《内经》风厥并陈，后世不察，概以卒倒暴厥之急候名为中风，仅以手足逆冷则名为厥
，抑
何颠倒之甚也。经云∶暴厥者，不知与人言。又云∶血之与气，并走于上，则为大厥，厥则
暴死，气复反则生，不反则死。又云∶手足少阴太阴，足阳明，五络俱竭，令人身脉俱动，
而形无知，其状若尸，或曰尸厥。观此则不但手足之谓，辨之之法，静而不搐者为厥，动而
伸搐者为风；脉微身冷者为厥，脉浮身暖者为风。风为邪气有余，病多经络之受伤。厥为正
气不足，或挟气食卒倒，纯系外邪。病形俱实者，乃为中风。气衰邪犯，形虚病实者，即名
风厥。绝无外邪，形病俱虚者，是名暴厥。又若因气、因食、因邪祟暴仆之证，既可名中气
、中恶、中食，亦可名气厥、食厥、尸厥也。如此则经旨彰明。风厥有别，而从来类中风证
纷纷辨喙可息矣。
（从李念莪删本）
伤寒一法，变态不测。其中立言之善，无出仲景。用药之善，须逊节庵。其于曲折之
靡不详尽，余复何言？然犹有不能已于言者，在于条目之洪繁，而后学求之不易也。陶节庵
曰∶得其纲领，易如拾芥，脉证与理而已，求之多歧，则支离破碎，如涉海问津矣。脉证者
，表里阴阳虚实寒热也。理者如其常，通其变也。多歧者，蔓衍之方书也。余有感于斯言，
约
六法以尽之。曰∶汗吐下温清补。汗者，治其表也，而汗法有三，一曰温散，寒胜之时，阴
胜之脏，阳气不充，则表不解，身虽有大热，必用辛温。一曰凉解，炎热炽盛，表里枯涸，
阴气不荣，亦不能汗，宜用辛凉。一曰平解，病在阴阳之间，既不可温，又不可凉，但宜平
用期于解表而已。吐者，治在上也，吐中有发散之意，可去胸中之实。经曰∶在上者，因而
越之是也。下者，攻其里也。而下法有五，痞满在气，燥实在血，四证具者，攻之宜峻也。
但见满燥实者，攻之稍缓。但见痞实者，攻之更缓，或行血蓄，或逐水停，轻重缓急，随证
变通也。温者温其中也，脏有寒邪，不温则死。夫气为阳，气虚则寒，故温即是补。又名救
里者，以阳虚可危，急当救里也。清者清其热也，有热无结，本非下证，若不清之，热何由
散，下后余邪亦宜清之。补者补其虚也，古人言之已详，今人畏而不用，使伤寒犯虚者，坐
而待毙，大可憾也！如屡发而汗不解，阴不能达也，人知汗属于阳，升阳可以解表，不知汗
生于阴，滋阴可以发汗也。又如内热不解，屡清火而不退，阴不足也，人知寒凉可以退热，
不知壮水可以清火。又如正虚邪炽，久而不痊，补正则里自除，温中则邪自散，此必见衰微
之阴脉者也。《伤寒论》曰∶阴证得阳脉者生，阳证见阴脉者死。人皆奉其言，未知释其义
。夫正气实者，多见阳脉；正气者，多见阴脉。证之阳者，假实也；脉之阴者，真虚也。陈
氏
曰∶凡察阴证，不论热与不热，惟凭脉用药，是为稳当，不论浮沉大小，但指下无力，重按
全无，便是伏阴。然则沉小者，人知为阴脉，而不知浮大者，亦有阴脉也，是则伤寒虽有万
变，虚实二字，可以提纲。正胜则愈，邪胜则死。正气实者，虽感大邪，其病亦轻。正气虚
者，虽感微邪，其病亦重。气实而病者，攻之即愈，虽不服药，经尽亦安，何足虑也。所可
虑者，惟挟虚耳。奈何庸浅之辈，不察虚实，但见发热，动手便攻，虚而攻之，无不死者。
且曰伤寒无补法，谬之甚矣！独不观仲景三百九十七法，而治虚寒者，一百有奇。垂一百一
十三方，而用人参附桂八十有奇，东垣、丹溪、节庵，亦有补中益气，回阳返本，温经益元
等汤，未尝不补也，而谓伤寒无补法可欤。
《黄帝内经》中同时论述了风病和厥病，后世医家没有仔细考察，一概将突然昏倒、暴然昏厥的急症命名为“中风”，仅仅将手足逆冷的症状命名为“厥”，这颠倒得也太严重了。经文说：突然昏厥的人，不能与人言语。又说：血与气一起向上冲逆，就会发生大厥，大厥会导致突然死亡，如果气机能够回复则生，不能回复则死。又说：手少阴心经、足少阴肾经、手太阴肺经、足太阴脾经以及足阳明胃经这五条经络的气血都衰竭时，会让人全身脉搏跳动，但形体无知觉，其状态像尸体一样，有的称之为“尸厥”。看这些记载，可知“厥”不仅仅指手足寒冷。辨别的方法在于：安静而不抽搐的是厥，躁动且伸展抽搐的是风；脉象微弱、身体冰冷的是厥，脉象浮起、身体温暖的是风。风邪属于邪气有余，多导致经络受伤；厥证属于正气不足，或者夹杂气滞、食积而突然昏倒，纯粹由外邪引起。病形表现为实证的，才称为中风；气衰微而外邪侵犯，形体虚弱而病势实盛的，就称为风厥；完全没有外邪，形体和病势都虚弱的，称为暴厥。另外，如果是因气、因食、因邪祟导致的突然仆倒之证，既可以称为中气、中恶、中食，也可以称为气厥、食厥、尸厥。这样，《内经》的宗旨就彰明了。风与厥有区别，而历来关于类中风证的纷纷争论就可以平息了。
（选自李念莪删减本）
治疗伤寒的方法，变化莫测。其中立论的精妙，没有超过张仲景的；用药的精当，应当逊于陶节庵（陶华）。对于其中曲折详尽之处，我还有什么可说的呢？然而仍有不能不说的，在于条文繁多，后学者难以掌握。陶节庵说：掌握了纲领，就容易得像捡草芥一样，关键在于脉、证与理。追求过多歧路，就会支离破碎，如同渡海寻找渡口。所谓脉证，就是表里、阴阳、虚实、寒热。所谓理，就是遵循常法，通晓变通。所谓多歧，是指繁杂蔓衍的方书。我对此深有感触，将其概括为六法来总结它。即：汗、吐、下、温、清、补。
汗法，是治疗表证的，但汗法有三种：一是温散，在寒气胜之时，阴胜的脏腑，阳气不充盛，则表证不解，虽然身体有大热，必须用辛温药物。二是凉解，炎热炽盛，表里枯涸，阴气不能荣养，也不能发汗，宜用辛凉药物。三是平解，病在阴阳之间，既不可温，又不可凉，只宜平和地运用以期解除表证而已。
吐法，是治疗上部病证的，吐法中有发散的意思，可以去除胸中的实邪。经文说：“病在上者，因而越之”，就是这个道理。
下法，是攻逐里证的。而下法有五种情况：痞满在气分，燥实在血分，四证（痞、满、燥、实）具备的，攻下宜峻猛。只见满、燥、实的，攻下稍缓。只见痞、实的，攻下更缓，或者是行血蓄，或者是逐水停，轻重缓急，随证变通。
