人伤于寒，有阴阳二证，阳证不具论。中所谓阴证者，传经之阴证，即三阳热病。以次
及于
三阴，而见腹满咽干，口燥渴，烦满，囊缩诸证是也。有直中之阴证，乃寒邪不由阳经直入
三阴而来，无热恶寒，唇青舌卷，厥冷自痢等证是也。有传阳变阴之阴证，即阳病汗下太过
，真气虚脱，或病中不慎，保摄失宜，以致热邪变寒，亦如直中阴经之证是也。舍二者无所
谓阴矣。乃今吴下俗传，凡系人房后而感寒邪，辄名证阴，殊属不解。若乃男因女而得曰阴
，则女因男而得者，当名阳证矣。夫既有讹称，则必误治而投温补之剂。设令其人阳虚感邪
，犹有邪得补而愈甚之误。若精亏火旺，与热邪并炽者，其误可胜言哉？使房劳受寒，谓之
邪乘虚入则可，直曰阴证则不可也。误称之害小，误治之害大，不得不辨。
六经以渐受病，其愈皆以七日为期，阳数七故也。伤寒例曰∶其不两感于寒者，更不传
经，
不加异气者，至七日太阳病衰，头痛少愈；八日阳明病衰，身热稍歇；九日少阳病衰，耳聋
渐闻；十日太阴病衰，腹减如故，则思饮食，十一日少阴病衰，渴止舌干，已而嚏；十二日
厥阴病衰，囊纵，少腹微下，大气皆去，病患精神爽慧也。此论六经七日病愈，本诸《素问
·论热篇》，彼此注释者，皆不能无误，皆未明也。敢释之曰∶其者指伤寒也，
不两感于寒者，不是一日并传阴阳二经也。更不传经者，邪在此经，更不传彼经也。不
加异气者，伤寒病热不重，感寒感风感湿感温热而变他病也。夫如是，则可期六经病愈日期
矣。太阳篇曰∶发于阳者七日愈，以是数计之，乃知六经之病自一日受者，七日当衰。二
日受者，至八日衰。亦是七日之数也。故七日邪在太阳，幸而更不传阳明，更无变证。则至
七日太阳病衰，头痛少愈，如或二日邪受阳明，更不传变。至八日而阳明病衰，身热少愈。
又或邪受少阳，更不传变，至九日少阳病衰，耳聋微闻，如四日邪传少阴，更不传变，至十
一日少阴病衰，渴止舌干已而嚏。又或六日邪传厥阴，传经尽而更不传变。至十二日厥阴病
衰，囊纵少腹微下也，大气皆去，病患精神爽慧。此二句总承六经而言，如言或传或不传，
当病衰时，则皆大气去而精神慧也。成氏注曰∶六经传变，则与更不传经之说背矣。《素问
》马氏注∶七日之际，巨阳病衰，头痛少愈。正以初时所感之邪太盛。既以二日传之阳明矣
。而其未尽传者何？在太阳至此，而比之一日之际少愈焉 ，六日传至厥阴，而其未尽传者，
尚在少阴，至十二日比之六日之际少愈焉，如果传至阳明，由此而传之厥阴，当六日之时。
前之邪气未尽传者，俱如太阳之尚在。头痛以至囊缩，诸证纷纭，甚于两感矣。七日之际，
焉得不死，反曰病衰乎？况太阳受病，若必传变六经，则二日阳明，三日少阳，本经犹有头
痛，至四日传太阴，太阴经不至头，当腹满咽干之时，不得有头痛矣。何必至七日而头痛少
愈也。或曰∶太阳传阳明，其未尽传者，尚在太阳，岂无是证欤？曰∶有之，是太阳阳明并
病之证也。若释太阳证衰而传之阳明，如此则非矣。由歧伯无更不传经，不加异气二句，而
马氏注《素问》∶遂失合仲景之意耳。或曰∶所谓更不传经者，谓六经传遍，七日当再传太
阳也，噫！此因成氏注释之谬，后世有是说耳，然已辨之详矣。或曰∶子谓更不传经，如曰
太阳更不传阳明者，有据乎？太阳篇曰∶伤寒一日，太阳受之，脉若静者，谓不传也。少阳
篇曰∶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，是皆当
传不传者也。虽仲景此篇似有可疑，曰头痛少愈，身热少歇，耳聋少闻，少腹微下，是病衰
而未全愈也。曰腹减如故，渴止舌干已，大气皆去，而后为全愈也。六经病衰与愈，何不同
欤？要之，仲景之论，本之《素问》，学其大体而已，即六经病衰之期，宁无先之者乎？后之
者乎？伤寒原不以日数拘也，况传经六日，至于囊缩，危且急矣。得至十二日病衰而囊纵者
，不可以为常也。学人当以圆通得之。
人感受寒邪，有阳证和阴证两种情况，阳证不再详细论述。文中所说的阴证，是指传经的阴证，即由三阳热病依次传入三阴经，出现腹部胀满、咽喉干燥、口燥渴、心烦腹满、睾丸收缩等症状的情况。还有直中的阴证，是寒邪不经过阳经而直接侵入三阴经，表现为无发热、怕冷、嘴唇发青、舌头卷缩、四肢厥冷、自发性腹泻等症状的情况。还有由阳证转变为阴证的阴证，即阳病时发汗或攻下太过，导致真气虚脱，或者患病期间护理不当，致使热邪转化为寒邪，其症状也如同寒邪直中阴经一样。除了这三种情况，就没有所谓的阴证了。然而如今吴地民间流传的说法，凡是房事后感受寒邪的，都称为阴证，这实在让人无法理解。如果男性因女性（房事）而得病叫阴证，那么女性因男性而得病的，难道应该叫阳证吗？既然有了这种错误的称呼，就必然会导致误治而使用温补的药物。假设这个人确实是阳虚感邪，尚且有因为误用补药而使邪气更盛的错误。如果是精血亏损、相火旺盛，与热邪一起炽盛的情况，这种误治的危害能说尽吗？使房劳后受寒，说是邪气趁虚而入是可以的，但直接称为阴证是不可以的。误称的危害小，误治的危害大，不得不加以辨析。
六经疾病是逐渐受邪的，其痊愈都以七日为一个周期，这是因为阳数七的缘故。《伤寒例》说：那些没有两感于寒的，如果不继续传经，也不夹杂其他病邪的，到第七天太阳病衰退，头痛稍微减轻；第八天阳明病衰退，身体发热稍微停止；第九天少阳病衰退，耳朵渐渐能听到声音；第十天太阴病衰退，腹部胀满消退恢复如常，开始想吃饭；第十一天少阴病衰退，口渴停止、舌干缓解，随后打喷嚏；第十二天厥阴病衰退，睾丸松弛，小腹轻微下坠，大气（指邪气）都已去除，病人精神清爽聪慧。这段关于六经七日病愈的论述，本于《素问·热论篇》，前后的注释者都有错误，都没有阐明清楚。我斗胆解释如下：“其”指的是伤寒，“不两感于寒”，意思是不是一天内同时传入阴阳两条经脉。“更不传经”，意思是邪气停留在此经，不再传入彼经。“不加异气”，意思是伤寒病热不重，没有感受寒、风、湿、温热等其他病邪而变成其他疾病。像这样，就可以推测六经病痊愈的日期了。《太阳篇》说：发于阳的七日痊愈，按这个数目计算，就知道六经的病从第一天受邪的，到第七天应当衰退。第二天受邪的，到第八天衰退。也是七日的数目。所以如果第七天邪气在太阳经，幸好不再传入阳明经，也没有发生变证，那么到第七天太阳病衰退，头痛稍微减轻；假如第二天邪气受于阳明经，不再传变，到第八天阳明病衰退，身体发热稍微减轻。又或者邪气受于少阳经，不再传变，到第九天少阳病衰退，耳朵微微能听到声音；假如第四天邪气传入少阴经，不再传变，到第十一天少阴病衰退，口渴停止、舌干缓解随后打喷嚏。又或者第六天邪气传入厥阴经，传经完毕不再传变，到第十二天厥阴病衰退，睾丸松弛、小腹轻微下坠，大气都已去除，病人精神清爽聪慧。这两句总括六经而言，意思是无论传还是不传，当病衰退时，都是大气去除而精神清爽。成无己注解说：六经传变，这与“更不传经”的说法相违背。《素问》马莳注解说：七日之际，巨阳病衰退，头痛稍微减轻。正是因为最初感受的邪气太盛。如果在第二天已经传入阳明经了。那还没有完全传入的在哪里呢？在太阳经到这里，比之一天的时候稍微减轻一些，第六天传到厥阴经，那还没有完全传入的，还在少阴经，到第十二天比之六天的时候稍微减轻一些，如果真的传到阳明经，由此再传到厥阴经，应当在第六天的时候。之前的邪气没有完全传入的，都像太阳经那样还在。头痛以至睾丸收缩，各种症状纷乱复杂，比两感证还要严重。到了第七天，怎么会不死，反而说病衰退呢？况且太阳经受病，如果一定要传遍六经，那么第二天阳明，第三天少阳，本经仍然会有头痛，到第四天传入太阴，太阴经不到头部，应该在腹部胀满、咽喉干燥的时候，不应该有头痛了。何必等到第七天头痛才稍微减轻呢？有人说：太阳传阳明，那没有完全传入的，还在太阳经，难道没有这样的证候吗？回答说：有的，这是太阳阳明并病的证候。如果解释为太阳证衰退而传给阳明，这样就错了。由于歧伯没有“更不传经，不加异气”这两句话，导致马氏注释《素问》失去了符合仲景原意的地方。有人说：所谓“更不传经”，是说六经传遍之后，第七天应当再传回太阳吧，唉！这是因成氏注释的错误，后世才有这种说法罢了，但我已经详细辨析过了。有人说：您说“更不传经”，比如说是太阳不再传阳明，有依据吗？《太阳篇》说：伤寒第一天，太阳经受邪，脉象平静的，叫做不传经。《少阳篇》说：伤寒第三天，三阳经邪气已尽，三阴经应当受邪，那人反而能吃饭且不呕吐，这是三阴经不受邪的表现，这些都是应当传而不传的。虽然仲景这篇似乎有疑问，说头痛稍微减轻，身体发热稍微停止，耳朵稍微能听到，小腹轻微下坠，这是病衰退而没有完全痊愈。说腹部胀满消退恢复如常，口渴停止舌干缓解，大气都已去除，这才是完全痊愈。六经病衰退与痊愈，为什么不同呢？总之，仲景的论述，本于《素问》，学习其大体而已，即使是六经病衰退的时期，难道没有先于此的吗？后有于此的吗？伤寒原本不以日数拘泥，何况传经六日，以至于睾丸收缩，危险且紧急了。能到第十二天病衰退而睾丸松弛的，不可以作为常规。学医的人应当圆通地理解它。
