按仲景自序言作《伤寒杂病论》合十六卷,则伤寒杂病,未尝分两书也。凡条中不冠伤寒者,即与杂病同义。
如太阳之头项强痛,阳明之胃实,少阳之口苦、咽干、目眩,太阴之腹满吐利,少阴之欲寐,厥阴之消渴、气上
撞心等症,是六经之为病,不是六经之伤寒,乃是六经分司诸病之提纲,非专为伤寒一症立法也。观五经提纲,
皆指内证,惟太阳提纲为寒邪伤表立;五经提纲皆指热证,惟太阴提纲为寒邪伤里立。然太阳中暑发热而亦恶寒,
太阴伤热亦腹痛而吐利,俱不离太阳主外、太阴主内之定法。而六经分症,皆兼伤寒、杂病也明矣。因太阳主表,
其提纲为外感立法,故叔和将仲景之合论全属伤寒,不知仲景已自明其书不独为伤寒设。所以太阳篇中,先将诸
病线索,逐条提清,比他经更详也。其曰太阳病,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,是伤寒另有提纲矣。此不特为太阳伤寒之提纲,即六经伤寒总纲,亦不外是。观仲景独于太阳篇,别其名
曰伤寒、曰中风、曰中暑、曰温病、曰湿痹,而他经不复分者,则一隅之举,可以寻其一贯之理也。其他结胸、
脏结、阳结、阴结、瘀热发黄、热入血室、谵语如狂等症,或因伤寒,或非伤寒,纷纭杂沓之中,正可思伤寒杂
病合论之旨矣。盖伤寒之外皆杂病,病名多端,不可以数计,故立六经而分司之;伤寒之中最多杂病,内外夹杂,
虚实互呈,故将伤寒杂病而合参之。正以合中见泾渭之清浊,此扼要法也。叔和不知此旨,谓痉、湿、 三种,
宜应别论,则中风、温病何得与之合论耶?
以三症为伤寒所致,与伤寒相似,故此见之,则中风非伤寒所致、温病与伤寒不相似者,何不为之另立耶?霍乱
是肝邪为患,阴阳易、瘥后劳复,皆伤筋动血所致,咸当属于厥阴,何得另立篇目?叔和分太阳三症于前,分厥
阴诸症于后,开后人分门类症之端。岂知仲景约法,能合百病,兼该于六经,而不能逃六经之外,只在六经上求
根本,不在诸病名目上寻枝叶。乃叔和以私意紊乱仲景之原集,于劳复后重集可发汗不可发汗诸篇。如弱反在关,
濡反在巅,微反在上,涩反在下,不知如何名反,岂濡弱微涩等脉有定位乎?此类姑不悉辨。其云大法春夏宜发
汗,春宜吐,秋宜下。设未值其时,当汗不汗,当下不下,必待其时耶?而且利水、清火、温补、和解等法,概
不言及,所以今人称仲景只有汗、吐、下三法,实由于此。夫四时者,众人所同,受病者,因人而异,汗、吐、
下者,因病而施也。立法所以治病,非以治时。自有此大法之谬,后人因有随时用药之迂。论麻黄、桂枝汤者,
谓宜于冬月严寒,而三时禁用。论白虎汤者,谓宜于夏,而大禁于秋分后与立夏之前。夫寒热温凉之逆用,必先
岁气,毋伐天和,为平人饮食调理之常耳。仲景因症立方,岂随时定剂哉?当知仲景治法,悉本《内经》。按岐
伯曰∶“调治之方,必别阴阳。阳病治阴,阴病治阳。定其中外,各守其乡。外者外治,内者内治。从外之内者,
治其外;从内之外者,调其内。从内之外而盛于外者,先调其内,后治其外;从外之内而盛于内者,先治其外,
后调其内。中外不相及,则治主病。微者调之,其次平之,盛者夺之。寒热温凉,衰之以属,随其攸利。”此大法
也。仲景祖述靡遗,宪章昭着。本论所称发热恶寒发于阳,无热恶寒发于阴者,是阴阳之别也。阳病制白虎、承
