太阳之为病，脉浮，头项强痛而恶寒。
仲景作论大法，六经各立病机一条，提揭一经纲领，必择本经至当之脉症而表章之。六经虽各有表症，惟太
阳主表，故表症、表脉，独太阳得其全。如脉浮为在表，太阳象三阳，其脉气浮而有力，与阳明之兼长大，少
阳兼弦细，三阴之微浮者不侔矣。头项主一身之表，太阳经络营于头，会于项，故头连项而强痛，与阳明头额
痛、少阳头角痛者少间矣。恶寒为病在表，六经虽各恶寒，而太阳应寒水之化，故恶寒特甚，与阳明二日自止、
少阳往来寒热、三阴之内恶寒者，悬殊矣。后凡言太阳病者，必据此条脉症。如脉反沉，头不痛，项不强，不
恶寒，是太阳之变局矣。
仲景立六经总纲法，与《内经·热论》不同。太阳只重在表症、表脉，不重在经络主病。看诸总纲，各立
门户，其意可知。
太阳病，发热、汗出、恶风、脉缓者，名为中风。
风为阳邪，风中太阳，两阳相搏，而阴气衰少。阳浮故热自发，阴弱故汗自出。中风，恶风，类相感也。
风性散漫，脉应其象，故浮而缓。若太阳初受病，便见如此脉症，即可定其名为中风而非伤寒矣。如寒风太厉，
中之重者，或汗不出而脉反紧，其内症必烦躁，与下伤寒之呕逆有别。
太阳病，或已发热，或未发热，必恶寒、体痛、呕逆，脉阴阳俱紧者，名曰伤寒。
太阳受病，当一二日发，故有即发热者，或有至二日发者。盖寒邪凝敛，热不遽发，非若风邪易于发热耳。
然即发热之迟速，则其人
所禀阳气之多寡，所伤寒邪之浅深，因可知矣。然虽有已发、未发之不齐，而恶寒、体痛、呕逆之症，阴阳俱
紧之脉先见，即可断为太阳之伤寒，而非中风矣。恶寒本太阳本症，而此复言者，别于中风之恶寒也。中风因见
风而兼恶寒，伤寒则无风而更恶寒矣。寒邪外束，故体痛，寒邪内侵，故呕逆。寒则令脉紧，阴阳指浮沉而言，
不专指尺寸也。然天寒不甚，而伤之轻者，亦有身不疼、脉浮缓者矣。
太阳病，发热而渴，不恶寒者，为温病。
太阳病而渴，是兼少阴矣。然太、少两感者，必恶寒而且烦满，今不烦满，则不涉少阴，反不恶寒，则非
伤寒而为温病矣。温病内外皆热，所以别于中风、伤寒之恶寒发热也。此条不是发明《内经》“冬伤于寒，
春必病温”之义，乃概言太阳温病之症如此。若以春温释之，失仲景之旨矣。夫太阳一经，四时俱能受病，不
必于冬。人之温病，不必因于伤寒。且四时俱能病温，不必于春。推而广之，则六经俱有温病，非独太阳一经
也。
发汗已，身灼热者，名曰风温。
此正与《内经》伏寒病温不同处。太阳中暑，亦有因于伤寒者，虽渴而仍恶寒。太阳温病，反不恶寒而渴
者，是病根不因于寒，而因于风。发热者，病为在表，法当汗解，然不恶寒，则非麻黄桂枝所宜矣。风与温相
搏，发汗不如法，风去而热反炽。灼热者，两阳相熏灼，转属阳明之兆也。
太阳病，关节疼痛而烦，脉沉而细者，此名湿痹。
上条不恶寒，是太阳变症；此条脉沉细，是太阳变脉。渴是少阴症，沉细是少阴脉，太阳、少阴为表里，故
脉症相似也。然湿自内发，与外感不同。湿伤于下，与伤上者不同。故同为太阳受病，而脉症与总纲异耳。湿流
骨节，故疼痛；太阳之气不宣，故烦；湿气痹闭而不行，故脉应其象而沉细。太阳之脉，从风则缓，从寒则紧，
从湿则细，伤上则浮，伤下则沉。当因症而合脉，勿据脉而断症。如病发热、头疼，脉当浮反沉，是表症得里脉，
故谓之反。如发汗多，因致痉而沉、细，与夏月中暑而弦、细、芤、迟，皆因症而然，不得概谓之反。
太阳病，欲解时，从巳至未上。
巳、午为阳中之阳，故太阳主之，至未上者，阳过其度也。人身阴阳，上合于天，天气至太阳之时，人身
太阳之病得藉其主气而解，此天人感应之理也。
欲自解者，必当先烦，乃有汗而解。何以知之？脉浮，故知汗出解也。
欲自解，便寓不可妄治意。诸经皆有烦，而太阳更甚，故有发烦、反烦、更烦、复烦、内烦等症。盖烦为阳
邪内扰，汗为阳气外发，浮为阳盛之脉，脉浮则阳自内发，故可必其先烦，见其烦必当待其有汗，勿遽妄投汤
剂也。汗出则阳胜，而寒邪自解矣。若烦而不得汗，或汗而不解，则审脉定症，麻黄、桂枝、青龙，随所施而
恰当矣。
太阳病未解，脉阴阳俱停，必先振栗汗出而解。但阳脉微者，先汗出而解，但阴脉微者，下之而解。若欲下
之，宜调胃承气汤。
言未解便有当解意，停者相等之谓。阳脉微二句，承上之词，不得作三段看。太阳病，阳浮而阴弱，是阳
