内经揭伤寒之症。未详伤寒之变。自仲景创论。分阴阳。析六经。立方治。人始知伤寒之病之
大。与伤寒之病之治矣。而实未知其所以大所以治也。伤寒之病。有传经。有直中。有始终不传。
有风寒交中。千态万状。棼如乱丝。稍涉疑似。汗吐下误施。致生他变。又复误治。至再至三。其
焉有不毙者乎。乃犹语于人曰。吾固用仲景法。其如病之不治何。夫不知病之所犯。于脏腑经络轻
重、虚实之何若。而但云用仲景法。其曷有济。乃又诡言仲景但知治外感。不知治内伤。又诡言但
取仲景法。不取仲景方。夫方因法立。法就方施。仲景方果不足取。仲景之法亦非法矣。不知一百
一十三方。方方皆活。三百九十七法。法法皆通。即其法与方。融会贯通之。诚有取之无尽。用之不
竭者。人顾不此之思。欲妄言以文其谬。可慨已。廿年来。余专读伤寒书。至百余家。人各一说。
不胜繁冗驳杂之虑。倘欲学人如是以为业。恐白首不获所据。不如是以为业。又空空罔所识知。乃不
揣。着为纲目一书。循六经之次。析各款之繁。以仲景论为纲。历代诸家之语。足以阐明仲景者为
目。庶览是书者。可寻流溯源。而晓然于仲景之旨矣。
时乾隆三十九年甲午十一月中浣沈金鳌芊录氏书
一、是书各循三阳三阴之六经。而又析六经所发之款症。不循经。但据款析言之。则如各经皆有头痛之
类。难于识别。不析款。但循经挨言之。则又根据文顺义。不能令读者一览易晓。故循经析款。是书
所由以成。
一、仲景伤寒书。自叔和窜乱后。其六经条款。凡注释家各以意为前后。讫无一定。独柯氏论注。其
分隶六经者。颇有理据。今纲目所定。皆根据柯本。
一、论者。即仲景之伤寒论。仲景有论。继仲景而言者亦为伤寒论也。
一、纲也者。以为主也。伤寒之论。创自仲景。故独主仲景而取其论以为纲。目也者。以为发明也。
仲景论后。说者无虑千百家。然或偏或驳。或浅或庸。无足取者甚多。故独采叔和以下若干家。
各摘其语之尤精且当者以为目。
一、各经各款。引仲景之论为纲。固已。或有遗而未备者。必其与逐款无关。不便夹入。或语意与
所已录者。大同小异。故亦置之。亦有条款太繁。不必备录者。阅者当为意会。毋以挂漏为咎。
一、各经条款。彼此相同。如各经俱备载。毋论已。其有详于此经。不复赘于他经者。或因候治相
同。或因所列之款相互。须彼此连及。故他经不必再详。阅者当以意会。前后参看。毋得拘泥。
一、采辑前人诸说。或由理势所及。或因仲景论之前后相附。不以世代之远近为拘。
一、诸家方论。俱系专集。择其至精至当者录之。固已骈珠刻玉。各咀其英。各撷其髓矣。癸巳春。
从邑中嵇氏假得钦定古今图书集成中艺术部。按次而详读之。不啻深入龙宫海藏。遍赏奇宝。
非复人间耳目近玩矣。私心窃喜。故特表而志之。
《黄帝内经》揭示了伤寒的症状，但未详尽阐述伤寒的变证。自从张仲景创立《伤寒论》，区分阴阳，辨析六经，制定方剂治法，人们才开始了解伤寒病的重大及其治疗方法。然而，实际上人们并不真正知道它为何重大以及如何治疗。
伤寒病，有的通过经络传变，有的直接侵犯脏腑（直中），有的始终不传变，有的风寒同时侵袭，形态千变万化，杂乱如乱丝。稍微涉及疑似情况，若误用汗、吐、下法，就会导致其他变证；如果再次误治，甚至反复多次，哪有不被治死的呢？
然而，有人还对别人说：“我固然使用的是张仲景的方法，但病情无法治愈又能怪谁呢？”如果不了解疾病所侵犯的部位，以及脏腑经络的轻重、虚实状况，只是空谈使用张仲景的方法，这怎么会有帮助呢？
又有人诡辩说张仲景只知道治疗外感病，不知道治疗内伤病；又诡辩说只取张仲景的方法，不取张仲景的方剂。方剂是根据方法建立的，方法是依据方剂施行的。如果张仲景的方剂真的不值得取法，那么张仲景的方法也不是正确的方法了。
殊不知张仲景的一百一十三首方剂，每一首都灵活有效；三百九十七条治法，每一条都通晓透彻。将这些方法与方剂融会贯通，确实有取之不尽、用之不竭的道理。人们却不这样思考，反而妄加言论来掩饰自己的谬误，真是令人感慨啊。
二十年来，我专门研读伤寒书籍，多达一百多家，各家说法不一，不胜其烦冗驳杂之虑。如果让学习者像这样作为学业，恐怕到老也找不到依据；如果不这样做，又觉得空空荡荡，一无所知。于是我不自量力，撰写了《纲目》一书。遵循六经的顺序，分析各款病症的繁杂内容，以张仲景的论述为“纲”，历代诸家足以阐明张仲景学说的言论为“目”。希望阅读这本书的人，能够寻流溯源，从而清楚地理解张仲景的宗旨。
时乾隆三十九年甲午十一月下旬，沈金鳌芊录氏书写。
凡例：
一、本书各篇均遵循三阳、三阴的六经顺序，并进一步分析六经所引发的具体症候款目。如果不遵循经络，仅根据症候款目进行分析，那么就像各经都有头痛之类症状，难以识别区别；如果不分析症候款目，仅按经络依次讲述，则又会拘泥于文字表面意义，不能使读者一目了然。因此，本书采用循经析款的方式，这也是本书得以成书的原因。