温法，是温补其中的，脏腑有寒邪，不温补就会死亡。气属阳，气虚则寒，所以温即是补。又名救里法，因为阳虚可危，急需救里。
清法，是清除热邪的，有热无结聚，本来不是下法的适应证，如果不清解它，热从哪里消散？下法之后残留的邪气也宜清解。
补法，是补益虚损的，古人已经讲得很详细了，现在的人畏惧而不用，使得患伤寒犯虚证的人坐以待毙，非常令人遗憾！比如多次发汗而病不解，是因为阴液不能达出，人们知道汗属于阳，升发阳气可以解表，却不知道汗生于阴，滋阴可以发汗。又如内热不解，多次清热火而退不了，是因为阴不足，人们知道寒凉可以退热，却不知道壮水（滋阴）可以清火。又如正气虚弱而邪气炽盛，久治不愈，补正气则里自除，温中焦则邪自散，这必定是见到衰微的阴脉的情况。《伤寒论》说：阴证得阳脉者生，阳证见阴脉者死。人们都信奉这句话，却不知解释其含义。正气实者，多见阳脉；正气虚者，多见阴脉。证候表现阳的，是假实；脉象表现阴的，是真虚。陈氏说：凡是诊察阴证，不论是否有热，只凭脉象用药，才是稳妥的，不论脉浮沉大小，只要指下无力，重按全无，便是伏阴。既然如此，沉小脉，人们知道是阴脉，却不知道浮大脉，也有阴脉的情况。那么伤寒虽然有万种变化，虚实二字，可以作为提纲。正气胜则痊愈，邪气胜则死亡。正气实者，即使感受大邪，病也轻。正气虚者，即使感受微邪，病也重。气实而发病的，攻下即愈，即使不服药，经过一个病程周期也能平安，有什么可忧虑的呢？所可忧虑的，只有兼夹虚证罢了。奈何庸俗浅薄之辈，不察虚实，只见发热，动手就攻下，虚证而攻下，没有不死的。还说“伤寒无补法”，谬误太严重了！难道没看过张仲景三百九十七法，其中治疗虚寒的有一百多种吗？列出一百一十三方，而用人参、附子、桂枝的有八十多方，李东垣、朱丹溪、陶节庵，也有补中益气、回阳返本、温经益元等汤剂，未尝不补，怎么能说伤寒无补法呢？
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) discusses both Wind (*Feng*) and Jue (*Jue*) together. Later generations failed to examine this carefully, generally naming acute conditions characterized by sudden collapse or violent syncope as "Zhong Feng" (Wind Strike), and merely naming conditions with cold extremities as "Jue". How inverted is this understanding! The classics state: "In cases of sudden Jue, the patient loses the ability to speak." It also states: "When blood and Qi rush upward together, it results in Da Jue (Great Jue); Da Jue leads to sudden death. If Qi returns, the patient lives; if it does not return, the patient dies." Furthermore, it states: "When the meridians of Hand-Shaoyin, Foot-Shaoyin, Hand-Taiyin, Foot-Taiyin, and Foot-Yangming are all exhausted, the body's pulses may move, but the form becomes insensible, resembling a corpse; this is sometimes called Shi Jue (Corpse Jue)." From these records, it is clear that "Jue" refers not only to cold extremities. The method for differentiation is as follows: Quietness without convulsions indicates Jue; agitation with extension and convulsions indicates Wind; a faint pulse with a cold body indicates Jue; a floating pulse with a warm body indicates Wind. Wind represents an excess of pathogenic factors, often injuring the meridians and collaterals. Jue represents a deficiency of healthy Qi, or sudden collapse due to Qi stagnation or food retention, purely caused by external pathogens. When the clinical presentation is excess, it is termed Zhong Feng. When Qi is deficient and invaded by external