《伤寒绪论》曰∶初发病时,头项痛、腰脊强、恶寒,足太阳也;发热面赤、恶风,手太阳也;目疼鼻干、不得卧,
足阳明也;蒸热而渴,手阳明也;胸胁满痛,口苦,足少阳也;耳聋及病寒热往来,手少阳也;腹满自利而吐,足太阴
也;口干津不到咽,手太阴也。脉沉细,口燥渴,足少阴也。舌干、不得卧,手少阴也;耳聋囊缩、不知人事,足厥阴
也;烦满厥逆,手厥阴也。《医略》曰∶太阳之脉,上连风府,循腰脊,故头项痛,腰脊强;阳明之脉,挟鼻络于目,
故身热目疼,鼻干、不得卧;少阳之脉,循胁络于耳,故胸胁痛而耳聋;太阴脉布胃中,络于嗌,故腹满而嗌干;少阴
脉贯肾,络于肺,系舌本,故口燥舌干而渴;厥阴脉循阴器,而络于肝,故烦满而囊缩。凡外感病,无论暴感伏气,或
由外而入内,则由三阳而传入三阴;或由内而达外,则由三阴而外出三阳。六经各有见证,即各有界限可凭。治病者,
指其见证,即可知其病之浅深;问其前见何证,今见何证,即可知病之传变。伤寒如此,温病何独不然?《素问·热病
篇》、仲景《伤寒论》,均以此立法。圣人复起,莫此易也。近贤叶氏,始有伤寒分六经,温病分三焦之论,谓出河间,
其实温热病之法,至河间始详,至温病分三焦之论,河间并无此说,其书具在,可覆按也。厥后吴鞠通着《温病条辨》,
遂专主三焦,废六经而不论。殊不知人身经络,有内外浅深之别,而不欲使上下之截然不通也。其《上焦篇》提纲云∶
凡温病者,始于上焦,在手太阴。试观温邪初发者,其果悉见上焦肺经之见证乎?即或见上焦之证,其果中、下焦能丝
毫无病乎?鞠通苟虚心诊视,应亦自知其说之不可通矣。况伤寒、温热为病不同,而六经之见证则同,用药不同,而六
经之立法则同,治温病者,乌可舍六经而不讲者哉?
《伤寒绪论》中说:疾病初发时,出现头项疼痛、腰脊僵硬、怕冷,这是足太阳经的病证;发热、面红、怕风,这是手太阳经的病证;眼睛疼痛、鼻子干燥、无法安卧,这是足阳明经的病证;身体蒸蒸发热且口渴,这是手阳明经的病证;胸胁部胀满疼痛、口苦,这是足少阳经的病证;耳聋以及寒热往来交替发作,这是手少阳经的病证;腹部胀满、自发性腹泻并伴有呕吐,这是足太阴经的病证;口干但津液不能到达咽喉,这是手太阴经的病证。脉象沉细、口燥渴,这是足少阴经的病证。舌头干燥、无法安卧,这是手少阴经的病证;耳聋、睾丸收缩、神志不清不知人事,这是足厥阴经的病证;心烦胀满、四肢逆冷,这是手厥阴经的病证。
《医略》中说:太阳经脉,向上连接风府穴,沿着腰脊下行,所以会出现头项痛、腰脊强直;阳明经脉,夹持鼻旁联络于目,所以会出现身热、眼痛、鼻干、无法安卧;少阳经脉,沿着胁肋联络于耳,所以会出现胸胁痛和耳聋;太阴经脉分布于胃中,联络于咽喉,所以会出现腹部胀满和咽喉干燥;少阴经脉贯穿肾脏,联络于肺,系连舌根,所以会出现口燥、舌干而渴;厥阴经脉循行经过阴器,联络于肝脏,所以会出现心烦胀满和睾丸收缩。
凡是外感病,无论是突然感受邪气(暴感)还是伏邪外发(伏气),如果是从外部侵入内部,就会由三阳经传入三阴经;如果是从内部达于外部,就会由三阴经外出至三阳经。六经各有其特定的见证,因此也各有其界限可以依据。治病的人,根据这些见证,就可以知道疾病的深浅程度;询问之前出现了什么证候,现在出现了什么证候,就可以知道疾病的传变情况。伤寒是这样,温病难道唯独不是这样吗?《素问·热病篇》和张仲景的《伤寒论》,都是依据这一原则确立治疗法则的。即使圣人再生,也没有比这更简易的方法了。
近代贤者叶天士,开始提出“伤寒分六经,温病分三焦”的理论,声称此说出自刘河间,其实温热病的治疗法则,直到刘河间才详尽阐述,至于“温病分三焦”的理论,刘河间并没有这种说法,他的著作都在,可以查证核对。此后吴鞠通撰写《温病条辨》,于是专门主张三焦辨证,废弃六经辨证而不加讨论。殊不知人体的经络,有内外浅深之别,但并不希望上下之间截然不通。吴鞠通在《上焦篇》的提纲中说:“凡是温病,起始于上焦,在手太阴肺经。”试看温邪初发的时候,果真全都见到上焦肺经的见证吗?即使见到了上焦的证候,果真中焦、下焦就丝毫没有病吗?如果吴鞠通能虚心诊察视诊,应该也会自知他的说法是讲不通的。况且伤寒与温热病的致病机理不同,但六经的见证却相同;用药不同,但六经的立法原则却相同,治疗温病的人,怎么能舍弃六经辨证而不加以研究呢?