气以存阴,阴病制附子、吴萸以扶阳。外者用麻、桂以治表,内者用硝、黄以治里。其于表虚里实,表热里寒,
发表和表,攻里救里,病有浅深,治有次第,方有轻重,是以定其中外,各守其乡也。太阳阳明并病,小发汗,
太阳阳明合病,用麻黄汤,是从外之内者,治其外也。阳明病,发热汗出,不恶寒,反恶热,用栀子豉汤,是从
内之外者,调其内也。发汗不解,蒸蒸发热者,从内之外而盛于外,调胃承气,先调其内也。表未解而心下痞者,
从外之内而盛于内,当先解表,乃可攻痞,是先治其外,后调其内也。中外不相及,是病在半表半里,大小柴胡
汤,治主病也。此即所谓微者调之,其次平之,用白虎、栀豉、小承气之类。盛者夺之,则用大承
气、陷胸、抵当之类矣。所云观其脉症,知犯何逆,以法治之,则寒热温凉,衰之以属,随其攸利之谓也。若分
四时以拘法,限三法以治病,遇病之变迁,则束手待毙矣。且汗、吐、下之法亦出于岐伯。而利水、清火、调补
等法悉具焉。其曰有邪者,渍形以为汗,在皮者,汗而发之,实者,散而泻之,此汗家三法。中满者,泻之于内,
血实者,宜决之,是下之二法。高者因而越之谓吐,下者引而竭之谓利小便。剽悍者,按而收之,是清火法。气
虚宜掣引之,是调补法也。夫邪在皮毛,犹未伤形,故仲景制麻黄汤,急汗以发表,邪入肌肉,是已伤其形,故制
桂枝汤、啜稀热粥以解肌,是渍形以为汗。若邪正交争,内外皆实,寒热互呈,故制大青龙于麻桂中加石膏以泻
火,是散以泻之也。吐剂有栀豉、瓜蒂,分胸中虚实之相殊;下剂有大小承气、调胃、抵当,分气血浅深之不同。
利水有猪苓、真武寒热之悬绝,清火有石膏、芩、连轻重之差等。阳气虚,加人参于附子、吴萸中以引阳;阴气
虚,加人参于白虎、泻心中以引阴。诸法井然,质之岐伯,纤毫不爽。先圣后圣,其揆一也。愚更有议焉,仲景
言“平脉辨症为《伤寒杂病论》”,是脉与症亦未尝两分也。夫因病而平脉,则平脉即在辨症中。病有阴阳,脉
合阴阳。发热恶寒发于阳,无热恶寒发于阴,是病之阴阳也,当列全论之首。浮、大、动、滑、数名阳,沉、涩、
弱、弦、微名阴,是脉之阴阳也,此条当为之继。叔和既云搜采仲景旧论,录其症候诊脉,是知叔和另立脉法,
从此搜采耳。试观太阳篇云∶“脉浮者,病在表。脉浮紧者,法当身疼痛。脉浮数者,法当汗出愈。”诸条脉法,
不入辨脉平脉篇,是叔和搜采未尽,犹遗仲景旧格也。由此推之,知寸口脉浮为在表,及寸口脉浮而紧、脉浮而数
诸条,皆从此等处采出。脉有阴结、阳结条,未始不在阳明中风、中寒之间;洒淅恶寒而发热者,未始不在少阳
寒热往来之部。脉阴阳俱紧者,未必非少阴之文;阴阳相搏条,未必不在伤寒脉结代之际。设仲景另集脉法,或
有上下之分,谅无辨平之别矣。名平名辨,皆叔和搜采之说,仲景所云各承家技者是也。世徒云《序例》为叔和
之文,而不知仲景之书,皆系叔和改换,独为伤寒立论。十六卷中,不知遗弃几何,而六经之文夹杂者亦不少,
岂犹然仲景旧集哉?如疑余见之谬,请看序例所引《内经》,莫不增句易字,彼尚敢改岐伯之经,况乎仲景之论
耶?欲识真仲景者,逐条察其笔法,知《考工记》自不合于《周官》,褚先生大不侔于太史矣。世皆以
《金匮要略》为仲景杂病论,则有若之似圣人,惟曾子为不可强乎?
