（三阳有合病而三阴无合病不可不知也）
伤寒合病脉浮长。长是阳明浮太阳。目痛鼻干知属胃。（阳明）头疼腰痛是膀
胱。（太阳）少阳
中得长
脉。少阳之病合阳明。\x（弦
脉浮而长者。太阳、阳明合病。浮而弦者。太阳、少阳合病。弦而长。外有少阳证者。
少阳
小便
不
者
气
俱
（并者譬如二人博金并归一家之义）
太阳元与阳明病。后并归来作一家。尚有太阳宜发汗。太阳证罢下无差。
太阳初得病发其汗。汗先出不彻。因转属阳明。续自微汗出。不恶寒者是也。若发大汗
不出
何以
汤。
（伤寒与他证不同投药一差生死立判李子健伤寒十劝不可不知人家有病
者知此十劝则不至有误所益非轻今详具之）
一、伤寒头痛及身热。便是阳证。不可用热药。
伤寒传变共六经。而太阳为首。太阳病。头疼身热。少阴病。有身热而无头疼。厥阴病。
有
二、伤寒必须直攻毒瓦斯。不可补益。
邪气在经络中。若随证早攻。只三四日痊。若妄谓先须补益。再行攻毒。则便毒瓦斯愈炽。
多
三、伤寒不思饮食者。不可服温脾胃药。
伤寒不思饮食自是常事。终无饿死之理。如理中丸之类不可轻用。若阳病服之。致热气
增重
四、伤寒腹疼亦有热证。不可轻服温暖之药。
难经云。痛为实。故仲景论腹有时痛之证。有曰病甚者加大黄。夫痛甚而加大黄。意可
见也
五、伤寒自利。当看阳阴证。不可例服补药。暖药。止泻药。
自利。惟身不热。手足温者。属太阴。身冷四逆者。属少阴、厥阴。其余身热下利属阳。
见
六、伤寒胸胁痛及腹胀满。不可妄用艾灸。
尝闻村落见有此证无药。即用艾灸。多致毒瓦斯随火而盛。膨胀发喘以死。不知胸胁痛自
属少
七、伤寒手足厥冷。当看阴阳。不可例作阴证。
厥有阴厥。有阳厥。医者少能分辨。若阳厥而投热药。杀人速于用刃。盖阳病不至于热
极不
身热至
宜急
见热
沉而
八、伤寒病已在里。即不可用药发汗。
伤寒病须看表里。如发热恶寒则是在表证。宜发汗。如不恶寒反恶热。即是里证。若一
例发
里之
九、伤寒饮水为欲愈。不可令病患恣饮过度。
病患大渴。当与之水以消热气。故仲景以饮水为欲愈。人见此说。遂令病者恣饮。因而
为
与半
十、伤寒初安不可过饱。及劳动或行房。或食羊肉。及食猪骨汁。并饮酒。
病方愈不须再服药。兼脾胃尚弱。食饱不能消化，病即再来。谓之食复。病方好气血尚
虚。劳动太早。病即再来。谓之劳复。又食羊肉行房并死。食猪骨汁并饮酒者。再病必重也。
凡饮食滋味所以养生。自非服药炼液。焉能不饮食乎。然食之有妨。反能为害。窃见时
人不
所食
汁以
肺病
不食
气入
炙不
及身本
者。不
皆有毒。
食
疫死牛肉
（三阳有合病而三阴无合病不可不知也）
三阳经存在合病的情况，而三阴经没有合病，这一点是不可不知道的。
伤寒合病脉浮长。长是阳明浮太阳。目痛鼻干知属胃。（阳明）头疼腰痛是膀胱。（太阳）少阳中得长脉。少阳之病合阳明。
伤寒合病的脉象表现为浮而长。脉长属于阳明经，脉浮属于太阳经。眼睛疼痛、鼻子干燥，知道是归属于胃（阳明经）。头痛、腰痛是归属于膀胱（太阳经）。在少阳经的病证中出现长的脉象，这是少阳病与阳明病相合。
（弦脉浮而长者。太阳、阳明合病。浮而弦者。太阳、少阳合病。弦而长。外有少阳证者。少阳小便不气俱）
（注：原文此处文字错乱严重，根据中医理论及上下文逻辑补全意译如下：）
脉象弦且浮而长的，是太阳经与阳明经的合病。脉象浮且弦的，是太阳经与少阳经的合病。脉象弦且长，外部有少阳经证候表现的，是少阳经……（原文残缺，意指少阳与其他经合病或涉及小便不利等症，因原文“小便不气俱”语意不通，仅保留前文清晰部分）。
（并者譬如二人博金并归一家之义）
所谓“并病”，就像两个人赌博输赢的钱合并归入一个家庭一样的含义。
太阳元与阳明病。后并归来作一家。尚有太阳宜发汗。太阳证罢下无差。
太阳经原本就有病，后来并与阳明经的病证结合成为一体。如果还有太阳经的表证，适宜用发汗法治疗。如果太阳经的证候已经消除，则可以使用下法，但如果没有差错的话……（原文此处逻辑跳跃，意指辨证施治）。
太阳初得病发其汗。汗先出不彻。因转属阳明。续自微汗出。不恶寒者是也。若发大汗不出何以汤。
太阳经刚患病时发汗，汗出得不透彻，因此病邪转属到阳明经。随后出现微微出汗，不恶寒，这就是转属阳明的表现。如果大发其汗却不出汗，用什么方剂呢？（原文此处似有缺漏或指代不明，依理译为疑问句）。
（伤寒与他证不同投药一差生死立判李子健伤寒十劝不可不知人家有病者知此十劝则不至有误所益非轻今详具之）
伤寒与其他病症不同，用药一旦出错，生死立刻判定。李子健《伤寒十劝》是不可不知道的。人家如果有病患，知道了这十条劝诫就不会有误，益处非常大，现在详细列举如下：
一、伤寒头痛及身热。便是阳证。不可用热药。
伤寒出现头痛和身体发热，就是阳证，不可以使用热性药物。
伤寒传变共六经。而太阳为首。太阳病。头疼身热。少阴病。有身热而无头疼。厥阴病。有……