强也。今阳脉微即是阴阳俱停，病虽未解，已是调和之脉，其解可知矣。脉但浮者，为阳盛，必先烦而有汗；
阳脉微者，为阳虚，必先振栗而汗出。振栗是阴津内发之兆，汗出是阳气外发之征也，此阴阳自和而愈，可勿药
矣。但阴脉微而阳脉仍浮，阳气重可知。与风寒国中之脉虽同，而热久汗多，津液内竭，不得更行桂枝汤，亦不
得执太阳禁下之定法矣。表病亦有因里实而不解者，须下之而表自解。若欲下之，有踌躇顾虑之意。宜者，审
定之词。以其胃不调而气不承，故宜之。
此条是桂枝汤变局。阳已微，须其自汗；阳尚存，当知调胃。以太阳汗多，恐转属阳明。
太阳病，下之而不愈，因复发汗，此表里俱虚，其人因致冒，冒家汗出自愈。所以然者，汗出表和故也。得
里未和，然后复下之。
太阳病，只得个表不和，初无下症，其里不和，多由汗下倒施而得也。表里俱虚，指妄汗下亡津液言。其
阳邪仍实，故表里不解。冒者如有物蒙蔽之状，是欲汗之兆也。因妄下后阳气怫郁在表，汗不得遽出耳。待汗出
冒自解，然但得个表和。其津液两虚，阳已实于里，故里仍未和。里症既得，然后下之，此虽复下，治不为逆矣。
问曰∶“病有战而汗出，因得解者，何也？”答曰“脉浮而紧，按之反芤，此为本虚，故当战而汗出也。其
人本虚，是以发战，以脉浮，故当汗出而解。若脉浮而数，按之不芤，此人本不虚。若欲自解，但汗出耳，不
发战也。”
战，即振栗之谓。治病必求其本，本者，其人平日禀气之虚实。紧者急也，与“数”同而有别，盖有虚实之
分焉。又必按之芤不芤，而虚实之真假毕具。
问曰∶“病有不战不汗出而解者，何也？”答曰∶“其脉自微，此以曾经发汗，若吐、若下、若亡血，以内
无津液。此阴阳自和，必自愈，故不战不汗出而解也。”
内无津液，安能作汗？战由汗发，无汗故不战也。复用“此”字须着眼∶妄治之后，内无津液，阴阳岂能
自和？必当调其阴阳，不然，脉微则为亡阳，将转成阴症矣。
问曰∶“伤寒三日，脉浮数而微，病患身凉和者，何也？”答曰∶“此为欲解也。解以夜半，脉浮而解者，
然汗出也；脉数而解者，必能食也；脉微而解者，必不汗出也。”
脉而浮数，今三日而转微，身初发热，今三日而身凉，即伤寒三日，少阳脉小为欲愈之义也。此伤寒本轻，
不须合六七日之期，亦不必再求其有汗，夜半时阳得阴，则余邪尽解矣。此微与前条不同，因未曾妄治，津液未
亡，故三日自解。阴平阳秘，不须汗出也，正教人不当妄汗耳。
上论太阳脉症大略。
太阳病的主要特征是：脉象浮，头部和颈部僵硬疼痛，并且怕冷。
张仲景撰写《伤寒论》的体例规范是：六经各自设立一条病机总纲，以此揭示每一经的纲领性特征，必须选择本经最典型、最确切的脉象和症状来加以阐明。六经虽然都有表证表现，但只有太阳经主管体表，所以表证和表脉，唯独太阳经具备得最为全面。例如，脉浮表示病邪在表，太阳经对应三阳之气，其脉气浮而有力，这与阳明经兼见长大之脉、少阳经兼见弦细之脉、三阴经仅见微弱浮脉的情况截然不同。头部和颈部主管一身之表，太阳经络循行于头部，会合于颈部，所以头痛牵连颈部且感到僵硬疼痛，这与阳明经的头额痛、少阳经的头角痛有所区别。怕冷表示病邪在表，六经虽然都可能出现怕冷，但太阳经应合寒水的化气特性，所以怕冷的症状特别严重，这与阳明经两天后自然停止怕冷、少阳经寒热往来、三阴经内部虚寒导致的怕冷相比，差异巨大。此后凡是提到“太阳病”，必定依据这条原文所述的脉症来判断。如果脉象反而沉，头不痛，颈部不强硬，也不怕冷，这就是太阳病的变局了。
张仲景确立六经总纲的方法，与《内经·热论》不同。太阳病只重在表证和表脉，并不重在经络本身的主病。观察各个总纲，各自独立成篇，其用意由此可见。
太阳病，如果出现发热、出汗、怕风、脉象缓弱的情况，称为中风。
风属于阳邪，风邪侵袭太阳经，两阳相搏结，导致阴气衰少。阳气浮越所以自发热，阴气虚弱所以自汗出。中风怕风，这是同类相感。风性散漫，脉象反映这种特性，所以脉浮而缓。如果是太阳初受病邪，就出现这样的脉症，就可以确定其名为中风而不是伤寒。如果寒风太猛烈，中邪较重的人，或者不出汗而脉象反而紧，其内症必然烦躁，这与下面提到的伤寒引起的呕逆有所不同。
太阳病，有的已经发热，有的尚未发热，但一定伴有怕冷、身体疼痛、呕吐气逆，脉象寸关尺三部都紧的，称为伤寒。