When a person is injured by cold, there are two types of syndromes: Yang and Yin. The Yang syndrome will not be discussed in detail. The Yin syndrome mentioned herein refers to the transmitted Yin syndrome, which originates from the heat diseases of the Three Yang meridians and subsequently transmits to the Three Yin meridians, presenting with symptoms such as abdominal fullness, dry throat, dry mouth with thirst, vexation and fullness, and retraction of the scrotum. There is also the direct invasion Yin syndrome, where cold pathogenic factors directly enter the Three Yin meridians without passing through the Yang meridians, presenting with symptoms such as absence of fever, aversion to cold, bluish lips, curled tongue, cold extremities, and spontaneous diarrhea. There is also the Yin syndrome resulting from the transformation of a Yang syndrome, which occurs when excessive sweating or purgation in a Yang disease leads to the depletion of true Qi, or when improper care during illness causes the heat pathogen to transform into cold, presenting similarly to the direct invasion of Yin meridians. Apart from these three, there is no so-called Yin syndrome. However, the common folk belief in the Wu region today is that any case of catching cold after sexual intercourse is termed Yin syndrome, which is truly incomprehensible. If a man contracting it due to women is called Yin syndrome, then should a woman contracting it due to men be called Yang syndrome? Since this erroneous terminology exists, it inevitably leads to misdiagnosis and the administration of warming and tonifying formulas. Even if the person indeed has Yang deficiency with pathogenic invasion, there is still the error of allowing the pathogen to intensify due to inappropriate tonification. In cases of essence depletion with hyperactive ministerial fire, combined with blazing heat pathogens, how can the harm of such misdiagnosis be overstated? It is acceptable to say that cold pathogenic factors invade due to deficiency after sexual exertion, but it is incorrect to directly term it Yin syndrome. The harm of misnaming is small, but the harm of misdiagnosis and mistreatment is great; therefore, it must be clarified.
The Six Meridians are affected gradually, and their recovery generally follows a seven-day cycle, based on the number Seven belonging to Yang. The *Shanghan Li* states: For those not suffering from simultaneous contraction of Yin and Yang meridians by cold, if the pathogen does not transmit further to other meridians and no mixed pathogenic factors are added, by the seventh day, the Taiyang disease declines, and headache slightly improves; by the eighth day, the Yangming disease declines, and body heat slightly subsides; by the ninth day, the Shaoyang disease declines, and hearing gradually returns; by the tenth day, the Taiyin disease declines, abdominal