据张仲景在自序中所述,他撰写了《伤寒杂病论》,共十六卷。由此可见,伤寒与杂病并未被分为两本书。凡是条文标题中没有冠以“伤寒”二字的,其含义就与杂病相同。
例如:太阳病的头项强痛,阳明病的胃家实(胃肠实热证),少阳病的口苦、咽干、目眩,太阴病的腹满而吐利,少阴病的欲寐(似睡非睡状态),厥阴病的消渴(口渴多饮)、气上撞心等症状,这些是六经所主的病证,而不是仅指六经受寒邪侵袭的病证;它们是六经分别统辖各类疾病的提纲,并非专门针对伤寒这一种病症确立的治疗法则。观察其他五经的提纲,都是指向内在脏腑的症状表现,只有太阳病的提纲是为寒邪损伤体表而立;其他五经的提纲都是指向热证,只有太阴病的提纲是为寒邪损伤体内而立。然而,太阳病中暑发热也会恶寒,太阴病受热也会腹痛并伴有吐利,这都不离太阳主外、太阴主内的固定法则。因此,六经分症,都兼有伤寒和杂病的内容,这是很明显的。因为太阳主表,其提纲为外感病确立法则,所以王叔和将张仲景的合论全部归属于伤寒,却不知道张仲景已经在书中明确说明,这部书不仅仅是为伤寒设立的。所以在太阳篇中,先将各种疾病的线索逐条提清,比其他经络的论述更为详细。文中说:“太阳病,或者已经发热,或者尚未发热,必定恶寒、身体疼痛、呕吐逆气,脉象寸关尺三部俱紧的,名叫伤寒”,这是伤寒另有专门的提纲。这不仅作为太阳伤寒的提纲,即使是六经伤寒的总体纲领,也不超出这个范围。看张仲景唯独在太阳篇中,将其名称分别称为伤寒、中风、中暑、温病、湿痹,而其他经络不再细分,那么从这一隅的举例,就可以推知其中一贯的道理。其他的如结胸、脏结、阳结、阴结、瘀热发黄、热入血室、谵语如狂等症状,有的因伤寒引起,有的非伤寒引起,在纷繁复杂的情况中,正可以思考伤寒与杂病合并论述的宗旨。大概伤寒之外都是杂病,病名繁多,无法计数,所以设立六经来分别统辖它们;伤寒之中最多夹杂杂病,内外夹杂,虚实互见,所以将伤寒与杂病合并参考论述。正是在合并论述中看清泾渭分明的界限,这是抓住要领的方法。王叔和不懂这个宗旨,认为痉、湿、暍(中暑)三种病,应当另作论述,那么中风、温病为何能与它们合并论述呢?如果认为这三种症状是由伤寒引起的,与伤寒相似,所以出现在这里,那么中风不是由伤寒引起、温病与伤寒不相似的,为什么不另外设立篇章呢?霍乱是肝邪为患,阴阳易(男女交接后传染疾病)、瘥后劳复(病愈后因劳累复发),都是伤筋动血所致,都应当属于厥阴病,为什么另外设立篇目?王叔和在前面分列太阳病的三种症状,在后面分列厥阴病的各种症状,开启了后人分类辨症的开端。哪里知道张仲景的简约法则,能够综合百病,兼括于六经之中,而不能逃脱六经的范围,只在六经上探求根本,不在诸病名目上寻找枝叶。然而王叔和凭私意扰乱张仲景的原集,在劳复之后重新集结可发汗不可发汗等篇章。如“弱反在关,濡反在巅,微反在上,涩反在下”,不知道如何称之为“反”,难道濡、弱、微、涩等脉象有固定的部位吗?这类问题暂且不一一辨析。他说大法是春夏适宜发汗,春季适宜催吐,秋季适宜泻下。假如没有遇到相应的时节,应当发汗而不发汗,应当泻下而不泻下,一定要等到那个时节吗?