太阳经受病，应当在一两天内发作，所以有立即发热的，也有到第二天才发热的。这是因为寒邪凝敛，热量不会立刻散发出来，不像风邪那样容易发热。然而，无论发热快慢，都可以由此推断此人禀赋阳气的多少，以及所伤寒邪的深浅。虽然已有发热和未发热的不同，但只要先见到怕冷、身体疼痛、呕吐气逆的症状，以及阴阳（指浮沉）俱紧的脉象，就可以断定为太阳伤寒，而不是中风。怕冷本是太阳病的本症，这里再次强调，是为了区别于中风中的怕冷。中风是因见风而兼有怕冷，伤寒则是无风却更觉怕冷。寒邪束缚于外，所以身体疼痛；寒邪侵入于内，所以呕吐气逆。寒邪会导致脉紧，“阴阳”在这里指脉象的浮沉而言，不仅仅指寸部和尺部。然而，如果天气寒冷不厉害，受伤较轻的，也有身体不疼、脉浮缓的情况。
太阳病，发热而且口渴，不怕冷的，称为温病。
太阳病出现口渴，是兼涉少阴经的表现。但是，太阳和少阴同时受邪（两感），一定会既怕冷又烦闷胀满，现在没有烦闷胀满，说明不涉及少阴；反而不怕冷，这就不是伤寒而是温病了。温病内外都是热，所以区别于中风、伤寒的怕冷发热。这一条并不是为了阐发《内经》中“冬天感受寒邪，春天必定发生温病”的含义，而是概括地讲述太阳温病的症状如此。如果用春温来解释，就失去了张仲景的本意了。太阳一经，四季都能受病，不一定非要在冬天。人的温病，不一定因为伤寒引起。而且四季都能发生温病，不一定非要在春天。推而广之，六经都有温病，不仅仅是太阳一经。
经过发汗治疗后，身体灼热的，称为风温。
这正与《内经》中伏寒发病为温病的情况不同。太阳中暑，也有因伤寒引起的，虽然口渴但仍然怕冷。太阳温病，反而不怕冷且口渴，这说明病根不是因为寒，而是因为风。发热，说明病邪在表，治法应当发汗解表，但是如果不恶寒，就不适宜用麻黄汤或桂枝汤了。风邪与温邪相搏结，发汗方法不当，风邪虽去但热势反而炽盛。身体灼热，是两阳相熏灼，转为属阳明病的征兆。
太阳病，关节疼痛且心烦，脉象沉而细的，此名湿痹。
上一条（温病）不怕冷，是太阳病的变症；这一条脉象沉细，是太阳病的变脉。口渴是少阴经的症状，沉细是少阴经的脉象，太阳与少阴互为表里，所以脉症相似。但是湿气从内生发，与外感不同。湿气伤害下部，与伤害上部不同。所以同样是太阳经受病，但脉症与总纲不同。湿气流注骨节，所以疼痛；太阳经的气机不能宣通，所以心烦；湿气痹阻闭郁而不运行，所以脉象反映这种状态而呈现沉细。太阳经的脉，随风则缓，随寒则紧，随湿则细，伤于上则浮，伤于下则沉。应当根据症状结合脉象判断，不要仅凭脉象就断定病症。比如生病发热、头疼，脉象应当浮反而沉，这是表证得了里脉，所以称为“反”。如果发汗过多，因此导致痉病而出现沉、细脉，或者夏天中暑出现弦、细、芤、迟脉，都是因为症状所致，不能一概称为“反”。
太阳病，想要解除的时间，是从巳时到未时这段时间。
巳时、午时是阳中之阳，所以由太阳经主令，到未时之前，是因为阳气超过了极点。人体的阴阳，上与天相通，当天气到达太阳主令之时，人体太阳经的病得以借助天时的主气而解除，这是天人感应的道理。
想要自行解除的，必定先出现心烦，然后才有汗出而解。怎么知道呢？因为脉浮，所以知道会通过出汗而解除。
想要自行解除，其中就包含了不可胡乱治疗的意思。各经都有烦的症状，但太阳经更为严重，所以有发烦、反烦、更烦、复烦、内烦等症状。大概烦是阳邪在内扰动，汗是阳气向外发散，浮是阳气盛的脉象，脉浮则阳气自然从内发散，所以可以肯定病人会先心烦，看到心烦必定要等待其出汗，不要急于乱投汤药。出汗则阳气胜，寒邪自然解除。如果心烦却不得汗，或者出汗后病仍未解，就要审察脉象确定症状，使用麻黄汤、桂枝汤或青龙汤，根据具体情况恰当施用。
太阳病未解除，脉象寸关尺三部都停伏不见（或指脉象趋于平和相等），必定先出现寒战栗抖，然后出汗而解。如果仅是阳脉（寸脉）微弱的，先出汗而解；如果仅是阴脉（尺脉）微弱的，通过泻下法而解。如果想要用泻下法，适宜用调胃承气汤。
