，或入太阴，而暴烦下利；或入少阴，而口燥舌干；或入厥阴，而心中疼热，皆入阴的说法。
太阳病，头痛至七天以上自愈的，是因为行其经尽的缘故。如果想要再作经的，针刺足阳明经穴，使经不传则愈。
旧说伤寒日传一经，六日至厥阴，七日再传太阳，八日再传阳明，谓之再经。自此说流行，而仲景之堂无门可入了。夫仲景未曾有日传一经之说，也未有传至三阴而尚头痛者。曰头痛，是未离太阳可知；曰行，则与传不同；曰其经，是指本经而非他经。发于阳者七日愈，是七日乃太阳一经行尽之期，不是六经传变之日。岐伯说“七日太阳病衰，头痛少愈”，有明证。故不曰传足阳明，而曰欲再作经，是太阳过经不解，复病阳明而为并病。针足阳明之交，截其传路，使邪气不得再入阳明之经，则太阳之余邪亦散，非归并阳明，使不犯少阳的说法。
本论传经之说，惟见于此。盖阳明经起于鼻旁纳太阳之脉，故有传经之义。目疼、鼻干，是其症。如果脚挛急，便非太阳传经。阳明经出大指端内侧，太阳经出小指端外侧，经络不相连接。十二经脉，足传手，手传足，阳传阴，阴传阳，与伤寒之六经先阳后阴，先太后少之次第迥别。不知太阳传六经，阳明传少阳之说何据乎？细审仲景转属、转系、并病、合病诸条，传经之妄，不辨自明。
风家表解而不了了（精神不爽快）的，十二日愈。
不了了，是余邪未除。七日表解后，复过一候，而五脏元气始充，故十二日精神慧爽而愈。此虽举风家，伤寒概之。如太阳七日病衰，头痛少愈，曰衰曰少，皆表解而不了了之谓。六经部位有高下，故发病有迟早之不同。如阳明二日发，八日衰，厥阴至六日发，十二日衰，则六经皆自七日解，而十二日愈。如果误治，又不在此例。
仲景分别六经，各经俱有中风伤寒脉症治法。叔和时太阳篇存者多，而失者少，他经存者少，而失者多。阳明篇尚有中风脉症二条。少阳经只症一条而不及脉。三阴俱有中风欲愈脉，俱无中风脉症。以《伤寒论》为全书，不亦疏乎？
以上论述伤寒诊病大略。
Diseases manifesting with fever and aversion to cold originate in the Yang channels; those without fever but with aversion to cold originate in the Yin channels.
"No fever" refers to the initial stage of the disease, not that there is no fever until the end. "Originating in Yin" refers to the Yin aspect within a Yang syndrome, not direct invasion into the Yin channels. Here, Yin and Yang refer to cold and heat manifestations; do not rigidly divide them into Ying (Nutrient) and Wei (Defensive) or meridians.
According to the Treatise: "Taiyang disease may present either without fever or with fever." Fever indicates fever with aversion to cold; absence of fever indicates no fever with aversion to cold. At this time, stiffness and pain of the head and neck are already present, but Yang Qi is constrained and has not yet been released. The aversion to cold, body pain, vomiting, and tight pulse are purely due to Yin-Cold pathogenic factors, hence termed "originating in Yin"; this is Taiyang disease originating in Yin. Furthermore, the Yangming Chapter states: "On the first day of illness, there is no fever but aversion to cold." At this time, Cold-Evil is constricting, and symptoms of body heat and aversion to heat have not yet appeared. However, unlike Taiyang disease, there is no stiffness and pain of the head and neck; thus, we know this is Yangming disease originating in Yin. By extension, Shaoyang disease with alternating chills and fever, if presenting only with aversion to cold and a wiry-thin pulse, also originates in Yin; conversely, San-Yin diseases (Taiyin, Shaoyin, Jueyin) that present with fever originate in Yang.
Those originating in Yang heal in seven days; those originating in Yin heal in six days, because Seven is the number of Yang and Six is the number of Yin.
Cold and Heat are the substance of Water and Fire; Water and Fire are the signs of Yin and Yang. Seven days correspond to the completed number of Fire; six days correspond to the completed number of Water. Upon reaching these points, Yin and Yang naturally harmonize, leading to recovery.
Yin and Yang are mutually rooted. Yang without Yin is called Solitary Yang; Yin without Yang is Dead Yin. If it were direct invasion by Yin pathogen with no vital Yang Qi, how could it conform to the number of Six for healing? The *Nei Jing* states: "Death often occurs between the sixth and seventh day, while recovery usually takes ten days or more." If the time of death conforms to the numbers of Yin and Yang, but the time of recovery does not, it is due to improper treatment.