pathogens, with a weak constitution but intense pathology, it is named Feng Jue. When there is absolutely no external pathogen, and both the constitution and pathology are deficient, it is named Bao Jue (Sudden Jue). Additionally, conditions of sudden collapse due to Qi, food, or malevolent influences can be named Zhong Qi (Qi Strike), Zhong E (Evil Strike), or Zhong Shi (Food Strike), and can also be referred to as Qi Jue, Shi Jue, or Shi Jue. In this way, the intent of the classics becomes clear. With Wind and Jue distinguished, the endless debates regarding "pseudo-Wind Strike" syndromes can cease.
(From Li Nian'e's abridged edition)
The methods for treating Shang Han (Cold Damage) are unpredictable in their variations. Among them, the excellence in theoretical exposition surpasses none compared to Zhang Zhongjing. The excellence in herbal prescription should yield to Tao Jie'an (Tao Hua). Regarding the detailed explanations of complex nuances, what more can I say? However, there is something I cannot refrain from discussing: the abundance of categories makes it difficult for students to grasp. Tao Jie'an said: "Once you grasp the general principles, it is as easy as picking up a mustard seed; it lies only in Pulse, Syndrome, and Principle. Seeking too many divergent paths leads to fragmentation, like crossing the sea looking for a ferry." By "Pulse and Syndrome," we mean Exterior/Interior, Yin/Yang, Deficiency/Excess, Cold/Heat. By "Principle," we mean following the constant laws and understanding the changes. By "divergent paths," we refer to the sprawling and redundant medical texts. Inspired by these words, I have summarized them into six methods: Sweating (Han), Vomiting (Tu), Purging (Xia), Warming (Wen), Clearing (Qing), and Tonifying (Bu).
The Sweating method treats Exterior syndromes, but it has three types: First, Warm Dispersal. When cold prevails, and the Yin-predominant organs lack sufficient Yang Qi, the Exterior remains unresolved. Even if there is high fever, acrid-warm herbs must be used. Second, Cool Resolution. When heat is blazing, causing dryness in the Interior and Exterior, and Yin Qi fails to nourish, sweating cannot occur naturally; acrid-cool herbs should be used. Third, Balanced Resolution. When the disease lies between Yin and Yang, neither warming nor cooling is appropriate; one should use balanced methods to resolve the Exterior.
