脉，血之所为，属阴。大，洪之别名，火之象，属阳。其病得之于内伤者，阴虚为阳所乘，故脉大当作虚治之。其
病得之于外伤者，邪客于经，脉亦大，当作邪胜治之。合二者而观之，皆病证方长之势也，谓之病进，不亦宜乎？海藏
云∶君侵臣之事也。孰为是否？幸有以教之。
《礼记》曰∶一年视离经。谓离析经理，在乎章句之绝。《内经·生气通天论》病因四章，第一章论因于寒，欲如运
枢。以下三句与上文意不相属，皆衍文也。体若燔炭，汗出而散两句，当移在此。夫寒邪初客于肌表，邪郁而为热，有
似燔炭，得汗则解。此仲景麻黄汤之类是也。第二章论因于暑。暑者君火为病，火主动则散，故自汗烦渴而多言也。第
三章论因于湿。湿者土浊之气，首为诸阳之会，其位高而气清，其体虚，故聪明得而系焉。浊气熏蒸，清道不通，沉重
而不爽利，似乎有物以蒙冒之。失而不治，湿郁为热，热留不去，大筋软短者，热伤血，不能养筋，故为拘挛。小筋弛
长者，湿伤筋，不能束骨。故为痿弱。因于湿，首如裹，各三字为句，湿热不攘以下各四字为句，文正而意明。第四章
论因于气，为肿。下文不序病证，盖是脱简。四维相代二句，与上文意不相属，亦衍文也。王太仆曰∶暑热湿气三病，
皆以为发于伤寒之毒，次第相仍，展转生病。五段通为一章，余有疑焉。暑病不治，伏而生热，热久生湿，湿久气病，
盖有之矣。《内经》止有冬伤于寒，不即病，至夏有热病之言。未闻寒毒伏藏，至夏发于暑病。至于湿病，亦蒙上文之热，
谓反湿其首，若湿物裹之，望除其热，当以因于湿首为句。如裹湿又为句，则湿首之湿，裹湿之湿，皆人为也。与上下
文列言寒暑之病，因文义舛乖，不容于不辩。或曰∶先贤言温湿、寒湿、风湿矣。未闻有所谓湿热病者，攻之《内经》，
亦无有焉，吾子无乃失之迂妄耶？予曰∶六气之中，湿热为病十居八九。《内经》发明湿热，此为首出。至真要大论曰∶
湿上甚而热，其间或言湿而热在中者。或曰热而湿在中者，此圣人爱人论道之极致，使天下后世不知湿热之治法者，太
仆启之也。君其归取《原病式》熟读而审思之，幸甚！
脉，是血液所化生的，属于阴。大脉，是洪脉的别名，是火的征象，属于阳。如果疾病是由于内伤引起的，阴虚被阳邪所乘袭，所以出现大脉应当当作虚证来治疗。如果疾病是由于外感引起的，邪气客居在经脉中，脉象也会变大，应当当作邪气盛实来治疗。综合这两种情况来看，都是病证正在发展的态势，称之为“病进”，不也是合适的吗？海藏（张元素）说：这是君火侵扰臣火的事情。究竟谁对谁错？希望有人能教导我。
《礼记》说：第一年考察能否离析经理。意思是剖析医理，关键在于章句的断绝与连接。《内经·生气通天论》中关于病因的四章，第一章论述因于寒，原文有“欲如运枢”一句。以下三句与上文的意思不相隶属，都是衍文（后人误增的文字）。体若燔炭，汗出而散这两句，应当移到这里。因为寒邪初客于肌表，邪气郁结而化为热，症状像燃烧的火炭一样，得到汗出则病解。这就是仲景麻黄汤之类的方剂适用的情况。第二章论述因于暑。暑是君火致病，火性主动且发散，所以会出现自汗、烦躁、口渴和多言的症状。第三章论述因于湿。湿是土之浊气，头部为诸阳之会，其位置高而气清，其体质虚，所以神聪明亮得以维系。浊气熏蒸，清窍不通，身体沉重而不爽利，似乎有东西蒙盖着头。如果不及时治疗，湿郁结化为热，热留滞不去，大筋软短缩的，是因为热伤了血，不能濡养筋脉，所以发生拘挛。小筋弛缓延长的，是因为湿伤了筋，不能约束骨骼，所以发生痿弱。因于湿，首如裹，这三个字为一句；湿热不攘以下的各四个字为一句，文辞正确而意思明确。第四章论述因于气，导致肿胀。下文没有叙述病证，大概是简牍脱漏了。“四维相代”两句，与上文意思不相隶属，也是衍文。王太仆（王冰）说：暑、热、湿三种病，都认为是发源于伤寒的毒气，依次相承，辗转生病。这五段通合为一章，我对此有疑问。暑病如果不治，伏留而生热，热久了生湿，湿久了导致气病，这种情况是有的。但《内经》只说有冬天受寒，当时不发病，到了夏天发生热病的话。没听说过寒毒伏藏，到夏天发作成暑病。至于湿病，也是承接上文的“热”，说是反过来使头潮湿，像湿物包裹一样，应当去掉这个“热”字，以“因于湿首”为一句。如果“如裹湿”又作为一句，那么“湿首”的湿和“裹湿”的湿，都是人为造成的错误。这与上下文中列举寒暑之病的文义乖谬，不容不辩驳。有人说：先贤说过温湿、寒湿、风湿了。没听说过有所谓湿热病的，攻求《内经》，也没有这种说法，您是不是失之迂腐狂妄呢？我说：六气之中，湿热致病占十之八九。《内经》阐发湿热理论，这里是最先提出的。《素问·至真要大论》说：湿在上部甚而发热，其中有时说湿而热在中焦，有时说热而湿在中焦，这是圣人爱人、论述医道的极致。使得天下后世不知道湿热治法的人，是王太仆误导了他们。希望您回去取来《原病式》熟读并审慎思考，那就太好了！
The pulse is generated by blood and belongs to Yin. The "large" pulse is an alias for the "surging" (Hong) pulse, representing the image of Fire, and belongs to Yang. If the disease arises from internal injury, where Yin deficiency is invaded by Yang pathogenic factors, a large pulse should be treated as a deficiency syndrome. If the disease arises from external injury, where pathogens lodge in the meridians, the pulse will also become large, and it should be treated as excess of pathogenic factors. Observing both cases together, they represent a trend where the disease condition is progressing; thus, calling it "disease progression" is appropriate. Haizang (Zhang Yuansu) stated: "This is the matter of the Sovereign invading the Minister." Who is correct? I hope someone can instruct me.