这句话的意思是病未解中蕴含着当解的意向，“停”是指脉象相等（平和）。关于阳脉微的两句话，是承接上文的话，不能看作三段独立的论述。太阳病，通常是阳浮而阴弱，这是阳强。现在阳脉微，就是阴阳俱停（平和），病虽然未解，但已经是调和的脉象，其自愈可知了。脉象只浮的，是阳盛，必定先心烦而后出汗；阳脉微弱的，是阳虚，必定先寒战栗而后出汗。寒战栗是阴津从内发出的征兆，出汗是阳气从外发的征象，这是阴阳自我调和而痊愈，可以不用服药了。如果仅是阴脉微而阳脉仍然浮，可知阳气重。虽然与风寒在体内的脉象相同，但因为热久汗多，津液在内枯竭，不能再行用桂枝汤，也不能固执于太阳病禁止攻下的定法。表病也有因为里实而不能解除的，必须通过泻下，表证才能自行解除。如果想要泻下，这里有犹豫顾虑的意思。“宜”字，是审慎确定的词语。因为其胃气不调而气机不承顺，所以适宜用调胃承气汤。
这一条是桂枝汤证的变局。阳气已微，须等待其自汗；阳气尚存，应当知道调理胃气。因为太阳病汗多，恐怕转属阳明病。
太阳病，经过泻下治疗而没有痊愈，又再次发汗，这样导致表里两虚，病人因此出现头目昏蒙（冒），昏蒙的病人通过出汗可以自愈。为什么会这样呢？因为出汗后表气调和的缘故。得到里气未和的症状后，然后再用泻下法。
太阳病，仅仅表现为表气不和，起初并没有可下之症，其里气不和，大多是由错误的发汗和泻下造成的。表里两虚，指的是胡乱发汗和泻下导致津液亡失。如果阳邪仍然实盛，所以表里都不解。“冒”是指好像有东西蒙蔽头目的状态，这是想要出汗的征兆。因为错误地泻下后，阳气怫郁在表，汗液不能立刻排出。等待出汗，昏蒙自然解除，但这只是表气调和。此时津液两虚，阳气已经实聚于里，所以里气仍未调和。里证既然明确，然后使用泻下法，这虽然是再次泻下，治疗也不算逆乱。
问曰：“有病人在寒战中出汗，因而得以解除的，是什么原因？”答曰：“脉象浮而紧，按之反而中空如葱管（芤脉），这是因为本身体质虚弱，所以应当寒战而后出汗。其人本来体质虚弱，所以发生寒战，因为脉浮，所以应当出汗而解。如果脉象浮而数，按之不中空，这个人本来不虚。如果想要自行解除，只是出汗而已，不会发生寒战。”
战，就是寒战的意思。治病必须探求根本，根本在于人平日禀赋的虚实。紧脉代表急迫，与“数”脉相同但有区别，盖因有虚实之分。又必须按脉看是否芤，虚实的真假就完全显露了。
问曰：“有病人不寒战也不出汗而解除的，是什么原因？”答曰：“其脉象自微，这是因为曾经发汗，或者吐法、下法，或者失血，导致体内没有津液。这是阴阳自我调和，必定自愈，所以不寒战也不出汗而解除。”
体内没有津液，怎么能作汗？寒战是由汗出引发的，没有汗所以不寒战。再次使用“此”字需要着眼思考：胡乱治疗之后，体内没有津液，阴阳怎么能自我调和？必须调理阴阳，否则，脉微就会变成亡阳，将转变成阴证了。
问曰：“伤寒三天，脉象浮数而微，病人身体凉爽平和，这是什么原因？”答曰：“这是病将要解除的表现。解除的时间在夜半，脉浮而解的，是因为出汗；脉数而解的，必定能进食；脉微而解的，必定不出汗。”
脉象原本浮数，现在三天后转为微，身体原本发热，现在三天后身体凉，即符合伤寒三日，少阳脉小为欲愈的道理。此伤寒本来轻浅，不需要等到六七天，也不必再要求必须有汗，夜半时阳气得到阴气的帮助，余邪就会全部解除。这里的“微”与前一条不同，因为未曾胡乱治疗，津液未亡，所以三天自行解除。阴平阳秘，不需要出汗，正是教导人们不要胡乱发汗。
以上论述太阳病脉症的大略情况。
The principal manifestation of Taiyang disease (Disease of the Taiyang/Bladder and Small Intestine channels) is a floating pulse (Pulse that feels superficial, indicating exterior syndrome), stiffness and pain in the head and nape, and aversion to cold.