而且利水、清火、温补、和解等方法,一概不提,所以现在的人称张仲景只有汗、吐、下三种治法,实际上就是由于这个原因。四季是众人相同的,但患病者因人而异,汗、吐、下法是因病施行的。确立法则是为了治病,不是为了适应时节。自从有了这种大法的谬误,后人便有了根据时令用药的迂腐做法。讨论麻黄汤、桂枝汤时,说适宜于冬季严寒,而春、夏、秋三季禁用。讨论白虎汤时,说适宜于夏季,而在秋分后和立夏前严禁使用。寒热温凉的逆向运用,必须先考虑岁气,不要破坏天和之气,这是普通人饮食调理的常规罢了。张仲景是根据症状制定方剂,难道是随着季节确定药剂的吗?应当知道张仲景的治疗方法,完全依据《黄帝内经》。按岐伯所说:“调治的方剂,必须辨别阴阳。阳病治阴,阴病治阳。确定病位的内外,各自坚守其所在。病在外者用外治法,病在内者用内治法。病从外传入内者,先治其外;病从内传至外者,调理其内。病从内传至外且在外部表现严重的,先调理其内,后治疗其外;病从外传入内且在内部表现严重的,先治疗其外,后调理其内。内外病位不相牵连的,则治疗主要病变。病情轻微的予以调和,其次予以平复,病情严重的予以攻夺。寒热温凉,根据其所属性质衰减病邪,顺应其有利的方面。”这就是大法。张仲景全面继承并阐述,章程显著。本论所说的“发热恶寒发于阳,无热恶寒发于阴”,这是阴阳的区别。阳病制作白虎汤、承气汤以保存阴液,阴病制作附子、吴茱萸汤以扶助阳气。病在外的用麻黄汤、桂枝汤治疗表证,病在内的用芒硝、大黄治疗里证。对于表虚里实、表热里寒、发表和表、攻里救里等情况,病有浅深,治疗有次第,方剂有轻重,这就是确定病位内外,各自坚守其所在的意思。太阳阳明并病,小发汗;太阳阳明合病,用麻黄汤,这是病从外传入内者,先治其外。阳明病,发热汗出,不恶寒,反恶热,用栀子豉汤,这是病从内传至外者,调理其内。发汗后病不解,蒸蒸发热者,是从内传至外且在外部表现严重,用调胃承气汤,先调理其内。表证未解而心下痞塞者,是从外传入内且在内部表现严重,应当先解表,然后才可攻痞,这是先治疗其外,后调理其内。内外病位不相牵连,即病在半表半里,大小柴胡汤,治疗主要病变。这就是所谓的病情轻微予以调和,其次予以平复,使用白虎汤、栀子豉汤、小承气汤之类。病情严重的予以攻夺,则使用大承气汤、陷胸汤、抵当汤之类。所谓“观其脉症,知犯何逆,以法治之”,就是指寒热温凉,根据其所属性质衰减病邪,顺应其有利方面的意思。如果拘泥于四时来限制法则,局限在三法中来治病,遇到病情的变化,就会束手待毙。况且汗、吐、下法也出于岐伯。而利水、清火、调补等方法也都具备。岐伯说:“有邪气的,浸渍形体以发汗,邪在皮表的,发汗发散它;实证,消散并泻下它”,这是汗法的三种情况。“中满者,从内部泻下;血实证,宜决破它”,这是下法的两种情况。“高者因而越之”叫做吐,“下者引而竭之”叫做利小便。“剽悍者,按而收之”,这是清火法。“气虚宜掣引之”,这是调补法。邪气在皮毛,尚未伤害形体,所以张仲景制作麻黄汤,急汗以发表;邪气进入肌肉,已经伤害形体,所以制作桂枝汤,喝稀热粥以解肌,这就是浸渍形体以发汗。