典藏书目

Zhou Yuzai stated: When warm pathogenic factors emerge, they affect all three Yang meridians. The excess and fullness of their pathogenic heat is self-evident; hence, the pulse is floating and large. I surmise that when the pathogen was latent in Shaoyin (Lesser Yin), the chi (cun-kuan-chi) pulse at the wrist had already been large. Now, because the pathogen emerges from the interior to the exterior and ascends from below to above, the floating and large qualities manifest above the guan (middle) position; thus it is said "ascending past the guan." Although the pathogen manifests in the Yang positions, if the root in Shaoyin remains unsettled, the patient desires sleep, revealing the fundamental syndrome of Shaoyin. Furthermore, sweating upon closing the eyes constitutes night sweats (Dao Han), which reveals the fundamental syndrome of Shaoyang (Lesser Yang). Why is only Shaoyang observed? Because when the mother organ (Kidney/Shaoyin) is deficient, the child organ (Gallbladder/Liver/Shaoyang) is also deficient, and the pathogenic fire of Shaoyin rises together with the ministerial fire of Shaoyang, causing scorching. Therefore, this differs slightly from typical warm diseases; in typical warm diseases, there is merely sweating upon eye closure, unlike the profuse, unceasing sweating seen in severe heat conditions. However, why are the syndromes of the Taiyang (Greater Yang) and Yangming (Yang Brightness) meridians not mentioned? Because a floating pulse corresponds to the Taiyang meridian, and a large pulse corresponds to the Yangming meridian.

Wang Shihiong's note: The Imperially Commissioned *Yizong Jinjian* (Golden Mirror of Medicine), in its chapter on corrections, states that the character "shang" (up/above) in "floating, large, and shang" should be "xian" (wiry/taut); this would align with the pulse of combined disease of the three Yang meridians. Regarding treatment methods, Miu Zhongchun proposed using: Baihe (Lilii Bulbus) 1 liang, Maidong (Ophiopogonis Radix) 5 qian, Zhi Mu (Anemarrhenae Rhizoma), Gualougen (Trichosanthis Radix), and Baishao (Paeoniae Radix Alba) each 2 qian, Biejia (Testudinis Carapax et Plastrum) 3 qian, Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 1 qian, and Zhuye (Bambusae Folium) 50 pieces.

Yang Yun stated: This passage follows the same sequence as wind-warmth (Feng Wen) characterized by burning heat after sweating. If one contracts this illness initially, it becomes wind-warmth after sweating. Xu Yazhi stated: Hou Yang once told me that the *Shanghan Lun* (Treatise on Cold Damage) should be read clause by clause, without rigidly seeking continuous logical connections. His point was that, similar to Huixi's *Shanghan Leifang* (Classified Formulas for Cold Damage), one should discuss formulas based on symptoms rather than deducing syndromes by following meridians, which is more direct. Generally, reading clause by clause allows one to naturally see the connecting threads; if one sticks to order seeking continuity, it inevitably becomes forced. Reading these comments further convinced me of his unique insight into reading texts.

The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: In warm malaria (Wen Nue), the pulse resembles that of a healthy person; the body has no chills but only fever, the joints are painful and vexed, and there is occasional vomiting. It is treated with Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction).

You Zhuowu stated: This differs from the discussion on malaria in the *Neijing* (Inner Canon). The *Neijing* discusses the etiology, whereas here the pulse and syndromes are detailed. Both Dan Nue (Crimson Heat Malaria) and Wen Nue present without chills, with only fever and vomiting, but their etiologies differ. In Dan Nue, the lungs possess inherent heat compounded by external contraction, resulting in a syndrome of exterior cold and interior heat. Because the Yin qi is internally deficient and cannot contend with Yang qi, chills do not occur. In Wen Nue, the pathogen is stored internally within Shaoyin and does not emerge until spring or summer; it is a condition where latent pathogenic qi moves outward. Cold accumulates for a long time and transforms into heat, so chills also do not occur. The pulse resembling a normal state occurs because the disease is not caused by external contraction, so the pulse remains like usual. Joint pain and vexation, along with occasional vomiting, occur because heat exits from Shaoyin, resides in the area associated with the Kidney, and merges upward with the Yangming meridian. Baihu Tang (White Tiger Decoction) uses sweet-cold properties to eliminate heat, while Guizhi (Cinnamomi Ramulus) guides the pathogen out according to its trend.

Wang Shihiong's note: Yu Shi argued that Zhang Zhongjing, in discussing malaria, first stated that a wiry and rapid pulse indicates excessive heat. He then added another point: a wiry and rapid pulse indicates wind generation. Seeing that heat persists, it must reach extreme heat; extreme heat generates wind. Wind generation causes Liver Wood to overact upon Spleen Earth, transmitting heat to the Stomach, thereby consuming body fluids. This cannot be resolved solely by medicine; dietary management is required to curb the blazing heat. Substances such as Pear Juice and Sugarcane Juice, which generate fluids and quench thirst, embody the principle of the *Neijing*: "For wind invading internally, treat with sweet-cold substances."