In establishing the general principles for his treatise, Zhang Zhongjing sets forth one pathogenesis clause for each of the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), highlighting the guiding纲领 (outline) of each channel. He selects the most appropriate pulse and symptoms specific to that channel to elucidate them. Although all six channels may present with exterior syndromes, only Taiyang governs the exterior; therefore, the combination of exterior symptoms and exterior pulses is uniquely complete in Taiyang. For instance, a floating pulse indicates the pathogen is at the exterior. Taiyang corresponds to the Qi of the Three Yangs, and its pulse energy is floating and forceful, which differs significantly from the Yangming pulse (which is large and long), the Shaoyang pulse (which is wiry and fine), or the faintly floating pulses seen in the Three Yin channels. The head and nape govern the exterior of the body. The Taiyang meridians circulate around the head and converge at the nape; thus, headache extends to the nape accompanied by stiffness and pain. This distinguishes it from the frontal headache of Yangming and the temporal headache of Shaoyang. Aversion to cold indicates the pathogen is at the exterior. Although all six channels may exhibit aversion to cold, Taiyang corresponds to the transformation of Cold Water; hence, aversion to cold is particularly severe here. This stands in stark contrast to Yangming (where aversion to cold ceases spontaneously after two days), Shaoyang (alternating chills and fever), and the internal cold aversion seen in the Three Yin channels. Henceforth, whenever "Taiyang disease" is mentioned, these pulse and symptom criteria must be applied. If the pulse is instead deep, there is no headache, no neck stiffness, and no aversion to cold, this constitutes an atypical presentation (Bian Ju) of Taiyang disease.