如果邪正交争,内外皆实,寒热互现,所以在大青龙汤中于麻黄汤、桂枝汤基础上加石膏以泻火,这就是消散并泻下。吐剂有栀子豉汤、瓜蒂散,区分胸中虚实的不同;下剂有大、小承气汤、调胃承气汤、抵当汤,区分气血浅深的不同。利水药有猪苓汤、真武汤寒热的悬殊差异,清火药有石膏、黄芩、黄连轻重的差别。阳气虚,在附子、吴茱萸中加入人参以引阳;阴气虚,在白虎汤、泻心汤中加入人参以引阴。各种方法井然有序,验证于岐伯的理论,毫厘不差。先圣后圣,其道理是一致的。我还有议论,张仲景说“平脉辨证为《伤寒杂病论》”,说明脉与症也未尝分开。因为因病而平脉,所以平脉就在辨证之中。病有阴阳,脉合阴阳。“发热恶寒发于阳,无热恶寒发于阴”,这是病的阴阳,应当列在全论之首。“浮、大、动、滑、数名为阳,沉、涩、弱、弦、微名为阴”,这是脉的阴阳,这一条应当紧随其后。王叔和既然说搜集采录张仲景旧论,记录其症候诊脉,就知道王叔和另外创立脉法,从此处搜集采录而来。试看太阳篇中说:“脉浮者,病在表。脉浮紧者,法当身疼痛。脉浮数者,法当汗出愈。”诸条脉法,不入辨脉平脉篇,说明王叔和搜集采录未尽,仍然遗漏了张仲景的旧格式。由此推断,可知寸口脉浮为在表,以及寸口脉浮而紧、脉浮而数诸条,都是从这些地方采出的。脉有阴结、阳结的条文,未始不在阳明中风、中寒之间;洒淅恶寒而发热的条文,未始不在少阳寒热往来的部分。脉阴阳俱紧的条文,未必不是少阴的文字;阴阳相搏的条文,未必不在伤寒脉结代之际。假设张仲景另外集结脉法,或许会有上下之分,谅不会有辨、平的区别。“名平名辨”,都是王叔和搜集采录的说法,也就是张仲景所说的“各承家技”。世人只说《序例》是王叔和的文章,却不知道张仲景的书,都被王叔和改换,单独为伤寒立论。十六卷中,不知遗弃了多少,而六经的文中夹杂的也不少,难道还是张仲景的旧集吗?如果怀疑我的见解有误,请看《序例》中所引用的《黄帝内经》,无不增句易字,他尚且敢改动岐伯的经典,何况是张仲景的论述呢?想要认识真正的张仲景,逐条考察其笔法,就知道《考工记》自然不合于《周官》,褚先生大大不如太史公了。世人都把《金匮要略》当作张仲景的杂病论,那就像孔子像圣人一样,只有曾参是不可勉强相比的吗?
According to Zhang Zhongjing's preface, he wrote *Shanghan Zabing Lun* (Treatise on Cold Pathogenic and Miscellaneous Diseases), comprising sixteen volumes. Thus, Shanghan (Cold Damage) and Zabing (Miscellaneous Diseases) were not divided into two separate books. Any clause not prefixed with "Shanghan" carries the same meaning as Zabing.