Question: "For any disease, how can one know when it was contracted and when it will heal?" Answer: "Suppose illness begins at midnight; it will heal at noon the next day. If it begins at noon, it will heal at midnight. Why? Because Noon illness heals at midnight as Yang resolves upon receiving Yin; Midnight illness heals at noon as Yin resolves upon receiving Yang."
The previous section discussed dates, healing according to the numbers of Yin and Yang; this section discusses the timing of healing, resolving during times of reversed excess of Yin and Yang. Why? When Yin reaches extreme excess, Yang is born; when Yang reaches extreme excess, Yin is born. The mutual generation of Yin and Yang is their mutual attunement, which is the self-harmonization of Yin and Yang. However, this refers to cases healing within one or two days. For cases healing in six or seven days, the Six Channels resolve according to their respective dominant times, indicating that Yang governs the day and Yin governs the night.
Question: "Pulses have Yin and Yang distinctions; what does this mean?" Answer: "Floating, large, slippery, agitated, and rapid pulses are named Yang; Deep, weak, choppy, wiry, minute, and slow pulses are named Yin."
There are ten types of pulses, divided into two Yin-Yang categories, encompassing five methods. Floating and Deep are pulse bodies; Large and Weak are pulse momentum; Slippery and Choppy are pulse Qi; Agitated and Wiry are pulse shape; Slow and Rapid are pulse frequency. These are all pathological pulses, not normal pulses. Pulse analysis involves looking oppositely, directly, inversely, equally, mutually, and thoroughly. For example, where there is Floating, there is Deep; where there is Large, there is Weak; where there is Slippery, there is Choppy; where there is Rapid, there is Slow. Correlating with disease: Floating indicates exterior; Deep indicates interior; Large indicates excess; Weak indicates deficiency; Slippery indicates abundant blood; Choppy indicates deficient Qi; Agitated indicates striking Yang; Wiry indicates striking Yin; Rapid indicates Fu organs; Slow indicates Zang organs. This is the method of looking oppositely. Floating, Large, Slippery, Agitated, and Rapid pulses indicate excess pulse Qi, named Yang; one must recognize the mechanism of Yang prevailing over Yin disease therein. Deep, Weak, Choppy, Wiry, and Slow pulses indicate deficient pulse Qi, named Yin; one must recognize the mechanism of Yin prevailing over Yang disease therein. This is the method of looking directly. In the world, where there is excess, deficiency follows; where there is deficiency, excess follows. Knowing this allows prediction of Qi changes. Thus, if initially Floating, Large, Slippery, Agitated, Rapid, but later becoming Deep, Weak, Choppy, Wiry, Slow, this is the mechanism of Yang declining and Yin growing, indicating disease progression. Conversely, if initially Deep, Weak, Choppy, Wiry, Slow, but later slightly becoming Floating, Large, Slippery, Agitated, Rapid, this is the mechanism of Yang advancing and Yin retreating, indicating impending recovery. This is the method of looking inversely. Floating is Yang; if accompanied by Large, Agitated, Slippery, Rapid Yang pulses, it is Pure Yang, indicating Yang excess and Yin deficiency disease. Deep is Yin; if accompanied by Weak, Choppy, Wiry, Slow Yin pulses, it is Heavy Yin, indicating Yin excess and Yang deficiency disease. This is the method of looking equally. If Floating is combined with Weak, Choppy, Wiry, or Slow, this is Yang containing Yin; the person has Yang deficiency, and Yin Qi has潜伏 (latent) within the Yang pulse, predisposing to collapse of Yang; urgent support of Yang is required. If Deep is combined with Large, Slippery, Agitated, or Rapid, this is Yin containing Yang; the person has Yin deficiency, and Yang Evil has sunk into the Yin pulse, predisposing to exhaustion of Yin; deep concern for preserving Yin is needed. This is the method of looking mutually. If the pulse bodies Floating, Large, Slippery, Agitated, Rapid remain unchanged, but shift from strong Yang force to weak Yang force, it indicates impending Yang collapse. If Deep, Weak, Choppy, Wiry, Slow pulses suddenly appear as Floating, Large, Slippery, Agitated, Rapid, this is Yin extreme resembling Yang; knowing that reflected light does not last long and embers extinguish easily, this is the method of looking thoroughly. There is also the view of True Yin and True Yang. What is called Yang is the Yang of the Stomach region; if the pulse has Stomach Qi, death is avoided. What is called Yin is the True Organ pulse; appearance of True Organ pulses indicates death. However, when Evil Qi arrives, it is tight and rapid; when Grain Qi arrives, it is slow and harmonious. Thus, Yin and Yang cannot be determined solely by Slowness and Rapidity.