Zhang Zhongjing’s method of establishing the general outlines for the Six Channels differs from that in *Neijing: Re Lun* (Treatise on Febrile Diseases). In Taiyang disease, emphasis is placed on exterior symptoms and pulses rather than solely on meridian-specific diseases. Observing that each general outline stands independently reveals the author's intent.
When Taiyang disease presents with fever, sweating, aversion to wind, and a moderate/slow pulse, it is named Wind Strike (Zhong Feng).
Wind is a Yang pathogen. When Wind strikes the Taiyang channel, the two Yangs contend, leading to a decline in Yin Qi. Because Yang floats, fever arises spontaneously; because Yin is weak, sweat issues spontaneously. Wind Strike involves aversion to wind, reflecting similarity in nature. The diffuse nature of Wind is reflected in the pulse, which becomes floating and moderate. If such pulse and symptoms appear immediately upon initial contraction of the disease in Taiyang, it can be diagnosed as Wind Strike rather than Cold Damage (Shang Han). However, if the Cold Wind is extremely fierce and the contraction is severe, the patient may not sweat and the pulse may instead be tight. In such cases, internal symptoms will likely include irritability, distinguishing it from the vomiting and reflux associated with subsequent Cold Damage.
In Taiyang disease, whether fever has already appeared or not, there is invariably aversion to cold, body pain, vomiting/reflux, and a pulse that is tight in both Yin and Yang positions (superficial and deep aspects). This is named Cold Damage (Shang Han).
Contraction in the Taiyang channel typically manifests within one or two days; thus, some patients develop fever immediately, while others take up to two days. This is because Cold pathogens are constrictive and凝敛 (condensing), so heat does not emerge abruptly, unlike Wind pathogens which easily induce fever. Nevertheless, the speed of fever onset allows one to infer the abundance of the person's constitutive Yang Qi and the depth of the contracted Cold pathogen. Despite variations in the timing of fever, the presence of aversion to cold, body pain, vomiting/reflux, and the tight pulse (referring to superficial and deep positions, not just Cun and Chi) allows for a definitive diagnosis of Taiyang Cold Damage, excluding Wind Strike. Aversion to cold is a fundamental symptom of Taiyang; reiterating it here serves to distinguish it from the aversion to cold in Wind Strike. Wind Strike involves aversion to cold secondary to exposure to wind, whereas Cold Damage involves aversion to cold even without direct wind exposure. External constriction by Cold causes body pain; internal invasion by Cold causes vomiting/reflux. Cold causes the pulse to become tight. "Yin and Yang" here refers to the superficial and deep qualities of the pulse, not exclusively to the Cun and Chi positions. However, in mild cold weather or light injury, there may be cases without body pain, presenting with a floating and moderate pulse.
When Taiyang disease presents with fever, thirst, and absence of aversion to cold, it is named Warm Disease (Wen Bing).
Thirst in Taiyang disease suggests involvement of the Shaoyin channel. However, simultaneous contraction of Taiyang and Shaoyin (Liang Gan) would present with both aversion to cold and irritability/fullness. The absence of irritability/fullness indicates Shaoyin is not involved; the absence of aversion to cold confirms this is not Cold Damage but Warm Disease. Warm Disease features heat internally and externally, distinguishing it from the aversion to cold and fever of Wind Strike and Cold Damage. This clause does not aim to expound on the *Neijing* principle of "Winter injury by Cold leads to Warm Disease in Spring," but rather generally describes the symptoms of Taiyang Warm Disease. Interpreting this solely as Spring Warmth misses Zhang Zhongjing's intent. The Taiyang channel can contract disease in all four seasons, not just winter. Human Warm Diseases are not necessarily caused by prior Cold Damage. Furthermore, Warm Diseases can occur in any season, not just spring. Extending this logic, Warm Diseases exist in all Six Channels, not just Taiyang.