二、张仲景的伤寒著作，在王叔和整理窜乱之后，其六经条款的顺序，历代注释家各自凭主观意见排列前后，始终没有定论。只有柯琴（柯氏）的论述注解，其将病症分隶于六经的做法，颇有理据。现在《纲目》所确定的结构，都依据柯琴的版本。
三、“论”，即指张仲景的《伤寒论》。张仲景著有《伤寒论》，继张仲景之后论述伤寒的著作也称为《伤寒论》。
四、“纲”意为主体。伤寒的理论由张仲景首创，所以独尊张仲景，选取他的论述作为“纲”。“目”意为阐发说明。在张仲景的论述之后，解说者无虑千家百家，但其中或偏颇或驳杂，或浅薄或平庸，不足取法的很多。所以只选取王叔和以下的若干家，分别摘录他们言论中最精当的部分作为“目”。
五、各经各款，引用张仲景的论述作为纲，已经完备。但有时会有遗漏而不周全的情况，必定是因为那些内容与该症候款目无关，不便插入；或者语意与已收录的内容大同小异，所以也将其搁置。也有条款过于繁杂，不必全部收录的情况。读者应当领会此意，不要以挂漏为责备。
六、各经的条款，彼此之间有相同之处。如果各经都详细记载，那就不必说了。有的在此经详述，不再在其他经赘述，可能是因为证候治法相同，或者所列症候相互关联，需要彼此连带提及，所以其他经不必再详细说明。读者应当意会，前后参照查看，不要拘泥固执。
七、采辑前人的各种学说，有的是基于医理逻辑所能推及的，有的是因为附属于张仲景论述的前后部分，不拘泥于世代的远近。
八、诸家的方剂论述，原本都是专集。选取其中最精当的记录下来，这固然是如同骈联珠玉、雕刻玉石一般珍贵，各自汲取其精华，采摘其精髓。癸巳年春季，我从本邑嵇氏处借得钦定的《古今图书集成》中的艺术部，按次序详细阅读，不啻深入龙宫海藏，遍赏奇珍异宝，不再是人间常见的耳目玩物了。私下里心中窃喜，所以特别标示并记录此事。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) reveals the symptoms of Shanghan (Cold Damage), but does not elaborate in detail on its variations. Since Zhang Zhongjing established the *Shanghan Lun* (Treatise on Cold Damage Pathogens), distinguishing Yin and Yang, analyzing the Six Channels (Taiyang, Yangming, Shaoyang, Taiyin, Shaoyin, Jueyin), and prescribing formulas and treatments, people began to understand the significance of Shanghan disease and its treatment. However, in reality, they did not truly understand why it was significant or how to treat it.
Shanghan disease may transmit through the channels (Chuan Jing), directly invade the Zang-Fu organs (Zhi Zhong), never transmit at all, or involve simultaneous attack by wind and cold. Its manifestations are myriad and chaotic like tangled silk. If one hesitates even slightly between similar conditions and erroneously applies sweating (Han), vomiting (Tu), or purging (Xia) methods, other complications will arise. If these errors are compounded by further mis-treatment, repeated two or three times, how could the patient avoid death?