The Vomiting method treats disorders in the Upper Jiao. Vomiting contains the intent of dispersal and can remove excess from the chest. As the classics state: "For disorders above, induce vomiting to expel them."
The Purging method attacks the Interior. There are five degrees of purging: Pi (stagnation/fullness) involves Qi; Zao (dryness) involves Blood. When all four signs (Pi, Man, Zao, Shi) are present, aggressive purging is suitable. If only Man (fullness), Zao (dryness), and Shi (excess) are seen, purging should be milder. If only Pi (stagnation) and Shi (excess) are present, purging should be even gentler, whether moving blood stasis or draining fluid retention; severity and urgency vary according to the syndrome.
The Warming method warms the Middle/Interior. If the zang organs harbor cold pathogens, failure to warm will lead to death. Qi belongs to Yang; Qi deficiency leads to cold, so warming is equivalent to tonifying. It is also called the "Rescue the Interior" method because Yang deficiency is critical and requires immediate intervention.
The Clearing method clears Heat. If there is Heat without accumulation, it is not a case for purging. If not cleared, how will the Heat dissipate? Residual pathogens after purging should also be cleared.
The Tonifying method tonifies Deficiency. Ancients discussed this in detail, yet modern practitioners fear it and do not use it, leaving those with Shang Han complicated by deficiency to wait passively for death, which is deeply regrettable! For instance, if repeated sweating fails to resolve the condition, it is because Yin fluids cannot reach the surface. People know sweat belongs to Yang and that raising Yang can resolve the Exterior, but they do not know that sweat is born from Yin, and nourishing Yin can promote sweating. Similarly, if internal Heat persists despite repeated clearing, it is due to Yin insufficiency. People know cold-natured herbs can reduce fever, but they do not know that strengthening Water (nourishing Yin) can extinguish Fire. Furthermore, when Healthy Qi is deficient and Pathogenic Factors are rampant, leading to prolonged illness, tonifying Healthy Qi removes the Interior disorder, and warming the Middle scatters the Pathogen; this situation typically presents with a faint Yin-type pulse. The *Shanghan Lun* states: "Yin syndromes presenting with Yang pulses indicate survival; Yang syndromes presenting with Yin pulses indicate death." Everyone reveres this statement but few explain its meaning. Those with robust Healthy Qi often show Yang pulses; those with deficient Healthy Qi often show Yin pulses. Yang manifestations in symptoms represent false excess; Yin manifestations in pulses represent true deficiency. Chen stated: "When examining Yin syndromes, regardless of the presence or absence of Heat, rely solely on the pulse for medication; this is secure. Regardless of whether the pulse is floating/sinking or large/small, if it feels powerless under the finger and vanishes upon heavy pressure, it indicates hidden Yin." Thus, while people know sinking/small pulses are Yin pulses, they fail to realize that floating/large pulses can also be Yin pulses. Therefore, although Shang Han has myriad variations, the concepts of Deficiency and Excess serve as the guiding principle. If Healthy Qi prevails, recovery occurs; if Pathogenic Factors prevail, death ensues. Those with robust Healthy Qi, even if infected by severe pathogens, suffer mild disease. Those with deficient Healthy Qi, even if infected by slight pathogens, suffer severe disease. Cases where Qi is excess and disease arises are cured by purging; even without medication, the disease resolves after the natural course, requiring no worry. The only thing to worry about is complications with deficiency. Alas, mediocre and shallow practitioners, failing to distinguish Deficiency and Excess, see only fever and immediately resort to purging. Purging in deficiency leads inevitably to death. They claim "there is no tonification method for Shang Han," which is extremely erroneous! Have they not observed Zhang Zhongjing's 397 methods, among which over 100 treat deficiency-cold? Of his 113 prescriptions, over 80 contain Renshen (Ginseng Radix), Fuzi (Aconite Lateralis Radix Praeparata), or Guizhi (Cinnamon Twig). Dongyuan (Li Dongyuan), Danxi (Zhu Danxi), and Jie'an (Tao Hua) also utilized formulas such as Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Huiyang Fanben Tang (Restore Yang and Return to Origin Decoction), and Wenjing Yiyuan Tang (Warm Meridians and Benefit Source Decoction). They did not neglect tonification; how can one say there is no tonification method for Shang Han?