At the Cun Kou (Radial Artery), Floating indicates Exterior; Deep indicates Interior; Rapid indicates Fu organs; Slow indicates Zang organs.
Cun Kou refers to both hands' six positions, not just the right Cun. In ancient times, the Three Regions and Nine Positions were used to determine life and death (comprehensive method); using Ying Chang, Cun Kou, and Zu Yang to distinguish auspiciousness and inauspiciousness was the key method. Since the *Nan Jing*, only Cun Kou is taken, excluding Ying Chang and Zu Yang. However, since Qi Kou becomes Cun and is the great meeting of pulses, determining life/death and fortune/misfortune, diagnosis of internal/external and Zang/Fu organs relies entirely on Floating, Deep, Slow, and Rapid as the main principles. Floating and Deep examine rising/falling; Slow and Rapid examine frequency. Between Floating and Deep, Slow and Rapid are contained. A pulse that is neither Floating nor Deep, located in the middle, and neither Slow nor Rapid, beating five times per respiration, is a Normal Pulse. It possesses Stomach Qi, which can be perceived spiritually but not sought through form. Once Floating, Deep, Slow, or Rapid forms appear, they become pathological pulses. Floating form is in the Exterior, corresponding to Exterior disease; although Floating pulses may have Interior signs, governing the Exterior is the main principle. Deep form is in the Interior, corresponding to Interior disease; although Deep pulses may have Exterior signs, governing the Interior is the main principle. Rapid is Yang, Yang governs Heat; Rapid pulses have Floating and Deep variations. Floating-Rapid corresponds to Exterior Heat; Deep-Rapid corresponds to Interior Heat. Although Rapid pulses can indicate Zang disease, since Fu organs are Yang and Yang pulses nourish Fu organs, governing Fu organs is the main principle. Slow is Yin, Yin governs Cold; Slow pulses have Floating and Deep variations. Floating-Slow corresponds to Exterior Cold; Deep-Slow corresponds to Interior Cold. Although Slow pulses often indicate Fu disease, since Zang organs are Yin and Yin pulses nourish Zang organs, governing Zang organs is the main principle. Various pulse conditions are summarized by Floating, Deep, Slow, and Rapid. Among these, isolated Floating, Deep, Slow, or Rapid serve as criteria. Wherever an isolated pulse appears, investigate the specific location's Exterior/Interior and Zang/Fu to uncover the disease fully.
Generally, Yin diseases showing Yang pulses indicate survival; Yang diseases showing Yin pulses indicate death.
The use of "Generally" opens the lecture, not continuing from before. This differs from the previous text on Yin-Yang pulses in meaning. Yang pulses refer to Stomach Qi (the so-called Twenty-Five Yangs); harmony of Zang Yang leads to life. Yin pulses refer to True Organ pulses; if Stomach Yang does not reach the Hand-Taiyin channel, manifestation of True Yin of Zang organs leads to death. Note that the previously mentioned Deep, Choppy, Weak, Wiry, Slow are pathological, not necessarily fatal pulses, often seen in Yang diseases. If True Organ pulses appear—Liver pulse tense inside/outside, Heart pulse firm and pounding, Lung pulse large and floating, Kidney pulse like rolling stones, Spleen pulse like bird beaks—showing excess signs, how can these be called Yang pulses? If one defines Stomach pulse as Slow and True Yin as Rapid, it would mislead people.
If the Cun pulse does not reach the Guan position, it is Yang Collapse; if the Chi pulse does not reach the Guan position, it is Yin Collapse. Both are untreatable and fatal determinations. To calculate remaining lifespan and time of death, one uses the clash of monthly solar terms.
Yin and Yang rise and fall, with Guan as the boundary. Yang originates at Chi and acts at Cun; Yin originates at Cun and acts at Chi, reflecting mutual rooting. Cun is superior and governs Yang; Chi is inferior and governs Yin, reflecting division of labor. If Cun does not reach Guan, Yang cannot generate Yin, called Solitary Yang, leading to Yang collapse. If Chi does not reach Guan, Yin cannot generate Yang, called Solitary Yin, leading to Yin collapse. Note that "not reaching Guan" is a sign of impending collapse, not absolute cessation, indicating a chance for continuation. Saying "untreatable" means caused by prior neglect, not that it is incurable, urging urgent treatment. If Upper pulses exist but Lower pulses do not, emetic therapy is possible; if Upper pulses do not exist but Lower pulses do, roots remain; even if pulses cease, moxibustion is possible. How can non-reaching Guan be deemed fatal? Regarding "remaining life," many survive treatment and escape monthly clashes. Pulses correspond to months; each month has a term, the Guan of the month. If neglected, Cun not reaching Guan meets Yin months, clashing Yang to death; Chi not reaching Guan meets Yang months, clashing Yin to death. This is the method for determining death time. With proper treatment, Yin receives Yang to resolve, Yang receives Yin to resolve, Yin and Yang self-harmonize and recover.