Yet, some still claim to others: "I certainly used Zhang Zhongjing's methods; what can be done if the disease remains untreatable?" If one does not know which part of the body is affected, nor the severity, deficiency, or excess within the Zang-Fu organs and meridians, merely claiming to use Zhang Zhongjing's methods is of no help.
Others falsely argue that Zhang Zhongjing only knew how to treat external contractions (Wai Gan) and not internal injuries (Nei Shang); or that one should only adopt Zhang Zhongjing's principles but not his formulas. Formulas are established based on principles, and principles are applied through formulas. If Zhang Zhongjing's formulas were truly unworthy of adoption, then his principles would also be invalid.
One fails to realize that among the 113 formulas, each is flexible and effective; among the 397 methods, each is thorough and penetrating. By integrating and mastering these principles and formulas, one finds resources inexhaustible. Yet people fail to reflect on this, instead making reckless claims to cover their fallacies—this is truly lamentable.
For twenty years, I have exclusively studied books on Shanghan, numbering over a hundred. Each author presents a different view, leading to overwhelming redundancy and confusion. If learners were to follow such diverse paths as their profession, they might reach old age without finding a solid basis; if they do not, they feel empty and ignorant. Thus, presumptuously, I composed this book titled *Gangmu* (Outline and Details). Following the sequence of the Six Channels, I analyze the complexities of various symptom categories. Zhang Zhongjing's discourse serves as the "Outline" (Gang), while statements from later generations that sufficiently elucidate Zhang Zhongjing's teachings serve as the "Details" (Mu). It is hoped that readers of this book can trace the source from the stream and clearly understand Zhang Zhongjing's intent.
Written by Shen Jin'ao, Qianlu Shi, in the latter half of the eleventh month of the Jiawu year of the Qianlong era (1774).
General Rules:
1. This book follows the order of the Three Yang and Three Yin Six Channels, and further analyzes the specific symptom categories arising from each channel. If one does not follow the channels but analyzes solely by symptom categories, it becomes difficult to distinguish conditions common to multiple channels, such as headache. If one does not analyze categories but proceeds strictly by channel, one may adhere too rigidly to textual meanings, failing to make it easy for readers to grasp at a glance. Therefore, this book adopts the method of analyzing categories within the framework of channels, which is the reason for its composition.
2. After Wang Shuhe edited and altered Zhang Zhongjing's Shanghan texts, the arrangement of the Six Channel clauses varied according to the subjective opinions of commentators, with no fixed standard. Only Ke Qin's commentary, which classified symptoms into the Six Channels, provided sound rationale. The structure determined in *Gangmu* is based entirely on Ke Qin's edition.
3. "Lun" refers to Zhang Zhongjing's *Shanghan Lun*. While Zhang Zhongjing authored the original *Shanghan Lun*, subsequent works discussing Shanghan are also referred to as *Shanghan Lun*.
4. "Gang" (Outline) means the main subject. Since Shanghan theory was pioneered by Zhang Zhongjing, his work is uniquely prioritized as the "Outline." "Mu" (Details) means elaboration and explanation. After Zhang Zhongjing's discourse, there were countless commentators, many of whom were biased, confused, shallow, or mediocre, offering little value. Therefore, only selected excerpts from later scholars (starting from Wang Shuhe) that are particularly precise and appropriate are chosen as the "Details."
5. For each channel and category, Zhang Zhongjing's discourse is cited as the Outline. Occasionally, omissions occur because certain content is irrelevant to the specific category and cannot be inserted, or because the meaning is largely identical to already recorded content. Some categories are too complex to record in full. Readers should understand this implicitly and not blame the author for omissions.
6. Clauses across different channels may overlap. If every channel detailed everything, it would be redundant. Some details appear in one channel but not others because the syndrome and treatment are identical, or because the listed categories are interrelated and require cross-reference. Readers should interpret this contextually, comparing sections front and back, rather than being dogmatic.
7. The collection of previous scholars' theories is based either on logical deduction or on their attachment to the preceding or succeeding parts of Zhang Zhongjing's discourse, without regard for the chronological distance between eras.
8. The formula discussions from various schools were originally separate collections. Selecting the most exquisite and appropriate ones for recording is akin to stringing pearls and carving jade, extracting their essence and marrow. In the spring of the Guisi year, I borrowed the "Arts Section" of the *Gujin Tushu Jicheng* (Comprehensive Illustrated References from Antiquity to Present), commissioned by the emperor, from the Ji family in my county. Reading it sequentially was like entering the Dragon Palace and Sea Treasury, admiring rare treasures, far beyond ordinary worldly pleasures. I privately rejoiced and specially noted this event.