fullness resolves as before, and appetite returns; by the eleventh day, the Shaoyin disease declines, thirst ceases, dry tongue alleviates, followed by sneezing; by the twelfth day, the Jueyin disease declines, the scrotum relaxes, lower abdomen slightly descends, the vital qi (pathogenic factor) is expelled, and the patient's spirit becomes clear and bright. This discussion on the recovery of Six Meridian diseases within seven days is based on the *Suwen · Lun Re Pian* (Treatise on Heat Diseases). Commentators on both texts have made errors and failed to clarify the matter. I dare to explain as follows: "Qi" here refers to Shanghan (cold damage). "Not suffering from simultaneous contraction of Yin and Yang meridians by cold" means that Yin and Yang meridians are not simultaneously affected on the first day. "Does not transmit further to other meridians" means the pathogen stays in the current meridian and does not transmit to others. "No mixed pathogenic factors added" means the heat of Shanghan is not severe, and there is no infection with cold, wind, dampness, or warm-heat pathogens causing transformation into other diseases. Under such circumstances, one can predict the recovery dates for the Six Meridian diseases. The *Taiyang Pian* states: Those originating from Yang recover in seven days. Calculating according to this number, we know that diseases of the Six Meridians contracted on the first day will decline by the seventh day. Those contracted on the second day will decline by the eighth day. This is also a seven-day cycle. Therefore, if on the seventh day the pathogen is in the Taiyang meridian and fortunately does not transmit to Yangming, nor undergoes transformation, then by the seventh day, Taiyang disease declines, and headache slightly improves. If, however, the pathogen was contracted in Yangming on the second day and did not transmit further, by the eighth day, Yangming disease declines, and body heat slightly subsides. Or if the pathogen was contracted in Shaoyang and did not transmit further, by the ninth day, Shaoyang disease declines, and hearing slightly returns. If on the fourth day the pathogen transmitted to Shaoyin and did not transmit further, by the eleventh day, Shaoyin disease declines, thirst ceases, dry tongue alleviates, followed by sneezing. Or if on the sixth day the pathogen transmitted to Jueyin, completing the transmission without further change, by the twelfth day, Jueyin disease declines, the scrotum relaxes, lower abdomen slightly descends, the vital qi is expelled, and the patient's spirit becomes clear and bright. These last two sentences summarize the Six Meridians, meaning whether transmitted or not, when the disease declines, the vital qi is expelled and the spirit becomes clear. Cheng Wuji commented: The transmission of the Six Meridians contradicts the statement "does not transmit further to other meridians." Ma Shi's commentary on the *Suwen* states: At the seventh day, the Great Yang (Taiyang) disease declines, and headache slightly improves. This is because the initially contracted pathogen was too strong. If it had already transmitted to Yangming on the second day, where is the part that has not fully transmitted? It remains in Taiyang, improving slightly compared to the first