After inducing sweating, if the body becomes burning hot, it is named Wind-Warmth (Feng Wen).
This differs from the *Neijing* concept of latent Cold transforming into Warm Disease. Taiyang Summerheat may sometimes result from Cold Damage; although thirsty, the patient remains averse to cold. In Taiyang Warm Disease, the patient is averse to neither cold nor heat but is thirsty, indicating the root cause is Wind, not Cold. Fever indicates the pathogen is at the exterior, warranting diaphoresis. However, without aversion to cold, Ma Huang Tang (Ephedra Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction) are inappropriate. When Wind and Warmth combine, improper diaphoresis may drive away the Wind but intensify the Heat. Burning heat signifies the scorching effect of two Yangs, marking a transition to Yangming disease.
In Taiyang disease, if joint pain and irritability are present with a deep and fine pulse, it is named Bi Syndrome due to Dampness (Shi Bi).
The previous clause (Warm Disease) lacked aversion to cold, representing an atypical Taiyang symptom; this clause features a deep and fine pulse, representing an atypical Taiyang pulse. Thirst is a Shaoyin symptom; deep and fine pulses are Shaoyin pulses. Since Taiyang and Shaoyin are interior-exterior pairs, their presentations may resemble each other. However, Dampness arising internally differs from external contraction. Dampness injuring the lower body differs from injuring the upper body. Thus, although contracting in Taiyang, the pulse and symptoms differ from the general outline. Dampness flowing into joints causes pain; stagnation of Taiyang Qi causes irritability; obstruction of Dampness causes the pulse to reflect this state as deep and fine. The Taiyang pulse follows Wind (becomes moderate), Cold (becomes tight), or Dampness (becomes fine); injuries above manifest as floating, injuries below as deep. One must correlate symptoms with pulses, not judge symptoms solely by pulses. For example, fever and headache should present with a floating pulse; if it is instead deep, this is an exterior syndrome presenting with an interior pulse, termed "reverse." Excessive sweating leading to spasms resulting in deep/fine pulses, or Summerheat in summer presenting with wiry/fine/knelling/slow pulses, are all symptom-driven and should not be indiscriminately called "reverse."
Taiyang disease tends to resolve between the hours of Si (9-11 AM) and Wei (1-3 PM).
Si and Wu (11 AM-1 PM) represent Yang within Yang, governed by Taiyang. Resolution occurring before Wei implies Yang has reached its peak. Human Yin and Yang correspond to Heaven. When heavenly Qi reaches the Taiyang phase, the body's Taiyang disease can resolve aided by this governing Qi, illustrating the principle of Heaven-Human resonance.
Spontaneous resolution requires preceding irritability, followed by sweating and resolution. How do we know? Because the pulse is floating, indicating resolution via sweating.
The possibility of spontaneous resolution implies avoiding reckless treatment. Irritability occurs in all channels but is more pronounced in Taiyang, manifesting as various forms of irritability. Irritability stems from internal disturbance by Yang pathogens; sweating is the outward emission of Yang Qi; a floating pulse indicates abundant Yang. A floating pulse suggests Yang emerging from within; thus, preceding irritability predicts sweating. Upon seeing irritability, one should wait for sweating rather than hastily administering decoctions. Sweating indicates Yang dominance, resolving Cold pathogens. If irritability persists without sweating, or sweating fails to resolve the condition, one must examine the pulse and symptoms to appropriately apply Ma Huang Tang, Gui Zhi Tang, or Qing Long Tang (Green Dragon Decoction).
If Taiyang disease remains unresolved, and the pulse appears equalized/stopped across all positions, the patient will first experience chills and tremors, then sweat and resolve. If only the Yang pulse (Cun) is slightly weak, resolution occurs via sweating; if only the Yin pulse (Chi) is slightly weak, resolution occurs via purgation. If purgation is indicated, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct the Qi Decoction) is suitable.