For instance: Head and nape stiffness and pain in Taiyang disease (Disease of the Taiyang channel), stomach fullness and hardness (Wei Shi, 胃实) in Yangming disease, bitter taste, dry throat, and vertigo in Shaoyang disease, abdominal fullness with vomiting and diarrhea in Taiyin disease, desire to sleep (Yu Mei, 欲寐) in Shaoyin disease, excessive thirst (Xiao Ke, 消渴), and Qi rushing up to strike the heart in Jueyin disease—these are diseases governed by the Six Channels, not merely cold pathogenic diseases of the Six Channels; they are outlines for various diseases administered by each of the Six Channels, not laws established exclusively for Shanghan. Observing the outlines of the other five channels, all refer to internal symptoms, whereas only the Taiyang outline is established for cold pathogen injuring the exterior; all outlines of the other five channels refer to heat syndromes, whereas only the Taiyin outline is established for cold pathogen injuring the interior. However, Taiyang disease due to summerheat fever also presents aversion to cold, and Taiyin disease due to heat injury also presents abdominal pain with vomiting and diarrhea; neither departs from the fixed principle that Taiyang governs the exterior and Taiyin governs the interior. Therefore, it is clear that the differentiation of symptoms among the Six Channels encompasses both Shanghan and Zabing. Since Taiyang governs the exterior, its outline establishes laws for external contraction. Wang Shuhe attributed Zhang Zhongjing’s combined treatise entirely to Shanghan, unaware that Zhang had already clarified in his book that it was not intended solely for Shanghan. Hence, in the Taiyang chapter, clues to various diseases are clarified item by item, more detailed than in other chapters. It states: "Taiyang disease, whether fever has already appeared or not, must present aversion to cold, body pain, vomiting, and reverse flow, with pulse tight at yin and yang positions; this is named Shanghan." This serves as a specific outline for Shanghan. This is not only the outline for Taiyang Shanghan but also the general outline for Shanghan across the Six Channels. Notably, Zhang Zhongjing alone in the Taiyang chapter distinguishes names such as Shanghan, Fengzhong (Wind Strike), Zhongshu (Summerheat Stroke), Wenbing (Warm Disease), and Shibi (Damp Bi), while other channels are not subdivided. From this example, one can infer the consistent logic throughout. Other conditions such as Jie Xiong (Chest Binding), Zang Jie (Organ Binding), Yang Jie (Yang Knotting), Yin Jie (Yin Knotting), yellowing due to blood stasis and heat, heat entering the Blood Chamber, delirium resembling madness, etc., some caused by Shanghan, others not, amidst this complexity, one can ponder the purport of combining Shanghan and Zabing. Generally, outside Shanghan lie Zabing, with numerous disease names incalculable; thus, the Six Channels were established to administer them. Within Shanghan, there are many mixed diseases, internal and external intermingled, deficiency and excess presenting together; thus, Shanghan and Zabing are analyzed jointly. Precisely by combining them, one sees the clarity between pure and impure; this is the essential method. Wang Shuhe did not understand this purport, claiming that Jing (Spasm), Shi (Dampness), and He (Summerheat) should be discussed separately, yet why are Fengzhong and Wenbing combined with them? If these three symptoms are caused by Shanghan and similar to it, appearing here, then why were Fengzhong, not caused by Shanghan, and Wenbing, dissimilar to Shanghan, not given separate chapters? Huoluan (Vomiting and Diarrhea) is caused by Liver pathogen; Yin Yang Yi (Transmission between sexes after recovery) and Chao Hou Lao Fu (Relapse due to overexertion after recovery) are caused by injury to sinews and blood, all belonging to Jueyin; why establish separate chapters? Wang Shuhe placed the three symptoms of Taiyang at the beginning and various symptoms of Jueyin at the end, initiating the trend for later generations to classify symptoms by category. Did he know that Zhang Zhongjing’s concise method could integrate hundred diseases within the Six Channels, without escaping their scope, seeking the root in the Six Channels rather than branches in disease