*Shanghan Xulun* (Introduction to Cold Damage) states: At the initial onset of the disease, if there is pain in the head and neck, stiffness in the waist and spine, and aversion to cold, it is a syndrome of the Foot-Taiyang Meridian (Foot-Taiyang Channel); if there is fever, redness of the face, and aversion to wind, it is a syndrome of the Hand-Taiyang Meridian (Hand-Taiyang Channel); if there is eye pain, nasal dryness, and inability to lie down comfortably, it is a syndrome of the Foot-Yangming Meridian (Foot-Yangming Channel); if there is steaming heat and thirst, it is a syndrome of the Hand-Yangming Meridian (Hand-Yangming Channel); if there is fullness and pain in the chest and hypochondrium, and bitter taste in the mouth, it is a syndrome of the Foot-Shaoyang Meridian (Foot-Shaoyang Channel); if there is deafness and alternating chills and fever, it is a syndrome of the Hand-Shaoyang Meridian (Hand-Shaoyang Channel); if there is abdominal fullness, spontaneous diarrhea, and vomiting, it is a syndrome of the Foot-Taiyin Meridian (Foot-Taiyin Channel); if there is dry mouth but saliva cannot reach the throat, it is a syndrome of the Hand-Taiyin Meridian (Hand-Taiyin Channel). If the pulse is deep and fine, with dry mouth and thirst, it is a syndrome of the Foot-Shaoyin Meridian (Foot-Shaoyin Channel). If the tongue is dry and there is an inability to lie down comfortably, it is a syndrome of the Hand-Shaoyin Meridian (Hand-Shaoyin Channel); if there is deafness, retraction of the testicles, and loss of consciousness, it is a syndrome of the Foot-Jueyin Meridian (Foot-Jueyin Channel); if there is vexation and fullness, and reversal cold of the limbs, it is a syndrome of the Hand-Jueyin Meridian (Hand-Jueyin Channel).
*Yilüe* (Medical Briefs) states: The Taiyang meridian connects upward to Fengfu (GV16), runs along the waist and spine; therefore, there is pain in the head and neck, and stiffness in the waist and spine. The Yangming meridian flanks the nose and connects to the eyes; therefore, there is body heat, eye pain, nasal dryness, and inability to lie down comfortably. The Shaoyang meridian runs along the costal region and connects to the ears; therefore, there is pain in the chest and hypochondrium, and deafness. The Taiyin meridian spreads within the stomach and connects to the pharynx; therefore, there is abdominal fullness and dryness of the pharynx. The Shaoyin meridian passes through the kidneys, connects to the lungs, and ties to the root of the tongue; therefore, there is dry mouth, dry tongue, and thirst. The Jueyin meridian circulates around the genitalia and connects to the liver; therefore, there is vexation, fullness, and retraction of the testicles.
In all exogenous diseases, whether they are acute infections (Bao Gan) or latent pathogens emerging from storage (Fu Qi), if the pathogen enters from the exterior into the interior, it transmits from the Three Yang meridians to the Three Yin meridians; if it moves from the interior to the exterior, it emerges from the Three Yin meridians to the Three Yang meridians. Each of the Six Meridians has its specific manifestations, and thus each has boundaries that can be relied upon. A practitioner treating disease, by pointing out these manifestations, can know the depth and superficiality of the disease; by asking what symptoms appeared previously and what appear now, one can know the transmission and transformation of the disease. This applies to Shanghan (Cold Damage); why should Wenbing (Warm Diseases) be any different? Both *Suwen: Re Bing Pian* (Plain Questions: Chapter on Hot Diseases) and Zhang Zhongjing’s *Shanghan Lun* (Treatise on Cold Damage Disorders) establish their laws based on this principle. Even if sages were to rise again, nothing would be simpler than this.
Recently, the learned Ye Tianshi proposed the theory that "Shanghan is differentiated by Six Meridians, while Wenbing is differentiated by Triple Burner," claiming it originated from Liu Hejian. In fact, the methods for treating Warm-Heat diseases were detailed starting from Liu Hejian, but Liu Hejian did not have the theory of "differentiating Wenbing by Triple Burner"; his works exist and can be verified. Later, Wu Jutong wrote *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases), exclusively advocating the Triple Burner differentiation and abandoning the Six Meridians without discussion. Little does he realize that the meridians of the human body have distinctions of interior/exterior and superficial/deep, but do not wish for the upper and lower parts to be completely disconnected. His outline in the *Shangjiao Pian* (Upper Burner Chapter) states: "All warm diseases begin in the Upper Burner, involving the Hand-Taiyin Lung Meridian." Let us observe: when warm pathogens first emerge, do they invariably present only with the manifestations of the Upper Burner Lung Meridian? Even if Upper Burner symptoms are seen, can it be said that the Middle and Lower Burners are entirely free of disease? If Jutong had examined patients with an open mind, he would likely have realized his theory was untenable. Moreover, although the pathogenesis of Shanghan and Warm-Heat diseases differs, the manifestations of the Six Meridians are the same; although the medications used differ, the legislative principles of the Six Meridians are the same. How can practitioners of Wenbing abandon the Six Meridians and neglect them?