伤寒的传变共有六经，以太阳经为首。太阳病，表现为头痛、身体发热。少阴病，有身体发热但没有头痛。厥阴病，有……（原文此处截断，通常厥阴病为寒热错杂或纯寒/纯热，依前文对比语境，此处仅翻译可见部分）。
二、伤寒必须直攻毒瓦斯。不可补益。
伤寒必须直接攻逐毒邪（毒瓦斯），不可以进行补益治疗。
邪气在经络中。若随证早攻。只三四日痊。若妄谓先须补益。再行攻毒。则便毒瓦斯愈炽。多……
邪气在经络中，如果根据证候早期攻逐，只需三四天就能痊愈。如果错误地认为必须先补益，然后再攻毒，那么毒邪就会更加炽盛，导致……（原文截断）。
三、伤寒不思饮食者。不可服温脾胃药。
伤寒不想吃东西，不可以服用温补脾胃的药物。
伤寒不思饮食自是常事。终无饿死之理。如理中丸之类不可轻用。若阳病服之。致热气增重
伤寒不想吃饭本来就是常事，终究没有饿死的道理。像理中丸之类的药物不可以轻易使用。如果是阳证病人服用了它，会导致热气加重。
四、伤寒腹疼亦有热证。不可轻服温暖之药。
伤寒腹痛也有热证，不可以轻易服用温热的药物。
难经云。痛为实。故仲景论腹有时痛之证。有曰病甚者加大黄。夫痛甚而加大黄。意可见也
《难经》说，疼痛属于实证。所以张仲景论述腹部有时疼痛的证候，有的说病情严重的加大黄。既然疼痛严重而加大黄，其中的意思就可以看出来了。
五、伤寒自利。当看阳阴证。不可例服补药。暖药。止泻药。
伤寒自发性腹泻，应当辨别是阳证还是阴证，不可以一概服用补药、暖药或止泻药。
自利。惟身不热。手足温者。属太阴。身冷四逆者。属少阴、厥阴。其余身热下利属阳。见……
自发性腹泻，只有身体不发热、手脚温暖的，属于太阴病。身体寒冷、四肢逆冷的，属于少阴病、厥阴病。其余身体发热伴腹泻的属于阳证。见到……（原文截断）。
六、伤寒胸胁痛及腹胀满。不可妄用艾灸。
伤寒出现胸胁疼痛以及腹部胀满，不可以胡乱使用艾灸。
尝闻村落见有此证无药。即用艾灸。多致毒瓦斯随火而盛。膨胀发喘以死。不知胸胁痛自属少……
曾经听说乡村里见到这种证候没有药，就立即使用艾灸，大多导致毒邪随着火势而旺盛，造成腹部膨胀、气喘而死。不知道胸胁疼痛自然归属于少阳……（原文截断）。
七、伤寒手足厥冷。当看阴阳。不可例作阴证。
伤寒出现手脚冰凉，应当辨别阴阳，不可以一概当作阴证。
厥有阴厥。有阳厥。医者少能分辨。若阳厥而投热药。杀人速于用刃。盖阳病不至于热极不……身热至……宜急……见热沉而……
厥证有阴厥，有阳厥，医生很少能分辨清楚。如果是阳厥却投用热性药物，杀人比用刀还快。因为阳证不至于热极……身体热至……应当紧急……见到热象沉伏而……（原文多处截断，仅翻译清晰部分）。
八、伤寒病已在里。即不可用药发汗。
伤寒病邪已经在体内（里证），就不可以用药发汗。
伤寒病须看表里。如发热恶寒则是在表证。宜发汗。如不恶寒反恶热。即是里证。若一例发……里之……
伤寒病必须看表里。如果发热恶寒，那就是表证，适宜发汗。如果不恶寒反而怕热，那就是里证。如果一概发汗……里证……（原文截断）。
九、伤寒饮水为欲愈。不可令病患恣饮过度。
伤寒病人想喝水是想要痊愈的表现，不可以让病患随意过量饮水。
病患大渴。当与之水以消热气。故仲景以饮水为欲愈。人见此说。遂令病者恣饮。因而为……与半……
病患极度口渴，应当给他水来消除热气。所以张仲景认为想喝水是即将痊愈的迹象。人们看到这种说法，就让病患随意大量饮水，因而导致……给一半……（原文截断）。
十、伤寒初安不可过饱。及劳动或行房。或食羊肉。及食猪骨汁。并饮酒。
伤寒刚刚安定（好转），不可以吃得太饱，以及从事体力劳动或性生活，或者吃羊肉，以及喝猪骨汤，并且饮酒。
病方愈不须再服药。兼脾胃尚弱。食饱不能消化，病即再来。谓之食复。病方好气血尚虚。劳动太早。病即再来。谓之劳复。又食羊肉行房并死。食猪骨汁并饮酒者。再病必重也。凡饮食滋味所以养生。自非服药炼液。焉能不饮食乎。然食之有妨。反能为害。窃见时人不……所食……汁以……肺病……不食……气入……炙不……及身本……者。不……皆有毒。食疫死牛肉
病刚好，不需要再吃药。加上脾胃还很虚弱，吃太饱不能消化，病就会再次发作，这叫“食复”。病刚好气血还虚弱，过早劳动，病就会再次发作，这叫“劳复”。另外吃羊肉、行房事可能导致死亡，喝猪骨汤并饮酒的人，再次生病一定会加重。凡是饮食的味道是用来养生的，除非服药炼液，怎么能不饮食呢？然而食物如果有妨碍，反而会成为危害。我私下看见当时的人不……所吃的……汁用来……肺病……不吃……气进入……烤不……以及身体根本……的人……都有毒。吃瘟疫死亡的牛肉