The *Book of Rites* states: "In the first year, examine their ability to separate and analyze the principles." This means dissecting medical theory, which lies in the segmentation of chapters and sentences. In the *Neijing · Shengqi Tongtian Lun*, there are four chapters on etiology. The first chapter discusses cold pathogenesis, containing the phrase "like turning a pivot." The following three sentences do not align with the preceding context and are likely interpolations. The two sentences "Body like burning charcoal, dispersal through sweating" should be moved here. When cold pathogens initially lodge in the muscle and surface, pathogenic stagnation transforms into heat, resembling burning charcoal; relief occurs through sweating. This corresponds to formulas such as Ma Huang Tang by Zhang Zhongjing. The second chapter discusses summer-heat pathogenesis. Summer-heat is caused by Sovereign Fire; since Fire is active and dissipative, symptoms include spontaneous sweating, irritability, thirst, and excessive talking. The third chapter discusses dampness pathogenesis. Dampness is the turbid Qi of Earth. The head is the convergence of all Yang meridians; its position is high, its Qi is clear, and its constitution is deficient, so clarity and consciousness depend upon it. Turbid Qi steams upward, blocking the clear orifices, causing heaviness and lack of crispness, as if something were covering the head. If left untreated, dampness stagnates and transforms into heat. If heat lingers, the large tendons become soft and short due to heat injuring Blood, which fails to nourish the tendons, resulting in contracture. The small tendons become lax and long because dampness injures the tendons, failing to bind the bones, resulting in flaccidity. The phrase "Yin Yu, shou ru guo" (Due to dampness, the head feels wrapped) consists of three characters per clause; the subsequent phrases starting with "Shi re bu rang" consist of four characters per clause, making the text correct and the meaning clear. The fourth chapter discusses Qi pathogenesis leading to swelling. The subsequent text lacks symptom description, suggesting missing bamboo slips. The two sentences "Si wei xiang dai" (Four corners substitute for each other) do not align with the preceding context and are also interpolations. Wang Taibu (Wang Bing) stated: "Summer-heat, heat, and dampness diseases are all considered to originate from the toxin of cold damage, succeeding one another sequentially, generating diseases in turn." Combining these five segments into one chapter raises my doubts. It is true that untreated summer-heat may lie dormant and generate heat; prolonged heat may generate dampness; prolonged dampness may affect Qi. However, the *Neijing* only mentions winter cold damage that does not manifest immediately but results in summer heat disease later. I have never heard of cold toxins lying dormant until summer to manifest as summer-heat disease. As for dampness disease, it seems to follow the previous mention of "heat," suggesting the head becomes wet as if wrapped in damp material. One should remove the character "heat" and read "Yin Yu shou" (Due to dampness, the head...) as one sentence. If "Ru Guo Shi" (Like wrapping dampness) is taken as a separate sentence, then the "dampness" in "dampness head" and "wrapping dampness" are artificial errors. This contradicts the textual logic listing cold and summer-heat diseases above and below, necessitating refutation. Some say: "Ancient sages spoke of warm-damp, cold-damp, and wind-damp. I have never heard of 'heat-damp' disease. Searching the *Neijing*, it is not mentioned. Are you not being pedantic and absurd?" I reply: Among the Six Qi, heat-damp diseases account for eight or nine out of ten. The *Neijing* elucidates heat-damp theory here for the first time. The *Suwen · Zhi Zhen Yao Da Lun* states: "When dampness is severe in the upper part, heat follows," sometimes mentioning dampness with heat in the middle, or heat with dampness in the middle. This represents the utmost extent of the Sage's benevolence and discussion of the Dao. Those who fail to understand heat-damp treatment methods today owe this misunderstanding to Wang Taibu. I urge you to retrieve the *Yuan Bing Shi*, read it thoroughly, and ponder it carefully. That would be greatly appreciated!