names? Yet Wang Shuhe, driven by personal opinion, disrupted Zhang’s original collection, reassembling chapters on sweating and non-sweating after relapse. For example, "weak pulse reversed at Guan, slippery pulse reversed at Duan, minute pulse reversed above, choppy pulse reversed below"—how can these be called 'reversed'? Do slippery, weak, minute, and choppy pulses have fixed locations? Such matters need not be fully debated here. He stated the great law is: spring and summer suit sweating, spring suits emesis, autumn suits purgation. If the time does not arrive, should one wait if sweating or purgation is indicated? Moreover, methods like promoting urination, clearing fire, warming and tonifying, and harmonizing are omitted, leading modern people to believe Zhang Zhongjing only used sweating, emesis, and purgation. The four seasons are common to all, but illness varies by individual; sweating, emesis, and purgation are applied according to disease. Laws are established to treat disease, not to adapt to seasons. Due to this erroneous 'great law,' later practitioners adopted rigid seasonal medication. Discussions on Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) claim suitability for winter cold and prohibition in other seasons. Discussions on Baihu Tang (White Tiger Decoction) claim suitability for summer and strict prohibition after Autumn Equinox and before Start of Summer. The counter-use of cold, heat, warm, and cool must first consider annual qi, avoiding damaging heavenly harmony; this is routine for healthy people's diet regulation. Zhang Zhongjing formulated prescriptions based on symptoms, not seasons. One should know Zhang’s methods are based on *Neijing*. As Qibo said: "Treatment formulas must distinguish yin and yang. Treat yin for yang diseases, treat yang for yin diseases. Determine internal and external, each guarding its place. External diseases treated externally, internal diseases treated internally. From external to internal, treat the external; from internal to external, regulate the internal. From internal to external and severe externally, regulate internal first, then treat external; from external to internal and severe internally, treat external first, then regulate internal. If internal and external are unrelated, treat the main disease. Mild cases regulate, moderate cases level, severe cases conquer. Cold, heat, warm, cool, reduce according to affiliation, follow what is beneficial." This is the great law. Zhang Zhongjing inherited and expounded it completely. The text says: "Fever with aversion to cold originates from yang; no fever with aversion to cold originates from yin," distinguishing yin and yang. For yang diseases, Baihu Tang and Chengqi Tang are formulated to preserve yin; for yin diseases, Fuzi (Aconite Root) and Wuyu (Evodia Fruit) are formulated to support yang. External diseases use Mahuang and Guizhi to treat the exterior; internal diseases use Xiaoshi (Sodium Sulfate) and Dahuang (Rhubarb Root) to treat the interior. For exterior deficiency and interior excess, exterior heat and interior cold, releasing exterior and harmonizing exterior, attacking interior and saving interior, with varying depth of disease and sequence of treatment, and weight of formulas, one determines internal and external, each guarding its place. Taiyang-Yangming concurrent disease, slight sweating; Taiyang-Yangming combined disease, using Mahuang Tang, treats the external when disease moves from external to internal. Yangming disease, fever, sweating, no aversion to cold, aversion to heat, using Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), regulates the internal when disease moves from internal to external. Sweating fails to resolve, steaming fever, moving from internal to external and severe externally, Tiaowei Chengqi Tang regulates the internal first. Exterior unresolved with epigastric fullness, moving from external to internal and severe internally, release exterior first, then attack fullness, treating external first, regulating internal second. Internal and external unrelated, disease at half-exterior half-interior, Xiao Chaihu Tang and Da Chaihu Tang treat the main disease. This corresponds to mild cases regulated, moderate cases leveled, using Baihu Tang, Zhizi Chi Tang, Xiao Chengqi