(Note: The original text contains significant fragmentation and corruption. The translation below reflects the available content, with ellipses or brief notes indicating missing parts where the source is unintelligible.)
(Three Yang meridians have combined diseases, while Three Yin meridians do not; this must be known.)
Combined diseases exist in the Three Yang meridians, but not in the Three Yin meridians; this fact must be understood.
In cold damage combined disease, the pulse is floating and long. Long indicates Yangming, floating indicates Taiyang. Eye pain and dry nose indicate involvement of the Stomach (Yangming). Headache and lower back pain indicate involvement of the Bladder (Taiyang). A long pulse obtained in Shaoyang indicates Shaoyang disease combined with Yangming.
In cold damage combined disease, the pulse presents as floating and long. A long pulse corresponds to the Yangming meridian, and a floating pulse corresponds to the Taiyang meridian. Pain in the eyes and dryness of the nose indicate pathology belonging to the Stomach (Yangming meridian). Headache and lower back pain indicate pathology belonging to the Bladder (Taiyang meridian). Obtaining a long pulse within Shaoyang pathology indicates Shaoyang disease combined with Yangming.
(Note: The following segment regarding pulse characteristics is fragmented in the source.)
A pulse that is wiry, floating, and long indicates combined disease of Taiyang and Yangming. A pulse that is floating and wiry indicates combined disease of Taiyang and Shaoyang. A pulse that is wiry and long, with external Shaoyang symptoms... [Text corrupted].
(The term "Bing" [combined disease] is like the meaning of two people merging their gambling winnings into one household.)
The concept of "Bing" (combined disease) is analogous to two individuals merging their assets into a single household.
Originally, Taiyang and Yangming diseases are separate. Later, they merge into one entity. If Taiyang symptoms remain, sweating therapy is appropriate. Once Taiyang symptoms cease, purgation may be used without error.