This passage implies that even when unresolved, resolution is imminent. "Stopped" (Ting) means equalized. The statements regarding the weak Yang pulse continue the previous thought and should not be viewed as three separate segments. In Taiyang disease, a floating Yang and weak Yin indicate Yang excess. A weak Yang pulse now signifies equilibrium (Ting). Although unresolved, the pulse is harmonious, predicting recovery. A purely floating pulse indicates Yang excess, leading to irritability and sweating. A weak Yang pulse indicates Yang deficiency, leading to chills/tremors and sweating. Chills/tremors signal the emergence of Yin fluids from within; sweating signals the emission of Yang Qi from without. This represents self-harmonization of Yin and Yang, requiring no medication. If only the Yin pulse is weak while the Yang pulse remains floating, Yang excess is evident. Although similar to pulses in Wind-Cold retention, prolonged heat and excessive sweating have depleted internal fluids. Gui Zhi Tang is contraindicated, as is the rigid rule against purgation in Taiyang. Exterior diseases may fail to resolve due to interior excess; purgation may be required to resolve the exterior. The term "suitable" (Yi) implies careful deliberation. Due to stomach disharmony and lack of Qi bearing, Tiao Wei Cheng Qi Tang is appropriate.
This clause represents a variation of the Gui Zhi Tang pattern. With diminished Yang, await spontaneous sweating; with residual Yang, regulate the Stomach. Given excessive sweating in Taiyang, there is risk of transition to Yangming.
If Taiyang disease is treated with purgation without success, followed by repeated sweating, this renders both exterior and interior deficient. The patient develops "Mao" (a sensation of being veiled/muddled). Such patients heal via sweating. Why? Because sweating harmonizes the exterior. Once interior harmony is achieved, purgation may be reapplied.
Taiyang disease primarily involves exterior disharmony, lacking initial indications for purgation. Interior disharmony often results from erroneous sweating and purging. "Exterior and interior deficiency" refers to fluid depletion from reckless sweating/purging. If Yang pathogens remain excess, exterior and interior remain unresolved. "Mao" describes a veiled sensation, signaling impending sweating. Erroneous purging causes Yang Qi to stagnate at the exterior, preventing immediate sweating. Waiting for sweating resolves the Mao, harmonizing the exterior. However, with dual fluid deficiency and Yang excess concentrated internally, the interior remains unharmonized. Once interior signs are clear, purgation is appropriate; re-purgation in this context is not a therapeutic error.
Q: "Why does a patient resolve via sweating after shaking/chills?"
A: "A floating and tight pulse, which feels knelling (Kou) upon pressure, indicates underlying deficiency. Thus, shaking precedes sweating. The patient's inherent deficiency causes shaking; the floating pulse indicates resolution via sweating. If the pulse is floating and rapid, feeling non-knelling, the patient is not inherently deficient. Resolution will occur via sweating alone, without shaking."
Shaking refers to chills/tremors. Treatment must address the root: the patient's constitutive deficiency or excess. Tight pulses indicate urgency, distinct from Rapid pulses due to deficiency/excess distinctions. Pressure testing for Knelling reveals the truth of deficiency/excess.
Q: "Why does a patient resolve without shaking or sweating?"
A: "A naturally weak pulse indicates prior sweating, vomiting, purging, or blood loss, leading to internal fluid depletion. Self-harmonization of Yin and Yang ensures spontaneous recovery, hence no shaking or sweating."
Without internal fluids, how can sweat form? Shaking triggers sweating; without sweat, there is no shaking. Emphasis on "this" is crucial: after reckless treatment, internal fluid depletion prevents Yin-Yang self-harmonization. One must regulate Yin and Yang; otherwise, a weak pulse indicates Yang collapse, transitioning to a Yin syndrome.
Q: "On the third day of Cold Damage, the pulse is floating, rapid, and slight, and the patient's body is cool and peaceful. What is this?"
A: "This indicates impending resolution. Resolution occurs at midnight. Floating pulse resolving implies sweating; Rapid pulse resolving implies ability to eat; Slight pulse resolving implies no sweating."
The shift from floating/rapid to slight over three days, and from fever to coolness, aligns with the principle that a small pulse in Shaoyang on the third day indicates recovery. This mild Cold Damage resolves without waiting for six/seven days or requiring sweating. At midnight, Yang receives Yin support, clearing residual pathogens. This "slight" pulse differs from the previous clause because no reckless treatment occurred, preserving fluids. Spontaneous resolution in three days reflects Yin-Ping Yang-Mi (balance), teaching against reckless sweating.
The above discusses the general principles of Taiyang pulse and symptoms.