day. By the sixth day, it reaches Jueyin, and the part not fully transmitted remains in Shaoyin, improving slightly compared to the sixth day by the twelfth day. If it truly transmitted to Yangming and then to Jueyin, it should have happened by the sixth day. The previously untransmitted pathogenic factors would remain like those in Taiyang. Headache to scrotal retraction, various symptoms chaotic and complex, worse than simultaneous contraction. How could one not die by the seventh day, yet claim the disease is declining? Moreover, if Taiyang disease must transmit through all Six Meridians, then on the second day Yangming, third day Shaoyang, the original meridian would still have headache. By the fourth day transmitting to Taiyin, since Taiyin does not reach the head, at the time of abdominal fullness and dry throat, there should be no headache. Why wait until the seventh day for headache to slightly improve? Some ask: When Taiyang transmits to Yangming, isn't there a condition where the untransmitted part remains in Taiyang? I answer: Yes, this is the syndrome of concurrent Taiyang and Yangming disease. Interpreting it as Taiyang syndrome declining and transmitting to Yangming is incorrect. Because Qibo did not include the phrases "does not transmit further to other meridians" and "no mixed pathogenic factors added," Ma Shi's commentary on the *Suwen* lost alignment with Zhang Zhongjing's intent. Some ask: What is meant by "does not transmit further to other meridians"? Does it mean that after the Six Meridians are fully transmitted, they should transmit back to Taiyang on the seventh day? Alas! This view arose from Cheng Wuji's erroneous commentary, propagated in later generations, but I have already refuted it in detail. Some ask: You say "does not transmit further to other meridians," such as Taiyang not transmitting to Yangming, is there evidence? The *Taiyang Pian* states: On the first day of Shanghan, Taiyang is affected; if the pulse is quiet, it is called non-transmission. The *Shaoyang Pian* states: On the third day of Shanghan, the Three Yang meridians' qi is exhausted, and the Three Yin meridians should receive the pathogen; if the person can eat and does not vomit, this indicates the Three Yin meridians do not receive the pathogen. These are instances of expected transmission not occurring. Although Zhang Zhongjing's text here seems questionable, stating "headache slightly improves, body heat slightly subsides, hearing slightly returns, lower abdomen slightly descends" indicates disease decline but not complete recovery. Stating "abdominal fullness resolves as before, thirst ceases, dry tongue alleviates, vital qi is expelled" indicates complete recovery. Why are the decline and recovery of the Six Meridian diseases different? In essence, Zhang Zhongjing's theory is based on the *Suwen*, learning its general principles. Regarding the timing of Six Meridian disease decline, are there precedents earlier or later? Shanghan is not rigidly bound by days. Furthermore, after six days of transmission leading to scrotal retraction, the condition is critical and urgent. To reach the twelfth day with disease decline and relaxed scrotum cannot be considered the norm. Students of medicine should understand this with flexibility.