Initially, Taiyang and Yangming diseases are distinct. Subsequently, they merge into a single clinical presentation. If Taiyang exterior symptoms persist, diaphoretic therapy should be employed. If Taiyang symptoms have resolved, purgative therapy may be applied, provided there is no diagnostic error.
When Taiyang disease is first acquired, sweating therapy is induced. If the sweat is initially incomplete, the pathogen may transfer to Yangming. Subsequent spontaneous slight sweating and absence of aversion to cold characterize this transfer. If massive sweating fails to produce sweat, what decoction should be used? [Text implies a query about treatment failure].
Upon initial acquisition of Taiyang disease, diaphoresis is induced. If the perspiration is insufficient, the pathogen may shift to the Yangming stage. This is characterized by subsequent mild spontaneous sweating and an absence of aversion to cold. If profuse sweating fails to induce perspiration, which formula should be utilized? [Source text is fragmented here].
(Cold damage differs from other conditions; a single medication error can determine life or death instantly. Li Zijian's "Ten Admonitions on Cold Damage" must be known. For households with illness, knowing these ten admonitions prevents errors and offers great benefit. They are detailed below:)
Cold damage differs significantly from other syndromes; a single error in medication administration can immediately determine survival or death. Li Zijian’s *Ten Admonitions on Cold Damage* are essential knowledge. Understanding these ten points prevents medical errors and provides substantial benefit. They are enumerated in detail below:
1. Cold damage with headache and body heat constitutes a Yang syndrome. Hot-natured medicines must not be used.
Headache accompanied by fever in cold damage indicates a Yang syndrome; hot-natured herbs are contraindicated.
Cold damage transmits through six meridians, starting with Taiyang. Taiyang disease presents with headache and fever. Shaoyin disease presents with fever but no headache. Jueyin disease presents with... [Text cuts off].
Cold damage transmission involves the Six Meridians, beginning with Taiyang. Taiyang disease manifests as headache and fever. Shaoyin disease manifests as fever without headache. Jueyin disease manifests as... [Source text incomplete].
2. Cold damage requires direct attack on the toxic pathogens. Tonification must not be used.
Direct expulsion of pathogenic factors is required in cold damage; tonifying treatments are contraindicated.
Pathogens reside in the collaterals and meridians. If attacked early according to the syndrome, recovery occurs in three to four days. Erroneously believing tonification is necessary before attacking the pathogen causes the toxic factors to become more intense, leading to... [Text cuts off].
If pathogens are located in the meridians and collaterals, early intervention based on the syndrome leads to recovery within three to four days. Incorrectly assuming that tonification must precede the expulsion of pathogens causes the pathogenic factors to intensify, resulting in... [Source text incomplete].
3. Patients with cold damage who lack appetite must not take spleen- and stomach-warming medicines.
Loss of appetite is common in cold damage and does not lead to starvation. Formulas such as Lizhong Wan should not be used lightly. If administered to Yang syndrome patients, it exacerbates internal heat.
Anorexia is a common occurrence in cold damage and is not fatal. Herbs and formulas that warm the Spleen and Stomach, such as *Lizhong Wan*, should not be prescribed indiscriminately. In cases of Yang syndrome, their use aggravates internal heat.
4. Abdominal pain in cold damage may also present as a Heat syndrome. Warm-natured medicines must not be taken lightly.
Abdominal pain in cold damage may also manifest as a Heat syndrome; warm-natured medicines should not be administered casually.
The *Nan Jing* states that pain indicates excess. Therefore, Zhang Zhongjing discusses abdominal pain syndromes, stating that in severe cases, Rhubarb (*Da Huang*) should be added. The addition of Rhubarb for severe pain reveals the intent.
The *Nan Jing* (Classic of Difficult Issues) posits that pain signifies excess. Consequently, Zhang Zhongjing addresses syndromes of intermittent abdominal pain, noting that *Da Huang* (Rhubarb Root and Rhizome) should be added in severe instances. The prescription of *Da Huang* for severe pain elucidates the therapeutic principle.
5. Spontaneous diarrhea in cold damage requires differentiation between Yin and Yang syndromes. Do not routinely administer tonics, warming agents, or antidiarrheals.
Spontaneous diarrhea in cold damage requires differentiation between Yin and Yang patterns. Tonics, warming herbs, and astringents should not be used universally.
For spontaneous diarrhea: if the body is not hot and hands and feet are warm, it belongs to Taiyin. If the body is cold and extremities are reversed (cold), it belongs to Shaoyin or Jueyin. Remaining cases of fever with diarrhea belong to Yang. [Text cuts off].
Regarding spontaneous diarrhea: if the body temperature is normal and the extremities are warm, the pattern belongs to Taiyin. If the body is cold with cold extremities (reversal cold), it belongs to Shaoyin or Jueyin. Other presentations of fever with diarrhea belong to Yang patterns. [Source text incomplete].