Tang. Severe cases conquered, using Da Chengqi Tang, Xianxiong Tang (Chest-Sinking Decoction), Didang Tang (Should-Resist Decoction). "Observe pulse and symptoms, know the deviation, treat according to method" refers to reducing cold, heat, warm, cool according to affiliation, following benefits. If constrained by four seasons and limited to three methods, one would be helpless against changing diseases. Furthermore, sweating, emesis, and purgation originate from Qibo. Methods for promoting urination, clearing fire, and regulating/tonifying are complete. Qibo said: "With pathogen, steep form to sweat; in skin, sweat and disperse; excess, scatter and purge"—three sweating methods. "Fullness in middle, purge from inside; blood excess, drain it"—two purgative methods. "High, cause to vomit"; "Low, draw and exhaust via urination"—emesis and diuresis. "Violent, press and collect"—clearing fire. "Qi deficiency, pull and guide"—regulating and tonifying. Pathogen in hair and skin, not yet injuring form, so Zhang made Mahuang Tang to urgently sweat and release exterior. Pathogen enters muscle, injuring form, so he made Guizhi Tang, drinking hot porridge to resolve muscle, steeping form to sweat. If pathogen and righteous qi contend, internal and external excess, cold and heat present, he made Da Qinglong Tang adding Shigao (Gypsum) to Mahuang and Guizhi to purge fire, scattering and purging. Emetics include Zhizi Chi Tang and Goudi San, distinguishing chest deficiency and excess. Purgatives include Da/Xiao Chengqi, Tiaowei, Didang, distinguishing qi and blood depth. Diuretics include Zhu Ling Tang and Zhenwu Tang, showing extreme cold and heat differences. Fire-clearing includes Shigao, Huangqin (Scutellaria Root), Lianhua (Lotus Stamen), showing light and heavy differences. Yang deficiency, add Renshen (Ginseng Root) to Fuzi and Wuyu to guide yang; Yin deficiency, add Renshen to Baihu and Xiexin Tang to guide yin. Methods are orderly, verified by Qibo, flawless. Ancient and sages share the same principle. I have further remarks: Zhang said "Ping Mai Bian Zheng constitutes Shanghan Zabing Lun," implying pulse and symptoms were not separated. Because pulse is assessed due to disease, assessing pulse is part of differentiating symptoms. Diseases have yin and yang, pulses match yin and yang. "Fever with aversion to cold originates from yang; no fever with aversion to cold originates from yin" describes disease yin/yang, listed at the start. "Floating, large, rapid, slippery, rapid named yang; deep, choppy, weak, string-taut, minute named yin" describes pulse yin/yang, following immediately. Wang Shuhe claimed to collect Zhang’s old theories, recording symptoms and pulse, implying he created a separate pulse method from this collection. Observe Taiyang chapter: "Pulse floating, disease in exterior; pulse floating-tight, body pain expected; pulse floating-rapid, sweating expected to cure." These pulse clauses are not in Bian Mai Ping Mai Pian, indicating Wang’s collection was incomplete, omitting Zhang’s old format. Inferring from this, Cun Kou pulse floating indicates exterior; Cun Kou floating-tight, floating-rapid, etc., were extracted from here. Pulse Yin-Jie/Yang-Jie clauses appear between Yangming Wind-Strike/Cold-Cold; chills and fever appear in Shaoyang alternating chills/fever. Pulse yin-yang tight may be Shaoyin text; yin-yang pulsing conflict may be during Shanghan knotted/replacement pulse. If Zhang collected pulse methods separately, there might be upper/lower distinction, but surely not 'bian' (differentiate) vs 'ping' (level). 'Bian' and 'Ping' are Wang’s editorial terms, corresponding to Zhang’s "each inheriting family skills." People say Preface is Wang’s writing, unaware Zhang’s book was altered by Wang, dedicated solely to Shanghan. Of sixteen volumes, much was discarded, Six Channel texts mixed; is it still Zhang’s original? Doubt my view? Check Preface citations of Neijing, all added sentences and changed words; he dared alter Qibo’s classic, let alone Zhang’s theory. To know true Zhang, examine brushwork line by line; one knows Kaogong Ji differs from Zhou Guan, and Chu Xiansheng is vastly inferior to Taishigong. World regards Jingui Yaolue as Zhang’s Zabing Lun, just as Confucius resembles sage, only Zengzi is incomparable?