Question: "How to distinguish whether a disease will heal or not via pulses?" Answer: "If at Cun, Guan, and Chi positions, the size, Floating/Deep, Slow/Rapid are equal, even if Chills/Heat persist, the pulse indicates Yin-Yang peace. Though severe, it will heal."
Yin-Yang peace here means pure Yin or pure Yang without mixture, not self-harmonization. It remains a pathological pulse for unresolved Chills/Heat. "Though severe, it will heal" does not mean spontaneous recovery without treatment, but rather recognizing this as a pulse of Yin-Yang imbalance. Excess Yang requires treating Yang; excess Yin requires treating Yin. One must regulate Yin and Yang to achieve peace. Neglecting this worsens the condition.
In Shanghan (Cold Damage) on Day 1, Taiyang is affected. If the pulse is quiet, transmission has not occurred. If there is strong desire to vomit or restlessness/agitation, and the pulse is rapid and urgent, transmission has occurred.
Taiyang governs the Exterior, so Cold-Evil affects Taiyang first. Taiyang pulse is Floating. If Floating is seen without the Tightness of Cold-Damage, it is "quiet." Quiet pulse implies quiet symptoms, no vomiting or agitation. Now, with fever, aversion to cold, head/neck stiffness, if it stops spontaneously on Day 1 without waiting for Day 7 decline, this is "no transmission." If on the day of Cold contraction, there is urge to vomit, vomiting mechanism is present. Restlessness indicates heavy Yang Qi. Urgent-Rapid pulse is a rhetorical variation of "both Yin and Yang are Tight." Transmission refers to the *Nei Jing* concept "Man injured by Cold transmits to Heat." It is Taiyang Qi generating Heat and transmitting to the Exterior. This aligns with "originating in Yang" transmitting after seven days, not meridian-to-meridian transmission between Taiyang, Yangming, and Shaoyang. "Desire" and "if" examine potentiality; Rapid-Urgent pulse examines actuality. This is the method of determining symptoms via pulse.
On Days 2-3 of Shanghan, if Yangming and Shaoyang symptoms are absent, transmission has not occurred.
Day 1 Taiyang, Day 2 Yangming, Day 3 Shaoyang refers to the timing of symptom appearance, not transmission days. Qibo said: "Evil entering the face goes down to Yangming; entering the nape goes down to Taiyang; entering the cheek goes down to Shaoyang. Entering chest/back/flanks also hits their meridians." Taiyang is highest, hence Day 1; Yangming is next, hence Day 2; Shaoyang is lower, hence Day 3. Qi has high/low levels, disease has far/near distances, fitting the arrival point. Three Yang channels can receive Cold independently, not necessarily starting from Taiyang. Scholars claiming Yangming/ShaoYang must come from Taiyang misunderstand this. On Day 2, Yangming should be sick; if no Yangming Exterior signs, Yangming Heat does not transmit to Exterior. On Day 3, Shaoyang should be sick; if no Shaoyang Exterior signs, Shaoyang Heat does not transmit to Exterior.
On Day 3 of Shanghan, Three Yang are exhausted, Three Yin should receive Evil. If the patient can eat and does not vomit, Three Yin do not receive Evil.
After three days of Cold, if no Three Yang Exterior signs appear, the person's Yang Qi is harmonious, not fighting Cold, so Cold cannot enter, and Three Yang remain unaffected. If Yin Deficiency cannot withstand it, Three Yin receive Evil. Qibo said: "Evil entering Yin starts from the arm." Thus, Three Yin receive Cold independently, not via Yang meridians. Taiyin Day 4, Shaoyin Day 5, Jueyin Day 6 refer to symptom timing based on meridian height, not sequential transmission. Three Yin disease is Interior. Evil entering Taiyin causes abdominal fullness, vomiting, inability to eat; entering Shaoyin causes desire to vomit but unable to; entering Jueyin causes hunger but no desire to eat, vomiting roundworms upon eating. Why? Evil enters Zang via Yin meridians; if Zang Qi is solid and rejects it, it flows to Fu. Fu is Stomach; once in Stomach, it has nowhere else to go, hence Three Yin disease. If entered Fu, purgation is possible. If Stomach Yang is sufficient, eating without vomiting predicts no Three Yin infection. Three Yang depend on Yangming's rotation. Three Yin avoiding infection relies on Stomach shielding the Exterior. Stomach is not only the exit for Six Channels but the shield for Three Yin. Strong Stomach Yang resolves Cold; weak Stomach Yang allows Cold to invade Yin channels; lost Stomach Yang leads to death from inability to take fluids. Note that Three Yin infection depends not on Taiyang but entirely on Yangming.