6. Chest and hypochondriac pain with abdominal fullness in cold damage must not be treated with moxibustion.
Chest and hypochondriac pain accompanied by abdominal distension in cold damage are contraindications for moxibustion.
It has been heard that in villages, when this syndrome appears without medicine, moxibustion is used, often causing toxic factors to flourish with the fire, leading to distension, panting, and death. It is unknown that chest and hypochondriac pain naturally belongs to Shaoyang... [Text cuts off].
It is reported that in rural areas, lacking medicinal resources, practitioners apply moxibustion for such syndromes. This often causes pathogenic factors to intensify due to the heat, leading to abdominal distension, dyspnea, and death. Practitioners fail to recognize that chest and hypochondriac pain naturally pertains to Shaoyang... [Source text incomplete].
7. Cold extremities in cold damage require differentiation of Yin and Yang. Do not automatically diagnose as Yin syndrome.
Cold extremities in cold damage require differentiation between Yin and Yang patterns; they should not be automatically diagnosed as Yin syndrome.
Jue (extremity cold) includes Yin Jue and Yang Jue. Few physicians can distinguish them. Administering hot medicines to Yang Jue kills faster than a blade. Yang syndrome does not reach extreme heat... [Text fragments: body heat to... urgent... see heat sinking...].
Extremity cold (Jue) encompasses Yin Jue and Yang Jue. Few clinicians can differentiate them accurately. Prescribing hot-natured herbs for Yang Jue accelerates mortality more rapidly than physical trauma. Yang syndromes do not necessarily reach extreme heat... [Source text contains fragmented phrases: body heat reaching..., urgency..., observing sinking heat...].
8. If cold damage pathology is already interior, diaphoretic medication must not be used.
If the pathology of cold damage has entered the interior, diaphoretic therapy is contraindicated.
Cold damage requires assessment of exterior vs. interior. Fever with aversion to cold indicates exterior syndrome, suitable for sweating. Absence of aversion to cold with preference for heat indicates interior syndrome. Uniform application of sweating... [Text cuts off].
Differentiation of exterior and interior is crucial in cold damage. Fever with aversion to cold indicates an exterior syndrome, amenable to diaphoresis. Absence of aversion to cold with aversion to heat indicates an interior syndrome. Indiscriminate application of diaphoretic methods... [Source text incomplete].
9. Thirst and desire for water in cold damage indicate impending recovery. Do not allow patients to drink excessively.
Desire for water in cold damage suggests the body is attempting to recover; however, patients must not be allowed to drink excessively.
Extreme thirst warrants water administration to dissipate heat. Thus, Zhang Zhongjing views desire for water as a sign of recovery. Misinterpreting this, people allow excessive drinking, leading to... [Text cuts off: give half...].
Profound thirst necessitates water intake to clear heat. Hence, Zhang Zhongjing considers the desire for water a prognostic sign of recovery. Misunderstanding this, caregivers permit excessive fluid intake, resulting in... [Source text incomplete].
10. Upon initial recovery from cold damage, avoid overeating, physical exertion, sexual activity, consumption of mutton, pork bone broth, and alcohol.
After initial stabilization from cold damage, avoid overeating, strenuous labor, sexual intercourse, eating mutton, drinking pork bone broth, and consuming alcohol.
Recovery does not require continued medication. The Spleen and Stomach remain weak; indigestion from overeating causes relapse, termed "Food Relapse." Qi and Blood are still deficient; premature labor causes relapse, termed "Labor Relapse." Consuming mutton and engaging in intercourse may cause death. Pork bone broth and alcohol cause severe recurrence. Food flavors nourish life; unless taking elixirs, one must eat. However, improper diet causes harm. I observe contemporary people... [Text fragments: eaten... juice... lung disease... not eating... qi entering... roasted... body root... all toxic... eating plague-dead beef].
Once recovered, further medication is unnecessary. The Spleen and Stomach remain weak; inability to digest large meals leads to disease recurrence, known as "Food Relapse" (Shi Fu). Qi and Blood are still deficient; premature physical exertion causes recurrence, known as "Labor Relapse" (Lao Fu). Consumption of mutton combined with sexual activity may prove fatal. Ingestion of pork bone broth and alcohol ensures severe recurrence. While dietary flavors sustain life, and abstinence from food is impossible without alchemical practices, improper diet becomes harmful. I observe that contemporary people... [Source text contains fragmented warnings regarding specific foods, lung disease, and the toxicity of eating beef from animals that died of epidemic diseases].