On Days 6-7 of Shanghan, without significant heat, but with restlessness/agitation, this is Yang departing and entering Yin.
Previous sections discussed each channel receiving Cold independently; this section discusses Yang Evil moving from Exterior to Interior. Generally, Shanghan fever lasting 6-7 days resolves when heat subsides and body cools. Here, "no significant heat" means slight heat remains. Without internal restlessness, it could be considered Exterior resolved but lingering discomfort. Restlessness on Day 1 indicates Yang Qi emerging externally; on Days 6-7, a time for Yin-Yang self-harmony, restlessness indicates Yang Evil sinking internally. "Yin" here refers to Interior, not specifically Three Yin. It may enter Taiyang root (heat binding Bladder), Yangming root (dryness in Stomach), Shaoyang root (hardness/fullness under ribs), Taiyin (sudden restlessness and diarrhea), Shaoyin (dry mouth/tongue), or Jueyin (pain/heat in heart). All are "entering Yin."
Taiyang disease headache resolving after seven days occurs because the channel cycle is complete. If it threatens to re-enter the cycle, needle Foot-Yangming to prevent transmission and ensure healing.
Old theories claimed daily transmission through one channel, reaching Jueyin on Day 6, returning to Taiyang on Day 7, then Yangming on Day 8, called "re-entering the channel." This blocked understanding of Zhang Zhongjing. Zhongjing never taught daily transmission, nor headache persisting until Three Yin. Headache implies Taiyang is still involved. "Walking" differs from "transmitting." "Its channel" means its own channel, not another. Healing in seven days for "originating in Yang" means completion of Taiyang's cycle, not Six Channel transmission. Qibo stated: "On Day 7, Taiyang disease declines, headache lessens," providing clear evidence. Thus, it is not "transmitting to Foot-Yangming," but "threatening to re-enter the cycle," meaning Taiyang passes its limit unresolved, combining with Yangming (Bing Bing). Needling Foot-Yangming intersection cuts the transmission path, preventing Evil from re-entering Yangming, dispersing residual Taiyang Evil, not merging into Yangming to avoid Shaoyang.
Transmission theory appears only here in the Treatise. Yangming starts near nose, receiving Taiyang pulse, hence transmission logic. Eye pain, nasal dryness are symptoms. Leg cramping is not Taiyang transmission. Yangming exits medial big toe; Taiyang exits lateral little toe; meridians do not connect. Twelve meridians transmit Foot-to-Hand, Hand-to-Foot, Yang-to-Yin, Yin-to-Yang, distinct from Shanghan's Six Channel order (Yang first, then Yin; Tai first, then Shao). What basis is there for Taiyang transmitting to Six Channels, Yangming to Shaoyang? Examining Zhongjing's terms "turning to belong," "turning to link," "combining disease," "conjoining disease" clarifies the absurdity of transmission theory.
Wind patients with resolved Exterior but lingering discomfort heal in twelve days.
"Lingering discomfort" means residual Evil remains. After seven days of Exterior resolution, passing another five-day period (one Hou), Five Zang Yuan Qi fills, leading to mental clarity and healing on Day 12. Though citing Wind patients, this applies to Shanghan generally. Taiyang Day 7 decline, headache lessens—"decline" and "lessen" describe Exterior resolved but lingering discomfort. Six Channels have varying heights, causing varied onset times. Yangming Day 2 onset, Day 8 decline; Jueyin Day 6 onset, Day 12 decline. Thus, all Six Channels resolve from Day 7 and heal by Day 12. Mis-treatment falls outside this rule.
Zhongjing distinguished Six Channels, each with Wind Strike and Cold Damage pulse/symptom/treatment methods. During He Sucao's time, Taiyang chapter had many preserved items and few lost; other channels had few preserved and many lost. Yangming chapter retains two Wind Strike pulse/symptom items. Shaoyang channel has only one symptom item, no pulse. Three Yin channels have Wind Strike impending-healing pulses but no Wind Strike pulse/symptoms. Calling *Shanghan Lun* a complete work is indeed negligent.
Above is the general overview of diagnosing Shanghan.